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2.  Public is concerned about gene testing. 
BMJ : British Medical Journal  1997;314(7093):1552-1553.
PMCID: PMC2126750  PMID: 9183216
3.  The clinical task. 
BMJ : British Medical Journal  1992;305(6848):288-290.
PMCID: PMC1882714  PMID: 1392862
5.  Latrine ownership as a protective factor in inflammatory trachoma in Egypt. 
We investigated the association between inflammatory trachoma in children aged 1-5 and environmental and sociodemographic risk factors in a rural Nile Delta hamlet. Inflammatory trachoma clustered in households, emphasising the child-to-child nature of transmission in the hamlet. Multiple logistic regression analysis revealed three factors predicting inflammatory trachoma in children: the absence of a latrine in the household, school-age siblings with inflammatory trachoma, and additional same-age siblings (with or without disease) in the household. In the Egyptian setting the presence of pit latrines in all houses, even when full and unscreened, might result in a reduction in trachoma prevalence in this population from the current 49% to 35%. The construction of pit latrines may offer the simplest and most acceptable environmental method for reducing trachoma in this trachoma endemic area.
PMCID: PMC1042373  PMID: 2043570
7.  The authors reply 
British Heart Journal  1989;62(5):415.
PMCID: PMC1224847  PMID: 18610366
8.  Trachoma and blindness in the Nile Delta: current patterns and projections for the future in the rural Egyptian population. 
A population based survey of trachoma and blindness was conducted in a rural Nile Delta hamlet. Trachoma remains hyperendemic in this region. Active trachoma was common among preschool children; over half had moderate to severe disease. Of residents 25 years old 90% had substantial conjunctival scarring. Severe conjunctival scarring was commoner among women (84%) than men (58%), and three-quarters of older women had trichiasis/entropion compared with 57% of older men. Males and females had equivalent age specific rates of inflammatory disease. Blindness was associated with old age; 17% of residents aged 50 and over were blind. Estimates of blindness based on this survey and other surveys in Egypt indicate that blindness is still a serious public health problem in rural Egypt. The number of blind persons in Egypt will increase from an estimated 420,000 in 1980 to 868,000 by the year 2020. The current crude blindness rate of 1.8% is expected to increase to 2.3% in the year 2000 and to 3.2% in 2020.
PMCID: PMC1041795  PMID: 2757994
9.  Transmitral velocities measured by pulsed Doppler in healthy volunteers: effects of acute changes in blood pressure and heart rate. 
British Heart Journal  1989;61(4):344-347.
The effect of a two minute cold pressor test on transmitral velocities measured by pulsed Doppler was studied in 11 healthy volunteers. Blood pressure increased significantly during cold immersion but peak atrial and peak early diastolic transmitral velocities and their ratio (A:E) were unchanged. There was no correlation between changes in Doppler variables and changes in calculated mean arterial blood pressure during the test. Heart rate changes were variable and not related to changes in blood pressure. In individual people the change in pulse interval during cold immersion was significantly and inversely correlated with the change in the A:E ratio. The large acute increase in arterial pressure seen during the cold pressor test in normal volunteers had no consistent effect on the transmitral velocity profile although small changes in heart rate were associated with large changes in A:E ratio. The effect of small changes in heart rate may be of considerable importance in determining transmitral velocity profiles. Thus in clinical and experimental studies in which the heart rate is not controlled, Doppler data on transmitral flow should be interpreted with caution.
PMCID: PMC1216674  PMID: 2653392
10.  Save the general practice record. 
BMJ : British Medical Journal  1989;298(6676):772.
PMCID: PMC1836071  PMID: 2496854
12.  Hospital clinical records. 
PMCID: PMC1417508  PMID: 3928049
13.  Why keep hospital clinical records? 
PMCID: PMC1417595  PMID: 3917779
14.  Production and characterization of monoclonal antibodies to tetanus toxin. 
Infection and Immunity  1984;43(2):710-714.
Monoclonal antibodies against tetanus toxin were produced to obtain highly specific antisera. Ten hybridoma cell lines producing monoclonal antibodies were derived from the fusion of rat myeloma cells and spleen cells from rats immunized with tetanus toxoid. Eight produced monoclonal antibodies specific for determinants on toxin and toxoid, whereas two were specific only for determinants on the toxoid. The antibodies produced by hybridomas were characterized by determination of the class of light and heavy chain components, epitope specificity, toxin neutralization, and subunit specificity. All of the antibodies contained kappa light chain, eight contained the gamma 1 heavy chain, and the remaining two contained the gamma 2a heavy chain. Five distinct epitopes were indicated by competition assay of paired monoclonal antibodies, and 4 of the 10 monoclonal antibodies neutralized the in vivo activity of tetanus toxin. The four neutralizing monoclonal antibodies and one other were specific for the C fragment of the heavy chain of the toxin molecule.
