A six question screen to facilitate primary cardiovascular disease prevention

Background: European guidelines on primary prevention of cardiovascular disease (CVD) recommend the SCORE risk charts for determining CVD risk, which include blood pressure and serum cholesterol as risk parameters. To facilitate cost-effective large-scale screening, we aimed to construct a risk score with 'non-invasive' parameters as a first screening step to identify persons at increased CVD risk requiring further risk assessment. Methods: We used data of Dutch employees from 25 organisations participating in a health risk assessment between August 2007 and January 2013. Backward multivariate logistic regression analysis was employed to select non-invasive, independent predictors of high CVD risk, defined as the 10-year risk of fatal CVD of ≥5 % based on the SCORE formula. The total CVD risk score was calculated as the summed coefficients of the retained variables. Results: Data of 6189 male participants was used for the development and validation of the risk score. Age, tobacco use, history of hypertension, alcohol consumption, BMI, and waist circumference were independent predictors of high CVD risk. Ten-fold cross-validation resulted in an area under the curve of 0.95 (SE 0.01, 95 % confidence interval 0.94-0.96). A cut-off score ≥45 on the CVD risk score yielded a sensitivity of 0.93, and a specificity of 0.85. Conclusions: We developed a simple, non-invasive risk score that accurately identifies persons at increased CVD risk according to the SCORE formula in a population of working men. The risk score enables a stepwise approach in large screening programmes, strongly reducing the number of persons that require full risk estimation including blood pressure and cholesterol measures

Spierzwakte of -verstijving door hereditaire kanalopathieën

Three men, aged 36, 16 and 66 years, had suffered for several years from muscular weakness; after a low serum potassium level had been established, supplementary examination revealed hypokalaemic periodic paralysis. A woman aged 25 had suffered since youth from muscular stiffness on sudden movements; she suffered from hereditary myotonia of the recessive type (Becker's disease). Both rare skeletal muscle ion channel diseases are characterized by the fact that the variable clinical expression complicates making the diagnosis. Since the causal mutations are known, genetic analysis is an essential step in confirming the diagnosis. Additional EMG procedures may be of diagnostic value, even in cases that cannot be clarified genetically

Supernormal muscle fiber conduction velocity during intermittent isometric exercise in human muscle

Muscle fiber conduction velocity (MFCV) and surface electromyographic parameters were studied in the brachial biceps muscle of healthy males during voluntary intermittent isometric contractions at 50% of maximum force. Recovery in the following 15 min was then observed. The measurements were performed during duty cycles of 33, 25, and 20%. The main finding was a supernormal MFCV during the exercise phase when the duty cycle was 25 and 20%. The level continued to increase during the recovery phase. During the exercise phase when the duty cycle was 33%, the MFCV decreased slightly (suggesting that the local anaerobic threshold had been surpassed) but increased during recovery to supernormal values. The ratio of median frequency to MFCV was constant during all experiments, indicating that the changes in median frequency reflect those in MFCV. We suggest that the supernormal MFCV was due to a combination of altered membrane properties, muscle fiber swelling, and temperature increase and hypothesize that the changes of electrical properties formed part of an adaptive mechanism of the muscle fiber membrane during exercise. In that respect, the increase of the MFCV could be a component of the well-known warm-up effect

Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: results of an open-label study

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