Hypoxia-Inducible Factor 1-Alpha Reduces Infarction and Attenuates Progression of Cardiac Dysfunction After Myocardial Infarction in the Mouse

ObjectivesThe aim of this research was to test whether constitutive expression of hypoxia-inducible factor 1-alpha (HIF-1α) influences infarction size and cardiac performance after myocardial infarction.BackgroundA major question in clinical medicine is whether infarction size and border zone remodeling of the heart can be influenced by the overexpression of specific genes in the peri-infarction region.MethodsWe investigated the role of constitutive HIF-1α expression in acute myocardial infarction using a transgenic model. Transgenic mice containing the HIF-1α gene under the control of the α-myosin heavy chain promoter were constructed. Myocardial infarction was produced by coronary ligation in HIF-1α transgenic mice and control animals. Extent of infarction was then quantitated by two-dimensional and M-mode echocardiography as well as by molecular and pathologic analysis of heart samples in infarct, peri-infarct, and remote heart regions at serial time points.ResultsConstitutive overexpression of HIF-1α in the murine heart resulted in attenuated infarct size and improved cardiac function 4 weeks after myocardial infarction. Significantly, we found an increase in both capillary density as well as vascular endothelial growth factor and inducible nitric oxide synthase expression in peri-infarct and infarct regions in the hearts of constitutive HIF-1α–expressing animals compared to control animals.ConclusionsThese observations suggest the involvement of HIF-1α in myocardial remodeling and peri-infarct vascularization. Our results show that supranormal amounts of this peptide protect against extension of infarction and improve border zone survival in myocardial infarction

Attracting health professionals into primary care: Strategies for recruitment

Workforce projections suggest a fall in the number of full-time equivalent general practitioners during the next decade unless more doctors choose general practice as a career. Australia is already experiencing a shortage of GPs and the crisis in the medical workforce is even more pronounced in rural and remote areas. This paper explores the factors that affect career and practice location choice of medical students and junior doctors.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Hyperbaric oxygen therapy in the treatment of sudden sensorineural hearing loss: a retrospective analysis of outcomes

OBJECTIVE: To analyse predictive factors affecting outcome after treatment with hyperbaric oxygen (HBOT) in patients with idiopathic sudden sensorineural hearing loss (ISSHL)

Staged Repair of an Aortic Pseudoaneurysm Secondary to Delayed Methylmethacrylate Plate Migration

Methylmethacrylate is a prosthetic material commonly used for the reconstruction of large chest wall defects. We present the first reported case of delayed methylmethacrylate plate migration, which resulted in an aortic pseudoaneurysm with aortopulmonary fistula. Treatment management, including staged repair combining endovascular and open approaches, is also discussed