PMCID: PMC264358  PMID: 6198285
15.  Illustrations from the Wellcome Institute Library. The Chain papers. 
Medical History  1983;27(4):434-435.
PMCID: PMC1140049  PMID: 6358729
16.  Sir Leonard Rogers, FRS (1868-1962) and his papers. 
Medical History  1983;27(2):214-215.
PMCID: PMC1139309  PMID: 6345969
18.  Evidence for an immunological relationship between Streptococcus mutans and human cardiac tissue. 
Infection and Immunity  1980;27(2):576-588.
Two-dimensional immunoelectrophoresis, indirect immunofluorescence, and radioimmunoassay were used to demonstrate that antisera from rabbits immunized with some strains of Streptococcus mutans contain antibodies that cross-react with human cardiac tissue. These rabbits were sensitized to a shocking dose of human heart antigen, and anaphylactic deaths were sometimes produced. Myocarditis was also a result of the immunization procedure. Data obtained with all five techniques were comparable. Cross-reactivity could be associated with three antigens designated ID, IF, and HL. Antigens ID and IF were major immunogens of S. mutans Ingbritt, but HL antibodies were produced only after hyperimmunization. Corss-reactivity was of an immunological nature and not the result of nonspecific factors such as bacterial Fc reactive components or antibody elicited to growth medium constituents. These findings support the hypothesis that immunization with S. mutans can induce autoimmune reactions and indicate that antigens must be selected with caution before formulating any dental caries vaccine.
PMCID: PMC550804  PMID: 6991419
19.  Complement activating factor(s) of Trypanosoma lewisi: some physiochemical characteristics of the active components. 
Of the complement activating factors present in Trypanosoma lewisi, the major component, a carbohydrate containing substance was further investigated. This component was found to have a lag time of complete activation of 2 CH50 units of bovine complement of approximately 15 minutes while 1% trypsin (a known activator of complement, used as a control system) was capable of instant consumption of a similar quantity of complement. In addition, the complement activating factor of trypanosomes was observed to be stable at 100 degrees C for 15 minutes and over a pH range of 3.0 to 11.0. Thin layer chromatography studies suggested that at least part of the active component contained lipid, perhaps indicating that it may be glycolipid in nature.
PMCID: PMC1277796  PMID: 25701
20.  Impact of age and sex on primary preventive treatment for cardiovascular disease in the West Midlands, UK: cross sectional study 
Objectives To establish the impact of age and sex on primary preventive treatment for cardiovascular disease in a typical primary care population.
Design Cross sectional study of anonymised patient records.
Participants All 41 250 records of patients aged ≥40 registered at 19 general practices in the West Midlands, United Kingdom, were extracted and analysed.
Main outcome measures Patients’ demographics, risk factors for cardiovascular disease (blood pressure, total cholesterol concentration), and prescriptions for primary preventive drugs were extracted from patients’ records. Patients were subdivided into five year age bands up to 85 (patients aged ≥85 were analysed as one group) and prescribing trends across the population were assessed by estimating the proportion of patients prescribed with antihypertensive drug or statin drug, or both, in each group.
Results Of the 41 250 records screened in this study, 36 679 (89%) patients did not have a history of cardiovascular disease and therefore could be considered for primary preventive treatment. The proportion receiving antihypertensive drugs increased with age (from 5% (378/6978) aged 40-44 to 57% (621/1092) aged ≥85) as did the proportion taking statins up to the age of 74 (from 3% (201/6978) aged 40-44 to 29% (675/2367) aged 70-74). In those aged 75 and above, the odds of a receiving prescription for a statin (relative to the 40-44 age group) decreased with every five year increment in age (odds ratio 12.9 (95% confidence interval 10.8 to 15.3) at age 75-79 to 5.7 (4.6 to 7.2) at age ≥85; P<0.001). There were no consistent differences in prescribing trends by sex.
Conclusions Previously described undertreatment of women in secondary prevention of cardiovascular disease was not observed for primary prevention. Low use of statins in older people highlights the need for a stronger evidence base and clearer guidelines for people aged over 75.
PMCID: PMC3395734  PMID: 22791787
22.  Organotherapy * 
PMCID: PMC2623208  PMID: 20892005

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