No evidence of endothelial dysfunction in patients with Alzheimer's disease

In view of accumulating evidence of vascular pathology in Alzheimer's disease (AD), we tested the hypothesis that AD patients have impaired endothelial function. This was assessed using the technique of strain-gauge venous occlusion plethysmography, which measures forearm blood flow (FBF). Intra-arterial (brachial) infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) was used to assess local endothelial dependent and independent responses, respectively. There was no difference in the basal FBF of patients and controls. ACh and SNP caused dose-related increases in FBF from baseline, but no difference was recorded between the AD and control group. This study provides no evidence of endothelial dysfunction in the systemic circulation of patients with AD.

A comparative analysis of the SF-12 and the SF-36 among ischaemic heart disease patients.

This paper investigated whether the SF-12 could replace the SF-36 in the measurement of health status among ischaemic heart disease patients. The SF-36 and SF-12 were administered to 105 cardiac patients. The SF-36 summary scores were strongly correlated and similar to the SF-12 summary scores. Also, the SF-12 scores were as powerful as the SF-36 summary scores in discriminating between subgroups of patients categorized according to their self-reported health status or angina classification. It is suggested that when there is a need to collect routine information about cardiac patients' general physical and mental health, the SF-12 is preferable to the SF-36 because of its brevity and acceptability to patients.

Qutting and restarting smoking: cohort study of patients with angina in primary care

Objective To examine variations in self-reported smoking habit among a cohort of individuals with chronic coronary heart disease over a five year period. Design Cross-sectional cohort; interviews at baseline, 2 years and 5 years. Setting Primary care. Participants A cross-sectional sample of 688 patients previously diagnosed as having angina, identified from 18 general practices in the Greater Belfast Area; a cohort of 487 were followed for five years. Outcome measures Changes in self-reported smoking habits; breath carbon monoxide measurement. Results Initially 92 of the 487 participants (19%) reported smoking, 34 (27%) subsequently reported non-smoking. Of the 395 self-reported non-smokers at baseline, 21 (5%) subsequently reported smoking. The prevalence of self-reported smoking amongst the cohort was 19% and 15% at two and five years respectively. However, changes in reported smoking habits indicating periods of abstinence and resumption were reported by 55/487 (11%) participants. Of the 21 non-smokers who changed their report, 20 had smoked previously, five reported having stopped for less than one year but nine for more than five years. Of the initial sample twice as many smokers as non-smokers had died by 2 years (10% v 5%; p

Modelling the flow of congestive heart failure patients through a hospital system

The number of hospital admissions in England due to heart failure is projected to increase by over 50% during the next 25 years. This will incur greater pressures on hospital managers to allocate resources in an effective manner. A reliable indicator for measuring the quantity of resources consumed by hospital patients is their length of stay (LOS) in care. This paper proposes modelling the length of time heart failure patients spend in hospital using a special type of Markov model, where the flow of patients through hospital can be thought of as consisting of three stages of care—short-, medium- and longer-term care. If it is assumed that new admissions into the ward are replacements for discharges, such a model may be used to investigate the case-mix of patients in hospital and the expected patient turnover during some specified period of time. An example is illustrated by considering hospital admissions to a Belfast hospital in Northern Ireland, between 2000 and 2004.