Intravenous magnesium for acute myocardial infarction

BACKGROUND: Mortality and morbidity from acute myocardial infarction (AMI) remain high. Intravenous magnesium started early after the onset of AMI is thought to be a promising adjuvant treatment. Conflicting results from earlier trials and meta-analyses warrant a systematic review of available evidence. OBJECTIVES: To examine the effect of intravenous magnesium versus placebo on early mortality and morbidity. SEARCH STRATEGY: We searched CENTRAL (The Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to June 2006) and EMBASE (January 1980 to June 2006), and the Chinese Biomedical Disk (CBM disk) (January 1978 to June 2006). Some core Chinese medical journals relevant to the cardiovascular field were hand searched from their starting date to the first-half year of 2006. SELECTION CRITERIA: All randomized controlled trials that compared intravenous magnesium with placebo in the presence or absence of fibrinolytic therapy in addition to routine treatment were eligible if they reported mortality and morbidity within 35 days of AMI onset. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed the trial quality and extracted data using a standard form. Odds ratio (OR) were used to pool the effect if appropriate. Where heterogeneity of effects was found, clinical and methodological sources of this were explored. MAIN RESULTS: For early mortality where there was evidence of heterogeneity, a fixed-effect meta-analysis showed no difference between magnesium and placebo groups (OR 0.99, 95%CI 0.94 to 1.04), while a random-effects meta-analysis showed a significant reduction comparing magnesium with placebo (OR 0.66, 95% CI 0.53 to 0.82). Stratification by timing of treatment (< 6 hrs, 6+ hrs) reduced heterogeneity, and in both fixed-effect and random-effects models no significant effect of magnesium was found. In stratified analyses, early mortality was reduced for patients not treated with thrombolysis (OR=0.73, 95% CI 0.56 to 0.94 by random-effects model) and for those treated with less than 75 mmol of magnesium (OR=0.59, 95% CI 0.49 to 0.70) in the magnesium compared with placebo groups.Meta-analysis for the secondary outcomes where there was no evidence of heterogeneity showed reductions in the odds of ventricular fibrillation (OR=0.88, 95% CI 0.81 to 0.96), but increases in the odds of profound hypotension (OR=1.13, 95% CI 1.09 to 1.19) and bradycardia (OR=1.49, 95% CI 1.26 to 1.77) comparing magnesium with placebo. No difference was observed for heart block (OR=1.05, 95% CI 0.97-1.14). For those outcomes where there was evidence of heterogeneity, meta-analysis with both fixed-effect and random-effects models showed that magnesium could decrease ventricular tachycardia (OR=0.45, 95% CI 0.31 to 0.66 by fixed-effect model; OR=0.40, 95% CI 0.19 to 0.84 by random-effects model) and severe arrhythmia needing treatment or Lown 2-5 (OR=0.72, 95% CI 0.60 to 0.85 by fixed-effect model; OR=0.51, 95% CI 0.33 to 0.79 by random-effects model) compared with placebo. There was no difference on the effect of cardiogenic shock between the two groups. AUTHORS' CONCLUSIONS: Owing to the likelihood of publication bias and marked heterogeneity of treatment effects, it is essential that the findings are interpreted cautiously. From the evidence reviewed here, we consider that: (1) it is unlikely that magnesium is beneficial in reducing mortality both in patients treated early and in patients treated late, and in patients already receiving thrombolytic therapy; (2) it is unlikely that magnesium will reduce mortality when used at high dose (>=75 mmol); (3) magnesium treatment may reduce the incidence of ventricular fibrillation, ventricular tachycardia, severe arrhythmia needing treatment or Lown 2-5, but it may increase the incidence of profound hypotension, bradycardia and flushing; and (4) the areas of uncertainty regarding the effect of magnesium on mortality remain the effect of low dose treatment (< 75 mmol) and in patients not treate...

