Wpływ płci i cukrzycy typu 2 na normalizację częstości rytmu serca u pacjentów z chorobą wieńcową po rehabilitacji kardiologicznej

Introduction: The purpose of this study was to clarify whether type 2 diabetic patients with coronary disease are subject to similar benefits in heart rate recovery (HRR) as non-diabetic counterpatrs after cardiac rehabilitation, assessing men and women subjects separately. Material and methods: The data used for this analysis were from an eight-week, phase-II cardiac rehabilitation including 284 patients with ischaemic heart disease who were managed at Tehran Heart Centre between July 2004 and January 2006. The heart rate parameters were compared between diabetic and non-diabetic patients before and after cardiac rehabilitation. Diabetic and non-diabetic patients had similar age and left ventricular ejection fraction. Results: Among men, the non-diabetic patients achieved a greater improvement in peak heart rate and heart rate recovery (HRR). Additionally, lower resting heart rate was found in nondiabetic men after rehabilitation. In the women &#8805; 50 years old, there was no significant difference between diabetic and non-diabetic. The non-diabetic women < 50 years old showed significantly higher peak heart rate and HRR compared with diabetic women. Conclusions: These results indicate that the benefit of cardiac rehabilitation in HRR is significantly lower in type 2 diabetic men. Improvement of HRR is not associated with diabetic status in women &#8805; 50 years old. The response to cardiac rehabilitation in women may appear to be influenced more by age at menopause rather than diabetes mellitus.Wstęp: Celem badania było wyjaśnienie czy pacjenci z cukrzycą typu 2 i chorobą wieńcową odnoszą podobne korzyści z rehabilitacji kardiologicznej dotyczące normalizacji częstości rytmu serca (HRR, heart rate recovery) jak osoby z chorobą wieńcową bez cukrzycy. Osobno oceniano mężczyzn i kobiety. Materiał i metody: Dane wykorzystane w analizie pochodziły z 8-tygodniowego II stadium rehabilitacji kardiologicznej przeprowadzonej u 284 pacjentów z chorobą niedokrwienną serca leczonych w Tehran Heart Center w okresie pomiędzy lipcem 2004 roku a styczniem 2006 roku. Porównywano parametry opisujące częstość rytmu serca u osób z cukrzycą i bez cukrzycy, przed i po rehabilitacji kardiologicznej. Pacjenci z cukrzycą i bez cukrzycy charakteryzowali się podobnym wiekiem i zbliżoną frakcją wyrzutową lewej komory. Wyniki: U mężczyzn bez cukrzycy uzyskano większą poprawę dotyczącą szczytowej częstości rytmu serca i normalizacji HRR. Dodatkowo po rehabilitacji, u mężczyzn bez cukrzycy stwierdzono mniejszą spoczynkową częstość rytmu serca. Nie zaobserwowano znamiennych różnic pomiędzy kobietami z cukrzycą i bez cukrzycy w wieku 50 lat i starszych. Kobiety bez cukrzycy poniżej 50. roku życia charakteryzowały się istotnie większą szczytową częstością rytmu serca i HRR w porównaniu z kobietami z cukrzycą. Wnioski: Uzyskane wyniki świadczą o tym, że korzyści z rehabilitacji kardiologicznej dotyczące HRR są istotnie gorsze u mężczyzn z cukrzcą typu 2. Poprawa dotycząca HRR u kobiet w wieku 50 lat i starszych nie zależała od obecność cukrzycy. Wydaje się, że u kobiet odpowiedź na rehabilitację kardiologiczną w większym stopniu zależy od wieku, w którym wystąpiła menopauza niż od obecności cukrzycy

DESIGNING DEVELOPED LOCAL MODEL TO ASSESS TECHNOLOGICAL CAPABILITY OF AUTOMOTIVE INDUSTRY IN IRAN (CASE STUDY: MEGA MOTOR COMPANY)

