Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SCOTLAND”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 793 records · Page 44Linked to original sources
PubMed2002

Staging quality is related to the survival of women with endometrial cancer: a Scottish population based study. Deficient surgical staging and omission of adjuvant radiotherapy is associated with poorer survival of women diagnosed with endometrial cancer in Scotland during 1996 and 1997.

The association between treatment variation and survival of women with endometrial cancer was investigated. A retrospective cohort based upon the complete Scottish population registered on in-patient and day-case hospital discharge data (Scottish Morbidity Record-1) and cancer registration (Scottish Morbidity Record-6) coded C54 and C55 in ICD10, between 1st January 1996 to 31st December 1997 were analysed. Seven hundred and three patients who underwent surgical treatment out of 781 patients that were diagnosed with endometrial cancer in Scotland during 1996 and 1997. The overall quality of surgical staging was poor. The quality of staging was related to both the year that the surgeon passed the Member of the Royal College of Obstetricians and Gynaecologists examination and also to 'specialist' status but was not related to surgeon caseload. Two clinically important prognostic factors were found to be associated with survival; whether the International Federation of Obstetrics and Gynaecology stage was documented, RHR=2.0 (95% CI=1.3 to 3.1) and also to the use of adjuvant radiotherapy, RHR=2.2 (95% CI=1.5 to 3.5). The associations with survival were strongest in patients with advanced disease, International Federation of Obstetrics and Gynaecology stages 1C through to stage 3. Deficiencies in staging and variations in the use of adjuvant radiotherapy represent a possible source of avoidable mortality in patients with endometrial cancer. Consequently, there should be a greater emphasis on improving the overall quality of surgical staging in endometrial cancer.

Endometrial Neoplasms↗
PubMed2003

BRCA1 and BRCA2 mutations in Scotland and Northern Ireland.

BRCA1 and BRCA2 mutations have been identified in 107 families in Scotland and Northern Ireland. Ninety-seven of these families had been referred to regional cancer genetics centres and a further 10 were identified from a sequential series of male breast cancers treated in Edinburgh. Fifty-nine of the families had a mutation in BRCA1 and 46 in BRCA2. Two families had both. Family trees were extended and cancer diagnoses verified by means of the unusually complete and accessible Scottish and Northern Irish records. Ten specific recurring mutations (five in each gene) accounted for almost half of the total detected, and almost one-quarter were accounted for by just two (BRCA1 2800 delAA and BRCA2 6503 delTT). The prevalence of breast cancer is similar for BRCA1 and BRCA2 mutation families (average 3.7 and 3.6 per family), but the former have a much greater risk of ovarian cancer (average 1.5 and 0.6 per family, respectively). For breast cancer, age of onset tended to be younger in BRCA1 mutation carriers but, for ovarian cancer, there was no difference between BRCA1 and BRCA2 families in mean age at diagnosis. Mutations within the 5' two-thirds of BRCA1 carry a significantly higher relative risk of ovarian cancer and the same is true for mutations within the central portion of BRCA2 (the 'OCCR'). In the former case, this appears to be because of differences in absolute risk for both ovarian and breast cancer, while, in the latter, only ovarian cancer risk varies significantly. The findings confirm that founder mutations are present within the Scottish/Northern Irish population and have implications for the organisation of molecular screening services.

Alternative Splicing↗
PubMed2003

Incidence of malignant neoplasms among HIV-infected persons in Scotland.

Among 2574 persons diagnosed with HIV throughout Scotland and observed over the period 1981-1996, cancer incidence compared to the general population was 11 times higher overall; among homosexual/bisexual males, it was 21 times higher and among injecting drug users, haemophiliacs and heterosexuals it was five times higher, mostly due to AIDS-defining neoplasms. However, liver, lung and skin cancers (all non-AIDS-defining) were also significantly increased.

Adolescent↗
PubMed2003

A randomised controlled trial of breast cancer genetics services in South East Scotland: psychological impact.

