PubMed Health⌕ Search

Biomedical subjects

P McLoone

Publications and source records attributed to P McLoone.

17 recordsLinked to original sources
PubMed2004

Whole-body UVB (TL-01) or UVA-1 irradiation does not alter the levels of immunomodulatory cytokines in the serum of human volunteers.

BACKGROUND/PURPOSE: Ultraviolet (UV) exposure of mammalian skin induces local and systemic immunosuppression. In mice it has been proposed that systemic immunosuppression is mediated by an UV-induced cytokine cascade involving systemic interleukin (IL)-4 and IL-10 and a reduction in IL-12 activity. To investigate whether there was a parallel mechanism in humans we examined the effect of whole-body narrowband ultraviolet B (UVB) (311-313 nm; TL-01) and ultraviolet A (UVA)-1 (340-400 nm) on serum cytokine levels. METHODS/RESULTS: In a first study, five male psoriatic subjects were whole-body irradiated with three sessions of a standard UVB (TL-01) phototherapy regimen previously shown to cause downregulation of natural killer cell activity and T helper 1 (Th1) and Th2 cytokine production by peripheral blood mononuclear cells. Enzyme-linked immunoabsorbent assay (ELISA) of sera taken before and after the third session showed no effect of phototherapy on IL-10 and tumour necrosis factor-alpha (TNF-alpha). In a second study, five healthy subjects received three whole-body exposures of UVB (TL-01) and five other healthy subjects received three exposures of UVA-1 on alternate days (total 22 J/cm(2)). Blood samples were taken before the first irradiation and at 0, 4, 8, 12, 14, 24 and 48 h after the third irradiation. The sera were subsequently analysed for IL-10, IL-12, IL-8, IL-1beta and TNF-alpha, by ELISA. The levels of IL-1beta and TNF-alpha were below detection limits (<5 pg/ml), while no significant change in the levels of IL-10, IL-12 or IL-8 was detected as a result of either TL-01 or UVA-1. CONCLUSIONS: It seems unlikely that a modulation in these circulating cytokines assessed in this study accounts for systemic UV-induced immunosuppression in human subjects.

Cytokines↗
PubMed2001

Changing patterns of hospital admission for asthma, 1981-97.

BACKGROUND: Hospital admission rates for asthma have stopped rising in several countries. The aim of this study was to use linked hospital admission data to explore recent trends in asthma admissions in Scotland. METHODS: Linked Scottish Morbidity Records (SMR1) for asthma (ICD-9 493 and ICD-10 J45-6) from 1981 to 1997 were used to describe rates of first admissions and readmissions by age and sex. As a measure of resource use, annual trends in bed days used were also explored by age and sex. RESULTS: There were 160 039 hospital admissions for asthma by 82 421 individuals in Scotland during the study period. The overall hospital admission rate increased by 122% (from 106.7 to 236.7 per 100 000 population) but this varied by sex, age, and admission type. First admissions rose by 70% from 73.2 per 100 000 in 1986 to 124.8 per 100 000 in 1997 while readmissions fell. Children (<15 years) experienced a decline in overall admissions after 1992 due to falls in both new admissions and readmissions. By 1997 the ratio of female to male admissions was 0.57 in children, but 1.50 above 14 years of age. Mean lengths of stay fell from 10.7 days to 3.7 days between 1981 and 1997 and bed days used showed little change except for a decline after 1992 in children. CONCLUSIONS: After a period of increasing hospitalisation for asthma in Scotland, rates of admission among children have begun to fall but among adults admissions continue to rise.

Adolescent↗
PubMed2000

Seasonal variation in mortality in Scotland.

