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PubMed1995

[The 69th annual meeting special lecture. Present situation of leprosy].

Many leprosy patients have deformity or disability owing to the characteristics of Mycobacterium leprae i.e. M. leprae affects skin and peripheral nerve. Optimum growth temperature of M. leprae was estimated by clinical manifestations and animal experiments, and it was concluded that the optimum temperature is 33 degrees C, and this characteristic of M. leprae may be one of the reason why M. leprae affects skin tissue. There was no reliable treatment of leprosy before 1943, but effectiveness of promin against leprosy was proven in 1943, and chemotherapy of leprosy was gradually improved especially since 1960 after the discovery of mouse footpad inoculation of M. leprae. In vitro cultivation technique of M. leprae is still unestablished, but susceptibility of ninebanded armadillo to M. leprae was discovered in 1970. Supply of M. leprae collected and purified from M. leprae infected armadillo tissue became available, then biochemistry, immunology and molecular biology of M. leprae was improved significantly. Ridley-Joppling's classification of leprosy i.e. two types (tuberculoid and lepromatous) and two groups (indeterminate and borderline) classification is being adopted at present. Rifampicin, DDS (dapsone) and clofazimine (lamprene) are widely used for chemotherapy of leprosy. WHO is recommending Multidrug Therapy (MDT) of leprosy i.e. administration of rifampicin and DDS for paucibacillary group, administration of rifampicin, DDS and clofazimine for multibacillary group. About 2.4 million leprosy patients are registered and under chemotherapy in the world at present, and about five hundred thousand new patients are being registered every year. Target of leprosy elimination by WHO is prevalence rate of leprosy should be less than one per ten thousand in every country.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

[Mechanisms of macrovascular involvement in diabetic subjects].

Diabetic macroangiopathy is often viewed as an accelerated and aggravated form of atherosclerosis. Several biological disturbances that are associated with diabetes partially account for a possible aggravation of atherosclerosis. Such are disorders of blood lipids (increased triglyceride concentration, modifications of low density lipoproteins) of haemostatis (increased platelet activity, decreased fibrinolytic activity) or of arterial vasomotility. Yet, many uncertainties and inconsistencies still obfuscate the links between diabetes and atherosclerosis, which remain hypothetical, and debatable. Clinical experience and all clinical epidemiological studies show that the incidence and severity of ischaemic arterial diseases (coronary heart disease, lower limb ischaemia, cerebral ischaemic events) are increased in diabetic individuals. However, intermediates other than worsened atherosclerosis may account for these associations. For instance, several anatomical epidemiological studies, based on routine autopsies, have note consistently found that atherosclerotic lesions (plaques) are larger and more extensive in diabetic than in non-diabetic individuals. The basic mechanisms of diabetic macroangiopathy could therefore be not as closely related to atherosclerosis as is usually thought. Among the non-atherosclerotic lesions that could explain the increased arterial risk in diabetic patients, the best documented and most plausible is arteriosclerosis--a pure sclerosis of the arterial wall (without lipid deposition) which, in its advanced forms, can compromise tissue vascularization. Arteriosclerosis is considered as a normal consequence of arterial ageing which would be accelerated in diabetes. Chronic hyperglycaemia is and independent and influent marker of arterial risk in diabetic patients. It could stimulate arterial sclerosis by enhancing non-enzymatic glycation of various components of the arterial matrix, through formation of advanced glycation end-products (AGEs).(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriosclerosis↗

PubMed1994

[Consensus hemorrhoids (Dutch Society for Surgery)].

