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12. Anticardiolipin antibodies in leptospirosis

Author

Rugman, F.P., Pinn, G., Palmer, M.F., Waite, M., and Hay, C.R.M.

Subjects
Leptospirosis -- Cases, Spirochetes, Anticardiolipin antibodies -- Measurement, Health
Abstract

Leptospirosis is an infection caused by a spirochete called leptospira, with reservoirs found on rodents, dogs, cattle and pigs. An infection with leptospira causes fever, and in severe cases, can damage the liver, kidneys, and blood vessels. The second stage of the infection occurs two weeks after the initial infection and it can cause inflammation of the brain (encephalitis), inflammation of the nerves (neuritis), and heart failure. It is thought that the symptoms that occur during the second stage of infection may be caused by a reaction of the immune system. The immune system makes substances called antibodies that attack and destroy microorganisms that invade the body. However, under abnormal circumstances the immune system may make antibodies that destroy the body's own tissues. Cardiolipin is a substance found in cell membranes; anticardiolipin antibodies are antibodies that attack and destroy cardiolipin. Anticardiolipin antibodies have been found in the blood of patients with spirochetal infections that cause Lyme disease and syphilis. It is not known what causes these antibodies to be produced, or whether these antibodies are responsible for the tissue damage that occurs during these infections. To determine if anticardiolipin antibodies are present in patients with leptospirosis, blood samples from 16 patients with leptospirosis were tested. Eight of the 16 patients had higher than normal levels of anticardiolipin antibodies in their blood, and these patients had more severe symptoms of infection. It is suggested that anticardiolipin antibodies may contribute to or worsen the symptoms of leptospirosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

13. Fenofibrate intervention and event lowering in diabetes (FIELD) study: baseline characteristics and short-term effects of fenofibrate [ISRCTN64783481]

