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Frequencies of PrP gene variants in healthy cattle and cattle with BSE in Scotland.

Bovine spongiform encephalopathy (BSE) is one of a family of scrapie-like diseases which affect various mammals. Polymorphisms and mutations of the PrP gene have been associated with the incidence of experimental and natural scrapie in other animals and this study of the bovine PrP gene was undertaken to discover whether there was a similar association with PrP genotype in cattle with BSE. There are two known polymorphisms of the coding region of the bovine PrP gene, a silent HindII restriction site polymorphism and a difference in the number of an octapeptide repeated sequence (either five or six copies). An analysis of 370 cattle in Scotland revealed no difference between the frequencies of these PrP genotypes in healthy cattle and cattle with BSE.

Animals↗

Association between natural scrapie and PrP genotype in a flock of Suffolk sheep in Scotland.

The incidence of natural scrapie in sheep is associated with polymorphisms of the PrP gene, particularly those at codons 136, 154 and 171. In many breeds, the PrP allele encoding valine at codon 136 confers an extremely high risk of scrapie, but in Suffolk sheep this allele is vanishingly rare. In this study of a single closed flock of Suffolk sheep in Scotland, scrapie occurred primarily in animals which were homozygous for glutamine at codon 171, a genotype which was significantly less frequent in healthy flockmates. However, the apparent linkage between glutamine at codon 171 and scrapie was not completely recessive because two of 64 scrapie cases were heterozygous glutamine/arginine. These results suggest that breeding for increased resistance to scrapie in Suffolks by the selection of animals according to their PrP genotype is a feasible option.

Alleles↗

Cataracts in farmed Atlantic salmon (Salmo salar) in Ireland, Norway and Scotland from 1995 to 1997.

From 1995 to 1997 cataracts were observed in Atlantic salmon (Salmo salar) in Ireland, Norway and Scotland at around the time of smoltification (when freshwater fish become adapted to the hypertonic seawater) in both fresh- and seawater fish. Over 38,000 fish were screened for the presence of cataracts. Posterior cortical cataracts were the earliest and most consistent change, followed by perinuclear, equatorial and anterior cortical cataracts. On histological examination vacuolation of the lens fibres was consistently present in the posterior cortex. The pattern of the outbreak suggested that a nutritional factor was involved although the variable incidence and severity of the condition indicated that a number of modifying factors may have been involved in the expression of the condition.

Animal Feed↗

Risk factors for Johne's disease in Scotland--the results of a survey of farmers.

The reported incidence of Johne's disease has been increasing in the east of Scotland since 1993. A postal questionnaire survey was sent to 127 farms to identify potential risk factors for Johne's disease in relation to wildlife and farm management practices, and 86 returns were obtained. Of 22 farms which had been assumed to be free of the disease, on the basis of information held by local veterinary centres, seven (32 per cent) reported cases of Johne's disease in the 1990s, indicating that the disease is under-reported. Logistic regression analyses showed that eight of 63 potentially explanatory variables were significant at the 5 per cent level in affecting the likelihood of farms reporting Johne's disease. Of these, large numbers of livestock and rabbits, and access of wildlife to feed stores were the clearest and most consistent risk factors associated with the disease. The application of manure to grazing pasture, the type of water supply for the cattle and the numbers of crows were also related to the presence of Johne's disease but the nature of these relationships was less clear. Only 38 per cent of the farms reported taking any control measures to combat Johne's disease, but three of the control measures were relevant to risk factors identified as significant by the survey, namely maintaining a clean water supply, controlling rabbits and not spreading manure on to grazing pasture.

Animals↗

Salmonella enterica subspecies enterica serotype Typhimurium and Escherichia coli O86 in wild birds at two garden sites in south-west Scotland.

Salmonella enterica subspecies enterica serotype Typhimurium and Escherchia coli O86:K61:NM are two bacteria that can cause outbreaks of mortality in garden birds visiting bird tables and other feeding stations. Two sites in south-west Scotland were monitored for the two organisms for 12 months. At site A, large numbers of birds fed throughout the year, and at site B smaller numbers of birds fed only in the winter months. Samples of composite faeces were collected from the feeding stations and screened for the organisms, and any dead birds were also screened. S Typhimurium definitive type (DT) 56 (variant) was found to be endemic at site A, and was recovered from 48 per cent of samples of composite faeces collected from the bird table, from 42 per cent of composite faeces from underneath a hanging feeder, and from 33 per cent of composite faeces from below a roost used by house sparrows; the organism was also isolated from the carcases of six wild birds found dead at the site. In contrast, S Typhimurium (DT41) was recovered only once at site B, from 2 per cent of the composite faeces from below a hanging feeder, and no dead birds were recovered from the site. E coli O86 was not recovered from the faeces collected from either site, but was isolated from a bird that died from trauma at site A.

