Particles in the outside air increase the risk of cardiovascular diseases

Evidence accumulated during the mid-1990 s that ambient particulate air pollution aerosol particles may not only exacerbate respiratory diseases but also be a risk factor for cardiovascular disease exacerbation. The aim of the studies described here was to assess the impact of the 1985 smog episode on the risk factor profile in the randomly selected population-based sample of the MONICA survey 1984/85 (S1). During a 13-day period in January 1985 sulphur dioxide concentrations increased four times and concentrations of total suspended atmospheric particles doubled. The impact of this time period on plasma viscosity, plasma C-reactive protein concentrations, heart rate and blood pressure was investigated. Regression models were used to assess these associations adjusting for individual risk factors such as gender, age, body mass index, serum total cholesterol and HDL-cholesterol, smoking, physical activity and medication for cardiovascular diseases and for weather conditions during the survey period. An increase in plasma viscosity, C-reactive protein and heart rate was estimated during the air pollution episode. There was also an increase in blood pressure, but this appeared to be attributable to the weather conditions during the air pollution episode. All the four outcomes were associated with the sulphur dioxide concentrations and the total suspended particle concentrations during the survey. These results indicate that ambient air pollution, particularly ambient particulate air pollution may induce systemic inflammation and modulate the autonomic function of the heart. These pathomechanisms may contribute to the observed associations between ambient air pollution concentrations and cardiovascular disease exacerbation such as hospitalisation and mortality due to cardiovascular diseases.     

Prevalence, awareness and treatment of hypercholesterolaemia in 32 populations: results from the WHO MONICA Project

BACKGROUND: Several studies have been conducted to estimate the population prevalence of hypertension, or its diagnosis and treatment. There is no multinationally comparable information on the prevalence of hypercholesterolaemia, or its diagnosis and treatment, since individual studies are often not directly comparable. METHODS: Data from the WHO MONICA Project's final risk factor surveys were used. Data were collected using standardized methods between 1989 and 1997 for the 35-64 year age range in 32 populations, in 19 countries on 3 continents. RESULTS: The prevalence of hypercholesterolaemia (total cholesterol > or = 6.5 mmol/l or taking lipid-lowering drugs) varied across populations from 3% to 53% in men, and from 4% to 40% in women. Awareness of hypercholesterolaemia varied from 1% to 33% in men, and from 0% to 31% in women. In most populations, over 50% of men and women on lipid-lowering drugs had a cholesterol level < 6.5 mmol/l. CONCLUSIONS: There is wide variation in the prevalence, awareness, and treatment of hypercholesterolaemia between populations. For the planning and implementation of primary prevention programmes and for the development of health care systems, monitoring of changes, both within and between populations, is essential. To obtain reliable information on these changes, well-standardized methods must be applied.     

Changes in challenge tests following hyposensitization with mite extract

The changes in a wide variety of in vivo and in vitro tests following a long course of low antigen dosage hyposensitization therapy in fifteen asthmatic patients with house dust mite allergy are reported. Evidence of clinical improvement was shown by decreased bronchodilator requirement. Bronchial challenge testing showed a significant increase in bronchial tolerance to mite antigen. Nasal and skin tests with mite extract, however, did not show a significant change. In contrast to the development of bronchial tolerance and to the clinical improvement, some of the in vitro tests seemed to provide evidence of hypersensitization. The leucocyte test, for example, showed increased sensitization to the mite antigen, as well as an increase in histamine release by anti-IgE serum. Total serum IgE was also increased, but this was apparently due to non-allergen specific IgE. Although the leucocyte test showed increased sensitization to mite antigen, serum reaginic activity as measured by the passive sensitization of human lung did not show any increase. Thus, there seemed to be a difference in the affinity of allergen-specific IgE for leucocytes as compared with lung tissue. It also appeared that leucocyte response to antigen bore no relationship to sensitization of other tissues, particularly the bronchial tree. The mechanism of clinical hyposensitization by low dosage immunotherapy is discussed. It is suggested that apart from the development of blocking antibodies, other mechanisms seem likely. Among these are a change in the affinity of IgE antibodies for different tissues, and a competition between non-specific IgE (produced in excess as a result of immunotherapy) and allergen-specific IgE.     

Antimicrobial effect of four different toothpastes

abstract – The study was undertaken to evaluate the antimicrobial effect of a commercial toothpaste, claimed to contain active chlorhexidine gluconate. Two traditional toothpastes and a 0.5 % chlorhexidine gel were used as negative and positive control pastes. To exclude the effect of mechanical cleaning, all the agents were applied twice daily to the tooth surfaces by means of individually constructed acrylic cap splints. Ten dental students used each paste in a 4-week cross-over double-blind study comprising four test periods of 4 d duration. The students were allowed normal mechanical oral hygiene during the 3 d between the test periods. At the beginning and the end of each test period the tooth surfaces in the right halves of the jaws were scored for the Plaque Index, after which disclosing solution was used and the teeth of the left halves of the jaws were scored for stained plaque. Of all the toothpastes tested, only the chlorhexidine gel exhibited an antimicrobial effect comparable to that of efficient mechanical oral hygiene measures. The effect of the toothpaste with claimed chlorhexidine content did not differ from that of the two traditional toothpastes.     

