Different atrial regional patterns of activation during atrial fibrillation: is there any relationship with the anatomy?

Right atrial (RA) mapping has been recently more carefully examined in patients with idiopathic atrial fibrillation (AF) in order to improve radiofrequency (RF) catheter-mediated ablation lines to control recurrences. The aim of this study was to map right atrial activation during AF to analyze relationship between anatomy and atrial activation for specific sites. Twenty-four patients with recurrent, drug-refractory, paroxysmal AF underwent an extensive mapping of the RA before attempting RF linear lesion catheter ablation. A typical pattern of atrial activation was recorded in all patients which was consistent with a more regular activity on the trabeculated right atrium (type I AF) and a more fragmented and complex activation on the posterior and the anterior septum (type II and III AF). This paper helps to understand the influence of the anatomic barriers to atrial activation during atrial fibrillation.     

Childhood allergies in Reunion Island: is there any difference with metropolitan France?

BACKGROUND: The present study had three aims: to estimate for the first time with standardized methodology allowing international comparisons the prevalence and the severity of childhood allergies in Reunion Island, to determine their risk factors and to make a comparison with metropolitan France. METHODS: The same standardized protocol (ISAAC) was used in population-based samples of adolescents recruited in metropolitan France between 1993 and 1994 (n=18555) and in Reunion Island in 2000 (n=2 362). RESULTS: Compared to metropolitans, the adolescents living in Reunion Island suffered significantly more from asthma in the past Year and in life (22 vs 13% and 19 vs 13% respectively). The trend was less clear for allergic rhinitis and eczema since in the case of these manifestations the adolescents reported more symptoms (27 vs 16% et 14 vs 10%, respectively) whereas the metropolitans reported more lifetime diagnostic labels (14 vs 17% et 18 vs 23%, respectively). In Reunion Island, allergies were slightly more severe (1.1 vs 0.8% for severe asthma and 15 vs 2% for eczema). Furthermore, 68% of asthmatics who had severe asthma attacks in the past Year and more than a third of adolescents with severe asthma did not take any asthma medication, which is different from the metropolitan situation. Risk factors for allergies were the same in Reunion Island and in metropolitan France, except the ownership of a pet in the first Year of life, which was not protective against the development of allergies as recently shown in some western countries but was a risk factor. CONCLUSIONS: Asthma and allied diseases are less frequent in metropolitan France than in Reunion Island where management appears to be insufficient. Improvement in prevention and management plans are required in Reunion Island.     

Supplement use: is there any nutritional benefit?

OBJECTIVE: To examine the role of dietary supplements in improving total nutrient intakes in adults. DESIGN: Dietitian-administered 24-hour recalls (of intake including supplements) were conducted in 1997 and 1998. Supplement users were categorized into groups based on the types of supplements used and nutrient intake was examined. SUBJECTS: Using a multistage, stratified random sampling, 1,530 Canadian adults aged 19 to 65 years were surveyed. STATISTICAL ANALYSES PERFORMED: Intakes from diet, supplements, and diet plus supplements were examined by age/gender stratification. RESULTS: Supplement users had dietary intakes, from food alone, similar to nonusers with mean intakes in some age/sex groups below the Recommended Daily Allowance (RDA)/Adequate Intake (AI) for iron, calcium, and folate. Multivitamin users had mean intakes (from diet plus supplement) of folate above the RDA and iron intakes also increased to RDA levels among women aged 19 to 50 years. Calcium supplement users had lower calcium and vitamin D intakes than nonusers from diet alone in some age/sex groups. Calcium tablets increased mean calcium intakes to AI levels among all age/sex groups. Many supplement users exceeded the new Upper Limits of safe intake; 47% in the case of niacin. APPLICATIONS: Supplements are commonly used and can help some persons adhere to Dietary Reference Intake recommendations concerning intake of folate, calcium, vitamin D. and iron. We found multivitamin users to have higher total intakes of folic acid, iron, calcium, and vitamin D. Also, targeted use of calcium supplements effectively enhanced intakes. However, concurrent vitamin D supplementation is important and awareness of product composition with respect to Upper Limits is essential.     

Short-term recovery from alcohol abuse or dependence: any evidence of a relationship with treatment use in a general population sample?

AIMS: To test whether survey respondents who report alcohol misuse in the past year are more likely to be abstinent or binge-free in the past 30 days if they have used treatment, than if they have not. METHODS: Analysis of data from the 2002 US National Survey on Drug Use and Health was obtained. RESULTS: A total of 5730 respondents scored positive for alcohol abuse or dependence in the preceding year. Fewer than 10% had used any treatment for alcohol or drugs in this period, but this was associated with a 10% increase in the past-month abstinence and past-month binge-free drinking compared with respondents who did not access treatment. Such an apparent short-term recovery appeared greater in those whose treatment had been received in a formal treatment setting, a doctor's office, or in self-help groups than in the emergency room or in prison. CONCLUSIONS: Even if part of the association between treatment and recent abstinence and non-binge drinking was causal, indicating that treatment has some impact, it is a pathway chosen only by the minority.     

