In vitro responses of human asthmatic airway and pulmonary vascular smooth muscle

Airway and pulmonary vascular smooth muscle was obtained from the surgically resected lobe of a human asthmatic allergic to grass pollen who presented with an endobronchial carcinoid tumor. Grass antigen induced sustained contractions of bronchial and pulmonary vein, but not pulmonary artery tissue. Capsaicin did not alter the bronchial response to grass antigen. Contractions to leukotrienes B4, C4, D4 and E4 and methacholine were equivalent to those seen in nonasthmatic human lung tissue, whereas those to histamine were strikingly greater and disproportionate to methacholine. The C3a octapeptide Ala-Ala-Ala-Leu-Gly-Leu-Ala-Arg produced contractions of pulmonary vein and pulmonary artery. These findings are compared with those obtained using human lung samples from nonasthmatic individuals.

Professional flab fighting at district level

A health care planning team set up in Harrow to tackle the problem of obesity has started a slimming club with ten-week courses. Authors explain the club's methods and review its progress so far.

The psychological and social effects of myocardial infarction on wives

Eighty-two wives of men suffering a first myocardial infarction were interviewed while their husbands were in hospital, and again two months and a year after they went home. The wives had substantial and persistent psychological symptoms, and the husbands' illness had continuing effects on their work, leisure and social activities, and family life and marriage, their psychosocial disability being comparable to that of the patients. Measures of psychosocial adjustment before the illness and the quality of the marriage and of family life were good predictors of outcome for the wives. The women had a major role in the patients' readjustment during convalescence, and their attitudes and behaviour as well as the general quality of family life were important determinants of the rate and extent of the patients' recovery. The wives of patients with myocardial infarction should have more practical help and advice during the hospital period, and the whole family should be given advice and help throughout the convalescence.

Hospital-treated myocardial infarction and the general practitioner

Patients who had a myocardial infarction were interviewed with their spouses in hospital and after returning home. Advice about rehabilitation, such as that recently recommended by the Working Party of the Royal College of Physicians, was often not received. General practitioners have great opportunities for organising a graded programme of rehabilitation and may often communicate ideas more easily to their patients than hospital staff. However, some practitioners are reluctant to do this work.

Attitudes and advice after myocardial infarction

While medical opinion increasingly favours an active approach to rehabilitation after myocardial infarction, interviews with 40 patients and their relatives showed a low degree of understanding of medical advice and information. There was general satisfaction with treatment, but communication was seen as often being inadequate, vague, and conflicting.