Attitudes toward prevention of cardiovascular diseases among first-year students at eight American medical schools, 1983-1985

First-year medical students at eight U.S. medical schools were surveyed by written questionnaire in 1983-1985 to determine their attitudes toward cardiovascular diseases prevention at medical school entry. An overall response rate of 92% was achieved (2,654 questionnaires), and 97% of responders provided complete and analyzable survey data. Response rates at five of eight medical schools were 98-100%, and one school each had rates of 67, 84, or 90%. Differences in mean attitude responses from school to school were small, as were differences between men and women or between blacks and whites. This survey found that entering medical students have generally positive attitudes toward the effectiveness of preventive cardiology practice as well as toward the importance of research efforts in cardiovascular disease prevention. Students frequently indicated, however, that it is "extremely difficult" to change patients' unhealthful habits and that "physician encouragement" may not be sufficient to help patients achieve more healthful behaviors. These findings could be helpful in directing educational efforts for medical students. The data suggest that major emphasis should be placed on conveying facts regarding the physicians' efficacy in clinical preventive cardiology and on teaching the skills of preventive cardiology practice. Less emphasis appears to be necessary on encouraging positive attitudes about the importance of prevention since current students' attitudes appear to be already positive in this dimension.     

An update on digoxin

This review deals briefly with recent developments in the therapeutic drug monitoring of digoxin. Strategies for decreasing the interference by digoxin metabolites, digoxin-like factors, and spironolactone metabolites in immunoassays of digoxin are discussed. Other issues addressed include the development of alternative methods of analysis, such as receptor assays and "high-pressure" liquid chromatography; digoxin-like factors in hypertension; drug-drug interactions; redistribution of digoxin stores in the body; and forensic considerations.     

Effects of lung hyperinflation on mean arterial pressure and postsuctioning hypoxemia

Our purpose was to determine the effect of five different lung hyperinflation volumes (tidal volume, 12 cc/kg, 14 cc/kg, 16 cc/kg, and 18 cc/kg lean body weight) on mean arterial pressure and postsuctioning hypoxemia (arterial blood gases). Subjects received three consecutive lung hyperinflations at one of the five randomly ordered volumes in 15 seconds via a ventilator "sigh" control at a fraction of inspired oxygen of 1.0. The three lung hyperinflations were followed by 10 seconds of continuous suction (flow rate 16 L/min). The procedure was repeated three times. The sample consisted of eight men and women 4 hours after coronary artery bypass graft surgery. Data indicated a statistically significant (by analysis of variance, p = 0.000) mean increase of 15 mm Hg in mean arterial pressure over the three lung hyperinflation sequences that was not volume dependent. There was a significant increase (p = 0.0001) in arterial oxygen pressure at 0 seconds after suctioning that increased with each increasing lung hyperinflation volume.     

Individual psychotherapy with victims of incest

In treating victims of incest, therapists need to be aware of the gamut of symptoms, personality traits, interpersonal difficulties, and clinical syndromes that occur with special frequency in this population. A list of these features is provided. Vignettes with typical therapist-patient dialogue are offered, demonstrating techniques for handling the initial consultation and opening phase of treatment. During later phases of treatment the focus will usually shift to the discussion of the pertinent symptoms (such as suicidal feelings, substance abuse, dissociative phenomena, sexual disturbances, and distorted self-image). Further on, therapy will focus on abnormal personality traits and attitudes that the incest experience may have set in motion. Examples include mistrustfulness, jealousy, seductiveness, hostility, impulsivity, defiance and emotional volatility. Many incest victims develop borderline personality disorder. Highly polarized attitudes ("splitting") toward sexual partners are characteristic of this group. Therapy relies upon supportive, re-educative, and interpretive work designed to help the victim develop more realistic and integrated views of self and other.     

Some factors affecting the strength of the cement-metal interface

A manufacturing technique to increase the bonding between bone cement and metal prostheses has been assessed in the laboratory by "push-out" tests, and the effects of contamination of the cement and of the prosthesis with blood and intramedullary contents have been studied. The technique, known as pre-coating, increases bond strength; this increase is preserved after contamination of the cement which does, however, cause some lowering of interface shear strength. The implications for clinical practice are discussed.     

