Management of atrial fibrillation: two decades of progress — a scientific statement from the European Cardiac Arrhythmia Society

Journal of Interventional Cardiac Electrophysiology - Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice. The aim of this review was to evaluate the...     

Unrecognized contralateral intrapleural catheter: bilateral blockade may obscure detection of failed epidural catheterization

Thoracic epidural analgesia has been widely used to reduce both postoperative and posttraumatic pain. We describe a case of inadvertent right-sided interpleural catheter placement and pneumothorax during attempted epidural catheter placement for left-sided rib fractures that went unrecognized because of bilateral blockade and adequate analgesia.     

High-fiber diet for treatment of constipation in women with pelvic floor disorders

OBJECTIVE: To examine the effect of high-fiber diet on constipation in women with pelvic floor disorders. METHODS: This was a study of a prospective cohort of 41 consecutive women presenting to a tertiary care facility for pelvic floor disorders with a complaint of constipation from March 2005 to September of 2005. Patient Assessment of Constipation Symptoms and Rome II criteria administered as a questionnaire were obtained through telephone interviews every 14 days and were evaluated at the end of the 42-day study period. Each patient was instructed to supplement her diet with a high-fiber cereal (14 g of fiber per one-half cup). Women gradually increased their cereal intake with a goal of reaching 28 g of fiber daily. Patients with adverse reactions, abdominal bloating or pain, and surgery during the study period were withdrawn. RESULTS: Median age and body mass index were 60 years (range 33-77 years), and 29.9 kg/m(2) (range 21.6-59.8), respectively. Thirty patients (73%) completed the study. Average Rome II scores improved from day 1 to day 42 (P<.05). The total, abdominal, rectal, and stool symptoms of the Patient Assessment of Constipation Symptoms improved significantly during the study period (P<.001). Weekly laxative use and vaginal splinting were decreased from 2.8, 1.5 to 1.4, 0.67 (P<.05), respectively. CONCLUSION: Increasing fiber intake gradually to the amount recommended by the National Academy of Sciences Institute of Medicine improves constipation and its associated symptoms. Reducing the incidence and severity of straining in constipated women may help a risk factor for the onset, progression, or recurrence of prolapse.     

Resistant tuberculosis by drugs

Among all infectious diseases, tuberculosis has probably been the most frequent cause of death and morbidity in the history of humanity. On a world-wide basis, the tuberculosis (TB) represents a serious public health problem, existing great differences between developed and developing countries in terms of controlling the disease. One of the problems inherent in this disease is the resistance of Mycobacterium tuberculosis to drugs, specially the multi-resistance (defined as resistance to isoniziade and rifampicine), it represents a problem of global health. Faced with clinical suspect, its diagnosis must be immediately done and treatment must be started as soon as possible. For this purpose, we have at our disposal such effective diagnosis and therapeutic methods. However, the most important the most important action is that all these patients must be subjected to a close evolved control carried by specialized units.     

Antigenic competition in IgE, IgG1 and IgG2 antibody production in the mouse

A comparative study of the effects of antigenic competition on the IgE, IgG1 and IgG2 antibody production was performed in mice immunized with two unrelated antigens. These antigens were injected as a mixture or in different sites. In addition, the groups of mice received one or three boosters of one or both antigens. The passive cutaneous anaphylaxis titres obtained in several bleedings showed a suppression of IgG1 and IgG2 antibody responses only in the groups injected with the two antigens in the same site, independently of antigenic boosters. The IgE antibody response was diminished when the antigens were given in a mixture, but this effect disappeared after a second booster. In contrast, groups injected with antigens separately started to show a suppressed response only at this time.     

Fine-scale population structure in five rural populations from the Spanish Eastern Pyrenees using high-coverage whole-genome sequence data

The area of the Spanish Pyrenees is particularly interesting for studying the demographic dynamics of European rural areas given its orography, the main traditional rural condition of its population and the reported higher patterns of consanguinity of the region. Previous genetic studies suggest a gradient of genetic continuity of the area in the West to East axis. However, it has been shown that micro-population substructure can be detected when considering high-quality NGS data and using spatial explicit methods. In this work, we have analyzed the genome of 30 individuals sequenced at 40× from five different valleys in the Spanish Eastern Pyrenees (SEP) separated by less than 140 km along a west to east axis. Using haplotype-based methods and spatial analyses, we have been able to detect micro-population substructure within SEP not seen in previous studies. Linkage disequilibrium and autozygosity analyses suggest that the SEP populations show diverse demographic histories. In agreement with these results, demographic modeling by means of ABC-DL identify heterogeneity in their effective population sizes despite of their close geographic proximity, and suggests that the population substructure within SEP could have appeared around 2500 years ago. Overall, these results suggest that each rural population of the Pyrenees could represent a unique entity.Subject terms: Genetic variation, Inbreeding