Absence From Work and Perceived Health Among Mine Rescue Workers

Studies of the relationship between various measures such asnature of work, family responsibilities, age and absence fromwork, have led to contradictory findings. Similar discrepanciesare found in studies comparing illness absence and absence followinginjury. It is argued that perceived health may be more importantthan objective morbidity in determining the reasons for absencefrom work. In a study of the reported absence during the previous6 months and perceived present health of 113 mine rescue workersit was found that 55 men had not been absent during the 6 monthsprior to the study, 37 had been absent through illness and 20as a consequence of injury; only 1 worker had had both illnessabsence and absence following injury. Generally, those workerswho had had illness absence had a poorer perceived health thanworkers who had had absence following injury or no absence atall. It is suggested that injuries may not be seen as healthproblems and that workers may be more ‘prone’ eitherto illness absence or to absence following injury. ⁰Requests for reprints should be addressed to:Dr J. McEwen, Department of Community Health. University of Nottingham, University Hospital, Queen's Medical Centre, Clifton Boulevard, Nottingham, NG7 2UH.     

Long-term-effects of two principally different antidepressant drugs on saliva secretion and composition

Abstract – In a double-blind, controlled, cross-over trial on 10 healthy volunteers, the effects of daily doses of maprotiline (75 mg) and zimelidine (100 mg) over a 14-day period were tested on saliva secretion rate and saliva composition. Based on current knowledge of salivary gland physiology and the difference in specificity between the two drugs, differences in salivary gland response could be expected. Since both drugs have anticholinergic effects which influence saliva secretion rate, the measured component concentrations had to be recalculated with regard to dependencies of secretion rate. Maprotiline, but not zimelidine, caused strong inhibition of secretion rate and accommodation ability. Maprotiline consistently caused around 50% increases in concentrations of the following saliva components: protein, amylase, fucose, hexose, sialic acid and potassium. The effects of zimelidine were less pronounced and resulted in initial increases of most organic components. 14 and 18 h after the intake of the drug these increases had disappeared and some of the components instead showed decreased concentrations. The results are consistent with current theories about facilitated serotoninergic and noradrenergic transmissions during treatment with antidepressants.     

Internal Cardioversion of Atrial Fibrillation with a Single Lead Configuration in a Patient with Massive Diaphragmatic Herniation

An anatomically related circumstance is reported as indication for the internal low energy Cardioversion instead of an external approach. A new single lead electrode configuration is described.     

Subjective health indicators and health promotion

This article gives an account of subjective (perceived) healthmeasurement based upon the development and use of an indicatorknown as the Nottingham Health Profile, an instrument that aimsto show the subjective elements of the experience of healthand illness by using the ordinary language of the intended respondent.The author discusses the possibility of using subjective healthindicators for the assessment of health promotion activitiesand examines ways in which these indicators might be used inhealth promotion research.     

INVERSE CORRELATION BETWEEN EXPRESSION OF HLA-B AND c-myc IN UVEAL MELANOMA

HLA class I is expressed in 75–85 per cent of uveal melanoma and cytoplasmic c- myc expression has been reported in 78 per cent of uveal melanoma. In skin melanoma, an inverse relationship has been observed between HLA class I expression and c- myc . The purpose of this study was to determine whether a similar correlation occurred between high expression of c- myc and low expression of HLA class I in uveal melanoma. The expression of c- myc , HLA-A, and HLA-B was determined by immunohistochemistry on formalin-fixed and paraffin-embedded sections of 30 uveal melanomas. Cell cultures from four primary uveal melanomas (lines 92-1, MEL 202, OCM-1, and EOM-3) and one uveal melanoma metastasis (line OMM-1) were tested for mRNA levels of c- myc and HLA-A and HLA-B in Northern blot assays. The high level of expression of cytoplasmic c- myc was significantly correlated with low expression of HLA-B ( P =0·03) and vice versa. High expression of HLA-B was significantly correlated with the presence of epithelioid cells ( P =0·004). The inverse correlation observed between c- myc and HLA-B expression is similar to previous observations in cutaneous melanoma. By downregulating HLA-B expression, c- myc may influence the immune response in uveal melanoma. Tumours containing epithelioid cells showed a significantly higher expression of HLA-B than tumours of the spindle cell type. © 1997 by John Wiley & Sons, Ltd.     

Building alliances: professional and political issues in community participation. Examples from a health and community development project

The notion of community participation in health finds favourin many circles, since, lacking close definition, it can beinterpreted in such a way as to be acceptable to all politicalpersuasions. This paper explores some of the consequences of these multipleinterpretations and gives examples from a community developmentand health promotion project in Scotland. Professional attitudes and behaviour and bureaucratic structuresare seen as significant barriers to public participation inhealth. Fundamental changes in the state of the public healthare blocked by a medical model which emphasizes individual responsibilityand treatment. It is argued that the public must retain ‘ownership’of the problems they define and the solutions to those problems.Professionals need to share their skills, rather than imposethem, and learn, in their turn, about the world inhabited bydisadvantaged groups.     

Does Radiofrequency Catheter Ablation Induce a Deterioration in Sympathetic Innervation? A Positron Emission Tomography Study

Radiofrequency catheter ablation (RFCA) is an effective treatment for the interruption of accessory bypass tracts in WPW syndrome or the modification of the Ay-nodal conduction system in patients with A V-nodal tachycardias. However RFCA may also damage cardiac innervation. The purpose of this pilot study was to assess possible changes in sympathetic innervation after RFCA as evaluated by the cathecholamine analog carbons-11- hydoxyephedrine (HED) positron emission tomography (PET) which allows the visualisation of sympathetic nerve terminals. We investigated nine patients with supraventricular tachycardias before and two to six weeks after RFCA. Myocardial perfusion was depicted by n-I3-ammonia-PET. In addition to visual analysis, HED retention was quantified in the myocardial quadrant distal to the location of intervention; these results were compared with values in remote areas. Before RFC A, myocardial perfusion showed homogenous distribution in 8 of 9 patients. One patient showed a perfusion defect in the posterior wall. HED retention matched perfusion distribution in all patients. After RF'CA there was no significant change observed either in ammonia or in HED distribution. Quantitative HED retention data showed no significant change before versus after RFC A. Thus, HED-PET does not demonstrate any abnormalities of tracer uptake indicating integrity of sympathetic nerve terminals after radiofrequency ablation therapy.