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Studies on filariasis in Malaya; the clinical features of filariasis due to Wuchereria malayi

TURNER LH

Trans R Soc Trop Med Hyg, 1959 Mar;53(2):154-69.

Studies on filariasis in Malaya: treatment of Wuchereria malayi filariasis with diethylcarbamazine in single daily doses

TURNER LH

Ann Trop Med Parasitol, 1959 Jun;53:180-8.

PMID: 13839951

Studies on filariasis in Malaya: a trial mass treatment of Wuchereria malayi filariasis with single daily doses of diethylcarbamazine

TURNER LH, SODHY LS

Ann Trop Med Parasitol, 1959 Sep;53:268-73.

PMID: 13839949

Fulltext The effect of pH on the survival of leptospires in water

Smith CE, Turner LH

Bull World Health Organ, 1961;24(1):35-43.

PMID: 20604084

One of the factors on which the incidence of leptospirosis is dependent is the survival time of shed leptospires in surface water or soil water, and this time is in turn affected by the acidity or alkalinity of the water. The authors have therefore studied the survival of four leptospiral serotypes in buffered distilled water at pH's ranging from 5.3 to 8.0. All survived longer in alkaline than in acid water, and significant differences between the serotypes were found in response to pH. Survival at pH's under 7.0 ranged from 10 to 117 days and at pH's over 7.0 from 21 to 152 days. Survival was also studied in aqueous extracts of soil samples from different areas in Malaya; no correlation was found between pH and survival time.It was also noted that in a group of Malayan ricefields a low incidence of leptospirosis in man was accompanied by a high infection rate among rodents, and when it was found that this phenomenon could not be explained by pH or salinity, attention was turned to the soil. Bentonite clay, similar to the montmorrillonite clay of the ricefields, was found to adsorb about half the leptospires in suspension. The authors recommend that field study of this laboratory observation be undertaken.

Studies on filariasis in Malaya: the periodicity of the microfilariae of Wuchereria malayi

TURNER LH, EDESON JF

Ann Trop Med Parasitol, 1957 Sep;51(3):271-7.

PMID: 13470766

Fulltext Yellow fever vaccination in Malaya by subcutaneous injection and multiple puncture. Neutralizing antibody responses in persons with and without pre-existing antibody to related viruses

Gordon Smith CE, Turner LH, Armitage P

Bull World Health Organ, 1962;27:717-27.

PMID: 13993152

Because of the risk of introduction of yellow fever to South-East Asia, comparative studies were made of yellow fever vaccination in Malayans who had a high prevalence of antibody to related viruses and in volunteers without related antibody. The proportions of positive neutralizing antibody responses to subcutaneous vaccination with 17D vaccine were not significantly different between volunteers with and without heterologous antibody but the degree of antibody response was greater in those without. The ID(50) of 17D in both groups was about 5 mouse intracerebral LD(50). Multiple puncture vaccination with 17D gave a much lower response rate than subcutaneous vaccination in volunteers with heterologous antibody. In both groups subcutaneous doses of about 50 mouse intracerebral LD(50) gave larger antibody responses than higher doses. The neutralizing indices and analysis of results were calculated by a method based on the survival time of the mice. This method, which has advantages over that of Reed & Muench, is fully described in an annex to this paper.

Studies on the chemotherapy of malaria. V. The suppression of malaria by amodiaquin (camoquin)

EDESON JF, TURNER LH, LAING AB

Med J Malaya, 1955 Jun;9(4):260-4.

PMID: 13253125

Acute febrile illnesses in Malaya: leptospirosis

TURNER LH, ELISBERG BL, SMITH CE, BROOM JC

Med J Malaya, 1959 Dec;14:83-98.

PMID: 13839948

Studies on the chemotherapy of malaria. IV. The treatment of acute malaria with amodiaquin (camoquin)

EDESON JF, WILSON T, TURNER LH, LAING AB

Med J Malaya, 1955 Jun;9(4):252-9.

PMID: 13253124

Fulltext Yellow fever vaccination in Malaya by subcutaneous injection and multiple puncture. Haemagglutinin-inhibiting antibody responses in persons with and without pre-existing antibody

Gordon Smith CE, McMahon DA, Turner LH

Bull World Health Organ, 1963;29:75-80.

