Dietary zinc concentration and lipopolysaccharide injection affect circulating trace minerals, acute phase protein response, and behavior as evaluated by an ear-tag-based accelerometer in beef steers.

To assess plasma trace mineral (TM) concentrations, the acute phase protein response, and behavior in response to a lipopolysaccharide (LPS) challenge, 96 Angus cross steers (average initial body weight [BW]: 285 ± 14.4 kg) were sorted into two groups by BW (heavy and light; n = 48/group), fitted with an ear-tag-based accelerometer (CowManager SensOor; Agis, Harmelen, Netherlands), and stagger started 14 d apart. Consecutive day BW was recorded to start the 24-d trial (days -1 and 0). Dietary treatments began on day 0: common diet with either 30 (Zn30) or 100 (Zn100) mg supplemental Zn/kg DM (ZnSO4). On day 17, steers received one of the following injection treatments intravenously to complete the 2 × 3 factorial: 1) SALINE (~2-3 mL of physiological saline), 2) LOWLPS: 0.25 µg LPS/kg BW, or 3) HIGHLPS: 0.375 µg LPS/kg BW. Blood, rectal temperature (RT), and BW were recorded on day 16 (-24 h relative to injection), and BW was used to assign injection treatment. Approximately 6, 24 (day 18), and 48 (day 19) h after treatment, BW, RT, and blood were collected, and final BW recorded on day 24. Data were analyzed in Proc Mixed of SAS with fixed effects of diet, injection, diet × injection; for BW, RT, dry matter intake (DMI), plasma TM, and haptoglobin-repeated measures analysis were used to evaluate effects over time. Area under the curve analysis determined by GraphPad Prism was used for analysis of accelerometer data. Body weight was unaffected by diet or injection (P ≥ 0.16), but there was an injection × time effect for DMI and RT (P < 0.05), where DMI decreased in both LPS treatments on day 16, but recovered by day 17, and RT was increased in LPS treatments 6 h post-injection. Steers receiving LPS spent less time highly active and eating than SALINE (P < 0.01). Steers in HIGHLPS spent lesser time ruminating, followed by LOWLPS and then SALINE (P < 0.001). An injection × time effect (P < 0.001) for plasma Zn showed decreased concentrations within 6 h of injection and remained decreased through 24 h before recovering by 48 h. A tendency for a diet × time effect (P = 0.06) on plasma Zn suggests plasma Zn repletion occurred at a greater rate in Zn100 compared to Zn30. These results suggest that increased supplemental Zn may alter the rate of recovery of Zn status from an acute inflammatory event. Additionally, ear-tag-based accelerometers used in this study were effective at detecting sickness behavior in feedlot steers, and rumination may be more sensitive than other variables.

Investigating the effects of a novel rumen-protected folic acid supplement on feedlot performance and carcass characteristics of beef steers.

Angus-crossbred steers (n = 180; 292 ± 18 kg) from a single ranch were used to investigate the effects of a novel rumen-protected folic acid (RPFA) supplement on feedlot performance and carcass characteristics. On d 0, steers were blocked by body weight to pens (5 steers/pen), and pens within a block were randomly assigned to dietary treatments (n = 6 pens/treatment): target intake of 0 (CON), 30 (RPFA-30), 60 (RPFA-60), 90 (RPFA-90), 120 (RPFA-120), or 150 (RPFA-150) mg RPFA·steer-1·d-1. Steers were weighed before feeding on d -1, 0, 55, 56, 86, 87, 181, and 182. Pen average daily gain (ADG), dry matter intake (DMI), and gain:feed (G:F) were calculated for growing (d 0 to 56), dietary transition (d 56 to 87), finishing (d 87 to 182), and overall (d 0 to 182). Liver and blood samples were collected from two steers/pen before trial initiation and at the end of growing and finishing. Steers were slaughtered on d 183, and carcass data were collected after a 48-h chill. Data were analyzed as a randomized complete block design using ProcMixed of SAS 9.4 (fixed effects of treatment and block; experimental unit of pen). Liver abscess scores were analyzed using the Genmod Procedure of SAS 9.4. Contrast statements assessed the polynomial effects of RPFA. Supplemental RPFA linearly increased plasma folate at the end of growing and finishing (P < 0.01), and linearly decreased plasma glucose at the end of growing (P = 0.01). There was a cubic effect of RPFA on liver folate at the end of growing (P = 0.01), driven by lesser concentrations for RPFA-30, RPFA-60, and RPFA-150. Growing period ADG and G:F were greatest for CON and RPFA-120 (cubic P ≤ 0.03). Transition period DMI was linearly increased due to RPFA (P = 0.05). There was a tendency for a cubic effect of RPFA on the percentage of livers with no abscesses (P = 0.06), driven by a greater percentage of non-abscessed livers in RPFA-30 and RPFA-60. Despite supplementing 1 mg Co/kg DM, and regardless of treatment, plasma vitamin B12 concentrations were low (<200 pg/mL), which may have influenced the response to RPFA as vitamin B12 is essential for recycling of folate.

