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Biomedical subjects

L Thornton

Publications and source records attributed to L Thornton.

At least 19 recordsLinked to original sources
PubMed1997

National survey of MRSA: Ireland, 1995.

The objective of this survey was to obtain an indication of the size of the methicillin-resistant Staphylococcus aureus (MRSA) problem in Ireland prior to introducing national MRSA control guidelines. A survey of all microbiology laboratories in Ireland was carried out over two weeks in Spring 1995. For patients from whom MRSA was isolated during the study period standard demographic and clinical data were requested and period prevalence/1000 discharges was calculated. All 45 microbiology laboratories surveyed responded. MRSA was isolated from 448 patients during the two-week period. The period prevalence of MRSA was 16.5/1000 discharges. Males aged > or = 65 had the highest rate (50/1000 discharges). Half of all isolates were from patients in surgical or medical wards, but 4% were from community-based sources such as GPs, nursing homes and hospices. Thirty-two percent of MRSA patients were infected rather than colonized. MRSA is clearly a significant problem in Ireland. While it is largely a hospital problem at present, the increasing trend towards day procedures and shorter hospital stay means that infection will increase in the community.

Adolescent↗
PubMed1997

Ten-year survival of Down syndrome births.

OBJECTIVE: To determine the survival status of children with Down syndrome (DS), and to document factors influencing survival. DESIGN: Follow-up study of cases identified from the Dublin European Register of Congenital Anomalies and Twins (EUROCAT) Register. Follow-up was attempted for each case until death or 1992 or until the date last known to be alive. SETTING: Eastern Health Board, Dublin. SUBJECTS: In all, 389 DS children, born between 1 January 1980 and 31 December 1989 were followed up. RESULTS: Survival rates of 88% at one year and 82% at 10 years were found. There was a non-significant improvement in survival between the cohort born in 1980-1984 and that born in 1985-1989. Congenital heart defects reduced survival to 72% and complete atrio-ventricular canal defects (CAVD) had the poorest prognosis (58% survival at 10 years). Cases with CAVD showed a trend towards improved survival when surgically treated. Maternal age mother's county of residence, sex of infant, season of birth and presence of additional non-cardiac congenital anomalies had no impact on survival. CONCLUSIONS: Four out of five DS children now survive at least 10 years. Adequate educational and health service provision needs to be made for them, especially those with congenital heart defects. The need for studies which compare survival and quality of life in DS children with CAVD who undergo cardiac surgery versus those who do not, taking account of various selection factors, is identified.

Child↗
PubMed1996

Cryptosporidiosis in children who visited an open farm.

In the summer of 1995, cryptosporidiosis was diagnosed in a child in hospital. This child had taken part in a summer activity project involving 161 children and nine adults. Reports of a similar illness among a number of other participants prompted an outbreak investigation. A cohort study was conducted in two phases. Thirteen children (aged 6 to 15 years) out of 161 respondents to the first questionnaire met the case definition for illness and cryptosporidium was detected in stools from seven of the 13. Illness was significantly associated with child participants who had visited an open farm (p < .000005). Nine of the cases sought medical attention, and two were admitted to hospital. The second phase of the cohort study was conducted among 52 of the 55 people who had visited the open farm. Illness was significantly associated with playing in sand to which animals had access, at the edge of a stream beside a picnic area (p < .005). Contact with various animals was not associated with illness. This outbreak emphasises the risk for children of visiting open farms. Managers of open farms need to be aware of the potential for transmission of infectious diseases to visiting children. Strict implementation of hygiene measures is essential to minimise risk.

Adolescent↗
PubMed1996

Simultaneous multipolar radiofrequency ablation in the monopolar mode increases lesion size.

Delivery of radiofrequency (RF) energy from the distal tip of electrophysiology catheters produces lesions that may be too small to ablate arrhythmogenic sites during a single application of RF energy. To produce larger lesions, we delivered RF energy via a quadripolar catheter in which all four electrodes were connected in unipolar fashion. The catheter (Webster Labs) had a 4-mm tip, 2-mm ring electrodes, and 2-mm interelectrode distance. Lesion size was compared using RF energy delivered in a multipolar configuration with that delivered only to the distal tip using fresh bovine ventricular tissue. In vivo, RF lesions were made in dogs using the distal tip as well as all four poles of the same catheter inserted percutaneously. RF energy was delivered using a constant voltage at a frequency of 400 kHz. Preliminary experiments were conducted to determine the maximum power deliverable without coagulation using each electrode configuration. The use of simultaneous multipolar RF ablation produced significantly larger lesions both in vitro and in vivo. The length of the lesion was increased by a factor of approximately 2 in both the in vitro and in vivo experiments. There was a trend toward an increasing depth of the lesion by simultaneously applying RF energy to all four electrodes. Lesion width was significantly increased in the in vivo studies. We concluded that simultaneous multipolar delivery of RF energy produces larger lesions than can be obtained with delivery of RF energy to the distal tip alone. This technique may offer a means of increasing lesion size, leading to a decrease in the number of applications of RF energy necessary for ablation of arrhythmias.

