Localized pleural plaques and lung cancer.

In a mass chest radiography survey conducted in 1971 for 7,986 residents of three Finnish communities, 604 subjects (7.6%) with pleural plaques but not other asbestos-related radiographic signs were identified. The same number of referents, each individually matched to each plaque carrier on sex, birth year, and community, was selected from among persons in the same source population with no pleural plaques. The two groups were followed for investigation of incidence of lung cancer during 1972-1989. Twenty-eight of those with plaques and 25 referents contracted lung cancer (crude conditional RR = 1.1; CL95 = 0.7, 1.9). The application of the proportional hazards model, with adjustment for sex, age, and residence, resulted in a hazard ratio of 1.1 (CL = 0.6, 1.8). The risk ratio estimate may be biased; hence, the result is inconclusive in regard to the predictive assessment of lung cancer risk among carriers of pleural plaques.     

Office employment, work with video display terminals, and course of pregnancy. Reference mothers' experience from a Finnish case-referent study of birth defects

In an examination of the possible harmful effects of work in an office environment and the use of a video display terminal (VDT) on the course of pregnancy, the experience of 1,475 reference mothers from a Finnish case-referent study of birth defects was analyzed. The study was based on the national Register of Congenital Malformations, whose data were supplemented with special interviews on mothers' work conditions. The group which worked in an office environment consisted of 239 women, of whom 60 had worked with video display terminals; 805 mothers had not worked in an office. Only mothers who had worked during most of their pregnancy and who had a singleton birth were included; hence 431 women were excluded from the analysis. The information on threatened abortion, length of gestation, birthweight, placental weight, and maternal blood pressure was analyzed. Office work involved no elevated risk of threatened abortion when compared with nonoffice work, and among the VDT users the proportion with symptoms related to an impending early termination of pregnancy was similar to that of other office workers. No unfavorable effects on the length of gestation were observed between the compared groups, and there were no differences in the birthweight of the babies when adjustment was made for gestational age or the other aspects under consideration. Thus the results did not suggest that office employment or work with video display terminals would be harmful for pregnancy.     

Intracerebroventricular immunization with TRH-antiserum lowers blood pressure in spontaneously hypertensive rats.

Centrally administered thyrotropin-releasing hormone exerts a well documented hypertensive effect. In this study, the possible physiological role of thyrotropin-releasing hormone in the central cardiovascular regulation was evaluated in spontaneously hypertensive rats receiving long-term (8-14 days) intracerebroventricular infusion of a heterologous antiserum to thyrotropin-releasing hormone. The effect of this passive immunization on the blood pressure was monitored from conscious animals by the tail-cuff method. Thyrotropin-releasing hormone antiserum significantly decreased the systolic arterial pressure in adult rats with established hypertension. No alterations in serum thyroid hormone status were observed indicating that the antihypertensive effect of immunological blockade of thyrotropin-releasing hormone was not due to changes in the serum thyroid hormone levels. These results provide evidence for a role of endogenous brain thyrotropin-releasing hormone in the maintenance of hypertension in spontaneously hypertensive rats.     

Assessment of class-specific antibodies against denatured DNA in patients with systemic lupus erythematosus

In this retrospective study 103 serum samples from 16 females with systemic lupus erythematosus (SLE), obtained during a mean follow-up time of 2 years, were investigated for the presence of anti-denatured [single-stranded (ss)] DNA antibodies of the IgG, IgM, and IgA classes. The anti-ssDNA antibodies were determined by an enzyme-linked immunosorbent assay (ELISA), and the results were expressed in three ways: as units derived from a single serum dilution and as two parameters,E andA, calculated from the dose-response curve,E being an estimate of the effective amount of antibodies andA a function of the reaction constant between the antigen and the antibody. The simultaneous occurrence of anti-ssDNA antibodies of all three immunoglobulin classes was seen most often in the patients with the shortest duration of the disease. Clinically active disease was found to correlate with high reaction constants of the IgA anti-ssDNA antibodies. There was also an association between the IgA anti-ssDNA antibody levels and the presence of nephritis. Great fluctuations in the amounts of effective antibodies of the IgG class were seen in seven patients, in six of whom changes in the disease activity also were seen. Changes in the disease activity were unaccompanied by fluctuations in the IgG anti-ssDNA levels in four patients; two of these patients were positive for antibodies against extractable nuclear antigens. We conclude that it is of value to express the results of the anti-ssDNA ELISA as a function of the dose-response curve when monitoring patients with SLE and that immunoglobulin class-specific determinations of anti-ssDNA antibodies may provide information about the disease activity in many patients with SLE.     

