Digoxin and the susceptibility of the canine heart to countershock-induced arrhythmia

This study investigated the effects of therapeutic and subtoxic doses of digoxin on the risk of ventricular tachycardia (VT) after graded, transthoracic shocks in anesthetized dogs. A series of direct current shocks (5, 10, 25, 50, 75, 100, 150 and 200 J) was delivered to 33 normal dogs and 6 dogs with a healed (32 +/- 7 days) myocardial infarct (MI). In 10 untreated dogs, the duration of post-shock VT was highly reproducible when 3 separate series of shocks were delivered at 2-hour intervals. In 6 normal dogs treated with oral digoxin (0.5 mg/day for 5 to 7 days), a series of shocks delivered before and during treatment (serum levels 1.5 +/- 0.5 ng/ml) resulted in the same duration of post-shock VT. In 18 normal and 6 dogs with MI, a series of shocks was given before and 90 minutes after a therapeutic dose of digoxin (0.05 mg/kg intravenously). At this dose of digitalis (serum level 2.5 +/- 1.0 ng/ml), there was no difference in the duration of post-shock VT in either normal dogs or dogs with MI. A third series of shocks was given after achieving subtoxic digitalization with additional intravenous digoxin (0.01 mg/kg) every 30 minutes until a premature ventricular stimulus evoked a repetitive ventricular response. The subtoxic doses of digitalis (serum levels 13.9 +/- 4.7 ng/ml) increased the duration of post-shock VT in both normal dogs (100%) and dogs with MI (700%) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

An investigation of managed health care case managers

Managed care case management is a relatively new concept within health and rehabilitation. As such, it lacks both definition and profiles of those providing services. This paper constructs a definition of managed care case management and presents the detailed results of a survey that identified the characteristics of case managers in the Midwest. The survey was mailed to 250 subjects. The respondents of the survey (N = 56) were relatively young (the largest number of respondents were 30 to 39 years of age), relatively new to their jobs (means = 2.2 years), and were typically employed full-time. They primarily served mental health (n = 43) and physically impaired (n = 30) clients. The highest number of their service referrals were made to vocational rehabilitation specialists, social workers, occupational therapists, nurses, and physical therapists.     

Prevention of occupational and community health problems using Falisan Universal liquid caustic

Based on tests with Falisan-Universal fluid caustic the authors report on measuring results of laboratory tests and analyses of utilization. The air pollution caused by the active agent phenyl mercury acetate and the formulation remedy dimethylformamide is assessed. Conclusions are made for the caustic's application and for its tests.     

Gastric cancer: Prevention,screening and early diagnosis

Gastric cancer continues to be an important healthcare problem from a global perspective. Most of the cases in the Western world are diagnosed at late stages when the treatment is largely ineffective. Helicobacter pylori (H. pylori) infection is a well-established carcinogen for gastric cancer. While lifestyle factors are important, the efficacy of interventions in their modification, as in the use of antioxidant supplements, is unconvincing. No organized screening programs can be found outside Asia (Japan and South Korea). Although several screening approaches have been proposed, including indirect atrophy detection by measuring pepsinogen in the circulation, none of them have so far been implemented, and more study data is required to justify any implementation. Mass eradication of H. pylori in high-risk areas tends to be cost-effective, but its adverse effects and resistance remain a concern. Searches for new screening biomarkers, including microRNA and cancer-autoantibody panels, as well as detection of volatile organic compounds in the breath, are in progress. Endoscopy with a proper biopsy follow-up remains the standard for early detection of cancer and related premalignant lesions. At the same time, new advanced high-resolution endoscopic technologies are showing promising results with respect to diagnosing mucosal lesions visually and targeting each biopsy. New histological risk stratifications (classifications), including OLGA and OLGIM, have recently been developed. This review addresses the current means for gastric cancer primary and secondary prevention, the available and emerging methods for screening, and new developments in endoscopic detection of early lesions of the stomach.     

Patterns of diabetic complications at jimma university specialized hospital, southwest ethiopia

Background

Diabetes Mellitus is common metabolic disease worldwide. Its complications in the Ethiopian care setup has not been well documented. The objective of this study was to assess the pattern and distribution of diabetic complications among patients having follow-up at Jimma University specialized Hospital diabetic clinic.

Methods

A cross sectional study based on record review of 305 patients, selected using systematic sampling with replacement was carried out in October 2008. The data were analyzed using SPSS for Windows version 13.0.

Results

Larger proportion, 189 (62.0%), of patients had type II diabetes and 163 (53.4%) of them were diabetic for less than 5 years. Seventy three of the 76 (96.1%) patients with type II diabetes mellitus had hypertension. Acute complications were observed in 93 (30.5%) of the patients of which Diabetic Ketoacidosis was documented in 66(71.0%).Forty eight (45.7%) of patients had proteinuria, 90 (29.5%) had peripheral neuropathy, 13(6.8%) had impotence. Diabetic foot ulcer, skin and/or subcutaneous tissue infection, dental problems and tuberculosis were documented in 14(4.5%), 31(10.0%), 31(10.0%), and 17(5.6%) patients, respectively. Any of the chronic complications were not different by sex of the patient but age had statistically significant association with hypertension, visual disturbance and neuropathy (p< 0.05). Type of diabetes had statistically significant association with all the tested complications except infection (P<0.05) where most of the complications occurred in type II diabetics. Statistically significant association was observed between the duration of the diabetes and impotence and visual disturbances (p < 0.05).

