Comments on methods and results in: Sherman et al., "Segregation analysis of balanced pericentric inversions in pedigree data"

The analysis by Sherman et al. (1986), its basis and results have been examined. The analysis relies on general methods, which may give acceptable results under the special conditions considered by the authors, but will usually produce more or less misleading results. The program POINTER (Lalouel & Morton 1981) is shown to be based partly on a chain of irrelevant arguments for the actual context. The so-called "conventional ascertainment rules" (Morton et al. 1983) are shown to produce misleading results in cases where their assumptions are not satisfied. The mean risk for unbalanced offspring is underestimated because of an erroneous ascertainment correction. The segregation frequencies are found to be different in three national samples, contrary to the claim by Sherman et al. Only a small proportion of all information available in the data has been utilized. Alternative and more appropriate models, hypotheses and procedures have been suggested. The frequent use of packages with computer programmes of standard statistical procedures in nonstandard situations with data from collaborative studies in human cytogenetics is discussed.     

Breast cancer risk associated with ovulation-stimulating drugs

BACKGROUND: Despite the recognized role of hormones in the aetiology of breast cancer, there has been little evaluation of hormonal preparations used to treat infertility. METHODS: A retrospective cohort study of 12,193 women evaluated for infertility between 1965 and 1988 at five clinical sites identified 292 in situ and invasive breast cancers in follow-up through 1999. Standardized incidence ratios (SIRs) compared breast cancer risks with those of the general population. Analyses within the cohort estimated rate ratios (RRs) associated with medications after adjustment for other breast cancer predictors. RESULTS: Infertile patients had a significantly higher breast cancer risk than the general population [SIR = 1.29, 95% confidence interval (CI) 1.1-1.4]. Analyses within the cohort showed adjusted RRs of 1.02 for clomiphene citrate and 1.07 for gonadotrophins, and no substantial relationships to dosage or cycles of use. Slight and non-significant elevations in risk were seen for both drugs after > or = 20 years of follow-up (RRs = 1.39 for clomiphene and 1.54 for gonadotrophins). However, the risk associated with clomiphene for invasive breast cancers was statistically significant (RR = 1.60, 95% CI 1.0-2.5). CONCLUSIONS: Although there was no overall increase in breast cancer risk associated with use of ovulation-stimulating drugs, long-term effects should continue to be monitored.     

To test or not to test: an ethical conflict with presymptomatic testing of individuals at 25% risk for Huntington's disorder

The first presymptomatic test for Huntington's disease was developed in the 1980s. With the detection of the gene causing the disorder in 1993, it became possible to do direct mutation tests with almost 100% sensitivity and specificity. The author discusses some of the ethical issues that arise when an adult child at 25% risk for the disease wishes to have the test, but the parent(s) at 50% risk refuses to have one. If the child tests positive, the genetic status of the parent will also be disclosed. No matter what course of action is chosen in this situation, the ethically legitimate interests of either child or parent might be violated. The author examines different alternatives and suggests a solution that might be acceptable to all parties.     

Cardiovascular ‘reactivity’ to graded splanchnic nerve stimulation in spontaneously hypertensive and normotensive control rats

Cardiovascular ‘reactivity’ to graded splanchnic nerve stimulations was compared in adult spontaneously hypertensive rats (SHR) and normotensive controls (NCR), during abolished adrenal medullary secretion and neurogenic cardiac control and depressed reflex vascular adjustments. Arterial pressure, heart rate and cardiac output were measured, and total peripheral resistance (TPR) and stroke volume (SV) computed before, during and after nerve stimulation. The neurogenic resistance increases in the major gastrointestinal-renal-hepatic circuits expressed themselves as TPR elevations, which were much accentuated in SHR. This reflects an increased w/r₁ of SHR resistance vessels rather than any altered effector sensitivity, since the responses were particularly accentuated at high discharge rates when noradrenaline junction concentrations approach maximal levels. The splanchnic capacitance responses expressed themselves as SV increases, being the most relevant aspect of capacitance control. SV increased less in SHR, mainly reflecting the reduced diastolic compliance of the hypertrophied SHR left ventricle and the consequent rightward shift of its Frank-Starling curve. The results indicate that an elevated resistance may well be maintained by a normal sympathetic discharge in established SHR hypertension. There seems, however, to be an increasing need for accentuated discharge to the capacitance side to maintain proper cardiac filling of the hypertrophied left ventricle.     

