Dixyrazine premedication for cataract surgery. A comparison with diazepam

Peroral dixyrazine (15–30 mg, n = 50) and diazepam (4–10 mg, n = 50) were used as premedicants for geriatric patients having cataract surgery under regional block. Compared to the diazepam patients, a larger number of the dixyrazine medicated patients appeared anxious, and there was a statistically significant difference between the groups, when summing up changes in anxiety throughout the study period. The dixyrazine patients needed more frequent supplementation with intravenous sedative drugs, compared with their diazepam counterparts. Peroral dixyrazine is an applicable choice for calm patients, when only slight sedation, or avoidance of somnolence are required.     

Prevention of non-communicable diseases: Risk factors in youth: The North Karelia Youth Project (1984-88)

The North Karelia Youth Project is based on the results of previouspilot studies in North Karelia and forms part of the North Kareliaintegrated programme for non-communicable diseases prevention,co-ordinated by the WHO and conducted by the Finnish NationalPublic Health Institute. The project is designed to test thefeasibility and effects of a largescale health programme among12–16 year old schoolchildren. The educational programmeaims to prevent cigarette smoking and alcohol use mainly bytraining pupils to resist social pressures and by modifyingperceived social norms which may lead to smoking and alcoholuse. The dietary intervention aims to improve dietary habitsto decrease serum cholesterol and blood pressure level. Theprogramme also aims to promote positive decision-making andcoping skills and to increase social support for coping withstress. The study, which began in the autumn of 1984 provides a comprehensivethree-year programme for all seventh graders (ages 12–13)and succeeding age cohorts in North Karelia (24 schools) andin selected schools in the county of Kuopio (eight schools),including approximately 4 000 students in the first year and12 000 over the entire study period. Simultaneously successivemeasurements are implemented in all the intervention schoolsand in eight randomized reference schools, which will allowus to evaluate the programme and to test a number of hypothesesabout programme effects. The preventive programme is designedto make the best possible use of existing resources (teachers,parents, community) and will require only relatively modestnew expenditure so that, if proved effective, it can be continuedon a permanent basis. A baseline survey of the schools was carried out in the springof 1984 among ninth-graders. Twenty-four per cent of the boysand 18% of the girls reported smoking daily and 13% and 9% respectivelywere occasional smokers. About 20% had used alcohol during thepast week, 7% reported "passing out" because of drinking duringthe last year and 12% had been deeply drunk. The mean serumcholestrol level was 4.7 mmol/l and the mean blood pressure130/66 mmHg. At this baseline survey, the levels of these variableswere generally comparable in the different randomly assignedstudy groups, although there was a trend towards less smokingand alcohol use at baseline in the schools in North Kareliathan in those in the county of Kuopio.     

Otorhinolaryngological training in Europe—a comparative study

Postgraduate training in the United Kingdom is undergoing radical changes following the `Calman Report'. Commissioned in response to a European Union (EU) Directive, this contained recommendations to allow reciprocal recognition of all EU trained specialists. We present the findings of a postal questionnaire sent to representatives of the European Federation of Oto-Rhino-Laryngological Societies and the otolaryngology professors of the UK and Ireland with a response rate of 62.7%. Aspects assessed included clinical and surgical experience, examinations, teaching, research, length, regulation and perception of training. The programmes share similar teaching and research experience but substantial differences exist in most other areas. The accredited UK trainee has a much wider clinical and surgical repertoire than those from the Continent. Greek trainees were trained to the lowest minimum standard. The requirements of a training system are largely determined by the level of clinical experience and surgical skill required by an independent specialist in a given country.     

The chamber vasoconstrictor assay

A comparison was made, using the vasoconstrictor assay, between a chamber test and patch tests in which the patch was either covered by an aluminium foil or left unoccluded. The unoccluded patch method produced an obviously less intense degree of pallor than the other methods. With the same test substances the chamber and the aluminium paper occlusion caused equally intense vasoconstriction. The chamber proved to have the following advantages over the aluminium foil method: (1) Test substance did not leak outside the test area, and therefore the pallor was clearly outlined and easier to define. (2) The chamber requires a smaller test area of skin. Of the test substances, clobetasol-17-propionate was unquestionably the most effective in the vasoconstrictor tests. Hydrocortisone-17-butyrate and betamethasone-i7-valerate were about equally effective. The skin blanching activity of hydrocortisone was the weakest of all.     

The East Finland Berry and Vegetable Project: A health-related structural intervention programme

The East Finland Berry and Vegetable Project was launched in1986 after the initiative of the North Karelia Project and asa broad co-operative effort to increase consumption of domesticberry and vegetable products. The aim is that as much as possibleof the increased consumption should be met from east Finland,where the bulk of berry farming is already located. The projectaims to combine health interests with several national and regional(east Finland) economic interests. The health interests relate,firstly, to the positive food choices provided by these productsand, secondly, to berry and vegetable growing being a potentialalternative to dairy farming, which will decline with the dropin consumption of dairy fat. The project employs a comprehensiveset of strategies, over the initial three-year period, includingresearch and evaluation, as discussed in this article.     

