Persistent impaired emotional functioning in survivors of a myocardial infarction?

The quality of life (QoL) of survivors of a myocardial infarction (MI) remains lower than that of their peers long after the acute event. Previous research on this subject has indicated, however, that this difference might lessen somewhat over time for the dimension 'emotional functioning' (as measured by the sickness impact profile (SIP): a generic instrument for QoL). The present study explores this phenomenon further using two instruments that specifically measure emotional functioning i.

Computer-assisted health impact assessment for intersectoral health policy.

Intersectoral health policy implies negotiations with politicians outside the health sector. Health politicians have a stronger position if they can quantify health impact. In this Dutch case-study we used a computer simulation approach to answer the following questions: Which anti-tobacco intervention has the largest health gain? Will a commuter cycling policy result in any substantial health gain? What is the relative health gain of promoting higher consumption of vegetables and fruit? We concluded that substantial health gain can be achieved if cigarette packet price were to increase by 2 Dutch guilders.

Major stressful life events in relation to prevalence of undetected type 2 diabetes: the Hoorn Study.

Objective: To test whether chronic psychological stress is positively associated 1) with the prevalence of type 2 diabetes; 2) with visceral adiposity; and to test whether 3) the relationship between stress and diabetes is mainly mediated by visceral adiposity

Research Design And Methods: In a general Caucasian population aged 50-74 years without a history of diabetes (n = 2,262), the number of major stressful life events experienced during the past 5 years was assessed by self-report before the administration of an oral glucose tolerance test.

Results: Diabetes was newly diagnosed among 5% of the subjects. The number of stressful events was positively associated with the prevalence of hitherto undetected diabetes.

Leptin and variables of body adiposity, energy balance, and insulin resistance in a population-based study. The Hoorn Study.

Objective: Leptin is thought to play a key role in the control of body weight. There is a complex interrelationship between leptin and insulin or insulin resistance, but it is unknown how leptin is regulated. We therefore explored, in a large population-based study of 2,484 Caucasian subjects aged 50-74 years, the relationship between leptin and variables of body adiposity, energy balance, and insulin resistance.

Dissimilar association of conventional immuno-reactive versus specific insulin with cardiovascular risk factors: a consequence of proinsulinaemia?

In this study involving 365 non-diabetic elderly Caucasians, we examined the relationship of immuno-specific insulin (ISI), total immuno-reactive insulin (IRI), proinsulin (PI) and proinsulin-insulin ratio (PI:ISI) to serum high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic blood pressure (SBP) and diastolic blood pressure (DBP), mean blood pressure (MBP) and pulse pressure. In a multiple regression analysis, adjusted for age, sex and obesity, a 1.3-fold stronger inverse association with HDL-C levels was found for IRI than for ISI, with a 1.

Intra-individual variation of glucose, specific insulin and proinsulin concentrations measured by two oral glucose tolerance tests in a general Caucasian population: the Hoorn Study.

We studied the intra-individual variation in plasma glucose, specific serum insulin and serum proinsulin concentrations, measured by two 75-g oral glucose tolerance tests in an age, sex, and glucose tolerance stratified random sample from a 50-74-year-old Caucasian population without a history of diabetes mellitus. The intra-individual variation was assessed by the standard deviation of the test-retest differences (SDdif). For subjects with normal (n = 246), impaired glucose tolerance (n = 198), and newly detected diabetes (n = 80) classified at the first test, the following (SDdif/median level of individual average scores) were found: fasting glucose: 0.

Impaired glucose tolerance and unidentified diabetes.

The epidemiology of impaired glucose tolerance and undiagnosed non-insulin-dependent diabetes mellitus is reviewed and the implications for screening strategies discussed.

New data on the rate of progression of impaired glucose tolerance to NIDDM and predicting factors.

The Hoorn study has investigated the prevalence of impaired glucose tolerance (IGT) and diabetes in a random sample of the population, 50-75 years of age, in the small Dutch town of Hoorn. The percentage of the population identified as having IGT was 10.3%, while 8.

Prevalence and determinants of glucose intolerance in a Dutch caucasian population. The Hoorn Study.

Objective: To study the prevalence and determinants of glucose intolerance in a general Caucasian population.

Research Design And Methods: A random sample of 50- to 74-year old Caucasians (n = 2,484) underwent oral glucose tolerance tests. Multiple regression analyses were performed to study the association of 2-h postload plasma glucose values with potential determinants.

