D. Goldberg | Drexel University College of Medicine (original) (raw)

Papers by D. Goldberg

Research paper thumbnail of Logging-while-coring --- First results from ODP Leg 204, Hydrate Ridge

A new logging-while-coring system, jointly by Lamont-Doherty Earth Observatory, Texas A&M Univers... more A new logging-while-coring system, jointly by Lamont-Doherty Earth Observatory, Texas A&M University, and Schlumberger Drilling and Measurements, was deployed and tested during Ocean Drilling Program (ODP) Leg 204 on the Hydrate Ridge off the coast of Oregon. The system consists of a two existing devices modified to be used together - Schlumberger's logging-while-drilling GeoVisionTM resistivity imaging tool and Texas A&M

Research paper thumbnail of Results of the Marine Ice Sheet Model Intercomparison Project, MISMIP

Research paper thumbnail of HIV infection among family planning clinic attenders in Glasgow: why prevalence has remained low in this general population group

Sexually Transmitted Infections, 1998

During 1991-2, unlinked anonymous testing of dried blood spots from neonatal metabolic screening ... more During 1991-2, unlinked anonymous testing of dried blood spots from neonatal metabolic screening cards showed the prevalence of HIV among childbearing women from Glasgow to be extremely low at 0.01%. A study was conducted to determine if non-pregnant sexually active women who engaged in unprotected sexual intercourse were more likely to be infected than those who were pregnant. Unlinked anonymous HIV testing of urine specimens submitted by attenders of the family planning clinic in Glasgow for pregnancy testing. Of 11,990 urine specimens tested, 7664 were from women with a negative pregnancy test and two of these were HIV positive (0.026%); none of the remainder from those with a positive pregnancy test had HIV antibodies. No hidden epidemic was unearthed among a population which had engaged in unprotected sexual intercourse and was not pregnant. Other data from Glasgow strongly suggest that the control of HIV transmission among the city's population of current injectors (HIV prevalence, 1% of 8500) has prevented the spread of infection into its wider heterosexual population. It is essential that preventive measures which have been responsible for this public health success should be maintained.

Research paper thumbnail of The benefits and costs of continuous inspections: At what point does patient care suffer?

Psychiatric Bulletin, 2002

Research paper thumbnail of Percutaneous liver biopsy post-fontan operation: a single pediatric institutional experience

Journal of Vascular and Interventional Radiology, 2014

Research paper thumbnail of Combined erbium:YAG and low-fluence carbon dioxide (CO2) laser resurfacing

Journal of the European Academy of Dermatology and Venereology, 1998

Research paper thumbnail of Mitochondrial respiration following acute hypoxia in the perfused rat heart

Journal of Molecular and Cellular Cardiology, 1985

  1. 17, 71 81. Mitochondria isolated from tissues of hypoxic animals have increased respiratory... more 1985) 17, 71 81. Mitochondria isolated from tissues of hypoxic animals have increased respiratory capacity (State 3 respiration) when assayed in vitro at ambient oxygen tensions. The present study utilized the isolated perfused rat heart to determine whether or not this change could be produced in the absence of the neural and hormonal changes that accompany hypoxia in vivo. Following 10-rain single pass retrograde perfusion with normoxic Krebs Henseleit buffer (Po 2 _ 600 mmHg), perfusion was continued for up to 15 min with either normoxic or hypoxic buffer (Po 2 _< 150 mmHg). After 10 min of hypoxic perfusion State 3 respiration of the mitochondria from the hypoxic hearts was 13 to 15% higher (P _< 0.05) than that of normoxic hearts when assayed with either glutamate/malate or succinate as substrate but was unchanged when TMPD and ascorbate was the substrate. Succinate-supported State 4 respiration of the hypoxic mitochondria also showed a small (10%) but significant (P _< 0.05) increase. These changes were not abolished by preperfusing the heart with propranolol ( 10-7, 10-6, or 10-5 M) indicating that the response was not attributable to release of local stores of catecholamines. Respiratory control and ADP/O ratios as well as contents of cytochrome c and aa a of the mitochondria from the hypoxic hearts were similar to those ofnormoxic hearts indicating that the mitochondria remained intact and tightly coupled. We concluded that the hypoxia-induced increase in mitochondrial State 3 respiration, while independent of neural and hormonal influences from the body requires an intracellular event, since they cannot by reproduced by subjecting isolated nfitochondria to hypoxia in vitro.

