AMIC Info-Flash – 06/2004

AMIC’s Newsletter, Montreal, Canada
AMIC’s Info-Flash
2340 Chemin Lucerne # 30
Ville Mont-Royal, Quebec
H3R 2J8, Canada
Tel : (514) 739 8950
Fax : (514) 738 2622
Web:
Email: [email protected]

June, 2004

1. Article 1: ” AMIC’s Annual General Assembly:
Discussions and Results
2. Article 2: ” Chronomically (time-structurally)
interpreted vascular monitoring in
pregnancy in the Armenian BIOCOS
arm”
3. Article 3: ” Conference- Mental Health
Perspectives in Public Health”
4. Article 4: ” A new initiative from the Ministry of
Health of Armenia”
5. Article 5: ” Announcement from the Armenian
Medical Association and Birthright
Armenia”
6. Article 6: “A new medical book”
7. Article 7: ” What is AMIC?”

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1. AMIC’s Annual General Assembly: Discussions and Results

On May 28 and 29th, 2004, AMIC held its annual General Assembly in Toronto
warmly hosted by AMIC member association the Armenian-Canadian Medical
Association of Ontario (ACMAO). The discussions focused primarily on the
following subjects:

– The AMIC Journal: an agreement was reached on a new formula of
collaboration with the publisher Regimedia USA to publish a quarterly
medical journal tentatively called the Armenian Medical Journal. Once a
contract is signed, the principal guidelines will be given out to our
readers.

– The 9th Armenian Medical World Congress, scheduled to be held in San
Francisco from June 29 to July 2, 2005. For all practical information (hotel
reservation rates and deadlines, registration fees, programs, please visit
the website for the Congress referred to above). Brochures and registration
forms are available; some associations have already received them and are
sending them out to their members. If you wish to receive one, please
contact AMIC’s office (Phone (514) 739 8950, e-mail: [email protected]).

We are proud and happy to announce that the Rector of Boston University, Dr.
Aram Chobanian, has accepted to be the keynote speaker at the Congress. Stay
tuned for other important announcements!

– AMIC has received official confirmation from the Minister of Health of
Armenia, Dr. Norayr Davidian, that the Second International Medical Congress
of Armenia will be held in 2007 in Yerevan, in accordance with the
understanding signed between AMIC and the Ministry of Health of Armenia.

– The site of the 10th Congress to be held in 2009, will be decided at the
2005 General Assembly in San Francisco during the 9th Congress. Any
interested candidates should contact the AMIC office. It would be
interesting to hold the next Congress in South America or Europe (including
Russia).

– The AMIC – AUA Health Projects Database () was
discussed and it was decided to continue updating the Database for another
year. All those who have projects in Armenia are requested to submit their
information to the database through the web site.

– Long discussions were held concerning AMIC’s mission and its finances and
the necessity of increasing its budget. It was strongly recommended that the
current budget be increased by $25 000 CDN (double its current budget) to
permit AMIC to fully reach its potential. The means to achieve that goal
will be reviewed later on.

-A very fruitful session was devoted to the on-going activities of member
associations in particular in Armenia and Artsakh. AMIC`s experience has
been that those associations which have active programs in Armenia as well
as in their local communities tend to be the most motivated and dynamic.

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2- “Chronomically (time-structurally) interpreted vascular monitoring in
pregnancy in the Armenian BIOCOS arm”

The following appeal was sent to AMIC’s Info-Flash by Professor Franz
Halberg of the University of Minnesota (USA). Please read it carefully and
respond to it. It is of the utmost importance that this kind of
collaboration be encouraged and supported by all means, by the Health Care
Community of the Armenian Diaspora. In his own words, Professor Halberg
remarked in his message: “I fully endorse this appeal, originating from
Armenia, not only for the sake of Armenia, but for the sake of all pregnant
women”.

“A group of Armenian physician-scientists under the guidance of Prof. Nubar
Levon Aslanyan at the suggestion of Prof. Franz Halberg (F. Halberg
Chronobiologic Center, University of Minnesota, Minneapolis, USA.
) has undertaken the investigation of
circadian blood pressure (BP) and heart rate (HR) rhythms in pregnant women
at the Maternal and Child Health Protection (M&Ch HP) Scientific Center of
Yerevan (Armenia). This follow-up on an earlier Minnesota investigation (1)
was begun in January 2001. Up to now, more than 310 pregnant women 18-35
years old, have been monitored and data from 176 of these have been
summarized, in addition to the use in everyday clinical practice of all data
from the chronomically interpreted monitoring.

