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At least 739 records · Page 41Linked to original sources
PubMed1977

Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases.

Data from 30 fatal cases of dextropropoxphene poisoning occurring in Northern Ireland over three years have been studied. All the victims had ingested more than therapeutic amounts, and many had also taken alcohol or other drugs. Most of the deaths were probably suicides. Death occurred very rapidly suggesting that the narcotic effects of dextropropoxyphene predominated, and this may explain the scarcity of clinical reports, It is suggested that many doctors are unaware of the danger of dextropropoxyphene in overdosage and that the problem of dextropropoxyphene poisoning in the United Kingdom has not been fully appreciated. This supposition, if correct, highlights the absence of a satisfactory early-warning system for serious drug effects including death.

Acetaminophen↗
PubMed1985

Renal transplantation in the United Kingdom and Ireland--the centre effect.

A detailed audit was done of eight of the twenty-nine transplant centres serving the UK and Ireland. These 8 centres account for one-third of the total renal transplant operations in these two countries. Information was obtained from each centre by means of a comprehensive questionnaire, a 1 1/2 day visit by the three authors, and an analysis of 50 consecutive first cadaver transplants. The 8 centres were chosen in the knowledge that 4 had high and 4 had low 3-month graft-survival rates. Our audit confirmed a centre effect, with a range in 1-year patient survival of from 82% to 96% and of first cadaver graft survival of from 54% to 82%. The two main factors affecting success rate were the rate of irreversible acute rejection and death with a functioning kidney. Our investigations suggested that the centre variation in acute rejection was influenced by blood transfusion and the variation in mortality by steroid dose and recipient age. Careful and well-organised clinical management cannot be easily quantified but was thought to have an important influence. Widespread adoption of pre-transplant blood transfusion and increasing use of cyclosporin will probably contribute to the further lessening of the centre effect which has already been observed over the past few years.

Aged↗
PubMed2000

The frequency and outcome of biliary atresia in the UK and Ireland.

BACKGROUND: Biliary atresia is an obliterative cholangiopathy of infancy that is fatal if untreated. Surgical treatment, the Kasai portoenterostomy, may restore bile flow and clear jaundice, and, if successful, achieve a 10-year survival of 90% with a native liver. The outcome of a 2-year cohort of children with biliary atresia in the UK and Ireland was assessed to find the current frequency, the factors influencing outcome, and the medium-term need for liver transplantation. METHODS: Cases diagnosed between March, 1993, and February, 1995, were notified by paediatricians to the British Paediatric Surveillance Unit via a monthly reporting system. Confirmed cases were followed up by postal questionnaires to notifying paediatricians. FINDINGS: 93 cases were confirmed, a frequency of 1/16700 livebirths. Primary surgery was done in 91 children in 15 surgical centres with an early success rate for clearing jaundice of 55% overall. Centres were grouped according to caseload; group A had more than 5 cases/year and group B fewer than 5 cases/year. Early success was higher in group-A centres, odds ratio 2.02 (95% CI 0.86-4.73), but this did not reach statistical significance. Of 41 children in whom surgery was unsuccessful in clearing jaundice 9 (22%) died and 30 (73%) underwent liver transplantation. Survival without liver transplantation and overall survival were both significantly greater in group-A centres, rate ratios 0.48 (95% CI 0.27-0.86) and 0.32 (0.11-0.94). Actuarial 5-year survival without transplantation was 61.3% in group-A centres and 13.7% in groupB centres. Actuarial 5-year overall survival was 91.2% in group A and 75% in group B. Once centre size was taken into account, no other factor, including age at surgery, was predictive of survival without transplantation or overall survival. INTERPRETATION: The outcome of children with biliary atresia is related to the caseload of the surgical centre where they have their primary surgery. Children with biliary atresia should be managed in surgical centres with a caseload of more than five cases annually.

Actuarial Analysis↗
PubMed2003

Comparison of phenotypic and genotypic characteristics of Salmonella bredeney associated with a poultry-related outbreak of gastroenteritis in Northern Ireland.