Research paper thumbnail of Dynamic clinical studies with radioisotopes and the scintillation camera. I. Sodium iodohippurate I-131 renography

JAMA: The Journal of the American Medical Association, 1966

Abstract The scintillation camera has been employed for dynamic liver function studies with rose ... more Abstract The scintillation camera has been employed for dynamic liver function studies with rose bengal I 131. This approach permits constant visual monitoring of hepatic uptake of labeled dye from the circulation and its excretion into the biliary tree and intestine. The ...

Research paper thumbnail of Cerebral basis of psychopathology

International Journal of Psychophysiology, 1987

Research paper thumbnail of Cloning of FSHβ, LHβ, and glycoprotein α subunits from the Russian Sturgeon (Acipenser gueldenstaedtii), β-subunit mRNA expression, gonad development, and steroid levels in immature fish

General and Comparative Endocrinology, 2005

The Russian sturgeon, Acipenser gueldenstaedtii, is a late-maturing Acipenseriformes. To elucidat... more The Russian sturgeon, Acipenser gueldenstaedtii, is a late-maturing Acipenseriformes. To elucidate the role of FSH and LH in its reproduction, we cloned its glycoprotein a-subunit (GPa) and gonadotropin b-subunits (FSHb and LHb) using 5 0 and 3 0 RACE-PCR. The nucleotide sequences of the Russian sturgeon (st) GPa, FSHb, and LHb are 345, 384, and 411 bp long, encoding peptides of 91, 115, and 114 amino acids, respectively. The deduced amino acid sequence of each mature subunit showed high similarity with those of other teleosts. Sequence analysis showed that stFSHb is more similar to higher vertebrate FSHbs (35-37%) than to higher vertebrate LHbs (26-30%). The next objective of this work was to compare the development of sturgeon gonads at the very first stages of their growth with the expression of their gonadotropins. Sturgeons at ages 1, 2, 3 or 4 years were sacrificed. The expression of their gonadotropin b-subunits was determined using quantitative real-time PCR, and their gonads were examined histologically, followed by a determination of the plasma levels of estradiol in females and 11-ketotestosterone (11-KT) in males. The expression levels of stFSHb subunit was found to be higher in fish at 3 and 4 years of age than in 1-year olds. mRNA levels of stLHb were higher than those of stFSHb in both genders. Moreover mRNA levels of stFSHb detected in females were significantly higher than those found in males. Even at age 4 years, all female Russian sturgeons tested contained gonads at the pre-vitellogenic stage, with small oocytes and very low levels of estradiol in the plasma. However, among the males, at ages 3 and 4 years, we found testes that contained spermatids and spermatozoa. Those males were found to have significantly high GSI (gonadosomatic index; gonadal weight as a percentage of BW) levels, stLHb expression and 11-KT levels.

Research paper thumbnail of Cloning of European eel (Anguilla anguilla) FSH-β subunit, and expression of FSH-β and LH-β in males and females after sex determination

Comparative Biochemistry and Physiology Part B: Biochemistry and Molecular Biology, 2003

The European eel (Anguilla anguilla) is a catadromic teleost species with a complex life cycle, b... more The European eel (Anguilla anguilla) is a catadromic teleost species with a complex life cycle, both in sea and freshwater environments. The sex determination phase of gonadal development occurs in a freshwater environment. Polymorphism occurs in increasing rates with respect to gender. While males stop growing at approximately 150 g, females continue to grow to being much larger. In this study, we cloned the cDNA FSH-b subunit of the European eel (A. anguilla), and measured the mRNA levels of FSH-b and LH-b in males and females after sex determination. The FSH-b subunit cDNA consisted of 1068 bp, encoding a 127 amino acid peptide. A comparison between European and Japanese eels of the FSH-b amino acid sequence showed 98% similarity. ᮊ

