Cortisol concentrations in blood and urine of horses.

A survey of the concentrations of cortisol in blood and urine samples taken from thoroughbred and standardbred horses after racing is presented. Statistical analysis showed the only significant difference between thoroughbred and standardbred horses was a higher cortisol concentration in thoroughbred urine. Urine volume and pH had no significant influence on the urinary cortisol concentration, however 9.5% of the urinary cortisol variation could be explained due to the influence of plasma cortisol concentration. The results of cortisol and ACTH administrations are also shown and compared with the survey results.

Diabetes and impaired glucose tolerance. A prevalence estimate based on the Busselton 1981 survey.

We have estimated the prevalence of diabetes and impaired glucose tolerance from the Busselton 1981 Population Survey using the 1980 World Health Organization (WHO) criteria. Standardized to the Australian non-Aboriginal population aged 25 years and over, the prevalence rates in this white community were 2.5% for known diabetes; 0.9% for newly discovered diabetes; 2.9% for impaired glucose tolerance; and 6.3% for all categories of abnormal glucose tolerance. There appears to have been a real increase in the frequency of diabetes since 1966. Using fasting serum C-peptide values and clinical criteria, 14% of all diabetic subjects were insulin-dependent. The male:female ratio for all categories of abnormal glucose tolerance was 1.4:1. Data from the United States indicate spectacularly higher rates for diabetes and impaired glucose tolerance in the white population. A national study of the prevalence of diabetes and impaired glucose tolerance in Australia is recommended. For epidemiological purposes, a single blood glucose value two hours after a 75 g oral glucose tolerance test is sufficient to categorize glucose tolerance as defined by WHO.

Cytological abnormalities of the cervix. Fifteen years' follow-up of a gynaecological cancer survey.

In a gynaecological cancer survey of 1026 women aged 21 years and over in May 1967, 74 women were found to have cervical cytological changes (designated as mild atypia in 71), which were followed to April 1982. No case of cervical cancer was found (0.3 were expected on the basis of population rates). Six women had had hysterectomies (6.2 were expected on the basis of rates of hysterectomy in the region of the survey). Reports on cervical smears taken since January 1, 1980, were available for 46 (75%) of 61 women who were alive and had not had a hysterectomy. Of these, 11 showed mild atypia; the remainder were within normal limits.

Q waves and ventricular extrasystoles in resting electrocardiograms. A 16 year follow up in Busselton study.

Isolated abnormalitites in the resting electrocardiograms of 1546 Busselton people with no history of angina or past myocardial infarction were examined in relation to 16 year mortality. Multivariate discriminate analysis in men showed significant independent relationship for Q waves with coronary heart disease and for ventricular extrasystoles with cardiovascular disease. In women multivariate analysis showed significant relations for ventricular extrasystoles with total mortality and coronary heart disease. There were higher trends in mortality for both men and women with frequent ventricular extrasystoles compared with those with infrequent ventricular extrasystoles.

Prolonged variability in plasma protein binding of disopyramide after acute myocardial infarction.

1 Disopyramide plasma binding was determined in vitro in plasma from 20 patients with acute myocardial infarction (aged 35-79 years) and in 20 age and sex matched healthy subjects. Plasma samples were collected on days 1, 5 and 12 after infarction and when the patient returned to the outpatient clinic. 2 In healthy subjects there was a significant negative correlation between disopyramide free fraction and plasma alpha 1-acid glycoprotein (AAG) concentration. A similar correlation was observed in the patients with myocardial infarction, however this correlation was dependent on time elapsed after infarction. Disopyramide free fraction did not correlate with albumin concentration in either group. 3 Mean plasma AAG concentrations were increased by 63% within 5 days after infarction and had returned to initial levels some months later (73.5 +/- 7.8 days). On each of the four sampling days, a two to four fold individual variability in plasma AAG concentrations was observed. 4 Maximum increases in disopyramide plasma binding were shown on days 5 and 12 after infarction. These increases were dependent on both drug and AAG concentrations. Increases in fraction bound were greater at the higher drug concentrations. Within the usual therapeutic plasma range for disopyramide (2 to 5 mg/l), the mean increases in fraction bound, compared to day 1 data, varied from 22 to 45% respectively. 5 Sequential alteration in AAG concentration after infarction indicates that disopyramide plasma binding may not reach a steady state until some months after infarction. Prediction of the time to achieve this steady state would be difficult due to inter- and intra-patient variability in binding.

Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia--13-year study.

The mortality of 1564 Busselton subjects has been studied from 1966-79 to determine whether risk factors for cardiovascular disease (CVD) and coronary heart disease (CHD) showed any change in emphasis compared with the Framingham Population Study of 20 yr previously. The Busselton analysis used subjects free of probable and suspect coronary heart disease at onset. In men aged 40-59, systolic blood pressure (SBP), forced expiratory volume (FEV), and serum cholesterol levels were significant independent determining variables for CVD mortality and cholesterol for CHD mortality, with SBP being related to CVD in men aged 60-74 yr. In women, there were few indicators of future vascular risk with no significant determining variable for CVD and CHD in 40-59 yr olds, but blood glucose and FEV were significant risk factors for CVD in women aged 60-74 yr. Cholesterol was unrelated to mortality in women but showed negative relationship with cancer in 60-74 yr old men. In total mortality, smoking in men and women, and obesity in women were significant risk factors; 1 hr serum insulin had a negative relationship in men aged 40-59 yr, and a stronger positive relationship in men aged 60-74 yr, but this may have been due to the close negative association of the variable with body size (i.e. height). More studies are required to ascertain whether glucose and insulin have an aetiological role in vascular disease.

Comparison of suicide rates and methods in English, Scots and Irish migrants in Australia.

A comparison was made of the suicide rates and methods for the period 1962-1971 of migrants in Australia from England and Wales, Scotland and Ireland with those in their country of origin. Suicide rates for all three migrant groups were very similar to each other, although greater than in their country of origin especially those for Eire. The data suggest that the official lower rates in Scotland compared with England and Wales are due to ascertainment differences. Similar conclusions were drawn regarding the official rates in Eire. Several hypotheses were raised regarding the influence of religion on suicide rates in Eire, Northern Ireland and Australia.

The relationship between suicide, undetermined deaths and accidental deaths in the Australian born and migrants in Australia.

Australian data pertaining to Suicide and Accidental Deaths (I.C.D.7) for the years 1962-69 are compared with those for suicide, undetermined deaths and accidental deaths (I.C.D.8) for 1968-71, specific for country of birth. The data strongly suggest that deaths classified as 'undetermined' after the introduction of that I.C.D. category in 1968, had been classified as accidental prior to that data, especially deaths from poisoning. There was some differential between the Australian and U.K. born and the European born. It was estimated that Australian suicide rates are possibly underestimated by 5-10% for males, and 10-20% for females by categorising some deaths from poisoning as being undetermined or accidental.

Suicide during 1961-70 migrants in Australia.

Rates and methods of suicide during 1961-70 migrants in Australia were compared with native born Australians. Large differences in both rates and methods of suicide were found in individual migrant groups. The rates were more akin to those in the country of origin than of the Australian-born, no matter how long the migrants had lived in Australia. By contrast, methods of suicide use by migrants approached more closely those of the Australian-born the longer they had lived in Australia. The change in methods used was greater in those migrant groups coming from countries with a language and culture more akin to those in Australia. A discussion follows of various possible sociological and cultural factors, both within the countries of origin and within Australia, which could have contributed to these results.

Alcohol and mortality in the Busselton study.

Non-smoking Busselton men and women who classed themselves in 1966 as non-drinkers had significantly higher 13-year mortality from all causes and from cardiovascular disease (CVD) compared with non-smoking drinkers. Such findings are the first to be reported in women. Smoking had no observed effect on the mortality of Busselton's non-drinkers, but in drinkers, smoking was associated with significantly higher mortalities from all causes CVD, CHD, and cancer compared with those of smoking non-drinkers. For all subjects, the recent prospective studies from Busselton and other selected populations have indicated that the lowest rates of total mortality have been found in those whose daily alcohol consumption ranged between 1-30 mls/day.

