Qualitative fitting characteristics of elastomeric half face-piece respirators using Isoamyl acetate agent

To examine the fit testing of elastomeric half face-piece respirators (EHRs), a total of 41 candidates were randomly assigned into seven EHRs equipped with organic vapor (OV) cartridges which were commonly used in the Iranian industrial workplaces. The qualitative fitting into the facial dimensions was assessed using the Allegro Isoamyl Acetate fit test kit. While the studied EHRs showed very low passing fit testing rates, the 3M, AoSafety (Medium), and AoSafety (Large) had the highest passing rates with 22.0%, 14.60%, and 9.76%, respectively. The AoSafety (All sizes) delivered a higher passing fit test rate than the 3M brand (29.30 vs. 22.0%). The one size fits all respirators including the DUO and Climax showed lower proportions of passing fit tests compared with AoSafety three-size system brands (2.40% and 4.90% vs. 29.30%). Low fit test passing rates were determined among different respirators. The respirators with various sizes and styles had more opportunities for different wearers to pass the fit test than single size models. The initial and annual fit testing requirements shall be developed by local government. Also, the manufacturers are required to pay attention to respirator features and subject characteristics during the production to obtain satisfactory protection for the end-users.     

Mapping and Ablation of Atypical AVNRT from the Morphologic Left Atrium in a Patient with Dextrocardia and Situs Inversus

A 75‐year‐old woman with dextrocardia, situs inversus, and subpulmonic outflow obstruction presented with recurrent supraventricular tachycardia (SVT). This SVT was easily inducible during electrophysiology study, and pacing maneuvers during SVT were consistent with atypical, slow‐slow atrioventricular nodal reentrant tachycardia (AVNRT). The His bundle was identified in the low postero‐septal morphologic right atrium, at the typical anatomic site for slow pathway ablation of AVNRT. Mapping of the retrograde earliest atrial electrogram during AVNRT localized this site to the mid‐septal morphologic left atrium, and cryoablation at this site terminated the AVNRT and rendered it noninducible. (PACE 2010; e106–e109)     

Bifocal Right Ventricular Resynchronization for the Failing Right Ventricle

The present case illustrates that in patients with right ventricular (RV) failure and right bundle branch block it is possible to resynchronize the RV without further worsening RV or left ventricular (LV) pump function, even in cases with various degrees of atrioventricular block. The acute response to different pacing configurations was analyzed in terms of dP/dt variations. Bifocal RV pacing (His bundle plus RV outflow tract pacing) achieved the best acute results and was chosen for permanent pacing. This pacing configuration was associated to clinical and echocardiographic improvement. (PACE 2011; 34:e78–e81)     

The interaction of zinc and vitamin A in human schistosomiasis

Levels of vitamin A and components of its transport protein complex, retinol binding protein and prealbumin, as well as zinc and its major binding proteins albumin and alpha 2-macroglobulin were measured in plasma of ninety-one male Egyptian patients with active schistosomal infection and thirty-two healthy adult males. Patients were divided into four groups: Group I had active schistosomiasis without associated complications; Group II had schistosomiasis complicated by colonic polyposis; Group III had advanced schistosomiasis, hepatosplenomegaly and/or ascites; and Group IV had chronic salmonella septicaemia in addition to schistosomiasis. Results showed that all patient groups had subnormal levels of plasma vitamin A, retinol binding protein, prealbumin, zinc and albumin (P less than 0.005 for all parameters) but elevated alpha 2-macroglobulin (P less than 0.001) when compared to the control group. Alterations in the vitamin A transport proteins increased with schistosomal complications and were closely correlated to changes in vitamin A (P less than 0.005), but alterations of albumin and alpha 2-macroglobulin were less consistent and did not correlate with changes in zinc levels. There was a highly significant correlation, however, between plasma zinc concentrations and those of vitamin A, retinol binding protein and prealbumin (P less than 0.001 for all correlations) in all groups of patients as well as the control group. These findings indicate that the binding and transport proteins of both zinc and vitamin A were adversely affected by schistosomiasis and its various complications. Deficiencies of both zinc and vitamin A seem to be interrelated in this disease and the vitamin A transport system may be largely dependent on zinc status.