bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinguishing angioimmunoblastic T‐cell lymphoma from peripheral T‐cell lymphoma, unspecified, using morphology, immunophenotype and molecular genetics
Authors: Attygalle A D , Chuang S‐S , Diss T C , Du M‐Q , Isaacson P G , Dogan A 
Published: March 2007

Aims:  To identify distinguishing histological, immunophenotypic and molecular genetic features between angioimmunoblastic T‐cell lymphoma (AITL) and peripheral T‐cell lymphoma (PTL).Methods:  Nodal T‐cell lymphomas examined (n =137), included AITL (n = 89), PTL (n = 22), anaplastic large cell lymphoma (n = 16) and ‘AITL/PTL indeterminate’ (n = 10) with overlapping features between AITL and PTL, showing morphology typical of AITL but lacking follicular dendritic cell expansion. Immunohistochemistry for CD3, CD20, CD21 and CD10, in situ hybridization for Epstein–Barr virus encoded RNA (EBER) and polymerase chain reaction for T‐cell and B‐cell clonality analysis were performed.Results:  Of the AITLs, 74/89 showed typical morphology, whereas 15/89 showed hyperplastic follicles. AITL and ‘AITL/PTL indeterminate’ showed a polymorphous infiltrate and prominent vascularity in all cases. In both groups, CD10 was present in the majority and clear cells and EBER positivity were specific (but not universal) features lacking in PTL. Detection of T‐cell clonality was significantly higher in AITL (90%) compared with PTLu (59%).Conclusion:  Clear cells and EBV infection (when present) are useful distinguishing features and CD10 a sensitive and specific marker of AITL. Hyperplastic follicles are present in a significant minority of AITL. AITL/PTL indeterminate probably falls within the spectrum of AITL rather than PTL.
Studies of associations between the Arg389Gly polymorphism of the β1‐adrenergic receptor gene (ADRB1) and hypertension and obesity in 7677 Danish white subjects
Authors: Gjesing A. P. , Andersen G. , Albrechtsen A. , Glümer C. , Borch‐Johnsen K. , Jørgensen T. , Hansen T. , Pedersen O. 
Published: March 2007

AbstractAims Activation of the β1‐adrenergic receptor (ADRB1) causes increased lipolysis in adipose tissue and enhances cardiac output. Analysis of the association of the functionalADRB1Arg389Gly variant with obesity and hypertension has given ambiguous results. To clarify the potential impact of this variant on obesity and hypertension in the general population, we examined the Arg389Gly variant in a relatively large‐scale population‐based study.Methods Case‐control studies and quantitative trait analyses were carried out in 7677 Danish Caucasians who were genotyped for the Arg389Gly variant (dbSNP rs1801253) using matrix‐assisted laser desorption/ionization time‐of‐flight mass spectrometry.Results A weak association between the Gly allele of the Arg389Gly variant and obesity was observed when comparing cases (n = 1540) defined as body mass index (BMI) > 30 kg/m2with control subjects (n = 6108) defined as BMI ≤ 30 kg/m2for both allele frequencies (P = 0.05) and genotype distribution (P = 0.05). Case‐control studies (casesn = 2518; controln = 3981) examining the effect on hypertension showed no association with allele frequencies (P = 0.3) or genotype distribution (P = 0.5); however, in the quantitative trait analyses, individuals carrying the Gly allele had slightly but significantly lower diastolic (Arg/Arg = 81.9 mmHg vs. Gly‐allele carriers = 81.5 mmHg) and systolic (Arg/Arg = 129.4 mmHg vs. Gly‐allele carriers = 128.8 mmHg) blood pressure as well as a lower mean arterial blood pressure.Conclusion Our results suggest that the Arg389Gly polymorphism does not have any clinically important impact on the pathogenesis of obesity in Danish white subjects. Furthermore, despite the observed minor influence on blood pressure, this variant is most likely not to be a major contributor to the development of hypertension.
Initial monotherapy with either metformin or sulphonylureas often fails to achieve or maintain current glycaemic goals in patients with Type 2 diabetes in UK primary care
Authors: Cook M. N. , Girman C. J. , Stein P. P. , Alexander C. M. 
Published: March 2007

