The combination of an acute ventricular septal defect (VSD) and left ventricular aneurysm (LVA) is a rare, life-threatening complication which usually occurs within the first week following acute myocardial infarct- tion (AMI). We describe the case of an apical VSD and LVA in a 77-year-old diabetic and dyslipidemic male patient after anterior AMI. The patient was an active smoker and had a history of chronic obstructive pulmonary disease, arterial hypertension and atrial fibrillation. The patient underwent ventriculotomy for VSD repair using a large equine pericardial patch followed by intraventricular patch remodelling of the LVA. He was discharged 2 months after surgery and underwent a successful hip replacement 10 months later.
8/26/2014
Acute ST-segment myocardial infarction—Evolution of treatment strategies
The commonest cause of acute myocardial infarction involves the rupture or erosion of vulnerable atherosclerotic plaques followed by aggregation of platelets and subsequent thrombus formation, leading to partial or complete epicardial coronary arterial occlusion. Over the last 25 years, advancement in therapeutic options for acute myocardial infarction has resulted in substantial improvement in morbidity and mortality. As a result, the absolute risk reduction of in-hospital deaths for patients presenting with STEMI has been on the decline in the last decade. The focus of the treatment for acute myocardial infarction involves achieving epicardial and microvascular patency, prevention of recurrent ischaemic events while balancing the risk of bleeding. This involves antiplatelet and antithrombotic therapies or fibrinolytic agents when timely performance of primary percutaneous coronary intervention is not possible. We review the evolution of treatment strategies for STEMI that has contributed to the improvement in patient outcome.
Acute myocardial infarction with normal coronary artery (MINCA) in a patient with multiple sclerosis
Interestingly, some patients with ST elevation myocardial infarction have normal coronary artery anatomy at cooronary angiography. This situation is called as MINCA (acute myocardial infarction with normal coronary artery). The incidence of MINCA varies between 1.0% and 8.5%. Although some reasons have been propounded, the exact underlying mechanism remains unclear. Nevertheless, thoracic myelitis can be as a possible cause of myocardial infarction. Herein, we report a case of acute myocardial infarction with normal coronary artery in a patient with multiple sclerosis.
White blood cell count and mortality in acute myocardial infarction
Introduction: Coronary atherosclerosis is increasingly viewed as an inflammatory process. We assessed the relation between WBC count on admission and mortality in STEMI patients treated with primary PCI. Material & Method: Totally 205 patients with STEMI less than 24 hours before admission who admitted for primary angioplasty enrolled in study. Study end points were defined as myocardial adverse cardiac event (MACE) and mortality at one month and one year follow-up. Result: Totally 205 patients (166 men) with mean age 56 ± 11 were enrolled in study. The mean WBC count was 8983 ± 34 and mean follow-up was 12.24 months. WBC count remained a significant predictor of mortality after multivariable adjustment in one month and 12 months follow-up (p = 0.02, p = 0.04). Conclusion: Our results extend previous find-ings that WBC count is an independent marker of cardiac mortality.
Rapid decrease of necrotic core after acute myocardial infarction
Author(s)：Jun Ho Lee, Eun-Seok Shin, Shin-Jae Kim, Jong Min Kim, Jung Won Hwang, Hector M. Garcia-Garcia, Patrick W. Serruys
It is well known that the increase of necrotic core in previous atherosclerotic coronary artery disease is one of the conditions of vulnerable plaque. However, it is not known how fast necrotic core could decrease in a vulnerable plaque. We had 2 patients who had suffered from acute myocardial infarction and had large amount of necrotic core in their culprit lesions at baseline, which decreased markedly within 7 days. Also, they were clinically stable and asymptomatic over 1 year follow-up. It is first report to show mar-kedly decrease of necrotic core amount within only 7 days in culprit lesions of 2 cases of acute myocardial infarction with angiographically minimal lesions.
8/20/2014
Effects of air pollution on the risk of acute myocardial infarction in Charleroi, Belgium
Atmospheric pollution would increase morbidity and mortality rates for various respiratory illnesses in urban areas, and could also be an explanatory factor of higher rates of myocardial infarction in Charleroi compared with the other Belgian cities. The present study investigates the health effects of acute exposure to air pollution on cardiovascular morbidity/mortality in Charleroi. The study is based on comparing hospital data taken from the registry of ischaemic cardiopathies in Charleroi (1999 to 2008) to data on the air quality in this region. To measure the association between atmospheric pollution and the number of cases of myocardial infarction, Poisson regression was carried out. The excess risk of myocardial infarction was analysed according to the month of admission. For men, a decrease in the attack rate of myocardial infarction is visible during the first three years of the study, later to remain stable. For women, attack rates are stable throughout the study. Most of the pollutants vary according to season. Except for ozone, concentrations are generally higher in winter. We observe an association between the concentrations of PM10 and NO2 and morbidity/mortality by acute myocardial infarction. The increased risk for an increase of 10 μg/m3 of pollutant is 1.8% for PM10 and 4.0% for NO2. Multivariate models must still be developed and applied to our data.
