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Abstract Isolates of Phoma clematidina , the cause of clematis wilt, were recovered from diseased clematis plants throughout England and tested in vitro and in vivo for their sensitivity to benzimidazole fungicides. More than one third of 14 isolates tested on fungicide-amended agar plates were found to be highly resistant to products containing carbendazim, benomyl or thiophanate-methyl. On unamended agar, the growth and morphology of benzimidazole resistant and sensitive isolates of P. clematidina were clearly distinct; on attached clematis leaves not treated with fungicide, the resistant isolates were markedly less virulent than the sensitive ones. In a 3-month trial on Clematis cv. Henryi, high volume sprays of a fungicide containing carbendazim reduced the incidence of leaf spotting caused by a benzimidazole sensitive isolate of P. clematidina by almost 80% but gave no significant reduction in disease caused by a resistant isolate. Fungicides found to be very effective against both benzimidazole sensitive and resistant isolates were products containing difenoconazole, azoxystrobin or kresoxim-methyl. This is the first report of benzimidazole resistance in P. clematidina in the UK. Our findings indicate that growers should consider alternative fungicides and non-chemical methods for the prevention and control of clematis wilt. [ABSTRACT FROM AUTHOR]

Examines the occurrence of wilt disease in a glasshouse crop of column stocks or Matthiola incana in England. Development white fungal growth; Detection of Fusarium oxysporum; Symptoms of the wilt disease.

Suggests that there may now be an increased risk of outbreaks of white mould, Ramularia vallisumbrosae, in eastern England where around 60% of Great Britain daffodils, Narcissus, are grown. Early foliage die-down; Associated reductions in bulb yield; Symptoms effecting the crops of Narcissus.

Background: Some 1.5 million people in the UK have a learning disability (LD). This vulnerable group derives less benefit from population-based education programs. They are prone to underenrolment in screening programs and may lack the ability to perform self-examination., Objective: To identify patients with LD in England and assess their testicular cancer (TC) survival in comparison to the general population., Design, Setting, and Participants: Patient records were identified from the Hospital Episode Statistics database. All patients resident in England with a diagnosis of mental debility, "developmental disorder of scholastic skills", or attending under the specialty of LD between April 1, 2001 and June 30, 2015 were included., Outcome Measurements and Statistical Analysis: We measured survival outcomes according to the Kaplan-Meier method and used log-rank tests to assess survival difference between demographic groups., Results and Limitations: Of 158138 male patients with LD, 331 had TC and 32 died of cancer. LD patients had a poorer prognosis, with 10-yr TC-specific survival of 88.4% (95% confidence interval [CI] 84.5-92.4%) in the LD group versus 96.8% (95% CI 96.6-97.1%) in the non-LD group. LD patients also had lower all-cause survival rates. The 10-yr survival rate was 77.6% (95% CI 72.2-83.3%) for LD patients versus 89.9% (95% CI 89.4-90.3%) for non-LD patients, while the corresponding 5-yr rates were 84% (95% CI 79.9-88.4%) versus 92.2% (95% CI 91.8-92.5%)., Conclusions: Education regarding self-examination for TC must be provided in a format suitable for those with LD. Carers for male patients with LD should be informed about testicular examination and sinister signs., Patient Summary: Testicular cancer patients who also have a learning disability (LD) have a one in nine chance of dying, compared to a one in 36 chance for testicular cancer patients without LD. This is because patients with LD are less likely to detect the disease at an earlier stage., (Copyright © 2018. Published by Elsevier B.V.)

