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Biomedical subjects

A Tomkins

Publications and source records attributed to A Tomkins.

66 records · Page 4Linked to original sources
PubMed1975

Meningococcal antigen in diagnosis and treatment of group A meningococcal infections.

Meningococcal antigen was measured by countercurrent immunoelectrophoresis in the blood and cerebrospinal fluid of 200 patients with group A meningococcal meningitis. Antigen was detected in the blood of 27 (13.5 per cent) patients. These patients had a worse prognosis and a higher incidence of allergic complications, such as arthritis and vasculitis, about 5 days after the start of antibiotic treatment. Antigen was found in the CSF of 129 (67.5 per cent) patients); antigen often persisted in the cerebrospinal fluid despite antibiotic treatment before admission. A combination of immunoelectrophoresis and routine bacteriologic study was used in the diagnosis of 162 (84.8 per cent) patients with meningococcal meningitis. High levels of antigen and a slow antigen disappearance were associated with neurologic damage. The antigen is stable and may be detected from specimens of cerebrospinal fluid dried on filter paper.

Antigens, Bacterial↗
PubMed1973

Trial of chloramphenicol for meningitis in northern savanna of Africa.

In a controlled trial chloramphenicol proved as effective and much cheaper than penicillin for the treatment of group A meningococcal meningitis in Zaria, Nigeria. A short course of five days cured most patients. Adults and older children were soon able to take chloramphenicol by mouth, which reduced the cost and simplified treatment.It is suggested that chloramphenicol is a suitable alternative to sulphonamides for the treatment of meningococcal meningitis in those parts of Africa where the organism is sulphonamide-resistant.

Administration, Oral↗
PubMedDate not supplied

The use of fermented and germinated cereals and tubers for improved feeding of infants and children in Uganda.

Interviews with mothers in 4 ecologically separate regions of Uganda (Arua, Mukono, Kabale and Mbarara) revealed considerable differences in patterns of infant and child feeding in health and during diarrhoea. There was considerable enthusiasm for the use of fermentation and germination of cereals and tubers in some areas (Arua 87% and Kabale 90%). These household food processes were especially recommended for improving dietary intake during diarrhoea. However, these techniques were not used by mothers in Mukono or Mbarara. The advantages of these procedures and possible reasons for differences in their popularity are discussed.

Child, Preschool↗
PubMedDate not supplied

Recent developments in the nutritional management of diarrhoea. 1. Nutritional strategies to prevent diarrhoea among children in developing countries.

This paper discusses various ways in which diarrhoea may be prevented from occurring in children living in developing countries, where it is still a major cause of morbidity and mortality. Possible strategies include promotion of breastfeeding, dietary supplementation with vitamin A, zinc and iron, the prevention of protein-energy malnutrition as far as possible, and improvement in the standard of preparation and hygiene of available weaning foods, involving in particular the wider use of fermented foods.

Breast Feeding↗
PubMedDate not supplied

Impact of acute malaria on plasma concentrations of transferrin receptors.

The acute-phase response to infection alters the plasma concentrations of most biochemical measures of iron status, rendering assessment of status difficult. Soluble transferrin receptors (TfR) may be an exception but have not been examined longitudinally during the major metabolic and inflammatory changes which occur during clinical malaria. Blood samples were collected daily during hospitalization, and again at a follow-up 2-6 weeks after discharge, from adult, mainly European, patients (n = 49) who developed uncomplicated Plasmodium falciparum malaria following visits to endemic areas. Parasitaemia and plasma concentrations of ferritin, TfR, C-reactive protein (CRP), alpha 1-acid glycoprotein (AGP) and alpha 1-antichymotrypsin (ACT) were measured. The concentrations of CRP, AGP and ACT correlated highly (P < 0.001) with each other and with plasma ferritin, and were significantly higher (P < 0.05) at all time points in hospital compared to the follow-up. TfR concentration correlated negatively and significantly (P < 0.05) with AGP and CRP but not with ACT or ferritin, and was significantly lower (around 30%) at all time points in hospital compared to follow-up, although in only 1 subject did it ever fall outside the normal reference range. In areas where both iron deficiency and clinical episodes of malaria are common, plasma TfR values need to be interpreted cautiously as indicators of iron status.

Adult↗
PubMedDate not supplied

The distribution of Ascaris lumbricoides in human hosts: a study of 1765 people in Bangladesh.

