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Biomedical subjects

D M Tappin

Publications and source records attributed to D M Tappin.

34 records · Page 2Linked to original sources
PubMed1996

Prevalence of smoking in early pregnancy by census area: measured by anonymous cotinine testing of residual antenatal blood samples.

AIM: To accurately measure the prevalence of smoking in early pregnancy by census area units (CAU) in Christchurch. METHODS: Smoking status in pregnancy was determined by serum cotinine assay for all antenatal blood samples taken over a 6 month period. CAUs in Christchurch were grouped into quartiles according to the proportion of maternal smokers. Social factors from 1991 census data were used to describe the characteristics of each quartile. RESULTS: The overall rate of smoking in pregnancy was 33.0%. Rates ranged from 10.6% to 56.9% for the census area groups. CAUs in the upper quartile (39-57% of women smoking in pregnancy) were clustered together geographically and were associated with lower socioeconomic indices. The strongest correlation was between average income with smoking rates (Pearson correlation coefficient 0.76). CONCLUSION: Smoking rates in pregnancy have remained at around 30% for at least 20 years, with some areas of the city having rates nearly double this. It would seem logical to promote smoke-free pregnancy activities in localities with the highest rates of smoking. Future evaluation of the efficacy of such programmes should be done using objective measurements.

Confidence Intervals↗
PubMed1996

Breathing, sleep state, and rectal temperature oscillations.

Overheating may cause terminal apnoea and cot death. Rectal temperature and breathing patterns were examined in normal infants at home during the first 6 months of life. Twenty one infants had continuous overnight rectal temperature and breathing recordings for 429 nights (mean 20.4 nights, range 7-30) spaced over the first six months of life. Periods when breathing was 'regular' were directly marked on single night records. Sleep state was determined from respiratory variables. 'Regular' breathing was a reliable marker of 'quiet' sleep (specificity 93%). The duration of 'quiet' sleep increased from 6 to 22 minutes from two weeks to three months of age and then remained static, as did the proportion of sleep spent in the quiet phase (9% to 34%). Rectal temperature fell during 66% of quiet sleep and usually rose during rapid eye movement (REM) sleep. The drop in rectal temperature was maximal at the start of quiet sleep, whereas the maximum rise during REM sleep was reached after 10 to 15 minutes. Oscillations in rectal temperature are associated with changes in sleep and breathing state. The maturation of rectal temperature patterns during the first six months of life are closely related to a maturation of sleep state and breathing patterns.

Aging↗
PubMed1995

Spread of maternal HIV infection in Scotland from 1990 to 1992.

In Scotland since January 1990, unlinked anonymous testing of Guthrie cards has documented maternal HIV-1 antibody in neonatal blood. District postcode and quarter year of birth determined prevalence and spread of infection. The Fujirebio particle agglutination assay screened for HIV-1 antibody, with confirmation by ELISA and full western blotting. Births to known HIV infected women were reported to the Royal College of Obstetricians and Gynaecologists. 0.3/1000 childbearing women were infected with HIV-1 with no significant increase from 1990 to 1992. Spread of infection from 11 to 26 districts has occurred. In 1990, 74%(14/19) of HIV positive deliveries were known to obstetricians falling to 33%(7/21) in 1992. Spread of HIV-1 infection has occurred to mothers who live outside closely defined areas and who do not belong to recognised high risk groups. In Scotland, two thirds of mothers and their infants will not receive early prophylactic care for their HIV disease.

AIDS Serodiagnosis↗
PubMed1994

Breast feeding in Scotland.

OBJECTIVE: To measure the prevalence of breast feeding and to examine the value of using information collected on Guthrie cards (used for detecting inherited metabolic disease and hypothyroidism when newborn infants are 7 days old) to calculate this prevalence. DESIGN: Analysis, by geographical area and maternity unit, of information on breast feeding collected on Guthrie cards for 131,759 babies born in 1990 and 1991, and comparison with prevalences from other sources. SETTING: Scotland. RESULTS: Of the 131,759 babies, only 46,949 (35.6%) were breast feeding on day 7. The prevalence of breast feeding ranged from 59.1% (376/636) in Shetland to 21.1% (1836/8719) in Lanarkshire and < 8% in some postcode districts of cities. Analysis of the data by hospital of birth showed that the prevalence ranged from 51.2% (2701/5275) to 16.4% (507/3090). CONCLUSION: The prevalence of breast feeding in Scotland is low and varies among areas and maternity units. Intervention to increase this prevalence is essential, and information collected on Guthrie cards is a useful indication of mothers' intentions to breast feed.

Breast Feeding↗
PubMed1994

Infant home apnoea monitors in Christchurch: an audit.

AIM: To audit parental perception of the apnoea monitor service given to neonatal graduates and infants surviving an apparent life threatening event in Christchurch. METHODS: Seventy-five of 103 sets of parents (74%), who had monitored their infants, between November 1990 and November 1992, were interviewed using a structured telephone questionnaire (apparent life threatening event (ALTE) n = 44, significant recurrent apnoea (NNU) n = 31. RESULTS: Anxiety present in most parents (83%) was relieved by monitoring (89%). Parents (97%) were satisfied with the instruction in monitor use. Eighty-nine percent had good contact with the technician, 73% called her to solve a problem. Most parents (84%) thought that initial instruction in cardiopulmonary resuscitation (CPR) was adequate. Sixty-eight percent would have liked a refresher course which only 7% of NNU and 22% of ALTE parents received. Sixty percent of parents had at least one significant alarm. Nine percent performed CPR to abort an apnoea. Ten percent of parents would have liked to monitor their child longer. CONCLUSIONS: Apnoea monitoring allays parental anxiety and may save the lives of a few infants. A technician is essential to coordinate all aspects of the service. Improvements could be made to instruction for cardiopulmonary resuscitation.

