Breast arterial calcification on mammography and risk of coronary artery disease: a SCOT-HEART sub-study.

AIM: To assess the prevalence of breast arterial calcification (BAC) in patients who also underwent routine surveillance mammography, and to determine the association with cardiovascular risk factors, coronary artery calcification, and coronary artery disease on coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Four hundred and five female participants were identified who had undergone CCTA and subsequent mammography in the SCOT-HEART randomised controlled trial of CCTA in patients with suspected stable angina. Mammograms were assessed visually for the presence and severity of BAC. RESULTS: BAC was identified in 93 (23%) patients. Patients with BAC were slightly older (63±7 versus 59±8 years, p<0.001), with a higher cardiovascular risk score (19±11 versus 16±10, p=0.022) and were more likely to be non-smokers (73% versus 49%, p<0.001). In patients with BAC, coronary artery calcification was present in 58 patients (62%; relative risk [RR] 1.26, 95% confidence intervals [CI]: 1.04, 1.53; p=0.02), non-obstructive coronary artery disease in 58 (62%; RR 1.27, 95% CI: 1.04 to 1.54, p=0.02), and obstructive coronary artery disease in 19 (20%; RR 1.62, 95% CI: 0.98, 2.66; p=0.058). Patients without BAC were very unlikely to have severe coronary artery calcification (negative predictive value 95%) but the diagnostic accuracy of BAC to identify coronary artery disease was poor (AUC 0.547). CONCLUSION: Although BAC is associated with the presence and severity of coronary artery calcification, the diagnostic accuracy to identify patients with coronary artery disease or obstructive coronary artery disease is poor.

RNP positivity in Maltese SLE patients.

The SLE database at the Rheumatology Clinic, St. Luke's Hospital currently includes 62 patients. The presentation, clinical features, ACR criteria and laboratory findings in RNP positive lupus patients [14] were compared to RNP negative subgroup [33]. RNP positivity was significantly associated with Raynaud's phenomenon (p < 0.01), myalgia (p < 0.02), myositis (p < 0.05), neuropsychiatric features (p < 0.05) and Sm positivity (p < 0.01). RNP positive patients had a higher frequency of positive family history, mortality, malar and maculopapular rashes, nail-fold infarcts, telangiectasia, digital vasculitis, photo-sensitivity, arthritis, pleurisy, pericarditis, pericardial effusions, depression, headache, psychosis and TIA.

Male SLE patients in Malta.

The SLE patient database at the Rheumatology Clinic, St. Luke's Hospital includes 62 patients, 58 of which have complete data. The patients were grouped according to sex (7 males vs 51 females). The presentation, clinical manifestations, ACR criteria and laboratory findings of the 2 groups were analyzed and compared. Serositis as the initial manifestation at presentation was significantly commoner in males (29% vs 2%; p < 0.05). Cardiorespiratory problems such as pleurisy, pericarditis, pericardial effusions and myocarditis were more frequent in the male subgroup. Female patients had more arthritis, myositis, neuropsychiatric manifestations (depression, psychosis and headache) anemia, leucopenia and ENA positivity than their male counterparts. All 6 mortalities recorded were in the female subgroup.

Pyridinium crosslinks excretion in patients with rheumatoid arthritis. Correlation with disease activity and glucocorticoid treatment.

In patients with rheumatoid arthritis, significant positive correlations were found between urinary pyridinium crosslinks and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and articular index. Also an inverse correlation was observed between pyridinium crosslinks excretion and grip strength. Glucocorticoid therapy, equivalent to daily doses of 7.5 mg of prednisolone or less, did not appear to have deleterious effect on bone metabolism in these patients as measured by urinary pyridinium crosslinks.

Paget's disease of bone in Malta. A preliminary survey.

We present the results of a preliminary survey carried out on 46 patients with Paget's disease of bone in Malta, 40 of whom were seen at a general medical outpatient clinic and a further 6 at a primary health care centre over the first 6 months of 1997. Various aspects of the disease have been analysed: prevalence, age and sex distribution, familial aggregates, mode of presentation, complications, pattern of bone involvement, a semi-quantitative assay of disease activity as assessed by bone scintigraphy and serum alkaline phosphatase (SAP) levels, and the factors that influenced disease activity. The results have been compared to previous published surveys on Paget's disease in different countries.

Incidence of salmonellosis in local hens' eggs.

Evidence indicates that outbreaks of salmonellosis may be due to infected eggs. This prompted a study on the incidence of salmonella in eggs. This study was done during summer 1991 and 900 eggs were examined in all. None of the eggs examined were found to be infected with salmonella. However, the result obtained should be treated with care and analysed with a critical eye. The result obtained does not imply that local flocks are not infected by salmonella.

Diffuse colonic varices: an uncommon cause of intestinal bleeding.

Varices of the colon are uncommon and when present they are usually segmental. The cause of these segmental varices is usually portal hypertension. Diffuse variceal involvement of the colon is even more uncommon and up until now the two cases described in the literature have had an idiopathic etiology. We describe herein the third such case, while pointing out that the diffuseness implies an unknown cause.