The Ascaris lumbricoides expelled by 1765 people in a poor urban community in Bangladesh were recovered and counted after the subjects had been treated with pyrantel pamoate. The subjects were divided into 22 classes by age and sex (mean n = 80) to examine how prevalence, mean worm burdens and measures of aggregation of worms varied with age and between the sexes, and to see how a measure of aggregation, k, calculated in 3 ways (by maximum likelihood, from moments, or from the percentage uninfected) compared with an empirical aggregation index (the percentage of subjects who expelled an arbitrary 80% of all worms) and with the proportion who were moderately to heavily infected (defined as > or = 15 worms). The prevalence of infection ranged from 64% to 95%, mean worm burdens ranged from 7 to 23 worms, and k ranged from 0.3 to 1.2. There were significant differences between adult males and females in the prevalence of infection, mean worm burdens and measures of aggregation, differences which are probably driven more by behaviour than immunity. The parameter k was better described in terms of the proportion who were moderately to heavily infected (linear; range 0.15-0.58) than by the empirical aggregation index (non-linear; range 0.30-0.49).

Adolescent↗
PubMedDate not supplied

Nutritional status and age at menarche in a rural area of Bangladesh.

The age at menarche and its association with nutritional status in a rural area of Bangladesh was determined. A cross-sectional study was conducted in four villages of Rupganj Thana of Narayanganj district. Data was collected through October to December 1996 using a pre-tested structured questionnaire interview schedule, and nutritional status was measured by weight, height, body mass index (BMI) and physical examination. Data were obtained on 436 adolescent girls aged 10-17 years. Among them, 165 (37.8%) girls had commenced menarche. The mean age at menarche as determined by retrospective recall was 13 years SD 0.89 (n = 165). The median age at menarche determined by the status quo method was 13.0. Among the adolescents 60.1% were thin (BMI < 5th centile WHO recommended reference) and 48.2% were stunted (< 3rd centile NCHS/WHO). The mean weight and BMI were significantly higher among the menstruating girls of 13, 14 and 15 years (p < 0.01) than non-menstruating girls. The mean height was found to be significantly higher at 11-14 years among the menstruating girls (p < 0.05). A lower prevalence of angular stomatitis was found among the menstruating adolescent girls compared with the non-menstruating girls, 36.4% versus 46.5%, although this was statistically non-significant (odds ratio = 0.66, 95% CI 0.43-1.00). For glossitis, no significant difference was found. Among the menstruating girls 12.1% were suffering from menorrhagia and 31.5% from dysmenorrhoea. We conclude that the age of menarche among this rural Bangladeshi community is not as delayed as expected. Not surprisingly, menarche is associated with better nutritional status. The surveyed population had extremely high rates of undernutrition which suggests that adolescents in this and similar situations require specific intervention programmes to improve their nutritional status.

Adolescent↗
PubMedDate not supplied

Growth status and menarche in urban and rural China.

OBJECTIVE: To examine the relationship between current age at menarche and growth status in an urban and rural area of Eastern China. STUDY DESIGN: Cross-sectional survey: self-completion questionnaire and anthropometry in 12 schools in urban Hangzhou and rural Chunan in Zhejiang Province. RESULTS: The median menarcheal age calculated by probit analysis was significantly different in the two areas: 12.8 years (SD 0.9) in the urban area and 13.2 (SD 1.0) in the rural area (p < 0.001). Girls who reach menarche are significantly heavier and taller with higher BMIs than those of the same age who are pre-menarche. After adjustment for BMI and other possible confounders, urban girls were still menstruating significantly earlier than girls in rural areas (OR 3.3, 2.1-5.2). CONCLUSIONS: The age of menarche is probably still declining in China. Although BMI is an important factor in the onset of menstruation, some other unmeasured environmental variable may be implicated in this population.

Adolescent↗
PubMedDate not supplied

Maternal age, social changes, and pregnancy outcome in Ribeirão Preto, southeast Brazil, in 1978-79 and 1994.

This study focused on changes in demographic, social, and health-care patterns and pregnancy outcome related to maternal age from 1978-79 to 1994 in Ribeirão Preto, São Paulo State, Brazil. Information on pregnancy outcome was obtained from two cohorts of singleton live births, 6,681 births in 1978/79 and 2,839 births in 1994. A standardized questionnaire was submitted to mothers after delivery, and demographic information was collected from official records. There was a significant increase in teenage pregnancies (from 5.1% to 7.4%) and a decrease in infant mortality (36/1,000 to 17/1,000). There were significant decreases in the proportion of mothers with low schooling (24.5% to 14.4%), smoking (28.9% to 21.%), and multiparity (14.7% to 9.0%). Prenatal coverage improved (from 23.4% to 9.0% of patients with fewer than 4 prenatal visits), while cesareans increased (from 30.6% to 50.8%), as did preterm delivery (7.2% to 13.6%) and low birthweight (7.2% to 10.6%). Despite significant improvements in some maternal characteristics, the proportion of teenage pregnancies, preterm deliveries, low birthweight, and cesareans increased, raising concerns about the health costs and consequences for mothers and infants.

Adolescent↗