Prediction of absolute risk reduction of cardiovascular events with perindopril for individual patients with stable coronary artery disease - results from EUROPA.

Background: Angiotensin-converting-enzyme inhibition reduces the risk of cardiovascular events at a group level. Presumably, the absolute effect of treatment varies between individuals. We sought to develop multivariable prediction scores to estimate individual treatment effect of perindopril in patients with stable coronary artery disease (sCAD).

[Quality of life after surgical correction of the aorta coarctation. Retrospective analysis of a group of patients with long-term follow-up].

Purpose: To report on the long-term results after operation for coarctation of the aorta.

Methods: One hundred and four patients were studied, divided in four groups (G1, G2, G3 and G4), according to age at operation. Data analysed: reoperation, persistent hypertension, residual lesions, left ventricular function and ability index.

Flour dust exposure variability in flour mills and bakeries.

As part of a longitudinal study to explore the exposure-response relationship between flour dust exposure and work-related symptoms and skin sensitivity the authors formed exposure groups and estimated various components of variability. This paper describes the between-exposure group, the between-worker and the within-worker variation of personal flour dust exposure in bakeries, flour mills and packing stations. In total 346 samples were collected in 13 exposure groups.

Correlation between different measures of exposure in a cohort of bakery workers and flour millers.

This paper describes the relationship between continuous and 'grouped' variables for several measures of exposure in a longitudinal study of bakery workers and flour millers. Average shift and peak levels, both for dust and for flour aeroallergen were measured, duration of exposure obtained from questionnaire and cumulative exposure both for dust and for flour aeroallergen calculated. Neither for dust nor for flour aeroallergen was there a correlation between duration of exposure and intensity measures of exposure (peak and average).

Peak exposure concentrations of dust and flour aeroallergen in flour mills and bakeries.

As part of an epidemiological study amongst workers exposed to flour we measured peak exposure levels to total dust and flour aeroallergen with personal samplers in bakeries, flour mills and packing stations. Short-term tasks which were expected to give rise to high concentrations of exposure (peaks) were identified. The frequency and duration of these tasks were estimated and their levels of exposure to dust and flour aeroallergen measured.

Exposure to dust and rat urinary aeroallergens in research establishments.

As part of an epidemiological study rat urinary aeroallergen (RUA) and total dust concentrations were measured at three research establishments. Personal RUA measurements in nine exposure groups over a workshift showed highest exposure for animal technicians (geometric mean (GM) = 32.4 micrograms/m3) and lowest for workers in slide production and office (GM > or = 0.

Dust and flour aeroallergen exposure in flour mills and bakeries.

As part of an epidemiological study among workers exposed to flour total dust and flour aeroallergen concentrations were measured with personal samplers over a workshift in three large bakeries and four flour mills and packing stations. In the bakeries geometric means for total dust concentrations ranged from 0.4 mg/m3 in the bread wrapping area up to 6.

The role of cereal and fungal amylases in cereal flour hypersensitivity.

To investigate the role of cereal alpha and beta-amylase in bakers' asthma, we have compared the IgE response of 30 wheat-flour-allergic individuals to barley alpha and beta-amylases with that of fungal alpha-amylase using radioallergosorbent test (RAST), RAST inhibition assays and Western blotting. RAST analysis showed 29 of the 30 subjects with inhalant induced cereal allergy had positive IgE to cereal amylases, but only 16 were positive to fungal alpha-amylase. Regression analysis showed an association between specific IgE to wheat-flour and to barley alpha-amylase (r = 0.

Measurement of airborne proteins involved in Bakers' asthma.

We have developed a competitive inhibition immunoassay to measure airborne flour, using purified polyclonal rabbit IgG antibodies to cereal flour antigens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed different flours contained proteins of molecular weight similar to those present in air sample eluates. Western blotting demonstrated that the purified rabbit IgG antibodies bound to proteins whose molecular weights are similar to human allergens.

Atenolol or nicardipine alone is as efficacious in stable angina as their combination: a double blind randomised trial.

Background: Beta blockers and calcium antagonists are widely used in the management of angina pectoris in the belief that the combination is more efficacious than either drug alone.

Methods: This double blind randomised crossover placebo controlled study compares the effects of nicardipine, atenolol and their combination in 30 patients with chronic stable angina. Each treatment period lasted 6 weeks with dose titration after 3 weeks.

Pseudomonas cepacia: pulmonary infection in patients with cystic fibrosis.