Research paper thumbnail of Long‐Term Probability of Detecting Drug‐Resistant HIV in Treatment‐Naive Patients Initiating Combination Antiretroviral Therapy

Clinical Infectious Diseases, 2010

Robust long-term estimates of the risk of development of drug resistance are needed for human imm... more Robust long-term estimates of the risk of development of drug resistance are needed for human immunodeficiency virus (HIV)-infected patients starting combination antiretroviral therapy (cART) regimens currently used in routine clinical practice. We followed a large cohort of patients seen in 1 of 11 HIV clinics in the United Kingdom after starting cART with nucleoside reverse-transcriptase inhibitors and either a nonnucleoside reverse-transcriptase inhibitor (NNRTI) or a ritonavir-boosted protease inhibitor (PI/r). Survival analysis was employed to estimate the incidence of virological failure and of detected drug resistance. Seven thousand eight hundred ninety-one patients were included; 6448 (82%) started cART with an NNRTI and 1423 (17%) with a PI/r. The cumulative risk of virological failure by 8 years was 28%. The cumulative probabilities of detecting any mutation, &gt; or =1 major nucleoside reverse-transcriptase inhibitor International AIDS Society-United States of America (IAS-USA) mutation, &gt; or =1 major NNRTI IAS-USA mutation (in those starting an NNRTI), and &gt; or =1 major PI IAS-USA mutation (in those starting a PI) were 17%, 14%, 15%, and 7%, respectively, by 8 years. The probability of detecting PI mutations in people who started PI/r-based regimens was lower than that of detecting NNRTI mutations in those starting NNRTI-based regimens (adjusted relative hazard, 0.36; 95% confidence interval, 0.26-0.50; P&lt;.001). The risk of detecting nucleoside resistance did not vary according to whether an NNRTI or a PI/r was used in the regimen (adjusted relative hazard, 1.00; 95% confidence interval, 0.80-1.26; P=.98). In patients who started modern cART in clinical practice in the United Kingdom, virological failure by 8 years was relatively common and was paralleled by an appreciable risk of resistance detection, although the detection rate of class-specific resistance was lower for those who started a PI/r-based regimen.

Research paper thumbnail of Use of the general health questionnaire in clinical work

BMJ, 1986

Questionnaires have been used many-times to detect psychiatric illness in general medical setting... more Questionnaires have been used many-times to detect psychiatric illness in general medical settings, with most. studies emphasising that a substantial proportion of people shown to have a psychiatric illness usinga research interview had not always been thought to be "eases" ...

Research paper thumbnail of Distinguishing mental illness in primary care

Research paper thumbnail of Vertically transmitted HIV infection in the British Isles

Research paper thumbnail of Active surveillance of hepatitis C infection in the UK and Ireland

Archives of Disease in Childhood, 2000

Aim-To investigate the prevalence, distribution, and clinical details of paediatric hepatitis C v... more Aim-To investigate the prevalence, distribution, and clinical details of paediatric hepatitis C virus (HCV) infection in the UK and Ireland. Methods-Active monthly surveillance questionnaire study coordinated through the British Paediatric Surveillance Unit, to all consultant paediatricians in 1997 and 1998. Results-A total of 182 HCV infected children were reported from 54 centres and by paediatricians from eight diVerent specialties. In 40 children HCV was acquired through mother to child transmission (MTC children); 142 were infected by contaminated blood products (n = 134), organ transplantation (n = 2), needles (n = 4), or unknown risk factor (n = 2). Intravenous drug use was the risk factor for 35 mothers of MTC children. Twelve children were coinfected with HIV and four with HBV. Recent serum aspartate aminotransferase or alanine aminotransferase values were at least twofold greater than the upper limit of normal in 24 of 152 children; this occurred in five of 11 HIV coinfected children. Liver histology, available in 53 children, showed normal (7%), mild (74%), moderate (17%), or severe (2%) hepatitis. Twenty eight children had received therapy with interferon alfa.

