Radiofrequency ablation of sustained ventricular tachycardia related to the mitral isthmus in Chagas' disease

This case report describes the electrophysiological findings of a 62-year-old patient with chronic Chagas' disease and two distinct morphologies of sustained ventricular tachycardia that involved a mitral isthmus. Multiple RF applications were necessary to obtain a bidirectional conduction block in the mitral isthmus that was related to the interruption of both tachycardias. After the procedure, the patient presented massive cerebral infarction that progressed to coma and death. Autopsy showed acute and old lesions at the mitral isthmus and recent mitral annulus thrombosis.     

NAT positivity in seronegative voluntary blood donors from western India

Background and objectives

Prevalence and composition of Hepatitis B, Hepatitis C and HIV-1, NAT positive but seronegative voluntary blood donors from western part of India is yet to be documented.

Understanding disparities in donor behavior: race and gender differences in willingness to donate blood and cadaveric organs.

BACKGROUND: Recent efforts to recruit blood and organ donors have only marginally improved demographic disparities in willingness to donate. Few studies have examined which factors are most important in explaining race and gender disparities in willingness to donate. OBJECTIVES: To assess race and gender differences in willingness to donate blood and cadaveric organs, and to determine the extent to which several factors (including sociodemographic characteristics and attitudes about religion and mistrust of hospitals) might explain differences in willingness to donate. RESEARCH DESIGN: Cross-sectional telephone survey of Maryland households contacted via random-digit dialing. MEASURES: Past blood donation, organ-donor status on driver's license, and measures of medical mistrust and religious and spiritual salience. SUBJECTS: Persons age 18 to 75 living in the Baltimore, Maryland metropolitan area. RESULTS: Of 385 respondents (84% of randomized households), 114 were black females, 46 were black males, 110 were white females, and 69 were white males. Before adjustment, black females were least willing to donate blood (41%), and black males were least willing to become cadaveric donors (19%) among all race-gender groups. Adjustment for respondent concerns about mistrust of hospitals and discrimination in hospitals explained most differences in willingness to donate blood, whereas adjustment for respondents' beliefs regarding the importance of spirituality and religion explained most differences in willingness to donate cadaveric organs. CONCLUSIONS: Both race and gender are important identifiers of those less willing to donate. To maximize efficiency, donor recruitment efforts should focus on race-gender groups with lowest levels of willingness. Potential donor concerns regarding mistrust in hospitals and religion/spirituality may serve as important issues to address when developing programs to improve donation rates.     

Ingeniería de diseño en Cirugía. ¿Cómo diseñar,probar y comercializar dispositivos quirúrgicos fabricados con impresión 3D?

Industry 4.0 offers new development opportunities for surgeons. Computer-aided design and 3 D printing allow for the creation of prototypes and functional end products. Until now, it was difficult for new devices to get to the manufacturing phase. Nowadays, the main limitations are our creativity, available spaces to test our creations and obtaining financing.     

A current review of Ebola virus: pathogenesis,clinical presentation,and diagnostic assessment

Ebola hemorrhagic fever (EHF) is an acute viral syndrome that presents with fever and an ensuing bleeding diathesis that is marked by high mortality in human and nonhuman primates. Fatality rates are between 50% and 100%. Due to its lethal nature, this filovirus is classified as a biological class 4 pathogen. The natural reservoir of the virus is unknown. As a result, little is understood about how Ebola virus is transmitted or how it replicates in its host. Although the primary source of infection is unknown, the epidemiologic mode of transmission is well defined. A variety of tests have proven to be specific and useful for Ebola virus identification. There is no FDA-approved antiviral treatment for EHF. Incubation ranges from 2 to 21 days. Patients who are able to mount an immune response to the virus will begin to recover in 7 to 10 days and start a period of prolonged convalescence. Supportive management of infected patients is the primary method of treatment, with particular attention to maintenance of hydration, circulatory volume, blood pressure, and the provision of supplemental oxygen. Since there is no specific treatment outside of supportive management and palliative care, containment of this potentially lethal virus is paramount. In almost all outbreaks of EHF, the fatality rate among health care workers with documented infections was higher than that of non-health care workers.     

The cytotoxic effect of palytoxin on Caco-2 cells hinders their use for in vitro absorption studies

Palytoxin (PLTX), found in Palythoa zoanthids and Ostreopsis dinoflagellates, has also been detected in crabs and fish, through which it can enter into the food chain. Indeed, PLTX is considered the causative agent of several cases of human seafood poisoning resulting in systemic symptoms. Available epidemiological data on PLTX human toxicity suggest that the intestinal tract may be one of its in vivo targets and its potential site of access into the bloodstream. Hence, the purpose of this study was to investigate the suitability of the human intestinal Caco-2 cell line for evaluating PLTX oral absorption. A detailed analysis of PLTX cytotoxicity revealed a high sensitivity of Caco-2 cells: 4h toxin exposure reduced mitochondrial activity (MTT assay, EC(50) of 8.9±3.7×10(-12)M), cell density (SRB assay, EC(50) of 2.0±0.6×10(-11)M) and membrane integrity (LDH release, EC(50) of 4.5±1.4×10(-9)M and PI uptake, EC(50) of 1.0±0.8×10(-8)M). After low PLTX concentration (1.0×10(-11)M) exposure for 1-8h, followed by 24h recovery time in toxin-free medium, cell density reduction was only partially reversible. These results indicate that, due to the high susceptibility to PLTX cytotoxic effects, Caco-2 cells do not represent an appropriate and reliable model for investigating intestinal barrier permeation by this toxin.     

The potential value of early screening for neurological deficits in participants in certain sports

Physicians occasionally encounter the punch-drunk syndrome among boxers after longlasting careers characterized by blows to the head. The list of sports leading to punch-drunk syndrome is rapidly increasing, making it a notable public health problem. A lack of specific findings leads to defects in reporting the condition, and consequently to delay in treatment. Although the rigorous enforcement of sport rules and constant improvements of sporting equipment have decreased the occurrence of the syndrome, early detection of punch-drunk syndrome is crucial and would have comprehensive benefits. Two groups of signs and symptoms can be identified: dementia and Parkinsonism. A prompt diagnosis with a correct classification of the suspected cases is crucial. Therefore, we offer an overview of the symptomatology as well as proposing the introduction of a screening method among risk groups based on generic and minute neurological examination and dementia testing.