Left atrial size after cardioversion for atrial fibrillation: effect of external DC shock

OBJECTIVE: The aim of this study was to evaluate the effect of external direct current (DC) shock on left atrial (LA) dimension and volumes after cardioversion for atrial fibrillation, and the relation between LA size and atrial function. METHODS: We evaluated 180 patients who were randomly cardioverted with DC shock (90 patients) or drugs (90 patients). Echocardiographic evaluations included LA size and volumes. LA passive and active emptying volumes were calculated, and LA function was measured as atrial ejection force. Changes in LA diameters and volumes were correlate with atrial systolic function. RESULTS: The LA was dilated in all patients during arrhythmia and decreased after the restoration of sinus rhythm. The entity of reduction was different in the 2 groups of patients. LA maximal and minimal volumes were increased after DC shock as compared with patients treated with drugs (LA maximal volume 34 +/- 4 vs 31 +/- 5; P <.01; LA minimal volume 18 +/- 2.6 vs 15 +/- 3.6; P <.01). The atrial function was also depressed after DC shock and the delay in the recovery of atrial contractility was related to LA dilation. Patients treated with drugs had a higher atrial ejection force that was associated with a more marked reduction in LA maximal volume after the restoration of in sinus rhythm. A relationship between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanic function (r = -0.78; P <.001). The active emptying fraction was lower, although not significantly, in this group, whereas the conduit volume was increased. CONCLUSION: External DC shock induced a depressed atrial mechanic function in many patients and this was associated with a persistence of LA dilation

Left atrial size and function after spontaneous cardioversion of atrial fibrillation and their relation to N-terminal atrial natriuretic peptide

In conclusion, higher levels of N-ANP during AF were independently associated with spontaneous conversion, as well as with smaller LA volume.An inverse correlation existed between LA volume and N-AN

Prognostic value of Iron, Nutritional Status Indexes and Acute Phase Protein in Acute Coronary Syndrome.

Background. The relation between the inflammatory status during unstable angina and nutritional parameters has not been well described. We sought to investigate the relation between the acute inflammatory status, as evaluated on the basis of high C-reactive protein (CRP) and serum amyloid A levels and laboratory indexes of iron and nutritional status in patients with unstable angina, and whether the variations in iron levels have a prognostic significance.Methods. The study population consisted of 98 patients admitted to our facility with unstable (group 1: 64 consecutive patients, 52 males, 12 females, mean age 66 \ub1 10 years) or stable angina(group 2: 34 patients, 30 males, 4 females, mean age 65 \ub1 9 years). The hemoglobin levels, the erythrocyte mean cell volume, serum iron levels, the increase in transferrin levels, the decrease in the percent transferrin saturation, ferritin levels, the nutritional status, and the CRP and serum amyloid A levels were measured.Results. On the basis of a CRP value > 1 mg/dl, 47 patients with unstable angina and 4 patients with stable angina were identified as having active inflammatory disease. The presence of inflammation was associated with significantly lower mean values of hemoglobin, erythrocyte mean cell volume, serum iron and transferrin levels, and percent transferrin saturation in comparison with patients without inflammation. A significant inverse correlation coefficient between a CRP level > 1 mg/dl and hemoglobin, transferrin levels and percent transferrin saturation was observed: the strongest correlation was with serum iron levels. The relative risk of total cardiac events was significantlygreater in patients with low serum iron levels than in those with high serum iron levels.Conclusions. Patients with acute inflammation present altered iron status indexes. Increased CRP levels and reduced serum iron levels are associated with a worse outcome in patients with unstable angina

Did Neoliberalizing West African Forests Produce a New Niche for Ebola?

A recent study introduced a vaccine that controls Ebola Makona, the Zaire ebolavirus variant that has infected 28,000 people in West Africa. We propose that even such successful advances are insufficient for many emergent diseases. We review work hypothesizing that Makona, phenotypically similar to much smaller outbreaks, emerged out of shifts in land use brought about by neoliberal economics. The epidemiological consequences demand a new science that explicitly addresses the foundational processes underlying multispecies health, including the deep-time histories, cultural infrastructure, and global economic geographies driving disease emergence. The approach, for instance, reverses the standard public health practice of segregating emergency responses and the structural context from which outbreaks originate. In Ebola's case, regional neoliberalism may affix the stochastic "friction" of ecological relationships imposed by the forest across populations, which, when above a threshold, keeps the virus from lining up transmission above replacement. Export-led logging, mining, and intensive agriculture may depress such functional noise, permitting novel spillovers larger forces of infection. Mature outbreaks, meanwhile, can continue to circulate even in the face of efficient vaccines. More research on these integral explanations is required, but the narrow albeit welcome success of the vaccine may be used to limit support of such a program.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Anthocyanins: a comprehensive review of their chemical properties and health effects on cardiovascular and neurodegenerative diseases

