Ischaemia modified albumin in radiofrequency catheter ablation.

Aim Ischaemia modified albumin (IMA) is considered a marker of myocardial ischaemia, in contrast to the biomarkers of myocardial injury [creatine kinase (CK), the MB isoenzyme of CK, and cardiac troponin I (Tn-I)] that are released when cardiac necrosis occurs. Ischaemia modified albumin has been reported to increase following percutaneous coronary intervention and in acute coronary syndromes. We sought to determine whether IMA increases following radiofrequency (RF) ablation. METHODS AND RESULTS: We studied 40 consecutive patients who underwent RF catheter ablation; 20 were men and 20 women and their age was 47 +/- 16 (16-77) years. All patients underwent electrophysiological study and subsequent RF ablation. Peripheral venous samples were collected before the procedure (baseline), immediately after the procedure, 2 h post-procedure and the following day (20 h post-procedure) and assayed for CK, the MB isoenzyme of CK, cardiac Tn-I and IMA. Ischaemia-modified albumin plasma levels did not differ significantly at all four time points, baseline, and following ablation (P = 0.5974), whereas CK, CK-MB, and Tn-I increased significantly at all time points compared with baseline (P < 0.0001). Post-ablation, all but three 3 CK measurements were in the normal range; 14 patients had CK-MB plasma levels above the upper limit of normal; all but one patient had Tn-I elevated. CONCLUSION: The IMA plasma levels do not change significantly following RF ablation, unlike biomarkers of myocardial injury, implying that myocardial necrosis occurs without preceding ischaemia.     

Interleukin-1B and interleukin-1 receptor antagonist gene polymorphisms in Greek multiple sclerosis (MS) patients with bout-onset MS

We investigated the association of specific polymorphisms of the interleukin IL-1b (AvaI ?511 and TaqI +3,953) and IL-1 receptor antagonist (IL-1RN) (a variable number of tandem repeats; VNTR) genes with both the susceptibility to and the clinical characteristics in Greek multiple sclerosis (MS) patients cohort with bout-onset. Genotypes were determined from 351 patients with clinically definite MS and 375 age- and sex-matched healthy controls. Our results showed no significant differences in the distribution of these polymorphisms between MS patients and controls. Furthermore, stratification for clinical characteristics, such as age at disease onset, clinical course, sex, and severity did not provide significant differences between patients and controls. Together, our findings suggest that IL-1B and IL-1RN gene polymorphisms may not be relevant to the susceptibility to MS or the clinical characteristics of Greek MS patients.     

Has the management of shoulder dislocation changed over time?

Anterior shoulder dislocation is a disabling injury affecting all ages, young and old alike. Recently, the treatment of traumatic shoulder dislocation has included immobilisation for varying periods of time followed by physiotherapy. This study is the first in this country to address the demographic data and recurrence rates of shoulder dislocation. Three hundred and eight patients (170 men and 138 women) were followed up for an average of 5.9 years. The most frequent mechanism of injury was a fall (65.66% of cases), and in 92.1% of the patients, the shoulder was reduced in the Emergency Department without the need for sedation or general anaesthesia. The overall recurrence rate in all ages was 50%, but rose to 88.9% in the 14–20-year age group. The duration of immobilisation did not affect the rate of re-dislocation of the humeral head. We believe that conventional shoulder immobilisation in a sling offers no benefits, and it would be preferable not to immobilise the shoulder at all.

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Résumé Les luxations antérieures de l’épaule sont une affection qui peut survenir à n’importe quel age, aussi bien chez les jeunes que chez les patients plus agés. Jusqu’à ce jour, le traitement des luxations de l’épaule comprend une immobilisation suivi d’une période de rééducation. Cette étude est la première qui met en évidence des données démographiques et des résultats concernant la récidive de la luxation. Trois cent huit patients (170 hommes et 138 femmes) ont été suivis pendant une période de 5,9 ans. Le mécanisme le plus fréquent a été la chute (65,66%) et dans 92,1% des cas la luxation a été réduite aux services d’urgence, sans anesthésie générale et sans sédation particulière. Le taux de récidive quel que soit l’age a été de 50% mais augmente à 88,9% dans le groupe des patients les plus jeunes (14 à 20 ans). Le temps d’immobilisation n’affecte pas le taux de reluxation. Nous pensons que l’immobilisation conventionnelle de l’épaule n’apporte aucun bénéfice et qu’il est préférable de ne pas immobiliser celle-ci à la suite d’une luxation.

