Prognosis of angina with and without a diagnosis: 11 year follow up in the Whitehall II prospective cohort study

Objective To investigate the prognosis of angina among people with and without diagnosis by a doctor and an abnormal cardiovascular test result.Design Prospective cohort study with a median follow up of 11 years.Setting 20 civil service departments originally located in London.Participants 10 308 civil servants aged 35-55 years at baseline.Main outcome measures Recurrent reports of angina; quality of life (SF-36 physical functioning); non-fatal myocardial infarction; death from any cause (n = 344).Results 1158 (11.4%) participants developed angina, and 813 (70%) had no evidence of diagnosis by a doctor at the time of the initial report. Participants without a diagnosis had an increased risk of impaired physical functioning (age and sex adjusted odds ratio of 2.36 (95% confidence interval 1.91 to 2.90)) compared with those who had neither angina nor myocardial infarction throughout follow up. Among reported cases of angina without a diagnosis, the 15.5% with an abnormality on a study electrocardiogram had an increased risk of death (hazard ratio 2.37 (1.16 to 4.87)). These effects were similar in magnitude to those in participants with a diagnosis of angina.Conclusion Undiagnosed angina was common and had an adverse impact on prognosis comparable to that of diagnosed angina, particularly among people with electrocardiographic abnormalities. Efforts to improve prognosis among people with angina should take account of this submerged clinical iceberg.     

Sickness absence as a global measure of health: evidence from mortality in the Whitehall II prospective cohort study

Objective To examine the association between sickness absence and mortality compared with associations between established health indicators and mortality.Design Prospective cohort study. Medical examination and questionnaire survey conducted in 1985-8; sickness absence records covered the period 1985-98.Setting 20 civil service departments in London.Participants 6895 male and 3413 female civil servants aged 35-55 years.Main outcome measure All cause mortality until the end of 1999.Results After adjustment for age and grade, men and women who had more than five medically certified absences (spells > 7 days) per 10 years had a mortality 4.8 (95% confidence interval 3.3 to 6.9) and 2.7 (1.5 to 4.9) times greater than those with no such absence. Poor self rated health, presence of longstanding illness, and a measure of common clinical conditions comprising diabetes, diagnosed heart disease, abnormalities on electrocardiogram, hypertension, and respiratory illness were all associated with mortality—relative rates between 1.3 and 1.9. In a multivariate model including all the above health indicators and additional health risk factors, medically certified sickness absence remained a significant predictor of mortality. No linear association existed between self certified absence (spells 1-7 days) and mortality, but the findings suggest that a small amount of self certified absence is protective.Conclusion Evidence linking sickness absence to mortality indicates that routinely collected sickness absence data could be used as a global measure of health differentials between employees. However, such approaches should focus on medically certified (or long term) absences rather than self certified absences.     

Improved methods for working with fish chromosomes with a review of metaphase chromosome banding

Improved methods for obtaining, preparing, and staining fish chromosomes are described. Included are procedures for resolving serial or G-type bands. A brief review of various metaphase banding procedures and their use in fishes is also presented.     

Improved medium and culture conditions for clonal growth with minimal serum protein and for enhanced serum-free survival of Swiss 3T3 cells

Summary Improved culture conditions have been developed that will support clonal growth of Swiss mouse embryo 3T3 cells at concentrations of serum protein as low as 125μg/ml. Survival of the cells under completely protein-free conditions also is enhanced greatly. The improvements that made these results possible include: (a) use of medium MCDB 402, which was developed specifically for Swiss 3T3 cells by adjusting the concentrations of all components of Dulbecco's modified Eagle's medium to optimum values for clonal growth with minimal serum protein and by adding other nutrients such as trace elements and “nonessential” amino acids that were not in the original formula; (b) use of culture surfaces that are coated with a positively charged polymer, poly-d-lysine; and (c) use of gentle low temperature trypsinization technique that minimizes cellular damage and the need to neutralize residual trypsin. Portions of this work were reported at the Thirtieth Annual Meeting of the Tissue Culture Association in Seattle, Washington. This work was supported by Grant CA-15305 from the National Cancer Institute     

An Update on the Louisiana and Texas Rigs-to-Reefs Programs in the Gulf of Mexico

Abstract

The Louisiana and Texas Rigs-to-Reefs programs enjoy widespread public, industry, and government support and have become models for similar programs around the world. Louisiana’s Rigs-to-Reefs program is the largest in the world, and since its inception in 1986 about 363 oil and gas platforms have been donated, or on average about 12 structures per year. Texas’s Rigs-to-Reefs program started in 1990, and since this time about 154 structures have been donated, or about six structures per year. A summary update of the Louisiana and Texas reef programs is provided, along with recent changes in legislative activity. Donation trends and statistics are reviewed. The Rigs-to-Reefs programs are unlikely to see donation activity above historic levels, and both programs should start planning for a future where the income generated from future projects diminishes.     

Phosphorus deficiencies invoke optimal allocation of exoenzymes by ectomycorrhizas

Ectomycorrhizal (EM) fungi can acquire phosphorus (P) through the production of extracellular hydrolytic enzymes (exoenzymes), but it is unclear as to the manner and extent native EM fungal communities respond to declining soil P availability. We examined the activity of six exoenzymes (xylosidase, N-acetyl glucosaminidase, β-glucosidase, acid phosphomonoesterase, acid phosphodiesterase [APD], laccase) from EM roots of Pseudotsuga menzesii across a soil podzolization gradient of coastal British Columbia. We found that APD activity increased fourfold in a curvilinear association with declining inorganic P. Exoenzyme activity was not related to organic P content, but at a finer resolution using ³¹P-NMR, there was a strong positive relationship between APD activity and the ratio of phosphodiesters to orthophosphate of surface organic horizons (forest floors). Substantial increases (two- to fivefold) in most exoenzymes were aligned with declining foliar P concentrations of P. menzesii, but responses were statistically better in relation to foliar nitrogen (N):P ratios. EM fungal species with consistently high production of key exoenzymes were exclusive to Podzol plots. Phosphorus deficiencies in relation to N limitations may provide the best predictor of exoenzyme investment, reflecting an optimal allocation strategy for EM fungi. Resource constraints contribute to species turnover and the assembly of distinct, well-adapted EM fungal communities.Subject terms: Ecology, Microbial ecology