This study compared the psychological impact of two models of breast cancer genetics services in South East Scotland. One hundred and seventy general practices were randomised to refer patients to the existing standard regional service or the novel community-based service. Participants completed postal questionnaires at baseline (n=373), 4 weeks (n=276) and 6 months (n=263) to assess perceived risk of breast cancer, subjective and objective understanding of genetics and screening issues, general psychological distress, cancer worry and health behaviours. For participants in both arms of the trial, there were improvements in subjective and objective understanding up to 4 weeks which were generally sustained up to 6 months. However, improvements in subjective understanding for the women at low risk of breast cancer (i.e. not at significantly increased risk) in the standard service arm did not reach statistical significance. Cancer worry was significantly reduced at 6 months for participants in both arms of the trial. The two models of cancer genetics services tested were generally comparable in terms of the participants' psychological outcomes. Therefore, decisions regarding the implementation of the novel community-based service should be based on the resources required and client satisfaction with the service.

Adolescent↗
PubMed2003

Referrals of women with a family history of breast cancer from primary care to cancer genetics services in South East Scotland.

As part of a cluster randomised trial to assess an alternative model of cancer genetics services, we gathered data on all referrals from general practitioners (GPs) to cancer genetics services in South East Scotland over a 4-year period. The referral rate per 1000 patients rose by 48% from 0.21 in the 2-year period before the trial to 0.31 during the trial. This increase was much greater in the trial group offered the GP clinic service (64% increase compared to a 38% increase in those referred to the regional service). Thus, the offer of a more local service appeared to have a marked effect on GP management of these women. Referral rates to cancer genetics services from general practices varied widely with higher referral rates from practices with more female partners. There was a negative correlation between referral rates and practice area deprivation scores. However, this was not found during the trial in the group which offered clinics in general practice, the provision of clinic appointments nearer to the homes of more socially deprived women resulting in improved access to women from deprived areas. The interaction with the GP appears to be associated with an inappropriate level of interest in and expectation of the appropriateness of genetic testing. The provision of the clinics within general practice did not result in higher levels of confidence among GPs in managing these women.

Breast Neoplasms↗
PubMed1997

The use of nutritional supplements by 4-12 year olds in England and Scotland.

OBJECTIVE: To determine the levels of and factors associated with the use of nutritional supplements by children participating in the National Study of Health and Growth (NSHG). DESIGN: Cross-sectional study. SETTING: Fifty-six study areas in England and Scotland. SUBJECTS: Fifteen thousand, two hundred and seventy five children aged between 4 and 12 y. INTERVENTIONS: Parental completion of a self-administered questionnaire on the child's health, social background and supplement use. Height, weight and skinfold measurements. RESULTS: An 88% response rate to the supplement question, 15.9% of responders reported using a supplement. Multivitamins were the most commonly consumed supplement (84%) with 52% taking a supplement daily. Younger children, those whose mothers reached further education, whose fathers were in non-manual occupations or who lived in the Midlands or South were significantly more likely to use a supplement, as were children from smaller families or whose parents were non-smokers. There was no significant association between supplement use and sex, height, birthweight, length of gestation, father's education, number of parents in the home or vegetarianism. Significant differences were found in the use of supplements between the ethnic origin groups. Children of Afro-Caribbean, Asian or other origin were more likely to take a supplement compared to white English and Scottish groups. There were differences in the type of supplements used with Afro-Caribbean and other origin children using more cod liver oil. CONCLUSION: We support the findings of other studies which show that children with the least need for supplements as defined by socio-economic variables are more likely to receive them and suggest that cultural background is also an important factor in influencing supplement use. SPONSORSHIP: This study was supported by grants from the Department of Health in England and the Scottish Home and Health Department.

Africa↗
PubMed2005

South-East Scotland trabeculectomy survey.

