Evidence for selective inhibition of limbic forebrain dopamine synthesis by 8-OH-DPAT in the rat

Summary Regional dopamine synthesis in the rat striatum was estimated by measuring DOPA accumulation following inhibition of cerebral aromatic l-amino acid decarboxylase by means of NSD-1015, 100 mg kg^–1 intraperitoneally. In animals treated with reserpine, 5 mg kg^–1 subcutaneously –18 h, there was a statistically significant increase in DOPA accumulation in the nucleus accumbens, the ventro-medial neostriatum, the dorso-lateral neostriatum and in the posterior limb of the neostriatum. This increase in DOPA accumulation was antagonized dose-dependently in the nucleus accumbens and ventro-medial neostriatum, but not in the other two regions, by treatment with the 5-HT_1A receptor agonist 8-OH-DPAT, 0.15–2.4 mol kg^–1, whereas the partial dopamine D₂ receptor agonist (–)3-PPP, 2.5–10.0 mol kg^–1, or the full dopamine D₂ receptor agonist quinpirole, 0.05–0.8 mol kg^–, antagonized the reserpine-induced increase in DOPA accumulation uniformly in all four regions of the striatum. The suppression of DOPA accumulation by 8-OH-DPAT in reserpine-treated animals, was completely antagonized by raclopride, 1 mol kg^–1, but not by (–)pindolol, 8 mol kg^–1. The accumulation of 5-HTP in all regions of the striatum as well as in the neocortex following decarboxylase inhibition and reserpine pretreatment, was also inhibited by 8-OH-DPAT, and this inhibition was unaffected by treatment with raclopride or (–)pindolol. It is concluded that 8-OH-DPAT, in addition to general effects on forebrain 5-hydroxytryptamine synthesis, selectively affects limbic forebrain dopamine synthesis. This latter effect is probably due to direct stimulation of dopamine autoreceptors, since it was obtained in reserpine-treated rats, and was completely antagonized by raclopride, but not (–)pindolol.Presented in part at the 7th General Meeting of the European Society for Neurochemistry, June 12–17th 1988, Göteborg, Sweden Send offprint requests to S. Ahlenius at the above address     

One-year clinical outcomes of BioMatrix™-Biolimus A9™ eluting stent: The e-BioMatrix multicenter post marketing surveillance registry in India

Objective

The e-BioMatrix is a post marketing multicenter registry with an objective to evaluate the 2 year clinical safety and efficacy outcomes in patients treated with BioMatrix™ - Biolimus A9™ (BA9™) drug eluting stents (DES).

Background

Drug-eluting stents still have late-stage disadvantages that might be attributable to the permanent polymer. BioMatrix a new generation DES containing anti-proliferative drug Biolimus A9™ incorporating a biodegradable abluminal coating that leaves a polymer-free stent after drug release enhancing strut coverage while preventing neointimal hyperplasia.

Methods

This interim analysis consists of a total of 1189 patients with 1418 lesions treated with BioMatrix stent who entered this multicenter registry in India. We analyzed the incidence of major adverse cardiac events (MACE) and stent thrombosis (ST) at 1, 6, and 12 months with an extended follow-up of 2 years. Recommended antiplatelet regimen included clopidogrel and aspirin for 12 months.

Results

The mean age was 57.6 ± 10.9 years, 81.8% were males, comorbidity index was 1.20 ± 1.33, 68% presented with acute coronary syndrome, 49% had hypertension and 40.8% had diabetes mellitus. One-year clinical follow-up was completed in 987 patients at the time of interim analysis. The incidence of MACE is 0.45 for 1544 person-year follow-up. There were only 03 cases of ST (01 late ST) reported during this time.

Conclusion

This registry demonstrates excellent one-year clinical safety and efficacy of BioMatrix stents. The 1-year result shows that BioMatrix stent may be a suitable alternative as compared to contemporary DESs which are currently available in the market for simple as well complex disease.     

MRI of the brain and thorax during extracorporeal membrane oxygenation: preliminary report from a pig model

Early diagnosis of cerebral hypoxic ischemic complications during extracorporeal membrane oxygenation (ECMO) is important to guide further treatment. However, diagnostic methods available during ECMO are limited, especially in adults and older children. Magnetic resonance imaging (MRI) is a sensitive and noninvasive method for assessment of vessel patency and brain parenchymal changes, and for measurement of brain perfusion. The use of MRI during ECMO has, to our knowledge, never been reported. We report the first animal experiment with MRI examination during ECMO. After a preliminary test with the mobile ECMO system in the MRI environment, a healthy pig was put on venoarterial ECMO, transported to the MRI department, and examined with sequences for anatomy and function of the brain and thorax. The results showed that the ECMO system was not adversely affected by the magnetic field at a distance from the camera where positioning and examination of the animal was possible. High-quality anatomical and functional images of the brain, heart, and thoracic vessels were acquired. The results suggest that MRI may be used for early diagnosis of cranial complications in patients on ECMO. MRI may also provide a useful tool for further research on flow dynamics and brain perfusion during ECMO.     