Research paper thumbnail of Prevalence of injecting drug use provides the context for epidemiology of HIV among injecting drug users

Research paper thumbnail of Selective versus universal antenatal HIV testing: epidemiological and implementational factors in policy choice

AIDS, 1999

To develop an epidemiological basis for economic analyses of selective and universal antenatal sc... more To develop an epidemiological basis for economic analyses of selective and universal antenatal screening strategies, and to apply it to the UK. The prevalence of higher-risk women and the prevalence of undiagnosed infection within groups of high-risk and low-risk women was estimated from surveillance and survey data. The numbers of women tested and the numbers of infected women who would be identified by universal and selective strategies were then calculated under a range of assumptions about the identification of higher-risk women and acceptance of testing. In higher-risk women estimated prevalence of undiagnosed infection was between 0.06% and 2.8%, comparing well with independent estimates. In low-risk women, estimates ranged from 0.014% in London to 0.002% in the rest of the UK. If uptake among the high-risk women was the same in selective and universal strategies, universal testing would entail testing between 7100 (London) and 50000 (rest of England) additional women to detect an additional case. However, if selective screening identified only 60% of those at high risk and achieved only 60% acceptance compared with a universal programme, then universal screening would require only 1150 additional women to identify one additional case in London, compared to 6470 in Scotland and 13140 in the rest of the UK. Overall prevalence does not form an adequate basis for determining screening strategy. Instead, universal screening can be justified either because the prevalence of HIV in the low-risk group is sufficiently high, or because it achieves sufficiently higher uptake relative to selective screening among those at higher risk.

Research paper thumbnail of A User's Guide to the General Health Questionnaire

Research paper thumbnail of Restoration of accommodation: new perspectives

Arquivos Brasileiros de Oftalmologia, 2014

Research paper thumbnail of Logging-while-coring --- First results from ODP Leg 204, Hydrate Ridge

A new logging-while-coring system, jointly by Lamont-Doherty Earth Observatory, Texas A&M Univers... more A new logging-while-coring system, jointly by Lamont-Doherty Earth Observatory, Texas A&M University, and Schlumberger Drilling and Measurements, was deployed and tested during Ocean Drilling Program (ODP) Leg 204 on the Hydrate Ridge off the coast of Oregon. The system consists of a two existing devices modified to be used together - Schlumberger's logging-while-drilling GeoVisionTM resistivity imaging tool and Texas A&M

Research paper thumbnail of Results of the Marine Ice Sheet Model Intercomparison Project, MISMIP

Research paper thumbnail of HIV infection among family planning clinic attenders in Glasgow: why prevalence has remained low in this general population group

Sexually Transmitted Infections, 1998

During 1991-2, unlinked anonymous testing of dried blood spots from neonatal metabolic screening ... more During 1991-2, unlinked anonymous testing of dried blood spots from neonatal metabolic screening cards showed the prevalence of HIV among childbearing women from Glasgow to be extremely low at 0.01%. A study was conducted to determine if non-pregnant sexually active women who engaged in unprotected sexual intercourse were more likely to be infected than those who were pregnant. Unlinked anonymous HIV testing of urine specimens submitted by attenders of the family planning clinic in Glasgow for pregnancy testing. Of 11,990 urine specimens tested, 7664 were from women with a negative pregnancy test and two of these were HIV positive (0.026%); none of the remainder from those with a positive pregnancy test had HIV antibodies. No hidden epidemic was unearthed among a population which had engaged in unprotected sexual intercourse and was not pregnant. Other data from Glasgow strongly suggest that the control of HIV transmission among the city&#39;s population of current injectors (HIV prevalence, 1% of 8500) has prevented the spread of infection into its wider heterosexual population. It is essential that preventive measures which have been responsible for this public health success should be maintained.

