Could successful cryoballoon ablation of paroxysmal atrial fibrillation prevent progressive left atrial remodeling?

<p>Abstract</p> <p>Background</p> <p>Radiofrequency catheter ablation of atrial fibrillation (AF) has been proved to be effective and to prevent progressive left atrial (LA) remodeling. Cryoballoon catheter ablation (CCA), using a different energy source, was developed to simplify the ablation procedure. Our hypothesis was that successful CCA can also prevent progressive LA remodeling.</p> <p>Methods</p> <p>36 patients selected for their first CCA because of nonvalvular paroxysmal AF had echocardiography before and 3, 6 and 12 months after CCA. LA diameters, volumes (LAV) and LA volume index (LAVI) were evaluated. LA function was assessed by: early diastolic velocities of the mitral annulus (Aa_sept, Aa_lat), LA filling fraction (LAFF), LA emptying fraction (LAEF) and the systolic fraction of pulmonary venous flow (PVSF). Detailed left ventricular diastolic function assessment was also performed.</p> <p>Results</p> <p>Excluding recurrences in the first 3-month blanking period, the clinical success rate was 64%. During one-year of follow-up, recurrent atrial arrhythmia was found in 21 patients (58%). In the recurrent group at 12 months after ablation, minimal LAV (38 ± 19 to 44 ± 20 ml; <it>p </it>< 0.05), maximal LAV (73 ± 23 to 81 ± 24 ml; <it>p </it>< 0.05), LAVI (35 ± 10 to 39 ± 11 ml/m²; <it>p </it>= 0.01) and the maximal LA longitudinal diameter (55 ± 5 to 59 ± 6 mm; <it>p </it>< 0.01) had all increased. PVSF (58 ± 9 to 50 ± 10%; <it>p </it>= 0.01) and LAFF (36 ± 7 to 33 ± 8%; <it>p </it>= 0.03) had decreased. In contrast, after successful cryoballoon ablation LA size had not increased and LA function had not declined. In the recurrent group LAEF was significantly lower at baseline and at follow-up visits.</p> <p>Conclusions</p> <p>In patients whose paroxysmal atrial fibrillation recurred within one year after cryoballoon catheter ablation left atrial size had increased and left atrial function had declined. In contrast, successful cryoballoon catheter ablation prevented progressive left atrial remodeling.</p

Hedera crebrescens (Araliaceae) a newly identified diploid taxon and triploid ivies from Hungary

Hedera crebrescens, a newly identified species in Hungary is described here. This diploid ivy is not identical with the diploid H. helix. It grows vigorously, is invasive, and has spread into most parts of the country and adjacent regions. We also present two triploid species of hybrid origin, which were known formerly as selected varieties of H. helix. Triploids differ from the presumed diploid and tetraploid parents based on their reproductive morphological traits and also based on their ecological demands

Erdőtársulások és fafajaik átrendeződési lehetőségei a változó klímában

Kutatásunk sokrétű megközelítést tükröz. Honos fafajaink becsült reakciói alapján elemeztük őshonos fafajú erdőtársulásaink várható átrendeződését. Az elméleti becsléseket összedolgoztuk az újulatra és mortalitásra vonatkozó terepi vizsgálatok eredményeivel. Potenciális, invázióbiológiai szempontból alacsony kockázatú cserefafajokat kerestünk a várhatóan visszaszoruló fafajaink esetleges helyettesítésére. A honos és inváziós fafafajok esetében országos adatokon nyugvó, cserefafajok esetében európai léptékű modellezéssel is becsültük a fajok potenciális és prognosztikus elterjedését. Potenciális természetes erdőtársulás (PTE) adatbázist építettünk fel az ország erdőterületeire az Országos Erdőállomány Adattár alapján, a jelenre és jövőre vonatkozóan egyaránt. Eredményeink alapján az erdő- és erdőssztyep-társulások esetében egyaránt a magas összetételi (elegyesség) és szerkezeti diverzitás (gyepekkel, cserjésekkel mozaikoló állományok) jelenthet nagyobb alkalmazkodóképességet. A kiválasztott tájidegen fafajok alkalmazására csak az új körülmények között is vitális, őshonos taxonok és az általuk alkotott (akár újszerű) társulások által nyújtott lehetőségek kimerülését követően kerülhet sor

Weed species composition of small-scale farmlands bears a strong crop-related and environmental signature

Weed species loss due to intensive agricultural land use has raised the need to understand how traditional cropland management has sustained a diverse weed flora. We evaluated to what extent cultivation practices and environmental conditions affect the weed species composition of a small-scale farmland mosaic in Central Transylvania (Romania). We recorded the abundance of weed species and 28 environmental, management and site context variables in 299 fields of maize, cereal and stubble. Using redundancy analysis, we revealed 22 variables with significant net effects, which explained 19.2% of the total variation in species composition. Cropland type had the most pronounced effect on weed composition with a clear distinction between cereal crops, cereal stubble and maize crops. Beyond these differences, the environmental context of croplands was a major driver of weed composition, with significant effects of geographic position, altitude, soil parameters (soil pH, texture, salt and humus content, CaCO3, P2O5, K2O, Na and Mg), as well as plot location (edge vs. core position) and surrounding habitat types (arable field, road margin, meadow, fallow, ditch). Performing a variation partitioning for the cropland types one by one, the environmental variables explained most of the variance compared with crop management. In contrast, when all sites were combined across different cropland types, the crop-specific factors were more important in explaining variance in weed community composition

Veseérintettség májátültetés során

Introduction: In liver cirrhosis renal function decreases as well. Hepatorenal syndrome is the most frequent cause of the decrease, but primary kidney failure, diabetes mellitus and some diseases underlying endstage liver failure (such as hepatitis C virus infection) can also play an important role. In liver transplantation several further factors (total cross-clamping of vena cava inferior, polytransfusion, immunosuppression) impair the renal function, too. Aim: The aim of this study was to analyse the changes in kidney function during the first postoperative year after liver transplantation. Method: Retrospective data analysis was performed after primary liver transplantations (n = 319). Results: impaired preoperative renal function increased the devepolment of postoperative complications and the first year cumulative patient survival was significantly worse (91,7% vs 69,9%; p<0,001) in this group. If renal function of the patients increased above 60 ml/min/1,73 m2 after the first year, patient survival was better. Independently of the preoperative kidney function, 76% of the patients had impaired kidney function at the first postoperative year. In this group, de novo diabetes mellitus was more frequently diagnosed (22,5% vs 9,5%; p = 0,023). Conclusions: Selection of personalized immunosuppressive medication has a positive effect on renal function. Orv. Hetil., 2013, 154, 1018-1025

Egészséges fiatalok augmentációs indexének napszaki változása

L