OBJECTIVES – The aim of this investigation was to collect reference values
and on this basis to detect pregnant women with disturbances of variability
in BP and HR; to do this by gauging circadian and infradian BP and HR
rhythms and yet broader chronomes (time structures) and, in the light of any
alterations, to carry out prophylactic and therapeutic measures for the
prevention of the development of any pathologic process by the treatment of
as early abnormalities as possible.

SUBJECTS – Completed analyses concern the results of chronomic BP and HR
monitoring of 53 healthy MESOR (chronome-adjusted mean) – normotensive
pregnant women, 55 pregnant women at risk for developing gestational
hypertension, 45 pregnant women with gestational MESOR-hypertension and 24
pregnant women with preeclampsia.

METHODS – The monitoring of BP and HR was performed by means of a
non-invasive device TM-2421 (A&D, Tokyo, Japan) at 30-min intervals during a
span of (only) 3-5 days (72-120 hours) (because of insufficient numbers of
available instruments). A processor, TM-2021, was used to transfer the data
of the monitor to a personal computer with the aid of manufacturer-supplied
software Doctor-pro 2430-13. The data were sent to Dr. Germaine Cornélissen,
director of the Halberg Chronobiology Center of the University of Minnesota,
where they were analyzed by rhythmometric methods and results returned by
e-mail with a turnaround time usually not exceeding one day, to be used in
everyday health care, primarily for the prediction of an elevated risk of
gestational hypertension and preeclampsia and for the institution of
countermeasures as well for scientific elaboration.

RESULTS – In healthy normotensive pregnant women statistically significant
circadian rhythms’ characteristics for systolic (S) and diastolic (D) BP and
HR, were mapped-MESOR, M; circadian amplitude, A (a measure of extent of
within-day change); and acrophase, _(a measure of timing)- as a function of
gestational age. The A of SBP and the MESOR of HR increased in the second
and third trimesters.

In healthy normotensive pregnant women, non-parametric indices, a hyperbaric
and tachycardic index and the timing and percent time of elevation of
circadian variation in blood pressure and heart rate above age-and
gender-matched peer values gave complementary information about the degree,
the timing and the duration of BP and HR elevation. All were near zero for
the healthy group by comparison to U.S. standards. Any increase of these
indices indicates a disturbance in the circadian chronostructure of BP and
HR.

These chronomic criteria served for the early detection of indications for
action on pregnant women at elevated risk for gestational hypertension:
MESOR- and/or circadian hyper-amplitude-tension (CHAT) were an increase of
MESORs and amplitudes of the circadian rhythm of SBP, above preliminary
reference values.

Rhythmometric criteria were also established for early detection of the risk
of preeclampsia, beginning in the second trimester of pregnancy. These
criteria are the changes of parametric (MESOR, double amplitude and
acrophase) indices of circadian rhythms in systolic and diastolic blood
pressures when compared with the data of healthy MESOR-normotensive pregnant
women.

A 10-50 fold increase of non-parametric indices of systolic and diastolic
blood pressure circadian rhythms (hyperbaric index and percent time excess)
has also been found, which potentially complements non-dipping, a reduction
of the extent of nocturnal sleep-associated BP fall, for an early
chronodiagnosis of gestational hypertension and preeclampsia, before
clinical symptoms appear.

Changes in MESOR, hyperbaric index, percent time of excess and acrophase of
circadian rhythms in systolic and diastolic BP, according to our data, are
chronodiagnostic criteria that differentiate gestational hypertension from
preeclampsia. An analogous test is the timing of excess of diastolic blood
pressure, found in the early morning hours in pregnant women with
gestational hypertension and during the early night hours in pregnant women
with preeclampsia.

These preliminary results of our investigations based on the monitoring of
BP and HR during a span of three days, were useful for obstetricians at the
Scientific Research Center of Maternal and Child Health Protection (MCHP) in
Yerevan (Armenia). Monitoring is in demand to have an objective diagnosis of
BP and HR behavior in pregnant women to detect any abnormal behavior in BP
and HR disturbances, whether during the day and/or by night. A similar
surveillance is impossible when only casual time-unspecified BP and HR
readings are taken with manual sphygmomanometers and even when 24-hour
profiles are examined only for daytime and nighttime averages and dipping.