The influence of dietary energy and zinc source and concentration on performance, trace mineral status, and gene expression of beef steers.

The objective of this study was to determine the effects of increased supplemental Zn from differing sources on growth performance of steers fed diets differing in net energy. Angus steers (n = 72, 324 ± 2.1 kg) with Genemax gain scores of 3, 4, or 5 were blocked by BW and stratified by Genemax gain score into 12 pens of 6 steers each for 158 d. Pens were randomly assigned to 1 of 3 Zn treatments (ZNTRT): 1) control (no supplemental Zn, analyzed 33 mg Zn/kg DM; CON); 2) inorganic Zn (CON + 120 mg supplemental Zn/kg DM as ZnSO4 for entire trial; INZN); or 3) 120 mg supplemental Zn/kg DM as Zn-amino acid complex (Availa-Zn; Zinpro, Eden Prairie, MN) for first 60 d, then a blend of ZnSO4 and Zn-AA complex (CON + 60 mg supplemental Zn/kg DM as ZnSO4 + 60 mg supplemental Zn/kg DM as Zn-amino acid complex) for the remainder of the trial (ZNBLD). Two dietary energy strategies (ENERGY) were formulated to reach ADG rates of 1) 1.6 kg/d (LE) or 2) 2.0 kg/d (HE) utilizing a 3 × 2 factorial arrangement (12 steers/treatment). All steers were fed LE for a 60 d growing period, then pens were randomly assigned to ENERGY treatments fed the remaining 91 d. Day 60 BW tended to be greater (P = 0.07) in steers receiving supplemental Zn vs. CON. Liver Cu was decreased in Zn supplemented steers vs. CON (P = 0.02). Liver Zn concentrations on d 56 did not differ for Zn vs. CON (P = 0.22) nor were there differences due to Zn source (P = 0.98). There were or tended to be ZNTRT × ENERGY effects for d 67-90 ADG and G:F (P ≤ 0.01), and d 122 BW and d 90-122 G:F (P ≤ 0.10) driven by improved performance for ZNBLD-HE over ZNBLD-LE, while ENERGY within CON and INZN did not differ. Day 90-122 ADG, overall ADG and overall G:F was greater (P ≤ 0.02) and d 67-90 G:F tended to be greater (P = 0.10) for HE vs. LE. No ZNTRT × ENERGY or ZNTRT effects were detected for HCW, REA, BF, KPH, MS, or YG (P ≥ 0.37) while HE increased HCW, BF, MS, and YG compared with LE (P ≤ 0.05). In the liver, ZNTRT affected d 97 MT1A expression (P = 0.03) where INZN was greater than ZNBLD or CON (P ≤ 0.02), while ZIP14 was unaffected due to ZNTRT, ENERGY, or the interaction (P ≥ 0.39). Supplying supplemental Zn as ZNBLD during the transition period appeared to improve performance measures, but no final performance advantages were noted due to increased supplemental Zn, regardless of source. Additionally, differences in liver MT1A expression may indicate differing post-absorptive metabolism between Zn sources.

Benefits of a Bacillus probiotic to larval fish survival and transport stress resistance.

The need for sustainable bacterial management approaches in aquaculture is crucial for advancement of the industry. Probiotics are a promising strategy as evidenced by benefits demonstrated in intensive larviculture of various marine fish species. In this study we investigate the effects of a mixed Bacillus species (B. licheniformis and B. amyloliquefaciens) probiotic on rearing of larval common snook (Centropomus undecimalis). Experimental treatments included (1) probiotics supplemented to the water and live feed, (2) probiotics supplemented to the water only, and (3) no probiotic controls. Data from two separate trials indicated up to 2.5 times higher survival with probiotic addition, as well as 20% higher survival 7 days following a transport event. These benefits were not explained by faster growth, measured water quality parameters, or innate immune enzyme activities. Microbiota analysis indicated the importance of system stabilization prior to larval stocking to improve rearing success and probiotic performance. ied Potential probiotic benefits include accelerated gastrointestinal tract development, enhanced immunity, inhibition of opportunistic bacteria, and improvements to water quality parameters. Results suggest this probiotic should be tested in other marine fish species in order to reduce larval rearing bottlenecks.

The influence of supplemental zinc and dietary fiber concentration on mineral retention of beef steers.