Acute Myocardial Infarction (AMI) and Intermediate Coronary Syndrome (ICS)
Author(s)：E. Stoupel, A. Tamoshiunas, R. Radishauskas, G. Bernotiene, E. Abramson, J. Sulkes, P. Israelevich
In recent studies it was shown that blood co-agulation and inflammation markers are raising at high geomagnetic activity; acute myocardial infarction and all his subtypes, mostly related to atheromatous plaque disruption with higher Cosmic Ray (Neutron) activity. The aim of this study was to explore AMI and ICS differences by concomitant physical conditions, accompany-ing each of these acute coronary syndromes. The data was a part of MONICA international study in Kaunas, Lithuania in years 2000-2005 (72 consecutive months). 4633 patients with AMI (2461 men) and 961 with ICS (654 men), (age up to 65) were studied. For comparison four indices of Solar (SA), three of Geomagnetic (GMA), Cosmic Ray (CRA) measured by Neutron activity imp/min. were used. Cosmophysical data were from space science institutions in the USA and Russia. Pearson correlation coefficients and their probabilities were obtained.Monthly num-ber of AMI and ICS shows different links with the physical parameters: AMI were significantly in-verse related to SA (r=-0.4, p=0.0021) and direct to CRA (Neutron) activity (r=0.23, p=0.048). ICS was not correlated with these two parameters, but show significant links to GMA (r=0.25, p=0.037). Gender differences were evident, men more close related to changes in the mentioned physical parameters.Conclusion: 1. Monthly nu- mber of AMI and ICS is different related to fluc-tuations of environmental physical parameters. 2. The described connections can affect differ-ences in the pathogenesis of these forms of Acute Coronary Insufficiency.
Acute myocardial infarction (AMI) in context with the paradigm―month of birth and longevity
Time and environmental physical activity are involved in timing of many medical events. In a recent study published by the National Academy of Science, USA it was shown that month of birth is related to longevity. The aim of this study was to check the month of birth distribution in a great group of AMI patients of both gender, one of the great killers in the developed countries, to check the mentioned paradigm of month of birth and longevity. Methods & Patients: Patients admitted to Cardiology Departments of a tertiary University Hospital in Kaunas, Lithuania with AMI at years 1990-2010 (n-22047) were studied. Month of birth of these patients, total and both gender were checked. Monthly, quarterly and trimester comparison were done. Statistical differences established using t-Student test and distribution by percents of the yearly months of birth. Results: It was a significant difference in the month of birth of the studied AMI population. January and first quarter and trimester born patients were more often in the studied AMI patients group. The higher morbidity by Cardiovascular diseases can be a significant ingredient in the structure of population longevity. Possible mechanisms explaining our findings are discussed. Conclusion: In the AMI population people born in January, first quarter or trimester of the year are dominating in both gender groups. The results of this study can be an additional confirmation of the paradigm about links between month of birth and longevity。
Effect of gestational protein restriction on left ventricle hypertrophy and heart angiotensin II signaling pathway in adult offspring rats
Author(s)：Renan Brisollada Silva, Flávia Fernandes Mesquita, Marília Andreo, Heloisa Balan Assalin, José Antônio Rocha Gontijo, Patrícia Aline Boer
Maternal protein restriction may be a risk factor for cardiovascular disorders in adulthood. The RAS (renin-angiotensin-system) plays a pivotal role in cardiac remodeling. Components of the RAS, including angiotensin II (AngII) and its receptors type 1 (AT1R) and 2 (AT2R) are expressed in the heart. This study investigates whether gestational protein restriction alters the expression and localization of AT1R and AT2R and RAS signaling pathway proteins in parallel with left ventricle hypertrophy and systemic hypertension in male offspring. Dams were kept on normal (NP, 17% protein) or low (LP, 6% protein) protein diet during pregnancy. Systolic blood pressure (SBP) of male offspring was measured from the 8th to 16th week and left ventricles of 16-wk-old rats were processed for histology, morphometric, immunoblotting and immunohistochemistry. LP offspring showed a significant reduction in birth body weight and SBP increased significantly from the 8th week. Left ventricle mass and cardiomyocytes area were also significantly higher in LP animals. Widespread perivascular fibrosis was not detected in the heart tissue. Analysis by immunoblotting and immunohistochemistry demonstrated a significant enhance in cardiomyocyte expression of AT1R and ERK1 in LP offspring. Expression of PI3K in LP was significantly reduced in cardiomyocytes and in the intramural coronary wall, while AT2R expression was unchanged in the NP group. We also found reduced LP expression of JAK2 and STAT3. In conclusion, our data also suggest that changes in the RAS may play a role in the ventricular growth through upregulation of the AT1-mediated ERK1/2 response, despite unchanged AT2R expression.
