Atenolol vs. propranolol in essential tremor A controlled, quantitative study

The beta-1 selective, hydrophilic adrenoceptor blocking drug atenolol (100 mg daily) was compared to the non-selective, lipid-soluble beta-blocker propranolol (240 mg daily), and to placebo, in a double-blind cross-over study in 24 patients with essential tremor. Atenolol and propranolol caused a similar decrease in heart rate. Both beta-blockers also suppressed the tremor intensity; there was no significant difference between them, but both were significantly better than placebo. These drugs did not affect tremor frequency. Twelve of the patients preferred propranolol subjectively, one preferred atenolol and none preferred placebo. No marked side-effects were observed. It was concluded that atenolol and other cardio-selective blockers offer an alternative for patients unable to tolerate the non-selective drugs. The site of action and receptor sub-type involved have still to be determined.     

Constant defect in neutrophil locomotion but with age decreasing susceptibility to infection in Shwachman syndrome

Chemotaxis, phagocytosis and bactericidal activity of neutrophils obtained from eight patients with Shwachman syndrome were studied repeatedly over a 9 year period. In a membrane filter the patient neutrophils migrated both toward casein and toward zymosan activated serum significantly less than did the control cells. Chemokinetic migration in casein was likewise significantly impaired. As determined by agarose assay, random locomotion of the patient neutrophils was significantly depressed. The differences in phagocytosis and bactericidal activity between the patients and the control subjects were not significant. However, phagocytosis by neutrophils obtained from healthy subjects was significantly impaired in sera from four patients, compared with that in control sera. The follow-up study showed the neutrophil migration defect to be constant in repeated tests, whereas infectious episodes diminished in number after the patients reached the age of 3-7 years.     

Optic disc drusen in children

Summary Among 1076 schoolchildren aged about 7, four were found to have anomalous elevation of the optic disc attributable to buried drusen. No superficial optic disc drusen were found in any of the children examined. The optic disc anomaly due to buried drusen is peculiar to children. The frequency of the condition in the child population examined corresponds to previous estimates of the frequency of drusen of the optic disc among adults.In all those affected the eyes were subjectively symptom-free. All four children had normal visual acuity but a visual field defect of the nerve fiber bundle defect type was observed in one. Two had severe headaches. Neurological examination revealed abnormal findings in all four subjects, one had abnormal EEG. Since neurological symptoms and findings are common in individuals with optic disc drusen, neurological examination is indicated after the ophthalmological diagnosis has been made.Presented at XXI Nordiska Oftalmologmötet in Turku, June 1973.Supported by grants from Silmäsäätiö and Finska Läkaresällskapet.     

Contribution of infectious diseases to a normal paediatric walk-in population

The case records of 7068 paediatric walk-in patients of Aurora Hospital, Helsinki were analysed during a period of one year 1978. Infectious diseases comprised the great majority of 39 diagnoses made during the observation period; in 77·5 per cent the cause of the consultation could be attributed to an infection.Sixteen diagnoses were made in at least one hundred cases (approximately 1·4 per cent of the visits). These were analysed in more detail according to the sex and age of the patient. With only two exceptions - urinary tract infections and abdominal pain - boys experienced a higher rate of illness than girls. The highest incidence was found among the one-year-old boys. Possible causes of these findings are discussed as well as the preventive measures available today.Infectious diseases are still the major cause of acute paediatric consultations; their significance has changed during decades less than is usually thought. For example, gastroenteritis is the second commonest cause of an acutely ill child in Finland as well as in Zambia.     

Conceptions of Finnish people about their periodontal situation

The conceptions of Finns regarding their own periodontal status were surveyed in 1972. The interviewed sample, drawn to cover the total Finnish population aged 15 years and over, comprised 965 persons. After exclusion of 233 edentulous subjects, a total of 732 dentulous persons were accepted for the present interview study. 10 percent of the interviewees were aware of their having gingivitis at that time. 57 percent were of the opinion that they had never had gingivitis. On the other hand, 20 percent of the interviewed persons had recently observed gum bleeding while 54 percent stated that they had never observed it. 21 percent of the interviewees were aware of their having dental calculus and 46 percent had the impression that they had never had calculus. 24 oercent of those interviewees who presently had calculus or had had calculus stated that they had never had it removed. Generally Finns failed to realize that gingival bleeding is a symptom of gingival inflammation. This point should be made clear in the dental health education of the future. The knowledge could help individuals to evaluate the state of their own periodontal tissues in order to obtain the best possible benefit from efficient home care.     

Probiotic intervention has strain-specific anti-inflammatory effects in healthy adults

AIM： To evaluate the effects of three potentially anti-inflammatory probiotic bacteria from three different genera on immune variables in setting based on previous in cytokine responses. healthy adults in a clinical vitro characterization of METHODS： A total of 62 volunteers participated in this randomized, double-blind and placebo-controlled parallel group intervention study. The volunteers were randomized to receive a milk-based drink containing either Lactobacillus rhamnosus GG （LGG）, Bifidobacterium animalis ssp. lactis Bb12 （Bb12）, or Propionibacterium freudenreichii ssp. shermanii JS （PJS） or a placebo drink for 3 wk. Venous blood and saliva samples were taken at baseline and on d 1, 7 and 21. Fecal samples were collected at baseline and at the end of intervention. RESULTS： The serum hsCRP expressed as the median AUC0-21 （minus baseline） was 0.018 mg/L in the placebo group, -0.240 mg/L in the LGG group, 0.090 mg/L in the Bb12 group and -0.085 mg/L in the PJS group （P = 0.014）. In vitro production of TNF-α from in vitro cultured peripheral blood mononuclear cells （PBMC） was significantly lower in subjects receiving LGG vs placebo. IL-2 production from PBMC in the Bb12 group was significantly lower compared with the other groups. CONCLUSION： In conclusion, probiotic bacteria have strain-specific anti-inflammatory effects in healthy adults.     

Improved arrhythmia detection in implantable loop recorders

Introduction: Implantable loop recorders (ILR) have an automatic arrhythmia detection feature that can be compromised by inappropriately detected episodes. This study evaluated a new ILR sensing and detection scheme for automatically detecting asystole, bradyarrhythmia, and tachyarrhythmia events, which is implemented in the next generation device (Reveal DX/XT). Methods and Results: The new scheme employs an automatically adjusting R‐wave sensing threshold, enhanced noise rejection, and algorithms to detect asystole, bradyarrhythmia, and tachyarrhythmia. Performance of the new algorithms was evaluated using 2,613 previously recorded, automatically detected Reveal Plus episodes from 533 patients. A total of 71.9% of episodes were inappropriately detected by the original ILR, and at least 88.6% of patients had one or more inappropriate episodes, with most inappropriate detections due to R‐wave amplitude reductions, amplifier saturation, and T‐wave oversensing. With the new scheme, inappropriate detections were reduced by 85.2% (P < 0.001), with a small reduction in the detection of appropriate episodes (1.7%, P < 0.001). The new scheme avoided inappropriate detections in 67.4% of patients that had them with the original scheme. Conclusions: The new sensing and detection scheme is expected to substantially reduce the occurrence of inappropriately detected episodes, relative to that of the original ILR.