Assessing survival in widowers,and controls -A nationwide,six- to nine-year follow-up

Background  

The aim of this study was to assess if widowers had an increased mortality rate during the first 6 to 9 years after the death of their wife, compared initially to an age-matched control group and also compared to the general population of Iceland.     

Long term results of surgery on patients with tubular fields due to glaucoma simplex

Summary From a survey of over 1700 glaucoma patients, I have found 33 cases where patients with impaired vision and tubular fields retained their sight almost unchanged for a long period of time of 10 to 22 years after having been operated on by iridencleisis. According to my own experience, I strongly advocate a surgical rather than a medical treatment of such patients, however, always with regard to age and other factors.

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Zusammenfassung Unter mehr als 1700 beobachteten Glaukompatienten habe ich 33 Fälle gefunden, bei denen das geschädigte Sehvermögen und ein röhrenförmiges Gesichtsfeld nach durchgeführter Iridencleisis während eines langen Zeitraumes von 10–20 Jahren unverändert erhalten geblieben war. Meinen eigenen Erfahrungen gemäss, bin ich in solchen Fällen entschieden mehr für eine operative als für eine medikamentöse Behandlung, jedoch unter Berücksichtigung des Alters des Patienten und anderer Faktoren.

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Résumé Parmi plus de 1700 malades observés j'ai trouvé 33 cas, où la vision et un champ visuel tabulaire restèrent presque inchangés pendant une longue période de 10 à 20 ans après un iridencléisis. D'après ma propre expérience, je recommande dans des cas de ce genre le traitement opératoire plutôt que la thérapeutique médicale, prenant toutefois l'âge du malade et d'autres facteurs en considération.

     

Resources and Productivity in Radiation Oncology in Denmark, Finland, Iceland, Norway and Sweden During 1987

Data concerning megavoltage equipment and use of mega-voltage external beams in cancer management during 1987 in Denmark, Finland, Iceland, Norway, and Sweden were collected from all 37 centres serving a population of 23 million in these countries. Population per Linear Accelerator Equivalent (LAE) unit ranged from 0.30 million/LAE unit (Denmark) to 0.19 million/LAE unit (Sweden). the number of field treatments were 227 548 (Denmark), 259 917 (Finland), 10 426 (Iceland), 147 960 (Norway) and 490 126 (Sweden). the number of field treatments per million population per year ranged from 35 229 (Norway) to 58 438 (Sweden). the number of field treatments per LAE unit/year ranged from 13 192 (Denmark) to 9 546 (Norway). the fraction of cancer patients receiving megavoltage radiotherapy in 1987 out of all newly diagnosed cancer patients during 1987 was 24% in Denmark, 37% in Iceland, 25% in Norway, and 34% in Finland and Sweden. We conclude that Denmark and Norway probably did not provide adequate levels of radiotherapy for their cancer patients during 1987.     

The physical spacing between the von Willebrand factor D'D3 and A1 domains regulates platelet adhesion in vitro and in vivo

Essentials

• The role of von Willebrand factor (VWF) domains in regulating platelet adhesion was studied in vivo.
• Multimeric VWF with spacers at the N‐ and C‐terminus of VWF‐A1 were systematically tested.
• N‐terminal modified VWF avidly bound platelet GpIbα, causing VWD Type2B like phenotype in mice.
• Novel anti‐D'D3 mAbs suggest that changes at the D'D3‐A1 interface may be biologically relevant.

Summary

Background

Previous ex vivo studies using truncated VWF (von Willebrand factor) suggest that domain‐level molecular architecture may control platelet‐GpIbα binding function.

Objective

We determined if this is the case with multimeric VWF in vivo.

Methods

Full‐length human VWF (‘hV’) was modified with a 22‐amino acid mucinous stretch at either the N‐terminus of VWF‐A1 to create ‘hNV’ or C‐terminus to yield ‘hCV’. This extends the physical distance between VWF‐A1 and the adjacent domains by ~6 nm. Similar mucin inserts were also introduced into a human‐murine chimera (‘h[mA1]V’) where murine‐A1 replaced human‐A1 in hV. This yielded ‘h[mA1]NV’ and ‘h[mA1]CV’, with N‐ and C‐terminal inserts. The constructs were tested ex vivo and in vivo.

Results

Mucin insertion at the N‐terminus, but not C‐terminus, in both types of constructs resulted in >50‐fold increase in binding to immobilized GpIbα. N‐terminal insertion also resulted in greater shear‐induced platelet activation, more thrombus formation on collagen, enhanced platelet accumulation and slower platelet translocation on immobilized VWF in microfluidics assays. Hydrodynamic injection‐based expression of h[mA1]NV, but not h[mA1]V or h[mA1]CV, in VWF^?/? mice caused profound thrombocytopenia, reduced plasma VWF concentrations, lower multimer distribution, and incessant tail bleeding that is reminiscent of von Willebrand disease type 2B. Platelet plugs were noted in the portal veins and hepatic arteries. An anti‐D'D3 mAb DD3.3 that displays enhanced binding to VWF containing the N‐terminal mucin insert also exhibited increased binding to wild‐type VWF under shear and upon ristocetin addition.

