Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “WALES”

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 883 records · Page 49Linked to original sources
PubMed2002

W135 meningococcal disease in England and Wales associated with Hajj 2000 and 2001.

An outbreak of W135 meningococcal disease was seen in 2000 and 2001 among pilgrims returning from Saudi Arabia and their contacts. The Public Health Laboratory Service set up enhanced surveillance to monitor spread and virulence of the outbreak strain, and to collect data on case characteristics. The number of cases reported from England and Wales in 2001 was similar to the number reported during 2000, despite a change in the recommendation for pilgrims to receive quadrivalent vaccine (against serogroup A, C, W135, and Y) instead of the A/C vaccine recommended in 2000. Both the recommendation and vaccine were not available until January, 2001, and coverage among pilgrims to the Hajj 2001 was low. The case--fatality ratio was high, and sustained transmission of the virulent outbreak strain was seen. Current control policies, both in primary and secondary prevention, might need better implementation.

Disease Outbreaks↗
PubMed2003

Ciprofloxacin resistance in Neisseria gonorrhoeae in England and Wales in 2002.

The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) monitors trends in antimicrobial resistance in consecutive gonococcal isolates from 26 genitourinary medicine clinics in England and Wales. In 2002, 2204 gonococcal isolates were tested, and the overall prevalence of ciprofloxacin resistance (minimum inhibitory concentration > or =1 mg/L) was 9.8%, compared with 3.1% in 2001 and 2.1% in 2000. Between 2001 and 2002, prevalence of ciprofloxacin resistance increased two to three-fold, irrespective of recent sexual contact overseas, sex, or residence within or outside of London. These findings suggest that national and local treatment guidelines need to be reviewed urgently.

Anti-Infective Agents↗
PubMed2004

Seamless management of biliary atresia in England and Wales (1999-2002).

BACKGROUND: Before 1999, infants born in the UK with suspected biliary atresia were investigated in regional centres, and, if confirmed, a Kasai operation was done there. Since 1999, all infants with suspected biliary atresia in England and Wales, UK, have been referred to one of three designated centres where both the Kasai operation and liver transplantation (if necessary) could be done. METHODS: We assessed clearance of jaundice (bilirubin <20 micromol/L) as an early outcome in all cases of biliary atresia referred from one of the three centres. We then estimated survival using the Kaplan-Meier method with endpoints of liver transplantation or death. FINDINGS: 148 infants with biliary atresia were treated between January, 1999, and June, 2002. A primary portoenterostomy was done in 142 (96%) infants and a primary liver transplant in five (3%). One child died before any intervention. Early clearance of jaundice after portoenterostomy was achieved in 81 of 142 (57%) infants. Liver transplantation was done in 52 (37%) of those undergoing portoenterostomy. 13 (9%) infants died. Of the 135 children who survived, 84 (62%) still have their native liver and 51 (38%) had transplantation. The median follow-up of survivors was 2.13 (range 0.5-4.1) years. The overall 4-year estimated actuarial survival was 89% (95% CI 82-94). The 4-year estimated actuarial survival with native liver was 51% (42-59%). INTERPRETATION: Our early results suggest that surgical outcome can be improved by centralisation of care to supra-regional centres.

Biliary Atresia↗
PubMed2005

Suicides in male prisoners in England and Wales, 1978-2003.

The number of suicides in English and Welsh prisons is increasing, but the excess compared with the general population has not been reliably quantified. We therefore compared, in narrow age bands, all 1312 suicides of male prisoners in England and Wales between 1978 and 2003 with suicide rates in the general male population. The overall standardised mortality ratio for suicide was 5.1 (95% CI, 4.8-5.3), suggesting a five-fold excess of suicides in male prisoners, with a particularly striking excess in boys aged 15-17 years (standardised mortality ratio 18 [13-26]). The proportional excess of suicides of male prisoners has been increasing during the past quarter of a century, which underscores the need for substantial improvements in suicide prevention in prisons.