AIM: Assessment of trabeculectomy in South-East Scotland (SESTS) with comparison to National Survey of Trabeculectomy (NST) and outcomes of consultant and trainee surgery. METHOD: A retrospective study of 304 consecutive, primary trabeculectomies, in two Scottish centres (Edinburgh and Dunfermline) with two glaucoma specialists and higher surgical trainees, was performed. The study group had primary open angle glaucoma (65.5%), pseudoexfoliation (6.9%), normal tension glaucoma (7.6%), pigment dispersion syndrome (1.6%), and other complicated glaucoma (18.4%). All patients underwent trabeculectomy by the glaucoma specialist (57.6%) and higher surgical trainee (42.4%) with close scrubbed supervision. RESULTS: Compared to the NST, the waiting time for surgery (<3 months) was significantly less in the SESTS (P<0.001). There was also significantly more use of intraoperative antimetabolites (P<0.01), bleb intervention (P<0.001), and a higher rate of early complications (P<0.025). There was no significant difference in outcome at intraocular pressure (IOP)<2/3 listing IOP (qualified and unqualified) between the SESTS and the NST. Significantly, more patients achieved an unqualified success of IOP<21 mmHg (P<0.01) and an unqualified success of IOP<16 mmHg in the SESTS than the NST (P<0.05). At 1 year post surgery, visual loss of greater than one Snellen line was more common in the NST (P<0.01) as was the use of anti-glaucoma medication (P<0.001). Trainee cases returned to theatre more frequently (P<0.025) and merited more bleb intervention (P<0.01) than consultant cases, but the long-term outcome was similar. CONCLUSION: Our study highlights significant changes in the practice and outcome of trabeculectomy compared to the national survey conducted a decade ago.

Aged↗
PubMed2006

Epidermolysis bullosa simplex in Scotland caused by a spectrum of keratin mutations.

Epidermolysis bullosa simplex (EBS) is an inherited skin disorder caused by mutations in keratins K5 (keratin 5) and K14 (keratin 14), with fragility of basal keratinocytes leading to epidermal cytolysis and blistering. Patients present with widely varying severity and are classified in three main subtypes: EBS Weber-Cockayne (EBS-WC), EBS Köbner (EBS-K), and EBS Dowling-Meara (EBS-DM), based on distribution and pattern of blisters. We could identify K5/K14 mutations in 20 out of the 43 families registered as affected by dominant EBS in Scotland; with previous studies this covers 70% of all Scottish EBS patients, making this the most comprehensively analyzed EBS population. Nine mutations are novel. All mutations lie within five previously identified rod domain hotspots and the severest blistering was associated with mutations in the helix boundary motifs. In some cases, the same mutation caused symptoms of EBS-WC and/or EBS-K, both within and between families, suggesting a contribution of additional factors to the phenotype. In some patients, no mutations were found in K5, K14, or K15, suggesting involvement of other genes. The results confirm that EBS is best considered as a single disorder with a spectrum of phenotypic variations, from severe EBS-DM at one extreme to mild EBS-WC at the other.

Adolescent↗
PubMed2004

The polycyclic aromatic hydrocarbon and geochemical biomarker composition of sediments from sea lochs on the west coast of Scotland.

Sediments from twelve sea lochs on the west coast of Scotland were analysed for parent and branched 2- to 6-ring polycyclic aromatic hydrocarbons (PAHs), n-alkanes and geochemical biomarkers (triterpanes). Where possible at least fourteen sediment samples were collected at random from each sea loch. All sea lochs were remote, most had limited industrial and urban inputs, although all had fish farms. Four lochs had moderate total PAH concentrations and eight lochs had high total PAH concentrations. Total PAH concentration was related to organic carbon content and particle size distribution, with sandier sediments having lower PAH concentrations. The highest total PAH concentrations, normalised for organic carbon, were in Loch Linnhe and Ballachulish Bay (Loch Leven), close to an aluminium smelter. PAH concentration ratios showed that pyrolysis was the main source of PAHs in most lochs. Only sediments from Loch Clash showed evidence of petrogenic input based on their geochemical biomarker (triterpane and sterane) and n-alkane profiles. PAH profiles were similar across lochs apart from Loch Linnhe and Ballachulish Bay, which had a greater proportion of heavy parent PAHs. West coast sediments had a smaller proportion of heavy PAHs than sediments collected from voes in Shetland and a smaller proportion of alkylated PAHs relative to sediments collected from coastal waters around Orkney.

