Specific and gender differences between hospitalized and out of hospital mortality due to myocardial infarction

In this paper, the authors evaluate gender related differences of myocardial infarction mortality before and after hospital admittance. Myocardial infarction mortality in the Clinical Hospital Split in the seven years period between 2000 and 2006, have been analyzed together with out of hospital sudden death patients with acute myocardial infarction established during autopsy. During the seven year period between 2000 and 2006, 3434 patients were treated for myocardial infarction in the Split Clinical Hospital, 2336 (68%) males and 1098 (32%) females with a 12% total mortality (427 patients). The annual number of hospitalized persons has been increasing during that period (474 in yr. 2000 us. 547 in yr. 2006), while mortality decreased from 15% in 2000 to 9.6% in 2006. Female patients had significantly higher hospital mortality than male patients, (228 or 21% vs. 202 or 9%, p<0.05). Women also had significantly higher total AMI mortality (23.7% vs. 15,7%, p <0.05). Anterior myocardial infarction with ST elevation in precordial leads had significantly higher mortality (19%) compared to patients with lateral (11%), inferior (10%) myocardial infarction with ST elevation and also NSTEMI (4%) mortality p<0.05. Female patients more frequently die in hospital, 84% (230) than out of hospital 16% (43). From the total number of AMI deaths (388) in male patients, 56% (217) were in hospital and 44% (171) out of hospital (p<0.001). Men had significantly higher prehospital mortality rate than women (81% vs. 19%, p<0.05). Men also more frequently died from ventricular fibrillation (22% vs. 10%, p<0.05), while women died more frequently of heart failure, cardiogenic shock, and myocardial rupture (33% vs. 15% p<0.05). Regarding the total number of deaths from myocardial infarction men had significantly higher prehospital mortality compared to women (178 or 7.3% vs. 43 or 3.7%, p<0.05). Anterior myocardial infarction had a significantly higher rate in patients dying pre-hospital (58%), in contrast to inferior (36%) and lateral myocardial infarction with ST elevation (6%) p<0.05. We have concluded that male patients die more frequently within the first few hours of AMI mostly due to malignant arrhythmias, while female patients died in sub acute stage due to heart failure while being hospitalized. Nevertheless total mortality of AMI remains significantly higher in women.     

The effect of analgesics and physical therapy on respiratory function after open and laparoscopic cholecystectomy

In this study we present prospective clinical trial included 100 patients. One half of the patients underwent open cholecystectomy, whereas laparoscopic cholecystectomy was performed in the other half Spirometric parameters, arterial blood gases, acid-base balance, were determined preoperatively, and then at 6 h, 24 h, 72 h and 144 h postoperatively. The impact of physical therapy on the respiratory parameter patterns, VAS-pain score and use of tramadol were studied after cholecystectomy. Significantly lower VAS-pain score and less tramadol use, higher values and faster recovery of ventilation parameters and PaO2 were recorded after laparoscopic cholecystectomy than after open cholecystectomy (p = 0.001 for both). Physical therapy resulted in a significant improvement in the values of respiratory parameters in the open cholecystectomy group within a short time (30 min) after therapy was performed. Physical therapy failed to produce any improvement of respiratory parameters in laparoscopic cholecystectomy, whereas in open cholecystectomy group who had a favorable although transient effect, strictly limited to the short time from its application. (p = 0.005). The patients operated on by open cholecystectomy had statistically significantly more pronounced disturbances including hypoxia, hypocapnia and hyperventilation when compared to the group submitted to laparoscopic cholecystectomy. It is recommended that physical therapy be more frequently performed during the postoperative period in patients submitted to open cholecystectomy.     

Towards an integration of psychoanalysis and neurobiology in 21st century

The "inner world" of the mind was, in the past, the traditional preserve of psychoanalysis and related disciplines, and it was therefore placed at the margins of neural science. During 1990-ies numerous investigations in the field of neuroscience have led to significant findings, which explain biological correlates ofpsychological functions. There are much scientific evidence that support association between psychoanalysis and neuroscience. Psychoanalysis offers a unique in-depth perspective on the psychology of human motivation, and furthermore has contributions both to make and to receive in the gathering scientific integration.     

