The effect of coffee on blood lipids and blood pressure. Results from a Norwegian cross-sectional study, men and women, 40-42 years

The association between boiled and filter coffee consumption and levels of cholesterol, triglycerides and blood pressure was studied, including 14168 men and 14859 women. A total of 94% drank coffee, 55% of the men and 48% of the women drank more than 4 cups per day. The type of coffee consumed varied between the counties, from 11 to 49% boiled and 49 to 87% filter coffee. Serum cholesterol increased linearly with increasing coffee consumption, and most strongly for boiled coffee. Controlling for other variables gave, for boiled coffee, an 8% increase for men and 10% for women. For filter coffee drinkers the coffee dose-cholesterol association remained significant only for women. Triglycerides showed a negative association with coffee, significant after adjustment for other variables. This effect was stronger for filter than for boiled coffee in both sexes. For men and women drinking 1 cup of coffee or more, a significant negative association between both systolic and diastolic blood pressure and number of cups of filter coffee was found. The influence of high consumption of different coffee-types on death rate from coronary heart disease is discussed.     

Clinical and histopathological findings of ''psoriatic neurodermatitis'' and of typical lichen simplex chronicus

BACKGROUND: We have seen several patients with itchy lichenified plaques located bilaterally on the elbows and/or knees and have named this condition 'psoriatic neurodermatitis' (PN). OBJECTIVE: The purpose of this study was to compare clinical and histopathological characteristics of these patients to those of patients with typical lichen simplex chronicus (LSC). METHODS: Nineteen patients with PN and 34 patients with typical LSC were included. Besides clinical dermatological evaluation, the prick test was carried out on 49 patients; the Phadiatop test on 40 patients; the patch test with European standard series on 47 patients; histopathological evaluation on 39 patients; and clinical psychiatric examination on 38 patients. RESULTS: Almost exclusively, PN was seen in females and was located on the extremities. It caused more plaques than typical LSC did. In PN, the plaques were smaller, sharper, more keratotic and less excoriated, and had fewer lichenoid papules around them. Itching was usually more severe in the evening, while resting and in a hot environment in typical LSC, but not in PN. In plaques of PN, microabscesses in the horny layer, hypogranulosis, regular acanthosis and thinning of the suprapapillary plates were more frequent, and hyperpigmentation in the basal layer was less. In patients with PN, depressive disorder was found more frequently; and generalized anxiety disorder or psychosomatic characteristics, less. There were no significant differences in the results of prick, Phadiatop and patch tests between patients with PN and those with typical LSC. CONCLUSION: In our opinion, it is most likely that the so-called PN is itchy psoriasis superimposed by LSC.     

Treatment of refractoriness to platelet transfusion by protein A column therapy

Ten thrombocytopenic patients (platelets < 10–24 × 10(9)/L) who were refractory to platelet transfusion were investigated for their responsiveness to staphylococcal protein A column therapy. Nine patients had previously been treated with steroids, intravenous immune globulin, and/or other forms of immunosuppressive therapy without improvement in their transfusion response. All patients were receiving multiple platelet transfusions without achieving 1-hour corrected count increments (CCIs) > or = 7500. Eight patients had antibodies that reacted with platelets and were directed against HLA class I antigens, ABO antigens, and/or platelet-specific alloantigens. Plasma (500-2000 mL) from each patient was passed over a protein A silica gel column and then returned to the patient. Patients received from 1 to 14 treatments. A positive response to protein A therapy was defined as at least a doubling of the pretreatment platelet count and/or two successive 10- to 120-minute posttransfusion CCIs > or = 7500. Following plasma treatments, 6 of 10 patients responded with daily platelet counts that averaged 48 +/− 11 × 10(9) per L as compared with counts of 16 +/− 7 × 10(9) per L (p < 0.0005) before treatment. Posttransfusion CCI values determined in four of these patients averaged 2480 +/− 810 and 10,010 +/− 3540 (p < 0.005) before and after treatment, respectively. In contrast, among the four unresponsive patients, platelet counts averaged 10 +/− 9 and 13 +/− 10 × 10(9) per L (p = NS), respectively, while posttransfusion CCIs were 700 +/− 1410 and 1520 +/− 2460 (p = NS), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

Seat belt use among drinking drivers in Minnesota.

