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Biomedical subjects

J Mawdsley

Publications and source records attributed to J Mawdsley.

6 recordsLinked to original sources

Cattle movements and bovine tuberculosis in Great Britain.

For 20 years, bovine tuberculosis (BTB) has been spreading in Great Britain (England, Wales and Scotland) and is now endemic in the southwest and parts of central England and in southwest Wales, and occurs sporadically elsewhere. Although its transmission pathways remain poorly understood, the disease's distribution was previously modelled statistically by using environmental variables and measures of their seasonality. Movements of infected animals have long been considered a critical factor in the spread of livestock diseases, as reflected in strict import/export regulations, the extensive movement restrictions imposed during the 2001 foot-and-mouth disease outbreak, the tracing procedures after a new case of BTB has been confirmed and the Government's recently published strategic framework for the sustainable control on BTB. Since January 2001 it has been mandatory for stock-keepers in Great Britain to notify the British Cattle Movement Service of all cattle births, movements and deaths. Here we show that movements as recorded in the Cattle Tracing System data archive, and particularly those from areas where BTB is reported, consistently outperform environmental, topographic and other anthropogenic variables as the main predictor of disease occurrence. Simulation distribution models for 2002 and 2003, incorporating all predictor categories, are presented and used to project distributions for 2004 and 2005.

Agriculture↗

Anesthetist to patient transmission of hepatitis C virus associated with non exposure-prone procedures.

A 44-year-old lady was diagnosed with acute hepatitis C virus (HCV) infection 8 weeks after hysterectomy at which the attending anesthetist was known to be hepatitis C seropositive. Comparative nucleotide sequence analysis and phylogenetic comparison proved that transmission had occurred from the anesthetist to the patient. The patient had received general anesthesia with endotracheal intubation and peripheral intravenous cannulation. No exposure-prone anesthetic procedures had been performed. This is the first case described in UK involving transmission from an anesthetist to a patient during anesthesia where no exposure prone procedures were carried out. It is the first example in which the anesthetist was known to be seropositive for hepatitis C prior to the operation.

Adult↗

An 11-year experience of enterocutaneous fistula.

BACKGROUND: Enterocutaneous fistula has traditionally been associated with substantial morbidity and mortality, related to fluid, electrolyte and metabolic disturbance, sepsis and malnutrition. METHODS: A retrospective review of enterocutaneous fistula in 277 consecutive patients treated over an 11-year period in a major tertiary referral centre was undertaken to evaluate current management practice and outcome. RESULTS: Most fistulas occurred secondary to abdominal surgery, and a high proportion (52.7 per cent) occurred in association with inflammatory bowel disease. A low rate of spontaneous healing was observed (19.9 per cent). The healing rate after definitive fistula surgery was 82.0 per cent, although more than one attempt was required to achieve surgical closure in some patients. Definitive fistula resection resulted in a mortality rate of 3.0 per cent. In addition, one patient died after laparotomy for intra-abdominal sepsis and an additional 24 patients died from complications of fistulation, giving an overall fistula-related mortality rate of 10.8 per cent. CONCLUSION: Early recognition and control of sepsis, management of fluid and electrolyte imbalances, meticulous wound care and nutritional support appear to reduce the mortality rate, and allow spontaneous fistula closure in some patients. Definitive surgical management is performed only after restitution of normal physiology, usually after at least 6 months.

Adolescent↗

Medical evacuations from offshore structures.

A retrospective study was carried out on medical evacuations from the installations of four major oil or gas producing companies, or both, operating offshore on the United Kingdom continental shelf. The study covered 1976-84 during which 2162 evacuations were recorded. Of these, 137 (7.7%) required the use of a chartered helicopter. In the earlier years of the study there were substantially more injuries sustained than episodes of illness recorded but from 1980 onwards the cases of illness equalled those of injury. Using the International Classification of Diseases, the digestive system was responsible for most evacuations for illness and of those, about half (115 evacuations) were for dental problems. Suspected fractures were responsible for about one third of those evacuated for an injury but injuries of hands and eye conditions were particularly common, accounting for 25% of all evacuations. As the age of the evacuee increased the proportion of evacuations for injury decreased and that for illness increased. The mean age for evacuation for injury was 28.3 years and for illness 34.4 years. Few evacuations were required for those aged over 45.

Accidents, Occupational↗