Biological bases of dentin hybridization

The aims of this study were threefold: (1) to characterize and quantify the number, diameter and surface area of exposed dentinal tubules on the cross section of the human coronal dentin; (2) to determine if any such differences in these properties arise in relation to the distance from the dentinoenamel junction; and (3) to evaluate whether such differences can influence dentin hybridization. To accomplish these aims, scanning electron microscopy comparative observation was carried out on 60 prepared human premolars, which were divided into three groups of 20 samples each. The three sample groups were cut as follows: (1) in the central fissure region, one millimeter from the enamel-dentine junction; (2) halfway between the enamel-dentine junction and the pulp; and (3) one millimeter from the roof of the pulp chamber. Using one-way analysis of variance (one-way ANOVA) and a regression linear model, the data enumerated below were obtained. First, the mean number of the tubule openings was 19600/mm2 on the first level, 32400/mm2 on the second and 42300/mm2 on the third. The mean tubule diameter on the first level was 0.67 microm, 1.52 microm on the second and 2.58 microm on the third. Finally, exposed tubules on the first level occupied 2.79% of of total dentinal surface area, 23.90% on the second, and 87.78% on the third level. Therefore, significant statistical differences (p < 0.01) between all three groups of the specimens for all three properties were observed, as well as positive correlation between the dentin depth and each of these properties. This indicates that the dentin structural variety, which ultimately determines adhesion to dentine, involves a complex interaction between biological material (dentin) and the particular adhesion system applied.     

Stabilization of human standing posture using functional neuromuscular stimulation

Functional neuromuscular stimulation (FNS)/functional electrical stimulation (FES) is a potential way to restore some functionality to the limbs of patients with spinal cord injury through direct/indirect stimulation of the motoneuron. One of the constraints for wider use of FNS on paraplegic patients is the lack of efficient control algorithm. Most of the published works on FNS/FES control are based on oversimplified models of human body dynamics. An innovative control strategy for stabilizing the standing posture of paraplegic patients is proposed here which is a combination of a proportional-plus-derivative controller for motions of the skeletal system and a control action prediction mechanism to produce musculotendon activation. The goal is to produce musculotendon torque which can approximate those demanded by the controller for the skeletal system. In computer simulations, using a detailed skeletal–musculotendon–muscle activation dynamics model of human body, this FNS/FES control approach can stabilize a paraplegic patient's standing posture with the minimum number of musculotendon groups. Also, it is found that this control strategy can maintain stability even in the presence of reasonable variations in the controller's musculotendon parameters.     

In vitro release of metal ions from a gold-platinum alloy in saliva-simulated conditions

The aim of this study was to evaluate the behavior of high-noble gold-platinum alloy samples (18 + 8 Rafinerija plemenitih kovina, Zagreb, Hrvatska), in a phosphate buffer pH 6.0. The aim of the study was to determine the type and amount of released metal ions from the alloy, and to evaluate how the time of exposure to the phosphate buffer pH 6.0 influences the release of metal ions from the alloy. Manufacturer samples 8.0 x 6.5 x 1.0 mm in size, with a surface area of 133 mm2 were used. The release of metal ions from the tested alloy was measured in ten time periods (after 1, 2, 3, 4, 5, 6, 7, 14, 21 and 30 days). Six samples were used (n = 6) for each time period that the alloy was in the solution, which means that a total of 60 samples was analyzed. Solutions, in which the samples were placed, were analyzed with the inductively coupled plasma atomic emission spectrometer (ICP-AES, JY 50P, Jobin-Ywon, France). It was found that four metal ions were released; zinc ions (Zn), chromium ions (Cr), copper ions (Cu) and iron ions (Fe). The most released ions from the gold-platinum alloy were those of zinc (Zn), and the least released were those of iron (Fe) (p < 0.01). The results of the study show that the time the tested alloy spent in the phosphate buffer pH 6.0 solution has an effect on the release of ions (p < 0.01).     

