Value of the aVR lead in differential diagnosis of atrioventricular nodal reentrant tachycardia

AimsDespite the several electrocardiographic (ECG) criteria, misclassification may still occur in differential diagnosis of the regular paroxysmal supraventricular tachycardia (PSVT). The aim of the present study was to evaluate the diagnostic accuracy of the aVR lead in ECG differentiation of atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT).Methods and resultsA 12-lead ECG was recorded in 150 consecutive patients (96 women, mean age, 45 ± 13.5 years) with drug-refractory regular PSVT during both sinus rhythm and tachycardia. All ECGs were reviewed by two experienced electrophysiologists who had no knowledge of the tachycardia mechanism. The ECG recordings were evaluated for standard criteria as well as our newly proposed criterion of pseudo-r� in the lead aVR. Mechanism of arrhythmia was confirmed by the electrophysiological study and the successful catheter ablation. Patients with AVNRT were older (50 ± 10 vs. 37 ± 15 years, P 0.001), predominantly female (71 vs. 53, P 0.03), and presented with slower tachycardia (175 ± 25 vs. 186 ± 26 b.p.m., P 0.01). Among the ECG criteria of the AVRT diagnosis, visible P-wave with RP interval <100 ms had highest diagnostic accuracy (sensitivity 79, specificity 87, and positive predictive value 79). For AVNRT diagnosis, pseudo-r� in aVR had a higher sensitivity, specificity, and predictive values compared with the conventional criteria of the pseudo-r� in V1 and pseudo-s in inferior leads (all P < 0.05).ConclusionsNew criterion of pseudo-r� in lead aVR appears to be more accurate than the standard ECG criteria for ECG diagnosis of AVNRT. © 2012 Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2012. For permissions please email: journals.permissionsoup.com

In-hospital and six-month outcomes of elderly patients undergoing primary percutaneous coronary intervention for acute st-elevation myocardial infarction

BACKGROUND: Elderly patients constitute a rapidly growing proportion of the population, and hence the increasing rises in the number of patients with ST-segment-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI), which is now established as the preferred reperfusion strategy in STEMI patients, has been inadequately investigated in this high-risk group. The aim of the present study was to investigate the in- hospital and 6-month outcomes of primary PCI in elderly patients (� 75 years) with STEMI. METHODS: A total of 100 elderly patients with STEMI including those with cardiogenic shock were included. Primary PCI procedures were performed in a tertiary referral center between 2009 and 2014. In-hospital and 6-month outcomes of patients were recorded and analyzed. RESULTS: The average age of the patients was 79.6 ± 3.8 years (range = 75-90 years) and 27.0 were women. Cardiovascular risk factors and prior events were common. Nearly, half of the patients had three-vessel disease and the left anterior descending artery (LAD) was the most common infarct-related artery. The presence of cardiogenic shock but not the other variables was associated with less anatomic and procedural success (P < 0.001). It was also the major independent predictors of 6-month mortality in the patients aged � 75 years, hazard ratio (HR) = 8.02; 95% confidence interval (CI): 1.75-25.97, P < 0.001. In-hospital mortality was 2.4% in the patients without and 83.0% in those with cardiogenic shock. CONCLUSION: Primary PCI in aged patients could be associated with low complication rates and improved survival if performed in high-volume centers with experienced operators. Considering the very high rate of mortality in patients with cardiogenic shock, there should be measures to treat these patients before the onset of hemodynamic instability. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Electrodeposited Co93.2P6.8 nanowire arrays with core-shell microstructure and perpendicular magnetic anisotropy

We demonstrate the formation of an unusual core-shell microstructure in Co93.2P6.8 nanowires electrodeposited by alternating current (ac) in an alumina template. By means of transmission electron microscopy, it is shown that the coaxial-like nanowires contain amorphous and crystalline phases. Analysis of the magnetization data for Co-P alloy nanowires indicates that a ferromagnetic core is surrounded by a weakly ferromagnetic or non-magnetic phase, depending on the phosphor content. The nanowire arrays exhibit an easy axis of magnetization parallel to the wire axis. For this peculiar composition and structure, the coercivity values are 2380 ± 50 and 1260 ± 35 Oe, parallel and perpendicular to the plane directions of magnetization, respectively. This effect is attributed to the core-shell structure making the properties and applications of these nanowires similar to pure cobalt nanowires with an improved perpendicular anisotropy. <br/

Place branding of seaports in the Middle East

This paper analyses seaports’ brand personalities as a means of understanding similarities and differences of these important locations and their relationship with their host place image. Drawing upon Aaker’s (J Mark Res 34:347–356, 1997) brand personality construct, the study presents lexical analysis from the websites of nine seaports in the Middle East. Each seaport’s website is content analysed, and the brand personality is measured using Aaker’s (1997) framework and Opoku’s (Licentiate Thesis, Lulea University of Technology, ISSN, 1402-1757, 2005) dictionary of synonyms. Findings show that seaports have developed a level of isomorphism upon particular dimensions of brand image; however, the findings also show the most distinctive seaports were linking their seaport to their place brand. In particular, the findings show only the Port of Jebel Ali has a clear and distinctive brand personality and to a lesser extent the Ports of Sohar, Shahid Rajee and Khor Fakkan. The research has important management implications of branding for public diplomacy and demonstrates seaport brand positioning in relation to place branding, used to inform public communication and marketing

