A survey on a rural in-hospital population diagnosed with Atrial Fibrillation in west Shewa region, Ethiopia.

BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia seen in clinical practice. It has been extensively studied in Western countries but less is known about developing countries. METHODS: We collected data on a rural population afferent to Wolisso hospital in Ethiopia, analysing epidemiology, clinical and cardiac ultrasound profile.We enrolled 54 patients with first diagnosis of AF who undertook cardiac ultrasound and a questionnaire about personal and clinical profile. RESULTS: Enrolled patients were younger than reported in the African urban population (mean age 51 years) and females were symptomatic at a younger age than males (61.8% of females were <50 years old versus 30% of males) and had complicated disease (100% of females had CHF). Rheumatic heart disease (RHD) was found in 38.9% of patients, especially in females (41.1%) and young patients, whereas hypertension (HTN) and degenerative valvular disease were predisposing to AF in old patients. CONCLUSION: Low socio-economic level may explain findings we observed, particularly male to female ratio, more relevant than in urban subsets. RHD and HTN are many etiological factors of AF in our small population, so low-cost strategies to prevent their complications are surely cost-effective in rural catchment area of Wolisso hospital.

The autobiographical fluency task: Validity and reliability of a tool to assess episodic autobiographical memory and experience-near personal semantics.

The assessment of autobiographical memory is challenging in clinical settings. The Autobiographical Fluency Task (AFT) - that is designed to test both Episodic Autobiographical Memory (EAM) and experience-near Personal Semantics (enPS) - may represent a feasible and rapid method to test access to autobiographical memories. Here we tested the reliability and the construct validity of the AFT. A total number of 51 individuals participated in the present study, with 24 included in Experiment 1 and 27 in Experiment 2. In Experiment 1, participants performed both the AFT and the Survey of Autobiographical Memory (SAM). In Experiment 2, participants completed the AFT and the Autobiographical Interview (AI). The AFT showed a moderate-to-high reliability. Also, EAM and enPS scores significantly correlated with the episodic subscale of the SAM. Results of Experiment 1 were replicated and expanded in Experiment 2. Again, the AFT showed a high reliability. Both EAM and enPS showed a significant correlation with the number of internal details produced during the AI; enPS also correlated with the number of external details. Overall, the present results show that the AFT may be a feasible instrument to assess autobiographical memory, especially for testing episodic autobiographical memory and experience-near personal semantics in clinical settings.

Lifelong impairment in episodic re-experiencing: Neuropsychological and neuroimaging examination of a new case of Severely Deficient Autobiographical Memory.

Autobiographical memory (AM) represents a complex and multimodal cognitive function, that allows an individual to collect and retrieve personal events and facts, enabling to develop and maintain the continuity of the self over time. Here we describe the case of DR (acronym of the fictional name Doriana Rossi), a 53-year-old woman, who complains of a specific and lifelong deficit in recalling autobiographical episodes. Along with an extensive neuropsychological assessment, DR underwent a structural and functional MRI examination to further define this impairment. The neuropsychological assessment revealed a deficit in episodic re-experiencing of her own personal life events. DR showed reduced cortical thickness in the Retrosplenial Complex in the left hemisphere, and in the Lateral Occipital Cortex, in the Prostriate Cortex and the Angular Gyrus in the right hemisphere. An altered pattern of activity in the calcarine cortex was detected during ordering of autobiographical events according to her own personal timeline. The present study provides further evidence about the existence of a severely deficient autobiographical memory condition in neurologically healthy people, with otherwise preserved cognitive functioning. Furthermore, the present data provide new important insights into neurocognitive mechanisms underpinning such a developmental condition.

[Electrocardiographic diagnosis: when QRS is wide.] / Diagnostica elettrocardiografica: quando il QRS è largo.

Differential diagnosis of one or more wide QRS complexes on an electrocardiogram under emergency conditions takes into account three main sets of clinical conditions: ventricular pre-excitation, aberrant conduction and ventricular beats and it is based on the morphological analysis of the ECG and patient's anamnestic data. Several criteria can facilitate the differential diagnosis and if properly used and integrated with clinic data they can achieve good diagnostic accuracy in most cases. In this review several criteria based on evidence and literature are presented, paying attention in recognizing some morphologic pathways that can be used in emergency room and allow a correct ECG assessment.

Pre-hospital oily chloramphenicol treatment in meningitis outbreaks in low resources environments.

Bacterial meningitis is an important cause of death and disability in sub-Saharan Africa and, with pre-treatment in peripheral health centres, the poorest populations could avoid early death, especially if they live far from hospital. During the 2001 meningitis epidemic in south Chad, Moyen Chari sanitary district peripheral health centres were equipped with oily chloramphenicol (CAP) to administer before hospital referral in suspected cases of meningitis. Eighty-six patients treated with CAP in whom the diagnosis was definitively confirmed subsequently in hospital were compared with patients receiving CAP at hospital admission during the same period. A statistically significant reduction in lethality rate, need of second line treatment or adjunctive antibiotics, and mean hospital stay were confirmed in pre-treated patients.

Erros profissionais: seus aspectos jurídicos / Legals aspects of professional mistakes

O objetivo do trabalho visa a difusäo do conhecimento atual acerca de responsabilidade civil, abordando questöes de eminente interesses para os cirurgiöes-dentistas. Essas questöes abrangem proteçäo dos profissionais, frente à lei