Cardiac CT for acute chest pain in the emergency department: advantages of prospective triggering

Coronary CT angiography (CCTA) is emerging as a powerful tool for the diagnosis and characterization of coronary artery disease. In the emergency department (ED) setting, the high negative predictive value of CCTA has been shown to reduce the length of stay and the cost of care in the evaluation of patients at low and intermediate risk for an acute coronary syndrome (ACS). In addition, CCTA and triple-rule-out protocol CT examinations which simultaneously evaluate the coronary arteries, aorta and pulmonary arteries, have the potential to diagnose not only significant atherosclerotic coronary artery disease (CAD) and coronary artery anomalies, but noncoronary etiologies of chest pain, including pulmonary embolism, aortic dissection, infection, pleural and pericardial disease. Caution has been raised about the widespread use of CCTA in this setting, particularly given the prevalence of repeat ED visits for chest pain, due to the radiation exposure associated with retrospectively-gated CCTA. However, the recent development of prospectively-triggered coronary artery CTA makes the ED evaluation possible with a substantially lower radiation exposure to the patient. Although most studies of CCTA to date are performed with retrospective ECG gating, early reports on prospectively triggered CCTA demonstrate equivalent image quality and accuracy when compared to studies acquired with retrospective ECG gating.     

N-Substituted piperazinyl quinolones as potential cytotoxic agents: Structure–activity relationships study

As part of a continuing search for new potential anticancer candidates in the piperazinyl quinolone series, the cytotoxicity evaluation of new N-substituted piperazinyl quinolones was of our interest. The growth inhibitory activities of 12 new compounds, namely N-[2-(5-chlorothiophen-2-yl)-2-oxoethyl] and N-[2-(5-chlorothiophen-2-yl)-2-oxyiminoethyl] piperazinyl quinolones 1–12 were determined against six cancer cell lines using MTT colorimetric assay. Preliminary screening showed that most of the new N-[2-(5-chlorothiophen-2-yl)ethyl]piperazinyl quinolones 4–12 containing (un)substituted oxime moiety showed significant cytotoxic activity and the modification of functionality on ethyl spacer produced a relatively minor change of activity. Thus, in the piperazinyl quinolone series, cytotoxic activity can be positively modulated through the introduction of 2-(5-chlorothiophen-2-yl)ethyl residue on the piperazine ring. The results revealed that the introduction of 2-(5-chlorothiophen-2-yl)ethyl moiety on the piperazine ring of quinolone antibacterials (ciprofloxacin, norfloxacin and enoxacin) changes the biological profile of piperazinyl quinolones from antibacterials to cytotoxic agents.     

Assessment of medical student burnout: toward an implicit measure to address current issues

Advances in Health Sciences Education - The feasibility of implicitly assessing medical student burnout was explored, using the Implicit Relational Assessment Procedure (IRAP), to measure...     

A deeper look at implicit weight bias in medical students

The Implicit Relational Assessment Procedure (IRAP, Barnes-Holmes et al. in Psychol Rec 60:527–542, 2010) was utilized as a relatively new tool to measure implicit weight bias in first- and third-year medical students. To date, only two studies (Miller et al. in Acad Med 88:978–982, 2013; Phelan et al. in Med Educ 49:983–992, 2015) have investigated implicit weight bias with medical students and both have found pro-thin/anti-fat implicit attitudes, on average, using the Implicit Association Test (IAT, Greenwald and Banaji in Psychol Rev 102:4–27, 1995) as the assessment tool. The IRAP, however, allows for a deeper analysis of implicit attitudes with respect to both thin and fat in isolation, and it was found that medical students are, on average, actually both pro-thin and pro-fat, and on average are more pro-thin than pro-fat, as opposed to anti-fat. Additionally, it was found that medical students’ implicit weight bias against fat/obese individuals improved over the first 2 years of medical training, and this improvement was specifically driven by improved implicit attitudes toward overweight and obese, while implicit attitudes toward thin remained constant over that time. The implications of more sensitive implicit bias assessment and specific changes in bias over time are discussed within the context of medical education curriculum development.     