Differential Effects of Angiotensin II on Intra-Renal Hemodynamics in Rats; Contribution of Prostanoids, NO and K+ Channels
Many agents are known to cause qualitative and quantitative differences in intrarenal blood flow. This study tested the hypothesis that angiotensin II (AII) evokes a differential effect on cortical (CBF) and medullary blood flow (MBF) and that AT2 receptor mediates AII-induced increase in renal MBF by mechanisms related to nitric oxide (NO) and prostanoids. AII (100, 300 and 1000 ng/kg/min) increased mean arterial blood pressure (MABP) by 24% ± 7% (p < 0.05); decreased CBF by 30% ± 2% (p < 0.05); but increased MBF by 21% ± 8% (p < 0.05). Indomethacin (5 mg/kg), enhanced AII effects on MABP by 154% ± 26% (p < 0.05), MBF by 141% ± 46 % but decreased CBF by 74% ± 54% (p < 0.05) indicating the involvement of dilator prostanoids in the systemic and medullary circulation but constrictor prostanoids in the cortex. NG nitro-L-arginine (L-NNA), an inhibitor of NO synthase (100 mg/L in drinking water) enhanced AII effects on MABP (169 ± 75, p < 0.05) and decreased CBF (107% ± 50%, p < 0.05) but blunted the effects of AII on MBF (150% ± 21%, p < 0.05). 1H-[1,2,4]oxadiazolo[4,3,-a]quinoxalin-1-one (ODQ; 2 mg/kg), a guanylyl cyclase inhibitor, enhanced AII effects on MABP (118% ± 32% , p < 0.05) and decreased CBF(85% ± 47% , p < 0.05) but blunted the effects of AII on MBF (96% ± 15%, p < 0.05). However, glibenclamide (20 μg/kg), a KATP channel blocker, did not affect intra-renal hemodynamics elicited by AII. Blockade of AT2 receptors with PD123319 (50 μg/kg/min) did not change basal or AII-induced changes MABP or CBF but blunted AII-induced increase in MBF by 60% ± 11 % (p < 0.05). CGP42112 (10 μg/kg/min), an AT2 receptor agonist, elicited a reduction in MABP and increases in CBF and MBF that were abolished or attenuated by PD123319. These findings demonstrate that AII elicited differential changes in intrarenal blood flow; an AT1-mediated reduction in CBF but an AT2-mediated increase in MBF. The AT2 receptor-mediated increase in MBF involves guanylase cyclase, NO and dilator prostanoids but not KATP channels.
Productive performance and blood metabolites as affected by protected protein in sheep
This investigation included two experiments. Experiment 1 was executed to study the effect of feeding different rations of protected protein of canola meal on digestibility and nutritive values within sheep. Twenty male, healthy sheep were divided into five treatments according to the methods of protein protection (control, heat, sodium hydroxide, formaldehyde, and acetic acid treatments). Experiment 2 was carried out on developing lambs to investigate the effect of protected protein on growth performance and some blood metabolites. Animals in this ex-periment were also divided into the same treatments as Experiment 1. Animals in the first and second experiment were fed concentrate ration (80%) and wheat straw (20%) to cover the feed requirements. Nutritive values expressed as total digestible nutrients (TDN %) and digestible crude protein (DCP%) of the experimental rations was calculated. In the second experimental all animals were weighed biweekly and the amounts of rations were adjusted throughout the experimental period (120 days) according to their body weight change. Results indicated that in the first experimental protected protein by heat (HE) and sodium hydroxide (NH) had positive (P<0.05) effects on most of digestibility coefficients of different nutrients. Protein protection methods also improved (P<0.05) the nutritive values (TDN and DCP) in the HE treatment and NH treatment. In the second experiment body weight increased by 14% and 7% and also daily gain by 27% and14 % in HE and NH, respectively, while FM and AC decreased body weight by 8% and 4.4%. Higher values (P<0.01) in both thyroid hormones were observed in HE and NH than those other treatments. Also, higher values (P<0.01) of total protein, albumin, and glucose were observed in HE and NH than other treatments. The control (CTL) group recorded higher concentrations of urea-N and creatinine at different periods of the experiment in comparison with other treatments. Generally, from the present investigation it can be concluded that protected protein of canola meal by heat or sodium hydroxide treatments were more efficient for productive performance and some blood metabolites of sheep.