Author

Scott, R, Best, J, Forder, P, Taskinen, M-R, Simes, J, Barter, P, Keech, A, Colman, P, D'Emden, M, Davis, T, Drury, P, Ehnholm, C, Glasziou, P, Hunt, D, Kesaniemi, YA, Laakso, M, Simes, RJ, Sullivan, D, Whiting, M, Ansquer, J-C, Fraitag, B, Anderson, N, Hankey, G, Lehto, S, Mann, S, Romo, M, Li, LP, Hennekens, C, MacMahon, S, Pocock, S, Tonkin, A, Wilhelmsen, L, Akauola, H, Alford, F, Beinart, I, Bohra, S, Boyages, S, Connor, H, Darnell, D, Davoren, P, Lepre, F, De Looze, F, Duffield, A, Fassett, R, Flack, J, Fulcher, G, Grant, S, Hamwood, S, Harmelin, D, Jackson, R, Jeffries, W, Kamp, M, Kritharides, L, Mahar, L, McCann, V, McIntyre, D, Moses, R, Newnham, H, Nicholson, G, O'Brien, R, Park, K, Petrovsky, N, Phillips, P, Pinn, G, Simmons, D, Stanton, K, Stuckey, B, Sullivan, DR, Suranyi, M, Suthers, M, Tan, Y, Templer, M, Topliss, D, Waites, JH, Watts, G, Welborn, T, Wyndham, R, Haapamaki, H, Kesaniemi, A, Lahtela, J, Levanen, H, Saltevo, J, Sodervik, H, Taskinen, M, Vanhala, M, Baker, J, Burton, A, Dixon, P, Doran, J, Dunn, P, Graham, N, Hamer, A, Hedley, J, Lloyd, J, Manning, P, McPherson, I, Morris, S, Renner, C, Smith, R, Wackrow, M, Young, S, Alard, F, Alcoe, J, Allan, C, Amerena, J, Anderson, R, Arnold, N, Arsov, T, Ashby, D, Atkinson, C, Badhni, L, Balme, M, Barton, D, Batrouney, B, Beare, C, Beattie, T, Beggs, J, Bendall, C, Benz, A, Bond, A, Bradfield, R, Bradshaw, J, Brearley, S, Bruce, D, Burgess, J, Butler, J, Callary, M, Campbell, J, Chambers, K, Chow, J, Chow, S, Ciszek, K, Clifton, P, Clifton-Bligh, P, Clowes, V, Coates, P, Cocks, C, Cole, S, Colquhoun, D, Correcha, M, Costa, B, Coverdale, S, Croft, M, Crowe, J, Dal Sasso, S, Davis, W, Dunn, J, Edwards, S, Elder, R, El-Kaissi, S, Emery, L, England, M, Farouque, O, Fernandez, M, Fitzpatrick, B, Francis, N, Freeman, P, Fuller, A, Gale, D, Gaylard, V, Gillzan, C, Glatthaar, C, Goddard, J, Grange, V, Greenaway, T, Griffin, J, Grogan, A, Guha, S, Gustafson, J, Hamblin, PS, Hannay, T, Hardie, C, Harper, A, Hartl, G, Harvey, A, Havlin, S, Haworth, K, Hay, P, Hay, L, Heenan, B, Hesketh, R, Heyworth, A, Hines, M, Hockings, G, Hodge, A, Hoffman, L, Hoskin, L, Howells, M, Hunt, A, Inder, W, Jackson, D, Jovanovska, A, Kearins, K, Kee, P, Keen, J, Kilpatrick, D, Kindellan, J, Kingston-Ray, M, Kotowicz, M, Lassig, A, Layton, M, Lean, S, Lim, E, Long, F, Lucas, L, Ludeman, D, Ludeman-Robertson, C, Lyall, M, Lynch, L, Maddison, C, Malkus, B, Marangou, A, Margrie, F, Matthiesson, K, Matthiesson, J, Maxwell, S, McCarthy, K, McElduff, A, Mckee, H, McKenzie, J, McLachan, K, McNair, P, Meischke, M, Miller, AMC, Morrison, B, Morton, A, Mossman, W, Mowat, A, Muecke, J, Murie, P, Murray, S, Nadorp, P, Nair, S, Nairn, J, Nankervis, A, Narayan, K, Nattrass, N, Ngui, J, Nicholls, S, Nicholls, V, Nye, JA, Nye, E, O'Neal, D, O'Neill, M, O'Rourke, S, Pearse, J, Pearson, C, Phillips, J, Pittis, L, Playford, D, Porter, L, Portley, R, Powell, M, Preston, C, Pringle, S, Quinn, WA, Raffaele, J, Ramnath, G, Ramsden, J, Richtsteiger, D, Roffe, S, Rosen, S, Ross, G, Ross, Z, Rowe, J, Rumble, D, Ryan, S, Sansom, J, Seymour, C, Shanahan, E, Shelly, S, Shepherd, J, Sherman, G, Siddall, R, Silva, D, Simmons, S, Simpson, R, Sinha, A, Slobodniuk, R, Smith, M, Smith, P, Smith, S, Smith-Orr, V, Snow, J, Socha, L, Stack, T, Steed, K, Steele, K, Stephensen, J, Stevens, P, Stewart, G, Stewart, R, Strakosch, C, Sullivan, M, Sunder, S, Sunderland, J, Tapp, E, Taylor, J, Thorn, D, Tolley, A, Torpy, D, Truran, G, Turner, F, Turner, J, Van de Velde, J, Varley, S, Wallace, J, Walsh, J, Walshe, J, Ward, G, Watson, B, Watson, J, Webb, A, Werner, F, White, E, Whitehouse, A, Whitehouse, N, Wigg, S, Wilkinson, J, Wilmshurst, E, Wilson, D, Wittert, G, Wong, B, Wong, M, Worboys, S, Wright, S, Wu, S, Yarker, J, Yeo, M, Young, K, Youssef, J, Yuen, R, Zeimer, H, Ziffer, RW, Aura, A, Friman, A, Hanninen, J, Henell, J, Hyvarinen, N, Ikonen, M, Itkonen, A, Jappinen, J, Jarva, A, Jerkkola, T, Jokinen, V, Juutilainen, J, Kahkonen, H, Kangas, T, Karttunen, M, Kauranen, P, Kortelainen, S, Koukkunen, H, Kumpulainen, L, Laitinen, T, Laitinen, M, Lehto, R, Leinonen, E, Lindstron-Karjalainen, M, Lumiaho, A, Makela, J, Makinen, K, Mannermaa, L, Mard, T, Miettinen, J, Naatti, V, Paavola, S, Parssinen, N, Ripatti, J, Ruotsalainen, S, Salo, A, Siiskonen, M, Soppela, A, Starck, J, Suonranta, I, Ukkola, L, Valli, K, Virolainen, J, Allan, P, Arnold, W, Bagg, W, Balfour, K, Ball, T, Ballantine, B, Ballantyne, C, Barker, C, Bartley, F, Berry, E, Braatvedt, G, Campbell, A, Clarke, T, Clarke, R, Claydon, A, Clayton, S, Cresswell, P, Cutfield, R, Daffurn, J, Delahunt, J, Dissnayake, A, Eagleton, C, Ferguson, C, Florkowski, C, Fry, D, Giles, P, Gluyas, M, Grant, C, Guile, P, Guolo, M, Hale, P, Hammond, M, Healy, P, Hills, M, Hinge, J, Holland, J, Hyne, B, Ireland, A, Johnstone, A, Jones, S, Kerr, G, Kerr, K, Khant, M, Krebs, J, Law, L, Lydon, B, MacAuley, K, McEwan, R, McGregor, P, McLaren, B, McLeod, L, Medforth, J, Miskimmin, R, Moffat, J, Pickup, M, Prentice, C, Rahman, M, Reda, E, Ross, C, Ryalls, A, Schmid, D, Shergill, N, Snaddon, A, Snell, H, Stevens, L, Waterman, A, Watts, V, Jayne, K, Keirnan, E, Newman, P, Ritchie, G, Rosenfeld, A, Beller, E, Gebski, V, Pillai, A, Anderson, C, Blakesmith, S, Chan, S-Y, Czyniewski, S, Dobbie, A, Doshi, S, Dupuy, A, Eckermann, S, Edwards, M, Fields, N, Flood, K, Ford, S, French, C, Gillies, S, Greig, C, Groshens, M, Gu, J, Guo, Y, Hague, W, Healy, S, Hones, L, Hossain, Z, Howlett, M, Lee, J, Li, L-P, Matthews, T, Micallef, J, Martin, A, Minns, I, Nguyen, A, Papuni, F, Patel, A, Pike, R, Pena, M, Pinto, K, Schipp, D, Schroeder, J, Sim, B, Sodhi, C, Sourjina, T, Sutton, C, Taylor, R, Vlagsma, P, Walder, S, Walker, R, Wong, W, Zhang, J, Zhong, B, Kokkonen, A, Narva, P, Niemi, E-L, Syrjanen, A-M, Lintott, C, Tirimacco, R, Kajosaari, M, Raman, L, Sundvall, J, Tukianen, M, Crimet, D, Sirugue, I, and Aubonnet, P

