Toxoplasmosis in Northern Ireland 1982-83

During 1982-83, 1161 sera were examined for the presence of haemagglutinating antibodies against Toxoplasma gondii. The Indirect Haemagglutination Test (IHAT) was positive in 416 (35.8%). Fourteen patients were judged to be suffering from acute acquired toxoplasmosis (active disease). In addition, 11 patients were also found to have glandular fever.     

Congenital toxoplasmosis in England, Wales, and Northern Ireland: some epidemiological problems

It has been suggested that congenital toxoplasmosis could be prevented by antenatal serological screening, followed by treatment or by termination of pregnancy if infection occurs. The only study of the incidence of congenital toxoplasmosis in England, Wales, and Northern Ireland took place more than 10 years ago. To obtain more recent figures laboratory reports of cases occurring from 1975 to 1980 were analysed. A total of 91 cases were reported over the six years. By criteria established to classify these infections only 34 were congenital, 20 were acquired postnatally, and 37 were unclassifiable. The mean annual number of cases of congenital toxoplasmosis was considerably smaller than that found in other recent studies. The condition could be underdiagnosed or rates of placental transmission could be lower in Britain than in other countries. Variation in reporting criteria of the laboratories made the data difficult to interpret. Improved diagnosis of congenital toxoplasmosis would not only clarify the epidemiology but would also help clinicians in management of suspected cases. Further antenatal surveys are necessary to assess the role of screening in the prevention of congenital toxoplasmosis.     

Survey of sickle-cell disease in England and Wales

The incidence and the clinical course of patients suffering from sickle-cell syndrome (Hb SS; Hb SC; Hb S thal) in England and Wales are not known. In 1979 an ad hoc committee was formed to investigate these problems. Initially, a questionnaire was sent to 227 haematologists in England and Wales to determine the number of cases in these countries. The replies have indicated that 1367 cases were seen in 1978 and 1979. Probably this may represent only half the total number of cases. From this survey it has been possible to draw up a composite map showing the location of patients, which has provided a basis to determine the clinical course of the disease, and for further studies into the complications and management of sickle-cell disease in England and Wales. From a second questionnaire preliminary data about the general management and mortality in England and Wales have been recorded.     

Deaths from rhesus haemolytic disease in England and Wales in 1982 and 1983

Examination of death certificates and the clinical notes of the patients concerned showed that the number of deaths from rhesus (D) haemolytic disease in England and Wales was 44 and 34 during 1982 and 1983, respectively, a substantial decrease from the figure of 106 for 1977. Of the 78 women whose infants died in 1982 and 1983, 49 had not received anti-Rh immunoglobulin after previous pregnancies with Rh positive infants; most of these deaths would presumably have been prevented had postnatal anti-Rh immunoglobulin been given. In 13 women anti-D was detected during, or immediately after, a first pregnancy, and in 15 women rhesus immunisation developed despite administration of anti-Rh immunoglobulin postnatally. One or two apparent failures of treatment may have been due to underdosage, but it must be concluded that about one third of the deaths in 1982 and 1983 could have been prevented only by giving anti-Rh immunoglobulin antenatally as well as postnatally.     

佛山市新生儿CH筛查的成本效益和成本效用研究

目的 研究佛山市新生儿先天性甲状腺功能减低症筛查的成本效益、成本效用方面的经济学数据,对筛查工作的效果做出评价.方法 通过筛查中心,文献、官方资源,问卷调查3种途径搜集经济学相关资料,并利用统计学工具、Tree Age Pro卫生决策分析软件对筛查工作进行成本效益和成本效用的评估.结果 2000年6月至2007年12月共投入成本1 794.61万元,获得效益11 769.99万元,净效益9 975.52万元,成本效益比为1.00∶6.56.筛查每投入3 216元可避免一个伤残调整寿命年.结论 筛查项目具有良好的经济学适用性,值得更多的资金投入,以进一步推广和普及.     

