Blood viscosity factor in persons with high and low risk of ischemic heart disease]

In the years 1986-1987, the blood viscosity factor, the content of haemoglobin in erythrocytes, the concentration of glucose in blood, the lipids and the blood coagulation system were examined in 180 subjects. They were divided into three groups according to the exposure to risk factors: group performing light manual work (L), group performing hard manual work (C) and group of engine drivers (M). No statistically significant differences in regard to age, employment period, number of cigarettes smoked, as well as arterial systolic and diastolic blood pressure were found between the subjects. Workers from group M had the highest body weight (P > 99%) and increased concentration in blood of triglycerides (P > 99% and Apo B (P > 99%. Subjects from group C had the lowest concentration of cholesterol in blood (P > 99%) and the smallest number of members with hypertensions (3.8%) and overweight (7.5%). Group L included the highest percentage of persons with arterial hypertension (17.5%), the highest, among all examined, blood viscosity factor determined at the coagulation rate of 18.6 s-1, and the lowest prothrombin factor (P > 99%).     

Screening persons aged 65 and older for coronary heart disease risk factors.

Because of limited clinical investigations addressing the effectiveness of intervention to reduce known risk factors, it is difficult for primary care physicians to decide on which coronary heart disease risk factors to continue to screen for among older patients. The recently published report of the United States Preventive Services Task Force, using explicit screening criteria, has recommended that several risk factors be investigated for use among older adults. Recent longitudinal studies have found that a number of risk factors persist with advancing age-hypertension, left ventricular hypertrophy, impaired glucose metabolism, elevated cholesterol levels, obesity, smoking, physical inactivity, decline in vital capacity, and increased heart rate. Screening to identify many of these risks and treatment and counseling to modify them appear to improve survival. Evidence is less clear that diabetes mellitus and elevated cholesterol levels have the same significance for men and women as they age. Left ventricular hypertrophy and diabetes seem particularly important as risk factors for older women, whereas a high heart rate may be a greater risk for men.     

Combined treatment with vessel dilator and kaliuretic hormone in persons with congestive heart failure

Vessel dilator and kaliuretic hormone, two cardiovascular peptide hormones, enhance urine flow 2- to 13-fold and 4-fold, respectively, in persons with class III New York Heart Association congestive heart failure (CHF). The natriuresis and diuresis secondary to vessel dilator and kaliuretic hormone are not blunted as are atrial natriuretic peptide and brain natriuretic peptide effects in persons with CHF compared with healthy individuals. The present investigation determined if the two peptide hormones that do not have blunted effects in persons with CHF may have added beneficial effects when given simultaneously to individuals with class III CHF. Together with each at 100 ng/kg of body weight per minute, vessel dilator and kaliuretic hormone increased urine flow rate 3.5-fold (P < 0.05) compared with their 60-min baseline and control CHF subjects' urine flow rates. Combined, they enhanced the excretion rate of sodium a maximum of 3.6-fold (P < 0.05) with 2.5- and 2-fold enhancement 2 and 3 hrs after infusion. These data indicate that vessel dilator and kaliuretic hormone have diuretic and natriuretic effects when used in combination, but these effects are not additive over their individual effects in persons with CHF.     

Hospitalization for heart disease, stroke, and diabetes mellitus among Indian-born persons: a small area analysis

Background

We set out to describe the risk of hospitalization from heart disease, stroke, and diabetes among persons born in India, all foreign-born persons, and U.S.-born persons residing in New York City.

Methods

We examined billing records of 1,083,817 persons hospitalized in New York City during the year 2000. The zip code of each patient's residence was linked to corresponding data from the 2000 U.S. Census to obtain covariates not present in the billing records. Using logistic models, we evaluated the risk of hospitalization for heart disease, stroke and diabetes by country of origin.

Results

After controlling for covariates, Indian-born persons are at similar risk of hospitalization for heart disease (RR = 1.02, 95% confidence interval 1.02, 1.03), stroke (RR = 1.00, 95% confidence interval, 0.99, 1.01), and diabetes mellitus (RR = 0.96 95% confidence interval 0.94, 0.97) as native-born persons. However, Indian-born persons are more likely to be hospitalized for these diseases than other foreign-born persons. For instance, the risk of hospitalization for heart disease among foreign-born persons is 0.70 (95% confidence interval 0.67, 0.72) and the risk of hospitalization for diabetes is 0.39 (95% confidence interval 0.37, 0.42) relative to native-born persons.