Environmental Monitoring↗
PubMed2004

14C and delta13C characteristics of organic matter and carbonate in saltmarsh sediments from south west Scotland.

The distribution of contaminant radionuclides from the Sellafield nuclear fuel reprocessing plant was used to establish chronologies for three saltmarsh sediment cores from south west Scotland. delta(13)C and (14)C analyses indicated that the cores provided a useful archive record of variations in input of organic matter and carbonate. The results imply that prior to major releases of contaminant (14)C from Sellafield, the (14)C specific activity of organic matter in Irish Sea offshore sediments was about 24 Bq kg(-1) C, while that of the carbonate component was below the limit of detection. These results provide baseline data for modelling the uptake of contaminant (14)C by the Irish Sea sediment system. The study confirmed that small(13)C analyses provide a sensitive means of apportioning the origin of saltmarsh organic matter between C(3) terrigenous plants, C(4) terrigenous plants and suspended particulate marine organic matter. For the <2 mm fraction of sediment, a clear pattern of decreasing marine organic input was observed in response to increasing elevation of the marsh surface as a result of sediment accumulation. Bulk sediment, including detrital vegetation, had a dominant input from terrigenous plants. The combined use of delta(13)C and (14)C data revealed that organic matter in the marine organic component of the <2 mm fraction of contemporary surface sediments of the saltmarshes is dominated by recycled old organic material.

Carbon Radioisotopes↗
PubMed2005

Investigation of the concentration and isotopic composition of inputs and outputs of Pb in waters at an upland catchment in NE Scotland.

As a consequence of the accumulation of anthropogenic Pb in upland catchments, there has been much recent concern about the potential mobilisation and transport of Pb from the soils to receiving waters and also the possible harmful effects that this might have on aquatic biota. This paper presents the findings of a two-year study of Pb behaviour in an organic-rich upland catchment at Glensaugh in NE Scotland. Pb inputs to the catchment were characterised by direct measurements of Pb concentration and (206)Pb/(207)Pb ratios in rain water and interception. Pb outputs from the catchment were calculated from measurements on stream water samples taken from the two main streams, the Cairn Burn and Birnie Burn. The relative contribution of Pb from groundwater and throughflow, under different flow conditions (base flow and high flow), to stream waters was investigated via analysis of springs sourced from groundwater and of waters flowing through the various soil horizons (S (surface), A, B, C, and D), respectively. The outcome of intensive sampling and analysis over the two-year time period was that, even with marked reduction in Pb inputs over the past two decades, the catchment was still acting as a net sink for the current atmospheric deposition. Although the Pb isotopic signature for stream water is very similar to that for the contemporaneous rain water ((206)Pb/(207)Pb approximately 1.15-1.16), only a small portion of the rain water is transferred directly to stream water. Instead, the Pb input is transferred to the stream waters mainly via groundwater and it was also confirmed that the latter had a similar Pb isotopic signature. From the Pb isotopic measurements on throughflow waters, however, Pb being removed via the streams contained some previously deposited Pb, i.e. mobilisation of a small portion of soil-derived anthropogenic Pb was occurring. These findings are important not only with respect to the source/sink status of the catchment but also for calculation of the extent of retention of the current atmospheric Pb inputs, which must take account of the release of previously deposited Pb from the catchment soils, a process occurring mainly under high flow conditions.

Air Pollutants↗
PubMed1999

Contrasting levels of adolescent drug use between adjacent urban and rural communities in Scotland.

AIMS: To compare life-time prevalence of illicit drug use between adolescents resident in adjacent urban and rural localities. DESIGN: Samples of schoolchildren attending urban and rural comprehensive schools (n = 2558) were obtained using an identical questionnaire survey method. SETTING: Respondents were recruited from 10 schools in two contrasting adjacent local authorities. Five representative schools in each locality were chosen. PARTICIPANTS: All children present in each school, in the two final compulsory school years, were eligible for this study. MEASUREMENTS: Respondents were asked to provide detailed information about their place of residence and use of illegal drugs. The data obtained in schools were compared with local geographical statistics, such as levels of deprivation. FINDINGS: As expected from the demographics of their respective localities, the urban schools displayed higher levels of deprived children and lower levels of school achievement. These socio-economic differences were not reflected in reported levels of life-time drug use. This was true both between and within the urban and rural samples. CONCLUSION: These findings suggest that adolescent drug use in Scotland is not particularly concentrated in areas of urban deprivation.