On the initiative of the Dutch Surgical Society a consensus meeting was held on December 3rd, 1993 in Utrecht, the Netherlands by the National Organisation for Quality Assurance in Hospitals (CBO), on the diagnosis and treatment of haemorrhoids. The following statements were formulated. Haemorrhoids are vascular cushions, covered by mucosa, originating from the plexus rectalis superior, and are part of the normal anatomy of man. Complaints from haemorrhoids occur if they prolapse. The usual 4-grade classification of haemorrhoids has no direct impact on their treatment. Portal hypertension is not a cause of haemorrhoids. Blood loss, a sensation of prolapse, pruritus and soiling are non-specific symptoms of haemorrhoids. Anaemia may only be attributed to haemorrhoids after other pathology has been excluded. Acute massive anorectal blood loss is frequently caused by traumatic damage to the rectum. Anticoagulant therapy is a risk factor. The presence of unexplained perianal skin lesions neccessitates further proctologic investigation. Haemorrhoids are not palpable on rectal digital examination. In patients under 50 with anorectal blood loss and a history of haemorrhoids, a proctoscopic examination is sufficient. Anorectal blood loss in patients over 50 requires exclusion of higher pathology. The regulation of defaecation and eating habits can have a preventive effect on the development of haemorrhoids. Conservative measures form the basis of treatment for haemorrhoidal complaints. Local antihaemorrhoidal treatment can only be expected to give short-term relief and is not a causal therapy. Barron elastic band ligation and sclerosing, in addition to infrared coagulation are treatment modalities in the outpatient setting that are very effective, inexpensive and optimally patient-friendly.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemorrhoids↗

PubMedDate not supplied

[Mathematical modelling in medicine and biology. Theoretical basis and fundamentals].

Mathematical modelling is currently a common tool in the study of physiological and biochemical systems. Its basis and fundaments are not, however, well known by the non-specialist. Its aims are to describe, explain and predict physiological and biochemical phenomena. Mathematical models provide a concise and objective description of complex dynamic processes by defining, through mathematical equations, the relationships between quantitative measurements; they indicate, also, ways to improve experimental designs, and allow the testing of hypotheses about physiological or biochemical phenomena. Mathematical models can be developed from simple non-compartmental representations to large scale multi-compartmental models. The basic steps in the formulation of a model include conceptualization, realization and solution of the model. Each step has to be verified and validated. In the case of compartmental models, mass-balance equations are used to represent each compartment. A brief review of the theory of system's analysis and the general aims of mathematical modelling is presented here. The modelling process is usually started with a definition of the problem and a parameter identification followed by the setting up of a clear conceptual model of the system. The model consists of the description of the principal flows of material (in and out) and of the main components which store, convert or transmit these flows. A selection of the class of mathematical representation follows, i.e. linear or non-linear, in order to formulate the equations relating the input and output flows of material for each individual component of the system.(ABSTRACT TRUNCATED AT 250 WORDS)

Models, Biological↗

PubMed1993

[Prevention of thromboembolic disease using mini doses of heparin in surgery patients].

In our study, the effect of the prophylaxis with the low doses of heparin on the occurrence of the deep venous thrombosis or the thromboembolic disease (TED) in the selected groups of the patients was investigated. From our work arises that the patients suffering from malignant diseases are actually at the high risk according to the shortened values of APTT in the preoperative period, which shows evidence of hypercoagulability and further according to the major occurrence of the deep venous thrombosis and the thromboembolic disease during the insufficient prevention by heparin (II. gr. 12%). Low doses of heparin evidently affected the values of APTT and elevated them to the more desirable levels in most of the patients. During the therapy by heparin is necessary to control regularly the values of APTT and to correct the dosage conditionally. Failure and complications of the therapy by heparin is mostly due to incorrectly dosed heparin or its delayed administration or further its improper and inadequate application in the group of the patients being contraindicated (mainly the patients suffering from the bleeding disorders or hepatic damage). The dosage of heparin must be consistent, then the therapy is safe and effective. At any postoperative complication it is necessary to applicate heparin again in the case of its previous abortion. It is also necessary to monitor the mobility of the patients after the operation, which is individual and according to correct the length of the administration of heparin. The period of the administration of heparin is individual, not overall. It is needless to afraid of the application of heparin in the surgical patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Heparin↗

PubMed1993

[Intra-articular and peri-articular injection therapy].

