Socioeconomic indicators and mortality from coronary heart disease and cancer: a 22-year follow-up of middle-aged men.

OBJECTIVES: Data from the Western Collaborative Group Study were used to determine the extent to which the inverse association between socioeconomic status (SES) and mortality can be explained by risk factors for major causes of mortality. METHODS: The relation of education and income to subsequent mortality was studied in 3154 employed, middle-aged men over 22 years of follow-up. RESULTS: Over the follow-up period, 584 (18.5%) men died, 214 (6.8%) from coronary heart disease and 70 (2.2%) from lung cancer. A significant inverse association with systolic blood pressure, serum cholesterol, and smoking was found only for education. For education, adjustment for risk factors reduced the relative risk for coronary heart disease mortality from 1.80 (95% confidence interval = 1.33, 2.44) to 1.54 (1.13, 2.09), for lung cancer mortality from 1.60 (0.95, 2.70) to 1.38 (0.81, 2.34), and for all-cause mortality from 1.49 (1.09, 1.13) to 1.33 (1.12, 1.60). For income, adjustment for risk factors did not change relative risk for mortality from coronary heart disease (1.27 [0.97, 1.66]) and all causes (1.21 [1.03, 1.43]), but it did increase the relative risk for lung cancer mortality from 1.68 (1.05, 2.68) to 1.83 (1.13, 2.96). CONCLUSIONS: In middle-aged, employed men, the association between SES and mortality is partially but not completely accounted for by major risk factors for mortality.     

FM sonography in diffuse liver disease: prospective assessment and blinded analysis

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.     

Effects of group socialization procedures on the social interactions of preschool children

We investigated the effects of group socialization procedures on the social behavior of preschool children in two studies. Group socialization procedures consisted of teachers using antecedent and consequent events to promote social interaction during children's games. During intervention, teachers discussed friendship with the children and then prompted and praised child-child social responding within the context of games. Children's social behavior was assessed during two sessions, group game periods (i.e., intervention sessions) and nonintervention play periods (i.e., generalization sessions). In both studies, a multiple baseline design across two target children and peers in their respective group was used to evaluate the effects of group socialization procedures. During group game periods, after intervention, target children increased their rates of both prompted and unprompted social interactions with peers. Also, in nonintervention play periods, target children improved both the rate and the duration of their social responding with peers. Results indicated that group socialization procedures were a practical and effective method for improving young children's social interaction during both structured games and unstructured play activities.     

Development of a new wound dressing with antimicrobial delivery capability

A bilaminar wound dressing composed of an outer membrane and an inner three-dimensional matrix of a fabric or a sponge may be considered to constitute an ideal structure that promotes wound healing: the outer membrane prevents body fluid loss, controls water evaporation, and protects the wound surface from bacterial invasion, and the inner matrix encourages adherence by tissue growth into the matrix. Using this concept, we developed a biosynthetic wound dressing with a drug delivery capability. This medicated wound dressing is composed of a spongy sheet of a chitosane derivative and collagen mixture that is laminated to an antimicrobial-impregnated polyurethane membrane. In this study, a gentamycin sulfate-impregnated wound dressing was prepared and evaluated. The antimicrobial efficacy of this wound dressing was examined on an agar plate seeded with Pseudomonas aeruginosa. Also, the cytotoxicity of an antimicrobial released from this wound dressing was examined in an in vitro system with cultured skin substitutes. Both in vitro tests have shown that this wound dressing is capable of suppressing bacterial growth and minimizing cellular damage. In addition, in the treatment of wounds inflicted on rats and rabbits, this wound dressing was shown to be efficacious in covering full-thickness and split-thickness skin defects. Finally, the efficacy of this wound dressing was evaluated in a nonrandomized open-label study of 31 clinical cases. In 31 cases treated with this wound dressing, good or excellent wound healing was achieved.     

Monoclonal antibody for avian thymic hormone.

Avian thymic hormone (ATH), a parvalbumin with immunomodulating properties, was used as antigen for development of a hybridoma cell line. Hybridoma screening by enzyme-linked immunosorbent assay (ELISA) led to the culture, purification, and characterization of an hybridoma, designated 4A6, which secretes IgG1 that is specific for ATH. The monoclonal antibody (MAb) was characterized by techniques involving indirect competitive and non-competitive ELISA, Western Blot analysis, and immunohistological staining. The MAb was highly specific for ATH with no cross-reactivity to other chicken tissue extracts or commercially available parvalbumins.     

Use of a Strecker oesophageal stent in the treatment of benign oesophageal stricture

The use of self-expanding prostheses in the management of malignant oesophageal strictures has become well established. The majority of benign peptic oesophageal strictures can be successfully managed using endoscopic or fluoroscopically guided balloon oesophageal dilatation combined with long-term drug therapy, particularly using proton pumper inhibitors. Although endoscopic oesophageal dilatation can be performed on an outpatient basis, it requires repeated hospital visits. There is a small risk of oesophageal perforation whilst cardio-respiratory complications may be encountered during the use of intravenous sedation in an elderly population. The use of a self-expanding Strecker stent in a 98 year old woman with a benign oesophageal stricture is described.