Are the Scots getting a better deal on prescribed drugs than the English?
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Five cases of thalassaemia minor and 11 symptomless trait carriers have been detected in four Scottish families, only one of which is known to have foreign ancestry. It is suggested that the condition is commoner than was once thought, and that the diagnosis should be considered in any patient with refractory hypochromic anaemia in which the red cells show increased osmotic resistance.
The purpose of the present investigation was to study bronchial responsiveness and pulmonary function in Swedish sawmill workers, who are not exposed to plicatic acid, the sensitizer in red wood cedar asthma. Bronchial responsiveness, transfer factor, spirometry, and precipitating antibodies in serum against sawmill fungi were measured in 164 workers at five sawmills. The results from workers inside the sawing area (sawyers, n=59), in the trimming department (trimmers, n=66), and from other workers in the sawmill (sawyer-referents, n=39) were compared. Sawyers had higher bronchial responsiveness than referents. In 55% of the sawyers FEV1 decreased by 20% or more within the highest dose of methacholine compared with 31% of sawyer-referents and 41% of trimmers (p<0.01, sawyers/referents). Sawyers decreased 74% more in FEV1 per milligram of inhaled methacholine compared with referents (geometric means, p<0.01). The transfer test in never-smokers was 13% lower in sawyers than in trimmers (p<0.01) and 8% lower compared with sawyer-referents (nonsignificant p<0.1). Presence of precipitating antibodies was not associated with changes in pulmonary function. Some agents in the sawing area of sawmills appear to increase bronchial responsiveness and decrease diffusion capacity.
Information was obtained on 952 persons who travelled from Scotland between 1973 and 1988 and who died while abroad. In the older age group cardio-vascular disease was the major cause of death whereas in the younger group traumatic deaths were commonest. Most died in the holiday resorts bordering the Mediterranean and the question is posed on the need for specific advice to those who are most vulnerable before embarking on overseas travel.
The element Strontium takes its name from the village of Strontian in Argyll. It was in ore samples taken from lead mines near the village that Strontium was first identified as a new element in 1970. A radioactive form of the element has reached medical prominence through its use in the palliation of pain in patients with painful skeletal metastases.
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Stephen Halpern concludes his three part series of articles on the impact of cash limits on the health service with a look at Scotland, which as more to spend than its counterparts in England; Wales, where Welsh wizardry has kept cuts to one per cent; and Northern Ireland which spends about one third more on health per head than England.
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