bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maximal Electric Separation–Guided Placement of Right Ventricular Lead Improves Responders in Cardiac Resynchronization Defibrillator Therapy
Authors: Miranda Rodrigo I. , Nault Michael , Johri Amer , Simpson Christopher S. , Michael Kevin A. , Abdollah Hoshiar , Baranchuk Adrian , Redfearn Damian P. 
Published: September 2012

Background—
Cardiac resynchronization therapy is widely used for the treatment of heart failure. Recent data suggest that electric separation during left ventricular pacing varies within the right ventricle (RV). We hypothesized that placement of the RV lead guided by maximal electric separation (MES) would improve response to cardiac resynchronization therapy compared with standard apical placement.

Methods and Results—

A single-blind, randomized controlled trial was conducted. Patients eligible for cardiac resynchronization therapy-D were enrolled. Left ventricular lead placement was performed at the coronary sinus branch. The RV outflow tract, septum, and apex were mapped during left ventricular pacing and MES recorded. Patients were randomized to receive either apical placement or RV lead placement at the site mapping MES. Left ventricular ejection fraction, 6-minute walk distance, and New York Heart Association functional class were recorded at baseline and 3 months by blinded observers. Response was defined as at least one of the following: 5% absolute increase in ejection fraction, 50 m increase in 6-minute walk distance, or an increase by
>
1 functional class. Primary end point was improvement in ejection fraction at 3 months. Fifty patients were randomized (25 MES-guided and 25 apical). Baseline characteristics were similar in the 2 groups. Electric separation was lower in the apex (143±23 versus 168±25 ms in MES group;
P
=0.01). MES was most commonly septal and rarely apical (4/50 patients). Responders in the MES-guided versus apical group are as follows: Echo 21 versus 13 patients (
P
=0.032), 6-minute walk distance 19 versus 12 patients (
P
=0.079), and functional class 22 versus 15 patients (
P
=0.051). No dislodgment or reposition for suboptimal defibrillation tests was reported.

Conclusions—
MES-guided placement of the RV lead improves cardiac resynchronization therapy responders compared with standard apical placement.
The Study of Antiarrhythmic Medications in Infancy (SAMIS)
Authors: Sanatani Shubhayan , Potts James E. , Reed John H. , Saul J. Philip , Stephenson Elizabeth A. , Gibbs Karen A. , Anderson Charles C. , Mackie Andrew S. , Ro Pamela S. , Tisma-Dupanovic Svjetlana , Kanter Ronald J. , Batra Anjan S. , Fournier Anne , Blaufox Andrew D. , Singh Harinder R. , Ross Bertrand A. , Wong Kenny K. , Bar-Cohen Yaniv , McCrindle Brian W. , Etheridge Susan P. 
Published: September 2012

Background—
Supraventricular tachycardia (SVT) is one of the most common conditions requiring emergent cardiac care in children, yet its management has never been subjected to a randomized controlled clinical trial. The purpose of this study was to compare the efficacy and safety of the 2 most commonly used medications for antiarrhythmic prophylaxis of SVT in infants: digoxin and propranolol.

Methods and Results—

This was a randomized, double-blind, multicenter study of infants <4 months with SVT (atrioventricular reciprocating tachycardia or atrioventricular nodal reentrant tachycardia), excluding Wolff-Parkinson-White, comparing digoxin with propranolol. The primary end point was recurrence of SVT requiring medical intervention. Time to recurrence and adverse events were secondary outcomes. Sixty-one patients completed the study, 27 randomized to digoxin and 34 to propranolol. SVT recurred in 19% of patients on digoxin and 31% of patients on propranolol (
P
=0.25). No first recurrence occurred after 110 days of treatment. The 6-month recurrence-free status was 79% for patients on digoxin and 67% for patients on propranolol (
P
=0.34), and there were no first recurrences in either group between 6 and 12 months. There were no deaths and no serious adverse events related to study medication.

Conclusions—
There was no difference in SVT recurrence in infants treated with digoxin versus propranolol. The current standard practice may be treating infants longer than required and indicates the need for a placebo-controlled trial.

