History of Cervical Cancer and the Role of the Human Papillomavirus, 1960-2000

Annotated and edited transcript of a Witness Seminar held on 13 May 2008. Introduction by Professor Anne M Johnson, Division of Population Health and Institute for Global Health, UCL. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2009. ©The Trustee of the Wellcome Trust, London, 2009. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 13 May 2008. Introduction by Professor Anne M Johnson, Division of Population Health and Institute for Global Health, UCLAnnotated and edited transcript of a Witness Seminar held on 13 May 2008. Introduction by Professor Anne M Johnson, Division of Population Health and Institute for Global Health, UCLAnnotated and edited transcript of a Witness Seminar held on 13 May 2008. Introduction by Professor Anne M Johnson, Division of Population Health and Institute for Global Health, UCLAnnotated and edited transcript of a Witness Seminar held on 13 May 2008. Introduction by Professor Anne M Johnson, Division of Population Health and Institute for Global Health, UCLThe history, largely untold, of the development of cervical cytology, of effective screening and its ultimate success in reducing cervical cancer incidence and mortality, and the viral cause of cervical cancer, took place within a complex social background of changing attitudes to women’s health and sexual behaviour. Dr Georges Papanicolaou’s screening method (the Pap smear) started in the US in the 1940s. It was widely used in the UK a decade later and a national programme of cervical screening was established in 1988. The association of sexually transmitted human papillomavirus (HPV) with cervical cancer was less readily accepted. The detection of HPV16 in cervical cancers at the end of the 1970s was aided by the explosion of laboratory, clinical, and public health research on new screening tests and procedures. These made possible the successful development, licensing and use of preventive vaccines against the major oncogenic HPV types, HPV16 and -18. The Witness Seminar was attended by virologists, cytologists, gynaecologists, epidemiologists and others and addressed the development of cytology as a pathological discipline. They discussed who became cytologists and screeners; the evolution of screening in the UK and elsewhere; the impacts of colposcopy and of HPV; and the discovery of virus-like particles and the development of the HPV vaccine. The meeting was chaired by Professor Glenn McCluggage and the topic was suggested by Professor David Jenkins. Contributors include: Professor Valerie Beral, Professor Saveria Campo, Professor Jocelyn Chamberlain, Professor Dulcie Coleman, Dr Lionel Crawford, Professor Heather Cubie, Professor Jack Cuzick, Dr Ian Duncan, Dr Winifred Gray, Dr Amanda Herbert, Professor David Jenkins, Dr Elizabeth Mackenzie, Dr Joan Macnab, Professor Anthony Miller, Professor Julian Peto, Dr Catherine Pike, Professor Peter Sasieni, Professor Albert Singer, Dr John Smith, Professor Margaret Stanley, Mrs Marilyn Symonds, Dr Anne Szarewski, Professor Leslie Walker, Mr Patrick Walker, Dr Margaret Wolfendale and Professor Ciaran Woodman. Two appendices with reminiscences from Professor Leopold Koss, Dr Arthur Spriggs and Dr O A N (Nasseem) Husain complete the volume. Reynolds L A, Tansey E M. (eds) (2009) History of cervical cancer and the role of human papillomavirus, 1960–2000, Wellcome Witnesses to Twentieth Century Medicine, vol. 38. London: The Wellcome Trust Centre for the History of Medicine at UCL. ISBN 978 085484 1233The Wellcome Trust Centre for the History of MedicineMat UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

British Contributions to Medical Research and Education in Africa after the Second World War

