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Biomedical subjects

S Barrow

Publications and source records attributed to S Barrow.

51 records · Page 3Linked to original sources
PubMed1995

Setting standards for cervical screening fail-safe mechanisms: a target based on an audit of cytopathology laboratory records.

OBJECTIVE: To examine the efficacy of cytopathology laboratories in monitoring action following an abnormal cervical smear. SETTING: 11 screening laboratories serving 19 districts in the former North Western region of the United Kingdom. METHOD: 944 validated cases were identified at 11 laboratories. The screening history for each abnormal smear was obtained from the screening laboratory and compared with the records from the relevant family health services authority (FHSA) database. RESULTS: Laboratories held complete follow up records in 740 (78.4%) cases; the FHSA records extended this to 910 (96.4%) cases. Poor communication was the main problem; computerisation was not necessary to improve fail-safe procedures. CONCLUSIONS: Audit of fail-safe procedures is a valuable purchasing tool, identifying weaknesses and strengths, setting and maintaining standards.

Communication↗
PubMed1995

Social deprivation and psychiatric admission rates among different diagnostic groups.

BACKGROUND: In the search for population-based indicators of need for mental health services, psychiatric admission rates have been correlated with sociodemographic variables. We explored such correlations for different diagnostic groups. METHOD: Admissions data for the 19 districts in the North West Region were derived from the Korner Episode System for 1992/93 and divided into eight broad diagnostic groups using ICD-9 codes. Admission rates per 1000 were correlated with measures of deprivation derived from the 1991 census data and with standardised mortality ratios. For the two largest diagnostic groups, correlations with age-standardised admission rates were also calculated. RESULTS: For schizophrenia/delusional disorder, eight of the 10 sociodemographic measures were significantly correlated with admission rates (Pearson's r 0.52 - 0.79). On all measures these correlations were greater than those seen for total mental illness. Significant positive correlations of a lower order were seen for organic brain syndromes and mania. Admission rates for depression, personality disorder and substance misuse were not significantly correlated with any of the sociodemographic measures. Admission rates for neurotic illness were negatively correlated with all deprivation measures, with the negative correlation statistically significant at the 5% level for ethnic composition and overcrowding. Standardising admission rates for age and repeating the analysis after removal of influential data points did not greatly alter these findings. CONCLUSIONS: The association between psychiatric admission rates and measures of deprivation varies considerably with diagnosis. Measures of social deprivation may indicate need for services for patients with psychotic disorders; admission rates for non-psychotic illnesses may reflect the availability of beds rather than need.

Adolescent↗
PubMed1994

General practitioner attitudes to day surgery.

BACKGROUND: Day surgery is increasing in importance. Unfortunately, its impact upon health professionals in the community is poorly documented. This paper reports the opinions of general practitioners (GPs) in a North Western Health District. METHODS: A structured attitude questionnaire was sent to all GPs in Trafford Health District. GPs were asked for their opinions of the relative merits of day and in-patient surgery for patients with similar conditions. Replies were received from 71 GPs, giving a response rate of 65 per cent. RESULTS: GPs gave only a mixed level of support to the idea of further expansion. This related less to considerations of workload in the Primary Care Team than it did to concerns about readmissions and complications. CONCLUSION: The further development of day surgery will require a greater sensitivity to the resource and information needs of professionals in the Primary Care Team.

Ambulatory Surgical Procedures↗
PubMed1992

Clinical trial with inactivated hepatitis A vaccine and recommendations for its use.