8/19/2014
Focal neurological deficit in acute anemia: Case reports and review of the literature
Introduction: Although anemia is not regarded as an usual vascular risk factor for stroke, it is one of the potential mechanism by which the brain does not receive adequate oxygenation. Moreover, the relationship between drop of hemoglobin and acute focal neurological deficits is not clear. We report two patients with cerebral infarction due to acute anemia. Case Reports: Case 1 was a 73-year-old man who complained an episode of loss of consciousness followed by right hemiparesis and dysarthria after few hours. The day after admission he presented melena caused by a duodenal ulcer bleeding. The hemoglobin dropped from 11.3 g/dl to5.6 g/dl in 24 hours. Areas of acute infarctions were evident at diffusion-weighted imaging (DWI) of the brain. Case 2 was a 77-year-old man with a transient episode of aphasia, right lower limb paresis and mental confusion twelve hours after an intervention of PTA and stenting of the left internal carotid artery. Hemoglobin was11.8 g/dl before intervention and9 g/dl 48 hours later. DWI showed bilateral and widespread acute infarcts. Conclusion: Anemia has to be considered as a potential factor in determining or worsening cerebral infarction, especially in patients with carotid or intracranial stenosis, high cerebrovascular lesions load or insufficient collateral supply. Acute or severe anemia may negatively impact the cerebral blood flow and decrease oxygen-carrying capacity, promote rapid deterioration of ischemic penumbra. Brain DWI and treatment of the underlying etiology of acute anemia are crucial in early identification and recovery of cerebral infarctions.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=31197
Nighttime feeding in Turkish children and its association with anemia
Background: Children who continue to wake up at night to be fed after 6 months of age are called trained nighttime feeders. Nighttime feeding may be associated with dental and medical complications, in addition to causing sleep deprivation in children and parents, as well as with iron-poor nutrition. Methods: We surveyed 614 Turkish children aged 6 months to 5 years from three centers (2 urban and 1 rural) to determine the prevalence of nighttime feeding. We also sought to determine factors associated with continuation of nighttime feedings after 6 months of age. Results: Fifty percent of the participants were night- time feeders. Nighttime feedings were given once, twice, and three times or more to 19.9%, 15.6%, and 14.5% of the participants, respectively. The rural population had a higher rate of nighttime feeding (57.0% rural vs 46.6% urban, p = 0.016). 168 urban children (median age 25 months) had blood count data. Fifty percent of these children were given night-time feedings: 19.6% once, 17.9% twice, and 12.5% three times or more. Nighttime meals were breast-feeding in 51.2%, cow’s milk by bottle in 33.3%, and other in 15.5%. Mean hemoglobin level of nighttime feeders was significantly lower: 11.3 ± 1.3 g/dL vs 12.2 ± 1.0 g/dL in non-nighttime feeders (p < 0.001), even dropping to 10.8 ± 1.4 g/dL in those that were fed 3 times or more at night (p < 0.001). 31.0% of nighttime-feeders were anemic compared to 17.9% in those that did not receive nighttime feedings (p = 0.048). We also noted that intense nighttime feeding was associated with lower MCV (p < 0.001) and lower ferritin levels (p < 0.001). Conclusions: Nighttime feeding is prevalent among Turkish children, especially among the rural population. Nighttime feeding was also noted to be associated with anemia in this study. Nighttime feeding should be screened for and treated in children after 6 months of age.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=18007
Influence of atrial fibrillation on acute myocardial infarction
Atrial fibrillation is an increasingly common significant arrhythmia with potentially serious outcomes. Myocardial infarction is a common consequence of atherosclerosis and coronary artery disease. When the two conditions occur together, the consequences can be compounded. This article briefly reviews some of the potentials for the relationship.
