Peripheral benzodiazepine receptor expression on leukocytes and neutrophil function during anticonvulsant monotherapy

AIM: To gain a full understanding of the concept of equity and means of promoting and monitoring a more equitable healthservice. BACKGROUND: With previous policy decisions having sidelined equity, a new government is likely to wish to reverse this trend. ORIGINS OF INFORMATION: Government and expert opinion. DATA ANALYSIS: A critical approach to previous literature. KEY ISSUES: Equity is not a unitary concept and so it is explored and dissected using the framework of: Distribution of Resources, Access and Uptake of Healthcare, Standards and Outcomes of Healthcare, Health Status. Means of improving and monitoring equity in these four areas are suggested. CONCLUSIONS: There are a number of ways of considering the concept of equity and for any fruitful discussion to occur there needs to be an agreed working definition. Specific topics are discussed where equity is lacking and a plan of action is suggested which is likely to improve equity in the areas identified.     

ATP-diphosphophydrolase activity in rat heart tissue

Extracellular nucleotides interact with specific receptors on the cell surface and are locally metabolized by ecto-nucleotidases. Biochemical characterization of the ATPase and ADPase activities detected in rat heart sarcolemma, under conditions where mitochondrial ATPase and adenylate kinase were blocked, supports our proposal that both activities correspond to a single enzyme, known as ATP-diphosphohydrolase or apyrase. The physiological function of this enzyme could be dephosphorylation of the nucleotides present in the interstitial heart compartment acting together with 5'-nucleotidase. Both hydrolytic activities have similarities in: sarcolemma localization, bivalent metal ion dependence, optimum pH, effect of several amino acid residue modifiers, competitive inhibition of nucleotide analogs, and broad nucleoside di-and triphosphate specificity. The ATPase activity could not be separated from the ADPase either through isoelectrofocusing or electrophoresis under acid conditions.     

Susceptibility to atrial fibrillation: a study in an ovine model of pacing-induced early heart failure

INTRODUCTION: The development of susceptibility to atrial fibrillation (AF) is a common consequence of many forms of cardiovascular disease, especially heart failure. In this study we used a sheep model of pacing-induced stable early heart failure to describe, quantify, and relate the level of susceptibility to AF to changes in structural and electrophysiologic parameters. METHODS AND RESULTS: Epicardial electrodes were implanted on the atria and right ventricles of nine sheep. The AF threshold, atrial vulnerability period, atrial effective refractory period (ERP), and interatrial conduction time were examined during control and over a 6-week period of ventricular pacing at 190 beats/min. Left atrial (LA) area and left ventricular (LV) fractional shortening were monitored using echocardiography. There were significant increases in LA susceptibility to AF (P < 0.0003), LA area (P < 0.0002), and LA ERP400 (P < 0.0002). Rate of increase in LA area was related positively to AF susceptibility (P = 0.02) and inversely to LA ERP400 (P = 0.002). LV fractional shortening decreased to approximately 50% of control value (P < 0.00001). No changes were observed in right atrial electrophysiology. CONCLUSION: In this study, susceptibility (the ability of an extrastimulus to induce AF) was rigorously measured within a predetermined format. Significant relationships were found to exist between susceptibility, certain of the observed changes in atrial electrophysiology and structure.     

Effects of clorazepate, diazepam, and oxazepam on a laboratory measurement of aggression in men

The liver S9 head space vial equilibration technique is an in vitro alternative that holds promises for a satisfactory in vivo extrapolation of liver metabolism of volatile organic chemicals. The aim of this study was to investigate the suitability of this methodology for the extrapolation of in vitro metabolic data from rodent to man by allometry with the two highly metabolized organic solvents toluene and n-hexane as model substances. The calculated hepatic clearance of toluene in man from rodent liver S9 in this study was equal to the reported total body clearance of toluene in man, suggesting insignificant extrahepatic clearance of toluene in humans. The calculated hepatic clearance of n-hexane was less than the reported values of total body clearance of n-hexane in man, indicating an about 80% extrahepatic clearance of n-hexane in humans. Both results are in line with our present knowledge of the metabolism of the two organic solvents in man. Allometric scaling from rodent liver S9 head space incubations to in vivo metabolism of toluene and n-hexane in man thus seems promising and could be a method of choice for scaling of organic solvent metabolism in general.     

Treatment of linea alba hernia and diastasis of rectus abdominis

The asynchronous development of structural and metabolic disorders of aponeurosis, leading to the development of defects in sheath of the rectus abdominis is the major factor of hernia of linea alba formation. Development of diastasis of m. rectus abdominis is caused by primary structural and metabolic changes of myocytes caused by the extreme overload. The important factor of the operation is restoration of anatomic and physiologic parameters of the abdominal wall by bringing mm. rectus abdominis together, shortening and enforsing of aponeurosis makes it possible to distribute regularly the load on the aponeurotic sheath of musculi recti.     

Modeling obesity using abductive networks

This paper investigates the use of abductive-network machine learning for modeling and predicting outcome parameters in terms of input parameters in medical survey data. Here we consider modeling obesity as represented by the waist-to-hip ratio (WHR) risk factor to investigate the influence of various parameters. The same approach would be useful in predicting values of clinical parameters that are difficult or expensive to measure from others that are more readily available. The AIM abductive network machine learning tool was used to model the WHR from 13 other health parameters. Survey data were collected for a randomly selected sample of 1100 persons aged 20 yr and over attending nine primary health care centers at Al-Khobar, Saudi Arabia. Models were synthesized by training on a randomly selected set of 800 cases, using both continuous and categorical representations of the parameters, and evaluated by predicting the WHR value for the remaining 300 cases. Models for WHR as a continuous variable predict the actual values within an error of 7.5% at the 90% confidence limits. Categorical models predict the correct logical value of WHR with an error in only 2 of the 300 evaluation cases. Analytical relationships derived from simple categorical models explain global observations on the total survey population to an accuracy as high as 99%. Simple continuous models represented as analytical functions highlight global relationships and trends. Results confirm the strong correlation between WHR and diastolic blood pressure, cholesterol level, and family history of obesity. Compared to other statistical and neural network approaches, AIM abductive networks provide faster and more automated model synthesis. A review is given of other areas where the proposed modeling approach can be useful in clinical practice.     

Caring for the older patient, Part II: Age-related anatomic and physiologic changes and pathologies

This is the second article of a four-part series on gerontology and its applications to the care of elderly patients in nuclear medicine. This article reviews anatomic and physiologic changes and pathology associated with aging. It also discusses tailoring nuclear medicine procedures according to patients' needs and conditions, as well as adopting changes within the nuclear medicine department to better serve older patients. Upon completion of this article, the reader should be able to: (a) describe normal age-related anatomic and physiologic changes that are observed in older patients; (b) identify common age-related disorders; (c) discuss considerations in tailoring nuclear medicine procedures for older patients; and (d) identify changes in the nuclear medicine facility that would better accommodate older patients.