Research paper thumbnail of The benefits and costs of continuous inspections: At what point does patient care suffer?

Psychiatric Bulletin, 2002

Research paper thumbnail of Percutaneous liver biopsy post-fontan operation: a single pediatric institutional experience

Journal of Vascular and Interventional Radiology, 2014

Research paper thumbnail of Combined erbium:YAG and low-fluence carbon dioxide (CO2) laser resurfacing

Journal of the European Academy of Dermatology and Venereology, 1998

Research paper thumbnail of Mitochondrial respiration following acute hypoxia in the perfused rat heart

Journal of Molecular and Cellular Cardiology, 1985

  1. 17, 71 81. Mitochondria isolated from tissues of hypoxic animals have increased respiratory... more 1985) 17, 71 81. Mitochondria isolated from tissues of hypoxic animals have increased respiratory capacity (State 3 respiration) when assayed in vitro at ambient oxygen tensions. The present study utilized the isolated perfused rat heart to determine whether or not this change could be produced in the absence of the neural and hormonal changes that accompany hypoxia in vivo. Following 10-rain single pass retrograde perfusion with normoxic Krebs Henseleit buffer (Po 2 _ 600 mmHg), perfusion was continued for up to 15 min with either normoxic or hypoxic buffer (Po 2 _< 150 mmHg). After 10 min of hypoxic perfusion State 3 respiration of the mitochondria from the hypoxic hearts was 13 to 15% higher (P _< 0.05) than that of normoxic hearts when assayed with either glutamate/malate or succinate as substrate but was unchanged when TMPD and ascorbate was the substrate. Succinate-supported State 4 respiration of the hypoxic mitochondria also showed a small (10%) but significant (P _< 0.05) increase. These changes were not abolished by preperfusing the heart with propranolol ( 10-7, 10-6, or 10-5 M) indicating that the response was not attributable to release of local stores of catecholamines. Respiratory control and ADP/O ratios as well as contents of cytochrome c and aa a of the mitochondria from the hypoxic hearts were similar to those ofnormoxic hearts indicating that the mitochondria remained intact and tightly coupled. We concluded that the hypoxia-induced increase in mitochondrial State 3 respiration, while independent of neural and hormonal influences from the body requires an intracellular event, since they cannot by reproduced by subjecting isolated nfitochondria to hypoxia in vitro.

Research paper thumbnail of Dynamic clinical studies with radioisotopes and the scintillation camera. I. Sodium iodohippurate I-131 renography

JAMA: The Journal of the American Medical Association, 1966

Abstract The scintillation camera has been employed for dynamic liver function studies with rose ... more Abstract The scintillation camera has been employed for dynamic liver function studies with rose bengal I 131. This approach permits constant visual monitoring of hepatic uptake of labeled dye from the circulation and its excretion into the biliary tree and intestine. The ...

Research paper thumbnail of Cerebral basis of psychopathology

International Journal of Psychophysiology, 1987

Research paper thumbnail of Cloning of FSHβ, LHβ, and glycoprotein α subunits from the Russian Sturgeon (Acipenser gueldenstaedtii), β-subunit mRNA expression, gonad development, and steroid levels in immature fish

