Traffic accidents and environmental physical activity.

Environmental physical activity (EPA) is considered as one of main regulators of human homeostasis. Evidence is growing that components of this activity through the "human factor" (i.e., changing human physiological and psychological status) can affect the dynamics of traffic accidents (TA)-the modern life epidemic. This paper presents results of studies conducted in order to reveal the potential influence of EPA [solar (SA), geomagnetic (GMA) and cosmic ray (CRA) activities] on the number of TA and related casualties in the years of the maximum and declining phase of SA cycle 23 (2000-2005). We selected the 7,160 most severe TA and their related 7,558 deaths and 1,647 severe injuries, registered in the Grand Baku Area (Azerbaijan, middle latitudes), for analysis. A significant increase of TA and victims was observed during the whole year and also during the last months of the year. The monthly numbers of TA and victims were inversely related to SA (probability p = 0.0002), and non-significantly to background GMA, but were significantly affected by major geomagnetic disturbances and storms. A strong correlation between CRA variations (cosmic ray intensity measured by ground-based neutron monitors on the Earth's surface) and the number of TA (p = 0.001) has been observed. It was found that the number of TA which occur within a month depends significantly on the particular month of the year, the CRA, and the SA levels (inverse correlation). The increase of the number of TA is also significantly linked to geomagnetic storms, but not to steady GMA. These effects can be related to changes in human functional and behavioral markers provoked by EPA influences.

Papaverine hydrochloride for the treatment of renal colic: an old drug revisited. A prospective, randomized study.

PURPOSE: We assessed the efficacy of papaverine hydrochloride, a commonly used smooth muscle relaxant, for the treatment of renal colic as a single agent and in combination with sodium diclofenac. MATERIALS AND METHODS: A prospective, single-blind clinical study was performed at 2 centers. A total of 86 patients with acute renal colic were randomized to 3 treatment groups of 120 mg intravenous papaverine hydrochloride (29), 75 mg intramuscular sodium diclofenac (30), and papaverine hydrochloride plus sodium diclofenac (27). Pain intensity was assessed with the Visual Analog Scale at 0, 20 and 40 minutes after treatment. Further analgesia given at patient request consisted of 1 mg/kg intramuscular meperidine. Urinalysis, complete blood evaluation and imaging were performed in all patients. All adverse effects were recorded. RESULTS: Baseline characteristics were similar in the 3 groups. Pain intensity decreased significantly (p <0.01) after 20 and 40 minutes in all groups. Papaverine hydrochloride was as effective as sodium diclofenac in alleviating pain and the combined treatment group showed a slight trend of more rapid relief. Significantly more patients in the papaverine group required further analgesia and 4 patients (14.8%) reported minor adverse effects (dizziness in 3, sleepiness in 1). CONCLUSIONS: Papaverine hydrochloride is as effective as sodium diclofenac for the short-term relief of acute renal colic pain and may be advantageous in patients with contraindications for nonsteroidal anti-inflammatory drugs. However, sodium diclofenac appears to provide a longer effective analgesia.

Alterations in QT dispersion in the surface electrocardiogram of female adolescents diagnosed with restricting-type anorexia nervosa.

OBJECTIVE: QT dispersion (QTd), defined as the difference between the longest interval and the shortest interval in the 12-lead electrocardiogram (ECG), is a measure of myocardial repolarization inhomogeneity. We assessed QTd in malnourished anorexia nervosa (AN) inpatients and following weight restoration. METHODS: QTd analysis, anthropometric evaluations, and laboratory tests were carried out in 30 malnourished female adolescent AN restricting-type (AN-R) inpatients and following weight restoration. RESULTS: A significant increase was found in weight/height ratio and body mass index from malnourished stage to weight restoration, paralleled by a significant decrease in QTd (70+/-16 vs. 47+/-16 ms; P<.0001). No correlations were found between ECG indices and anthropometric and laboratory measures. CONCLUSION: Elevated QTd in malnourished AN-R inpatients may indicate possible cardiac autonomic imbalance and/or myocardial damage, likely corrected following weight restoration.

Assessment of functional capacity in patients with chronic obstructive pulmonary disease: correlation between cardiopulmonary exercise, 6 minute walk and 15 step exercise oximetry test.

