bluuebunny/crossref_metadata_2025_split huggingface dataset:
The incidence of injuries in persons with and without epilepsy—A population‐based study
Authors: Kwon Churl‐Su , Liu Mingfu , Quan Hude , Wiebe Samuel , McChesney Jane , Wirrell Elaine , Hamiwka Lorie , Jetté Nathalie 
Published: August 2010

SummaryPurpose:  To compare the 1‐year population‐based incidence and types of injuries in persons with and without epilepsy.Methods:  Three administrative databases (inpatient visits, physician claims, and emergency room visits) were linked from fiscal years 1996–2003 using a provincial insurance plan registry, which captures 99% of a population of 1.4 million in a large Canadian health region. Epilepsy cases (all age groups) from fiscal year 1996–2002 were identified. Three people without epilepsy were matched to one person with epilepsy for age (±1 year) and sex. Injuries were defined as any of 16 types of injuries for which medical attention was sought that occurred within fiscal year 2003.Results:  Eight thousand eight hundred ninety subjects with epilepsy were identified and matched to 26,670 controls for age and sex. The mean age was 37.4 years (range 0.01–96.4 years), and 51.3% of subjects were male. The 1‐year incidence of one or more injuries was 20.6% among persons with epilepsy and 16.1% among those without epilepsy (p < 0.001). Of the 16 types of injuries studied, 11 were higher in persons with epilepsy compared to those without epilepsy, and included fractures, crushing injuries, intracranial injuries, other types of head injuries, and multiple injuries. The difference was still significant after adjusting for age, gender, and comorbidities.Discussion:  The 1‐year incidence of injuries in this study was greater in persons with epilepsy compared to those without epilepsy, for nearly all injury types. Injury prevention should be discussed during routine visits in persons with epilepsy.
The incidence of epilepsy in a rural district of Vietnam: A community‐based epidemiologic study
Authors: Tuan Nguyen Anh , Cuong Le Quang , Allebeck Peter , Chuc Nguyen Thi Kim , Persson Hans E. , Tomson Torbjörn 
Published: August 2010

SummaryPurpose:  Epidemiologic studies of epilepsy from developing countries are scarce. As part of a population‐based epidemiologic project in Vietnam, EPIBAVI, we studied the incidence and etiology of epilepsy in people in a representative rural region of the country.Methods:  Two identical field surveys were carried out 3 years apart (January to December 2005, and June to December 2008) in the same population of the Bavi District in Vietnam. On both occasions, close to 50,000 members of approximately 13,000 households were screened using a questionnaire for epilepsy. A clinical examination of all screened positive was performed by a neurologist to verify the epilepsy diagnosis, and all incident cases were offered EEG and a CT scan.Results:  In the first survey 2.8% screened positive according to the questionnaire. Of these, 19 had epilepsy onset within 1 year preceding the screening, yielding an incidence rate of 40.2 per 100,000 [95% confidence interval (CI) 22.1–58.3]. In the second survey 1.8% were screened positive, and 21 of these had epilepsy onset within 1 year preceding the screening, giving an incidence rate of 42.9 per 100,000 (95% CI 24.5–61.2). The age‐adjusted incidence was 44.8 per 100,000 (95% CI 30.6–59.0). The incidence was higher in those younger than 16 years, among people with lower education, and among people with lower income. CT scan was performed in 29 cases and only two cases were found with some abnormalities.Discussion:  The incidence rate of epilepsy in rural Vietnam in our study was lower than in developing countries in Latin America and Africa and similar to rates in Europe and North America.
The effect of valproate and levetiracetam on steroidogenesis in forskolin‐stimulated H295R cells
Authors: Von Krogh Kristine , Harjen Hannah , Almås Camilla , Zimmer Karin E. , Dahl Ellen , Olsaker Ingrid , Taubøll Erik , Ropstad Erik , Verhaegen Steven 
Published: August 2010