Antigenic properties of Chlamydia trachomatis lipopolysaccharide.

The antigenic properties of the lipopolysaccharide (LPS) of Chlamydia trachomatis L2 were investigated. By means of passive hemolysis, passive hemolysis inhibition, and absorption experiments, it was shown that antiserum raised against chlamydial elementary bodies contained at least two different antibody specificities which reacted with different antigenic determinants of chlamydial LPS. One of these antibodies cross-reacted with enterobacterial Re LPS, recognizing a structure which is shared by both LPSs, whereas the reactivity of the second antibody was restricted to chlamydial LPS. The former antibody could be absorbed with Salmonella minnesota Re LPS, whereas the latter was not affected by this absorption. Therefore, chlamydial LPS possesses two distinct antigenic determinants, one of which is C. trachomatis specific, the other of which is responsible for the cross-reactivity with enterobacterial Re-type LPS. Both antigenic determinants were destroyed during mild acid-catalyzed hydrolysis. It was further shown that free chlamydial lipid A exhibits antigenicity that cross-reacts with free enterobacterial lipid A. This antigenicity, however, as in enterobacterial LPS, is present in a cryptic form, i.e., it is unmasked only after acid hydrolysis of LPS.     

Arterial hypertension associated with the use of a tourniquet with either general or regional anaesthesia

A hypertensive patient with left cardiac enlargement developed marked hypertension under general anaesthesia, during which time a tourniquet was applied around his thigh. When the tourniquet was released, severe hypotension ensued which responded to therapy. The patient, however, died 16 h later of a myocardial infarction. Because of this incident, the anaesthetic and haemodynamic data of 699 patients who underwent limb surgery with a pneumatic tourniquet inflated for at least an hour were retrospectively examined using multivariate analysis. A 30% increase in systolic and/or diastolic arterial blood pressure occurred in 27% of the total patient material and in 67% of those who had had a general anaesthetic. There was a higher frequency of the occurrence of "tourniquet hypertension" with older age, longer operations and the operation site being the lower rather than the upper limb. Tourniquet hypertension rarely occurred in patients with spinal anaesthesia (2.7%) and brachial plexus blockade (2.5%), while those with intravenous regional anesthesia had a higher incidence (19%) of hypertension.     

Malaria prophylaxis and self-therapy in airline crews

The risk of malaria infection in airline crews is estimated to be 0.5 per 1,000 persons per night in areas with high levels of malaria transmission. Routine chemoprophylaxis for years is not recommended because of possible side effects. Airline crews should therefore use appropriate measures to prevent mosquito bites. In addition, they may need to carry "standby" medication with them to be used for presumptive treatment of a febrile illness if medical attention is not readily available.     

The holistic approach to rehabilitation: A commentary

Abstract

Maria Pachalska's approach to aphasia rehabilitation is from a holistic perspective. Traditionally, aphasia therapists have tried to promote communicative ability using several methods. Pachalska has combined the most important approaches and created a model which she calls the Complex Aphasia Rehabilitation Model (CARM). She offers this model as an example of a holistic approach to aphasia rehabilitation. It stresses the importance of taking into account both psychological and social factors in aphasia rehabilitation.