Speciation of beryllium, nickel, and vanadium in soil samples from Csepel Island, Hungary.

Sequential leaching methods have been used for the speciation of Be, Ni, and V in five soil samples from Csepel Island on the Danube river located near an oil-fired power plant. The concentrations of the elements of the extracts were determined by inductively coupled plasma mass spectrometry. The total efficiency (the sum of the extracted metals divided by metal fraction which is soluble in aqua regia) of the five-step method was always higher. The difference for Ni was considerable, because of the high abundance of Ni found in the moderately reducible fraction, which is absent from the three-step method. The sum of the mobile species (exchangeable, carbonatic, and easily reducible) determined by both methods, were in reasonable agreement; this was not so for the individual fractions. There were greater differences between the non-mobile fractions (moderately reducible and oxidizable), because of the presence or absence of the moderately reducible fraction. For both methods there was good correlation between the oxidizable fraction and the organic matter content of the soils.

Combined use of non-invasive techniques to predict pulmonary arterial pressure in chronic respiratory disease.

The value of non-invasive procedures for predicting pulmonary arterial pressure was investigated in 370 patients with chronic obstructive lung diseases and in 73 with fibrosing alveolitis in a combined study at nine centres in six European countries. Measurements included forced expiratory volume in one second, arterial blood gas tensions, standard electrocardiogram, radiographic dimensions of pulmonary artery, right ventricle dimensions by M mode echocardiography, and myocardial scintigraphy with thallium-201; and certain clinical signs were also used. No single variable was correlated closely enough to allow accurate prediction of pulmonary arterial pressure. Four methods were used to incorporate several variables into mathematical functions for predicting pulmonary arterial pressure. In patients with chronic obstructive lung disease multiple stepwise regression explained 49% of the variance in pulmonary arterial pressure but was not useful for prediction. Discriminant analysis allowed patients to be allocated to bands of pulmonary arterial pressure, as did two non-parametric procedures, in which decision trees were established using either the Kolmogoroff-Smirnoff statistic or Fisher's exact test. Patients with a pulmonary arterial pressure of 30 mm Hg or more were identified with a sensitivity of 83% and a specificity of 91%. The non-parametric tests gave better results than discriminant function. A further 54 patients were studied to validate the functions. Of these, 90% with a pulmonary arterial pressure above 20 mm Hg were correctly identified, and 80% of those with a pulmonary arterial pressure above 29 mm Hg. Similar results were obtained in subjects with fibrosing alveolitis. These mathematical functions allow the use of combinations of non-invasive procedures to select from populations at risk of pulmonary hypertension those in whom direct measurement is required. The mathematical functions are capable of further development by incorporation of variables from newer non-invasive procedures.

Prediction of stable high blood pressure in adolescents.

We studied the relative importance of the initial BP and associated factors in adolescents to predict stable high BP. Out of 17,634 children aged 12-13 yrs an upper group/the upper 5% of the distribution curves for both SBP and DBP/a lower group/10% random from the remainder/were yearly followed for 4 yrs/boys: 1680, girls: 1643/. About 2/3 of children remained at the same percentile point: less than 30% and greater than or equal to 70% of SBP and half of them of DBP distribution. Significant positive tracking correlations were found both for SBP and DBP between the initial BP and follow-up BP readings in the same individual. Stepwise regression analysis showed that the SBP taken at the fourth follow-up can be explained by 29% in boys, 24% in girls on the basis of screening SBP and by 47% in boys, 42% in girls on the basis of SBP measured at the four previous examinations. Using discriminant analysis, 6-9 variables out of 18 studied could correctly allocate adolescents with stable SBP or DBP/less than 70% or greater than or equal to 70% at least 3 examinations/. Our study shows the importance of initial BP and a number of factors associated with stable high BP.

Factors associated with stable high blood pressure in adolescents.

Our aim was to study the relative importance of the factors associated with stable high blood pressure (BP) in adolescents. Out of 17 634 children born in 1964 and screened in 1977, two samples, an upper group [the upper 5% of the distribution curves for both systolic (SBP) and diastolic (DBP) blood pressures] and a lower group (a 10% random sample from the remainder), were chosen for yearly follow-up (1680 boys and 1143 girls) from 1978 to 1981. A multiple logistic function was used to analyse the factors associated with stable high SBP and DBP (with at least three different measurements of BP at or above the 95th percentile). Different sets of variables were studied. Of the boys with stable high SBP, 55% were found in the upper quintile of risk distribution when Quetelet's index was taken into consideration, 63% when Quetelet's index + age + heart rate+sexual maturation, 67% when Quetelet's index + age + heart rate + serum uric acid and 74% when Quetelet's index + age + heart rate + cardiothoracic index + heart volume index were taken into consideration. Of the girls with a stable high SBP, 68% were found in the upper quintile of risk distribution when any of the following variables was added to Quetelet's index + age + heart rate: R and S waves, serum cholesterol or post-load blood sugar. Similar but smaller effects of associated factors on DBP were observed. Our study shows that Quetelet's index and heart rate are the most important factors associated with stable high BP in adolescents.

