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Biomedical subjects

I K Crombie

Publications and source records attributed to I K Crombie.

At least 91 records · Page 5Linked to original sources
PubMed1990

An investigation into factors that may influence tonsil morphology.

To investigate whether tonsillar size was related to human morphology, age or duration of disease, 100 consecutive patients undergoing tonsillectomy for recurrent tonsillitis were investigated. The lengths, widths and volumes of each resected tonsil were measured and compared with patient characteristics ascertained on the day before surgery. The volume of tonsillar tissue was directly related to height (p = 0.46, P less than 0.001) and weight (p = 0.45, P less than 0.001) and age, but at any age (or body size) there was a wide range of tonsil size. A weak inverse relationship was found with the duration of recurrent tonsillitis. Tonsil size is of no relevance in the assessment of recurrent tonsillitis or adenoid hypertrophy.

Adenoids↗
PubMed1990

Suicide in England and Wales and in Scotland. An examination of divergent trends.

The suicide rates in England and Wales and Scotland converged during the late 1960s, and from 1970 were higher in Scotland. The convergence occurred because of differences in the falls in rates of those aged over 45 years and not because of differences in frequency and decline of coal gas suicide. Male suicide increased more rapidly in Scotland during the 1970s. In England and Wales overall female suicide rates fell during 1958-76 whereas in Scotland there was no clear trend. Suicide by car exhaust increased similarly in both countries, but that by hanging and drug poisoning increased more rapidly in Scotland.

Adolescent↗
PubMed1989

Trends in suicide and unemployment in Scotland, 1976-86.

To establish whether a correlation exists between unemployment and suicide the trends in the rates of both among men in Scotland during 1976-86 were studied. Both rates showed rapid increases in the late 1970s and then much slower increases after 1982. In contrast, among women, although the rate of unemployment followed a similar pattern, there was a gradual fall in the rate of suicide. The trends in regional unemployment for men during 1971-81 were compared with the suicide rates for the period before the increase (1974-7) and the period after the rapid increase (1983-6). No association was observed between trends in suicide and unemployment when analysed by health board areas or aggregates of local government districts. These data do not support the hypothesis that the rise in unemployment is a direct cause of the rise in suicide rates among men.

Adult↗
PubMed1989

Unemployment, socioenvironmental factors, and coronary heart disease in Scotland.

Scotland, which has one of the highest death rates in the world from coronary heart disease, also has considerable regional variation in mortality from this cause. The relation between standardised mortality ratios for coronary deaths (1979-83) for 56 local government districts and a range of socioeconomic factors from the 1981 Census as well as climatic factors and water hardness were investigated. Strong associations were seen with several measures of social disadvantage, the strongest being with percentage of male unemployment. A fitted multiple regression model with mortality from coronary heart disease in men found independent effects of two social variables (percentage male unemployment and percentage social class III-V) and one climatic factor (rainfall). The model explained much (73%) of the geographical variation in mortality from coronary heart disease, but part of the geographical pattern, in particular some of the east-west gradient in mortality, remained unexplained by it. Explanations for the geographical variation and the association with economic factors are currently being sought in terms of individual risk factors in a large screening study, the Scottish Heart Health Study.

Adult↗
PubMed1989

Concomitants of excess coronary deaths--major risk factor and lifestyle findings from 10,359 men and women in the Scottish Heart Health Study.

The Scottish Heart Health Study is a study of lifestyle and coronary heart disease risk factors in 10,359 men and women aged 40-59 years, in 22 districts of Scotland. The study was conducted during 1984-86, when Scotland had the highest national coronary heart disease mortality reported by the World Health Organisation. A self-completed questionnaire, complemented by a 40 minute visit to a survey clinic, staffed by nurses, enabled the classical major risk factors and some more newly described ones to be measured. The study emphasised quality control and representativeness, and incorporated a World Health Organisation protocol for measurement of key items to allow comparisons in place and time, and therefore also to provide a definitive baseline against which interventions can be assessed. This paper describes the overall findings. Current cigarette smokers constitute 39% of men and 38% of women, higher levels than those reported in England but lower than previous Scottish reports. Mean blood pressure levels were 134/84 mmHg for men and 131/81 mmHg in women, lower than in British studies of the 1960s and 1970s. Mean body mass index levels, 26.1 Kg/m2 in men and 25.7 Kg/m2 in women, were not high by international standards. However, mean serum cholesterol levels were 6.4 mmol/l in men and 6.6 mmol/l in women--as high as those in previous British studies and high by international standards. Levels of high density lipoprotein cholesterol, non-fasting triglycerides and fibrinogen are also reported. Physical activity both at work and in leisure time was low.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Coronary risk factor and lifestyle variation across Scotland: results from the Scottish Heart Health Study.