Randomized Comparison of Efficacy of Cooled Tip Catheter Ablation of Atrial Flutter: Anatomic Versus Electrophysiological Complete Isthmus Block

There is a subset of patients with failed ablation of the cavotricuspid isthmus (CTI) using standard catheters and with 10% of the patients having recurrences. The purpose of this study was to compare the cooled and standard ablation with regard to acute successful electrophysiological achievement of bidirectional isthmus block and the subacute anatomic characteristics of the lesions. This randomized, experimental study compares the effects of ablation on the isthmus using a cooled catheter with those of a standard ablation catheter in 16 pigs. In 12 animals, CTI block was achieved after ablation (8/8 cooled and 4/8 standard). In two animals, it was not possible to achieve complete isthmus block and two had persistent slow conduction (all four using the standard catheter). After 1 week, the animals were slaughtered. The size of the lesion was greater with the irrigated tip catheters. Transmural lesions were found in 14 animals. A complete line of anatomic isthmus block was not documented after thefirst line in six animals, four with the standard and two with the cooled catheter. A conduction block was never present across gaps > or = 5 mm. In conclusion cooled catheters achieved a complete line of electrophysiological and anatomical block in a significantly higher percentage than the standard catheters.     

Assessment of Selected Patient Educational Materials of Various Chain Pharmacies

Pharmacy literature commonly used to inform patients about medication side-effects and complications was examined for readability. Forty-five (45) informational sheets were obtained from nine national and regional pharmacies. According to the McLaughlin's SMOG (Simple Measure of Gobbledegook) formula, the reading level of the informational sheets ranged from grade 8–14 (8 = 8th grade level and 14 = collegiate level), with a mean reading level of 12. The sampled pharmacy educational materials may be too difficult for most Americans to read and comprehend. The pharmacist may assist in increasing patient compliance by offering education in a form that is understandable, which increases the likelihood of adherence to desired health behaviors.     

Syntactic comprehension in Broca's aphasic Spanish-speakers: null effects of word order

The syntactic and nonsyntactic strategies used for understanding sentences by Spanish-speaking Broca's aphasic patients in off-line tasks were analysed. It is emphasized that given the characteristics of syntax in Spanish, such as its flexibility (greater freedom in the order of constituents), the function of the direct object with the preposition a (to) and the effect of determiners, research with Spanish-speaking patients will allow for a characterization of specific disorders that cannot be generalized on the basis of research conducted in other languages. A linguistic instrument was applied to 10 Broca's aphasic patients. A forced choice task was used in which the patient listened to 190 different reversible sentences and was asked to select one of four options presented on a plate; each option contained a pair of animals performing a specific act and only one option was correct. The results showed significant differences in the use of syntactic and nonsyntactic strategies. Broca's aphasic patients used only morpho-syntactic marks with high cue validity. No significant effects of word order were found. These findings imply the existence of specific off-line linguistic mechanisms that influence the comprehension in non-fluent aphasic patients.     

Is lower IQ in children with epilepsy due to lower parental IQ? A controlled comparison study

Aim The aim of this study was to determine the relationship between parent and child Full‐scale IQ (FSIQ) in children with epilepsy and in typically developing comparison children and to examine parent–child IQ differences by epilepsy characteristics. Method The study participants were 97 children (50 males, 47 females; age range 8–18y; mean age 12y 3mo, SD 3y1mo) with recent‐onset epilepsy including idiopathic generalized (n=43) and idiopathic localization‐related epilepsies (n=54); 69 healthy comparison children (38 females, 31 males; age range 8–18y; mean age 12y 8mo, SD 3y 2mo), and one biological parent per child. All participants were administered the Wechsler Abbreviated Scale of Intelligence (WASI). FSIQ was compared in children with epilepsy and typically developing children; FSIQ was compared in the parents of typically developing children and the parents of participants with epilepsy; parent–child FSIQ differences were compared between the groups. Results FSIQ was lower in children with epilepsy than in comparison children (p<0.001). FSIQ of parents of children with epilepsy did not differ from the FSIQ of the parents of typically developing children. Children with epilepsy had significantly lower FSIQ than their parents (p<0.001), whereas comparison children did not. The parent–child IQ difference was significantly higher in the group with epilepsy than the comparison group (p=0.043). Epilepsy characteristics were not related to parent–child IQ difference. Interpretation Parent–child IQ difference appears to be a marker of epilepsy impact independent of familial IQ, epilepsy syndrome, and clinical seizure features. This marker is evident early in the course of idiopathic epilepsies and can be tracked over time.