'Public health status and perspectives' 1997. II. Developments in health status]

As a part of the report 'Public health status and forecasts' 1997 recent developments in the health status of the Dutch population and its determinants are described. Developments until the year 2015 are forecast on the basis of expected demographic and epidemiologic trends, according to expert opinions. Important findings are the unfavourable trends in lifestyle factors in adolescents and the expected increase by 25-60% in 2015 of the prevalence of diseases of old age like cancer, cardiovascular diseases, diabetes mellitus, dementia, chronic nonspecific lung diseases, visual and hearing impairments and diseases of the locomotor system.     

'Public health status and perspectives' 1997. I. Introduction

The 'Public health status and forecasts' 1997 presents a comprehensive and integrated overview of health, disease and health care in the Netherlands, to which more than 250 experts contributed. On the basis of the findings, policy recommendations are formulated regarding target groups, planning, prevention, health care, monitoring and research.     

Current status of laser therapy in dermatology]

Indications for dermatological laser therapy have been enlarged during the last few years. In this article the physics and biophysics of laser therapy and the common laser systems in dermatology are described. Modern pulsed laser systems are combined with little side effects. Nevertheless, successfully used alternative methods should not be neglected.     

'Public health status and perspectives' 1997. IV. Health status and life expectancy weighted

The construction of composite measures of population health status meets the need to combine data on mortality and morbidity into one single population health index. Such indices can serve in principle to monitor population health status over time, or as support for the allocation of resources. In the framework of the 'Dutch public health status and forecasts report' for 1997 several calculations, new for the Netherlands, are made along the lines of both the 'health expectancy and the 'disability-adjusted life years' (DALY) concepts.     

'Public health status and perspectives' 1997. III. Health inequalities in the Netherlands

The theme report 'Health inequalities' of the Dutch 'Public health status and forecasts' 1997 indicates that there are substantial health inequalities between population groups in the Netherlands, most notably with respect to socioeconomic status, but also in respect to other sociodemographic characteristics. It is expected that the numbers of people in several of these disadvantaged groups will increase. Improving the health status of disadvantaged groups can therefore theoretically produce great health gains.     

Exercise testing and exercise rehabilitation for patients with peripheral arterial disease: status in 1997

The reactions of 2-acetylpyridine N(4)-methyl, (HAc4Me) N(4)-ethyl (HAc4Et) and N(4)-Phenyl (HAc4Ph) thiosemicarbazone with palladium(II) were studied. The ligands and the palladium(II) complexes have been characterized by spectroscopic techniques. The structure of [Pd(Ac4Me)Cl] has been determined by single-crystal x-ray diffraction. The protonation constants of HAc4Me and HAc4Et, Ka1 and Ka2, were determined by spectrophotometry. The effect of palladium compounds on DNA synthesis of P388 and L1210 cell cultures is also reported. Some of these compounds increased the life span of mice bearing tumors.     

The sensitivity of 11 substance abuse scales from the MMPI to change in clinical status.

Evaluated the sensitivity of 11 scales (for the identification of individuals prone to substance abuse) from the Minnesota Multiphasic Personality Inventory (MMPI) to current substances abuse. 137 male substance abusers (aged 21–57 yrs) took the MMPI within 48 hrs of admission to a hospital and after 4 wks. Inpatient treatment and abstinence did not result in reliable increases in scores on any substance abuse scales. Therefore, these scales did not appear to be appropriate measures of change as a result of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The adjunctive usage of botulinum toxin

BACKGROUND: Botulinum toxin is a safe, helpful adjunct to many other treatments for facial rejuvenation. Used together, the final result is more polished and refined. In addition, botulinum toxin can be used to maintain the surgical laser results by preventing dynamic facial muscular action re-establishing expressive wrinkles and folds. OBJECTIVES: We describe the facial areas best treated with botulinum toxin and our adjunctive techniques so that the cosmetic physician can easily incorporate these into their practice. RESULTS: The aesthetic results are improved with the combination of botulinum toxin and the surgical or laser procedure over either modality alone. CONCLUSIONS: We believe that there are many new treatment options for combined therapy with botulinum toxin, laser resurfacing, and surgical procedure in periocular and facial rejuvenation that the aesthetic physician can easily incorporate into their practice.     

Evaluation of acute mental status change in the nonhead injured trauma patient

Acute mental status change in the first 24 hours after trauma is uncommon in nonhead injured patients who initially present with a normal sensorium. Although arterial hypoxemia is the classic etiology for such a mental status change, three less common etiologies should always be considered: cerebral fat embolism, blunt carotid artery injury, and vertebrobasilar artery thrombosis. Prompt diagnosis and appropriate treatment can significantly improve patient morbidity and mortality. Three nonhead injured trauma patients are described illustrating cerebral fat embolism, blunt carotid artery injury, and vertebrobasilar artery thrombosis as causes of acute mental status change. Each patient initially presented with a clear sensorium, but subsequently developed neurological deficits within 24 hours after admission. All had a normal admission CT scan of the head. MRI or conventional arteriography was diagnostic in each case. Any patient who is initially lucid and subsequently develops a neurological deficit, or a patient whose neurological status does not correlate with brain CT findings should undergo immediate evaluation for possible cerebral fat embolism or cervical vessel injury. An algorithm for management of nonhead injured trauma patients with acute mental status deterioration is presented.     

