Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

Background:Heart failure and atrial fibrillation (AF) often coexist in a deleterious cycle.Objective:To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF) ablation.Methods:Patients with ventricular systolic dysfunction [ejection fraction (EF) <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class) and echocardiographic (EF, left atrial diameter) data were compared (McNemar test and t test) before and after ablation.Results:31 patients (6 women, 25 men), aged 37 to 77 years (mean, 59.8±10.6), underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%). During a mean follow-up of 20.3±17 months, 24 patients (77%) were in sinus rhythm, 11 (35%) being on amiodarone. Eight patients (26%) underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures). Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001). The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005) and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026). No major complications occurred.Conclusion:Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.

Dieta de Mazama gouazoubira (Mammalia, Cervidae) en un ambiente secundario de Yungas, Argentina

The trophic spectrum of the Brown brocket deer, Mazama gouazoubira Fischer, 1814, was analyzed between September 1993 to February 1994, in a secondary environment of Yungas, Argentina and in semicaptivity conditions. Seventy three vegetable species and two fungi species were recorded. It was registered also the consumption of ticks, salt, land, bricks and scats of another animals. The main vegetable parts consumed in order of importance were young leaves and outbreaks (green parts), fruit and flowers.

Fator de condição gonadal, índice hepatossomático e recrutamento como indicadores do período de reprodução de Loricariichthys platymetopon (Osteichthyes, Loricariidae), bacia do rio Uruguai médio, sul do Brasil

The recruitment period of Locariichthys platymetopon (Isbrucker & Nijssen, 1979) was investigated. It has been found out, through the data analysis, that the gonadal condition factor is a good indicator of the reproductive period and that the hepatossomatic index is probably related to the storage of reservation for the winter period. The recruitment occurred in November coinciding with the reproductive activity of May.

Indução do crescimento ovariano em Aegla uruguayana (Crustacea, Anomura, Aeglidae) mediante a incorporação de neuroreguladores ao alimento

O efeito estimulante da spiperona e da naloxana sob a maturação ovariana foram avaliados em fêmeas de Aegla uruguayana Schmitt, 1942 e, para isto, tais neuroreguladores foram incorporados ao alimento e administrados a uma dose de 10-8 mol/animal a cada sessão de alimentação. Fêmeas adultas foram coletadas com puçá em um arroio próximo à cidade de Salto, Província de Buenos Aires, Argentina. Dez fêmeas foram sacrificadas, medidas, pesadas e os seus ovários foram retirados e pesados para a determinação do índice gonadossomático (IG). As demais fêmeas (30) foram divididas em três grupos experimentais - (a) controle: alimentadas com pellets controle composto por ração para peixe - 34% de proteína e 43% de proteína; (b) spiperona: alimentadas com pellets controle enriquecidos com spiperona; (c) naloxana: alimentadas com pellets controle enriquecidos com naloxana. Após 7 semanas as fêmeas foram sacrificadas e avaliado o IG. Os ovários e o hepatopâncreas foram quantificados quanto aos níveis de lipídeos totais e colesterol. A naloxana produziu um aumento significativo nos níveis de lipídeos tanto nas gônadas como no hepatopâncreas em relação ao grupo controle. A spiperona produziu aumento significativo nos níveis de lipídeos nas gônadas e no hepatopâncreas e de colesterol no hepatopâncreas quando comparados ao controle. Os níveis de lipídeos foram significativamente menores na hemolinfa das fêmeas que foram alimentadas com pellets com spiperona e maiores nas fêmeas tratadas com naloxana quando comparadas as fêmeas que foram alimentadas apenas com ração. A spiperona e a naloxana, ao inibir os efeitos da dopamina e dos opióides endógenos, provavelmente causaram a secreção do hormônio estimulante das gônadas e a inibição do hormônio inibidor das gônadas, causando, portanto indução do desenvolvimento ovariano. Tal hipótese é reforçada pelos aumentos do índice gonadossomático verificado nestes grupos experimentais.

