Cardioplegia and ventricular late potentials in cardiac surgical patients

Background and objective: Ventricular late potentials (LP) recording with signal-averaged electrocar- diogram allow identifying patients at risk of sudden death and ventricular tachycardia. Cardiac surgery with cardiopulmonary bypass (CPB) could predispose to the development of myocardial ischemia related to imperfect cardioplegia. To the best of our knowledge, no study investigated the protection of cardioplegia and CPB regarding the occurrence of LP in patients without previous myocardial infarction and undergoing cardiac surgery. Methods: In 61 elective patients scheduled for cardiac surgery involving CPB, signal-averaged electrocar- diogram was performed the day before and 24-48h after the surgery. The electrodes were positioned according to Frank's orthogonal derivations. Twenty five patients were excluded because of poor quality signals, leaving 36 patients (age, 64 ± 14) available for the analyses. An abnormal signal-averaged electrocardiogram was considered when ≥2 of the recorded indexes were present. McNemar's tests were performed on the dichotomized values to investigate differences in pre-post scores. Results: The mean CPB duration was of 110 ± 57min. Patients scheduled for cardiac surgery do not exhibited LP after CPB (no significant difference in pre-post CPB scores, P=NS). The probability of a patient with a negative score transitioning to a positive score was 0.23 (P=NS). Conclusions: The present study in cardiac surgical patients suggests that cardioplegia associated to CPB has no significant impact on the occurrence of LP, irrespective of surgery performe

Habitat selection in a changing environment: the relationship between habitat alteration and Scops Owl (Aves: Strigidae) territory occupancy

Abstract The Scops Owl Otus scops (L., 1758) is a species of European concern, which suffered a noticeable decrease in distribution in the last decades, and changes in agricultural practices have been proposed as a major threat for this owl. We studied the habitat preference of the Scops Owl by assessing the habitat occupancy of 401 territories distributed in a large area in northwest Italy, with a special focus on 98 territories located in a high-density area (Monferrato). Habitat characteristics were analyzed with maximum entropy (MAXENT) models that included both vegetational (16 land use categories) and physical features estimated from a Digital Terrain Model (DTM) (altitude, slope, hillshade). In the Monferrato area, a comparison of 2009 landcover was also made with year 1954/55 characteristics obtained from aerial photographs. In the full northwest Italy area, the Scops Owl preferred areas located at middle altitude with intermediate slope. The preferred habitats included riparian areas and pasture-grassland, while woodlands and zones with Robinia pseudoacacia shrublands were avoided. In the Monferrato area, Scops Owl occupancy occurred in sites where the landuse (croplands/vineyard mosaic) had changed little since the mid-1950s. Our study suggests that conservation activity should focus on interventions halting riparian zone transformation and subsidies promoting agricultural practices favouring pastures and grassland

Secondary infarction in single or in multiple vascular territories: two different entities following subarachnoid hemorrhage?

The pathogenesis of secondary infarctions (SI) after aneurysmal subarachnoid hemorrhage (SAH) is poorly understood. To assess whether SI in single (SSI) or multiple (MSI) vascular territories represent different disease entities, we compared clinical profiles of patients with these patterns of SI. CT/MRI-examinations of 448 patients were reviewed for new infarctions within 28 days after SAH, and categorized into SSI or MSI. Only patients with adequate follow-up imaging excluding any new infarctions were included for analysis (269 patients). Procedure-related infarctions were excluded. Odds ratios (ORs) with corresponding 95% confidence intervals (CI) were calculated for patients with SSI or MSI versus patients without SI to analyze differences in demographic characteristics, vascular risk factors, disease-related characteristics and treatment modalities. Thirty-six patients had SSI, 53 MSI and 180 no SI. ORs in MSI-patients were >1.5 times higher compared with ORs in SSI-patients for multiple vascular risk factors [MSI:5.4 (2.3–13) versus SSI:1.2 (0.5–2.8)], poor clinical condition on admission [MSI:4.6 (2.4–8.9) versus SSI:2.4 (1.1–5.2)], initial loss of consciousness [MSI:2.6 (1.3–5.3) versus SSI:1.1 (0.5–2.3)] and large amounts of intraventricular blood [MSI:2.9 (1.4–5.8) versus SSI:1.5 (0.7–3.2)]. In multivariate analysis ORs remained higher in MSI for presence of multiple vascular risk factors [MSI:1.9 (1.2–2.9) versus SSI:1.1 (0.8–1.7)] and initial loss of consciousness [MSI:3.0 (1.0–8.9) versus SSI:1.6 (0.6–4.0)]. Our findings suggest that SSI and MSI after SAH are not distinct disease entities. MSI was related to the same characteristics as SSI but to a larger extent, specifically to the presence of multiple vascular risk factors, initial loss of consciousness, larger amounts of intraventricular blood, and poor clinical status on admission

Early anti-pseudomonal acquisition in young patients with cystic fibrosis: Rationale and design of the EPIC clinical trial and observational study,

The primary cause of morbidity and mortality in patients with cystic fibrosis (CF) is progressive obstructive pulmonary disease due to chronic endobronchial infection, particularly with Pseudomonas aeruginosa (Pa). Risk factors for and clinical impact of early Pa infection in young CF patients are less well understood