COMPARISON OF RETEPLASE DOUBLE-BOLUS ADMINISTRATION WITH STREPTOKINASE IN ACUTE MYOCARDIAL INFARCTION

Objective: To evaluate the thrombolytic treatment in acute myocardial infarction (AMI) and to compare the costs and the effectiveness of Reteplase double-bolus vs Streptokinase in our clinic, to compare this data with other studies.Methods: Two thrombolytic treatments were compared; Reteplase and Streptokinase in AMI by following the patients during hospital stay and at certain periods of time of 6 months, 12 months and 24 months. Differences between the two groups (streptokinase and reteplase) for discrete variables were performed by the Student test for two samples and Hi-square test. Data analysis was performed with SPSS statistical package, version 18Results: The analysis showed no significant differences between the treatments regarding the effectiveness. After 6 months, 12 months and 24 months observation, the survival rate was 96.4% for reteplase group and 96.9% for streptokinase group. The mean age was 64.29 years for reteplase group and 56.03 years for streptokinase group (p=0.001). Hospitalization in reteplase group was at an average of 13.04days, and in streptokinase group was at an average of 17.79days (p=0.01)Cost in each respective group was 90184.90 Lek (646€) and 54148.63 Lek (388€). The difference is 36036.27 Lek or 258€ (p=0.001).Conclusion: Both thrombolytics (reteplase and streptokinase) have similar effectiveness in treatment of Acute Myocardial Infarction. Reteplase is an effective drug in the treatment of clinically Acute Myocardial Infarction, but the cost of reteplase is higher than streptokinase. It is safe, easily applied and it will be a useful addition to the valid list of thrombolytic drugs.Â

Using a dichoptic moving window presentation technique to investigate binocular advantages during reading

Reading comes with a clear binocular advantage, expressed in shorter fixation times and fewer regressions in binocular relative to monocular visual presentations. Little is known, however, about whether the cost associated with monocular viewing derives primarily from the encoding of foveal information or in obtaining a preview benefit from upcoming parafoveal text. In the present sentence reading eye tracking experiment, the authors used a novel dichoptic binocular gaze-contingent moving window technique to selectively manipulate the amount of text made available to the reader both binocularly and monocularly in the fovea and parafovea on a fixation-by-fixation basis. This technique allowed the authors to quantify disruption to reading caused by prevention of binocular fusion during direct fixation of words and parafoveal preprocessing of upcoming text. Sentences were presented (a) binocularly; (b) monocularly; (c) with monocular text to the left of fixation; (d) with monocular text to the right of fixation; or (e) with all words other than the fixated word presented binocularly. A robust binocular advantage occurred for average fixation duration and regressions. Also, while there was a limited cost associated with monocular foveal processing, the restriction of parafoveal processing to monocular information was particularly disruptive. The findings demonstrate the critical importance of a unified binocular input for the efficient preprocessing text to the right of fixation

Effect of galactomannan hydrocolloids on gelatinization and retrogradation of tapioca and corn starch

The aim of the present study was to investigate the effect of galactomannan hydrocolloids (guar gum and locust bean gum) on gelatinization and retrogradation of tapioca and corn starch. Differential scanning calorimetry (DSC) was used to characterize the behaviour of tapioca and corn starch with and without additives. Results showed that guar gum and locust bean gum retarded the retrogradation of tapioca and corn starch at both investigated temperatures (4 and 25 °C). Guar gum retarded retrogradation of tapioca starch more than locust bean gum, on the other hand, locust bean gum had a greater effect on reduction of the recrystallization of corn starch. Temperatures of gelatinization did not vary significantly in starch-hydrocolloid systems. Additions of galactomannan hydrocolloids caused a decrease in gelatinization enthalpy of both starches

LONG-TERM PROGNOSIS AND MODES OF DEATH IN HEART FAILURE PATIENTS WITH REDUCED VERSUS PRESERVED LEFT VENTRICULAR SYSTOLIC FUNCTION

Background: There are conflicting reports regarding the prognosis of heart failure patients with preserved (HFPSF) comparative to reduced systolic left ventricular function (HFRSF). We evaluated the clinical characteristics, mortality rates and modes of death in 309 consecutive symptomatic heart failure patients. In 133(56%) patients LVEF was <50% (HFRSF), and in 133 (44%), LVEF was ≥50% (HFPSF). Methods: Three hundred nine consecutive patients hospitalized between January 1, 2009 and January 1, 2010 (176 men and 133 women, mean age 64.3 years) were followed up for a mean period of 23±14 months. The severity of symptoms at admission was assessed by NYHA classification. 196 patients were in NYHA class I-II, and 113 in III–IV. All patients underwent chest X-ray, echocardiogram, and a 6-minute walking test. We compared the clinical profiles, mortality rates and modes of death. Results: More than a third (44%) of the patients had preserved systolic LVEF based on echocardiography. Compared to the HFPSF group, HFRSF patients were predominantly younger males with ischemic aetiology and less cardiovascular comorbidities such as obesity, hypertension, diabetes mellitus and atrial fibrillation. During a mean follow-up period of 1.9 years, 22 (7.1%) patients died: 14 of cardiac causes and 8 of non-cardiac causes (4 of respiratory causes, 2 of stroke, 1 of major bleeding and 1 of cancer). Overall mortality was similar between the two groups: 8 (6%) in HFPSF patients and 14 (7.9%) in HFRSF patients (p=0.67). HFRSF patients had higher death rates due to pump failure compared to the HFPSF group [ 5/14(36%) vs. 1/8(12%) patients, p=0.5]. Non-cardiac deaths were more frequent in HFPSF group [4/8 (50%) patients vs. 4/14(28%) patients, respectively, p=0.5]. The prevalence of arrhythmic death was similar in the two groups [5/14(36%) vs.3/8(37%) patients, p=0.6]. With Cox stepwise regression analysis for survival, the independent predictors for mortality were age, gender, ischemic etiology of heart failure and renal impairment. Conclusions: Although the characteristics of HFPSF and SHF patients are different, the mortality rates were similar in our study. The mode of death was different among the two groups of patients, as pump failure death rate was higher in patients with LVEF <50%, while non-cardiac death was higher in heart failure patients with preserved systolic function. The differences were not statistically significant. A high NYHA class at admission, age over 65, male gender and renal impairment were related to a worse prognosis