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Biomedical subjects

J Connelly

Publications and source records attributed to J Connelly.

At least 19 recordsLinked to original sources

Intracranial ependymoma in children: analysis of prognostic factors.

Between 1955 and 1986, 25 children (aged 2 weeks to 15 years) were treated for intracranial ependymoma at M.D. Anderson Cancer Center. Nine patients had supratentorial primaries (5 high-grade, 4 low-grade), and 16 had infratentorial primaries (9 high-grade, 7 low-grade). Five patients had gross complete resection and 20 had incomplete resection. Seven patients received craniospinal irradiation (25-36 Gy to the neuro-axis, 45-55 Gy to tumor bed), 12 received local field irradiation (29-60 Gy, median 50 Gy). Five infants had adjuvant chemotherapy without radiotherapy, and 6 children had post-radiotherapy adjuvant chemotherapy, and 12 patients had salvage chemotherapy with various agents and number of courses. Eight patients are alive, disease-free and without relapse from 1 year to 12 1/2 years from diagnosis (median 42 months). The primary failure pattern was local recurrence. The data suggest that 1) the long-term cure rate of children with ependymoma is suboptimal; 2) histologic grade may be of prognostic importance for supratentorial tumors; 3) prognosis appears worse for girls and infants under 3 years of age; 4) in well-staged patients routine spinal irradiation could be omitted; 5) the role of adjuvant chemotherapy is unclear.

Adolescent

Malignant blue nevus.

To elucidate the histologic features and biologic behavior of malignant blue nevus (MBN), 12 cases were analyzed in which the tumor showed no junctional activity and arose in a blue nevus background. Seven patients were men and five were women; their mean age was 48.8 years. Eight lesions were on the scalp, and no patient had a family history of melanoma. The histologic appearance of most lesions was a nodule or nodules of malignant cells in a blue nevus. Mitoses were present in all lesions with atypical forms in eight; however the mitotic rate exceeded two per ten high-power fields in only one lesion. Four lesions had necrosis, and four had a heavily pigmented malignant component. Four patients had recurrences; ten patients had metastases, and eight died of their disease. Therefore MBN is an aggressive neoplasm.

Adult

Is housing a public health issue? A survey of directors of public health.

OBJECTIVE: To determine the views of directors of public health on the importance of housing for public health and their departments' and health authorities' participation in housing issues. DESIGN: Postal self administered questionnaire survey. SETTING: All district health authorities in England and health boards in Wales, Scotland, and Northern Ireland. SUBJECTS: All 221 district directors of public health in England and chief administrative medical officers in Wales, Scotland, and Northern Ireland. MAIN OUTCOME MEASURE: Response to questionnaire consisting of fixed and open ended questions on housing issues. RESULTS: The response rate was 89% (196/221). Housing was perceived as a major health problem by 33% (65/196) of directors. Positive responses were most likely from inner city districts. In 47% (93/196) of departments there was a formal time commitment to housing issues with a median time of one session/week (range one per month to 10 per week). The main function was allocation of medical priority for public sector rehousing. Overall, 73% (144/196) reported some participation in this process. Reported participation in joint care planning and links with non-statutory housing organisations were uncommon. 53% (104/196) of directors had included housing issues in their annual health report. In 16% (32/196) of districts specific services for the homeless had been set up. CONCLUSIONS: Although concern about the impact of current housing policy on public health was shown by a substantial number of directors, the main activity was still allocation of medical priority despite a background of increasing housing need and homelessness. The underlying need is for greater advocacy to produce a healthy housing policy for all, and the annual public health report could be used to promote this objective.

Attitude to Health

Pseudofungi in a lymph node. A case report with energy dispersive X-ray elemental analysis.

A case of pseudofungi in axillary lymph nodes is presented. They resembled septate hyphae and were stained with a periodic acid-Schiff stain. Gomori methenamine silver stain failed to stain them. Because of morphologic similarity to true septate fungi and positive staining with periodic acid-Schiff stain, these structures can be misinterpreted as septate hyphae forming true fungal organisms. Further studies, some of which included energy-dispersive x-ray elemental analysis and special stains, revealed that they were composed of iron, phosphorus, and calcium. The relationship of these pseudofungi to previously published cases and clues that enable one to make a correct diagnosis are described.

Aged

An unusual case of variegate porphyria with possible homozygous inheritance.

We report an unusual case of variegate porphyria in a young girl with epilepsy, mental retardation and premature adrenarche. Symptoms of porphyria commenced about the age of 12 years and death occurred about 18 months later. The patient had very low protoporphyrinogen oxidase activity in her cultured fibroblasts. Both parents had half the normal activity of this enzyme in lymphocytes and are heterozygous for the abnormal gene for variegate porphyria. Therefore, it is possible that the patient was a homozygous variant. Anticonvulsant therapy and low hepatic 5 alpha reductase activity were probably other contributing factors to the severity of the condition in this patient.