OBJECTIVES: To employ a combination of phenotypic and genotypic subspecies typing methods to aid in an epidemiological investigation of an outbreak of Salmonella bredeney involving ten persons. METHODS: Isolates were characterised by employing antibiogram typing, in addition to two genotyping techniques, including pulsed field gel electrophoresis (PFGE), random amplification of polymorphic DNA (RAPD) with two oligonucleotide primers. RESULTS: An outbreak of gastroenteritis associated with S. bredeney (serovar O:4 H:Lv 1,7) occurred in Belfast, Northern Ireland in November 1997. In total, ten cases were confirmed, of which eight had consumed chicken cooked at local butchers and retailed through one of two local bakeries. One of the remaining cases was secondarily infected within her home and the final case had eaten a product other than cooked chicken from one of the bakeries. Food preparation practices were inadequate in one of the bakeries in question and record keeping and possibly cooking procedures were inadequate in the butchers. S. bredeney was isolated from an uncooked chicken supplied to the butchers confirming that improperly cooked chicken was most likely the source of the outbreak. All outbreak clinical isolates were indistinguishable from each other and were similar to the isolate obtained from the uncooked poultry demonstrating that these DNA-based methods were valuable in the molecular characterization of S. bredeney. CONCLUSIONS: This report emphasises the importance and maintenance of an effective hazard analysis critical control point (HACCP) approach to the processing and retailing of foodstuffs containing chicken in order to help eliminate hazards to public health.

Adult↗
PubMed2003

Bovine tuberculosis in badgers in four areas in Ireland: does tuberculosis cluster?

We described the distribution of badger populations in four different areas in the Republic of Ireland. The data came from periodic targeted badger-removal and subsequent post-mortem examinations conducted between 1989 and September 1997, and from a formal badger-removal project in the same areas from 1997 through 1999. Records were complete for 2292 badgers regarding the date of capture, tuberculosis status, geographical area and specific sett from where the badgers were snared. Of 3187 setts, 2290 had no badgers recorded against them (i.e. were inactive). The badger-level prevalence of tuberculosis differed among areas (range 13-29%). Badger populations were highly clustered by sett, and this result was similar over the four study areas. The median number of badgers per active sett was 2. Tuberculous badgers also clustered within a sett. The third quartile of tuberculous badgers was 1 per active sett. The prevalence of tuberculous badgers within a sett was not related to the total number of badgers. There was little evidence of spatial clustering with only one local cluster of tuberculous setts in each of three areas, and none in the fourth area. After adjusting for the number of badgers per sett, only one area had spatial clusters identified.

Animals↗
PubMed1998

The influence of selected herd factors and a badger-intervention tuberculosis-control programme on the risk of a herd-level trade restriction to a bovine population in Ireland.

The risk of a trade restriction to cattle herds between 1990-1994, as a result of failing the tuberculin skin test or disclosure of visible lesions in the abattoir, was compared in two areas in East Offaly, Ireland. Cattle herds from the Project area where badgers were systematically removed over a 7-year period (1989-1995) were compared to herds from a Control area where no wildlife-intervention programme had taken place. A Cox proportional hazard model indicated, for example, that the risk of a herd-level trade restriction to herds with 30 animals in the Control area was 1.4 times the risk to similar-sized herds in the Project area. The study provides evidence that a badger-control programme is effective in reducing the risk of a trade restriction to cattle herds as the badger represents an important reservoir of Mycobacterium bovis infection for cattle.

Animals↗
PubMed2002

A study of cross-contamination of food-borne pathogens in the domestic kitchen in the Republic of Ireland.

To date, there have been no published information and empirical data available on the role played by the food preparer in the domestic kitchen in the Republic of Ireland. In this study, we have looked at the incidence of potential food pathogens and their cross-infection in the domestic kitchen during the preparation of a Sunday roast chicken lunch. Key contact sites in the domestic kitchen were sampled, including the chicken carcass before and after the preparation of a roast chicken meal. Twelve contact sites in twenty-five domestic kitchens were analysed and tested for aerobic plate count, Salmonella, Campylobacter, Escherichia coli and Staphylococcus aureus. Our findings identified the ability of food-borne disease microorganisms to become disseminated from infected foods, such as fresh chickens, to hand and food contact surfaces in the domestic kitchen, reiterating the need for consumer awareness and knowledge of effective hygiene procedures in the domestic kitchen.

Animals↗
PubMed1997

Impact of Acinetobacter spp. in intensive care units in Great Britain and Ireland.

