Purpose: Due to the stentless design and supra-anular position, the new generation SOLO bovine pericardial valve may be superior to stented models. A potential hazard is the significantly lower early postoperative platelet count (PC) as compared with stented valves. Analytical errors in laboratory testing were speculted to cause pseudothrombocytemia.

Objectives: The danger of aortic dissection following cardiac surgery is recognized. Information on incidence, etiology and outcome is sparse but increasing experience defines a more distinct clinical management.

Background Exhaustive exercise has been implicated in the generation of reactive oxygen species, resulting in oxidative stress. We studied the effect of a long-distance, endurance exercise on oxidative stress parameters in athletes who participated in the ultramarathon race Spartathlon (246 km).Materials and methods This study included 18 runners (16 men and 2 women) aged 42.8 +/- 1.4 years. Blood samples were obtained 24 h before (prerace), at the end (postrace) and 48 h after the end of the race (48 h postrace). We measured oxidative stress indices, including red cell glutathione, malonyldialdehyde and 8-iso-prostaglandin F-2a, as well as the total antioxidant capacity.Results 8-Iso-prostaglandin F-2a level increased significantly at the end of the race, compared to prerace levels (up to 914.7 +/- 61.4 pg mL(-1) from 197.6 +/- 8.4 pg mL(-1)), and remained 2.5-fold increased over the baseline 48 h after the race (532.0 +/- 54.2 pg mL(-1), P 0.000). The total antioxidant capacity of the athletes increased from a baseline of 289.6 +/- 9.0 mu mol L-1 to 358.7 +/- 11.0 mu mol L-1 immediately after the race and remained elevated 48 h later (350.6 +/- 7.6 mu mol L-1) (P < 0.001).Conclusions Prolonged exercise induces a marked response of oxidative stress biomarkers, which in part is compensated by serum ability to scavenge free radicals. Whether these changes have long-term negative effects in the organism needs further investigation.

Aims: We evaluated the application of a new combined surgical and endovascular technique for the treatment of the aortic arch. The technique is used to treat extensive aortic disease by a single-stage procedure. Surgical outcomes and follow-up data are summarized and analyzed.

Aim of the study: Bradycardia may represent a serious emergency. The need for temporary and permanent pacing is unknown.Methods: We analysed a registry for the incidence, symptoms, presenting rhythm, underlying mechanism, management and outcome of patients presenting with compromising bradycardia to the emergency department of a university hospital retrospectively during a 10-year period.Results: We identified 277 patients, 173 mate (62%), median age 68 (IQR 58-78), median ventricular rate 33 min(-1) (IQR 30-40). The leading symptoms were syncope [94 (33%)], dizziness [61 (22%)], collapse [46 (17%)], angina [46 (17%)] and dyspnoea/heart failure [30 (11%)]. The initial ECG showed high grade AV block [134 (48%)], sinus bradycardia/AV block [46 (17%)], sinu-atrial arrest [42 (15%)], bradycardic atrial fibrillation [39 (14%).] and pacemaker-failure [16 (6%)]. The underlying mechanisms were primary disturbance of cardiac automaticity and/or conduction [135 (49%)], adverse drug effect [58 (21%)], acute myocardial infarction [40 (14%)], pacemaker failure [16 (6%)], intoxication [16 (6%)] and electrolyte disorder [12 patients (4%)]. In 107 (39%) patients bed rest resolved the symptoms. Intravenous drugs to increase ventricular rate were given to 170 (61%) patients, 54 (20%) required additional temporary transvenous/transcutaneous pacing. Two severely intoxicated patients could be stabilised only by cardiopulmonary bypass. A permanent pacemaker was implanted in 137 patients (50%). Mortality was 5% at 30 days.Conclusion: In our cohort, about 20% of the patients presenting with compromising bradycardia required temporary emergency pacing for initial stabilisation, in 50% permanent pacing had to be established. (c) 2006 Elsevier Ireland Ltd. All rights reserved.

BACKGROUND:Ultra-endurance running is emerging as a popular sport in Western industrialised countries. Gastrointestinal bleeding has been reported to be an adverse effect in these runners.OBJECTIVE:To see if the oral administration of a proton pump inhibitor would reduce the incidence of gastrointestinal bleeding in an ultramarathon.METHODS:In a randomised, double blinded, placebo controlled study, a prophylactic regimen of three days of an oral proton pump inhibitor (pantoprazole 20 mg) was tested in healthy athletes participating in the Spartathlon ultramarathon. The incidence of gastrointestinal bleeding was assessed by a stool guaiac test.RESULTS:Results were obtained for 70 healthy volunteers. The data for 20 of 35 runners in the intervention group and 17 of 35 runners in the placebo group were entered into the final analysis. At the end of the ultramarathon, two subjects in the intervention group and 12 in the placebo group had positive stool guaiac tests (risk difference 0.86; 95% confidence interval 0.45 to 0.96; p = 0.001).CONCLUSION:A short prophylactic regimen of oral proton pump inhibition can successfully decrease the incidence of gastrointestinal bleeding in participants in an ultramarathon.