AbstractAims  To describe initial achievement of glycaemic targets and subsequent hyperglycaemia in patients with Type 2 diabetes managed with oral agent monotherapy in UK primary care from 1998 to 2004.Methods  Electronic medical records of patients initiating metformin (n = 3362) or a sulphonylurea agent (n = 3070) in 290 UK primary care practices were retrieved from the General Practice Research Database (GPRD). Patients included had an HbA1c recorded 0–90 days before and 90–365 days after initiating monotherapy. The probability of achieving glycaemic thresholds in the first year, and for those achieving such targets, the probability of inadequate glycaemic control (HbA1c > 6.5%, > 7.0%, > 7.5%) over time is described.Results  Low baseline HbA1c and drug initiation within 3 months of diabetes diagnosis were the strongest predictors of initial achievement of glycaemic targets. The proportion of patients with diabetes duration ≥ 4 months who achieved HbA1c < 7% in the first year ranged from 24% to 88% for highest to lowest baseline HbA1c category in sulphonylurea initiators and from 19% to 86% in metformin initiators, with slightly higher proportions for newly diagnosed patients. Kaplan–Meier analyses suggested that 55% and 70% of patients who initially achieved glycaemic targets had HbA1c measurements above these targets at 2 and 3 years.Conclusions  Many patients fail to achieve glycaemic goals with initial monotherapy and, of those who achieve current goals, few consistently maintain these targets over 3 years. Research is needed to evaluate whether more aggressive treatment or alternative treatments can improve the long‐term maintenance of glycaemic control in patients with Type 2 diabetes.
Maternal glycated haemoglobin, pre‐gestational weight, pregnancy weight gain and risk of large‐for‐gestational‐age babies: a Danish cohort study of 209 singleton Type 1 diabetic pregnancies
Authors: Nielsen G. L. , Dethlefsen C. , Møller M. , Sørensen H. T. 
Published: March 2007

AbstractAims  To examine the association between maternal glycated haemoglobin in the second half of diabetic pregnancies and the relative risk of delivering large‐for‐gestational‐age (LGA) babies, controlling for maternal body mass index (BMI) before pregnancy, weight gain, age, White class and smoking habits.Methods  We identified all pregnant diabetic women in North Jutland County, Denmark from 1985 to 2003. Data on HbA1c values from the 20th gestational week to term were collected from medical records and the babies were classified as large, normal or small for gestational age. The association between glycated haemoglobin (HbA1c) and relative risk of delivering an LGA baby was quantified based on logistic regression models and stratified analysis controlling for the five covariates.Results  We included 209 singleton pregnancies with assessable HbA1c values of which 59%[95% confidence interval (CI) 52–65%] terminated with an LGA baby. Increasing levels of HbA1c, BMI and weight gain were all associated with increasing risk of delivering an LGA baby. Analyses stratified according to maternal BMI showed that the association between HbA1c and risk of delivering an LGA baby was restricted to pregnancies with pre‐pregnancy BMI > 23 kg/m2. We found no association between HbA1c and risk of delivering an LGA baby in pregnancies with lower BMI.Conclusion  The positive association between glycated haemoglobin and birth of an LGA baby seems to be restricted to women with BMI > 23 kg/m2.
Low HDL‐cholesterol is common in European Type 2 diabetic patients receiving treatment for dyslipidaemia: data from a pan‐European survey
Authors: Bruckert E. , Baccara‐Dinet M. , Eschwege E. 
Published: March 2007

