Comparative actions of substances affecting cyclic AMP metabolism on the isometric contractions of fast and slow skeletal muscle during single-pulse and subtetanic stimulation

Increasing concentrations of isoprenaline (0.5-4 muM) produced a dose-dependent increase in both TD and dT/dtmax during direct single-pulse stimulation of hemidiaphragm of the rat. The same drug during the same type of stimulation produced an insignificant change in these parameters of the isometric contraction of the isolated guinea-pig soleus muscle. On the contrary, isoprenaline produced a dose-dependent decrease of the isometric contraction during subtetanic stimulation of the soleus muscle. Contrary to the results obtained on hemidiaphragm, there was no interaction between halothane and aminophylline on the soleus muscle. In the soleus muscle, aminophylline (0.3-3.2 mM) produced a dose-dependent increase in TD and dT/dtmax during single-pulse stimulation, whereas isoprenaline failed to do so under the same experimental conditions, in spite of the fact that both substances are activators of cyclic AMP system. The beta2-selective adrenoceptor agonist terbutaline acted in the same way as isoprenaline. During subtetanic stimulation aminophylline (0.3-3.2 mM) produced a dose-dependent decrease of both parameters of the isometric contraction of hemidiaphragm, which is opposite to the results obtained during single-pulse stimulation. It is concluded that various types of electrical stimulation can produce different responses in slow and fast-contracting muscles, depending on the fundamental biochemical differences of two types of muscle, but some of these responses are the same irrespective of the method of muscle activation.     

Trends in consumption of psychiatric drugs in Serbia and Montenegro 2000-2004

PURPOSE: To investigate the trends in psychiatric drugs utilization in Serbia and Montenegro over the 5-years period (2000-2004). MATERIALS AND METHODS: The wholesale data issued by the manufacturers or distributors were used. Also, the lists of drugs used from the Institute of Mental Health (institution which provides primary, secondary and tertiary psychiatric care) were used to corroborate the wholesale data. The utilization of drugs in general population was calculated using ATC/DDD methodology, and was expressed in Defined Daily Doses (DDD) per 1000 inhabitants per day. The utilization of drugs in the Institute of Mental Health was calculated from the hospital pharmacy records and was expressed as the number of DDDs per 100 bed-days. The statistics was performed using standard statistical methods. RESULTS: The general consumption of psychiatric drugs in Serbia and Montenegro significantly increased during the 2000-2004 period (from 45.1 DDD/1000 inhabitants/day in 2000 to 69.1 DDD/1000 inhour/day in 2004). The general utilization of anxiolytic/hypnotic drugs surged significantly, but the inhospital use remained rather stable. The most prominent changes were noted in the utilization of antidepressants, which doubled in that period, both in general and inhospital settings. Among antipsychotics in general population, there is a significant increase in the utilization of clozapine. In inhospital setting, there is a significant increase of total utilization of antipsychotic drugs, but this is also mainly on the account of atypicals. CONCLUSIONS: The total consumption of psychiatric drugs significantly increased. The utilization of anxiolytic/hypnotic drugs in 2004 reached 60 DDDs/1000 inhabitants/day, which is in collision with the trend in developed countries. It is necessary to form national guidelines for prescribing anxiolytic/hypnotic drugs, in order to rationalize their use. More favourable is the antidepressant (SSRIs in particular) and atypical antipsychotic drugs utilization increase.     

Maternal identity change as a consequence of antenatal hospitalization

Despite low fertility rates in Western countries, maternity remains one of the major goals of women from various socioeconomic backgrounds. While most women will have low-risk pregnancies, common serious disorders of pregnancy, such as preeclampsia, premature rupture of the membranes, placenta previa, or fetal growth restriction, may compromise maternal and infant outcomes. The experiences of urban and rural women in Australia who have had difficulties in maintaining their pregnancies are analyzed in this article. We study the impact of individual and social factors that facilitate or impede women's adjustment to the risks associated with these disorders. The analysis of in-depth interviews with 27 women hospitalized antenatally indicates that most women were unfamiliar with the diagnoses and acted as passive "decision takers," complying with medical advice to remain in the hospital. Admission to a tertiary hospital ward that provided care to women with pregnancy disorders promoted the formation of a new identity, that of a woman whose pregnancy did not follow the expected path. Further, hospitalization offered women the opportunity to interact with others in similar difficult situations and, hence, feel less isolated.     

Temperature dependence of the effects of isoprenaline, aminophylline and calcium ionophores on the isometric contraction of the isolated hemidiaphragm of the rat.

Both parameters of isometric contraction, Td and dT/dt max, of the isolated hemidiaphragm of the rat, as measured during the action of isoprenaline in the course of direct electrical stimulation, were significantly affected by lowering the temperature of the bath to 18°C. The action of isoprenaline was only depressed, whereas the effect of aminophylline was completely blocked by this procedure. The effect of calcium chloride in antagonizing the blocking action of di-Na-EDTA was even stronger at 18°C than at 36°C. Calcium ionophores Ro-2-2985 and A 23187 produced an increase in Td and dT/dt max when used in lower concentrations, but higher concentrations regularly produced depression or block of the isometric contraction. The increasing effect of Ro-2-2985 on Td and dT/dt max was completely reversed by lowering the temperature to 18°C. It was shown that at 18°C neither calcium nor isoprenaline antagonized the blocking action of verapamil on Td and dT/dt max, thus indicating the alteration of calcium channels at low temperatures. A 23187 potentiated the action of isoprenaline on Td and dT/dt max, whereas Ro-2-2985 blocked it. Similarly, the inrcreasing effect of db-cAMP on Td and dT/dt max was reversed by Ro-2-2985. It is concluded that both lowering the temperature of the medium and the calcium ionophores produce changes in the response to isoprenaline and aminophylline, during direct electrical stimulation, in a way which is compatible with the view that the interaction between calcium and cAMP system is essential to the isometric contraction of skeletal muscle.     