Unlabelled: The aim of this study was to determine the relationship between reduced muscle mass (sarcopenia) and areal bone mineral density (BMD(a)) in middle-aged and elderly community-dwelling European men. Men with sarcopenia had significantly lower BMD(a) and were more likely to have osteoporosis compared with men without sarcopenia., Introduction: In men, the relationship between reduced muscle mass (sarcopenia) and BMD(a) is unclear. This study aimed to determine this relationship in middle-aged and elderly community-dwelling men., Methods: Men aged 40-79 years from the Manchester (UK) and Leuven (Belgium) cohorts of the European Male Ageing Study were invited to attend for assessment including dual-energy X-ray absorptiometry, from which appendicular lean mass (aLM), fat mass (FM) and whole-body, spine and hip BMD(a) were determined. Relative appendicular skeletal muscle mass (RASM) was calculated as aLM/height². Muscle strength was assessed in subjects from Leuven. Sarcopenia was defined by RASM at <7.26 kg/m² and by the recent definition of the European Working Group on Sarcopenia in Older People (RASM at <7.26 kg/m(2) plus low muscle function). Linear regression was used to determine the associations between aLM, FM, muscle strength and BMD(a) and logistic regression to determine the association between sarcopenia and osteoporosis., Results: Six hundred seventy-nine men with a mean age of 59.6 (SD = 10.7), contributed data to the analysis; 11.9 % were sarcopenic by the conventional definition. After adjustment for age and centre, aLM, RASM and FM were positively associated with BMD(a). Men with RASM at <7.26 kg/m² had significantly lower BMD(a) compared with those with RASM at ≥7.26 kg/m(2). In a multivariable model, aLM was most consistently associated with BMD(a). Men with sarcopenia were more likely to have osteoporosis compared with those with normal RASM (odds ratio = 3.0; 95 % CI = 1.6-5.8)., Conclusions: Sarcopenia is associated with low BMD(a) and osteoporosis in middle-aged and elderly men. Further studies are necessary to assess whether maintaining muscle mass contributes to prevent osteoporosis.

Background: Osteoporotic hip fractures have been extensively studied in women, but they have been relatively ignored in men., Objective: To study the mortality, morbidity, and impact on health related quality of life of male hip fractures., Methods: 100 consecutive men aged 50 years and over, with incident low trauma hip fracture, admitted to Royal Cornwall Hospital, UK during 1995-97, were studied. 100 controls were recruited from a nearby general practice. Mortality and morbidity, including health status assessed using the SF-36, were evaluated over a 2 year follow up period., Results: Survival after 2 years was 37% in fracture cases compared with 88% in controls (log rank test 62.6, df = 1, p = 0.0001). In the first year 45 patients died but only one control. By 2 years 58 patients but only 8 controls had died. Patients with hip fracture died from various causes, the most common being bronchopneumonia (21 cases), heart failure (9 cases), and ischaemic heart disease (8 cases). Factors associated with increased mortality after hip fracture included older age, residence before fracture in a nursing or residential home, presence of comorbid diseases, and poor functional activity before fracture. Patients with fracture were often disabled with poor quality of life. By 24 months 7 patients could not walk, 12 required residential accommodation, and the mean SF-36 physical summary score was 1.7SD below the normal standards., Conclusions: Low trauma hip fracture in men is associated with a significant increase in mortality and morbidity. Impaired function before fracture is a key determinant of mortality after fracture.

This paper summarizes the contribution of the Arthritis Research Campaign Epidemiology Unit, in particular in its role as coordinator of the European Vertebral Osteoporosis Study, to our current understanding of osteoporosis. One in three postmenopausal women has osteoporosis in the UK. The cost to the NHS is around pound 1.7 billion per year. With the ageing population this is destined to rise.

Objectives: To determine the one year period prevalence of falls by age and sex in patients with rheumatoid arthritis and the influence of concurrent medical treatment and disability on the occurrence of falls in this group., Methods: A consecutive series of rheumatoid patients aged 35 years and over, attending hospital outpatient clinics at Hope hospital, Salford, were asked to complete an interview assisted questionnaire which asked about the occurrence and number of falls in the previous 12 months., Subjects: who took part were asked about current treatment with antihypertensive agents, diuretics, sedatives or hypnotics, antidepressants, and a history of previous hip/knee surgery. They also completed the health assessment questionnaire (HAQ). Logistic regression was used to determine the association between these variables and falls in the previous 12 months., Results: 253 men and women, mean age 62 years, were studied, and 84 (33%) reported falling in the previous year (36% of women and 26% of men). Of these, 52% had fallen on more than one occasion. There was no important increase in the frequency of falls with age. After adjusting for age and sex, those who had fallen in the previous year were more likely to report taking antidepressant treatment (odds ratio (OR) = 2.09) and to have impairment in both walking (OR = 1.37) and rising (OR = 1.41). The HAQ score was higher in those who reported a fall than those who did not, though the difference was not statistically significant., Conclusions: In this hospital based survey, one in three patients with rheumatoid arthritis reported falling in the previous 12 months. Falls were associated with self reported impairment in lower limb function.

Background: Anecdotal reports from rheumatologists in the United Kingdom suggest that patients from South Asian backgrounds are more likely to report widespread body pain., Objective: To confirm the presence of an excess of widespread pain in South Asians, and to evaluate the relationship of their symptoms with levels of 25-OH vitamin D., Methods: Two population studies involving over 3135 subjects were carried out in the North West and Midlands areas of England., Results: The first study confirmed an excess of widespread pain among South Asians (OR = 1.6, 95% CI 1.3 to 2.1). The second smaller study conducted only among young women also showed a similar excess of widespread pain among South Asians (OR = 1.8, 95% CI 0.7 to 4.7) and found that low levels of 25-OH vitamin D (<10 ng/ml) were more common among those with widespread pain (OR = 3.5, 95% CI 0.4 to 31.0)., Conclusions: Owing to the small numbers, the relationship between 25-OH vitamin D and widespread pain must be considered preliminary and requires further investigation. However, it may be one potentially treatable cause of widespread pain.

Objective: To determine the risk factors associated with fracture of the distal forearm, and to evaluate the influence of falls on these risks., Design: This was a case-control study., Setting: Manchester, UK., Participants: The cases were 62 white women aged 45-82 years who had sustained a fracture of the distal forearm and had attended local hospitals. Two control groups were studied - 50 women who had fallen onto the hand but had not sustained a fracture (recruited from the same source as those with fracture) and 116 women randomly selected from primary care age and sex registers in the catchment area of the hospitals. Both cases and controls were sent a letter inviting them to take part in the study. Data were collected by questionnaire completed by an interviewer., Main Results: Compared with the population control group, those with fracture were more likely to walk at a brisk pace (odds ratio (OR) = 3.5; 95% confidence interval (CI) 1.3, 9.6) though they had undertaken less physical activity at home or work on a daily basis throughout life (OR = 0.4; 95% CI 0.2, 0.9). The risk associated with brisk walking was less marked when the cases were compared with fall controls. Other lifestyle factors including calcium intake, smoking, and alcohol consumption were not associated with fracture. Analysis of gynaecological and hormonal factors suggested that compared with population controls, those with fracture of the distal forearm had had fewer fertile years (OR = 0.4; 95% CI 0.1, 0.9) and were less likely to have used oral contraceptives (OR = 0.3; 95% CI 0.1, 0.9)., Conclusions: The data highlight the need for caution when advising middle aged and elderly subjects about exercise. Such advice should be combined with practical information about the prevention of falls. Hormonal factors seem to be additional determinants of fracture. Other lifestyle interventions seem unlikely to play an important part in preventing distal forearm fracture.

A retrospective study was conducted into all the children admitted to a regional burns unit over a 6-year period. The whole childhood age group (up to 16 years of age) was examined epidemiologically. The study highlighted differences in the injuries and their acquisition, between the older children (10-16 years of age) and the younger children (up to 10 years of age). The study included data on the social background of the families, and points to the shortcomings of such retrospective material. Aspects of the epidemiology illustrated in the study are discussed with a view to their influence on programmes aimed at the prevention of such injuries to children.