Heart rate reactivity and heart period variability throughout the first year after heart transplantation

Heart rate reactivity to mental stress is substantially blunted early after heart transplantation, suggesting that the loss of neural modulation limits the cardiovascular response to mental stress. We tested whether reactivity to mental stress recovers during the first year after heart transplantation. Hemodynamic and respiratory responses to mental arithmetic challenge were studied in 20 heart transplant recipients 3, 6, and 12 months after surgery. A normal comparison group was studied at equivalent intervals. Heart rate reactivity to mental arithmetic was significantly reduced in the cardiac transplant group compared to the normal subjects. This effect persisted up to 1 year after transplantation. Heart period variability in the heart transplant recipients was minimal in all three-test sessions. The findings suggest that no functional reinnervation or other compensatory adaptation occurs up to 1 year after heart transplantation.     

Preprocessor Adapts Cardiovascular Signals to a Minicomputer

A laboratory-developed analog signal processor, driven by a conventional polygraph recorder and associated signal conditioning devices, provides automatic heart beat-by-heart beat preprocessing of various cardiovascular functions for input to a laboratory-type minicomputer. The technique of preprocessing individual functions, integrated with the minicomputer system which includes an A/D converter and teletype as input-output peripherals, provides a low-cost data acquisition and reduction system for the on-line computation and analysis of cardiovascular functions in experimental research applications. Such preprocessing more efficiently uses the minicomputer's memory to handle large amounts of information since the digitized data is in the form of one data sample, per function, per heart beat. Preprocessing analog data provides a low density data format and simplified software programs that are ideally suited for the utilization of a minicomputer in this on-line application.     

Effects of Stimulus Intensity on Cardiovascular Activity

A between-groups design (N = 75) was employed to investigate the effects of stimulus intensity and repetition on cardiovascular activity. It was predicted that as intensity increased, the pattern of physiological activity would change, indicating a transition from the orienting to the defense reflex. Cardiovascular activity was represented by measures of heart rate, digital pulse amplitude, and cephalic blood content. Subjects received 12 presentations of a 1000 Hz tone of 45, 60, 75, 90, or 105 dB. Stimulus risetime was 30 msec and the duration 2 sec. Analyses of variance revealed reliable effects of intensity and repetition on all cardiovascular variables. However, neither these results nor additional multivariate analyses supported the differentiation of orienting and defense reflexes as suggested by Sokolov (1963) or Graham (1979). The importance of the startle reflex in the interpretation of these findings was discussed.     

Fractal system — A time domain approach

A method to analyze the fractal system in the time domain is presented so that the dynamic behavior of the system can be studied. The fractal system is represented by a set of linear time-varying differential equations whose order depends on the order of the system under non-fractal condition. Four different types of fractal system are considered and their solutions in the time domain are presented. These analyses show that the fractal system is dynamically more stable with smooth changes of magnitude and less oscillatory than the non-fractal system. Examples of the physiological system of the conduction pathways in the heart and also the polarization phenomena of noble metal are presented to illustrate the phonomena.     

Environmental risk factors for hepatitis A infection in the Zenica–Doboj Canton, Bosnia and Herzegovina

In the Zenica-Doboj Canton, 1106 hepatitis A virus (HAV) infections were reported during 2000 (an incidence rate of 252/100 000 population), with 996 (90.1%) cases occurring in nine community-wide outbreaks. Analysis of water supplies showed that 398 (19.1%) samples contained coliforms, including 202 (50.8%) that were contaminated with thermotolerant Escherichia coli. Sewage sanitation systems were absent or substandard in 53 910 (81.8%) rural households. The group most affected during outbreaks comprised children aged 7-14 years (incidence rate of 598/100 000). The development of health promotion and prevention initiatives in schools, combined with rigorous hygiene measures, will be necessary to achieve control of the spread of HAV.