BACKGROUND: Different exercise tests are used to evaluate the functional capacity in chronic obstructive pulmonary disease. The cardiopulmonary exercise test is considered the gold standard, but the 6 minute walk and the 15 step exercise oximetry test are considerably less expensive. OBJECTIVES: To determine whether reliable data could be obtained at lower cost. METHODS: The study sample consisted of 50 patients with mild to severe stable COPD. All underwent pulmonary function test and the cardiopulmonary exercise test, 6 minute walk and 15 step exercise oximetry test as part of their regular follow-up visit. Functional capacity was graded according to each test separately and the functional capacities obtained were correlated. RESULTS: The results showed that most of the patients had severe COPD according to pulmonary function tests (mean forced expiratory volume in the first second 46.3 +/- 19.9% of predicted value). There was a good correlation between the cardiopulmonary exercise test and the 6 minute walk functional capacity classes (r = 0.44, P = 0.0013). We did not find such correlation between the 15 step exercise oximetry test and the cardiopulmonary exercise test (r = 0.07, P = 0.64). CONCLUSIONS: The study shows that the 6 minute walk is a reliable and accurate test in the evaluation of functional capacity in COPD patients.

Cytokine gene polymorphisms in patch-stage mycosis fungoides.

Cytokine production is under genetic control and certain allelic variants of cytokine genes are associated with lower or higher cytokine production in vitro and in vivo. The general concept is that a shift from a Th1 to a Th2 cytokine profile accompanies disease progression from patch-stage mycosis fungoides to tumour stage, although the results of the studies carried out have not been entirely conclusive. We aimed to investigate whether certain cytokine polymorphisms might represent a risk factor for developing patch-stage mycosis fungoides. Genotyping for IFN-gamma (Th1 cytokine), IL-6, IL-10 (Th2 cytokines), TNF-alpha and TGF-beta 1 was undertaken for 33 patients with patch-stage mycosis fungoides and the results were compared with those in a control group. Genotype distribution showed no significant differences between the patients and the controls for any of the five cytokines studied. Our study suggests that patch-stage mycosis fungoides is not determined by a specific genotype polymorphism. However, further studies on larger numbers of cases are needed before definite conclusions can be drawn.

Complexity of the dynamic QT variability and RR variability in patients with acute anterior wall myocardial infarction: a novel technique using a non-linear method.

QT and RR intervals' fluctuations are implicated in the development of malignant arrhythmias. Recent research has quantified repolarization lability using stochastic and linear methods. However, QT-RR intervals are nonlinearly coupled. To this end, QT and RR intervals were extracted from twenty four patients with acute myocardial infarction (AMI) and 13 controls, and a measure of local dimensional complexity (pointwise correlation dimension, PD2) was calculated. PD2 of QT intervals was significantly higher for the patients than for controls (4.83 +/- 0.81 versus 3.40 +/- 0.76, P =.0001), and vice versa for RR intervals (2.51 +/- 0.62 versus 2.91 +/- 0.42, P =.028). The RR and QT measures of complexity were highly correlated only among controls (r = 0.769, P =.0021). Our results support the presence of autonomic abnormalities during infarction and might complement existing tools for assessment of increased risk for sudden death after AMI.

Link between monthly rates of four subtypes of acute myocardial infarction and their corresponding cosmophysical activity parameters.

UNLABELLED: The aim of this study was (1) to examine the relation between the monthly rate of acute myocardial infarction (AMI) and three cosmophysical activity parameters: solar activity (SA), geomagnetic activity (GMA), and cosmic rays activity (CRA) levels; (2) to study whether different subtypes of AMI: ST-elevation MI (STEMI), non-ST-elevation (NSTEMI), Q-wave (Q-waveMI) and non-Q-wave (NQ-wave MI) are linked with monthly cosmophysical indices or with the daily level (I degrees-IV degrees) of GMA. METHODS: For the first question, we studied for 204 consecutive months (1983-1999) 16,683 patients (including 10405 males) with AMI who were included in the Kaunas Registry and for the second, 3824 AMI patients (2342 males), 72-month data. Cosmophysical data were obtained from the Apatity Neutron Monitoring Station of the Russian Academy of Science. RESULTS: According to neutron monitoring data, total AMI and all its subtypes significantly correlated with monthly levels of CRA and inversely correlated with SA and GMA indices (r = 0.32-0.45; p = 0.0007-0.0001). No significant correlation was found between AMI subtypes and the daily level (I degrees-IV degrees) of GMA. All cosmophysical parameters were stronger in female patients. CONCLUSION: The monthly rates of all subtypes of AMI were significantly correlated with CRA and inversely correlated with SA and GMA, more strongly in female patients. We presume that the environmental factors studied here affect the general patho-physiological components of AMI, and that different subtypes are a consequence of the localization and extent of the process.