Medical science monitor : international medical journal of experimental and clinical research
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Progress in the management of myocardial infarction has contributed to the increased population of patients with asymptomatic left ventricular dysfunction or congestive heart failure. These patients are at high risk of sudden cardiac death. Factors that worsen this prognosis include exacerbation of coronary artery disease and acute coronary syndrome. We aimed to define and compare risk factors of acute coronary syndrome and sudden cardiac death as well as the cumulative incidence of both in patients after myocardial infarction with asymptomatic left ventricular dysfunction or congestive heart failure during a 2-year follow-up period. ⋯ Predictors of acute coronary syndrome and sudden cardiac death differ in patients after myocardial infarction with asymptomatic left ventricular dysfunction or chronic heart failure and are inconsistent at different stages of development of chronic heart failure.
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Case Reports
Early prediction of ventricular recovery in Takotsubo syndrome using stress and contrast echocardiography.
Takotsubo syndrome is a primary, stress-provoked acquired cardiomyopathy mimicking acute myocardial infarction. Because of the less severe prognosis of takotsubo patients, a reliable method of predicting complete functional recovery has great practical value. ⋯ Microcirculation assessment using myocardial contrast echocardiography as well as early contractile reserve in a low-dose dobutamine echocardiographic test might be useful in the prediction of functional recovery in suspected takotsubo syndrome.
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Ageing reduces the resting blood flow to the skin as well as the blood flow response to thermal stimuli. However, the interrelationships between skin thickness, subcutaneous fat, and skin blood flow in determining the heat dissipation characteristics of the skin have not been investigated. ⋯ The results support a reduction in both the resting and post local heat skin blood flows associated with ageing. Some of this may be due to a reduction in dermal layer thickness due to ageing.
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A review of the current literature was attempted in order to determine to what degree new technological features, such as the use of proteomics, genomics, and gene microarrays, have contributed to the elucidation of the specific pathways to the formation of endometriosis as well as to the discovery of potential biomarkers and new treatment strategies. Endometriosis is well described as a condition in which multiple genetic components and still foggy environmental risk factors are important determinants of the disease's origin, maintenance, persistence, and clinical outcome. ⋯ The evolving genomic and proteomic technologies remain poised to revolutionize the diagnosis and treatment of endometriosis but have not yet lead to a single new therapy or tested biomarker. The reasons have mainly to do with the complex and multifactorial character of the disease itself.
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General anesthesia is characterized by unconsciousness, analgesia, muscle relaxation, and depression of reflexes, generally in response to the administration of chemical agents that induce reversible unconsciousness. Study of the cognitive neuroscientific basis of general anesthesia involves evaluation of the effect of anesthetic agents on consciousness and the brain mechanisms underlying cognitive function. Central nervous system dysfunction after anesthesia and/or surgery can occur at any age but is a particular issue for elderly patients. Studies of delirium and postoperative cognitive dysfunction have been published in many countries since the end of the last century. We present a discussion of delirium disorders and a review of the literature. ⋯ The brain is the main target organ for anesthetic and adjuvant drugs, and age-associated changes in the brain have important implications with respect to general anesthesia. Anesthetists and surgeons have suspected for many years that some patients suffer a postoperative decline in cognitive function. The condition generally has a good outcome because oxidative nerve cell derangements and neurotransmitter imbalances are transient.