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Biomedical subjects

S Day

Publications and source records attributed to S Day.

At least 91 records · Page 5Linked to original sources
PubMed1994

Attitudes to contraception among Asian women in Britain.

To understand the attitudes of a woman from the Indian subcontinent towards contraception, it is necessary to be aware of her religious and cultural background. A strict sexual morality is practised by Muslim, Hindu and Sikh women, for whom pre-marital and extra-marital sexual relationships are forbidden. Girls are brought up to be shy and modest, and submitting to a vaginal examination is regarded with abhorrence except as a matter of life and death. Large families, and particularly sons, are regarded as blessings from the Almighty. The condom and IUD are considered the least offensive methods, although among more enlightened women the pill is gaining ground.

Bangladesh↗
PubMed1993

Prostitution and risk of HIV: female prostitutes in London.

OBJECTIVE: To measure the prevalence of HIV and to describe established risk factors in female prostitutes. DESIGN: A cross sectional survey. SETTING: A genitourinary medicine clinic, streets, and magistrates' courts in London. SUBJECTS: 280 female prostitutes recruited between April 1989 and August 1991. MAIN OUTCOME MEASURES: Infection with HIV-1, reported risk behaviours, and prevalence of sexually transmitted infections. RESULTS: 228 of the women had HIV tests, and two (0.9% (95% confidence interval 0% to 2.1%)) were infected with HIV-1. Reported use of condoms was high for commercial clients and low for non-paying partners: 98% (251/255) of women used condoms with all clients and 12% (25/207) with non-paying partners for vaginal intercourse. Twenty two women were current or past injecting drug users. Of the 193 women examined for sexually transmitted infections, 27 had an acute infection (gonorrhoea, chlamydia, trichomonas, or primary genital herpes) at the time of interview. Infection was associated with younger age and increasing numbers of non-paying sexual partners, but not with duration of prostitution, numbers of clients, or reports of condom failures. When age and numbers of non-paying partners were analysed by logistic regression they remained significantly associated with sexually transmitted infections. CONCLUSIONS: A large and diverse sample of prostitutes had a low prevalence of infection with HIV and high levels of use of condoms in commercial sex. There was a significant risk of other sexually transmitted infections associated with prostitutes' non-commercial sexual relationships, in which unprotected sex is common. Interventions to reduce the risk of sexually transmitted infections in prostitutes should address both commercial and non-commercial sexual partnerships.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Prostitution and risk of HIV: male partners of female prostitutes.

OBJECTIVE: To describe risk behaviours for infection with HIV in male sexual partners of female prostitutes. DESIGN: A cross sectional study. SETTING: Genitourinary medicine clinic, St Mary's Hospital, London. SUBJECTS: 112 self identified male sexual partners of female prostitutes: 101 who reported commercial sexual relationships only, five who reported non-commercial relationships only, and six who reported both commercial and non-commercial relationships. MAIN OUTCOME MEASURES: Reported risk behaviours for infection with HIV. RESULTS: Of the 40 men who had had previous HIV tests or were tested during the study, two (5%) were infected with HIV. Of the men who would answer the questions, 34/94 reported having sex with other men, 2/105 reported using injected drugs, 8/105 had a history of blood transfusion, 14/108 reported a past history of gonorrhoea, 44/102 reported paying for sex abroad, and 8/92 said that they had also been paid for sex. Of the 55 men who reported paying for vaginal intercourse in the past year, 45 (82%) said that they had always used a condom. In contrast, of the 11 non-paying partners of prostitutes, only two (18%) reported ever using a condom with their partners. CONCLUSIONS: Men who have sex with female prostitutes cannot be assumed to be at risk of infection with HIV only by this route: homosexual contact may place them at greater risk. Despite the heterogeneity among male sexual partners of prostitutes, patterns of use of condoms were uniform when they were considered as a reflection of the type of relationship a man had with a female prostitute rather than a consequence of an individual's level of risk.

Condoms↗
PubMed1993

Interaction of hepatitis B and hepatitis C infection in haemophilia.