Sex differences in incidence rate,and temporal changes in surgical management and adverse events after hip fracture surgery in Denmark 1997–2017: a register-based study of 153,058 hip fracture patients

Background and purpose — Extensive research and national multidisciplinary programs have striven to introduce uniform standards of treatment and mitigate mortality and adverse events after hip fracture surgery over the past decades. A large-scale overview of temporal developments in hip fracture surgery and care is warranted.Patients and methods — We studied Danish patients aged ≥ 60 years, sustaining their first ever hip fracture between 1997 and 2017. Patients were identified from the Danish National Patient Registry (DNPR). Incidence rates of first hip fracture were calculated per 1,000 patient-years and stratified by age group and sex. Information on pre-injury living settings, comorbidities, and medications were obtained from national administrative registers. Type of fracture and treatment choice were recorded, and patients were followed for 1 year to observe mortality, readmission, and surgical complications.Results — Data from 153,058 patients was analyzed. Incidence rate decreased in both sexes, but only led to a reduction in the annual number of hip fractures in the female population. Choice of surgery shifted away from sliding hip screws and parallel implants (SHS-PI), towards intramedullary nailing and hemi-/arthroplasties for trochanteric and femoral neck fractures, respectively. Pre-injury diagnosed morbidity and 1-year readmissions increased contrary to mortality. Median age remained stable around 83 (IQR 77–88) for women and 80 (IQR 73–86) for men.Interpretation — Over the past 2 decades important aspects of hip fracture management have improved. However, sex differences were observed, and men remain more vulnerable than women in terms of morbidity, mortality, and incidence rate.

The collateral effects of hip fractures are tremendous in terms of healthcare costs, morbidity, mortality, and lost quality of life for the patients and their families (Vochteloo et al. 2013, Schemitsch et al. 2019). Increasing incidence of hip fractures in the last 50 years, longer life expectancy, and large birth cohorts during World War II have predicted a significant rise in the incidence of hip fractures in the coming decades (Cooper et al. 1992, 2011, Rosengren and Karlsson 2014).In the past 20 years, extensive research has striven to develop and amend fracture prevention, algorithms for operative treatment, and multidisciplinary approaches to care and rehabilitation, in order to improve survival and mitigate adverse events after hip fractures. Many aspects thereof have been analyzed, changed, and evaluated as the perception of hip fracture surgery has shifted from routine surgery often performed by younger surgeons to a global ambition for complex highly specialized treatment regimens in multidisciplinary settings. In 1999 the first national Danish reference program for the management of hip fractures emerged as a part of a government-initiated National Indicator Project (NIP) aimed to improve uniformity and quality. The aim was to suggest, describe and implement quality indicators suitable for benchmarking and monitoring the management of hip fractures in Denmark across regions and departments. Since then, several national cross-sectional quality projects have been deployed.A large-scale overview of temporal developments in hip fracture surgery and care is warranted to help clinicians, politicians, and caretakers to see new opportunities to improve safety and care for patients with hip fractures in the future.In this study we report how the Danish hip fracture population and management have changed over 2 decades in terms of incidence rates, pre-fracture comorbidity, choice of primary implant, surgical complications, readmissions, and mortality after hip fracture surgery.     

Traumatic experiences and post-traumatic stress disorder in Kurdistanian children and their parents in homeland and exile: an epidemiological approach

The prevalence and correlates of post-traumatic stress disorder (PTSD) were assessed in random samples of school-aged Kurdistanian children and their parents in homeland and exile. Of the 376 eligible children at the two sites, 312 children and their parents (293 mothers and 248 fathers) completed the Harvard-Uppsala Trauma Questionnaire and Posttraumatic Stress Symptom interviews for children, and Harvard Trauma Questionnaire for parents. Unlike their children, fathers showed significantly higher PTSD frequencies in exile than in the homeland. The fathers' PTSD negatively correlated with the living standard and fathers' education, while child PTSD mostly correlated with maternal education and living in exile. Living in exile seems to have a negative impact on fathers' post-traumatic reactions, despite its positive influence on children. High drop-outs in exile limit the conclusions.     

Survey of medico-legal investigation of homicides in the city of Turku, Finland

Finland has one of the highest homicide rates in western Europe but the clear-up rate is also exceptionally high. To create a detailed analysis of homicides (n=161) in a region of western Finland during the 20-year period from 1983 to 2002 all available information was collected retrospectively from multiple sources including medico-legal reports, reports of police investigations, and court proceedings. Among the data collected and analysed were location, time, circumstances, and motives of homicides, forensic pathologists' role at the scene-of-the-crime and in court, autopsy findings, demographics and substance abuse of both victims and offenders, criminal background, forensic psychiatric examinations, and the verdicts of the offenders. A typical homicide was committed without premeditation during the weekend by a drunken male with a knife at hand and with a history of violent crimes. The perpetrator was later found guilty of manslaughter and received a prison sentence. Some noted shortcomings both in the police and the medico-legal investigation procedures are discussed, as well as the forensic pathologist's role in the judicial process in Finland.     

Eye injuries from fireworks in Western Sweden

PURPOSE: To investigate the extent and type of as well as the circumstances connected with, ocular injuries caused by pyrotechnical products in the Western region of Sweden (1 750 000 inhabitants). METHODS: A three-year prospective observational study was carried out to register, interview and follow-up all patients with ocular injuries caused by fireworks. The patients were reported by all ophthalmologists in the area. RESULTS: 52 patients (72 injured eyes) were reported, 49 males and 3 females. 39 of 52 (75%) were younger than 18 years. 15 patients (including the three females) were bystanders. The injuries ranged from conjunctivitis to complete loss of the eye. The pyrotechnical device had been manipulated or misused in 19 (37%) of the 52 accidents. Seriousness of injury could not be correlated to type of device or to whether the injured person was active in launching the firework or not. 20 (38%) of the 52 patients had permanent damage to the eye. CONCLUSION: Ocular injuries from fireworks remain a problem. Preventive measures such as protective glasses and legislation are being discussed.