AbstractAims  To measure the prevalence of low high‐density lipoprotein (HDL)‐cholesterol (men < 1.03 mmol/l; women < 1.29 mmol/l) in European Type 2 diabetic patients receiving treatment for dyslipidaemia.Methods  The pan‐European Survey of HDL‐cholesterol measured lipids and other cardiovascular risk factors in 3866 patients with Type 2 diabetes and 4436 non‐diabetic patients undergoing treatment for dyslipidaemia in 11 European countries.Results  Diabetic patients were more likely to be obese or hypertensive than non‐diabetic patients. Most patients received lifestyle interventions (87%) and/or a statin (89%); treatment patterns were similar between groups. Diabetic patients had [means (SD)] lower HDL‐cholesterol [1.22 (0.37) vs. 1.35 mmol/l (0.44) vs. non‐diabetic patients, P < 0.001] and higher triglycerides [2.32 (2.10) vs. 1.85 mmol/l (1.60), P < 0.001]. More diabetic vs. non‐diabetic patients had low HDL‐cholesterol (45% vs. 30%), high triglycerides (≥ 1.7 mmol/l; 57% vs. 42%) or both (32% vs. 19%). HDL‐cholesterol < 0.9 mmol/l was observed in 18% of diabetic and 12% of non‐diabetic subjects. Differences between diabetic and non‐diabetic groups were slightly greater for women. LDL‐ and total cholesterol were lower in the diabetic group [3.02 (1.05) vs. 3.30 mmol/l (1.14) and 5.12 (1.32) vs. 5.38 mmol/l (1.34), respectively, P < 0.001 for each].Conclusions  Low HDL‐cholesterol is common in diabetes: one in two diabetic women has low HDL‐cholesterol and one diabetic man in four has very low HDL‐cholesterol. Management strategies should include correction of low HDL‐cholesterol to optimize cardiovascular risk in diabetes.
Ineffectiveness of Precordial Thump for Cardioversion of Malignant Ventricular Tachyarrhythmias
Authors: AMIR OFFER , SCHLIAMSER JORGE E. , NEMER SAMNIAH , ARIE MILITIANU 
Published: March 2007

Background:The Precordial Thump (PT) is commonly used for cardiopulmonary resuscitations both in and out of hospitals. However, the support for its efficiency relies mainly on sporadic cases. In this current prospective large study, we tested the effectiveness and safety of PT in a wide range of malignant ventricular tachyarrhythmias.
Methods: The study included 80 patients who underwent electrophysiological study and/or implantation of a cardiodefibrillator device. During these procedures, once a malignant ventricular tachyarrhythmia was induced, PT was used as the first treatment option. If the PT failed, other means were used to discontinue the arrhythmia.
Results: Polymorphic ventricular tachycardia occurred in 32 (40%) patients, ventricular fibrillation in 28 (35%) patients, and 20 (25%) patients had sustained monomorphic ventricular tachycardia. Except in one patient with monomorphic ventricular tachycardia, the PT was unsuccessful in terminating any of the other malignant tachyarrhythmias, and internal or external defibrillation was eventually required in all other 79 (99%) patients. The PT was not associated with any damage either to the sternal bone, ribs, or to the cardiodefibrillator device.
Conclusions: PT is not effective in terminating malignant ventricular tachyarrhythmia and should be reserved to a situation in which a defibrillator is not available.
Effect of Programmed Number of Intervals to Detect Ventricular Fibrillation on Implantable Cardioverter‐Defibrillator Aborted and Unnecessary Shocks
Authors: GUNDERSON BRUCE D. , ABEYRATNE ATHULA I. , OLSON WALTER H. , SWERDLOW CHARLES D. 
Published: March 2007

Introduction: Detection of self‐terminating arrhythmias by implantable cardioverter‐defibrillators (ICDs) causes unnecessary battery depletion and unnecessary shocks. Our goal was to estimate the effect of the programmed number of intervals to detect (NID) ventricular fibrillation (VF) on ICD temporal episode rate, unnecessary shocks, and delay in detection of VF.
Methods and Results: We analyzed 773 ICD‐detected VF episodes in 875 patients. The number of intervals to detect VF was programmed to 12 of 16 (NID 12) in 305 patients and 18 of 24 (NID 18) in 570 patients. For patients with NID 12, we estimated the increase of mean cumulative episode rate at 6 months since implant and decrease in detection time for VF compared with a hypothetical NID 18. For patients with NID 18, we estimated the decrease of mean cumulative episode rate and unnecessary shocks compared with a hypothetical NID 12. Patients with NID 12 had a 17% increased episode rate resulting in unnecessary capacitor charging for self‐terminating arrhythmias. Patients with NID 18 had a 22% decreased episode rate. In patients with NID 12, hypothetical NID 18 would have delayed detection of 273 VF episodes in 1.8 seconds. In patients with NID 18, hypothetical NID 12 would have resulted in inappropriate delivery of 14 aborted shocks in 10% of patients with episodes.
Conclusion: In patients with self‐terminating device‐detected VF, increasing the number of intervals to detect VF from 12/16 to 18/24 results in a clinically significant decrease in ICD detections and fewer unnecessary shocks with minimal incremental delay in VF detection.
A Percutaneous Catheter‐Based System for the Measurement of Potential Gradients Applicable to the Study of Transthoracic Defibrillation
Authors: ROSBOROUGH JOHN P. , DENO D. CURTIS , WALKER ROBERT G. , NIEMANN JAMES T. 
Published: March 2007