Deaths in children with a diagnosis of acute appendicitis in England and Wales 1980-4

Thirty five children died of acute appendicitis in England and Wales in 1980-4 compared with 204 in 1963-7. Thirteen of the 35 deaths in 1980-4 took place at home or on the day of admission to hospital before operation and a further 18 on the day of operation or the first day after it. Thirty one of the children had peritonitis. A third of the deaths were in children aged 0-4 years, and the hospital fatality rate in this age group was one death in 320 cases compared with one death in 4760 cases in children aged 5-14 years. The fall in the number of deaths between the 1960s and the 1980s was due to improvements in medical care, a reduction in the incidence of appendicitis, and changes in the age structure of the child population. Difficulty and delay in diagnosis and inadequate intravenous therapy are now the main factors contributing to death.     

Trends in self-poisoning with drugs in Newcastle, New South Wales, 1980-1982

A review has been carried out of 747 cases of self-poisoning with drugs which were treated in the three major Newcastle hospitals over the three-year period 1980-1982. The data obtained have been compared with earlier published data for the years 1976-1979. The number of patients who were admitted to hospital fell from 290 in 1980 to 226 in 1982. The most common drugs used were benzodiazepine (34.5% of cases) and antidepressant agents (9.1%), paracetamol (7.9%), barbiturates (7.1%) and phenothiazines (3.8%). Although this indicated a gratifying drop in the use of barbiturate drugs, the use of several drugs in combination in self-poisoning rose disturbingly. Five patients died in hospital; 23 who committed suicide with drugs were not admitted to hospital but were investigated by the Regional Forensic Pathologist.     

芜湖市新生儿先天性甲状腺功能低下症筛查及切值研究

目的:了解芜湖市新生儿先天性甲状腺功能低下症(CH)的筛查情况和发病率,建立芜湖市新生儿促甲状腺素(TSH)筛查切值。方法:新生儿出生72 h充分哺乳6次后足跟采血,滴在特殊的滤纸(Whatman S&S 903#滤纸)上,采用时间分辨荧光免疫分析方法(TRFIA)测定新生儿足跟血促甲状腺素浓度。结果:芜湖市2014年1月~2015年12月间共筛查新生儿43 820例,其中健康新生儿43 796例,确诊CH患儿24例,发病率1/1826。建立芜湖市新生儿TSH切值为8.0μU/m L。结论:芜湖市新生儿CH发病率高于全国发病率,新生儿TSH筛查切值的建立为芜湖市今后的新生儿CH筛查提供了依据。     

Prevalence of antibody to poliovirus in England and Wales 1984-6

Serum from 995 subjects aged 6 months to 99 years was screened at a dilution of 1/8 for neutralising antibodies to poliovirus. Of these samples, 975 (98%) contained antibody to at least one serotype, and 763 (77%) contained antibody to all three, an improvement since previous studies. Children aged 8 to 15, however, had a low prevalence of antibody to poliovirus type 3, with only four (40%) of those aged 12 protected. This finding is possibly due to the waning of antibodies induced by the type 3 component of oral poliovirus vaccine and emphasises the continued importance of a booster dose of vaccine for those leaving school.     

Renal replacement treatment for diabetic nephropathy in Northern Ireland 1979-1987

Twenty-three patients with end-stage renal failure due to diabetic nephropathy received renal replacement treatment. All patients had insulin-dependent diabetes mellitus. Nineteen transplants were performed in seventeen patients. Two-year graft survival for all transplants was 74% with a two-year patient survival post-transplantation of 81%. Overall two-year patient survival was 73%, compared with 82% in non-diabetic patients receiving renal replacement treatment. In diabetic patients accepted for treatment there was a high incidence of non-renal complications, particularly vascular disease. An aggressive approach to the treatment of vascular disease in these patients may improve overall survival rates.     

Transplantation for chronic pulmonary disease: referral and outcome in Northern Ireland, 1986-1990.

