Book Reviews

Reviews of the following books: Mainers in the Civil War by Harry Gratwick; The 22nd Maine Volunteer Infantry in the Civil War: A History and Roster by Ned Smith; Write Quick: War and a Woman\u27s Life in Letters 1835-1867 Edited by Ann Fox Chandonnet and Robert Gibson Pevear; Civil War Senator: William Pitt Fessenden and the Fight to Save the American Republic by Robert J. Cook; Lincoln\u27s Friend: Leonard Swett by Robert S. Eckley; We Are in His Hands Whether We Live or Die: The Letters of Brevet Brigadier General Charles Henry Howard edited by David K. Thomson; Fanny & Joshua: The Enigmatic Lives of Frances Caroline Adams and Joshua Lawrence Chamberlain by Diane Monroe Smith; This Birth Place of Souls:The Civil War Nursing Diary of Harriet Eaton edited with an Introduction by Jane E. Schultz; Army at Home: Women and the Civil War on the Northern Home Front by Judith Giesberg; A Visitation of God: Northern Civilians Interpret the Civil War by Sean A. Scott; Freedom National: The Destruction of Slavery in the United States, 1861-1865 by James Oakes; War Upon the Land: Military Strategy and the Transformation of Southern Landscapes during the American Civil War by Lisa M. Brady; Remembering the Civil War: Reunion and the Limits of Reconciliation by Caroline E. Janne

Older Adults’ Awareness and Knowledge of Beans in Relation to Their Nutrient Content and Role in Chronic Disease Risk

Awareness and knowledge of nutrient-dense foods are important for older adults to help them make dietary choices that support a food-first approach to healthy aging. This is especially important since age is a major risk factor for chronic disease and the proportion of older adults in North America is increasing. Beans can contribute to a food-first approach to healthy aging as they are nutrient-dense and can reduce the risk of chronic diseases. However, studies exploring awareness and knowledge of beans in older adults are lacking. Therefore, the aim of this study was to explore older adults’ awareness of beans in relation to their nutrient content and role in chronic disease risk. Community-dwelling older adults (≥65 years old) were recruited and completed a validated researcher-administered questionnaire (n = 250), which was followed by 10 focus groups (n = 49). Results showed that the majority of older adults considered beans as a healthy food and thought consuming them could improve their health (99.2% and 98.0%, respectively); however, only 51.2% were bean consumers. While the majority (83.6%) of older adults were aware that a serving of beans is high in dietary fibre, bean consumers were significantly more likely to think that consuming beans could improve health areas related to dietary fibre including body weight management and constipation. Furthermore, most (84.8%) older adults thought consuming beans could improve heart health; however, bean consumers were significantly more likely to be aware that one serving of beans is low in nutrients relevant to heart health including total fat, saturated and trans fat as well as cholesterol. This research can help to inform healthcare professionals and public health agencies to create specific dietary strategies focusing on increasing older adults’ awareness and knowledge of beans in relation to their nutrient profile and role in promoting health

Design of a clinical trial for the assessment cardioversion using Transesophageal Echocardiography (The ACUTE Multicenter Study)

