PubMed Health⌕ Search

Biomedical subjects

S Millership

Publications and source records attributed to S Millership.

14 recordsLinked to original sources
PubMed2006

Methicillin-resistant Staphylococcus aureus in the community in West Essex.

The study was undertaken in response to local concerns of a rising number of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections. All patients resident in the community in Essex at the time of diagnosis with a first isolate of MRSA between 1994 and 2001 identified by the diagnostic microbiology laboratory were included. Although the annual incidence rose throughout the study period the majority of those with MRSA (82%) had had hospital contact within the last 5 years. The subset of patients without hospital contact had a median age of 79.5 years, 63% were female and 32% were residents of care homes. Carriage in this population was detected for up to 41 months post-diagnosis. Neither antibiogram nor clinical presentation distinguished these isolates from local hospital-acquired strains.

Adolescent↗
PubMed2004

Prevention of perinatal hepatitis B transmission in a health authority area: an audit.

The aim of this audit was to provide baseline measurement of antenatal hepatitis B virus (HBV) screening uptake, coverage of HBV vaccination in infants born to high- and low-risk HBsAg carrier mothers, completion of post-vaccination serological testing, outcome for vaccinated infants, and an assessment of the factors that influenced the effectiveness of the whole programme. Methods included identifying HBV positive pregnancies by laboratory results, and follow up of at-risk infants by a GP survey. Uptake of antenatal HBV screening was 99.9%. Thirty-one HBV positive pregnancies were identified, and twenty-nine infants were followed up. The overall HBV vaccination completion rate was 93%. Fifty per cent of eligible infants were tested for hepatitis carriage, the majority of whom were high-risk infants. None had acquired HBV infection and all had gained adequate immunity. We conclude that, although the local screening programme has been implemented effectively, there is inconsistency in the follow up of infants at high and low risk of acquiring HBV.

England↗
PubMed2003

Incidence and prevalence of head lice in a district health authority area.

There are very few recent studies of the incidence and prevalence of head lice in the UK. A population-based questionnaire survey was carried out in a district health authority area. Two hundred and four of 235 primary schools (87%) agreed to participate. A total of 21,556 of 43,889 (49%) questionnaires were returned by parents. Overall 438 children had head lice at the time of the survey, giving a prevalence of 2.03%; 8,059 had had lice at some time in the last year giving an annual incidence of 37.4%.

Age Distribution↗
PubMed2002

Description of an HIV patient notification exercise in Essex involving a dental healthcare worker.

During 2000, one of the Consultants in Communicable Disease Control (CsCDC) for North Essex Health Authority was advised that a healthcare worker (HCW) in dentistry had recently been diagnosed as HIV positive. As a result of the HCW's history and taking account the Guidance on HIV infected healthcare workers of the United Kingdom Expert Advisory Group on AIDS, North and South Essex Health Authorities embarked on the largest patient notification exercise in the United Kingdom, to date. This involved an examination of 36,000 patient records and resulted in the identification of 5,929 exposed patients. Of these 5,929 patients, 3,825 contacted the health authority helpline and 3,096 were counselled and screened for evidence of HIV infection. All tests were negative. This was also the first patient notification exercise to use salivary samples for patient screening. The exercise cost in excess of 300,000 Pounds, ignoring the opportunity costs of staff having to devote time to the exercise.

Contact Tracing↗
PubMed2001

Antibody responses to Hepatitis A vaccine in healthy adults.

Hepatitis A vaccination has been used in a number of settings to control community outbreaks of the disease. Yet United Kingdom guidance for post-exposure prophylaxis continues to promote the administration of human normal immunoglobulin, despite concerns about the administration of human derived blood products. Little is known about the time frame of the antibody response to hepatitis A vaccine which, if rapid, could permit the exclusive use of vaccine for post-exposure prophylaxis. We report the findings of a pilot study in healthy adult volunteers given a single dose of Havrix monodose.

Adult↗
PubMed1999

Control of a community hepatitis A outbreak using hepatitis A vaccine.