Economic Evaluation of Continuous Subcutaneous Insulin Infusion for Children with Diabetes—Part II
The aim of this study is to assess long-term metabolic outcomes in children with diabetes mellitus and to compare the efficacy, feasibility and metabolic control expenses for treatment with continuous subcutaneous insulin infusion (CSII), compared to human insulin treatment. The study sample included 34 children aged 3 to 18 years with type 1 diabetes, 17 with continuous subcutaneous insulin infusion (CSII) therapy and 17 with standard treatment with human insulin. The study observed for the following variables: duration of the disease, diabetic control, HbA1c deviation scores; height and weight deviation and price of the treatment. Methods applied include meta-analyses in the published medical literature, pharmacoeconomic analysis and statistical analysis. From the 34 children with diabetes type 1 observed retrospectively during the period 1999-2012, 17 were on CSII (mean age 10 years, mean duration of the disease—7 years, average usage of CSII—3 years). The test stripes cost 533 Euro/year (1100 stripes per year) and their average cost according to the duration of the disease is 3779.45 Euro since diagnosis. The blood glucose monitoring system costs 20 Euro and for the duration of the disease—4.96 Euro per patient per year. The average improvement of HbA(1c) after the CSII introduction is 1.85, while after the application of human insulin—0.28. The treatment with CSII leads to significant improvement in glycemic control compared to the treatment with human insulin. The reduced HbA(1c) shows good diabetes management, from one point of view, and good quality of life—from another.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=38212
The Acute Administration of Carnosine and Beta-Alanine Does Not Improve Running Anaerobic Performance and has No Effect on the Metabolic Response to Exercise
An increase in muscle carnosine content, following its chronic supplementation, has been shown to im- prove anaerobic performance. In addition, carnosine can affect plasma glucose concentration and insulin response. However, it is not clear whether the acute ingestion of carnosine can have the same effects. Aim of this study was to investigate the acute effects of carnosine ingestion on anaerobic intermittent per- formance and the responses of blood insulin, glucose, bicarbonate and lactate concentrations to exercise. Twelve healthy, young, active participants (BMI 23.5 ± .6, age: 22 ± 2 years) underwent in two separate occasions (double-blind, randomized, crossover design) the running-based anaerobic test (RAST), con- sisting of 6 × 35-m sprints interspersed with 10 s rest after acute (4 hours before the test) ingestion of ei- ther 1 g of L-carnosine and 1 g of β-alanine or placebo. None significant difference was found between the acute ingestion of carnosine and the placebo conditions in terms of running performance (30.0 ± .8 and 29.8 ± .8, p = .302), perceptual response to exercise (RPE), blood lactate, insulin (23.8 ± 13.0 and 19.5 ± 9.0 μU·ml-1, p = .329), blood glucose (109 ± 23 and 104 ± 12 mg·dl-1, p = .969), and blood bicarbonates (16 ± 2 and 16 ± 2 mEq·l-1, p = .277). In conclusion, the acute ingestion of carnosine had no effect on performance, perceptual response to exercise, blood lactate concentration, insulin, glucose, and bicarbonates responses to exercise compared to a placebo treatment. It is not clear whether these results may be attributed to an insufficient dose of carnosine or to a lack of acute effect per sé.
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=39014
Inhibition of the Renin-Angiotensin System and Cardiovascular Mortality in Chronic Hemodialysis Patients
INTRODUCTION: Since the outcomes associated with the use of renin-angiotensin-system inhibitors (RASi) by hemodialysis (HD) patients are not fully known, we investigated their effect on the cardiovascular mortality of chronic HD patients. METHODS: Data from 388 HD patients (237 men and 151 women) who were routinely treated for at least 6 months were analyzed. Treatment with a RASi was the major predictor variable. The main outcome measure was cardiovascular mortality. Cox regression analysis was used to assess for the use of RASi and risk of death. RESULTS: Hypertension was diagnosed in 320 patients (82.5%), and 197 (50.8%) of them were treated with a RASi (treated group) and 191 (49.2%) were not (untreated group). The treated group had a higher prevalence of hypertension, history of congestive heart failure, and presence of ST-T changes. Kaplan-Meier analysis revealed a reduction in risk of cardiovascular death in the treated group during the follow-up period (fig. 2; log-rank: p=0.0379). The multivariate analysis showed that treatment with a RASi was also independently associated with reduced cardiovascular mortality (hazard ratio= 0.184; p=0.0161). CONCLUSIONS: The results of this study suggest a possible association between the treatment with RASi and reduced risk of cardiovascular mortality, independent of their effect of lowering blood pressure.
