Dietary polyamines promote the growth of azoxymethane-induced aberrant crypt foci in rat colon

We have examined whether dietary polyamines influence the formation and initial growth of azoxymethane (AOM)-induced aberrant crypt foci (ACF) in rat colon. Effects of a combination of dietary polyamines at three dose levels (putrescine: 50, 280, 740 nmol/g; spermidine: 10, 261, 763 nmol/g; spermine: 1, 31, 91 nmol/g) in the polyamine-poor AIN-76A diet were studied in animals in two different experimental situations: animals treated with AOM alone and animals treated with AOM + difluoromethylornithine (DFMO), a specific inhibitor of endogenous polyamine synthesis. In both experimental situations, dietary polyamines enhanced the growth of ACF, expressed as the number of large ACF (foci with three or more aberrant crypts, ACF > or = 3), whereas the formation of ACF, expressed as the number of ACF, was apparently not altered. In animals treated with AOM alone, maximal growth enhancing effect on ACF was nearly obtained with the median level of dietary polyamine. In rats fed a low polyamine diet, basic AIN-76A, DFMO reduced the growth of AOM-induced ACF by 83%. This inhibitory effect of DFMO was counteracted by dietary polyamines in a dose- dependent manner, and it was abolished at the highest level of polyamines. In conclusion, it was demonstrated that dietary polyamines are able to enhance the growth of AOM-induced ACF. Further, dietary polyamines reversed the DFMO-caused inhibition of ACF growth, probably by compensating for the DFMO-reduced endogenous polyamine synthesis.      

Superior performance of 18F-fluorocholine digital PET/CT in the detection of parathyroid adenomas

To compare detectability of hyperfunctioning parathyroid tissue (HPT) by digital and analog 18F-fluorocholine PET/CT in patients with primary hyperparathyroidism and negative/inconclusive 99mTc-MIBI scintigraphy-SPECT/CT. Thirty-three patients with primary hyperparathyroidism and negative/inconclusive 99mTc-MIBI scintigraphy-SPECT/CT were prospectively included. All patients accepted to be scanned by digital and analog PET/CT in the same imaging session after a single injection of 18F-fluorocholine. Three nuclear medicine physicians evaluated the digital and analog PET/CT datasets to assess the detection rate of HPT. Maximum standard uptake values (SUVmax) of HPT and locoregional lymph nodes were measured in both systems. HPT was detected in 30/33 patients by the digital system, whereas it was detected in 22/33 patients by the analog system (p < 0.01). Moreover, in 21 of these 33 patients, both systems detected one focal 18F-fluorocholine uptake, and in one patient the digital system detected two foci. Histopathology demonstrated HPT in 32 patients and it was inconclusive in one patient. The digital PET/CT detected HPT in 29 of the 32 patients, and the analog system in 22 of the 32 (p < 0.01). All HPT suspected lesions resected and detected only by the digital system (n = 8) were < 10 mm (7.5 ± 1.3 mm), while those detected by both systems (n = 22) were > 10 mm (13 ± 3.8 mm). SUVmax of HPT lesions was significantly higher than SUVmax of locoregional lymph node independently of the PET/CT system used (4.5 ± 1.9 vs. 2.9 ± 1.3, p < 0.0001). Digital PET/CT offers superior performance over analog system in patients with suspected HPT and previous negative/inconclusive imaging examinations, particularly in sub-centimeter lesions. SUVmax can help in the differentiation between HTP and locoregional lymph nodes.     

Hygienic assessment of trace element levels in drinking water and food products within the system of socio-hygienic monitoring system

The paper provides a comprehensive hygienic assessment of the levels of the essential and toxic trace elements chosen in terms of regional features in drinking water and foodstuffs of locally manufactured products. Priority pollutants of drinking water and foodstuffs are defined in the eastern, western, and central lands of the Orenburg Region. A significant imbalance of essential trace elements was revealed. Daily oral intake of priority and toxic trace elements were calculated in foodstuffs and drinking water.     