Conclusions

South Asians have considerably lower rates of hospitalization in New York than reported in countries with national health systems. Access may play a role. Clinicians working in immigrant settings should nonetheless maintain a higher vigilance for these conditions among Indian-born persons than among other foreign-born populations.     

Cellular cardiomyoplasty with autologous skeletal myoblasts for ischemic heart disease and heart failure

Cell transplantation to repair or regenerate injured myocardium is a new frontier in the treatment of cardiovascular disease. Even though it is based on many years of pre-clinical studies, much remains to be understood about this methodology, even as it progresses to the clinic. For example, controversies exist over the specific cells to be used, the dosages needed for tissue repair, how cells will affect the electrical activity of the myocardium, and even whether the cells can improve myocardial function after transplantation — all of which are briefly reviewed here. Autologous skeletal myoblasts appear to be the most well studied and best first generation cells for cardiac repair. Yet cardiocytes and, more recently, stem cells have been proposed as cell sources for this technology. Their advantages and limitations are also discussed. Although cellular cardiomyoplasty (cell transplantation for cardiac repair) shows great pre-clinical promise, its future will heavily depend on conducting carefully controlled, randomized clinical trials with appropriate endpoints. Utilizing biologically active cells provides both an opportunity for tissue repair and the potential for not yet understood outcomes. As with any frontier, many pioneers will attempt to conquer it. But also as with any frontier, there are pitfalls and consequences to be considered that may surpass those of previous endeavors. The future thus requires careful consideration and well-designed trials rather than haste. The promise for cell transplantation is too great to be spoiled by ill-designed attempts that forget to account for the biology of both the cells and the myocardium.     

Experimentation in persons wtih a neurodegenerative disease

Neurodegenerative diseases, of which the Alzheimer's disease, are more and more frequently the object of researches and new experiments. One wishes these experiments to be promising. Experiment with persons affected by a degenerative disease can begin at a moment when the subject is capable, and can be pursued beyond his incapacity. Law authorizes that a person of full age incapable of giving consent be subject of experiment. On the other hand, from the report of the incapacity, consent has to come from the legal representative: the mandatary, tutor or curator. The mandate given in anticipation of the mandator's incapacity empowers another person (the mandatary) to represent her. The use of this mandate confines the inconveniences of the mandator's incapacity to an interruption of the experiment for a duration of some weeks.     

GABA synthesis by cultured fibroblasts obtained from persons with Huntington's disease.

Abstract— A consistent observation in particular regions of brains of persons having died with Huntington's disease (HD) is a reduction in the concentration of γ-aminobutyric acid (GABA) and a decrease in the activity of its synthetic enzyme, glutamate decarboxylase (EC 4.1.4.15). GABA levels are also reduced in HD cerebrospinal fluids. This study suggests that skin fibroblasts obtained from persons with HD can be used to study their GABA system. A rapid and specific assay for [¹⁴C]glutamate– [¹⁴C]GABA based on Aminex A-7 chromatography has been developed. Cell monolayers and homogenates of HD cells convert [¹⁴C]glutamate to [¹⁴C]GABA. GABA synthesis by HD cell homogenates is pyridoxal dependent and is inhibited by 1 mm -aminooxyacetic acid. GABA synthesis by HD and control cell homogenates also show the same thermal sensitivity as rat brain GAD. When compared to non-HD human cells the HD cells reveal disturbances in the non-neuronal GABA metabolic pathway. Concentrated HD cell homogenates synthesize approx 3 times the amount of GABA as control cells. When diluted both extracts made similar amounts of GABA. Synthesis of GABA by HD cell homogenates is not inhibited by cysteine sulfinate. Decarboxylation of glutamate in these cells is therefore most likely due to glutamate decarboxylase and not cysteine sulfinate decarboxylase. HD cells in monolayer also synthesize 3 times the amount of GABA as compared to control cells. In addition, glutamate upake is altered in HD cells. This report indicates there may be a different pattern of enzyme regulation between HD and control cells.