Background: The local electric (E) field or potential gradient produced by a shock reliably predicts VF termination. In this study we evaluated a multiple electrode, catheter‐based device for closed‐chest 3D measurements of E field from transthoracic defibrillation shocks.
Methods: Catheters with multiple electrodes on the tip were placed in intracardiac locations in anesthetized swine. An empirically derived calibration matrix and custom microprocessor was used to transform simultaneously measured voltages into orthogonal E field vector components. E fields produced in six intracardiac locations by 30 and 300 J shocks were compared in eight animals. Correlations were determined for measured current and E field at various shock strengths at two different transthoracic impedances in five additional animals. VF was induced in 12 animals and E field measured during defibrillation attempts.
Results: The E field measurements resulting for 30 J transthoracic shocks were not significantly different among different intracardiac sites. At 300 J, however, significant differences were observed between sites with the greatest intensities recorded in the coronary sinus and right ventricle. Within animals, the variability of the measurement at each site was small, ranging from 2.8 ± 1.6% to 5.7 ± 4.5%. Significant correlations (P < 0.001) between measured E field and peak current were observed at native impedance (34 ± 4 Ω, r = 0.81) and at adjusted impedance (76 ± 4 Ω, r = 0.78) with transthoracic shocks of 200, 300, and 360 J. In VF studies, the probability of defibrillation was closely fit by a sigmoidal dose response curve in the coronary sinus E field with an approximate threshold of 4.7 V/cm with 50% defibrillation success at 9.3 V/cm.
Conclusions: The measured intracardiac E field variability within animals and at a specific site was small, exhibiting a median value of 5.1%, contrasted to median variabilities across animals of 5–11% suggesting the capacity of this measurement system to provide subject specific information on the distribution of E fields. The measured E field magnitudes across animals in the coronary sinus were linearly correlated with applied shock current with a very strong linear relation to effective shock voltage observed in vitro in a saline tank. When evaluated as a predictor of shock success, the observed values were consistent with previously reported critical fields. This technique may be of value in evaluating waveforms for transthoracic defibrillation as well as electrode size, placement, and composition.
Permanent and Atrial‐Synchronized Ventricular Stimulation for Clinically Stable Patients with Normal or Impaired Left Ventricular Systolic Function
Authors: CHILADAKIS JOHN A. , KOUTSOGIANNIS NIKOLAOS , KALOGEROPOULOS ANDREAS , ZAGLI FANI , SIHLIMIRIS ILIAS , ALEXOPOULOS DIMITRIOS 
Published: March 2007

Background: Ventricular desynchronization imposed by permanent dual‐chamber ventricular pacing (VDD) may compromise ventricular function.
Methods: We investigated the impact of background VDD pacing on the right and left ventricular (LV) function on 129 clinically stable outpatients (mean age 69 ± 10) implanted chronically with a dual‐chamber pacemaker or an automatic defibrillator by using echocardiographic techniques including tissue doppler imaging (TDI) and color M‐mode (CMM) examinations, and B‐type natriuretic peptide (BNP) measurements. Patients were divided into two groups of normal (n = 65) or impaired (n = 64) LV systolic function (ejection fraction 63 ± 6% and 38 ± 10%, respectively) according to clinical and echocardiographic criteria. Each patient group included two subgroups on the basis of the underlying permanent and atrial‐synchronized heart rhythm: either intrinsic ventricular activation (IVA) or VDD pacing.
Results: The BNP levels (mean, 95% CI) of patients with impaired LV systolic function were approximately threefold higher than those of patients with normal LV systolic function [189 (145–245) pg/mL vs 65 (50–85) pg/mL, P < 0.0001], but did not differ between subgroups of patients with IVA vs VDD pacing. By two‐way analysis of variance and analysis of covariance, and after adjustment for age and gender, significant VDD pacing effects were found in terms of lower E/A ratio (P < 0.05) and increased LV end‐systolic volume (P < 0.05). VDD pacing did not significantly affect the BNP levels and the LV filling pressures, as determined by the E/Ea and E/Vp ratios.
Conclusions: Long‐term VDD pacing may not be harmful in clinically stable patients with normal or moderately reduced LV systolic function.
Poor Prognosis for Patients with Chronic Kidney Disease Despite ICD Therapy for the Primary Prevention of Sudden Death
Authors: CUCULICH PHILLIP S. , SÁNCHEZ JOSÉ MAURICIO , KERZNER ROGER , GREENBERG SCOTT L. , SENGUPTA JAY , CHEN JANE , FADDIS MITCHELL N. , GLEVA MARYE J. , SMITH TIMOTHY W. , LINDSAY BRUCE D. 
Published: March 2007