Anxiety↗
PubMed1993

Prevalence of maternal HIV infection in Scotland based on unlinked anonymous testing of newborn babies. Update.

In January 1990, unlinked anonymous testing of Guthrie cards for HIV antibody commenced in Scotland. Ethics Committee approval allowed testing of 99.6% of Scottish births. Twenty-one mothers spontaneously refused to allow testing of their baby's blood. Samples were coded by district postcodes. For 1990 through 1991, eluates of 132,531 dried blood spots were initially tested for HIV-1 antibody with the Fujirebio technique. Of the 49 positive samples 38 were confirmed to be positive by enzyme-linked immunosorbent assay and western blot (seroprevalence 0.3 per 1000). Thirty-five of 38 samples came from large metropolitan areas in Scotland. Prevalences were 2.0 per 1000 for Edinburgh city, 0.7 per 1000 for Dundee and Aberdeen, 0.15 per 1000 for Glasgow and 0.05 per thousand for all other areas in Scotland. Recent spread of HIV infection to Aberdeen may have occurred. These figures do not support an overall increase of HIV infection in childbearing women in Scotland.

Adult↗
PubMed1992

Ethics and ethics committees: HIV serosurveillance in Scotland.

Knowledge of the heterosexual spread of HIV is needed to plan future health-care needs. In December 1989 we gained approval and finance for unlinked anonymous testing of neonatal Guthrie card samples in Scotland. Local ethics committee approval was required before testing could start. Twenty ethics committees were approached in the 15 Scottish health board areas. Nineteen of the committees have agreed, representing 99.6 per cent of births in Scotland. Our method of contacting ethics committees is discussed, as are the points raised.

Anonymous Testing↗
PubMed1991

Prevalence of maternal HIV infection in Scotland based on unlinked anonymous testing of newborn babies.

Dried blood spot samples from newborn babies have been successfully tested for HIV-1 antibody by the particle agglutination method to assess the prevalence of infection in the mothers. In January, 1990, unlinked anonymous testing of Guthrie cards for HIV antibody was begun in Scotland. 99.6% of Scottish births were tested. 9 mothers spontaneously refused to allow testing of their baby's blood. Samples were coded by district postcodes. Eluates of 65,773 dried blood spots were initially tested for HIV-1 antibody with the Fujirebio technique. Of the 31 positive samples 19 were confirmed to be positive by enzyme-linked radioimmunoassay and western blot (seroprevalence 0.29 per 1000). All these samples came from large metropolitan areas on the east coast. Prevalences were 2.5 per 1000 for Edinburgh city, 1.4 per 1000 for Dundee, and 0.7 per 1000 for Aberdeen. We identified as HIV-positive all babies known to be so in named testing programmes. HIV testing of Guthrie cards can be used to monitor HIV status in mothers who have just given birth. The use of district postcode data in sample identification will allow accurate targetting of prevention strategies and early detection of spread of infection by geographic area.

Agglutination Tests↗
PubMed1989

A prospective study of children with first acute symptomatic E. coli urinary tract infection. Early 99mtechnetium dimercaptosuccinic acid scan appearances.

Between 1985 and 1987 102 children, age 0-14 years, presented with a first acute symptomatic E. coli urinary tract infection. Investigations included early 99mtechnetium dimercaptosuccinic acid (DMSA) scan (which was performed at a median of 27 days), ultrasonography, micturating cysto-urethrography and indirect voiding radionuclide cystography using 99mTc DTPA. Follow-up DMSA scan was carried out after 6 months. Twenty-one of 102 of initial DMSA studies showed diminished uptake of radionuclide and 12 showed cortical scarring. Twenty-nine patients had significant vesicoureteral reflux (VUR). The finding of diminished uptake on the initial scan was significantly associated with fever, systemic upset, length of symptoms and a peripheral blood leucocytosis, (p less than 0.05). In addition the finding was associated with fever and loin pain in the older child. Both diminished uptake and scarring were more common in refluxing kidney units. We propose that, in children with UTI, diminished uptake on early DMSA scan localises infection in the renal parenchyma.

Acute Disease↗
PubMedDate not supplied

HIV testing and prevalence in pregnancy in Edinburgh.

The objective was to study the changes in pregnancy HIV prevalence with time. Data were collected from multiple sources to provide a comprehensive record of all HIV seropositive pregnant women identified in the Edinburgh area (Scotland) until December 1992. There were 177 pregnancies in 108 HIV seropositive identified women. Risk factors were injection drug use (79% of pregnancies) and a known HIV seropositive injection drug-using partner (16%). Prevalence has decreased for Edinburgh City women from 0.5% of all pregnancies in 1986 to 0.1% in 1992; It was higher for induced abortion (0.6%) than for delivery (0.2%). HIV testing in pregnancy has declined. Comparison with unlinked anonymized testing showed that in 1990-1991, 20/22 seropositive women were known. In 1992, only 3 of 10 seropositive pregnancies were identified. The cohort initially infected by exposure to a 'drug related' risk factor between 1983 and 1985 may have increasingly finished childbearing, deliberately decided against pregnancy because of HIV status, and declined because of death, illness and emigration from the area, There may not have been major early tertiary heterosexual spread; however, data from 1992 suggest that this could now be impacting on pregnancy prevalence. Local testing policies have not adapted to this possible change.

AIDS Serodiagnosis↗