The author in the article in the form of an assembled report deals with the problem of intraarticular and periarticular injection therapy. The author divides the matter in two parts, the diagnostics and therapy. In general, there are four possibilities of influencing the joint by means of an injection. First, the evacuation of intraarticular contents, second, the introducing of pharmacy into the joint, third, the mechanical irritation of certain connective tissue structures of the joint which ought to evoke the formation of a scar, and fourth, the mechanical stabilization of the structure inflicted by lesion. Owing to the removal of pain, the negative effects of neuromuscular reflexes due to algesic stimuli, are eliminated. There are two basic types of affections subjectable to injection intraarticular treatment, namely the diseases coinciding with the damage of articular biomechanics, particularly disturbances of both, the sliding in arthrosis and articular stability. In such cases the application of chondroprotectives, eventually formation of a scar by irritation of the appropriate connective tissue structures, decreasing of instability and removal of contractures are theoretically justified. Evacuation punction is indicated in post-traumatic states, inflammatory states indicate diagnostic punction, and aseptic inflammation requires infiltration of pharmacy with antiphlogistic effect. Injection intrarticular intervention represents a justified diagnostic procedure and an effective therapeutical administration. It is necessary to become familiar with the topographic anatomy of joints, just as with the technique of application, contraindications, and determination of possible limitations of intraarticular treatment and surgical reconstructive intervention into the joint or extremity. The most serious complications of intraarticular injection administration are represented by iatrogenic infections and cortisone-like arthropathies.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗

PubMed1993

[Integrins: a family of cell adhesion receptors].

Integrins are a family of cell adhesion molecules (CAM's) that mediate the communication between the intracellular and the extracellular compartments. The growing interest in CAM's is due to the essential role they play in cell-cell and cell-matrix recognition processes. These receptors are formed by a non-covalently associated glycoprotein complex of two distinct polypeptide chains, called, alpha and beta. The association of different subunits results in the formation of, at least, 16 different integrins that provide cells with a great versatility in their adhesion properties. An integrin molecule comprises a cytoplasmic domain that interacts with the cytoskeleton, a transmembranous domain and an extracellular domain that binds to one or more ligands. beta 1, beta 2 and beta 3, are the best characterized integrin subfamilies; they are expressed, in different amounts, in epithelial and endothelial cells, leukocytes, fibroblasts and platelets. b1 integrins are essentially involved in cell-extracellular matrix interactions and beta 2 subfamily in leukocyte-leukocyte and leukocyte-endothelial cell communications. The integrin subfamily beta 3 mediates the adhesion of platelets with fibrinogen and other ligands. During embryonic development, integrins in association with other CAM's, play an essential role in cell migration and morphogenesis. Moreover, in processes like inflammation, wound healing and thrombosis, integrins and other CAM's mediate the interactions among the injured tissue and circulating cells. In two genetic diseases like the leukocyte adhesion deficiency and the Glanzmann's thrombasthenia an impairment in leukocyte-endothelial cell interactions and platelet aggregation is detected, due to deficiencies or abnormalities in beta 2 or beta 3 integrin subfamilies, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Adhesion↗

PubMed1988

[Morphologic studies in criminal justice--requirements and reality].

A critical analysis is given of the investigation and examination of fatalities for the public prosecution office and for the courts. Rationalistic simplifications in legal quarters, changes in legal procedures and bureaucracy have had negative effects on the field of forensic medicine. It is questionable whether forensic science today can fulfil the scientific demands with regard to a complete and thorough explanation of the cause of death. The reduced interest in expert opinions concerning the pattern of injuries that can help in the reconstruction of the act or in judging the intention and guilt of the perpetrator is a striking and alarming development in criminal justice. Medical examinations in the somatic field are no longer used enough in forensic cases; with regard to the administration of justice, the role of the forensic expert is limited to the postmortem findings and the cause of death. On the other hand, there is increased interest in the expert opinion of psychologists, psychiatrists and specialists in the field of drugs and alcohol. The fact that the number of autopsies and histological as well as toxicological examinations ordered by the public prosecutor is rather small has serious and negative implications for establishing the truth. Such orders are merely dependent on the circumstance of death and the situation in which the body was found. However, the external circumstances can be misleading or they can be manipulated. That is why some crimes are not revealed. In the Federal Republic of Germany, if there is no suspicion of external violence permission is granted for corpses to be buried without the cause of death being clarified by autopsy. However, the fact that the opinions of forensic specialists differ regarding this development in the administration of justice must also be criticized. There is an increasing tendency for investigations to be carried out only if they are ordered by the prosecutor and for questions to be answered only if they are asked officially. Even our colleagues are influenced too much by external circumstances and consider an autopsy unnecessary if the cause of death seems to be clear (for instance in cases of hanging, drowning or bleeding to death). Second autopsies have shown that the thoroughness and the quality of the first autopsy often leave much to be desired. It is, for instance, unforgivable if organs are described without being examined. Special interest is afforded to the necessity for the significance of histological examinations.(ABSTRACT TRUNCATED AT 400 WORDS)

Autopsy↗

PubMed1989

[Recovery process of injured ureters in dogs].

