Serum lipid profiles in acute myocardial infarction patients in Gorgan

Acute myocardial infarction is one of the important reasons of death and unhealthiness in the world. The present study was undertaken to investigate the changes in serum lipids and lipoproteins in patients with acute myocardial infarction. This study was performed in the Biochemistry and Metabolic Disorder Research Center of Gorgan, Golestan province (South East of Caspian Sea), Iran in 2011.The levels of lipid profile were significantly changed in the acute myocardial infarction patients. acute myocardial infarction patients had significantly higher levels of total cholesterol, LDL-cholesterol, VLDL-cholesterol, TG, LDLcholesterol /HDL-cholesterol, total cholesterol /HDL-cholesterol, LDH, CPK and CPK-MB and lower level of HDL-cholesterol, as compared to the control subjects. We found a significant association of lipid profiles with acute myocardial infarction. Changing of dietary and social activity habits of people in this area can help to prevent future atherogenic damaging in AMI patients. Copyright © 2012, Scientific Publisher of India

Appropriateness of referrals for single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in a developing community: A comparison between 2005 and 2009 versions of ACCF/ASNC appropriateness criteria

Appropriateness of referrals for myocardial perfusion imaging (MPI) in developing countries has not been extensively studied. Our study was conducted to describe the ordering practices of physicians and appropriateness of MPI referrals in Iran. We prospectively applied 2005 and 2009 versions of the Appropriateness Use Criteria published by the American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC) to 291 consecutive patients (age 55.3 ± 10.3 years) who underwent SPECT-MPI. For this purpose, we convened a panel, consisting of two academic cardiologists, one academic clinician in internal medicine, and one academic clinician in nuclear medicine. The panelists were invited for a face-to-face meeting to judge appropriateness of SPECT-MPI and independently assign a specific indication (scenario), whenever possible, for each case in accordance with ACCF/ASNC appropriateness scenarios. Based on the 2005 ACCF/ASNC criteria, SPECT-MPI studies were judged appropriate for 211 (72.5%), uncertain for 36 (12.4%), inappropriate for 32 (11.0%), and unclassifiable for 12 (4.1%) referrals. The same figures based on the 2009 version were 219 (75.3%), 15 (5.2%), 49 (16.8%), and 8 (2.7%) patients, respectively. Overall agreement between the 2005 and 2009 versions was good (κ 0.63). Lack of chest pain and age below 60 years were significant indicators increasing the likelihood of inappropriate referrals by 2.9-3.4 fold. Absence of diabetes mellitus and hypertension, a normal lipid profile, lack of a past history of myocardial infarction or cardiovascular interventions (CABGs or PCI), as well as lack of application and exercise ECG stress test as the gate keeper (keeping abnormal ETT or inability of the patient to perform exercise as the appropriate indication for SPECT-MPI referral) were significant indicators, decreasing the odds of appropriate referrals. Generally a higher percentage of referrals with inappropriate indications had normal MPI. Our study provides an evidence for the fact that SPECT-MPI ordering practices in our developing community largely parallel the ACCF/ASNC recommendations. The implementation of appropriateness criteria is feasible in clinical settings and might provide an alternative to utilization management. © 2011 American Society of Nuclear Cardiology

Wettability and hydrophilicity of rigid and soft contact lens surfaces

In the last two decades an abundance of contact lens materials with unknown surface properties have been introduced as well as new contact lens design. Recent studies have identified the importance of physical and chemical interactions between materials and liquids. The purpose of this experimental research work was to investigate the relationship between a contact lens surface and a liquid. The wettability and hydrophilicity of both soft and rigid contact lens surfaces were determined using two novel techniques and an established method. The two novel techniques were the un-separated adherent quid/laser method and the adherent liquid/ maximum force method whereas the established technique involved monitoring the receding wetting angle and interface are a diameter of a sessile drop. Contact lens surface preparation and the method of removing a liquid from hydrated surfaces were found to be important variables when determining wettability or hydrophilicity. Experiments showed that the use of surface tension to remove liquid from hydrated surfaces significantly improved the reproducibility of subsequent measurements. Variation of the sessile drop wetting angle and interface area diameter with evaporation time demonstrated different values for different contact lenses. The clinical consequence of monitoring the receding values would be; if a material to spread tear break up time occurs the dry patches will be advanced on PMMA, rather than Paraperm contact lens. Surface hydrophilicity, if defined in terms of the maximum adherent force, describes the ability of a lens surface to attract a liquid, whereas wettability may be defined as the ability of a liquid to spread on a contact lens surface. The wettability and hydrophilicity, therefore, are two different issues. When a wetting angle is 01, or close to 0" the surface is described as wettable. Results demonstrated that Equalens had a greater surface wettability and hydrophilicity than the PMMA for pre-wear, but the post-wear hydrophilicity for PMMA was greater than Equalens. The use of each measurement method, therefore, resulted in a value that is intrinsically related to measurement method and definition. The clinical consequenceo f the valuesi s to help practitioners prescribea lens material either on wettability or hydrophilicity values. In contact lens practice, a lens surface is required to maintain a stable tear film and produce a long tear film break up time. A combination of hydrophilicty and wetting angle values can help to determine the requirement of wettability and hydrophilicity in the contact lens industry and also in practice. It can be concluded that no single test can fully describe the surface properties of contact lens surface materials, but it is proposed that information and results from a series of tests provides the most useful clinical description

