The AFFIRM Study enrolled 4060 predominantly elderly patients with atrial fibrillation to compare ventricular rate control with rhythm control. The patients in the AFFIRM Study were representative of patients at high risk for complications from atrial fibrillation, which indicates that the results of this large clinical trial will be relevant to patient care.

Premature ventricular contractions (PVC) elicit larger bursts of multiunit muscle sympathetic nerve activity (MSNA), reflecting the ability to increase postganglionic axonal recruitment. We tested the hypothesis that chronic heart failure (CHF) limits the ability to recruit postganglionic sympathetic neurons as a response to PVC due to the excessive sympathetic activation in these patients. Sympathetic neurograms of sufficient signal-to-noise ratio were obtained from six CHF patients and from six similarly aged control individuals. Action potentials (APs) were extracted from the multiunit sympathetic neurograms during sinus rhythm bursts and during the post-PVC bursts. These APs were classified on the basis of the frequency per second, the content per burst, and the peak-to-peak amplitude, which formed the basis of binning the APs into active clusters. Compared with controls, CHF had higher APs per burst and higher number of active clusters per sinus rhythm burst (P < 0.05). Compared with sinus rhythm bursts, both groups increased AP frequency and the number of active clusters in the post-PVC burst (P < 0.05). However, compared with controls, the increase in burst integral, AP frequency, and APs per burst during the post-PVC burst was less in CHF patients. Nonetheless, the PVC-induced increase in active clusters per burst was similar between the groups. Thus, these CHF patients retained the ability to recruit larger APs but had a diminished ability to increase overall AP content.

No abstract

Emerging research suggests that head trauma, causing clinical (medically diagnosed, ie. concussion), or sub‐clinical minor Traumatic Brain Injury (mTBI) is cumulative and correlates negatively with cognitive function. Given the high prevalence of head trauma in contact athletics, better understanding the relationship between contact‐athletic activity, mTBI, and independent aspects of cognitive function is imperative.Sixty‐eight varsity football athletes were recruited to examine how cumulative head trauma and self‐reported mTBI affect cognitive function. Participants completed a 12‐test online cognitive battery (www2.cbstrials.com) at time points prior to, bi‐weekly throughout, and after the season. With each cognitive test, participants also completed a personal history questionnaire to assess their ongoing athletic activity and mTBI status. Through assessing three distinct aspects of cognitive function (verbal ability, short‐term memory, and reasoning ability) via the cognitive battery in a longitudinal fashion, we will comprehensively examine the effects of contact athletic participation on independent aspects of cognitive function. Results look to better characterize the relationship between mTBI and cognitive function as well as inform sport decisions made by athletes, recreationalists and athletic governance councils to guide participation and safe play decisions.

Background Cerebral toxoplasmosis infection presents with non-specific neurologic symptoms in immunocompromised patients. With lack of measurable adaptive immune responses and reluctance to sample affected brain tissue, expedient diagnosis to guide directed treatment is often delayed. Case presentation We describe the use of cerebrospinal fluid polymerase chain reaction and plasma cell-free DNA technologies to supplement neuroimaging in the diagnosis of cerebral toxoplasmosis in an immunocompromised pediatric patient following allogeneic hematopoietic cell transplantation for idiopathic severe aplastic anemia. Successful cerebral toxoplasmosis treatment included antibiotic therapy for 1 year following restoration of cellular immunity with an allogeneic stem cell boost. Conclusions Plasma cell-free DNA technology provides a non-invasive method of rapid diagnosis, improving the likelihood of survival from often lethal opportunistic infection in a high risk, immunocompromised patient population.