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PubMed1998

The change of attitude of Hungarian physicians towards the importance of risk factors of coronary heart disease over the period 1985-1996.

Cardiovascular mortality in Hungary is still increasing, while it shows a continual decrease in the developed Western world. The authors examined, by means of a questionnaire, the attitude of physicians, in a large county hospital, to prevention of cardiovascular diseases and promotion of a healthy way of life. The questionnaire was answered by 170 physicians, 107 (63%) males and 63 (37%) females. Eighty-six percent of them believed coronary heart disease to be preventable. Twenty-six percent of the physicians currently smoked, and 53% did not know their own cholesterol level. As a cardiovascular mortality risk factor smoking was considered the most important risk factor, with sedentary lifestyle the second, high cholesterol level the third, and hypertension being only the fourth. Hungarian hospital physicians' rating of the effect of reducing the risk factors for coronary heart disease was similar to those results published in 1986 of American doctors, there being no significant difference in the importance attributed to smoking and elevated blood cholesterol. American doctors believed that hypertension had a more important effect on coronary heart disease than did Hungarian physicians, whilst the Hungarians attributed greater importance to a diet high in fat, being overweight, having a sedentary life-style, stress, elevated triglyceride level and type A behaviour. The results of this present study which related to the doctors attitudes towards health education for their patients were compared to results obtained from a study relating to physicians in the same hospital in 1985. Only in two aspects was a significant change observed. According to the authors' opinion greater efforts should be made regarding physician education on the subject of disease prevention. Additionally the employment of well educated nurses with specific training in preventive medicine could improve the effectiveness of the prevention of coronary heart disease.

Attitude of Health Personnel↗
PubMed1985

Seasonal periodicity of peptic ulcer disease. A prospective radiologic study.

The possible seasonal periodicity of the occurrence of X-ray-negative dyspepsia (RND), first-time-diagnosed gastric ulcer (GU), and first-time-diagnosed duodenal ulcer (DU) was studied in a 3-year period from 1980 to 1983. Of the 1936 patients studied, 1749 had RND, 100 had GU, and 87 had DU. One or more of the three types of dyspeptic disease were more frequently seen in the period from September through January and less frequently in the period from April through August. In conclusion, the present study suggests true seasonal periodicity in the occurrence of peptic ulcer disease, at least in a population living in the northern part of Norway.

Adolescent↗
PubMed1979

[Late results of operations for megadolichosigmoid in the "cold" period of the disease].

During the last 30 years the author has been performing comprehensive clinical observations of numerous patients with megadolichosigmoids. Among them 180 patients were operated for extreme pathological forms of megadolichosigmoids without a single lethal outcome. The analysis of remote results of the treatment of 173 patients is presented. The period of observation was from 3 to 25 years. The author believes that the operative method of choice in megadolichosigmoids is a one-step subtotal mesosigmoresection. It saves the patients from chronic ileus and is a reliable prophylaxis of acute volvulus of the sigmoid.

Adolescent↗
PubMed1997

[Forensic autopsies performed because of suspected occupational disease during the period 1987-1991--counties of Funen and Southern Jutland. Guidelines for physicians' notifications and a review of autopsy practice during 5 years].

One hundred and thirty-six forensic autopsies were conducted at the Institute of Forensic Medicine, University of Odense, Denmark (covering the counties of Funen and Southern Jutland) between 1987 and 1991 suspecting occupational disease as the cause of death. The autopsy were requested by the National Board of Industrial Injuries (NBII). The most frequent exposures were asbestos, solvents, sand, dust and welding fumes. Death was caused by lung disease in 92/136 of the cases, of which 48 were lung cancers and ten mesotheliomas. Totally, cancer diseases were found to be the cause of death in 70/136. Comparing data from the official death register and from NBII on mesothelioma it is concluded that only a minor part of the deaths caused by occupational disease are reported. Only a fraction of the diseases listed in the official Danish inventory for occupational diseases were represented among these deaths. To ensure the relatives their rightful compensation and improve the statistical data used for prevention, it is important that doctors report all deaths which may have been caused by occupational diseases.

Adult↗
PubMed1997

Risk factors for cardiovascular disease during the period 1985-1995 in Göteborg, Sweden. The GOT-MONICA Project.