Conclusion

The majority of patients were type II diabetics. Acute complications were observed more commonly among type I diabetics and DKA was the commonest acute complication. The frequency of chronic complications was high. Increased occurrence of retinopathy, peripheral neuropathy, hypertension and nephropathy was observed with longer duration of illness. Impotence and diabetic nephropathy were more common in type II diabetics. The study showed that age, sex, type of diabetes mellitus and duration of diabetes were significantly associated with the development of diabetic complications.     

Surgical treatment of gastric cancer in Latvia: Results of centralized experience

Background

Although the mortality for gastric cancer is decreasing in Western Europe and United States, it still remains high in Eastern Europe. This study was aimed at evaluating short- and long-term results of surgical treatment of gastric cancer performed in Latvia Oncology Center.

Methods

Retrospectively collected data from 461 patients who underwent gastrectomy with curative intent in Latvia Oncology Center from January 2001 to December 2005 were analyzed statistically.

Results

An average (range) of 92.2 (81–102) R0–R1 gastrectomies was performed each year. Post-operative complications occurred in 75 patients (16.3%); in-hospital mortality was 3.3%. The overall 5-year survival was 50.8%. In 444 cases (96.3%) there was histopathologic confirmation of R0-resection with a 5-year survival of 52.5% (P < 0.001). Considering pT category, 5-year survival was 88.6% for pT1 patients, 65% for pT2, 42.3% for pT3 and 27% for pT4 (P < 0.001). Considering pN category, 5-year survival was 67% for pN0 patients, 30% for pN1 and 29% for pN2-3 (P < 0.001).

Conclusions

Clinico-pathologic characteristics of patients who underwent resection with curative intent are comparable to other Western experiences. Short- as well as long-term results are also similar if not for pN+ patients where no difference between pN1 and pN2 cases was observed.     

Evaluation of T7 and lambda phage display systems for survey of autoantibody profiles in cancer patients

In the current study we attempted to evaluate the suitability of T7 Select 10-3b and λKM8 phage display systems for the identification of antigens eliciting B cell responses in cancer patients and the production of phage-displayed antigen microarrays that could be exploited for the monitoring of autoantibody profiles. Members of 15 tumour-associated antigen (TAA) families were cloned into both phage display vectors and the TAA mini-libraries were immunoscreened with 22 melanoma patients' sera resulting in the detection of reactivity against members of 5 antigen families in both systems, yet with variable sensitivity. T7 phage display system showed greater sensitivity for the detection of antibodies against members of CTAG, MAGEA and GAGE families, both systems showed equal performance in detecting the reactivity against MAGEC and SSX2 while only λKM8 allowed the detection of anti-CTAGE5 antibodies. The biological properties of both phages turned out to be equally suitable for the production of antigen microarrays however in line with the plaque assay the sensitivity for the detection of various autoantibodies differed between the vectors. However, presumably due to the higher variability of the background signals in the microarray assay, it turned out to have comparable, in some cases even slightly lower sensitivity than the plaque assay.

Next, we explored the repertoire of antigens that could be identified by screening T7 phage-displayed testis cDNA library with sera from melanoma patients. From the 243 antigens identified, only 24 represented known genes translated in their natural reading frame and included known TAAs like Annexin XI-A and a novel potential CT antigen SPAG8. Another 12 were uncharacterised genes but the remaining clones contained DNA fragments in non-natural reading frames that most likely represent mimotopes, nevertheless, they may turn out to be valid biomarkers.     

Paraneoplastic encephalomyelitis/sensory motor peripheral neuropathy - an autopsy case study

Paraneoplastic neurological anti-Hu syndrome is one of the most frequent remote effects of cancer and usually manifests as encephalomyelitis combined with peripheral neuropathy. Subacute sensory neuronopathy, which results from the inflammatory destruction of sensory neurone cell bodies in the dorsal root ganglia, is thought to be the principal presentation of peripheral neuropathy. In addition to sensory involvement, evidence of motor nerve involvement is frequently found. The mechanisms of motor involvement remain largely unclear and there have been only a limited number of pathological studies. We present an autopsy case study of anti-Hu paraneoplastic encephalomyelitis/sensory-motor neuropathy, which confirms an inflammatory paraneoplastic destruction of sensory neuron cell bodies in the dorsal root ganglia and lower motor neurons in the spinal cord, as a cause of clinically rapidly progressive peripheral sensory-motor neuropathy.     

Thermodynamic effects of laser irradiation of implants placed in bone: an in vitro study

Lasers have been proposed for various applications involving dental implants, including uncovering implants and treating peri-implantitis. However, the effect of laser irradiation on the implant surface temperature is only partially known. The aim of this pilot study was to determine the effect of irradiation with diode, carbon dioxide, and Er:YAG lasers on the surface temperature of dental implants placed in bone, in vitro. For this study, one dental implant was placed in a bovine rib. A trephine bur was used to create a circumferential defect to simulate peri-implantitis, and thermocouples were placed at the coronal and apical aspect of the implant. The implant was irradiated for 60 s using four different lasers independently and change in temperature as well as time to reach a 10 °C increase in temperature were recorded. There was wide variability in results among the lasers and settings. Time for a 10 °C increase ranged from 0.9 to over 60 s for the coronal thermocouple and from 18 to over 60 s for the apical thermocouple. Maximum temperature ranged from 5.9 to 70.9 °C coronally and from 1.4 to 23.4 °C apically. During laser irradiation of dental implants, a surface temperature increase beyond the “critical threshold” of 10 °C can be reached after only 18 s.