Adult attachment style and interpersonal distance.

We tested for an association between adults' attachment style and their regulation of interpersonal physical distance. In Study 1, the stop-distance paradigm was used to derive measures reflecting tolerance of and reactiveness to spatial-intrusion. As predicted, university students who were classified as avoidantly attached (by a 3-category attachment style measure) were less tolerant of close interpersonal physical proximity than were securely attached individuals.

The pharmacokinetics and hemodynamics of sildenafil citrate in male hemodialysis patients.

Background: Erectile dysfunction (ED) is highly prevalent in men with renal disease. The clearance of sildenafil citrate, a highly effective oral treatment for ED, is decreased in men with severe renal insufficiency, but the pharmacokinetic and hemodynamic profiles during maintenance hemodialysis in men with end-stage renal disease have not been studied.

Methods: Fifteen men undergoing chronic outpatient maintenance hemodialysis received a single 50-mg oral dose of sildenafil on 2 occasions, once 2 hours before, and once 2 hours after hemodialysis, with randomized assignment to sequence.

beta-Blockers in hypertension: is carvedilol different?

Most studies assessing the effects of beta-blockers were carried out with traditional, beta(1)-selective beta-blockers, such as metoprolol and atenolol. Pathophysiologic and pharmacologic studies have documented that not all beta-blockers are created equal. In particular, the pharmacologic and clinical profiles of the newer, vasodilating beta-blockers, such as carvedilol, have been shown to differ from those of the traditional beta-blockers.

Acute respiratory failure in a patient with sarcoidosis and immunodeficiency--an unusual presentation and a complicated course.

Pulmonary sarcoidosis is usually a chronic, insidious disease resulting from granuloma formation in the lung parenchyma. The epithelioid non-caseating granulomata of sarcoidosis are the result of a T-helper1-mediated immune reaction to an unknown self or foreign antigen. We describe the case of a patient with sarcoidosis and a coexistent common variable immunodeficiency who presented with rapidly progressive respiratory failure.

Susceptibility of the influence of weight on blood pressure in men versus women: lessons from a large-scale study of young adults.

Background: Weight and blood pressure (BP) are closely related. The aim of this study was to quantify this relationship and compare it to other factors in a population of relatively young adults, with particular focus on the possible role of gender.

Methods: We conducted a cross-sectional analysis of the Young Adult Periodic Examinations in Israel (YAPEIS) database of healthy people aged 25 to 45 years undergoing routine periodic examinations.

Spreadability of two glass ionomer cements used in atraumatic restorative treatment (ART).

'Press finger' in atraumatic restorative treatment (ART) is used to spread a glass ionomer cement (GIC) to seal the restoration margin and adjacent pits and fissures. This study compared the spreadability of Fuji IX and Ketac-Molar to establish which was best suited for this purpose. Twenty equally spaced cavities (35 mm apart) were machine-cut in each of two Perspex slabs 200 x 100 x 20 mm.

Orthostatic hypotension in the elderly: are the diagnostic criteria adequate?

Orthostatic hypotension (OH) is a common finding in the elderly. OH is defined as a fall of at least 20 mmHg in systolic blood pressure (BP) and/or 10 mmHg in diastolic BP upon assuming an upright posture. Some patients exhibit a fall in BP of less than the defined OH upon standing.

Marginal adaptation of mineral trioxide aggregate (MTA) compared with amalgam as a root-end filling material: a low-vacuum (LV) versus high-vacuum (HV) SEM study.

Aim: To compare the marginal adaptation of mineral trioxide aggregate (MTA) or amalgam root-end fillings in extracted teeth under low-vacuum (LV) versus high-vacuum (HV) scanning electron microscope (SEM) viewing conditions.

Methodology: Root-end fillings were placed in 20 extracted single-rooted maxillary teeth. Ten root ends were filled with MTA and the other 10 root ends were filled with amalgam.

Coronary calcium by spiral computed tomography predicts cardiovascular events in high-risk hypertensive patients.

Objective: The ability of coronary artery calcium (CAC) to predict coronary events has been shown in several studies. We aimed to investigate the hypothesis that CAC as assessed by dual slice spiral computed tomography (DSCT), is an independent risk factor for cardiovascular events in hypertensive patients.

Methods: We followed 446 participants of INSIGHT (International Nifedipine Study Intervention as Goal for Hypertension Therapy) calcification study, for the incidence of cardiovascular events as a function of CAC and other factors.

Sleep apnea as a risk factor for hypertension.

Purpose Of Review: High blood pressure and obstructive sleep apnea are closely related, and the latter is considered to induce hypertension. The primary underlying mechanism is sympathetic activation triggered by apneic episodes. This type of hypertension is difficult to treat.

Are calcium antagonists beneficial in diabetic patients with hypertension?

Purpose: We analyzed the available data to assess the effects of calcium antagonists in hypertensive patients with diabetes mellitus.

Methods: We performed a MEDLINE search of English-language articles published until April 2003, using the terms diabetes mellitus, hypertension or blood pressure, and therapy. Pertinent articles cited in the identified papers were also reviewed.

Clinical, histological and microbiological study of hand-excavated carious dentine in extracted permanent teeth.