Subjects
Male, Cardiac & Cardiovascular Systems, Endocrinology, Diabetes and Metabolism, Atorvastatin, Coronary Disease, Fibrate, SECONDARY PREVENTION, ATORVASTATIN, law.invention, Placebos, Randomized controlled trial, Fenofibrate, law, Myocardial infarction, 1102 Cardiorespiratory Medicine and Haematology, Finland, Original Investigation, Hypolipidemic Agents, PLASMA, CHOLESTEROL, Middle Aged, INSULIN, CARDIOVASCULAR-DISEASE, Cardiovascular Diseases, Female, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, medicine.drug, medicine.medical_specialty, medicine.drug_class, Diabetes Complications, Endocrinology & Metabolism, Double-Blind Method, Internal medicine, Diabetes mellitus, Intervention (counseling), medicine, Humans, CORONARY-HEART-DISEASE, Obesity, Triglycerides, Aged, Apolipoproteins B, Bezafibrate, Science & Technology, business.industry, Cholesterol, HDL, Australia, Cholesterol, LDL, medicine.disease, BEZAFIBRATE, FIELD Study Investigators, MYOCARDIAL-INFARCTION, Diabetes Mellitus, Type 2, Cardiovascular System & Hematology, Cardiovascular System & Cardiology, business, HIGH-DENSITY-LIPOPROTEIN, New Zealand
Abstract