This retrospective study reviews the patterns of P. cepacia pulmonary infection in 75 of a total of 872 mainly adults with cystic fibrosis, registered here during the 4 years 1987-1990; 35 (47%) were female. During this period, 55 patients acquired P.

Auxotrophy of Pseudomonas aeruginosa in cystic fibrosis.

Seventy-four of 403 (18.4%) sputum isolates of Pseudomonas aeruginosa from 49 of 136 (36.0%) adults with cystic fibrosis (CF) were auxotrophic mutants.

Domiciliary nocturnal nasal intermittent positive pressure ventilation in hypercapnic respiratory failure due to chronic obstructive lung disease: effects on sleep and quality of life.

Background: Domiciliary assisted ventilation, using negative or positive pressure devices, is an effective treatment for respiratory failure due to chest wall deformity and neuromuscular disease. Negative pressure ventilators have been used with some success in patients with chronic obstructive lung disease in hospital, but attempts to continue treatment at home have been disappointing. This study evaluates the practicalities of nasal intermittent positive pressure ventilation at home in patients with chronic obstructive lung disease and the effect on sleep and quality of life.

Attitudes of cardiothoracic surgeons in the UK to human immunodeficiency virus.

A survey was carried out into attitudes of cardiothoracic surgeons in the UK to human immunodeficiency virus type 1 (HIV-1) infection associated with clinical situations that would normally have been managed surgically with low operative mortality rates and long median survival times. The survey response rate was 72.4 per cent.

Effects of treatment on airway inflammation and thickening of basement membrane reticular collagen in asthma. A quantitative light and electron microscopic study.

We have obtained airway mucosal biopsies by fiberoptic bronchoscopy for light and electron microscopic analysis of three distinct airway levels of the left lung in three subject groups. Group A: 11 subjects with mild atopic asthma (mean age, 29 yr; %FEV1, 89 to 116%; mean PC20 histamine, 2.42 mg/ml), each biopsied twice, one prior to 4 wk of treatment with either inhaled terbutaline (250 micrograms, two puffs four times daily; n = 5) or inhaled budesonide (200 micrograms, one puff twice daily; n = 6) followed by a second biopsy to allow determination of the effects of treatment.

Effects of coronary artery bypass surgery and angioplasty on the total ischemic burden: a study of exercise testing and ambulatory ST segment monitoring.

To assess the effects of standard therapeutic interventions on the total ischemic burden, 86 patients with stable angina underwent 48 hours of ambulatory ST segment monitoring and treadmill exercise testing before and at a mean of 10 weeks after coronary artery bypass surgery (CABG) (group 1, N = 46) or percutaneous transluminal coronary angioplasty (PTCA) (group 2, N = 40). There were 72 male and 14 female patients with a mean age of 56.4 years.

The development of a light curing prosthesis for chest wall replacement.

In conjunction with colleagues in the chemical industry, we have developed and evaluated a new plastic prosthesis which we hope will supplant presently used materials for chest wall replacement. We have modified the basic chemical of a reactive resin routinely used in orthopaedic and dental work by the inclusion of a polypropylene mesh. The resultant material is thin enough to cut with scissors and yet supple enough to shape to fit the defects.

The effects of nisoldipine on the total ischaemic burden: the results of the ROCKET study.

This study was designed to examine the effects of nisoldipine (relative to placebo), a new dihydropyridine calcium entry blocking agent, in the treatment of silent ischaemia in conventional doses. A total of 409 patients with proven coronary artery disease were screened and of this 64 had at least six episodes or a total duration of 30 min of ST segment depression (1 mm lasting at least 1 min) over 48 h. Fifty-two patients ultimately completed a randomized double-blind cross-over study comparing nisoldipine 5 mg twice a day, nisoldipine 10 mg daily and placebo.

Clinical validation of four solid state ambulatory monitoring devices in detecting shift of the ST segment.

Continuous monitoring for detection of changes in the ST segment during daily life in patients with stable angina has received increasing attention in recent years. Various reports testify to its role in the detection of silent ischaemia, and its potential usefulness in stratification of risk. Frequency modulated recorders, using magnetic tape for recording with subsequent visual analysis, have been previously validated for the detection of such changes.

Aortic counterpulsation for up to 28 days with autologous latissimus dorsi in sheep.

This article reports the development and assessment of an entirely autologous extraaortic counterpulsation system using skeletal muscle (latissimus dorsi). The technique has been performed and assessed in 16 sheep to quantify the effectiveness of counterpulsation over periods up to 28 days and to optimize the stimulation regimens for muscle contraction and fiber-type transformation. Hemodynamic changes have been quantified by calculation of the endocardial viability ratio.