Clinical Trial Registration Information—

http://clinicaltrials.gov
; NCT-00390546.
Trends in Blood Pressure and Hypertension Detection, Treatment, and Control 1980 to 2009
Authors: Luepker Russell V. , Steffen Lyn M. , Jacobs David R. , Zhou Xia , Blackburn Henry 
Published: September 2012

Background—
Hypertension is common and treatable, but detection and control remain a major health challenge. This study sought to determine population trends in blood pressure and in the control of hypertension in the Minneapolis/St. Paul area (2010 population, 2.85 million) from 1980 to 2009.

Methods and Results—

Surveys of risk factors were performed every 5 years among randomly selected adults aged 25 to 74 years. Data on hypertension knowledge and use of medications were collected by interview. Blood pressure was measured by standardized methods, with hypertension defined as blood pressure ≥140 mm Hg systolic and/or 90 mm Hg diastolic or controlled at <140 and/or 90 mm Hg with medications. Six surveys included 11 192 men and 12 795 women. Mean systolic blood pressure fell from 124.9 mm Hg in 1980 to 1982 to 121.1 mm Hg in 2007 to 2009 for men (
P
<0.0001) and from 120.1 to 114.7 mm Hg for women (
P
<0.0001). Similar trends for diastolic blood pressure were observed. The percentage of adults with uncontrolled blood pressure (≥140 and/or 90 mm Hg) with or without medication use fell from 20.3% to 5.8% (
P
<0.001) for men and from 13.1% to 2.7% (
P
<0.0001) for women. Antihypertensive medication use rose to >50% among all adults aged 55 to 74 years. Sixty-six percent of men and 72% of women with hypertension had their hypertension treated or controlled by 2007 to 2009. A majority of the decline in mean population blood pressure was the result of control with aggressive use of antihypertensive drugs. Stroke mortality in this population fell in parallel.

Conclusions—
The rate of hypertension detection and control in this community is among the highest observed in a US population and already exceeds Healthy People 2020 goals.
Long-Term Cardiovascular Risk of Nonsteroidal Anti-Inflammatory Drug Use According to Time Passed After First-Time Myocardial Infarction
Authors: Olsen Anne-Marie Schjerning , Fosbøl Emil L. , Lindhardsen Jesper , Folke Fredrik , Charlot Mette , Selmer Christian , Bjerring Olesen Jonas , Lamberts Morten , Ruwald Martin H. , Køber Lars , Hansen Peter R. , Torp-Pedersen Christian , Gislason Gunnar H. 
Published: September 2012

Background—
The cardiovascular risk after the first myocardial infarction (MI) declines rapidly during the first year. We analyzed whether the cardiovascular risk associated with using nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with the time elapsed following first-time MI.

Methods and Results—
We identified patients aged 30 years or older admitted with first-time MI in 1997 to 2009 and subsequent NSAID use by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. We calculated the incidence rates of death and a composite end point of coronary death or nonfatal recurrent MIs associated with NSAID use in 1-year time intervals up to 5 years after inclusion and analyzed risk by using multivariable adjusted time-dependent Cox proportional hazards models. Of the 99 187 patients included, 43 608 (44%) were prescribed NSAIDs after the index MI. There were 36 747 deaths and 28 693 coronary deaths or nonfatal recurrent MIs during the 5 years of follow-up. Relative to noncurrent treatment with NSAIDs, the use of any NSAID in the years following MI was persistently associated with an increased risk of death (hazard ratio 1.59 [95% confidence interval, 1.49–1.69]) after 1 year and hazard ratio 1.63 [95% confidence interval, 1.52–1.74] after 5 years) and coronary death or nonfatal recurrent MI (hazard ratio, 1.30 [95% confidence interval,l 1.22–1.39] and hazard ratio, 1.41 [95% confidence interval, 1.28–1.55]).

Conclusions—
The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in the use of NSAIDs for patients after MI.
Genome-Wide Association Study of Intracranial Aneurysms Confirms Role of Anril and SOX17 in Disease Risk
Authors: Foroud Tatiana , Koller Daniel L. , Lai Dongbing , Sauerbeck Laura , Anderson Craig , Ko Nerissa , Deka Ranjan , Mosley Thomas H. , Fornage Myriam , Woo Daniel , Moomaw Charles J. , Hornung Richard , Huston John , Meissner Irene , BaileyWilson Joan E. , Langefeld Carl , Rouleau Guy , Connolly E. Sander , Worrall Bradford B. , Kleindorfer Dawn , Flaherty Matthew L. , Martini Sharyl , Mackey Jason , De Los Rios La Rosa Felipe , Brown Robert D. , Broderick Joseph P. ,   the FIA Study Investigators
Published: September 2012

Background—
Genomewide association studies have identified novel genetic factors that contribute to intracranial aneurysm (IA) susceptibility. We sought to confirm previously reported loci, to identify novel risk factors, and to evaluate the contribution of these factors to familial and sporadic IA.