The objective was to determine if zinc (Zn) retention improved with supplemental Zn above recommended concentrations with increasing dietary fiber concentration. Angus steers (n = 32; 309 ± 4.2 kg body weight [BW]) with GeneMax gain scores of 3, 4, or 5 were utilized in a 2 × 2 factorial arrangement (8 steers per treatment). Steers were stagger started (four blocks of eight steers) and stratified by BW within growing diets to one of two Zn strategies (ZNTRT), no supplemental Zn (analyzed 36 mg Zn/kg dry matter [DM]; CON) or supranutritional Zn (CON + 60 mg Zn/kg DM as ZnSO4 + 60 mg Zn/kg DM as Zn-amino acid complex; SUPZN). Dietary fiber strategies (FIBER) were formulated to target two fiber supplementation rates representing high fiber (HF; ~35% neutral detergent fiber [NDF]) or low fiber (LF; ~25% NDF). Within block, steers received HF for 60 d; then pens were randomly assigned to LF or HF for finishing. Steers fed LF were transitioned for 15 d; on day 75, steers were moved to metabolism crates and adapted for 10 d, followed by 5 d of total fecal and urine collection. Retention of Zn, Mn, Fe, Cu, and N were calculated. The model for analysis of metabolism data included the fixed effects of ZNTRT, FIBER, block, and the interaction of ZNTRT × FIBER, with the three-way interaction of ZNTRT × FIBER × block as random. Steer was the experimental unit (n = 8 per treatment combination). Zinc did not affect initial 60-d performance (P ≥ 0.62). DM and organic matter digestibility were lesser (P = 0.02) and N digestibility tended to be lesser (P = 0.07) in CON vs. SUPZN. Intake and digestibility of NDF and acid detergent fiber were greater (P ≤ 0.01) in HF vs. LF. Digestibility and retention of N as a percentage of intake were greater (P ≤ 0.04) whereas N retention as grams per day tended to be greater in HF vs. LF (P = 0.06). Apparent absorption of Zn tended to be greater (P = 0.06) in CON vs. SUPZN. A ZNTRT × FIBER effect was identified for Zn retention (milligrams per day; P = 0.01) where within SUPZN Zn retention was greater in HF vs. LF (P < 0.01). Apparent absorption and retention of Zn were greater (% of intake; P ≤ 0.02) in HF vs. LF. Apparent absorption of Cu, Fe, and Mn was unaffected by ZNTRT or FIBER (P ≥ 0.24). Increasing dietary Zn increased Zn retained regardless of changes in coefficient of absorption. In addition, dietary fiber content may impact trace mineral and N metabolism by steers, potentially due to increased release of these nutrients from feed as fiber digestibility increases. It appears dietary Zn concentrations and diet composition influence trace mineral absorption in beef steers.

Influence of dietary zinc concentration and supplemental zinc source on nutrient digestibility, zinc absorption, and retention in sheep.

The objective of this study was to assess whether supplemental Zn source or concentration would affect ruminant Zn retention and nutrient digestibility. Thirty-six weaned crossbred Polypay wethers, were sorted by BW to 3 periods and stagger started on a common diet (22 mg Zn/kg DM) for a 52-d depletion period. Day 52 BW was used to assign Zn treatments (3 lambs/treatment/period): no supplemental Zn (CON), or supplemental Zn (40 mg Zn/d) from Zn sulfate (ING; Zinc Nacional, Monterrey, SA, Mexico), Zn methionine (ORG; Zinpro 120; Zinpro, Eden Prairie, MN), or Zn hydroxychloride (HYD; IntelliBond Z; Micronutrients USA LLC, Indianapolis, IN). On day 53 (day 1 of Zn treatments), lambs were moved to metabolism crates for 10 d of adaptation and 5 d of total fecal and urine collection. Blood for plasma Zn analysis was collected on day 52 and day 68. Data were analyzed as a randomized complete design with fixed effects of treatment, period and the interaction, which was significant (P ≥ 0.19) for day 68 plasma Zn but was removed for all other variables. Contrast statements were used to separate treatment means: CON vs. ZINC (ING, ORG, HYD), ING vs. HYD, and ORG vs. HYD. Day 52 plasma Zn concentrations were similar when CON was compared with ZINC (P = 0.84), and when ING and ORG were compared with HYD (P ≥ 0.19). Dry matter and neutral detergent fiber digestibility were lesser in ORG compared with HYD (P = 0.05) and organic matter and acid detergent fiber digestibility tended (P ≤ 0.08) to be lesser in ORG compared with HYD. Intake and fecal excretion of Zn was lesser, while apparent absorption of Zn was greater, in CON compared with ZINC (P ≤ 0.001). Zinc retained as a percent of Zn intake was greater in CON compared with ZINC (P = 0.001). Zinc retained (mg/d) was similar in CON compared with ZINC (P = 0.58) and when ING or ORG were compared with HYD (P ≥ 0.83). There was a treatment × period interaction for day 68 plasma Zn where treatments did not differ for periods 1 and 3 but ORG lambs had increased plasma Zn in period 2 compared with other treatments (P = 0.02). Lambs receiving no supplemental Zn had increased apparent absorption, suggesting Zn absorption may be upregulated in these lambs. Similarities in Zn retention across treatments suggests Zn requirements of these lambs were met regardless of supplementation concentration or source. Nutrient digestibility was improved in HYD lambs compared with ORG, and further work is needed to clarify the influence of supplemental Zn source on nutrient digestion.

The influence of supplemental zinc and ractopamine hydrochloride on trace mineral and nitrogen retention of beef steers.

