Psychological problems in Christian and Moslem primary care patients in Greece

OBJECTIVE: Psychiatric problems are often expressed through, or coexist with, somatic symptoms. Cultural factors may influence this association. This study aims to 1) estimate the prevalence of mental health problems in a sample of primary care attendees in a rural area of Greece, and 2) investigate the differences in psychiatric symptomatology among patients from different religious/cultural backgrounds. METHOD: Over a three-month period, 300 consecutive adult patients (Christians and Moslems) at the rural Primary Care Health Centre of Iasmos in Thrace, Greece, were assessed with the 28-item General Health Questionnaire. RESULTS: The probable prevalence of mental health problems was estimated at 32 percent. Only for a small minority of the patients (3.3 percent) psychological problems were the presenting complaint. Moslems scored significantly higher than Christians in the somatic complaints subscale (p < 0.001). CONCLUSION: Mental health problems are common in primary care although they rarely constitute a reason for consultation. Sociocultural background may affect the presentation of psychological distress. Primary health care staff have a significant role in identifying hidden psychiatric morbidity.     

Massive pulmonary embolism with ST elevation in leads V1-V3 and successful thrombolysis with tenecteplase

A 42 year old woman was referred to the emergency department from the radiology department after having a syncopal episode during a triplex examination of the lower extremities for acute painful right leg swelling five hours earlier that morning. She had no significant medical history, smoked 3-5 cigarettes a day, and had been taking contraceptive medication for menorrhagia for the preceding three months. On presentation she was cyanotic, dyspnoeic, and haemodynamically unstable. ECG showed sinus tachycardia of 120 beats/min with ST elevations from V1 through V3 mimicking anteroseptal acute myocardial infarction. Ten minutes after presentation she was thrombolysed with 80 mg tenecteplase leading to ST elevation resolution and remarkable haemodynamic recovery after 20 minutes. This case shows how pulmonary embolism can mimic anteroseptal acute myocardial infarction on ECG and the life saving results from rapid thrombolysis with tenecteplase.     

变形杆菌对β—内酰胺类和氨基糖苷类抗生素的敏感性取决于其种属和来源

文献中化学药物对变形杆菌代表性菌种,主要是部分吲哚阴性和吲哚阳性变形杆菌属的抗菌活性已有报道。在吲哚阴性变形杆菌中除奇异变形杆菌外,还有Proteus penner,在吲哚阳性变形杆菌中除普通变形杆菌外,还有摩氏变形杆菌和普罗威登斯菌。各种变形杆菌对化学药物的敏感性不同。然而,它们对化学药物敏感性取决于其来源的报道不多。因此,我们用分离自不同病理材料的变形杆菌培养物对β-内酰胺类和氨基糖苷类抗生素的敏感性进行了研究。对1985年分离自各种病理材料的130株变形杆菌菌株培养物进行了敏感性测定,其中分离自脓汁30株,分离自各种化脓炎症性疾病患者的尿和急性肠道感染患者的粪各50     

INHIBITION OF BRAIN RENIN–ANGIOTENSIN SYSTEM IMPROVES DIASTOLIC CARDIAC FUNCTION FOLLOWING MYOCARDIAL INFARCTION IN RATS

• 1 Recently, we demonstrated that oral captopril treatment improved diastolic function and attenuated cardiac remodelling after myocardial infarction (MI) in rats. Considering the feasible role of the brain renin–angiotensin system (RAS) in heart failure, in the present study we investigated the role of the captopril injected intracerebroventricularly (i.c.v.) on the progression of cardiac dysfunction.
• 2 Male Wistar rats underwent experimental MI or sham operation. Infarcted animals received daily i.c.v. injections of captopril (approximately 200 mg/kg; MI + Cap) or saline (MI) from 11 to 18 days after infarction. Electro‐ and echocardiogram assessments were performed before and after i.c.v. treatment (10 and 18 days after MI, respectively). Water and hypertonic saline ingestion were determined daily between 12 and 16 days after MI.
• 3 Electrocardiograms from the MI and MI + Cap groups showed signs that resembled large MI before and after i.c.v. treatment. However, despite similar systolic dysfunction observed in both groups, only captopril‐treated rats exhibited reduced left ventricular (LV) dilatation and improved LV filling, as assessed by echocardiograms, and low levels of water ingestion compared with the saline‐treated control group.
• 4 The results of the present study suggest that the brain RAS may participate in the development of cardiac dysfunction induced by ischaemia and that inhibition of the brain RAS may provide a new strategy for the prevention of diastolic dysfunction.

     

Melatonin and colon carcinogenesis: I. Inhibitory effect of melatonin on development of intestinal tumors induced by 1,2-dimethylhydrazine in rats

