Increased myocardial apoptosis in patients with unfavorable left ventricular remodeling and early symptomatic post-infarction heart failure

AbstractObjectivesThe purpose of this study was to evaluate a potential correlation between apoptotic rate (AR), post-infarction left ventricular (LV) remodeling, and clinical characteristics in subjects who died late (≥10 days) after an acute myocardial infarction (AMI) with evidence of persistent occlusion of the infarct-related artery at autopsy.BackgroundApoptosis contributes to myocardiocyte loss in cardiac disease and may have a pathophysiologic role in post-infarction LV remodeling.MethodsThe AR was calculated at the site of infarction and in remote unaffected LV regions, using co-localization of in situ end labeling for deoxyribonucleic acid fragmentation and immunohistochemistry for caspase-3, in 14 subjects who died within two months after AMI. Correlation between AR and clinical characteristics such as age, site of AMI, transmural extension, multivessel coronary disease, and signs and/or symptoms of heart failure (HF), at the time of initial hospitalization for AMI or subsequently before death, was assessed using non-parametric statistical tests. Parameters of LV remodeling including diameters, free wall thickness, diameter-to-wall-thickness ratio, and mass were measured at gross examination at autopsy. Values are expressed as median (interquartile range).ResultsAmong clinical variables, early symptomatic post-infarction HF (9 cases, 64%) was associated with nearly fourfold increased AR at the site of infarction (26.2% [24.5% to 28.8%] vs. 6.4% [1.9% to 13.3%], p = 0.001). Moreover, AR both at the site of infarction and in unaffected regions was significantly correlated with parameters of progressive LV remodeling (p < 0.05).ConclusionsOur data show that in patients dying ≥10 days after AMI, myocardial apoptosis is strongly associated with and may be a major determinant of unfavorable LV remodeling and early symptomatic post-infarction HF

Melanoacanthoma Simulating Pigmented Spitz Nevus: an Unusual Dermoscopy Pitfall

The starburst pattern is the dermoscopic hallmark of pigmented Spitz nevus, although it has been rarely observed in melanoma as well

Measures for reducing the vehicle fleet of Komunala Nova Gorica company, with an estimation of cost-cuts and related improvements

Magistrsko delo obravnava možnosti za zmanjševanje voznega parka podjetja Komunala Nova Gorica d.d. in ima dva cilja. Primarni cilj je zniževanje stroškov odvoza odpadkov, posredni cilj pa je povečevanje deleža ločeno zbranih odpadkov, saj je delež ločeno zbranih odpadkov glede na prihajajoče uredbe prenizek. Med ukrepi, s katerimi želimo doseči navedena cilja, najprej obravnavamo spremembo kontejnerskih mest v ekološke otoke in navodila za pravilno izvajanje del v enoti za zbiranje in odvoz odpadkov. V osrednjem delu pa se posvetimo izboljševanju transportnih poti, ki jih ob primerni izvedbi omogoča uporaba navigacijskih naprav. Na podlagi analiz stanja pred ukrepi in po njih so ovrednoteni učinki obravnavanih ukrepov. Rezultat je zmanjšanje števila potrebnih smetarskih vozil za odvoz mešanih odpadkov v podjetju Komunala Nova Gorica d.d. in povečan delež ločeno zbranih odpadkov v občinah, v katerih deluje to podjetje.The thesis suggests several ways to achieve the decrease of the vehicle fleet of the company Komunala Nova Gorica d.d., and has two objectives. The primary objective is cost reduction concerning waste disposal. The second objective is to increase separate waste collection since the amount of the latter proves to be inadequate concerning the coming regulations. In order to achieve the aforementioned goals, it is crucial to first address the turning of the waste collection points into ecological islands. In addition, we provide the instructions for the effective implementation of waste collection and disposal. The central part of the thesis focuses on transport routes and their improved planning considering the use of the navigation devices. We analyse the conditions before taking any measures and after their introduction in order to evaluate the effect of the measures taken. The result is the decreased number of the waste collection vehicles that are used for mixed municipal waste disposal in the company Komunala Nova Gorica d.d. Furthermore, the proposed measures resulted in the increase of separate waste collection in the municipality of the company

Diabetes Prevention: Knowledge and Perception of Risk among Italian Population

The risk perception for developing diabetes has not been well established. The aim of this study is to evaluate knowledge and perception of risk for developing diabetes. A cross-sectional study was conducted among a sample of 527 parents of children attending public schools in Naples (Italy). A self-administered anonymous questionnaire was used to collect the data. In total, 97.3% of participants have heard about diabetes, but only 16.7% knew the main risk and protective factors. This knowledge was statistically significantly higher in those who had close relatives with diabetes. Moreover, those who had middle school or lower and high school education, compared with those who had a college degree or higher, were less knowledgeable. The mean total value of the risk perception for developing diabetes was 1.9. Females those who had more than 40 years of age, those who needed of additional information, those who had a higher BMI, those who had close relatives with diabetes, those who had at least one chronic disease, and those who reported a lower value of self-rated health status were more likely to perceive a higher risk for developing diabetes. Moreover, this perception was statistically significantly lower among those who had a middle school or lower and high school education, compared with those who had a college degree or higher. The knowledge about diabetes needs to be improved, and the low risk perception for developing diabetes among the sample is worrying given the severity of the disease and the preventive measures available