The genetics of alcoholism: 1997

The relationship between trunk muscle morphology as measured on transverse magnetic resonance images and isokinetic lifting, psychophysical lifting, and static back muscle endurance testing was examined in 110 men, ages 35-67 years (mean, 48 years), who had been chosen based on their exposure to a wide variety of occupational and leisure-time physical activities. The computed T2-relaxation times and the T2-weighted and proton density-weighted signal intensities of the erector spinae, quadratus lumborum, and psoas major muscles had almost no association with any of the strength tests. The cross-sectional areas of the muscles had good correlations with isokinetic lifting strength (r = 0.46-0.53). They did not correlate well with psychophysical lifting and static back muscle endurance. Other characteristics or neurological or psychological factors may have more influence on those tests.     

Self-concepts and self-concept change: A status dynamic approach.

In this article, a new formulation of the self-concept and of self-concept change is presented. The article comprises the following parts: (a) a status dynamic conceptualization of the self-concept; (b) a delineation of the self-concept's many implications for the quality of persons' lives; (c) an analysis of why self-concepts tend not to change in the face of disconfirming evidence; (d) logical and empirical justifications for preferring the present formulation to existing alternatives; and (e) a presentation of core therapeutic approaches to modifying self-concepts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ultrastructural change of enamel exposed to a normal pulsed Nd-YAG laser

Most discussions on modern research ethics--particularly the formation of research ethics committees (institutional review boards)--focus on the revelations of the dreadful practices in the Nazi concentration camps at the Nuremberg trial after the second world war, with the subsequent production of the Nuremberg and Helsinki Codes. In fact, however, these trials were not pivotal: there was a long history of such concerns, going back at least to the 1830s, when William Beaumont introduced a contract with his patient Alexis St Martin, as well as the later part of the century when the celebrated leprosy worker Hansen was prosecuted in Bergen for having experimented on a patient without her consent, losing his post as a result. Probably, had it not been for the entry of the USA into the First World War, public indignation at the growing number of reports of unethical experimentation in public hospitals would have resulted in regulations, while official codes were introduced in Prussia at the turn of the century and in Berlin again in 1931. Nevertheless, the impetus for modern developments came principally from the furore aroused by the proselytising of two physicians: Henry Beecher, an anesthesiologist at Harvard, and Maurice Pappworth in London, whose respective books Experimentation in Man and Human Guinea Pigs, documented case histories of egregiously less than ethical research practices that went largely unquestioned by other clinical research workers. Here I shall discuss the reactions to and influence of some of these episodes, as well as more recent developments.     

The GDB Human Genome Database Anno 1997

MMP-9 (gelatinase B) and urokinase-type plasminogen activator receptor (u-PAR), which are involved in cancer cell invasion and metastasis, are reported to be predominantly expressed by immune/inflammatory cells in human colorectal cancers. To investigate their significance in cancer progression, we morphometrically analyzed the tissue expression of MMP-9 and u-PAR among different stages of colorectal cancer. The numbers of MMP-9- and u-PAR-positive cells along the invasive margin were significantly smaller in cases with liver metastasis than in cases without liver metastasis, and were also smaller in cases with an infiltrating margin than in cases with an expanding margin. Both variables were larger in colon cancer cases with conspicuous lymphocytic infiltration. These results indicated that the degree of tissue expression of MMP-9 and u-PAR by host cells is inversely associated with liver metastasis and an infiltrating growth pattern in human colorectal cancers. Essentially the same results were obtained for the number of macrophages distributed along the invasive margin. We also found that the expression pattern of MMP-9 was similar to that of MMP-8 (polymorphonuclear leukocyte collagenase). These data are consistent with clinicopathologic studies of host cells. Therefore, our data suggest a dual role of MMP-9 and u-PAR expression in colon cancer tissue; i.e., not only are these proteinases cancer-promoting factors, but also they are related to the host defensive mechanism when they are expressed by host cells.     

Intraoperative radiotherapy in 1997

Codon usage bias of 1,117 Drosophila melanogaster genes, as well as fewer D. pseudoobscura and D. virilis genes, was examined from the perspective of relative abundance of isoaccepting tRNAs and their changes during development. We found that each amino acid contributes about equally and highly significantly to overall codon usage bias, with the exception of Asp which had very low contribution to overall bias. Asp was also the only amino acid that did not show a clear preference for one of its synonymous codons. Synonymous codon usage in Drosophila was consistent with "optimal" codons deduced from the isoaccepting tRNA availability. Interestingly, amino acids whose major isoaccepting tRNAs change during development did not show as strong bias as those with developmentally unchanged tRNA pools. Asp is the only amino acid for which the major isoaccepting tRNAs change between larval and adult stages. We conclude that synonymous codon usage in Drosophila is well explained by tRNA availability and is probably influenced by developmental changes in relative abundance.     

The change in employee loyalty

Employee loyalty affects company performance, competitiveness and ultimately the bottom line. Today, the old employment contract is null and void. Employee loyalty cannot be taken for granted; it must be fostered and cultivated. The new employment contract encourages participative decision making, career development, pay for productivity and flexible benefits.