bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary results of a monitoring system to confirm the preservation of cavernous nerves
Authors: Kurokawa Kohei , Suzuki Takanori , SuzukI Kazuhiro , Terada Naoki , Ito Kazuto , Yoshikawa Daisuke , Arai Yoichi , Yamanaka Hidetoshi
Published: December 2004

Background: It is important to preserve the neurovascular bundle (NVB) during nerve‐sparing surgery. This article presents the preliminary results of our monitoring system for the postoperative preservation of erectile function.

Methods: In 15 patients undergoing radical prostatectomy and 20 patients undergoing radical cystoprostatectomy, intraoperative electrical stimulation along the NVB was performed to measure changes in intracavernous pressure before and after prostate removal. Seven of the radical prostatectomy patients and eight of the radical cystoprostatectomy patients underwent nerve‐sparing surgery. Postoperative erectile function was evaluated in 25 patients not receiving adjuvant hormonal therapy.

Results: The NVB was judged to be preserved at least on one side electrophysiologically in 14 of 15 patients. Pathologically, three patients had pT3 cancer. Postoperatively, sufficient erectile function was demonstrated using the International Index of Erectile Function 5 in three patients, nocturnal penile tumescence in three patients, and a questionnaire or an interview in three patients. The other patients were incompletely erectile. None of the 11 patients not receiving adjuvant hormonal therapy, in whom NVB was not preserved, were erectile.

Conclusion: If the successful criterion of nerve‐sparing surgery is defined as a change in intracavernous pressure of 4 cm H2O or more being observed at least unilaterally, and the successful criteria of erectile function preservation includes being sufficiently erectile as revealed by an interview, the sensitivity of our system was 69.2% (9/13) and the specificity was 100% (12/12). Neither adverse reactions to the measurement, nor inadequacy of cancer excision accompanying NVB sparing, were observed. These results suggest that our system can predict postoperative erectile function fairly accurately.
Health effects of kava use in an eastern Arnhem Land Aboriginal community
Authors: Clough A. R. , Jacups S. P. , Wang Z. , Burns C. B. , Bailie R. S. , Cairney S. J. , Collie A. , Guyula T. , McDonald S. P. , Currie B. J.
Published: December 2004

Abstract

Background:  Heavy kava use in Aboriginal commun­ities has been linked to various health effects, including anecdotes of sudden cardiac deaths.

Aims:  To examine associations between kava use and potential health effects.

Methods:  A cross‐sectional study was carried out within a kava‐using east Arnhem Land Aboriginal community in tropical northern Australia. One‐hundred‐and‐one adults who were current, recent or non‐users of kava were enrolled in March 2000. Main outcome measures were physical, anthropometric, biochemical, haematological, immunological and neurocognitive assessments.

Results:  Kava users more frequently showed a characteristic dermopathy (P < 0.001). They had increased levels of γ‐glutamyl transferase and alkaline phosphatase (P < 0.001). Lymphocyte counts were significantly lower in kava users (P < 0.001). Fibrinogen, plasmin­ogen activator inhibitor‐1 and neurocognitive tests were not different between kava use categories. IgE and IgG antibodies were elevated across the whole group, as were C‐reactive protein and homocysteine.

Conclusions:  Kava use was associated with dermopathy, liver function abnormalities and decreased lymphocytes. If kava continues to be used by Aboriginal populations, monitoring should focus on the health consequences of these findings, including a possible increase in serious infections. The interaction between kava, alcohol and other substances requires further study. Although markers of cardiovascular risk are increased across the population, these were not higher in kava users, and this increase may be linked to the large infectious pathogen burden reflective of the socioeconomic disadvantage seen in many remote Aboriginal communities. (Intern Med J 2003; 33: 336−340)
Helicobacter pylori, Chlamydia pneumoniae and myocardial infarction
Authors: Fraser A. G. , Scragg R. K. , Cox B. , Jackson R. T.
Published: December 2004

Abstract

Background:  Several epidemiological studies have suggested a positive association of coronary heart disease with both Helicobacter pylori and Chlamydia pneumoniae infection. The issue has been difficult to resolve because of the potential impact of several confounding factors, in particular, socioeconomic status for H. pylori and smoking for C. pneumoniae.

Methods:  A case‐control study was carried out of 341 patients with a recent myocardial infarction (MI) and 831 community controls who had serology tests for H. pylori and C. pneumoniae (selected from a total study number of 1745 subjects). Individuals of Pacific Island or Maori ethnicity were excluded because they were infrequent.

Results:  H. pylori seropositivity was associated with increasing age (P < 0.001) and lower household income (P = 0.0003) but not with gender, smoking status or alcohol intake. H. pylori was associated with lower high‐density lipoprotein cholesterol (P = 0.007) and a higher body mass index (P = 0.007). The overall seropositivity for H. pylori was 41.6% for patients with MI and 34.5% for age and sex‐matched population controls. The odds ratio was 1.34 (95% confidence interval (CI): 1.00−1.80; P = 0.038) after adjusting for age and sex. C. pneumoniae seropositivity was significantly associated with male sex, younger age (P = 0.03) and smoking status (P = 0.004) but not associated with household income or any other measured risk factor for coronary heart disease. The overall seropositivity for C. pneumoniae was 51.2% for patients with recent MI and 43.5% for controls. After adjusting for age and sex, the odds ratio was 1.24 (95%CI: 0.95−1.62; P = 0.11). Subgroup analysis showed no clear pattern within different age groups. In particular, the odds ratio for H. pylori seropositivity in younger subjects (aged 35−49 years) was similar to the overall group (1.38; 95%CI: 0.83−2.29).