SummaryPurpose:  Endocrine disruptive effects have been frequently observed in patients using antiepileptic drugs (AEDs). Two different AEDs, valproate (VPA) and levetiracetam (LEV), were tested in forskolin‐stimulated human adrenal carcinoma (H295R) cells to explore their effect on steroidogenesis. VPA has a long history as an anticonvulsant and is linked with many of the endocrine disorders associated with AED use. LEV is a newer AED, and no endocrine disruptive effects have been reported in humans to date.Methods:  H295R cells, which are capable of full steroidogenesis, were stimulated with forskolin and exposed to either VPA or LEV for 48 h. Medium was collected and analyzed for hormone production. For the VPA‐exposed cells, steroidogenic gene expression analysis was also conducted.Results:  VPA exposure resulted in a significant reduction in progesterone and estradiol (E2) production, whereas testosterone (T) levels remained unchanged. There were also significant alterations in expression level for most genes analyzed. LEV exposure resulted in a minor, but statistically significant, reduction in T and E2 production.Discussion:  Exposure of forskolin‐stimulated H295R cells to VPA led to an increased T/E2 ratio through a significant decrease in estradiol production. Gene analysis suggested that VPA affects NR0B1 expression. NR0B1 inhibits promoters of other genes involved in steroidogenesis, and the altered expression of NR0B1 might explain the observed down‐regulation in hormone production. The effects of LEV exposure on hormone secretion were not considered to be biologically significant.
Communicating throughout Katrina: Competing and Complementary Conceptual Lenses on Crisis Communication
Authors: Garnett James L. , Kouzmin Alexander 
Published: August 2010

Hurricane Katrina was as much a communication disaster as it was a natural and bureaucratic disaster. Communication gaps, missed signals, information technology failures, administrative buffering, turf battles, and deliberate and unintentional misinterpretations delayed and handicapped both the recognition of the crisis that Katrina posed and the response to its devastation. This essay views crisis communication through four conceptual lenses: (1) crisis communication as interpersonal influence, (2) crisis communication as media relations, (3) crisis communication as technology showcase, and (4) crisis communication as interorganizational networking. A conceptual framework is presented that compares these lenses with regard to agency, transparency, technology, and chronology. The planning, response, and recovery stages of the Hurricane Katrina disaster are viewed through these communication conceptual lenses, illustrating key facets of each perspective and adding to our deepening understanding of the events.
Many of the problems we have identified can be categorized as “information gaps”—or at least problems with information‐related implications, or failures to act decisively because information was sketchy at best. Better information would have been an optimal weapon against Katrina. Information sent to the right people at the right place at the right time. Information moved within agencies, across departments, and between jurisdictions of government as well. Seamlessly. Securely. Efficiently … One would think we could share information by now. But Katrina again proved we cannot. —U.S. House Select Bipartisan Committee With the floodwalls gashed and hemorrhaging billions of gallons of water into the city, it was only a matter of a few hours on Monday before the communications citywide began to fail … Communication was about to become the biggest problem of the catastrophe. —Christopher Cooper and Robert Block, Disaster: Hurricane Katrina and the Failure of Homeland Security Truth became a casualty, news organizations that were patting their own backs in early September were publishing protracted mea culpas by the end of the month. —Matt Welch, “They Shoot Helicopters, Don’t They?”
Axillary/Subclavian Vein Puncture Using Navigation by Parallax with an Imaginary Target
Authors: Lau Ernest W. 
Published: August 2010

Background:

The parallax principles allow the relative positions of two overlapping objects with respect to the receiver of a two dimensional image to be determined, and can reliably navigate an object to a target in three dimensional space. Navigation by parallax can direct axillary/subclavian vein puncture under fluoroscopy with a guide wire inside the vein. The axillary/subclavian vein has a constant relationship with the first rib and an imaginary target just cranial and lateral to the middle part of the first rib may serve as a surrogate position marker for the vein adequate for guiding puncture.
Method:

Patients requiring axillary/subclavian vein puncture were considered for the new technique. In an appropriate postero‐anterior (P‐A) caudal projection such that the middle part of the first rib lay outside the second rib concavity, the needle was inserted into the body medial to the coracoid process and advanced dorsally and medially towards an imaginary target cranial and lateral to the middle part of the first rib. Once the needle tip had reached the imaginary target, it was moved ventro‐dorsally while staying stationary in the fluoroscopic image until venous blood was aspirated.
Result:

Navigation by parallax was successful in 21/24 cases (88%) and 42/45 separate venous punctures (93%) with an imaginary target, and in the remaining three cases with a real guide wire target. There were four insignificant axillary arterial punctures.
Conclusions:

Navigation by parallax with an imaginary or a real target is effective, easy, and simple, and should facilitate axillary/subclavian vein puncture in multiple clinical scenarios.
Clustering of Device‐Related Concerns and Type D Personality Predicts Increased Distress in ICD Patients Independent of Shocks1
Authors: PEDERSEN SUSANNE S , THEUNS DOMINIC AMJ , ERDMAN RUUD AM , JORDAENS LUC 
Published: August 2010

