bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circadian Rhythm and Personality Profile in Juvenile Myoclonic Epilepsy
Authors: Pung Tamara , Schmitz Bettina 
Published: November 2006

Summary:  Juvenile Myoclonic Epilepsy (JME) is a prototype of idiopathic generalized epilepsy and is characterized by a strong genetic predisposition. According to clinical observations by Janz and Christian (1), the syndrome is associated with a characteristic sleep/wake rhythm and a typical personality profile. These features have subsequently been interpreted as a mild frontal lobe behavior syndrome. Recent neuropsychological and imaging studies confirmed mesiofrontal and prefrontal dysfunction in JME.We studied 20 patients with JME and a matched comparison group with temporal lobe epilepsy (TLE) using standardized questionnaires with respect to the sleep‐wake rhythm and with respect to personality profiles. We confirmed the characteristic circadian rhythm in JME with the tendency to go to bed later at night, to get up later in the morning, and to feel fit at a later time during the day compared to patients with TLE. With the exception of some subanalyses we did not find evidence for a specific personality profile in JME.
Increased Ventricular Ectopic Activity in Relation to C‐Reactive Protein, and NT‐Pro‐Brain Natriuretic Peptide in Subjects With No Apparent Heart Disease
Authors: SAJADIEH AHMAD , NIELSEN OLAV WENDELBOE , RASMUSSEN VERNER , OLE HEIN HANS , HANSEN JØRGEN FISCHER 
Published: November 2006

Background: Subjects with frequent ventricular premature complexes (VPC) and no apparent heart disease make a heterogenic group with regard to prognosis. Some biomarkers have recently proved useful in risk stratification in different heart diseases. We examined prognostic impact of NT‐Pro‐brain natriuretic peptide (NT‐Pro BNP), and C‐reactive protein (CRP) in relation to frequent VPC in subjects with no apparent heart disease.
Methods: Six hundred seventy‐eight healthy subjects between 55 and 75 years of age with no history of cardiovascular disease were included in the study. All were tested with fasting laboratory testing and 48‐hour ambulatory ECG monitoring. Frequent VPC was defined as VPC ≥30/hour.
Results: In 56 subjects (8%) with frequent VPC the prognosis was much poorer compared to those without frequent VPC (Hazard ratio and 95% CI: 2.3;1.2–4.4, P = 0.01), after adjustment for conventional risk factors. In subjects with frequent VPC increased levels of CRP (above 2.5 μg/mL) was the only factor among the tested biomarkers, which was associated with a poor prognosis. Taking subjects without frequent VPC as reference, the hazard ratio and 95% CI for subjects with frequent VPC and increased CRP was 3.6;1.8–7.1, P = 0.0004, and for those with frequent VPC and normal CRP 0.8;0.2–3.5, P = 0.83, after correction for conventional risk factors.
Conclusions: Among middle‐aged and elderly subjects with no apparent heart disease and frequent VPCs, a CRP value ≥2.5 μg/mL is associated with a significantly higher risk of death and acute myocardial infarction. These subjects deserve primary prevention measures and further work up for structural heart disease.
Psychological Distress in Patients with ICD Recall
Authors: CUCULI FLORIM , HERZIG WERNER , KOBZA RICHARD , ERNE PAUL 
Published: November 2006

Background: Multiple clinical trials have shown that a properly functioning implantable cardioverter‐defibrillator (ICD) is capable of interrupting sudden death caused by ventricular tachyarrhythmias. However, ICDs are complex medical devices, and they do not always perform as expected or they may fail completely. Exposure of ICD recipients to professional or media reports that their specific device type is potentially malfunctioning could negatively influence their psychological status.
Methods: This study aimed to evaluate and quantify psychological distress in patients implanted with an ICD‐recall device. Thirty patients implanted with ICD‐recall devices (ICD‐recall group) and 25 patients with unaffected ICD devices (ICD‐control group) were interviewed using the Brief Symptom Inventory (a psychological self‐report symptom scale).
Results: Mean values of all primary psychiatric distress symptom dimensions and global indices were within the normal range for both the ICD‐recall and the ICD‐control group. New York Heart Association (NYHA)
class was a predictor of higher distress symptoms in all categories, independently of the ICD group. NYHA II group patients tended toward higher stress levels than the NYHA I group, but only somatization was significantly different. An upward, but not significant, trend in 7 of the 12 scales was associated with symptomatic shock experience.
Conclusion: This study demonstrates that psychological distress was not significantly increased in patients recently informed about a potential malfunction of their device.
Evaluating Fluctuations in Human Atrial Fibrillatory Cycle Length Using Monophasic Action Potentials
Authors: NARAYAN SANJIV M. , KRUMMEN DAVID E. , KAHN ANDREW M. , KARASIK PAMELA L. , FRANZ MICHAEL R. 
Published: November 2006