Effects of both ecdysone and the acclimation to low temperature, on growth and metabolic rate of juvenile freshwater crayfish Cherax quadricarinatus (Decapoda, Parastacidae)

Growth, metabolic rate, and energy reserves of Cherax quadricarinatus (von Martens, 1868) juveniles were evaluated in crayfish acclimated for 16 weeks to either 25ºC (temperature near optimum) or 20ºC (marginal for the species). Additionally, the modulating effect of ecdsyone on acclimation was studied. After 12 weeks of exposure, weight gain of both experimental groups acclimated to 25ºC (control: C25, and ecdysone treated: E25) was significantly higher than that of those groups acclimated to 20ºC (C20 and E20). A total compensation in metabolic rate was seen after acclimation from 25ºC to 20ºC; for both the control group and the group treated with ecdysone. A Q10value significantly higher was only observed in the group acclimated to 20ºC and treated with ecdysone. A reduction of glycogen reserves in both hepatopancreas and muscle, as well as a lower protein content in muscle, was seen in both groups acclimated to 20ºC. Correspondingly, glycemia was always higher in these groups. Increased lipid levels were seen in the hepatopancreas of animals acclimated to 20ºC, while a higher lipid level was also observed in muscle at 20ºC, but only in ecdysone-treated crayfish.

Cytochemical characterization of gill and hepatopancreatic cells of the crab Ucides cordatus (Crustacea, Brachyura) validated by cell metal transport

Ucides cordatus (Linnaeus, 1763) is a hypo-hyper-regulating mangrove crab possessing gills for respiratory and osmoregulatory processes, separated in anterior and posterior sections. They also have hepatopancreas, which is responsible for digestion and absorption of nutrients and detoxification of toxic metals. Each of these organs has specific cells that are important for in vitro studies in cell biology, ion and toxic metals transport. In order to study and characterize cells from gills and hepatopancreas, both were separated using a Sucrose Gradient (SG) from 10 to 40% and cells in each gradient were characterized using the vital mitochondrial dye DASPEI (2-(4-dimethylaminostyryl)-N- ethylpyridinium iodide) and Trichrome Mallory's stain. Both in 20 and 40% SG for gill cells and 30% SG for hepatopancreatic cells, a greater number of cells were colored with DASPEI, indicating a larger number of mitochondria in these cells. It is concluded that the gill cells present in 20% and 40% SG are Thin cells, responsible for respiratory processes and Ionocytes responsible for ion transport, respectively. For hepatopancreatic cells, the 30% SG is composed of Fibrillar cells that possess larger number of membrane ion and nutrient transporters. Moreover, the transport of toxic metal cadmium (Cd) by isolated hepatopancreatic cells was performed as a way of following cell physiological integrity after cell separation and to study differences in transport among the cells. All hepatopancreatic cells were able to transport Cd. These findings are the first step for further work on isolated cells of these important exchange epithelia of crabs, using a simple separation method and to further develop successful in vitro cell culture in crabs.

Increasing quasiconcave production and utility functions with diminishing returns to scale

In microeconomic analysis functions with diminishing returns to scale (DRS) have frequently been employed. Various properties of increasing quasiconcave aggregator functions with DRS are derived. Furthermore duality in the classical sense as well as of a new type is studied for such aggregator functions in production and consumer theory. In particular representation theorems for direct and indirect aggregator functions are obtained. These involve only small sets of generator functions. The study is carried out in the contemporary framework of abstract convexity and abstract concavity.

Learning from errors

We present a model of learning in which agents learn from errors. If an action turns out to be an error, the agent rejects not only that action but also neighboring actions. We find that, keepng memory of his errors, under mild assumptions an acceptable solution is asymptotically reached. Moreover, one can take advantage of big errors for a faster learning.