Background: This study examined the impact of clustering of device‐related concerns and Type D personality on anxiety and depressive symptoms during a six‐month period and the clinical relevance of shocks, implantable cardioverter defibrillator (ICD) concerns, and Type D.
Methods: Consecutively implanted ICD patients (n = 176) completed questionnaires at baseline and six months and were divided into four risk groups: (1) No risk factors (neither ICD concerns nor Type D); (2) ICD concerns only; (3) Type D only; (4) Clustering (both ICD concerns and Type D).
Results: The prevalence of Type D and concerns were 21.6% and 34.7%. Analysis of variance for repeated measures showed a reduction in anxiety over time (P < 0.001), with the risk groups exerting a stable (P = 0.14) but differential effect (P < 0.001); the highest level was seen in the clustering group. Similar results were found for depression, although depressive symptoms did not decrease (P = 0.08) and the impact of clustering was less clear. These results were confirmed in adjusted analysis, with shocks (P = 0.024) also being associated with anxiety but not depression. The impact of ICD concerns and Type D personality on anxiety and depression at baseline and six months was large (≥0.8) compared to negligible to moderate for shocks (0.0–0.6).
Conclusions: ICD patients with psychosocial risk factor clustering had the highest level of anxiety, whereas the pattern for depression was less consistent. Shocks influenced outcomes, but the impact was smaller compared to ICD concerns and Type D personality. It may be timely to expand the focus beyond shocks when seeking to identify ICD patients at risk for adverse clinical outcome due to their psychological profile.
Health Status in Patients Treated with Cardiac Resynchronization Therapy: Modulating Effects of Personality
Authors: SCHIFFER ANGÉLIQUE A. , DENOLLET JOHAN , PEDERSEN SUSANNE S. , BROERS HERMAN , WIDDERSHOVEN JOS W. 
Published: August 2010

Background: Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated with CRT improved in patient‐centered outcomes and functional capacity, and (2) whether personality traits exert a stable effect on these outcomes over two months.
Methods: Analyses are based on 31 patients (65% male; mean age 70 ± 8) with CHF treated with CRT. Two weeks before and two months after CRT, patients completed the Type‐D Scale (negative affectivity, i.e., tendency to experience negative emotions, and social inhibition, i.e., tendency to inhibit self‐expression), the Minnesota Living with Heart Failure Questionnaire (disease‐specific health status), and the Health Complaints Scale (cardiac symptoms and perceived disability), and performed the six‐minute walking test (functional capacity).
Results: There was an improvement in disease‐specific health status (P< 0.001), cardiac symptoms (P = 0.001), perceived disability (P< 0.001), and functional capacity (P = 0.007) in all patients over two months. However, high negative affectivity patients reported significantly lower disease‐specific health status (P = 0.046), and more cardiac symptoms (P = 0.035), and perceived disability (P = 0.015) as compared to low negative affectivity patients. There was no significant main effect for negative affectivity on functional capacity. High negative affectivity patients still reported lower disease‐specific health status (P = 0.06) and significantly more perceived disability (P = 0.04) when adjusting for left ventricular ejection fraction, gender, and age. The effects of negative affectivity on patient‐centered outcomes, as measured by Cohen's effect size index, were moderate to large.
Conclusions: Patient‐centered outcomes improved over a two‐month period in patients treated with CRT, but negative affectivity exerted a stable, negative effect on health status, cardiac symptoms, and perceived disability. Personality traits should be taken into account when evaluating effects of CRT.
A Real‐Time Three‐Dimensional Echocardiographic Validation of an Intracardiac Electrogram‐Based Method for Optimizing Cardiac Resynchronization Therapy
Authors: PORCIANI MARIA CRISTINA , RAO CARMELO MASSIMILIANO , MOCHI MATTEO , CAPPELLI FRANCESCO , BONGIORNO GABRIELLA , PERINI ALESSANDRO PAOLETTI , LILLI ALESSIO , RICCIARDI GIUSEPPE , HASHTROUDI LAWRENCE , SILVESTRI PAOLO , BAROLD S. SERGE , PADELETTI LUIGI 
Published: August 2010

