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Biomedical subjects

J Emmanuel

Publications and source records attributed to J Emmanuel.

At least 19 recordsLinked to original sources
PubMed2001

Validity of the haemoglobin colour scale in blood donor screening.

BACKGROUND AND OBJECTIVES: The haemoglobin colour scale (HCS) has been developed as a simple, reliable and inexpensive clinical device for diagnosing anaemia and estimating its severity when laboratory-based haemoglobinometry is not available. The purpose of this study was to assess its validity for screening blood donors for anaemia. MATERIAL AND METHODS: The HCS was tested at five blood transfusion centres on a total of 2801 donors. Blood was obtained by skin puncture as part of the routine procedure at the donor sessions. HCS readings were compared with screening by the copper sulphate method, which was in routine use in the centres, and with haemoglobin (Hb) measurements by means of calibrated HemoCue haemoglobinometers. HCS readings were considered as normal when the readings were > or = 12 g/dl. RESULTS: Analysis of the paired results showed that the HCS had an accuracy of 97.5% in distinguishing subjects with normal Hb from those below the acceptable limit, when checked against the HemoCue. The HCS was more reliable than the copper-sulphate specific-gravity method, yielding 3.7% false readings compared with 6.1% false readings, respectively. When discrimination was set at 12 g/dl with the HemoCue, the HCS gave an incorrect reading in 2.4% of donors. The majority of these false results (44 donors; 1.58%) were caused by the HCS indicating rejection of the donor (i.e. Hb < 12 g/dl) when the correct Hb was higher, whilst in 23 donors (0.82%) the HCS incorrectly indicated a normal Hb; however, in all but four of these donors the correct Hb values were 11.0-11.9 g/dl, and none were below 10 g/dl. CONCLUSION: The operators were able to master the HCS technique after a few minutes of practice, and all found the test to be user friendly and easy to read. The HCS is proposed as a replacement for the copper sulphate method for blood transfusion donor selection.

Adult↗
PubMed2001

Instrumental psychosis: the Good Soldier Svejk syndrome.

The possession of severe mental illness, mainly schizophrenia and affective psychosis, may be perceived in positive terms. We have identified a group of patients, most of them with a history of previous psychotic disorder, who present with deliberately created symptoms and behaviour, and who are defined as having instrumental psychosis. Because most such patients have had a psychotic disorder in the past the symptoms are very like those of a real psychosis. A parallel is drawn with the fictional anti-hero of the Czech nation, the Good Soldier Svejk, who demonstrated both real and instrumental psychosis. A rating scale, the 'pseudopsychosis inventory', was devised to identify the main components of this disorder and was applied in 15 consecutive patients presenting with putative psychotic disorders in whom assessment could be made by two raters within five days. The inter-rater reliability of the items of the scale was good (intra-class correlation coefficient 0.68). An epidemiological study with this scale in 45 patients with a putative psychotic disorder suggested the presence of instrumental psychosis in 2.

Adult↗
PubMed1998

Systematic review of the outcome of anxiety and depressive disorders.

BACKGROUND: Although there have been many changes in the diagnosis of anxiety and depressive disorders in the past 20 years there have been few comparative enquiries into the clinical outcome of greater diagnostic categories. We therefore compared the outcome of all studies which compared the outcome of specific anxiety and depressive disorders using the standard procedures of systematic review. METHOD: A Medline search was carried out of all studies comparing the outcome of anxiety and depressive disorders or mixed anxiety--depressive disorders in which information was available separately for each disorder. RESULTS: Eight studies satisfied the search criteria (all involving a period of observation of two years or greater); only one of these included randomisation of treatment and comparison between specific anxiety disorder outcome. There was a somewhat better outcome in patients with depressive disorders compared with anxiety ones, and strong evidence that both anxiety and depressive disorders singly had better outcomes than comorbid mixed disorders. CONCLUSION: Comorbid anxiety--depressive disorders have a poor outcome compared with single anxiety and depressive disorders, and there is some evidence that anxiety disorders have a worse outcome than depressive ones.

Anxiety Disorders↗
PubMed1994

The association of tuberculosis and HIV infection in Harare, Zimbabwe.

SETTING: The tuberculosis (TB) service responsible for all TB treatment in Harare, Zimbabwe. OBJECTIVES: (1) To determine HIV seroprevalence among TB patients and controls. (2) To compare clinical and demographic characteristics of HIV-infected and uninfected TB patients. DESIGN: Cohort study. Entry criterion: TB diagnosed during the 18 month study period. Assessment included HIV serology. Matched community controls were HIV serotested. RESULTS: In 1434 TB patients tested, HIV seroprevalence was 48% in men and 44% in women, peaked in the 25-34 year age group and was higher than in controls (relative risk [RR] = 3.1, 95% confidence interval [CI] = 2.6-3.7). In adults, seroprevalence was 34%, 49% and 58% in successive 6 month periods. A history of entry of prior TB treatment was less common in the HIV-seropositive (RR = 0.57, CI = 0.37-0.88). In adults, tuberculin negativity, TB at 2 sites, lymph node, pericardial and miliary TB, hilar adenopathy and pleural effusion were significantly more common in HIV-seropositive patients; cavitation and upper lobe involvement were significantly less frequent. Pulmonary TB and sputum smear positivity had similar frequencies in the 2 groups. CONCLUSION: HIV was strongly and increasingly associated with TB in Harare and altered the clinical and radiologic features of TB. Failed standard TB treatment in HIV-infected individuals contributed minimally to new cases of TB.