Animals↗
PubMed1995

The risk of hepatitis A from sewage contamination of a water supply.

The drinking water supply of a town became contaminated with sewage. The town's population was surveyed to determine the baseline prevalence of hepatitis A antibodies and to establish whether an associated outbreak of hepatitis A had occurred. Samples of saliva were obtained from 540 people in 200 randomly selected households, and tested for IgG and IgM antibodies to hepatitis A. Fifty-six per cent (279/495) were susceptible to hepatitis A and 43% (213/495) immune as a result of previous infection. Immunity was directly related to age; those who were immune were significantly older than those who were susceptible (mean ages: 43.5 years and 19.0 years; p < 0.0001). Six people were found to have had a recent infection with hepatitis A, but exposure to hepatitis A during the water pollution incident was possible in only one case. The results offer no evidence that this incident caused an outbreak of hepatitis A, but the study has provided useful epidemiological data on hepatitis A.

Adolescent↗
PubMed1995

Illness in a community associated with an episode of water contamination with sewage.

Following an episode of water contamination with sewage in a rural Irish town, a community-wide survey of gastrointestinal-associated illness and health service utilization was conducted. Random sampling of households yielded residents who were surveyed using a self-administered questionnaire. Of 560 respondents from 167 (84%) households, equal proportions lived in areas known to have been exposed and unexposed to the contaminated water, although 65% of subjects reported using contaminated water. Sixty-one percent of subjects met the case definition. The most common symptoms among cases were abdominal cramps (80%), diarrhoea (75%), appetite loss (69%), nausea (68%) and tiredness (66%). Mean duration of illness was 7.4 days. Only 22% of cases attended their general practitioner. Drinking unboiled water from the exposed area was strongly associated with being a case. A substantial degree of community illness associated with exposure to contaminated water was observed. The episode ranks as one of the largest reported water-borne outbreaks causing gastrointestinal illness in recent times.

Disease Outbreaks↗
PubMed1995

An outbreak of hepatitis A among Irish haemophiliacs.

BACKGROUND: An outbreak of hepatitis A (HAV) occurred in 1992 in Irish haemophilia A patients treated with high purity solvent-detergent (SD) treated factor VIII. Similar outbreaks were reported in Italy, Germany and Belgium. The aim of this study was to investigate the outbreak, and to test the hypothesis that it was caused by exposure to SD-treated factor VIII. METHODS: A case-control study was started in early 1993. Haemophilia A cases with acute HAV (n = 29) were compared with haemophilia A controls for exposure to SD-treated factor VIII and other environmental factors. Details of factor VIII usage were obtained from the National Haemophilia Register and environmental data were obtained by a telephone-administered questionnaire. The response rate was approximately 90%. RESULTS: The incidence of acute HAV infection among haemophilia A patients exceeded the notified national incidence of HAV by a factor of approximately 300. The incidence was higher in younger patients and those with more severe bleeding disorders. Contact with hepatitis, with children, and exposure to factor VIII were associated with increased risk. The association with factor VIII was the strongest risk factor after controlling for other factors (odds ratio = 27.6, 95% confidence interval [CI] 6.5-117.3). A dose-response effect was demonstrated. CONCLUSIONS: Although person-to-person transmission is likely to have caused a few of the cases, the results of our investigation suggest that the major contributing factor was exposure to certain batches of SD-treated factor VIII.

Adolescent↗
PubMed1994

Investigation of an outbreak of hepatitis A in Irish haemophilia A patients.