Three-dimensional consensus structure of sst2-selective somatostatin (SRIF) antagonists by NMR

The three-dimensional NMR structures of seven octapeptide analogs of somatostatin (SRIF), based on octreotide, with the basic sequence H-Cpa/Phe2-c[DCys3-Xxx7-DTrp/DAph(Cbm)8-Lys9-Thr10-Cys14]-Yyy-NH2 (the numbering refers to the position in native SRIF), with Xxx7 being Aph(Cbm)/Tyr/Agl(NMe,benzoyl) and Yyy being Nal/DTyr/Thr, are presented here. Most of these analogs exhibit potent and highly selective binding to sst2 receptors, and all of the analogs are antagonists inhibiting receptor signaling. Based on their consensus 3D structure, the pharmacophore of the sst2-selective antagonist has been defined. The pharmacophore involves the side chains of Cpa2, DTrp/DAph(Cbm)8, and Lys9, with the backbone for most of the sst2-selective antagonists comprised a Type-II' beta-turn. Hence, the sst2-selective antagonist pharmacophore is very similar to the sst2-selective agonist pharmacophore previously described.

Design and in vitro characterization of highly sst2-selective somatostatin antagonists suitable for radiotargeting

Radiolabeled sst 2 and sst 3 antagonists are better candidates for tumor targeting than agonists with comparable binding characteristics (Ginj, M.; Zhang, H.; Waser, B.; Cescato, R.; Wild, D.; Erchegyi, J.; Rivier, J.; Mäcke, H. R.; Reubi, J. C. Proc. Natl. Acad. Sci. U.S.A. 2006, 103, 16436-16441.). Because most of the neuroendocrine tumors express sst 2, we used the known antagonists acetyl- pNO 2Phe (2)- c[ dCys (3)-Tyr (7)- dTrp (8)-Lys (9)-Thr (10)-Cys (14)]- dTyr (15)-NH 2 ( 1) (Bass, R. T.; Buckwalter, B. L.; Patel, B. P.; Pausch, M. H.; Price, L. A.; Strnad, J.; Hadcock, J. R. Mol. Pharmacol. 1996, 50, 709-715. Bass, R. T.; Buckwalter, B. L.; Patel, B. P.; Pausch, M. H.; Price, L. A.; Strnad, J.; Hadcock, J. R. Mol. Pharmacol. 1997, 51, 170; Erratum.) and H-Cpa (2)- c[ dCys (3)-Tyr (7)- dTrp (8)-Lys (9)-Thr (10)-Cys (14)]-2Nal (15)-NH 2 ( 7) (Hocart, S. J.; Jain, R.; Murphy, W. A.; Taylor, J. E.; Coy, D. H. J. Med. Chem. 1999, 42, 1863-1871.) as leads for analogues with increased sst 2 binding affinity and selectivity. Among the 32 analogues reported here, DOTA- pNO 2Phe (2)- c[ dCys (3)-Tyr (7)- dAph (8)(Cbm)-Lys (9)-Thr (10)-Cys (14)- dTyr (15)-NH 2 ( 3) and DOTA-Cpa (2)- c[ dCys (3)-Aph (7)(Hor)- dAph (8)(Cbm)-Lys (9)-Thr (10)-Cys (14)]- dTyr (15)-NH 2 ( 31) had the highest sst 2 binding affinity and selectivity. All of the analogues tested kept their sst 2 antagonistic properties (i.e., did not affect calcium release in vitro and competitively antagonized the agonistic effect of [Tyr (3)]octreotide). Moreover, in an immunofluorescence-based internalization assay, the new analogues prevented sst 2 internalization induced by the sst 2 agonist [Tyr (3)]octreotide without being active by themselves. In conclusion, several analogues (in particular 3, 31, and 32) have outstanding sst 2 binding and functional antagonistic properties and, because of their DOTA moiety, are excellent candidates for in vivo targeting of sst 2-expressing cancers.