AIDS-Related Opportunistic Infections↗
PubMed1994

Blood donor counselling for HIV: results of a multi-country feasibility study.

A qualitative characterisation study was conducted by the World Health Organisation's Global Programme on AIDS, and the International Federation of Red Cross and Red Crescent Societies, in six developing countries in order to determine the feasibility of introducing blood donor counselling into procedures for blood donation at blood transfusion sites. After careful preparation of consultants, in-country visits were made to include structured discussions with key BTS and Red Cross, and national AIDS programme staff, and donors, and observations of relevant facilities. Necessary resources, management requirements, obstacles to and options for blood donor counselling were explicated, together with information on the role of HIV testing in motivating blood donation, and problems associated with this and with donor notification. Blood donor counselling is seen as feasible, provided minimum conditions can be established to ensure appropriate standards and availability of resources.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Reducing the cost of HIV antibody testing.

Available tests to detect antibody to human immunodeficiency virus (HIV) have a range of applications, and injudicious selection and inappropriate use can add a significant financial burden to budgets for AIDS programmes in developing countries. There are several ways by which the cost of HIV antibody testing can be reduced; they include use of tests appropriate for existing laboratory capabilities; adoption of cost-effective testing strategies; pooling of serum samples before testing; and ensuring best possible purchase prices. Each approach can significantly reduce the cost of HIV antibody testing alone or in combination, which increases the potential sustainability of antibody testing programmes, even in settings of limited resources.

AIDS Serodiagnosis↗
PubMed1990

The association between HLA and rheumatoid arthritis in Zimbabwean blacks.

HLA-A, B, C, DR and DQ typing was done on 26 black Zimbabweans with rheumatoid arthritis and the respective antigen frequencies were compared with those in a group of 119 normal individuals from the same ethnic background. Only the DR4 antigen was significantly increased in frequency in the patients, confirming the association with this disease seen in other Black African populations.

Arthritis, Rheumatoid↗
PubMed1990

The spondyloarthropathies in Zimbabwe: a clinical and immunogenetic profile.

Spondyloarthropathies are rare in Africa and there is little data regarding HLA association. We prospectively studied 19 patients with spondyloarthropathy, recording clinical details and performing tissue typing (ABC loci). There were 9 patients with ankylosing spondylitis (8 males), all had severe spinal disease but none had ocular or cardiac involvement and HLA-B27 antigen was not found in any of the 7 patients tested; only one patient possessed a B7 crossreacting antigen. The 10 patients with Reiter's syndrome (8 males) had typical clinical features but again the HLA-B27 tissue type was not found. B7-CREG antigen was found in 7 of the 10 patients with Reiter's syndrome.

Adult↗
PubMed1989

Referrals from general practice to hospital outpatient departments: a strategy for improvement.

OBJECTIVE: To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN: Prospective audit of referrals from a group practice over one year. SETTING: Six handed practice in a southern coastal town. SUBJECTS: All patients referred during the study period for whom a copy of the referral letter was available. MAIN OUTCOME MEASURES: The investigations carried out by the consultant that led to the diagnosis; the diagnosis reached; and the management. RESULTS: Of roughly 3000 patients referred during the year, 277 with various skin and soft tissue disorders could probably have been managed solely by the general practitioner. Referrals for cryotherapy (96 in this series) and diabetes (19) could probably also have been avoided by specialist training of the general practitioner. In addition, in cases of haematuria and prostatic hypertrophy (34 and 22 referrals) substantial time could have been saved for both the patient and the consultant had the general practitioner supplied the results of relevant investigations. Probably the most important outcome was the model that the study offered for other general practitioners to improve the appropriateness of referrals. CONCLUSION: This approach to determining the appropriateness of referrals benefits the general practitioners, the consultant, and the patient.

England↗
PubMed1989

Acute arthritis in Zimbabwean patients: possible relationship to human immunodeficiency virus infection.

The clinical features of an acute arthritis in 20 Zimbabwean patients, 17 of whom fulfilled criteria for the diagnosis of complete or incomplete Reiter's syndrome, are described. Fourteen of 19 patients tested were positive for human immunodeficiency virus (HIV) antibodies and most had features of the AIDS related complex. None of 14 patients tested possessed the HLA-B27 tissue antigen commonly associated with Reiter's syndrome. The relationship between HIV infection, immunogenetic factors and the arthropathy we have observed remains to be elucidated.

AIDS-Related Complex↗
PubMed1977

[Biological criteria for the surveillance of hydatidiform moles and choriocarcinomas].

Secretion of choriogonadotropin (hCG) remains until now the more accurate biochemical label of trophoblastic disease and a close follow-up is possible by means of sensitive and specific radioimmunoassays. After hydatidiform moles, drawing the decreasing curve of hCG concentrations by weekly measurements in plasma or urine, would generally allow distinguishing within a few weeks cases with and without retention of active trophoblastic tissue, although in only 30 p. 100 of moles hCG spontaneously disappears within a month. In some choriocarcinoma under therapy, low persisting hCG levels (lower than 100 or 50 I.U./24 hours) could only be evidenced by repeated radioimmunoassays. Even with apparently physiological hLH/hCG concentrations, the use of anti-beta hCG antiserum could demonstrate, if any, a secretion of choriogonadotropin. In castrated women the same technique would elude the interference of hLH and make easier the diagnostic of relapses.

Castration↗