PMID: 14043754

In view of the risk of introduction of yellow fever into South-East Asia, comparative studies have been made of yellow fever vaccination in Malayan volunteers with a high prevalence of antibody to related viruses and in volunteers without related antibody. In a previous paper the neutralizing antibody responses of these volunteers were reported. The present paper describes the haemagglutinin-inhibiting (HI) antibody responses of the same groups of volunteers and discusses the relationship of these responses to the neutralizing antibody responses.The HI responses to yellow fever following vaccination closely paralleled the neutralizing antibody responses whether vaccination was subcutaneous or by multiple puncture. Volunteers with a high level of YF HI antibody due to infection with other group B viruses were found to be less likely to show a significant YF HI response than those without antibody. 90% of HI responses could be detected by the 21st day after vaccination.As with neutralizing antibody responses, volunteers given vaccine doses of 50-500 mouse intracerebral LD(50) subcutaneously gave greater responses than those given higher doses.

Fulltext Animal leptospirosis in Malaya: 3. Incidence in rats by sex, weight and age

Gordon Smith CE, Turner LH, Harrison JL, Broom JC

Bull World Health Organ, 1961;24(6):807-16.

PMID: 20604093

In previous papers it has been demonstrated that ground-dwelling rats are the principal reservoir of leptospirosis in Malaya. The present paper considers the distribution of infection by sex and weight in the ten principal rat species. There appears to be a general tendency for females to be infected more frequently than males, but significant differences were demonstrated only in R. sabanus (more than three times as many females as males infected) and R. whiteheadi. In Malaya, where seasonal changes are minimal, weights can be used as a good index of age in rats. In rat species with a low incidence of infection the incidence appeared to rise steadily with age. In species with a medium incidence the infection rate rose at first with age, fell in the 6-8-month age-group, and then rose again. In high-incidence species the rate rose rapidly from the second month.There appear to be three types of enzootic infection; (1) intensive transmission of a single serogroup in a crowded population of rats of a single species (transmission probably being through urinary contamination of damp soil); (2) low-intensity transmission of several serogroups among ground-rats frequenting wet places (probably with urinary transmission); and (3) low-intensity transmission of several serogroups among ground-rats in dry places (the transmission may be venereal).

Fulltext Animal leptospirosis in Malaya: 1. Methods, zoogeographical background, and broad analysis of results

Smith CE, Turner LH, Harrison JL, Broom JC

Bull World Health Organ, 1961;24(1):5-21.

PMID: 20604085

In recent years leptospirosis has been shown to be an important cause of human febrile illness in Malaya. Studies were therefore undertaken to determine its animal reservoirs and the factors influencing spread of infection from them to man and domestic animals. This paper presents the board picture obtained. A wide range of animal species were trapped in forest localities, ricefield areas, areas of scrub and cultivation and in several towns and villages. The maintenance hosts of leptospirosis in Malaya appear to be mainly or entirely rats, although evidence of infection has been found throughout the animal kingdom. Some rat species have characteristics which suggest that they are better maintenance hosts than others. Evidence was found of practically every serogroup of leptospires infecting animals in Malaya. Altogether 104 strains were isolated and identified, and 155 animals were found to have serological evidence of infection. Of 1763 rodents examined, 194 had evidence of infection, and 41 of 1083 other animals. A serum survey of domestic animals showed the highest incidence of antibodies to be in goats and the lowest in oxen.

Fulltext Animal leptospirosis in Malaya: 2. Localities sampled

Smith CE, Turner LH, Harrison JL, Broom JC

Bull World Health Organ, 1961;24(1):23-34.

PMID: 20604083

In a previous paper the authors reported on the methods and zoogeographical background of a survey of animal leptospirosis in Malaya, giving a broad analysis of results. In the present paper the localities studied in towns and villages, in ricefields, in secondary forest and scrub and in primary forest are compared in detail. In towns and villages infection rates in rats were low, except in a seaport town where the invading R. norvegicus was heavily infected. In ricefields infection is maintained in R. argentiventer, alone or in association with R. exulans. In secondary forest and scrub there is overlap with forest species and the main hosts of leptospires appear to be R. exulans and R. jalorensis. In primary forest giant rats and, to a lesser degree, spiny rats are the main hosts.Ground-living rats appear to be better maintenance hosts than those scrambling on vegetation or arboreal rats. With some exceptions the incidence of infection of a rat species in an area was found to be in direct relation to the proportion that species formed of the total rat population. The critical number of rats for maintenance of leptospirosis in an area is estimated to be about two rats of the maintenance species per hectare.