Comparison of Somatostatin Receptor Agonist and Antagonist for Peptide Receptor Radionuclide Therapy: A Pilot Study

Preclinical and clinical studies have indicated that somatostatin receptor (sst)-expressing tumors demonstrate higher uptake of radiolabeled sst antagonists than of sst agonists. In 4 consecutive patients with advanced neuroendocrine tumors, we evaluated whether treatment with (177)Lu-labeled sst antagonists is feasible. METHODS After injection of approximately 1 GBq of (177)Lu-DOTA-[Cpa-c(DCys-Aph(Hor)-DAph(Cbm)-Lys-Thr-Cys)-DTyr-NH2] ((177)Lu-DOTA-JR11) and (177)Lu-DOTATATE, 3-dimensional voxel dosimetry analysis based on SPECT/CT was performed. A higher tumor-to-organ dose ratio for (177)Lu-DOTA-JR11 than for (177)Lu-DOTATATE was the prerequisite for treatment with (177)Lu-DOTA-JR11. RESULTS Reversible minor adverse effects of (177)Lu-DOTA-JR11 were observed. (177)Lu-DOTA-JR11 showed a 1.7-10.6 times higher tumor dose than (177)Lu-DOTATATE. At the same time, the tumor-to-kidney and tumor-to-bone marrow dose ratio was 1.1-7.2 times higher. All 4 patients were treated with (177)Lu-DOTA-JR11, resulting in partial remission in 2 patients, stable disease in 1 patient, and mixed response in the other patient. CONCLUSION Treatment of neuroendocrine tumors with radiolabeled sst antagonists is clinically feasible and may have a significant impact on peptide receptor radionuclide therapy.

Effects of a Transdiagnostic Internet Intervention («velibra») for Anxiety Disorders in Primary Care: Results of a Randomized Controlled Trial

Internet-based cognitive behavioral self-help treatment (ICBT) for anxiety disorders has shown promising results in several trials, but there is yet a lack of studies of ICBT in „real world” primary care settings. In this randomized controlled trial we recruited participants through general practitioners. The aim of the study was to examine whether treatment-as-usual (TAU) in primary care settings plus ICBT is superior to TAU alone in reducing anxiety symptoms and other outcome measures among individuals meeting diagnostic criteria of a least one of three anxiety disorders (social anxiety disorder, panic disorder with or without agoraphobia, generalized anxiety disorder). 150 adults fulfilling diagnostic criteria for a least one of the anxiety disorders according to a diagnostic interview are randomly assigned to one of the two conditions: TAU plus ICBT versus TAU. Randomization is stratified by primary disorder, medication (yes/no) and concurrent psychotherapy. ICBT consists of a transdiagnostic and tailored Internet-based self-help program for several anxiety disorders which also includes cognitive bias modification for interpretation (CBM-I). Primary outcomes are symptoms of disorder-specific anxiety measures and diagnostic status after the intervention (9 weeks). Secondary outcomes include primary outcomes at 3-month follow-up and secondary measures such as general symptomatology, depression, quality of life, adherence to ICBT and satisfaction with ICBT. The study is currently being completed. Primary results along with results for specific subgroups (e.g. primary diagnosis, concurrent medication and/or psychotherapy) will be presented and discussed.

Improving Automaticity with Basic Addition Facts: Do Taped Problems Work Faster Than Cover, Copy, Compare?

This small pilot study compared the effectiveness of two interventions to improve automaticity with basic addition facts: Taped Problems (TP) and Cover, Copy, Compare (CCC), in students aged 6-10. Automaticity was measured using Mathematics Curriculum-Based Measurement (M-CBM) at pretest, after 10 days, and after 20 days of intervention. Our hypothesis was that the TP group will gain higher levels of automaticity more quickly than the CCC and control groups. However, when gain scores were compared, no significant differences were found between groups. Limitations to the study include low treatment integrity and a short duration of intervention.

Vicisitudes de la constitución de un archivo literario en la Argentina : El caso del Archivo de Escritores Platenses

Durante nuestros trabajos de investigación, dedicados a la búsqueda y estudio de archivos literarios, hemos percibido la necesidad de que exista un espacio institucional aplicado a la conservación de documentos manuscritos, mecanografiados o impresos sin editar, vinculados con el patrimonio cultural de la ciudad de La Plata. A partir de diversos hallazgos documentales, en pos de resguardar esos materiales valiosos para los estudios literarios, decidimos crear un Archivo de Escritores Platenses. Este se encuentra domiciliado en el Complejo Bibliotecario Municipal Francisco López Merino, y está disponible para su consulta en la siguiente página web: http://cbm.laplata.gov.ar/aep/

