Effect of a public awareness campaign on the incidence of symptomatic objectively confirmed deep vein thrombosis: a controlled study

BACKGROUND

Although there have been attempts to raise public awareness about deep vein thrombosis (DVT), their influence on identifying confirmed cases is unknown.

OBJECTIVE

To determine the effect and its duration of a public awareness campaign about venous thromboembolism.

PATIENTS/METHODS

A campaign to raise public awareness of DVT was conducted during one year in an urban population of approximately 100,000 (pop A). A comparison urban population of approximately 1,574,000 (pop B) was not exposed to this campaign. Patients symptomatic for DVT in both populations were referred by general practitioners for a standardized compression ultrasound (CUS) of the whole leg at no charge. Positive CUS examinations documented by photographs were analyzed by an independent adjudication committee blinded to the population. Pop A was followed for 8 months after the information campaign ended.

RESULTS AND CONCLUSIONS

  Symptomatic objectively confirmed DVT was found in 48 of 800 subjects tested in pop A and 226 of 2384 tested in pop B. The 1-year incidence of confirmed DVT (proximal and distal) was 46/100,000 (95% CI, 33-59) in A and 14/100,000 (95% CI, 12-16) in B (P < 0.001). The increase in pop A was due to distal DVT (36/100,000 vs. 5/100,000 in pop B, P < 0.001). The DVT rate for pop A in an 8-month follow-up period was 12/100,000, significantly lower than in the first 8 months of the study period (34/100,000/8 months) (P = 0.001). The public awareness campaign significantly increased the diagnosis of distal DVT. When the campaign ended, DVT rates returned to community baseline.

Germline MSH2 and MLH1 mutational spectrum including large rearrangements in HNPCC families from Poland (update study)

Germline mutations in the DNA mismatch repair genes MSH2 and MLH1 account for a significant proportion of hereditary non-polyposis colorectal cancer (HNPCC) families. One approach by which development of an efficient DNA-testing procedure can be implemented is to describe the nature and frequency of common mutations in particular ethnic groups. Two hundred and twenty-six patients from families matching the Amsterdam II diagnostic criteria or suspected HNPCC criteria were screened for MSH2 and MLH1 germline mutations. Fifty different pathogenic mutations were found, 25 in MSH2 and 25 in MLH1. Twenty-four of these had not previously been described in other populations. Among our 78 families with MSH2 or MLH1 mutations, 54 (69.2%) were affected by recurrent mutations including 38 found at least twice in our own series. Two of the most frequent alterations were a substitution of A to T at the splice donor site of intron 5 of MSH2 and a missense change (A681T) of MLH1 found in 10 and eight families, respectively. Among large deletions detected by the multiplex ligation-dependent probe amplification assay, exon 9 deletions in the MSH2 gene were found in two families. Our results indicate that a screening protocol specific for the Polish population that is limited to the detection of all reported mutations will result in the identification of the majority of changes present in MLH1 and MSH2 genes in Polish HNPCC kindreds.

Background level of 8-oxo-2'-deoxyguanosine in lymphocyte DNA does not correlate with the concentration of antioxidant vitamins in blood plasma

Antioxidant vitamins, being effective free radical scavengers, can protect cellular DNA from oxidative damage. Therefore, in the present study we report on the relationship between basal level of 8-oxo-2'-deoxyguanosine in human lymphocyte DNA and the concentration of antioxidant vitamins (A, C and E). The average level of 8-oxo-2'-deoxyguanosine in lymphocytes of the studied group (15 males and 20 females) was 9.57 per 10(6) dG molecules. The endogenous level of ascorbic acid (vitamin C) in the plasma was, on average, 56.78 microM, while the mean concentrations of retinol (vitamin A) and alpha-tocopherol (vitamin E) were 1.24 uM and 25.74,uM, respectively. No correlations were found between individual 8-oxo-2 micro-deoxyguanosine levels in lymphocyte DNA and endogenous concentration of the vitamins.

Background level of 8-oxo-2'-deoxyguanosine in lymphocyte DNA does not correlate with the concentration of antioxidant vitamins in blood plasma

Antioxidant vitamins, being effective free radical scavengers, can protect cellular DNA from oxidative damage. Therefore, in the present study we report on the relationship between basal level of 8-oxo-2'-deoxyguanosine in human lymphocyte DNA and the concentration of antioxidant vitamins (A, C and E). The average level of 8-oxo-2'-deoxyguanosine in lymphocytes of the studied group (15 males and 20 females) was 9.57 per 10(6) dG molecules. The endogenous level of ascorbic acid (vitamin C) in the plasma was, on average, 56.78 microM, while the mean concentrations of retinol (vitamin A) and alpha-tocopherol (vitamin E) were 1.24 uM and 25.74,uM, respectively. No correlations were found between individual 8-oxo-2 micro-deoxyguanosine levels in lymphocyte DNA and endogenous concentration of the vitamins.

[Duodenogastric reflux in patients with irritable bowel syndrome treated with wheat bran]

The aim of this study was to estimate the influence wheat bran enriched diet on incidence of duodenogastric reflux and symptoms in patients suffering from irritable bowel syndrome with predominant constipation. Duodenogastric reflux was examined in 31 patients by means of the cholangioscintigraphy. The results of this investigation were compared with the symptom score before and after 12 weeks of treatment with wheat bran. The incidence of duodenogastric reflux was not decreased post bran consumption. Bowel dysfunction symptom score was significantly lower in both subgroups-with and without duodenogastric reflux. However dyspeptic symptom score was not significantly lower in these groups.

[Duodenogastric reflux in patients with functional dyspepsia]

In 66 patients with manifestations of functional dyspepsia and in nine volunteers duodenogastric reflux was studied by the cholangio-scintigraphic method. The results of the study were compared with the presence of the symptoms and sings and their intensity expressed in degrees, and with histopathological changes of gastric mucosa. In the symptomatic group the incidence of reflux was 42.4%. No reflux was found in the group of healthy volunteers. No relationship was demonstrated between duodenogastric reflux and the intensity of dyspeptic manifestations, nor between the reflux and the intensity of inflammatory changes in gastric mucosa.