bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Duration Ventricular Fibrillation Exhibits 2 Distinct Organized States
Authors: Li Li , Zheng Xiangsheng , Dosdall Derek J. , Huang Jian , Pogwizd Steven M. , Ideker Raymond E. 
Published: November 2013

Background—
Previous studies showed that endocardial activation during long-duration ventricular fibrillation (VF) exhibits organized activity. We identified and quantified the different types of organized activity.

Methods and Results—

Two 64-electrode basket catheters were inserted, respectively, into the left ventricle and right ventricle of dogs to record endocardial activation from the endocardium during 7 minutes of VF (controls, n=6). The study was repeated with the K
ATP
channel opener pinacidil (n=6) and the calcium channel blocker flunarizine (n=6). After 2 minutes of VF without drugs, 2 highly organized left ventricular endocardial activation patterns were observed: (1) ventricular electric synchrony pattern, in which endocardial activation arose focally and either had a propagation sequence similar to sinus rhythm or arose near papillary muscles, and (2) stable pattern, in which activation was regular and repeatable, sometimes forming a stable re-entrant circuit around the left ventricular apex. Between 3 and 7 minutes of VF, the percent of time ventricular electric synchrony was present was control=25%, flunarizine=24% (
P
=0.44), and pinacidil=0.1% (
P
<0.001) and the percent of time stable pattern was present was control=71%, flunarizine=48% (
P
<0.001), and pinacidil=56% (
P
<0.001). The remainder of the time, nonstable re-entrant activation with little repeatability was present.

Conclusions—

After 3 minutes, VF exhibits 2 highly organized endocardial activation patterns 96% of the time, one potentially arising focally in the Purkinje system that was prevented with a K
ATP
channel opener but not a calcium channel blocker and the other potentially arising from a stable re-entrant circuit near the apical left ventricular endocardium.
Implantable Cardioverter-Defibrillator Therapy Before Death
Authors: Kinch Westerdahl Annika , Sjöblom Johanna , Mattiasson Anne-Cathrine , Rosenqvist Mårten , Frykman Viveka 
Published: November 2013

Background—
Several trials have demonstrated improved survival with implantable cardioverter-defibrillator (ICD) therapy. The cause and nature of death in the ICD population have been insufficiently investigated. The objective of this study was to analyze ICDs from deceased patients to assess the incidence of ventricular tachyarrhythmias, the occurrence of shocks, and possible device malfunction.

Methods and Results—
We prospectively analyzed intracardiac electrograms in 125 explanted ICDs. The incidence of ventricular tachyarrhythmia, including ventricular fibrillation, and shock treatment was assessed. Ventricular tachyarrhythmia occurred in 35% of the patients in the last hour of their lives; 24% had an arrhythmic storm, and 31% received shock treatment during the last 24 hours. Arrhythmic death was the primary cause of death in 13% of the patients, and the most common cause of death was congestive heart failure (37%). More than half of the patients (52%) had a do-not-resuscitate order, and 65% of them still had the ICD shock therapies activated 24 hours before death. Possible malfunctions of the ICD were found in 3% of all patients.

Conclusions—
More than one third of the patients had a ventricular tachyarrhythmia within the last hour of life. Cardiac death was the primary cause and heart failure the specific cause of death in the majority of the cases. Devices remained active in more than half of the patients with a do-not-resuscitate order; almost one fourth of these patients received at least 1 shock in the last 24 hours of life.
Atherosclerotic Biomarkers and Aortic Atherosclerosis by Cardiovascular Magnetic Resonance Imaging in the Framingham Heart Study
Authors: Hong Susie N. , Gona Philimon , Fontes Joao D. , Oyama Noriko , Chan Raymond H. , Kenchaiah Satish , Tsao Connie W. , Yeon Susan B. , Schnabel Renate B. , Keaney John F. , O'Donnell Christopher J. , Benjamin Emelia J. , Manning Warren J. 
Published: November 2013

Background
The relations between subclinical atherosclerosis and inflammatory biomarkers have generated intense interest but their significance remains unclear. We sought to determine the association between a panel of biomarkers and subclinical aortic atherosclerosis in a community‐based cohort.

Methods and Results

We evaluated 1547 participants of the Framingham Heart Study Offspring cohort who attended the 7th examination cycle and underwent both cardiovascular magnetic resonance imaging (
CMR
) and assays for 10 biomarkers associated with atherosclerosis: high‐sensitivity C‐reactive protein, fibrinogen, intercellular adhesion molecule‐1, interleukin‐6, interleukin‐18, lipoprotein‐associated phospholipase‐A2 activity and mass, monocyte chemoattractant protein‐1, P‐selectin, and tumor necrosis factor receptor‐2. In logistic regression analysis, we found no significant association between the biomarker panel and the presence of aortic plaque (global
P
=0.53). Using Tobit regression with aortic plaque as a continuous variable, we noted a modest association between biomarker panel and aortic plaque volume in age‐ and sex‐adjusted analyses (
P
=0.003). However, this association was attenuated after further adjustment for clinical covariates (
P
=0.09).

Conclusions
In our community‐based cohort, we found no significant association between our multibiomarker panel and aortic plaque. Our results underscore the strengths and limitations of the use of biomarkers for the identification of subclinical atherosclerosis and the importance of traditional risk factors.
Factor II Activity is Similarly Increased in Patients With Elevated Apolipoprotein CIII and in Carriers of the Factor II 20210A Allele
Authors: Olivieri Oliviero , Martinelli Nicola , Baroni Marcello , Branchini Alessio , Girelli Domenico , Friso Simonetta , Pizzolo Francesca , Bernardi Francesco 
Published: November 2013

Background

Few studies have so far investigated the relationship between apolipoprotein CIII (Apo CIII) and coagulation pathway in subjects with or without coronary artery disease (
CAD
).

Methods and Results

Serum Apo CIII concentrations and plasma coagulant activities of factor II (FII:c), factor V (FV:c), and factor VIII (FVIII:c), and activated factor VII (FVIIa) were analyzed in a total of 933 subjects, with (n=687) or without (n=246) angiographically demonstrated
CAD
and not taking anticoagulant drugs. Activated factor X (FXa) generation assay was performed on plasma from subgroups of subjects with low and high levels of Apo CIII. A statistical incremental concentration of FII:c, FV:c, and FVIIa levels was observed through the quartiles of Apo CIII distribution in the population considered as a whole. Significant results were confirmed for FII:c in
CAD
and
CAD
‐free subgroup when separately considered. Subjects within the highest Apo CIII quartile (>12.6 mg/dL) had high FII:c levels not statistically different from those of carriers of 20210A allele (n=40; 4.28%). In a multiple linear model, Apo CIII was the best predictor of FII:c variability, after adjustment for age, gender, plasma lipids,
CRP
, creatinine, diagnosis, and carriership of 20210A allele. FXa generation was increased and its lag time shortened in plasmas with high Apo CIII levels. However, after thrombin inhibition by hirudin, differences between low and high Apo C‐III samples disappeared.

Conclusions
Elevated concentrations of Apo CIII are associated with an increase of thrombin activity to an extent comparable with the carriership of G20210A gene variant and mainly modulating the thrombin generation.
Limited Evidence: Higher Efficacy of Nasal Saline Irrigation over Nasal Saline Spray in Chronic Rhinosinusitis—An Update and Reanalysis of the Evidence Base
Authors: van den Berg Jelle W. G. , de Nier Linden M. , Kaper Nina M. , Schilder Anne G. M. , Venekamp Roderick P. , Grolman Wilko , van der Heijden Geert J. M. G. 
Published: November 2013

ObjectiveTo assess the effectiveness of nasal saline irrigation in adult patients with chronic rhinosinusitis.Data SourcesPubMed, EMBASE, the Cochrane Library.Review MethodsA comprehensive search was performed, and 2 authors independently screened publications. The design of selected studies was assessed on directness of evidence and risk of bias.ResultsOf 1596 publications, 1 open‐label randomized trial with high directness of evidence and moderate risk of bias was included. In this study, 127 patients were randomly allocated to isotonic nasal saline irrigation or isotonic nasal saline spray, as added to their usual medication. The mean 20‐Item Sinonasal Outcome Test (SNOT‐20) scores of those treated with nasal irrigation improved more than those allocated to nasal spray. While the authors consider an improvement of 16 or more to be clinically meaningful, the changes from baseline in mean SNOT‐20 scores of those treated with irrigation (and the differences with those treated with nasal spray) at 2, 4, and 8 weeks were 12.2 (difference 5.5, [95% confidence interval −0.04 to 11.0]), 16.2 (difference 8.8 [3.2 to 14.4]), and 15.0 (difference 6.5 [0.4 to 12.6]), respectively. Side effects of posttreatment nasal dripping were common but minor and did not lead to discontinuation of treatment.Conclusion and RecommendationIt should be explained to adult patients with chronic rhinosinusitis that there is limited information on the relative effect of nasal saline irrigation and nasal saline spray on subjective symptom improvement, since there is only 1 trial available with a moderate risk of bias showing limited benefit of irrigation over spray.
No Evidence for Distinguishing Bacterial from Viral Acute Rhinosinusitis Using Fever and Facial/Dental Pain: A Systematic Review of the Evidence Base
Authors: Hauer Allard J. , Luiten Eric L. , van Erp Nicole F. , Blase Peter E. , Aarts Mark C. J. , Kaper Nina M. , van der Heijden Geert J. M. G. 
Published: November 2013

ObjectiveTo assess the diagnostic value of fever and facial and dental pain in adults suspected of acute bacterial rhinosinusitis.Data SourcesPubMed, EMBASE, and the Cochrane Library.Review MethodsA comprehensive systematic search was performed on March 18, 2013. We included articles reporting studies on the diagnostic value of fever or facial and dental pain in patients suspected of acute bacterial rhinosinusitis. For included articles, the reported study design was assessed for directness of evidence and risk of bias. Prevalences, positive predictive values, and negative predictive values were extracted.ResultsOf 3171 unique records, we included 1 study with a high directness of evidence and a moderate risk of bias. The prior probability of bacterial rhinosinusitis was 0.29 (95% confidence interval: 0.24 to 0.35). We could not extract posterior probabilities with accompanying positive and negative predictive values. The study reported an odds ratio from univariate analysis for fever of 1.02 (0.52 to 2.00) and 1.65 (0.83 to 3.28) for facial and dental pain. In subsequent multivariate analysis, the odds ratio of facial and dental pain was 1.86 (1.06 to 3.29).Conclusion and RecommendationThere is 1 study with moderate risk of bias, reporting data in such a manner that we could not assess the value of fever and facial and dental pain in adults suspected of an acute bacterial rhinosinusitis. Therefore, these symptoms should not be used in clinical practice to distinguish between a bacterial and viral source of acute rhinosinusitis or for decision making about prescribing antibiotic treatment.
Prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: a blinded sonographic evaluation
Authors: Tromba L , Blasi S , Vestri A , Kiltzanidi D , Tartaglia F , Redler A 
Published: November 2013

Objectives: To verify the prevalence of chronic cerebrospinal venous insufficiency in patients affected by different clinical forms of multiple sclerosis and in healthy subjects using the Zamboni ultrasound protocol combined with M-mode ultrasound examination. Materials and methods: We enrolled 112 patients with multiple sclerosis and 67 healthy subjects from 20 to 67 years of age. All the patients underwent Duplex and color-Doppler sonography of the neck vessels, transcranial colour duplex sonography, M-mode study of the valve system and of venous abnormalities. Subjects were positive for chronic cerebrospinal venous insufficiency when at least two of five hemodynamic criteria of the Zamboni protocol were fulfilled. Chronic cerebrospinal venous insufficiency condition was further analyzed by a multivariate analysis including age, sex, disease duration, subtypes of multiple sclerosis and expanded disability status scale score as independent variables. Results: No healthy subjects was positive for chronic cerebrospinal venous insufficiency, while in the sample of patients affected by multiple sclerosis the diagnosis was made in 59.8% of cases ( p < 0.0001). The first criterion was the most frequent in patients affected by multiple sclerosis and chronic cerebrospinal venous insufficiency (respectively 54.4% and 76.1%, p < 0.001). The second, third and fourth criteria were never present in healthy subjects but were detected in patients with multiple sclerosis. The positivity of the second criterion was associated with diagnosis of chronic cerebrospinal venous insufficiency in 100% of cases. The third criterion had a prevalence of 52.2% in the subgroup of chronic cerebrospinal venous insufficiency patients. It was positive in 36 multiple sclerosis patients and was associated with chronic cerebrospinal venous insufficiency diagnosis in all cases except one. The multivariate analysis showed that age, disease duration, sex, subtypes of multiple sclerosis and expanded disability status scale score were not considered predictors of this haemodynamic condition. Conclusion: Chronic cerebrospinal venous insufficiency is a haemodynamic condition strongly associated with multiple sclerosis and is not found in normal controls. The addition of M-mode ultrasound to the diagnostic protocol allows improved observation of venous valve abnormalities.
Comparing cold and warm tumescent anesthesia for pain perception during and after the endovenous laser ablation procedure with 1470 nm diode laser
Authors: Dumantepe Mert , Uyar Ibrahim 
Published: November 2013

Objective: The aim of this study was to compare the pain perception and side effects during and after endovenous laser ablation with a 1470 nm diode laser using cold or room temperature tumescence anesthesia. Methods: One hundred and one patients were randomly assigned in two groups. Group A received room temperature (+24℃) and Group B received cold (+4℃) tumescence fluid, which was used for local anesthesia in the track of great saphenous vein. A visual analog score was recorded immediately after the procedure. Patients were asked to register pain scores and the amount of pain medication consumed during the week. Results: There was no significant difference concerning gender, age, Clinical Etiological Anatomical Pathological Classification, body mass index, or diameter of the treated vein. In Group A, the mean linear endovenous energy density was 59.5 J/cm and in Group B, it was 60.4 J/cm. The average visual analog score after the endovenous laser ablation procedure in Group A was 5 and in Group B was 2. Third day after the procedure, the average visual analog score in Group A was 3 and in Group B was 1. Patients in Group B needed significantly less analgesics compared with patients in Group A ( p<0.05). The most frequent side effects in both groups were ecchymosis, induration, and minor paraesthesia, all of which were more common in Group A ( p < 0.001). Conclusions: To date, most published endovenous laser ablation series describe the use of room temperature tumescence fluid infiltration of the perivenous stroma for tumescent analgesia and protection against thermal injury to the nearby structures. We describe an alternative technique using cold tumescence fluid infiltration, which is equally effective as, but safer than, room temperature tumescence fluid infiltration, and which yields better visual analog scores.
Transitional cell and clear cell renal carcinoma: differentiation of distinct histological types with multiphase CT
Authors: Bata Pal , Tarnoki David Laszlo , Tarnoki Adam Domonkos , Novak Pal Kaposi , Gyebnar Janos , Kekesi Dora , Szendroi Attila , Fejer Bence , Szasz A Marcell , Nyirady Peter , Karlinger Kinga , Berczi Viktor 
Published: November 2013

Background Transitional cell carcinoma (TCC) may mimic renal cell carcinoma (RCC) when it develops in a similar location, therefore, differentiation with imaging techniques might be challenging. Preoperative differentiation may have a significant role indicating the type of surgical treatment (nephrectomy vs. ureteronephrectomy). Purpose To retrospectively analyze the differences in the contrast enhancement of TCC and RCC. Material and Methods Images of 20 RCC and 12 TCC (mean ages, 62.3 ± 14.1 and 67.4 ± 12.0 years, respectively) were analyzed from patients who underwent multiphase computed tomography (CT) examinations following 1.5 mL/kg non-ionic contrast agent administration. Unenhanced corticomedullary (30–45 s), nephrographic (70–90 s), and excretory (300–480 s) phases were imaged. The attenuation characteristics of RCC and TCC were compared to the attenuation of the normal renal cortex. Results Significant differences were found in the attenuation ratios between RCC or TCC in the corticomedullary ( P = 0.040) and nephrographic ( P = 0.004) phases using three regions of interest (ROIs) of 10 mm2 size. If measuring ROIs comprising the complete tumor lesion instead of three small ROIs, no significant difference was observed in the attenuation ratios between RCC in TCC in any phases. Conclusion Our study reports significant attenuation differences between RCC and TCC in the corticomedullary and nephrographic phases by multiphase CT. The findings underscore the importance of multiphase CT in the differentiation of these two different entities. Using multiple small (three) ROIs is more accurate than measuring the whole tumor attenuation.
Insulin resistance in migraineurs: Results from a case-control study
Authors: Sacco S , Altobelli E , Ornello R , Ripa P , Pistoia F , Carolei A 
Published: November 2013

Objectives: Several studies have suggested an association between migraine and insulin resistance (IR) without adequately addressing the issue according to migraine type. We assessed IR in subjects with migraine with aura (MwA) and migraine without aura (MwoA) to estimate the consistency of the possible association. Methods: In a case-control study we included case subjects with MwA and MwoA, who were consecutively selected from those referred to our Regional Headache Center from September 2011 to February 2013, and age-matched control subjects selected using general practitioners’ databases. IR was calculated by means of the homeostatic model assessment of IR (HOMA-IR), β-cell function (HOMA-B), and the quantitative insulin sensitivity check index (QUICKI) measuring glucose and insulin values in a blood sample collected in the morning after overnight fasting. Data regarding anthropometric measures, comorbidity risk factors, and migraine characteristics were also recorded. Results: We recruited 50 case subjects with MwA (38 women) and 50 with MwoA (40 women) and 50 control subjects (40 women). Proportions of arterial hypertension, cigarette smoking, hypercholesterolemia, use of oral contraceptives, and mean values of the body mass index (BMI) were similar in the three groups. We found significantly different glucose values among and within groups considering case subjects with MwA and MwoA and control subjects (4.9 ± 0.6 vs 4.7 ± 0.5 vs 4.6 ± 0.5 mmol/l; p = 0.018) in the absence of any difference in insulin (53.1 ± 24.0 vs 56.7 ± 34.4 vs 53.8 ± 24.4 pmol/l; p = 0.811), HOMA-IR (1.6 ± 0.8 vs 1.7 ± 1.0 vs 1.6 ± 0.7; p = 0.765), HOMA-B (121.4 ± 71.1 vs 149.2 ± 93.8 vs 162.8 ± 109.7; p = 0.107), and QUICKI (0.36 ± 0.03 vs 0.37 ± 0.03 vs 0.37 ± 0.03; p = 0.877) values. The logistic regression model showed increased odds of MwA in subjects exposed to the highest tertile of glucose values. This association was confirmed in the adjusted model, in which case subjects with MwA were compared with those with MwoA but not with control subjects. Conclusions: In contrast to what has been shown by the majority of the available studies, the results of our study do not support the association of migraine with IR. As our study was not population-based and several patients had low disease activity, these findings need further confirmation.
Age and Test Setting Affect the Prevalence of Invalid Baseline Scores on Neurocognitive Tests
Authors: Lichtenstein Jonathan D. , Moser Rosemarie Scolaro , Schatz Philip 
Published: November 2013

Background: Prevalence rates of invalid baseline scores on computerized neurocognitive assessments for high school, collegiate, and professional athletes have been published in the literature. At present, there is limited research on the prevalence of invalid baseline scores in pre–high school athletes. Hypothesis: Pre–high school athletes assessed with baseline neurocognitive tests would show higher prevalence rates of invalidity than older youth athletes, and those athletes, regardless of age, who were tested in a large group setting would show a higher prevalence rate of invalidity than athletes tested in a small group setting. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 502 athletes between the ages of 10 and 18 years completed preseason baseline neurocognitive tests in “large” or “small” groups. All athletes completed the online version of ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing). Baseline test results that were “flagged” by the computer software as being of suspect validity and labeled with a “++” symbol were identified for analysis. Participants were retrospectively assigned to 2 independent groups: large group or small group. Test administration of the large group occurred off-site in groups of approximately 10 athletes, and test administration of the small group took place at a private-practice neuropsychology center with only 1 to 3 athletes present. Results: Chi-square analyses identified a significantly greater proportion of participants obtaining invalid baseline results on the basis of age; younger athletes produced significantly more invalid baseline scores (7.0%, 17/244) than older athletes (2.7%, 7/258) (χ2 (1) = 4.99; P = .021). Log-linear analysis revealed a significant age (10-12 years, 13-18 years) × size (small, large) interaction effect (χ2 (4) = 66.1; P < .001) on the prevalence of invalidity, whereby younger athletes tested in larger groups were significantly more likely to provide invalid results (11.9%) than younger athletes tested in smaller groups (5.4%), older athletes tested in larger groups (2.7%), and older athletes tested in smaller groups (2.7%). Conclusion: Younger athletes tend to exhibit a greater prevalence of invalid baseline results on neurocognitive computerized tests than older youth athletes; the prevalence increases when testing is conducted in a large group and nonclinical setting.