     

Acute lung injury in a rat model of intestinal ischemia-reperfusion: the potential time depended role of phospholipases A(2)

BACKGROUND: A pivotal role of phospholipase A(2) (PLA(2)) and platelet-activating factor-acetylhydrolase (PAF-AcH) as enzymes involved in lung inflammation has recently been suggested. The objective of this study was to elucidate the role and the time dependence of PLA(2) and PAF-AcH fluctuations in the lung relative to the evolution of intestinal ischemia-reperfusion (IIR). MATERIALS AND METHODS: Rats were randomly allocated to five groups of IIR induced by occlusion of the superior mesenteric artery for 45 min followed by 1 min, 2, 4, and 8 h of reperfusion (expGroups) and five corresponding sham groups (sGroups). Bronchoalveolar lavage fluid was obtained from the right lung and its biochemical (protein, PLA(2), PAF-AcH) and cytological characteristics were determined. Plasma malonyldialdehyde was measured as a marker of lipid peroxidation. The 4 and 8 h reperfusion expGroups had significantly (P < 0.05) elevated alveolar-arterial O(2) gradient values compared with the corresponding controls. Total protein, PLA(2) and PAF-AcH levels significantly (P < 0.05) increased in expGroups compared with the corresponding shams after 4 h of reperfusion. Total bronchoalveolar lavage fluid cells and plasma malonyldialdehyde were significantly (P < 0.05) elevated in expGroups compared with the sGroups after 2 h of reperfusion. CONCLUSIONS: PLA(2) could act synergistically or parallel with the reactive oxygen species produced during IIR, resulting in the induction or even in the exacerbation of the inflammatory reaction in acute respiratory distress syndrome. PAF-AcH could play an anti-inflammatory role by reducing the concentration of PAF.     

Minimum of the order parameter fluctuations of seismicity before major earthquakes in Japan

It has been shown that some dynamic features hidden in the time series of complex systems can be uncovered if we analyze them in a time domain called natural time χ. The order parameter of seismicity introduced in this time domain is the variance of χ weighted for normalized energy of each earthquake. Here, we analyze the Japan seismic catalog in natural time from January 1, 1984 to March 11, 2011, the day of the M9 Tohoku earthquake, by considering a sliding natural time window of fixed length comprised of the number of events that would occur in a few months. We find that the fluctuations of the order parameter of seismicity exhibit distinct minima a few months before all of the shallow earthquakes of magnitude 7.6 or larger that occurred during this 27-y period in the Japanese area. Among the minima, the minimum before the M9 Tohoku earthquake was the deepest. It appears that there are two kinds of minima, namely precursory and nonprecursory, to large earthquakes.     

Translation and validation of the dizziness handicap inventory in Greek language

Objective: The aim of the study was to test the reliability and validity of the Dizziness Handicap Inventory in the Greek language (DHI). Design: This study was performed in a university tertiary centre. Internal consistency was estimated using Cronbach’s alpha for the DHI, physical (DHI-P), functional (DHI-F) and emotional (DHI-E) subscale scores. Correlation between DHI (total and subscales) and the SOT (sensory organisation test) as well as correlation between the DHI and FGA (functional gait assessment) was tested using Spearman’s correlation coefficient. Test–retest reliability was tested using ICC (Intraclass Correlation Coefficient). Sample size: Ninety (90) patients were included in the study. Results: Internal consistency was excellent for the total score and very good for the physical functional and emotional subscale scores. No statistically significant correlation was found between SOT and DHI. There was a moderate correlation between FGA and total DHI scores (r?=??0.472; p?r₁?=??0.342; p₁?=?0.001, DHI-F r₂?=??0.448 p₂?r₃?=??0.472 p₃?Conclusion: Greek version of DHI is recommended as a valid measure for patients with vestibular disorders.