The management of haemophilia has been greatly complicated by the clinical sequelae of viral infection acquired through contaminated blood products. Many haemophiliacs have been infected by several viruses and the interaction between these viruses may be complex. In a cohort of 42 anti-HCV positive haemophiliacs, five were also found to be positive for HBsAg. All five were HCV reverse transcriptase/PCR negative compared to the 4/37 (11%) anti-HCV positive haemophiliacs who were HBsAg negative (P = 0.0001). We have identified a striking interaction between hepatitis C (HCV) and hepatitis B (HBV) in haemophiliacs co-infected by these agents, suggestive of the phenomenon of viral interference.

Cohort Studies↗
PubMed1993

Use of anti-GOR testing in the screening of blood donors for hepatitis C virus infection.

Sera from 12/1,155 (1%) anti-HCV-negative (Elisa) UK blood donors were found to be anti-GOR positive. None out of 12 of those sera were positive for HCV RNA by the reverse transcriptase/polymerase chain reaction (RT/PCR). In a cohort of 316 anti-HCV Elisa-positive sera, 27/57 RIBA-positive, and 1/188 RIBA-negative sera were anti-GOR positive, resulting in a sensitivity of 47% and a specificity of 99.5% for anti-GOR as a marker for RIBA-confirmed HCV infection. Four out of 71 (6%) of RIBA-indeterminate sera were anti-GOR positive. Donors with anti-GOR reactivity were more likely to have antibodies against each of the individual HCV antigens represented in the RIBA, and those antibodies were of greater intensity, when compared to the anti-GOR negative cohort. Twenty out of 36 (55.6%) of RT/PCR-positive sera were anti-GOR positive, compared to 1/7 (14.3%) of RT/PCR-negative sera (p = 0.09). The usefulness of anti-GOR testing of UK blood donors is discussed in the light of these results.

Autoantibodies↗
PubMed1993

Idiopathic pulmonary fibrosis and hepatitis C virus infection.

A possible role for hepatitis C virus (HCV) infection in the pathogenesis of idiopathic pulmonary fibrosis (IPF) has recently been suggested on the basis of an unusually high seroprevalence rate of anti-HCV in such patients from Japan. In an attempt to confirm these findings, we tested sera from 62 patients with IPF by two second-generation anti-HCV ELISAs. Only one serum was reactive. Serum from this patient gave an indeterminate result when tested by four-antigen RIBA (c22 band only), and it was negative for the presence of HCV RNA when tested by the reverse transcriptase polymerase chain reaction assay. HCV infection is thus no more prevalent in patients with IPF from the UK than in the general population.

Aged↗
PubMed1992

Modulation of human upper intestinal nutrient transit by a beta adrenoreceptor mediated pathway.

To explore the role played by beta adrenoreceptor mediated pathways on human upper gut function a series of studies were conducted into the effects of beta adrenoreceptor agonists and antagonists on orocaecal and duodenocaecal transit and on antral and duodenal motor activity. Under control conditions orocaecal transit was consistent within individuals (mean coefficient of variation (18.0%) but varied widely between individuals (median transit 63 minutes, range 33-164). Prior administration of the non-selective beta adrenergic antagonist propranolol consistently hastened orocaecal transit (median transit 51:25-93, v control p < 0.005). The selective beta-1 antagonist, atenolol, also hastened transit (median transit 50:35-93 minutes, v control p < 0.01). The magnitude of an individual's response to beta blockade correlated closely with the orocaecal transit (Tau = 0.54, p < 0.01). Duodenocaecal transit was also hastened by propranolol from control values of 66:45-107 minutes to 50:16-62 minutes, p < 0.025). In contrast neither duodenal nor antral motility were consistently altered by beta blockade. The beta adrenoreceptor agonist, isoprenaline, delayed both orocaecal transient (97:55-178 minutes, v control p < 0.005) and also duodenocaecal transit (160:45-215 minutes, v 73:40-133) (p < 0.025). Isoprenaline also reduced antral motility by an effect which appeared to occur predominantly through a reduction in contraction amplitude (from a median amplitude of 27:5.39 mm Hg to 14:3-24 mm Hg, p < 0.03) rather than an effect on the interval between contractions. No effect on either amplitude or frequency of duodenal motor activity was observed. A beta adrenoreceptor mediated pathway thus appears to exert a biologically relevant effect on gut function not only under conditions of sympathetic stimulation, but also at rest when a basal beta adrenergic tone appears to influence the speed of nutrient transit through the human upper gut.