In an outbreak of hepatitis A infection among children attending a village primary school hygiene measures and prophylaxis of household contacts of initial cases with human normal immunoglobulin did not prevent spread. Over two months 16 pupils and two household contacts were infected, and seven children aged 6 to 10 years were jaundiced. Testing for salivary IgG and IgM among staff and pupils and their household contacts identified asymptomatic cases. Hepatitis A vaccine was offered to staff and pupils. Coverage was 78%. If those with previous infection are included 81% were protected. Two cases arose in the seven days after the vaccination campaign. No further cases were identified in the following 30 weeks. Our experiences illustrate a lack of public and professional awareness of the seriousness of hepatitis A in adults, and suggest that hepatitis. A vaccine alone is a useful outbreak control measure. Salivary antibody testing showed that only a quarter of those over 40 years of age (17/69) were immune to hepatitis A.

Adult↗
PubMed1998

Distribution of stable iodine in a nuclear emergency--are we prepared?

BACKGROUND: In the event of a nuclear accident health authorities are responsible for the provision of stable iodine to an affected population. Following an emergency exercise deficiencies in local arrangements were apparent, and a survey of other districts with nuclear reactors was carried out to examine alternative solutions to some of the practical problems created. METHODS: Health districts in England and Wales and health boards in Scotland with nuclear sites within their boundaries were identified from literature supplied by the Health and Safety Executive, and a copy of their current nuclear emergency plans together with any field experience of their use requested. Information from the plans was extracted and categorized according to a pre-defined list of criteria. RESULTS: Sixteen districts with 18 nuclear sites had plans for distribution of stable iodine. Plans concentrated on the population within a small area around the site; more remote populations and special groups such as those in the emergency services were rarely mentioned. The most common arrangement was predistribution of tablets to local centres for onward distribution by community nurses, police or the public. Predistribution to households was unusual, although two districts were in the process of redrafting plans to accommodate this. Two districts with operating reactors did not have any agreed plans. No district had any experience of use in a real situation and only two with operating reactors had attempted field testing. CONCLUSIONS: There is considerable uncertainty and confusion about the best method of distribution, with significant omissions from the majority of current plans. This is exacerbated by a lack of practical experience and a failure to share exercise experiences.

Health Planning↗
PubMed1993

Typing of Aeromonas spp. by numerical analysis of immunoblotted SDS-PAGE gels.

One hundred and three isolates of Aeromonas spp., collected from both environmental sources and patients, were examined by SDS-PAGE of whole cells followed by immunoblotting with polyclonal rabbit antiserum raised against whole cells of A. sobria. All isolates were typable, yielding 15-20 well separated bands. Reproducibility of the technique was good and discrimination excellent, yielding 30 types amongst 103 isolates. Immunoblot type was not related to biochemical phenotype. Attempts to correlate immunoblot type with serotype were unsuccessful because only 42% of the strains tested could be serotyped.

Adolescent↗
PubMed1992

Automated lanes detection and comparison of bacterial electrophoretic protein fingerprints using fast Fourier transformation.

A method of computer-automated analysis of bacterial fingerprints produced by electrophoresis of proteins in a one-dimensional slab gel system is described. Proteins were visualized by silver staining. Western blotting, or autoradiography. Gels were recorded with a CCD camera, and after initial manual removal of the unwanted image margins, track margins were identified and extracted and a normalized trace was produced automatically using Fourier routines to smooth plots required for this process. Normalized traces were then compared by Fourier correlation after application of a high-pass step filter.

Aeromonas↗
PubMed1991

Hypergastrinaemia: a new mechanism.

The mechanism by which lack of gastric acid causes hypergastrinaemia was investigated in seven patients with pernicious anaemia. Perfusion of gastric juice from the fasting patients (adjusted to pH 7.0) into the stomachs of conscious rats caused a significant rise in plasma gastrin (median 14 [range 2-20] pmol/l to 27 [12-65] pmol/l; p less than 0.01), whereas perfusion of bicarbonate buffer (18 [13-23] pmol/l to 20 [9-25] pmol/l) or gastric juice from a duodenal ulcer patient (also pH 7.0; 13 [3-30] pmol/l to 17 [9-27] pmol/l) had no significant effect. During gastric lavage at pH 7.0 the median plasma gastrin concentration of the pernicious anaemia patients fell from 320 (63-1760) pmol/l to 125 (46-760) pmol/l (p less than 0.03).

Aged↗