Introduction: Although optimization of atrioventricular and interventricular delays has been demonstrated to improve hemodynamics in patients with cardiac resynchronization therapy (CRT), the required time‐consuming procedure discourages its use in clinical practice. Recently, a new method for CRT optimization based on the intracardiac electrogram (IEGM) detected by the implanted leads, has been developed. We evaluated the effectiveness of this method in improving left ventricular (LV) asynchrony and performance using real‐time 3D echocardiography (RT3DE).
Methods and Results: Twenty patients with CRT were prospectively studied. RT3DE was performed before and after IEGM optimization. The standard deviation of the time to the regional LV minimum systolic volume (Tmsv) for all 16 segments (Tmsv 16‐SD), six basal and six mid segments (Tmsv 12‐SD), and the six basal segments (Tmsv 6‐SD) were assessed as a asynchrony indexes. LV end‐diastolic and end‐systolic volumes (EDV, ESV), stroke volume (SV), ejection fraction (EF), myocardial performance index (MPI), ejection time (ET), and filling time (FT), corrected by R‐R interval, were also evaluated. After IEGM optimization, as compared with baseline Tmsv 12‐SD and Tmsv 16‐SD decreased (P = 0.01, P< 0.001, respectively), EF and SV improved (P < 0.001, P = 0.01 respectively), FT/RR and ET/RR increased (P = 0.02 for both), and MPI improved (P < 0.001). Tmsv 6‐SD, EDV and ESV did not change.
Conclusion: A simple IEGM‐based method of CRT optimization decreased LV dyssynchrony and improved systolic function.
Electrical Remodeling and Cardiac Dimensions in Patients Treated by Cardiac Resynchronization and Heart Failure Controls
Authors: STOCKBURGER MARTIN , NITARDY AISCHA , FATEH‐MOGHADAM SUZANNE , KREBS ALICE , CELEBI ÖZLEM , KARHAUSEN TIM , DIETZ RAINER 
Published: August 2010

Background: Cardiac resynchronization therapy (CRT) reduces the left ventricular diameter (LVEDD) in heart failure (HF) patients with left bundle branch block (LBBB). The study compares structural and electrical remodeling in HF patients on CRT and matched HF controls without LBBB.
Methods

: In 42 patients (64 ± 9 years left ventricular ejection fraction [LVEF] 25 ± 8%, 16 coronary artery disease, 26 nonischemic cardiomyopathy, 21 with LBBB and CRT indication vs 21 controls [matched for gender, age, LVEF, and underlying disease]) an unpaced electrocardiogram (ECG) and echocardiogram were recorded at baseline (bl) and after 20.6 ± 13.8 months (fup). LVEDD, left atrial (LA) width, mitral regurgitation (MR), P‐wave, PR interval, QRS width, QRS vector, and QT interval were analyzed.
Results: LVEDD diminished with CRT (bl 68.7 ± 10.3 vs fup 62.0 ± 7.7 mm, P = 0.002). Controls showed no change (bl 64.1 ± 9.4 vs fup 64.8 ± 8.4 mm, P = n.s.). MR improved with CRT (bl 1.2 ± 0.6 vs fup 0.8 ± 0.7, P = 0.02), but not among controls. LA width tended to decrease on CRT (CRT bl 48.9 ± 4.4 vs fup 46.9 ± 7.2 mm, P = 0.17, controls bl 48.5 ± 5.1 vs fup 47.5 ± 6.5 mm, P = 0.49). PR interval lengthened in both groups (CRT bl 175 ± 29 vs fup 188 ± 30 ms, P = 0.03, controls bl 177±25 vs fup 187 ± 19 ms, P = 0.27). QRS increased in both groups (CRT bl 165 ± 22 vs fup 171 ± 20 ms, P = 0.07, controls bl 111 ± 17 vs fup 118 ± 19 ms, P = 0.01). Analyses revealed no significant association of echocardiographic and ECG parameters.
Conclusions

: Despite LVEDD reduction with CRT, electrical activation does not recover. Electrical remodeling does not differ between LBBB patients under CRT and matched controls without CRT indication.
Atrial Activation Occurring Immediately after Successful Cardioversion of Atrial Fibrillation
Authors: MARTÍN PEÑATO MOLINA ARTURO , COSÍO FRANCISCO G. , PASTOR AGUSTÍN , NÚÑEZ AMBROSIO , AWAMLEH PAULA 
Published: August 2010