Serotonin uptake rates in platelets from angiotensin II-induced hypertensive mice
Angiotensin II (Ang II) is a critical component of the reninangiotensin system that contributes to hypertension. Although platelets in blood from hypertensive subjects have an abnormal biological profile, it is unclear if circulating Ang II influences platelet aggregation or thrombus formation. One of the abnormalities presented to the platelets during hypertension is an elevated plasma concentration of serotonin (5-HT) caused by reduced 5-HT uptake secondary to loss of the 5-HT transporter (SERT) on the platelet plasma membrane. In the current study, we evaluated in vivo platelet function after 7 days of subcutaneous Ang II infusion to establish hypertension in mice and additionally assessed the biology of isolated platelets exposed to Ang II in vitro. The administration of Ang II elevated systolic blood pressure, but markers of platelet activation including P-selectin and PEJon/A staining were not changed. However, the aggregation response to collagen was reduced in isolated platelets from Ang II-infused mice, which also showed reduced 5-HT uptake by SERT. In vitro exposure of isolated platelets to Ang II also resulted in a loss of surface SERT associated with a reduced aggregation response to collagen. These abnormalities were reversed by increasing concentra tions of the Ang II receptor antagonist, valsartan. Interestingly, SERT KO mice failed to fully develop hypertension in response to Ang II infusion and isolated platelets from these animals were insensitive to the anti-aggregatory influence of Ang II. Thus, Ang II blunts the aggregation responses of platelets and the mechanism underlying this action may involve a loss of SERT on the platelet plasma membrane. Thelatter event depletes intracellular 5-HT in platelets, an event that is associated with reduced aggregation. The widespread use of antihypertensive drugs that target the renin-angiotensin system suggest the potential clinical utility of our findings and emphasize the importance of understanding the impact of Ang II on platelet function.
Neuroprotective Effects of Sodium Ferulate and Its Antidepressant-Like Effect Measured by Acute and Chronic Experimental Methods in Animal Models of Depression
Antidepressants with novel targets and without side effects are in great demand. Ferulic acid (FA) is a ubiquitous phenolic acid of low toxicity, and sodium ferulate (SF) is its sodium salt. Our previous studies have revealed that FA and SF show significant protective effect on excitotoxicity, we now test its potential neuroprotective and antidepressant-like effects. MTT assay and morphological analysis by fluorescence microscopy were adopted to measure the neuroprotective effects of SF; forced-swimming, tail-suspension, and chronic mild stress (CMS) tests were performed to assess its antidepressant-like activity. The results showed that SF had protection against H2O2-induced oxidative damage and dexamethasone (DXM)-induced neurotoxicity pheochromocytoma (PC12) cells. Acute administration of SF markedly decreased the duration of immobility during forced-swimming in rats and mice and tail-supension tests in mice. However, SF has no any effects on reserpine-induced hypothermia, 5-hydroxytryptophan-induced head-twitch response, and potentiation of noradrenaline toxicity in mice. Chronic administration of SF reversed the effects of CMS on consumption of food and sucrose solution, weight gain, and histopathology of hippocampus by light microscopy, and potently shortened the immobility time during forced-swimming test following CMS in rats. This study provides evidence that SF possesses obviously antidepressant-like activity, and the antidepressant-like effect may result from its neuroprotective effects.
Acute anemia after dental extraction: A case report
A patient treated with a vitamin K antagonist (VKA) since the implantation of two mechanical heart valves developed acute anemia after the extraction of a tooth. This case report and data in the literature indicate a need for specific measures before, during, and after oral surgery in patients taking anticoagulant therapy: 1) the bleeding risk should be evaluated before the procedure. The INR should be measured routinely, 2) the procedure should be scheduled early in the week to allow an evaluation at the fibrinolysis peak, i.e., 48 to 72 hours after surgery, which is the time of greatest risk of delayed bleeding, 3) the surgical procedure should be appropriate for the elevated bleeding risk, 4) postoperative monitoring is of the most importance, as bleeding is usually delayed in patients on VKA therapy, 5) when poor treatment adherence is expected, day-hospital admission is useful to ensure that the postoperative protocol is implemented properly and to detect early bleeding. The treatment of post-extraction acute anemia includes local hemostasis protocol with the revision of the socket followed by red-blood-cell pack transfusion. A daily fluindione dosage control, and a normal hemoglobin level will allow the patient to leave the hospital.
D-Aspartate, a Key Element for the Improvement of Sperm Quality
Introduction: D-Aspartate is an endogenous amino acid involved in LH and testosterone release in humans. In this study we investigate the impact of nutritional supplementation of sodium D-aspartate on the improvement of sperm quality in sub-fertile patients and the rate of pregnancies that occurred with their partners. Materials and Methods: A group of 30 patients affected by oligo-asthenozoospermia and a group of 30 patients affected by asthenozoospermia were treated with a daily dose of sodium D-aspartate for 90 days. After which, the change in spermatozoa concentration and their motility and the pregnancies that occurred with their partners were recorded. Results: We found that the supplementation of D-aspartate significantly increased the concentration and the motility of spermatozoa. In oligo- asthenozoospermic patients the increase of sperm concentration was found to be 2.0-fold, P < 0.001 (from a mean of 8.2 ± 4.5 million spermatozoa/ml of seminal plasma before treatment to a mean of 16.5 ± 5.5 million after treatment). In asth- enozoospermic patients, the increase of spermatozoa was 1.6-fold, P < 0.001 (from a mean of 29.9 ± 5.7 million spermatozoa/ml before treatment to a mean of 48.7 ± 12.8 after treatment). The same positive effects also occurred for sperm motility. Oligo-asthenozoospermic patients showed an increase of rapid progressive spermatozoa motility from a mean of 15.5% ± 4.4% before treatment to a mean of 23.1% ± 4.7% after D-aspartate treatment (1.49-fold increased, P < 0.001). The same effects occurred in oligo-asthenozoospermic patients. In these subjects the increase of rapid pro- gressive spermatozoa motility was 1.86-fold (from 11.6% ± 3.9% before treatment to 21.6 ± 7.5 after treatment, P < 0.001). In addition, the treatment of D-aspartate in these patients consequently led to a significantly increased number of pregnancies occurring in the partners of the treated patients. Conclusions:Treatment of sub-fertile patients with sodium D-aspartate improved the number and the motility of the spermatozoa and consequently improved the rate of pregnancies of their partners.