Conclusion

Conformation changes at the VWF D'D3‐A1 interface may be a key regulator of thrombosis in vivo. Structural features at the A1‐A2 interface are likely of less significance.

     

The relation of fatness to insulin is independent of fitness in 9- but not 15-yr-olds

PURPOSE: To explore the relationship between varying aerobic fitness (fitness), fatness, and fasting insulin levels in healthy children. METHODS: A population-based sample of 9-yr-old (9YO, 47 boys, 56 girls) and 15-yr-old (15YO, 53 boys, 51 girls) Icelandic children. Body fatness was evaluated via body mass index, waist circumference adjusted for height (waist adj), and sum of four skinfolds. Fitness was assessed with a graded maximal cycle ergometer test. Fasting insulin was measured using an ECLIA. RESULTS: Fasting insulin correlated to all fatness measures (9YO, r = 0.43-0.46, P < 0.001; 15YO, r = 0.30-0.37, P < 0.003) and fitness (9YO, r = -0.29, P = 0.003; 15YO, r = -0.32, P = 0.001). Adjustment for fitness did not affect the relations between fatness and fasting insulin in 9YO (r = 0.33-0.37, P < 0.001); however, only waist adj remained significantly related to fasting insulin (r = 0.24, P = 0.016) in 15YO. Children in the upper half of fitness and fatness split on the median did not differ in fasting insulin from children in the upper half of fitness but lower half of fatness. Fatness was related to fasting insulin in 9YO (r = 0.51-0.54, P = 0.001) and 15YO (r = 0.31-0.35, P = 0.011-0.028) in the lower half of fitness, but no association was observed in the upper half of fitness in either group. CONCLUSION: Fatness has a greater association with fasting insulin than fitness, especially among 9YO; however, fitness attenuates the adverse relation of fatness to fasting insulin in 15YO but does not change it in 9YO. In both age groups, being fitter and fatter does not result in greater fasting insulin than being fitter and leaner, and fatness is primarily associated with fasting insulin in lower-fit children.     

Limited effects of a 2-year school-based physical activity intervention on body composition and cardiorespiratory fitness in 7-year-old children

The aim of this study was to assess the effects of a 2-year cluster-randomized physical activity and dietary intervention program among 7-year-old (at baseline) elementary school participants on body composition and objectively measured cardiorespiratory fitness. Three pairs of schools were selected and matched, then randomly selected as either an intervention (n = 151) or control school (n = 170). None of the effect sizes of body composition were statistically significant. Children in the intervention group increased their fitness by an average of 0.37 z score units more than the controls (95% CI:-0.27 to 1.01, P = 0.18), representing an improvement of 0.286 W/kg. Boys had higher fitness (mean(diff) = 0.35 z scores, 95% CI: 0.13-0.58, P = 0.001) than girls, independent of study group, fitness z score at baseline and body mass index. Post hoc analysis showed that the intervention school with the highest fitness z score change was significantly different from two of the lowest control schools (mean(diff) = 0.83 z scores, 95% CI: 0.44-1.21, P < 0.0001 and mean(diff) = 0.70 z scores, 95% CI: 0.29-1.10, P = 0.01), but it was also significantly different from the lowest intervention school (mean(diff) = 0.59 z scores, 95% CI: 0.19-0.99, P = 0.05). The results of this intervention are inconclusive as regards to the effects on fitness, but the intervention did not have any statistically significant effect on body composition.     

Clinical features of microscopic colitis in a nation-wide follow-up study in Iceland

Objective. The long-term natural history of collagenous colitis (CC) and lymphocytic colitis (LC) is not well known. The few reports available that address these issues have a limited follow-up. The aims of this study were to evaluate the natural history of microscopic colitis (MC), to describe the treatment medications prescribed and to assess the use of non-steroidal anti-inflammatory drugs (NSAIDs) in MC. Material and methods. This study is based on an earlier epidemiological study conducted in Iceland where 125 patients with MC (71 with CC and 54 with LC) were diagnosed in the period 1995–99. All patients still alive and available were questioned about symptoms, treatment and NSAID use in the 3 months preceding the interview. Results. In a mean follow-up time of 6.4 years from diagnosis, 15% of the patients had diarrhoeal symptoms more than once a week, 30% less than once a week and 55% had no diarrhoea. Abdominal pain was reported in 18% of the patients. There was no statistically significant difference in symptoms of CC and LC patients. Forty-eight patients (50%) were receiving medication for MC, 16% used aminosalicylates and 14% corticosteroids. Patients using medication for MC had significantly more diarrhoeal symptoms compared with those who did not (p=0.002). Patients using NSAIDs regularly or as required, statistically did not have more symptoms related to MC than non-NSAID users. Conclusions. Only a minority of patients with MC had diarrhoea more than once a week in a long-term follow-up and the symptom pattern was similar between CC and LC patients. The use of NSAIDs was not associated with more diarrhoeal symptoms.