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At least 379 records · Page 21Linked to original sources
PubMed1987

Paralytic poliomyelitis in England & Wales, 1970-84.

In 1962 the Public Health Laboratory Service (PHLS) became responsible for the Poliomyelitis Surveillance Scheme for England and Wales, which since 1970 has included the World Health Organisation (WHO) enquiry into Acute Persisting Spinal Paralysis. All the records have been kept, including those of patients who were later considered not to have had poliomyelitis. This paper reviews the cases between 1970-84 of patients normally resident in England and Wales, where the clinical features of the illness were considered by the clinician in charge to be those of poliomyelitis and in which either poliovirus was isolated or there was serological evidence of recent infection. Seventy cases met these criteria. Two patients died. A wild strain of poliovirus was isolated in 19 cases; a vaccine-like strain in 27; an intermediate strain in 5; and in 19 cases the strain was not known or there was no isolate. Eleven patients had a history of overseas travel; 17 had been vaccinated recently; and 12 had been in contact with a recent vaccine. In the remaining 30 cases, the source of the infection was not found. Other details, including the age distribution, vaccination history and the laboratory findings are discussed.

Adult↗
PubMed2002

The burden of Helicobacter pylori infection in England and Wales.

The prevalence of active infection with Helicobacter pylori in the general population of England and Wales was estimated using high reactivity for specific IgG in serum ELISA as a marker. A total of 10,118 anonymized residues of serum samples collected in 1986 and 1996 from persons aged 1-84 years were used. Estimated prevalence of active infection varied by region and was highest in London. Prevalence was related to decade of birth and increased from 4-3% in those born during the 1980s to 30% in those born before 1940. An estimated total of 7.5 million people living in England and Wales have an active infection and analysis by decade of birth showed no significant difference between samples collected in 1986 and 1996. These data suggest H. pylori infection is becoming less common, is acquired at an early age and is unlikely to be resolved unless suitable antimicrobial treatment is sought.

Adolescent↗
PubMed2005

Past mortality from infectious diseases and current burden of allergic diseases in England and Wales.

This study documents the changes in mortality in England and Wales over the last 100 years as a possible explanation for our increasingly allergy-prone Western society. A total of 53 million computerized recorded deaths, which occurred from 1901 to 2000 were analysed retrospectively. Childhood mortality decreased by 98%, from 40.6% of total annual deaths in 1901 to 0.9% in 2000. In 1901, 36.2% of all deaths and 51.5% of childhood deaths were from infectious diseases. By contrast in 2000, 11.6% of all deaths and only 7.4% of childhood deaths were from infectious diseases. Infectious diseases were a significant cause of childhood mortality in British cities until about 40 years ago. Several factors, including vaccination, antibiotics and improved sanitation have contributed to this trend. Survival of individuals with heightened immunity to infections may have led to natural selection of allergy-prone individuals in England and Wales. However, the relationship between changes in rates of infection and allergy is complex and not fully understood.

Adolescent↗
PubMed2006

Hepatitis C virus: laboratory surveillance in England and Wales, 1992-2004.

Between 1992 and 2004, a total of 49,819 confirmed hepatitis C infections have been reported to the Health Protection Agency (HPA) by laboratories in England and Wales; the annual number of reports increased from 241 in 1991 to 8149 in 2004. Most reports with a known risk factor were in injecting drug users (87%, 12,438/14,221), but 71% (35,598/49,819) of the total had no reported identified risk. The age-sex distribution of the latter cases was similar to that in injecting drug users. Using names to assign ethnicity, individuals with South Asian names had an older age distribution and a different risk factor profile from non-South Asians. Using published age-specific prevalence data from 1996, it was estimated that around 28,1764 cases of hepatitis C infection exist in England and Wales, and that only 17% of these cases have been reported to the HPA. Surveillance reports continue to provide important information regarding trends in hepatitis C infection in specific risk groups.

Adolescent↗
PubMed1998

Outbreaks of waterborne infectious intestinal disease in England and Wales, 1992-5.