Animals↗

Epidemiology of Salmonella enterica serovars enteritidis and Typhimurium in animals and people in Scotland between 1990 and 2001.

Two serovars of salmonella which are currently of particular importance in both human and animal infections are Salmonella enterica serovars Enteritidis phage type 4 (PT4) and Typhimurium definitive type 104 (DT104). This paper describes the trends in the relationships between the levels of infection of people and a range of farm animal species with these two serovars and explores some of the reasons behind them. In 1996, there was a peak of 520 reports of S Typhimurium DT104 infection in people in Scotland, but the number has decreased every year since, to 96 in 2001. In cattle the incidence of S Typhimurium DT104 also peaked in 1996, with 138 incidents, and it has similarly decreased every year to 2001 when there were 10 reported incidents. Similar declines have been observed in its incidence in sheep and pigs. In people the number of reports of S Enteritidis PT4 peaked in 1997 at 1684 and then declined to 457 in 2001. In chickens, the number of reports of S Enteritidis PT4 peaked in 1998 at 34 incidents, but no incidents were reported in the following three years.

Animals↗

Myocarditis and myositis due to infection with Hepatozoon species in pine martens (Martes martes) in Scotland.

Postmortem examinations of four pine martens which had died as a result of road accidents in Scotland revealed focal, granulomatous lesions in the heart and skeletal muscles of three of them. An immunoperoxidase staining technique showed that the lesions were due to infection with Hepatozoon species. A PCR-based assay was used to confirm the presence of Hepatozoon DNA in the infected tissues. The nucleotide base sequence of the PCR products suggested that the infecting organism was probably a new species of Hepatozoon, most closely related to, but distinct from, Hepatozoon canis. The pine martens were in good physical condition and there was no indication that the infection was causing ill health.

Animals↗

Survey of zoonoses recorded in Scotland between 1993 and 2002.

All the human and animal laboratory reports of zoonoses sent to Health Protection Scotland between 1993 and 2002 were identified. There were 24,946 reports from veterinary laboratories, and 94,718 (20 per cent) of the 468,214 reports from medical laboratories were considered to be zoonotic. The most common reports of zoonoses from people were Campylobacter, Salmonella, Cryptosporidium and Giardia species and Escherichia coli o157. The most common reports of zoonoses from animals were Salmonella, Cryptosporidium, Chlamydia and Campylobacter species and Mycobacterium avium paratuberculosis. For all the zoonoses in people, the National Health Service Board areas Borders, Dumfries and Galloway, Forth Valley, Grampian, Lanarkshire and Lothian had a higher than expected standardised incidence rate of infection, whereas Ayrshire and Arran, Fife, Greater Glasgow, Shetland, Tayside and Western Isles had a lower than expected rate. The organisms and diseases considered to be new and emerging were Rhodococcus species, Cyclospora cayetanensis, Leishmania species, Pneumocystis carinii (jiroveci) and bovine spongiform encephalopathy/variant Creutzfeldt-Jakob disease.

Animals↗

The role of cytokine gene polymorphisms in colorectal cancer and their interaction with aspirin use in the northeast of Scotland.

