Left atrial size after cardioversion for atrial fibrillation: effect of external DC shock

OBJECTIVE: The aim of this study was to evaluate the effect of external direct current (DC) shock on left atrial (LA) dimension and volumes after cardioversion for atrial fibrillation, and the relation between LA size and atrial function. METHODS: We evaluated 180 patients who were randomly cardioverted with DC shock (90 patients) or drugs (90 patients). Echocardiographic evaluations included LA size and volumes. LA passive and active emptying volumes were calculated, and LA function was measured as atrial ejection force. Changes in LA diameters and volumes were correlate with atrial systolic function. RESULTS: The LA was dilated in all patients during arrhythmia and decreased after the restoration of sinus rhythm. The entity of reduction was different in the 2 groups of patients. LA maximal and minimal volumes were increased after DC shock as compared with patients treated with drugs (LA maximal volume 34 +/- 4 vs 31 +/- 5; P <.01; LA minimal volume 18 +/- 2.6 vs 15 +/- 3.6; P <.01). The atrial function was also depressed after DC shock and the delay in the recovery of atrial contractility was related to LA dilation. Patients treated with drugs had a higher atrial ejection force that was associated with a more marked reduction in LA maximal volume after the restoration of in sinus rhythm. A relationship between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanic function (r = -0.78; P <.001). The active emptying fraction was lower, although not significantly, in this group, whereas the conduit volume was increased. CONCLUSION: External DC shock induced a depressed atrial mechanic function in many patients and this was associated with a persistence of LA dilation

Nutrition and prevention of venous thromboembolism

Prophylaxis of venous thromboembolism is a major health problem in everyday clinical practice. The therapeutic anticoagulants available to clinicians for prophylaxis of VTE is mainly composed by parenteral anticoagulants and oral vitamin K antagonists, warfarin. Oral vitamin K antagonists have several limitations, including a narrow therapeutic window and a metabolism that is affected by multiple drug and herbal interactions, vitamin K intake and genetic polymorphisms. The present review explore causes of poor prevention of thromboembolism and evaluated some new anticoagulants. The main target of new anticoagulants is to replace oral vitamin K antagonists for long-term anticoagulation. Moreover the role of genetics and the novel concept of cell therapy is evaluated. The hypothesis is that the patho-physiology of thrombosis may involve a "physiologic" cell that provides the same repair molecules that are used for treatment of thrombotic disorders

Left atrial size and function after spontaneous cardioversion of atrial fibrillation and their relation to N-terminal atrial natriuretic peptide

In conclusion, higher levels of N-ANP during AF were independently associated with spontaneous conversion, as well as with smaller LA volume.An inverse correlation existed between LA volume and N-AN

Prognostic value of Iron, Nutritional Status Indexes and Acute Phase Protein in Acute Coronary Syndrome.

Background. The relation between the inflammatory status during unstable angina and nutritional parameters has not been well described. We sought to investigate the relation between the acute inflammatory status, as evaluated on the basis of high C-reactive protein (CRP) and serum amyloid A levels and laboratory indexes of iron and nutritional status in patients with unstable angina, and whether the variations in iron levels have a prognostic significance.Methods. The study population consisted of 98 patients admitted to our facility with unstable (group 1: 64 consecutive patients, 52 males, 12 females, mean age 66 \ub1 10 years) or stable angina(group 2: 34 patients, 30 males, 4 females, mean age 65 \ub1 9 years). The hemoglobin levels, the erythrocyte mean cell volume, serum iron levels, the increase in transferrin levels, the decrease in the percent transferrin saturation, ferritin levels, the nutritional status, and the CRP and serum amyloid A levels were measured.Results. On the basis of a CRP value > 1 mg/dl, 47 patients with unstable angina and 4 patients with stable angina were identified as having active inflammatory disease. The presence of inflammation was associated with significantly lower mean values of hemoglobin, erythrocyte mean cell volume, serum iron and transferrin levels, and percent transferrin saturation in comparison with patients without inflammation. A significant inverse correlation coefficient between a CRP level > 1 mg/dl and hemoglobin, transferrin levels and percent transferrin saturation was observed: the strongest correlation was with serum iron levels. The relative risk of total cardiac events was significantlygreater in patients with low serum iron levels than in those with high serum iron levels.Conclusions. Patients with acute inflammation present altered iron status indexes. Increased CRP levels and reduced serum iron levels are associated with a worse outcome in patients with unstable angina

