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PubMed1998

Natural prevalence of infection with Ehrlichia (Cytoecetes) phagocytophila of Ixodes ricinus ticks in Scotland.

Ixodes ricinus nymphs and adults were collected from vegetation and from sheep at four sites in Scotland typical of areas endemic for tick-borne fever in sheep caused by infection with Ehrlichia (Cytoecetes) phagocytophila (Rickettsiales). The great majority of ticks examined was from woodland sites adjacent to sheep farms where there was a high probability of them feeding on roe deer (Capreolus capreolus) in a non-domestic focus of infestation and infection. Ticks were examined for infection by five methods. Batches of ticks were examined either by feeding on susceptible sheep or by feeding on rabbits and then prepared as stabilate which was inoculated into susceptible sheep. The sheep were monitored for clinical signs of tick borne fever. Batches of ticks were examined by polymerase chain reaction for Ehrlichia phagocytophila. Salivary glands were dissected out and stained by the Feulgen method to detect Ehrlichia masses, and were examined by indirect fluorescent antibody test. Each of the methods detected infection in ticks and the prevalence of infection in nymphs with the various methods ranged from >0.25% to 2.0%. Small samples of adults examined by Feulgen staining of salivary glands indicated infection prevalences of 2.1% in males and 1.6% in females. It is considered that these low infection prevalences may be typical of natural foci of infection where deer could be a major host of ticks and E. phagocytophila.

Animals↗

PubMed2002

A review of Brucella sp. infection of sea mammals with particular emphasis on isolates from Scotland.

Brucellae recovered from sea mammals were first reported in 1994. In the years since both culture and serological analysis have demonstrated that the infection occurs in a wide range of species of marine mammals inhabiting a vast amount of the world's oceans. Molecular studies have demonstrated that the isolates differ from those found amongst terrestrial animals and also distinguish between strains which have seals and cetaceans as their preferred hosts. At the phenotypic level seal and cetacean strains can also be differed with respect to their CO(2) requirement, primary growth on Farrells medium and metabolic activity on galactose. Two new species B. cetaceae and B. pinnipediae have been proposed as a result. This paper provides a review of Brucella in sea mammals and updates findings from the study of sea mammals from around the coast of Scotland.

Animals↗

PubMed1999

Role of drugs and alcohol in impaired drivers and fatally injured drivers in the Strathclyde police region of Scotland, 1995-1998.

During the 4-year study period, 1995-1998, the Department of Forensic Medicine and Science, University of Glasgow received a total of 752 biological samples from drivers suspected of driving under the influence of drink and/or drugs in the Strathclyde region of Scotland. The majority of samples were blood and had been primarily obtained from males. Drugs were detected in 68 and 90% of blood and urine samples, respectively. Toxicological analyses revealed that cannabis was the most frequently encountered illegal drug which was detected in 39% of all drug positive blood samples. Benzodiazepines were detected in the majority of drug positive samples with 82% containing at least one member of this group. Polydrug use was prevalent, with the average number of drugs detected per sample increasing from 2.0 in 1995 to 3.1 in 1998. For comparison, the results of toxicological analyses from 151 fatally injured drivers are described. Although the majority of samples tested negative for the presence of drugs and alcohol, drugs were found to be present in 19% and alcohol was detected in 33%. As the majority of drugs had been prescribed or administered post-accident, this study shows that alcohol was the main causative factor conducive to fatal road traffic accidents.

Accidents, Traffic↗

PubMed1999

Injury analyses of fatal motorcycle collisions in south-east Scotland.

The timing of death and pathological findings in fatal motorcycle accidents in south-east Scotland between 1987 and 1997 were investigated. Of the 59 motorcyclists who died, 38 were dead when found at the accident scene, six others were alive when found but died at the scene, two died in an ambulance in transit to hospital and 13 died after reaching hospital. Scoring of the injuries according to the Abbreviated Injury Scale revealed Injury Severity Scores (ISS) ranging from 25 to 75. Overall, injuries to the head, neck and chest were responsible for the most severe injuries. Twenty-five motorcyclists had injuries acknowledged to be unsurvivable (ISS = 75), most of which involved the thoracic aorta, brainstem and cervical spinal cord. The greatest potential to reduce the death rate amongst motorcyclists lies with accident prevention/injury reduction measures, rather than through improved treatment of injuries. Efforts to try to alter driving behaviour and to improve the design of vehicles and helmets need to continue.

Abbreviated Injury Scale↗

PubMed2002

Reliability of cancer registration data in Scotland, 1997.