BACKGROUND: Seasonal patterns in mortality have been recognized for many years. This study assesses seasonal variation in mortality in Scotland between 1981 and 1993 and considers its association with socioeconomic status and outdoor temperature. METHODS: Lagged Poisson regression analysis of numbers of deaths and average weekly temperature with adjustment for serial autocorrelation and influenza epidemics. RESULTS: There was significant seasonal variation in weekly death rates with a difference of about 30% between a summer trough and a winter peak. This variation was principally attributable to respiratory disease, cerebrovascular disease and coronary artery disease. Seasonal variation in mortality fell from around 38% in 1981-1983 to around 26% in 1991-1993. There was no clear evidence of a relationship between socioeconomic status and seasonal mortality, however the extent of the fall in seasonal variation was greater in deprived areas than in affluent areas. Overall, a 1 degree C decrease in mean temperature was associated with a 1% increase in deaths one week later. The lag in this relationship varied by cause of death and underlying temperature. CONCLUSIONS: Seasonal variations in mortality and the relationship between temperature and mortality are a significant public health problem in Scotland. It is likely that the strength of this relationship is a result of the population being unable to protect themselves adequately from the effects of temperature rather than the effects of temperature itself.

Adolescent↗
PubMed1999

The value of in-patient dermatology: a survey of in-patients in Scotland and Northern England.

Dermatology in-patient units are frequently threatened with reduction or closure, yet there are few objective data regarding the nature and use of in-patient management with which to assess their value. We have surveyed 300 patients admitted during March 1997 to dermatology units throughout Scotland and Northern England, to establish their clinical and social profile, and the outcome of admission. All departments provided phototherapy and out-patient treatment services, and 84% of those admitted lived within an hour's travel of one of these. Three diagnostic groups (psoriasis, eczema and leg ulcers) accounted for 83% of in-patient days. Patients were admitted principally because of disease severity but many, including half of those with psoriasis, had concurrent medical problems such as alcohol abuse, psychiatric disorder or arthropathy. Many patients with psoriasis and leg ulcers were from socially deprived areas, as defined by low Carstairs index scores, and a similar proportion received income support. Eighteen per cent of patients, mainly those with acute disorders, would have needed admission irrespective of dermatology bed availability. Out-patient management was considered the next best alternative for only 28% of patients, and many patients would have been expected to treat themselves. By contrast, 84% of patients admitted were cleared or substantially improved, or had procedures completed as planned, and another 12% were partially improved. Outcomes were particularly good in psoriasis, eczema and infection groups. We have demonstrated that in-patient management is highly effective in providing remission in chronic skin disease, and our survey also suggests that concomitant disability or social factors mean that for many such patients ambulatory care cannot replace this service.

Dermatology↗
PubMed1999

Speech and language therapy caseloads in seven districts in the UK.

This paper provides managers and clinicians with an analysis of routine data collected by seven speech and language therapy services in the UK. Managers in seven districts in the UK of varying size and location were asked to provide information on referrals, waiting times and attendances during the six month period, and to give a breakdown of the types of intervention offered and type of clients seen. These data were aggregated and comparisons were made with existing data on speech and language therapy services. The results revealed considerable variations in prevalence, staffing ratios and client management practices. The implications for service planning are discussed.

Adult↗
PubMed1998

Does the availability of prescribed drugs affect rates of self poisoning?

The trends in self-poisoning rates and in rates of prescribing of the major drug groups were compared. Over the period 1981-91, barbiturate prescribing and self poisoning both fell by 80%; for antidepressants, prescribing increased by over 40% and self poisoning by 30%; for antipsychotics, both rose by 30%; for benzodiazepines, poisoning fell by 30% and prescribing by 20%. Even for analgesic drugs, which are also available over the counter, there was a correspondence between changes in self poisoning and prescribing. The availability of prescribed drugs is directly related to their use for self poisoning. Restricting the availability of these drugs is a possible preventative strategy, although further research on this is needed.

Adolescent↗
PubMed1996

Hospitalisation for deliberate self-poisoning in Scotland from 1981 to 1993: trends in rates and types of drugs used.

BACKGROUND: Rates of self-poisoning fell during the 1980s, although recent reports suggest this trend may have reversed. METHODS: Data on all hospital discharges with a diagnosis of deliberate self-poisoning were obtained from the Information and Statistics Division of the NHS in Scotland. Rates of self-poisoning were investigated by overall trend, and for trends by age and by type of drug. RESULTS: Deliberate self-poisoning rates for men and women began increasing in the late 1980s, and did so steadily during the early 1990s. Because the rates are increasing faster in men, the traditional excess of self-poisoning among women is being eroded. For men rates increased in all age groups up to the age of 60, but the greatest rise occurred between ages 15-29. For women the increase was largely restricted to 15-24-year-olds, and rates fell among women over the age of 50. Self-poisoning with paracetamol increased most rapidly; in contrast to aspirin which showed little change. Opiate analgesics, antirheumatics, antidepressants and antipsychotics have also shown some increase in their use in both genders. There has been a substantial fall in the use of benzodiazepines in women, but little change among men. CONCLUSION: Rapid increases in self-poisoning particularly among young adults present a serious public health problem. Controlling this epidemic is made difficult because the principal drug involved, paracetamol, is readily available.