The study objective was to determine whether N retention was improved with supplemental Zn above NRC concentrations with or without ractopamine hydrochloride inclusion. Angus crossbred steers (n = 32, 485 ± 26 kg BW) with Genemax gain scores of 4 or 5 were utilized in a 2 × 2 factorial arrangement (8 steers/treatment). Steers were blocked by BW to a finishing diet with 1 of 2 mineral supplementation strategies (ZNTRT), no supplemental Zn (analyzed 32 mg Zn/kg DM; CON) or supranutritional Zn (CON + 60 ppm ZnSO4 + 60 ppm Zn-amino acid complex; analyzed 145 mg Zn/kg DM; SUPZN), fed 56 days in pens equipped with GrowSafe bunks and assigned to ß-agonist (BA) supplementation strategies of 0 (NON) or 300 mg steer-1 d-1 ractopamine hydrochloride (RAC) fed the last 30 d before harvest. Initial 56-d ADG was not affected by ZNTRT (P = 0.66), but DMI was greater in CON vs. SUPZN (P < 0.01). On day 56 (day 1 of BA supplementation), steers (4 groups; 8 steers/group; 2 steers/treatment) were moved to metabolism crates and adapted for 10 d, followed by 5 d of total fecal and urine collection. Total retention of Zn, Mn, Fe, Cu, and N were calculated. Data were analyzed as a 2 × 2 factorial arrangement, with group as a fixed effect and the 3-way interaction of ZNTRT × BA × group as random. No interactions between ZNTRT and BA were noted for any data (P ≥ 0.19). Collection DMI did not differ among treatments (P ≥ 0.23); however, Zn intake was lesser in CON vs. SUPZN (P < 0.01). Fecal and urinary Zn excretion and Zn and Mn retention were lesser in CON vs. SUPZN (P ≤ 0.03); however, Zn retention was not different between NON and RAC (P = 0.43). Retention of Cu and Fe was unaffected by strategies (P ≥ 0.49). Urine output and urine N excretion were greater in NON vs. RAC (P ≤ 0.05). Nitrogen retention (as percent of N intake) was lesser (P = 0.05) in CON (40.0%) vs. SUPZN (44.3%) and lesser (P = 0.02) in NON (39.5%) vs. RAC (44.8%). Zinc and N retention were found to be positively correlated (r = 0.46, P < 0.01). Average daily gain and G:F across the 86-d trial were lesser in NON vs. RAC (P < 0.03). Overall, SUPZN appears to improve N retention, suggesting that increasing dietary Zn may be important for cattle growth beyond that induced by ractopamine hydrochloride.

Idiopathic VPC: Distribution Of FOCI And Tips Of Ablation.

Idiopathic Ventricular Premature Contraction (VPC) is currently more routinely referred for electrophysiology evaluation. Usually it carries a good prognosis but, when symptomatic or suspected to produce ventricular dysfunction, will require treatment. Nowadays, RF ablation has great advantages over antiarrhythmic drugs. Classically the outflow tract (right or left), with the typical inferior axis with left (eventually right) bundle brunch block like ECG morphology, is considered the most frequent site of origin for idiopathic VPC, but with the widespread of EP procedures and advancement of technology making possible to map and ablate difficult locations, it is possible to see a growing and changing population referred for idiopathic VPC ablation, displaying that, almost any region of the heart may be source of this kind of arrhythmia that can be successfully treated. A well-planned procedure, with the presumed region of origin settled and employing the current technology and knowledge (tips), will have a high chance of cure.

Frontal Motor Cortex Activity During Reactive Control Is Associated With Past Suicidal Behavior in Recent-Onset Schizophrenia.

BACKGROUND: Suicide is prevalent in schizophrenia (SZ), yet the neural system functions that confer suicide risk remain obscure. Circuits operated by the prefrontal cortex (PFC) are altered in SZ, including those that support reactive control, and PFC changes are observed in postmortem studies of heterogeneous suicide victims. AIMS: We tested whether history of suicide attempt is associated with altered frontal motor cortex activity during reactive control processes. METHOD: We evaluated 17 patients with recent onset of DSM-IV-TR-defined SZ using the Columbia Suicide Severity Rating Scale and functional magnetic resonance imaging during Stroop task performance. Group-level regression models relating past suicidal behavior to frontal activation controlled for depression, psychosis, and impulsivity. RESULTS: Past suicidal behavior was associated with relatively higher activation in the left-hemisphere supplementary motor area (SMA), pre-SMA, premotor cortex, and dorsolateral PFC, all ipsilateral to the active primary motor cortex. CONCLUSION: This study provides unique evidence that suicidal behavior in patients with recent-onset SZ directly relates to frontal motor cortex activity during reactive control, in a pattern reciprocal to the relationship with proactive control found previously. Further work should address how frontal-based control functions change with risk over time, and their potential utility as a biomarker for interventions to mitigate suicide risk in SZ.

Control-related frontal-striatal function is associated with past suicidal ideation and behavior in patients with recent-onset psychotic major mood disorders.

