Antiarrhythmic potential of aldosterone antagonists in atrial fibrillation

Upstream therapy is the promising issue in the treatment of atrial fibrillation (AF) especially in patients with arterial hypertension and heart failure. The possible beneficial effects of renin– –angiotensin–aldosterone system blockade with ACE-inhibitors and angiotensin receptor antagonists in AF prevention have been demonstrated in experimental and clinical studies. There is growing mass of evidence, from both theoretical and experimental research studies, to suggest that upstream therapy using spironolactone or eplerenone may reduce the deleterious effect of excess aldosterone secretion and further modify the environment of AF including inhibition of atrial muscle fibrosis. It refers to patients with different forms of AF, including chronic AF. Aldosterone antagonists treatment may be a simple and valuable additional option in low-risk, hypertensive and heart failure patients in primary and secondary prevention of refractory paroxysmal and persistent AF

The right ventricle in patients with chronic heart failure and atrial fibrillation

Under normal conditions function of the right ventricle (RV) is determined by the heart rhythm, RV filling time, RV systolic synchrony and interdependence between both ventricles. Failure ofthe left ventricle (LV) can lead to RV failure. Impaired function of the RV significantly worsensthe prognosis in patients after myocardial infarction and with LV failure. Permanent atrialfibrillation (AF) is one of the most common arrhythmia in patients with depressed RV function. Frequent coexistence of chronic heart failure (CHF) and AF causes overlapping of the arrhythmiaand RV dysfunction in the setting of CHF. They may lead to hemodynamic compromiseand worsen prognosis in patients with chronic RV failure of various etiologies. RV structureand function can be assessed in 2D, 3D echocardiography, cardiac magnetic resonance imagingand computed tomography

Using plant spectral response curves in detecting plant stress

Understanding the way in which electromagnetic radiation interacts with vegetation is extremely important when studying the possibility of using new remote sensing technologies for monitoring forests and crops. Remote sensing methods enable an early detection of changes occurring within plants, simplifying the locating of affected areas and determining the severity of the changes. The optical properties of leaves (reflection and absorption coefficients) in selected segments of leaves in different ranges of the electromagnetic spectrum may be useful in detecting any deficiencies or surplus of selected substances which are essential for plant growth and development. Changes in the spectral response curves of damaged leaves can be cause both by changes in the leaf structure (Chandrasekharan 2005; Jacquemoud & Ustin 2008) and biochemical changes within the plant (Chandrasekharan 2005). A series of experiments was conducted at the Military University of Technology in Warsaw using a terrestrial hyperspectral system. Spectral reflection coefficients acquired from imagery in the 420–1100 nm range have enabled the establishing of how various growing conditions affect vegetation and their spectral response curves

Cardioversion of Atrial Fibrillation (RHYTHM-AF) International Registry in Poland

Background: A key procedure of the rhythm control strategy in atrial fibrillation (AF) is cardioversion to normal sinus rhythm. The aim of the present study was to provide a review of treatment patterns for the cardioversion of patients with AF in a hospital setting in Poland and document the success rate of various cardioversion procedures.Methods: We herein present the results from Poland of a prospective observational study to characterize patients with recent onset episodes of AF for whom cardioversion is one of the planned therapeutic options — the RHYTHM-AF registry. Consecutive patients in the hospital setting, age > 18 years, with documented AF at the time of enrollment, excluding those with atrial flutter and those treated with vernakalant, were recruited. No treatment was recommended nor discouraged.Results: Five hundred and one patients were recruited (mean age 64.2 ± 12.1), with 294 (58.7%) patients finally undergoing cardioversion. Primary electrical cardioversion (ECV) was successful in 131 (88.5%) patients. Primary pharmacological cardioversion (PCV) was successful in 110 (75.3%) patients. Amiodarone and propafenone were most commonly used (52.1% and 24.7%, respectively). Fourteen complications and adverse events were recorded (no stroke was observed).Conclusions: Conversion to sinus rhythm was attempted in < 60% of the patients with AF admitted to the hospital with an intention to terminate arrhythmia. ECV was successful in ~90% of the patients, while PCV in ~75% of the patients (amiodarone and propafenone were most commonly used). The rate of complications was low (2.8%).