Method—
We utilized 2 complementary samples, one recruited on the basis of a dense family history of IA (discovery sample 1: 388 IA cases and 397 controls) and the other without regard to family history (discovery sample 2: 1095 IA cases and 1286 controls). Imputation was used to generate a common set of single nucleotide polymorphisms (SNP) across samples, and a logistic regression model was used to test for association in each sample. Results from each sample were then combined in a metaanalysis.

Results—

There was only modest overlap in the association results obtained in the 2 samples. In neither sample did results reach genomewide significance. However, the metaanalysis yielded genomewide significance for SNP on chromosome 9p (
CDKN2BAS
; rs6475606;
P
=3.6 × 10
−8
) and provided further evidence to support the previously reported association of IA with SNP in
SOX17
on chromosome 8q (rs1072737;
P
=8.7 × 10
−5
). Analyses suggest that the effect of smoking acts multiplicatively with the SNP genotype, and smoking has a greater effect on risk than SNP genotype.

Conclusion—

In addition to replicating several previously reported loci, we provide further evidence that the association on chromosome 9p is attributable to variants in
CDKN2BAS
(also known as
ANRIL
, an antisense noncoding RNA).
Lipoprotein Phospholipase A2 and Cerebral Microbleeds in the Framingham Heart Study
Authors: Romero José Rafael , Preis Sarah R. , Beiser Alexa S. , DeCarli Charles , Lee Dong Young , Viswanathan Anand , Benjamin Emelia J. , Fontes Joao , Au Rhoda , Pikula Aleksandra , Wang Jimmy , Kase Carlos S. , Wolf Philip A. , Irrizary Michael C. , Seshadri Sudha 
Published: September 2012

Background and Purpose—
Cerebral microbleeds (CMB) attributable to cerebral amyloid angiopathy generally occur in lobar regions, whereas those attributable to hypertensive vasculopathy are deep. Inflammation may be an underlying mechanism for CMB, with varying associations according to CMB location. Lipoprotein phospholipase-A2 (Lp-PLA2) is a circulating enzyme marker of vascular inflammation associated with risk of ischemic stroke and dementia. We hypothesized that higher Lp-PLA2 levels would be related to higher prevalence of CMB, with possible regional specificity.

Methods—

Framingham Offspring participants aged 65 years or older with available Lp-PLA2 measures and brain magnetic resonance imaging were included. Logistic regression models were used to relate Lp-PLA2 activity and mass to presence of CMB, adjusted for age, sex, medication use (aspirin, anticoagulants, and statins), systolic blood pressure,
APOE
, current smoking, and diabetes.

Results—

Eight-hundred nineteen participants (mean age, 73 years; 53% women) were included; 106 (13%) had CMB, 82 (10%) were lobar, and 27 (3%) were deep. We did not observe significant associations of CMB and LpPLA2 measures in multivariable adjusted analyses. However, there was a significant interaction between
APOE
genotype and Lp-PLA2 activity in their relation to presence of deep CMB (
P
interaction=0.01). Among persons with
APOE
ɛ
3
/ɛ
3
, the odds ratio for deep CMB was 0.95 (confidence interval, 0.59-1.53;
P
=0.83), whereas among those with at least 1 ɛ
2
or ɛ
4
allele, odds ratio was 3.46 (confidence interval, 1.43-8.36;
P
=0.006).

