Sarcoid heart disease

Myocardial sarcoidosis is not a rare disease in the UK and it is still probably under-diagnosed. A high index of suspicion in necessary for diagnosis of myocardial sarcoidosis, which should be thought of in any unusual form of heart disease for which there is no adequate explanation, particularly if there are serious rhythm changes or unexplained heart failure. Mitral systolic murmurs occur frequently. Histological proof of the aetiology should be sought. The heart is frequently massively involved when other organs have little involvement. Most of these patients present with cardiac symptoms or signs and the high incidence of sudden death is disturbing. The high rate of occurrence in East Anglia is noted, and merits further study. Treatment should be energetic where indicated--but its effects are difficult to assess. This study, representing the largest single source of information on this topic, continues in the hope of shedding more light on a sinister disease.

Effect of remaining family members on fatness prediction

As shown first by stepwise multiple correlations and then by family "sets" the probability that a parent or a child will be obese is a direct function of the fatness level of remaining family members. For a four-member nuclear family the probability that one member will be obese is well below chance expectancy (i.e., 12.6%) if the remaining three members are all lean and far higher (i.e., 40.7%) if the remaining family members are all obese. While mothers follow family line fatness expectancy, there is an excess of obese mothers in lean nuclear families, consistent with the inverse relationship between adult female fatness and socioeconomic status.

Persistent lone atrial fibrillation--its prognosis after clinical diagnosis

Eighty-three patients whose atrial fibrillation appeared to be permanent and the sole cardiac abnormality at the time of diagnosis were followed for one to 19 years (mean 7.5 years). None suffered systemic embolism. Three died, none of cardiac disease. Sinus rhythm returned in seven. Another six developed features suggestive of other heart disease. In the remaining 67, the initial diagnosis of persistent lone atrial fibrillation remained tenable and they remained well.The medium-term prognosis for patients with this disorder seems good.

Level of education, level of income, and level of fatness in adults

Socioeconomic status is systematically related to the level of fatness, and therefore the incidence of obesity, in a total community survey of nearly 5,000 adults. Among males with more than 12 years of schooling, the average thickness of 4 fatfolds is 10% greater, amounting to about 2 kg of total fat, than those with 8 years or less of education. In females, however, the opposite trend is observed, those in the higher educational group averaging 20% thinner fatfolds, or about 5.5 kg total fat, than females in the lower educational group. These findings confirm the need for standards of obesity that take socioeconomic status into account.

Similarities between parents and their adopted children

As show in 7,230 parent-child pairs (6,726 biological and 504 adoptive), adoptive parents and their adopted children tend to resemble each other in height, weight and fatfolds to an extent paralleling height, weight and fatfold resemblances of natural (biological) parents and their children. Accordingly, the magnitudes of parent-child resemblances commonly given may not be indicative of the extent of heritability of stature, weight and subcutaneous fat.

Intravenous urography in investigation of hypertension

Eighty intravenous pyelograms, carried out as part of the routine investigation of hypertension, revealed only one unsuspected renal lesion of possible relevance to the long-term management. Such a low therapeutic return, in the light of its cost and not entirely negligible risk, raises doubts about the place of excretion urography amongst the screening tests aimed at discovering tractable underlying causes of hypertension.

Investigation of the transport of metals and orthophosphate away from a sewage treatment plant outfall

The distribution of O2, chlorophyll a, alkalinity, phosphate, Ca, Mg, Mn, Fe, Cu, Zn, Cd and Pb has been measured in the discharge plume of the large sewage treatment plant on Back River, Maryland. The concentrations of phosphate and the trace metals decrease downstream more rapidly than can be accounted for by conservative dilution. Solubility calculations suggest that saturation with respect to phosphate or oxyhydroxide phases could limit the mobility of phosphate, Fe, Mn, and Pb. For Cu, Zn, and Cd, saturation is not a feasible control mechanism, and other processes such as biofixation or adsorption are probably involved.

Mitral valve disease, systemic embolism and anticoagulants

Over a period of 9½ years patients in East Anglia with mitral valve disease not requiring immediate surgery have been followed.

There has been a high incidence of systemic embolism before the patients are referred.

Long-term treatment with anticoagulants appears to offer a good degree of protection to these patients and, provided the control of the treatment is good, the risks arising from it are small and less than the risks of embolism.