Objective: To study fluctuations in intracardiac atrial fibrillation (AF) cycle length (CL).
Background: Sites of short AF CL may be good ablation targets, and cycle lengthening predicts ablation success. However, the optimum method for measuring AF CL, and its stability, are unclear. We hypothesized that autocorrelation better estimates AF CL than spectral dominant frequency (DF), which is susceptible to double counting, using monophasic action potentials (MAPs) to separate atrial activation from artifact.
Methods: In 28 patients with paroxysmal or persistent AF, we analyzed 49 AF epochs using MAPs at the high (HRA) and low (LRA) right atrium. We estimated AF CL over 2 seconds, 10 seconds, and 2 minutes using spectral DF and autocorrelation in MAPs and filtered bipoles.
Results: In the HRA, manually measured CL was 167 ± 25 ms. Spectral DF poorly estimated AF CL in bipolar signals (R = 0.31; P = NS), due to double counting, but accurately estimated MAP CL (R = 0.73, P < 0.001). Autocorrelation estimated MAP (R = 0.92; P < 0.001) and bipolar (R = 0.83; P < 0.001) CL, with lower errors than spectral DF (P < 0.0001). Over time, changes in DF consistently preceded reciprocal changes in organization (P < 0.001). Finally, excluding inaccurate spectra, DF and AF organization differed between HRA and LRA over 2 seconds, but correlated over 10 seconds and 2 minutes (P < 0.05).
Conclusions: AF CL is better estimated by autocorrelation than spectral DF, particularly for bipoles, and stable when measured for >10 seconds. Notably, changes in AF CL preceded reciprocal changes in organization, yet changes in organization did not precede changes in AF CL. These results may help to interpret AF CL fluctuations.
Atriofascicular Pathways: Where to Ablate?
Authors: KOTHARI SNEHAL , GUPTA ANOOP K. , LOKHANDWALA YASH Y. , VORA AMIT M. , KERKAR PRAFULLA G. , THAKUR RANJAN K. 
Published: November 2006

Background: Atriofascicular accessory pathway (AP), often referred to as Mahaim pathway, is an uncommon form of preexcitation. The usual target for ablation is at the site of a high‐frequency potential along the tricuspid annulus (TA). We present our observations in mapping and ablation of 29 patients with atriofascicular APs.
Methods and Results: Twenty‐nine consecutive patients who underwent radiofrequency ablation (RFA) for atriofascicular pathways comprised the series. Demographic factors, clinical features of the tachycardia, ablation site, and results were analyzed. The mean age was 19 ± 8 years; 15 were men. Three patients had Ebstein's anomaly of the tricuspid valve. Four patients had an additional AP and two patients had concomitant typical atrioventricular nodal reentrant tachycardia. RFA was successful in 28 patients (97%); repeat ablation was required in two patients. The site of successful ablation was on the TA at the site of a sharp, high frequency potential in 15 patients (52%). In the remaining 14 patients, a potential was not found along the TA, and ablation was targeted at the ventricular insertion of the AP into the distal right bundle. At the successful ventricular ablation site, local ventricular activation preceded the surface electrocardiogram by 20 ± 6 ms. Eight of the 14 patients (57%) undergoing ablation in the ventricle, developed right bundle branch block (RBBB). One patient who underwent successful ablation along the TA also manifested RBBB after ablation; however, this patient had Ebstein's anomaly and preexcitation had completely masked the RBBB. The mean procedure and fluoroscopy time was 150 ± 32 and 35 ± 12 minutes, respectively.
Conclusions: In atriofascicular pathways, an AP potential was found along the TA in only 52% of patients. Ablation at the ventricular insertion site often resulted in RBBB (57%), but the AP was also successfully ablated.
Slow Pathway Ablation Decreases Vulnerability to Pacing‐Induced Atrial Fibrillation: Possible Role of Vagal Denervation
Authors: RAZAVI MEHDI , CHENG JIE , RASEKH ABDI , YANG DONGHUI , DELAPASSE SCOTT , AI TOMOHIKO , MEADE THOMAS , DONSKY ALAN , GOODMAN MARY J. , MASSUMI ALI 
Published: November 2006