The aim of this study was to assess the reliability of cancer registration data in Scotland following a major re-organisation of the Scottish Cancer Registry. From a random sample of 3500 primary cancers (excluding non-melanoma skin cancers and death certificate only (DCO) registrations) diagnosed between April and September 1997, 3175 (90.7%) had medical records available for scrutiny. Data were re-abstracted by a team of trained medical coders and compared with information registered originally. Reliability was generally high for demographic, diagnostic, and fact of treatment details, but less reliable for grade of differentiation, staging variables and dates of treatment. Some discrepancies probably arose because of differing availability of information at the time of registration compared with the time of re-abstraction. Although data quality is high overall, further improvements might be achieved through continued training, structured recording of information by clinicians in medical records, and continued exploitation of the data.

Data Collection↗

PubMed2003

What features of the home and the area might help to explain observed relationships between housing tenure and health? Evidence from the west of Scotland.

This study aimed to explore the role of dwelling conditions and neighbourhood characteristics in explaining the frequently observed association between housing tenure and health. A postal questionnaire, focusing on a number of specific aspects of the home and the area, was sent to a random sample of adults in the west of Scotland (achieved sample size 2867, response rate 50%). The health measures were limiting long-standing illness, self-assessed health, recent symptoms, and anxiety and depression. Having controlled for age, sex, and marital status, housing tenure explained, respectively, 2.7%, 5.4%, 3.9%, 2.4% and 5.4% of the variance in these variables. These percentages were reduced by between 93% (for anxiety) and 73% (for self-assessed health) when housing problems, housing fixtures, overcrowding, dwelling type, access to garden, area type and area amenities were introduced into the model. This suggests that features of the dwelling and its surroundings help to explain observed associations between tenure and health in the UK, and that housing and area problems may be particularly important. Housing improvements and urban regeneration may help to reduce the health gap between housing tenures, and more generally to reduce inequalities in health.

Adult↗

PubMedDate not supplied

The identification of a US serviceman recovered from the Holy Loch, Scotland.

During February and March 2000, human remains were recovered from the Holy Loch, Scotland. Police enquiries identified 13 males that had gone missing, presumed drowned in the Holy Loch or the adjoining lochs, over the previous 35 years. Osteological examination of the remains established they were from a male, aged between 15 and 23 and 168-174 cm tall. This information eliminated ten of the known missing persons. DNA profiles, both STR and mitochondrial were generated from the remains and compared to the profiles generated from relatives of the missing men. A positive match between the unidentified individual and one of the maternal relatives identified the remains as belonging to a US serviceman who had gone missing 35 years ago. The successful identification led to the repatriation of the serviceman's remains.

Forensic Anthropology↗

PubMed2005

An analysis of urinary tract trauma in Scotland: imnpact on management and resource needs.

OBJECTIVE: We report the incidence, distribution, aetiology and outcome of urological trauma in a unique national database to provide an insight into its contemporary management. PATIENTS AND METHODS: The Scottish Trauma Audit Group prospectively collected data from severe trauma presenting to all major Scottish hospitals. We examined data from 24,666 trauma admissions from 1999 to 2002. Patients who sustained urological injuries were identified and studied in detail. RESULTS: 362 patients had urological injuries, comprising 1.5% of the trauma population, and an incidence of 1 per 45,000 head of adult population per year. Blunt injury (n = 285, 79%) was the main cause of urological trauma. Road traffic accidents were most frequent (197 patients, 54%), followed by assaults (76, 21%) and high falls (45, 12%). Renal injuries were the most common (n = 241, 67%), followed by injuries to the external genitalia (71, 20%), bladder (65, 18%), urethra (16, 4%) and ureter (3, 1%). Only 52 patients (14%) had isolated urological trauma. One hundred and fifty nine out of 310 (51%) urological patients with associated injuries were physiologically compromised on arrival in A&E, compared with only 4/52 (8%) patients with isolated urological trauma. All patients with isolated urological trauma survived, whereas 110/310 (35%) of those with associated injuries died. CONCLUSION: Urological injuries in Scotland mostly result from blunt trauma due to high-energy impacts. Isolated urological injuries are uncommon and all such patients survived. The majority of patients with urological trauma have multiple injuries and require a multi-disciplinary approach. Current urological services appear adequately distributed to cope with contemporary demands of urological trauma.

Adult↗

PubMed2006

Outcome of inguinal hernia repair at two rural hospitals in northern Scotland.