Objective The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study is examining the effects of long-term fibrate therapy on coronary heart disease (CHD) event rates in patients with diabetes mellitus. This article describes the trial's run-in phase and patients' baseline characteristics. Research design and methods FIELD is a double-blind, placebo-controlled trial in 63 centres in 3 countries evaluating the effects of fenofibrate versus placebo on CHD morbidity and mortality in 9795 patients with type 2 diabetes mellitus. Patients were to have no indication for lipid-lowering therapy on randomization, but could start these or other drugs at any time after randomization. Follow-up in the study was to be for a median duration of not less than 5 years and until 500 major coronary events (fatal coronary heart disease plus nonfatal myocardial infarction) had occurred. Results About 2100 patients (22%) had some manifestation of cardiovascular disease (CVD) at baseline and thus high risk status. Less than 25% of patients without CVD had a (UKPDS determined) calculated 5-year CHD risk of 30), most were men, two-thirds were aged over 60 years, and substantial proportions had NCEP ATP III features of the metabolic syndrome independent of their diabetes, including low HDL (60%), high blood pressure measurement or treatment for hypertension (84%), high waist measurement (68%), and raised triglycerides (52%). After a 6-week run-in period before randomisation with all participants receiving 200 mg comicronized fenofibrate, there were declines in total and LDL cholesterol (10%) and triglycerides (26%) and an increase in HDL cholesterol (6.5%). Conclusion The study will show the effect of PPAR-alpha agonist action on CHD and other vascular outcomes in patients with type 2 diabetes including substantial numbers with low to moderate CVD risk but with the various components of the metabolic syndrome. The main results of the study will be reported in late 2005.

Published
2005

14. The need for a large-scale trial of fibrate therapy in diabetes: The rationale and design of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. [ISRCTN64783481]

Author

Barter, P, Best, J, Colman, P, d'Emden, M, Davis, T, Drury, P, Ehnholm, C, Glasziou, P, Hunt, D, Keech, A, Laakso, M, Scott, R, Simes, RJ, Sullivan, D, Taskinen, M-R, Whiting, M, Ansquer, J-C, Fraitag, B, Anderson, N, Hankey, G, Lehto, S, Mann, S, Romo, M, Li, LP, Akauola, H, Alford, F, Beinart, I, Bohra, S, Boyages, S, Connor, H, Darnell, D, Davoren, P, Lepre, F, De Looze, D, Duffield, A, Fassett, R, Flack, J, Fulcher, G, Grant, S, Hamwood, S, Harmelin, D, Jackson, R, Jeffries, W, Kamp, M, Kritharides, L, Mahar, L, McCann, V, McIntyre, D, Moses, R, Newnham, H, Nicholson, G, O'Brien, R, Park, K, Petrovsky, N, Phillips, P, Pinn, G, Simmons, D, Stanton, K, Stuckey, B, Sullivan, DR, Suranyi, M, Suthers, M, Tan, Y, Templer, M, Topliss, D, Waites, JH, Watts, G, Welborn, T, Wyndham, R, Haapamaki, H, Kesaniemi, A, Lahtela, J, Levanen, H, Saltevo, J, Sodervik, H, Taskinen, M, and Vanhala, M

Abstract

Background: Fibrates correct the typical lipid abnormalities of type 2 diabetes mellitus, yet no study, to date, has specifically set out to evaluate the role of fibrate therapy in preventing cardiovascular events in this setting. Methods: Subjects with type 2 diabetes, aged 50-75 years, were screened for eligibility to participate in a long-term trial of comicronized fenofibrate 200 mg daily compared with matching placebo to assess benefits of treatment on the occurrence of coronary and other vascular events. People with total cholesterol levels 3.0-6.5 mmol/L plus either a total-to-HDLc ratio >4.0 or triglyceride level >1.0 mmol /L with no clear indication for lipid-modifying therapy were eligible. Results: A total of 9795 people were randomized into the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) trial. All received dietary advice, followed by a 6-week single-blind placebo run-in, then a 6-week active run-in period before randomization. Participants are being followed up every 6 months for outcome events and safety assessments. The study is designed to yield at least 500 coronary events (primary endpoint: first nonfatal myocardial infarction or coronary death) over 5 years, to have 80% power to identify as statistically significant at 2P = 0.05 a 22% reduction in such events, using intention-to-treat methods. Conclusions: Type 2 diabetes is the most common endocrine disorder worldwide, and its prevalence is increasing. The current evidence about use of fibrates in type 2 diabetes, from around 2000 people treated, will increase with FIELD to evidence from around 12000. FIELD will establish the role of fenofibrate treatment in reducing cardiovascular risk in people with type 2 diabetes. The main results are expected to be available in late 2005. © 2004 The FIELD Study Investigators; licensee BioMed Central Ltd.

