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At least 127 records · Page 7Linked to original sources
PubMed1995

Clinical pharmacology of estrogens: cardiovascular actions and cardioprotective benefits of replacement therapy in postmenopausal women.

The use of estrogens in postmenopausal women has been the subject of much controversy regarding hormone formulation, dosage, use in combination with progestins, duration of treatment, and contraindications. Estrogens have been prescribed to relieve menopausal symptoms for more than three decades. The hormones reduce the gynecologic and psychologic changes associated with menopause while inhibiting bone resorption and possibly reducing the risk of cardiovascular disease. Their use however has been complicated by an increased risk of endometrial cancer and possibly breast cancer. The use of estrogens as cardioprotective agents is discussed and the clinical experiences and the possible mechanisms of action are reviewed. The clinical pharmacology of estrogens and the various formulations that are available as monotherapy or in combination with progestins will also be reviewed.

Adult↗
PubMed1994

Oxygen free radicals and calcium homeostasis in the heart.

Many experiments have been done to clarify the effects of oxygen free radicals on Ca2+ homeostasis in the hearts. A burst of oxygen free radicals occurs immediately after reperfusion, but we have to be reminded that the exact levels of oxygen free radicals in the hearts are yet unknown in both physiological and pathophysiological conditions. Therefore, we should give careful consideration to this point when we perform the experiments and analyze the results. It is, however, evident that Ca2+ overload occurs when the hearts are exposed to an excess amount of oxygen free radicals. Through ATP-independent Ca2+ binding is increased, Ca2+ influx through Ca2+ channel does not increase in the presence of oxygen free radicals. Another possible pathway through which Ca2+ can enter the myocytes is Na(+)-Ca2+ exchanger. Although, the activities of Na(+)-K+ ATPase and Na(+)-H(+) exchange are inhibited by oxygen free radicals, it is not known whether intracellular Na(+) level increases under oxidative stress or not. The question has to be solved for the understanding of the importance of Na(+)-Ca2+ exchange in Ca2+ influx process from extracellular space. Another question is 'which way does Na(+)-Ca2+ exchange work under oxidative stress? Net influx or efflux of Ca2+?' Membrane permeability for Ca2+ may be maintained in a relatively early phase of free radical injury. Since sarcolemmal Ca(2+)-pump ATPase activity is depressed by oxygen free radicals, Ca2+ extrusion from cytosol to extracellular space is considered to be reduced. It has also been shown that oxygen free radicals promote Ca2+ release from sarcoplasmic reticulum and inhibit Ca2+ sequestration to sarcoplasmic reticulum. Thus, these changes in Ca2+ handling systems could cause the Ca2+ overload due to oxygen free radicals.

Animals↗
PubMed2000

Timing of surgery/catheter intervention in common congenital cardiac defects.

A large load of children with congenital heart disease (CHD) exists in our country. Fortunately facilities for treatment of almost all types of defects are available, although in few centres only. Many children are however, referred late for correction making them either high risk for surgery or inoperable due to development of irreversible pulmonary vascular obstructive disease. Therefore, it is important to recognise the ideal time of intervention in different types of CHD. A child with large atrial septal defect should have its closure by 3 to 4 years of age; on the other hand, a large ventricular septal defect (VSD) producing congestive heart failure needs very early surgery. Infants with small VSD may be medically managed as chances of spontaneous closure are high. Ligation of patent ductus arteriosus should be done at about one year of age if there is no pulmonary arterial hypertension or congestive heart failure. Similarly, coarctation should be dealt with either balloon dilatation or surgery at about one year of age provided the left ventricular function is normal and blood pressure in upper limb is well under control. For tetralogy of Fallot, correction is best done at about 9 months to one year of age. In case the child is symptomatic early, either a palliative shunt is done or total correction is performed if anatomy is suitable. In admixture lesions like transposition of great arteries (TGA), persistent truncus arteriosus or total anomalous pulmonary venous drainage, a very early intervention is needed so as to avoid development of severe hypoxia and early pulmonary vascular obstructive changes. Arterial switch operation is best performed in first two to three weeks of life for TGA with intact ventricular septum cases. Knowledge of natural history of the CHD is essential to plan for optimal timing of surgery or catheter intervention.

