Factors Predicting Coronary Sinus Rupture Following Cannula Insertion for Retrograde Cardioplegia

Background Coronary sinus rupture (CSR) is a rare preventable complication of cannula insertion for retrograde cardioplegia. In the hands of an inexperienced surgeon, this complication has the risk of potential mortality and morbidity, and its repair is technically challenging. Techniques for repairing CSR have been reported previously. In this study, we determined predictors of CSR following coronary artery bypass graft (CABG) surgery. Methods Over a four-year period, we retrospectively analyzed 1500 patients in whom a retrograde coronary sinus catheter was used to administer cardioplegic solution. CSR occurred in 15 patients. (12 women and 3 men). Variables such as age, weight, body mass index, gender, aortic clamp time, pump time, cardiomegaly, ejection fraction, and number of grafts were determined for each patient. Factors correlated with CSR were analyzed using multiple regression analysis, and odd ratios of significant variables were determined. Results In multiple regression analysis, factors such as female gender, age, weight, and body mass index showed a significant correlation with CSR, and their odd ratios were 4.2, 1.0, 0.96, and 2.2, respectively. Conclusion In all 15 cases, a retrograde cannula with a self-inflatable balloon was used and 12 patients were woman with low body mass index. Forceful insertion due to coronary sinus web, fragility of arteries in thin patients, or a small coronary sinus caused CSR in the hands of an inexperienced surgeon

Subthreshold dynamics of the neural membrane potential driven by stochastic synaptic input

In the cerebral cortex, neurons are subject to a continuous bombardment of synaptic inputs originating from the network's background activity. This leads to ongoing, mostly subthreshold membrane dynamics that depends on the statistics of the background activity and of the synapses made on a neuron. Subthreshold membrane polarization is, in turn, a potent modulator of neural responses. The present paper analyzes the subthreshold dynamics of the neural membrane potential driven by synaptic inputs of stationary statistics. Synaptic inputs are considered in linear interaction. The analysis identifies regimes of input statistics which give rise to stationary, fluctuating, oscillatory, and unstable dynamics. In particular, I show that (i) mere noise inputs can drive the membrane potential into sustained, quasiperiodic oscillations (noise-driven oscillations), in the absence of a stimulus-derived, intraneural, or network pacemaker; (ii) adding hyperpolarizing to depolarizing synaptic input can increase neural activity (hyperpolarization-induced activity), in the absence of hyperpolarization-activated currents

Prostitution, IV Drug Use, and Sex-for‐Crack Exchanges Among Serious Delinquents: Risks for HIV Infection

There is mounting evidence that HIV infection among adolescents is increasing, particularly among minorities and inner‐city youths involved in certain high‐risk activities, such as multiple sex partners and intravenous drug use. Interviews conducted “on the street” with 611 seriously delinquent male and female adolescents (ages 12–17) included questions about their involvement in prostitution, intravenous drug use, and sex‐for‐crack exchanges. Findings included high percentages of youths engaged in these HIV‐risk activities and a consistent association between all of them and greater illicit drug use. This would suggest that these risk behaviors may be surprisingly prevalent among some inner‐city adolescent groups. Special AIDS prevention/intervention targeting these groups is warranted and urgently needed. Drug treatment should be a central focus of such programs. Copyright © 1991, Wiley Blackwell. All rights reserve

Echinuria uncinata (Rudolphi) (Nematoda, Acuariidae) in Netta peposaca (Vieillot) (Aves, Anatidae) in South America

This is the first report of a species of Echinuria Soloviev, 1912, on anatid hosts in South America, causing granulomas. It is also the first detailed description and record of a species of Echinuria, for South America in the Rosy-billed Pochard, Netta peposaca (Vieillot, 1816). Fifty-two rosy-billed pochards were examined for helminths in the Municipalities of Santa Vitória do Palmar (locality of Fazenda Sossego) and (locality of Ponta da Antena), State of Rio Grande do Sul, Brazil, and Alvear, Province of Corrientes, northern Argentina. Samples were obtained from 2003 to 2004. After the catch each bird was immediately frozen with dry ice. Prior to necropsy birds were sexed, weighted, measured, and the state of maturity (juvenile or adult) determined, based on the presence or absence of a bursa of Fabricius. The granulomas with the nematodes were found in the proximal esophagus at the junction with the proventriculus. Two birds had one (fistulated) and two granulomas, respectively. One of the birds was from the wintering grounds along the coastal region in the State of Rio Grande do Sul, southern Brazil. The other, from one of the breeding grounds in northern Argentina, was captured before the trip to the wintering grounds along the migratory flyway. Prevalence was 3.8% while the mean intensity of infection was 7.2. Morphometry of males and females and the comparison with previous descriptions and illustrations allowed the identification of the present specimens as E. uncinata.<br>Este é o primeiro registro de uma espécie do gênero Echinuria Soloviev, 1912, em hospedeiros anatídeos na América do Sul, causando granulomas. É, também, a primeira descrição detalhada e o primeiro registro de Echinuria uncinata (Rudolphi, 1819) Soloviev, 1912, para a América do Sul, e o primeiro registro de um nematóide acuarióideo em Netta peposaca (Vieillot, 1816). Cinqüenta e dois marrecões foram examinados para helmintos nas localidades de Fazenda Sossego e Ponta da Antena, Município de Santa Vitória do Palmar, Estado do Rio Grande do Sul, região Sul do Brasil e Alvear, Província de Corrientes, região Norte da Argentina. As amostras foram obtidas no período de 2003 a 2004. Imediatamente após o abate, cada ave foi congelada em gelo seco. As aves foram separadas por sexo, pesadas e medidas. O estado de maturidade de cada ave foi avaliado (juvenil ou adulto) com base na presença ou ausência da bolsa de Fabricius. Os granulomas, contendo os nematóides, estavam situados na base do esôfago quase junto à junção com o proventrículo. Duas aves estavam positivas, com um (fistulado) e dois granulomas, respectivamente. Uma das aves era proveniente do Brasil (pólo de invernia na planície costeira do Estado do Rio Grande do Sul). A outra da região Norte da Argentina, capturada em um dos pólos de nidificação, antes de empreender sua viagem em direção à costa brasileira ao longo de sua rota de migração. A prevalência da infecção foi de 3,8% e a intensidade média de infecção de 7,2. A morfometria de machos e de fêmeas permitiu a identificação dos espécimes como E. uncinata