General and Comparative Endocrinology, 2005

The Russian sturgeon, Acipenser gueldenstaedtii, is a late-maturing Acipenseriformes. To elucidat... more The Russian sturgeon, Acipenser gueldenstaedtii, is a late-maturing Acipenseriformes. To elucidate the role of FSH and LH in its reproduction, we cloned its glycoprotein a-subunit (GPa) and gonadotropin b-subunits (FSHb and LHb) using 5 0 and 3 0 RACE-PCR. The nucleotide sequences of the Russian sturgeon (st) GPa, FSHb, and LHb are 345, 384, and 411 bp long, encoding peptides of 91, 115, and 114 amino acids, respectively. The deduced amino acid sequence of each mature subunit showed high similarity with those of other teleosts. Sequence analysis showed that stFSHb is more similar to higher vertebrate FSHbs (35-37%) than to higher vertebrate LHbs (26-30%). The next objective of this work was to compare the development of sturgeon gonads at the very first stages of their growth with the expression of their gonadotropins. Sturgeons at ages 1, 2, 3 or 4 years were sacrificed. The expression of their gonadotropin b-subunits was determined using quantitative real-time PCR, and their gonads were examined histologically, followed by a determination of the plasma levels of estradiol in females and 11-ketotestosterone (11-KT) in males. The expression levels of stFSHb subunit was found to be higher in fish at 3 and 4 years of age than in 1-year olds. mRNA levels of stLHb were higher than those of stFSHb in both genders. Moreover mRNA levels of stFSHb detected in females were significantly higher than those found in males. Even at age 4 years, all female Russian sturgeons tested contained gonads at the pre-vitellogenic stage, with small oocytes and very low levels of estradiol in the plasma. However, among the males, at ages 3 and 4 years, we found testes that contained spermatids and spermatozoa. Those males were found to have significantly high GSI (gonadosomatic index; gonadal weight as a percentage of BW) levels, stLHb expression and 11-KT levels.

Research paper thumbnail of Cloning of European eel (Anguilla anguilla) FSH-β subunit, and expression of FSH-β and LH-β in males and females after sex determination

Comparative Biochemistry and Physiology Part B: Biochemistry and Molecular Biology, 2003

The European eel (Anguilla anguilla) is a catadromic teleost species with a complex life cycle, b... more The European eel (Anguilla anguilla) is a catadromic teleost species with a complex life cycle, both in sea and freshwater environments. The sex determination phase of gonadal development occurs in a freshwater environment. Polymorphism occurs in increasing rates with respect to gender. While males stop growing at approximately 150 g, females continue to grow to being much larger. In this study, we cloned the cDNA FSH-b subunit of the European eel (A. anguilla), and measured the mRNA levels of FSH-b and LH-b in males and females after sex determination. The FSH-b subunit cDNA consisted of 1068 bp, encoding a 127 amino acid peptide. A comparison between European and Japanese eels of the FSH-b amino acid sequence showed 98% similarity. ᮊ

Research paper thumbnail of Long‐Term Probability of Detecting Drug‐Resistant HIV in Treatment‐Naive Patients Initiating Combination Antiretroviral Therapy

Clinical Infectious Diseases, 2010

Robust long-term estimates of the risk of development of drug resistance are needed for human imm... more Robust long-term estimates of the risk of development of drug resistance are needed for human immunodeficiency virus (HIV)-infected patients starting combination antiretroviral therapy (cART) regimens currently used in routine clinical practice. We followed a large cohort of patients seen in 1 of 11 HIV clinics in the United Kingdom after starting cART with nucleoside reverse-transcriptase inhibitors and either a nonnucleoside reverse-transcriptase inhibitor (NNRTI) or a ritonavir-boosted protease inhibitor (PI/r). Survival analysis was employed to estimate the incidence of virological failure and of detected drug resistance. Seven thousand eight hundred ninety-one patients were included; 6448 (82%) started cART with an NNRTI and 1423 (17%) with a PI/r. The cumulative risk of virological failure by 8 years was 28%. The cumulative probabilities of detecting any mutation, &gt; or =1 major nucleoside reverse-transcriptase inhibitor International AIDS Society-United States of America (IAS-USA) mutation, &gt; or =1 major NNRTI IAS-USA mutation (in those starting an NNRTI), and &gt; or =1 major PI IAS-USA mutation (in those starting a PI) were 17%, 14%, 15%, and 7%, respectively, by 8 years. The probability of detecting PI mutations in people who started PI/r-based regimens was lower than that of detecting NNRTI mutations in those starting NNRTI-based regimens (adjusted relative hazard, 0.36; 95% confidence interval, 0.26-0.50; P&lt;.001). The risk of detecting nucleoside resistance did not vary according to whether an NNRTI or a PI/r was used in the regimen (adjusted relative hazard, 1.00; 95% confidence interval, 0.80-1.26; P=.98). In patients who started modern cART in clinical practice in the United Kingdom, virological failure by 8 years was relatively common and was paralleled by an appreciable risk of resistance detection, although the detection rate of class-specific resistance was lower for those who started a PI/r-based regimen.