Combined surgical and endovascular treatment of a giant vertebral artery aneurysm in a child. Case report.

The case is presented of a 5-year-old child who suffered a subarachnoid hemorrhage from a giant left vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm. Initial treatment consisted of surgical occlusion of the parent vertebral artery combined with a PICA-to-PICA bypass. Because of persistent filling of the aneurysm, the left PICA was occluded at its takeoff from the aneurysm.

Chronic haemodialysis with bicarbonate dialysate. Technical and clinical aspects.

Bicarbonate as a physiological buffer should be preferred in haemodialysis treatments. The use of bicarbonate dialysis, however, varies from 30 to 100% in the different industrialised countries. Except for the many advantages using bicarbonate dialysate, there are also clinical pitfalls in the use of the bicarbonate buffer substrate.

Tethered cord syndrome: clinical signs and results of operation in 42 patients with spina bifida aperta and occulta.

The results of tethered spinal cord operations in 42 patients were evaluated. Over a period of 10 years, 20 spina bifida occulta (S.B.

Thin-basement-membrane nephropathy in adults with persistent hematuria.

Thin-basement-membrane nephropathy, also called benign recurrent hematuria, is characterized by diffuse thinning of the glomerular basement membrane and by hematuria. To determine the incidence of thin-basement-membrane nephropathy among patients with idiopathic hematuria, we conducted a prospective study in the nephrology units of three large hospitals in the Netherlands. Eighty normotensive adults without azotemia underwent renal biopsy because of recurrent macroscopic hematuria (n = 26) or persistent microscopic hematuria (n = 54).

Pharmacokinetics of nitrendipine in terminal renal failure.

The pharmacokinetics and plasma protein binding of nitrendipine in patients with terminal renal failure have been compared with those in subjects with normal renal function. Kinetic parameters were calculated after a single 40 mg oral dose, an i.v.

Echography of the inferior vena cava is a simple and reliable tool for estimation of 'dry weight' in haemodialysis patients.

Using echography, the diameter of the inferior vena cava (IVC) and its decrease on deep inspiration (collapse index) were evaluated in haemodialysis patients. The diameter of the IVC was expressed as an index to the body surface area (VCD) in mm/m2. Non-linear regression analysis in predicting mean right atrial pressure by VCD (mm/m2) and collapse index revealed a good correlation (r = 0.

The use of calcium antagonists in patients with renal failure.

Calcium antagonists are now frequently used for the treatment of high blood pressure, angina pectoris and cardiac arrhythmias. Increasingly, these drugs are also given to patients with renal failure, since several studies have demonstrated that calcium antagonists lower blood pressure in patients with renal hypertension and renal insufficiency. Relevant pharmacokinetic parameters for verapamil, nitrendipine and diltiazem are not altered in renal failure.

A long-term study of plasma catecholamine levels and plasma renin activity in borderline hypertension.

Blood pressure and plasma catecholamine levels were followed up for a total of 7 years in 26 subjects with borderline hypertension and in 24 normotensive subjects. During the observation period, five subjects from the borderline hypertensive group became definitely hypertensive, 10 remained in the borderline hypertensive range and in 10, blood pressure fell below borderline hypertensive levels. Of the original 24 normotensive subjects, 15 remained in the normotensive range.

Hearing loss in a uraemic patient: indications of involvement of the VIIIth nerve.

A case of acute renal failure associated with severe uraemic hearing loss is presented. Audiometric site-of-lesion testing revealed cochlear as well as neural involvement. After therapy hearing recovered up to an almost normal level, with normal auditory nerve conduction velocities.

The effects of verapamil and propranolol on exercise tolerance in hypertensive patients.

In a single-blind, placebo-controlled crossover study the effects of verapamil (450 +/- 30 mg/day) and propranolol (160 +/- 20 mg/day) on endurance time during submaximal exercise were compared in eight patients with essential hypertension. The drugs were given in randomized order. Each active drug period was preceded by a placebo phase.

The influence of antituberculosis drugs on the plasma level of verapamil.

The influence of antituberculosis drugs on the plasma level of verapamil was studied after its oral and intravenous administration. Six patients who had been treated for at least 6 months with a combination of rifampicin, ethambutol and isoniazid received a single oral dose of 40 mg verapamil. As compared to untreated subjects, the antituberculosis drugs greatly reduced the bioavailability of the calcium antagonist.