Small vessel disease after heart transplantation: impact of immunologic and nonimmunologic risk factors*

To determine risk factors for small vessel disease after heart transplantation (HTx), characteristics of donors and organ harvesting were evaluated in 246 HTx patients (205 male, 41 female, mean survival 5.4 years). In right ventricular endomyocardial biopsies (EMB, n = 5421) evidence of microvascular disease [endothelial cell (EC) swelling/vessel wall thickening] was evaluated by light microscopy (hematoxylin and eosin staining, ×200). Mild EC swelling/vessel wall thickening were found in 204 and 213 patients, severe EC swelling/vessel wall thickening were present in 23 and 142 patients respectively. Evidences of mild and severe acute cellular rejection were found in 2064 and 421 EMB respectively. Microvascular disease was positively correlated with mild acute rejection episodes (P < 0.05). EC swelling was more frequent in patients with donors dieing of craniocerebral trauma. No correlations were present to further demographical data. Microvascular alterations after HTx seem to be the result of an immunologic conflict rather than to depend on nonimmunologic factors.     

Die Gruppe Arbeitsmedizin der Suva

Zusammenfassung Die Berufskrankheitenprophylaxe in allen schweizerischen Betrieben liegt von Gesetzes wegen bei der Schweizerischen Unfallversicherungsanstalt (Suva), deren Gruppe Arbeitsmedizin (GAM), ein Bestandteil der Medizinischen Abteilung der Suva, für die Durchführung der arbeitsmedizinischen Vorsorge zuständig ist. Es ist das Ziel der GAM, einerseits beginnende Berufskrankheiten möglichst in präklinischen Stadien zu erfassen und andererseits Arbeitnehmer, die an bestimmten Krankheiten leiden, von schädigenden Einflüssen am Arbeitsplatz fernzuhalten. Zu diesem Zweck organisiert, überwacht und bezahlt die GAM arbeitsmedizinische Eintritts-, Kontroll- und Nachuntersuchungen und erlässt unter bestimmten Bedingungen Ausschlussverfügungen. Die damit verbundenen grossen administrativen Arbeiten werden durch die der GAM angegliederte Sektion Medizinische Berufskrankheiten-Prophylaxe (MBP) vorgenommen.

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The group of occupational medicine of the Suva

Summary According to the Swiss Federal Accident Insurance Law, the Swiss National Accident Insurance Company (Suva) is responsible for the prevention of occupational disease in all Swiss industries. In the Suva medical division, a special group concerned with occupational medicine ensures that these measures are implemented. It first of all organizes and supervises preliminary check-ups and follow-up examinations and then may also exclude endangered employees from their present activity. Such employees are entitled to free advice and in certain cases may qualify for interim daily allowances.

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Le Groupe de médecine du travail de la CNA

Résumé Selon la loi, c'est la Caisse nationale suisse d'assurance en cas d'accidents (CNA) qui est chargée de la prévention des maladies professionnelles dans toutes les entreprises de Suisse; est c'est le Groupe de médecine du travail (GMT), qui appartient à la Division médicale de cette institution, qui est compétent pour l'application de cette prophylaxie. Le GMT a deux buts: d'une part, diagnostiquer à un stade aussi précoce que possible une maladie professionnelle débutante; d'autre part, soustraire les travailleurs souffrant de certaines affections aux influences nocives provenant de leurs postes de travail. Pour y parvenir, le GMT organise, contrôle et finance des examens médicaux au début, pendant et après l'exposition à ces influences, et il édicte dans certaines conditions des décisions d'exclusion. Les importants travaux administratifs y relatifs sont exécutés par la Section de prévention médicale des maladies professionnelles (PMMP), qui est rattachée au GMT.

     

Die künstliche Darstellung der immunisirenden Substanzen (Nucleasen-Immunproteïdine) und ihre Verwendung zur Therapie der Infectionskrankheiten und zur Schutzimpfung an Stelle des Heilserums

Ohne ZusammenfassungReferent: R. Emmerich.     

Altered expression of the human retinoblastoma gene in monocytic leukaemias

Summary. Inactivation of the retinoblastoma growth suppressor gene (RB) is responsible for the development of retinoblastomas and occurs frequently in osteosarcomas and small cell lung carcinoma. Knowledge about the involvement of RB in the pathogenesis of myeloid leukaemias is still scarce. In this study we looked at the expression of the retinoblastoma gene product (p105) in 20 primary myelomonocytic and monoblastic leukaemias by Western blotting and immunocytochemistry using the anti-p105-monoclonal antibody PMG3-245. We found absence of or barely detectable levels of p105 in 11 patients (55%). Absence of or low levels of p105 were correlated with a higher leucocyte count at presentation (133 × 10⁹/l v 83 × 10⁹/l) and with the occurrence of extramedullary leukaemia (8/10 v 2/10). We conclude that abnormal expression of RB with absence of p105 or strongly reduced p105 levels occurs frequently in myelomonocytic and monoblastic leukaemias and that this may be correlated with a more malignant course of the disease.     

Subjective sleep problems in later life as predictors of cognitive decline. Report from the Maastricht Ageing Study (MAAS).

BACKGROUND: Although biological sleep criteria seem to be associated with cognitive changes in older people, it is not clear if subjective sleep parameters are related to cognitive decline in later life. OBJECTIVES: The aim of this study was to determine whether subjective sleep complaints in a population-based sample of 838 middle aged and older adults (>or= 50 years) predicted cognitive decline over a period of 3 years. METHODS: Sleep complaints at baseline, assessed with the subscale Sleep Problems of the Symptoms Checklist-90, were used as a predictor variable. Cognitive performance at follow-up, measured with the Mini Mental Status Examination, was employed as a dependent variable. RESULTS: Controlling for the effects of age, gender, length of follow-up interval, systemic diseases, and cognitive function at baseline, subjective sleep complaints were negatively associated with cognitive performance at follow-up. CONCLUSION: Subjective sleep complaints predict cognitive decline in middle aged and older adults. Mechanisms behind the effect of subjective sleep complaints on cognitive performance are discussed.     

Reaktionstyp und chronische Nebenhöhlenentzündung

Ohne ZusammenfassungMit 11 Textabbildungen