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Biomedical subjects

G A McFarlane

Publications and source records attributed to G A McFarlane.

7 recordsLinked to original sources
PubMed2000

Trends over time in Helicobacter pylori gastritis in Kenya.

OBJECTIVE AND DESIGN: There is increasing evidence to link infection of the gastric mucosa by Helicobacter pylori with the subsequent development of gastric cancer. This study was undertaken to document the progression of H. pylori gastritis in a rural Kenyan population with a moderate gastric cancer risk. METHOD: Biopsy follow-up study of 51 H. pylori-positive patients over an average of 5.5 years. RESULTS: In the study group, the number of individuals with moderate to severe atrophy rose from 17 (33%) to 22 (43%), an annual increase of 1.8% [95% confidence interval (CI) -0.9% to 4.4%]. There was significant progression of atrophy (P< 0.05) in those with low overall scores for graded morphological variables at initial endoscopy. Intestinal metaplasia did not progress; indeed four out of 12 patients initially diagnosed with intestinal metaplasia showed no evidence of it in their follow-up biopsies. CONCLUSIONS: H. pylori gastritis with atrophy may provide a suitable environment within the gastric mucosa for the development of gastric cancer but it is likely that other factors in this population determine further progress towards dysplasia and cancer.

Adult↗
PubMed2000

A prepaid healthcare scheme in rural Africa.

Healthcare providers in Africa are having to increasingly rely on the resources of the populations they serve. An 8-year experience with one of the first rural-based health insurance schemes in East Africa is described. Initial difficulties included adverse selection of members with chronic ill health, fraudulent claims and overuse of health services, leading to considerable financial losses. External technical assistance introduced member tracking and regular reports, reduced adverse selection, fraud and overuse of services to a minimum, and achieved financial stability. Local market research and a comprehensive marketing plan is essential for the overall success of an insurance plan. Health insurance in this part of Africa is likely to assist middle income earners rather than the poor.

Africa, Eastern↗
PubMed2000

Abdominal cocoon: report of five cases.

Abdominal cocoon (idiopathic sclerosing peritonitis) has now been reported in many parts of the world but remains principally a disease of the tropics and sub-tropics. Five cases diagnosed at a rural Kenyan hospital between 1993 and 1998 are presented and the operative findings and management is discussed. Although the condition normally occurs in adolescent girls, one patient was noted to be forty two years of age, and was subsequently found to have AIDS.

Adolescent↗
PubMed1997

Helicobacter pylori and gastric cancer.

BACKGROUND: Considerable progress has been made over the past two decades in understanding gastric carcinogenesis. Genetic and environmental factors have been shown to play a part. Infection with Helicobacter pylori leads to chronic gastritis and evidence is accumulating to link this disease with the subsequent development of gastric cancer. METHOD: A literature review was undertaken using Medline (National Library of Medicine, Washington DC, USA) searches of the headings gastrointestinal neoplasms and H. pylori for the years 1993-1997; further relevant references were examined. RESULTS: H. pylori is implicated in gastric carcinogenesis. Proposed mechanisms centre on the inflammatory response of the gastric mucosa to the bacterium. CONCLUSION: Investigation is still required to elucidate the exact role of H. pylori in the development of gastric carcinoma. Eradication of the organism in high-risk groups might lead to a reduction in the incidence of gastric cancer.

Gastritis↗
PubMed1987

Epidemiology and outcome of acute pancreatitis.

Acute pancreatitis in North-East Scotland from January 1983 to December 1985 was examined. The criteria for diagnosis were a serum amylase greater than 1000 units/l with a consistent clinical presentation, or acute pancreatitis confirmed at laparotomy or post mortem. All serum amylase assays were performed in one regional laboratory. The commonly used diagnostic coding search for pancreatitis yielded only half the cases found. We identified 378 episodes of acute pancreatitis (196 males and 182 females). The mean annual incidence for first attacks of acute pancreatitis was 242 per million of the population. The commonest aetiology was biliary tract disease (30 per cent of males and 53 per cent of females). Alcohol related pancreatitis occurred in 26.5 per cent of males but only 3 per cent of females. Complications included 26 pseudocysts, 11 pancreatic abscesses, 9 patients with respiratory failure, 11 patients with renal failure and 6 patients with disseminated intravascular coagulation.

Acute Disease↗