Trace element concentrations in red swamp crayfish (Procambarus clarkii) and surface sediments in Lake Preola and Gorghi Tondi natural reserve, SW Sicily.

Concentrations of trace elements (Cd, Pb, As, V, Cr, Ni, Cu and Zn) were determined in superficial sediments and in muscle and hepatopancreas tissues of the red swamp crayfish Procambarus clarkii from Lake Preola and Gorghi Tondi Natural Reserve (SW Sicily). In particular, hepatopancreas showed a decidedly higher content of all analysed trace elements with respect to muscles (two- to threefold higher for Cd, Cu, As, Zn and V; four- to fivefold higher for Pb and Cr and seven times higher for Ni). However, no statistically reliable differential accumulation pattern emerged with regard to length and weight for trace elements (except for Cd for which significant positive correlations with length were recorded). Trace element concentrations found in crayfish tissues were in the range considered harmful to human health (except for Cd and Cr). Moreover, the As and Pb concentrations, either in sediment or crayfish tissues, are clearly related to intense agricultural activities, with extensive use of fertilizers and pesticides, that significantly affect the levels of these toxic metals in the study area.

Effect of buspirone on withdrawal symptoms associated with smoking cessation.

BACKGROUND: Preliminary information suggests that buspirone hydrochloride ameliorates symptoms of nicotine withdrawal. In a double-blind, randomized, placebo-controlled trial, we determined the effects of buspirone on the withdrawal symptoms associated with smoking cessation in 40 long-term cigarette smokers. METHODS: Subjects were randomized to 4 weeks of treatment with either buspirone (n = 20) or placebo (n = 20). Subjects were instructed to maintain their usual cigarette intake during the first 21 days of treatment and to cease smoking on day 22 of treatment. Withdrawal symptoms were subjectively rated before and during smoking cessation. RESULTS: Before smoking cessation, there were no significant differences in the intensity of any withdrawal symptom between the buspirone- and placebo-treated subjects, with the exception of a significantly higher rating for drowsiness in the buspirone group. During the smoking cessation period, the ratings for craving, anxiety, irritability, restlessness, and sadness were significantly lower in the buspirone group than the placebo group. There were no significant differences between the groups in their ratings for hunger, inability to concentrate, or drowsiness. Fifteen buspirone-treated subjects and nine placebo-treated subjects were able to abstain from cigarettes during the entire 7-day smoking cessation period. No subject dropped out of the study for perceived drug side effects. Eight buspirone-treated subjects and five placebo-treated subjects reported side effects, all of which were mild. CONCLUSIONS: Buspirone ameliorated most of the short-term withdrawal symptoms associated with smoking cessation. Further controlled studies will be needed to define the benefit in smoking cessation.

Acute myocardial infarction. Management after discharge from the coronary care unit.

Although interventional techniques have changed the management of acute phases of myocardial infarction, they have not altered the need for evaluating long-term risk factors. As many as 60% of patients with multiple risk factors die within one year after discharge from the hospital, and these patients often need coronary angiography and interventional therapy to improve their prognosis. Patients who have had thrombolytic therapy and subsequently manifest recurrent myocardial ischemia need coronary angiography as a prelude to angiography or surgery. The long-term outlook for the myocardial infarction patient may be improved by modification of such risk factors as smoking, hypertension, and hypercholesterolemia.

Use of routine functional testing after percutaneous transluminal coronary angioplasty: results from the ROSETTA Registry.

BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for exercise testing suggest that only selected groups of high-risk patients should undergo routine functional testing after percutaneous transluminal coronary angioplasty (PTCA) for the detection of restenosis. OBJECTIVES: Our purpose was (1) to document the patterns of use of post-PTCA functional testing and (2) to determine whether the choice of functional testing strategy is related to clinical characteristics of patients or whether physicians use a similar strategy for all their patients. METHODS: The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) Registry is a prospective study examining the use of functional testing among 788 patients at 13 centers in 5 countries. RESULTS: During the 6-month period after a successful PTCA, 49% of patients underwent functional testing (range among centers 10%-81%). Among patients who underwent functional testing, 39% had a clinical indication and 61% had functional testing as a routine follow-up. The first functional test was performed a median of 7 weeks after PTCA, with 13% of patients having second tests at a median of 14 weeks and 4% having additional tests at a median of 20 weeks. Univariate and multivariate analyses demonstrated that the chief determinant of the use of routine functional testing was clinical center. Aside from age (P <.0001), no baseline clinical or procedural characteristics were consistently associated with the use of routine functional testing after PTCA. CONCLUSIONS: Physicians do not appear to be adhering to the ACC/AHA guidelines for exercise testing regarding the routine use of post-PTCA functional testing. None of the clinical characteristics identified by the ACC/AHA guidelines were associated with the routine use of post-PTCA functional testing, and the primary determinant of functional testing was the location of the center at which the patient had the PTCA.