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Biomedical subjects

S Croxson

Publications and source records attributed to S Croxson.

8 recordsLinked to original sources
PubMed2002

Diabetes in the elderly: problems of care and service provision.

Diabetes is common in the elderly and old UK citizens, affecting between 10% and 25%. There is considerable associated morbidity and mortality, with dementia being a common problem. The diabetic elder is also at risk of drug side-effects. Most of the evidence base for treatment is based on trials performed in younger diabetic subjects or older nondiabetic subjects; however, we can practice evidence-biased medicine whilst awaiting the results of ongoing trials. The older persons national service framework (NSF) may share some similarities with the diabetes NSF; it was 1 year late, and had no clear funding, amongst several other worries. Residential care, which is more likely to be required by diabetic elders, is also under-funded with major concerns about the quality of care for the diabetic resident. The little evidence that we have regarding care of the older diabetic person also suggests inadequacies. Given the likelihood that we will have to manage with present resources, managed clinical networks may be one way to cope.

Aged↗
PubMed1998

Universal hearing screening using transient otoacoustic emissions in a community health clinic.

Since 1993, targeted screening of high risk Camden and Islington babies has been carried out in hospital using the transient otoacoustic emission (TEOAE) technique and auditory brainstem responses (ABR). Because targeted screening is difficult to implement, a community pilot study using TEOAE was started in 1995, covering 7% of the resident population. Although uptake has not been above 80%, client satisfaction has been high and numbers requiring more detailed tertiary assessment have been modest (0.5% of the population screened). A comparison was made between the cost of a universal neonatal screen using TEOAE and distraction testing at 7 months of age. The neonatal screen would be no more expensive to implement universally, even when equipment costs are included. A combination of a universal neonatal screen with distraction testing at 7 months for those not screened is likely to give 96% coverage of hearing screening in the first year of life.

Community Health Services↗
PubMed1991

Dietary modification of Parkinson's disease.

To investigate the efficacy of a low-protein diet suitable for long-term use, and to observe the effect in a double-blind manner of re-introducing large neutral amino acids or an inactive placebo amino acid, eight patients with 'on-off' phenomenon were given a low-protein diet suitable for long-term use, and then the diet was supplemented with large neutral amino acids (LNAA) or placebo in a double-blind crossover trial. Five patients had improved Parkinsonian disability on a low-protein diet compared to normal diet. On supplementing the diet with LNAA or placebo, three subjects' Parkinson's disease was significantly better on placebo and there was a trend towards improvement on placebo noticed subjectively by seven patients; however, there was no overall significant difference in disability measured by mobility diaries. Thus, we have been unable to show that the improvement on a low-protein diet is due to a reduction in LNAA, rather than a placebo effect, possibly due to the paucity of subjects; however, the patients' identification of the LNAA supplement suggests that it is a genuine effect.

Aged↗
PubMed1989

Unsuspected cardiac abnormalities in the acquired immune deficiency syndrome. An echocardiographic study.

To investigate the frequency of unsuspected cardiac abnormalities in AIDS, M-mode and two-dimensional echocardiograms were performed on 27 homosexual males with this syndrome. Twenty-one homosexual males without the disease were used as controls. Subjects with clinical heart disease or a history of intravenous drug abuse were excluded. Fractional shortening was reduced in eight patients (30 percent) and in one control (5 percent) (p less than 0.05). Pericardial effusions were found in seven patients (26 percent); one control subject had a small effusion (5 percent) (p = 0.05). Overall, echocardiographic abnormalities were found in 13 of 27 patients (48 percent) compared with 2 of 21 control subjects (10 percent) (p less than 0.02). We conclude that although often not diagnosed clinically, the incidence of cardiac involvement in AIDS is high.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Entamoeba histolytica antigen-specific induction of human immunodeficiency virus replication.

Replication of human immunodeficiency virus (HIV) may be initiated in infected lymphocytes by antigenic or mitogenic stimulation. A soluble protein derived from an invasive strain of Entamoeba histolytica (amoebic antigen [AA]) was used to study the lymphoblastic responses of T lymphocytes derived from 8 HIV-seronegative homosexual men (controls) and 15 HIV-seropositive homosexual men (patients). The soluble protein was also used in long-term cultures as a stimulus for HIV replication. No control or patient produced detectable lymphoblastic responses to AA in a 6-day tritiated-thymidine incorporation assay. Of 15 patients, 5 (33%) produced HIV p24 (ranging from 31 pg/ml to 151 ng/ml) in response to AA in 30-day cell cultures. HIV p24 was expressed in three of seven patients in response to AA but not to the T-lymphocyte mitogen phytohemagglutinin. Implications for managing HIV-infected patients are discussed.

AIDS-Related Complex↗