Acinetobacter spp. are of increasing importance as hospital pathogens in intensive care units (ICUs) but it is unclear what clinical impact these bacteria have in Great Britain and Ireland. A survey was carried out by questionnaire on the impact of Acinetobacter in ICUs and the laboratory methods used to identify and type isolates. There were 70 respondents, of whom 25 reported that Acinetobacter had not been recovered from ICU patients within the previous 12 months. The remaining 45 respondents reported that the respiratory tract was the most common site from which these bacteria were isolated, but they were currently endemic in one ICU only. There were considerable differences in methods used to identify Gram-negative bacilli recovered from ICU patients, which may partly explain differences in the reported prevalence of isolates between centres, and 12 laboratories attempted to type isolates by a range of techniques. The availability and use of agreed antibiotic policies specific for ICUs may be particularly important in prevention and control where infection with Acinetobacter is prevalent.

Acinetobacter↗
PubMed2003

Mercury and organochlorine content of Dipper Cinclus cinclus eggs in south-west Ireland: trends during 1990-1999.

A sample of 124 deserted/infertile dipper (Cinclus cinclus) eggs was collected in south-west Ireland during six seasons (1990-1994 and 1999) and analysed for mercury and organochlorines. Mercury was detected in three of the 6 years but no trend was observed. DDT occurred above the limit of detection in only two eggs, one each in 1993 and 1994. In contrast, two derivatives of DDT (DDE and TDE) were found much more commonly. DDE occurred in over 87% of eggs, while TDE contamination was less widespread and reached a maximum of 60% in 1993, with none detected in 1991 or 1999. There was no trend in occurrence of DDE or TDE across years. PCB contamination was present consistently over the 10-year period, with little change in the proportion of contaminated eggs collected over time. In all years, the lowest recorded occurrence of total PCBs was 69% expressed on a formulation basis as Arochlor 1254. PCB congeners 138, 153 and 180 dominated. The congener pattern was similar across years with the exception of 1990 when congener 118 dominated. A distinct trend of high values of contaminants was observed in 1990 and 1993. In 1990, PCB 118 was the dominant contaminant, while in 1993, HEOD, DDE, PCB 138 and PCB 153 were primary contributors to the observed result. Other contaminants (HCB, PCB 101, gamma-HCH, PCB 170 and PCB 180) showed little obvious patterns between years and occurred at relatively low levels. No pattern was observed in contaminants when eggs were grouped according to river or altitude. These data provide a baseline for organochlorine contamination levels in Irish freshwater ecosystems against which future trends can be assessed.

Animals↗
PubMed2003

The impact on breastfeeding of labour market policy and practice in Ireland, Sweden, and the USA.

In recent decades there has been a marked rise in the labour market participation of women with infants in many countries. Partly in response to this trend, there are calls for greater emphasis on infant and child health in research and policy development on parental leave and other work-family balancing measures. Yet achieving high rates of breastfeeding as a health objective has thus far received relatively little attention in this context. Biomedical literature outlines the important health benefits conferred by breastfeeding, including upon infants and young children among middle class populations in developed countries. International recommendations now advise exclusive breastfeeding for 6 months. However, research indicates that the timing of the mother's resumption of employment is a key factor influencing the duration of exclusive breastfeeding. There would thus appear to be considerable potential for labour policy and practice, particularly maternity/parental leave provisions, to positively influence breastfeeding practice. Taking the case studies of Ireland, Sweden, and the United States, this paper explores the implications of labour market and early childhood policy for breastfeeding practice. The equity tensions posed by the breastfeeding-maternal employment intersection are also examined. The paper concludes that both socio-cultural support and labour market/health/early childhood policy are important if high rates of both breastfeeding and women's employment are to be achieved in industrialised countries.

Breast Feeding↗
PubMed1997

Male mortality differentials by socio-economic group in Ireland.

There is very little information on differences in mortality by socio-economic group in Ireland. Only one major study has been done in this area. That study was based on data for 1981 and confined to aggregate deaths for males aged between 15 and 64. The objective of this paper is to extend the previous work along a number of important dimensions. Combined deaths data for males for the period 1986-1991 are used, thereby allowing differentials to be estimated with more precision. Mortality differentials for males by cause of death are also explored using this data. Methodological issues associated with trend analysis are highlighted in the paper. There is some discussion on both causal relationships and policy implications arising from analysis of the data. The results confirm international trends in this area: poorer people have higher mortality relative to people in more advantaged circumstances.

Adolescent↗
PubMed2002

A survey of helminth control practices in equine establishments in Ireland.