©The Trustee of the Wellcome Trust, London, 2001. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2001. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 3 June 1999. Introduction by Dr Maureen Malowany.Annotated and edited transcript of a Witness Seminar held on 3 June 1999. Introduction by Dr Maureen Malowany.Annotated and edited transcript of a Witness Seminar held on 3 June 1999. Introduction by Dr Maureen Malowany.Annotated and edited transcript of a Witness Seminar held on 3 June 1999. Introduction by Dr Maureen Malowany.Differences in health services, research and medical education between British East and West Africa over the period to 1980, including the effects of the transition to independent states, were discussed by witnesses with an extraordinary wealth of diverse talent and experience, directed by the chairman, Professor David Bradley. The increased postwar influence of the Medical Research Council in the tropics was described, aided by a seat on the Colonial Medical Research Committee and its successor body, the MRC-based Tropical Medicine Research Board. Research outcomes of programmes in non-infectious diseases and nutrition, along with the great vector-borne diseases, including sleeping sickness and malaria, and helminth eradication spread through the tropics and also influenced treatment in the UK. The importance of Africa for the postwar development of drug treatments for tropical diseases was underlined. Witnesses include: Dr Murray Baker, Sir Christopher Booth, Dr Christopher Draper, Professor Alan Fleming, Professor Herbert Gilles, Dr Len Goodwin, Professor Ralph Hendrickse, Dr Tom Hopwood, the late Professor Michael Hutt, Professor Sir Ian McGregor, Professor George Nelson, Professor Eldryd Parry, Professor Gerry Shaper, Professor John Waterlow, and Dr Roger Whitehead. Reynolds L A, Tansey E M. (eds) (2001) British contributions to medical research and education in Africa after the second world war, Wellcome Witnesses to Twentieth Century Medicine, vol. 10, London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Cholesterol, Atherosclerosis and Coronary Disease in the UK, 1950–2000.

Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2006. ©The Trustee of the Wellcome Trust, London, 2006. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Annotated and edited transcript of a Witness Seminar held on 8 March 2005. Introduction by Dr Nick Myant, Hammersmith Hospital, London.Cholesterol began to be accepted after the Second World War as a significant cause of atherosclerosis and associated conditions such as coronary heart disease (CHD). This Witness Seminar, chaired by Professor Michael Oliver, included a discussion of the basic research on cholesterol. Early epidemiological studies demonstrated the relationship between excess saturated fat consumption and elevated levels of cholesterol, although cholesterol alone did not explain all population differences. Work on lipoprotein metabolism pointed to hypercholesterolaemia as one of, if not the major, risk factors for CHD, culminating in the development of cholesterol-lowering drugs, particularly the successful statins, available in the UK from the 1980s, and confirmed by randomized controlled trials. The role of diet in heart disease had always been controversial in the UK, and although extreme diets could reduce cholesterol, patient conformity remains difficult. Later, recommended limits on the composition of dietary fat were agreed, assisted by the food industry's introduction of functional foods such as cholesterol-lowering margarine. An introduction by Dr Nick Myant and appendices, on the diet-heart hypothesis by Professor Gerry Shaper and the development of lovastatin by Dr Jonathan Tobert, compliment the transcript. Contributors include Professor David Barker, Professor John Betteridge, Professor Gustav Born, Professor Richard Bruckdorfer, Professor George Davey Smith, Professor Paul Durrington, Professor David Galton, Dr Arthur Hollman, Professor Steve Humphries Professor Gordon Lowe, Professor Vincent Marks, Dr Paul Miller, Professor Jerry Morris, Professor Chris Packard, Professor Stuart Pocock, Professor Kalevi Pyörälä, Professor Thomas Sanders, Professor James Scott, Dr Elspeth Smith, Professor Anne Soutar, Professor Gilbert Thompson, Professor Hugh Tunstall-Pedoe, Professor Neville Woolf and Professor John S Yudkin. Reynolds L A, Tansey E M. (eds) (2006) Cholesterol, atherosclerosis and coronary disease in the UK, 1950–2000, Wellcome Witnesses to Twentieth Century Medicine, vol. 27. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Childhood asthma and beyond

Consists of the edited transcripts of Witness Seminars organized by the History of Twentieth Century Medicine Group and held at the Wellcome Institute for the History of Medicine, London, on 4 April 2000.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2001. ©The Trustee of the Wellcome Trust, London, 2001. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Consists of the edited transcripts of Witness Seminars organized by the History of Twentieth Century Medicine Group and held at the Wellcome Institute for the History of Medicine.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