This paper is the 13th report in a series of studies on the application of microexplosion to medicine and biology. The recovery process of injured ureters was investigated in the day. The 60 ureters of 42 mongrel dogs were used. The ureter was injured with a nail, punch or surgical knife. The "pierced injury" was passed through the ureter with a nail of 1 mm or 2 mm in diameter, the "punch injury" was punched out in the ureter by a puncher of 1 mm or 2 mm in diameter and the "cut injury" was cut in the ureter 5 mm or 10 mm in size with a surgical knife. The recovery process of the injured ureter was observed in each of the two ureters 3 days, 1 week, 3 weeks, 6 weeks and 12 weeks after the injury by means of IVP, for macroscopic and microscopic findings. The results were as follows: 1) In IVP, it was observed that the 1 mm pierced injury resulted in no urine leakage after 3 days, that the 2 mm pierced injury and 1 mm punch injury in no urine leakage after almost 1 week and that the 2 mm punch injury and 5 mm cut injury and 10 mm cut injury in no urine leakage after almost 3 weeks. Hydroureter due to tissue edema was observed only in one ureter with a 10 mm cut injury after 1 week. No ureteral stricture, hydronephrosis or hydroureter was observed in the other ureters.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMedDate not supplied

[5 new species of blackflies (Diptera: Simuliidae) from Siberia, the Far East and Central Asia].

Five new species of the family Simuliidae Stegopterna byrrangii Yankovsky, sp. n. and Cnephia chaurensis Yankovsky sp. n., from Taimyr peninsula, Metacnephia olyutorii Yankovsky sp. n. from Kamchatka, Metacnephia karakechensis Yankovsky sp. n. and Montisimulium sonkulense Yankovsky sp. n. from Kirghizia, are described. Stegopterna byrrangii differs from related species: in male--from all known species of the genus by peculiar form of apical end of gonostyles, when apical spine is approximately parallel to inner surface of gonostyle; in female--from all known species of the genus by very long genital lobes (their length twice more than width), from S. longicoxa Rubzov, 1971 and S. duodecimata (Rubzov, 1940) by long stem of genital fork, absence of anterolateral sclerotized projections of branches of genital fork; in pupa--from all known species of the genus by number of filaments of respiratory organ (14-16, when in other species no more than 12). Cnephia chaurensis differs from related species: in male--from C. intermedia Rubzov, 1956 and C. toptchievi Yankovsky, 1996 by absence of medial projection or ridge of gonosternum, from C. intermedia by widened body of gonosternum, from C. toptchievi by ridge on gonocoxites and wide triangular projections near base of arms of gonosternum; in female--from C. intermedia by sclerotized finger-like anterolateral projections of branches of genital fork, subdivision of branches into two lobes, wide flat apical end of stem of genital fork. Metacnephia karakechensis differs from related species: in male--from M. subalpina (Rubzov, 1956) by form of gonostyles, absence of triangular medial projection of gonosternum, short widened gonofurca and more number of spines in parameres, from M. kirjanovae (Rubzov, 1956) and M. slepjani (Rubzov, 1967) by triangular body of gonosternum, widened gonostyles, more number of spines in parameres; in larva--from M. subalpina by more number of rays of primary fan of premandibles, less number of ridges of hooks in posterior attachment organ, from M. kirjanovae by short thick antennae; in pupa--from M. subalpina by character of divergence of upper thick filaments of respiratory organ, from M. kirjanovae by presence of thick filaments of the organ. Metacnephia olyutorii differs from related species: in female--from M. larunae Worobez, 1984 and M. aldanica Worobez, 1987 by thick sclerotized anterolateral projections of branches of genital fork, from M. taimyrica Patrusheva, 1976 by 1-ended (not 3-ended) anterolateral projections of branches of genital fork, large (not shortened) anal lobes, from M. crassifistula (Rubzov, 1956) by very long stem of genital fork. Montisimulium sonkulense differs from related species: in male--from M. brachystylum (Rubzov, 1976) by more prolonged gonostyles, less number of spines of parameres, from M. ocreastylum (Rubzov, 1956) by form of gonostyles, from M. odontostylum (Rubzov, 1947) by more number of spines of parameres; in female--from M. brachystylum and M. odontostylum by stricktly developed posteromedial projections of branches of genital fork, from species having posteromedical projections of branches of genital fork--from M. (ABSTRACT TRUNCATED)

Animals↗

PubMed1992

[Impotence from the 70's through the 90's: 20 years of evolution of diagnosis and therapy].