We report the results of a survey to assess the attitudes of horse owners and managers of equine businesses in Ireland to the control of helminth parasites, and the extent to which veterinary practitioners are involved in providing advice on parasite control of horses. Replies to our questionnaire indicated that there is a high level of awareness on the need for helminth control, typically leading to several doses of anthelmintic being administered to each animal every year. While a majority of respondents (61%) were concerned about the issue of anthelmintic resistance, only a few were of the opinion that it was a problem on their establishment. Measures to minimise the development of resistance, such as decreasing the frequency of dosing, optimising non-drug-based control strategies and assessing the need for dosing by faecal egg counts (FECs), were not widely employed in a strategic manner. Just over half (54%) of respondents indicated that they devised worming control programmes based on veterinary advice, and a large majority did not perceive any need for modification of their current worm control programmes. We concluded that there is considerable scope for increased veterinary involvement in the design and implementation of control programmes for helminths in horses, and that veterinarians do not always provide advice in accordance with "best practice" in helminth control.

Animal Husbandry↗
PubMed1999

Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland.

The efficacy of legislation in reducing firework associated injuries is uncertain as is the nature of the problem within the United Kingdom (UK). In September 1996 the legislation governing firework sale in Northern Ireland was relaxed thus equalling that of the rest of the UK. For the 2 years following the change in legislation we prospectively assessed those patients who were admitted with a firework injury over the Halloween period. We then compared these results with retrospective data for the 3 years prior to the change in firework law. In the pre-legislation series the mean number of patients admitted annually was 0.38 per 100,000 while in the post-legislation series the mean was 0.43 per 100,000. Blast injury to the hand was the commonest injury accounting for 53% of cases in both series. Burn injuries were the second commonest form of injury comprising 30% of all admissions. Of those admitted with a hand injury 47% had at least one finger terminalised and nearly half of those patients admitted with burns (44%) required skin grafting. We conclude that early evidence suggests that liberalisation of the law on firework sale has not resulted in a significant increase in firework related injuries requiring hospital admission.

Adolescent↗
PubMed2001

Incidence of Mycobacterium paratuberculosis in raw sheep and goats' milk in England, Wales and Northern Ireland.

A blind survey of 104 raw sheep and goats' milk samples (90 goat, 14 sheeps) from bulk tanks on farms throughout England, Wales and Northern Ireland was carried out over a 5-month period (January-May 1998) in order to determine the incidence of Mycobacterium paratuberculosis. Each milk sample (100 ml) was divided into two 50ml portions. One portion was decontaminated with 0.75% hexadecylpyridinium chloride for 5h before culture on slopes of Herrold's egg yolk medium and in BACTEC radiometric medium. The second portion was subjected to immunomagnetic separation followed by IS900 PCR (IMS-PCR). The IMS-PCR assay was employed in order to provide a more rapid indication of the presence of M. paratuberculosis in each milk sample than is possible by culture. Information on the Johne's disease status of the sheep and goat herds that took part in the survey was not sought at the time of milk sampling. However, it subsequently emerged that at least some of the herds whose bulk milk was tested during this study were previously or currently infected with Johne's disease. Overall, during this survey one raw goats' milk sample tested positive for the presence of M. paratuberculosis by IMS-PCR (<1% of milk samples tested) but no viable M. paratuberculosis were isolated by culture. The results of this study suggest that bulk raw sheep and goats' milk from these regions of the UK may not represent significant vehicles of transmission of M. paratuberculosis to humans.

Animals↗
PubMed1999

Isolation and characterisation of circoviruses from pigs with wasting syndromes in Spain, Denmark and Northern Ireland.

A porcine circovirus (PCV) was isolated from tissues of pigs with wasting syndromes from Spain, Denmark and N. Ireland. The antigenic profiles of these viruses were determined by indirect immunofluorescence assays using polyclonal antisera and monoclonal antibodies (mAbs) prepared against previously isolated PCVs. A rapid and convenient PCR-based test was developed and used for the genotyping of these PCV isolates. These PCV isolates were found to be antigenically and genomically similar to previously reported isolates of PCV from pigs with wasting disease (PCV2), but distinct from the isolate of PCV from continuous PK/15 cell cultures (PCV1).

Animals↗
PubMed1997

Determination of the furazolidone metabolite, 3-amino-2-oxazolidinone, in porcine tissues using liquid chromatography-thermospray mass spectrometry and the occurrence of residues in pigs produced in Northern Ireland.