Is there any relationship between obesity and mental flexibility in children?

Cognitive profiles of 12 schoolboys with obesity were compared with their peers with normal weight. For the cognitive assessment five clinical tasks were selected: digit span memory, Raven's progressive matrices (intelligence), semantic verbal fluency, D2 attention endurance and Wisconsin card sorting test. We found no differences in memory, intelligence and verbal fluency between the two groups. Children with obesity performed worse on D2 and Wisconsin tests. Correlations confirmed relationships between body weight, body mass index, attention and Wisconsin measured perseveration in set-shifting. This suggests that childhood obesity involves cognitive deficits in shifting and attention abilities.     

Self-reflection and academic performance: is there a relationship?

The purposes of the present study were two-fold: first, to evaluate whether reflection journal writing was effective in promoting self-reflection and learning, and whether students become better at self-reflection if they engage continuously in reflection journal writing. To that end, the reflection journals of 690 first-year applied science students at a local polytechnic were studied by means of an automated coding procedures using software. Data was collected twice, once at the beginning and again towards the end of an academic year. Outcomes of the textual content analyses revealed that students reflected on both the process and contents of their learning: critical review of past learning experiences, learning strategies and summaries of what was learned. Correlational analyses showed weak to moderate inter-relationships between the textual categories and their classroom and knowledge acquisition test grades. Taken together, the findings suggest that self-reflection on both how and what students have learned does lead to improvements in academic performance, although to a limited extent.     

Bioactive lipids are altered in the kidney of chronic undernourished rats: is there any correlation with the progression of prevalent nephropathies?

Background

Undernutrition during childhood leads to chronic diseases in adult life including hypertension, diabetes and chronic kidney disease. Here we explore the hypothesis that physiological alterations in the bioactive lipids pattern within kidney tissue might be involved in the progression of chronic kidney disease.

Methods

Membrane fractions from kidney homogenates of undernourished rats (RBD) were submitted to lipid extraction and analysis by thin layer chromatography and cholesterol determination.

Results

Kidneys from RBD rats had 25% lower cholesterol content, which disturb membrane microdomains, affecting Ca²⁺ homeostasis and the enzymes responsible for important lipid mediators such as phosphatidylinositol-4 kinase, sphingosine kinase, diacylglicerol kinase and phospholipase A₂. We observed a decrease in phosphatidylinositol(4)-phosphate (8.8?±?0.9 vs. 3.6?±?0.7 pmol.mg^?1.mim^?1), and an increase in phosphatidic acid (2.2?±?0.8 vs. 3.8?±?1.3 pmol.mg^?1.mim^?1), being these lipid mediators involved in the regulation of key renal functions. Ceramide levels are augmented in kidney tissue from RBD rats (18.7?±?1.4 vs. 21.7?±?1.5 fmol.mg^?1.min^?1) indicating an ongoing renal lesion.

Conclusion

Results point to an imbalance in the bioactive lipid generation with further consequences to key events related to kidney function, thus contributing to the establishment of chronic kidney disease.

     

Diet and adolescent behavior: is there a relationship?

Behavioral problems such as hyperactivity, learning disabilities, mental illness, aggressive and antisocial behavior, and juvenile delinquency have been purportedly linked to the potential influence of foods or nutrients. This article examines the scientific evidence of the relationship between food and behavior in children and adolescents. It highlights the implications for practitioners important to consider in the assessment of the relationship between diet and behavior.     

Evaluation of interns by senior residents and faculty: is there any difference?

INTRODUCTION: Both senior residents and faculty members evaluate family practice interns (PGY-1) on the inpatient family medicine service at the University of Missouri-Columbia. The purpose of this study was to investigate the content and nature of narrative comments on a clinical evaluation sheet. METHODS: Objective 1. The authors placed the subjective comments made by faculty and senior residents in their evaluations of PGY-1 residents into 12 distinctive categories. Objective 2. Comments were coded with a positive or negative valence. Objective 3. The genders of the evaluator and learner were recorded. RESULTS: All evaluations made between 1996 and 1999 were analysed. A total of 1341 individual comments were reviewed. Objective 1. Categories used most often were generic comments (20.2%), personal attributes (18%), and clinical competence (14.1%). There was no difference in category use based on the experience level of the evaluator (P = 0.17). Objective 2. The majority of the comments (81.9%) were positive in nature. Senior faculty members were significantly less likely to make negative comments than were junior faculty members or senior residents (P = 0.004). Objective 3. There were no differences in category use based on the gender of the evaluator (P = 0.13). CONCLUSIONS: Objective 1. Narrative evaluation comments may be placed into 12 distinctive categories. Most comments are generic and do not help to inform learning. Objective 2. A total of 82% of comments were positive. Residents were more likely to make negative comments than senior faculty members. Objective 3. There was no demonstrable gender bias in writing negative comments.     