Adult↗
PubMed1992

A comparison between commercial kits and conventional methods for enumeration of salivary mutans streptococci and lactobacilli.

Mutans streptococci (ms) and lactobacilli levels were determined by conventional and commercial dip-slide methods in three groups of young subjects, aged 5-6 years (93 subjects), 12-13 years (78 subjects) and 18-20 years (81 subjects). Using the same paraffin-stimulated saliva samples, ms and lactobacilli were estimated by conventional viable counts on modified mitis-salivarius agar (MSB) and Rogosa agar plates, and by inoculation of Dentocult SM and Dentocult LB dip-slides (Orion Diagnostica, Finland). The salivary ms and lactobacilli counts obtained from conventional agar plates were significantly correlated (P < 0.0001) with the dip-slide estimates of these organisms (Kendal Tau = 0.56, 0.71 respectively). Subjects in Group 2 showed the highest proportion (77 per cent) of individuals with salivary ms levels above 2.5 x 10(5) cfu/ml saliva; 99 per cent of that group had detectable levels of lactobacilli. Significantly different median salivary ms and lactobacilli levels were demonstrated between all groups except for lactobacilli levels between Groups 2 and 3. These dip-slide tests provided suitable and simple methods for screening salivary lactobacilli and ms levels which may have a useful role in the assessment of caries risk.

Adolescent↗
PubMed1992

Improving obstetric outcomes in ethnic minorities: an evaluation of health advocacy in Hackney.

Ethnic differences in birthweight, perinatal mortality and other obstetric outcomes are now well known. In some districts with a significant ethnic minority population, services are provided for non-English-speaking women using maternity units. Various models have developed, including translators, interpreters, Linkworkers, the Department of Health funded Asian Mother and Baby Campaign and health advocates. This paper describes the evaluation of a health advocacy programme in Hackney, East London. The advocates do more than simply interpret language. Anecdotal examples of how this approach changes clinical practice encouraged the project steering group to commission a study to test the hypothesis that health advocacy could improve obstetric outcomes in non-English-speaking women. A retrospective study was carried out comparing 1000 non-English-speaking women delivering at the Mothers' Hospital, Hackney, in 1986 who had been accompanied by an advocate with women delivering at the same hospital in 1979 and at a reference hospital, Whipps Cross. The study found significant differences between the groups in three outcomes: antenatal length of stay, induction and mode of delivery. The changes in Caesarean section were of particular note. The rates rose from 11 to 17 per cent at the reference hospital, whereas they fell from 10.8 to 8.5 per cent at the Mothers' Hospital. This is highly statistically significant. Although these changes cannot be directly attributed to health advocacy, it was considered reasonable to deduce that improved communication could have influenced clinical practice. These findings suggest that health advocacy may offer a mechanism to address some of the adverse obstetric outcomes observed in ethnic minorities.

Adult↗
PubMed1992

A successful education program for parents of infants with newly diagnosed sickle cell disease.

The most dramatic recent advance in the care of young children with sickle cell disease was the demonstration by a cooperative study that the use of oral penicillin prophylaxis is highly effective in decreasing the risk of pneumococcal sepsis. Subsequently, the need for more comprehensive education of the parents of these children to ensure compliance with penicillin administration has become apparent. Over the past 4 years, the Mid-South Sickle Cell Disease Program has used a seven-phase educational process for the parents of more than 200 infants with newly diagnosed sickle cell disease. This has resulted in excellent compliance and a marked decrease in the incidence of pneumococcal sepsis among sickle cell patients at our center.

Anemia, Sickle Cell↗