Much more informative results are anticipated from routine chronomically
interpreted 7-day monitoring. Thereby, one can evaluate reference values for
the characteristics of about half-weekly and weekly rhythms, with one
replication of the half-weekly characteristics.

Consequently the Armenian chronobiologists and obstetricians at MCHP need
more monitors for the prophylaxis and treatment of blood pressure disorders
in pregnant women, while the MCHP is at the forefront of research aimed at
exploring the merits of continuous monitoring during pregnancy.

Added monitors are available with an 85% reduction in actual price through
the courtesy of a Japanese firm. Because of this price reduction, U.S. $ 10
680 would buy 20 monitors instead of just three or four, but any lesser
number would also be helpful. The team at MCHP provides new kinds of
reference values that may improve the detection of abnormality in pregnancy
and otherwise, not only in Armenia but also worldwide.”

Donations can be sent according to your geographic location, to the
following persons and countries:
-Dr. Nubar L, Aslanyan (Doctor of Medical Sciences, Professor and Chief,
Laboratory of Clinical Chemistry & Chronobiology, Institute of Cardiology,
P. Sevak Str. 5, Yerevan 375044, Armenia.
Phone + 374-2 288583, e-mail: [email protected]
-Dr. Germaine Cornélissen, Director, Halberg Chronobiology Center,
University of Minnesota, Mayo Mail Code 8609, Dept. of Laboratory Medicine
Minneapolis Campus 420 Delaware Street SE Minneapolis, MN 55455, USA.
Phone (651) 454-6334 or 484-3160 Fax (612) 624-9989. E-mail:
[email protected] Web site:
-Mrs. Aida Boudjikanian, Administrative Director, Armenian Medical
International Committee, 2340 Chemin Lucerne, # 30, Ville Mont-Royal, Qc.
H3R 2J8, Canada.
Phone (514) 739 8950. E-mail: [email protected]

The amount donated will be immediately sent to Dr. Germaine Cornélissen,
from whom you will receive a confirmation.

(1) Cornélissen G, Kopher R, Brat P, Rigatuso J, Work B, Eggen D, Einzig S,
Vernier R, Halberg F. Chronobiologic ambulatory cardiovascular monitoring
during pregnancy in Group Health of Minnesota. Proc. 2nd Ann. IEEE Symp. On
Computer-Based Medical Systems, Minneapolis, June 26-27, 1989. Washington
DC: Computer Society Press; 1989. p. 226-237.

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3. Conference – ” Mental Health Pespectives in Public
Health”

Announcement and Invitation from the Vice-Chairman of the Organizing
Committee, Vardan Karamyan, Ph.D.

Dear Colleague,

The World Psychiatrists Association, the Armenian Association of
Psychiatrists and Narcologists and the Armenian Medical Association take
pleasure in inviting you to participate in a Conference concerning “Mental
Health Perspectives in Public Health”, devoted to the 100th anniversary of
Academician A.H. Mehrabyan.
The Conference will take place in Yerevan, Armenia, from October 7-10, 2004.

We invite you to participate in the conference with an oral presentation
and/or a poster. Your best research work will be carefully reviewed by the
Scientific Committee. There will be an award for the best oral presentation.
There will also be a special A.H. Mehrabyan’s Award, Conference President’s
Award, as well as several other awards (for detailed information please
visit ).

We hope to welcome a number of attendees who we believe, will benefit from
and contribute to, the discussion of recent advances in our understanding of
Mental Health.

The Conference will also have extensive cultural and social programs, which
will give you an opportunity to get to know Armenia, its ancient history and
tradition. The period during which the Conference will take place coincides
with the celebration of the 2786th anniversary of the ancient town
Erebouni – Yerevan, which will make your visit even more interesting.

Hope to meet you in Yerevan,

With Best Regards, on behalf of the Organizing Committee,

Vardan Karamyan Ph.D.

Armenian Medical Association
P.O. Box 143, Yerevan, 375010, Armenia
Phone: + (3741) 535868. Fax + (3741) 534879. E-mail : [email protected]

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4. A new initiative from the Ministry of Health of
Armenia.