How does early decompressive craniectomy influence the intracranial volume relationship in traumatic brain injury (TBI) patients?

Background. Decompressive craniectomy (DC) is a common neurosurgical procedure involving the removal of part of the skull vault combined with subsequent duroplasty. The goal of DC is to produce extra space for the swollen brain and/or to reduce intracranial pressure. In the present study, DC was performed in order to create space for the swollen brain. Aim of the study: to compare the volume alteration of selected intracranial fluid spaces before and after DC, to evaluate the volume of post-decompressive brain displacement (PDBD) and the largest dimension of oval craniectomy (LDOC), and to assess the early clinical effects of DC. Material and methods. The study group consisted of 45 patients with traumatic brain injury (four females and 41 males, mean age 54.5 years) who underwent DC (not later than five hours after admission to hospital) due to subdural haematomas and/or haemorrhagic brain contusions localised supratentorially and diagnosed by computed tomography (CT). The mortality rate in the study group was 40%. Study calculations were performed using Praezis Plus software by Med Tatra, Zeppelin and Pax Station by Compart Medical Systems. For statistical analysis, IBM SPSS Statistics software was used. Results. The DC-related additional space was responsible for a statistically significant increase in the volume of preoperatively compressed intracranial fluid spaces. The mean volume of extra space filled by the swollen brain was 42.2 ml ± 40.7. The best early treatment results were achieved in patients under the age of 55. Conclusions. DC has limited effectiveness in patients aged over 70 years. In every patient with clamped basal cisterns, a skin incision enabling appropriate LDOC should be planned before surgery. DC should be as large as possible, and the limits of its dimensions should be the limits of anatomical safety

ACE inhibitor therapy: Possible effective prevention of new-onset atrial fibrillation following cardiac surgery

Background: Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG). The aims of the study were to assess possible predictors and identify modes of prevention of new-onset AF following coronary surgery. Methods: Retrospective clinical and statistical analysis was made of the medical records of 217 patients who had undergone coronary surgery. Results: AF occurred in 28% (61/217) of the patients. In univariate analysis the age of the patients with AF was higher (p = 0.0033), they had a longer history of coronary disease (p = 0.0417) and more had > 3 grafts (p < 0.05). Low ejection fraction (< 40%) was also a risk factor of arrhythmia (p < 0.0001). In multivariate regression analysis two independent predictors of AF were identified: no ACE inhibitor treatment before surgery (p = 0.0005) and age > 60 years (p < 0.01). Patients with AF had a higher mean heart rate after the procedure: 115 &#177; 34 vs. 78 &#177; 21/min (p < 0.0005). Patients treated with ACE inhibitors before and after surgery had a lower incidence of AF than non-treated patients: 8% vs. 48% (p < 0.0001) and 4% vs. 61%, p < 0.0001) respectively. Beta-blocker treatment before and after surgery resulted in a lower incidence of AF: at 23% vs. 75% (p < 0.001) and 19% vs. 96% (p < 0.0001), respectively. Conclusions: No ACE inhibitor therapy before surgery, advanced age, low ejection fraction, high post-procedure heart rate, duration of coronary disease and the number of grafts (corresponding to the length of the procedure) were found to be strong probable predictors of AF following cardiac surgery. ACE inhibitor therapy may be effective in the prevention of newonset AF. Treatment based on individual variables is crucial for proper treatment and to diminish the risk of arrhythmia. (Cardiol J 2007; 14: 274-280

Utilization of microfluidics as a models for studying co 2 injection into deep saline aquifers

The article discusses the problems of utilization of microfluidics as a models for studying CO 2 injection into deep saline aquifers. long term effects of capture and storage (CCS) technology are considered. CO 2 capture and storage will be essential for Europe to become climate neutral, but so far has been economically unprofitable. The justification for CO 2 capture and storage (CCS) is stronger than ever, because CO2 removal is now acceptable as an unavoidable component of climate action if the countries wants to meet the Paris Agreement goals