Background and Objective: Electrical defibrillation is very effective in interrupting atrial fibrillation (AF). However, its mechanism is not completely understood. We report our observations in patients subjected to external electriocardioversion (ECV) of atrial fibrillation and contrast them with recent theories about defibrillation mechanism.
Methods: In 13 consecutive patients transthoracic electrical cardioversion for AF was performed during an electrophysiological study (11 monophasic ‐200–360 J‐ and 9 biphasic shocks ‐50–150 J‐). About 10–16 electrograms were obtained with multipolar catheters recording right atrium, coronary sinus, and right pulmonary artery. AF was defined by interelectrogram intervals and changing sequences among recordings, indicating complete lack of organization. We evaluated the presence of propagated activations immediately (<300 ms) after successful shocks (≥1 discrete electrogram in all recordings). In unsuccessful shocks we evaluated changes in electrogram morphology (discrete/fragmented) and interelectrogram intervals before and after defibrillation.
Results: About 16/20 shocks terminated AF. In 6/16 one or two cycles of atrial activation were recorded just after the shock and before AF ended. In 10/16 AF was interrupted immediately after the shock. 4/20 shocks did not interrupt the arrhythmia. After these shocks, transient organization of recorded activity with longer interelectrogram cycle length and disappearance of fragmented activity were transiently observed.
Conclusion: Our clinical findings in atrial defibrillation in vivo reproduce experimental data that show myocardial activations early after successful direct current shocks. These observations suggest that successful defibrillation depends not only on the immediate effects of the shock, but also on transient effects on electrophysiological properties of the myocardium, capable of interrupting persistent or reinitiated activations.
The Inferior Radiolucent Area Within the Cardiac Silhouette: Validation as a Landmark for Coronary Sinus Catheterization
Authors: GONZALEZ‐VASSEROT MAR , GNOATTO MARIANA , MERINO JOSE L. , PEINADO RAFAEL , ABELLO MAURICIO , SOBRINO JOSE A. , LÓPEZ‐SENDON JOSE L. 
Published: August 2010

Background:

Catheterization of the coronary sinus (CS) plays a preponderant role in device implantation and electrophysiology. Nevertheless, catheterization of this structure can be time‐consuming and is related to operator experience. An inferior radiolucent area of the cardiac right anterior oblique (RAO) view has been suggested as a landmark to guide CS catheterization. However, the true relationship of this area with the CS ostium (CSO) has not been studied.
Methods:

Thirty‐five consecutive patients who underwent right coronary angiography were prospectively enrolled in the study. Fluoroscopic images of the heart in the right anterior oblique, both immediately before and during the venous phase of right coronary angiography, were recorded and digitally stored. Postprocedure measurements of the inferior radiolucent area within the cardiac silhouette and, subsequently, the distance of this area to the CSO, were performed by two independent observers.
Results:

A radiolucent area of 9.5 ± 3.0 × 11.0 ± 3.4 mm was identified in the inferior annulus by the two evaluators in all patients. No significant differences in the dimensions of this area were found between the two observers. The CSO was 9.6 ± 7.2 mm superior and 0.1 ± 9.0 mm posterior to the radiolucent area and no statistically significant differences were found between the two observers.
Conclusion:

An inferior radiolucent area can be identified within the cardiac silhouette in most patients in the RAO view. This area is slightly anterior and inferior to the CSO and can be used for catheterization guidance of this latter structure.
Four‐Chamber Pacing in Patients with Poor Ejection Fraction but Normal QRS Durations Undergoing Open Heart Surgery
Authors: PICHLMAIER MAXIMILIAN , BAGAEV ERIC , LICHTENBERG ARTHUR , TEEBKEN OMKE , KLEIN GUNNAR , NIEHAUS MICHAEL , HAVERICH AXEL 
Published: August 2010

Background:

Poor ejection fraction (EF) comprises a critical risk factor in cardiac bypass surgery (CABG). It has been unclear, whether biventricular or four‐chamber pacing confers benefit upon patients with intact atrioventricular and interventricular conduction especially following surgery.
Methods:

Twenty‐one consecutive patients with an EF ≤ 35% underwent hemodynamic evaluation (continuous pressures and thermodilution) 3, 6, and 18 hours post‐CABG and biatrial (AA), biatrial‐right ventricular (AAV), and biatrial‐biventricular (AAVV) pacing were compared.
Results:

Patients (65 ± 9 years) presented with an average EF of 29.5% (15–35%). 514 measurements of cardiac index (CI) were taken. Nineteen patients (91%) showed highly significant increases in CI with AAVV as compared to AA pacing (P < 0,001) at all times post surgery. The increase in CI with pacing mode varied from 6% to 25% and decreased with time following surgery. No consistent difference in CI was seen between four‐chamber (AAVV) and biventricular pacing (AVV). The QRS‐widths prior to surgery never exceeded 120 ms; postoperatively QRS‐complexes widened in all patients on average by 15.9 ms ±6 and returned to starting values by 48 hours.
Conclusions:

Biventricular pacing improves CI in patients with poor EF following cardiac surgery in the absence of preoperative atrioventricular‐ or interventricular conduction block. This benefit decreases with time after surgery as the QRS width returns to preoperative values. Four‐chamber pacing did not confer additional benefit as compared to biventricular pacing in this series. Biventricular pacing should be considered as an adjunct in patients with critically low EF undergoing cardiac surgery.