El pluralisme mèdic: una clau interpretativa per a una història integral de la medicina

El recurs als professionals sanitaris es sols una part de totes aquelles iniciatives, actuacions o creences que els nostres avantpassats van desenvolupar per conservar o millorar la salut, prevenir la malaltia o recuperar la salut. El recurs a altres tipus d'instàncies assistencials o terapèutiques, que es coneix com "pluralisme assistencial", sol ser la norma més que l'excepció. Per a enfocar adequadament aquest problema, cal centrar la indagació històrica sobre aquells -les persones malaltes o sanes- que volien i buscaven la salut. Aquests tipus d'acostaments pretenen tenir en compte totes les possibilitats a les quals es va recórrer en el passat per tal d'afrontar els problemes de salut.

Leadership and overcoming coordination failure with asymmetric costs

We study how the heterogeneity of agents affects the extent to which changes in financial incentives can pull a group out of a situation of coordination failure. We focus on the connections between cost asymmetries and leadership. Experimental subjects interact in groups of four in a series of weak-link games. The treatment variable is the distribution of high and low effort cost across subjects. We present data for one, two and three low-cost subjects as well as control sessions with symmetric costs. The overall pattern of coordination improvement is common across treatments. Early coordination improvements depend on the distribution of high and low effort costs across subjects, but these differences disappear with time. We find that initial leadership in overcoming coordination failure is not driven by low-cost subjects but by subjects with the most frequent cost. This conformity effect can be due to a kind of group identity or to the cognitive simplicity of acting with identical others.

Perfeccionamiento de las metodologías docentes en la enseñanza de la construcción mixta en grado y postgrado en la Universidad Politécnica de Cataluña (UPC) y la Universidad de Camaguey (UC)

Estudio elaborado a partir de una estancia en la Universitat Polictecnica de Cataluña entre marzo i junio del 2007.El proyecto tiene como objetivo general el perfeccionamiento de las metodologías docentes en la enseñanza de la construcción mixta en grado y postgrado en la Universidad Politécnica de Cataluña (UPC) y la Universidad de Camagüey (UC), en correspondencia con la situación actual y perspectiva de la normativa europea, española y cubana. En el trabajo se realiza una valoración sobre programas experimentales en estructuras mixtas y sus resultados, así como su interrelación con la modelación numérica. Se evalúa la correspondencia entre las normativas europeas, española y cubana y se definen los aspectos específicos que deben ser perfeccionados o complementados en la normatividad vigente en Cuba, así como la estrategia general para acometerlo. Para caracterizar la enseñanza de la construcción mixta en la UPC y la UC, se parte de la valoración de información sobre asignaturas similares en un grupo seleccionado de universidades y sobre el contexto que sirve de marco al perfeccionamiento. Se realiza el diagnostico del sistema de objetivos, conocimientos y organización metodológica en los programas de grado y postgrado y se ofrecen recomendaciones generales para el perfeccionamiento de la enseñanza de la construcción mixta en la UPC y la UC. Finalmente, se realizan propuestas detalladas para ambas instituciones, para el perfeccionamiento de las metodologías docentes, con enfoques generales similares, respetando los criterios específicos y formatos de cada entorno. Se concibe un sistema integrado de actividades para cada asignatura, lográndose que, a pesar de las particularidades de cada contexto, el enfoque de trabajo sea coincidente en gran medida, lo que favorece la continuidad en las relaciones de colaboración entre ambas instituciones.

Non-hyperbolic boundary equilibrium bifurcations in planar Filippov systems: a case study approach

Boundary equilibrium bifurcations in piecewise smooth discontinuous systems are characterized by the collision of an equilibrium point with the discontinuity surface. Generically, these bifurcations are of codimension one, but there are scenarios where the phenomenon can be of higher codimension. Here, the possible collision of a non-hyperbolic equilibrium with the boundary in a two-parameter framework and the nonlinear phenomena associated with such collision are considered. By dealing with planar discontinuous (Filippov) systems, some of such phenomena are pointed out through specific representative cases. A methodology for obtaining the corresponding bi-parametric bifurcation sets is developed.

On the existence and uniqueness of limit cycles in Liénard differential equations allowing discontinuities

"Vegeu el resum a l´inici del document del fitxer adjunt."