Adolescent↗
PubMed1980

Relation between vaccination and notification rates for whooping cough in England and Wales.

The number of notified cases of whooping cough in the 1977-79 outbreak in England and Wales was the largest for over 20 years. The percentage of children receiving pertussis vaccine has declined sharply since 1974. Area Health Authorities with low vaccination acceptance had notification-rates 60% above those with higher acceptance. There was a partial correlation coefficient of -0.57 (p less than 0.001) between vaccination and notification rates after elimination of the effects of social class and overcrowding. The 1-4 year age-group, which contained the children most affected by the decline in vaccination-rates, showed a much bigger increase in notifications than other age-groups. The evidence suggests a direct relation between the decline in vaccination-rate and the increase in notifications.

Adolescent↗
PubMed1981

Testicular cancer in England and Wales: some epidemiological aspects.

Testicular-cancer incidence and mortality rates have been rising among young men in England and Wales since the beginning of the century, and this is now the most common neoplasm registered among men aged 25--34. Death rates are highest among professional, administrative, and clerical workers and lowest among manual workers; differential social-class rates were already apparent in 1921. Little is known about the aetiology of the disease.

Adolescent↗
PubMed1981

20 years of hospital admissions for peptic ulcer in England and Wales.

Mortality and hospital admission rates for peptic ulcer in England and Wales have fallen in the past twenty years. Within this pattern there has been a wide range of variation. Perforated ulcers have become less common in young adults, and perforated gastric ulcers in young men now occur with between a quarter and a tenth of their previous frequency. Perforated duodenal ulcer has become more common in middle-aged and elderly women. The reasons for these changes are not understood, but they are likely to reflect the impact of environmental influences on people of different ages.

Adolescent↗
PubMed1983

Geographical variation in mortality from conditions amenable to medical intervention in England and Wales.

There is a need for indicators of the outcome of health-care services against which the use of resources can be evaluated. From a previously published series of outcome indicators, which included diseases for which mortality is largely avoidable given appropriate medical intervention, causes were selected which were regarded as most amenable to medical intervention (excluding conditions whose control depends mainly on prevention) and for which there were sufficient numbers of deaths to allow an analysis of the variation in mortality rates among the 98 area health authorities of England and Wales. Considerable variation between AHAs was found in mortality from most of these diseases, and this variation remained even after adjustment for social factors. This substantial variation should be examined further in relation to health-service inputs and other factors. A finding of large variations in the quality of health-care delivery in different parts of the country would have important implications for resource allocation.

Adolescent↗
PubMed1984

Mumps surveillance in England and Wales 1962-81.

A study of routine data on mumps in England and Wales suggests that its epidemiological features are changing from those of an epidemic disease in young adults and older children to a more endemic disease in younger children. Infection now occurs at an earlier age, at which complications are less frequent and symptomless infection may be more common. The incidence of clinical disease may be falling. The high proportion of registered deaths in the middle aged and elderly may be an artifact due to misclassification of causes of death and to misdiagnosis. These changes lessen the need for routine immunisation. Indeed with low acceptance rates of measles vaccination of 50% at age 15 months, mumps/measles routine vaccination at the same age is contraindicated because similarly low acceptance rates might lead to an increase in the number of cases of mumps in older children and young adults, at which ages complications are more frequent.

Adolescent↗
PubMed1984

Apparent doubling of frequency of undescended testis in England and Wales in 1962-81.

Examination of Hospital Inpatient Enquiry data for England and Wales for the years 1962-81 shows that the annual number of discharges with a diagnosis of undescended testicle has risen by a factor of 2.3. Cohort analysis suggests that the cumulative rate to age 15 of discharge for undescended testis has risen from 1.4% for the 1952 birth-cohort to 2.9% for the 1977 birth-cohort. Whether this is a reflection of an increase in true cryptorchidism is not known. Changes in known risk factors for cryptorchidism--exogenous oestrogen exposure, being first-born, and low birth-weight--cannot fully account for the apparent increase. With the tendency to carry out orchidopexies on apparently undescended testes at younger ages in order to preserve fertility, it is possible that a considerable number of boys with retractile testes that would have descended naturally at puberty are now being operated upon.

