ENDOTOXIN IMPAIRS THE HUMAN PACEMAKER CURRENT I f

Abstract

all 10 cities including the rural areas of the province of Kerman. All data were finally analyzed by SPSS software (version 11.5). Results On the basis of recorded statistical analysis, the mortality cases of human rabies in the province of Kerman during one decade was 10 persons (eight males and two females). One-half of them (50%) were bitten by dogs and the others (50%) by foxes. Among the reported deaths, 40% were from Kahnooj county (Jiroft region). The reported data indicated that 21,546 persons were bitten by animals during 10 years in the province of Kerman. The mean of age of the people who were bitten by dogs was 24.80 years (SD = ±14.6), while the mean age of the people who were bitten by foxes was 57.25 years (SD = ±1.50). There was a significant difference between the mean age of these two groups of the people (P < 0.05). The most frequent rate of injured people was reported in the age group 10-19 years old and the frequency rate of males (76.00%) was more than females (24.00%). Therefore, there was a statistically significant difference between males and females in this study (P < 0.01). About 60% of all persons that were bitten by animals were from rural areas and 40% of them were from urban areas (P < 0.05). Among the people who were bitten and injured by animals during one decade in the province of Kerman, 85.70% of them were not treated by the rabies prophylaxis treatment regimen. Among all of them who were bitten by animals, 50% were injured through hands and feet, 40% of them through heads and faces, and 10% of them through trunks, cervical regions and other organs of the bodies. In the persons who were bitten by animals in the head region, the mean latency period for rabies was 33 days (SD = ±12.2 days), while the mean latency period in the persons who were bitten through hands and feet was 77 days (SD = ±45.8 days). The P value was <0.1. The results of this study showed that there is a significant reciprocal correlation between annual raining level and the frequency rate of animal bites in the province of Kerman (r = 0.5, P < 0.01). Conclusions According to this study, the role of foxes in the epidemiology of human rabies in the province of Kerman, located in the southeast of Iran, seems very important. Since most of the animal bite individuals, during the one-decade survey in this region of Iran, did not seem aware of the risk of exposure to the viral infection of rabies through animal bites, the public education of preventive measurements of rabies seems imperative by the public health authorities as well as vaccination of animals against rabies, especially dogs and cats, as well as mass vaccination of wild animals by means of distribution of oral vaccines in the vast and scattered forests by helicopters belonging to Veterinary Organization Authorities being recommended. Collaboration of intersectional public health relationships of medical science universities of the province of Kerman as well as all related authorities to control rabies prevalence in the regional and interregional provi...

Cardiac Arrhythmias in a Septic ICU Population: A Review

“…[48][49][50] One explanation of the development of new onset atrial fibrillation events in sepsis is the imbalance between sympathetic and vagal tone in sepsis leading to a reduction of heart rate variability (HRV) [3,51]. In a study on human atrial cardiomyocytes, Zorn-Pauly et al [26] identified a gram-negative bacteria -endotoxin-induced I(f) impairment, which might contribute to a reduced responsiveness to both sympathetic and vagal autonomic stimuli. It might be argued that decreased responsiveness to autonomic stimuli would affect HRV [52].…”

“…These arrhythmias may be explained by autonomic dysfunction or impairment and involvement of the cardiac conduction system rather than to pre-existing cardiac co-morbidities [26,27]. This paper will focus on clinical features of arrhythmias and potential pathophysiologic mechanisms of the cardiac conduction system disturbances in septic patients.…”

Lipopolysaccharide prolongs action potential duration in HL-1 mouse cardiomyocytes

“…Based on telemetry studies in mice, this reduction in HRV is attributable to lipopolysaccharide (LPS; Ref. 5); however, it remains uncertain whether this action of LPS results from its direct effect on heart cells (41,47) or broader effects involving the central and autonomic nervous systems (6).…”

Septischer Kreislaufschock und septische Kardiomyopathie

“…Dass diese Beein trächtigung der Herzfrequenzregulation nicht ausschließlich auf indirekten, durch Mediatoren des Immunsystems vermit telte Mechanismen beruht, sondern zu mindest teilweise auf eine direkte Inter aktion von Endotoxin mit Sinusknoten zellen zurückzuführen ist, konnten wir zwischenzeitlich anhand von Zellkultur versuchen nachweisen: Elektrophysiolo gische Untersuchungen an isolierten hu manen Vorhofmuskelzellen konnten bele gen, dass Endotoxin zum einen direkt den Schrittmacherstrom ("funny current", If) durch Beeinflussung der verantwortlichen HCNKanäle ("hyperpolarizationactiva ted cyclic nucleotidegated cation chan nel") zu hemmen vermag und anderer seits diese Kanäle gegenüber der Sympa thikusbeeinflussung empfindlicher macht -in einem mathematischen Modell kön nen diese Beobachtungen etwa 50% der HRVStarre erklären [27].…”