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Biomedical subjects

R J Eason

Publications and source records attributed to R J Eason.

16 recordsLinked to original sources
PubMed1990

Familial iron overload with possible autosomal dominant inheritance.

A 96 member Melanesian kindred with 31 cases of iron overload is reported. Liver biopsies from 19 of these patients showed features similar to those of genetic haemochromatosis in Caucasians, but in contrast to the previous reported HLA-linked autosomal recessive pattern of inheritance for haemochromatosis, this family shows a pattern that is most consistent with autosomal dominant inheritance. This is suggested by involvement of three and possibly four consecutive generations, with a high frequency of transmission from parents to children and equal gender distribution. Linkage and segregation analysis supported dominant inheritance, with no demonstrable HLA linkage.

Female↗
PubMed1987

Changing patterns of hypertension, diabetes, obesity and diet among Melanesians and Micronesians in the Solomon Islands.

A cross-sectional survey of diabetes, hypertension, obesity and dietary patterns has been conducted in the Western Province of the Solomon Islands. Three groups--traditional and more urbanized Melanesians and semitraditional Micronesians--were compared. Abnormal glucose tolerance was rare (less than 1% over all) in Melanesians regardless of acculturation, but was present in 9.7% of adult Micronesians in whom it was associated with age; obesity; female sex; and a diet that was high in energy and refined carbohydrates. Hypertension, which was associated with advancing age and obesity, was recorded in 6.0% and 8.3% of traditional and partly urbanized Melanesians, respectively, and in 4.8% of Micronesians. Systolic and diastolic blood pressures correlated significantly with age for all except traditional Melanesian women among whom the association was limited to the systolic blood pressure only. Significant correlation coefficients were recorded between diastolic blood pressure and body mass index for both sexes and all groups, and between systolic blood pressure and body mass index for all women but only for Micronesian men. Dramatic differences in life-style and dietary patterns are described for rural and more urbanized Melanesians among whom the mean daily urinary sodium outputs were 67 and 119 mmol/L, respectively.

Acculturation↗
PubMed1987

Tuberculin sensitivity.

A prospective study of tuberculin sensitivity has been conducted among 3610 subjects under 20 years old in the Solomon Islands, Western Province. Mantoux positivity (greater than or equal to mm induration after 5 TU) fell from 81% during the 6 months following birth BCG vaccination to 13% for children aged 1-8 years of age among whom it was not significantly higher than the rate of 9% noted for unvaccinated subjects. Birth BCG does not, therefore, hinder the diagnostic usefulness of tuberculin testing for such children. For the study population as a whole, BCG-induced Mantoux positivity was restricted to induration under 15 mm diameter. Stronger responses were considered specific for tuberculin infection and indicated a prevalence rate that rose from 2% to 16% with age. Accelerated BCG reactions recorded among 45% of 162 tuberculin non-reactors under 8 years old indicated that the waning of tuberculin responsiveness at this time could not be equated with loss of clinical protection against tuberculosis.

BCG Vaccine↗
PubMed1986

Chronic suppurative otitis media in the Solomon Islands: a prospective, microbiological, audiometric and therapeutic survey.

Chronic suppurative otitis media affected 3.8% of 3500 Solomon Island children under 15 years (and 6.1% under 5 years) and was the sole cause of conductive hearing loss recorded in 265 children tested audiometrically. It was characterised by early onset (65% under 18 months) male preponderance and large central tubotympanic perforations. Measles, respiratory infections, swimming and malnutrition were identified as aetiological factors amenable to intervention. Proteus and pseudomonas were the principle aerobes isolated from ear pus and gentamicin the only antibiotic tested to be effective against them. However although a prospective therapeutic trial demonstrated a significantly improved outcome after aural toilet, no additional benefit was imparted by concurrent ototopical boric acid or aminoglycoside solution or oral antianaerobic clindamycin. Parental tuition in aural cleaning, avoidance of ear water entry, nose blowing and breathing will yield a good result in up to 60% of children in half of whom tympanic healing occurred.

Adolescent↗
PubMed1985

Resurgent yaws and other skin diseases in the Western Province of the Solomon Islands.

A clinical study of the extent and nature of skin disease was undertaken among 10,224 Melanesians in the Western Province of the Solomon Islands. It was performed concurrently with a survey and selective mass treatment campaign for yaws which has reappeared in the area for the first time in 20 years. For children under 15 years old, prevalence rates for pyoderma and infectious yaws were 52% and 8.5%, respectively. Tinea versicolor was the commonest superficial dermatomycosis affecting nearly half of all adults seen. Glabrous skin (16% of all cases) and nails (25% of all cases) were the principle sites infected by the dermatophytes. Tinea imbricata, whilst uncommon, was restricted to small endemic foci. Pediculosis capitis was universal but scabies was present in only 4% of young children. Unfavourable environmental conditions and misconceptions about personal hygiene are important aetiological determinants. Education and motivation at a village level will be the mainstay of future control with specific therapy generally reserved for treponematoses, extensive dermatophytoses and scabies.

Adolescent↗
PubMed1985

Resurgent yaws in the Solomon Islands.