Adolescent↗
PubMed1986

Hydatidiform mole in England and Wales 1973-83.

The number of cases of hydatidiform mole (HM) registered annually in England and Wales has risen since 1973 to 1.54 per 1000 live births in 1983. For women over 50 the risk per pregnancy was 411 times and for girls under 15 it was six times greater than that for women aged 25-29. 7.75% of patients had chemotherapy for invasive mole or choriocarcinoma. Patients who had had oxytocin-induced or prostaglandin-induced uterine evacuation or hysterotomy were more likely to need chemotherapy. Human chorionic gonadotropin (HCG) was undetectable by 56 days after evacuation in 42% of patients, none of whom required chemotherapy; a considerable reduction in follow-up time for this subgroup is proposed. For patients whose HCG values became normal more than 56 days after evacuation and stayed normal for 6 months the risk of recrudescent disease was 1 in 286. In subsequent pregnancies the risk of a second HM was 1 in 76 and that of a third was 1 in 6.5. 11 (0.2%) patients died, 2 from drug-resistant choriocarcinoma.

Adolescent↗
PubMed1986

Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales.

Although the rise in ischaemic heart disease in England and Wales has been associated with increasing prosperity, mortality rates are highest in the least affluent areas. On division of the country into two hundred and twelve local authority areas a strong geographical relation was found between ischaemic heart disease mortality rates in 1968-78 and infant mortality in 1921-25. Of the twenty-four other common causes of death only bronchitis, stomach cancer, and rheumatic heart disease were similarly related to infant mortality. These diseases are associated with poor living conditions and mortality from them is declining. Ischaemic heart disease is strongly correlated with both neonatal and postneonatal mortality. It is suggested that poor nutrition in early life increases susceptibility to the effects of an affluent diet.

Adolescent↗
PubMed1987

Haemorrhagic colitis and Vero-cytotoxin-producing Escherichia coli in England and Wales.

Vero-cytotoxin-producing strains of Escherichia coli (VTEC) were identified by the use of DNA probes in 39% of faecal samples from patients with haemorrhagic colitis in England and Wales. The patients with VTEC were distributed widely and their ages ranged from 2.5 to 86 years (mean 41). 3 patients died, including a child of 2.5 years. 30 of the 32 VTEC strains belonged to serogroup O157. Plating on sorbitol agar for non-fermenters followed by agglutination with a specific O157 antiserum was a useful screening method for O157 VT+ strains. However, it was not as sensitive as the DNA probe technique and did not detect VTEC of other serogroups.

Adolescent↗
PubMed1988

Motoneuron disease and past poliomyelitis in England and Wales.

Past notification rates for poliomyelitis show a close geographical relation with current mortality from motoneuron disease in England and Wales. The increasing rate of poliomyelitis during the first half of this century and its predilection for affluent places and families were unique amongst infectious diseases. The unusual epidemiology of poliomyelitis is now being paralleled by motoneuron disease. These observations provide new evidence for a causal connection between the two conditions.

Cause of Death↗
PubMed1989

Outbreak of botulism in north west England and Wales, June, 1989.

The clinical features of 27 patients identified in an outbreak of botulism in Lancashire, England, and North Wales are reviewed. All but 1 of the patients (age range 14 months to 74 years) were admitted to hospital: 12 were treated in intensive care units, and 8 received positive pressure ventilation. 1 patient died with an aspiration pneumonia. The clinical presentations contained several unusual features, with evidence of segmental demyelination in some patients and drowsiness, sore throats, and fever in others. The widely dispersed source of intoxication with patients presenting singly to several hospitals added to the difficulties of diagnosis. Successful clinical management depends on full and early recognition both of the dangers of impaired oropharyngeal function and of the rapid neurological changes in botulism.

