PURPOSE: To bring up-to-date information about all the cardiac rehabilitation (CR) units in the UK, including their staffing and the services they offer, and to determine the numbers and diagnoses of the patients they treat. METHODS: Questionnaire survey to establish the continued functioning of the centers, the disciplines of their staff, the number of patients treated, their diagnoses, and the outcomes measured. RESULTS: 286 centers were identified. Of the 236 who returned their questionnaires, 171 (72%) gave figures of the numbers and diagnoses of their patients. The median number treated in the different programs was 150, with a total of 32,499 patients. Of those, 63% were recovering from myocardial infarction, 25% from coronary artery bypass graft (CABG), and 4% from percutaneous transluminal coronary angioplasty (PTCA). Twenty-four percent of patients were female, 87% were between the ages of 40 and 74, and 10% were older than 75. Of the responders, 80 (34%) performed an exercise test both before and after the course. Of the 171 who gave figures, 113 (66%) measured outcomes. CONCLUSIONS: In the UK, between 14% and 23% of infarct patients, between 33% and 56% of CABG patients, and between 6% and 10% of PTCA patients are enrolled into CR programs.

Adult↗

PubMedDate not supplied

Plasma triglyceride determines structure-composition in low and high density lipoproteins.

Because the association of hypertriglyceridemia and premature atherosclerosis is not due to the direct effects of the triglyceride molecule itself, we studied the effects of increased plasma triglyceride-rich lipoproteins on the composition and structure of low density lipoprotein (LDL) and high density lipoprotein (HDL). We found profound changes in the core and surface domains of both lipoproteins with increasing triglyceridemia. Core cholesterol esters were progressively depleted and replaced by triglyceride molecules. Highly significant negative correlations were found between cholesterol ester/protein ratios (r = -0.64 for LDL and -0.58 for HDL (p less than 0.001); positive correlations were found for triglyceride/protein ratios (r = 0.62 for LDL and 0.58 for HDL) and for triglyceride/cholesterol ester ratios (r = 0.70 for LDL and 0.83 for HDL) when these variables were assayed as a function of plasma triglyceride concentrations. With severe hypertriglyceridemia, triglyceride/cholesterol ester ratios of more than 1.0 were consistently observed (normal, less than 0.02). This leads to an underestimation of LDL and HDL levels when cholesterol alone is measured. At the surface, LDL and HDL were depleted of phospholipid and free cholesterol, with a relative enrichment of protein. These changes can be explained on the basis of high levels of plasma triglyceride-rich lipoproteins serving as acceptors for cholesterol esters and other constituents from LDL and HDL. Concomitantly, triglycerides are transferred to LDL and HDL. These transfer processes are likely to be mediated by the activity of lipid transfer proteins present in human plasma.

Blood Proteins↗

PubMedDate not supplied

Advertising refractive surgery.

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Advertising↗

PubMedDate not supplied

Use of health services before diagnosis of head and neck cancer among Boston residents.

One hundred thirty incident cases of head and neck cancer in Boston between September 1, 1985, and March 31, 1988, provided interview or medical record review data on the use of health services in the 24 months preceding the diagnosis of cancer. One hundred twenty-four subjects were able to recall whether and how often they visited health care sites in this period, reporting a median number of 10.5 visits; 94% recalled at least one visit. Eighty-nine medical record reviews indicated a median of seven visits. For the most part, these visits were to providers whom subjects considered their regular source of care--sources that provided care in a broad range of locations. These data support a strategy of integrating screening for head and neck cancers into existing health care services.

Adult↗

PubMedDate not supplied

Restriction endonuclease analysis of infectious laryngotracheitis viruses: comparison of modified-live vaccine viruses and North Carolina field isolates.

Six modified-live (ML) infectious laryngotracheitis (ILT) vaccine viruses, three reference strains, and 18 field isolates were compared by restriction endonuclease analysis of their DNA. Viral DNA digestion patterns were established for vaccine viruses using restriction endonucleases PstI, BamHI, KpnI, and HindIII. Using these enzymes, five of six ML vaccine viruses had identical restriction endonuclease cleavage patterns. Vaccine viruses had distinct patterns compared with ILT virus reference strains Illinois-N71851, Cover, and NVSL. Restriction endonuclease cleavage patterns of 18 field isolates of ILT virus, obtained from ILT outbreaks in North Carolina, were indistinguishable from vaccine viruses. These results suggest a possible role of vaccine or vaccine-like viruses in recent ILT outbreaks.

Animals↗

PubMedDate not supplied

Hard and soft contact lens fitting in infants.

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Contact Lenses↗

PubMedDate not supplied

Depression in battered women.

Sex differences in rates of depression and of battering by intimate partners are substantial: 3:1 and 10:1, respectively. The relationship between battering and depression has been documented for more than two decades, but has rarely been noted in the depression literature. This paper presents a brief summary of the major etiological theories of depression with a discussion of the evidence that links these theories with research on battered women. It seems clear that battering can be an important component of depression in battered women. Understanding the mechanisms involved in the relationship between depression and battering can result in a better approach to the diagnosis and treatment of depression in battered women. This discussion has particular ramifications for the primary health care system as well as the mental health care system.

Battered Women↗

PubMedDate not supplied

One-step surgical placement of Brånemark implants: a prospective multicenter clinical study.

This prospective longitudinal multicenter study evaluated the clinical outcomes after placement and restoration of one-step Brånemark implants into the maxillae and mandibles of completely and partially edentulous patients. Six surgical treatment centers participated in this study, in which 135 implants were placed into 63 adult patients. All implants were stable after placement. The majority of implants were placed into type B bone with minimal jaw resorption and type 2 bone quality. After implant placement, standard transmucosal healing abutments were firmly placed. The average amount of time between implant placement and prosthetic abutment connection was 170 days in the maxillae and 147 days in the mandibles. To evaluate crestal bone changes caused by implant placement, a periodontal probe was used to measure midbuccally from the top of the implant cylinder to the alveolar crest; in 29 patients, 54 midbuccal bone crest sites were remeasured following prosthetic abutment connection. Crestal bone changes in mandibles and maxillae were statistically and clinically insignificant. Six implants were lost prior to loading and one implant has not been restored. No implants or restorations were lost after loading. At 1 year, the implant success rate was 95.6%. Mesiodistal radiographic measurements from 34 patients were averaged, and changes from prosthetic abutment connection to, on average, 12 months follow-up were compared. The radiographs, which were digitalized, measured from the bottom of the implant cylinder to the most coronal bone in contact with implant thread. For mandibular implants, the mean radiographic bone level at prosthetic abutment connection was 1.07 mm; after loading, it was 1.35 mm. For maxillary implants, the mean radiographic bone height at prosthetic abutment connection was 1.16 mm; after loading, it was 1.36 mm. These changes were not statistically significant. The 1-year outcomes from this patient series indicate that one-step Brånemark implants provide excellent clinical results when placed in patients with good bone quality and quantity.

Adult↗