Background: Studies indicate that success of radiofrequency (RF) ablation of atrial fibrillation (AF) may be in part due to vagal denervation. RFA
of supraventricular tachycardia (SVT) has been associated with vagal denervation. The effects of slow pathway (SP) ablation on AF inducibility have not been studied.
Objective: To test the hypothesis that SP ablation renders AF less inducible.
Methods: Consecutive patients referred for SVT were studied. After atrioventricular nodal reentrant tachycardia (AVNRT) was confirmed they underwent induction of AF. After SP ablation AF induction was reattempted. Vulnerability to AF was reassessed.
Results: Twenty‐four patients were enrolled; eight were not inducible for AF in the preablative state. Mean CL
of the AVNRT was 340 ± 16 ms. The average RF ablation time was 131 ± 42 seconds. Presence of junctional rhythm was required. Of the 16 with inducible AF two patients had AF induced during routine invasive electrophysiology study. None of these had inducible AF after SP ablation. Fourteen of 16 patients required specific AF induction. Ten of these were noninducible after SP ablation; two were inducible after SP ablation but with a more aggressive pacing protocol (P < 0.03 compared to preablation) and two had no change in AF vulnerability. Seven of the eight noninducible patients remained noninducible for AF post SP ablation. In the 12 patients who were inducible prior but noninducible after ablation the mean atrial effective refractory period (AERP) increased for both BCL at 400 and 600 ms (400/216 ± 8 ms preablation vs 400/248 ± 12 ms postablation, P < 0.03; 600/228 ± 8 ms preablation vs 600/259 ± 6 ms postablation, P < 0.04). There were no significant changes in AERP of patients who remained inducible or who were noninducible before ablation. The average ablation time for patients who became noninducible after ablation was significantly higher than those who had no change in inducibility or remained inducible but at a more aggressive pacing threshold (157 ± 24 seconds vs 35 ± 5 seconds; P < 0.005).
Conclusion: SP ablation acutely decreases vulnerability to pacing‐induced AF in patients with AVNRT. This may reflect the effect of ablation on atrial vagal tone.
Diagnostic Patterns in the Evaluation of Patients Hospitalized with Syncope
Authors: SUZUKI TAKEKI , MATSUNAGA NAOHISA , KOHSAKA SHUN 
Published: November 2006

Background: Syncope accounts for 5% of all hospital admissions. The etiology of syncope varies broadly, and nonselective, inpatient diagnostic evaluations to determine the cause of syncope are often inconclusive. We analyzed the yield of inpatient diagnostic tests for syncope, comparing patients with and without an initial suspected diagnosis of vasovagal syncope.
Methods: We retrospectively reviewed the medical records of consecutive adult patients with a principal diagnosis of syncope (ICD‐9 Code 780.2) who were admitted through the emergency department of an 800‐bed teaching hospital from January 1, 2000, to May 31, 2001.
Results: A total of 267 patients (150 women, 117 men; mean age, 72.4 ± 15.3 years) were identified. On admission, a diagnosis of vasovagal syncope was suspected in 47% of patients. Inpatient tests, including telemetry monitoring, echocardiography, and stress testing, were significantly lower yielding in patients with suspected vasovagal syncope when compared to patients with other suspected etiologies (P < 0.05).
Conclusions: Despite the significant length of hospital stay (median 4 days), we found that inpatient diagnostic workups for patients with suspected vasovagal syncope were low yielding, especially with regard to cardiac testing. Furthermore, abnormal test results did not change the discharge diagnosis.
A framework for evidence‐based mental health care and policy
Authors: Salvador‐Carulla L. , Haro J. M. , Ayuso‐Mateos J. L. 
Published: November 2006

Objective:  Care planning integrates a growing number of disciplines, research fields and analysis techniques. A framework of the main areas of interest with regard to evidence‐based health care in mental health is provided here.Method:  The framework is based on the experience of working with data analysts and health and social decision makers at the PSICOST/RIRAG network, a Spanish research association which includes psychiatrists, health economists and health policy experts, as well as on a review of the literature.Results:  Three main areas have been identified and described here: outcomes management, knowledge discovery from data, and decision support systems. Their use in mental health care is reviewed.Conclusion:  It is important to promote bridging strategies among these new fields in order to enhance communication and information transfer between the different parts involved in mental health decision making: i) clinicians and epidemiologists, ii) data analysts, iii) care policy makers and other end‐users.
Assessment of service use patterns in out‐patients with schizophrenia: a Spanish study
Authors: Pezzimenti M. , Haro J. M. , Ochoa S. , González J. L. , Almenara J. , Alonso J. , Moreno B. , Muñoz P. E. , Jáuregui V. M. , Salvador‐Carulla L. ,   the PSICOST Group
Published: November 2006