Effects of tomato extract on oxidative stress induced toxicity in different organs of rats

Tomato products containing lycopene are believed to be associated with decreased risk of chronic diseases including cancer, and its effects are suggested to be due to antioxidant effect of lycopene. The aim of this research was to study the effects of tomato extract on acetaminophen (APAP), amiodarone (ADN) and cyclosporine A (CsA)-induced liver, lung and kidney toxicity, respectively. Previous studies have shown that free radical reactions may play important roles in toxicity of these drugs. Rats received a single dose of APAP (750mg/kg, i.p.) before treatment with tomato extract (5mg/kg, oral) for seven consecutive days, ADN (100mg/kg, i.p.) plus tomato extract (5mg/kg, oral) for 10 consecutive days, or CsA (250mg/kg, i.p.) plus tomato extract (5mg/kg, oral) for 14 consecutive days. At the end of each treatment, the animals were sacrificed and the related organ tissues were collected for biochemical and histopathological examinations. Simultaneous treatment of tomato extract ameliorated tissue damage, biochemical indices, and oxidative stress parameters against APAP-induced acute hepatotoxicity, but had less beneficial effects on ADN-induced lung toxicity and little effect against CsA-induced nephrotoxicity. Therefore, tomato products may be beneficial for the prevention and therapy of toxicity induced by ADN and APAP.     

Mental fitness during transition to fatherhood

Transition into fatherhood is often marked by a period of adjustment, uncertainty and psychological distress and challenges for many men, along with social isolation and relationship problems. Risk factors for paternal mental health issues are maternal depression, marital distress, parenting stress, gender role stress, mismatched expectations for pregnancy and after childbirth, poor physical health, inadequate self-care behaviours, avoiding seeking help for mental health issues, and having a child with sleeping, feeding and temperament problems. Paternal depression, anxiety and post-traumatic stress disorder can have negative impacts on the social and emotional wellbeing of fathers, their partners and their children. Nevertheless, these issues are not widely acknowledged, recognised or treated. Men’s mental health illness is a silent crisis. They often fail to seek help due to their feeling of shame, stigma for a lack of emotional control, distress or anxiety related to utilising mental health support services, and underrating the severity of their symptoms. These necessitate the need for timely attention, psychological support and proper education to minimise their risk of mental health issues. Although research has indicated fathers’ inclination toward being included in practices such as the mental health assessment, perinatal education and postnatal educational approaches need to be inclusive of fathers and encourage them to seek support for their paternal mental health issues and parenting difficulties.     

The outcome of arginase activity inhibition in BALB/c mice hosting Leishmania tropica

Two species of Leishmania (L), L. tropica and L. major, are among the main causative agents of cutaneous leishmaniasis. Arginase (ARG) is an essential enzyme for cell growth, thus an attractive drug target. In this study, we tried to survey the inhibitory impact of ARG by nor-NOHA (N-ω-hydroxy-L-nor-arginine) on in vivo infection caused by L. tropica. BALB/c mice were inoculated with L. tropica^EGFP-LUC (Ltrop) or L. major^EGFP-LUC (Lmj) and then were treated by nor-NOHA. ARG inhibitor only indicated a delay in generation of a cutaneous lesion in inoculated footpad with nor-NOHA-Ltrop and nor-NOHA-Lmj. ARG activity has been significantly reduced in nor-NOHA-Ltrop group. In this group, ARG activity inhibition correlated with increased levels of nitric oxide (NO). In both inoculated mice with Ltrop or Lmj, parasite load showed a significant decrease at later steps during the CL course post-treatment. In vivo bioluminescence intensity did not show any ARG's inhibitory effect on treated-Ltrop. The findings verified that the ARG activity may partially control the L. tropica infection in BALB/c mice through reduction of parasite proliferation and parasite killing through NO generation. This effect is dose-dependent.