OBJECTIVE: Suicide is highly-prevalent in major mood disorders, yet it remains unclear how suicidal ideation and suicidal behavior relate to brain functions, especially those that support control processes. We evaluated how prefrontal cortex (PFC) activity during goal-representation (an important component of cognitive control) relates to past suicidal ideation and behavior in patients with psychotic major mood disorders. METHOD: 30 patients with recent-onset of either DSM-IV-TR-defined bipolar disorder type I (n=21) or major depressive disorder (n=9) with psychotic features, but neither in a major mood episode nor acutely psychotic at study, were evaluated for past suicidal ideation and behavior (Columbia Suicide Severity Rating Scale) and functional MRI during cognitive control task performance. Group-level regression models of brain activation accounted for current depression, psychosis and trait impulsivity. RESULTS: Intensity of past suicidal ideation was associated with higher control-related activation in right-hemisphere regions including the ventrolateral PFC (VLPFC) and orbitofrontal cortex, rostral insula, and dorsal striatum. Among those with past suicidal ideation (n=16), past suicidal behavior (n=8) was associated with higher control-related activation in right-hemisphere regions including VLPFC, rostrolateral PFC, and frontal operculum/rostral insula; and relatively lower activity in midline parietal regions, including cuneus and precuneus. LIMITATIONS: The sample size of subjects with past suicidal behavior was modest, and all subjects were taking psychotropic medication. CONCLUSIONS: This study provides unique evidence that in early-course psychotic major mood disorders, suicidal ideation and behavior histories directly relate to PFC-based circuit function in support of cognitive control.

Simplified Method for Vagal Effect Evaluation in Cardiac Ablation and Electrophysiological Procedures.

OBJECTIVES: The aim of this study is to show a simplified reversible approach to investigate and confirm vagal denervation at any time during the ablation procedure without autonomic residual effect. BACKGROUND: Parasympathetic denervation has been increasingly applied in ablation procedures such as in vagal-related atrial fibrillation and cardioneuroablation. This method proposes an easy way to study the vagal effect and to confirm its elimination following parasympathetic denervation through vagal stimulation (VS) by an electrophysiological catheter placed in the internal jugular vein. METHODS: A prospective controlled study including 64 patients without significant cardiopathy (48 male [75.0%], age 46.4 ± 16.4 years) who had a well-defined RF ablation indication for symptomatic arrhythmias, comprising a "denervation group" (DG), with indication for ablation with parasympathetic denervation (vagal-related atrial fibrillation or severe cardioinhibitory syncope) and a "control group" (CG), with ablation indication without parasympathetic denervation (accessory pathway or ventricular arrhythmia). By using a neurostimulator, both groups underwent non simultaneous bilateral VS (8 to 12 s, frequency: 30 Hz, pulse width: 50 µs, amplitude: 0.5 to 1 V/kg up to 70 V) through the internal jugular vein pre- and post-ablation. RESULTS: Significant cardioinhibition was achieved pre-ablation in all cases (pause of 11.5 ± 1.9 s in DG vs. 11.4 ± 2.1 s in CG; p = 0.79). Eight patients (12.5%) presented catheter progression difficulty in 1 jugular vein (2 right, 6 left); however, the contralateral VS was adequate for cardioinhibition. After ablation, the cardioinhibition was reproduced only in CG (pause of 11.2 ± 2.2 s) as in DG it was entirely eliminated. There was no significant difference between pre- and post-ablation cardioinhibition in CG (p = 0.84). There was no complication (follow-up 8.8 ± 5 months). CONCLUSIONS: The vagal stimulation was feasible, easy, and reliable, and showed no complications. It may be repeated during the procedure to control the denervation degree without residual effect. It could be a suitable tool for vagal denervation confirmation or autonomic tests during electrophysiological studies. Ablation without parasympathetic denervation did not change the vagal response.

Frontal cortex control dysfunction related to long-term suicide risk in recent-onset schizophrenia.

OBJECTIVE: Suicide is highly-prevalent and the most serious outcome in schizophrenia, yet the disturbances in neural system functions that confer suicide risk remain obscure. Circuits operated by the prefrontal cortex (PFC) are altered in psychotic disorders, and various PFC changes are observed in post-mortem studies of completed suicide. We tested whether PFC activity during goal-representation (an important component of cognitive control) relates to long-term suicide risk in recent-onset schizophrenia. METHOD: 35 patients with recent-onset of DSM-IV-TR-defined schizophrenia (SZ) were evaluated for long-term suicide risk (using the Columbia Suicide Severity Rating Scale) and functional MRI during cognitive control task performance. Group-level regression models associating control-related brain activation with suicide risk controlled for depression, psychosis and impulsivity. RESULTS: Within this group, past suicidal ideation was associated with lower activation with goal-representation demands in multiple PFC sectors. Among those with past suicidal ideation (n=18), reported suicidal behavior was associated with lower control-related activation in premotor cortex ipsilateral to the active primary motor cortex. CONCLUSIONS: This study provides unique evidence that suicide risk directly relates to PFC-based circuit dysfunction during goal-representation, in a major mental illness with significant suicide rates. Among those with suicidal ideation, the overt expression in suicidal behavior may stem from impairments in premotor cortex support of action-planning as an expression of control. Further work should address how PFC-based control function changes with risk over time, whether this brain-behavior relationship is specific to schizophrenia, and address its potential utility as a biomarker for interventions to mitigate suicide risk.