Conclusions—

In our community-based sample of older adults, there was no significant association of Lp-PLA2 with total or lobar CMB. The association of higher levels of Lp-PLA2 activity with deep CMB among those with at least 1
APOE
ɛ
2
or ɛ
4
allele merits replication.
Clientelistic Stability and Institutional Fragility
Authors: Sánchez Ana Belén Benito , Lozano Wilfredo 
Published: September 2012

Since 1978, with the disappearance of the historical caudillos (Joaquín Balaguer, Juan Bosch, and José Francisco Peña Gómez), institutional fragility and electoral power have been the keys to the survival of the political party system in the Dominican Republic. The current parties are more stable but not more institutionalized. The authoritarianism that characterized the Dominican political system from the 1960s until the end of the twentieth century relied for its stability not just on power and repression but on political control through clientelism and prebendalism. These mechanisms served not only as an instrument of social control but also as a strong basis for legitimacy. Desde 1978, tras la desaparición de los caudillos históricos (Joaquín Balaguer, Juan Bosch y José Francisco Peña Gómez), la fragilidad institucional y la fuerza electoral han sido las claves de la supervivencia del sistema de partidos en República Dominicana. Los partidos son hoy más estables pero no más institucionalizados. El autoritarismo que ha caracterizado al sistema político dominicano desde los años sesenta hasta finales del siglo XX no se ha apoyado únicamente en la apelación a la fuerza y a la represión; la clave de la estabilidad ha sido el control político a través del clientelismo y la movilización prebendalista. Este mecanismo, no solo es un arma de control social, sino que asegura bases firmes de legitimidad.
Validation of the Knee Injury and Osteoarthritis Outcome Score Subscales for Patients With Articular Cartilage Lesions of the Knee
Authors: Engelhart Luella , Nelson Lauren , Lewis Sandy , Mordin Margaret , Demuro-Mercon Carla , Uddin Sharif , McLeod Lori , Cole Brian , Farr Jack 
Published: September 2012

Background: The Knee Injury and Osteoarthritis Outcome Score (KOOS) assesses acute and chronic knee injuries or early-onset osteoarthritis in young, active patients. The United States Food and Drug Administration guidelines recommend that patient-reported outcome instruments used to support clinical trial label claims should demonstrate content validity using patient input and have acceptable psychometric properties in the target population. To use the KOOS subscales in safety and efficacy trials assessing new treatments for patients with articular cartilage lesions, additional validation work, using input from patients with articular cartilage lesions, was necessary. Purpose: Qualitative and quantitative evaluations of the KOOS subscales’ validity among patients with articular cartilage lesions were conducted to support their use as clinically meaningful end points in clinical trials. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: For qualitative analysis, cognitive interviews involving concept elicitation and cognitive debriefing with the KOOS items were conducted with 15 participants aged 25 to 52 years. Participants either were candidates for cartilage repair or had undergone cartilage repair 6 months or more before the study. For the quantitative analysis, a psychometric evaluation of the KOOS was conducted with clinical trial data from 54 patients, aged 18 to 55 years, evaluating the Cartilage Autograft Implantation System in the United States (n = 29) and the European Union (n = 25). Data were collected before surgery and at 7 postsurgical visits up to 12 months. Internal consistency and test-retest reliability, construct validity, responsiveness, and estimates of the minimal detectable change (MDC) were assessed. Test-retest reliability was assessed using data from months 2 and 3 on a subset of stable patients. Results: Qualitative research confirmed that concepts measured on the KOOS are important to patients with articular cartilage lesions. Most participants reported the KOOS was comprehensive and appropriate. In the quantitative research, KOOS subscales showed excellent internal consistency reliability (range, .74-.97 at baseline) and test-retest reliability (range, .78-.82). Construct validity results supported hypothesized relationships, with significant correlations ( r ≥ .50) in the expected directions. Responsiveness analyses demonstrated excellent sensitivity to change; standardized response means ranged from 0.8 to 1.2, and MDC estimates ranged from 7.4 to 12.1. Conclusion: The study results support the use of the KOOS subscales among patients with articular cartilage lesions.
Reliability of Tunnel Measurements and the Quadrant Method Using Fluoroscopic Radiographs After Anterior Cruciate Ligament Reconstruction
Authors: Sullivan Jaron P. , Matava Matthew J. , Flanigan David C. , Gao Yubo , Britton Carla L. , Amendola Annunziato ,   MOON Group, Wolf Brian R. , Spindler Kurt S. , Dunn Warren R. , Carey James L. , Cox Charles L. , Andrish Jack T. , Parker Richard D. , Jones Morgan H. , Marx Robert G. , McCarty Eric C. , Vidal Armando F. , Wolcott Michelle , Wright Rick W. , Brophy Robert H. , Smith Matthew V. , Kaeding Christopher C. 
Published: September 2012