The reduced risk of colorectal cancer associated with cyclooxygenase enzyme inhibitors, such as aspirin and other nonsteroidal anti-inflammatory drugs, strongly suggests that chronic inflammation is a key mediator in the development of colorectal cancer. This complements recent molecular evidence demonstrating an association between a number of proinflammatory genetic polymorphisms and risk of colorectal cancer. We assessed polymorphisms in the IL-1, IL-10, TNF-A, and TGF-B genes in a population-based case-control study of colorectal cancer cases (n = 264) and frequency-matched controls (n = 408) in the Northeast of Scotland and analyzed their interaction with regular aspirin use. There was no evidence of a relation between any of the individual polymorphisms, or pairs of polymorphisms, and risk of colorectal cancer. There was a significant interaction between the IL-10-592 C/A polymorphism and aspirin use (Pinteraction = 0.03). Carriers of the variant IL-10-592 (A) allele, who produce less of the anti-inflammatory cytokine interleukin-10, had a statistically significant 50% reduced risk of colorectal cancer when taking regular aspirin (odds ratio, 0.5; 95% confidence interval, 0.25-0.97), whereas risk was not reduced in carriers of the A allele who did not use aspirin, or among aspirin users with the CC genotype. It is possible that carriers of the mutant IL-10-592 allele are more likely to derive anti-inflammatory and chemopreventive benefits from aspirin in the presence of a lower production of their own endogenous anti-inflammatory interleukin-10. These results suggest that host genetics may play a role in predicting response to chemopreventive strategies. Confirmation of these findings in other populations is required.

Aged↗

Stroke services in Scotland.

Stroke services are developing rapidly in Scotland. Most of the 33 hospitals which admit stroke patients from the community have a stroke unit and access to brain imaging. However, acute stroke units are few and many of the 10,000 patients each year still do not access a stroke unit bed. A recently introduced National Strategy aims to ensure that all patients have access to early stroke unit care, brain imaging and appropriate specialist rehabilitation and secondary prevention. A national system to monitor the progress of the strategy is being developed.

Coronary Disease↗

Changing patterns of prostatectomy in Scotland: 1971-1989.

Analysis of 81,374 prostatectomies performed in Scotland between 1971 and 1989 showed that the annual prostatectomy rate (per 100,000 men) increased 3-fold for procedures performed by urologists, but remained static for general surgeons. In 1971, transurethral prostatectomy comprised 16% of all prostatectomies performed by general surgeons and 55% of those performed by urologists, but by 1989 it comprised 93% of prostatectomies performed by general surgeons and 96.5% of those performed by urologists. The relative increase in the annual number of prostatectomies was greatest (2.61) in the older age group (80-89 years) and smallest (1.76) in the younger age group (60-69 years). The relative increase in the age-specific prostatectomy rate was greatest (1.79) in the youngest age group (50-59 years) and smallest (1.54) in the oldest age group (80-89 years). This indicates that the increase in the annual number of prostatectomies performed in the older age groups is largely the result of an increase in the number of elderly men in the population, but this is compounded by an expansion of the indications for prostatectomy in all age groups.

Age Factors↗

Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study.

BACKGROUND: The National Cholesterol Education Program (NCEP) recently proposed a simple definition for metabolic syndrome. Information on the prospective association of this definition for coronary heart disease (CHD) and type 2 diabetes is currently limited. METHODS AND RESULTS: We used a modified NCEP definition with body mass index in place of waist circumference. Baseline assessments in the West of Scotland Coronary Prevention Study were available for 6447 men to predict CHD risk and for 5974 men to predict incident diabetes over 4.9 years of follow-up. Mean LDL cholesterol was similar but C-reactive protein was higher (P<0.0001) in the 26% of men with the syndrome compared with those without. Metabolic syndrome increased the risk for a CHD event [univariate hazard ratio (HR)=1.76 (95% CI, 1.44 to 2.15)] and for diabetes [univariate HR=3.50 (95% CI 2.51 to 4.90)]. Metabolic syndrome continued to predict CHD events (HR=1.30, 95% CI, 1.00 to 1.67, P=0.045) in a multivariate model incorporating conventional risk factors. Men with 4 or 5 features of the syndrome had a 3.7-fold increase in risk for CHD and a 24.5-fold increase for diabetes compared with men with none (both P<0.0001). C-reactive protein enhanced prognostic information for both outcomes. With pravastatin, men with the syndrome had similar risk reduction for CHD as compared with those without (HR, 0.73 and 0.69; pravastatin versus placebo). CONCLUSIONS: A modified NCEP metabolic syndrome definition predicts CHD events, and, more strikingly, new-onset diabetes, and thus helps identify individuals who may receive particular benefit from lifestyle measures to prevent these diseases.

Body Mass Index↗

Risk factors and 20-year stroke mortality in men and women in the Renfrew/Paisley study in Scotland.