Ablación de la fibrilación auricular por catéter con radiofrecuencia guiada por mapeo espectral de los Nidos de FA en ritmo sinusal / Atrial fibrillation catheter RF-ablation guide

Usando el mapeo espectral endocárdio en ritmo sinusal nosotros podemos definir dos tipos de miocardio auricular: el fibrilar con espectro segmentado hacia la derecha - llamado Nido-FA (NFA) - y el compacto con espectro no segmentado hacia la izquierda. Al inducir FA nosotros hemos observado constantemente activación muy desorganizada sobre los Nidos-FA [tejido resonante reactivo] mientras el compacto mantiene una activación bien regular [ tejido pasivo]. Ambos son activados por una taquicardia protegida de alta frecuencia "Taquicardia de Background" (TB). Describir el tratamiento de la FA a través de la ablación - RF de los Nidos-FA y la TB. 92 p (76 H, 52,4 ± 11 a) con FA refractaria muy frecuente, 56 paroxístina, 25 persistente, 11 permanente sin cardiopatía significativa (AI 41, 9 ± 5mm). 1- Ablación- RF con catéter de los NFA [4/8 mm-60°/30-40J/30s] guiado por mapeo espectral en ritmo sinusal fuera de las venas pulmonares (VP); 2- Estimulación auricular (300 ppm); 3- Adicional ablación de los NFA cuando era inducida FA; 4- Ablación de TB focal o Flutter cuando eran inducidos; 4 - Seguimiento Clínico SC (EKG/Holter). Una media de 50 ± 18 nidos-FA / p fueron tratados. Después de SC 0 11,3 ± 8 meses 81p (88%) no tenía FA (28,3 % previamente utilizaban drogas AA no eficaces). Después de ablación los NFA: fue imposible reinducir FA en 61p (71 %); en 31p (29%) solo FA no sostenida (< 10s) fue inducida; TB fue inducida y tratada en 24p (26%). Dos derrames pericárdicos ocurrieron (tratada en 24p (26%). Dos derrames pericárdicos ocurrieron (tratada en 24p (26%). Dos derrames pericárdicos ocurrieron (tratados 1 clínicamente y 1 quirúrgicamente) descrito utilizando una específica y no más usada vaina. El mapeo espectral de los Nidos - FA fue fácil de hallar y ablacionar; Durante la FA los Nidos _ FA juegan un papel resonante reactivo mientras el compacto juega un papel pasivo, uno o ambos son activados por la TB de elevada frecuencia; Después de la ablación de los...

Using endocardial spectral mapping in sinus rhythm we found two kinds of atrial myocardium: fibrillar with a rightward - segmented spectrum - named AF - Nest (AFN) - and compact with a leftward non - segmented spectrum. Inducing AF we have consistently observed very highly disorganized activation only in the AF - Nest [reactive resonant tissue] while the compact myocardium maintains well - organized, predominantly regular activation [passive tissue]. Both are activated by a high frequency protected tachycardia "Background Tachycardia" (BT). To describe treatment of AF by AF - Nests and BT catheter RF - ablation. 92 (76 males, 52.4 ± 11 y) with very frequent refractory AF, paroxysmal in 56, persistent in 25, and permanent in 11 without any significant cardiopathy (LA 41. 9 ± 5mm). 1 - AFN Catheter RF ablation [4/8mm - 60°/30-40J/30s] guided by spectral mapping in sinus rhythm outside the pulmonary veins (PV); 2 - Atrial stimulation (300ppm); 3 - AFN additional ablation if AF induced; 4 - BT focal or flutter ablation if induced; 4 - Clinical FU (EKG/Holter). A mean of 50 ± 18 AF nests/person were treated. After 11. 3 ± 8 months of follow up, 81 (88%) patients had no AF (28. 3 % previously on no effective AA drugs). After AFN ablations, it Was not possible to reinduce AF in 61 (71%) cases. In 31 patients (29 %) only non - sustained AF (< 10s) was induced; BT was induced and treated in 24 patientns (26%). Two pericardial effusions occurred (1 clinically and 1 surgically treated) related to an isolated cause and the other to a sheath no longer in use. Using spectral mapping, AF - Nests were easily found and ablated. During AF - Nests play a reactive resonant role while the compact myocardium plays a passive one, both activated by the high frequency BT. After AF - nest and BT ablations it was not possible to reinduce sustained AF; AF - nest and BT ablation around the PV is safe, feasible and very efficient for the cure or control of AF.

Syncopal high-degree AV block treated with catheter RF ablation without pacemaker implantation.