Vicisitudes de la constitución de un archivo literario en la Argentina : El caso del Archivo de Escritores Platenses

Durante nuestros trabajos de investigación, dedicados a la búsqueda y estudio de archivos literarios, hemos percibido la necesidad de que exista un espacio institucional aplicado a la conservación de documentos manuscritos, mecanografiados o impresos sin editar, vinculados con el patrimonio cultural de la ciudad de La Plata. A partir de diversos hallazgos documentales, en pos de resguardar esos materiales valiosos para los estudios literarios, decidimos crear un Archivo de Escritores Platenses. Este se encuentra domiciliado en el Complejo Bibliotecario Municipal Francisco López Merino, y está disponible para su consulta en la siguiente página web: http://cbm.laplata.gov.ar/aep/

Vicisitudes de la constitución de un archivo literario en la Argentina : El caso del Archivo de Escritores Platenses

Durante nuestros trabajos de investigación, dedicados a la búsqueda y estudio de archivos literarios, hemos percibido la necesidad de que exista un espacio institucional aplicado a la conservación de documentos manuscritos, mecanografiados o impresos sin editar, vinculados con el patrimonio cultural de la ciudad de La Plata. A partir de diversos hallazgos documentales, en pos de resguardar esos materiales valiosos para los estudios literarios, decidimos crear un Archivo de Escritores Platenses. Este se encuentra domiciliado en el Complejo Bibliotecario Municipal Francisco López Merino, y está disponible para su consulta en la siguiente página web: http://cbm.laplata.gov.ar/aep/

Inhibition of Secretion by 1,3-Cyclohexanebis(methylamine), a Dibasic Compound That Interferes with Coatomer Function

We noted previously that certain aminoglycoside antibiotics inhibit the binding of coatomer to Golgi membranes in vitro. The inhibition is mediated in part by two primary amino groups present at the 1 and 3 positions of the 2-deoxystreptamine moiety of the antibiotics. These two amines appear to mimic the ε-amino groups present in the two lysine residues of the KKXX motif that is known to bind coatomer. Here we report the effects of 1,3-cyclohexanebis(methylamine) (CBM) on secretion in vivo, a compound chosen for study because it contains primary amino groups that resemble those in 2-deoxystreptamine and it should penetrate lipid bilayers more readily than antibiotics. CBM inhibited coatomer binding to Golgi membranes in vitro and in vivo and inhibited secretion by intact cells. Despite depressed binding of coatomer in vivo, the Golgi complex retained its characteristic perinuclear location in the presence of CBM and did not fuse with the endoplasmic reticulum (ER). Transport from the ER to the Golgi was also not blocked by CBM. These data suggest that a full complement of coat protein I (COPI) on membranes is not critical for maintenance of Golgi integrity or for traffic from the ER to the Golgi but is necessary for transport through the Golgi to the plasma membrane.

Análise química e atividades biológicas de Guatteria elliptica R. E. Fries (Annonaceae)

