The efficiency of a questionnaire in detecting heavy drinkers

The suitability of the nine-question Malmö modified Michigan Alcoholism Screening Test (Mm-MAST) was tested on 133 40-year-old men and 140 45-year-old men attending a voluntary population health screening in a typically week-end-drinking society. With a cut-off level of two yes' answers 29% of the middle-aged male population has been reported to give a positive result in this questionnaire. In our study alcoholics were excluded. The amount and type of alcohol consumed per week was asked. The subjects were divided into three groups: (1) social drinkers (0 or 1 yes' answer), (2) suspect abusers (two “yes” answers), and (3) abusers (three or more yes' answers or drinking at least 280 g absolute alcohol per week). Group 2 reported drinking more than group I, but according to biological markers they belonged better to group 1 than group 3. With the originally recommended cut-off level of two yes'answers 50.8% of 40-year-old men and 36.5% of 45-year-old men in our study proved positive. With the three yes’answer criterion the corresponding percentages were 28.5 and 24.0. Forty- and 45-year-old men in group 2 gave many positive answers in the question concerning week-end drinking and avoidance of alcohol for a time, as did 40-year-old men in the question concerning bad conscience after drinking. Beer and spirits were the most popular beverage combination and week-end drinking was the commonest drinking habit. The number of positive answers correlated well with the announced amount of alcohol. In Mm-MAST typical week–end drinking is linked with many positive answers although the weekly amount of alcohol remains low. In many cases the questionnaire was the only way to diagnose alcohol abuse. It should be kept in mind that the specificity of questionnaires is not equal in different cultures. Concerning the Mm-MAST questionnaire we recommend three yes’answers as a cut-off level in week-end-drinking societies.     

Removal of Monofilamental and Multifilamental Temporary Pacing Leads Following Open-Heart Surgery: Occurrence of Arrhythmias

This study compared multifilamental and monofilamental temporary pacing leads in a clinical series of 83 patients who underwent valve replacement or coronary artery bypass grafting. The leads were used in the bipolar mode and were implanted into the outer layers of the right ventricular myocardium. The force required for wire removal (newtons), and the arrhythmias which occurred during removal were monitored. During electrode removal, 48% of the patients had transient arrhythmias (46% with monofilamental and 51% with multifilamental leads). The most common was a single ventricular premature contraction. In one case, wire removal caused non-sustained ventricular tachycardia. All the arrhythmias subsided spontaneously. There was no statistical difference between results of the two leads. The force needed for removal was monitored directly by applying force via a graduated spring; they were equal in both groups (2.6 newtons). Both electrode types behaved similarly during wire removal, and the spiral tail of the monofilamental lead did not provoke arrhythmias.     

Tumour-associated antigen CA 125 in patients with ovarian cancer

Summary. The serum levels of antigen CA 125 expressed by epithelial ovarian carcinoma were measured in 27 postmenopausal women with ovarian tumours and in 16 controls. Increased serum levels of CA 125 were found in nine (75%) out of 12 patients with ovarian cancer; in three with stage I disease levels were not elevated. No significant difference was found in the concentration of CA 125 detected in peripheral or ovarian venous blood. Decreased antigen levels were found 6–30 weeks after radical operation and cytostatic chemotherapy in the ovarian cancer group. The results indicate the value of measuring CA 125 as a tumour marker in the follow-up of ovarian cancer.     

Albumin excretion rate and its relation to kidney disease in non-insulin-dependent diabetes mellitus

Abstract. Objective . To estimate the occurrence of increased albumin excretion rate (AER) and its significance as a marker of diabetic kidney disease in non-insulin-dependent diabetic subjects. Design . Population-based, controlled cross-sectional study. Setting . A primary health care centre in the city of Tampere, south-west Finland. Subjects . Consecutive, recently diagnosed (n = 150) and long-term (n = 146) middle-aged non-insulin-dependent diabetic subjects. Matched non-diabetic control subjects (n = 150). Main outcome measures . Albumin excretion rate, fractional AER, microalbuminuria (AER 30–300 mg 24 h^?1), clinical nephropathy (AER exceeding 300 mg 24 h^?1) and kidney biopsy in diabetic subjects with an AER exceeding 100 mg 24 h^?1. Results . Mean (± standard deviation [SD]) 24-h AER was increased in recently diagnosed diabetic subjects, 54 (111) mg, and long-term diabetic subjects, 134 (479) mg, compared to non-diabetic control subjects, 16 (19) mg. The fractional AER was 7.5 (18.3) × 10^?6 in recent diabetic subjects, 53.1 (306.9) × 10^?6 in long-term diabetic subjects and 2.8 (3.7) × 10^?6 in non-diabetic control subjects. Microalbuminuria was found in 8% of non-diabetic subjects, in 29% of recent and in 27% of long-term diabetic subjects. The prevalence of clinical nephropathy was 7% in long-term and 4% in recent diabetic subjects, whilst no non-diabetic subject had nephropathy. In 12 of 16 eligible kidney biopsies, diabetic glomerulosclerosis was found, in four subjects the finding was normal. Conclusions . The AER is clearly increased in recent non-insulin-dependent diabetic subjects and further increased in diabetic subjects with a mean disease duration of 10 years. An increased AER in non-insulin-dependent diabetic subjects suggests diabetic kidney disease.     

Effects of methoxamine,an alpha-1 adrenoceptor agonist,and prazosin,an alpha-1 antagonist,on the stages of the sleep—waking cycle in the cat

In these experiments the effects of α₁-adrenoceptor agonism and antagonism were studied on the stages of the sleep-waking cycle of the cat, in order to determine optimal levels of α₁-adrenergic transmission for these stages. Polygraphic 16-h recordings showed that prazosin, an α₁-adrenoceptor antagonist, at 1 mg/kg i.p., increased paradoxical sleep (PS) time from 15.3% to 26.4% (p<0.001) of total time, and the number of PS episodes from 30.4 to 43.6 (p<0.001). The effect was prompt, reaching a maximum during the first 4 h with a shortening of PS latency from 40.4 min to 11.0 min (p<0.001). Prazosin at doses of 0.5 and 3.0 though not at 10.0 mg/kg also slightly, but significantly, increased PS. Methoxamine, an α₁-adrenoceptor agonist, at doses of 0.5 and 3.0 mg/kg, increased aroused waking time (low voltage mixed frequency EEG) during the first 4 h from 23.5% to 33.3% (p<0.05) and to 50.3% (p<0.01), and decreased PS. Prazosin potentiated dose-dependently clonidine-induced drowsiness (hypersynchronized 4–8 Hz EEG), whereas the decrease in deep slow wave sleep and PS were potentiated only at the largest dose of it. These results indicate that moderate inhibition of cerebral α₁-adrenergic transmission facilitates paradoxical sleep in the cat. Furthermore, they suggest that the level of cerebral α₁-adrenergic transmission is high during aroused waking and low during drowsy waking.