Patients with atrial fibrillation (AF) undergoing cardioversion are at an increased risk of cardioembolic stroke and require anticoagulation, The Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) Multicenter Study is a randomized clinical trial of patients undergoing electrical cardioversion of AF of >2 days' duration comparing a transesophageal-guided strategy (TEE) with brief anticoagulation to the conventional anticoagulation strategy. patients randomly assigned to the TEE-guided strategy receive therapeutic anticoagulation before TEE and cardioversion, followed by 4 weeks of anticoagulation, Patients with thrombus imaged by TEE have postponement of cardioversion, continue anticoagulation for 3 weeks, and undergo a repeat TEE, Conventional strategy patients receive 3 weeks of anticoagulation before cardioversion, followed by 4 weeks of anticoagulation after cardioversion, The primary end point events are ischemic stroke, transient ischemic attack, and systemic embolization for an 8-week period from enrollment, Secondary end points are major and minor bleeding, all-cause mortality, successful return to and maintenance of sinus rhythm, and cost effectiveness, Analysis is based on the intention-to-treat principle. The anticipated rates of embolism of 2.9% for conventional strategy and 1.2% for the TEE-guided strategy are based on published research and the completed pilot study, The ACUTE Multicenter Study will randomize therapy and follow an estimated 3,000 patients from 65 study sites to determine the relative efficacy of the TEE-guided and conventional approaches to electrical cardioversion for patients in AF, The results of this investigation will have important clinical implications for the management of patients with AF undergoing electrical cardioversion. (C) 1998 by Excerpta Medica, Inc.Cleveland Clin Fdn, Dept Cardiol, Sect Cardiovasc Imaging, Cleveland, OH 44195 USAUniv Louisville, Louisville, KY 40292 USAUniv Nebraska, Omaha, NE 68182 USAWinthrop Univ Hosp, Mineola, NY 11501 USAEscorts Heart Inst & Res Ctr, New Delhi, IndiaCtr Med Caracas, Caracas, VenezuelaUniv Fed Sao Paulo, Sao Paulo, BrazilLancaster Heart Fdn, Lancaster, PA USAUniv Essen Gesamthsch, Essen, GermanyEl Azhar Univ, Cairo, EgyptSt Elisabeth Hosp, Tilburg, NetherlandsUniv Pittsburgh, Med Ctr, Pittsburgh, PA USARiverside Methodist Hosp, Columbus, OH 43214 USAUniv Rochester, Strong Mem Hosp, Rochester, NY 14642 USAUniv Calif San Francisco, San Francisco, CA 94143 USAUniv Massachusetts, Worcester, MA 01605 USAHosp Vera Cruz, Belo Horizonte, MG, BrazilHosp Socor, Belo Horizonte, MG, BrazilSaginaw Heart Grp, Saginaw, MI USAUniv Calif San Diego, San Diego, CA 92103 USANew England Med Ctr, Boston, MA 02111 USAWhite River Junction VA Med Ctr, White River Junction, VT USAUniv Cincinnati, Cincinnati, OH USAVet Affairs Med Ctr, Bronx, NY USAVirginia Commonwealth Univ, Med Coll Virginia, Richmond, VA 23298 USAHarbor UCLA Med Ctr, Torrance, CA 90509 USAOsped Civile, Cento, ItalyUniv Chicago, Med Ctr, Chicago, IL 60637 USAUniv Texas, SW Med Ctr, Dallas, TX USAManly Hosp, Manly, NSW, AustraliaPrince Henry Hosp, Sydney, NSW, AustraliaN Shore Univ Hosp, Manhasset, NY USABaylor Coll Med, Methodist Hosp, Houston, TX 77030 USATexas Heart Inst, Houston, TX 77025 USAUniv New Mexico, Albuquerque, NM 87131 USARoyal Victoria Hosp, Montreal, PQ H3A 1A1, CanadaColumbia Cardiovasc Clin, Columbia, SC USAAustin Heart, Austin, TX USAOhio State Univ, Columbus, OH 43210 USAMed Coll Wisconsin, Froedtert Mem Lutheran Hosp, Milwaukee, WI 53226 USASt Nicholas Hosp, Milwaukee Cardiovasc Res, Milwaukee, WI USABlodgett Mem Med Ctr, Grand Rapids, MI USAClearwater Cardiovasc Consultants, Largo, FL USAN Cent Heart Fdn, Sioux Falls, SD USASentara Norfolk Gen Hosp, Norfolk, VA USALoma Linda VA Med Ctr, Loma Linda, CA USAMacNeal Ctr Clin Res, Berwyn, IL USATemple Univ Hosp, Philadelphia, PA 19140 USAHungarian Inst Cardiol, Budapest, HungaryBoston Univ, Boston, MA 02215 USABeth Israel Hosp, Boston, MA 02215 USAHosp Servidores Estado, Logoa, BrazilE Carolina Univ, Greenville, NC USAHartford Hosp, Hartford, CT 06115 USAGrad Hosp Philadelphia, Philadelphia, PA 19146 USASt Lukes Roosevelt Hosp, New York, NY 10025 USAAlton Ochsner Med Fdn & Ochsner Clin, New Orleans, LA 70121 USAEaston Hosp, Easton, PA USASt Johns Mercy Med Ctr, St Louis, MO 63141 USAMichigan Capital Med Ctr, Lansing, MI USAAlbany Med Coll, Albany, NY 12208 USAMontefiore Med Ctr, Bronx, NY 10467 USAUniv Kansas, Med Ctr, Kansas City, KS 66103 USAAndroscoggin Cardiol Associates, Auburn, ME USACleveland Clin Fdn, Dept Biostat & Epidemiol, Cleveland, OH 44195 USAEmory Univ, Sch Publ Hlth, Atlanta, GA USACleveland Clin Fdn, Dept Biostat, Cleveland, OH 44195 USACleveland Clin Fdn, Dept Vasc Med, Cleveland, OH 44195 USACleveland Clin Fdn, Dept Neurol, Cleveland, OH 44195 USAUniv Fed Sao Paulo, Sao Paulo, BrazilWeb of Scienc

Postoperative atrial fibrillation:mechanisms, manifestations and management

Postoperative atrial fibrillation (POAF) complicates 20-40% of cardiac surgical procedures and 10-20% of non-cardiac thoracic operations. Typical features include onset at 2-4 days postoperatively, episodes that are often fleeting and a self-limited time course. Associated adverse consequences of POAF include haemodynamic instability, increased risk of stroke, lengthened hospital and intensive care unit stays and greater costs. Underlying mechanisms are incompletely defined but include intraoperative and postoperative phenomena, such as inflammation, sympathetic activation and cardiac ischaemia, that combine to trigger atrial fibrillation, often in the presence of pre-existing factors, making the atria vulnerable to atrial fibrillation induction and maintenance. A better understanding of the underlying mechanisms might enable the identification of new therapeutic targets. POAF can be prevented by targeting autonomic alterations and inflammation. beta-Blocker prophylaxis is the best-established preventive therapy and should be started or continued before cardiac surgery, unless contraindicated. When POAF occurs, rate control usually suffices, and routine rhythm control is unnecessary; rhythm control should be reserved for patients who develop haemodynamic instability or show other indications that rate control alone will be insufficient. In this Review, we summarize the epidemiological and clinical features of POAF, the available pathophysiological evidence from clinical and experimental investigations, the results of prophylactic and therapeutic approaches and the consensus recommendations of various national and international societies