Animals

Use of hospital services by homeless families in an inner London health district.

Over the past decade the number of families in London who were considered officially to be homeless appreciably increased. In response to this many families have been given temporary accommodation, usually in bed and breakfast hotels, while awaiting permanent rehousing. About 200 of the roughly 600 hotels in London that provide such accommodation are located in the area of the former Paddington and North Kensington Health Authority, now part of Parkside Health Authority. The use made by the homeless population of hospital services was studied by finding out the numbers of inpatients admitted to hospital and the numbers presenting to the walk in paediatric clinic and the casualty department at one hospital. These figures were compared with those for local residents and the overall workload. The bed and breakfast population were high users of inpatient beds, the casualty department, and the paediatric clinic. Overall, about one tenth of the beds were used by these people. The health authority receives no additional funding for this group of patients. Further research is needed to find out if the high use of hospital services made by these patients reflects their increased morbidity or their inability to obtain primary care services.

Catchment Area, Health

Small intestine permeability in schizophrenia.

Gastrointestinal permeability was assessed by means of absorption of 51Cr-labelled EDTA in 24 patients with schizophrenia (12 in relapse and 12 in remission). The results were compared with those for patients with coeliac disease and those for normal controls. Significant differences between the schizophrenic patients and the normal controls were not established. The results for the schizophrenic patients in remission were no different from those for the patients in relapse, and there was no evidence from the study of an effect on gastrointestinal permeability of either anticholinergic or antidepressant medication. It is concluded that schizophrenia is, at least in the majority of cases, unrelated to coeliac disease.

Adolescent

Effects of monensin on voluntary intake, eating and ruminating behavior and ruminal motility in heifers fed corn silage.

Eating and ruminating behavior and associated ruminal motility of six heifers (1/4 Brahman X 1/4 Jersey X 1/2 Angus, 290 kg average weight) given ad libitum access to corn silage with or without 100 mg monensin X head-1 X d-1 were examined according to a two-period crossover design. There was no effect (P greater than .05) of monensin on level of intake, daily and unitary eating, ruminating and masticating times [min X g dry matter-1 X (kg body weight X 75)-1], duration or number of these activity periods, duration of main meals or latency time for onset of rumination following cessation of main eating activities. With the monensin treatment, daily numbers of normal boli and total boli were decreased (P less than .05) and mean duration of one rumination bolus cycle was longer (P less than .05). Analysis of covariance indicated relationships between intake of corn silage and duration of the main morning meal, duration or number of rumination boli and total ruminal contractions were affected (P less than .01) by monensin. Frequency and unitary number of strong cranio-dorsal ruminal contractions were similar for both treatments. During eating, number of contractions per minute was about twice (2.55/min) that during idling and rumination activity (1.43/min and 1.22/min, respectively). The unitary daily number of contractions was negatively (P less than .05) related to level of intake. Total daily ruminal contractions were slightly reduced (-3.96%, P greater than .05) by monensin. Results are interpreted to suggest that monensin indirectly affects rumination through a lowered motility and thereby affects turnover, gut fill and intake.

Animals

Genetic screening of newborn in Australia. Results for 1981.

Since screening of newborn infants for phenylketonuria (PKU) by the Guthrie bacterial inhibition assay was established in the 1960s, 3 017 703 infants have been tested in Australia. Two hundred and fifty-one cases of PKU (0.83/10 000) and six cases of the variant forms of malignant hyperphenylalaninaemia (MHPA) (0.02/10 000) have been detected. In 1981, 11 infants with PKU were detected. Screening for congenital hypothyroidism was carried out in seven States, and 66 new cases were detected in 1981 (2.13/10 000). In Adelaide, 154 310 infants have been tested for galactosaemia and a total of seven cases have now been detected (0.45/10 000). In New South Wales, 35 955 infants have been tested for cystic fibrosis of the pancreas, and 17 cases were found (4.73/10 000).

Australia

Genetic screening of newborn in Australia: results for 1980.

Since screening of newborn infants for phenylketonuria (PKU) by Guthrie bacterial inhibition assay was established in the 1960s, 2779 790 infants have been tested in Australia. Two hundred and forty cases of PKU (rate: 1/11 582) and six cases of the variant forms of malignant hyperphenylalaninaemia (MHPA) (rate: 1/463 298) have been detected. In 1980, 18 infants with PKU were detected. Screening for congenital hypothyroidism was carried out in six centres, and 40 new cases were detected in 1980.

Australia