The effect of pineal indole hormone melatonin on colon carcinogenesis was firstly studied in rats. Two-month-old outbred female LIO rats were weekly exposed to 15 (experiment 1, groups 1 and 2) or to five (experiment 2, groups 1 and 2) s.c. injections of 1,2-dimethylhydrazine (DMH) at a single dose of 21 mg/kg of body weight. From the day of the first injection of the carcinogen DMH, the rats from groups 2 (experiments 1 and 2) were given melatonin five days a week during the night-time (from 18:00 h to 8:00 h), dissolved in tap water at 20 mg/l. The experiment was finalized in 6 months after the first injection of DMH. In both experiments the majority of tumors were localized in the descending colon. Tumors of the small intestines developed only in rats from experiment 1. Total incidence of colon tumors as well as tumors in different parts of the colon and the mean number of tumors per rat were much higher in rats from both groups in experiment 1 than that in rats from experiment 2. In experiment 1 melatonin failed to influence the total incidence of colon tumors. However, incidence of carcinomas in the ascending colon was significantly reduced (P < 0.01). The multiplicity of total colon tumors per rat, as well as the mean number of tumors, ascending and descending colon per rat, was also decreased under the influence of melatonin (group 2 vs group 1, P < 0.01). In the same experiment, melatonin slightly decreased the depth of tumor invasion and increased number of highly differentiated colon carcinomas induced by DMH. The percentage of small tumours in the descending colon among rats from group 2 was higher than that of group 1. Treatment with melatonin was also followed by a decrease in the multiplicity of DMH- induced tumors of the duodenum (group 2 vs group 1, P < 0.05) and by a decrease in the incidence of jejunum and ileum tumors (group 2 vs group 1, P < 0.05). In experiment 2, the inhibitory effect of melatonin on DMH-induced colon carcinogenesis was much more expressed than that in experiment 1. Thus, in group 1 the incidence of total colon tumors, ascending and descending colon tumors, was significantly decreased in comparison with group 2; also melatonin reduced the number of tumors per rat in the ascending and descending colon. The number of colon tumors that invaded only mucosa was significantly higher in group 2 than in group 1, P < 0.05. The ratio of highly differentiated tumors was increased (P < 0.05) and the ratio of low-differentiated tumors was decreased (P < 0.05) in rats exposed to melatonin (group 4) as compared with group 3. The number of large size tumors in the ascending and descending colon was decreased whereas the number of small size tumors (<10 mm2) was increased in those parts of the colon that were under the influence of melatonin in experiment 2. Thus, our results demonstrate the inhibitory effect of melatonin on intestinal carcinogenesis induced by DMH in rats.      

The Association of Bipolar Spectrum Disorders and Borderline Personality Disorder

Bipolar Disorder (BD) and Borderline Personality Disorder (BPD) are two different entities sharing a variety of common features in a number of fields and, thus, presenting difficulties in their differential diagnosis. The aim of the review is to identify similarities and differences between BD and BPD concerning the symptomatology, causes, course and treatment of the two disorders. A systematic electronic search of Pubmed (Medline) was conducted in order to identify all relevant scientific articles published between 1990 and 2010. The main common clinical features of BD and BPD are affective instability and impulsivity, which, however, present with quality differences in each disorder. In the field of neuroanatomy, BD and BPD demonstrate similarities such as alterations in the limbic system, as well as specific differences, such as the increase in size of the amygdala in BD and the decrease in BPD. Both disorders appear to have a significant percentage of heritability, but environmental factors seem to hold an important role in BPD, in particular. Both BD and BPD are affected by alterations in the dopaminergic and serotonergic system. Fuctionability and prognosis are slightly worse for BPD. Concerning medication treatment, antidepressants are considered effective in BPD, whereas mood stabilizers are the main treatment of choice in BD. The effectiveness of a variety of psychotherapeutic methods is still under research for both disorders. Despite the similarities and differences already being traced in clinical and biological fields, the relationship of the two disorders has not yet been thoroughly defined.     

Etched-metal resin-bonded intracoronal cast restorations. Part II: Design criteria for cavity preparation

Intracoronal cast restorations can now be designed without dentinal involvement and with minimal alterations of the enamel. Exposure of the dentin is avoided during cavity preparation unless necessitated by disease, trauma, or previous restorations. Bonded retention also compensates for reduced frictional retention and provides support to weakened cusps. This article compared conventional intracoronal cast restorations with a design based on resin-bond retention. The proposed etched-metal resin-bonded restorations were found to be less invasive and more retentive.     

Promotion of high school blood donations: testing the efficacy of a videotaped intervention

"Life to Life," an 11-minute videotape based on social learning principles, was used by 10 blood centers in presentations to 4970 high school students one week before school blood drives. At each school, some students saw the videotape and others attended a blood center's customary presentation. Students also completed a brief questionnaire assessing donation attitudes, donation history, and intent to donate. The videotape accounted for a relative increase of 18.7 percent in donations even when other factors were not controlled for. Results were analyzed with logistic models and showed a consistently positive effect over all models used. For students who had never donated, the estimated odds ratio for actual donation (videotape:control) was 1.528. When the model included both type of presentation and ethnicity, the relative increase in donation over that after the blood centers' usual presentation was 69.8 percent for first-time donors. Among previous donors considered alone, the effect on donation was not significant. Whatever their donor history, students who viewed the videotape showed significantly more positive attitudes toward donation and had greater intention to donate than students who saw the blood centers' standard presentations. These results suggest that this videotape is a useful tool for recruitment of high school blood donors.     

Indirectly formed matrix for multiple composite core restorations: two clinical treatments illustrating an expanded technique

The technique described in this report is an expansion of a previously reported intraoral procedure for directly developing a matrix for the fabrication of composite cores. The expanded method allows a matrix to be created indirectly after the involved teeth are trimmed or restored on a cast into slightly oversized crown preparations before the treatment visit. The cast may serve for both the matrix and the interim fixed restoration, enabling fabrication by the dental laboratory. A semirigid (occlusal registration) elastomeric material is used to form the matrix. The matrix is used to apply the composite and shape the cores after the abutment teeth have been prepared, pins or posts have been placed, and adhesive procedures have been implemented. The elastomeric matrix can be modified for use as the impression matrix. The described technique allows the simultaneous formation of multiple composite cores. An alternative method in which light-polymerized core composite is used with a vacuum-formed, dual-laminate transparent matrix is described and compared with the semirigid elastomeric matrix.