A espécie endêmica G. elliptica R. E. Fries não apresentava estudos fitoquímicos e biológicos detalhados na literatura. Assim, o objetivo desse trabalho foi avaliar a composição química e as propriedades biológicas dos óleos essenciais, extratos brutos, alcaloides totais, tortas, frações das tortas, amostras isoladas dessa espécie. O material vegetal foi coletado em Paranapiacaba (Santo André, SP, Brasil). O óleo essencial extraído das folhas por destilação à vapor apresentou um rendimento de 0,2%. A análise histológica das folhas encontrou óleo em células oleíferas localizadas no parênquima esponjoso. A composição do óleo (CG-EM) indicou espatulenol e óxido de cariofileno como compostos majoritários. Os alcaloides totais foram obtidos dos extratos brutos das folhas e dos galhos e analisados por CG-EM, identificando quatro aporfinas (nornuciferina, estefarina, corituberina e asimilobina) e duas protoberberinas (discretamina e caseadina). Os alcaloides totais foram fracionados em coluna cromatográfica ou por Extração em Fase Sólida e purificados por cromatografia em camada preparativa, originando duas amostras (Amostra 9 e 10). Na Amostra 9, foram identificados dois alcaloides aporfinicos nornuciferina e asimilobina (CG-EM e RMN-1H). Na Amostra 10, foram identificados (LC-EM/EM) cinco alcaloides aporfínicos (desidronantenina, glaunidina, liriodenina, N-óxido de oliverina e telikovina) e um alcaloide protoberberínico (caseadina). Caseadina, glaunidina, N-óxido de oliverina e telikovina não foram previamente identificados em Guatteria. Os resíduos dos extratos brutos livres de alcaloides foram fracionados pelo método de partição com solventes de polaridade crescente. Os extratos brutos e as frações acetato de etila e butanólicas de folhas e galhos apresentaram flavonoides (NP-PEG). Nos ensaios biológicos, a melhor atividade antioxidante (sequestro do radical DPPH) foi encontrada para a fração clorofórmica dos galhos (EC50=24,25±1,14 µg/mL) e a torta dos galhos (EC50=26,23±4,20 µg/mL). No ensaio antimicrobiano pelo método turbidimétrico a atividade mais importante foi obtida contra Staphylococcus aureus (ATCC 6538) para os alcaloides totais dos galhos (CIM/CBM=0,12±0,01/0,26 mg/mL) e das folhas (CIM/CBM=0,21±0,01/0,28 mg/mL), e fração hexânica das folhas (CIM/CBM=0,24±0,02/>1 mg/mL). Uma alta atividade antitumoral foi observada frente a células humanas de mama (MCF-7) para Amostra 10 (IC50=2,28±0,18 µg/mL), fração de acetato de etila das folhas (IC50=4,47±0,40 µg/mL), óleo essencial (IC50=7,01±0,23 µg/mL) e os alcaloides totais das folhas (IC50=9,32±0,36 µg/mL). Para as células de próstata (PC-3), foi encontrada atividade para a Amostra 10 (IC50=1,37±0,36 µg/mL) e o óleo essencial (IC50=5,32±0,35 µg/mL). A futura aplicação dos extratos e frações de G. elliptica como um agente antitumoral parece ser segura, pois mantiveram uma viabilidade celular maior do que 90% no ensaio de citotoxicidade com culturas de fibroblasto murino (BALB/c 3T3, ATCC CCL-163) nas concentrações onde a atividade antitumoral foi promissora (<30 µg/mL) contra MCF-7 e/ou PC-3.

Efeito da aplicação de composto orgânico sobre a qualidade do solo cultivado com cana-de-açúcar (Saccharum spp.)

A dinâmica ambiental possui capacidade limitada de reciclagem e a crescente utilização resíduos agroindustriais, especialmente na agricultura, pode levar a situações de poluição do solo e demais componentes ambientais. A manutenção da produtividade de ecossistemas agrícolas e naturais depende do processo de transformação da matéria orgânica e, por conseguinte, da biomassa microbiana do solo, e que é responsável pela decomposição e mineralização de resíduos no mesmo. A dinâmica natural dos microrganismos do solo, em constante mudança e adaptação, os torna um indicador sensível às mudanças resultantes de diferentes práticas de manejo agrícola. Sendo assim, conhecer essas alterações e suas interferências é fundamental para identificar estratégias adequadas de manejo, apontando técnicas de utilização adequadas. O objetivo deste trabalho foi avaliar a qualidade de um solo agrícola, cultivado com três variedades de cana-de-açúcar (Saccharum spp.), comparando a utilização de adubação mineral frente à utilização de fertilizante orgânico composto no período final de formação dos perfilhos (120 dias após o plantio). Foi implantado, em condições de campo, o cultivo de cana-de-açúcar (cana planta), utilizando as variedades RB 867515, RB 962869 e RB 855453, onde cada variedade foi cultivada de três formas distintas, sendo elas: plantio controle (CT) sem aplicação de insumos para adubação; plantio orgânico (OG) com aplicação de fertilizante orgânico; e plantio convencional (CV) com aplicação de adubação mineral, seguindo recomendações de adubação após análise química inicial do solo local. Cada parcela possuía 37 m2, com 5 sulcos de 5,0 m de comprimento e espaçamento de 1,5 m entrelinhas, sendo os três sulcos centrais formando a área útil. De acordo com a variedade e o tipo de adubação, foram formados nove tratamentos: T1 86CT, T2 96CT, T3 85CT, T4 6OG, T5 96OG, T6 85OG, T7 86CV, T8 96CV e T9 85CV, com delineamento estatístico de blocos ao acaso e quatro repetições. Os parâmetros químicos do solo analisados foram macronutrientes e micronutrientes; os parâmetros microbiológicos foram carbono da biomassa microbiana (CBM), respiração basal do solo (RBS), quociente metabólico (qCO2), número mais provável de fungos e bactérias do solo (NMP); e, por fim, a produtividade agrícola (t/ha). Os resultados foram submetidos a análise de variância (ANOVA) e à comparação das médias através do teste de Tukey (10%). Também foi realizada a análise de variância dos dados e correlação cofenética de Pearson para formação de dendogramas. Com base no período estudado, considerado como fase crítica da formação do canavial, concluiu-se que os parâmetros químicos que evidenciaram alterações no solo foram pH e os macronutrientes Mg, Al e SB, sendo os tratamentos orgânicos equivalentes e/ou melhores que os tratamentos convencionais. Para os parâmetros microbiológicos, o NMP de fungos apresentou os maiores valores nos tratamentos convencionais e controle. A produtividade agrícola não foi influenciada pelos diferentes tratamentos e insumos utilizados, independente da variedade de cana-de-açúcar utilizada. Por fim, foram observadas correlações positivas entre as variáveis CTC e quociente metabólico (qCO2) apontando potencial melhoria da qualidade do solo, com o emprego de insumos orgânicos

