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Objective: To improve time to treatment, the effects of acute myocardial infarction (AMI) symptoms on prehospital delay time (PDT) were investigated., Methods: Patients with AMI completed a questionnaire on their AMI symptoms and their general knowledge of AMI symptoms., Results: In total, 116 patients completed questionnaires. The mean PDT was 7.3 ± 2.4  h; the median PDT was 2.2 h. Each patient experienced a mean of 3.6 symptoms during their AMI. PDT was significantly shorter in the following groups: patients with chest compression pain/chest discomfort, profuse sweating or dyspnoea than in patients with other symptoms; patients presenting with typical rather than atypical symptoms; patients with pain scores >6 compared with scores ≤6; patients who were aware rather than unaware of AMI symptoms. Patients actually having AMI symptoms and patients being aware of AMI symptoms were inversely correlated with PDT. There was a linear relationship between pain scores and PDT., Conclusion: Public awareness of AMI symptoms should be enhanced, in order to shorten PDT and improve AMI survival rates.

In a three-week oral gavage toxicity study in rats, a high incidence of respiratory symptoms and high mortality was noted in compound-dosed rats only. Because of audible respiration, an effect in the upper respiratory tract was suspected and the nasal cavity was included for examination. Histology revealed extensive necrosis and purulent inflammation within the nasal passages, indicative of direct irritation. Since posterior nasal regions were most affected, with food material present within the inflammatory exudates, reflux and retrograde aspiration of irritant material (possibly stomach contents with test formulation) into the nasal cavity were suspected. Lowering the dose volume and fasting the rats prior to gavage dosing substantially reduced the respiratory effects and mortality. The current article focuses on the histological changes in the nasal cavity indicative of gavage-related reflux and provides guidance on differentiation between technical gavage error and gavage-related reflux.