Adolescent↗
PubMed2000

Capture-recapture estimates of drug misuse in urban and non-urban settings in the north east of Scotland.

AIMS: To estimate the prevalence of opiate or benzodiazepine misuse in the Grampian Health Board area, Scotland and illustrate the use of the capture-recapture method in both rural and urban settings. DESIGN: Capture-recapture analyses on six distinct sources of data with unequal coverage of the geographical area. SETTING: Grampian Health Board area, including the City of Aberdeen. PARTICIPANTS: Data were collated from the Police, Social Work Departments, GPs contributing to the Scottish Drug Misuse Database, statutory drug agencies, a voluntary sector drug agency and a needle/syringe exchange. MEASUREMENTS: In total 1770 individuals were identified as misusing opiates or benzodiazepines and residing in the Grampian Health Board area; 1129 individuals were resident in the City of Aberdeen. FINDINGS: The total number of opiate or benzodiazepine misusers in the City of Aberdeen was estimated to be 2519 (95% CI 2048-3200). This figure corresponds to 2.0% (1.6-2.5%) of the population aged 15-54 years. In a town to the north of Aberdeenshire where high levels of heroin use had previously been reported in the media, 2.5% of the population aged 15-54 (1.8-3.8%) were estimated to be misusing opiates or benzodiazepines. CONCLUSIONS: Although there may be difficulties in applying capture-recapture methods in all settings, the methodology can give valuable information on the extent of drug misuse in both urban and non-urban areas. This information is particularly important to assess the spread of drug misuse from cities to rural areas.

Adolescent↗
PubMed2001

Patterns of recreational drug use at dance events in Edinburgh, Scotland.

AIMS: To describe the patterns of drug use at dance (rave) events in terms of prevalence, frequency, type of drugs used, patterns of use, access and risk-associated behaviours. DESIGN: Self-selecting participant-completed survey. SETTING: Three dance events in Edinburgh, Scotland, UK. PARTICIPANTS: One hundred and twenty-two drug users (57% males, 43% females), 90% of whom were in employment or education, with an age range of 16-47, 80% between 18 and 23 years. MEASUREMENTS: Participants who answered 'yes' to the question 'Have you used drugs for dance events in the past year' reported (i) the prevalence, types and frequency of drugs used; (ii) prevalence and contents of mixing drugs; (iii) accessing drugs; and (iv) engagement with drug-associated risk behaviours. FINDINGS: Over 80% of the participants had used ecstasy and amphetamine, over 30% cocaine and LSD; over 10% nitrites, psilocybin and ketamine and less than 5% had used crack or tranquillizers. Participants reported regular consumption of ecstasy and amphetamine (e.g. 35% used ecstasy and 25% amphetamine on a weekly basis) often taken in combination, with the occasional use of cocaine, LSD, ketamine and psilocybin. Poly- and mixing-drug behaviours were significantly more likely than monodrug usage. Drugs were accessed through friends than from any other source. Eighty-five per cent reported mixing drugs and/or alcohol, 35% driving on drugs, 36% having a bad experience on drugs; 30% unprotected sex; and 0.9% injecting drugs. Women in the sample reported higher consumption than men. CONCLUSIONS: Dance-drug use has a characteristic pattern that has implications for health promotion and criminal policy.

Adolescent↗
PubMed2002

Community pharmacy services for drug misusers in Scotland: what difference does 5 years make?

