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Biomedical subjects

J T Hart

Publications and source records attributed to J T Hart.

At least 19 recordsLinked to original sources
PubMed1992

Rule of halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care.

Evidence from one practice and from the literature suggest that approximately half of most common chronic disorders are undetected, that half of those detected are not treated, and that half of those treated are not controlled: the 'rule of halves'. Workload in primary care would increase by at least 12% if all common and important chronic disorders were fully diagnosed, treated and followed up; the accompanying effects on prescribing costs would be complex, but not necessarily inflationary. The relationship between these data and the new general practitioner contract is discussed.

Adult↗
PubMed1991

Deposits of amyloid beta protein in the central nervous system of transgenic mice.

Alzheimer's disease is characterized by widespread deposition of amyloid in the central nervous system. The 4-kilodalton amyloid beta protein is derived from a larger amyloid precursor protein and forms amyloid deposits in the brain by an unknown pathological mechanism. Except for aged nonhuman primates, there is no animal model for Alzheimer's disease. Transgenic mice expressing amyloid beta protein in the brain could provide such a model. To investigate this possibility, the 4-kilodalton human amyloid beta protein was expressed under the control of the promoter of the human amyloid precursor protein in two lines of transgenic mice. Amyloid beta protein accumulated in the dendrites of some but not all hippocampal neurons in 1-year-old transgenic mice. Aggregates of the amyloid beta protein formed amyloid-like fibrils that are similar in appearance to those in the brains of patients with Alzheimer's disease.

Alzheimer Disease↗
PubMed1991

Twenty five years of case finding and audit in a socially deprived community.

OBJECTIVE: To evaluate audit and case finding (whole population care) in a community over 25 years. DESIGN: Contemporary screening for and audits of care of chronic disease and risk factors; retrospective review of computerised practice records; and comparisons of mortality and social indices with neighbouring communities. SETTING: One general practice in Glyncorrwg, West Glamorgan. SUBJECTS: 1800 people registered with the practice in 1987 and 558 people who died from 1964 to 1987, whose records had been retained. MAIN OUTCOME MEASURES: Detection of high blood pressure, smoking, airways obstruction, obesity, diabetes, and alcohol problems in adults aged 20-79; prevalence of smoking in this population and in hypertensive and diabetic groups; age standardised mortality ratios in relation to indices of social deprivation. RESULTS: In the population aged 20-79 (1207 patients) 249 (21%) had peak expiratory flow rate less than 50% of expected value or which improved by 15% or more with an inhaled beta agonist, 207 (17%) had body mass index at or over 30 kg/m2, 118 (10%) had untreated mean arterial pressures greater than 159/104 mm Hg (three readings), 80 (7%) (65 (16%) men, 15 (4%) women) had recognised alcohol problems, and 35 (3%) had diabetes. The proportion of men aged 20-64 who said they smoked fell from 61% (290/476) in 1968-70 to 36% (162/456) in 1985 whereas that of women who smoked was unchanged (43%, 187/436 v 42%, 190/448 respectively). In 116 screened hypertensive patients group mean blood pressure fell from 186/110 mm Hg before treatment to 146/84 mm Hg at 1987 audit, as did the proportion of smokers (56% v 20%), but body mass index and total cholesterol concentration showed no significant change. In 34 diabetic patients mean blood pressure and the proportion of smokers fell (171/93 mm Hg v 155/81 mm Hg; 44% v 12%). The age standardised mortality ratio in 1981-6 was lower than in a neighbouring village without a developed case finding programme (actual to expected deaths less than 65 = 21 to 22 in Glyncorrwg, 48 to 30 in control village). CONCLUSIONS: Whole population care through organised case finding and audit is feasible but only with a labour intensive approach combining accessibility, flexibility, and continuity, as well as a planned and structured approach, which requires substantial expansion of staff numbers and assiduous recording. It may reduce risks for at least some high risk groups. Despite their shortcomings the available data are consistent with the hypothesis that whole population care helps reduce mortality. Incentives in the new contract, which encourage the uncritical development of structured process, may diminish health outputs.

Adult↗
PubMed1990

The use of flow cytometry to monitor chitin synthesis in regenerating protoplasts of Candida albicans.

Flow cytometry was used to monitor chitin synthesis in regenerating protoplasts of the yeast Candida albicans. Comparisons of cells stained with Calcofluor White, a fluorochrome with known affinity for chitin, and cells incubated in the presence of N-[3H]-acetylglucosamine, the precursor substrate for chitin, showed a linear relationship between fluorescence and incorporation of label over time. Changes in both the fluorescence and light scatter of regenerating protoplasts treated with inhibitors of fungal chitin synthase were also quantitated by flow cytometry.

Aminoglycosides↗
PubMed1990

Primary medical care in Spain.

The extremely complex and rapidly but unevenly developing system of primary care in Spain is described. The health centre movement in Spain merits close attention, and could be a useful model for our own service.

Ambulatory Care↗
PubMed1979

Ten years' experience in general practice of dip-slide urine culture in children under five years old.

Of 567 children under five registered with an industrial general practice over a 10-year period, 559 presented with symptoms of ill health in the first five years of life, and of these, 158 (27.9 per cent of those registered) had urine cultured using the dip-slide method. Thirty-four (12.3 per cent) girls and 23 (7.9 per cent) boys had at least one episode of significant bacteriuria. Two boys and three girls were found to have radiological abnormalities of the genito-urinary tract, of which two were obstructive lesions requiring surgery.Symptoms usually ascribed to the urinary tract in older children and adults did not discriminate for infection in this age group and were not a reliable indicator of the presence, or of the absence, of significant bacteriuria.The incidence of significant bacteriuria was considerably above that recorded by surveys on asymptomatic children. Proteus infections were four times more common among boys than girls, and under the age of three the proportion of boys with bacteriuria exceeded that of girls.Dip-slide culture is a valuable tool in the diagnosis, management, and follow-up of urinary tract infection.

Bacteriological Techniques↗