8/18/2014
New report asks why Canadian jurisdictions under fund mental health despite significant social and economic costs
New report asks why Canadian jurisdictions under fund mental health despite significant social and economic costs
(Monday, August 18, 2014) – In spite of ongoing concerns about the staggering social and economic costs of mental illness, funding in Canada and Ontario pales in comparison to other global jurisdictions, according to a new report authored by a Toronto mental health expert.
In Why Can’t Canada Spend More on Mental Health, author and longtime mental health advocate Steve Lurie, Executive Director of Canadian Mental Health Association, Toronto Branch, lays out the tale of chronic underfunding of mental health services and offers remedies to fix the imbalance.
The research paper, published online in Health, states that in 2011 Canadian per capita investments in mental health was $5.22, far lower than investments in the United Kingdom ($62.22), Australia ($98.13) and New Zealand ($198.93).
Lurie states that Canada, unlike jurisdictions such as Australia, does not earmark a portion of federal transfer payments directly to mental health. And that might make a difference when you consider Ontario’s share of transfer payments between 2005 and 2011 increased by $2.9 billion, but only $220 million was invested to expand community mental health services.
“Why is a high-income country like Canada and its provinces falling behind other jurisdictions by woefully under-funding mental health care?” asks Lurie, whose experience in Ontario’s mental health sector spans 39 years. “Improving access to mental health services and supports such as supportive housing, through the establishment of a mental health transition fund was recommended eight years ago by Senators Kirby and Keon in their report Out of the Shadows at Last. Unfortunately we have failed to act on those recommendations, even though these types of investments have been shown to reduce health and social costs.”
The study points out the substantial gap between the burden caused by mental disorders and the resources available to treat and prevent them, with Canada a prime example.
The indirect costs of mental health issues to the Canadian economy are $50 billion per year. The cumulative costs to the national economy over the next three decades are pegged at $2.5 trillion. In Ontario, the burden of mental health and addictions is estimated at more than 1.5 times of all cancers and more than seven times that of infectious diseases.
The author recommends acting upon the Mental Health Strategy for Canada, created by the Mental Health Commission of Canada. The Strategy includes increasing the mental health share of the health and social services budgets at the national and provincial levels in order to fix the deficit in mental health care and supportive housing.
For more, read the full report, Why Can’t Canada Spend More on Mental Health, and theExecutive Summary
About CMHA Toronto:
CMHA Toronto is the largest community-based mental health agency in Canada providing a range of services to individuals living with serious mental health issues, helping them to live, work and belong in our community. We also provide information and education on mental health issues, and advocate for policies that lead to improved quality of life for those living with mental health problems, their families and our community.
Overlooking the harmful effects of drinking socially during the working hours
Author：Elizabeth Espindola Halpern
There is a tendency to assign responsibility for the act of drinking alcohol to the drinkers. The common sense leads many people and even professionals to blame them for their frequent relapses, misuses, and abuses. Modern society expects that alcoholics resist the temptation to have another sip and remain sober, overcoming the magnetism of the beverages that surround them. In effect, the focus is mainly directed to these individuals. The predominant point of view among families, friends, therapists, and also the alcohol users is that the “problem” resides in the “disease”/”disorder” of those “bad drinkers”; thus, the “solution” or “cure” would depend on their tenacity to suppress the craving for this substance, as well as opportunities to drink.
As a result, psychotherapy usually tries to help patients to achieve sobriety by encouraging them to review their behaviors, lifestyles, values, and to understand their weakness, distresses, problems that made them choose alcohol as a way out.
Yet, a study conducted by the PhD in Mental Health and Commander of the Brazilian Navy,Elizabeth Halpern, with military patients treated at the Center for Chemical Dependency demonstrated a different facet of the alcoholism issue. The deeply rooted tradition to drink alcohol on board was reported by these men.
