Health gains from home energy efficiency measures: The missing evidence in the UK net-zero policy debate.

Objectives: This study examined the health gains from a programme of external wall insulation works to homes in south-west Scotland, and in particular the impact upon hospitalisations for respiratory and cardiovascular conditions. Furthermore, to consider how evidence on health outcomes could form part of the debate around actions to meet net-zero goals in the UK. Study design: This was a two-part study. Part one involved before-and-after interviews with 229 recipient households. The second part comprised an observational study of hospital admissions in 184 postcode areas. Methods: Across three years, interviews collected thermal comfort and self-reported health data(Sf-36) in the winter months prior to installation, and again in follow-up interviews the next winter. Standarised monthly data on non-elective admissions for each set of conditions were compared between the intervention postcodes and the wider health board area over a ten year period. Results: Following receipt of wall insulation, inability to achieve thermal comfort in winter reduced by two-thirds. Improvements in thermal comfort were associated with gains in physical health scores. Relative standardised admissions fell in the treatment areas, remaining lower than the district-wide standardised rate for the majority of a five year period, this effect ending during the Covid-19 pandemic. The impact on admissions was greater for respiratory conditions than for cardiovascular conditions. Conclusion: A weak policy commitment to energy efficiency could be strengthened with further evidence of the cost-savings and reduced hospital bed demand resulting from insulations works. The potential health gain may also encourage more home owners to participate.

Selective androgen receptor modulators based on a series of 7H-[1,4]oxazino[3,2-g]quinolin-7-ones with improved in vivo activity.

Modification on a lead series of [1,4]oxazino[3,2-g]quinolin-7-ones at the 2-position led to selective androgen receptor modulators with improved in vivo activity. The most potent analog (-)-33a exhibited full maintenance of levator ani muscle at 3mg/kg and reduced activity on ventral prostate weight in a 2-week orally-dosed and orchidectomized rat maintenance assay.

Potent, nonsteroidal selective androgen receptor modulators (SARMs) based on 8H-[1,4]oxazino[2,3-f]quinolin-8-ones.

A series of androgen receptor modulators based on 8H-[1,4]oxazino[2,3-f]quinolin-8-ones was synthesized and evaluated in an androgen receptor transcriptional activation assay. The most potent analogues from the series exhibited single-digit nanomolar potency in vitro. Compound 18h demonstrated full efficacy in the maintenance of muscle weight, at 10 mg/kg, with reduced activity in prostate weight in an in vivo model of androgen action.

Male-to-female transmission of human immunodeficiency virus.

Ninety-seven female sexual partners of 93 men infected with human immunodeficiency virus were studied. All of the women had sexual contact within the year before their partner had been diagnosed as having acquired immunodeficiency syndrome or was found to have a positive reaction on the human immunodeficiency virus serologic test. Fifty-seven percent were the partners of bisexual men. Overall, 23% of the women were infected (95% confidence interval, 15% to 32%). The total number of exposures to the index case (sexual contacts with ejaculation) and the specific practice of anal intercourse, also with the infected partner, were associated with transmission. Neither condom use, total number of sexual partners since 1978, nor lifetime number of sexually transmitted diseases was associated with infection.

Immunization roulette: influenza occurrence in five nursing homes.

Immunization with A/Bangkok 1/79 (H3N2) vaccine appeared to be protective for immunized nursing home residents during an influenza outbreak in 1983. All thirteen deaths during the 4-month period of the study were among residents of two of five nursing homes where influenza immunization was low or nonexistent. Death certificates included a diagnosis of I-ILI for only six of the 13 decedents, showing that I-ILI may be greatly underreported as a cause of death, and skewing statistical evaluation of the impact of influenza in nursing home populations. The cost of protection is only a small fraction of the cost to society of caring for seriously ill nursing home residents with I-ILI who must be admitted to a hospital.

Focus on Cryptococcosis.

A case report of disseminated cutaneous cryptococcosis with Hodgkin's disease is presented. No foci in the lungs, central nervous system, bones, gastro-intestinal tract, liver, kidneys or heart were detected. C.neoformans was cultured, identified by its capsule, growth at 37'C ability to produce urease, specific nitrate and sugar assimilation and pathogenicity for the mouse. Histo-pathologically the organism was demonstrated in the tissue sections. Clinical subsidence was seen with amphotericin B 0.5 mg/kg. for 22 days. The fact that present day use of steroids, immuno-suppressives and anti-neoplastic agents are known to predispose to this infection is emphasised.

Doxycycline in the Treatment :uncomplicated Gonorrohea.

Gonorrhoea constitutes nine per cent of the sexually transmitted diseases seen at the department of Dermatology and Venereology, Nair Hospital, Bombay. Fifty cases of uncomplicated males were treated with doxycycline 200mgs iv on the first day and 100 mgs, iv for 2 more - a total of 400 mgs doxycycline. Smears for gonococci and blood V D R L were treatment. The cases were reviewed every week for a period 3 weeks. Three cases showed a positive serology and 44 cases responded well to therapy giving a success rate of 88%. Side effects were minimal.

Comparative Investigation with Fluprednylidene Acetate (decoderma).

The therapeutic efficacy of a new fluorinated steriod, 0. 1% fluprednylidene -21 acetate (Decoderm) cream was compared to betamethasone and triamcinolone in two double blind clinical trials. All the three topical steroids were effective in various steroid responsive dermatoses within one week and the beneficial effects continued throughout the four weeks of the trials. The various signs and symptoms, such as erythema, pruritus, oedema, exudation, scaling, vesicles, crusting, lichenification and burning, improved significantly with each of the steroid under trial. Fluprednylindine-21 acetate (Decoderm) cream represents an important addition to the present,y available topical steroids.

Inhibition of adjuvant-induced arthritis in the hyperuricemic rat.

In man, there is a strong negative correlation between gout and rheumatoid arthritis. To investigate this apparent mutual exclusion, we studied the influence of oxonate-induced hyperuricemia on the development of adjuvant arthritis in male Wistar rats. The results indicate that in the primary reaction (inflammation of the injected paw) the differences are weak (0.10 greater than p greater than 0.05) between normouricemic and hyperuricemic rats. In hyperuricemic rats the secondary reaction (induced polyarthritis) is delayed and significantly reduced (p less than 0.005). Non-immunologic carrageenin paw edema is not statistically different between the two groups (p greater than 0.25). Experimental hyperuricemia in rats seems to influence essentially the secondary, cell mediated, reaction without affecting the acute inflammatory phases.

Dermabrasion and Retinoic Acid in the Treatment of Pachyonychia Cogenita.

A typical case of pachyonychia congenita in a female is presented. Of the sixty cases of pachyonychia congenita reported in the literature, only one case is a female. Cases have been seen in families upto five generations. In our case five family members belonging to two generations manifested the disease. The hyperkeratotic plantar lesions were painful and incapacitating to the patients. With combined dermabrasion and topical retinoic acid the patients were made rapidly ambulatory. This new modality of treatment seemed gratifying in that the symptomatic relief to the patient was excellent.