AllergyVolume 60, Issue 4 p. 545-545 Anaphylaxis after the ingestion of lamb meat K. Welt, K. WeltSearch for more papers by this authorR. Hinrichs, R. HinrichsSearch for more papers by this authorS. Ott, S. OttSearch for more papers by this authorM. Thalmann, M. ThalmannSearch for more papers by this authorJ. Dieckmännken, J. DieckmännkenSearch for more papers by this authorL. A. Schneider, L. A. SchneiderSearch for more papers by this authorG. Staib, G. StaibSearch for more papers by this authorK. Scharffetter-Kochanek, Corresponding Author K. Scharffetter-Kochanek *Universitätsklinik für Dermatologie und Allergologie Maienweg 12 89081 Ulm, Germany E-mail: [email protected]Search for more papers by this author K. Welt, K. WeltSearch for more papers by this authorR. Hinrichs, R. HinrichsSearch for more papers by this authorS. Ott, S. OttSearch for more papers by this authorM. Thalmann, M. ThalmannSearch for more papers by this authorJ. Dieckmännken, J. DieckmännkenSearch for more papers by this authorL. A. Schneider, L. A. SchneiderSearch for more papers by this authorG. Staib, G. StaibSearch for more papers by this authorK. Scharffetter-Kochanek, Corresponding Author K. Scharffetter-Kochanek *Universitätsklinik für Dermatologie und Allergologie Maienweg 12 89081 Ulm, Germany E-mail: [email protected]Search for more papers by this author First published: 02 February 2005 https://doi.org/10.1111/j.1398-9995.2005.00716.xCitations: 3 An immediate-type allergy to lamb meat is important to diagnose to prevent cross-reactivity. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 Wuthrich B. Allergy to meat proteins in adults. Allergologie 1996; 19: 130–134. Web of Science®Google Scholar 2 Restani P, Fiocchi A, Beretta B, Velina T, Giovannini M, Galli CL. Meat allergy: III – Proteins involved and cross-reactivity between different animal species. J Am Coll Nutr 1997; 16: 383–389. 10.1080/07315724.1997.10718701 CASPubMedWeb of Science®Google Scholar 3 Ayuso R, Lehrer SB, Lopez M, Reese G. Identification of bovine IgG as a major cross-reactive vertebrate meat allergen. Allergy 2000; 55: 348–354. 10.1034/j.1398-9995.2000.00285.x CASPubMedWeb of Science®Google Scholar 4 Hawkins CA, Katelaris CH. Nitrate anaphylaxis. Ann Allergy Asthma Immunol 2000; 85: 74–76. 10.1016/S1081-1206(10)62438-6 CASPubMedWeb of Science®Google Scholar 5 Jäger L, Wüthrich B. Nahrungsmittelallergien und –intoleranzen. München: Urban & Fischer, 2002. Google Scholar 6 Chua YY, Bremner K, Llobet JL, Kokubu HL, Collins-Williams C. Diagnosis of food allergy by the radioallergosorbent test. J Allergy Clin Immunol 1976; 58: 477–482. 10.1016/0091-6749(76)90191-3 PubMedWeb of Science®Google Scholar Citing Literature Volume60, Issue4April 2005Pages 545-545 ReferencesRelatedInformation

C. pneumoniae does not play a clinically relevant role in acute and chronic aortic disease. The impact of other organisms of the family Chlamydiaceae needs further evaluation.

SummaryFourteen patients with severe hypotension and adult respiratory distress syndrome after trauma (n= 7), general surgery (n = 6) or burns (n = 1) were studied. After volume loading with 6 ml.kg‐1 hydroxyethyl starch over 30 min (time I), dobutamine was infused intravenously at 5 μg.kg‐1.min‐1 (time II) and 10 μg.kg‐1 .min‐1 (time III). A 5 MHz transoesophageal echocardiographic probe was used to image a standard transgastric short axis view of the left ventricle. Haemodynamic data were obtained from thermodilution studies using pulmonary flotation catheterisation. Echocardiographic measurements (off‐line from videotape) and qualitative visual assessment of left ventricular function (visual assessment, on‐line) were performed. All measurements were made after fluid replacement, and during infusion of the two dobutamine doses. An improvement in mean systemic arterial blood pressure and mean stroke volume occurred from time I to the end of dobutamine infusion (p < 0.05). All patients, after volume infusion, were normovolaemic according to transoesophageal echocardiography and there was a good correlation between end‐diastolic area and stroke volume (r = 0.73). During dobutamine infusion, echocardiographic measurements showed no significant dose‐related increase in mean (SD) percentage left ventricular short axis area change from baseline after hydroxyethyl starch (time I: 60 (2); time II: 63 (2); time III: 64 (2)). However, a significant increase in short axis area change was seen in nine of the 14 patients (67%). Analysis of the end‐diastolic area/short axis area change relationship revealed a heterogeneous response to dobutamine. Dobutamine infusion resulted in an improvement in haemodynamics in the majority of patients with sepsis‐related adult respiratory distress syndrome, and transoesophageal echocardiography provided important additional information on ventricular performance.