The Ministry of Health of Armenia has decided to put up big posters in all
the entry halls of the hospitals and the polyclinics of the country. The
objective is to inform the population of the medical services and care which
the concerned establishments should provide freely. Dr. Ara Ter Grigoryan,
president of the Social Healthcare Agency, explained the objectives of the
initiative during a press conference held on June 9, warning the population
of the importance of taking note and reading the posters, which are written
in simple and understandable language. They will explain to patients what
are their rights in the health care system, also normalizing the relations
between patients and physicians.

This initiative has the material support of USAID.
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5. Announcement from the Armenian Medical
Association and Birthright Armenia

The Armenian Medical Association would like to extend an invitation to any
young Diaspora Armenians interested in the field of medicine who would like
to volunteer in Armenia. The Armenian Medical Association, in collaboration
with Birthright Armenia, has begun a new program that aims to give Diasporan
Armenians between the ages of eighteen and thirty-two, the opportunity to
volunteer in a medical capacity in Armenia – networking with healthcare
professionals in Armenia and forging future links between medicine in
Armenia and in Armenian communities abroad. The Armenian Medical
Association, with its extensive network of medical professionals, will be
able to find and place those interested in suitable medical positions.

The Armenian Medical Association is a non-governmental, non-partisan
organization of medical professionals who strive to advance medicine in
Armenia. For more information, please refer to our website at

Unlike other opportunities, this program offers many ways to easily discover
Armenia, including fully subsidized round-trip travel costs to any
individual who qualifies with Birthright Armenia’s criteria. It is
Birthright Armenia’s mission to strengthen ties between the homeland and
Diasporan youth by affording young Armenians an opportunity to be a part of
Armenia’s daily life and to contribute to Armenia’s development through
work, study and volunteer experiences, while developing life-long personal
ties and a renewed sense of Armenian identity.

For the exact specifications for qualifying for Birthright Armenia, and for
more information on the organization, please refer to their website at

There are currently three (3) available positions for the summer of 2004.
Interested candidates who qualify under Birthright Armenia’s specifications
should contact Birthright Armenia at [email protected] immediately
to secure their position.

APPLY NOW TO BE IN ARMENIA IN JULY!

Gevorg Yaghjyan, MD Ph.D.
Chairman of the Educational Committee, Armenian Medical Association.

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6. A new medical book

Drs. Jerry and Mariam Manoukian, besides presiding the organizing committee
of the 9th World Armenian Medical Congress in San Francisco (see above),
have managed to find the time to write a book entitled “Metabolic Syndrome
Survival Guide”, bearing the subtitle “Learn to Prevent Diabetes and Heart
Attack”. Inspired by their patients, and written for them, the book is very
easy to read and to understand.

The authors would like to hear your comments and questions, and to include
the answers in the second volume. Dr. Jerry Manoukian says that “Metabolic
Syndrome is increasingly recognized as the precursor to most adult diabetes
and a large percentage of cardiovascular disease.”

Their website, , describes the syndrome and the book.

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7. What is AMIC?

The Armenian Medical International Committee was created fourteen years ago.
It is an umbrella organization that unites Armenian medical associations
throughout the Diaspora, creating thus a large network through which
information and data are exchanged.
AMIC organizes Armenian Medical World Congresses. So far eight have been
held in different cities of the Diaspora. In 2003, “The First International
Medical Congress of Armenia”, organized by Armenia, was held in Yerevan from
July 1 to July 3.
The 9th AMIC Congress will be held in 2005 (from June 29 to July 3), in San
Francisco (USA). You can have the latest news by visiting the website

AMIC publishes since 1998 an online newsletter and sends it freely to all
Armenian Health Care professionals. If you are a health care professional
and are interested in receiving Info-Flash, please send us your e-mail
address ([email protected]) . To all those who already receive the Info, please
do not forget to send us your new e-mail address when you change it.
For further information visit our website:

A useful information to remember: you can send freely from wherever you are
located, medical equipment/medicine through the services of the United
Armenian Fund; President Mr. Harout Sassounian ([email protected])

http://www.msi.umn.edu/~halberg/
http://revilla.mac.cie.uva.es/chrono
http://9amwc.org
www.amic.ca
www.amicdatabase.org
www.apa.am
www.armeda.am
www.armeda.am
www.birthrightarmenia.org
www.manoukian.org
www.amic.ca