The Development of Sports Medicine in Twentieth-century Britain

Annotated and edited transcript of a Witness Seminar held on 29 June 2007. Introduction by Dr John Lloyd Parry, Institute of Sports and Exercise Medicine. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2009. ©The Trustee of the Wellcome Trust, London, 2009. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 29 June 2007. Introduction by Dr John Lloyd Parry, Institute of Sports and Exercise Medicine.Annotated and edited transcript of a Witness Seminar held on 29 June 2007. Introduction by Dr John Lloyd Parry, Institute of Sports and Exercise Medicine.Annotated and edited transcript of a Witness Seminar held on 29 June 2007. Introduction by Dr John Lloyd Parry, Institute of Sports and Exercise Medicine.Annotated and edited transcript of a Witness Seminar held on 29 June 2007. Introduction by Dr John Lloyd Parry, Institute of Sports and Exercise Medicine.Sports medicine has grown in importance and visibility in recent years, yet as a discipline it struggled to gain broad recognition within the medical profession from c.1952 until specialty status was granted in 2005. It has also been neglected by historians: we have little beyond the image of a coach with his ‘magic sponge’ as a cure for all injuries, although the late twentieth-century picture is of new specialists developing high-tech interventions for elite athletes. This Witness Seminar arose from the Wellcome Trust-funded project on ‘Sport and Medicine in Britain, 1920–2000’ at the University of Manchester and examined the establishment of a recognizably modern specialty. Chaired by Professor Domhnall MacAuley, topics addressed included the importance of the 1948 London Olympics; the first 4-minute mile; training and altitude physiology; the postwar institutionalization of sports medicine; the relationship between the different main bodies involved in sport and their aims; the changing practice of professionals including physiotherapists, etc.; the relationship of NHS and private sports medicine practitioners and insurance companies; and the key debates within the sports medicine community over the period. Contributors include: Sir Roger Bannister, Dr Malcolm Bottomley, Dr Ian Burney, Professor John Elfed Davies, Professor Charles Galasko, Dr Robin Harland, Dr Vanessa Heggie, Mr Barry Hill, Professor Michael Hobsley, Dr Michael Hutson, Professor Monty Losowsky, Professor Domhnall Macauley (chair), Mrs Rose Macdonald, Professor Donald Macleod, Professor Moira O’Brien, Dr Malcolm Read, Professor Peter Sperryn, Professor Harry Thomason, Dr Dan Tunstall Pedoe and Mrs Sally Williams. Reynolds L A, Tansey E M. (eds) (2009) The development of sports medicine in twentieth century Britain. Wellcome Witnesses to Twentieth Century Medicine, vol. 36. London: The Wellcome Trust Centre for the History of Medicine at UCL. ISBN 978 085484 1219The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

WHO Framework Convention on Tobacco Control

Annotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical Medicine. First published by Queen Mary, University of London, 2012. ©The Trustee of the Wellcome Trust, London, 2012. All volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/ wellcome_witnesses/Annotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineAnnotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineAnnotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineAnnotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineAnnotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineAnnotated and edited transcript of a Witness Seminar in collaboration with the Department of Kowledge Management and Sharing, WHO, held in Geneva, 26 February 2010. Introduction by Professor Virginia Berridge, London School of Hygiene and Tropical MedicineThe World Health Organization (WHO)’s Framework Convention on Tobacco Control (FCTC) is the first global convention on public health. Comprehensive tobacco control had been the subject of 20 resolutions – consensus statements of all the member states – passed by the World Health Assembly beginning in 1970. This was 20 years after Sir Richard Doll and Sir Austin Bradford Hill suggested a link between smoking and cancer. The idea of a legally binding international convention, proposed by the late Dr Ruth Roemer and supported by a report from Dr Judith Mackay, was given priority by the new WHO Director-General Dr Gro Brundtland in 1998 when she elevated tobacco control as one of WHO’s three flagship programmes and created the Tobacco Free Initiative. The idea took wing with the publication of a review of tobacco company strategies to undermine tobacco control activities at WHO, which drew on 13 million documents released by the US courts to the public in 1998. This Witness Seminar, held in Geneva on the fifth anniversary of the WHO FCTC in 2010, heard from key individuals actively involved with the treaty negotiations, held between 2000 and 2003, and which came into force on 27 February 2005.The History of Modern Biomedicine Research Group is funded by the Wellcome Trust, which is a registered charity, no. 210183

