Percutaneous Catheter Ablation of Epicardial Accessory Pathways.

Radiofrequency (RF) catheter ablation is the treatment of choice in patients with accessory pathways (APs) and Wolff-Parkinson-White syndrome. Endocardial catheter ablation has limitations, including the inability to map and ablate intramural or subepicardial APs. Some of these difficulties can be overcome using an epicardial approach performed through the epicardial venous system or by percutaneous catheterisation of the pericardial space. When a suspected left inferior or infero-paraseptal AP is refractory to ablation or no early activation is found at the endocardium, a transvenous approach via the coronary sinus is warranted because such epicardial pathways can be in close proximity to the coronary venous system. Associated congenital abnormalities, such as right atrial appendage, right ventricle diverticulum, coronary sinus diverticulum and absence of coronary sinus ostium, may also hamper a successful outcome. Percutaneous epicardial subxiphoid approach should be considered when endocardial or transvenous mapping and ablation fails. Epicardial mapping may be successful. It can guide and enhance the effectiveness of endocardial ablation. The finding of no epicardial early activation leads to a more persistent new endocardial attempt. When both endocardial and epicardial ablation are unsuccessful, open-chest surgery is the only option to eliminate the AP.info:eu-repo/semantics/publishedVersio

On certain modules of covariants in exterior algebras

We study the structure of the space of covariants $B:=\left(\bigwedge (\mathfrak g/\mathfrak k)^*\otimes \mathfrak g\right)^{\mathfrak k},$ for a certain class of infinitesimal symmetric spaces $(\mathfrak g,\mathfrak k)$ such that the space of invariants $A:=\left(\bigwedge (\mathfrak g/\mathfrak k)^*\right)^{\mathfrak k}$ is an exterior algebra $\wedge (x_1,...,x_r),$ with $r=rk(\mathfrak g)-rk(\mathfrak k)$. We prove that they are free modules over the subalgebra $A_{r-1}=\wedge (x_1,...,x_{r-1})$ of rank $4r$. In addition we will give an explicit basis of $B$. As particular cases we will recover same classical results. In fact we will describe the structure of $\left(\bigwedge (M_n^{\pm})^*\otimes M_n\right)^G$, the space of the $G-$equivariant matrix valued alternating multilinear maps on the space of (skew-symmetric or symmetric with respect to a specific involution) matrices, where $G$ is the symplectic group or the odd orthogonal group. Furthermore we prove new polynomial trace identities.Comment: Title changed. Results have been generalised to other infinitesimal symmetric space

Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Malaria and Sexually Transmitted and Reproductive Tract Infections

: We conducted a prospective cohort study in Zambia among pregnant women who received intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP). : We calculated the odds ratios (ORs) of adverse birth outcomes by IPTp-SP exposure, 0-1 dose (n = 126) vs ≥2 doses (n = 590) and ≥2 doses (n = 310) vs ≥3 doses (n = 280) in 7 categories of malaria infection and sexually transmitted and reproductive tract infections (STIs/RTIs). : We found no significant differences in baseline prevalence of infection across IPTp-SP exposure groups. However, among women given 2 doses compared to 0-1 dose, the odds of any adverse birth outcome were reduced 45% (OR, 0.55; 95% confidence interval [CI], 0.36, 0.86) and 13% further with ≥3 doses (OR, 0.43; 95% CI, 0.27, 0.68). Two or more doses compared to 0-1 dose reduced preterm delivery by 58% (OR, 0.42; 95% CI, 0.27, 0.67) and 21% further with ≥3 doses (OR, 0.21; 95% CI, 0.13, 0.35). Women with malaria at enrollment who received ≥2 doses vs 0-1 had 76% lower odds of any adverse birth outcome (OR, 0.24; 95% 0.09, 0.66), and Neisseria gonorrhoeae and/or Chlamydia trachomatis had 92% lower odds of any adverse birth outcome (OR, 0.08; 95% CI, 0.01, 0.64). Women with neither a malaria infection nor STIs/RTIs who received ≥2 doses had 73% fewer adverse birth outcomes (OR, 0.27; 95% CI, 0.11, 0.68). : IPTp-SP appears to protect against malaria, STIs/RTIs, and other unspecified causes of adverse birth outcome.<br/

Gene expression differs in susceptible and resistant amphibians exposed to Batrachochytrium dendrobatidis.

Chytridiomycosis, the disease caused by the fungal pathogen Batrachochytrium dendrobatidis (Bd), has devastated global amphibian biodiversity. Nevertheless, some hosts avoid disease after Bd exposure even as others experience near-complete extirpation. It remains unclear whether the amphibian adaptive immune system plays a role in Bd defence. Here, we describe gene expression in two host species-one susceptible to chytridiomycosis and one resistant-following exposure to two Bd isolates that differ in virulence. Susceptible wood frogs (Rana sylvatica) had high infection loads and mortality when exposed to the more virulent Bd isolate but lower infection loads and no fatal disease when exposed to the less virulent isolate. Resistant American bullfrogs (R. catesbeiana) had high survival across treatments and rapidly cleared Bd infection or avoided infection entirely. We found widespread upregulation of adaptive immune genes and downregulation of important metabolic and cellular maintenance components in wood frogs after Bd exposure, whereas American bullfrogs showed little gene expression change and no evidence of an adaptive immune response. Wood frog responses suggest that adaptive immune defences may be ineffective against virulent Bd isolates that can cause rapid physiological dysfunction. By contrast, American bullfrogs exhibited robust resistance to Bd that is likely attributable, at least in part, to their continued upkeep of metabolic and skin integrity pathways as well as greater antimicrobial peptide expression compared to wood frogs, regardless of exposure. Greater understanding of these defences will ultimately help conservationists manage chytridiomycosis

Chiral zero-mode for abelian BPS dipoles

We present an exact normalisable zero-energy chiral fermion solution for abelian BPS dipoles. For a single dipole, this solution is contained within the high temperature limit of the SU(2) caloron with non-trivial holonomy.Comment: 9 pages, 1 figure (in 2 parts), presented at the workshop on "Confinement, Topology, and other Non-Perturbative Aspects of QCD", 21-27 Jan. 2002, Stara Lesna, Slovaki

An Adiabatic Theorem without a Gap Condition

The basic adiabatic theorems of classical and quantum mechanics are over-viewed and an adiabatic theorem in quantum mechanics without a gap condition is described.Comment: Talk at QMath 7, Prague, 1998. 10 pages, 7 figure