Published
2004

15. Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study: Baseline characteristics and short-term effects of fenofibrate [ISRCTN64783481]

Author

Keech, AC, Scott, R, Best, J, Forder, P, Taskinen, MR, Simes, J, Barter, P, Colman, P, d'Emden, M, Davis, T, Drury, P, Ehnholm, C, Glasziou, P, Hunt, D, Kesaniemi, YA, Laakso, M, Simes, RJ, Sullivan, D, Whiting, M, Ansquer, JC, Fraitag, B, Anderson, N, Hankey, G, Lehto, S, Mann, S, Romo, M, Li, LP, Hennekens, C, MacMahon, S ; https://orcid.org/0000-0003-2064-7699, Pocock, S, Tonkin, A, Wilhelmsen, L, Akauola, H, Alford, F, Beinart, I, Bohra, S, Boyages, S, Connor, H, Darnell, D, Davoren, P, Lepre, F, De Looze, F, Duffield, A, Fassett, R, Flack, J ; https://orcid.org/0000-0001-6691-0558, Fulcher, G, Grant, S, Hamwood, S, Harmelin, D, Jackson, R, Jeffries, W, Kamp, M, Kritharides, L, Mahar, L, McCann, V, McIntyre, D, Moses, R, Newnham, H, Nicholson, G, O'Brien, R, Park, K, Petrovsky, N, Phillips, P, Pinn, G, Simmons, D, Stanton, K, Stuckey, B, Sullivan, DR, Suranyi, M, Suthers, M, Tan, Y, Templer, M, Topliss, D, Waites, JH, Watts, G, Welborn, T, Wyndham, R, Haapamaki, H, Kesaniemi, A, Lahtela, J, Levanen, H, Saltevo, J, Sodervik, H, Taskinen, M, Vanhala, M, Baker, J, Burton, A, Dixon, P, Doran, J, Dunn, P, Graham, N, Hamer, A, Hedley, J, Lloyd, J, Manning, P, McPherson, I, Morris, S, Barter, Philip, Keech, AC, Scott, R, Best, J, Forder, P, Taskinen, MR, Simes, J, Barter, P, Colman, P, d'Emden, M, Davis, T, Drury, P, Ehnholm, C, Glasziou, P, Hunt, D, Kesaniemi, YA, Laakso, M, Simes, RJ, Sullivan, D, Whiting, M, Ansquer, JC, Fraitag, B, Anderson, N, Hankey, G, Lehto, S, Mann, S, Romo, M, Li, LP, Hennekens, C, MacMahon, S ; https://orcid.org/0000-0003-2064-7699, Pocock, S, Tonkin, A, Wilhelmsen, L, Akauola, H, Alford, F, Beinart, I, Bohra, S, Boyages, S, Connor, H, Darnell, D, Davoren, P, Lepre, F, De Looze, F, Duffield, A, Fassett, R, Flack, J ; https://orcid.org/0000-0001-6691-0558, Fulcher, G, Grant, S, Hamwood, S, Harmelin, D, Jackson, R, Jeffries, W, Kamp, M, Kritharides, L, Mahar, L, McCann, V, McIntyre, D, Moses, R, Newnham, H, Nicholson, G, O'Brien, R, Park, K, Petrovsky, N, Phillips, P, Pinn, G, Simmons, D, Stanton, K, Stuckey, B, Sullivan, DR, Suranyi, M, Suthers, M, Tan, Y, Templer, M, Topliss, D, Waites, JH, Watts, G, Welborn, T, Wyndham, R, Haapamaki, H, Kesaniemi, A, Lahtela, J, Levanen, H, Saltevo, J, Sodervik, H, Taskinen, M, Vanhala, M, Baker, J, Burton, A, Dixon, P, Doran, J, Dunn, P, Graham, N, Hamer, A, Hedley, J, Lloyd, J, Manning, P, McPherson, I, Morris, S, and Barter, Philip

