No abstract

Gagging increased heart velocity and had differential effect on two branches of cardiac autonomic nerves. The paradoxical relation between average heart rate and HRV indexes of sympatovagal tone may be due to unequal rate of change in autonomic fiber activities which is masked by 5 minutes interval averaging.

AimsEchocardiography is known as the most useful diagnostic test in the assessment of patients with heart failure (HF), and the prognostic significance of echocardiographic findings in HF is well known. In this report, we aim to present the prognostic significance of a limited set of echocardiographic parameters obtained within 24 h of admission of patients enrolled in the Rajaie Acute Systolic Heart Failure registry.Methods and resultsA total of 230 patients with the diagnosis of acute systolic HF (left ventricular ejection fraction ≤ 35%) were enrolled into the study. Transthoracic echocardiography was performed for all study population within 24 h of admission. The primary endpoint of the study was the occurrence of worsening renal function (WRF) during the hospitalization course.Acquiring data of transthoracic echocardiography within 24 h of admission was feasible in all study participants. The median (inter‐quartile range) of left ventricular ejection fraction was 20% (15–23%). Severe right ventricular dysfunction was observed in 21.5% of patients. The grade of inferior vena cava collapse and right ventricular systolic dysfunction were associated with WRF. In multivariable analysis, right ventricular systolic dysfunction was among the independent predictors of WRF [β = 0.8, P = 0.01, odds ratio (OR) = 2.4 (1.2–4.9)] and in‐hospital mortality [β = 0.6, P = 0.04, OR = 1.5 (0.5–4.6)].ConclusionsEchocardiographic parameters are useful for baseline assessment and provide additional information besides other clinical variables for prognostication. Right ventricular dysfunction is the most important risk factor in developing WRF and in‐hospital mortality in patients with acute HF.

Background:During the four steps of the Valsalva maneuver (VM), opposite changes can be observed in some physiologic parameters. Manifestations of the VM in the electrocardiogram (ECG) have been studied in detail, but there have been few reports comparing VM-related biochemical and hemodynamic changes with a focus on the strain phase of the VM.Objectives:We studied strain-related ECG changes during the VM.Patients and Methods:This self-control descriptive study was conducted in 20 healthy male college students aged 20.12 ± 2.23 years. They were well trained to perform the standard VM: maintenance of a 15-second expiratory pressure at 40 mmHg with open glottis. An ECG was continuously recorded in the supine position at (a) rest (before the VM) and at (b) the start and (c) end of strain maintenance in the second phase of the VM. The averages of four successive beats were computed for each set of (a), (b), and (c). Means ± standard errors of the mean were used for comparison.Results:Following the VM, the RR and PR intervals, corrected QT interval (QTc), P wave duration and amplitude, T wave amplitude, and the ratio of T/R amplitudes showed significant changes. The QRS duration and R wave amplitude did not show significant changes.Conclusions:The VM caused time and voltage changes in some ECG waves during the strain phase. Alterations in heart or lung volume, electrode-related alterations, and autonomic tone may cause these changes.

The antibiotic resistance or susceptibility patterns of common bacterial pathogens vary between geographical regions. We investigated the antibiotic resistance pattern of common uropathogens in a population of young children. In this cross- sectional retrospective study, children suspected of having urinary tract infection (UTI) that were referred to Taleghani Pediatric Hospital from March 2009 until March 2010 were included. Urine cultures were performed before initiation of antibiotics. Demographic information and results of cultures and antibiograms were obtained from the laboratory archive. Cultures with colony count ≥ 105 cfu/ml in midstream urine samples or any colony count in the suprapubic samples were considered to be positive. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. We evaluated 7844 urine cultures of which 153 (2%) were obtained from supra-pubic aspiration route. 3839 (48.9%) were male. In total, 533 (6.8%) of cultures were positive (64.2% were female). E. coli was the most common organism in positive samples in both sexes, but it was significantly more common in the females than males (83.3% vs. 75.4%, P < 0.05). E. coli showed the highest percentage of resistance to ampicillin (84.1%) and the lowest resistance to amikacin (11%). We found that E. coli was the predominant bacterial pathogen and that the antimicrobial resistance patterns of the different uropathogens were highly variable, emphasizing the importance of continuous surveillance of trends in resistance patterns of uropathogens. © 2013 - IOS Press and the authors. All rights reserved