Mode of delivery directs the phagocyte functions of infants for the first 6 months of life.

Factors that direct the immune responsiveness of the newborn beyond the immediate post-natal period are not known. We investigated the influence of mode of delivery and type of feeding on the phagocyte activity during the first 6 months of life. Sixty-four healthy infants (34 delivered vaginally and 30 by elective Caesarean section) were studied at birth and at the ages of 2 and 6 months. Phagocyte functions were studied by measuring the chemiluminescence (CL) activity of whole blood and isolated leucocytes and by investigating the expression of phagocyte receptors (FcgammaRI (CD64), FcgammaRII (CD32), FcgammaRIII (CD16), CR1 (CD35), CR3 (CD11b) and FcalphaR (CD89)) on neutrophils, monocytes and eosinophils by using receptor-specific MoAbs and immunofluorescence flow cytometry. Infants born by elective Caesarean section had significantly higher CL activity than those delivered vaginally during the entire 6-month follow up. In addition, infants who received formula feeds had significantly higher CL activity at 6 months of age and higher expression of FcgammaRI-, Fcalpha- and CR3-receptors on neutrophils than infants exclusively breast-fed. We suggest that stress reaction associated with labour influences the phagocytic activity measured in the cord blood but later during infancy the intraluminal antigens, gut microflora and diet, become important determinants in immune programming of human individuals.     

Continuous Circulation of Yellow Fever among Rural Populations in the Central African Republic

Yellow fever remains a public-health threat in remote regions of Africa. Here, we report the identification and genetic characterisation of one yellow-fever case observed during the investigation of a cluster of nine suspected haemorrhagic fever cases in a village in the Central African Republic. Samples were tested using real-time RT-PCR targeting the main African haemorrhagic fever viruses. Following negative results, we attempted virus isolation on VERO E6 cells and new-born mice and rescreened the samples using rRT-PCR. The whole viral genome was sequenced using an Illumina NovaSeq 6000 sequencer. Yellow-fever virus (YFV) was isolated from one woman who reported farming activities in a forest setting several days before disease onset. Phylogenetic analysis shows that this strain belongs to the East–Central African YFV genotype, with an estimated emergence some 63 years ago. Finally, five unique amino-acid changes are present in the capsid, envelop, NS1A, NS3, and NS4B proteins. More efforts are required to control yellow-fever re-emergence in resource-limited settings.     

Lysosomal changes related to exercise injuries and training-induced protection in mouse skeletal muscle

Three experiments were designed to study the lysosomal changes associated with the development and maintenance of the endurance training induced resistance against exercise injuries in mouse skeletal muscles. The activities of arylsulphatase, cathepsin C, cathepsin D, and β-glucuronidase were assayed from the red part of mouse quadriceps femoris muscle 4 days after prolonged strenuous running of 4–9 h duration. Exercise injuries were characterized by necrotic fibers and focal inflammation. Strenuous running of untrained mice induced necrotic lesions and a 4–5 fold increase in the activities of lysosomal enzymes. This lysosomal response was considerably reduced already by daily training bouts on the 3 days preceding the strenuous exertion. Simultaneously exercise injuries were markedly reduced. Extending the endurance training program increased the running ability of mice and further reduced the necrotic lesions and lysosomal changes induced by the strenuous exercise. The detraining of 1 week after the termination of regular endurance training considerably increased the degree of exercise induced lysosomal response. The detraining of longer durations further increased the lysosomal response and no effect of prior endurance training existed after 1 month detraining. Our observations suggest that the severity of exercise injuries is related to the strength of the exercise stimulus and the level of preceding physical activity and can be characterized by the lysosomal changes.     

Effect of nasal CPAP treatment on plasma volume, aldosterone and 24-h blood pressure in obstructive sleep apnoea

Polycythaemia, peripheral oedema formation and hypertension have classically been described in association with obstructive sleep apnoea (OSA). However, there is very limited information about blood volume in OSA and how it changes during long-term treatment with nasal continuous positive airway pressure (nCPAP). Plasma (PV) and red-cell volumes (RCV), 24-h ambulatory blood pressure (BP), 24-h natriuresis and morning plasma aldosterone, renin activity and atrial natriuretic peptide in 11 men with a mean age of 47 y (range 37–55), apnoea index (AI) of 55 (22–106), body mass index of 36 (30–43) and seated BP of ≥140/90 mmHg without any medication were measured. BP-measurements were repeated after 3 weeks and all measurements after 3 mo of nCPAP treatment. Aldosterone and 24-h mean heart rates decreased during treatment. Twenty-four-h BP decreased after 3 weeks but that decrease did not persist after 3 mo of treatment. There was a relationship between changes in night-time mean BP and PV and aldosterone. The haematocrit declined in every patient. No significant changes were found in the mean PV or RCV. They were in all instances lower than has earlier been described for normal, non-obese subjects. These data also suggest that OSA causes divergent individual disturbances in blood volume homeostasis which can be corrected by nCPAP.