AIMS: To assess current levels of participation of community pharmacists in needle exchange provision, assess participation in dispensing any drugs for drug misuse, explore methadone dispensing practice, assess involvement in health promotion for drug misusers, assess levels of training in drug misuse and compare all of the above with data from 5 years previously. DESIGN: A cross-sectional postal questionnaire. SETTING: All community pharmacies in Scotland (n = 1162). PARTICIPANTS: A total of 969 pharmacists managing community pharmacies on a day-to-day basis (response rate 83.4%). MEASUREMENTS: Descriptive data were collected on demography, drug misuse services provided and training. Data were combined with a dataset from an identical survey conducted 5 years previously for statistical comparison. RESULTS: Levels of needle exchange provision has not changed significantly (9.7% in 2000 compared to 8.6% in 1995). Of all respondents, 71.5% now dispense drug for the management of drug misuse, 68.9% dispense methadone and 56.7% provide a supervised methadone consumption service. The number of methadone clients receiving methadone through pharmacies has increased from 3387 in 1995 to 8792 in 2000 and the mean number of clients dispensed methadone per pharmacy has increased from 7.3 in 1995 to 13.2 in 2000; 65.1% of all methadone clients now consume their methadone under pharmacist supervision. The proportion of pharmacists dispensing methadone who provide a supervised consumption service has increased significantly from 37% to 82.8%. Considerable changes in pharmacy practice are evident with significant increases in the number of pharmacists who always lay down ground rules, ask for identification on first visits, make up prescriptions in advance and provide verbal advice and leaflets on the management of drug misuse. Training in drug misuse doubled from 31.8% to 66.8%. CONCLUSIONS: Community pharmacy involvement with drug misusers has increased dramatically in the last 5 years. However, this increase is largely in methadone dispensing and supervision. Pharmacists appear to be more proactive in providing advice and information, perhaps as a result of greater training.

Community Pharmacy Services↗
PubMed2003

General practice management of illicit drug users in Scotland: a national survey.

AIMS: To describe the level of involvement of general practitioners (GPs) in the management of illicit drug dependency; nature of current practice in the management of illicit drug dependency; influence of guidelines on practice; GP training experience and needs; and to consider the policy implications of the findings. DESIGN: A cross-sectional postal questionnaire survey. SETTING: General practice in Scotland. PARTICIPANTS: A 1 : 4 randomized sample (n = 926) of general practice principals, stratified according to age, gender and number of practice partners. MEASUREMENTS: A structured postal questionnaire. FINDINGS: A 63% response rate was achieved after two reminders (n = 583). Sixty per cent of respondents treated drug users, 51.5% provided methadone maintenance but only 58% used doses in the recommended range. Maintenance prescribing of dihydrocodeine and benzodiazepines was provided by 24% and 44.8% of respondents, respectively. While 79.3% had received the national clinical guidelines only 22.5% believed this had influenced their practice. Only a third of respondents had received drug dependency training. Beliefs about whether prescribing for drug misusers is part of a GPs professional remit was split. CONCLUSIONS: There was relatively high involvement with drug users, with methadone maintenance being the most common treatment provided. Maintenance prescribing of dihydrocodeine and benzodiazepines were common despite a lack of clinical evidence supporting the effectiveness of these treatments. This may reflect the nature of the presenting drug problems and highlights the difficulties some GPs may face in managing multiple drug dependencies within current guidelines. Further local training to implement guidelines along with trials of alternative treatments currently outwith guidelines should be considered.

Adult↗
PubMed1999

Theatre monitor alarm settings: a pilot survey in Scotland and Belgium.

The use of alarms on operating theatre equipment was explored in a questionnaire to anaesthetists in Belgium and Scotland. They were presented with a scenario of a fit male having an anaesthetic for an abdominal operation. The overall response rate was 72%, giving 100 records for analysis. The responses from Scottish and Belgian anaesthetists were similar except for views on setting an upper limit for systolic arterial pressure; Scottish anaesthetists seemed relatively unwilling to set an upper systolic arterial pressure limit. Beyond this, the respondents considered alarms to be a method of detecting problems before they occur and they readjust alarms for each patient. They would set systolic arterial pressure alarms 30 mmHg above and below the patients normal pressure, the heart rate alarms 30 bpm above and 20 bpm below the actual rate, and the peripheral oxygen saturation lower alarm limit to 90%.

Abdomen↗