Plasma lipoprotein (a) protein concentration and coronary artery disease in black patients compared with white patients.

PURPOSE: This study examines the relation between lipoprotein (a) protein levels and other lipid parameters and coronary artery disease in white and black patients. PATIENTS AND METHODS: Plasma lipoprotein (a) protein levels were measured prior to coronary angiography in a population of 127 white and 111 black patients. Each angiogram was given a total coronary artery disease score based on the number and severity of atherosclerotic coronary lesions. RESULTS: White and black patients exhibited no differences in total plasma cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. Black patients had higher lipoprotein (a) protein levels than white patients (8.6 versus 4.0 mg/dL; p < 0.0001). The extent and severity of coronary artery disease was the same in white and black patients. White and black patients with coronary artery disease had higher lipoprotein (a) levels than patients without coronary lesions (4.37 versus 1.99 mg/dL, p = 0.027 for white; 9.23 versus 6.87 mg/dL, p = 0.072 for black). In both groups of patients, there was a weak but significant positive correlation between lipoprotein (a) protein levels and coronary artery disease score. CONCLUSION: Lipoprotein (a) is higher in patients with coronary artery disease. Black patients have higher plasma lipoprotein (a) protein levels than white patients and a comparable degree of coronary artery disease. It follows that the cardiovascular pathogenicity of lipoprotein (a) is not significantly greater in black patients despite higher lipoprotein (a) levels.     

Cumulative pregnancy rates and selective drop-out of patients in in- vitro fertilization treatment

The validity of the cumulative pregnancy rate (CPR) calculated by life- table approach, obtained in a transport in-vitro fertilization (IVF) programme, was tested by the determination of possible influence of selective drop-out of patients with a poor treatment prognosis. A cohort of 1211 patients who had a first IVF cycle was followed, and the CPR after three IVF cycles was assessed. First cycles of patients who discontinued treatment after failed IVF, and of those who did not achieve a pregnancy but proceeded to a subsequent cycle, were compared for fertilization rate and for occurrence of prognosticators of poor treatment outcome: oocyte yield < or =2, and replacement of <2 embryos. The CPR after three cycles was 54.9%. No differences were found in the first and second cycles of patients who continued treatment and those who dropped out. Selective drop-out of patients with a poor treatment prognosis was not found. Therefore, although calculations of CPR using life-table analysis generally overestimate the real probability of pregnancy after successive IVF cycles, the calculated CPR after three IVF cycles gives a reliable indication of the chance of occurrence of a pregnancy for the population studied.      

2,4-Disubstituted thiazoles II. A novel class of antitumor agents, synthesis and biological evaluation

A series of 2,4-disubstituted thiazole derivatives bearing N-n-butyl or N-cyclohexylthioureido synthon at position 2 and N-substituted thiosemicarbazone moiety at position 4 have been synthesized and tested for antitumor activity using the National Cancer Institute's in-vitro-disease-oriented antitumor screen. All of the tested compounds showed antineoplastic activity at concentrations less than 100 μM. Compounds 7, 9, 15 and 17 in particular showed activity with GI₅₀ (mean-graph midpoint) of 17.8, 8.5, 9.5 and 7.4 μM, respectively. The detailed syntheses, spectroscopic and biological data are discussed.     

PGD13 Does the Duration of Pulmonary Rehabilitation Affect the Magnitude of Patient Response?

OBJECTIVE: To determine if there is a dosage effect associated with the length of pulmonary rehabilitation (PR).
METHODS: We used a battery of outcome measures to quantify the amount of change that was achieved from baseline to discharge in 286 patients completing a PR program in 1 of 12 institutions participating in PROAS. The programs were of varying durations. Paired t-tests indicated overall that while the pulmonary rehabilitation programs did not yield improvements in physiologic (FEV1, FVC, % predicted FEV1) outcomes, the patients did achieve significant improvements in symptomatic (Borg score), functional (6-minute walk), general healthrelated quality of life [SF-36 Health Survey (SF-36)], and disease-specific HRQL [Chronic Respiratory Disease Questionnaire (CRQ) variables.
RESULTS: Based on a series of stepwise multiple regressions using the amount of change in each outcome variable as the dependent variable and adjusting for the corresponding baseline value and 11 clinical and sociodemographic characteristics, the number of hours of education (HREDU, 13.5 hr ± 6.7), activities of daily living (HRADL, 2.2 hr ± 6.6), and psychosocial support (6.5 hr ± 5.6) both individually and collectively (42.4 hr ± 11.8) generally did not contribute to explaining the magnitude of change achieved by the patients. However, the number of hours of supervised exercise (HREX, 25.4 hr ± 9.2) did contribute to explaining increases in 5 of the 8 SF-36 domains: physical function (p = 0.027), physical role (p = 0.0002), health perceptions (p = 0.0167), vitality (p = 0.034), and social function (p = 0.0035).
CONCLUSION: These data suggest that outcomes specifically related to pulmonary diseases are not affected by a longer duration for this type of intervention, but that broader, population-based assessments may need an additional period of intervention, or elapsed time, to detect improvement.