Dietary energy density and body weight: is there a relationship?

The energy density of foods and beverages is defined as the available energy per unit weight (kJ/g). Energy density of the diet is usually calculated excluding non-caloric beverages and drinking water. Because water contributes more to the weight of foods than any macronutrient, energy-dense foods are not necessarily those high in sugar or fat, but those that are dry. Evidence linking dietary energy density with body weight is critically evaluated in this review. Existing reports of a positive association between dietary energy density, higher energy intakes, and weight gain are based on laboratory and clinical studies. Although some cross-sectional epidemiological studies have linked dietary energy density with higher body mass index (BMI) values, the data are not consistent. At this time, there are no longitudinal cohort data linking dietary energy density with higher obesity risk.     

Treatment of hypertension in Germany: is there a social gradient?

Objectives  

Effective hypertension control remains low without much improvement since the 1990s. However, information is limited whether and how social status impacts on hypertension control.     

Sex differences in psychosocial impairment associated with eating-disordered behavior: What if there aren't any?

ObjectiveWe sought to test the hypothesis that eating-disordered behavior (EDB) is associated with comparable levels of impairment in psychosocial functioning in men and women.MethodPostal questionnaires that assessed EDB (binge eating, purging, extreme dietary restriction, excessive exercise and weight/shape overvaluation) and psychosocial impairment (general psychological distress, life satisfaction and social support) were completed by a general population sample of men (n = 957) and women (n = 1899).ResultsBinge eating, purging and overvaluation were associated with comparable levels of psychosocial impairment for both men and women and this was the case for each of the three measures of psychosocial functioning employed. Extreme dietary restriction was associated with greater psychosocial impairment in women than in men, whereas excessive exercise was not associated with psychosocial impairment in either women or men.ConclusionsThere appear to be few differences between men and women in terms of psychosocial impairment associated with EDB. It may no longer be appropriate to base the development of eating disorder prevention programs on the premise that EDB is primarily a problem of women. Health professionals may be more likely to see more men with EDB in their practices in the future.     

Seatbelt usage: is there an association with obesity?

Wearing a seatbelt can prevent motor vehicle crash deaths. While primary seatbelt laws are designed to encourage vehicle passengers to wear seatbelts by allowing law enforcement officers to issue tickets when passengers do not wear seatbelts, discomfort may discourage obese individuals from wearing a seatbelt. The objective of this study is to assess the association between state-level obesity and seatbelt usage rates in the US, and to examine the possible role played by seatbelt laws in these associations. The strength of the association between obesity rates, seatbelt usage, and primary seatbelt laws at the state level is investigated using data from 2006 to 2011. Linear regression analysis is employed. This model estimates that increasing the obesity rate by 1% in a state where a primary seatbelt law (by which law enforcement officers can issue a ticket when seatbelts are not worn) is in effect is associated with a 0.06% decrease in seatbelt usage. However the same percentage of increase in the obesity rate in a state where no primary seatbelt law is in effect is associated with a 0.55% decrease in seatbelt usage. The magnitude of the statistical association between state obesity rates and state-level seatbelt usage is related to the existence of a primary seatbelt law, such that obesity has less impact on seatbelt usage in states where primary seatbelt laws are in effect.     

HDL cholesterol and bone mineral density in normal-weight postmenopausal women: is there any possible association?

AIM: Epidemiological investigation of the association between lipid profile, atherosclerosis and bone mass has produced conflicting RESULTS: The present paper reports the assessment of the lipid profile, bone mineral density (BMD) and turnover in a cohort of Italian women. METHODS: In this cross sectional study we enrolled 173 women in menopause (101 osteoporotic and 72 normal). In each subject the authors evaluated BMD, bone turnover, lipid profile (total cholesterol, high density lipoprotein [HDL], low density lipoprotein [LDL] and triglycerides), and risk factors for osteoporosis, cardiovascular diseases and eating habits using a questionnaire. RESULTS: HDL was significantly higher in osteoporotic patients than in controls and the risk of osteoporosis was significantly higher in women with higher level of HDL. The authors suggest that the level of HDL could be used as screening for postmenopausal osteoporosis: the cut-off points recommended are HDL >61 mg/dL to detect women with a high risk (sensitivity 74%) and <45 mg/dL to detect those with a low risk (specificity 83%). CONCLUSION: This study provides evidences of the relation between HDL, but not total cholesterol or LDL levels with BMD in a cohort of normal-weight women and equally distributed cardiovascular risks. It also suggests that a proatherogenic lipid profile is associated with higher bone mineral density, and that HDL can be used in deciding whether a patient's BMD should be measured.