Medical hypotheses
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Postoperative delirium represents a serious complication after major surgery. Patients suffer from anxiety, hallucinations and delusions, and have higher postoperative morbidity and mortality. Generally, the role of acetylcholine deficiency in delirium pathophysiology is widely accepted. ⋯ These morphological changes lead to a decrease of nutritive perfusion and to longer diffusion distance for oxygen. Because acetylcholine synthesis is especially sensitive to low oxygen tension, symptoms of its deficiency readily develop. Therapeutic tools to modulate excessive inflammation are available, therefore new strategies of delirium treatment should be implemented in clinical praxis, as well as in preventive measures.
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Editorial Historical Article
Which are the best nations and institutions for revolutionary science 1987-2006? Analysis using a combined metric of Nobel prizes, Fields medals, Lasker awards and Turing awards (NFLT metric).
I have previously suggested that Nobel prizes can be used as a scientometric measurement of 'revolutionary science'; and that for this purpose it would be better if more Nobel prizes were awarded, especially in three new subjects of mathematics, medicine and computing science which have become major sciences over recent decades. In the following analysis of the last 20 years from 1987 to 2006, I use three prestigious prizes in mathematics (Fields medal), medicine (Lasker award for Clinical Medical Research) and computing science (A. M. ⋯ Second is France, with three institutions having three or more winners; the UK and Norway have one each. The NFLT metric confirms previous observations that many public universities in the Western USA have now become a major focus of revolutionary science; and that Harvard has declined from its previous status as the top world centre of revolutionary science to about seventh-place. This analysis confirms the potential value of increasing the number of Nobel prizes as a means of identifying and monitoring centres of excellence in revolutionary science.
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Since the launch in 1998 of the anti-impotence drug sildenafil (viagra), the American food and drug administration has identified 50 cases of drug-related blindness, the so-called nonarteritic anterior ischemic optic neuropathy. This, very serious, side effect frequently leads to sudden, mostly irreversible loss of vision, and there is no proven effective treatment to cure patients or to prevent recurrence. ⋯ These data are consistent with the hypothesis that sildenafil, surgery and anesthesia, taken together, could be a potentially dangerous cocktail of risk factors for sudden irreversible loss of vision. To reduce the risk, sildenafil use should be avoided at least one week before surgical operations, since the reported cases of blindness developed 36h after drug ingestion.
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In scientific writing, although clarity and precision of language are vital to effective communication, it seems undeniable that content is more important than form. Potentially valuable knowledge should not be excluded from the scientific literature merely because the researchers lack advanced language skills. Given that global scientific literature is overwhelmingly in the English-language, this presents a problem for non-native speakers. ⋯ This model bears some conceptual relationship to the recent trend in computing science for component-based or component-oriented software engineering - in which new programs are constructed by reusing programme components, which may be available in libraries. A new functionality is constructed by linking-together many pre-existing chunks of software. I suggest that journal editors should, in their instructions to authors, explicitly allow this 'component-oriented' method of constructing scientific articles; and carefully describe how it can be accomplished in such a way that proper referencing is enforced, and full credit is allocated to the authors of the reused linguistic components.
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Diabetic foot ulcers (DFUs) consist of an interaction of neuropathy, ischemia and infection. Neuropathy affects sensory, motor and autonomic pathways. Pathogenic factors for neuropathy include hyperglycemia, nonenzymatic glycosylation, oxidative stress, ischemic and hypoxic factors, nerve growth factor anomalies, activation of polyol pathway and immunologic abnormalities. ⋯ In addition, recent in vivo and in vitro investigations have evidenced that statins have a favorable effect on diabetic peripheral neuropathy independent of its lipid-lowering effect by demonstrating restoration or preservation of microcirculation of the sciatic nerve. We hypothesized that statins can be useful for the prevention and treatment of diabetic foot. Possible mechanisms include the reduction of neuropathy and ischemia or through growth factors, the effectiveness of which has been shown for fracture healing in animal models.