Cardiac Catheterization↗
PubMed2006

[Hemostasis disorders in severe infections: State of the art].

The haemostatic system is greatly modified during severe infections. The early activation of coagulation is triggered by tissue factor expression and secondary fibrinolysis impaired by the upregulation of fibrinolysis inhibitors. This imbalance is a major cause of subsequent organ dysfunction. Natural anticoagulants (Tissue factor pathway inhibitor (TFPI), Antithrombin (AT), and Protein C (PC) are consumed or inhibited in this pathological process justifying a therapeutic supplementation with these inhibitors to improve sepsis-induced organ failure and mortality. No effect on the mortality rate could be documented in controlled studies using recombinant TFPI or AT concentrates but a biological interaction with heparin therapy could have biased the results. Treatment with recombinant activated PC was associated with a significant reduction in the mortality rate of severely ill patients. An increase in the rate of hemorrhagic adverse effects was observed with these compounds, justifying a strict observance of contraindications and of patient selection.

Anticoagulants↗
PubMed2002

Diagnostic imaging.

Imaging technology continues to advance and simplify the diagnosis of neurotologic pathology. Namely, high-resolution magnetic resonance imaging has provided detailed evaluation of the internal auditory canal and membranous labyrinth. Conversely, the role of high-resolution magnetic resonance imaging as a screening tool remains controversial. Functional imaging studies, such as functional magnetic resonance imaging and single photon emission computed tomography are beginning to find significant roles in the evaluation of patients with cochlear implants. General imaging principles and imaging strategies for specific pathologic conditions of the temporal bone are also discussed.

Cerebellar Neoplasms↗
PubMed2003

The role of P fimbriae for Escherichia coli establishment and mucosal inflammation in the human urinary tract.

Bacterial adhesion to the bladder mucosa is a critical step for the establishment of Escherichia coli bacteriuria. The P-fimbriae, encoded by the pap gene cluster, are considered as virulence factors but the mechanisms have been debated. This study defined the roles for P fimbriation during the early colonization of the human urinary tract. Patients with recurrent UTI were first subjected to deliberate colonization with the non-fimbriated ABU strain E. coli 83972. Bacteriuria was established long term (1-4 years) in patients with dysfunctional bladders, but not in the patients with normal bladder function. Super-infections were transient and asymptomatic. P fimbriated transformants of the ABU strain (E. coli 83972pap+/prs+) reached 105 CFU/ml more rapidly than E. coli 83972 and the vector control. This was demonstrated by group wise and intra-individual analysis in patients colonized on different occasions with E. coli 83972 or the P fimbriated transformants. Higher neutrophil numbers and IL-8 and IL-6 concentrations in urine were obtained after colonization with the P fimbriated transformants. These results demonstrated that transformation of E. coli 83972 with the pap sequences is sufficient to convert it to a more potent host response inducer. The P fimbriae were shown to lower the significant bacteriuria threshold. The P fimbriated transformants needed lower bacterial numbers (103-4 CFU/ml) to predict a positive second urine culture with a >80% accuracy and to trigger a significant host response. These studies show that P fimbriae fulfil the Koch Henles molecular postulates for bacterial establishment and host response induction in the human urinary tract.

Escherichia coli↗
PubMed1998

Mental illness and Irish people: stereotypes, determinants and changing perspectives.