Conclusion:  The association between H. pylori or C. pneumoniae seropositivity and coronary heart disease was significant but may not indicate a causal association. (Intern Med J 2003; 33: 267−272)
Full publication of trials initially reported as abstracts in the Australian and New Zealand Journal of Medicine 1980−2000
Authors: Hopewell S. , McDonald S.
Published: December 2004

Abstract

Failure to identify all relevant reports of controlled trials is a potential source of bias in systematic reviews of health‐care interventions. The present study aims to identify how many reports of trials ­initially published as conference abstracts in the Australian and New Zealand Journal of Medicine were subsequently published in full. We identified trial reports by handsearching conference abstracts published in the Journal from 1980 to 2000. We then searched the Cochrane Controlled Trials Register and PubMed to determine how many of these had been subsequently published in full. A total of 962 reports of controlled trials was identified from the conference proceedings of 17 medical societies. Of these, 589 (61%) reports of trials were subsequently published in full, and on average within 1−2 years. Handsearching conference abstracts identified a large number of reports of controlled trials, over one‐third of which were unpublished and therefore not easily accessible. (Intern Med J 2003; 33: 192−194)
Utility of Exit Block for Identifying Electrical Isolation of the Pulmonary Veins
Authors: GERSTENFELD EDWARD P. , DIXIT SANJAY , CALLANS DAVID , RHO ROBERT , RAJAWAT YADAVENDRA , ZADO ERICA , MARCHLINSKI FRANCIS E.
Published: December 2004

Pulmonary Vein Exit Block.
Introduction: Electrical isolation of the pulmonary veins (PVs) to treat paroxysmal atrial fibrillation (AF) has been described using “entry block” as an endpoint for PV isolation. We describe a new technique for guiding PV isolation, using “exit block” out of the PV after ablation as a criterion for successful isolation.

Methods and Results: A circular mapping catheter was positioned at the os of arrhythmogenic PVs and ablation was performed proximal to the mapping catheter until entry block into the vein was achieved. Pacing was performed from the mapping catheter and from the ablator inside the PV to document exit block out of the PV. In patients in whom cardioversion did not restore sinus rhythm, PV isolation was performed in AF. Entry and exit block were reassessed in ablated veins after a 20‐minute waiting period. Ninety‐five PVs were ablated in 41 patients. A total of 66 PVs in 34 patients were ablated in sinus rhythm. After entry block was achieved, exit block was present in only 38 (58%) of 66 PVs. A total of 29 PVs in 21 patients were ablated in AF. After cardioversion to sinus rhythm, there was evidence of entry block into the PV in 20 (69%) of 29 PVs and exit block in only 14 (48%) of 29 PVs. There was no significant difference between the total number of lesions applied per vein in sinus rhythm compared with AF (11.6 ± 8.6 vs 10.3 ± 6.2; P = NS). There was recovery of conduction after a 20‐minute waiting period in 9 (11%) 84 PVs.

Conclusion: Identification of exit block after ostial PV ablation provides a clear endpoint for electrical isolation of the PVs. Isolation of the PVs can be performed during sustained AF without the need to apply excess RF lesions. Applying a 20‐minute waiting period after electrical isolation will identify reconnection in approximately 10% of PVs.
Extended Distribution of Prolonged and Fractionated Right Atrial Electrograms Predicts Development of Chronic Atrial Fibrillation in Patients with Idiopathic Paroxysmal Atrial Fibrillation
Authors: NAKAO KOJIRO , SETO SHINJI , UEYAMA CHIAKI , MATSUO KIYOTAKA , KOMIYA NORIHIRO , ISOMOTO SHOJIRO , YANO KATSUSUKE
Published: December 2004

Prolonged and Fractionated RA Electrogram in PAF Folio.
Introduction: This study evaluates whether electrophysiologic abnormalities in patients with idiopathic paroxysmal atrial fibrillation (PAF) predict the transition to chronic atrial fibrillation (CAF).

Methods and Results: Ninety‐six patients with idiopathic PAF underwent electrophysiologic study and were followed up. During electrophysiologic study, endocardial mapping was performed at 12 sites in the right atrium (four aspects of the high, middle, and low right atrium). During follow‐up of 60 to 130 months, conversion from PAF to CAF was observed in 17 patients (CAF group). The remaining 79 patients remained in sinus rhythm (PAF group). Although a high frequency of abnormal atrial electrograms was observed in the high right atrium in both groups, the frequency of those recorded from the middle right atrium was significantly higher in the CAF group than in the PAF group (70.6% vs 13.9%, P < 0.0005). Kaplan‐Meier analysis showed that > 50% of the patients with abnormal atrial electrograms in the middle right atrium developed CAF after 10 years, whereas only 7% of patients without those developed CAF (P < 0.0001).

Conclusion: Our data suggest that extended distribution of abnormal atrial electrograms from the high to middle right atrium is predictive of the development of CAF in patients with idiopathic PAF.
P Wave Signal‐Averaged Electrocardiography Predicts Recurrence of Paroxysmal Atrial Fibrillation in Patients with Wolff‐Parkinson‐White Syndrome Who Underwent Successful Catheter Ablation: A Prospective Study
Authors: HIRAKI TATSURO , IKEDA HISAO , YOSHIDA TERUHISA , INAGE TOMOHITO , OHE MASATSUGU , OHTSUBO HITOSHI , MATSUMOTO MANABU , HAMADA TAKASHI , KUBARA ICHIRO , IMAIZUMI TSUTOMU
Published: December 2004

P‐SAECG Predicts Recurrence of PAF After Ablation.
Introduction: Paroxysmal atrial fibrillation (PAF) frequently occurs in patients with Wolff‐Parkinson‐White (WPW) syndrome. Catheter ablation of the accessory pathway eliminates PAF in some patients, but PAF frequently recurs in other patients. The present study was designed to determine prospectively whether P wave signal‐averaged electrocardiography (P‐SAECG) predicts the recurrence of PAF after successful ablation in patients with WPW syndrome.

Methods and Results: Forty‐six patients with WPW syndrome who had episodes of PAF were prospectively followed. SAECG recording was performed on day 7 after successful ablation of the accessory pathway at study entry. Abnormal P‐SAECG for the prediction of recurrence of PAF was defined as a filtered P wave duration > 130 msec. Eleven patients had an abnormal P‐SAECG (group 1), whereas 35 patients (group 2) did not. The two groups did not differ in terms of gender, age, left atrial dimension, and atrial vulnerability as determined by electrophysiologic study. During follow‐up (40 ± 19 months), the recurrence of PAF was noted in 10 (91%) of 11 patients in group 1, whereas it was observed in only 2 (6%) of 35 patients in group 2. Kaplan‐Meier analysis revealed that the recurrence of PAF was significantly more frequent in group 1 than in group 2 (log rank test, P < 0.0001). By multivariate analysis, filtered P wave duration > 130 msec was an independent predictor of recurrence of PAF after ablation (Chi‐square = 21.5, P < 0.0001).

Conclusion: The results of this study indicate that P‐SAECG may be useful for identifying patients at risk for recurrence of PAF after successful ablation of WPW syndrome.
Total Pulmonary Vein Occlusion as a Consequence of Catheter Ablation for Atrial Fibrillation Mimicking Primary Lung Disease
Authors: ERNST SABINE , OUYANG FEIFAN , GOYA MASAHIKO , LÖBER FELIX , SCHNEIDER CARSTEN , HOFFMANN‐RIEM MARTIN , SCHWARZ STEFAN , HORNIG KLAUS , MÜLLER KLAUS‐MICHAEL , ANTZ MATTHIAS , KAUKEL ECKHARD , KUGLER CHRISTIAN , KUCK KARL‐HEINZ
Published: December 2004

Introduction: Catheter ablation has recently been used for curative treatment of atrial fibrillation.

Methods and Results: Three of 239 patients who underwent ablation close to the pulmonary vein (PV) ostia at our institute developed severe hemoptysis, dyspnea, and pneumonia as early as 1 week and as late as 6 months after the ablation. Because the patients were arrhythmia‐free, the treating physician initially attributed the symptoms to new‐onset pulmonary disease (e.g., bronchopulmonary neoplasm). After absent PV flow was confirmed by transesophageal echocardiography, transseptal contrast injection depicted a totally occluded PV in all three patients. Successful recanalization, even in chronically occluded Pvs, was performed in all patients. During follow‐up, Doppler flow measurements by transesophageal echocardiography demonstrated restenosis in all primarily dilated PV, which led to stent implantation.

Conclusion: PV stenosis/occlusion after catheter ablation of atrial fibrillation occurs in a subset of patients. However, because in‐stent restenosis occurred in two patients after 6 to 10 weeks, final interventional strategy for PV stenosis or occlusion remains unclear. To prevent future PV stenosis or occlusion, a decrease in target temperature and energy of radiofrequency current or the use of new energy sources (ultrasound, cryothermia, microwave) seems necessary.
(J Cardiovasc Electrophysiol, Vol. 14, pp. 366‐370, April 2003)
Site‐Specific Arrhythmogenesis in Patients with Brugada Syndrome
Authors: MORITA HIROSHI , FUKUSHIMA‐KUSANO KENGO , NAGASE SATOSHI , TAKENAKA‐MORITA SHIHO , NISHII NOBUHIRO , KAKISHITA MIKIO , NAKAMURA KAZUFUMI , EMORI TETSURO , MATSUBARA HIROMI , OHE TOHRU
Published: December 2004

Introduction: It has been believed that electrophysiologic abnormality of the epicardial region of the right ventricular free wall may play an important role in arrhythmogenesis of phase 2 reentry in Brugada syndrome, but clinical evidence of the occurrence of ventricular arrhythmias at the right ventricular free wall has not been evaluated. In this study, we evaluated the site‐specific inducibility of ventricular fibrillation (VF) and the origin of spontaneous premature ventricular contractions (PVCs) in patients with Brugada syndrome.

Methods and Results. Forty‐five patients with Brugada‐type ECG were enrolled in this study. Spontaneous PVCs were recorded in 9 patients. Programmed electrical stimulation (PES) was performed at the right ventricular apex (RVA), the free wall and septal region of the right ventricular outflow tract (RVOT), and the left ventricle (LV). The inducibility of PVT/VF was evaluated at each ventricular site, and the origin of PVC was determined by pace mapping. Sustained VF was induced in 17 patients. VF was induced in all 17 patients by PES at RVOT. Although PES at the septal region of the RVOT induced VF in only 5 patients (29%), PES at the free‐wall region of the RVOT induced PVT/VF in 13 patients (76%). PES at RVA induced VF in only 2 patients (12%), and PES at LV failed to induce any arrhythmic events. Ventricular pace mapping showed that 64% of PVCs occurred at the free‐wall region of the RVOT, 18% at the septal region of the RVOT, 9% at RVA, and 9% at LV.

Conclusion: VF in patients with Brugada syndrome frequently is induced at the free‐wall region of the RVOT area. The origin of PVC appears to be related to the site of PVT/VF induction by PES.
(J Cardiovasc Electrophysiol, Vol. 14, pp. 373‐379, April 2003)
A Newly Characterized SCN5A Mutation Underlying Brugada Syndrome Unmasked by Hyperthermia
Authors: MOK NGAI‐SHING , PRIORI SILVIA G. , NAPOLITANO CARLO , CHAN NGAI‐YIN , CHAHINE MOHAMED , BAROUDI GHAYATH
Published: December 2004

Febrile illness has been rarely reported to modulate ST segment elevation in right precordial leads on ECG or even precipitate ventricular fibrillation in patients with Brugada syndrome. We report the case of a patient whose Brugada ECG pattern was unmasked by hyperthermia secondary to acute cholangitis. Serial ECGs showed progressive attenuation of ST segment elevation as body temperature gradually returned to normal. Structural heart disease was ruled out. Intravenous flecainide injection reproduced a less remarkable ST segment elevation. Genetic screening demonstrated a single amino acid substitution (H681P) in the SCN5A gene, thus confirming the diagnosis of Brugada syndrome. In vitro expression of this newly characterized genetic defect revealed novel biophysical abnormalities consisting of a shift in both steady‐state activation and inactivation, resulting in a 60% reduction of sodium window current. Thus, SCN5A‐H681P mutation induces a significant loss of transmembrane current and is clinically associated with a pathologic phenotype that is elicited by hyperthermia. Overall the observed clinical features are in agreement with previous observations and strongly suggest that fever may be an environmental modifier among Brugada syndrome patients with a detrimental (and possibly arrhythmogenic) effect on cardiac repolarization.
(J Cardiovasc Electrophysiol, Vol. 14, pp. 407‐411, April 2003)
Inherited Arrhythmic Disorders in Japan
Authors: HIRAOKA MASAYASU
Published: December 2004

The clinical and genetic characteristics of inherited arrhythmic disorders in Japan are briefly summarized. The incidence of hereditary long QT syndrome (LQTS) in Japan seems comparable to that in western countries. The genotypes are mainly LQT1 and LQT2; LQT3 and other types are rare. Mutations found in Japanese LQTS families are mostly novel compared to mutations reported in other countries and in different ethnic populations. Functional assays of the mutants in heterologous expression systems have disclosed novel mechanisms of current suppression in LQT1 and LQT2, and of gain of function in LQT3. Mutations in KCNJ2 may provide a new genotype (LQT7) of LQTS. In addition, mutations or single nucleotide polymorphisms in the channel genes responsible for LQTS (KvLQT1, HERG, and SCN5A) may predispose to drug‐induced LQTS. A relatively high prevalence of Brugada syndrome is suspected in the Japanese population, and 1 of ∼2,000 asymptomatic individuals present Brugada‐type ECG changes upon annual examination. Genetic screening of the symptomatic Brugada syndrome and suspected cases has revealed SCN5A mutations in only ∼12%. Therefore, the genetic basis of the majority of cases is not known. The expressed Na+ current of SCN5A mutant channels showed the phenotype of decreased channel function commonly seen in Brugada mutations. A case of idiopathic ventricular fibrillation was found to have a novel mutation in SCN5A, in which the expressed current showed marked suppression of channel function.
(J Cardiovasc Electrophysiol, Vol. 14, pp. 431‐434, April 2003)
Spiral Wave Control by a Localized Stimulus:
Authors: ASHIHARA TAKASHI , NAMBA TSUNETOYO , ITO MAKOTO , IKEDA TAKANORI , NAKAZAWA KAZUO , TRAYANOVA NATALIA
Published: December 2004

Introduction: It has been reported that electrical stimulation can control spiral wave (SW) reentry. However, previous research does not account for the effects of stimulus‐induced virtual electrode polarization (VEP) and the ensuing cathode‐break (CB) excitation. The aim of the present study was to examine the interaction of VEP with SW reentry in a bidomain model of electrical stimulation and thus provide insight into the mechanistic basis of SW control.

Methods and Results: We conducted 3,168 simulations of localized stimulation during SW reentry in an anisotropic bidomain sheet. Unipolar cathodal 2‐ms stimuli of strengths 4, 8, 16, and 24 mA were delivered at 99 locations in the sheet. The interaction between stimulus‐induced VEP and SW reentry resulted in 1 of 3 possible outcomes: SW shift, SW breakup, or no effect. SW shift, which could be instrumental in SW termination at an anatomic or functional line of block, resulted from CB rather than cathode‐make excitation. Stimulus timing, site, and strength all were important factors in VEP‐mediated SW control. Furthermore, we found that the number of episodes of SW shift across the fibers was more sensitive to stimulus strength than that of SW shift along the fibers. SW shift can be explained by the interaction between the four VEP‐induced wavebreaks and the wavebreak of the SW, ultimately resulting in termination of the original SW and the survival of one of the VEP‐induced wavebreaks. This establishes a new SW reentry.

Conclusion: This study provides new mechanistic insight into SW control. (J Cardiovasc Electrophysiol, Vol. 15, pp. 226‐233, February 2004)
Mechanism of Repolarization Change During Initiation of Supraventricular Tachycardia
Authors: LIN YENN‐JIANG , TAI CHING‐TAI , CHIANG CHEN‐EN , LEE KUN‐TAI , YUNIADI YOGA , HUANG BIEN‐HSIEN , LIU TU‐YING , LEE PI‐CHIANG , KUO JEN‐YUAN , CHEN SHIH‐ANN
Published: December 2004

Introduction: Previous literature has documented the association between narrow QRS supraventricular tachycardia (SVT) and pronounced ST‐T segment change. The aim of this study was to evaluate repolarization changes during SVT initiation and demonstrate the possible mechanism.

Methods and Results: Fifty‐one consecutive patients (20 men and 31 women; mean age 46.1 ± 16.4 years) with narrow QRS SVT (32 patients with AV nodal reentrant tachycardia and 19 patients with AV reentrant tachycardia) were included. We retrospectively analyzed the intracardiac recordings and ST‐T segment changes on 12‐lead surface ECGs during SVT initiation. Twenty‐six (51%) patients developed ST segment repolarization changes during SVT initiation. Patients with shorter baseline sinus cycle length, shorter tachycardia cycle length, elevated systolic blood pressure before tachycardia induction, and greater reduction of systolic blood pressure had a higher incidence of repolarization changes. However, multivariate analysis showed that reduction of systolic blood pressure after SVT induction was the only independent predictor of repolarization changes. Furthermore, the maximal degree of ST segment depression during SVT correlated with the reduction of systolic blood pressure (r = 0.75, P < 0.001).

Conclusion: Repolarization changes during SVT initiation were caused mainly by concurrent hemodynamic change after SVT initiation with abrupt cycle length shortening.
Prevalence, Predictors, and Mortality Significance of the Causative Arrhythmia in Patients with Electrical Storm
Authors: VERMA ATUL , KILICASLAN FETHI , MARROUCHE NASSIR F. , MINOR STEPHEN , KHAN MOHAMMED , WAZNI OUSSAMA , BURKHARDT J. DAVID , BELDEN WILLIAM A. , CUMMINGS JENNIFER E. , ABDUL‐KARIM AHMAD , SALIBA WALID , SCHWEIKERT ROBERT A. , TCHOU PATRICK J. , MARTIN DAVID O. , NATALE ANDREA
Published: December 2004

Introduction: Electrical storm (ES) is characterized by either refractory ventricular tachycardia (VT) or ventricular fibrillation (VF). However, little is known about the prevalence, predictors, and mortality implications of the causative arrhythmia in ES. We sought to assess the prevalence, predictors, and survival significance of VT and VF as the causative arrhythmia of ES in implantable cardioverter defibrillator (ICD) patients.

Methods and Results: Consecutive patients from January 2000 to December 2002 who presented to the ICD clinic with ≥2 separate ventricular arrhythmic episodes requiring shock within 24 hours were included in the study. ICD interrogation confirmed the number of shocks and provided electrograms for interpretation of the causative arrhythmia. Patients were grouped as VF or VT according to the causative arrhythmia. Their prevalence, predictors, and mortality rates were compared. Of 2,028 patients assessed in the ICD clinic, 208 (10%) presented with ES. VF was the cause of ES in 99 of 208 patients, for an overall prevalence of 48%. Original ICD indication, coronary artery disease, and amiodarone therapy were predictive for the causative arrhythmia. There was no mortality difference between the VT and VF groups; however, both groups had significantly increased mortality compared to a control ICD population without ES.

Conclusion: VF is the causative arrhythmia for a sizable proportion of patients with ES. The initial ICD indication, coronary artery disease, and amiodarone therapy are predictors of the causative arrhythmias in ES. There does not appear to be any mortality difference between ES patients with VT and VF, but mortality is increased in patients with ES versus control ICD patients without ES.
Fever as a Precipitant of Idiopathic Ventricular Fibrillation in Patients with Normal Hearts
Authors: PASQUIÉ JEAN LUC , SANDERS PRASHANTHAN , HOCINI MÉLÈZE , FERN HSU LI , SCAVÉE CHRISTOPHE , JAIS PIERRE , TAKAHASHI YOSHIHIDE , ROTTER MARTIN , SACHER FRÉDERIC , VICTOR JACQUES , CLÉMENTY JACQUES , HAÏSSAGUERRE MICHEL
Published: December 2004

Introduction: Ventricular fibrillation (VF) is the main mechanism of sudden cardiac death. The clinical precipitants of sudden cardiac death due to idiopathic VF are poorly characterized. Emerging evidence implicates triggers originating predominantly from the distal Purkinje arborization and the right ventricular outflow tract.

Methods and Results: We report three patients without structural heart disease or repolarization abnormalities in whom a febrile illness was the only concurrent disease associated with unexpected sudden cardiac death due to VF storm. An automated defibrillator was implanted in all three patients. In one patient with persistent recurrent VF episodes, mapping demonstrated the origin of these triggers was from the Purkinje arborization of the anterior wall of the right ventricle. Ablation at a site of earliest activation during ectopy, where pace mapping was concordant and Purkinje potential preceded the onset of ventriculogram, resulted in suppression of all arrhythmias. After follow‐up of 22, 9, and 18 months in the three patients, no ventricular arrhythmias have been recorded.

Conclusion: We present a series of patients in whom an apparently benign febrile illness was associated with malignant ventricular arrhythmias in the absence of cardiac disease or other factors known to precipitate sudden cardiac death. Physicians should be aware of this possible phenomenon in cases of febrile illness associated with syncope.
If You Can Use Them: Flexibility Policies, Organizational Commitment, and Perceived Performance
Authors: Eaton Susan C.
Published: December 2004

This study links workplace flexibility policies—formal, informal, and perceived usable—to organizational commitment and self‐reported productivity. Professional and technical employees of biotechnology firms were surveyed. Where employees could freely use policies, a positive association with outcomes is found. The article contributes a new measure to capture employees’ organizational experience, relevant to work and family research.
Family‐Friendly Management in Great Britain: Testing Various Perspectives
Authors: Wood Stephen J. , De Menezes Lilian M. , Lasaosa Ana
Published: December 2004

Five main perspectives on family‐friendly management are differentiated by their conceptions about the nature of such management and not just by its assumed predictors. Multivariate analysis of the relationships among a set of family‐oriented practices shows that some but not all are used in a systematic way. Regression analysis reveals that employers’ adoption of family‐friendly approaches is explained by factors that span all five perspectives, but overall, the organizational adaptation perspective fares best.
Individual accounts in social security: can they be progressive?
Authors: Sherraden Michael
Published: December 2004

The trend toward individual asset accounts in social security, and the regressivity of these accounts, provide the motivation for this article. The article asks: why not asset building for the poor as well? Research on Individual Development Accounts in the United States finds that the poor can save when they have a structure and incentive to do so. Steps toward universal and progressive asset‐based policy are pointed out in Singapore, the United States and the United Kingdom. Future policy directions and challenges are considered.
Attitudes towards the unemployed. An analysis of Swedish survey data
Authors: Furåker Bengt , Blomsterberg Marianne
Published: December 2004

To be unemployed is often associated with being stigmatised by others. People may blame the unemployed themselves, insist that they could find a job if they tried harder, maintain that too little is demanded from recipients of unemployment benefits and consider differences in standard of living between the unemployed and the employed too small. This article is aimed at studying the prevalence of such negative attitudes and to examine the determinants behind them. In May 2000, questions were added on to a randomly selected subsample in the regular Swedish labour force survey. The results indicate that own unemployment experience and perceived risks of becoming unemployed make people less apt to blame the unemployed. Having family members or close friends with unemployment experience tends to have a similar impact. In contrast, young people more often express stigmatising attitudes. With respect to social class position the results are divided.
Trader associations and urban food systems in Ghana: institutionalist approaches to understanding urban collective action
Authors: Lyon Fergus
Published: December 2004

This article explores the activities and functioning of urban food trader associations in Ghana. These associations are strong indigenous groups of women traders who have been able to sustain cooperation over many years in contrast to many other forms of collective action. They shape urban food systems and link urban consumers with rural producers. The analysis relates the findings to the literature on socio‐economics, institutional economics and collective action. Of particular interest are the social relations and networks within associations that allow traders to access informal credit and information with contracts based on trust. The factors that contribute to the ability to sustain collective action are explored. These include leadership structures and acceptance of the authority of market queens by other women traders, as well as the need to have the benefits that come from membership of associations.

Cet article porte sur les activités et le fonctionnement d'associations urbaines de commerce alimentaire au Ghana. Il s'agit de puissants groupes autochtones de marchandes qui ont pu préserver une coopération sur de nombreuses années, contrairement à bien d'autres formes d'action collective. Ces associations configurent les systèmes d'approvisionnement des villes, reliant consommateurs urbains et producteurs ruraux. L'analyse rapproche résultats et références documentaires en socio‐économie, économie institutionnelle et action collective. On soulignera les relations et réseaux sociaux au sein des associations, lesquels permettent aux commerçantes d'accéder à des sources parallèles d'information et de crédit sur la base de contrats de confiance. L'article étudie les facteurs facilitant la pérennisation d'une action collective, notamment les structures de leadership et la reconnaissance de l'autorité de reines du marché par d'autres commerçantes, ainsi que la nécessité de tirer des avantages de l'appartenance à ces associations.
Conjuncture or disjuncture? An institutionalist analysis of local regeneration partnerships in the UK
Authors: Davies Jonathan S.
Published: December 2004

Following Vivien Lowndes' injunction for scholars to take the new institutionalism seriously, this article offers an institutionalist explanation for the development of regeneration partnerships in the UK. Drawing on four complete case studies and evidence from ongoing research into New Deal for Communities, it argues that UK‐style partnerships tend to embody conflicting values and hierarchical patterns of organization. This is therefore a path‐shaping period, since partnerships have not established themselves as coordinating mechanisms built on strong‐weak ties.

Vivien Lowndes ayant enjoint les intellectuels à prendre au sérieux le nouvel institutionnalisme, cet article propose une explication institutionnaliste à l'essor des partenariats de régénération au Royaume‐Uni. A partir de quatre études de cas terminées et d'indices issus de recherches en cours sur la ‘Nouvelle Donne pour les Communautés’, il affirme que les partenariats de type britannique tendent à exprimer des valeurs opposées et des modes hiérarchiques d'organisation. Il se dégage donc une phase d'orientation de trajectoire, les partenariats ne s'étant pas créés comme des mécanismes coordinateurs reposant sur des liens forts‐faibles.
The unique mutation in ace‐1 giving high insecticide resistance is easily detectable in mosquito vectors
Authors: Weill M. , Malcolm C. , Chandre F. , Mogensen K. , Berthomieu A. , Marquine M. , Raymond M.
Published: December 2004

High insecticide resistance resulting from insensitive acetylcholinesterase (AChE) has emerged in mosquitoes. A single mutation (G119S of the ace‐1 gene) explains this high resistance in Culex pipiens and in Anopheles gambiae. In order to provide better documentation of the ace‐1 gene and the effect of the G119S mutation, we present a three‐dimension structure model of AChE, showing that this unique substitution is localized in the oxyanion hole, explaining the insecticide insensitivity and its interference with the enzyme catalytic functions. As the G119S creates a restriction site, a simple PCR test was devised to detect its presence in both A. gambiae and C. pipiens, two mosquito species belonging to different subfamilies (Culicinae and Anophelinae). It is possibile that this mutation also explains the high resistance found in other mosquitoes, and the present results indicate that the PCR test detects the G119S mutation in the malaria vector A. albimanus. The G119S has thus occurred independently at least four times in mosquitoes and this PCR test is probably of broad applicability within the Culicidae family.
The transcriptome of adult female Anopheles darlingi salivary glands
Authors: Calvo E. , Andersen J. , Francischetti I. M. , DeL. Capurro M. , DeBianchi A. G. , James A. A. , Ribeiro J. M. C. , Marinotti O.
Published: December 2004

Anopheles (Nyssorhynchus) darlingi is an important malaria vector in South and Central America; however, little is known about molecular aspects of its biology. Genomic and proteomic analyses were performed on the salivary gland products of Anopheles darlingi. A total of 593 randomly selected, salivary gland‐derived cDNAs were sequenced and assembled based on their similarities into 288 clusters. The putative translated proteins were classified into three categories: (S) secretory products, (H) housekeeping products and (U) products with unknown cell location and function. Ninety‐three clusters encode putative secreted proteins and several of them, such as an anophelin, a thrombin inhibitor, apyrases and several new members of the D7 protein family, were identified as molecules involved in haematophagy. Sugar‐feeding related enzymes (α‐glucosidases and α‐amylase) also were found among the secreted salivary products. Ninety‐nine clusters encode housekeeping proteins associated with energy metabolism, protein synthesis, signal transduction and other cellular functions. Ninety‐seven clusters encode proteins with no similarity with known proteins. Comparison of the sequence divergence of the S and H categories of proteins of An. darlingi and An. gambiae revealed that the salivary proteins are less conserved than the housekeeping proteins, and therefore are changing at a faster evolutionary rate. Tabular and supplementary material containing the cDNA sequences and annotations are available at http://www.ncbi.nlm.nih.gov/projects/Mosquito/A_darlingi_sialome/
Nurse–patient communication: an exploration of patients’ experiences
Authors: McCabe Catherine
Published: December 2004

Background.  Patient‐centred communication is a basic component of nursing and facilitates the development of a positive nurse‐patient relationship which, along with other organizational factors, results in the delivery of quality nursing care. Nurses are frequently described in the literature as poor communicators, however, very few studies have examined patients’ experiences of how nurses communicate.

Aims and objectives.  The aim of the study was to explore and produce statements relating to patients’ experiences of how nurses communicate.

Design.  A qualitative perspective using an hermeneutic phenomenological approach was considered to be the most appropriate methodology for this study.

Methods.  Using purposeful sampling, eight patients in a general teaching hospital in the Republic of Ireland were interviewed. Data were collected using unstructured interviews. Data analysis was a reflective process and the findings were presented through the description and interpretation of themes and sub‐themes.

Results.  Following data analysis four themes emerged. These were, ‘lack of communication’, ‘attending’, empathy’ and ‘friendly nurses’.

Conclusions.  The findings of this study indicate that, in contrast to the literature that suggests that nurses are not good at communicating with patients, nurses can communicate well with patients when they use a patient‐centred approach. However, health care organizations do not appear to value or recognize the importance of nurses using a patient‐centred approach when communicating with patients to ensure the delivery of quality patient care.

Relevance to clinical practice.  The implication of these findings for clinical practice is that the task‐centred approach to patient care that is associated with nursing in the past, appears to be alive and well. If health care management want to ensure that patients receive quality nursing care, they will need to consider patient‐centred communication to be essential to encourage and support nurses to communicate in this manner.
A comparison of restricted selection procedures to control genetic gains
Authors: Ieiri S. , Nomura T. , Hirooka H. , Satoh M.
Published: December 2004

Using Monte Carlo simulation, two schemes of restricted selection were compared under various combinations of genetic parameters and constraints on the genetic gains. The first selection scheme is the combination of best linear unbiased prediction (BLUP) evaluation and linear programming technique (BLUP + LP), and the second one is based on the restricted BLUP selection (RBLUP). Selection for two traits was supposed, in which animals were selected to maximize the genetic gain in trait 2 (Δg2) under a proportional restriction on the genetic gain in trait 1 (Δg1) to satisfy the intended ratio (Δg1:Δg2). Little differences were found between the two selection schemes with respect to the genetic gains averaged over replicates. However, in all the cases studied, the variance of genetic gains among replicates under BLUP + LP selection was smaller and less sensitive to the genetic parameters and the intended restriction than RBLUP selection. Under the situations of antagonistic selection, the difference tended to be larger. When the heritabilities of the two traits were different, RBLUP selection remarkably increased the variance of genetic gain in a trait with a higher heritability. These results suggest that BLUP + LP selection should always be preferable to RBLUP selection because of the smaller risk of selection. This choice is especially important for the situation where the genetic parameters act as limiting factors for the achievement of intended genetic gains.
Genetic structure of milk protein polymorphisms and effects on milk production traits in a local dairy cattle
Authors: Caroli A. , Chessa S. , Bolla P. , Budelli E. , Gandini G. C.
Published: December 2004

The milk protein genetic structure of the Reggiana dairy local cattle with remarkable milk quality properties was analysed and compared with the structure of Italian Friesian and Italian Brown cattle. A total of 1138 individual milk samples from the three breeds were typed by isoelectrofocusing. Polymorphism was found at the αs1‐casein (CSN1S1), β‐casein (CSN2), κ‐casein (CSN3), and β‐lactoglobulin (LGB) loci. High frequencies were observed for some casein alleles in Reggiana (CSN1S1*C, 25%; CSN2*B: 28%) with considerable differences to those observed in a survey carried out 30 years before. A great variation among breeds was observed for casein haplotype frequencies and high linkage disequilibrium was detected at the three polymorphic casein loci CSN1S1‐CSN2‐CSN3. The prevalent haplotypes were CA2B (23%; Reggiana), BA2A (48%; Italian Friesian) and BA2B (51%; Italian Brown). Higher GST values between breeds were observed when haplotype frequencies were considered instead of gene frequencies. In the Reggiana cattle, the occurrence of two casein alleles at a rather high frequency (CSN1S1*C, CSN2*B) allowed to estimate the effects of rare casein haplotypes on milk traits. The CA2B haplotype was associated with a significantly higher milk protein and fat content and a significantly higher protein per cent was found also for the BA1B haplotype.
Genetic diversity analysis of two buffalo populations of northern India using microsatellite markers
Authors: Arora R. , Lakhchaura B. D. , Prasad R. B. , Tantia M. S. , Vijh R. K.
Published: December 2004

The genetic diversity in two buffalo populations of northern India, the Bhadawari and the Tarai was assessed using a set of 22 heterologous (bovine) microsatellite markers. The average number of alleles across all loci in both populations was found to be 4.7, indicating that this set of 22 bovine microsatellite markers could be used to study genetic variation in buffalo species also. The overall polymorphic information content (PIC) value for these markers was 0.54. The average observed and expected heterozygosities for both populations were 0.59 and 0.64, respectively. Common alleles with varying allele frequencies in both populations also represented the genetic variability existing between Bhadawari and Tarai buffaloes. However the θ estimates for population differentiation indicated low levels of differentiation between the two populations. This was further supported by the low genetic distance (0.155) between Bhadawari and Tarai, which was calculated using Nei's standard genetic distance method. The present study on Bhadawari and Tarai populations represents a much‐needed preliminary effort that could be extended to other local buffalo populations of India as well.
The effects of an open design on trial participant recruitment, compliance and retention – a randomized controlled trial comparison with a blinded, placebo-controlled design
Authors: Avenell Alison , Grant Adrian M , McGee Maureen , McPherson Gladys , Campbell Marion K , McGee Magnus A ,   RECORD Trial Management Group
Published: December 2004

Background In randomized trials there may be no overriding reason whether or not to have a placebo control.

Purpose We assessed the effects of an open trial design (no placebo and people know what tablets they are given) compared with a blinded, placebo-controlled design on recruitment, compliance and retention within a randomized trial of secondary osteoporotic fracture prevention.

Methods We undertook a randomized controlled comparison nested within a placebo-controlled trial of nutritional supplementation amongst people aged 70 years or over who had previously sustained a fracture, recruited in a UK teaching hospital. Randomization was 2: 1 in favour of the blinded, placebo-controlled trial design.

Results From 180 eligible participants randomized to receive information based on the open trial design, 134 (74.4%) consented to take part, compared with 233 (65.1%) of 358 people randomized to the blinded, placebo-controlled design (difference 9.4%, 95% confidence interval 1.3–17.4%). Reluctance to take a placebo and the desire to know tablet allocation were reasons given for not taking part in the blinded, placebo-controlled design. There was no significant difference in tablet compliance. Open trial participants were more likely to remain in the trial for one year (difference 13.9%, 95% confidence interval 3.1–24.6%), mainly reflecting the high retention of the open trial no tablet group compared to the open trial tablet group (difference 23.6%, 95% confidence interval 11.9–35.2%). The odds ratio for reporting an adverse event in the open trial compared to the blinded, placebo-controlled design was 0.64 (95% confidence interval 0.28–1.49), and for reporting a fracture was 0.81 (0.36–1.85).

Conclusions We conclude that using an open trial design may enhance participant recruitment and retention and thus improve generalizability and statistical power, but withdrawal rates may differ between the study allocations and may threaten the internal validity of the trial.
The role of measurement reliability in clinical trials
Authors: Lachin John M
Published: December 2004

One of the principal characteristics of an outcome measure in a clinical trial, and any measurement in general, is its reliability. Reliability refers to the reproducibility of the measurement when repeated at random in the same subject or specimen. Reliability is often confused with validity, which refers to the extent to which the variable properly measures the underlying trait of interest. The coefficient of reliability is an estimate of the proportion of all variation that is not due to measurement error and is readily estimated from replicate measurements. The reliability of a measurement determines its maximal correlation or R2 and slope (or effect size) in regression models, its sensitivity and specificity when used for classifications or predictions, and the power of a statistical test employing the measurement. All decline as the reliability of the measure declines. The reliability of a measurement is an important consideration in the choice of the primary outcome measure for a clinical trial and in the choice of measures used for assessment of eligibility and exclusion. Reliability of measures should be assessed and assured by a quality control program based on randomly selected duplicate assessments. Just as the power of a study is reported in a final publication, so also should the reliability of the outcome and eligibility measurements so as to allow the authors to better describe, and readers to better understand, the sources of imprecision in study results, and those who follow to improve the design of future trials.