The association between in vivo physicochemical changes and inflammatory responses against alginate based microcapsules

Application of alginate-polylysine (PLL) capsules for immunoisolation of living cells are suffering from a varying degree of success and large lab-to-lab variations. In this study we show that these differences in success rates can be attributed to alginate dependent essential physicochemical changes of the properties of capsules in?vivo that will render the capsules more susceptible to inflammatory responses. Capsule properties were studied before and after implantation by XPS, by immunocytochemistry, and by measuring zeta potentials. We studied a capsule type which provokes for unknown reasons a strong inflammatory response, i.e. high-guluronic (G) alginate capsules and a capsule type with near identical physicochemical properties but which evokes a minimal inflammatory response, i.e. intermediate-G alginate capsules. The cause of the difference in response was a decrease in nitrogen content on high-G capsules due to detachment of PLL in?vivo and an increase of the zeta-potential. Our data illustrate an important overlooked phenomena; the physicochemical properties are not necessarily the properties after exposure to the in?vivo microenvironment and might induce undesired inflammatory responses and failure of encapsulated cellular grafts.     

Autonomic effects of refractory epilepsy on heart rate variability in children: influence of intermittent vagus nerve stimulation

Aim Vagus nerve stimulation (VNS) is a therapeutic option for individuals with refractory epilepsy. Individuals with refractory epilepsy are prone to dysfunction of the autonomic nervous system. Reduced heart rate variability is a marker of dysfunction of the autonomic nervous system. Our goal was to study heart rate variability in children with refractory epilepsy and the influence of VNS on this parameter. Methods In 17 children (13 male; four female; mean age 7y 6mo; age range 3–16y) with refractory epilepsy, electroencephalographic and electrocardiographic data were obtained before and after implantation of VNS during stage 2 and slow‐wave sleep. Time and frequency domain parameters were calculated and the results were compared with an age‐ and sex‐matched group of individuals without refractory epilepsy. Results Our results show that autonomic cardiac control is affected in individuals with refractory epilepsy. There is a striking reduction in vagal tone during slow‐wave sleep and modulation capacity is smaller than in individuals without refractory epilepsy. Implantation of VNS induces a shift in sympathovagal balance towards sympathetic predominance and an improvement in autonomic modulation. Interpretation Heart rate variability is affected in children with refractory epilepsy, and changes after implantation of VNS. The observed changes could be of importance in the cardiac complications of individuals with epilepsy and should be explored in more detail.     

Appendicitis in puerperium--case report

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atip cal appendix presentation makes dificulties in diagnosis. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chanse for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.     

Preoperative preparation of pregnant women

All the elective surgeries are to be avoided during pregnancy and pregnant women should undergo only emergency surgical interventions. Pregnancy is associated with different physiological changes in the organism, which should be taken into account in preparative preparation of the pregnant women. Expanded body fluid volume leads to dilutional anemia, however other hematological disorders may be present as well. Extreme obesity is a frequent comorbidity, while hypertension is associated with the highest risks since it may lead to a life-threatening complication--eclampsia. As for other coexisting diseases, urinary tract infections and gestational diabetes are the most common as well as hyperthyroidism and other diseases that may also develop. The type and severity of the acute surgical disease, extensiveness of the planned surgery as well as the type of planned anesthesia to be applied, occasionally necessitate, depending on the gestational age, termination of pregnancy to be considered. Gynecological-obstetric consultations are mandatory in all surgical interventions planned in pregnant women.     

Is identification of malignant lesions of the liver and of hemangiomas possible by Doppler ultrasonography and radionuclide angiography?

The aim of this study was to try to diagnose malignant liver lesions and hemangiomas by means of vascularisation and perfusion studies. The study was performed in 32 patients with hepatocellular carcinoma (HCC), in 74 with metastatic liver carcinoma (MLC) and in 40 with hemangiomas (H). Color Doppler ultrasonography (DUS) was done with an ATL Ultramark 9 apparatus with convex probe 2.5 MHz using pulse and DUS. Hepatic radionuclide angiography (HRA) was performed with bolus injection of 740 MBq (99m)Tc-pertechnetate, (1 min, 1 f/s), using ROTA scintillation camera and MicroDelta computer. Hepatic perfusion index (HPI) indicated the percentage of the portal blood inflow to the liver. Our results showed that in HCC and MLC there was a decrease of portal inflow while arterial inflow was increased resulting in pulse arterial wave velocity increase and in continuous venous waves velocity in the tumors. There was significant linear correlation between the increase of the arterial inflow and the arterial pulse wave found in the center and in the margin of the tumors. In hemangiomas, hepatic perfusion index related to arterial inflow was within normal range. In conclusion, our results suggest that HCC and MLC have specific characteristics in vascular and/or perfusion studies while hemangiomas show normal liver parenchyma findings.