Introduction: Chronic kidney disease (CKD) has been independently associated with increased cardiovascular mortality. Little is known about the benefit of implantable cardioverter defibrillator (ICD) therapy for prevention of sudden death in this large, high‐risk population. We sought to evaluate the impact of CKD on survival in patients who received an ICD for primary prevention of sudden death.
Methods and Results: In this retrospective study of patients who underwent ICD implantation for primary prevention of sudden death, patients were stratified by CKD, defined as serum creatinine ≥2 mg/dL or dialysis use. Primary endpoint was mortality. CKD was identified in 35 of 229 patients (15.3%). There were 33 deaths during a follow‐up period of 18.0 ± 15.2 months: 17 of 35 CKD patients and 16 of 194 patients without CKD (48.6% vs 8.2%, P < 0.00001 by log‐rank). One‐year survival for patients with and without CKD was 61.2% and 96.3%, respectively. Cox regression analysis controlling for age, sex, comorbidities, ejection fraction, and medications proved CKD to be the strongest independent predictor of death (hazard ratio 10.5; 95% confidence interval 4.8–23.1; P = 0.0001). This risk was dependant on severity of CKD; a 10 mL/min reduction in creatinine clearance was associated with a 55% increase in hazard of death (P < 0.0001).
Conclusions: In patients receiving an ICD for primary prevention of sudden death, CKD significantly reduced long‐term survival. This poor prognosis may limit the impact of primary prevention ICD therapy in this patient population.
Rapid Atrial Pacing: A Useful Technique During Slow Pathway Ablation
Authors: LIBERMAN LEONARDO , HORDOF ALLAN J. , PASS ROBERT H. 
Published: March 2007

Background: Catheter ablation is the treatment of choice for atrioventricular nodal reentrant tachycardia (AVNRT) with a success rate of 95–98%. The appearance of junctional rhythm during radiofrequency (RF) application to the slow pathway has been consistently reported as a marker for the successful ablation of AVNRT. Ventriculoatrial (VA) conduction during junctional rhythm has been used by many as a surrogate marker of antegrade atrioventricular nodal (AVN) function. However, VA conduction may not be an accurate or consistent marker for antegrade AVN function and reliance on this marker may leave some patients at risk for antegrade AVN injury.
Objective: The purpose of this study is to describe a technique to ensure normal antegrade AVN function during junctional rhythm at the time of RF catheter ablation of the slow pathway.
Methods: Retrospective review of all patients less than 21 years old who underwent RF ablation for AVNRT at our institution from January 2002 to July 2005. During RF applications, immediately after junctional rhythm was demonstrated, RAP was performed to ensure normal antegrade AVN function. Postablation testing was performed to assess AVN function and tachycardia inducibility.
Results: Fifty‐eight patients underwent RF ablation of AVNRT during the study period. The mean age ± SD was 14 ± 3 years (range: 5–20 years). The weight was 53 ± 15 Kg (range: 19–89 Kg). The preablation Wenckebach cycle length was 397 ± 99 msec (range: 260–700 msec). Fifty‐four patients had inducible typical AVNRT, and four patients had atypical tachycardia. The mean tachycardia cycle length ± SD was 323 ± 62 msec (range: 200–500 msec). Patients underwent of 8 ± 7 total RF applications (median: 7; range 1 to 34), for a total duration of 123 ± 118 seconds (median: 78 sec, range: 20–473 sec). Junctional tachycardia was observed in 52 of 54 patients. RAP was initiated during junctional rhythm in all patients. No patient developed any degree of transient or permanent AVN block. Following ablation, the Wenckebach cycle length decreased to 364 ± 65 msec (P < 0.01). Acutely successful RF catheter ablation was obtained in 56 of 58 patients (96%).
Conclusion: Rapid atrial pacing during radiofrequency catheter ablation of the slow pathway is a safe alternative approach to ensure normal AVN function.