OBJECTIVES. Among the reasons cited for recent declines in alcohol-related traffic fatalities is the enactment of seat belt use laws by most states. It is suspected that drinking drivers are less likely to comply with such laws, although evidence on the relationship between belt use and drinking by drivers is sparse and conflicting. The purpose of this study was to examine the relationship of drinking to driver seat belt use. METHODS. Observational, self-report, and chemical breath test data were collected on nighttime drivers in 16 Minnesota communities during September, 1990. RESULTS. Drivers with an illegal blood alcohol concentration (> or = 100 mg/dL) were substantially less likely to be wearing a seat belt (odds ratio [OR] = 2.17). Belt use was also more common among females (OR = 2.02) and before midnight (OR = 1.47). Males who had been drinking were less likely to be belted. Belt use was related to drinking before, but not after, midnight. Belt use was not related to drinking status among college graduates, but it was strongly related to drinking status among those with less education. CONCLUSIONS. The present findings provide further argument for rapid implementation of passive countermeasures (airbags) and for development of creative, carefully focused interventions to target high-risk populations.     

High-dose epirubicin in chemotherapy refractory non-seminomatous germ cell cancer: a phase II study. EORTC Genito-Urinary Tract Cancer Co-operative Group. EORTC Early Clinical Trials Group.

Eighteen patients with progressive disseminated, platinum-resistant germ cell tumors were treated with epirubicin 135 mg/m2, every 3 weeks. One patient had stable disease, 17 developed progression. Myelosuppression was dose-limiting. One patient died of neutropenic septicemia. High-dose epirubicin is not active against platinum-resistant germ cell cancer.     

Recombinant interferon alfa-2a with or without vinblastine in metastatic renal cell carcinoma: results of a European multi-center phase III study.

A total of 178 patients with metastatic renal cell cancer were randomized to receive interferon alfa-2a (rIFN alfa-2a) or interferon alfa-2a+vinblastine (VLB). IFN alfa-2a was injected intramuscularly at a dose of 18 MIU 3 times a week and VLB was given intravenously at a dose of 0.1 mg/kg once every 3 weeks. The response rate was 11% for patients on monotherapy and 24% for those on combination treatment. The 5-year survival for 145 eligible patients was 9%, independently from the treatment arm. The performance status was significantly related to long-term prognosis, and 13% of the patients with performance status 0 were alive at 5 years, as compared to 6% and 0% for patients with a WHO grade of 1 and 2, respectively. The most frequent adverse events in both treatment arms were flu-like symptoms (95%), fatigue (70%) and gastrointestinal disturbances (68%). Leukopenia was observed more frequently with combination treatment (53%) than with IFN alfa-2a alone (30%). In conclusion, rIFN alfa-2a monotherapy at this dose and schedule has modest antitumor activity in metastatic renal cell cancer. The combination of rIFN alfa-2a+VLB results in a doubling of the response rate, but this does not translate into prolonged survival. Toxicity (except leukopenia) and tolerance were similar in both treatment arms.     

Cranial nerve dysfunction in metastatic cancer of the prostate

We report 11 patients with cranial nerve dysfunction due to bone metastases from advanced prostatic cancer. Diplopia, speech disturbances, tongue deviation and headache were the typical clinical symptoms. X-ray and/or computed tomography of the base of the skull demonstrated bone destruction (and the surrounding soft tissue tumour) in 8 cases. In 1 patient the bone destruction was visualised only by bone scan. In 2 cases no bone destruction could be demonstrated in spite of the clinical findings. In 9 of the 10 evaluable patients the clinical symptoms improved after high voltage radiotherapy and high dose corticosteroid treatment. Cranial nerve dysfunction is a late complication of hormone-resistant prostatic cancer. The symptoms are usually due to bone destruction at the base of the skull. Radiotherapy combined with corticosteroid treatment is an excellent palliative measure if started immediately after the onset of symptoms.