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Cardiac valvular abnormalities are frequent in systemic lupus erythematosus patients with manifest arterial disease.

The objective of this study was to study cardiac valve morphology and function and ventricular function in systemic lupus erythematosus (SLE) patients with and without co-existing cardiovascular disease (CVD) and in population controls. Twenty-six women (52 +/- 8.2 years) with SLE (SLE cases) and a history of CVD (angina pectoris, myocardial infarction, cerebral infarction or intermittent claudication) were compared with 26age-matched women with SLE but without manifest CVD (SLE controls) and 26 age-matched control women (population controls). Echocardiographywas performed to assess valvular abnormalities and manifestations of ischaemic heart disease. Thirteen of the 26 SLE cases but only one of the SLE controls and one of the population controls had cardiac valvular abnormalities. Three of the SLE cases had already undergone valve replacement and another had significant aortic insufficiency; the other nine had thickening of mainly mitral leaflets without hemodynamic significance. Among SLE cases, patients with valvular abnormalities had higher homocysteine (P < 0.001) and triglyceride (P = 0.02) concentrations than patients without valvular disease. In contrast atherosclerosis as determined by IMT, oxidized LDL as measured by the monoclonal antibody E06, autoantibodies against epitopes of OxLDL (aOxLDL) or phospholipids (aPL), disease duration or activity, or acute phase reactants did not differ between SLE cases with or without valvular abnormalities. Valvular abnormalities were not more common in SLE cases with stroke as compared to those with myocardial infarction, angina or claudication. In conclusion, valvular abnormalities are strongly associated with CVD in SLE. Raised levels of homocysteine and triglycerides characterize patients with cardiac valve abnormalities.

Acute-Phase Reaction↗

The prevalence of coffee drinking among hospitalized and population-based control groups.

Data on coffee-drinking habits obtained from a case-control study conducted in Detroit were used to compare the proportions of coffee drinkers in a hospital and a population control series. The comparison was based on interviews with 262 hospitalized controls and 427 population controls. The overall proportion of coffee drinkers in the total hospital control group was similar to that in the population control group. However, the proportion of moderate-to-heavy coffee drinkers among controls hospitalized for conditions that may have caused them to alter their diet (eg, gastrointestinal disorders and cardiovascular disease) was lower than that among population controls. In contrast, the proportion of moderate-to-heavy coffee drinkers among controls hospitalized for conditions that probably did not cause a change in diet (eg, fractures) was almost identical to that among population controls. These results suggest that, in hospital-based case-control studies of the effects of coffee consumption, it would be prudent to restrict the referent group to those patients hospitalized for conditions that probably did not cause a change in diet. The magnitude of bias resulting from failure to exclude controls hospitalized for diet-altering conditions will depend on two factors that may vary between studies: (1) the distribution of diet-altering conditions among the hospital controls, and (2) the relationship of these diseases to coffee consumption.

Adult↗

President puts renewed emphases on family planning.

President Jiang Zemin called for major improvements in the country's family planning, resources management and environmental protection at a work conference held in Beijing on March 12 this year on population control, natural resources and environmental protection. In his address, the president noted that the country will strive to control its population within 1.4 billion by the year 2010, halt the deterioration of the environment and noticeably improve it, and enhance resources management. ¿It is an arduous and important task for the Party and the whole nation,¿ the president said. As the world's most populous developing nation, China has limited per capita natural resources. ¿We must always see population control, preservation of resources and environmental protection from a strategic point of view,¿ Jiang said. In the 21st century, China must continue to make great efforts to stabilize the fertility level, maintain rational use and strict management of resources, and protect and improve the environment. ¿Our success or failure will have a direct bearing on the country's economic and social security, the quality of people's lives and the long-term development of China,¿ the president said. In the new century, it is imperative that we earnestly carry out the decisions of the Party and central government on family planning and the stabilization of a low fertility. On environmental protection, the president stressed that continued efforts should be devoted to both pollution prevention and control and ecological protection. The country should implement the strictest rules and regulations, and continue to uphold the principle of ¿developing while protecting: protecting while developing,¿ he said. In developing China's vast western region, it is also necessary to handle well the relationship between economic development and population control.

Asia↗

Caprine alpha- and beta-mannosidase activities: effects of age, sex, and reproductive status and potential use in heterozygote detection of beta-mannosidosis.

Effects of age, sex, and reproductive status on caprine plasma alpha- and beta-mannosidase activities were studied. The potential use of these plasma assays was evaluated for heterozygote detection of caprine beta-mannosidosis in populations of control goats and a breeding herd composed of known and putative heterozygotes for beta-mannosidosis. In the control population, the mean plasma alpha- and beta-mannosidase activities decreased in both sexes with maturity. Male goats generally had higher plasma mannosidase activity than did females, and plasma beta-mannosidase activity was affected by the reproductive status of the goats examined. Although putative carriers in the beta-mannosidosis breeding herd could not be differentiated from age- and sex-matched controls, known carriers had plasma beta-mannosidase values intermediate between those of control and affected goats. The lack of any correlation between alpha- and beta-mannosidase activities excluded alpha-mannosidase as a reference enzyme for carrier detection, but there are still differences between known carriers and the control population with respect to the alpha- and beta-mannosidase ratio.

Age Factors↗

Fungal speciation using quantitative polymerase chain reaction (QPCR) in patients with and without chronic rhinosinusitis.

OBJECTIVES/HYPOTHESIS: The objectives of this study were to determine the mycology of the middle meatus using an endoscopically guided brush sampling technique and polymerase chain reaction laboratory processing of nasal mucous; to compare the mycology of the middle meatus in patients with sinus disease with subjects without sinus disease; to compare the responses on two standardized quality-of-life survey forms between patients with and without sinusitis; and to determine whether the presence of fungi in the middle meatus correlates with responses on these data sets. STUDY DESIGN: The authors conducted a single-blind, prospective, cross-sectional study. METHODS: Patients with sinus disease and a control group without sinus disease were enrolled in the study. A disease-specific, validated Sinonasal Outcomes Test survey (SNOT-20) was completed by the subjects and a generalized validated Medical Outcomes Short Form 36 Survey (SF-36) was also completed. An endoscopically guided brush sampling of nasal mucous was obtained from the middle meatus. Fungal specific quantitative polymerase chain reaction (QPCR) was performed on the obtained sample to identify one of 82 different species of fungus in the laboratory. Statistical analysis was used to categorize the recovered fungal DNA and to crossreference this information with the outcomes surveys. RESULTS: The fungal recovery rate in the study was 45.9% in patients with sinus disease and 45.9% in control subjects. Patients with chronic rhinosinusitis had a mean SNOT-20 score of 1.80 versus the control group mean score of 0.77 (P < .0001). SF-36 data similarly showed a statistically significant difference between diseased and control populations with controls scoring a mean of 80.37 and patients with chronic rhinosinusitis scoring a mean of 69.35 for a P value of .02. However, no statistical significance could be ascribed to the presence or absence of fungi recovered, the type of fungi recovered, or the possible impact of fungi on the quality-of-life survey results. CONCLUSION: The recovery rate of fungi from the middle meatus of patients with chronic rhinosinusitis and a control population without chronic rhinosinusitis is 45.9% using QPCR techniques. No direct causation with regard to fungal species or presence was proven; however, a species grouping for future studies is proposed based on trends in this data and other reports. Disease-specific outcomes surveys revealed a statistically significant difference between the two groups.

Chronic Disease↗