The surgical treatment of vascular impotence has evolved as our understanding of the haemodynamics of erection advanced. In the early Seventies the direct revascularization techniques which create an anastomosis between an artery and the corpora cavernosa came to be so much in use that an era of so-called "pure arteriogenic impotence" seemed to be dawning. An arterial role in the pathogenesis of importance gained increasing support during that decade, as the use of a number of techniques for the diagnostic assessment of penile haemodynamics becomes widespread (Doppler ultrasound, determination of the penile-brachial index, selective hypogastric arteriography, penile radionuclide scan, penile plethysmography). Corpora cavernosa-direct revascularization techniques, such as the Epigastric-Corporal and Femoro-Corporal trans-Saphena anastomoses, were developed, the latter being proposed by Michal in 1973. By the late Seventies, however, most Authors had abandoned these techniques. Severe haemodynamic side-effects, such as uninterrupted intra-cavernous high pressure and attendant permanent tumescence of penis, were found to induce the microfibrosis of erectile tissues and the thrombosis at the site of the anastomosis. In this period, "venous leakage" became, with the advent of cavernosography, a recognized factor in the pathogenesis of impotence. However, the concept of venogenic impotence, characterized as it is by transient erection, and featuring pathological cavernosograms as well as high cavernometric figures, belongs more appropriately to a clinical syndrome and is, therefore far from being unambiguous. Arterial-arterial bypass and selective veins ligation were then introduced to treat cases of "pure" arteriogenic or venogenic insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Erectile Dysfunction↗

PubMed1992

[Noise, sleep and behavior].

The negative effects of noise on sleep and behaviour have been related to three mechanisms: a physiological arousal (above a certain threshold of noise), an aversive reaction and an interference with non auditive neurophysiological and mental processes. The perturbation of verbal communication and the effects of sleep are the directly observable consequences. The negative effects of noise above a certain threshold on sleep have been demonstrated both in experimental conditions and in real life. They concern length, EEG pattern, and subjective quality and produce an increase of irritability and tiredness. There is no habituation. In all populations studied, strong discomfort is expressed by 50% of the subjects living in an area with an Ldn of 75 dB in the case of air traffic noise, the same results being obtained with ground traffic for a 5-15 dB higher level. Objective expressions of discomfort: use of aural protections, closing the windows, staying indoor, changing residence, increase linearly with the intensity of noise. Noise influences the incidence of stress-related disorders: hypertension, related cardio-vascular diseases, psychosomatic and psychological disorders. It has been shown by the use of different techniques (epidemiological studies based on the frequency of medical contacts, on the diagnoses made by general practitioners, on the use of specific drugs, and on the examination of the whole population) that the prevalence increases in relation with the level of noise in the vicinity of airports.(ABSTRACT TRUNCATED AT 250 WORDS)

Behavior↗

PubMed1992

[Environmental hygienic aspects of echinococcosis].

A literature review on the current situation of echinococcosis in Central Europe is given. The only final host for Echinococcus granulosus in this region ist the dog. The infection rate of dogs with E. granulosus in Central Europe is less than 1%. According to meat inspection statistics in Germany less than 0.008% of sheep, pigs and horses carry larval stages of E. granulosus. Parasitologically confirmed is the occurrence of a cattle-dog strain, the cysts of which were found in 0.26% of slaughter cattle. It is not known whether this strain infects also man as does the sheep-dog strain. Cases of cystic echinococcosis (E. granulosus) diagnosed in Central Europe are often imported from mediterranean countries. In Baden-Wurtemberg, the only state where human cases of echinococcosis are recorded, 50-100 cases are diagnosed per year. In areas with endemic E. multilocularis infection also dogs and cats may be infected with the adult worm besides the red fox. Recent investigations have revealed that not only in classical endemic areas (Switzerland, Austria, Baden-Wurtemberg, Rhineland-Palatinate) foxes have infection rates of up to 67% but that E. multilocularis-infection is also wide-spread in Thuringia, Hesse, Northrhine-Westphalia and in the southern parts of Lower Saxony. The most northern infested area seems to be the region of Detmold (infection rate of foxes 9%). The infection rates with alveolar echinococcosis (E. multilocularis) in humans even in endemic areas are low. In Baden-Wurtemberg 140 new cases became known during the past ten years.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1992

[The new biomedical and health research program of the European Economic Community--BIOMED 1 (1990-94)].

The new EEC Biomedical and Health Research Programme (BIOMED 1) is presented. After a brief introduction on the background of the Programme--in which an overview of the ongoing Medical and Health Research Programme (MHR 4) is given--the main features of the new Programme are pointed out. On what concerns its aims and objectives, concertation and coordination of national research programmes at community level are stressed as well as the need to apply to the maximum possible extent the principles of subsidiary and community added value, in order to ensure an European dimension to the actions which are going to be supported and to achieve the harmonization of research methodologies, procedures and data. As regards the content of the Programme a description is made of its four main areas: Area 1--Development of co-ordinated research on prevention, care and health systems (main topics: drugs and the administration of medicines; risk factors and occupational health; biomedical technology; health services research); Area 2--Major health problems and diseases of great socio-economic impact (AIDS; cancer; cardiovascular disease; mental illness and neurological disease; the ageing process, and age-related health problems and handicaps); Area 3--Human Genoma Analysis (improvement of the genetic map; physical mapping; DNA sequencing; data-handling and databases; technology development and applications of human genome analysis); Area 4--Research on biomedical ethics (compilation of legislation; evaluation of questions of biomedical ethics linked with the Programme; evaluation of the social impact of the Programme and its risks).(ABSTRACT TRUNCATED AT 250 WORDS)

European Union↗

PubMed1992

[The effect of ethanol on the metabolism of methamphetamine].

In order to clarify the effects of ethanol (EtOH) on metabolism of methamphetamine hydrochloride (MA-HCl), the plasma and urine samples were taken from three groups of three male crab-eating monkeys (Macaca fascicularis). MA-HCl was given to the first group, both MA-HCl and EtOH were given once to the second group, the after consecutive administration of EtOH for four weeks, both MA-HCl and EtOH were given to the third group. Comparisons were made of the sequential change in the concentration of unchanged methamphetamine (MA) and its supposed metabolites, amphetamine (AP), p-hydroxymethamphetamine (p-HOMA), and p-hydroxyamphetamine (p-HOAP). Additional hematological and plasma-biochemical tests were performed to monitor the influences under the administration of MA-HCl and EtOH on the animals. For the extraction of MA and its metabolites from blood and urine, a solid phase extraction was carried out with which an excellent recovery was achieved. Gas chromatography mass spectrometry (GC-MS) was used to measure the metabolites after changing them to the form of TFA derivative, producing good results. EtOH concentration in the blood was measured by GC using a head-space method. The biological half-life (t1/2) of MA tended to be shortened slightly in the plasma when EtOH was given consecutively. The maximum concentration of AP obtained by administration of EtOH was half that obtained by single administration of MA-HCl and the detectable time was shortened. A high concentration of p-hydroxy metabolites that the been almost undetectable when both MA-HCl and EtOH were administered once, was detected when EtOH was administered consecutively, compared with that when only MA-HCl was administered. Particularly, considerable amounts of p-HOAP was detected even after 72 hours. The trends seen in the excretion of MA and its metabolites into the urine were the same as seen in their plasma concentrations, although there was a difference in the detectable time. The urine collected in a metabolic cage for the monkey was contaminated with drinking water, so that the total amounts of metabolites, rather than sequential change as in the case of plasma, were considered to be of greater significance. When EtOH was administered consecutively, the excreted amounts of p-HOAP in the urine increased saliently and characteristically.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMedDate not supplied

[The direction of Croatian health care in the post-war period].

