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Biomedical subjects

S Hewitt

Publications and source records attributed to S Hewitt.

At least 37 records · Page 2Linked to original sources
PubMed1996

Emergency medicine at a large rock festival.

The organisation of on-site medical personnel and facilities is described for an open air rock concert attended by 62,000 people. Care of the majority of patients was completed on site, avoiding an increased workload for local hospitals and general practitioners. Many of the head injuries could have been avoided by preventing the distribution of promotional items and large drinks containers which were thrown as missiles.

Accident Prevention↗
PubMed1995

[Development of risk factors for cardiovascular diseases among persons aged 40-42 years in the county of Finnmark 1973-93].

During the period 1973-1993, the National Health Screening Service carried out five screenings of risk factors for cardiovascular disease among 40-42 years of age in the county of Finnmark. Risk for myocardial infarction has decreased, mainly due to reductions in total cholesterol, which fell by more than 10% in both sexes from 1973-74 to 1993. Cholesterol levels now seem to be stabilizing. Considerably fewer persons smoked daily in 1977-78 than in 1973-74. From 1977-78 to 1993, little change occurred among men, but the percentage of women who smoked daily increased by 10%. Systolic and diastolic blood pressure were slightly higher in 1993 than in 1990. Since 1987-88 consumption of butter and of traditionally made coffee (boiled, not filtered) has decreased. Compared with other counties, Finnmark shows high values for cholesterol, smoking habits and "boiled" coffee. Preventive measures still have a potential to influence the future trend.

Adult↗
PubMed1995

Pyrethroid-sprayed tents for malaria control: an entomological evaluation in Pakistan.

Field trials were undertaken in the North West Frontier Province of Pakistan to determine the effects of pyrethroid-sprayed tents on feeding success, mortality and biting-rates of wild mosquitoes attracted to bait cows confined within the tents. Under natural conditions, endophagic mosquitoes rested only briefly in untreated tents during the night, followed by complete exodus at dawn. In tents sprayed on the interior surface with permethrin 0.5 mg/m2 or with deltamethrin 0.03 g/m2 the biting rate of Anopheles stephensi was reduced by about 40%; deterrency against culicines and other anophelines was much less. Mortality-rates of bloodfed mosquitoes from the treated tents were 75% An.stephensi, 65% An.subpictus but only 10% of culicines. Outer fly-sheets prolonged the effective life of the treatment; bioassays on the sprayed inner-sheets showed that insecticidal efficacy remained high for over a year, whereas on tents without fly-sheets permethrin residual efficacy declined rapidly 20-40 weeks post-treatment. It is concluded that tent-spraying with fast-acting photostable residual pyrethroid insecticide would probably provide effective protection against malaria transmission for the inhabitants of tents in any part of the world where the vector mosquitoes are endophilic and susceptible to pyrethroids.

Animals↗
PubMed1994

An entomological investigation of the likely impact of cattle ownership on malaria in an Afghan refugee camp in the North West Frontier Province of Pakistan.

Field trials were undertaken to determine the effect of close proximity of humans to livestock on the human biting rates exhibited by various anophelines. The results indicate that proximity to cattle and to goats increases the subject's chances of being bitten by anophelines. Man-biting by Anopheles stephensi rose by 38% (8-68% CI) in the presence of a cow, and by 50% (16-84% CI) in the presence of two goats. Other species exhibited similar trends. These findings explain the results of an earlier trial which revealed that malaria prevalence was higher amongst families that kept cattle than those that did not. The findings are discussed in relation to existing information regarding the host preferences of local anophelines and classic theories regarding zooprophylaxis. Our findings suggest that animals are only likely to have a worthwhile prophylactic affect when the vector is zoophilic, and then only when the animals are deployed to form a barrier between that vector and man. In situations where deployment of livestock to form a zoobarrier is impractical, the livestock should be located as far from man as possible.

Afghanistan↗
PubMed1994

Hepatitis B immunisation status of A&E healthcare workers.

Hepatitis B immunisation has still not been taken up by all 'at risk' healthcare workers, even though it remains a significant occupational hazard. Angela Dancocks and Susanne Hewitt's research in an Accident and Emergency Department highlights the need for better information to ensure uptake and questions the current definition of those 'at risk'.

Emergency Service, Hospital↗
PubMed1993

'Mercury spillage'.

Explore the source record for details and available documents.

Air Pollution, Indoor↗
PubMed1991

A phase II evaluation of cisplatin, bleomycin, and mitomycin-C in patients with recurrent squamous cell carcinoma of the cervix.

Cisplatin, bleomycin, and mitomycin-C were used to treat 25 patients with recurrent squamous cell carcinoma of the cervix. Six patients had a partial response, yielding a total response rate of 27%. Nine patients had stable disease. The median survival for the whole group was 30 weeks. The median survival for responders was 32 weeks. The median progression free interval for the whole group was 12 weeks and the median progression-free free interval for responders was 14 weeks. The toxicities noted were primarily nausea, vomiting, and myelosuppression. The combination of cisplatin, bleomycin, and mitomycin-C has modest effectiveness in the treatment of recurrent squamous cell carcinoma of the cervix, but represents no improvement over single-agent chemotherapy.