Adenylate kinase AK1 knockout heart: energetics and functional performance under ischemia-reperfusion

Deletion of the major adenylate kinase AK1 isoform, which catalyzes adenine nucleotide exchange, disrupts cellular energetic economy and compromises metabolic signal transduction. However, the consequences of deleting the AK1 gene on cardiac energetic dynamics and performance in the setting of ischemia-reperfusion have not been determined. Here, at the onset of ischemia, AK1 knockout mice hearts displayed accelerated loss of contractile force compared with wild-type controls, indicating reduced tolerance to ischemic stress. On reperfusion, AK1 knockout hearts demonstrated reduced nucleotide salvage, resulting in lower ATP, GTP, ADP, and GDP levels and an altered metabolic steady state associated with diminished ATP-to-P(i) and creatine phosphate-to-P(i) ratios. Postischemic AK1 knockout hearts maintained approximately 40% of beta-phosphoryl turnover, suggesting increased phosphotransfer flux through remaining adenylate kinase isoforms. This was associated with sustained creatine kinase flux and elevated cellular glucose-6-phosphate levels as the cellular energetic system adapted to deletion of AK1. Such metabolic rearrangements, along with sustained ATP-to-ADP ratio and total ATP turnover rate, maintained postischemic contractile recovery of AK1 knockout hearts at wild-type levels. Thus deletion of the AK1 gene reveals that adenylate kinase phosphotransfer supports myocardial function on initiation of ischemic stress and safeguards intracellular nucleotide pools in postischemic recovery.     

Bioinversion of R-flurbiprofen to S-flurbiprofen at various dose levels in rat, mouse, and monkey

Information about the potential and extent of bioinversion of chiral drugs in laboratory animal species and humans is critical to the interpretation of preclinical pharm-tox studies with these drugs. Unlike in the dog, guinea pig, and rabbit, in humans the 2-arylpropionic acid (APA) R-flurbiprofen (R-FB) undergoes very little bioinversion to S-flurbiprofen. The primary objective of this research was to identify laboratory animal species with an R- to S-bioinversion profile similar to humans. Detailed evaluations of the pharmacokinetics parameters of R-flurbiprofen in male and female rats and mice, and male nude rats and monkeys demonstrated R- to S-bioinversion of 30% (average) in monkeys, 15-24% in mice, and approximately 4% in rats. To date, no laboratory animal species has been identified with an R-flurbiprofen bioinversion profile identical to humans. However, the rat has a bioinversion profile sufficiently similar to humans to be useful for preclinical.     

Assessment of Carcinogenic Risk and Non-Carcinogenic Health Hazard from Exposure to Toxicants in Water from the Southwestern Coastal River System in Ghana

This study evaluated cancer risk and non-cancer human health hazard from exposure to the toxicants such as As, Cu, Pb, Zn, Mn, and CN in water from a southwestern river system in Ghana that drains through gold mining areas, using 108 water samples collected with random sampling techniques and analyzed in accordance with standard methods of chemical analysis outlined by the U.S. Environmental Protection Agency (USEPA). The concentrations of Cu and Zn were within World Health Organization and USEPA guideline values; Mn, free cyanide, As, and Pb values in most cases either exceeded USEPA and WHO values or both. The concentrations of the toxicants were used as input parameters in the cancer and non-cancer study that was conducted in line with USEPA risk assessment guidelines. The results of As cancer health risk revealed higher risk cases in two locations (Potroase and Dominase); non-cancer health risk for As was higher in 10 of the 14 locations, with other metals being of health concern at few locations in the study area. In conclusion, the findings of this study hold several policy implications as residents of mining communities still depend on these water bodies as their source of drinking water.     

