Three patients with indications for percutaneous transluminal angioplasty of a totally occluded coronary artery also had distal opacification by a collateral vessel. The balloon catheter and guide wire were manipulated proximally through the guide catheter. With a second catheter, angiography of the collateral vessel opacified the occluded artery distal to the obstruction. In all three cases, simultaneous catheterization was safe and aided our assessment of distal vessel contour, length of occlusion, and the intraluminal position of the wire beyond the complete obstruction. We conclude that this technique may improve success rates for dilating chronic total obstructions by allowing safer manipulation of less flexible wires.

Angioplasty, Balloon↗

PubMedDate not supplied

The genetics of osteoporosis: vitamin D receptor gene polymorphisms and circulating osteocalcin in healthy Irish adults.

BACKGROUND: A relationship between bone turnover and the vitamin D receptor (VDR) genotype is reported in Australian subjects of UK-Irish descent. There is conflicting evidence of linkage between the VDR genotype and differences in bone mineral density. No such study has been carried out on a resident Irish population. AIMS: This study examined the relationship between serum osteocalcin (a marker of bone turnover) and VDR genotype in Irish adults. METHODS: One hundred and eighteen healthy Irish adults aged between 19 and 67 were recruited and had two fasting blood samples taken. One sample was analysed for osteocalcin by enzyme immunoassay. The other was used to isolate genomic DNA and determine VDR genotype. RESULTS: Tt was the most prevalent VDR genotype (53%) and tt (15%) the least prevalent in this group of healthy Irish adults. The tt VDR genotype was associated with significantly higher levels of serum osteocalcin (29% and 40%) than the Tt or TT VDR genotypes. CONCLUSIONS: These findings suggest that healthy Irish adults with the tt VDR genotype have higher rates of bone turnover than those with Tt or TTVDR genotypes. They may have a higher risk of low bone mineral density and osteoporosis in later life.

Adult↗

PubMedDate not supplied

Apolipoprotein E gene polymorphisms and serum cholesterol in healthy Irish adults: a proposed genetic marker for coronary artery disease risk.

BACKGROUND: The apolipoprotein (Apo) E gene, and thus its gene product, plays a central and pervasive role in lipid metabolism by serving as a ligand for lipoprotein receptors. Polymorphisms of this gene have been associated with variation in lipid phenotypes in some Caucasian and Asian populations, but not in others. No such study has been carried out in a resident Irish population. AIM: A study was designed to examine the relationship between serum cholesterols and Apo E genotype in a cohort of healthy Irish adults. METHODS: One hundred healthy Irish adults, aged 19-65 years, were recruited from the Cork City area. Two fasting blood samples were collected from each subject. One was assayed for serum cholesterols--total and low-density lipoprotein (LDL), and high-density lipoprotein (HDL)--while the other sample was used for isolation of genomic DNA and determination of Apo E genotype. RESULTS: While the E2 (12%) was the least prevalent, E3 was the most prevalent Apo E genotype (66%) in this group of healthy Irish adults. A significant Apo E gene-dosage effect was evident, whereby individuals with the Apo E2 genotype had a lower level of total cholesterol, E3 had intermediate levels, and E4 had a higher level. Moreover, those with the Apo E4 genotype had a significantly higher level of LDL cholesterol compared to E2 or E3 genotypes. There was no significant difference in mean serum adjusted HDL-cholesterol levels between the three Apo E genotypes. CONCLUSION: These findings suggest that healthy Irish adults with the Apo E4 genotype have higher serum total and LDL-cholesterol levels than those with E2 or E3 Apo E genotypes and therefore may have a higher risk of atherosclerotic coronary artery disease and coronary heart disease in later life.

Adult↗

PubMedDate not supplied

Trends and variations in perinatal mortality and low birthweight: the contribution of socio-economic factors.

OBJECTIVE: To examine trends and regional variations in perinatal mortality and low birthweight (LBW) and regional variations in socio-economic risk factors. METHODS: Population-based study of Central West Region of Ontario with approximately 28,000 births annually during the period 1988-1995 using vital statistics records and Census data. RESULTS AND CONCLUSIONS: There was no significant change in the perinatal mortality rate averaging 9.4 per 1,000 births per year. The LBW rate increased from 49.7 to 54.8 per 1,000, while the prematurity rate increased from 56.1 to 75.8 per 1,000. Significant variation occurred in outcomes among different regions, which was partially explained by socio-economic factors. The increases in LBW and prematurity rate emphasize the need for effective targeted services and programs. In their planning and implementation, regional variations in socio-economic factors, and other factors such as: the availability and utilization of services and barriers to access in services, require further evaluation and consideration.

Cause of Death↗

PubMedDate not supplied

Breastfeeding outcomes of women following uncomplicated birth in Hamilton-Wentworth.

OBJECTIVE: To examine infant feeding practices up to 8 weeks postpartum in Hamilton-Wentworth. METHODS: A cross-sectional survey of 227 women using a pre-discharge, self-administered questionnaire, medical record review and follow-up telephone interview. RESULTS: Breastfeeding initiation rate was 85%. By 6-8 weeks postpartum, 30% of women had stopped breastfeeding; 55% had switched to formula within the first 14 days. Infants who did not receive supplementation in hospital were 2.49 times more likely than infants who received supplementation to breastfeed for at least 6 weeks. Although 54% of mothers who initiated breastfeeding reported receiving formula gift packs, no association was found. CONCLUSIONS: The breastfeeding initiation rate appears to have increased in Hamilton-Wentworth since 1995. However, this study reinforces the need to address early cessation and infant supplementation, and raises concern about violation of the WHO/UNICEF International Code of Marketing of Breastmilk Substitutes through mailing of formula coupons.

Adult↗

PubMedDate not supplied

A systematic review of the relationship between breastfeeding and early childhood caries.

This systematic review investigated the relationship between early childhood caries (ECC) and breastfeeding. The systematic review methodology used by the Cochrane Collaboration was modified and adopted for this review. 28 of 151 articles (18.5%) were relevant for the study and were rated as strong (0), moderate (3), weak (9) or very weak (16). Validity scores indicated whether a study met the reviewer's criteria for research rigour. The percentage of studies that received a passing score for each criterion examined were: study design (3.6%), confounders (21%), data collection method (54%), definition of ECC (57%), dental health practices (28%) and infant feeding practices (4%). A lack of methodological consistency related to the study of the association of breastfeeding and ECC, and inconsistent definitions of ECC and breastfeeding, make it difficult to draw conclusions. Moderate articles indicate that breastfeeding for over one year and at night beyond eruption of teeth may be associated with ECC. Due to conflicting findings in less rigorous research studies, no definitive time at which an infant should be weaned was determined, and parents should begin an early and consistent mouth care regime.

Breast Feeding↗