Eighteen patients have been referred for lung transplantations from Northern Ireland in 1986-1990. Fourteen were accepted but only four achieved transplantation. These rates are lower than for comparable regions in the North of England. The lung donation rate from Northern Ireland during the same period was similar to that for the United Kingdom as a whole. The low referral and transplant rates for Northern Ireland require reassessment of the procedures involved.     

金华市2003～2006年新生儿先天性甲状腺功能低下和苯丙酮尿症筛查结果分析

目的了解新生儿先天性甲状腺功能低下(CH)和苯丙酮尿症(PKU)的发病情况,为制定干预措施提供依据。方法对金华市2003年至2006年新生儿CH和PKU的筛查资料进行分析。结果4年中共筛查新生儿176973例,筛查率为91.27%;共检出CH154例,发病率为0.87‰,高于浙江省平均发病率(0.7‰);检出PKU6例,发病率为0.03‰,与浙江省发病率(0.04‰)相近。CH发病率高于全市平均水平的县(市、区)有婺城区(1.32‰)、市区(1.130‰)、武义县(1.26‰)和浦江县(1.06‰);PKU发病串较高的有武义县(0.17‰)、金东区(0.13‰)和兰溪市(0.10‰)。结论我市新生儿CH及PKU的发病率仍处于较高水平,地区间差异有显著性(P<0.05)。     

Management and outcome of children with congenital hypothyroidism detected on neonatal screening in South Australia

Thirty-eight congenitally hypothyroid children who were detected in a neonatal screening programme have been treated for a mean period of 3.8 years (range, 0.5-8.5 years) by the maintenance of the free thyroxine index in the upper normal range as the main determinant of the dose of thyroxine. Only excessive elevation of, or serial rises in, thyroid stimulating hormone (TSH) level influenced the dose of thyroxine. This treatment strategy, which aims to avoid the potentially adverse effects of thyroxine overdosage, has often resulted in delayed return of TSH levels to normal, especially in athyrotic children (mean TSH +/- SD at one year of age in athyrotic children, 72 +/- 90 mU/L; in children with ectopic thyroid glands, 24 +/- 16 mU/L; normal range, 0-7 mU/L). The mean thyroxine dose of about 100 micrograms/m2 did not change significantly with age, and is lower than the doses that are sometimes quoted in the literature; athyrotic children require significantly more thyroxine (P less than 0.05) than those with ectopic thyroid glands. Symptoms and signs of congenital hypothyroidism, although subtle, were significantly more common (P less than 0.05 for symptoms and P less than 0.001 for signs) in athyrotic children compared with those with ectopic glands. No physical or developmental abnormality related to congenital hypothyroidism has been demonstrated on follow-up; mean height and weight percentiles approximate the 50th percentile at ages one to six years and mean developmental scores +/- SD at about two years of age by the Griffiths Mental Development Scale and at 4.5-6.5 years by the Wechsler Preschool and Primary Scale are 102.4 +/- 10.4 and 111.2 +/- 12.2, respectively. Long-term follow-up studies are necessary to exclude more subtle developmental and neurological abnormalities.     

The changing pattern of alcohol consumption in England and Wales 1978-85

An alcohol consumption survey of 926 people aged 18 or over in England and Wales was conducted by Gallup in 1985. The results were compared with those obtained in a similar survey conducted by the Office of Population Censuses and Surveys in 1978. Overall alcohol consumption remained virtually unchanged. Men showed little difference in drinking habits, except for the 18-24 age group, who seemed to be drinking less. For women mean alcohol consumption in 1985 was similar to that in 1978, but more women were not drinking at all so the mean alcohol consumption per drinker had risen. As with earlier work, this study showed that social class had little influence on alcohol consumption, while being married seemed to have a moderating effect. A variable regional pattern of alcohol intake was found. In a separate analysis under-age drinking was common among 16-17 year olds (65%). Their pattern of drinking was similar to that of other age groups, except for those over 65 years, who drank less. Change in alcohol intake in the UK over the seven years was in the middle of the range of values for other European countries. The stable UK overall consumption was perhaps due to the constant relative price of alcohol.