Abstract

Objective: The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study is examining the effects of long-term fibrate therapy on coronary heart disease (CHD) event rates in patients with diabetes mellitus. This article describes the trial's run-in phase and patients' baseline characteristics. Research design and methods: FIELD is a double-blind, placebo-controlled trial in 63 centres in 3 countries evaluating the effects of fenofibrate versus placebo on CHD morbidity and mortality in 9795 patients with type 2 diabetes mellitus. Patients were to have no indication for lipid-lowering therapy on randomization, but could start these or other drugs at any time after randomization. Follow-up in the study was to be for a median duration of not less than 5 years and until 500 major coronary events (fatal coronary heart disease plus nonfatal myocardial infarction) had occurred. Results: About 2100 patients (22%) had some manifestation of cardiovascular disease (CVD) at baseline and thus high risk status. Less than 25% of patients without CVD had a (UKPDS determined) calculated 5-year CHD risk of <5%, but nearly all had a 5-year stroke risk of <10%. Despite this, half of the cohort were obese (BMI >30), most were men, two-thirds were aged over 60 years, and substantial proportions had NCEP ATP III features of the metabolic syndrome independent of their diabetes, including low HDL (60%), high blood pressure measurement (41%), high waist measurement (65%), and raised triglycerides (52%). After a 6-week run-in period before randomisation with all participants receiving 200 mg comicronized fenofibrate, there were declines in total and LDL cholesterol (10%) and triglycerides (26%) and an increase in HDL cholesterol (6.5%). Conclusion: The study will show the effect of PPAR-alpha agonist action on CHD and other vascular outcomes in patients with type 2 diabetes including substantial numbers with low to moderate CVD risk but with the various components of the metabolic

Published
2005

19. Pure Red Cell Aplasia and Carcinoma

Author

MITCHELL, A. B. S., PINN, G., and PEGRUM, G. D.

Abstract

A patient presented with pure red cell aplasia, which responded to corticosteroids. Thirteen months later, a malignant pleural effusion developed, with subsequent death from adenocarcinomatosis. The reports of cases in which pure red cell aplasia has been associated with carcinomata are reviewed. An autoimmune mechanism can be postulated in these circumstances, and the complete response to corticosteroids in the present case would support this hypothesis.

Published
1971
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20. Which patients benefit from preoperative biliary drainage in resectable pancreatic cancer?

Author

Blacker S, Lahiri RP, Phillips M, Pinn G, Pencavel TD, Kumar R, Riga AT, Worthington TR, Karanjia ND, and Frampton AE

Subjects
Aged, Bilirubin blood, Drainage, Female, Humans, Jaundice, Obstructive blood, Jaundice, Obstructive etiology, Jaundice, Obstructive mortality, Male, Middle Aged, Pancreatic Neoplasms blood, Pancreatic Neoplasms complications, Pancreatic Neoplasms mortality, Preoperative Care mortality, Retrospective Studies, Jaundice, Obstructive surgery, Pancreatic Neoplasms surgery
Abstract

Recent studies have indicated that preoperative biliary drainage (PBD) should not be routinely performed in all patients suffering from obstructive jaundice before pancreatic surgery. The severity of jaundice that mandates PBD has yet to be defined. The evaluated paper examines the impact of PBD on intra-operative, and post-operative outcomes in patients initially presenting with severe obstructive jaundice (bilirubin ≥250 μmol/L). In this key paper evaluation, the impact of PBD versus a direct surgery (DS) approach is discussed. The arguments for and against each approach are considered with regards to drainage associated morbidity and mortality, resection rates, survival and the impact of chemotherapy and malnutrition. Concentrating on resectable head of pancreas tumors, this mini-review aims to scrutinize the authors' recommendations, alongside those of prominent papers in the field.

Published
2021
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21. Herbal medicine in pregnancy.

Author

Pinn G and Pallett L

Subjects
Female, Humans, Patient Education as Topic, Pregnancy, Prenatal Care standards, Self Medication psychology, Surveys and Questionnaires, Attitude to Health, Health Knowledge, Attitudes, Practice, Plants, Medicinal adverse effects, Pregnancy Complications drug therapy, Pregnancy Complications psychology, Self Medication adverse effects
Abstract

The objective of the study was to assess the frequency of alternative medical usage in an antenatal population. A survey of alternative medicine usage was carried out among 305 consecutive patients over 2 months at their registration in mid-pregnancy at an Australian Antenatal Clinic. The study showed that something like 40% of patients used alternative medical therapy, including 12% herbal therapy. No specific study of pregnancy outcome was carried out, but it is of concern that some herbs taken had the potential to adversely affect pregnancy outcome. The herbal therapies commonly used in pregnancy are reviewed with their potential complications; examples of toxicity are also discussed. It is important to obtain a herbal medicine history at any time but particularly in pregnancy. Herbs may have unrecognised effects on pregnancy or labour, have interactions with prescribed medications and have potentially serious complications for the foetus.

