Aspirin in the primary prevention of angina pectoris in a randomized trial of United States physicians

Article Abstract:

Angina pectoris is chest pain associated with myocardial ischemia, an insufficient supply of blood to the heart. An inadequate blood flow may result from narrowing of the blood vessels due to atherosclerosis, the accumulation of fatty plaques within the blood vessels. Several lines of evidence suggest that platelets, cells involved in blood clotting, may contribute to the atherosclerotic process. Studies show that low doses of aspirin help to prevent heart attacks, possibly by inhibiting thrombosis, the formation of blood clots. However, there is limited information concerning the effect of aspirin on the development of angina pectoris. The effectiveness of aspirin in preventing angina pectoris was assessed in 21,738 male physicians aged 40 to 84 years who were participants in the United States Physicians' Health Study. These subjects were free of angina when the study began, and were followed for an average period of 60.2 months. Half were assigned to take one aspirin every other day, while the other half took an inactive placebo. Of the entire group, 331 developed angina pectoris during the study, and 194 of them underwent either coronary artery bypass surgery or angioplasty, both of which improve the flow of blood to the heart. The risk of developing angina did not differ between the aspirin group and the placebo group (an equivalent proportion of each group developed angina). Thus, the inhibition of platelets with low-dose aspirin given for an average of 60.2 months did not reduce the incidence of angina pectoris. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prevention, Physiological aspects, Blood platelets, Aspirin, Angina pectoris

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Carbonless copy paper: a review of published epidemiologic studies

Article Abstract:

Carbonless copy paper (CP), a substitute for interleaved carbon paper, was introduced by the National Cash Register Company in the early 1950s. The types and numbers of solvents, developers, inks, papers, and workplaces where CP products are used have been alleged to contribute to a variety of allergic and other symptoms among workers. This extensive review of international epidemiologic studies, which deal with complaints from a single person to several thousand, addresses the possible adverse health effects of working with CP products. The authors also evaluate the reliability of the research designs used in previous studies. Complaints have included: dermatologic manifestations (itchy, burning rashes, eczema); eye, nose and throat involvement (runny nose and eyes, sore throat, hoarseness, sinusitis); pulmonary symptoms (coughing, wheezing, angioedema, shortness of breath); and other mucosal and systemic disorders. Studies have examined work sites and the conditions under which CP products were used, the components of the various products, CP produced by of different manufacturers, the actual complaints and the work site venues of their occurrence. Complaints of alleged adverse CP exposure were primarily reported from the United States, England and Scandinavia, principally Sweden. The conclusion of all the studies, at this point, is that no statistically significant association has been established between the reported symptoms and the use of CP. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Reproduction paper, Copy papers

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Randomized controlled trial of tissue plasminogen activator in proximal deep venous thrombosis

Article Abstract:

Tissue plasminogen activator (t-PA) is a drug used to dissolve blood clots blocking the major blood vessels that supply various organs and tissues of the body. Several reports have described the effectiveness of t-PA in treating thrombosis (existence of a blood clot) in leg or neck veins in both humans and experimental animals. Recombinant human tissue-type plasminogen activator (rt-PA) is a form of t-PA derived from man and artificially produced in large amounts. This form of t-PA was shown to be effective in treating clot formation within blood vessels of the heart and lungs. The effectiveness and safety of rt-PA, with or without the anticoagulant heparin, was assessed in 64 patients with deep vein thrombosis (DVT) of the leg. Clots were completely or more than 50 percent dissolved in ten of 36 patients treated with rt-PA, five of 17 patients treated with rt-PA and heparin, and none of the 12 patients given heparin alone. No lysis (dissolving) was observed in 16 of 36 patients treated with rt-PA and heparin and 10 of 12 patients treated with heparin alone. A nonfatal intracranial hemorrhage, or bleeding within the brain, developed in a patient receiving rt-PA alone. Thus, rt-PA with or without heparin produces more lysis than heparin alone, and heparin added to rt-PA does not further increase lysis or risk of bleeding. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Thrombosis, Heparin, Plasminogen activators, Fibrinolytic agents

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