Effects of N-acetyl-l-cysteine,in vivo,against pathological changes induced by malathion

Malathion toxicity has been related to the inhibition of acetylcholinesterase, induction of oxidative stress, liver damage and impairment of kidney function as well as hematotoxicity. N-acetyl-l-cysteine (NAC) has been shown to possess curative effects in experimental and clinical investigations. The present study was designed to evaluate the protective effect of NAC against toxic consequences of malathion exposure in Wistar rats. Malathion was given daily to rats via oral gavage and NAC in drinking water during seven days. When malathion-treated rats were compared with control, a leukocytosis and reduced hemoglobin (HGB) content were detected. Furthermore, malathion produced a significant increase in liver enzymes such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, lactate dehydrogenase and creatinine kinase. In addition, a decrease in acid phosphatase activity, protein and globulin levels were observed in malathion-treated rats compared with control. Moreover, analyses of the mineral status showed a disturbance in calcium, magnesium, phosphore and iron contents of the malathion-treated rats. Interestingly, NAC showed therapeutic effects against malathion toxicity. Indeed, HGB content and all liver enzymes were restored to normal values. Finally, the use of NAC as therapeutic agent for only seven days during malathion exposure showed interesting results on tissues damages.     

MDCT angiography and coronary catheter angiography in patients with chest pain which is first

Back ground

In some patients suffering from chest pain, we must start by non-invasive coronary CT angiography (CCTA) to protect these patients from unnecessary invasive coronary catheter angiography (CCA).

Obstetric deaths in Menoufia Governorate, Egypt

Summary. A survey of all registered deaths which occurred during 1981–1983 in women of reproductive age was carried out in Menoufia Governorate, Egypt. Surviving family members were interviewed by trained social workers, and Information was collected on Symptoms of the disease that led to death. The completed questionnaires were reviewed by a panel of local physicians and a cause of death was assigned by the panel. Maternal mortality was a leading cause of death, second only to heart disease. There were 190 maternal deaths per 100 000 livebirths and 45 maternal deaths per 100 000 married women aged between 15 and 49 years. Most of the maternal deaths (63%) were due to direct obstetric causes of which haemorrhage was the main cause. Another 27% of the maternal deaths were due to indirect obstetric causes of which rheumatic heart disease was the main cause.     

Bayesian estimation of six different sets of carbamazepine pharmacokinetic parameters in Egyptian adult epileptic patients.

The individualization of carbamazepine (CBZ) dosage regimen based on estimation of pharmacokinetic (PK) parameters and measurement of serum drug concentration in epileptic patients can help to control epilepsy. In a retrospective study, the predictive performance of six different sets of CBZ PK parameters selected according to the literature was evaluated in 60 adult epileptic patients. Patients were administered controlled release CBZ (dose range: 200-1200 mg day(-1)) as monotherapy and one steady state serum concentration of the drug was available for each patient. The Bayesian Program of Abbott (PKS system; Abbott Laboratories, Wiesbaden, Germany) was used in the prediction process. Predictive measures included estimation of mean prediction error (mpe) for bias, mean squared prediction error (mspe) and root mean squared prediction error (rmspe) for precision. The analysis showed that three of the investigated six sets achieved the best predictive performance in Egyptian patients and consequently, the PK parameters of any of these three sets can be used by the Bayesian approach as prior information for CBZ dose optimization among the Egyptian adult population.     

Evolution of treatment of high-risk metastatic gestational trophoblastic tumors: Ain Shams University experience