Between 1984 and 1986 the Scottish Heart Health Study recorded coronary risk factors and lifestyle in 10,359 men and women aged 40-59 years across 22 districts of Scotland--districts whose standardised mortality ratio for coronary heart disease in men varied from 61 in Eastwood to 136 in Monklands. This paper presents the results by district. Cigarette smoking levels showed the greatest variation, from 29% to 52% in men and 24% to 51% in women. Blood pressure means varied but were not high (129-138mmHg systolic in men, 126-137mmHg in women, 81-88mmHg diastolic in men and 77-84mmHg in women). Mean serum cholesterol values were high and varied little by district in men, (6.1 to 6.5mmol/l), although there was more variation in women (6.3 to 7.0mmol/l). Body mass index (25.3 to 26.6kg/m2 in men and 24.8 to 26.3kg/m2 in women) also varied little. Distribution of other lipids, fibrinogen, exercise levels and fruit and vegetable consumption is also described. When district mean levels of major coronary risk factors are entered into predictive formulae, cigarette smoking and blood pressure could explain part of the regional variation in mortality, but much remains unaccounted for. Nonetheless, these levels provide data for local preventive initiatives. While the overall pattern and interaction of the factors will repay further study, the high levels of serum cholesterol in all districts, and the level and variation in cigarette smoking, are a challenge for action.

Adult↗
PubMed1989

A classification of prescription errors.

Three independent methods of study of prescription errors led to the development of a classification of errors based on the potential effects and inconvenience to patients, pharmacists and doctors. Four types of error are described: type A (potentially serious to patient); type B (major nuisance - pharmacist/doctor contact required); type C (minor nuisance - pharmacist must use professional judgement); and type D (trivial). The types of frequency of errors are detailed for a group of eight principals from one health centre. There were a total of 504 errors from 15,916 prescription items (3.17%) during a three month observation period. A close correspondence was found between individual doctor's types of error rates, suggesting that doctors who make type C and D errors are also likely to make type B (major nuisance) errors. A system of feedback of errors from each doctor was devised. No significant reduction was seen in error rates, possibly because the group of self selected doctors taking part had low error rates initially. It is suggested that pharmacists and doctors should work closely together to prevent the potentially harmful consequences of prescription errors.

Drug Prescriptions↗
PubMed1989

Ayrshire and Arran coronary prevention programme--baseline risk factor survey.

Scotland has very high mortality rates for coronary heart disease in both men and women. The Ayrshire and Arran health Board Area is co-terminus with four local government districts which all have male coronary mortality rates above the Scottish average. A survey of lifestyle and coronary risk factors was conducted in these four districts in preparation for the launch of a Prevention Programme's 'Healthy Heart Campaign'. This survey will be used as a baseline for evaluation of lifestyle modification and risk factor change over the next 5-10 years. The information provided by the survey is valuable to the direction and targeting of the Prevention Programme. The methods developed in this survey could be used for evaluation of other coronary prevention programmes. Similar data has been collected from another 20 districts as part of the Scottish Heart Health Study and has been distributed to all the Scottish mainland health boards.

Adult↗
PubMed1988

Urinary electrolyte excretion, alcohol consumption, and blood pressure in the Scottish heart health study.