Freight car reflectorization.

Federal Railroad Administration, Office of Research and Development, Washington, D.C.

Technical and economic factors in applying the enhanced coalbed methane recovery process

Geological sequestration of CO2 is a technically feasible and potentially economic option for significantly and safely reducing greenhouse gas emissions, with CO2 injection already practiced in Canada and the USA to enhance crude oil production. The Enhanced Coalbed Methane (ECBM) process is seen as the next most economical sequestration options. The authors estimate an incremental methane recovery factor from 20% to 50%, depending on coal rank and seam depth. Others have estimated the potential to increase worldwide CBM production, utilising ECBM, by 18 Trillion cubic meters, while simultaneously sequestering 345 Giga tonnes of CO2. This paper presents technical and economic factors to consider for developing a commercial ECBM project. Technical factors include: geostructural and hydrogeological issues, geochemical reactions, stressed and competitive sorption, counter-diffusion, effective and relative 4-D coal permeability and methane recovery levels. Key economic factors are injectant acquisition price, sale price of methane and the level of carbon credits.

Computer based monitoring in U.K. service organizations : a comparative study

The majority of the literature about CBM is American in origin, and (inter alia) notes that there were differing uses of similar technology, indicating that context has an important role to play in the use of CBM. The literature maps the psychological effects of CBM in considerable detail, but only two published studies examine the context of CBM. These grounded results provide scant support for any systematic, quantitative, large scale analysis of computer based monitoring in the UK context. This thesis thus aims to systemically examine the context of CBM using discourse analysis. Forty four interviewees were theoretically sampled using a structured sample technique in four organizations. All were national or multinational enterprises. The interviews were semi structured in nature and divided into three sections. The first addressed the respondents' thoughts and perceptions about CBM, the second elicited talk about the departmental context (focusing the management - worker relationship), and the final section addressed the organizational context. The cases demonstrated variation in the use of CBM, measured according to the criteria of Westin (1987, 1988) and according to the interpretive repertoires used by the respondents in each case. Seven analytical categories of talk emerged from the data: three at the organizational level and four at the departmental level of analysis. Discourse analysis revealed two discrete interpretive repertories - the procedural and the substantive repertoires - in respondents' talk whose main variation occurred at the departmental level of analysis. Furthermore, patterns were found in the use of these repertories within cases and between categories. Between the cases, variation in the use of the repertories matched the between case variation according to the criteria of Westin. It would thus appear that the source of variation in the use of CBM lies in its context, more specifically in the relative emphasis of humanistic, interpersonal and idiosyncratic values within the management worker relationship.