Horizontal Gene Transfer of a ColV Plasmid Has Resulted in a Dominant Avian Clonal Type of Salmonella enterica Serovar Kentucky

Salmonella enterica continues to be a significant cause of foodborne gastrointestinal illness in humans. A wide variety of Salmonella serovars have been isolated from production birds and from retail poultry meat. Recently, though, S. enterica subsp. enterica serovar Kentucky has emerged as one of the prominent Salmonella serovars isolated from broiler chickens. Recent work suggests that its emergence apparently coincides with its acquisition of a ColV virulence plasmid. In the present study, we examined 902 Salmonella isolates belonging to 59 different serovars for the presence of this plasmid. Of the serovars examined, the ColV plasmid was found only among isolates belonging to the serovars Kentucky (72.9%), Typhimurium (15.0%) and Heidelberg (1.7%). We demonstrated that a single PFGE clonal type of S. Kentucky harbors this plasmid, and acquisition of this plasmid by S. Kentucky significantly increased its ability to colonize the chicken cecum and cause extraintestinal disease. Comparison of the completed sequences of three ColV plasmids from S. Kentucky isolated from different geographical locales, timepoints and sources revealed a nearly identical genetic structure with few single nucleotide changes or insertions/deletions. Overall, it appears that the ColV plasmid was recently acquired by a single clonal type S. Kentucky and confers to its host enhanced colonization and fitness capabilities. Thus, the potential for horizontal gene transfer of virulence and fitness factors to Salmonella from other enteric bacteria exists in poultry, representing a potential human health hazard

Avian Pathogenic Escherichia coli (APEC) Infection Alters Bone Marrow Transcriptome in Chickens

Avian pathogenic Escherichia coli (APEC) is a major cause of disease impacting animal health. The bone marrow is the reservoir of immature immune cells; however, it has not been examined to date for gene expression related to developmental changes (cell differentiation, maturation, programming) after APEC infection. Here, we study gene expression in the bone marrow between infected and non-infected animals, and between infected animals with mild (resistant) versus severe (susceptible) pathology, at two times post-infection. We sequenced 24 bone marrow RNA libraries generated from the six different treatment groups with four replicates each, and obtained an average of 22 million single-end, 100-bp reads per library. Genes were detected as differentially expressed (DE) between APEC treatments (mild pathology, severe pathology, and mock-challenged) at a given time point, or DE between 1 and 5 days post-infection (dpi) within the same treatment group. Results demonstrate that many immune cells, genes and related pathways are key contributors to the different responses to APEC infection between susceptible and resistant birds and between susceptible and non-challenged birds, at both times post-infection. In susceptible birds, lymphocyte differentiation, proliferation, and maturation were greatly impaired, while the innate and adaptive immune responses, including dendritic cells, monocytes and killer cell activity, TLR- and NOD-like receptor signaling, as well as T helper cells and many cytokine activities, were markedly enhanced. The resistant birds’ immune system, however, was similar to that of non-challenged birds. The DE genes in the immune cells and identified signaling models are representative of activation and resolution of infection in susceptible birds at both post-infection days. These novel results characterizing transcriptomic response to APEC infection reveal that there is combinatorial activity of multiple genes controlling myeloid cells, and B and T cell lymphopoiesis, as well as immune responses occurring in the bone marrow in these early stages of response to infection

Spleen transcriptome response to infection with avian pathogenic Escherichia coli in broiler chickens

<p>Abstract</p> <p>Background</p> <p>Avian pathogenic <it>Escherichia coli </it>(APEC) is detrimental to poultry health and its zoonotic potential is a food safety concern. Regulation of antimicrobials in food-production animals has put greater focus on enhancing host resistance to bacterial infections through genetics. To better define effective mechanism of host resistance, global gene expression in the spleen of chickens, harvested at two times post-infection (PI) with APEC, was measured using microarray technology, in a design that will enable investigation of effects of vaccination, challenge, and pathology level.</p> <p>Results</p> <p>There were 1,101 genes significantly differentially expressed between severely infected and non-infected groups on day 1 PI and 1,723 on day 5 PI. Very little difference was seen between mildly infected and non-infected groups on either time point. Between birds exhibiting mild and severe pathology, there were 2 significantly differentially expressed genes on day 1 PI and 799 on day 5 PI. Groups with greater pathology had more genes with increased expression than decreased expression levels. Several predominate immune pathways, Toll-like receptor, Jak-STAT, and cytokine signaling, were represented between challenged and non-challenged groups. Vaccination had, surprisingly, no detectible effect on gene expression, although it significantly protected the birds from observable gross lesions. Functional characterization of significantly expressed genes revealed unique gene ontology classifications during each time point, with many unique to a particular treatment or class contrast.</p> <p>Conclusions</p> <p>More severe pathology caused by APEC infection was associated with a high level of gene expression differences and increase in gene expression levels. Many of the significantly differentially expressed genes were unique to a particular treatment, pathology level or time point. The present study not only investigates the transcriptomic regulations of APEC infection, but also the degree of pathology associated with that infection. This study will allow for greater discovery into host mechanisms for disease resistance, providing targets for marker assisted selection and advanced drug development.</p