Smoking patterns in the coloured population of the Cape Peninsula (CRISIC study)

A cross-sectional study of tobacco-smoking habits in a random sample of 976 coloured subjects aged 15-64 years revealed that smoking was common, 57% of men and 41% of women being current smokers and 10.4% of men and 9.6% of women having stopped smoking. Heavy smoking prevailed, indicating by mean daily consumption of 14.2 and 13.1 cigarettes among male and female smokers respectively; only 33.5% of male and 39.6% of female smokers used less than 10 cigarettes per day. Coloured smokers smoked more heavily during the weekend. Both men and women smoked mostly filter cigarettes. Forty-four per cent of male and 49.5% of female smokers stated that they had attempted to stop smoking, mainly for health reasons. More than one-third of the participants had a positive attitude to combating smoking, particularly those with an educational level higher than Standard 7. Former smokers and heavy smokers had a significantly higher prevalence of ischaemic heart disease than the other participants. Smoking was associated with a low body mass index, low high-density lipoprotein cholesterol levels, low socio-economic standing, high alcohol consumption and type A coronary-prone behaviour in men. In 1982 the economically active coloured population of the Cape Peninsula spent an estimated R36.2 million on cigarettes.     

Effect of ankle position on isometric quadriceps strengthening

A prospective study of 20 normal subjects was undertaken to determine the effect of three ankle positions (active dorsiflexion, active plantar flexion, natural or rest position) on comfort and facilitation of quadriceps contraction in isometric strengthening in a supine position with the hip and knee fully extended. Surface EMG activity was found to be greatest for the vastus lateralis followed by the vastus medialis and least for the rectus femoris. Equal facilitation was apparent with either active ankle dorsiflexion or plantar flexion. Both were superior to the natural (rest) position. In situations where isometric quadriceps exercises are required, the authors recommend either active ankle dorsiflexion or plantar flexion to facilitate quadriceps strengthening. The choice between the two positions should be based on patient comfort.     

Inhibition by oral N-acetylcysteine of cigarette smoke-induced "bronchitis" in the rat

Specific pathogen-free rats were exposed to the cigarette smoke (CS) of 25 cigarettes daily for 14 days and concurrently given N-acetylcysteine (Nac) as 1% of their drinking water (average daily dose 973 mg/kg). The thickness of the epithelium was measured at four airway levels and the numbers of mucus-containing secretory cells, stained for neutral or acidic glycoprotein (NGP or AGP respectively), were counted in surface epithelium at eight airway levels. Cigarette smoke increased the thickness of the epithelium at three of the airway levels studied by between 37 and 72%. The number of secretory cells was increased at all airway levels distal to the upper trachea by between 102 and 421%. Secretory cells containing NGP were reduced in number but this was more than offset by a large increase in the number of secretory cells containing AGP at all airway levels. N-acetylcysteine inhibited CS-induced epithelial thickening. Nac also inhibited the CS-induced increase in the number of secretory cells with AGP, but had little effect on the CS-induced reduction in the number of cells with NGP. Thus, prophylactic oral N-acetylcysteine led to an overall inhibition of CS-induced mucous cell hyperplasia and epithelial hypertrophy. The results suggest a novel anti-inflammatory action for a drug with known mucolytic effects.     

Exercise intensity, training, diet, and lactate concentration in muscle and blood

With some, but not all, types and intensities of exercise, lactate accumulates in the blood and in the muscles engaged in the exercise. A great deal of attention has been directed towards attempting to understand the dynamics of lactate production and removal at the onset of exercise, during exercise, and during the recovery process following exercise. It has been hoped that an unravelling of these events would provide a key to understanding cellular metabolism and its regulation during exercise. The purpose of this introductory paper to a symposium on lactate is to present a brief overview of some of the conditions that influence the rate and magnitude of lactate accumulation during exercise. It is pointed out that many conditions influence the rate and magnitude of the accumulation of lactate in blood and muscles. Included are diet, state of physical fitness, and the type and duration of the exercise. We have cautioned against trying to evaluate the state of oxygen delivery to muscle and the state of tissue oxygenation from the appearance of lactate in blood. We have pointed out the positive aspects of lactate production based on how it augments the cellular supply of ATP, thereby allowing for high intensity exercise, and also the negative aspects that develop as a result the reduction in pH which adversely influences many cellular processes essential for muscular activity.     

Pursuit gaze defects in acute and chronic unilateral parieto-occipital lesions

Isolated abnormalities of pursuit gaze were studied in 8 patients with unilateral acute (hemorrhage) or chronic (tumor) lesions of the parieto-occipital lobes. Ipsilateral pursuit was impaired in all patients, being superimposed with cogwheel saccades. Foveal pursuit was more disturbed than full-field pursuit. Impairment of contralateral pursuit was observed in all patients, but was severe only after acute involvement of the nondominant hemisphere. These findings provide further evidence for some asymmetric organization of hemispheric command of ocular movements. In these patients with hemianopia, the bilateral alterations of pursuit gaze probably correspond to an inter- and intrahemispheric disconnection syndrome.     

Aseptic bone necroses as a late complication following successful treatment of leukemias and severe aplastic anemia

Aseptic bone necrosis is a well known complication after corticosteroid treatment in adults and several hundred cases have been reported. Alterations in fat metabolism with vascular occlusion due to fat embolization, as well as microtraumata and osteoporosis are discussed as etiologic factors. In contrast, aseptic bone necrosis in relation to corticosteroid treatment is rare in children and adolescents. We therefore report 3 patients, aged from 10 to 18 years, suffering from severe aplastic anemia, meningeal relapse after acute lymphocytic leukemia and acute myelocytic leukemia respectively, who developed aseptic bone necrosis 6, 11, and 20 months following the onset of corticoid therapy. The patients survive from 28+ to 50+ months after diagnosis of their initial hematologic disease, as it can be expected today for increasing numbers of patients. We therefore believe, that aseptic bone necrosis may represent a serious therapy related complication and suggest that, diagnostic examination in patients with suspicious complaints of the hip, shoulder or knee should also exclude the possibility of a bone necrosis after leucemic relapse has been ruled out. Since radiological changes only develop several weeks to months after the onset of the clinical symptoms and because of the disabling consequences for patients, misdiagnosed at the beginning, a 99 technetium bone scan should be done as early as possible. Corticosteroids, despite their serious side effects are still being considered as a important part of hematologic therapy and are not being omitted in the near future, so that the earliest possible diagnosis of bone necrosis will remain of great importance.(ABSTRACT TRUNCATED AT 250 WORDS)