Is chronic nitrate therapy associated with a different clinical presentation of acute coronary syndrome?

BACKGROUND: Nitrate therapy can induce ischemic preconditioning with a consequent increase in tolerance to ischemia. In the context of acute coronary syndromes (ACS), nitrates may result in a different presentation. with greater protection. OBJECTIVES: To investigate in a population of patients with ACS whether previous chronic use of nitrates results in a different presentation of ACS. METHODS: We studied 287 patients (65 +/- 13 years, 66% male) admitted to our department in the first six months of 2005 with ACS (with and without ST-segment elevation). Of these, 8% were under nitrate therapy at the time of admission. In this group, 27% presented ACS without ST-segment elevation, while in the group without nitrates this value was 58% (p = 0.005). By univariate analysis, the use of nitrates was a predictor of the preferential occurrence of non-ST-segment elevation ACS (OR 0.27, 95% CI 0.10-0.71). After correction for the potential influence of variables (age, gender, previous revascularization and smoking) by multivariate logistic regression, nitrate therapy remained a borderline predictor of clinical presentation as non-ST-segment elevation ACS (OR 0.37, 95% CI 0.13-1.04, p = 0.059). CONCLUSIONS: Previous use of nitrates was associated with a tendency to present as non-ST-segment elevation ACS. This finding may be explained by the hypothesis that nitrates induce pharmacological preconditioning, reducing the transmural extent of myocardial infarction.     

Clinical performance of non-contact tonometry by Reichert AT550® in glaucomatous patients

Measuring intraocular pressure (IOP) by non-contact tonometry (NCT) has been demonstrated to be a valid and reliable technique to be used in primary eye care; it is easier to use, it does not transmit infectious diseases, and it is not necessary to use anaesthetic or staining eye drops. Recently, a new NCT device has showed an excellent level of agreement with Goldmann tonometry, but there are no records of its performance in glaucomatous eyes. To rectify this, IOP was measured in twenty-two patients (44 eyes) receiving medical treatment to control elevated IOP, with AT550 and Goldmann tonometry. Mean values of IOP were 18.98 +/- 2.77 and 19.08 +/- 3.02 mmHg using Goldmann and AT550, respectively. Plots of differences against means displayed good agreement (mean difference +/- limits of agreement, -0.09 +/- 3.30); this value was not significantly different from zero (t-test for dependent samples, p = 0.709). In conclusion, IOP values as measured with the AT550 NCT are clinically comparable with those obtained with Goldmann tonometry in glaucomatous patients. This validates this NCT not only for screening of IOP but to follow-up glaucomatous patients with a rapid, non-invasive method.     

Clinical Observation on Effect of Acupuncture in the Treatment of Optic Atrophy

Opticatrophy,acommondiseasewhichleadstoblindness,respondstofewtreatment.However,acupuncturehasbeenactuallyusedandtheclinicaleffectintreatingthisconditionisratherpreferable.Byusingtheacupunctureformula"Three--EyeNeedling",remarkableclinicaloutcomeisachievedandtheresultoftherelatedelectrophysiologicalparametersfollowingtheacupuncturepracticeintreatingopticatrophyhasbeenobserved.METHODSClinicalD8tsTheclinicalmaterialswerecollectedintheSpecialClinicofOpticAtrophyoftheDepartmentofAcupuncture…     

Topical application of fluorides on teeth

Abstract Prevention of caries in exposed root surfaces constitutes an important clinical problem. It is thus important that clinicians involved with periodontology have an insight into fluoride prophylaxis. The understanding of the cariostatic mechanism of fluoride has improved during recent years. The aim of the present review is to give a short account of the present concept. Calcium fluoride appears to be the only product which is formed on enamel, dentin or cementum during brief topical treatments with fluoride or use of toothpaste containing fluoride. This calcium fluoride is stable in the oral environment: this is contrary to what was believed until recently. The calcium fluoride constitutes a pH-dependant reservoir of fluoride which releases fluoride when pH drops. The practical consequences of this concept is discussed.     

Neurologic outcome after heart transplantation in Chagas' disease

Objective - To evaluate the neurologic morbidity after orthotopic heart transplantation (OHT), we examined consecutive Chagas' (Ch) and non-Chagas' (NCh) patients, before and after surgery. Material and methods - We undertook neurological and neuropsychological evaluations in Ch and NCh patients with end-stage cardiac failure, from September 1993 to September 1995. Results - Of 10 Ch patients (mean age=33.6 years; 7 male; mean follow-up=10.8 months) and 13 NCh patients (mean age=50.9 years; 12 male; mean follow-up=15 months) 3 died (rejection and sepsis) without neurologic symptoms. Neurologic complications occurred in 4 Ch and 5 NCh patients. Two Ch patients had skin and myocardial Chagas' reactivation successfully treated, without CNS involvement. NPS performance and return to work rates were similar in both groups. Conclusions - Although Ch patients are potentially at a higher risk of Trypanosoma cruzi reactivation, in addition to all known neurologic complications of OHT, early neurologic complications detected in this sample were similar in Ch and NCh patients and could not be specifically related to Chagas' disease.     

Prolactin activates protein kinase C and stimulates growth-related gene expression in rat liver.

We have examined the effect of prolactin (PRL) on growth-related gene expression, protein kinase C (PKC) activity and diacylglycerol (DAG) mass in rat liver. Hepatic levels of messenger (m)RNA for c-myc, ornithine decarboxylase (ODC) and beta-actin increased in a dose-dependent manner within 1 h after PRL administration. Prolactin also caused a transient elevation of liver DAG levels and particulate-associated PKC activity. The PRL-provoked increases in DAG mass and particulate PKC activity were coincident and maximal at 20 min and began declining toward control levels by 30 min. These results suggest a temporal relationship between PRL-stimulated DAG accumulation and PKC activation. Furthermore, the subsequent rapid induction of growth-related gene expression provides new information on the role of PRL as a hepatic mitogen.     

氟罗沙星的体内外试验相关性研究

本文研究了新型喹诺酮类药物氟罗沙星体外溶出与体内吸收之间的相关性。实验表明，本品口服吸收在血清中达峰时间较快，作用持久，消除半衰期为９．６０ｈｒ。在人工胃液中溶出速率较快，在血清达峰之前，体内吸收与体外溶出量之间呈现良好的相关性。     

A preliminary study of reaction time in schizophrenics

The aim of this study was to make a preliminary study of auditory reaction time (ART) and its significance in cases of schizophrenia. It was found that ART is significantly affected and prolonged in schizophrenia as compared to normal healthy controls (P less than 0.001) when the stimulus is presented to both ears or either car separately. Distractability was higher in schizophrenics as compared to adult controls (P less than 0.001). There was no significant difference in ART within the patient group when the stimulus was presented to the right ear or left ear (P greater than 0.05). There was no significant difference between ART of male and female schizophrenics (P greater than 0.05).