Research paper thumbnail of Use of the general health questionnaire in clinical work

BMJ, 1986

Questionnaires have been used many-times to detect psychiatric illness in general medical setting... more Questionnaires have been used many-times to detect psychiatric illness in general medical settings, with most. studies emphasising that a substantial proportion of people shown to have a psychiatric illness usinga research interview had not always been thought to be "eases" ...

Research paper thumbnail of Distinguishing mental illness in primary care

Research paper thumbnail of Vertically transmitted HIV infection in the British Isles

Research paper thumbnail of Active surveillance of hepatitis C infection in the UK and Ireland

Archives of Disease in Childhood, 2000

Aim-To investigate the prevalence, distribution, and clinical details of paediatric hepatitis C v... more Aim-To investigate the prevalence, distribution, and clinical details of paediatric hepatitis C virus (HCV) infection in the UK and Ireland. Methods-Active monthly surveillance questionnaire study coordinated through the British Paediatric Surveillance Unit, to all consultant paediatricians in 1997 and 1998. Results-A total of 182 HCV infected children were reported from 54 centres and by paediatricians from eight diVerent specialties. In 40 children HCV was acquired through mother to child transmission (MTC children); 142 were infected by contaminated blood products (n = 134), organ transplantation (n = 2), needles (n = 4), or unknown risk factor (n = 2). Intravenous drug use was the risk factor for 35 mothers of MTC children. Twelve children were coinfected with HIV and four with HBV. Recent serum aspartate aminotransferase or alanine aminotransferase values were at least twofold greater than the upper limit of normal in 24 of 152 children; this occurred in five of 11 HIV coinfected children. Liver histology, available in 53 children, showed normal (7%), mild (74%), moderate (17%), or severe (2%) hepatitis. Twenty eight children had received therapy with interferon alfa.

Research paper thumbnail of Prevalence of injecting drug use provides the context for epidemiology of HIV among injecting drug users

Research paper thumbnail of Selective versus universal antenatal HIV testing: epidemiological and implementational factors in policy choice

AIDS, 1999

To develop an epidemiological basis for economic analyses of selective and universal antenatal sc... more To develop an epidemiological basis for economic analyses of selective and universal antenatal screening strategies, and to apply it to the UK. The prevalence of higher-risk women and the prevalence of undiagnosed infection within groups of high-risk and low-risk women was estimated from surveillance and survey data. The numbers of women tested and the numbers of infected women who would be identified by universal and selective strategies were then calculated under a range of assumptions about the identification of higher-risk women and acceptance of testing. In higher-risk women estimated prevalence of undiagnosed infection was between 0.06% and 2.8%, comparing well with independent estimates. In low-risk women, estimates ranged from 0.014% in London to 0.002% in the rest of the UK. If uptake among the high-risk women was the same in selective and universal strategies, universal testing would entail testing between 7100 (London) and 50000 (rest of England) additional women to detect an additional case. However, if selective screening identified only 60% of those at high risk and achieved only 60% acceptance compared with a universal programme, then universal screening would require only 1150 additional women to identify one additional case in London, compared to 6470 in Scotland and 13140 in the rest of the UK. Overall prevalence does not form an adequate basis for determining screening strategy. Instead, universal screening can be justified either because the prevalence of HIV in the low-risk group is sufficiently high, or because it achieves sufficiently higher uptake relative to selective screening among those at higher risk.

Research paper thumbnail of A User's Guide to the General Health Questionnaire

Research paper thumbnail of Restoration of accommodation: new perspectives

Arquivos Brasileiros de Oftalmologia, 2014