Biomedical subjects
G Howie
Publications and source records attributed to G Howie.
Survey of the implementation of workplace alcohol and smoking policies among employers in Fife.
A survey of major employers in Fife shows that at present 33% of respondents have implemented written alcohol policies, while 40% have implemented written smoking policies. A total of 19% have both alcohol and smoking policies in place. The initiative for policy development appears to have arisen mainly from management, but trade unions and management have co-operated well during policy formulation. The majority of policies have been implemented for more than three years. A small number of companies in Fife appear to be interested in the development and implementation of written alcohol and smoking policies in the workplace.
Response to a Haemophilus influenzae type b diphtheria CRM197 conjugate vaccine in children with a defect of antibody production to Haemophilus influenzae type b polysaccharide.
A defect in antibody response to immunization with Haemophilus influenzae type b (Hib) capsular polysaccharide vaccine has been reported in children with recurrent infections and normal immunoglobin levels. We identified 15 children, aged 2 to 6 years, with this defect, and we evaluated their response to immunization with an Hib capsular oligosaccharide diphtheria CRM197 protein-conjugate vaccine (HbOC). The children received a series of three vaccines: HbOC at 0 and 8 weeks, and the Hib polysaccharide vaccine at 16 weeks. Levels of antibody to the Hib capsular polysaccharide (polyribosyl ribitol phosphate, PRP) and to diphtheria toxoid were obtained before and 4 weeks after each vaccination. The geometric mean serum anti-PRP concentration was 0.17 microgram/ml before immunization and 29.3 micrograms/ml after the second HbOC immunization (week 12). All 15 children had postvaccination anti-PRP antibody levels greater than 1.0 microgram/ml after receiving the second HbOC (week 12). In addition, booster responses were observed after the second Hib conjugate in 13 of the patients and after the Hib polysaccharide in four of the patients. All patients with low preimmunization diphtheria titers had a response to the diphtheria toxoid. These results suggest that conjugation of Hib polysaccharide with diphtheria CRM197 overcomes the defective antibody response to Hib oligosaccharide in children who are initially observed with recurrent infections and inability to respond to the Hib polysaccharide vaccine.
Selective defect in the antibody response to Haemophilus influenzae type b in children with recurrent infections and normal serum IgG subclass levels.
We studied 15 children with recurrent infections and normal serum IgG, IgM, IgA, and IgG-subclass levels. After immunization, the geometric mean serum IgG antibody concentration to Haemophilus influenzae type b (Hib) was eightfold lower than that of age-matched control subjects (p = 0.002). The patients also had a lower geometric mean concentration of serum IgM and IgA directed to Hib, although these differences did not reach significance. However, the groups did not differ in their response to diphtheria toxoid and pneumococcal polysaccharides. To confirm these findings, an additional 11 patients were identified and immunized. The geometric mean serum IgG anti-Hib concentration for this group of patients was also significantly lower than of normal subjects (p = 0.004). We propose that the defect in the antibody response to Hib may be a marker for a poor antibody response to a variety of bacterial and viral antigens that results in an increased propensity to recurrent infections. The defect was not associated with IgG-subclass deficiency. The identification of children with selective antibody deficiency and recurrent infections is important for diagnostic and therapeutic reasons.
Controlled trial of therapy in covert bacteriuria of childhood.
Sixty-three girls with covert bacteriuria were included in a controlled trial of therapy. Recurrent infection in the treated group was common and was not significantly different from the rate of persistent infection in the untreated control group. Two children in each group developed clinical pyelonephritis; the others have remained healthy and all of them have a normal rate of growth. 2 years after diagnosis three of the thirty-four children in the control group and one of twenty-six children in the treated group have radiological evidence of new scars of pyelonephritis. These changes were relatively minor and in both groups of children renal growth was similar to that in normal children. It is suggested that for most of these children therapy is not essential, and that when renal changes occur they are of little or no significance. Prescriptive screening for cobert bacteriuria of childhood cannot be recommended at present.
Late results of autogenous-vein grafting and lumbar sympathectomy in ischaemic limbs.
Explore the source record for details and available documents.
Current status of thermography in peripheral vascular disease.
Explore the source record for details and available documents.
Quality improvement study of day surgery for tonsillectomy and adenoidectomy patients.
Ongoing efforts to contain costs in health care have had an impact on the delivery of care in the ambulatory setting. Many patients previously admitted to the hospital for an overnight stay are now discharged home within hours of surgery. In response to concerns raised by nursing staff about same-day discharge of patients undergoing tonsillectomy and adenoidectomy (T&A), a quality improvement (QI) study was conducted. Data from more than 150 families over a 2-year period were collected, using the clinical indicator of safe discharge. The data were obtained during the patient's recovery room stay, the first post-operative day, and 2 weeks after surgery. Findings suggested that some of the teaching done by nurses was useful and some needed revision to meet patients' needs. Changes regarding pain management, fluid management, and post-operative bleeding were addressed.