Acetaminophen↗
PubMed1994

Deprivation and mortality in Scotland, 1981 and 1991.

OBJECTIVE: To compare the mortality experience of Scottish postcode sectors characterised by socioeconomic census variables (Carstairs scores) in 1980-2 and 1990-2. METHODS: Variables derived from the 1981 and 1991 censuses were combined according to the method devised by Carstairs and Morris to obtain Carstairs scores for 1010 postcode sectors in Scotland in 1981 and 1001 sectors in 1991. For most analyses, these scores were grouped into seven deprivation categories ranging from affluent (category 1) to deprived (category 7) localities. MAIN OUTCOME MEASURES: Death rates and standardised mortality ratios for localities according to deprivation category. RESULTS: Postcode sectors in Scotland that were categorised as deprived in 1981 were relatively more deprived at the time of the 1991 census; the mortality experience of deprived localities relative to either Scotland or affluent neighbourhoods worsened over this period, with a 162% difference between the most affluent and most deprived categories in 1991-2. Although the age and sex standardised mortality for ages 0-64 in Scotland declined by 22% during the 1980s, the reduction in the deprived categories was only about half that of the affluent groups. Increases in the death rate for men (29%) and women (11%) aged 20-29 in the deprived groups were largely attributable to an increase in the rates of suicide. Death rates from ischaemic heart disease and carcinoma of the lung and bronchus at ages 40-69 were lower in all deprivation categories in 1990-2, but the reduction was greater in more affluent areas; the difference in rates for these conditions between affluent and deprived groups therefore increased over the decade. The observed worsening of the standardised mortality ratio for Glasgow relative to Scotland could be explained on the basis of these mortality differentials and the concentration of deprived postcode sectors in Glasgow. CONCLUSIONS: Differences in mortality experience linked to relative poverty increased in the 10 years between 1981 and 1991 censuses. Although mortality for Scotland as a whole is improving, the picture is one of an increasing distinction between the experience of the majority and that of a substantial minority of the population.

Adult↗
PubMed1993

Factors limiting the effectiveness of prenatal screening for anencephaly and spina bifida in a high-risk area.

The effectiveness of a prenatal screening programme in reducing the birth prevalence of anencephaly and spina bifida (ASB) is influenced by three principal factors: the proportion of affected pregnancies screened (uptake), the proportion of affected pregnancies detected on screening (sensitivity) and the proportion of affected pregnancies terminated when detected (compliance). The purpose of the study was two-fold: to develop an epidemiologically-based method for the retrospective monitoring of these three factors and to attempt to quantify their relative importance in relation to the outcome of screening. Data on births and terminations associated with ASB for the period 1976-1986 were obtained from the Glasgow Register of Congenital Anomalies and from the Department of Medical Genetics, Yorkhill Hospitals. Increasing proportions of affected pregnancies screened, detected and terminated were observed, to a greater degree for anencephaly than for spina bifida. The relationships between uptake, sensitivity, compliance and terminations are described in the form of a simple arithmetic expression. In policy terms, further efforts are required to increase all three in order to improve the effectiveness of screening for spina bifida.

Abortion, Therapeutic↗
PubMed1992

The Chief Scientist reports.... Pattern of decline in prevalence of anencephaly and spina bifida in a high risk area.

