The Healthy Hearts Project: Development and evaluation of a website for cardiovascular risk assessment and visualisation and self-management through healthy lifestyle goal-setting.

Materially deprived communities in the UK have excess morbidity and mortality from cardiovascular disease (CVD) but are less likely to engage with formal care pathways. Community engagement and e-health may be more effective ways to promote risk-reducing lifestyle change. The "Healthy Hearts Project" website was designed for use by community health workers (CHWs) for cardiovascular risk assessment and lifestyle goal setting, or for independent use by community members.

Rectal lymphoma in ulcerative colitis treated with azathioprine.

Primary malignant lymphoma of the bowel is a rare complication of inflammatory bowel disease. The association of gastrointestinal lymphoma, inflammatory bowel disease and prior immunosuppression remains unclear. We report the first case of azathioprine-treated ulcerative colitis developing rectal lymphoma.

The parallel stripes mystery.

A series of artefacts seen on intra-oral radiographs are described. These have been shown to be caused by contamination from fixing solution on the clips used to hold the films during processing. Thorough cleaning of these clips between uses prevented recurrence of these artefacts.

Intestinal obstruction secondary to uterine perforation: an unusual cause of vaginal bleeding.

A patient with intestinal obstruction is described in whom small bowel was incarcerated within the uterine lumen. This is thought to have arisen as a result of undiagnosed uterine perforation during a previous dilatation and curettage.

Pathology of common bile duct stenosis in cystic fibrosis.

A case of cystic fibrosis complicated by common bile duct stenosis is described. Surgery successfully relieved the obstruction, but was complicated by Candida septicaemia. The previously unreported histological abnormalities of the common bile duct are discussed.

Cutaneous haemangioendothelioma: a possible link with chronic exposure to vinyl chloride.

A patient who worked with polyvinyl chloride developed a malignant haemangioendothelioma of a toe. This rare tumour is more commonly found in the liver where it has been reported to arise in association with exposure to the vinyl chloride monomer.

Jejunal carcinoma associated with non-absorbable suture material.

A case of adenocarcinoma of the jejunum arising at the site of non-absorbable surgical material is reported. This appears to be a unique observation.

Ursodeoxycholic acid dissolution of gallstones in cystic fibrosis.

The dissolution of cholesterol gall stones is documented in two adults with cystic fibrosis.

Idiopathic spontaneous haemoperitoneum.

A case is described of bleeding arising from the falciform ligament which occurred in the absence of obvious local pathology. Spontaneous bleeding from this site hitherto has not been reported. Previously described cases of idiopathic spontaneous haemoperitoneum and factors implicated in the aetiology of this rare condition are reviewed.

The incidence of schizophrenia in Nottingham.

Attempts were made to identify, and include in a two-year follow-up study, every patient living in the catchment area of the Mapperley group of psychiatric hospitals in Nottingham (population 390,000) who made their first-ever contact with the psychiatric services for a potentially schizophrenic illness during a two-year period (1 August 1978 to 31 July 1980). Screening was based upon symptoms rather than diagnosis, covering both in-patient and out-patient services; a consensus diagnosis using ICD-9 was made by the project team. The Nottingham Psychiatric Case Register was used in a retrospective Leakage Study which added nine cases to the 99 identified by the screening procedures.

Expression of HLA-D sub-region products on human colorectal carcinoma.

The major histocompatibility complex (MHC) status of normal, inflamed, pre-malignant and malignant epithelia of the human gastrointestinal tract was investigated by immunocytochemical methods using monoclonal antibodies (MAbs) directed against heavy (alpha)- and light (beta 2m)-chain Class-I molecules and sub-locus products (DP, DQ, DR) of the HLA-D region. Class-I expression on epithelial cells appeared to vary little with pathological status except in the case of 4/32 (13%) colorectal carcinomas in which the antigens were undetectable or scanty. The pattern of Class-II expression was more complex.

The effect of oestrogen and progesterone receptors on recurrence and survival in patients with carcinoma of the breast.

Recurrence and survival rates were studied in 175 women with breast cancer who, until the development of recurrent disease, received no treatment other than a modified radical (Patey) mastectomy, and in whom the oestrogen (REc) and progesterone (RPc) receptor content of the primary tumour was measured. At the time of first relapse most patients received endocrine therapy. At a minimum follow-up of 58 months post menopausal patients who possessed REc had an increased relapse-free survival (RFS) (P = 0.

Controlled trial of adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil for breast cancer.

327 patients with cancer of the breast and involvement of axillary lymph nodes were randomised, after total mastectomy and axillary clearance, to receive either no additional treatment or oral cyclophosphamide 80 mg/m2 on days 1-14, intravenous methotrexate 32 mg/m2 on days 1 and 8, and intravenous fluorouracil 480 mg/m2 on days 1 and 8 (CMF), which was repeated every 28 days for twelve cycles. There was a significantly longer relapse-free survival (RFS) in patients treated with CMF. A prolonged RFS was seen in premenopausal patients, those with 1-3 nodes involved, and those with 4 or more nodes involved, but a similar trend in postmenopausal patients failed to reach statistical significance.

Carcinoma of the vagina presenting as a ruptured procidentia with an entero-vaginal fistula and prolapse of the small bowel.

A case of a carcinoma of the vagina which presented as a ruptured procidentia with an entero-vaginal fistula and prolapse of the small bowel is reported.

The association of cytosol oestrogen and progesterone receptors with histological features of breast cancer and early recurrence of disease.

Two hundred and eighty-eight primary breast tumours were examined for the presence or absence of oestrogen (REc) and progesterone (RPc) receptors. Analysis has shown a relative interdependence between the steroid receptor status of primary breast cancer and other prognostic variables such as histological grade, lymphocytic infiltration and tumour elastosis. There were significant associations between epithelial cellularity, stromal fibrosis and the value of REc in those tumours in which the receptor was present.

Controlled trial of adjuvant chemotherapy with melphalan for breast cancer.

370 patients who had carcinoma of the breast with involved axillary lymph-nodes were randomised after total mastectomy and axillary clearance to receive either no additional treatment or melphalan 6 mg/m2 daily for 5 days every 6 weeks for sixteen cycles. There was a trend towards longer relapse-free survival (RFS) in patients treated with melphalan, but this was not significant either in the whole series or in sub-groups according to menopausal status or extent of nodal involvement. In patients receiving melphalan RFS was not significantly affected by either the occurrence of amenorrhoea or the dosage of melphalan received.

Serum glycoprotein hormone alpha subunit, hormone receptors and disease stage in patients with breast cancer.

The concentration of the common alpha subunit of the glycoprotein hormones was high in the serum of 21/56 (38%) of premenopausal patients and 22/106 (21%) of postmenopausal patients with primary breast cancer, at the time of presentation. 7/59 (12%) of patients with benign disease also had high alpha subunit levels. Tumour cytosol oestrogen and progesterone receptor status was determined in 80% of the patients with cancer, and there was a trend towards higher alpha levels in patients without receptors, but this was not statistically significant.