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Biomedical subjects

S Barrow

Publications and source records attributed to S Barrow.

49 records · Page 3Linked to original sources

General practitioner attitudes to day surgery.

BACKGROUND: Day surgery is increasing in importance. Unfortunately, its impact upon health professionals in the community is poorly documented. This paper reports the opinions of general practitioners (GPs) in a North Western Health District. METHODS: A structured attitude questionnaire was sent to all GPs in Trafford Health District. GPs were asked for their opinions of the relative merits of day and in-patient surgery for patients with similar conditions. Replies were received from 71 GPs, giving a response rate of 65 per cent. RESULTS: GPs gave only a mixed level of support to the idea of further expansion. This related less to considerations of workload in the Primary Care Team than it did to concerns about readmissions and complications. CONCLUSION: The further development of day surgery will require a greater sensitivity to the resource and information needs of professionals in the Primary Care Team.

Ambulatory Surgical Procedures↗

Clinical trial with inactivated hepatitis A vaccine and recommendations for its use.

OBJECTIVE: To compare the reactogenicity and immunogenicity of an inactivated hepatitis A vaccine in two different immunisation schedules. DESIGN: Randomised trial. SETTING: One London teaching hospital. SUBJECTS: 104 healthy adult volunteers (71 men, 33 women aged 19-60). INTERVENTIONS: Hepatitis A vaccine to group 1 (54 volunteers) at 0, 1, and 2 months and to group 2 (50) at 0, 1, and 6 months. MAIN OUTCOME MEASURES: Symptoms at and after each dose; liver function, hepatitis A virus specific serum immune response; and responses in saliva and parotid fluid in immunised volunteers and subjects with natural immunity. RESULTS: The vaccine was well tolerated; 97% (96/99) and 100% of those immunised developed serum antibody after one and two doses of vaccine respectively. Geometric mean titres increased progressively after each dose and were significantly higher in men but not women in group 2 after the third dose (ratio between geometric mean titres 0.265, 95% confidence interval 0.18 to 0.39; p less than 0.001). At one year this group-sex interaction was absent; geometric mean titres for both sexes were significantly higher in group 2 (ratio 0.330, 0.227 to 0.478; p less than 0.0001). Antibody responses were not significantly different between the groups at two years. Compared with naturally infected subjects immunised volunteers developed poor or undetectable virus specific IgG and IgA responses in saliva and parotid fluid. CONCLUSIONS: The vaccine was safe and highly immunogenic, and the differences in the immune responses in saliva and parotid fluid are unlikely to affect its efficacy.

Adult↗

Effect of hepatitis A vaccination schedules on immune response.

An inactivated hepatitis A vaccine was given to 104 seronegative volunteers aged between 19 and 60 years according to two schedules: 0, 1 and 2 months or 0, 1 and 6 months. The vaccine was well tolerated and 97 and 100% of vaccinees developed a serum antibody response following a single and two doses of vaccine respectively. Geometric mean titres increased progressively after each dose; responses following the 0, 1, 6 month schedule were significantly higher at one year but, among those tested at two years, these differences were less marked. Vaccinees, when compared with naturally infected persons, developed poor or undetectable hepatitis-A-virus-specific immunoglobulin G and A antibody responses in saliva and parotid fluid. Such differences are, however, unlikely to affect the protective efficacy of the vaccine.

Adult↗

Paracoccidioidomycosis in Trinidad.

Paracoccidioidomycosis is a systemic disease endemic to South America, but rarely recognised in other parts of the world. The patient we describe represents the first case of paracoccidioidomycosis observed in Trinidad.

Humans↗

Rehospitalization in chronic schizophrenia.

This report on rehospitalization in chronic schizophrenia is based on a 1-year study of the postdischarge experiences of 119 chronic schizophrenics in New York City. The life table method of analysis identified the important role of discharge planning, community treatment compliance, and interpersonal stress in the patient's living environment in determining the number of days postdischarge that the patient remained in the community without further inpatient care. A mathematical model to predict days in hospital over the follow-up period, based on three specific components of time in hospital defined in numerical terms (PR, NR, LSR), was devised and tested. The first component, the experience of rehospitalization (PR), was determined by interpersonal stress, social supports, and aftercare treatment compliance. Adequacy of discharge planning, an intervention designed to link the patient to community treatment services, has its greatest impact in identifying number of rehospitalizations for the rehospitalized group (NR). Aftercare treatment compliance has its greatest effect in relation to length of subsequent rehospitalization episodes (LSR). Test of the model revealed that it can predict time in hospital within less than one half of a standard deviation of observed hospital days in approximately 50% of cases.

Actuarial Analysis↗

Anesthetization of a Cape fur seal (Arctocephalus pusillus) for the treatment of a chronic eye infection and amputation of a metatarsal bone.

Tranquilization using 3 mg/kg of ketamine by intramuscular injection followed by inhalation anaesthesia using halothane was performed on an adult Cape fur seal in order to perform a metatarsal amputation and ophthalmic examination. Ketamine was found to have little effect at the dosage used while halothane proved to be a rapid induction agent providing a safe, continued level of surgical anaesthesia. Variations in cardiac rate and body temperature were recorded during anesthasia and blood was sampled for haematology.

Amputation, Surgical↗