ABSTRACT
Syncope is the most frequent cause for transient loss of consciousness. Recent ESC guidelines pinpoint the position of syncope within the context of loss of consciousness. The individual risk of syncope is determined by various factors. Odds are that almost one in two women and one in four men suffers from syncope at least once in their lives. Age-dependent risk is highest at both the age of 15 and after the 60(th) birthday. Only a fraction of cases are witnessed by a doctor, which makes it difficult to analyze. Prognosis after syncope is strictly related to the existence of structural heart disease. Therefore, its diagnosis and therapy should be given priority. In case of high risk of recurrence, syncope should be adequately treated to prevent further relapse, regardless of the primary disease. Syncopes are classified on the basis of their pathophysiological cause: reflex syncope, orthostatic syncope, arrhythmic cardiac syncope, mechanically caused syncope due to structural cardiovascular disease, and syncope due to cerebrovascular disease. The cause of up to one third of syncopes remains unknown; however, the majority of which are probably reflex syncopes.
Subject(s)
Cardiac Pacing, Artificial , Electrocardiography , Syncope/diagnosis , Syncope/therapy , Diagnosis, Differential , Female , Humans , Male , Syncope/classification , Unconsciousness/diagnosis , Unconsciousness/therapyABSTRACT
Concomitant microwave ablation for curative treatment of atrial fibrillation (AF) was performed in 18 patients with history of chronic atrial fibrillation and indication for open heart surgery, 11 patients with mitral valve replacement and 7 patients with coronary artery bypass grafting. There were no perioperative complications. During the postoperative period most of the patients had intermittent AF, they received low dose Sotalol therapy and electric cardioversions. Up to now seven patients have reached follow-up day 90. One patient has persistent AF. Two patients had typical atrial flutter that was electrically converted to sinus rhythm (SR), isthmus ablation is planned. The other four patients have SR, one patient without cardioversions. These four patients show recovered atrial function with observed A-wave for transmitral flow. Under visual guidance the continuous atrial lesion lines could be induced effectively and safely by the intraoperative device Lynx.
Subject(s)
Atrial Fibrillation/surgery , Cardiac Surgical Procedures/methods , Catheter Ablation/instrumentation , Microwaves/therapeutic use , Aged , Atrial Fibrillation/diagnosis , Catheter Ablation/methods , Equipment Design , Female , Follow-Up Studies , Germany , Humans , Male , Middle Aged , Pilot Projects , Surgical Instruments , Treatment OutcomeABSTRACT
Killing of 61 seroresistant E. coli strains equipped with virulence plasmids (F, Ent, Hly, Col) and resistance plasmids (R) in polymorphonuclear leukocytes (PMNL) of healthy donors was determined by the cultivation plate and fluorescence methods of phagocytosis. Killing of the control E. coli strain K12 which does not possess any plasmids was studied by the fluorescent method. Compared to the fluorescent method, the cultivation plate method yielded a significantly higher killing rate of the bacteria after opsonization by 5% (p less than 0.05) and concentrated serum (p less than 0.001). Compared to the control E. coli strain K12, the killing rate of seroresistant E. coli strains in PMNL of healthy donors was significantly lower (p less than 0.001).