Gradually, it became clear that this organization also played an important role in this scenario. In fact, based on the military patients’ interviews, the Brazilian Navy displays an ambivalent position towards the matter of drinking during the working journey.
While the Disciplinary Regulation prohibits inebriation, drinking can be stimulated depending on the command. The majority of the statements of these patients revealed that naval authorities disregard the harm effects of the distribution of alcohol to accomplish hard tasks or to celebrate and party, for different reasons. The shared belief that one can drink socially and that alcohol consumption will not lead to any problem, contribute to consolidate this widely accepted practice. In truth, this study is considered to be more than a person’s addiction to alcohol itself; this custom is profoundly internalized, named by the present researcher as an alcoholic habitus.
Therefore, it would be seen as a pattern of behaviors, attitudes, and ways of thinking related to manners of ingesting alcohol, which is gradually assimilated. This research focused on emphasizing the socio-cultural dimension of alcoholism understood as a phenomenon, distinct from the prevailing perspective of the biomedicine which usually considers the addicted as one who has a mental and behavioral disorder due to the use of alcohol.
Along the interviews, some patients stated the following opinions which demonstrated that the military institution plays an important part in the construction of their alcoholism: (1) I worked on a ship that had brews in almost every occasion! All of this is an encouragement to drink; (2) Ah! The vibes contributed to my alcoholism, for sure! All warehouses that I’ve worked in Navy always had the blessed “cachaça” (a kind of sugar cane brandy)! (3) I worked on a ship that had brews in almost every occasion! All of this is an encouragement to drink.
Some of the findings of Dr. Elizabeth Halpern’s research were published in Psych Journal, vol. 5, n. 2, February 2014 by Scientific Research Publishing: Examining the role of Brazilian Navy before alcohol intake in the workplace.
In sum, drinking socially can bring (un)expected consequences. Although it usually is disregarded as a potential problem, someone may become a heavy drinker or addicted after many years of consumption. Most importantly, despite the dosage that one consumes, the tradition to drink during the working day increases the chances to cause injuries to individuals and damages to the organization.
source:
See also: Comments to Paper
8/17/2014
New report asks why Canadian jurisdictions under fund mental health despite significant social and economic costs
(Monday, August 18, 2014) – In spite of ongoing concerns about the staggering social and economic costs of mental illness, funding in Canada and Ontario pales in comparison to other global jurisdictions, according to a new report authored by a Toronto mental health expert.
In Why Can’t Canada Spend More on Mental Health, author and longtime mental health advocate Steve Lurie, Executive Director of Canadian Mental Health Association, Toronto Branch, lays out the tale of chronic underfunding of mental health services and offers remedies to fix the imbalance.
The research paper, published online in Health, states that in 2011 Canadian per capita investments in mental health was $5.22, far lower than investments in the United Kingdom ($62.22), Australia ($98.13) and New Zealand ($198.93).
Lurie states that Canada, unlike jurisdictions such as Australia, does not earmark a portion of federal transfer payments directly to mental health. And that might make a difference when you consider Ontario’s share of transfer payments between 2005 and 2011 increased by $2.9 billion, but only $220 million was invested to expand community mental health services.
“Why is a high-income country like Canada and its provinces falling behind other jurisdictions by woefully under-funding mental health care?” asks Lurie, whose experience in Ontario’s mental health sector spans 39 years. “Improving access to mental health services and supports such as supportive housing, through the establishment of a mental health transition fund was recommended eight years ago by Senators Kirby and Keon in their report Out of the Shadows at Last. Unfortunately we have failed to act on those recommendations, even though these types of investments have been shown to reduce health and social costs.”
The study points out the substantial gap between the burden caused by mental disorders and the resources available to treat and prevent them, with Canada a prime example.
The indirect costs of mental health issues to the Canadian economy are $50 billion per year. The cumulative costs to the national economy over the next three decades are pegged at $2.5 trillion. In Ontario, the burden of mental health and addictions is estimated at more than 1.5 times of all cancers and more than seven times that of infectious diseases.
The author recommends acting upon the Mental Health Strategy for Canada, created by the Mental Health Commission of Canada. The Strategy includes increasing the mental health share of the health and social services budgets at the national and provincial levels in order to fix the deficit in mental health care and supportive housing.
For more, read the full report, Why Can’t Canada Spend More on Mental Health, and theExecutive Summary
About CMHA Toronto:
CMHA Toronto is the largest community-based mental health agency in Canada providing a range of services to individuals living with serious mental health issues, helping them to live, work and belong in our community. We also provide information and education on mental health issues, and advocate for policies that lead to improved quality of life for those living with mental health problems, their families and our community.
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