BACKGROUND AND PURPOSE: The aim of this study was to relate risk factors in middle-aged men and women to stroke mortality over a long follow-up period. METHODS: In the early to mid 1970s, 7052 men and 8354 women from the Renfrew/Paisley prospective cohort study in Scotland were screened when aged 45 to 64 years. Risk factors measured included blood pressure, blood cholesterol and glucose, respiratory function, cardiothoracic ratio, smoking habit, height, body mass index, age, preexisting coronary heart disease, and diabetes. These were related to stroke mortality over 20 years of follow-up. RESULTS: Women's stroke mortality rates were similar to men's, unlike coronary heart disease mortality, in which case women's rates were lower than men's. Diastolic and systolic blood pressure, smoking, cardiothoracic ratio, preexisting coronary heart disease, and diabetes were positively related to stroke mortality for men and women, while adjusted forced expiratory volume in 1 second and height were negatively related. Cholesterol and body mass index were not related to stroke mortality. Glucose in nondiabetics was positively related to stroke mortality for women but not men, and there was evidence of a threshold effect at the highest levels of glucose. Former smokers had mortality rates that were similar to those of never-smokers. In sex-specific multivariate models, most variables retained a statistically significant association with stroke mortality, illustrating the multifactorial etiology of stroke. CONCLUSIONS: Overall, findings for women were similar to those for men. Control of risk factors for reduction of stroke mortality should be targeted at men and women in a similar fashion, particularly with reference to smoking cessation and blood pressure control.

Blood Glucose↗

Comparison of risk factors for stroke incidence and stroke mortality in 20 years of follow-up in men and women in the Renfrew/Paisley Study in Scotland.

BACKGROUND AND PURPOSE: The aim of this study was to relate risk factors in middle-aged men and women to stroke incidence (defined by having a hospital discharge with a main diagnosis of stroke) and compare this with the associations between risk factors and stroke mortality. METHODS: In the early to mid-1970s, when they were 45 to 64 years of age, 7052 men and 8354 women from the Renfrew/Paisley prospective cohort study in Scotland were screened. Risk factors measured included blood pressure, blood cholesterol and glucose, respiratory function, cardiothoracic ratio, smoking habit, height, body mass index, preexisting coronary heart disease, and diabetes. These were related to stroke incidence over 20 years of follow-up. RESULTS: Diastolic and systolic blood pressure, smoking, cardiothoracic ratio, preexisting coronary heart disease, and diabetes were positively related to stroke incidence for men and women, whereas adjusted FEV(1) (forced expiratory volume in 1 second) and height were negatively related. Cholesterol was not related to stroke. Glucose for nondiabetic subjects had a U-shaped relationship with stroke. Body mass index was not clearly related to stroke, although participants with the highest body mass index had the highest stroke rate. Former smokers had similar stroke rates to never-smokers. Tests between the associations of risk factors and stroke incidence revealed these were not statistically different from the associations with stroke mortality. CONCLUSIONS: The risk factors had a similar effect on stroke incidence as on stroke mortality. Epidemiological studies with information on stroke mortality are likely to give results applicable to stroke incidence.

Blood Glucose↗

Increasing incidence of anorexia nervosa in the female population of northeast Scotland.

OBJECTIVE: The aim of the study was to determine whether there has been an increase in the incidence of anorexia nervosa in the female population in the northeast of Scotland since the 1960s. METHOD: Standardized diagnostic criteria were applied to the case records of female subjects who had been diagnosed as suffering from anorexia nervosa and had presented for the first time to psychiatric services between 1965 and 1991 or had been admitted for the first time to a general hospital between 1970 and 1991. Age-standardized annual incidence rates were calculated from 1965 through 1991. As a broad measure of severity, the weights of patients in 3 early years of the study, 1970-1972, were compared with those of patients in the last 3 years, 1989-1991. RESULTS: Over the 27-year period studied, 287 patients received confirmed diagnoses of anorexia nervosa, and the mean annual increase in incidence was 5.3%. The rate of increase was highly statistically significant. Comparison of weights at presentation showed a trend for patients presenting in 1970-1972 to be lighter than those presenting in 1989-1991. CONCLUSIONS: Rates of referral for female subjects with anorexia nervosa have greatly increased since the 1960s. These rates likely reflect a genuine increase in incidence, but the data suggest that less severely ill patients are now being referred.

Adolescent↗

Smoking habits, current symptoms, and premorbid characteristics of schizophrenic patients in Nithsdale, Scotland.