AIMS: To report levels of cardiovascular risk factors in 1985, 1990 and 1995 in three population samples in Göteborg, Sweden, and to compare with previous population risk factor levels. POPULATION: The study was performed within the framework of the WHO MONICA Project which compares risk factor levels as well as the incidence of coronary heart disease and stroke in 38 populations. METHODS: Three random samples of men and women aged 25-34, 35-44, 45-54 and 55-64 comprising 152-218 subjects in each age group who responded to the invitation for screening procedures which included questionnaires, physical and laboratory investigations in 1985, 1990 and 1995. RESULTS: More men than women had smoked, except for those aged 35-44 where there was no difference between men and women. The proportion of men who had smoked decreased strongly between the first and third investigations (P < 0.0001), particularly amongst the younger age-groups, with a similar tendency amongst women. In the 25-44-years age group there was a tendency towards more women than men to be smokers in 1995. Snuff was used by 27% and 19% of men aged 25-34 and 35-44 years, respectively, in 1995. Up to 5% of women used snuff; higher in the younger age groups. More young men than women reported regular physical activity during leisure time with a tendency towards an increase from 1985 to 1995. The proportion of men reporting psychological stress varied little over the study period, but women aged 25-34 reported increased stress from 1985 to 1995. Body weight increased whereas height remained stable and consequently body mass index increased in men and women (P = 0.0001). Similarly, waist:hip ratio (measured in 1990 and 1995 only) also increased (P = 0.0001). Mean systolic and diastolic blood pressure increased with age and there was also a small increase between 1985 and 1995. Systolic blood pressure increased by a mean of 1.24 mmHg per 5-year period independent of sex and age (P = 0.0001). Antihypertensive treatment increased with age, but was stable between 1985 and 1995. Serum total and LDL cholesterol concentrations increased with age, and there was a nonsignificant tendency also to higher HDL cholesterol concentrations at older ages. Serum total cholesterol concentration declined between 1985 and 1995, and HDL cholesterol declined significantly between 1985 and 1995 in all age groups for men and women only when all age groups were analysed together. Similar to total cholesterol, levels of LDL cholesterol declined between 1985 and 1995 for all ages. Serum triglyceride levels increased for men and women between 1985 and 1995.

Adult↗
PubMed2006

Nicotine and biochanin A, but not cigarette smoke, induce anti-inflammatory effects on keratinocytes and endothelial cells in patients with Behçet's disease.

During periods of smoking, patients with Behçet's disease have less oral aphthae than in abstinence. To elucidate this observation, human keratinocytes and dermal microvascular endothelial cells (HMEC-1) were incubated with serum of 20 patients with Behçet's disease and 20 healthy controls for 4 hours. Maximum non-toxic concentrations were determined and the cells were further treated with 6 microM nicotine, 3.3% cigarette smoke extract (CES), 100 microM biochanin A, and 6.25/12.5 microM pyrrolidine dithiocarbamate alone and in combinations for 24 hours. Serum IL-8 levels of patients were significantly lower than those of controls. However, after 4 hours incubation with patients' sera, IL-8 release by both cell types was markedly increased when compared with the corresponding serum levels. The levels of IL-6 and vascular endothelial growth factor (VEGF) release were after 4 hours similar with the corresponding levels in serum. IL-1 was not detected. Nicotine significantly decreased IL-8 and -6 release by HMEC-1 maintained in both patients' and controls' sera, but only IL-6 release by keratinocytes maintained in patients' sera. VEGF release by both cells was markedly increased after nicotine treatment in either serum. CES significantly decreased IL-8 release and increased production of VEGF in keratinocytes maintained in patients' serum. The phytoestrogen biochanin A alone and in combination with nicotine further decreased the secretion of IL-8, -6, and VEGF in all experimental settings. Our data support a specific anti-inflammatory effect of nicotine on keratinocytes and endothelial cells maintained in the serum of patients with Behçet's disease. Moreover, biochanin A is likely to exhibit similar and even more profound results than nicotine.

Adult↗
PubMed1999

Increase in fiber density for immunoreactive serotonin, substance P, enkephalin and thyrotropin-releasing hormone occurs during the early presymptomatic period of motoneuron disease in Wobbler mouse spinal cord ventral horn.

The Wobbler mouse is a useful small animal model for the study of human motoneuron diseases. Besides showing the loss of motoneurons when the symptoms are expressed around the age of 3 weeks, we have also demonstrated the presumed 'sprouting' of neuronal processes in the cervical spinal ventral horn which contain immunoreactive (IR) serotonin (5-HT), substance P (SP) and methionine and leucine enkephalins (ME, LE), as well as thyrotropin-releasing hormone (TRH). This occurs during the symptomatic period when IR-5-HT, ME and LE sprout at Stage 1, around the age of 3 weeks, whereas IR-SP sprouts only at a late stage (stage 4) of the disease (at age 3 months). The present investigation shows that the presumed sprouting occurs even before the appearance of symptoms and prior to significant motoneuron losses. IR-5-HT containing neuronal processes sprout by postnatal day 7, whereas IR-SP, -ME, -LE, and -TRH processes sprout by day 14. Hypothetically the early sprouts may contribute to the loss of motoneurons. They also respond to ciliary and brain derives neurotrophic factors cotreatment. IR-SP neuronal processes, although they sprout by day 14, show normal fiber density by the time symptoms appear (stage 1, age 21 days). However the SP sprouting is biphasic and a significant increase in number also occurs at an advanced stage of the disease (stage 4, age 3 months).

Aging↗
PubMedDate not supplied

[Longitudinal radiologic study of the esophagus, in an endemic area of Chagas disease, in a period of 13 years].

A radiological study of the oesophagus of a cohort of patients was carried during a 13 year period in the municipality of Mambaí Goiás. Barium swallow findings were recorded on 70mm film using a portable machine. Of 731 patients examined 382 (52.3%) were seropositive for T. cruzi. The sexes were equally divided. The incidence of detectable megaoesophagus was 7.9% among the cohort and 14.2% in the seropositive individuals. Progression of the disease was noted during this longitudinal study in 21.7% of males and 16.6% of females.