Adult↗
PubMed1991

Williams' vulvovaginoplasty after supralevator total pelvic exenteration.

Seven patients had delayed Williams' vulvovaginoplasty after supralevator total pelvic exenteration. Of the three patients who died of carcinoma of the cervix (at 2, 5, and 15 months after vulvovaginoplasty), the first died before having a chance to attempt intercourse, but the other two had reported intercourse on at least two occasions after the reconstruction. One of the patients described the experiences as neither pleasant nor unpleasant but stated that her husband seemed satisfied. The other patient described the experience as satisfactory to both herself and her husband. The remaining four patients are alive with no evidence of recurrent disease at 28, 42, 56, and 106 months after operation. Two of these patients have reported entirely satisfactory sexual relations approximating pre-exenteration frequency, but the remaining two have not had sexual relations since surgery. Both give the main reason for this as lack of opportunity. The Williams' vulvovaginoplasty appears to be a reasonable alternative for vaginal reconstruction in patients who will have and especially who have had exenteration. To improve results, other methods of vaginal reconstruction should continue to be evaluated.

Adult↗
PubMed1990

Red cell autoantibodies, multiple immunoglobulin classes, and autoimmune hemolysis.

The effects and interrelationships of multiple immunoglobulin coating (i.e., increased red cell [RBC]-bound IgM and/or IgA in addition to IgG) were investigated in 404 patients with warm-reactive RBC autoantibodies on 590 occasions. Multiple immunoglobulins were detected by enzyme-linked direct antiglobulin tests in 218 samples (37%), but in only 87 (15%) by agglutination methods. Differences in populations were examined by chi-square, with p less than 0.005 being required for significance because of the multiple tests. Compared with IgG coating alone, multiple immunoglobulins were significantly associated with larger quantities (greater than 800 molecules/RBC) of IgG, multiple IgG subclasses, IgG3 and C3d bound to the cells, and with serum haptoglobin levels of less than 0.1 g per L. The latter association was still significant when higher levels of RBC-bound IgG and subclass pattern were taken into account. In samples with multiple immunoglobulin coating, there was no significant relationship (p greater than 0.05) between haptoglobins of less than 0.1 g per L and either C3d or multiple IgG subclasses. It was concluded that multiple immunoglobulin coating, even when undetected by agglutination methods, is a major cause of hemolysis: it is part of a more generalized autoimmune response and acts with other factors such as the quantity of bound IgG, the IgG subclass pattern, and complement; it also has an important hemolytic effect in its own right.

Autoantibodies↗
PubMed1990

Erythrocyte autoantibodies, subclasses of IgG and autoimmune haemolysis.

The subclass pattern of red cell bound IgG autoantibody was studied in 304 patients on 426 occasions. Subclass interrelationships with time, other cell bound immunoglobulins (IgM, IgA), amount of bound IgG and serum haptoglobin levels were investigated using population proportions; because of the multiple statistical tests, P less than 0.01 was required for significance. IgG1 was most common, being found in 98% of cases and as the sole subclass in 64%; multiple subclasses occurred in 34.5%. The IgG subclass pattern possibly changed with time (P less than 0.02, greater than 0.01), populations being compared at 6 and 12 months. There was a highly significant and important correlation between multiple IgG subclasses and multiple immunoglobulin coating; in our further studies, this necessitated the use of samples where only cell bound IgG was increased. Multiple IgG subclasses strongly correlated with larger amounts of cell bound IgG, groups with greater than 2 and less than 1 OD units by the enzyme-linked direct antiglobulin test being compared (approximately greater than 800 and less than 400 molecules IgG per red cell respectively). Multiple subclasses (P less than 0.05, greater than 0.01), but not IgG3, were possibly associated with low haptoglobin levels; significance was reached, however, if the multiple immunoglobulin effect was ignored. IgG subclass interrelationships are clearly complex and require strictly defined populations for their study.

Adolescent↗
PubMed1989

Concomitant radiation therapy and chemotherapy in the treatment of advanced squamous carcinoma of the lower female genital tract.

Twenty-three consecutive patients with advanced squamous carcinoma of the lower female genital tract were entered into a pilot study to determine the response rate and toxicity of a combination of intravenous cisplatin and 5-fluorouracil given concomitantly with radiation therapy. Twenty (87%) of the patients had a complete clinical response. Two patients (9%) had a partial response and one (4%) had stable disease. Nine (45%) of the complete responders have recurred with a median time to recurrence of 4 months. Seven (35%) had some component of local recurrence. The complete responders who have not recurred have been followed a median of 17 months. The acute toxicity was generally mild and there was no life-threatening acute complications. Three patients developed significant late complications. The response rate in this study was very high. The responses were usually prompt and dramatic, but often not sustained.

Adult↗