The role of the spleen in regulating the plasma levels of factor VIII-- von Willebrand's factor after DDAVP

Organ transplantation and perfusion studied indicate that the spleen plays an important role in the regulation of plasma levels of factor VIII-von Willebrand's factor (FVIII-vWF). To better understand the mechanisms that regulate the FVIII-vWF increases after infusion of 1- deamino-8-D-arginine vasopressin (DDAVP), we have measured factor VIII coagulant activity (FVIII:C) and antigen (FVIII:CAg) and von Willebrand's factor antigen (vWF:Ag) and ristocetin cofactor (vWF:RCof) in 9 asplenic subjects with normal baseline concentrations, in 7 asplenic subjects with high concentrations, and in 14 normal controls with intact spleens. In "normal" aasplenics, all the FVIII-vWF-related measurements increased significantly over baseline values, indicating that responsiveness to DDAVP is not abolished by splenectomy. The maximal vWF:Ag and vWF:RCof responses were no different from those of normal controls, suggesting that DDAVP releases vWF from storage sites other than the spleen. The FVIII:C response was significantly lower than in normal controls, but FVIII:CAg did not differ, making FVIII:CAg higher than FVIII:CAg in "normal" asplenics. These findings suggest that the spleen, rather than being a storage site for FVIII, is the organ in which a partially inactive form of FVIII acquires full coagulant activity. In "high" asplenics, all the FVIII-vWF-related measurements increased less than in "normal" splenics, indicating that long-term elevations of plasma concentrations of FVIII-vWF are accompanied by decreased release from those storage pool(s) mobilized by DDAVP.     

Ten-year trends in acute cardiovascular morbidity in an open population

The paper treats the data concerning the acute cardiovascular pathology occurrence examined during ten years in an open population of one of the districts of Novosibirsk. It is shown that at first there was a tendency towards the incidence increase followed by its stabilization and then by a tendency towards reduction over the last year. It is proved that the district selected for prolonged monitoring is a typical district of the city and that the tendencies in the incidence among its community should be classified as objective. Comparison of the WHO programs: The Register of Acute Myocardial Infarction (1969) and the Monitoring of the Trends in Cardiovascular Diseases and Determining Factors (1983) has shown no substantial differences in the incidence and death rates obtained in accordance with both programs. It is stressed that this enables one to compare the data of both programs applied to different populations.     

WHO MONICA program-based study of awareness of their health and health attitude in males and females aged 25-64 years from Novosibirsk

AIM: To assess the attitude of the Novosibirsk population towards its health, its readiness to participate in preventive measures and to implement guidelines for changing lifestyle. MATERIALS AND METHODS: A random representative sample of males and females (a total of 2400 individuals) aged 24 to 64 years from one of the Novosibirsk districts was examined within the framework of the second screening of the MONICA program studying the trends and monitoring cardiovascular diseases and the "MOPSY-MONICA-psychosocial" subprogram. The examination included the conventional procedures described in the MONICA project. Sleep disorders, health self-assessment, and attitude to smoking were studied by means of the questionnaire "Awareness and Attitude towards Health" adapted to the studied population. RESULTS: More than 60% of the males and 85% of the females reported that they were not quite healthy or ill, only 7% of the individuals had their health examined although almost 100% noted that they were most likely to fall ill with a serious disease within 5-10 years. The males were more optimistic in their assessments than were the females. With age, the frequency of assessments, such as "not quite healthy" and "ill", concern about their health, and participation in prophylactic examinations increased. 45% of the respondents reported about the high level of stress in their working place. The opportunity of the examinees to have a rest at home was extremely little. Family stress was significant for both sexes. The females showed a more negative attitude towards smoking than did the males (55% of the males and 5% of the females were smokers). The males more frequently considered that they did not need to alter dietary habits and to do exercises than did the females. A total of 2.4% of the males and 2.5% of the females changed their dietary habits for their health. Only 50% of the males and 31% of the females slept well or very well, this parameter decreased with age. CONCLUSION: Despite a positive motivation in the context of prophylaxis, there are negative trends in both social and behavioral characteristics of the population. The most intensive measures for altering the behavioral characteristics of the population and for softening the impact of stress on the population are required at the governmental level.