Il bambino con il batticuore in Pronto Soccorso: dalla teoria alla pratica andata e ritorno

Palpitations are a common cause of complaint in the paediatric population and can be a reason of serious concern for children, adolescents and parents. Despite this, palpitations are known to have a benign prognosis, but still are cause of referral to the Emergency Unit (EU). The aim of the present retrospective study was to make a review of prevalence and long-term prognosis of emergency accesses for palpitations between 2009-2015. The study was conducted in the EU of the Paediatric Hospital \u201cBurlo Garofolo\u201d, Trieste, Italy. Despite a low prevalence of access to the EU, namely 0.1%, 96 patients in a time span of 7 years, 16.7% of patients (n = 16) had an underlying arrhythmic cause for the symptom. The presence of a heart rate above 150 beats per minute was highly suggestive of cardiac arrhythmia, more often of paroxysmal supraventricular tachycardia. As far as the long-term follow-up is concerned, 10.4% of patients (n = 10) received medical therapy and 6.2% (n = 6) underwent transcatheter ablation for supraventricular arrhythmia. In conclusion, palpitations turned out to be an infrequent cause of access to the EU. Nonetheless, 1 out of 6 patients requires long term medical therapy or percutaneous intervention

Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization.

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD

A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EURO bservational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry

Aims: Given the advances in atrial fibrillation (AF) management and the availability of new European Society of Cardiology (ESC) guidelines, there is a need for the systematic collection of contemporary data regarding the management and treatment of AF in ESC member countries. Methods and results: We conducted a registry of consecutive in- and outpatients with AF presenting to cardiologists in nine participating ESC countries. All patients with an ECG-documented diagnosis of AF confirmed in the year prior to enrolment were eligible. We enroled a total of 3119 patients from February 2012 to March 2013, with full data on clinical subtype available for 3049 patients (40.4% female; mean age 68.8 years). Common comorbidities were hypertension, coronary disease, and heart failure. Lone AF was present in only 3.9% (122 patients). Asymptomatic AF was common, particularly among those with permanent AF. Amiodarone was the most common antiarrhythmic agent used (~20%), while beta-blockers and digoxin were the most used rate control drugs. Oral anticoagulants (OACs) were used in 80% overall, most often vitamin K antagonists (71.6%), with novel OACs being used in 8.4%. Other antithrombotics (mostly antiplatelet therapy, especially aspirin) were still used in one-third of the patients, and no antithrombotic treatment in only 4.8%. Oral anticoagulants were used in 56.4% of CHA 2DS2-VASc = 0, with 26.3% having no antithrombotic therapy. A high HAS-BLED score was not used to exclude OAC use, but there was a trend towards more aspirin use in the presence of a high HAS-BLED score. Conclusion: The EURObservational Research Programme Atrial Fibrillation (EORP-AF) Pilot Registry has provided systematic collection of contemporary data regarding the management and treatment of AF by cardiologists in ESC member countries. Oral anticoagulant use has increased, but novel OAC use was still low. Compliance with the treatment guidelines for patients with the lowest and higher stroke risk scores remains suboptimal. © The Author 2013

Analysis of the parameters required to properly define nanofluids for heat transfer applications

Nanofluids are obtained by dispersing nanoparticles and dispersant, when present, in a base fluid. Their properties, in particular their stability, however, are strictly related to several other parameters, knowledge of which is important to reproduce the nanofluids and correctly interpret their behavior. Due to this complexity, the results appear to be frequently unreliable, contradictory, not comparable and/or not repeatable, in particular for the scarcity of information on their preparation. Thus, it is essential to define what is the minimum amount of information necessary to fully describe the nanofluid, so as to ensure the possibility of reproduction of both their formulation and the measurements of their properties. In this paper, a literature analysis is performed to highlight what are the most important parameters necessary to describe the configuration of each nanofluid and their influence on the nanofluid's properties. A case study is discussed, analyzing the information reported and the results obtained for the thermophysical properties of nanofluids formed by water and TiO2 nanoparticles. The aim is to highlight the differences in the amount of information given by the different authors and exemplify how results can be contradictory. A final discussion gives some suggestions on the minimum amount of information that should be given on a nanofluid to have the possibility to compare results obtained for similar nanofluids and to reproduce the same nanofluid in other laboratories