Effect of nitric oxide modulation on the basic and rate-dependent electrophysiological properties of AV-node in the isolated heart of rabbit: The role of adrenergic and cholinergic receptors

Introduction: Recent studies showed that nitrergic system have specific modulatory effects on electrophysiological properties of atrioventricular (AV) node. The aim of this study was to determine the effects of nitric oxide (NO) on the electrophysiological properties of isolated rabbit AV node and to investigate the role of adrenergic and cholinergic receptors in the mechanism of its action. Methods: In our laboratory, an experimental model of isolated double-perfused AV-node of rabbits weighing 1.5-2 kg was used. Specific experimental protocols of recovery, Facilitation, Fatigue and Wenckbach were applied in both control and in the presence of the drug. A total number of 35 rabbits were divided randomly into the following groups (n=7): 1) L-Arg (NO donor) (250, 750 and 1000 μmol), 2) L- NAME, a NO synthesis inhibitor (25, 50 and 100 μmol), 3) L-Arg + L- NAME, 4) Nadolol (1 μmol), 5) Atropine (3 μmol). All data were shown as mean ± SE. The level of statistical significance was set at p<0.05. Results: Our results revealed the depressant effect of L-Arg on the basic and rate-dependent electrophysiological properties of AV-node. L- NAME did not deteriorate the effects of L-Arg on the basic and rate-dependent properties, nevertheless, at high concentration (100 μmol) it had a direct inhibitory effect on the AV-node. Nadolol and atropine could prevent the effects of NO on the basic nodal characteristics and the fatigue phenomenon, respectively. Conclusion: Nitergic system can affect basic and rate-dependent electrophysiological properties of the AV-node through adrenergic and cholinergic receptors

Management of Patients with Refractory Cardiogenic Shock and Cardiointestinal Syndrome with Impella 5.5 as Bridge to Decision: Case Series

Patients with advanced heart failure require multi-system management as a majority succumb to end-organ dysfunction, including gastrointestinal sequelae. Temporizing measures, such as early mechanical circulatory support, can assist in the recovery of patients with acute cardiogenic shock. The temporary support can improve patient characteristics to enable future definitive heart failure therapies such as durable left ventricular assist devices and orthotopic heart transplantation. We present two cases of cardiogenic shock that were successfully bridged with an Impella 5.5 (Abiomed). The management enabled the patients to recover from reversible cardiointestinal syndrome and undergo successful definitive therapies

Conduction disturbances in acute myocardial infarction: A clinical study and brief review of the literature

Introduction: Heart blocks may occur as complications of acute myocardial infarction (AMI) and are accompanied by increased in-hospital mortality. The objective of this investigation was to study heart blocks in patients with AMI and to assess their association with clinical features and therapeutic measures. Methods: Four hundred consecutive patients (263 men, 137 women, mean age 59.6 ± 8.4 years) who were admitted with the diagnosis of AMI were assessed. The initial ECG, recorded immediately after the patient's admission to the emergency department, was considered as baseline. Any heart blocks occurring over the following days were noted by comparing the relevant ECGs with this baseline ECG. Results: The overall prevalence of heart blocks was 15.8. There was no significant statistical correlation between the incidence of heart blocks and the patients' age and sex. Although the prevalence of cigarette smoking, hypertension, hypercholesterolaemia and diabetes mellitus in patients with heart block was greater than in patients without, the differences were not statistically significant. The development of heart blocks was more common among those patients treated with thrombolytic therapy (21.1 vs. 12, p=0.01). Also, the development of heart blocks was associated with a significantly lower left ventricular ejection fraction. It was found that 25 of patients who died following AMI had experienced heart blocks, compared with only 13.6 of those who survived (p<0.01). Conclusions: Development of heart blocks has important prognostic significance. The higher prevalence of heart blocks in anterior wall or Q-wave infarctions indicates that the increased mortality following heart block development is probably not related solely to the conduction disturbance itself, but also to the relatively larger infarcted area

Wettability and hydrophilicity of rigid and soft contact lens surfaces

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN015945 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Prevention of calcification with TPEN in pericardial bio-prosthetic heart valve material 3

[No abstract is available

Prevalence of obesity among type 2 diabetes mellitus in Gorgan (south east of Caspian Sea), Iran

The present study aimed to assess the prevalence of obesity in patients diagnosed with type 2 diabetes mellitus in Gorgan (South East of Caspian Sea), Iran. The subjects consist of 122 females and 78 males type 2 diabetic patients. Anthropometric and laboratory parameters in both sexes were determined (2011). Waist circumference was higher in males than females subjects (p<0.05), but the females had higher body fat percent (p<0.05) than males subjects. Using BMI, 86.88% females and 83.33% males were obese and 13.11% and 16.66% of them were none-obese (p=0.739, p=0.505). Using waist circumference, 86.06% females and 74.35% males were obese and 13.92% and 25.63% of them were none-obese (p<0.001, p=0.008). Waist circumference is correlated positively with BMI and body fat percent in diabetic female (r=0.233 and r=0.892, p<0.05) and male (r=0.280 and r=0.931, p<0.05). Waist circumference is very highly correlated with body fat percent likely to behave similarly in diabetes prediction. Body mass index, despite lower correlation with waist circumference, appears to have the same ability to predict diabetes as do body fat percent. Waist circumference appears to be a better predictor for diabetes risk than other parameters. © IDOSI Publications, 2011