ABSTRACT Today, technology is accounted for as a capability in new behaviors, products and strategies for companies which are in economic cycle. So, due to scientific and technological advances in various levels and also the necessity of using new and modern technologies, the assessment technology and innovation is needed more than ever. One of the major factors of failure to apply technology in order for gaining competitive advantage, in developing countries&apos; enterprises, is the lack of knowledge and understanding of enterprise&apos;s level of technological capabilities as well as utilizing these capabilities to the relative advantages. Due to considerable importance of the development of technology, companies&apos; senior managersare compelled to identify and evaluate their company&apos;s technological capabilities, and similarly recognizethe world&apos;s technological evolutions as well as monitor the competitors&apos; efforts to achieve new technologies and also to improve organizational capabilities. On the other hand, this evaluation should be carried out with a model which is consistent with business atmosphere and which is localized along with the country&apos;s enterprises. This study,through applying available models and theories in the field of technological capabilities assessment, aims at providing a developed and localized model, which assesses the technology of automotive industry in Iran including Mega motor company that is one of the major partners in automotive industry; then, the utility of this model for applying in automotive Industry of Iran will be proved by statistical and computational techniques as well as experts opinions

The synthesis of methotrexate-loaded F127 microemulsions and their in vivo toxicity in a rat model

Methotrexate (MTX) has been often formulated as nano and micro-emulsions, nominally to address its poor solubility and off-target effects. Nanoformulated MTX is universally reported to be a more efficacious anti-cancer agent than direct-dissolved drug; however, these investigations generally fail to screen for in vivo toxicity. This study aims to remedy this oversight. MTX was formulated as a standard Pluronic oil-in-water microemulsion with good drug encapsulation efficiency (73.0% ± 8.4). Preliminary in vitro free radical scavenging studies found that formulation reduces drug oxidation four-fold. The toxic effects of formulated and unformulated MTX were investigated in a Wistar rat model. Rats received 0.05 mg/kg MTX as either the microemulsion or directly dissolved in phosphate-buffered saline. A drug-free microemulsion, PBS solution, and saline solution were used as controls. After 28 days, serum levels of enzymes indicative of kidney and liver damage were quantified. Significantly higher serum liver, and serum kidney enzymes were observed in the rats that received the directly dissolved MTX drug (P \u3c 0.05) compared to those who received the encapsulated form. Following sacrifice, the levels of catalase and superoxide dismutase (SOD) were significantly lower and the level of malondialdehyde higher, in rats who received either form of MTX relative to untreated controls. However, the SOD levels were lower in those who received the microemulsion than those who received free MTX. Histology supported the observation that the microemulsion formulation caused no gross structural toxicity to the liver, unlike the free drug. Although toxicity was reduced compared to the free drug, the microemulsion still caused damage to the kidneys. This organ-specific toxicity is consistent with the mode of clearance of the drug. This data demonstrates that the toxicity of formulated drugs must be considered when discussing the relative merits of formulations: encapsulation almost always improves efficacy but may not improve safety

Melatonin inhibits endothelin-1 and induces endothelial nitric oxide synthase genes expression throughout hepatic ischemia/reperfusion in rats

The production of reactive oxygen species (ROS) and dysfunction of vasculature play a central role in the pathophysiology of hepatic ischemia/reperfusion (I/R) injury. The aim of this study was to evaluate the beneficial effects of melatonin on reducing liver I/R injury in rats. Four study groups were formed: (1) saline - administered, control group (Control), (2) melatonin-administered group (MEL), (3) saline -administered I/R group (I/R) and (4) melatonin-administered I/R group (MEL+ I/R). Melatonin was injected intraperitoneally (15 mg/kg) 20 min before ischemia and immediately after reperfusion. After reperfusion, blood and ischemic liver tissues were collected. The group subjected to ischemia showed a significant increase in the serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, as well as an increase in hepatic malondialdehyde (MDA) concentration. These increases were significantly inhibited by melatonin. Although, I/R augmented the endothelin-1 (ET-1) gene expression and the level of big endothelin-1 (big ET-1) in liver tissue, melatonin attenuated these increases. Conversely, non-significant decrease in endothelial nitric oxide synthase (eNOS) mRNA expression in I/R group was significantly elevated by melatonin in MEL+ I/R group. Melatonin exerts beneficial effects on ischemia/reperfusion liver injury through its anti-oxidative function as well as regulation of hepatic microcirculation.Key words: Melatonin, oxidative stress, ischemia/reperfusion injury, endothelin and nitric oxide synthase