Since 1990, Irish haemophilia A patients have been treated with solvent-detergent(SD)-treated virally inactivated high-purity factor VIII concentrate prepared from plasma from Irish voluntary non-remunerated donors. In 1992, 13 haemophilia A patients developed clinical hepatitis A and a further 17 patients showed serological evidence of recent infection by hepatitis A. All but 3 of these patients had had recent exposure to SD-treated product. A case-control study is underway to determine whether these cases represent transmission through product or environmentally acquired hepatitis A.

Blood Component Transfusion↗
PubMed1993

The epidemiology of rubella in the Republic of Ireland.

The trend in notified cases of rubella in the Republic of Ireland from 1950 to 1990 has been downward, with a mean interval of four years between peak periods. Vaccine uptake and antenatal immunity levelled out in the 1980s at 85% and 87%, respectively. One hundred and six cases of congenital rubella were recorded between 1975 and 1990, 66 being reported by paediatricians. The fact that cases of congenital rubella still occur highlights the need for a continued and aggressive immunisation policy, up-to-date and cohort-based data on vaccine uptake, and the introduction of a congenital rubella register.

Humans↗
PubMed1993

The problems of tracing a geographically widespread outbreak of salmonellosis from a commonly eaten food: Salmonella typhimurium DT193 in north west England and north Wales in 1991.

Geographically widespread outbreaks involving commonly isolated organisms and where the vehicles of infection are commonly eaten foodstuffs pose particular difficulties at a technical and organizational level. An outbreak of Salmonella typhimurium infection, affecting 39 people, spread over a wide area in North West England and North Wales in April and May 1991, was detected thanks to the practice of sending specimens to the national reference laboratory where phage typing and characterizing of antibiotic resistance patterns enabled the identification of a cluster of distinctive isolates (S. typhimurium DT193 resistant to sulphonamides, trimethoprim and furazolidone). An investigation, involving twenty environmental health departments in addition to health authorities and the Public Health Laboratory Service, showed an association between the illness and eating loose sliced cooked ham (P = 0.004). Detailed tracing of the chain of supply of the ham showed this to be particularly cooked ham originating from a single small local producer (P = 0.00003). Further investigation of that producer revealed that a batch of ham distributed on one day in early April was undercooked due to a malfunction in cooking equipment.

Adolescent↗
PubMed1991

Evaluation of a taurine containing amino acid solution in parenteral nutrition.

Vaminolact, an amino acid solution containing taurine, was given to 15 sick newborn babies. They were compared with a group of 10 babies who received a solution that did not contain taurine (Vamin glucose). Efficacy and safety were evaluated by monitoring plasma amino acid patterns, growth patterns, nitrogen balance, and biochemical and haematological profiles. No serious abnormalities in amino acid concentrations were found. After an initial fall the taurine concentration recovered more rapidly in those receiving the taurine supplement, though this difference was not significant. Phenylalanine concentrations were within the reference range in the group receiving Vaminolact, and were significantly lower than in the group receiving Vamin glucose. Metabolic acidosis, which occurred in several subjects in each group, was not a serious problem. Liver function tests remained satisfactory. Nitrogen retention was greater among those receiving Vaminolact than in the control group. Vaminolact is a safe and effective amino acid solution for use in critically ill babies.

Amino Acids↗
PubMed1990

Prader-Willi syndrome in New Zealand: a survey of 36 affected people.

The Prader-Willi syndrome consists of infantile hypotonia, failure to thrive, hypogonadism and developmental delay. It was first described in 1956. Later in life hypotonia improves. Between the age of two and four obesity becomes noticeable and between six and ten there is uncontrollable behaviour. A survey has been carried out of the 36 known cases in New Zealand and the pattern of the disease is similar to that elsewhere. In most cases the diagnosis was not established until between the ages of six and 10 when the obesity was marked and uncontrolled behaviour a problem. Early control of the obesity is helpful.

Adolescent↗
PubMed1990

Narcotic addiction: the expectant mother and her baby.

In a retrospective study of the period 1982-1985, the records of 29 narcotic-addicted mothers and their 42 babies were reviewed. All mothers were from socially deprived backgrounds, had a poor record of ante-natal attendance and had frequent admissions to hospital. Thirteen mothers had a past history of hepatitis B and four were HBsAg positive. The babies had significantly lower mean gestational age and mean birth weight than the control group. Features of withdrawal were recorded in 84% of babies where a history was available. A high incidence of twins (10.5%) was also observed. Testing for HIV antibody in more recent cases has revealed positive results in seven mothers and three babies; one infant has since died from acquired immune deficiency syndrome.

Adolescent↗