As part of a study of risk factors for coronary heart disease 24 hour urine collections were obtained from 7354 men and women aged 40-59 selected at random from 22 districts throughout Scotland (Scottish heart health study). The mean of two standardised measurements of blood pressure was related to the reported consumption of alcohol and measurements of height, weight, pulse rate, and electrolyte excretion. Several significant correlations were found with both systolic and diastolic pressure, but only the coefficients for age, body mass index, and pulse rate were greater than 0.1. Alcohol consumption showed a weak positive correlation with blood pressure in men. Sodium excretion showed a weak positive correlation with blood pressure in both sexes, and potassium excretion showed weak negative correlations. In multiple regression analysis age, pulse rate, body mass index, alcohol consumption, and potassium excretion had significant independent effects but sodium excretion did not. Although measuring blood pressure twice on one occasion and 24 hour urinary sodium excretion only once may have weakened any potential correlation, the most likely explantation of these results is that the relation between sodium and blood pressure in the population is weak and that potassium and alcohol are of greater importance.

Adult↗
PubMed1988

Evaluation of a portable measure of expired-air carbon monoxide.

There are a variety of independent methods of estimating smoking status; measurement of expired air carbon monoxide has proven to be reliable and convenient. This article describes a new, inexpensive, portable analyzer for measuring expired-air carbon monoxide --the Bedfont EC50. We have compared this analyzer with the standard instrument for measuring expired-air carbon monoxide in 138 normal subjects and found good correlation and agreement. The Bedfont was demonstrated to be better at identifying smoking status, and the relevance of this finding for classification of smokers and nonsmokers by fixed-threshold carbon monoxide levels is discussed. The features of the Bedfont EC50 are particularly appealing for field and clinical use.

Adult↗
PubMed1988

Cardiovascular risk factor profile and mortality in two Scottish cities.

Edinburgh and Glasgow are the two largest cities in Scotland, which has one of the highest coronary heart disease mortality rates in the world. Within Scotland, there is a geographical variation in these rates and Glasgow has a higher mortality rate than Edinburgh. However, the cities also differ socially and economically. Population surveys have been conducted in centres in both Edinburgh and North Glasgow using the MONICA project methods. These surveys were performed simultaneously in 1986 in men and women aged 25-64 years. Preliminary analysis shows that the differences in cigarette smoking, blood pressure and body mass index in men and women between the two centres are consistent with the difference in cardiovascular mortality. However there is no difference between the centres in reported exercise levels, and the difference in mean serum total cholesterol between the centres is in the opposite direction to that expected. Possible explanations of these differences are discussed.

Adult↗
PubMed1987

Trends in suicide in Scotland 1974-84: an increasing problem.

A detailed investigation of trends in suicide rates in Scotland from 1974 to 1984 showed a complex pattern. Overall rates for men increased by 40% with the greatest increases in those aged 45-64. In contrast, rates for women showed a small decline, which was most noticeable in those aged 15-24. The well recognised decline in poisoning by domestic gas was seen over this period, and suicide by this method virtually stopped. Both sexes showed a decline in suicide by poisoning with drugs, although the decrease was larger among women. The fall in suicide rates among young women was almost all due to the decrease in this method. The rise in rates for men was largely due to increases in hanging and poisoning with vehicle exhaust gases, although all methods except drugs and domestic gas showed some increase. These findings indicate that suicide is an increasing problem with causes that are far from understood, so that prevention may be difficult.

Adolescent↗
PubMed1987

International differences in coronary heart disease mortality and consumption of fish and other foodstuffs.

The relationship between fish consumption and coronary heart disease mortality was investigated using data on foodstuff consumption and mortality from 21 countries. A moderate negative association was found which appeared stable over different periods. This association disappeared when the effects of other foodstuffs were controlled for in multiple regression analysis. One feature to emerge was the anomalous position of Japan in consumption of several foodstuffs. Inclusive or exclusion of this country from regression analysis had a powerful effect on which independent variables entered the model. This illustrates the danger of using single countries, for example Japan with a high fish consumption and low CHD mortality, to support causal hypotheses about diet and disease.

Animals↗
PubMed1987

Coronary heart disease and water hardness in Scotland--is there a relationship?

Scotland has a mortality rate from coronary disease which is one of the highest in the world. There is also a considerable variation in this mortality rate within Scotland. Data on water hardness throughout Scotland have been collected from Regional Water Authorities to see whether variations in coronary mortality rates can be explained by variations in water hardness. Analysis demonstrates a much weaker negative association than has been demonstrated in studies in other countries. The geographical variation in coronary mortality rates in Scotland cannot be explained by variations in water hardness, and weak association between these in Scotland is discussed.

Adult↗