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Biomedical subjects

A Busuttil

Publications and source records attributed to A Busuttil.

At least 19 recordsLinked to original sources
PubMed1996

Rate, causes and prevention of deaths from injuries in south-east Scotland.

Data on all deaths after injuries in Lothian and Borders regions of south-east Scotland were collected prospectively over 2 years. Post-mortems were performed after all deaths and Injury Severity Scores (ISS) calculated. There were 331 deaths at a rate of 20 per 100,000 per year; of those who died 49 per cent were younger than 40 years and most were male; 37 per cent of deaths were caused by road traffic accidents, 16 per cent by falls and 15 per cent by hangings. Two hundred and forty-eight patients (75 per cent) were either dead when found or died instantly with unsurvivable injuries (ISS = 75). A further five patients died in the first hour after injury and before reaching hospital. Nineteen (7 per cent) died between 1 and 4 h after injury, 59 (17 per cent) died more than 4 h after. These results demonstrate the rate, causes and timing of deaths following injuries in one UK region. The pattern of these deaths differs markedly from that previously described in the US. There is no evidence to support the concept of a trimodal distribution of trauma deaths. The greatest potential to reduce the number of trauma deaths lies with prevention.

Accident Prevention↗
PubMed1996

Fire fatalities in elderly people.

Fatal dwelling-house fires account for 10% of all accidental deaths in the United Kingdom with one-quarter of the deaths being of elderly people. No study had described the characteristics of elderly individuals who die in fires. We report results from a retrospective review of all fatal dwelling-house fires in Scotland from 1980 to 1990. Of 1096 people dying in fires, 243 (23%) were aged over 75. When compared with patients under the age of 75, older patients were significantly less likely to be smokers. Significantly more fires killing elderly people were caused by faulty or misused electrical items in the house, particularly electric blankets. These differences between elderly and younger individuals dying in dwelling-house fires may suggest that preventive strategies for the elderly population require a different emphasis from those for younger people.

Accidents, Home↗
PubMed1996

Developmental and environmental factors that enhance binding of Bordetella pertussis to human epithelial cells in relation to sudden infant death syndrome (SIDS).

Asymptomatic infection due to Bordetella pertussis has been suggested to be one cause of sudden infant death syndrome (SIDS). We examined developmental and environmental factors previously found to affect binding of another toxigenic species, Staphylococcus aureus, to human epithelial cells: expression of the Lewis(a) antigen; infection with respiratory syncytial virus (RSV); exposure to cigarette smoke; and the inhibitory effect of breast milk on bacterial binding. Binding of two strains of B. pertussis (8002 and 250825) to buccal epithelial cells was significantly reduced by treating the cells with monoclonal antibodies to Lewis(a) (P < 0.05) and Lewis(x) (P < 0.01) antigens. Both strains bound in significantly greater numbers to cells from smokers compared with cells from non-smokers (P < 0.05). HEp-2 cells infected with RSV subtypes A or B had higher binding indices for both 8002 (P < 0.001) and 250825 (P < 0.01). On RSV-infected cells, there was significantly enhanced binding of monoclonal antibodies to Lewis(x) (P < 0.05), CD14 (P < 0.001) and CD18 (P < 0.01); and pre-treatment of cells with anti-CD14 or CD18 also significantly reduced binding of both strains of B. pertussis. Pre-treatment of the bacteria with human milk significantly reduced their binding to epithelial cells. The results are discussed in relation to our three-year survey of bacterial carriage among 253 healthy infants, their mothers and local SIDS cases between 1993-1995 and in relation to the change to an earlier immunisation schedule for infants and the recent decline in SIDS in Britain.

Antibodies, Monoclonal↗
PubMed1996

Collagen alteration in an animal model of colonic diverticulosis.

BACKGROUND: Changes in the structure and integrity of the colon dependent on collagen content and crosslinkage occur with age. AIMS: This study using an animal model examines colonic collagen content and crosslinkage over the lifetime of rats on fibre deficient and higher fibre diets. METHODS: Two groups of 20 rats were fed either a fibre deficient diet (1.7 g NSP (non-starch polysaccharide)/100 g) or a higher fibre diet (13.3 g NSP/100 g) for 18 months. Diverticula were identified by postmortem examination. Caecal and colonic contents were weighed and assayed for short chain fatty acids. Collagen solubility in weak acid was measured to give an indication of the nature and amount of crosslinks in the collagen of the bowel wall. RESULTS: The incidence of colonic diverticula was greater (42.1% fibre deficient rats; 0% higher fibre rats). Colonic collagen solubility index in fibre deficient rats was significantly lower than higher fibre diet fed rats (p < 0.001 in all four sections of the large bowel). Rats with diverticula had the lowest solubility index (p < 0.001 in all four sections of the large bowel). Higher fibre diet rats had increased caecal and colonic contents, caecal and colonic tissue wet weights, and greater caecal short chain fatty acids. Fibre deficient diet fed rats had more pathological abnormalities. CONCLUSIONS: This animal model permits a study of the relation between collagen crosslinkage and the development of colonic diverticulosis. A higher fibre diet protects against collagen crosslinking and this is related to a decreased incidence of diverticula.

