Absence of the suprarenal segment of the inferior vena cava with a coexisting absence of the right brachiocephalic vein in a 22-year-old Caucasian male with arterial hypertension

Congenital anomalies of the inferior vena cava (IVC) are rarely observed malformations of the venous system, occurring in 0.3% of otherwise healthy individuals, and in 0.6% to 2% of patients with coexisting cardiovascular defects. They are usually asymptomatic and recognised incidentally during imaging, operations or dissection studies. In this paper we report an extremely rare case of a 22-year-old Caucasian male, admitted for the purpose of excluding secondary causes of hypertension. During imaging of the abdomen and the thorax we found a complete lack of the suprarenal segment of the IVC, with a coexisting absence of the right brachiocephalic vein. We discuss the problem of congenital defects of the IVC and we review the relevant literature

Psychological and Environmental Correlates of Well-being Among Undergraduate University Students

This study explored whether the university environment provides similar well-being enhancing elements to those that have been found in the workplace and school contexts. Whether psychological inflexibility accounts for well-being over and above personality and environmental influences was also explored. A representative sample of 163 undergraduate university students in an Australian university completed an online survey measuring the key constructs. Environmental influences assessed included financial resources, physical security, opportunity to use new skills, externally generated goals, variety, environmental clarity, interpersonal contact, and valued social position. Hierarchical multiple linear regression analyses were then conducted to test for predictors of three domains of subjective well-being: positive affect, negative affect, and life satisfaction. The results suggested that university context contributes significantly to undergraduate students’ well-being by providing a valued social role, externally generated goals, and variety. Students’ perception of their physical security was also an important influence on their well-being. These results are consistent with the literature on well-being and employment. Neuroticism significantly predicted negative affect, while psychological inflexibility accounted for unique variance in life satisfaction and negative affect even when personality and environmental influences were taken into account. The implications of these findings for enhancing undergraduate university students’ well-being are discussed

Radio-frequency ablation as primary management of well-tolerated sustained monomorphic ventricular tachycardia in patients with structural heart disease and left ventricular ejection fraction over 30%.

AIMS: Patients with well-tolerated sustained monomorphic ventricular tachycardia (SMVT) and left ventricular ejection fraction (LVEF) over 30% may benefit from a primary strategy of VT ablation without immediate need for a 'back-up' implantable cardioverter-defibrillator (ICD). METHODS AND RESULTS: One hundred and sixty-six patients with structural heart disease (SHD), LVEF over 30%, and well-tolerated SMVT (no syncope) underwent primary radiofrequency ablation without ICD implantation at eight European centres. There were 139 men (84%) with mean age 62 ± 15 years and mean LVEF of 50 ± 10%. Fifty-five percent had ischaemic heart disease, 19% non-ischaemic cardiomyopathy, and 12% arrhythmogenic right ventricular cardiomyopathy. Three hundred seventy-eight similar patients were implanted with an ICD during the same period and serve as a control group. All-cause mortality was 12% (20 patients) over a mean follow-up of 32 ± 27 months. Eight patients (40%) died from non-cardiovascular causes, 8 (40%) died from non-arrhythmic cardiovascular causes, and 4 (20%) died suddenly (SD) (2.4% of the population). All-cause mortality in the control group was 12%. Twenty-seven patients (16%) had a non-fatal recurrence at a median time of 5 months, while 20 patients (12%) required an ICD, of whom 4 died (20%). CONCLUSION: Patients with well-tolerated SMVT, SHD, and LVEF > 30% undergoing primary VT ablation without a back-up ICD had a very low rate of arrhythmic death and recurrences were generally non-fatal. These data would support a randomized clinical trial comparing this approach with others incorporating implantation of an ICD as a primary strategy

Original articleThe LocaLisa system as the key to shortening the procedure duration and fluoroscopy time during ablation of atrial fibrillation

Background: Ablation of atrial fibrillation (AF) can be difficult and time-consuming. Systems facilitating catheter navigation may be helpful. Aim: To compare the efficacy of the LocaLisa system with the conventional mapping/ablation approach to radiofrequency (RF) ablation of AF. Methods: Group 1, consisting of 64 patients (48 male; aged 51.5±10.6 years), underwent segmental isolation of the pulmonary veins with the Lasso catheter and the LocaLisa system. Group 2, consisting of 64 patients (44 male, aged 51.4±11.0 years), had RF ablation guided by means of a conventional fluoroscopy-based approach. Clinical and procedural data were analysed. Results: Nine patients from group 1 and three patients from group 2 had persistent AF. In group 1 the mean number of isolated veins was 3.98±0.96, while in group 2 – 4.0±0.95 (NS). In group 1 cavotricuspid isthmus lines were created in four patients and lines in the roof of the left atrium in two patients. One patient needed slow pathway ablation. In group 2 six patients had ablation of the cavotricuspid isthmus and a line was created at the roof of the left atrium in one patient. Two patients had ectopic activity ablated in the crista terminalis. Procedure times were 131.6±40.3 and 170.0±56.5 min (pWstęp: Ablacja podłoża migotania przedsionków jest uznaną metodą leczenia migotania przedsionków (AF). Do ablacji AF wykorzystuje się różne systemy elektrofizjologiczne i nawigacyjne. Cel: Porównanie zabiegów ablacji podłoża AF wykonanych z wykorzystaniem systemu nawigacyjnego LocaLisa (Medtronic) i bez niego. Metodyka: Grupę 1. stanowiło 64 chorych (48 mężczyzn, 16 kobiet; wiek 51,5±10,6 roku), u których wykonano izolację przepustów mięśniowych z wykorzystaniem elektrody Lasso 2515 (Johnsn & Johnson) i systemu LocaLisa. Do grupy 2. włączono ostatnich 64 chorych (44 mężczyzn, 20 kobiet; wiek 51,4±11,0 lat) poddanych ablacji z użyciem elektrody Lasso bez systemu LocaLisa. Analizowano dane kliniczne i związane z zabiegiem. Wyniki: Przewlekłe AF stwierdzono u 9 chorych z grupy 1. i u 3 z grupy 2. Izolacji poddano odpowiednio 3,98±0,96 vs 4,0±0,95 żył. W grupie 1. dodatkowo wykonano linię w cieśni dolnej prawego przedsionka u 4 chorych i w dachu lewego przedsionka u 2 chorych. U jednego chorego wykonano jednocześnie ablację drogi wolnej z powodu nawrotnego częstoskurczu węzłowego. W grupie 2. dodatkową linię w cieśni dolnej wykonano u 6 chorych, linię w dachu lewego przedsionka u jednego chorego, ablację dodatkowego ogniska w grzebieniu granicznym u 2 chorych. W grupie 1. dwóch chorych miało wszczepiony dwuprzedsionkowy układ stymulujący, jeden miał wszczepiony okluder do uszka lewego przedsionka (PLAATO). W grupie 2. jeden chory miał implantowany układ stymulujący typu AAI, inny był po zaszyciu przegrody międzyprzedsionkowej (ASD) i komorowej (VSD). U jednego chorego występowała przetrwała żyła główna lewa z atrezją żyły głównej górnej. Porównanie grup 1. i 2. pod względem czasu zabiegu i skopii RTG: 131,6±40,3 vs 170,0±56,5 min (

Correlating Summarization of Multi-source News with K-Way Graph Bi-clustering

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Mapping QTLs for traits related to phenology, morphology and yield components in an inter-specific Gossypium hirsutum × G. barbadense cotton RIL population.

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