Following the introduction of an improved surveillance system for infectious intestinal disease outbreaks in England and Wales, the Public Health Laboratory Service Communicable Disease Surveillance Centre received reports of 26 outbreaks between 1 January 1992 and 31 December 1995 in which there was evidence for waterborne transmission of infection. In these 26 outbreaks, 1756 laboratory confirmed cases were identified of whom 69 (4%) were admitted to hospital. In 19 outbreaks, illness was associated with the consumption of drinking water from public supplies (10 outbreaks) or private supplies (9 outbreaks). The largest outbreak consisted of 575 cases. In 4 of the remaining 7 outbreaks, illness was associated with exposure to swimming pool water. Cryptosporidium was identified as the probable causative organism in all 14 outbreaks associated with public water supplies and swimming pools. Campylobacter was responsible for most outbreaks associated with private water supplies. This review confirms a continuing risk of cryptosporidiosis from chlorinated water supplies in England and Wales, and reinforces governmental advice to water utilities that water treatment processes should be rigorously applied to ensure effective particle removal. High standards of surveillance are important for prompt recognition of outbreaks and institution of control measures. As microbiological evidence of water contamination may be absent or insufficient to implicate a particular water supply, a high standard of epidemiological investigation is recommended in all outbreaks of suspected waterborne disease.

Communicable Diseases↗
PubMed2000

The law concerning the conduct of lineups in England and Wales: how well does it satisfy the recommendations of the American Psychology-Law Society?

Four rules minimize the likelihood of a false conviction resulting from the misidentification of a suspect from a lineup: (1) The person conducting the lineup should not know which member of the lineup is the suspect. (2) The eyewitness should be warned that the criminal might not be present. (3) Foils should be selected based on the eyewitness's verbal description of the criminal. (4) Confidence should be recorded at the time of identification. In this paper the relevant law relating to lineups in England and Wales is outlined and the extent to which they satisfy the four rules is reviewed. It is concluded that the way in which lineups are conducted in England and Wales would, with minor modifications, satisfy the four rules, and this demonstrates that the rules can be applied practically.

Criminal Law↗
PubMed2002

Characterisation of airborne particles collected within and proximal to an opencast coalmine: South Wales, U.K.

Airborne particulate matter has been collected from within, and proximal to, an opencast coal mine in south Wales. This work forms the first part of a three year project to collect and characterise, then determine the possible toxicology of airborne particles in the south Wales region. High-resolution Field Emission SEM has shown that the coal mine dusts consist largely of an assemblage of mineral grains and vehicle exhaust particles. SEM-EDX has shown that the mineralogical make-up of the PM10 is complex, heterogeneous, and constantly changing. These findings are supported by analytical TEM-EPXMA. However, patterns can be determined relating the mineralogical composition of the airborne particles to collection locations and mining activities within the opencast. At our study opencast, Park Slip West, quartz, which has known health effects, never exceeded 30% of the total collection mass, and average levels were much less. Vehicle exhaust emissions was the largest source in terms of particle numbers. The mass of airborne particulate matter within the pit averaged approximately twice that of outside the pit: importantly however, this higher mass was due to relatively large, and non-respirable, mineral grains. This study demonstrates that the physicochemical and mineralogical characterisation of airborne particles from mining and quarrying is essential to quantify the respirable fraction, and to identify potentially hazardous components within the PM10.

Air Pollutants↗
PubMed1990

Stomach cancer and migration within England and Wales.

Rates of stomach cancer vary from place to place within England and Wales. To determine whether this reflects influences acting earlier or later in life, we have analysed mortality from the disease by county of birth and county of death. Among 749,035 men and women who died during 1969-72 in a different county from that in which they were born, proportional mortality from stomach cancer was more closely related to county of birth than of death. This association with place of birth was found in migrants both out of and into high-risk areas. We conclude that studies seeking to explain local differences in the incidence of stomach cancer within England and Wales should focus on the environment of patients in their youth.