Changes in cultivable flora in dentine samples collected before and after hand excavation were examined in association with clinical status of the cavity surface, light microscopy and scanning electron microscopy (SEM). Thirty-five extracted permanent molar teeth with an occlusal caries lesion were excavated with hand instruments according to the atraumatic restorative treatment (ART) approach. Excavation pressure, dentine colour and consistency were recorded at the dentine-enamel junction (DEJ) prior to carious dentine removal and at the cavity floor after the final excavation; a microbiological sample of dentine was taken at both stages.

Do thiazide diuretics confer specific protection against strokes?

Several large studies have suggested that therapy with thiazide diuretics confers a particular benefit in reducing the risk of strokes that seem to be, at least to some extent, independent of the blood pressure-lowering effect. Such a cerebroprotective effect was documented not only with monotherapy but also when diuretics were used in combination with other drugs. The cerebroprotective effect does not seem to be shared by other drug classes, such as the beta-blockers or the angiotensin-converting enzyme inhibitors, in patients without manifest cardiovascular disease.

Adenosine protects against angiotensin II-induced apoptosis in rat cardiocyte cultures.

Adenosine has been found to be cardioprotective during episodes of cardiac ischemia/reperfusion through activation of the A1 and possibly A1 receptors. Therefore, we have investigated whether activation of these receptors can protect also against apoptotic death induced by angiotensin II (Ang II) in neonatal rat cardiomyocyte cultures. Exposure to Ang II (10 nM) resulted in a 3-fold increase in programmed cell death (p < 0.

[Treatment of hypertension with device-guided breathing exercise].

Hypertension has been documented as a major risk factor for cardiovascular morbidity and mortality and lowering blood pressure (BP) can reduce this risk. Life style modifications such--as physical exercise, salt restriction and weight reduction can lower BP. Recently, a number of studies showed that device-guided breathing exercise, which lowers the respiration rate and modifies respiratory patterns, can also lower BP.

A prospective national survey of management and clinical outcome of acute myocardial infarction in Israel, 2000.

Background: Little information is available on the clinical practice and implementation of guidelines for treating acute myocardial infarction patients in Israel.

Objective: To assess patient characteristics, hospital course, management, and 30 day clinical outcome of all AMI patients hospitalized in Israel during a 2 month period in 2000.

Method: We conducted a prospective 2 month survey of consecutive AMI patients admitted to 82 of 96 internal medicine departments and all 26 cardiac departments operating in Israel in 2000.

Accelerated coronary artery calcification in mildly reduced renal function of high-risk hypertensives: a 3-year prospective observation.

Objective: To examine the effect of mild renal dysfunction on coronary artery calcifications.

Methods: We examined the progression of coronary atherosclerosis, as measured by dual-section spiral computed tomography, using the total coronary artery calcium score as a quantitative measure of the burden of atherosclerosis. Of 547 high-risk Israeli hypertensive patients, who were participants of the prospective calcification study (a side-arm of the international INSIGHT study), 313 patients completed the 3-year follow-up.

Hospital and 1-year outcome after acute myocardial infarction in patients with diabetes mellitus and hypertension.

Hypertension (HT) and diabetes mellitus (DM) lead to structural and functional cardiac impairment and worsen the prognosis after myocardial infarction (MI). However, the prognosis of male or female patients with the coexistence of HT and DM after MI has not been clearly demonstrated. The study sample comprised 4317 consecutive patients with an acute MI from a prospective nationwide survey conducted in 1992, 1994 and 1996 in all 25 coronary care units operating in Israel.

[Pyogenic liver abscess--an unusual presentation of colonic villous adenoma].

A pyogenic liver abscess is a final common pathway of many pathologic processes, mainly suppurative cholangitis or suppurative pyephlebitis, arising from abdominal or pelvic infection. There are many other etiologies, and some abscesses are idiopathic-namely, cryptogenic abscess. We present a case of a man with a pyogenic liver abscess.

How well do fourth year Wits dental students place resin composite restorations?

Objectives: To evaluate, by means of a scanning electron microscope (SEM) the quality of resin composite restorations, placed as a first attempt by fourth-year dental students.

Methods: Ten Class IV direct composite restorations, placed in plaster-mounted extracted incisor teeth as part of pre-clinical course requirements, were selected. Specimens were evaluated and graded on a two-point scale by a staff member according to departmental clinical evaluation criteria.

Association of decreased quality of life and erectile dysfunction in hemodialysis patients.

Background: Quality of life in hemodialysis patients has been associated with treatment outcomes. We explored the impact of erectile dysfunction on quality of life in a cohort of hemodialysis subjects.

Methods: A random sample of 302 Philadelphia area hemodialysis (HD) subjects was enrolled using a cross-sectional design.

[Standpoint on the use of angiotensin receptor blockers in the treatment of hypertension].

Angiotensin receptor blockers (ARBs) have gained widespread use in clinical medicine during the past decade. Several large, prospective and randomized multi-center trials have led us to reconsider the role of ARBs in the treatment of hypertension. Firstly, in view of the favorable safety and side effect profile of ARBs, we recommend their use in hypertensive subjects in whom ACE inhibitors are indicated but are unable to tolerate agents of this type due to intractable cough.

Impaired nocturnal melatonin secretion in non-dipper hypertensive patients.

Background: Melatonin plays a role in the biologic regulation of circadian rhythms, including sleep. Melatonin has also been shown to modulate vascular smooth muscle tone and to induce hemodynamic effects in humans.

Objective: To evaluate whether melatonin plays a role in the circadian rhythm of blood pressure in hypertensive patients.