Do we need continuous ECG monitoring in patients transferred for primary angioplasty?

The primary goal in patients with acute ST-elevation myocardialinfarction (STEMI) is prompt restoration of blood flow. Thecurrent guidelines for the treatment of patients with STEMIinclude primary angioplasty with the goal of medical contact-to-balloonor door-to-balloon time of 90 min or less.¹ This is basedon the findings of a reduction in mortality in inverse relationshipwith the time to reperfusion.² However, early revascularizationdoes not guarantee optimal myocardial perfusion in patientsundergoing primary angioplasty. In some patients, myocardialperfusion remains impaired despite the restoration of TIMI 3flow, as demonstrated angiographically by TIMI frame count³and myocardial perfusion blush.⁴ These patients have adverseoutcome. In contrast, reversal of ST-segment on     

The effect of the administration of human gamma globulins in a model of BCG infection in mice

The effect of the administration of a commercial preparation of human gamma globulins has been evaluated in a mouse model of intranasal infection with BCG. First, we demonstrated the passage of specific antibodies to saliva and lung lavage following the intranasal or intraperitoneal administration to mice of human gamma globulins. This treatment of mice inhibited BCG colonization of the lungs (p < 0.01). A similar inhibitory effect was observed after infection of mice with gamma globulin opsonized BCG organisms (p < 0.01). These results are relevant for the development of new strategies for the control and treatment of tuberculosis.     

Multimodality Hyperpolarized C-13 MRS/PET/Multiparametric MR Imaging for Detection and Image-Guided Biopsy of Prostate Cancer: First Experience in a Canine Prostate Cancer Model

Molecular Imaging and Biology - To assess whether simultaneous hyperpolarized C-13 magnetic resonance spectroscopy (MRS)/positron emission tomography (PET)/multiparametric magnetic resonance (mpMR)...     

Hepatocellular carcinoma in the very elderly: To treat or not to treat?

The authors briefly review the age distribution of HCC and the treatments used. We concluded that therapy should not be arbitrarily withheld based solely on chronological age. Older cancer patients deserve the right to be treated if they so wish. © 1994 Wiley-Liss, Inc.     

Voltage-dependent and -independent titration of specific residues accounts for complex gating of a ClC chloride channel by extracellular protons

The ClC transport protein family comprises both Cl⁻ ion channel and H⁺/Cl⁻ and H⁺/NO₃⁻ exchanger members. Structural studies on a bacterial ClC transporter reveal a pore obstructed at its external opening by a glutamate side-chain which acts as a gate for Cl⁻ passage and in addition serves as a staging post for H⁺ exchange. This same conserved glutamate acts as a gate to regulate Cl⁻ flow in ClC channels. The activity of ClC-2, a genuine Cl⁻ channel, has a biphasic response to extracellular pH with activation by moderate acidification followed by abrupt channel closure at pH values lower than ∼7. We have now investigated the molecular basis of this complex gating behaviour. First, we identify a sensor that couples extracellular acidification to complete closure of the channel. This is extracellularly-facing histidine 532 at the N-terminus of transmembrane helix Q whose neutralisation leads to channel closure in a cooperative manner. We go on to show that acidification-dependent activation of ClC-2 is voltage dependent and probably mediated by protonation of pore gate glutamate 207. Intracellular Cl⁻ acts as a voltage-independent modulator, as though regulating the p K _a of the protonatable residue. Our results suggest that voltage dependence of ClC-2 is given by hyperpolarisation-dependent penetration of protons from the extracellular side to neutralise the glutamate gate deep within the channel, which allows Cl⁻ efflux. This is reminiscent of a partial exchanger cycle, suggesting that the ClC-2 channel evolved from its transporter counterparts.     

Monitoring and evaluation framework for hypertension programs. A collaboration between the Pan American Health Organization and World Hypertension League

The Pan American Health Organization (PAHO)–World Hypertension League (WHL) Hypertension Monitoring and Evaluation Framework is summarized. Standardized indicators are provided for monitoring and evaluating national or subnational hypertension control programs. Five core indicators from the World Health Organization hearts initiative and a single PAHO‐WHL core indicator are recommended to be used in all hypertension control programs. In addition, hypertension control programs are encouraged to select from 14 optional qualitative and 33 quantitative indicators to facilitate progress towards enhanced hypertension control. The intention is for hypertension programs to select quantitative indicators based on the current surveillance mechanisms that are available and what is feasible and to use the framework process indicators as a guide to program management. Programs may wish to increase or refine the number of indicators they use over time. With adaption the indicators can also be implemented at a community or clinic level. The standardized indicators are being pilot tested in Cuba, Colombia, Chile, and Barbados.