A 23-year-old-female patient had undergone a very successful gastric banding surgery to treat obesity. Six months later she began to present recurrent syncope due to very frequent, intermittent high-degree AV block referred to as pacemaker implantation. The electrophysiological study showed impaired AV nodal conduction but the His-Purkinje conduction was preserved. Partial catheter radiofrequency ablation of the cardiac autonomic nervous system guided by spectral endocardial mapping (cardioneuroablation) was performed. The electrophysiological parameters were normalized. Holter recordings were normal and the patient was asymptomatic with normal life without pacemaker implantation in a follow-up 21 months later.

Sleep parameters in patients using pacemakers with sleep rate function on.

INTRODUCTION: The cardiovascular system (CVS) is heavily influenced by the autonomic nervous system. Additionally, there is a functional alteration during the various stages of sleep. In nonrapid eye movement (NREM), a state of cardiovascular relaxation occurs during stages three and four. A large amount of rapid ocular movements is concentrated in rapid eye movement (REM) sleep. During this phase, fluctuations in arterial pressure (AP) and heart rate (HR) can be readily noted. Sleep disordered breathing (SDB) has been associated with cardiac rhythm disorders. Recently, cardiac rhythm disorder treatment with pacemaker (PM) highlighted a reduction in abnormal respiratory events during sleep. OBJECTIVE: Comparison of sleep parameters of patients using PM with a sleep rate (SR) algorithm based on its rate-modulated capability during physical activity (Integrity PM with SR function on and off). METHODS: Twenty-two patients (14 women, 8 men), implanted with an Integrity PM (St. Jude Medical Cardiac Rhythm Management Division, Sylmar, CA) with SR function for standard clinical indications, were evaluated utilizing a double-blind protocol. The indication for pacing included sinus node disease (SND), atrium ventricular blockage (AVB), and atrial fibrillation (AF). Following randomization, half of our patients had SR function switched to "on" mode while the other half were on "off" mode. During the first stage of the protocol, all patients underwent two consecutive nights of polysomnographic sleep recordings (PSG). During the first night patients slept in the sleep lab only for adaptation purpose. PSG full recording was carried out in the subsequent night. At a later stage, the programing of SR functions was shifted to "on" or "off" modes. One week later, a third assessment was undertaken. RESULTS: Twelve patients (54%) showed sleep efficiency improvement (total sleeping time/recording time) with PM SR on. This group had the least effective sleep efficiency with PM off, if compared with the others who highlighted no change in this sleep parameter (72 +/- 12 vs 81 +/- 7%, P = 0.01, respectively). This first group displayed a lower latency for REM sleep than the last one (89 +/- 55 vs 174 +/- 107 minutes, P = 0.01, respectively). In 11 (50%) patients, the number per sleep hour of microarousals was reduced when PM SR was switched on. When we compared such findings to the group whose parameters had not changed, we noted that the first set of patients were sleepier (ESE: 9 +/- 4 vs 5 +/- 5, P = 0.04, respectively), and showed more microarousals with PM SR off (20 +/- 14 vs 7 +/- 5 microarousal/hour, P = 0.007). CONCLUSION: In PM patients with sleep-related issues, the SR function activation improved sleep both from a qualitative and quantitative perspective.

"Cardioneuroablation"--new treatment for neurocardiogenic syncope, functional AV block and sinus dysfunction using catheter RF-ablation.

Cardiac neuroablation is a new technique for management of patients with dominantly adverse parasympathetic autonomic influence. The technique is based on radiofrequency (RF) ablation of autonomic connections in the three main ganglia around the heart. Their connections are identified by Fast-Fourier Transforms (FFTs) of endocardial signals: sites of autonomic nervous connections show fractionated signals with FFTs shifted to the right. In contrast, normal myocardium without these connections does not show these features. RF-ablation is thought to inflict permanent damage on the parasympathetic autonomic influence because its cells are adjacent to the heart whereas sympathetic cells are remote. Twenty-one patients with a mean age of 48 years, neurally mediated reflex syncope in six, functional high grade atrioventricular block in seven and sinus node dysfunction in 13 (there is overlap between the second and third groups) were treated. Follow-up for a mean of 9.2 months demonstrated success in all cases with relief of symptoms. No complications occurred.

A new treatment for atrial fibrillation based on spectral analysis to guide the catheter RF-ablation.