We report a resurgence of yaws in the Solomon Islands and describe the combined clinico-serological survey and mass penicillin treatment campaign to define and curb it.

Adolescent↗
PubMed1984

Goitre and thyroid dysfunction during chronic amiodarone treatment.

We measured thyroid function in a cross-sectional survey of 37 unselected patients receiving chronic amiodarone treatment. Palpable goitre was presented in 17 patients and was a new finding in ten. Despite frequent elevations of serum free T4 (67%) or free T4 index (43%), all 37 patients were clinically euthyroid with a normal or decreased serum free T3 or free T3 index. Mean urine iodide/creatinine excretion was increased 13-fold. Three patterns of thyroid function were seen; in 21 patients with normal TRH responses, the mean basal serum TSH was significantly elevated. Five patients had biochemical hypothyroidism which did not require treatment. Eleven patients had evidence of thyroid autonomy and the three patients with absent TRH responses each gave a past history of goitre or thyrotoxicosis; a trial of carbimazole treatment in these three was without clinical benefit. The observed spectrum of subclinical goitre and thyroid dysfunction may result from an unpredictable thyroid response to excessive free iodide combined with a weak goitrogenic effect of amiodarone mediated by increased TSH secretion.

Adult↗
PubMed1982

Addison's disease, adrenal autoantibodies and computerised adrenal tomography.

The present study describes 53 patients with Addison's disease, who attended Auckland hospitals between 1971-1980, 32 of whom presented for the first time during this period, when the mean annual incidence of Addison's disease was 4.5 cases/million population, and the respective frequency of idiopathic (auto-immune) and tuberculous aetiologies was 92 percent and 4 percent for caucasians, but 25 percent and 63 percent for Polynesians. In addition, adrenal reserve was tested by ACTH stimulation in 20 clinically non-Addisonian patients in whom circulating adrenal antibodies had been incidentally demonstrated and present for periods of up to six years, and was normal in all cases. Such antibodies therefore lack functional disease specificity. The diagnostic value of CT adrenal scanning in illustrating the contrasting appearances between tuberculous and auto-immune adrenalitis is shown in four patients.

Addison Disease↗
PubMed1982

Inflammatory bowel disease in Auckland, New Zealand.

Four-hundred-and-fifty-six patients with ulcerative colitis (UC) and 137 patients with Crohn's disease (CD) attended public hospitals within Auckland between 1969 and 1978. Polynesians comprised 15% of the population at risk but accounted for only 0.4% of UC cases and no CD cases. Annual incidence rates were 5.4/100,000 Caucasians for UC and 1.75 for CD. CD was significantly less common in Auckland than in European and North American centres. For patients presenting for the first time between 1969 and 1978, the cumulative probability of surviving 10 years was 93.9% for UC and 89.1% for CD. An excess of observed over expected mortality was limited to the first year of observation in UC and did not occur in CD. Clinical features and local complications of UC and CD have been correlated with the anatomic location of disease. In this first clinical study of inflammatory bowel disease of New Zealand, 61% of CD and 23% of UC patients required at least one surgical resection.

Adolescent↗
PubMed1981

Progressive systemic sclerosis in Auckland: a ten year review with emphasis on prognostic features.

The clinical records of all patients with scleroderma or Raynaud's phenomenon who attended hospitals or specialist practice in Auckland during the ten year period of 1970--79 were examined. Forty-seven patients were found to satisfy the American Rheumatism Association criteria for progressive systemic sclerosis (PSS). Thirteen of these patients had CRST features which comprise calcinosis, Raynaud's phenomenon, sclerodactyly and telangiectasiae. All but two of the 23 surviving patients were interviewed. The incidence of PSS was 6.3/million/year and no significant difference in incidence was found between Caucasians and Polynesians. Raynaud's phenomenon was most frequently the presenting symptom. Oesophageal involvement was the commonest clinical visceral manifestation. Cumulative survival rates showed that the adverse prognostic features were renal, cardiac and to a lesser extent pulmonary involvement. Patients with the CRST features had a better prognosis and none had renal complications. The natural history of the CRST group was characterised by a long latency between the presenting symptom and the other features of the disease. Therefore, the recognition of the CRST variant was of retrospective rather than predictive clinical value. In this first clinical study of PSS patients in New Zealand, results of therapeutic intervention were disappointing.

Adolescent↗
PubMed1980

Deaths from influenza A, subtype H1N1, during the 1979 Auckland epidemic.

We report seven cases of influenza-associated deaths in persons under twenty-two years of age, five of whom were previously fit and well, during an influenza A epidemic affecting Auckland city during the second quarter of 1979. Despite intensive care in three of the patients, all followed a similar course of fatal hypoxaemia. The failure of appropriate therapy in those patients with staphylococcal superinfection was a further feature. Influenza A-subtype H1N1 was isolated from throat swabs and/or post-mortem lung in five of the cases. This subtype has not been responsible for epidemic influenza or influenzal outbreaks in New Zealand since the early 1950s. The isolates were most similar to the A/Brazil/11/78 strain which has not previously been isolated in New Zealand. The susceptibility of young people is attributed to lack of previous antigenic exposure in those born since the mid-1950s.

Adolescent↗