The effect of 2,4-dinitrophenol and related compounds on bile secretion

1. 2,4-dinitrophenol, 2,4-dinitrophenetole, 2,4-dinitronaphthol, 4,6-dinitro-o-cresol, and to a lesser extent picric acid, produced an increase in bile flow and a rise in body temperature in the anaesthetized dog. The total biliary bromsulphalein (BSP) excretion in unit time was either slightly reduced, increased or remained at its pre-injection level.2. Picramic acid, the nitrochlorophenols and 2,4-dinitrobenzaldehyde caused a moderate increase in bile flow without an effect on the temperature of the animal.3. The three mononitrophenols, the five remaining isomeric dinitrophenols, isopicramic acid, the aminonitrophenols, phenol, 2,4-dinitroanisole, 2,4-dinitrobenzoic acid, 2,4-dinitrobenzene sulphonic acid, 2,4-dinitroresorcinol and 4-nitracatechol had little effect on bile secretion or body temperature.4. It thus appears that, in order for a compound of this type to have a pronounced effect on bile secretion, it is necessary to have nitro groups in positions 2 and 4 of the benzene ring, and a free or potential hydroxyl group.     

Responses to intensive training and methandrostenelone administration: II. Hormonal,organ weights,muscle weights and body composition

The hormonal levels of the gonadotropins, the weight of selected organs and of the triceps surae as well as body composition were determined in Sprague Dawley rats at 3 and 6 weeks after intensive training with or without a methandrostenelone (Dianabol) supplement (0.35 mg/kg/day). The controls were sedentary rats of similar age and weight at the start of the experiment. The dianabol treated rats in the sedentary and exercise groups had a depression of plasma LH levels. There were no differences in body weight, specific gravity, lean body weight, fat or % fat between the two trained groups. Dianabol had no apparent effect on the measured parameters other than a depression of LH.     

Desensitization in vitro—The specific inhibition, by antigen, of the passive transfer of delayed hypersensitivity by peritoneal exudate cells

A preliminary experiment showed that the injection of bovine γ-globulin into guinea-pigs with delayed hypersensitivity to bovine γ-globulin reduced the 24-hour skin reactions to bovine γ-globulin and (to a lesser extent) PPD. The peritoneal exudate cells from the desensitized donors had a reduced ability to transfer delayed hypersensitivity to bovine γ-globulin but a normal ability to transfer delayed hypersensitivity to PPD.

Likewise, it was possible to diminish the passive transfer of delayed hypersensitivity to bovine γ-globulin by peritoneal exudate cells, by exposure of the cells to bovine γ-globulin in vitro. The recipients were tested immediately after cell transfer. This in vitro desensitization was specific, in that the transfer of delayed hypersensitivity to PPD was unaffected.

Exposure of cells in vitro to hypotonic conditions and antibody to guinea-pig γ-globulin did not prevent the passive transfer of delayed hypersensitivity.

     

Studies of human myeloid antigens using monoclonal antibodies and variant lines from the promyeloid cell line HL60.

Monoclonal antibodies were produced using mice immunized with the human promyeloid cell line HL60. Two antibodies are described which identify antigens selectively expressed by myeloid cells. Studies using normal bone marrow and myeloid leukaemia cells demonstrated that one of these antibodies (AGF4.48) identifies an antigen expressed throughout the promyeloid to neutrophil stages of maturation. In contrast, the second antibody (AGF4.36) identifies an antigen expressed at the promyeloid to metamyeloid stages and is absent from most blood neutrophils. The HL60 line can be induced to differentiate into neutrophils by 1 . 25% dimethylsulphoxide (DMSO) (Collins et al., 1978). Variant lines from HL60, unresponsive to 1 . 25% DMSO, lack the 'transient' myeloid antigen (AGF4.36) and show a reduced expression of the myeloid antigen (AGF4.48). The variant lines can be induced to mature using higher DMSO concentrations (1 . 5-1 . 75%) and do not express the 'transient' antigen (AGF4.36) during their maturation. The use of these lines in studies of myelopoiesis is discussed.