AUTONOMIC DYSFUNCTION IN LONG-STANDING ALCOHOLISM

Twenty-eight male alcoholics were studied for peripheral sensory-motorand autonomic neuropathy. The patients were examined neurologicallyand neurophysiologically after a period of withdrawal treatmentin hospital. The function tests of the autonomic nervous systemperformed were: measurement of the variation of the heart rateat rest and during maximal breathing, Valsalva manoeuvre, posturalpulse and blood pressure reactions, and isometric test. Slight abnormalities in the peripheral nervous system were observedin 8 patients, but a frank clinical polyneuropathy supportedby neurophysiological findings could be diagnosed only in 2.All of the parameters which reflect the function of the parasympatheticdivision of the autonomic nervous system were lower in the alcoholicscompared with the controls. The most sensitive variables werethe heart rate variation at rest, and the postural pulse reaction.The functions mediated by the sympathetic nervous system werenot abnormal among this group of alcoholics.     

Effect of a sport drink mixture with and without addition of fluoride and magnesium on plaque formation, dental caries and general health of rats

Abstract – A sport drink mixture (pH 3.2) containing 6% sucrose was given to Osborne-Mendel rats for 42 days. In some experimental groups the drink was supplemented with 15 ppm F, 38.5 ppm Mg or both F and Mg. The rats were fed a slightly cariogenic powdered diet containing 15% sucrose. Sport drink mixture increased significantly the accumulation of plaque but, compared with a group that drank distilled water, did not affect caries. Addition of fluoride to the sport drink mixture, alone or with magnesium, significantly reduced caries and tended to decrease plaque; addition of magnesium had no clear effect on plaque or caries. In spite of the fact that the rats had a sport drink mixture as the only drink for 6 wk, there were no untoward effects on growth, in histological studies of the inner organs, or in Ca, Mg, Na and K contents of kidney, heart and aorta.     

Value of computed tomography (CT) in the diagnosis of cochlear otosclerosis

The temporal bones of 40 patients with surgically confirmed otosclerosis were studied with high-resolution CT. The hearing of these patients was re-examined 5 years later. Foci of demineralization in the cochlear capsule were detected in 36% of operated ears and in 44% of otosclerotic ears not operated on. Mean bone conduction (BC) thresholds of ears with positive radiological findings did not differ significantly from those of otosclerotic ears with normal CT, either at the time of CT examination or 5 years later. Over 5 years, elevation of BC thresholds by 10 dB or more was observed significantly more often in operated ears with abnormal CT than in operated ears with normal CT, but in otosclerotic ears not operated on the corresponding difference was non-significant. It was concluded that CT examination is of little value in predicting sensorineural hearing loss in patients with otosclerosis.     

INCREASE OF CREATINE KINASE ACTIVITY IN SERUM AS SIGN OF MUSCULAR INJURY CAUSED BY INTERMITTENTLY ADMINISTERED SUXAMETHONIUM DURING HALOTHANE ANAESTHESIA

The serum creatine kinase (creatine phosphokinase) activitywas determined immediately before anaesthesia and 24–28hours later in patients undergoing ophthalmic operations. Halothanewith nitrous oxide and oxygen was given. Suxamethonium was administeredas a single dose, as a single dose followed by infusion, orin intermittent doses. Increased enzyme activity was found afterintermittent administration; this increase was about seven timesas great when halothane with nitrous oxide and oxygen was used,as when nitrous oxide and oxygen was given without halothane.After thiopentone induction there was less increase in activitythan after gaseous induction. The increase in enzyme activityshowed some correlation with the degree of visible fasciculations,whereas correlation with the occurrence of muscular pains couldnot be statistically ascertained.     

A Controlled Randomized Study on the Effect of Long-term Physical Exercise on the Metabolic Control in Type 2 Diabetic Patients

ABSTRACT The effects of 4 months' physical exercise on the metabolic control in non-insulin-dependent diabetes were studied in 25 patients divided randomly into exercise (n=13) and control (n=12) groups. In the exercise group glycosylated hemoglobin A₁ fell from 9.6–8.6% (p<0.01) and the 2 hour plasma glucose in oral glucose tolerance test decreased from 19.7–16.5 mmol/l (p<0.01). The mean fall in fasting plasma glucose from 11.8–10.5 mmol/l was not statistically significant. The responses of plasma insulin and C-peptide to oral glucose increased significantly during the exercise period. However, patients with initially poorest metabolic control were not able to improve their physical fitness and did not show significant improvement in metabolic control. In the control group no changes occurred in any parameter of glucose metabolism. The results suggest that physical exercise is beneficial for the glycemic control in patients with mild and moderate non-insulin-dependent diabetes. Increased insulin response is at least one main mechanism of the action of exercise.     

Towards healthy public policy: experiences in Finland 1972-1987

This article is an account of the attempts made in Finland inthe last 15 years to broaden the traditional perspectives inhealth policy, both by intersectoral action to promote healthand by a reorientation of the health service system. Any public policy can only be understood in a historical andsocietal context. Therefore, a brief introduction to the political,economic, social and cultural background is necessary. A systematic framework for goal-setting in public policy-makingwas worked out in Finland in the early 1970s. Since then thegeneral thinking in health policy has been dominated by an analyticalapproach of goals and means, exploring options for effectiveaction that would be politically feasible. The article aimsat describing and analysing the experiences gained thus farwith both successful and unsuccessful policies. In a broad overviewit is impossible to be comprehensive or analytically profound;instead a number of examples illustrate what has worked, whathas not, and why, in the process of developing healthy publicpolicies. Some of the examples might be spec to conditions inFinland, but the framework for thinking and policy analysis–aswell as several experiences of action, constraints and challenges–willprobably be of some general interest for people working towardshealthier public policies.