The aim of the current study is to evaluate the different treatment modalities used in the management of high-risk metastatic gestational trophoblastic tumors (GTT) between June 1992 and December 2004 at the Gynecologic Oncology Unit, Ain Shams University. Out of 261 patients diagnosed and treated for GTT, 70 (26.8%) were high risk metastatic patients based on the National Institutes of Health clinical classification. The mean age was 29.39 +/- 9.38 years (16-55 years), with six patients (8.6%) being older than 39 years, and the mean duration of follow-up was 79.74 +/- 40.44 months (6-157 months). Forty patients (57.14%) were diagnosed after molar pregnancy, 22 (31.43%) after abortion, and 8 (11.43%) after term pregnancy. Forty-two patients (60%) were diagnosed within 4 months of the occurrence of the disease, and 28 (40%) were diagnosed after more than 4 months. Sixty-seven patients were treated using different regimens according to the protocol of treatment at that time. The MAC regimen was used initially but has been subsequently abandoned in favor of EMA-CO (etoposide, methotrexate, dactinomycin, cyclophosphamide, and vincristine [Oncovin]) regimen, which was later modified by omitting the CO arm to decrease its toxicity. If resistance developed, platinum-based therapy was given in the form of EMA-EP. Recently, our unit incorporated paclitaxel in the third-line treatment. Surgical intervention was used selectively. Fifty-seven (81.4%) patients could be cured; 43 by initial chemotherapy, with a mean of 7 +/- 0.46 courses (6-15), and 14 were salvaged by second- or third-line chemotherapy. Fourteen patients (20%) died during the study period; one was unrelated to GTT, while three died of acute respiratory distress syndrome before instituting proper therapy and two died of treatment complications. Using univariate and multivariate Cox regression analyses, the presence of brain and/or liver metastases was found to be the worst prognostic variable affecting the survival, followed by resistance to combination chemotherapy and then the type of antecedent pregnancy. The projected 5-year survival as estimated by Kaplan-Meier method was 78%.     

不同程度肩峰下撞击综合征的临床检查准确性

背景：已经有多种检查方法用于诊断肩袖疾病，但尚缺乏它们用于诊断单纯滑囊炎、肩袖部分撕裂及全层撕裂方面的研究。本研究假设肩袖损伤的严重程度可影响常用临床检查方法的诊断价值。方法：三种不同程度的肩袖损伤，即滑囊炎、肩袖部分撕裂和肩袖全层撕裂，通过八项物理检查方法（Neer撞击征、Hawkins-Kennedy撞击征、疼痛弧征、冈上肌肌力试验、Speed试验、交叉内收试验、坠臂试验和冈下肌肌力试验）来评价它们的诊断价值，以似然比和验后概率作为评价指标。并用前向逐步logistic回归分析法确定诊断不同程度撞击征的最佳组合检查。结果：八项检查方法的灵敏度、特异度、阳性预测值、阴性预测值和总体准确性差异非常大。Hawkins-Kennedy撞击征、疼痛弧征和冈下肌肌力试验的组合对各种程度撞击征的验后概率最高（95％），疼痛弧征、坠臂征和冈下肌肌力试验组合对肩袖全层撕裂的验后概率最高（91％）。结论：撞击征的严重程度影响这些常用临床检查方法的诊断价值。评估肩袖损伤患者的病情时，应考虑这些检查方法准确性的差异。     

心理理论中的规则理论

目的:心理理论现有的规则理论是"认知复杂及控制理论"与"关系复杂理论",通过对这两个理论的比较、分析,意图对个体心理理论能力发展做深入探讨。资料来源:应用计算机检索Elsevier数据库和CNKI数据库1996/2005相关文章,检索词为"theroy of mind,rule,cognitivecomplexity,relational complexity,心理理论,规则"。资料选择:选择阐述"认知复杂及控制理论"与"关系复杂理论"的文章,排除重复文章。资料提炼:共检索到47篇关于心理理论的规则理论方面的文献,纳入33篇。资料综合:认知复杂及控制理论将执行上的失败归因于缺少对规则的反思,而不是归因于缺少对规则的意识;关系复杂理论通过概念组块和分段法降低加工负荷,它对变量进行压缩处理。关系复杂理论中的概念组块和认知复杂及控制理论中的反思来自于不同的方向,概念组块可以认为是来自通过组块对工作记忆负担的减轻,进而对复杂性程度的降低;而反思是个体本身对规则的再认识,这一过程又受到诸多因素的影响才能从多个简单规则整合成一个规则。关系复杂理论和认知复杂及控制理论都能够对心理理论任务进行解释,而真正非实验条件下的心理理论任务就需要更多的考量因素。结论:当面对多样性和层次性的心理理论任务时,这两个理论所作出的自上而下的"反思"与自下而上的"组块"有必要整合起来,形成解决任务的整合规则。