Validity of TIMI Risk Score and HEART Score for Risk Assessment of Patients with Unstable Angina/Non-ST Elevation Myocardial Infarction Presented to an Emergency Department in Jordan

Muhannad J Ababneh,1 Mahmoud Mustafa Smadi,2 Abdullah Al-Kasasbeh,1 Qutaiba Ali Jawarneh,3 Mohammad Nofal,3 Mohanad El-Bashir,4 Mohamad Ismail Jarrah,1 Liqaa A Raffee5 1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 4Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Accident and Emergency Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Muhannad J Ababneh, Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box 3030, Irbid, 22110, Jordan, Tel +962799964654, Fax +962 2 7095010, Email [email protected]: To examine the validity and predictability of thrombolysis in myocardial infarction (TIMI) risk and HEART scores in patients presenting to the emergency department (ED) with chest pain in Jordan (representative of the Middle East and North Africa Region, MENA).Patients and Methods: Risk scores were calculated for 237 patients presenting to the ED with chest pain. Patients were followed-up prospectively for the need for percutaneous coronary intervention, major adverse cardiovascular events, and all-cause mortality, looking for correlation and accuracy between the predicted cardiovascular risk from TIMI risk score and HEART score and the clinical outcome.Results: Of the 237 patients, approximately 77% were diagnosed with unstable angina and 23% diagnosed with non-ST elevation myocardial infarction (NSTEMI). about two thirds of the study population were smokers and known to have hypertension and dyslipidaemia. In 50 patients, the primary outcome (need for percutaneous coronary intervention (PCI) and/or major adverse cardiovascular events (MACE) at days 14 and 40, all-cause mortality) was observed. Regarding the predictability of the TIMI score, a larger number of events were observed in the study population than predicted. Patients with TIMI scores of 3 to 5 have about a 5– 8% higher event rate than predicted.Conclusion: Both TIMI and HEART risk scores were able to predict an elevated risk of major cardiovascular adverse events (MACE). The overall impression was that the TIMI risk score tended to underestimate risk in the study population.Keywords: acute coronary syndrome, risk stratification, cardiovascular diseases, emergency departmen

A step foreword historical data governance in information systems

From major companies and organizations to smaller ones around the world, databases are now one of the leading technologies for supporting most of organizational information assets. Their evolution allows us to store almost anything often without determining if it is in fact relevant to be saved or not. Hence, it is predictable that most information systems sooner or later will face some data management problems and consequently the performance problems that are unavoidably linked to. In this paper we tackle the data management problem with a proposal for a solution using machine-learning techniques, trying to understand in an intelligent manner the data in a database, according to its relevance for their users. Thus, identifying what is really important to who uses the system and being able to distinguish it from the rest of the data is a great way for creating new and efficient measures for managing data in an information system.This work has been supported by COMPETE: POCI-01-0145-FEDER-007043 and FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/2013

MPTP: advances from an evergreen neurotoxin

Since its discovery in 1976, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) models in rodents and nonhuman primates have continuously renewed to keep up with progresses of Parkinson’s disease (PD) research. MPTP is able to reproduce almost all the clinical and neuropathological features of PD when administered to monkeys. In contrast, up to date no rodent model has been able to reproduce all PD features in one. Nevertheless, MPTP is a very versatile neurotoxin that can reproduce different aspects of PD pathology, depending upon the dose and regimen of administration. At the present time, a number of different MPTP models have been developed, allowing researchers to investigate either the classical PD neuropathology and neuroprotective mechanisms or known pathological processes underlining more recently discovered aspects of the disease, such as nonmotor symptoms. In this chapter primate and rodent MPTP models are reviewed, focusing mainly on the contribution that different MPTP protocols can offer to reproduce the multifaceted aspects of the disease