OBJECTIVE: Previous studies of smoking habits of schizophrenic patients have found rates as high as 88%. The authors report the smoking habits of all known schizophrenic patients within a discrete geographical area and compare them with the smoking habits of a general population sample. METHOD: All known schizophrenic patients in Nithsdale in South-West Scotland (N = 168) were invited to complete a questionnaire on smoking habits. Also assessed were mental state, drug-related side effects, and premorbid childhood personality and social adjustment. RESULTS: One hundred thirty-five of the 168 patients returned the questionnaires. The rate of smoking among the patients was 58% (N = 78), compared with 28% in the general population. Sixty-eight percent of the patients who smoked (N = 53) had 25 or more cigarettes per day. The mean age at starting smoking was 17 years in both patients and normal subjects. Ninety percent of the patients who smoked (N = 70) started smoking before the onset of schizophrenia. Patients who smoked were younger than nonsmokers, and more of them were male. They had had more hospitalizations, and more were in contact with psychiatric services. More were receiving intramuscular antipsychotic medication. Smokers had poorer childhood social adjustment. Among the female patients, there was a positive correlation between age at starting smoking and age at onset of schizophrenia. CONCLUSIONS: The rate of smoking and level of nicotine addiction are greater in schizophrenic patients than in the general population. Smoking may be a marker for the neurodevelopmental form of the illness and may be another environmental risk factor for schizophrenia in vulnerable individuals.

Adolescent↗

Summer birth and deficit schizophrenia in Dumfries and Galloway, southwestern Scotland.

OBJECTIVE: An association between deficit schizophrenia and summer birth has previously been reported. Confirmation of a separate risk factor for this group of patients is potentially important, but the number of subjects with deficit schizophrenia in previous reports has been small. This analysis used data from an epidemiological study of incident cases of psychosis to test the hypothesis that deficit schizophrenia is associated with summer birth. METHOD: Data were drawn from records for the first year of clinical contact for all new patients coming into treatment for psychosis in the region of Dumfries and Galloway, Scotland, from 1979 to 1998. Patients with schizophrenia were classified as having deficit (N=65) or nondeficit (N=277) schizophrenia. Time of birth in the deficit and nondeficit groups was compared, and time of birth in the deficit group was compared with that for all births in Dumfries and Galloway during the study period. RESULTS: The deficit schizophrenia group had an excess of summer births, compared to both the nondeficit schizophrenia group and all births in Dumfries and Galloway. The difference between the deficit and nondeficit schizophrenia groups remained significant after accounting for demographic characteristics and symptoms of disorganization and hallucinations plus delusions. A measure of negative symptoms (as opposed to deficit schizophrenia) was a weaker predictor of summer birth. CONCLUSIONS: This study confirmed an association between deficit schizophrenia and summer birth in the nontropical regions of the Northern Hemisphere. The existence of a risk factor for deficit but not nondeficit schizophrenia is also consistent with other evidence that the pathophysiology of deficit schizophrenia differs from that for other types of the disorder.

Adult↗

Anorexia nervosa mortality in Northeast Scotland, 1965-1999.

OBJECTIVE: Most previous studies of mortality in anorexia nervosa patients have shown an increased risk of premature death but have been limited by methodological constraints. This study aimed to overcome some of these constraints by having a large original sample size, diagnosis confirmed by case note review, a long duration of follow-up, and a clear base population. METHOD: The authors identified 524 anorexia nervosa cases seen in specialist services in Northeast Scotland; anorexia nervosa diagnosis was confirmed by scrutinizing case notes. Those who had died were identified from the National Health Service register or register of deaths. The death rates and causes of death were analyzed. RESULTS: Twenty-three patients died, giving a crude death rate of 4.4% and a standardized mortality rate of 3.3 (95% CI=2.2-4.9). In only one-third of the cases was anorexia nervosa on the death certificate, but an eating disorder or other psychiatric pathology probably contributed to several of the other deaths. Older age at the time the patient was seen at the specialist service was the only identifiable risk factor in the group of patients who died. The median length of time between diagnosis and death was 11 years. CONCLUSIONS: Anorexia nervosa is associated with increased risk of premature death. It is possible that death rates could be reduced by early diagnosis and by long-term specialist care.

Adolescent↗