Pulmonary embolism in a patient with unstable angina treated with surgical revascularisation--a case report

A case of a 58-year-old female patient with unstable angina is presented. Two weeks earlier the patient suffered from acute myocardial infarction treated with thrombolysis. The patient underwent surgical revascularisation which was complicated by acute pulmonary embolism. Repeated surgery and inspection of pulmonary arteries revealed the presence of thrombus which was successfully removed. The post-operative course was uneventful. The causes and treatment of pulmonary embolism complicating coronary artery by-pass grafting are discussed.     

Control of fertility in the red fox (Vulpes vulpes): effect of a single oral dose of cabergoline in early pregnancy

Single oral doses of 100 microg kg(-1) cabergoline (CAB) were previously found to affect the reproductive success of silver fox (Vulpes vulpes) vixens from Day 28 post insemination (PI) onwards by causing abortions and postnatal mortality. The present trial investigated the effect of a single oral dose of 100 microg kg(-1) CAB given to farmed silver fox vixens at 7, 14, 21 or 28 days PI. Six vixens were dosed with CAB at each day PI and abortions, total post-partum litter loss and the combined effects of both were compared with a group of vixens that received a placebo and a control group of vixens that received no treatment. No significant difference existed between the placebo and control groups in the incidence of abortion, postnatal litter loss and litter size at 3 weeks post partum. Overall, a significantly higher frequency of abortions were detected in vixens dosed with CAB (6/24) compared with the combined placebo and control (0/41) groups (P<0.01). Cabergoline administration was significantly associated with complete litter loss (P<0.01) and the combined effects of abortion and litter loss (P<0.001). Oral CAB significantly reduced the reproductive success of vixens when given at Day 21 and Day 28 PI, but not at Day 7 and Day 14 PI.     

The acute nootropic effects of Ginkgo biloba in healthy older human subjects: a preliminary investigation

Ginkgo biloba has been shown to have chronic memory enhancing effects in healthy subjects and patients with dementia. There is limited research on the acute nootropic effects of Ginkgo biloba in humans. The current study aimed to examine the acute effects of Ginkgo biloba (120 mg) on memory functioning in healthy older volunteers using the cognitive drug research (CDR) battery of memory tests and the Rey auditory verbal learning task (AVLT). The study was a double-blind placebo-controlled design, with each participant tested under both placebo and Ginkgo biloba treatment conditions. Testing was conducted pre- and 90 min post-drug administration for each treatment condition. Treatment conditions were separated by a 7 day wash out period. No acute effects of Ginkgo biloba were found for any of the memory tests examined. The findings suggest that 120 mg of Ginkgo biloba has no acute nootropic effects in healthy older humans.     

Effect of coronary artery bypass graft in patients with unstable angina on left ventricular remodelling in medium-term follow-up

INTRODUCTION: Left ventricular remodelling is a process of change in size, shape, wall thickness and heart function, initiated by a noxious stimulus such as ischaemia. Methods of pharmacological and surgical inhibition or reversal of remodelling are being sought. AIM: To assess the influence of coronary artery bypass grafting on echocardiographic measures of left ventricular size and shape in medium-term follow-up. METHODS: In a group of 30 patients three echocardiographic examinations were performed: before CABG operation, 3 months after and 20 months after the operation. Left ventricular area and volumes as well as indices of sphericity, thinning and expansion were calculated. RESULTS: After the operation, left ventricular areas measured in short axis and in apical four-chamber view increased among patients with a history of myocardial infarction. Improvement in the sphericity index occurred after the operation in patients with a history of myocardial infarction in whom the ejection fraction before the operation was less than 50%. CONCLUSIONS: The left ventricular remodelling process progresses after coronary artery bypass grafting in patients with a history of myocardial infarction. Inhibition of remodelling may be expected in patients without myocardial infarction, with preserved left ventricular systolic function.     

Prediction of fusion and importance of radiological variables for the outcome of anterior cervical decompression and fusion

In a prospective randomised study with a 2-year follow-up, 103 patients were randomised to anterior cervical decompression and fusion (ACDF) with a cervical carbon-fibre intervertebral fusion cage (CIFC) or the Cloward procedure (CP). The purpose of the present study was to report predictors for fusion and also to investigate the importance of radiological variables for the clinical outcome. Gender, age, smoking habits, disc height, segmental kyphosis and type of surgical procedure were used as independent (before surgery) variables in a multiple regression model. Male gender, one-level surgery and CP treatment were significant predictors of fusion and explained 14% of the variability of fusion status at follow-up. Number of levels operated on, however, did not influence the clinical outcome. Fifty-two per cent of the women and 17% of the men in the CIFC group, and 25% of the women and 8% of the men in the CP group, had pseudarthrosis. Although patients with a healed fusion had significantly less pain intensity than patients with pseudarthrosis, radiological variables explained only 4% of the variability of pain at follow-up. Apart from a significant correlation between preoperative kyphosis and neck disability index at follow-up, no significant correlation between either postoperative kyphosis or preoperative or postoperative disc height and clinical outcome was found. Neither degree of segmental kyphosis nor disc height was different between patients with healed fusion and pseudarthrosis. One can conclude that male gender and type of surgery were significant predictors for a healed fusion and that pseudarthrosis affected outcome. In contrast to the commonly held view based mainly on theoretical considerations, no effect on clinical outcome could be demonstrated for segmental kyphosis and disc height at follow-up. Overall, the study shows that the importance of radiological factors as predictors for fusion as well as clinical outcome is limited.