Antihypertensive efficacy, tolerance and safety of lisinopril (sinopril) and captopril (capoten) in patients with mild and moderate arterial hypertension

AIM: To compare effectiveness, tolerance and safety of two inhibitors of angiotensin-converting enzyme--sinopril (lisinopril) and capoten (captopril)--in outpatient treatment of patients with mild and moderate hypertension. MATERIALS AND METHODS: The patients were randomly assigned to sinopril or capoten groups. Sinopril was given in daily dose 10-40 mg, capoten--in daily dose 25-100 mg for 8 weeks. In insufficient antihypertensive effect of monotherapy on day 21, hydrochlortiaside was added. The effect was judged by influence on arterial pressure, heart rate, tolerance (questionnaire), safety (blood count, urinalysis. ECG). RESULTS: Sinopril produced good antihypertensive effect in 73.3% of patients (monotherapy) and 88.9% (combined therapy). For capoten it was 68.9 and 82.2%, respectively. The time of the beginning of the antihypertensive effect (4-20 days after the start of the treatment) for sinopril and copoten differed insignificantly and depended on hypertension severity (mild or moderate). Tolerance of both drugs was good, serious side effects were absent. Discontinuation of the drugs was needed in 4% of patients, only. No negative action on bioelectric activity of the heart, clinical and biochemical blood indices were found. CONCLUSION: Sinopril and capoten demonstrate high antihypertensive activity.     

Functional activity of platelet guanylate cyclase and cardiac hemodynamics in patients with chronic heart failure and relevant changes after treatment with isosorbide-5-mononitrate]

AIM: To study effects of long-term administration of isosorbide-5-mononitrate (monochinquare retard-MR) on functional activity of soluble guanylate cyclase (GC), cardiohemodynamics and exercise tolerance in patients with coronary heart disease (CHD) complicated by chronic cardiac failure (CCF). MATERIALS AND METHODS: The trial included 20 males aged 58 to 77 years with CHD, effort angina (NYHA class II-III), CCF (NYHA class I-II). Endothelial function was assessed before the treatment and 12 weeks after it by indirect measurement of production of endothelial relaxing factor (NO)--by activation of platelet soluble GC in the presence of its activators: L-arginine, disulphide, sodium nitroprusside and protoporfirine IX. Hemodynamic parameters, morphofunctional condition of the heart, exercise tolerance test results were compared with changes in GC functional activity after 12 weeks of MR monotherapy. RESULTS: Two types of the changes were revealed. Type I (n = 14): high GC basal activity and low activity before the treatment with normalization of all the parameters after the treatment. Type II (n = 6): initially normal basal activity and GC activation with their lowering after the treatment. MR in a single daily dose 50 mg given for 12 weeks has improved morphofunctional cardiac parameters with a reduction of left ventricular volume, a 8.3% increase in the ejection fraction and a 117% increase in exercise tolerance. GC activity inhibition was recorded in some cases, in angina class III, in particular. In patients with normalization of GC activity the response was higher than in those who demonstrated inhibition of GC activity. CONCLUSION: MR therapeutic action may be due to enhancement of soluble GC activity which was observed in 70% of the cases.     

Main points of a modular approach to developing educational programs for the postgraduate training of physicians in the area of anesthesiology and reanimatology

The uniquely shaped and contained structure of a modular approach to organizing an academic process, which comprises a conceptual rationale for the conversion of an educational process in accordance with a modular design, is detailed in the paper. All learning modules have the similar structure consisting of the following sections: background, general and specific objectives, contents, methods of teaching and assessment, the place and conditions of training. The authors provide evidence for the use of a module as a form of organization of individual educational programs, curricula, and academic plans of subject-matter during postgraduate training of physicians. Module education is shown to get over the fragmentariness of an academic process, by working out a comprehensive educational program and making a problem presentation of the contents in the module. The development of educational modules is to eliminate parallelism, temporary and logic gaps between various topics, to upgrade the quality of education, and to enhance the efficiency of a medical specialist's self-work. The authors analyze in detail the advantages of the module approach in improving an academic process during postgraduate training of physicians. They also present guidelines for the introduction of module technology in accordance with the principles of the European educational system.