Biomedical subjects
Publications and source records attributed to S Horsley.
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BACKGROUND: The Barrow-in-Furness stable iodine (potassium iodate) tablet pre-distribution scheme was the first of its kind to be introduced to protect the population living around a fixed site nuclear facility in the United Kingdom. Pre-distribution schemes have attracted critical comment principally because the certainty of availability of potassium iodate tablets was unknown. This study aimed to establish the reliability of such a scheme. METHOD: A structured interviewer-administered survey of a random sample of households served by the pre-distribution scheme was carried out using a standardized questionnaire. RESULTS: The ability of this scheme to provide stable iodine protection declined from 100 per cent to 60 per cent coverage over a period of two years for the designed worst-case demand (the ability to supply stable iodine tablets to all household residents normally living within the pre-distribution scheme zone). CONCLUSIONS: Pre-distribution has value in areas where evacuation to a centre where stable iodine tablets are available or post-accident distribution to sheltering households is difficult. The value of such a scheme must be calculated against a predictable decline in its effectiveness. In implementing such a scheme it should be noted that this decline in coverage can be reduced by calculating the frequency with which tablet packs are redistributed to take account of this factor.
BACKGROUND: We aimed to examine and quantify the relationship between psychiatric morbidity and the provision of informal care in the community. METHODS: The study involved a comparison of carers and non-carers in a mixed urban and rural community (Morecambe Bay Health Authority). Data were collected by postal survey for 4550 adults; 10.9 per cent of respondents were identified as carers. Subjects were selected by quasi-random methods from the Family Health Services Authority (FHSA) registers. Potential psychiatric morbidity was defined as three or more symptoms on a standardized measure, the General Health Questionnaire (12-item version). RESULTS: The prevalence of morbidity was significantly higher in people who care for others in their own homes, even after adjustment for other known risk factors for psychiatric morbidity (odds ratio 1.51, 95 per cent confidence interval 1.11-2.05). In contrast, there was no significant relationship between morbidity and care outside the home in these data. CONCLUSION: Health Authorities need to review support for carers and to consider ways to improve monitoring.
We report a deletion of 1p36.3 in a child with microcephaly, mental retardation, broad forehead, deep set eyes, depressed nasal bridge, flat midface, relative prognathism, and abnormal ears. The phenotype is consistent with that described for partial monosomy for 1p36.3. Reverse chromosome painting and microsatellite and Southern blot analyses were used to map the extent of the deletion. Fluorescence in situ hybridisation (FISH) analysis using probes from every telomere indicates that the rearrangement is likely to be a chromosomal truncation or rearrangement involving subtelomeric repetitive DNA. The deletion was identified by screening a sample of children and adults with idiopathic mental retardation. In conjunction with previous work on this sample, we estimate that 7.4% of the group have subtelomeric rearrangements.
The mouse homologue of the polycystic kidney disease 1 gene (PKD1) was mapped to chromosome 17 using somatic cell hybrids, B x D recombinant inbred strains, and FISH. The gene is located within a previously defined conserved synteny group that includes the mouse homologue of tuberous sclerosis 2 (TSC2) and is linked to the alpha globin pseudogene Hba-ps4. Although the human genome contains multiple copies of genes related to PKD1, there is no evidence for more than one copy in the mouse genome. Like their human counterparts, the mouse Tsc2 and Pkd1 genes are arranged in a tail-to-tail orientation with a distance of only 63 bp between the polyadenylation signals of the two genes.
Describes the results of a postal questionnaire survey of all 1,383 hospital consultants in the North Western Region of the UK in 1994; updating a similar survey conducted in 1987. In both surveys, consultants were asked to describe their current management role, management training received and any perceived future training needs. A series of open questions in the 1994 survey explored barriers and incentives to the take-up of management training. The results show that in 1994 more doctors were taking on greater management responsibility and from an earlier age. Consequently, the proportion of consultants expressing a need for management training had risen from 62 per cent in 1987 to 73 per cent in 1994. The most useful courses were local budgeting and business planning. However, many consultants described problems in accessing training. Concludes by highlighting policy implications arising from the surveys which will need to be addressed if consultants are to fulfil their management potential.
The ATP-sensitive K-channel plays a central role in insulin release from pancreatic beta-cells. We report here the cloning of the gene (KCNJ6) encoding a putative subunit of a human ATP-sensitive K-channel expressed in brain and beta-cells, and characterisation of its exon-intron structure. Screening of a somatic cell mapping panel and fluorescent in situ hybridization place the gene on chromosome 21 (21q22.1-22.2). Analysis of single-stranded conformational polymorphisms revealed the presence of two silent polymorphisms (Pro-149: CCG-CCA and Asp-328: GAC-GAT) with similar frequencies in normal and non-insulin-dependent diabetic patients.