OBJECTIVE: To compare the reactogenicity and immunogenicity of an inactivated hepatitis A vaccine in two different immunisation schedules. DESIGN: Randomised trial. SETTING: One London teaching hospital. SUBJECTS: 104 healthy adult volunteers (71 men, 33 women aged 19-60). INTERVENTIONS: Hepatitis A vaccine to group 1 (54 volunteers) at 0, 1, and 2 months and to group 2 (50) at 0, 1, and 6 months. MAIN OUTCOME MEASURES: Symptoms at and after each dose; liver function, hepatitis A virus specific serum immune response; and responses in saliva and parotid fluid in immunised volunteers and subjects with natural immunity. RESULTS: The vaccine was well tolerated; 97% (96/99) and 100% of those immunised developed serum antibody after one and two doses of vaccine respectively. Geometric mean titres increased progressively after each dose and were significantly higher in men but not women in group 2 after the third dose (ratio between geometric mean titres 0.265, 95% confidence interval 0.18 to 0.39; p less than 0.001). At one year this group-sex interaction was absent; geometric mean titres for both sexes were significantly higher in group 2 (ratio 0.330, 0.227 to 0.478; p less than 0.0001). Antibody responses were not significantly different between the groups at two years. Compared with naturally infected subjects immunised volunteers developed poor or undetectable virus specific IgG and IgA responses in saliva and parotid fluid. CONCLUSIONS: The vaccine was safe and highly immunogenic, and the differences in the immune responses in saliva and parotid fluid are unlikely to affect its efficacy.

Adult↗
PubMed1992

Effect of hepatitis A vaccination schedules on immune response.

An inactivated hepatitis A vaccine was given to 104 seronegative volunteers aged between 19 and 60 years according to two schedules: 0, 1 and 2 months or 0, 1 and 6 months. The vaccine was well tolerated and 97 and 100% of vaccinees developed a serum antibody response following a single and two doses of vaccine respectively. Geometric mean titres increased progressively after each dose; responses following the 0, 1, 6 month schedule were significantly higher at one year but, among those tested at two years, these differences were less marked. Vaccinees, when compared with naturally infected persons, developed poor or undetectable hepatitis-A-virus-specific immunoglobulin G and A antibody responses in saliva and parotid fluid. Such differences are, however, unlikely to affect the protective efficacy of the vaccine.

Adult↗
PubMed1987

Paracoccidioidomycosis in Trinidad.

Paracoccidioidomycosis is a systemic disease endemic to South America, but rarely recognised in other parts of the world. The patient we describe represents the first case of paracoccidioidomycosis observed in Trinidad.

Humans↗
PubMed1985

Rehospitalization in chronic schizophrenia.

This report on rehospitalization in chronic schizophrenia is based on a 1-year study of the postdischarge experiences of 119 chronic schizophrenics in New York City. The life table method of analysis identified the important role of discharge planning, community treatment compliance, and interpersonal stress in the patient's living environment in determining the number of days postdischarge that the patient remained in the community without further inpatient care. A mathematical model to predict days in hospital over the follow-up period, based on three specific components of time in hospital defined in numerical terms (PR, NR, LSR), was devised and tested. The first component, the experience of rehospitalization (PR), was determined by interpersonal stress, social supports, and aftercare treatment compliance. Adequacy of discharge planning, an intervention designed to link the patient to community treatment services, has its greatest impact in identifying number of rehospitalizations for the rehospitalized group (NR). Aftercare treatment compliance has its greatest effect in relation to length of subsequent rehospitalization episodes (LSR). Test of the model revealed that it can predict time in hospital within less than one half of a standard deviation of observed hospital days in approximately 50% of cases.

Actuarial Analysis↗
PubMed1982

Anesthetization of a Cape fur seal (Arctocephalus pusillus) for the treatment of a chronic eye infection and amputation of a metatarsal bone.

Tranquilization using 3 mg/kg of ketamine by intramuscular injection followed by inhalation anaesthesia using halothane was performed on an adult Cape fur seal in order to perform a metatarsal amputation and ophthalmic examination. Ketamine was found to have little effect at the dosage used while halothane proved to be a rapid induction agent providing a safe, continued level of surgical anaesthesia. Variations in cardiac rate and body temperature were recorded during anesthasia and blood was sampled for haematology.

Amputation, Surgical↗