Objective:  The objective is to describe and characterize patterns of service use by out‐patients with schizophrenia in Spain.Method:  A representative treated prevalence sample of cases with schizophrenia was selected from four Spanish health areas. The evaluation included health service use, clinical severity, functioning and disability. Statistical analysis was based on hierarchical clustering methods.Results:  A total of 356 patients were included in the analysis. Five patterns of health service use were defined: heavy out‐patient mental health users; mental health and general health service users; heavy hospital service users; nursing service users; low users of mental health services. Patients in each group showed differences in clinical and disability status. Patterns of health service use showed consistency, but also variability, among the geographical areas.Conclusion:  Development and organization of mental health services should take into account the combinations of services patients most frequently use.
Changes of mineralization of free autogenous bone grafts used for sinus floor elevation
Authors: Schlegel Karl Andreas , Schultze‐Mosgau Stefan , Wiltfang Jörg , Neukam Friedrich Wilhelm , Rupprecht Stephan , Thorwarth Michael 
Published: November 2006

Abstract: For augmentations before implant placement in areas of minor bone quantity, autogenous bone is considered the reference to all bone substitutes used alternatively. Autogenous bone transplants originate from various donor areas and can be prepared in different ways before augmentation. They may either be used as block grafts or may be milled to granules that can be used solitarily or in combination with a bone substitute. In a prospective study, 61 patients of the Maxillofacial Surgery Department of our University receiving two‐stage sinus floor elevation because of insufficient bone supply were randomly selected. At first‐stage surgery, the local augmentation procedure, monocortical probes were obtained on the site of bone harvesting. At second‐stage surgery, the implant insertion 6 months after the elevation procedure, bone cores were harvested in the areas of implant placement. Donor regions were the following three areas: the posterior (N=28) and anterior pelvic region (N=15) and the chin region (N=18). The implanted bone in all three groups was particulated to granules of 2–3 mm2 using a bone mill. All biopsies were analyzed by means of microradiography. The anterior pelvic bone grafts showed a mineralized tissue grade of 35.1±7.6% before milling and augmentation. The posterior pelvic bone grafts exhibited a mineralization of 30.7±9.5% and the chin bone grafts 74.6±8.6%.At second‐stage surgery after 6 months, the mineralization was 36.1±7.59% in the areas where bone grafts from the anterior pelvic crest were used. Probes harvested from sites with posterior pelvic bone augmentations showed a mineralization rate of 34.5±6.5%, and sites were chin bone grafts were applied expressed a mineralization of 54±8.6% (P=0.003 compared with the pre‐operative value). The comparison of the microradiographical results demonstrated significant differences in the mineralization grades depending on the origin of the graft. The origin of the grafts and their remodeling influenced the mineralization rates found at 6 months. How these data may influence the long‐term clinical outcome considering implant survival and bone resorption has to be examined in further long‐term studies.
Expression of bone matrix proteins during the osseus healing of topical conditioned implants: an experimental study
Authors: Schlegel Karl Andreas , Thorwarth Michael , Plesinac Alexandra , Wiltfang Joerg , Rupprecht Stephan 
Published: November 2006