BACKGROUND: One of the targets for the Health of the nation is to increase the proportion of women smokers who give up smoking at the start of their pregnancy, from a quarter to at least one-third, by the year 2000. This study uses a regional lifestyle survey to look at the characteristics of pregnant women who smoke. METHODS: The lifestyle survey was based on a structured questionnaire which was sent by post to a systematic random sample of 60,000 adults across the North Western Region. A total of 513 respondents were pregnant; of these, 150 (29 per cent) reported that they smoked. The responses of pregnant smokers and non-smokers were compared to identify differences in age, demographic and social characteristics, mental distress and attitudes to lifestyle variables. RESULTS: Women in the North Western Region who smoked tended not to give up during pregnancy, but they did tend to smoke less. Smokers were more likely to be under 25 than non-smokers, less likely to be home-owners, and less likely to be living with a husband or partner. There was no difference in mental distress between smokers and ex-smokers, but they both experienced significantly greater mental distress than those who had never smoked. The difference between smokers and ex-smokers was in their type of occupation, housing tenure and whether they were living with a partner, ex-smokers being much more similar to non-smokers. CONCLUSIONS: More work needs to be done to improve the design of smoking cessation programmes, to make them more culturally appropriate for pregnant women who appear to be socially disadvantaged, have poor housing and lack a stable relationship.
A 19 week female fetus is described with a de novo X;1 reciprocal balanced translocation, with the breakpoint on the X chromosome at Xp11.4, and eye pathology consistent with the early stages of Norrie disease. The fetus seems to be an example of a female manifesting an X linked recessive disease, and it was shown that the normal X chromosome was completely inactivated in all cells examined. Norrie disease has been mapped to Xp11.3, and fluorescence in situ hybridisation studies showed that the Norrie disease gene had not obviously been disrupted. Mutation screening by SSCP analysis showed no aberrant fragments of the coding region of the gene. Several eye disease genes map to the same region of the X chromosome, but are excluded on grounds of pathology. One possibility is that this fetus has a Norrie-like eye disease caused by the mutation of another gene located at Xp11.4. If this is so, there are implications for prenatal diagnosis.
Current quality of life (QOL) assessments, whilst being suitable for patients undergoing active treatment, are often too cumbersome for patients who are in the terminal phase of their illness, and may themselves produce distress. In an attempt to measure QOL in these patients a simple assessment was piloted (PEPS--patient evaluated problem score) in which patients were asked to identify and grade major problems as they perceived them and also to grade problems previously identified by the medical and nursing staff. A global QOL score and a self-administered WHO score completed the assessment. Of 70 patients admitted to the unit over a seven-month period, 44 completed questionnaires, 38 in full. Subsequently, uptake has been far greater (due to establishment of the method as part of routine care) with 73% of all patients admitted to our unit completing PEPS. Overall, a mean of 5.6 problems per patient were identified, of which 14% were psychosocial. Of those patients who completed questionnaires, 58% identified problems not picked up by the nursing and medical staff; 52% of these were psychosocial problems. Of 28 patients who died having previously completed questionnaires 22 had done so in the previous three weeks including eight in the previous seven days. PEPS has proved very useful in the management of patients, enabling the identification of previously unrecognized or underrated problems, particularly of a psychosocial nature, and also as a means of evaluating progress. It is readily acceptable to patients, even those close to death.
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Eight sailors on board the Asiafreighter were exposed to arsine that had escaped from a cylinder in the cargo hold. Four suffered severe toxicity and within a few hours had developed fever, weakness, nausea, vomiting, diarrhoea, abdominal pain, and haemoglobinuria. These patients had pronounced intravascular haemolysis, which in one patient was complete. This patient was also stuporose and anoxic, a condition attributed to failure of oxygen transport and sludging of red cell debris in the cerebral and pulmonary circulations, but he regained a normal level of consciousness after exchange transfusion. Evidence of marrow depression was present: the reticulocyte response to the haemolysis was poor and there was a thrombocytopenia. All four patients developed renal failure, one being totally anuric for five weeks. Two patients developed peripheral neuropathy, and one was still severely disabled six months after the incident. The other four patients had a similar, though less severe, illness.
A combined intraoperative and postoperative adjuvant program of 5 minus Fluorouracil (5 FU) for patients undergoing "curative" resection for adenocarcinoma of the colon and rectum was initiated as a randomized clinical trial in January 1968. Patients at the Medical College of Virginia and the University of Virginia were randomly assigned to an intraluminal 5 FU or intraluminal control (Saline) group and were so treated at the time of surgical resection if findings at operation indicated that all gross neoplastic disease could be resected. Patients with operative findings denoting incurability were eliminated from the study after surgical exploration. Those patients receiving intraluminal 5 FU (30mg/kg) received intravenous 5 FU (10mg/kg) on each of the two first postoperative days and 5 subsequent postoperative courses of oral 5FU (90 mg/kg in each 18 day course) over a one year period. By December 31, 1973 (6 years) 156 patients undergoing "curative" resection were entered into the study. SU therapy with the control or "No Treat" group reveal no significant benefit from this intensive adjuvant course of 5 FU thus far. Continued assessment of these patient groups and their subgroups will be required to develop confidence in these findings but the data thus far suggest no potential benefit from this particular adjuvant program.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.