Published
2002
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22. Herbs and cardiovascular disease. From past to present.

Author

Pinn G

Subjects
Blood Platelets drug effects, Humans, Phytotherapy, Cardiovascular Diseases therapy, Plants, Medicinal
Abstract

This is the second article in the series on herbal medicine. It reviews historical treatments for heart failure and those drugs which have been developed from plants to treat cardiovascular related problems.

Published
2000

23. Herbal medicine. An overview.

Author

Pinn G

Subjects
Australia, Complementary Therapies standards, Female, Forecasting, Humans, Male, Complementary Therapies trends, Plants, Medicinal
Published
2000

25. Malaria treatment in Queensland.

Author

Pinn G

Subjects
Guideline Adherence, Humans, Malaria, Falciparum prevention & control, Malaria, Vivax prevention & control, Practice Guidelines as Topic, Queensland, Malaria, Falciparum drug therapy, Malaria, Vivax drug therapy
Published
2000
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26. Quinine for cramps.

Author

Pinn G

Subjects
Humans, Male, Middle Aged, Drug Eruptions etiology, Muscle Cramp drug therapy, Muscle Relaxants, Central adverse effects, Purpura, Thrombocytopenic chemically induced, Quinine adverse effects
Abstract

Background: The bark of the cinchona tree was used by the Incas of South America to treat tropical fevers. It was brought back to Europe by the Jesuit priests and used in error to treat all types of fever. Because of its cost and lack of availability, apothecaries found an alternative antipyretic in willow bark. Subsequently salicylates were isolated from willow and quinine from cinchona bark. Quinine is used worldwide for the treatment of fever due to malaria, but in the Western environment has long been used for muscle cramps because of its neuro muscular junction blocking action., Discussion: Quinine is a widely used medication which has been reported to cause thrombocytopenia on occasion. This potentially life threatening complication should be borne in mind when it is prescribed for minor symptoms such as muscle cramps.

Published
1998

27. Alcohol-related cardiomyopathy in the Seychelles.

Author

Pinn G and Bovet P

Subjects
Adult, Alcohol Drinking drug therapy, Cardiomyopathy, Alcoholic drug therapy, Cross-Sectional Studies, Diuretics therapeutic use, Female, Hospitalization, Humans, Male, Medical Records, Middle Aged, Retrospective Studies, Risk Factors, Seychelles epidemiology, Thiamine therapeutic use, Alcohol Drinking epidemiology, Cardiomyopathy, Alcoholic epidemiology
Abstract

Objective: To determine the frequency and features of alcohol-related cardiomyopathy in the Seychelles., Design and Subjects: The study was multifaceted investigation involving: a randomised cross-sectional survey of drinking habits in the general population; a cross-sectional survey of blood alcohol levels in patients admitted to hospital; a prospective case series of all consecutive patients hospitalised with alcohol-related cardiomyopathy; a retrospective review of medical records; and an analysis of volatile oils and trace metals in alcoholic drinks., Setting: Data on drinking habits were obtained from a randomised sample of 1309 adults from the total population of the Seychelles (66,000). All clinical data were obtained from patients in the Victoria Hospital, which is the single reference hospital of the country., Intervention: Hospitalised patients with alcohol-related cardiomyopathy were treated initially with vitamin B1 and/or diuretics., Results: The survey of alcohol habits revealed that 75% of the male population were regular alcohol consumers, with 19% of men consuming more than 100 g of alcohol per day. The estimated annual consumption of alcohol per capita was 26.4 L for men and 3.5 L for women. The survey of blood alcohol levels showed that 28% of male and 13% of female patients had raised alcohol levels at hospital admission. Throughout 1989, 96 patients were diagnosed as having alcohol-related cardiomyopathy and 12 of these had beriberi. The majority of young patients responded with marked diuresis within four hours of a single administration of thiamine. Overall, one-third of all male medical admissions were due to alcohol-related disease. The pathological effects of alcohol consumption were detected in 47% of autopsies and in 20% there was evidence of alcohol-related cardiomyopathy., Conclusions: These findings confirm the high frequency of alcohol-related disease in general and cardiomyopathy in particular.

Published
1991
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