A method is presented for the detection of the furazolidone metabolite, 3-amino-2-oxazolidinone (AOZ), in porcine tissue. Bound and extractable residues are detected following methanol-water homogenisation, repeated solvent washing and derivatisation with 2-nitrobenzaldehyde. Samples are analysed by using thermospray mass spectrometry-liquid chromatography, monitoring the positive ion m/z 253 with filament-assisted ionisation. There is no interference from tissue matrices or excess 2-nitrobenzaldehyde reagent. The limit of determination for liver and muscle is 10 ng/g. Recoveries are greater than 80%. The assay was used to investigate the occurrence of furazolidone residues in pigs from Northern Ireland. One hundred samples were analysed. Seventeen of these contained bound AOZ residues. The stability of tissue samples post mortem was investigated in order to achieve optimum storage conditions for samples. When liver was stored at 4 degrees C, the concentration of bound AOZ decreased by 22% within 48 h. However, there were no significant changes in AOZ concentrations in liver that was stored at -20 degrees C for six months.

Animals↗
PubMed2000

Characterization of oxytetracycline-resistant heterotrophic bacteria originating from hospital and freshwater fishfarm environments in England and Ireland.

This ecotaxonomic study compared the antibiotic tolerance among culturable oxytetracyline-resistant (Ot(r)) heterotrophic strains isolated from two aquatic environments representing human activities in health care and aquaculture, namely hospital effluents and freshwater fishfarms. Using a standardized methodology, samples taken in England and Ireland were analyzed to determine the antibiotic tolerance profiles of two groups of culturable Ot(r) bacterial isolates at the intergeneric and intrageneric level comprising heterotrophs (189 strains) and mesophilic Aeromonas spp. (153 strains), respectively. Antibiogram data of heterotrophic isolates revealed that Irish hospital strains comprised higher frequencies of multi-tolerance than those originating from fishfarm environments whereas a reverse correlation was found among the English heterotrophs. Polyphasic identification of the isolates using fatty acid analysis and API 20E profiling showed that this difference arose from the unique taxonomic diversity within each heterotrophic strain set. Acinetobacter (27%) and Brevundimonas (22%) were predominant among the Irish Ot(r) fishfarm isolates, whereas isolates originating from the English aquaculture site almost entirely consisted of Stenotrophomonas maltophilia (86%) exhibiting high frequencies of tolerance to ampicillin and streptomycin. Within both the English and the Irish Ot(r) Aeromonas strain sets, on the other hand, the hospital strain sets displayed higher numbers of multi-tolerant isolates than to fishfarm isolates although country-specific differences were observed for individual antimicrobial agents. The typical occurrence of kanamycin-tolerant aeromonads in the Irish hospital site could to some extent be linked to the typical presence of A. hydrophila DNA hybridization group (HG) 3 strains as determined by fatty acid analysis and fluorescent amplified fragment length polymorphism (FAFLP) fingerprinting. Essentially, these data indicate that tolerance profiles in a specific environment of one country do not necessarily reflect the corresponding tolerance profiles of the same type of environment in another country, and this mainly as a result of the unique taxonomic composition of each site. Ot(r) representatives of Acinetobacter, S. maltophilia, and A. veronii biovar sobria HG8 were common to most if not all of the four sites under study, indicating that these three taxa may serve as potential indicator organisms for monitoring antibiotic tolerance among indigenous bacterial populations in various aquatic environments.

Aeromonas↗
PubMed1998

Equity and orthodontic treatment: a study among adolescents in Northern Ireland.

This epidemiological study investigated the reasons why children in Northern Ireland who need orthodontic treatment do not receive treatment even when it is provided free by the state. A total of 1584 15- and 16-year-olds were examined in 23 high schools with the Index of Orthodontic Treatment Need. The characteristics of the adolescents who had received orthodontic treatment were compared with those who had a definite need for treatment and yet did not receive treatment or advice. One in 10 of the adolescents examined had an unmet need for orthodontic treatment. Logistic regression analysis was used to assess the influence of 11 variables including socioeconomic status, religion, and standard of dental health on the uptake of orthodontic care. This analysis revealed that the only significant predictors of whether an adolescent received orthodontic treatment was the dental attendance pattern of the adolescent, the adolescent's dental health, and the dental attendance pattern of the adolescent's mother. Those adolescents who had good dental health, who regularly attended a dentist, and whose mother regularly attended a dentist were more likely to receive orthodontic treatment.

Adolescent↗