INTRODUCTION: Audit of inguinal hernia repair is important in view of the magnitude of the problem and the fact that it is a common operation often performed by surgical trainees. Due to the disparity of the results of various workers with regard to the rate of complications, individual surgeons have been advised to audit their patients' outcomes. METHOD: Retrospective audit was performed, of all the inguinal hernias repaired between 1997 and 2003 inclusive, at two rural hospitals in northern Scotland, under a single consultant. Data were gathered from a hospital database and by means of postal questionnaire specifically aimed at wound complications, recurrence and chronic groin pain. RESULTS: One hundred and sixty-three inguinal hernias were repaired during this period. One hundred and fifty-eight questionnaires were sent to patients ascertained to be living at the time of audit initiation with a response from 129 (86%). At a mean follow-up of 4.34 years, no recurrences were noted and eight patients complained of chronic groin pain of whom only three (1.5%) were experiencing moderate to severe pain. The results achieved by senior house officers were comparable to those obtained by the senior surgeon. CONCLUSION: The incidence of recurrence of hernia after open mesh repair of inguinal hernias is very low. Excellent outcomes can be obtained for inguinal hernia even at remote and rural hospitals in the hands of both experienced and trainee surgeons

Adult↗

PubMed1983

Congenital anomalies in twins in Aberdeen and Northeast Scotland.

Data with regard to the proportion of congenital malformations found at birth are presented from a survey of 657 pairs of twins of known zygosity and placentation delivered in Aberdeen and Northeast Scotland between 1968 and 1979. There was an excess of malformed individuals from monozygotic (MZ) pairs, but this did not reach statistical significance. The possible effect of monochorionic placentation in the causation of malformations in MZ twins in general is discussed. It seems that this type of placentation may be of less causative importance than has been previously suggested.

Congenital Abnormalities↗

PubMed1980

Helminth parasites of wild cats in north-east Scotland.

Three cestode species, namely Taenia taeniaeformis Batsch, 1786, Taenia pisiformis (Bloch, 1780) and Mesocestoides litteratus (Batsch, 1786) and one nematode species, Toxocara cati Schrank, 1788, were found in wild cats collected in Grampian region, Scotland. Of the 41 cats examined, 25 were Felis silvestris, 12 were feral Felis catus and four were hybrids of F. silvestris and F. catus.

Animals↗

PubMed1997

The ecology of Diplostomum phoxini infections in two minnow (Phoxinus phoxinus) populations in Scotland.

Data are presented on the infection dynamics of the brain-dwelling metacercariae of Diplostomum phoxini (Digenea: Trematoda) parasitizing European minnow (Phoxinus phoxinus) populations in a lowland river (River Endrick) and a highland loch (Loch Maragan) in central Scotland. Prevalence of the parasite approached 100% in all samples taken from both populations over a 12-month period, and within each population the intensity of infection increased with increasing host fork length. However, the two relationships differed, and size-matched minnows from the Endrick exhibited significantly higher intensities than those from Loch Maragan, suggesting that metacercarial acquisition occurred at different rates in the two populations. Data regarding seasonal trends in the acquisition of D. phoxini indicated that fish in both populations become infected with the parasites mainly during the spring and summer, with negligible infection occurring during winter months. Analysis of size-matched fish from individual samples revealed apparent differences in the distribution of D. phoxini within the two host populations. Whereas D. phoxini metacercariae appeared to be overdispersed amongst length-matched fish from Loch Maragan samples, the parasite was distributed normally amongst fish from the Endrick. Possible reasons for the observed differences in the infection characteristics of D. phoxini in the two minnow populations are discussed, with reference to the parasite's transmission dynamics and local environmental conditions.

Animals↗

PubMed1979

Food poisoning in hospitals in Scotland.

A review of 50 hospital-based outbreaks of food poisoning which were reported in Scotland during 1973--7, is described. At least 1530 persons consuming hospital-prepared food were involved. Thirty-one episodes were associated with Clostridium perfringens (C. welchii), 11 were due to food-borne salmonella infection, three to enterotoxigenic Staphylococcus aureus, and five incidents were of undetermined aetiology. This differs noticeably from the experience in England and Wales where salmonellas appear to predominate as the main cause of hospital outbreaks. Twenty-two incidents occurred in hospitals for psychiatric or mentally subnormal patients, and ten others were located in geriatric units. Only 33 hospitals were involved in the 50 outbreaks as nine hospitals experienced two or more episodes. The role of the hospital in the occurrence of food poisoning may be over-emphasized in comparison with other catering establishments, as outbreaks are more readily recognized and laboratory facilities are usually available for investigation, but it is also believed that many episodes may not be reported. The peculiar problems of the hospital-catering service and particularly those of the older long-stay hospitals, are discussed in relation to preventive measures which would minimize the hazards of food poisoning.

Aged↗

PubMed1970

A survey of infectious mononucleosis in the North-East Regional Hospital Board area of Scotland, 1960-9.

This report, based largely on 1258 laboratory proven cases of infectious mononucleosis (IM) detected in the North-Eastern Regional Board area of Scotland during the years 1960-9 inclusive, describes and discusses some of the epidemiological and diagnostic aspects of the disease.During the period of study, the annual rate of incidence increased fourfold from 11.1 to 44.3 cases per 100,000 population. Evidence is presented to indicate that this does not represent a true increase in prevalence but reflects improvements in disease detection. The annual incidence rates as reported by the C.D.S. for 1967-9 inclusive are regarded as a considerable underestimation of the ;true' incidence of the disease. Over a 3-year period an annual incidence equivalent to 100 per 100,000 population was found in each of two selected group practices. This value was constant and is thought to approximate the ;true' incidence of symptomatic, seropositive IM in the general community.Of the 1258 seropositive cases, 48.7% were males and 51.3% females. The peak age incidence was 15-19 years for both sexes. Twenty-one per cent of the cases were in children under 15 years and only 8.1% in adults older than 25 years. No significant variation was found in the seasonal or urban/rural incidence. Marked differences were found in the leucocyte patterns of seropositive and ;seronegative' cases.

Adolescent↗

PubMed1978

Single radial haemolysis: a survey of antibody titres in the highland region of Scotland to recent strains of influenza A.

The single radial haemolysis test is conveniently practical and economical and promises to have wide applicability in the study of influenza antibodies in human populations. It can also be adapted for preliminary examination of new virus isolates during epidemics. Using this test a rather higher proportion of the population in the Highland Region of Scotland were found to possess antibody to a recent epidemic strain of influenza (A/Scotland/74) than was the case in the south of England. Antibody was detected and apparently evenly spread throughout all but the most remote island communities. Some evidence of the spread of the subsequent variant, A/Victoria/75, was obtained. Most of the school children in our study had high antibody titres to recent strains but the proportion with high antibody titres to these strains declined speedily from the age of 17 years onwards.

Adolescent↗

PubMed1976

Enteric fever in Scotland, 1967-1974.

A review of 194 cases of enteric infection in Scotland during 1967-74, is reported. Diagnosis was confirmed by the laboratory isolation of Salmonella typhi (64 cases), S. paratyphi A (3) and S. paratyphi B (127), from blood or faeces; 174 persons were clinically ill and 20 were symptomless infections. Most patients (81-0%) were under 35 years of age, with the highest incidence occurring among young adults of 15-24 years, many of whom had been travelling overseas. One-third of all cases (65) were imported infections; the remaining 129 patients had not been outside the United Kingdom. A significantly greater proportion of typhoid infection (54-7%) was contracted overseas, in contrast to paratyphoid B with only one-fifth of cases (21-2%) being imported; all three cases of paratyphoid A were imported. The geographic distribution of origin of imported infections is discussed, along with the frequency of organisms belonging to different phage types. Two deaths occurred, one of which was the result of complications of paratyphoid fever. All other patients responded well to treatment, although two persons continued to excrete and became chronic carriers. A few examples are given of episodes of particular epidemiological interest. It is expected that in future years there will be a continued increase in the proportion of imported infections as more persons travel overseas, concurrent with the continuing decline in the number of chronic carriers resident in the British Isles.

Adolescent↗

PubMed1985

Salmonellae in sewage sludge and abattoir effluent in south-east Scotland.

A survey into the prevalence of salmonella organisms in sewage in the Borders Region of South-east Scotland is described. A total of 317 isolates representing 34 different serotypes were made, of which only 5 serotypes appeared in animals, supporting the view that the spreading of sewage sludge on to pastureland presents little risk to livestock provided the recommended guidelines are followed. Nevertheless, Salmonella typhimurium phage type 12, identified in sewage, was also recovered from animals in incidents on 11 farms, including 4 which had received sludge from this source. A further 48 isolates (13 serotypes) were obtained from the parallel monitoring of abattoir effluents, indicating that the background level of salmonella infection in the animal population appears to be low in comparison to that in humans.

Abattoirs↗

PubMed1986

Further investigations of a hydatid focus in North-West Scotland.

A serological survey carried out on 1379 school-children from Skye and Mallaig in the N.W. of Scotland failed to show evidence of subclinical cases of hydatidosis. There appeared to be a relatively low level of exposure to the parasite, as judged by ELISA and IHA tests. Thirty-one children reacted positively in the ELISA; only one child had a transient positive result in the IHA test. Surveillance of these children will be continued for the present but the duration required is uncertain. The local population appeared to be well aware of the mode of spread of the parasite and the methods for its control.

Animals↗