Pharmacokinetic-pharmacodynamic study of subcutaneous injection of depot nandrolone decanoate using dried blood spots sampling coupled with ultrapressure liquid chromatography tandem mass spectrometry assays

Singh GK, Turner L, Desai R, Jimenez M, Handelsman DJ

J Clin Endocrinol Metab, 2014 Jul;99(7):2592-8.

PMID: 24684468 DOI: 10.1210/jc.2014-1243

Testosterone (T) and nandrolone (N) esters require deep im injections by medical personnel but these often deposit injectate into sc fat so that more convenient sc self-administration may be feasible.

Fulltext Pharmacokinetics and Acceptability of Subcutaneous Injection of Testosterone Undecanoate

Turner L, Ly LP, Desai R, Singh GKS, Handelsman TD, Savkovic S, et al.

J Endocr Soc, 2019 Aug 01;3(8):1531-1540.

PMID: 31384715 DOI: 10.1210/js.2019-00134

Context: Can injectable testosterone undecanoate (TU) be administered effectively and acceptably by the subcutaneous (SC) route?

Objective: To investigate the acceptability and pharmacokinetics (PK) of SC injection of TU.

Design: Randomized sequence, crossover clinical study of SC vs IM TU injections.

Setting: Ambulatory clinic of an academic andrology center.

Participants: Twenty men (11 hypogonadal, 9 transgender men) who were long-term users of TU. injections. Intervention: Injection of 1000 mg TU (in 4 mL castor oil vehicle) by SC or IM route. Main Outcome Measures: Patient-reported pain, acceptability, and preference scales. PK by measurement of serum testosterone, dihydrotestosterone (DHT), and estradiol (E2) concentrations with application of population PK methods and dried blood spot (DBS) sampling.

Results: Pain was greater after SC compared with IM injection 24 hours (but not immediately) after injection but both routes were equally acceptable. Ultimately 11 preferred IM, 6 preferred SC, and 3 had no preference. The DBS-based PK analysis of serum testosterone revealed a later time of peak testosterone concentration after SC vs IM injection (8.0 vs 3.3 days) but no significant route differences in model-predicted peak testosterone concentration (8.4 vs 9.6 ng/mL) or mean resident time (183 vs 110 days). The PK of venous serum testosterone, DHT, and E2 did not differ according to route of injection.

Conclusions: We conclude that SC TU injection is acceptable but produces greater pain 24 hours after injection that may contribute to the overall majority preference for the IM injection. The PK of testosterone, DHT, or E2 did not differ substantially between SC and IM routes. Hence whereas further studies are required, the SC route represents an alternative to IM injections without a need to change dose for men for whom IM injection is not desired or recommended.

Leptospirosis in Malaya. I. Sporadic cases among military and civilian personnel

MCCRUMB FR, STOCKARD JL, ROBINSON CR, TURNER LH, LEVIS DG, MAISEY CW, et al.

Am J Trop Med Hyg, 1957 Mar;6(2):238-56.

PMID: 13424900

Fulltext Developing a digital intervention for cancer survivors: an evidence-, theory- and person-based approach

Bradbury K, Steele M, Corbett T, Geraghty AWA, Krusche A, Heber E, et al.

NPJ Digit Med, 2019;2:85.

PMID: 31508496 DOI: 10.1038/s41746-019-0163-4

This paper illustrates a rigorous approach to developing digital interventions using an evidence-, theory- and person-based approach. Intervention planning included a rapid scoping review that identified cancer survivors' needs, including barriers and facilitators to intervention success. Review evidence (N = 49 papers) informed the intervention's Guiding Principles, theory-based behavioural analysis and logic model. The intervention was optimised based on feedback on a prototype intervention through interviews (N = 96) with cancer survivors and focus groups with NHS staff and cancer charity workers (N = 31). Interviews with cancer survivors highlighted barriers to engagement, such as concerns about physical activity worsening fatigue. Focus groups highlighted concerns about support appointment length and how to support distressed participants. Feedback informed intervention modifications, to maximise acceptability, feasibility and likelihood of behaviour change. Our systematic method for understanding user views enabled us to anticipate and address important barriers to engagement. This methodology may be useful to others developing digital interventions.

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