Foot and Mouth Disease: The 1967 outbreak and its aftermath

The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 11 December 2001. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2003. ©The Trustee of the Wellcome Trust, London, 2003.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.Annotated and edited transcript of a Witness Seminar held on 11 December 2001. Introduction by Dr Lise Wilkinson.In 1967–68 Britain experienced the worst foot and mouth disease (FMD) epidemic of the twentieth century. Attributed to pig swill containing infected Argentine lamb, 2,228 outbreaks were recorded during a nine-month period, resulting in the slaughter of nearly 450,000 animals, statistics only surpassed by the 2001 FMD epidemic. Lord Soulsby led the discussion among veterinarians, virologists, academics and farmers. The edited, annotated and illustrated transcript considers MAFF’s State Veterinary Service procedures and organization and the subsequent investigations for the 1968 Northumberland Committee, with some comparisons with the 2001 outbreak; the contribution of the Animal Virus Research Institute and the International Vaccine Bank for FMD at Pirbright, Surrey; the hardship endured by the farmers during the outbreak; and political aspects of the historic slaughter policy and the debate over vaccination, both in Westminster and in Europe. Reynolds L A, Tansey E M. (eds) (2003) Foot and Mouth Disease: The 1967 outbreak and its aftermath, Wellcome Witnesses to Twentieth Century Medicine, vol. 18. London: Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Early Development of Total Hip Replacement

Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2007. ©The Trustee of the Wellcome Trust, London, 2007. All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Annotated and edited transcript of a Witness Seminar held on 14 March 2006. Introduction by Dr Francis Neary and Professor John Pickstone,Total hip replacement effectively began in the UK in 1938 and has led to widely used, commercially successful, mass-produced devices that relieve pain for an ever increasing period. The Witness Seminar, chaired by Mr Alan Lettin, discussed the remarkable postwar collaboration of British surgeons, engineers and manufacturing firms in the development of efficient alloys, surgical procedures, instruments and the implementation of clean, bacteria-reduced air in enclosed operating theatres, as illustrated by successful prostheses and techniques developed in Norwich (Kenneth McKee), Wrightington (Sir John Charnley), Stanmore (John Scales), Redhill (Peter Ring), and Exeter (Robin Ling and Clive Lee). Early failures - such as loosening from infection, osteolysis, and wear debris - stimulated the search for improved materials and fixation methods, as well as the addition of antibiotics to bone cement to reduce infection. National hip registers that record the survival of different implants were adopted in Europe in the 1970s (2003 in the UK), and they pinpoint the successful devices, as measured by survival and low rates of revision. An introduction to the volume by Dr Francis Neary and Professor John Pickstone, and appendices on materials by Professor Alan Swanson; on international standards by Mr Victor Wheble; and of details of selected prosthesis supplement the transcript. Contributors include: Lady Charnley, the late Mr Harry Craven, Mr Graham Deane, Professor Duncan Dowson, Mr Reg Elson, Dr Alex Faulkner, Professor Michael Freeman, Mrs Phyllis Hampson, Mr Kevin Hardinge, Mr Mike Heywood-Waddington, Mr John Kirkup, Mr Krishna (Ravi) Kunzru, Miss Betty Lee, Mr Alan Lettin (chair), Mr John Older, Mr John Read, Mr Peter Ring, Mr Ian Stephen, Mr Malcolm Swann, Professor Alan Swanson, Sir Rodney Sweetnam, Mr Keith Tucker, Mr Victor Wheble and Professor Michael Wroblewski. Reynolds L A, Tansey E M. (eds) (2007) Early development of total hip replacement, Wellcome Witnesses to Twentieth Century Medicine, vol. 29. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Clinical Pharmacology in the UK, c.1950-2000: Industry and Regulation

Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2008. ©The Trustee of the Wellcome Trust, London, 2008.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Annotated and edited transcript of a Witness Seminar held on 25 September 2007. Introduction by Professor Parveen Kumar, Barts and the London School of Medicine and Dentistry, University of London.Clinical pharmacology in the UK in the 1950s and 1960s was an exciting profession. Many important new drugs were developed and brought to market and a more systematic knowledge of drug effects in humans was needed, as well as ensuring the safety and efficacy of new and existing drugs, especially following the unexpected problems arising from the use of thalidomide. This Witness Seminar followed an earlier meeting on the history of the general development of clinical pharmacology and focuses on the development of clinical pharmacology in pharmaceutical companies and drug regulation. Professor Rod Flower chaired the meeting of clinical pharmacologists and others who shaped the discipline, which discussed the main centres of influence; the attraction to clinical pharmacologists of working in industry; whether the decline in the number of academic clinical pharmacologists was paralleled in drug companies; what drove drug regulation; and the relationships between companies and regulatory authorities. Participants included Dr Jeffrey Aronson, Professor Nigel Baber, Sir Alasdair Breckenridge, Sir Iain Chalmers, Professor Joe Collier, Professor Donald Davies, Dr Peter Fletcher, Dr Arthur Fowle, Professor Sir Charles George, Professor David Grahame-Smith, Professor John Griffin, Dr Andrew Herxheimer, Professor Ray Hill, Dr Peter Lewis, Dr Tim Mant, Professor Denis McDevitt, Professor Michael Orme, Dr Anthony Peck, Professor Brian Prichard, Professor Sir Michael Rawlins, Professor John Reid, Professor Philip Routledge, Dr Julian Shelley, Dr Robert Smith, Professor Cameron Swift, Professor Tilli Tansey, Dr Duncan Vere, and the late Professor Owen Wade. Reynolds L A, Tansey E M. (eds) (2008) Clinical pharmacology in the UK, c. 1950–2000: Industry and regulation. Wellcome Witnesses to Twentieth Century Medicine, vol. 34. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Prenatal Corticosteroids for Reducing Morbidity and mortality after Preterm Birth

Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2005.©The Trustee of the Wellcome Trust, London, 2005.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.Annotated and edited transcript of a Witness Seminar held on 15 June 2004. Introduction by Barbara Stocking, Oxfam.In 1959 the New Zealand obstetrician Graham (Mont) Liggins began investigating mechanisms that triggered premature labour. Supported by the Wellcome Trust, he examined the effects of hormones on labour in sheep, and demonstrated coincidentally that in utero corticosteroids accelerated fetal lung maturation. A randomized controlled trial (RCT) of prenatal corticosteroids in humans by Liggins and pediatrician Ross Howie, showed a reduction of respiratory distress syndrome in preterm babies. This Witness Seminar, chaired by the late Dr Edmund Hey, discussed the influence of Liggins' and Howie's 1972 paper announcing these results, and subsequent work by Avery and Kotas on induction of pulmonary surfactant in lambs. Other subjects included Crowley's 1981 systematic review of four RCTs; the low uptake of corticosteroids in practice until the Royal College of Obstetricians and Gynaecologists issued usage guidelines in 1992; trials to determine optimum drug, dose and number of courses; potential adverse effects; and cost-benefit analysis. Participants included the late Dr Mel Avery, Sir Iain Chalmers, Dr Patricia Crowley, the late Professor Harold Gamsu, Professor Jane Harding, Professor Richard Lilford, Professor Miranda Mugford, Professor Ann Oakley, Professor Dafydd Walters and Mr John Williams. Appendices from Liggins and Howie; Liggins' Wellcome Trust grant; and the protocol of the 1975 UK trial of betamethasone, complete the volume. Reynolds L A, Tansey E M. (eds) (2005) Prenatal corticosteroids for reducing morbidity and mortality after preterm birth, Wellcome Witnesses to Twentieth Century Medicine, volume 25. London: The Wellcome Trust Centre for the History of Medicine at UCL.The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183