AbstractObjectives: Osseointegration of implants depends on time and local bone conditions regarding quality and quantity. This led to the bone classification by Lekholm et al. The aim of the present study was to follow the expression of bone matrix proteins during the phase of osseointegration after conditioning of the bone bed by means of immunohistochemistry.Methods: In the porcine frontal skull, implant beds of identical size were created. Before placement of the implants (Ankylos® 4 × 3.5 mm), the implant beds were conditioned using bone condensation (cond), an osteoinductive collagen (Co) and platelet‐rich plasma (PRP). These conditioning methods were compared with standard procedure. The animals were sacrificed after 2, 4 and 8 weeks. The specimens were then analyzed by light microcopy and immunohistochemistry for expression of bone morphogenic proteins (BMP)2, procollagen I and osteocalcin (OC).Results: Light microscopy revealed an initial effect of condensation and the bovine collagen at 2 weeks in comparison with the standard group. The PRP did not achieve a significant effect. At 8 weeks, the results of the standard, bone condensation and the bovine collagen group had aligned. The PRP group showed a significantly lower bone–implant contact (BIC) (P=0.003) compared with the standard group. BMP2 expression was significantly higher in all evaluated test groups at 4 and 8 weeks, as well as at 2 weeks in the condensation group. The procollagen I expression at 2 weeks was significantly increased for PRP and lower in the collagen and condensation group compared with standard procedure. Values for 4 and 8 weeks were slightly higher than in the standard group. No significant differences were obvious in the OC group at any time.Conclusions: During the initial healing phase, an effect of the evaluated methods of topical bone conditioning can be demonstrated by differences in the expression of BMP2 and procollagen I. These findings had leveled at 8 weeks and were, in contrast, not detectable in the expression of OC or by means of light microscopy.
Tissue modeling following implant placement in fresh extraction sockets
Authors: Araújo Mauricio G. , Sukekava Flavia , Wennström Jan L. , Lindhe Jan 
Published: November 2006

AbstractObjective: To study whether osseointegration once established following implant placement in a fresh extraction socket may be lost as a result of tissue modeling.Material and methods: Seven beagle dogs were used. The third and fourth premolars in both quadrants of the mandible were used as experimental teeth. Buccal and lingual full‐thickness flaps were elevated and distal roots were removed. Implants were installed in the fresh extraction socket. Semi‐submerged healing of the implant sites was allowed. In five dogs, the experimental procedure was first performed in the right side of the mandible and 2 months later in the left mandible. These five animals were sacrificed 1 month after the final implant installation. In two dogs, the premolar sites on both sides of the mandible were treated in one surgical session and biopsies were obtained immediately after implant placement. All biopsies were processed for ground sectioning and stained.Results: The void that existed between the implant and the socket walls at surgery was filled at 4 weeks with woven bone that made contact with the SLA surface. In this interval, (i) the buccal and lingual bone walls underwent marked surface resorption and (ii) the height of the thin buccal hard tissue wall was reduced. The process of healing continued, and the buccal bone crest shifted further in the apical direction. After 12 weeks, the buccal crest was located>2 mm apical of the marginal border of the SLA surface.Conclusion: The bone‐to‐implant contact that was established during the early phase of socket healing following implant installation was in part lost when the buccal bone wall underwent continued resorption.
A longitudinal study of early childhood caries in 9‐ to 18‐month‐old Thai infants
Authors: Thitasomakul Songchai , Thearmontree Angkana , Piwat Supatcharin , Chankanka Oitip , Pithpornchaiyakul Wattana , Teanpaisan Rawee , Madyusoh Sorae 
Published: November 2006

Abstract –  Objective:  To examine the rate and pattern of early childhood caries (ECC) development and to investigate the transitional changes of the carious lesions during a follow‐up period of 3–9 months.Methods:  A longitudinal observational community‐based survey of 599 children, 9–18 months old. The children's dental examinations were first carried out at the age of 9 months with re‐examination at 12 and 18 months by five dentists using standardized methods. The affected rates of dental caries were determined for prevalence, incidence density for risk of caries per person (IDp) and risk by surface (IDs). Changes in dental status over time were explored from unerupted (U) to sound (S), including enamel caries (D1), dentine caries (D2) and caries involving pulp (D3) by computing transitional probabilities.Results:  The prevalence of caries was 2.0%, 22.8% and 68.1% among 9‐, 12‐ and 18‐month olds, respectively. The IDp observed for newly affected children 9–12 and 12–18 months old was 10.32 and 15.70 persons/100 person‐months, respectively. The IDs for children 9–12 months old was 2.17 newly affected surfaces/100 surface‐months whereas it was 2.22 surfaces/100 surface‐months for children 12–18 months old. The buccal surface of maxillary incisors was the most affected (44.9%) followed by lingual, mesial and distal surfaces, respectively. The transitional probability of caries progression ranged between 1.79% and 15.38% during the follow‐up period from 9 to 12 months old. It was 3.43–39.60% from 12 to 18 months old.Conclusions:  An extremely high caries‐affected rate was found among the study children even before the age of 18 months. The buccal surface of the maxillary incisors was the most affected. The teeth acquired caries at 3–6 months after initial eruption and carious lesions developed continuously over time.