Effects of Prepartum Monensin Feeding on Energy Metabolism and Reproductive Performance of Postpartum High-Producing Holstein Dairy Cows

This study was designed to determine the effects of monensin in preparturient diet on postpartum milk production, energy metabolism, and reproductive performance of Holstein dairy cows. Forty Holstein dairy cows on close-up period were randomly divided into monensin treated (300 mg/day in close-up ration, top dress) and control groups. Body condition score (BCS) was estimated three weeks before and three weeks after calving. Milk production and milk fat percentage were recorded in both groups within 3 weeks postpartum. Blood samples were collected from five randomly selected cows of each group three weeks after calving. Serum concentrations of insulin like growth factor-I (IGF-I), insulin, glucose, and beta-hydroxybutyrate (BHBA) were measured. Calving to the first observed estrus interval and calving to conception interval were compared between two groups. The results of the experiment showed that loss of BCS (P=0.3), increase of milk production (P=0.9), and milk fat percentage (P>0.05) were not significantly different between two groups during the period of study. In addition, mean serum glucose concentration (P=0.001) and serum insulin concentration (P=0.01) in monensin group were significantly higher than control cows in the first week postpartum. Moreover, serum BHBA concentration did not significantly change in monensin group. Serum IGF-I concentration in monensin group was significantly higher than control group in three weeks postpartum (P<0.01). The present study indicated that monensin treatment decreased calving to the first observed estrus interval (P=0.05) and calving to conception interval (P=0.002). In conclusion, supplementing the close-up ration can increase postpartum serum IGF-I concentration and prevent the increase of serum BHBA concentration. These may result in enhancement reproductive performance of high-producing dairy cows

Determinants of increasing trends of self-medication: physicians, perspectives

The objective of study was to take and evaluate opinions of the physicians about various aspects of self-medication. A self-fabricated questionnaire of 38 questions was distributed among 292 physicians. Prominent involvement of females in self-medication was suggested by 176 (60 %) physicians. The self-medication trend is more common in financially lower class as reported by 146 (50 %) physicians and in uneducated community as suggested by 165 (57 %) physicians. Family habits and easy to remember brand names were considered as a major source of drug information reported by 155 (53 %) and 187 (64 %) physicians, respectively. Both over the counter (OTC) and prescription only medicines (POM) drugs are used for self-medication as agreed by 131 (49 %) physicians. Medical stores were considered as the major source of drug provider for this purpose suggested by 264 (90 %) practitioners. The extensive use of analgesics for self-medication was reported by 52 % of the respondents. Presence of pharmacist at the points of drug dispensing and a comprehensive health care policy from Government were important suggestions to reduce the self-medication.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Are 'Village Doctors' in Bangladesh a curse or a blessing?

<p>Abstract</p> <p>Background</p> <p>Bangladesh is one of the health workforce crisis countries in the world. In the face of an acute shortage of trained professionals, ensuring healthcare for a population of 150 million remains a major challenge for the nation. To understand the issues related to shortage of health workforce and healthcare provision, this paper investigates the role of various healthcare providers in provision of health services in Chakaria, a remote rural area in Bangladesh.</p> <p>Methods</p> <p>Data were collected through a survey carried out during February 2007 among 1,000 randomly selected households from 8 unions of Chakaria <it>Upazila</it>. Information on health-seeking behaviour was collected from 1 randomly chosen member of a household from those who fell sick during 14 days preceding the survey.</p> <p>Results</p> <p>Around 44% of the villagers suffered from an illness during 14 days preceding the survey and of them 47% sought treatment for their ailment. 65% patients consulted Village Doctors and for 67% patients Village Doctors were the first line of care. Consultation with MBBS doctors was low at 14%. Given the morbidity level observed during the survey it was calculated that 250 physicians would be needed in Chakaria if the patients were to be attended by a qualified physician.</p> <p>Conclusions</p> <p>With the current shortage of physicians and level of production in the country it was asserted that it is very unlikely for Bangladesh to have adequate number of physicians in the near future. Thus, making use of existing healthcare providers, such as Village Doctors, could be considered a realistic option in dealing with the prevailing crisis.</p

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study

Background Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. Method The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. Results The mean age of participants was 49.38(SD = +/- 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. Conclusion The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers