Scottish Medical Journal

The Glasgow Register of Congenital Anomalies reports the highest birth prevalence of congenital anomalies of all 18 participating centres in the EUROCAT project for the years 1980 to 1988. A high prevalence is found in most defect categories, with Glasgow in the top three places in the EUROCAT “league” in 7 of the 10 categories studied. While the high rate could reflect a high level of ascertainment, we have concluded that there is enough reason to be seriously concerned that the high Glasgow rate is a reflection of risk rather than methodology.

A postal enquiry to professionals involved in service delivery points to a number of problems in the process of referring elderly people appropriately. These problems related to lack of choice and constrained options, rather than mis-referral through inadequate assessment.

The serotyping of gonococcal isolates has enabled detailed studies of the epidemiology of gonorrhoea in different geographical areas. This study reports the patterns of infection found in 1992 in Aberdeen and relates these to a variety of clinical parameters. 140 cases of gonorrhoea were isolated the majority of which belonged to one strain (lA-2) in contrast to the diversity of strains seen in other Scottish cities. Most isolates were highly sensitive to penicillin and only 3 penicillinase producing strains were found. A low rate of infections in homosexual men is reported again in contrast to the situation seen in other geographically close cities. Compared to the rest of Scotland Aberdeen has a high prevalence of gonorrhoea.

A patient who developed pure alexia without agraphia following a stroke is described. An infarction of the left occipital pole was demonstrated by Magnetic Resonance Imaging (MRI). The literature on this rare syndrome is reviewed, and the localisation of damage in relation to the clinical findings discussed.

In 1988 Inverclyde Royal Hospital became the pilot site for the resource management initiative in Scotland. Real benefits have been achieved through the implementation of an information system which allows doctors to closely monitor every aspect of health care in the hospital, enabling them to continually reassess and evaluate their own work. The ability of doctors to use the clinical information system to fulfil operational requirements, such as the production of automated discharge summaries, whilst supporting the medical audit process through the same dataset has been a major achievement. Within the hospital the creation of an ‘information flow’ has been helpful to all clinical and medical records staff and at the same time has produced patient based information to support the management process. The availability of over four years of fully costed activity data is a considerable advantage for the Unit as Trust status approaches.