Adolescent↗
PubMed1998

Measuring the rate of progression and estimating the preclinical period of Parkinson's disease with [18F]dopa PET.

OBJECTIVES: To measure the rate of progression in striatal [18F]dopa metabolism in a large group (n=32) of patients with Parkinson's disease, to estimate the average duration of preclinical period, and to examine the influence of the PET method on the assessment of rate of progression and preclinical period. METHODS: Thirty two patients with Parkinson's disease (mean age 58 (SD 13) years, mean duration 39 (SD 33) months) were assessed with [18F]dopa PET and UPDRS scoring on two occasions a mean of 18 (SD 6) months apart. PET data were sampled with separate caudate and putamen and total striatal regions of interest, and both graphical (Ki) and ratio methods of analysis. RESULTS: The mean annual rate of deterioration in [18F]dopa uptake varied according to structure and method of analysis, with putamen Ki showing the most rapid mean rate of progression (4.7% of normal mean per year). The group showed a significant deterioration (p<0.0004, paired two tailed t test) in UPDRS and in the putamen (p=0.008) and total striatal (p=0.012) [18F]dopa uptake measured using a graphical analysis, but no significant change in caudate or putamen uptake measured by a ratio approach. A study of sensitivity confirmed that putamen Ki was the most sensitive measure of disease progression, caudate ratio the least. Symptom onset in Parkinson's disease was estimated at a mean putamen [18F]dopa uptake (Ki) of 75% of normal and a mean caudate [18F]dopa uptake (Ki) of 91% of normal. CONCLUSIONS: Estimation of mean rate of progression varies according to the sensitivity of a functional imaging method to clinical severity. Sensitivity and reproducibility of method must be considered when designing studies of disease progression and neuroprotection. The mean preclinical period in Parkinson's disease is unlikely to be longer than seven years.

Aged↗
PubMed1995

Usefulness of immunohistochemical staining for p53 in the prognosis of breast carcinomas: correlations with established prognosis parameters and with the proliferation marker, MIB-1.

Mutations of the p53 gene often result in the overexpression of p53 protein. Previous studies have suggested that the function of p53 and its mutant protein forms may be linked with the disease course of patients with a breast carcinoma. In the present study, we tested 462 primary breast carcinomas for the presence of p53 antigen using immunohistochemical methods employing antibodies against the clone, DO-1. These tumors were also immunohistochemically stained using the monoclonal antibody, MIB-1, in order to demonstrate the presence of Ki67. Comparison of the presence of p53 with other prognostic parameters revealed highly significant negative correlations with estrogen- and progesterone-receptor status (P < 0.001 and P = 0.001, respectively) as well as positive correlations with both the presence of MIB-1 (P < 0.001) and the histological grading (P = 0.008). The presence of p53 was not correlated with tumor stage and node status. Evaluation of the findings for all 462 tumors as well as for node-positive and -negative subgroups revealed less favorable findings for overall survival and the disease-free period for both p53-positive tumors (for total group, overall survival, P = 0.0002, disease-free period, P = 0.02; for node-positive group, overall survival, P = 0.0004, disease-free period, P = 0.1045) and breast carcinomas with higher proportions of cell nuclei positive for MIB-1 (total, overall survival, P = 0.0026, disease-free period, P = 0.0022; node-positive, overall survival, P = 0.021, disease-free period, P = 0.0882). We were able to demonstrate that p53 expression in breast carcinomas means a significantly worse prognosis for grade II tumors (overall survival, P = 0.0002; disease-free period, P = 0.0116), for overall survival in the case of estrogen-receptor-positive tumors (P = 0.014), and for tumors showing increased proliferation activity (overall survival, P = 0.0477).

Antibodies, Monoclonal↗
PubMedDate not supplied

[Dynamics of the renal excretion of glycosaminoglycans as affected by thyroid therapy of hypothyroidism].

The state of renal excretion of glycosaminoglycans (GAG) was investigated in 15 patients with hypothyrosis of various degree of gravity before and during thyroid therapy. A raised level of GAG excretion with urine reflecting excessive GAG tissue accumulation was revealed. A degree of elevation was unrelated to a gravity of disease and grew with a period of disease. Thyroid therapy considerably increased GAG renal excretion, particularly in patients with a longer period of disease. A GAG level in daily urine can be used as an additional diagnostic criterion in hypothyrosis and the time course of GAG can serve for assessment of therapeutic efficacy.

Adult↗
PubMed1988

[Status of the coronary vessels and functional state of autovenous shunts in patients with ischemic heart disease at remote periods after aortocoronary bypass].

Repeated coronarography in 89 coronary patients at late dates after aortocoronary shunting, including 74 (83%) patients with residual or recurrent angina and only 15 (17%) angina-free patients, demonstrated that the progress of atherosclerosis continued in both the shunted and intact coronary arteries after the operation. Thrombosis of autovenous shunts had a pronounced effect on clinical condition of the patients. Only 50% of the shunts were open in patients with residual or recurrent angina, while bypass patency was 81% in the absence of anginal attacks.

Coronary Artery Bypass↗