Professional independence in general practice

The first association one gets when thinking about independence in is that independence is good. We all want to be independent and free. For me, coming form Slovenia, this feeling is perhaps even deeper. Slovenia regained its independence after a thousand years of being ruled by Germans, Austrians, Italians, Hungarians and Serbs. Nevertheless, we have always cherished the fact that we are different and have tried hard to maintain our independence as much as possible. What is interesting is that even though it took us a thousand years to reach independence, we are now trying very hard to join the European union. We are trading our independence for a value of belonging to EU. And the feelings of pride that we are achieving its standards are comparable to the feelings of pride when we became independent from Yugoslavia. This is a strange contradiction. When I lecture about independence to medical students, I do that in a context of family as a unit of care. I try to describe family as a system and how it develops over time and the problems it faces during various stages. I can not do that without addressing the systems theory, which is very useful in describing complex systems.peer-reviewe

Cardiopulmonary Exercise Test in heart failure: A Sine qua non

A robust literature, over the last years, supports the indication of cardiopulmonary exercise testing (CPET) in patients with cardiovascular diseases. Understanding exercise physiology is a crucial component of the critical evaluation of exercise intolerance. Shortness of breath and exercise limitation is often treated with an improper focus, partly because the pathophysiology is not well understood in the frame of the diagnostic spectrum of each subspecialty. A vital field and research area have been cardiopulmonary exercise test in heart failure with preserved/reduced ejection fraction, evaluation of heart failure patients as candidates for LVAD-Implantation, as well as for LVAD-Explantation and ultimately for heart transplantation. All the CPET variables provide synergistic prognostic discrimination. However, Peak VO2 serves as the most critical parameter for risk stratification and prediction of survival rate

FPGA based speeded up robust features

We present an implementation of the Speeded Up Robust Features (SURF) on a Field Programmable Gate Array (FPGA). The SURF algorithm extracts salient points from image and computes descriptors of their surroundings that are invariant to scale, rotation and illumination changes. The interest point detection and feature descriptor extraction algorithm is often used as the first stage in autonomous robot navigation, object recognition and tracking etc. However, detection and extraction are computationally demanding and therefore can't be used in systems with limited computational power. We took advantage of algorithm's natural parallelism and implemented it's most demanding parts in FPGA logic. Several modifications of the original algorithm have been made to increase it's suitability for FPGA implementation. Experiments show, that the FPGA implementation is comparable in terms of precision, speed and repeatability, but outperforms the CPU and GPU implementation in terms of power consumption. Our implementation is intended to be used in embedded systems which are limited in computational power or as the first stage preprocessing block, which allows the computational resources to focus on higher level algorithms

Limit cycles by FEM for a one - parameter dynamical system associated to the Luo - Rudy I model

An one - parameter dynamical system is associated to the mathematical problem governing the membrane excitability of a ventricular cardiomyocyte, according to the Luo-Rudy I model. Limit cycles are described by the solutions of an extended system. A finite element method time approximation (FEM) is used in order to formulate the approximate problem. Starting from a Hopf bifurcation point, approximate limit cycles are obtained, step by step, using an arc-length-continuation method and Newton's method. Some numerical results are presented.Comment: Presented at the 18th Conference on Applied and Industrial Mathematics - CAIM 2010, Ia\c{s}i, Romania, October 14-17, 2010; http://www.romai.ro, http://rj.romai.r

Association of common mental disorders and quality of life with the frequency of attendance in slovenian family medicine practices: longitudinal study.

Most research on frequent attendance has been cross-sectional and restricted to one year attendance rates. A few longitudinal studies suggest that frequent attendance is self-limiting. Frequent attenders are more likely to have social and psychiatric problems, medically unexplained physical symptoms, chronic somatic diseases (especially diabetes) and are prescribed more psychotropic medication and analgesics

Surface Expressed Nucleolin Is Constantly Induced in Tumor Cells to Mediate Calcium-Dependent Ligand Internalization

BACKGROUND: Nucleolin is one of the major proteins of the nucleolus, but it is also expressed on the cell surface where is serves as a binding protein for variety of ligands implicated in tumorigenesis and angiogenesis. Emerging evidence suggests that the cell-surface expressed nucleolin is a strategic target for an effective and nontoxic cancer therapy. METHODOLOGY/PRINCIPAL FINDINGS: By monitoring the expression of nucleolin mRNA, and by measuring the level of nucleolin protein recovered from the surface and nucleus of cells, here we show that the presence of nucleolin at the cell surface is dependent on the constant induction of nucleolin mRNA. Indeed, inhibitors of RNA transcription or translation block expression of surface nucleolin while no apparent effect is observed on the level of nucleolin in the nucleus. The estimated half-life of surface nucleolin is less than one hour, whereas that of nuclear nucleolin is more than 8 hours. Nucleolin mRNA induction is reduced markedly in normal fibroblasts that reach confluence, while it occurs continuously even in post-confluent epithelial tumor cells consistent with their capacity to proliferate without contact inhibition. Interestingly, cold and heat shock induce nucleolin mRNA concomitantly to enhanced mRNA expression of the heat shock protein 70, thus suggesting that surface nucleolin induction also occurs in response to an environmental insult. At the cell surface, one of the main functions of nucleolin is to shuttle specific extracellular ligands by an active transport mechanism, which we show here to be calcium dependent. CONCLUSION/SIGNIFICANCE: Our results demonstrate that the expression of surface nucleolin is an early metabolic event coupled with tumor cell proliferation and stress response. The fact that surface nucleolin is constantly and abundantly expressed on the surface of tumor cells, makes them a preferential target for the inhibitory action of anticancer agents that target surface nucleolin

"Broken Heart" and "Broken Brain": Which Connection?

The interconnections between brain and heart are increasingly recognized. Takotsubo cardiomyopathy, also known as "broken heart syndrome", is characterized by a cardiovascular dysfunction provoked by an emotional or stressful situation. Similar events can trigger a neurological pathology called transient global amnesia. These conditions can occur simultaneously, although their precise connection is not well understood. We aim to present the case of a patient who experienced them and to review the relevant literature