England↗
PubMed1990

Poor housing in childhood and high rates of stomach cancer in England and Wales.

In a search for aetiological processes which might explain the association of stomach cancer with poverty, we have related mortality from the disease in the local authority areas of England and Wales during 1968-78 to indices of living standards derived from the 1971, 1951 and 1931 censuses. We have also analysed recently released data from a national survey of overcrowding carried out in 1936. Geographical differences in stomach cancer were most closely related to occupationally derived indices of socio-economic structure from the 1971 census, and to measures of domestic crowding from the 1931 census and 1936 survey. Unlike other indices of poor living standards, levels of past domestic crowding in north-west Wales were consistent with its previously unexplained high death rates from stomach cancer. We conclude that overcrowding in the home during childhood may be a major determinant of stomach cancer, and might act by promoting the transmission of causative organisms.

Adult↗
PubMed1992

Cancer mortality in African and Caribbean migrants to England and Wales.

Cancer mortality during 1970-85 of immigrants from East and West Africa and the Caribbean to England and Wales is described. Overall cancer mortality was raised in West African males (RR 1.38, 95% CI 1.25-1.54), and non-significantly raised in West African females (RR 1.14, 0.96-1.37) compared to mortality in the England and Wales-born population. Much of the increased risk was due to very high rates of liver cancer in males (RR 31.6, 23.8-41.9), but rates were also raised for a wide range of other cancers in each sex. Only lung and brain cancer had significantly decreased mortality. In East Africans, overall cancer mortality was low in males (RR 0.63, 0.56-0.70), and in females (RR 0.80, 0.72-0.89). Mortality was significantly low for cancers of the stomach, pancreas and testis, and Hodgkin's disease in males, for cervical cancer in females, and for lung cancer and melanoma in both sexes. Cancer sites with significantly raised mortality included oropharyngeal cancer, leukaemia, and multiple myeloma in both sexes. In Caribbean immigrants overall cancer rates were significantly low in males (RR 0.71, 0.68-0.74) and in females (RR 0.76, 0.73-0.80). Mortality was significantly low for many cancers including colorectal, lung, testis and brain cancers. Mortality was significantly raised only for cancer of the prostate in males, of the placenta in females, and of the liver, non-Hodgkin's lymphoma and multiple myeloma in both sexes. Overall, mortality was high from prostatic cancer and liver cancer, and was low from brain cancer, in predominantly ethnic African immigrant groups. Both East and West African immigrants had raised rates of leukaemia. All of the migrant groups had high rates of multiple myeloma and low rates of testicular, ovarian and lung cancer. Genetic and environmental factors that may contribute to these patterns are discussed.

Adolescent↗
PubMed1995

Childhood thyroid cancer in England and Wales.

A total of 154 cases of thyroid cancer in children under 15 were registered in England and Wales over a period of 30 years, an incidence of about 0.5 per million per year. A total of 4.5 cases per year were registered in 1963-72, 4.9 in 1973-82 and 5.8 in 1983-92. A rapid rise in incidence with age occurred after the age of 5. Malignancy was confirmed in 92% of the cases in which tissue was available. Of these, 68% were papillary carcinomas, 11% follicular carcinomas and 17% medullary carcinomas. There were two spindle cell tumours with mucous cysts and one teratoma. The increased frequency but small size of medullary carcinomas in the second half of the period suggested that this increase was due to the introduction of screening; it accounted for most of the rise in crude incidence rats with time. The sex ratio (F:M) in all registered cases in the differentiated follicular cell carcinoma groups in children aged under 10 was 1.2:1, and 3.6:1 in the older children. Five children with differentiated thyroid cancer of follicular cell origin died up to 17 years after diagnosis. Two of the eight children aged 9 or less with a 20 year follow-up died, compared with three of 28 older children. An unusual group of differentiated carcinomas showed solid or follicular architecture. These tumours were unencapsulated, often widely invasive, contained psammoma bodies but little or no papillary architecture and the nuclei often lacked prominent grooving. This childhood type of papillary carcinoma contrasted with the classical type commonly found in the adult, which was present in one of 13 confirmed papillary carcinomas in children aged less than 10, compared with 20 of 35 older children. These observations show that thyroid carcinoma in very young children has a different spectrum of histological types from both older children and adults. From the age of about 10 well-differentiated papillary carcinomas rapidly increase in frequency in females, so that the other types come to form only a small proportion of the total. These differences, and the lower incidence but poorer prognosis of thyroid carcinoma in men and the poorer prognosis in post- as compared with premenopausal women, are compatible with a major role for sex hormones in thyroid carcinogenesis in females during the reproductive period. This study documents the incidence of childhood thyroid cancer in England and Wales, explains the rise in crude incidence rates, shows differences between carcinomas in children under and over the age of ten which may correlate with puberty, and draws attention to an unusual aggressive type of childhood papillary carcinoma. It illustrates the value to crude registry data of a pathology review.

Adenocarcinoma, Follicular↗
PubMed2001

Comparison of decisions regarding prophylactic removal of mandibular third molars in Sweden and Wales.

OBJECTIVE: To test the hypothesis that Swedish dentists schedule more mandibular third molars for prophylactic removal compared with UK dentists and oral surgeons. DESIGN: Clinical and radiographic information relating to a stratified sample of 36 disease-free mandibular third molars (equal distribution of males and females, patients' age, angular position and degree of impaction) was presented to 26 general dental practitioners (GDPs) and 10 oral surgeons in Sweden and 18 GDPs and 10 oral surgeons in Wales who were asked to decide whether or not the third molars should be removed. RESULTS: There was no evidence of any difference in mean number of molars scheduled for removal by the GDPs, but the Swedish oral surgeons scheduled significantly more third molars for removal than oral surgeons in Wales. CONCLUSION: The less interventionist approach among oral surgeons in the UK may reflect the development and application of authoritative guidelines in the UK and an extensive debate concerning appropriateness of prophylactic removal there.

Adult↗
PubMed2003

Up-to-date estimates of long-term cancer survival in England and Wales.

Cancer survival in England and Wales has improved over the last 30 years. However, cohort survival estimates delay recognition of these improvements. Here we show that period survival estimates, based on survival in a recent time period, suggest a more optimistic pattern for England and Wales than cohort-based measures for most cancers.British Journal of Cancer (2003) 89, 74-76. doi:10.1038/sj.bjc.6600976 www.bjcancer.com

Adolescent↗
PubMed2004

Trends and socioeconomic inequalities in cancer survival in England and Wales up to 2001.

We examined national trends and socioeconomic inequalities in cancer survival in England and Wales during the 1990s, using population-based data on 2.2 million patients who were diagnosed with one of the 20 most common cancers between 1986 and 1999 and followed up to 2001. Patients were assigned to one of five deprivation categories (from 'affluent' to 'deprived') using characteristics of their electoral ward of residence at diagnosis. We estimated relative survival up to 5 years after diagnosis, adjusting separately in each deprivation category for background mortality by age, sex and calendar period. We estimated trends in survival and in the difference in survival between deprivation categories ('deprivation gap') over the periods 1986-90, 1991-95 and 1996-99. We used period analysis to examine likely survival rates in the near future. Survival improved for most cancers in both sexes during the 1990s, and appears likely to continue improving for most cancers in the near future. The deprivation gap in survival between rich and poor was wider for patients diagnosed in the late 1990s than in the late 1980s. Increases in cancer survival in England and Wales during the 1990s are shown to be significantly associated with a widening deprivation gap in survival.

England↗
PubMed2006

Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971-2001.

In the last two decades, mortality from primary liver cancer has increased in the UK. We aimed to determine whether the incidence trends for these cancers were similar and in particular if the increasing occurrence of cholangiocarcinoma has continued. We calculated directly age-standardised incidence rates (using the European standard population) by subsite and histological type for all cancers of the liver, gallbladder and biliary tract in England and Wales from 1971 to 2001, using cancer registry data. The incidence of cancers of the liver, gallbladder and biliary tract increased, with the greatest rise, around 12-fold, in intrahepatic bile duct cancers. The rate of liver cell cancer increased by around 45% in males, but by <10% in females. There were marked reductions in the incidence of gallbladder and extrahepatic bile duct cancer. Cholangiocarcinoma increased around 16-fold and became the most common type of primary liver cancer in females, while hepatocellular carcinoma remained the commonest type in males. The age-specific incidence rates showed that intrahepatic bile duct cancer continued to increase throughout the 1990s in those aged 75 and over, while liver cell cancer decreased in the older age groups. In conclusion, there were increases in the incidence of primary liver cancer, which have been particularly dramatic for intrahepatic bile duct cancer, over the last three decades of the 20th century in England and Wales. There has been a halving in the incidence of gallbladder cancer and a reduction of a third in extrahepatic bile duct cancer.

Adult↗
PubMed2006

Human papillomavirus infection: an anonymous prevalence study in South Wales, UK.

The objective of this study was to describe human papillomavirus (HPV) prevalence in South Wales in relation to age, cytology and social deprivation. This was an unlinked, prospective, anonymous, population-based study. DNA was purified from 1911 liquid-based cytology samples (mean age 37.7 years, cytology 93.2% negative, social deprivation average score 17.9) using quality assured techniques and the presence of virus determined by PCR-Enzyme Immuno Assay (PCR-EIA). 209 (10.9%) samples contained high-risk (HR) HPV infection of which 36.4% had multiple HR-HPV types. The most frequent HR types were HPV 16 (19.6%), HPV 35 (9.5%), HPV 66 (9.2%), HPV 59 (8.5%) and HPV 56 (7.6%). There was a strong association between HPV infection and cytological abnormality. Significantly more HR-HPV infections were detected in women under the age of 30 years (68.9% of all HR-HPV infections Fisher's exact test P=0.0001) compared to 30 years and above. There was no difference in HPV prevalence between different socioeconomic groups. The data presented suggest a different HPV type distribution in South Wales in comparison to that reported for other populations.

Adult↗
PubMed1997

Dietary and lifestyle differences between Scottish teenagers and those living in England and Wales.

OBJECTIVE: To investigate the dietary differences reported by teenagers in Scotland compared with teenagers from elsewhere in Britain, allowing for a range of other demographic, personal and lifestyle variables. DESIGN: Data was taken from the 1970 longitudinal birth cohort study which collected data cross-sectionally at 16-17 y. SETTING: The respondents were distributed throughout Britain. SUBJECTS: A sub-sample of 1615 respondents was selected (M = 658, F = 957). The criterion for selection were a completed 4 d dietary diary and a 4 d activity diary and the completion of a number of other questionnaires to provide demographic and lifestyle data by both the respondent and the parent of the respondent. RESULTS: The diets of Scottish teenagers were significantly different to those of teenagers in England and Wales even when allowing for differences in smoking habits, parental smoking, alcohol intake, family size and housing tenure: factors which were also different among the Scottish cohort. Intakes of fibre, magnesium, phosphorous, retinol equivalents, carotene and riboflavin were significantly lower in Scotland among males and females, as were intakes of non-processed vegetables and non-fried potato, skimmed milks, fat spreads high in polyunsaturates and beer. Scottish teenagers drank more soft drinks and ate more chips and white bread than their counterparts in England and Wales. No differences were noted in intakes of vitamin C and fruit based on regional distribution: lower intakes of fruit in Scotland appeared to be associated with the higher incidence of teenage smoking. CONCLUSIONS: The diets of Scottish teenagers appeared to be further from current dietary recommendations than the diets of teenagers elsewhere in Britain, but the lower intakes of fruit among Scottish teenagers commonly reported is likely to be associated with teenage smoking rather than living in Scotland itself. Care should be taken when evaluating dietary surveys that known confounding variables are included.

Adolescent↗