Pharmacological Therapy of Atrial Fibrillation

Fibrilacija atrija (FA) najčešća je aritmija u kliničkoj praksi. Prevalencija i incidencija značajno se povećavaju s dobi. Strategija liječenja ovisi o brojnim kliničkim parametrima koji određuju vrstu FA (paroksizmalna, perzistentna, permanentna). Ključna odluka odnosi se na kontrolu ritma ili frekvencije, što definira terapijsku strategiju. Bez obzira na odabrani pristup, nužno je odabrati optimalan način prevencije tromboembolijskih komplikacija, tj. antitrombotsku terapiju. Iako postoje brojne i dijelom vrlo učinkovite nefarmakološke metode za odabrane bolesnike s FA, lijekovi su još uvijek dominantan način liječenja i glavna su tema ovog pregleda s najnovijim podacima i terapijskim preporukama.Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. Prevalence and incidence increase significantly with age. Treatment strategy depends on numerous clinical parameters which also determine the type of AF (paroxysmal, persistent, permanent). The most important decision involves rhythm or rate control and defines the therapeutic strategy. Regardless of the preferred approach, it is necessary to select the appropriate means for the prevention of thromboembolic complications, i.e. antithrombotic therapy. Although there are several and largely very efficient nonpharmacological interventions for selected patients with AF, drug therapy is still the mainstay of treatment and the main topic of this review, including most recent data and therapeutic recommendations

La cova Negra

[cat] Presentam la descripció i topografia d'una important cavitat submarina situada al cap de Catalunya (península de Formentor, Pollença). Es tracta d'una cova d'abrasió marina de 200 m de longitud i 24 m de fondària màxima, que conté al seu interior dunes fòssils que conformen bona part de les parets i sòtil de la gruta. Les eolianites devien de reblir quasi per complet la cova al llarg d'un cicle climàtic fred, en el qual la mar havia sofert un procés de regressió i les platges acumulaven importants dipòsits que s'adossaven als penya-segats. Una posterior transgressió marina erosionaria bona part dels dipòsits eòlico-marins.[eng] We present the description and survey of an important submarine cave located at the Cap de Catalunya (Península de Formentor, Pollença). It is a marine abrasion cave, 200 m in length and with 24 m maximum depth, which has in its interior fossil dunes which make up the larger part of its walls and roof. The eolianites almost completely filled the cave during a cold climatic cycle, when the sea-level must have suffered a regression and the beaches accumulated important deposits of sand which banked up against the cliffs. A posterior marine transgression eroded a good part of these eolian-marine deposits

Long-Term Results and Learning Curve for Radio Frequency Ablation of Accessory Pathways

Radio frequency (RF) catheter ablation of accessory pathways represents an interventional method in modern cardiology that has become the first-line treatment for patients with symptomatic WPW-syndrome. The aim of this study was to analyze: (1) the learning curve for the ablation procedure; (2) procedural parameters and success; and (3) personal assessment of the treatment by the patients. Learning curve analysis included 195 consecutive patients, who underwent ablation between 1991 and 1996. The follow-up survey included 65 consecutive patients. The analysis of the procedural parameters showed significant improvement after 100 cases, implying a completion of the learning curve at this point. Long-term follow-up showed a high success rate for all pathways (95.4%). All procedure parameters indicated significantly higher degree of difficulty for right free-wall and septal pathways, with lowest long-term success rate for right-sided pathways (78.6%). Personal assessment survey showed high acceptance of the treatment; the procedure was described as a significant improvement of overall quality- of-life by 92.3% of patients. The results of this study confirm the catheter ablation of accessory pathways – in particular after completion of the learning curve – as a low-risk and highly efficient treatment for symptomatic WPW-syndrome, with a high degree of patient-related acceptance

Evidències geomorfològiques dels canvis del nivell marí

Els canvis climàtics succeïts al llarg del Quaternari han ocasionat variacions del nivell de la mar, amb la conseqüent modificació de la linia de costa. La configuració i extensió de les terres emergides estan en funció d'aquestes oscil·lacions glacioeustàtiques que repercuteixen tambe en la dinàmica dels ecosistemes insulars. Diverses evidències geomorfològiques d'aquests episodis transgressius i regressius han quedat enregistrades al litoral, tant per damunt com per davall de l'actual nivell marí. En aquest treball es passa revista a moltes d'aquestes proves dels canvis climàtics, que en si mateixes formen part del nostre paisatge litoral, tant del que es visible a l'exterior, com del que roman amagat sota les aigües de la mar o a l'interior d'espectaculars cavitats càrstiques.Climatic changes during the Quaternary have led to sea-level changes and consequently to changes in the coast line. The shape and size of emerged lands are directly related to glacio-eustatic oscillations which also effect the dynamics of insular ecosystems. Diverse geomorphological evidence of these transgressive and regressive episodes have been recorded along the coast, both above and below the current sea-level. In this paper, many of the proves for these climatic changes, which in themselves form part of the island's seascape, are looked at. These proves can be seen on the surface, under the sea, and inside spectacular karstic cave