Normal rabbits were injected Intravenously with horseradish peroxldase (HRP) and 125 l-labeled human low density lipoprotein (LDL), and the aortas were pertuslon-flxed. Subsequent visualization of HRP In the aortas was produced by reaction of the tissue with diaminobenzldine and hydrogen peroxide. The lumlnal surface of the aortas showed many small punctate foci of brown reaction product to the HRP, which represented penetration of the HRP into the vessel wall. The foci were scattered over the luminal surface, and most of the focal areas were less than 1 mm In diameter. The concentration of LDL was up to 47 times greater in these focal areas than in surrounding noncolored regions not showing Increased permeability to HRP. Small circumscribed foci of heightened permeability to LDL may predispose to the local accumulation of llpld and ultimately to the formation of atherosclerotic plaques. (Arteriosclerosis 6:64-69, January/February 1986) T wo salient features of atherosclerotic lesions are the focal nature of plaque formation and the accumulation of cholesterol, cholesterol esters, triglycerides, and other lipids. The process by which atherosclerotic lesions originate is poorly understood. It is possible, however, that endothelial injury leading to increased arterial wall permeability could be a first stage in atherogenesis. In vivo studies with the protein-binding dye Evans blue 1 " 3 have shown that the dye is taken up preferentially by certain regions of the aortas of rabbits, dogs, and pigs. In pigs these relatively broad regions of enhanced permeability have also been shown to incorporate

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Chronic heart failure is a significant public health concern. The prognosis for many patients is often poor, with many experiencing frequent hospital readmissions and an impaired quality of life. Innovative and effective nurse-led management strategies have successfully improved the overall management of patients with heart failure, with the emergence of telemonitoring enabling the early detection of clinical deterioration. Telemonitoring promotes patient participation and self assessment, key elements in the successful treatment of heart failure patients. This paper has reviewed three articles, all randomized controlled trials, exploring the concept of telemonitoring in heart failure. All of the studies provide encouraging results that are both statistically and clinically meaningful. In addition to traditional models of care, telemonitoring as a treatment option may, indeed, play an important role in the delivery of effective patient care.

Aim: Chronic heart failure (CHF) is a complex clinical syndrome associated with recurrent hospitalizations and high mortality. Evidence suggests that many patients are not receiving effective pharmacotherapy. The aim of this retrospective audit was to formally describe and evaluate the pharmacotherapy of an established heart failure nurse led clinic in North West London. Methods: A retrospective audit was undertaken in January 2007 on all patients diagnosed with CHF attending the out-patient nursing clinic between October and December 2006. Descriptive statistics were used to summarise patient data. Results: 77 patient letters were audited. Mean age 73 years (SD ± 13), with 32 patients (42%) female and 14 (18%) South Asian. ACE inhibitors were prescribed in 60 (78%) patients, with beta blockers and loop diuretics prescribed in 47 (61%) and 71 (92%) respectively. No statistically significant difference was found in prescription rates between male and female patients. A statistical significant difference (P=0.043) was observed in the age of patients prescribed aldosterone antagonists. Conclusions: Demographic data is consistent with survey evidence from the EuroHeart failure surveys (EHFS) and ADHERE registries and is appropriate to the local population. Pharmacological prescription rates are comparable with national and international survey standards and adhere to the European Society of Cardiology (ESC) guidelines.