Aging↗
PubMed1996

An association between maternal diet and colonic diverticulosis in an animal model.

BACKGROUND/AIMS: Maternal diet may have an effect on the health of the offspring in middle and later life. This study used the laboratory rat as an animal model to examine whether the fibre content of the maternal diet during pregnancy affected subsequent development of colonic diverticula in the offspring fed lifelong fibre deficient or higher fibre diets. METHODS: The parents of experimental animals were fed either a diet that was known to predispose to colonic diverticulosis or a control diet for one month prior to mating. The offspring were fed one of these diets for 18 months. The incidence of colonic diverticulosis, submucosal collagen content, collagen solubility in weak acid, and the composition of intestinal contents were then measured. RESULTS: Offspring of rats fed a higher fibre diet from higher fibre diet fed parents had 0% incidence of colonic diverticulosis. When offspring (regardless of parental diet) were fed a low fibre diet for life the acid solubility was lowered compared with rats fed lifelong higher fibre diet mean (SD) (0.044 (0.0007) v 0.073 (0.0015) sigmoid colon (ratio of soluble:insoluble collagen)); 21.1% had diverticulosis and there was reduced fibre fermentation. However, when the diet of the parents of the fibre deficient diet fed rats was considered, the animals whose mothers had a fibre deficient diet had lower acid solubility (0.032 (0.0007)) and an increased incidence of colonic diverticulosis (42.1%) than the animals fed a fibre deficient diet from higher fibre diet fed parents (p < 0.01 in all instances). CONCLUSION: Maternal diet and the subsequent nutrition of the progeny seem to be of importance in the development of colonic diverticulosis in the rat.

Animals↗
PubMed1996

Deaths among drug abusers in south-east Scotland (1989-1994).

A survey of deaths of chronic drug abusers who came to medico-legal autopsy in the South-east of Scotland revealed a total of 179 fatalities in the six-year period between 1989 and 1994 inclusive. There was an almost linear increase in the number of such deaths reported to the Procurator Fiscal per year over this period, rising from 14 in 1989 to 45 in 1994. The majority of deaths (86%) were seen in males and the peak age at death was in the third decade of life. In the majority of cases (60%) death was deemed to be accidental and most were due to accidental drug overdoses, with methadone being the drug most commonly detected on toxicological analysis. The number of HIV-positive cases peaked in the years 1991 and 1992 with a decline over the subsequent two years.

Adolescent↗
PubMed1995

Child fatalities in Scottish house fires 1980-1990: a case of child neglect?

This paper considers 168 child (< 17 years) fatalities killed in house fires in Scotland. Data were obtained from the records retained by the procurators fiscal, as part of a survey into all Scottish fire fatalities during the period 1980 to 1990. Although these fires were generally perceived as being tragic "accidents," we conclude that they were largely a direct result of the activities of adults in the home. We analyze this in terms of contemporaneous supervision and the child-care environment. The role of alcohol in domestic fires is particularly important. Behavioral patterns of parents and caregivers are seen to be placing children in a very high risk category and fatality rate could be significantly reduced if behavior was modified to reduce the risk. Whether these considerations imply "neglect" is partly a question of definition. It is important to recognize that the fire safety message could usefully be integrated within a more general child care or family welfare scheme. Front line professionals in these fields are ideally placed to convey this message and to make a contribution towards reducing the risk of children being killed or injured in fire.

Adolescent↗
PubMed1995

Cross linking of collagen is increased in colonic diverticulosis.

Development of colonic diverticulosis is a function of age and declining colonic wall mechanical strength. The latter is partly a consequence of changes in the collagen structure. Collagen from unaffected human colons (n = 20, age range 20-80 years) and those with colonic diverticulosis (n = 5, age range 67-80 years) were obtained at necropsy. The total collagen content was measured as the hydroxyproline content and cross linkage by collagen solubility in weak acid was studied. The colonic total collagen content was constant with age (mean (SD) 15.8 (0.3) mg/100 mg wet weight of tissue). The acid solubility of the collagen, however, increased after the age of 40 years: at over 60 years, colonic diverticulosis was associated with an increased acid solubility ratio compared with values in unaffected colons (15.3 (0.2); compared with 9.2 (0.2), p < 0.001). The cross linking of colonic collagen increases with age. These changes seem to be a factor in the aetiology of colonic diverticulosis.

Adult↗
PubMed1994

Myocardial bars and bridges and sudden death.

A congenital variant of the anatomical arrangement of the coronary arteries, that can be observed both angiographically and at autopsy, is the embedding of these vessels within a tunnel of the subepicardial myocardium. Both clinical and pathological claims and counterclaims have been made as to the functional consequences of this variation, the implication being that the contraction of the peri-vascular myocardium particularly at accentuated heart rates would cause occlusion of the blood flow within these arteries. The consensus is that this variant is only of significance when it occurs around a significant portion of a dominant left main coronary artery in which instances it may be the cause of sudden death during the course of strenuous exercise.