A radical transformation of the health-care system in Croatia has begun after the first free and democratic elections in the country. Changes were initiated along the lines suggested by the World Health Organization experts and in accordance with the positive experiences of the earlier health-care organization and practice. The newly introduced changes involved the introduction of market mechanisms in health care (private medical practice and contracting for medical services), establishment of health insurance funds, formulation of rules and standards for the provision of medical services, and reorganization of management in medical institutions. With the start of the armed aggression against the Republic of Croatia, all of these activities ceased and the health-care system switched very quickly from peace-time to war-time operation. At the same time, preparatory work continued on the definitive reorganization of the health-care and health insurance systems. The present paper discusses the underlying principles for the three basic pieces of legislation: Health Care Act, Professional Chambers Act, and Health Insurance Act. The Health Care Act will be based on new patterns of property relations in health-care organizations. Three types of ownership are envisaged - state, private and mixed. Most of the existing health-care institutions will be state-owned, and the owner (government, district or municipal authority) will appoint a governing board in each case, which, in turn, will appoint the director or manager. A separate piece of legislation will regulate the status of health workers.(ABSTRACT TRUNCATED AT 250 WORDS)

Croatia↗

PubMed1991

[New findings on the use of specific alpha-1 adrenergic blockers in the treatment of high blood pressure].

Adrenergic alpha-receptors blockers have been used for a long time in the treatment of hypertension. The use of original non-selective alpha 1-blockers was restricted by the occurrence of undesirable side-effects. Therapeutic interest in alpha-blockers was restored after the discovery of selective adrenergic alpha 1-blockers. Since 1976 when the first selective alpha 1-blocker, prazosine, appeared on the market a number of quinazoline derivatives was developed (terazosine, doxazosine, trimazosine) and non-quinazoline alpha 1-blockers (indoramine, ketanserine, urapidil etc.). Selective alpha 1-blockers normalize the BP by reducing the pathologically raised peripheral vascular resistance without changing the cardiac output. They influence the capacity as well as resistant vascular system and reduce thus the pre-load and after-load. Alpha 1-blockers do not affect, or increase slightly the renal blood flow without altering glomerular filtration. Treatment with selective alpha 1-blockers is associated with a smaller tachycardia than treatment with direct vasodilatating agents or non-selective alpha-blockers. Contrary to saluretics and some beta-blockers, alpha 1-blockers have a favourable effect on plasma lipoproteins, insulin resistance, glucose metabolism and they support the regression of hypertrophy of the vascular wall and the left ventricle. Alpha 1-blockers are effective as monotherapy and when combined with other antihypertensive drugs. They are well tolerated with a small number of undesirable side-effects. Selective alpha 1-blockers reduce the BP in a haemodynamically favourable way and exert a favourable effect on other risk factors of ischaemic heart disease in hypertonic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗

PubMedDate not supplied

[Chemotherapies of negative schizophrenia].

Five years ago, Goldberg claimed that negative symptoms of schizophrenia do respond to neuroleptics. This apparent discovery is, in fact, a very common way of thinking for European schools of psychiatry, specially the French one guided by Delay and Deniker. Initially focused on reserpine and some alerting phenothiazines such as thioproperazine, this opinion has been extended to benzamides in the 1970s. The analysis of the publications devoted to this point indicates that several drugs are actually considered as potent disinhibitors (i.e. active on negative symptoms of schizophrenia): Phenothiazines: As shown in the controlled studies by Itil (1971), Poirier-Littré (1988), fluphenazine and pipotiazine improve the BPRS anergia factor and the SANS score. Butyrophenones: The first description of the "imipramine like" effect of trifluperidol by Janssen (1959) initiated the studies by Gallant (1960), Fox (1963). They compared trifluperidol at low doses versus haloperidol and chlorpromazine at medium and high doses, BPRS anergia factor improved only at low doses. Diphenylbutylpiperidines (DPBP): Meltzer's review (1986) concluded to the efficacy of such drugs on negative symptoms appearing as a specific biochemical relationship effect. A definite analysis about doses leads to a very different interpretation: DPBP low doses and only low doses improved negative symptoms as much as some low doses of phenothiazines. On the opposite, DPBP, phenothiazines and butyrophenones high doses are inefficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Antipsychotic Agents↗