Anthocyanins are a class of water-soluble flavonoids widely present in fruits and vegetables. Dietary sources of anthocyanins include red and purple berries, grapes, apples, plums, cabbage, or foods containing high levels of natural colorants. Cyanidin, delphinidin, malvidin, peonidin, petunidin, and pelargonidin are the six common anthocyanidins. Following consumption, anthocyanin, absorption occurs along the gastrointestinal tract, the distal lower bowel being the place where most of the absorption and metabolism occurs. In the intestine, anthocyanins first undergo extensive microbial catabolism followed by absorption and human phase II metabolism. This produces hybrid microbial–human metabolites which are absorbed and subsequently increase the bioavailability of anthocyanins. Health benefits of anthocyanins have been widely described, especially in the prevention of diseases associated with oxidative stress, such as cardiovascular and neurodegenerative diseases. Furthermore, recent evidence suggests that health-promoting effects attributed to anthocyanins may also be related to modulation of gut microbiota. In this paper we attempt to provide a comprehensive view of the state-of-the-art literature on anthocyanins, summarizing recent findings on their chemistry, biosynthesis, nutritional value and on their effects on human health

Iron and liver diseases.

A mild to moderate iron excess is found in patients with liver diseases apparently unrelated to genetic hemochromatosis. Iron appears to affect the natural history of hepatitis C virus-related chronic liver diseases, alcoholic liver disease and nonalcoholic steatohepatitis by leading to a more severe fibrosis and thus aiding the evolution to cirrhosis.Ahigher frequency of mutations of the HFE gene, the gene responsible for hereditary hemochromatosis, is found in patients with liver diseases and increased liver iron than in normal patients. Patients with excess iron are potentially at a higher risk of developing hepatocellular carcinoma. Iron depletion therapy could interfere with fibrosis development and possibly reduce the risk of liver cancer occurrence

Evaluation of Nile tilapia in monoculture and polyculture with giant freshwater prawn in biofloc technology system and in recirculation aquaculture system.

Abstract: Biofloc technology system (BFT), recirculation aquaculture system (RAS) and polyculture promote efficient use of water, area and nutrient recycling, which are essential practices for sustainable aquaculture development. The aim of this study was to evaluate the growth, feed efficiency, biofloc composition and water quality of Nile tilapia Oreochromis niloticus (Linnaeus, 1758) in monoculture and polyculture with giant freshwater prawn Macrobrachium rosenbergii (De Man, 1906) in BFT and RAS, over a period of 30 days. Fish (n = 128; 7.29 +/- 0.67 g) were distributed randomly in 16 experimental tanks (8 fish/tank). Prawn (n = 96; 0.50 +/- 0.09 g) were allocated in 8 experimental tanks (12 prawn/tank) in a polyculture. The experimental design was completely randomized with four treatments with four replicates each, in a factorial design 2 x 2 (BFT and RAS vs. monoculture and polyculture). The experimental diet (28% of digestible protein; 3100 kcal kg(-1) of digestible energy) was used both to fish and prawn in BFT and RAS. There was significant effect (p < 0.01) of the system and the culture for weight gain, apparent feed conversion and protein efficiency ratio. The average weight gain and apparent feed conversion of tilapia in monoculture (30.04 g and 1.39) and in polyculture (36.44 g and 1.27) were superior (p < 0.01) in BFT than in monoculture (23.64 g and 1.74) and in polyculture (24.14 g and 1.61) in RAS. Weight gain and survival of giant freshwater prawn was superior (p < 0.01) in BFT (0.43 g and 87%) compared to RAS (0.26 g and 79%). The data showed that BFT provides better growth performance responses in monoculture for Nile tilapia and in polyculture with giant freshwater prawn compared to RAS