BACKGROUND: By studying the spectrum of atrial potentials by fast Fourier transform (FFT) we have found two types of atrial muscle: the compact (CM) and the fibrillar (FM) myocardium. The former presents normal in-phase conduction inferring a great number of cellular connections, long-lasting refractoriness and leftward FFT-shift. The latter shows anisotropic out-of-phase conduction, fewer cellular connections, short refractoriness and a segmented right-FFT-shift. The compact is the normal predominant muscle and the fibrillar is different and may be neural input, vein insertion, interatrial (1A) septum, left atrial (LA) roof, etc. or pathological tissue, being so by loss of cellular connections this is a possible mechanism for conversion of compact into fibrillar-like myocardium. During atrial fibrillation (AF), clusters of FM (AF nests) present higher frequencies than any surrounding tissue. PURPOSE: The purpose was to describe a new method for paroxysmal AF RF-ablation targeting AF nests. METHOD: Forty patients, six control and 34 having idiopathic drug-refractory paroxysmal or persistent AF were studied and treated. Two catheters were placed in the LA by transseptal approach. RF (30-40 J/60-70 degrees C) was applied to all sites outside the pulmonary veins (PV) presenting right-FFT-shift (AF nests). RESULTS: Numerous AF nests were found in 34/34 AF patients and only in 1/6 controls (only in this case it was possible to induce AF despite an absence of AF history). The main FM sites were: LA roof, LA septum, close to the insertion of the superior PV, near the insertion of the inferior PV, LA posterior wall, RA near the superior vena cava insertion, RA lateral and anterior wall and the right IA septum. Ablation of all AF nests near PV insertions resulted in 35 PV isolations. After 9.9 +/- 5 months only two AF patients presented relapse of a different AF form (coarse AF) which was very well controlled with medication previously ineffective. The AF was more frequent as the ratio FM/CM increased. CONCLUSIONS: The RF-ablation of AF nests decreasing the fibrillar/compact myocardium ratio eliminated 94% of the paroxysmal AF in patients in the FU of 9.9 +/- 5 months. The AF nests may be easily identified by spectral analysis and seem to be the real AF substrate. Paroxysmal AF may be cured or controlled by applying RF in several places outside the PV and, thereby, avoiding PV stenosis.

Multi-pathogens sequence containing plasmids as positive controls for universal detection of potential agents of bioterrorism.

BACKGROUND: The limited circulation of many of the agents that are likely to be used in a bioterrorism attack precludes the ready availability of positive controls. This means that only specialized laboratories can screen for the presence of these agents by nucleic amplification assays. Calibrated controls are also necessary for quantitative measurements. Primers and probes to be used in both conventional and real-time PCR assays were designed for the detection of agents likely to be used by a bioterrorist. Three plasmids, each of which contains 4 to 6 specific sequences from agents on the CDC Category A and B list (excluding RNA viruses) were constructed. Two plasmids incorporate the sequences of Category A and B agents, respectively. The third plasmid incorporates sequences from Variola major and organisms that cause rash-like illnesses that may be clinically confused with smallpox. An "exogenic sequence", introducing a NotI restriction site was incorporated in the native sequences of the bioterrorism agents inserted in plasmids. The designed molecular system for detection of bioterrorism agents was tested on each of these agents (except Monkeypox virus, Smallpox virus and 2 Burkholderia species for which no native DNA was available) and a collection of 50 isolates of C. burnetii using constructed plasmids as positive controls. RESULTS: Designed primers and probes allowed molecular detection, in either single or multiplex assays, of agent-specific targets with analytical sensitivities of between 1 and 100 DNA copies. The plasmids could be used as positive controls. False-positive results due to contamination by the positive control were easily detected by sequencing and eliminated by digestion with NotI. CONCLUSION: Plasmid A and B can be used as positive controls in molecular assays for the detection of bioterrorism agents in clinical specimens or environmental samples. Plasmid C can be used as a positive control in differentiation of vesicular rashes. It is also possible to avoid or to ensure immediate detection of false positive results due to contamination by positive controls using these plasmids. These plasmids and the corresponding primers and probes are immediately available for all clinical microbiology laboratories provided they have molecular amplification equipment.

Heavy metal pollution of road dust and roadside soil near a major rural highway.

The concentrations of lead, copper, cadmium, zinc, nickel and chromium were measured in road dust and roadside soils from a French major highway. The profiles of total levels in the soil as a function of distance from the road edge and as a function of depth were investigated. Lead, zinc, copper and, to a lesser extent, cadmium contamination were found in samples taken on the surface and in the immediate vicinity of the road. The observed concentrations decreased rapidly with distance and depth. Soil samples appeared to exhibit little nickel and chromium pollution. The geochemical phases on which heavy metals (lead, copper, zinc, cadmium and chromium) were fixed preferentially, as well as the potential mobility of the different metals under certain physical and chemical conditions were evaluated. Sequential extractions and single extractions with different reagents were performed. Chromium, which was present mostly in residual form, was mainly of natural origin in the studied samples and was not highly mobilisable. Cadmium was the most easily exchangeable element in case of variations in the physical and chemical conditions but the quantities involved remained small. Lead and copper did not appear to be highly mobile. Only drastic conditions, such as those that may be produced by accidental spillage of a chemical product (acid or complexing agent), mobilised them quantitatively. A significant risk of mobilisation was to be feared only in the case of zinc, which is very sensitive to acid pH.

In vitro and in vivo evaluation of new radiolabeled neurotensin(8-13) analogues with high affinity for NT1 receptors.

The potential utility of neurotensin (NT) in cancer diagnosis and therapy is limited by its rapid degradation. New stabilized analogues were synthesized, labeled with [99mTc] and screened in vitro and in vivo. High affinity and rapid internalization were obtained in binding assays. Despite their longer human plasma half-lives, a rapid degradation was observed with low concentrations as used in biodistribution tests. The tumor uptake rates were rather low but tumor/blood ratios increased according to the stability raise.