Risk factors for coronary heart disease in rural Hungary.

This is a ten-year study of a cohort of 1088 Hungarian men aged 40-59 at entry, with a 99% baseline response rate and complete ascertainment of cases and follow-up. The methods were state of the art for the period the survey was performed, with quality control for standard procedure and training. Zero, five- and ten-year examinations were carried out and standard risk factors measured and analysed in relation to the ten-year experience, ie, age, blood cholesterol, blood pressure, smoking, body mass, vital capacity, and skinfolds. Risk factor levels were high relative to the Mediterranean and Oriental populations in the Seven Countries Study. The five-year coronary heart disease rates were intermediate between the low rates in Yugoslavia and Greece and high rates in Finland. Ten-year events were significantly and linearly related to quintile values of serum cholesterol and of 3, 4, 6, and 9 risk factors in the Walker-Duncan logistic model. Discrimination was not substantially improved beyond three factors apart from age. The maximal prediction concentrated 62% of events in the upper 20% of multifactor risk, and up to 80% in the upper 40% of risk. The authors conclude, from this separate but comparable study to the Seven Countries Study, that the results are not greatly different from that study or from the US Pooling Project. Unique features of the study, and its results, are the eastern European population, the absence of a strong CHD relationship with smoking, and the strong independent relationship with body mass.

International collaborative study on juvenile hypertension. 1. Study procedures and screening data.

The study procedures and the results of blood pressure screening from 8 centres are reported. Data are also presented on age, sex, sexual maturity for girls, height, weight, Quetelet's index, smoking, and use of antihypertensive drugs for 92.1% of the 18 609 children born in 1964 in the 8 districts and surveyed in 1977. The girls who had reached sexual maturity had the highest means for blood pressure, height, weight, and Quetelet's index. The proportion of girls who had attained menarche differed geographically. Certain differences were found among the 8 centres in the variables measured, but when age-specific comparisons were made most of the differences in the variables disappeared. Nevertheless a lower systolic blood pressure and height and a higher pulse rate were observed in Havana, Cuba, than in the European cities. Using multivariate analysis, height, weight, pulse rate, age at survey, and sexual maturity together explained somewhat less than 20% and 10% of the variation of systolic and diastolic blood pressures, respectively. These screening data provide a baseline for a longitudinal study that will continue until 1982.

Clinical-pharmacological evaluation of a new beta blocker, GYKI-41099 (tobanum).

The acute and chronic circulatory effects of a new beta adrenergic blocking drug, dl-1-(2,5-dichlorophenoxy)-3-tertiary-butylamino-2-propanol hydrochloride, GYKI-41099, have been assessed in patients with hyperkinetic circulation/or mild hypertension. The acute effects of GYKI-41099 2.5, 5 and 10 mg have been compared with those of propranolol 10, 20 and 40 mg using a cross-over design in 18 patients with elevated cardiac index. Each dose of both drugs produced a significant reduction in sitting and exercise heart rate. The potency of GYKI-41099 compared with propranolol proved to be 3:1. 13 patients with hyperkinetic circulation on GYKI-41099 5-15 mg daily for 2 months exhibited a significant reduction in resting heart rate and cardiac index. In 13 patients with mild hypertension the drug exerted marked antihypertensive effect. Side effects were minimal and short-lived.

Incidence and fatality of acute myocardial infarction in the community.

The incidence rate for acute myocardial infarction (AMI; diagnostic categories "definite AMI" + "possible AMI" + "insufficient data"), defined as number of cases per 10 000 population (20 years and older) and year, are highest in Berlin, GDR (63 for males, 42 for females), intermediate in Budapest (46/22) and lowest in Warsaw (38/21). In Budapest and Warsaw younger and middle-aged men suffer more frequently from AMI than in Berlin, while in the GDR capital AMI is more frequent in older men and women. In younger and middle-aged groups AMI occurs in women ten years later than in men. After standardization for age, the AMI incidence rates are not significantly different between Budapest and Warsaw, but are significantly higher in Berlin, particularly for older women. The standardized fatality rates of AMI (percentage of cases died within 28 days from all cases) for males were equally high for Berlin and Budapest (each about 50%), but in Warsaw significantly lower (42%). For females they are significantly highest in Berlin (69%), intermediate in Budapest (57%) and significantly lowest in Warsaw (40%). This is due mainly to an excess fatality within the oldest groups in the Berlin Register.