The results of three studies spanning the period 1964 to 1989 were aggregated in an attempt to identify secular trends which might contribute to aetiological understanding of anencephaly and spina bifida (ASB). All data related to the prevalence of ASB in a geographically defined population in Glasgow, a known high risk area of neural tube defects. Multiple sources of ascertainment were employed to identify affected cases, whether live births, still births or induced abortions following prenatal diagnosis. The birth prevalence of ASB dropped by 82%, from 5.63 per 1,000 births in 1964-1968 to 1.04 per 1,000 births in 1979-1989, while the pregnancy prevalence (adjusted by including induced abortions) declined by 46%, from 5.63 per 1,000 births in 1964-1968 to 3.02 per 1,000 births in 1979-1989. Thus, prenatal screening contributed just under half of the observed decline in ASB birth prevalence. The pregnancy prevalence appeared to decline throughout the 1970's and early 1980's, and to increase again, temporarily, in the mid-1980s. These data could be interpreted as being broadly consistent with socio-economic hypotheses of ASB aetiology.

Anencephaly↗
PubMed1991

Measures of performance in Scottish maternity hospitals.

OBJECTIVE: To develop measures of hospital performance over time with particular reference to maternal and neonatal care by controlling for case mix. DESIGN: Analysis of computerised records of births. SETTING: Scotland, 1980-7. SUBJECTS: Over half a million singleton live births and stillbirths. MAIN OUTCOME MEASURES: Numbers of perinatal deaths and caesarean sections. RESULTS: Scottish maternity hospitals perform more or less equally with regard to perinatal mortality. When caesarean sections are considered, there is evidence that hospitals differ in their treatment of different groups of women; in two examples one hospital had an increased rate among women of parity 2 or more and another had a reduced rate of repeat caesarean section. CONCLUSIONS: Developing measures of performance over time by controlling for case mix is a valid system for monitoring hospital outcomes and activity, and allows comparison either between hospitals or with data for all Scottish maternity hospitals. Hospital profiles permit identification of differences for particular patient groups after allowance is made for other case mix variables.

Adult↗
PubMed1988

Quality of life on angina therapy: a randomised controlled trial of transdermal glyceryl trinitrate against placebo.

In a randomised controlled trial in 427 men with chronic stable angina continuous use of 5 mg transdermal glyceryl trinitrate (GTN) showed no advantage over placebo in terms of efficacy (anginal attack rates and sublingual GTN consumption) or quality of life (as measured with the sickness impact profile and a health index of disability). Patients on the active drug reported headaches more frequently than patients on placebo, and a higher proportion of them withdrew from the trial because of headache. Quality-of-life measurements showed a significant adverse effect of active treatment, principally in the social interaction dimension of the sickness impact profile. A similar effect was observed in placebo patients when crossed to active treatment in a 4-week single-blind period. The results suggest no benefit in the relief of chest pain from 5 mg transdermal GTN when used continuously.

Administration, Cutaneous↗
PubMed1987

Trends in suicide in Scotland 1974-84: an increasing problem.

A detailed investigation of trends in suicide rates in Scotland from 1974 to 1984 showed a complex pattern. Overall rates for men increased by 40% with the greatest increases in those aged 45-64. In contrast, rates for women showed a small decline, which was most noticeable in those aged 15-24. The well recognised decline in poisoning by domestic gas was seen over this period, and suicide by this method virtually stopped. Both sexes showed a decline in suicide by poisoning with drugs, although the decrease was larger among women. The fall in suicide rates among young women was almost all due to the decrease in this method. The rise in rates for men was largely due to increases in hanging and poisoning with vehicle exhaust gases, although all methods except drugs and domestic gas showed some increase. These findings indicate that suicide is an increasing problem with causes that are far from understood, so that prevention may be difficult.

Adolescent↗
PubMed1987

International differences in coronary heart disease mortality and consumption of fish and other foodstuffs.

The relationship between fish consumption and coronary heart disease mortality was investigated using data on foodstuff consumption and mortality from 21 countries. A moderate negative association was found which appeared stable over different periods. This association disappeared when the effects of other foodstuffs were controlled for in multiple regression analysis. One feature to emerge was the anomalous position of Japan in consumption of several foodstuffs. Inclusive or exclusion of this country from regression analysis had a powerful effect on which independent variables entered the model. This illustrates the danger of using single countries, for example Japan with a high fish consumption and low CHD mortality, to support causal hypotheses about diet and disease.

Animals↗