High incidence of Angina pectoris in patients treated with 5-fluorouracil - A planned surveillance study with 102 patients

Objective: Angina pectoris, arrhythmic sudden death and myocardial infarction, all these cardiac events have occasionally been reported during 5-fluorouracil (5-FU) chemotherapy. Underlying mechanisms leading to these events are unknown; damage to the myocytes or vasospasms have been discussed. Methods: 102 consecutive and unselected patients were monitored with 12-lead ECG, echocardiography and radionuclide ventriculography prior to the first cycle of 5-FU chemotherapy and 3 months from baseline. Results: 19% of the patients developed reversible symptoms of angina pectoris during treatment which lasted up to 12 h after cessation of the infusion. Most of the 19 patients showed corresponding ECG changes. 6 out of the 19 patients with severe angina pectoris had subsequent coronary angiography. In none of these patients the coronary angiography showed coronary artery disease, but it showed low ventricular function (ejection fraction <50%) in 2 patients. The ejection fraction did not increase overtime. Arrhythmias were screened for with Holter monitoring during 5-FU chemotherapy. The frequency of bradycardia and ventricular extrasystoles increased significantly (p < 0.05) during treatment compared to arrhythmias in Holter monitoring 3 months later. Furthermore the Qtc time in the ECG 3 months later was significantly prolonged (p < 0.05) compared to baseline values. Conclusions:The incidence of angina pectoris in patients during 5-FU treatment seems higher than previously suspected. As myocardial ischemia can be fatal, attentiveness to these symptoms and immediate treatment are crucial. Copyright (C) 2003 S. Karger AG, Basel

THE EFFECT OF DIFFERENT FOOTWEAR ON THE MYOELECTRIC ACTIVITY OF M. TIBIALIS POSTERIOR DURING TREADMILL RUNNING

Overload running injuries of the lower extremity, particularly the knee, are associated with excessive pronation of the foot resulting in tibial rotation (Nigg et al., 1995). M. tibialis posterior (TP) is shown to have an active influence on pronation and the medial longitudinal arch (Kaye & Jahss, 1991). Its functional role during running and interaction with footwear is still not clearly understood (Reber et al., 1993; O’Connor & Hamill, 2004). Therefore the purpose of this study is to investigate the influence of different footwear on the muscle’s EMG pattern

WIRE EMG OF FLEXOR HALLUCIS LONGUS DURING BAREFOOT AND SHOD RUNNING ON A TREADMILL: A PILOT STUDY

Excessive pronation is associated with overload injuries of the lower extremity (Nigg, 1995). The flexor hallucis longus (FHL) acts against the pronation of the calcaneus (Klein, 1996). The influence of different footwear on the activity of the FHL was neither measured in walking nor running. The purpose of this study was to investigate the activity of the FHL during different phases in stance of walking and running in different footwear conditions

The Effect of Perioperative Auditory Stimulation with Music on Procedural Pain: A Narrative Review.

PURPOSE OF REVIEW Music therapy has seen increasing applications in various medical fields over the last decades. In the vast range of possibilities through which music can relieve suffering, there is a risk that-given its efficacy-the physiological underpinnings are too little understood. This review provides evidence-based neurobiological concepts for the use of music in perioperative pain management. RECENT FINDINGS The current neuroscientific literature shows a significant convergence of the pain matrix and neuronal networks of pleasure triggered by music. These functions seem to antagonize each other and can thus be brought to fruition in pain therapy. The encouraging results of fMRI and EEG studies still await full translation of this top-down modulating mechanism into broad clinical practice. We embed the current clinical literature in a neurobiological framework. This involves touching on Bayesian "predictive coding" pain theories in broad strokes and outlining functional units in the nociception and pain matrix. These will help to understand clinical findings in the literature summarized in the second part of the review. There are opportunities for perioperative practitioners, including anesthesiologists treating acute pain and anxiety in emergency and perioperative situations, where music could help bring relieve to patients

Analgesia for the Bayesian Brain: How Predictive Coding Offers Insights Into the Subjectivity of Pain.

