81 research outputs found
Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.
BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden
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Novel anticonvulsant action of chronic melatonin in gerbils
MELATONIN, a hormone from the pineal gland, was tested for its anticonvulsant effects in male gerbils. Daily administration of melatonin (25 μg injection, s.c.) for ten weeks reduced the number and severity of seizures (total convulsion score7.67 ± 1.83 in controls vs 2.47 ± 0.90 in melatonin-injected animals, p < 0.05) associated with the injection of the convulsant, pentylenetetrazol (PTZ, 60 mg kg, s.c.). However, neither 12 weeks of short photoperiod exposure (LD 10:14) nor biweekly administration of melatonin pellets altered PTZ-induced convulsions. Overall, melatonin-injected gerbils were better able to survive and respond to seizures than control animals. No melatonin-injected gerbils died during seizure induction (0/31) while 5 out of 33 control gerbils died after PTZ injection. The mechanism for melatoninʼs anticonvulsant effects could be due to a direct inhibitory action on neural activity or a conversion of melatonin to an anticonvulsant compound that resembles the kynurenines
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Axial Image Orientation in Anatomy Disciplines: Clinical View not Anatomical View
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Ethical Issues in the Use of Willed Bodies in Anatomical Education
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Involvement in Productive Activities and Satisfaction With Living Situation Among Severely Mentally Disabled Adults
Eighty-three adults with severe mental disabilities participated in a study examining effects on life satisfaction of having nothing to do, receipt of a housing subsidy, and enrollment in an intensive case management program. The clients were divided into four groups receiving subsidized bousing and intensive case management, subsidized housing and nonintensive case management, intensive case management and nonsubsidized housing, and nonintensive case management and nonsubsidized housing. Initially and at ten months, clients reported how much time they spent with nothing to do and their level of satisfaction with supported-living arrangements. A significant association was found between time spent with nothing to do and both satisfaction and change in satisfaction and between having a housing subsidy and satisfaction. Results suggest that getting clients involved in activities of their own choosing would result in much greater increases in satisfaction
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Propranolol Blockade of Short Photoperiod‐Induced Gonadal Regression: Modification by Melatonin Injections or Implants
Male Syrian hamsters were exposed to short photoperiods (10L: 14D) for ten weeks and received daily ethanolic saline (1:10), propranolol (125 μg, sc) or melatonin (25 μg, sc) injections at 16: 45. Some hamsters also received melatonin implants (1 mg in 24 mg beeswax, sc) every two weeks in addition to the above treatments. Testicular weights were determined at the beginning, every three weeks, and at the end of the experiment. Serum hormone levels, hypothalamic amine levels and cortical amine levels were also determined at the conclusion of the experiment. Propranolol prevented the decline in testes weight produced by short photoperiod (P<0.001 versus control). Propranolol was not able to prevent daily injections of melatonin from producing gonadal regression. Melatonin implants blocked testicular regression produced by both short photoperiod and melatonin injections. No differences in hypothalamic or cortical amine levels were observed between the treatment groups. These results add further support to the suggestion that propranolol is acting at the pineal gland preventing melatonin synthesis and not at a post‐pineal central site which would affect melatonin binding and action
<b>SHORT PHOTOPERIOD EXPOSURE ALTERS THE TESTOSTERONE SURGE DURING PUBERTAL DEVELOPMENT IN MALE MONGOLIAN GERBILS <i>(MERIONES UN</i></b><b><i>GUICULATUS)</i></b>
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Reductions in Hamster Serum Thyroxine Levels by Melatonin Are Not Altered by Changes in Serum Testosterone
Daily melatonin injections reduce reproductive and thyroid hormones in male Syrian hamsters. The interrelationship between the decline in these hormones is not known. To explore this relationship, male Syrian hamsters were divided into four groups: castrated, implanted with testosterone (5-mm silastic implants), both treatments, or neither treatment. One-half of each group of hamsters (n = 7 or 8) were injected with melatonin (25 mg) daily at 1730 h. The other half of each group received daily vehicle injections. Ten weeks later, the hamsters were anesthetized and decapitated. Testes weights, serum testosterone, and serum thyroxine levels were measured. As expected, testes and serum testosterone levels were uniformly low in all of the melatonin-treated hamsters. All of the melatonin-treated groups also had lower than normal thyroxine values irrespective of gonadal treatment. Interestingly, in the non-melatonin-treated hamsters, serum thyroxine values were decreased in the castrated group and increased in the testosterone-implanted group. These results suggest that castration can reduce serum thyroxine levels in male Syrian hamsters and that replacement of testosterone restores these levels to normal. Notably, the declines in thyroxine levels produced by daily melatonin injections were not restored by testosterone implants in castrated or intact hamsters. Therefore, melatonin-induced reductions in thyroxine are not mediated by concurrent reductions in serum testosterone levels. It appears that melatonin-induced reductions in serum thyroxine levels do not use the same mechanism as castration-induced reductions
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