Electrocardiograms and 13 year cardiovascular mortality in Busselton study.

In 2119 unselected Busselton subjects 40 to 79 years of age, the 13 year mortality from cardiovascular disease was significantly higher in those whose initial electrocardiogram showed Q and QS patterns, left axis deviation, ST depression, T wave depression, flat or biphasic T waves, atrial fibrillation or flutter, and ventricular extrasystoles. In angina-free subjects whose electrocardiographic codes occurred in isolation from any other electrocardiographic abnormality, ventricular extrasystoles were associated with significantly higher mortality from cardiovascular disease compared with controls.

Final examinations in surgery: support for the retention of the clinical examination.

Students' results in the final M.B., B.S. (W.A.) examination in surgery between 1976 and 1979 inclusive (375 students) were analysed. Marks in all parts of the examination, namely clinical, multiple choice, essays, pathology, and fifth year multiple choice, were correlated with each other and the total mark in surgery. Multivariate analysis showed that the marks in the clinical examination accounted for most of the variation in a student's total mark, and this was only in part due to its heavy weighting in Western Australia. The authors of this paper strongly support the retention of the clinical examination in surgery and consider that the loading placed on this part of the final examination in Western Australia is justified.

Alcohol consumption and cigarette smoking in Busselton, 1966-1978.

In Busselton, mass health examination (MHE) questionnaires about alcohol consumption indicate that more people are drinking wine and fewer people are drinking beer. The evidence suggests an increase in the number of women consuming alcohol. The proportion of drinkers was higher among patients attending doctors with interests in wineries and/or vineyards compared with those patients attending doctors without such interests. More patients of doctors who smoked were smokers compared with those patient of doctors who were non-smokers. Smoking in Busselton appears to be declining at the rate of 0.5% to 1% of the population per annum; this decline is more marked in people who had attended one or more MHEs than in newcomers to MHEs. These trends have encouraged a more active approach to the prevention of smoking in school children.

Changing mortality due to strokes in men following treatment of Busselton hypertensives 1967-77.

Regular biennial health screenings of the Busselton population between 1966-75 resulted in the recognition of individuals with hypertension and a progressive increase in the adequacy of control of blood pressure in those on treatment. Between 1973-77 observed mortality from strokes (CVA) in males 50 yrs and over declined significantly as might be expected from the smaller numbers at risk from raised blood pressure. No favourable trends occurred in the incidence of CVA in women despite better control of hypertension. In the population as a whole, CVA mortality in untreated or inadequately controlled hypertensives was significantly greater than in normo-tensives or adequately controlled hypertensives.

Gastric mucosal damage by taurine and glycine conjugates of chenodeoxycholic acid.

Bile damage to gastric mucosa may be demonstrated by means of changes in the transmucosal movement of H+ and Na+ ions. In the present study pure 10 mM solutions of taurine and glycine conjugates of chenodeoxycholic acid were instilled into canine Heidenhain pouches. Solutions were prepared at pH 2, 4, and 8, as previous work had shown a greater damaging effect at low pH. The present study confirmed this pH effect, but only with respect to movement of Na+ ion for taurine conjugates. The magnitude of the changes in ionic movements was much greater with pure bile acid solutions than that seen previously with whole bile. These findings are discussed. The greater damage seen below the pKa of the bile acid conjugates suggests that its nonionized form is the more damaging.

Community control of hypertension.

The adequacy of treatment of hypertension in a community was monitored at triennial mass health examinations. Hypertensives were not adequately retained on treatment until a disease register was developed and a practice nurse given responsibility for maintaining contact with patients on the register. The advent of newer therapeutic agents and intensification of the interest of both doctor and patient in the results of treatment were associated with progressive improvement in the adequacy of control of blood pressure.