Animals↗
PubMed1994

Redistribution of HIV outside the lymphoid system with onset of AIDS.

The basis for many of the symptoms and pathological changes found in patients with the acquired immunodeficiency syndrome (AIDS) remains poorly understood. We have used a quantitative polymerase chain reaction technique to investigate the extent to which direct infection with human immunodeficiency virus (HIV) produces the disease manifestations of AIDS. In five patients who died with AIDS-defining illnesses (Centers for Disease Control and Prevention class IV), we found variable, but in many cases extensive, infection by HIV at various sites, including brain, lung, colon, and liver. By contrast, in three HIV-positive subjects who died without HIV-related disease (CDC class II), we found no evidence of significant infection of any non-lymphoid organ. In both groups of patients there were high levels of infection in cells of the spleen, lymph nodes, and peripheral blood. Pathological examination of tissues from the AIDS patients revealed many abnormalities, of which some, such as giant-cell encephalitis in the brain, were specifically associated with the presence of high levels of HIV infection. These findings suggest that spread of HIV outside cells of the immune system is a late event in HIV infection and is extremely sensitive to the degree of immunosuppression in the patient.

Acquired Immunodeficiency Syndrome↗
PubMed1994

A review of completed suicides in the Lothian and Borders Region of Scotland (1987-1991).

A review of 400 completed suicides encountered during a 5-year period (January 1987-December 1991) in the Lothian and Borders Region of Scotland (LBRS) was conducted. The incidence was 9.4 per 100,000 with a M:F ratio of 2.4:1; the elderly had a significantly higher (P < 0.001) rate (9.9 per 100,000) compared to adolescents (3.3 per 100,000). Significantly (P < 0.001) more cases occurred in the rural communities. Overall, the peak incidence was in the 45- to 54-year age group. Drug overdose was the most common (39%) method used by both sexes and in both urban and rural communities; it was the first choice for virtually all age groups, and females exhibited greater preference. Analgesics and tricyclic antidepressants were the most common drugs used. Hanging (19.8%) was popular among the young and the elderly (> 64 years) suicides. Inhalation of car exhaust (13.3%) was a rural phenomenon and was common in the 25- to 54-year age group. Jumping from heights (9.8%) was more common in the urban areas; an increasing trend in the use of this method by females was possibly emerging. Drowning (8.3%) exhibited no particular pattern and the use of firearms was relatively uncommon (2.8%). This study and any subsequent assessment of socio-medical factors associated with completed suicide in this region should provide a basis for the formulation of preventive strategies. A continuous monitoring of the trends in the LBRS is necessary.

Adolescent↗
PubMed1994

Dextropropoxyphene-related deaths--a problem that persists?

A total of 48 cases of dextropropoxyphene-related deaths that occurred over a 6-year period (1987-1992) in the Lothian and Borders region of Scotland were reviewed. No significant gender difference was found but a significantly greater proportion of the deaths occurred in the urban areas (P < 0.05). Suicide accounted for 81.3% of cases while the other deaths were caused accidentally and involved drug addicts, alcoholics and those who had taken their dextropropoxyphene-containing prescriptions following consumption of alcohol. Overall concomitant alcohol abuse was identified in 41.7% of all the victims. Compound analgesic preparations containing dextropropoxyphene are still widely prescribed and the persistence of deaths from its overdose may suggest the need for stricter prescription control and for educational programmes for users.

Accidents↗
PubMed1994

A semi-automated micro-method for the histological assessment of fat embolism.

A method of quantitatively determining the volume of fat emboli in a tissue using an image analysis system (I.B.A.S.) was developed. This procedure is an interactive, semi-automated tool allowing the quick and accurate gathering of large quantities of data from sections of different tissue samples stained by osmium tetroxide. The development of this procedure was aimed at producing a system which is reliable, reproducible and semi-automated thereby enabling epidemiological and serial studies to be made of a large number of histological sections from different tissues. The system was tested in a study of tissue sections from a series of fatalities from an aircraft crash in an attempt at correlating the incidence of fat emboli with the presence of multiple fractures and soft tissue injuries, the correlation to be made being between the quantitative presence of fat emboli and the extent and severity of injuries suffered.

Accidents, Aviation↗
PubMed1994

Sudden unexpected nocturnal deaths among Thai immigrant workers in Singapore. The possible role of toxigenic bacteria.

Sudden Unexpected Nocturnal Deaths (SUND) occur in young, apparently healthy immigrant workers from Thailand, the Philippines and Bangladesh living among ex-patriot labour forces in countries such as Singapore and Saudi Arabia. Several factors associated with these deaths are similar to those observed for Sudden Infant Death Syndrome (SIDS): sleep related and mainly nocturnal occurrence; no prodromal illnesses other than mild respiratory tract infection; exposure to cigarette smoke; absence of invasive microorganisms at autopsy. The hypotheses proposed to explain these deaths in adults are examined. Based on our studies of the role toxigenic bacteria might play in some cases of SIDS, we suggest a new approach to the investigation of SUND.

Adult↗