New molybdenum(V) complexes based on the {Mo2O4} structural core with esters or anions of malonic and succinic acid

A series of malonato complexes of molybdenum(V) was prepared by reacting (PyH)₅[MoOCl₄(H₂O)]₃Cl₂ or (PyH)_n[MoOBr₄]_n with malonic acid (H₂mal) or a half-neutralized acid, hydrogen malonate (Hmal⁻), at ambient conditions: (PyH)₃[Mo₂O₄Cl₄(μ₂-Hmal)] · CH₃CN (1), (PyH)₃[Mo₂O₄Br₄(μ₂-Hmal)] · CH₃CN (2), (PyH)₂[Mo₂O₄Cl(η²-mal)(μ₂-Hmal)Py] (3), (3,5-LutH)₂(H₃O) [Mo₂O₄(η²-mal)₂(μ₂-Hmal)] (4), (PyH)[Mo₂O₄Cl₂(μ₂-Memal)Py₂] (5), (3,5-LutH)[Mo₂O₄Cl₂(μ₂-Memal)(3,5-Lut)₂] (6), (PyH)[Mo₂O₄Cl₂(μ₂-Etmal)Py₂] (7), (3,5-LutH)[Mo₂O₄Cl₂(μ₂-Prmal)(3,5-Lut)₂] (8) and [{Mo₂O₄(μ₂-Memal)Py₂}₂(μ₂-OCH₃)₂] (9) (where Py = pyridine, C₅H₅N; PyH⁺ = pyridinium cation, C₅H₅NH⁺; 3,5-Lut = 3,5-lutidine, C₇H₉N; 3,5-LutH⁺ = 3,5-lutidinium cation, C₇H₉NH⁺; mal²⁻ = malonate, ⁻OOCCH₂COO⁻; Memal⁻ = monomethyl malonate, ⁻OOCCH₂COOCH₃; Etmal⁻ = monoethyl malonate, ⁻OOCCH₂COOC₂H₅ and Prmal⁻ = monopropyl malonate, ⁻OOCCH₂COOC₃H₇). The complex anions of compounds 1-8 have a common structural feature: a dinuclear, singly metal-metal bonded {Mo₂O₄}²⁺ core with the carboxylate moiety of the malonato ligand coordinated in a syn-syn bidentate bridging manner to the pair of metal atoms. The remaining four coordination sites of the {Mo₂O₄}²⁺ core are occupied with halides in 1 and 2, with halides/pyridine ligands in 5-8, with a pair of bidentate malonate ions in 4 and with the combination of all in 3. The neutral molecules of 9 consist of two {Mo₂O₄}²⁺ cores linked with a pair of methoxide ions into a chain-like, tetranuclear cluster. An esterification of malonic acid was observed to take place in the reaction mixtures containing alcohols. Solvothermal reactions with malonic acid carried out at 115 °C produced anionic acetato complexes as found in (PyH)[Mo₂O₄Cl₂(μ₂-OOCCH₃)Py₂] · Py (10), (PyH)[Mo₂O₄Cl₂(μ₂-OOCCH₃)Py₂] (11), (3,5-LutH)[Mo₂O₄Cl₂(μ₂-OOCCH₃)(3,5-Lut)₂] (12) and (4-MePyH)₃[Mo₂O₄Cl₂(μ₂-OOCCH₃)(4-MePy)₂]₂Cl (13) (4-MePy = 4-methylpyridine, C₆H₇N). The acetate coordinated in the syn-syn bidentate bridging mode in all. Reactions of (PyH)₅[MoOCl₄(H₂O)]₃Cl₂ with succinic acid (H₂suc) at ambient conditions resulted in a complex with a half-neutralized acid, (PyH)[Mo₂O₄Cl₂(μ₂-Hsuc)Py₂] · Py (14) (Hsuc⁻ = hydrogen succinate, ⁻OOC(CH₂)₂COOH), while those carried out at 115 °C in a tetranuclear succinato complex, (4-MePyH)₂[{Mo₂O₄Cl₂(4-MePy)₂}₂(μ₄-suc)] (15) (suc²⁻ = succinate, ⁻OOC(CH₂)₂COO⁻). The tetranuclear anion of 15 consists of two {Mo₂O₄}²⁺ cores covalently linked with a tetradentate succinato ligand. The compounds were fully characterized by infrared vibrational spectroscopy, elemental analyses and X-ray diffraction studies.