The causes of psychological illness in Irish people have been identified with colonial rule and the catastrophic conditions deriving from famine in the nineteenth century. In particular, the scourge of unremitting emigration, resulting from famine, has formed a background against which speculative theories of inferiority, alienation and mental illness have been constructed. In particular, the long standing idea that Irish people exhibit higher rates of schizophrenia, both in Ireland and abroad, is discussed. Contemporary studies which suggest that these elevated rates do not correspond to international diagnostic criteria for schizophrenia are introduced. Rather, these enhanced rates may reflect a malaise which resembles schizophrenia but which is really a product of historical dispossession. The importance of these factors is underscored by the previous neglect of Irish people, considered as an ethnic minority, as well as the particular distaste which many Irish people display towards such a notion.

Attitude to Health↗
PubMed2006

Uterine contractility and embryo implantation.

PURPOSE OF REVIEW: The aim of this article is to assess the importance of uterine contractility in the implantation of human embryos. RECENT FINDINGS: Recent findings show that the receptive phase of the endometrium seems to occur in close association with the appearance of pinopodes and endometrial integrins that may be activated by the IL-1 system. Throughout the menstrual cycle wavelike activity patterns of the uterus were identified with adequate wave patterns appearing to be related to successful reproduction in spontaneous cycles and in assisted reproduction. Such patterns are controlled by steroid hormones. Embryo attachment to the predecidualized endometrium and its invasion may be determined by the expression of proteolytic enzymes that require uterine quiescence for implantation. The uterine activity was detected both in vitro and in vivo by using invasive intrauterine pressure and noninvasive ultrasound approaches. Progesterone promotes local vasodilatation and uterine musculature quiescence by inducing nitric oxide synthesis in the decidua. At present, until new evidence emerges to demonstrate otherwise, the effects of progesterone are, directly or indirectly, the only determinant of endometrial preparation for embryo nidation, with the induction of uterine quiescence being one of these effects. SUMMARY: Adequate uterine contractility may provide for gamete/embryo transportation through the utero-tubal cavities and successful embryo implantation in spontaneous or assisted reproduction. Inadequate uterine contractility may lead to ectopic pregnancies, miscarriages, retrograde bleeding with dysmenorrhea and endometriosis.

Embryo Implantation↗
PubMed2001

A late developing mandibular premolar supernumerary tooth.

This paper presents a case of a patient who developed a mandibular premolar supernumerary tooth between the age of 11 and 20 years. Evidence for the late development of the supernumerary tooth comes from consecutive panoramic radiographs. A review of the international literature concerning late developing supernumerary teeth is included.

Adult↗
PubMed2005

Progress in the development of selective inhibitors of aurora kinases.

Errors in the mitotic process are thought to be one of the principal sources of the genetic instability that hallmarks cancer. Unsurprisingly, many of the proteins that regulate mitosis are aberrantly expressed in tumour cells when compared to their normal counterparts. These may represent a good source of targets for the development of novel anti-cancer agents. The Aurora kinases represent one such family of mitotic regulators. In recent years there has been intense interest in both understanding the role of the Aurora kinases in cell cycle regulation and also in developing small molecule inhibitors as potential novel anti-cancer drugs. With several companies now starting to take Aurora kinase inhibitors into clinical development, the time is right to review the medicinal chemistry contribution to developing the field, in particular to review the increasingly broad range of small molecule inhibitors with activity against this kinase family.

Animals↗
PubMed2001

Capacity for research in minority health: the need for infrastructure plus will.

Cardiovascular mortality has continued to decline, but racial disparities in cardiovascular diseases (CVD) continue to grow. To build the capacity to address these racial disparities, two things will be required. First, a research and policy infrastructure must be in place to provide guidance on what to do and how to do it. Second, the will to implement and activate this infrastructure must be present at the community and policy-making levels. The Jackson Heart Study is an example of a research infrastructure with the economic resources, scientific expertise, and technical manpower required to monitor, organize, assess, and follow a cohort of individuals over time to study the burden, natural history, predictive factors, and level of care for CVD in an African American community. The creation of will within the community for CVD research may require additional strategies than in the majority community, such as community organization and local policy development. These additional efforts at the community level should create a fertile environment to develop research and, ultimately, test strategies for reducing national disparities in cardiovascular health.

Black People↗