PURPOSE OF REVIEW In order to better treat pain, we must understand its architecture and pathways. Many modulatory approaches of pain management strategies are only poorly understood. This review aims to provide a theoretical framework of pain perception and modulation in order to assist in clinical understanding and research of analgesia and anesthesia. RECENT FINDINGS Limitations of traditional models for pain have driven the application of new data analysis models. The Bayesian principle of predictive coding has found increasing application in neuroscientific research, providing a promising theoretical background for the principles of consciousness and perception. It can be applied to the subjective perception of pain. Pain perception can be viewed as a continuous hierarchical process of bottom-up sensory inputs colliding with top-down modulations and prior experiences, involving multiple cortical and subcortical hubs of the pain matrix. Predictive coding provides a mathematical model for this interplay

Spin-locking in low-frequency reaction yield detected magnetic resonance

The purported effects of weak magnetic fields on various biological systems from animal magnetoreception to human health have generated widespread interest and sparked much controversy in the past decade. To date the only well established mechanism by which the rates and yields of chemical reactions are known to be influenced by magnetic fields is the radical pair mechanism, based on the spin-dependent reactivity of radical pairs. A diagnostic test for the operation of the radical pair mechanism was proposed by Henbest et al. [J. Am. Chem. Soc., 2004, 126, 8102] based on the combined effects of weak static magnetic fields and radiofrequency oscillating fields in a reaction yield detected magnetic resonance experiment. Here we investigate the effects on radical pair reactions of applying relatively strong oscillating fields, both parallel and perpendicular to the static field. We demonstrate the importance of understanding the effect of the strength of the radiofrequency oscillating field; our experiments demonstrate that there is an optimal oscillating field strength above which the observed signal decreases in intensity and eventually inverts. We establish the correlation between the onset of this effect and the hyperfine structure of the radicals involved, and identify the existence of ‘overtone’ type features appearing at multiples of the expected resonance field positio

Charge Symmetry Breaking in dd->4He{\pi}0 with WASA-at-COSY

Charge symmetry breaking (CSB) observables are a suitable experimental tool to examine effects induced by quark masses on the nuclear level. Previous high precision data from TRIUMF and IUCF are currently used to develop a consistent description of CSB within the framework of chiral perturbation theory. In this work the experimental studies on the reaction dd->4He{\pi}0 have been extended towards higher excess energies in order to provide information on the contribution of p-waves in the final state. For this, an exclusive measurement has been carried out at a beam momentum of p=1.2 GeV/c using the WASA-at-COSY facility. The total cross section amounts to sigma(tot) = (118 +- 18(stat) +- 13(sys) +- 8(ext)) pb and first data on the differential cross section are consistent with s-wave pion production.Comment: 14 pages, 5 figure

Measurement of the pn→ppπ0π−pn \to pp\pi^0\pi^- Reaction in Search for the Recently Observed Resonance Structure in dπ0π0d\pi^0\pi^0 and dπ+π−d\pi^+\pi^- systems

Exclusive measurements of the quasi-free $pn \to pp\pi^0\pi^-$ reaction have been performed by means of $pd$ collisions at $T_p$ = 1.2 GeV using the WASA detector setup at COSY. Total and differential cross sections have been obtained covering the energy region $\sqrt s$ = (2.35 - 2.46) GeV, which includes the region of the ABC effect and its associated resonance structure. No ABC effect, {\it i.e.} low-mass enhancement is found in the $\pi^0\pi^-$-invariant mass spectrum -- in agreement with the constraint from Bose statistics that the isovector pion pair can not be in relative s-wave. At the upper end of the covered energy region $t$-channel processes for Roper, $\Delta(1600)$ and $\Delta\Delta$ excitations provide a reasonable description of the data, but at low energies the measured cross sections are much larger than predicted by such processes. Adding a resonance amplitude for the resonance at $m$=~2.37 GeV with $\Gamma$ =~70 MeV and $I(J^P)=~0(3^+)$ observed recently in $pn \to d\pi^0\pi^0$ and $pn \to d\pi^+\pi^-$ reactions leads to an agreement with the data also at low energies