Background: Anterior cruciate ligament (ACL) reconstruction tunnel placement is often evaluated by radiographs. This study examines the interobserver reliability of various radiographic measurements of ACL tunnels. Hypothesis: When ideal radiographic views are obtained, the interobserver reliability of the measurements among experienced surgeons would be good to excellent. Study Design: Descriptive laboratory study. Methods: Tunnels for single-bundle ACL reconstruction were drilled and filled with metal interference screws or a tibial reamer on 73 cadaveric knees. Ideal fluoroscopic radiographs were obtained. Three independent reviewers performed 18 measurements including a modification of the grid method. For the grid method analysis, reviewers fit a 16 × 12 grid to the lateral knee radiograph, and the center of the femoral tunnel was marked. Interobserver reliability of the measurements was performed using intraclass correlation coefficients (ICCs). A precision grouping analysis was performed for the grid measurements to calculate the mean radius and standard deviation grouping distances. Results: The ICCs were excellent (>.75) for the tibial tunnel angles and tunnel measurements, the clock face measurement, and the Aglietti et al and Jonsson et al measurements. The ICCs were good (.4-.75) for an estimation of graft impingement, Harner et al measurements, and notch height. The mean radius for grid measurements was 0.6 ± 0.4 units (range, 0-2.36 units), with each unit being 1 box in the 16 × 12 grid. When a circle was constructed with a 1.3-unit radius, 95% of the 3 surgeons’ measurements would be included in the area of that circle. Conclusion: Reliability of ACL tunnel measurements was good to excellent under ideal circumstances for the majority of measurements. The modified grid method demonstrated very acceptable reliability. Clinical Relevance: Measurements with good to excellent reliability can be used to evaluate ACL tunnel placement when ideal radiographic views are obtained.
Clinical and Second-Look Arthroscopic Study Comparing 2 Tibial Landmarks for Tunnel Insertions During Double-Bundle ACL Reconstruction With a Minimum 2-Year Follow-up
Authors: Ohsawa Takashi , Kimura Masashi , Hagiwara Keiichi , Yorifuji Hiroshi , Takagishi Kenji 
Published: September 2012

Background: Few studies have reported the clinical results of tibial tunnel placement during double-bundle anterior cruciate ligament (ACL) reconstruction. It is important to recognize arthroscopic tibial landmarks during this procedure. Hypothesis: During arthroscopic double-bundle ACL reconstruction, anterior tibial landmarks such as the intermeniscal (transverse) ligament and the Parsons knob for the anteromedial (AM) tunnel provide better knee stability and clinical outcomes than do posterior tibial landmarks such as the fovea anterior to the tibial intertubercle ridge for the posterolateral (PL) tunnel. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 121 patients underwent primary unilateral double-bundle ACL reconstructions using autogenous medial hamstring tendons. Fifty-nine patients from December 2008 through July 2009 underwent reconstructions using posterior tibial landmarks (PL group), and 62 patients from August 2009 through February 2010 underwent reconstructions using anterior tibial landmarks (AM group). Forty-seven patients (follow-up rate, 79.7%) in the PL group and 52 patients (follow-up rate, 83.9%) in the AM group underwent second-look arthroscopy and clinical evaluations under anesthesia at 1 year postoperatively and 3-dimensional computed tomography (3-D CT) evaluations at 3 weeks postoperatively. Results: Lachman test results indicated no significant differences, and pivot-shift test results were significantly lower in the AM group ( P = .007). Mean side-to-side differences using the Telos device at 130 N were significantly lower in the AM group (1.4 ± 1.6 mm) compared with the PL group (2.4 ± 2.5 mm) ( P = .012). Results for lack of extension were not significantly different, while those for lack of flexion were significantly better in the AM group than in the PL group ( P = .036). No significant differences were observed in the Lysholm scores between the groups. In measurements of the tibial tunnel position by 3-D CT, with regard to anteroposterior depth, the AM bundle of the PL group was 41.6% ± 7.4% and the AM group was 29.1% ± 5.3% ( P < .001), and the PL bundle of the PL group was 55.6% ± 7.7% and the AM group was 46.4% ± 5.8% ( P < .001). No significant differences were found in mediolateral width. In second-look arthroscopy, there were significant differences with respect to the synovial cover with regard to the AM bundle ( P = .024). Conclusion: Patients in the AM group showed better knee stability and range of motion than those in the PL group. Transverse ligaments and Parsons knobs proved to be useful landmarks during ACL reconstruction.