Adolescent↗
PubMed1997

Risks of breast and testicular cancers in young adult twins in England and Wales: evidence on prenatal and genetic aetiology.

BACKGROUND: Aetiology of breast and testicular cancers may have prenatal factors, possibly exposure of the fetus to high concentrations of maternal oestrogen. Dizygotic twinning probably involves high hormone concentrations, and therefore, dizygotic twins might be at raised risk of these cancers. The aetiologies of breast and testicular cancers have genetic components, for breast cancer, especially at younger ages. Twins of these probands may, therefore, be at high risk. We investigated risk in twins of patients with breast cancer at young ages or with testicular cancer. METHODS: We identified twins with breast cancer incident at ages younger than 45 years and with incident testicular cancer in England and Wales during 1971-89 by cross-matching national cancer-registration and births records. We determined zygosity by questionnaires to the patients. The twins of probands were followed up for cancer incidence and death. We analysed risks of breast and testicular cancer in dizygotic twins compared with monozygotic twins, and in monozygotic and dizygotic twins of probands. FINDINGS: We identified 500 twins with breast cancer and 194 with testicular cancer. We found a non-significantly raised risk of breast cancer in dizygotic compared with monozygotic twins younger than 30 years (odds ratio 2.3 [95% CI 0.9-5.9]) but not older. The overall risk of testicular cancer was significantly higher in dizygotic twins than in monozygotic twins (1.5 [1.1-2.2]) consequent on a risk for seminomas was high (3.2 [1.6-6.5]; p = 0.001). Risk of breast cancer was significantly raised in female twins of probands (standardised incidence ratio 7.7 [4.9-12.2], p < 0.001). The relative risk of breast cancer was 34.7 (9.5-126.5) in monozygotic twins of women in whom breast cancer had occurred before age 35 years. The cumulative risk of breast cancer for these twins by age 40 years was 29% (13-56). The relative risk of testicular cancer was 37.5 (12.3-115.6) in twins of men with testicular cancer. The cumulative risk by age 40 years in monozygotic twins of men with testicular cancer was 14% (4-46). INTERPRETATION: The higher risks of these cancers in dizygotic than in monozygotic twins support a prenatal aetiology, and are compatible with aetiology related to raised maternal concentrations of free, unbound oestrogens. The results for twins of probands have implications for genetic aetiology; appropriate clinical action for monozygotic twins needs consideration.

Adult↗
PubMed1997

Resistance to methicillin and other antibiotics in isolates of Staphylococcus aureus from blood and cerebrospinal fluid, England and Wales, 1989-95.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) strains are colonising hospital patients in most areas of England and Wales, UK. The extent to which they cause invasive infection can be gauged from their presence in isolates from blood or cerebrospinal fluid. METHODS: About 200 clinical laboratories reported the results of susceptibility testing of between 4501 and 6370 isolates of S aureus from blood or cerebrospinal fluid in each of the years 1989-95. We assessed the rate of resistance to methicillin and other antibiotics for each of these years. FINDINGS: Resistance to methicillin was stable at about 1.5% of isolates during 1989-91, but increased thereafter to 13.2% in 1995 (p < 0.001). At the same time there was a significant increase in the percentage of isolates resistant to erythromycin, clindamycin, ciprofloxacin, gentamicin, trimethoprim, and rifampicin (p < 0.001 for each)-resistance characteristics often seen in MRSA. Resistance to benzylpenicillin increased slightly but significantly (p < 0.001); resistance to fusidic acid was stable (p > 0.05); resistance to tetracycline decreased significantly (p < 0.001). INTERPRETATION: Among cases of S aureus bacteraemia, the proportion due to MRSA has increased significantly. Bacteraemia due to MRSA has a poor prognosis, especially if not treated with suitable antibiotics. Therefore, these findings are important, especially for management of patients and the development of antibiotic policies.

Anti-Bacterial Agents↗