Physics and application of photon number resolving detectors based on superconducting parallel nanowires

The Parallel Nanowire Detector (PND) is a photon number resolving (PNR) detector which uses spatial multiplexing on a subwavelength scale to provide a single electrical output proportional to the photon number. The basic structure of the PND is the parallel connection of several NbN superconducting nanowires (100 nm-wide, few nm-thick), folded in a meander pattern. PNDs were fabricated on 3-4 nm thick NbN films grown on MgO (TS=400C) substrates by reactive magnetron sputtering in an Ar/N2 gas mixture. The device performance was characterized in terms of speed and sensitivity. PNDs showed a counting rate of 80 MHz and a pulse duration as low as 660ps full width at half maximum (FWHM). Building the histograms of the photoresponse peak, no multiplication noise buildup is observable. Electrical and optical equivalent models of the device were developed in order to study its working principle, define design guidelines, and develop an algorithm to estimate the photon number statistics of an unknown light. In particular, the modeling provides novel insight of the physical limit to the detection efficiency and to the reset time of these detectors. The PND significantly outperforms existing PNR detectors in terms of simplicity, sensitivity, speed, and multiplication noise

Comment on ‘The latency period of mesothelioma among a cohort of British asbestos workers (1978–2005)': the effect of left censoring

none4noWe read with extreme interest the article by Frost on mesothelioma latency period among asbestos workers (Frost, 2013). Despite the main aim of the study being to investigate ‘the determinants of mesothelioma latency among a cohort of asbestos workers, paying particular attention to indicators of intensity of asbestos exposure’ (Frost, 2013), the reported lack of evidence of an association between duration of exposure and latency attracted some attention. Commenters argued that right censoring occurring in the underlying cohort could have biased an analysis restricted to cases (Consonni et al, 2014; Mirabelli and Zugna, 2014).openFarioli, A; Mattioli, S; Curti, S; Violante, F SFarioli, A; Mattioli, S; Curti, S; Violante, F

Calcareous nannofossil assemblages across the Pliensbachian/Toarcian boundary at the Peniche section (Ponta do Trovão, Lusitanian Basin)

The Peniche section has revealed moderately-to-well preserved calcareous nannofossil assemblages across the Pliensbachian/Toarcian boundary. This good record has allowed the proposition of a refined biostratigraphic scheme. The stage boundary, as defined by ammonites, is comprised within the NJ5b C. impontus (NW Europe; BOWN & COOPER, 1998) or the NJT5b L. sigillatus (Mediterranean Tethys; MATTIOLI & ERBA, 1999) nannofossil subzones. Since in the Lusitanian Basin a mixing of N- and S-Tethyan taxa is observed, both biozonation schemes can be applied. Some nannofossil events (mainly first occurrences) are observed earlier in Portugal than in other Tethyan settings. It is still unclear if these events are real first occurrences. A diversification phase occurred across the Pliensbachian/Toarcian boundary. This phase is well recorded at Peniche, where a change is observed passing from the Pliensbachian, when assemblages are dominated by muroliths, to the Toarcian showing assemblages where placoliths are abundant. A quantification of nannofossils per gram of rock shows that absolute abundances are the highest across the Pliensbachian/Toarcian boundary. Indeed, Peniche exhibits nannofossil abundances very high with respect to correlative levels in other Tethyan settings. The pelagic carbonate fraction (produced by nannofossils) is important in the marly hemi-couplets of Peniche. In some levels, nannofossils account for more than 50% of the total carbonate fraction

Perfectionism or Perfectionisms in Orthorexia Nervosa

Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa