bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brugada Syndrome in Pure Black Africans
Authors: BONNY AIMÉ , TONET JOELCI , FONTAINE GUY , LACOTTE JÉRÔME , COIGNARD ELISABETH , DUTHOIT GUILLAUME , HIDDEN‐LUCET FRANÇOISE , CHARRON PHILIPPE , BRUGADA PEDRO , FRANK ROBERT 
Published: March 2008

Aims: Although all races are concerned with the Brugada syndrome, no case has ever been reported among black Africans. We describe five different cases in this specific group of populations. Methods and Results: In all patients, Brugada syndrome was identified after detailed noninvasive and invasive evaluations. Sex ratio was four males for one female. Convulsive syncope was noticed in 1 patient with a family history of sudden death. Diagnostic coved‐type pattern was observed spontaneously in the normal position of right precordial leads in 3 patients and in a higher position of leads in 3 patients. Sixty percent had first‐degree atrioventricular block. An ajmaline test was performed in 4 patients and was positive either in normal position of leads or in superior position in all of them. Sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) was inducible during programmed ventricular stimulation in 3 patients. Right ventricular cineangiography found localized apical hypokinesia with preserved systolic function in 1 patient. Automatic cardioverter defibrillator was implanted in 2 patients. SCN5A was not found in any of the patients. Conclusion: These observations demonstrate that Brugada syndrome is also present in black African populations, and increasingly reported cases of apparent sudden death in the sub‐Saharan part of the world need to rule out cardiac electrical disturbance such as Brugada syndrome.
Time and Temperature Profile of Catheter Cryoablation of Right Septal and Free Wall Accessory Pathways in Children
Authors: KALTMAN JONATHAN R. , TANEL RONN E. , WEGRZYNOWICZ BRADLEY , KOZODOY ERIC , WIEAND TAMMY , ENNIS JEAN , VETTER VICTORIA L. , SHAH MAULLY J. 
Published: March 2008

Introduction: The overall acute success with cryoablation for accessory pathways (APs) has been reported to be lower than with radiofrequency ablation. Generally, prior cryomapping (limited to −30°C) has been used to test for loss of AP conduction and absence of atrioventricular (AV) node impairment. However, the temperature at which loss of AP conduction occurs may be variable. The purpose of this study was to evaluate the time and temperature profile at which loss of AP conduction occurs. Methods and Results: A retrospective study evaluated 25 patients (mean age 13.3 ± 3.6 years) who underwent cryoablation for right‐sided APs (22 manifest/3 concealed). Direct cryoablation (–80°C) without cryomapping was performed using a “time to success” strategy. If AP conduction was successfully interrupted within 25 seconds of the onset of cryoablation, the lesion was continued for 240 seconds; otherwise it was terminated and further mapping was performed. Cryoablation was successful in 24/25 (96%) patients. Temperature at loss of AP conduction was −66.2 ±−16.7°C (range +32 to −84°C) with conduction block at temperatures lower than −30°C for all but 3 APs. Critical time to success (interval from cryoadherence to loss of AP conduction) was significantly shorter for permanently successful cryolesions, compared with transiently successful lesions (6.3 ± 4.1 vs. 11.2 ± 2.2 sec; P < 0.001). There were no major complications. Conclusions: Cryothermal energy required for successful ablation may be variable and restricting test applications to −30°may limit its efficacy. A “time to success” strategy may improve outcome of cryoablation for right‐sided APs in children without compromising safety.
Differences in 12‐Lead Electrocardiogram Between Symptomatic and Asymptomatic Brugada Syndrome Patients
Authors: JUNTTILA M. JUHANI , BRUGADA PEDRO , HONG KUI , LIZOTTE ERIC , DE ZUTTER MARC , SARKOZY ANDREA , BRUGADA JOSEP , BENITO BEGONA , PERKIOMAKI JUHA S. , MÄKIKALLIO TIMO H. , HUIKURI HEIKKI V. , BRUGADA RAMON 
Published: March 2008

Introduction:
Brugada syndrome (BrS) is an inherited disorder that predisposes some subjects to sudden cardiac death (SCD). It is not well established which BrS patients are at risk of severe arrhythmias. Our aim was to study whether standard 12‐lead electrocardiogram (ECG) would give useful information for this purpose.
Methods:
This study included 200 BrS probands (142 male, 62%; mean age 42 ± 16 years). Symptoms related to BrS were defined as syncope, documented ventricular tachyarrhythmia, or SCD. We determined PR, QRS, QTc, Tpeak, and Tend interval from leads II and V2 and QRS from lead V5, R′/S ratio from lead aVR (aVR sign), QRS axis, and J‐point elevation amplitude from right precordial leads from the baseline ECGs.
Results:
Sixty‐six subjects (33%) had experienced symptoms related to BrS. The only significant difference between the symptomatic and asymptomatic BrS subjects was the QRS duration measured from lead II or lead V2, for example, the mean QRS in V2 was 115 ± 26 ms in symptomatic versus 104 ± 19 ms in asymptomatic patients (P < 0.001). The optimized cut‐off point of V2 QRS ≥120 ms gave an odds ratio (OR) of 2.5 (95% CI: 1.4–4.6, P = 0.003) for being symptomatic. In a multivariate analysis adjusted with gender, age, and SCN5A mutation, the OR was 2.6 (95% CI: 1.4–4.8, P = 0.004).
Conclusion:
Prolonged QRS duration, measured from standard 12‐lead ECG, is associated with symptoms and could serve as a simple noninvasive risk marker of vulnerability to life‐threatening ventricular arrhythmias in BrS.
Automatic 3D Mapping of Complex Fractionated Atrial Electrograms (CFAE) in Patients with Paroxysmal and Persistent Atrial Fibrillation
Authors: WU JINJIN , ESTNER HEIDI , LUIK ARMIN , ÜCER EKREM , REENTS TILKO , PFLAUMER ANDREAS , ZRENNER BERNHARD , HESSLING GABRIELE , DEISENHOFER ISABEL 
Published: March 2008

Background:
Complex fractionated atrial electrograms (CFAE) are a possible target for atrial fibrillation (AF) ablation and can be visualized in three‐dimensional (3D) mapping systems with specialized software.
Objective:
To use the new CFAE software of CartoXP® (Biosense Webster, Diamond Bar, CA, USA) for analysis of spatial distribution of CFAE in paroxysmal and persistent AF.
Methods:
We included 16 consecutive patients (6 females; mean 59.3 years) with AF (6 paroxysmal and 10 persistent) undergoing AF ablation. Carto maps of left atrium (LA) were reconstructed. Using the new CFAE software, the degree of local electrogram fractionation was displayed color‐coded on the map surface. LA was divided into four regions: anterior wall, inferior wall, septum, and pulmonary veins (PV). The relationship among regions with CFAE visualized and CFAE ablation regions (persistent AF only) was analyzed retrospectively.
Results:
In paroxysmal and persistent AF, CFAE were observed in all four LA regions. In paroxysmal AF, the density of CFAE around the PV was significantly higher than in other regions (P < 0.05) and higher than in persistent AF (P < 0.05). In persistent AF, CFAE were evenly distributed all over the LA. Of 40 effective ablation sites with significant AF cycle length prolongation, 33 (82.5%) were judged retrospectively by CFAE map as CFAE sites.
Conclusion:
CFAE software can visualize the spatial distribution of CFAE in AF. CFAE in persistent AF were observed in more regions of LA compared to paroxysmal AF in which CFAE concentrated on the PV. Automatically detected CFAE match well with ablation sites targeted by operators.
Anatomy and Physiology of the Right Interganglionic Nerve: Implications for the Pathophysiology of Inappropriate Sinus Tachycardia
Authors: ZHOU JING , SCHERLAG BENJAMIN J. , NIU GUODONG , HOU YINGLONG , LU ZHIBING , ZHANG YUAN , DING YANSHENG , LAZZARA RALPH , JACKMAN WARREN M. , PO SUNNY S. 
Published: March 2008

Objective:
To simulate inappropriate sinus tachycardia (IST) in experimental animals.
Background:
We recently found that epinephrine injected into the anterior right ganglionated plexi (ARGP) adjacent to the sinoatrial (SA) node induced an arrhythmia simulating IST.
Methods:
In 19 anesthetized dogs, via a right thoracotomy, the course of the interganglionic nerve (IGN) from the right stellate ganglion along the superior vena cava to the heart was delineated. High‐frequency stimulation (HFS; 0.1 msec duration, 20 Hz, 4.5–9.3 V) was applied to IGN at the junction of innominate vein and SVC.
Results:
HFS of the IGN significantly increased the sinus rate (SR) (baseline: 156 ± 19 beats/minutes [bpm], 4.5 V: 191 ± 28 bpm*, 8.0 V: 207 ± 23 bpm*, 9.3 V: 216 ± 18 bpm*; *P < 0.01 compared to baseline) without significant changes in A‐H interval or blood pressure. P‐wave morphology, ice mapping, and noncontact mapping indicated that this tachycardia was sinus tachycardia. In 8 of 19 dogs, injecting hexamethonium (5 mg), a ganglionic blocker, into the ARGP attenuated the response elicited by IGN stimulation (baseline: 160 ± 21 bpm, 4.5 V: 172 ± 32 bpm, 8.0 V: 197 ± 32 bpm*, 9.3 V: 206 ± 26 bpm*; *P < 0.05 compared to baseline). In 19 of 19 animals, after formaldehyde injection into the ARGP, SR acceleration induced by IGN stimulation was markedly attenuated (baseline: 149 ± 17 bpm, 4.5 V: 151 ± 21 bpm, 8.0 V: 155 ± 23 bpm, 9.3 V: 167 ± 24 bpm*; *P < 0.05 compared to baseline).
Conclusions:
HFS of the IGN caused a selective and significant acceleration of the SR. A significant portion of IGN traverses the ARGP or synapses with the autonomic ganglia in the ARGP before en route to the SA node. Dysautonomia involving the IGN and/or ARGP may play an important role in IST.
Estimating Observation Unit Profitability with Options Modeling
Authors: Baugh Christopher W. , Stephen Bohan J. 
Published: March 2008

AbstractBackground:  Over the past two decades, the use of observation units to treat such common conditions as chest pain, asthma, and others has greatly increased. These units allow patients to be directed out of emergency department (ED) acute care beds while potentially avoiding inpatient admission. Many studies have demonstrated the clinical effectiveness of care delivered in such a setting compared to the ED or inpatient ward. However, there are limited data published about observation unit finance.Methods:  Using the economic principles of stock options, opportunity costs, and net present value (NPV), a model that captures the value generated by admitting a patient to an observation unit was derived. In addition, an appendix is included showing how this model can be used to calculate the dollar value of an observation unit admission.Results:  A model is presented that captures more complexity of observation finance than the simple difference between payments and costs. The calculated estimate in the Appendix suggests that the average value of a single observation unit admission was about $2,908, which is about 40% higher than expected.Conclusion:  Subtraction of costs from payments may significantly underestimate the financial value of an observation unit admission. However, the positive value generated by an observation unit bed must be considered in the context of other projects available to hospital administrators.
Caffeinated Cocktails: Energy Drink Consumption, High‐risk Drinking, and Alcohol‐related Consequences among College Students
Authors: O’Brien Mary Claire , McCoy Thomas P. , Rhodes Scott D. , Wagoner Ashley , Wolfson Mark 
Published: March 2008

AbstractObjectives:  The consumption of alcohol mixed with energy drinks (AmED) is popular on college campuses in the United States. Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol. This study examines the relationship between energy drink use, high‐risk drinking behavior, and alcohol‐related consequences.Methods:  In Fall 2006, a Web‐based survey was conducted in a stratified random sample of 4,271 college students from 10 universities in North Carolina.Results:  A total of 697 students (24% of past 30‐day drinkers) reported consuming AmED in the past 30 days. Students who were male, white, intramural athletes, fraternity or sorority members or pledges, and younger were significantly more likely to consume AmED. In multivariable analyses, consumption of AmED was associated with increased heavy episodic drinking (6.4 days vs. 3.4 days on average; p < 0.001) and twice as many episodes of weekly drunkenness (1.4 days/week vs. 0.73 days/week; p < 0.001). Students who reported consuming AmED had significantly higher prevalence of alcohol‐related consequences, including being taken advantage of sexually, taking advantage of another sexually, riding with an intoxicated driver, being physically hurt or injured, and requiring medical treatment (p < 0.05). The effect of consuming AmED on driving while intoxicated depended on a student’s reported typical alcohol consumption (interaction p = 0.027).Conclusions:  Almost one‐quarter of college student current drinkers reported mixing alcohol with energy drinks. These students are at increased risk for alcohol‐related consequences, even after adjusting for the amount of alcohol consumed. Further research is necessary to understand this association and to develop targeted interventions to reduce risk.
Sildenafil‐mediated neovascularization and protection against myocardial ischaemia reperfusion injury in rats: role of VEGF/angiopoietin‐1
Authors: Koneru Srikanth , Varma Penumathsa Suresh , Thirunavukkarasu Mahesh , Vidavalur Ramesh , Zhan Lijun , Singal Pawan K. , Engelman Richard M , Das Dipak K , Maulik Nilanjana 
Published: March 2008

AbstractSildenafil citrate (SC), a drug for erectile dysfunction, is now emerging as a cardiopulmonary drug. Our study aimed to determine a novel role of sildenafil on cardioprotection through stimulating angiogenesis during ischaemia (I) reperfusion (R) at both capillary and arteriolar levels and to examine the role of vascular endothelial growth factor (VEGF) and angiopoietin‐1 (Ang‐1) in this mechanistic effect. Rats were divided into: control sham (CS), sildenafil sham (SS), control + IR (CIR) and sildenafil + IR (SIR). Rats were given 0.7 mg/kg, (i.v) of SC or saline 30 min. before occlusion of left anterior descending artery followed by reperfusion (R). Sildenafil treatment increased capillary and arteriolar density followed by increased blood flow (2‐fold) compared to control. Treatment with sildenafil demonstrated increased VEGF and Ang‐1 mRNA after early reperfusion. PCR data were validated by Western blot analysis. Significant reduction in infarct size, cardiomyocyte and endothelial apoptosis were observed in SC‐treated rats. Increased phosphorylation of Akt, eNOS and expression of anti‐apoptotic protein Bcl‐2, and thioredoxin, hemeoxygenase‐1 were observed in SC‐treated rats. Echocardiography demonstrated increased fractional shortening and ejection fraction following 45 days of reperfusion in the treatment group. Stress testing with dobutamine infusion and echocardiogram revealed increased contractile reserve in the treatment group. Our study demonstrated for the first time a strong additional therapeutic potential of sildenafil by up‐regulating VEGF and Ang‐1 system, probably by stimulating a cascade of events leading to neovascularization and conferring myocardial protection in in vivo I/R rat model.
Treatment of diabetic rats with encapsulated islets
Authors: Sweet Ian R. , Yanay Ofer , Waldron Lanaya , Gilbert Merle , Fuller Jessica M. , Tupling Terry , Lernmark Ake , Osborne William R. A. 
Published: March 2008

AbstractImmunoprotection of islets using bioisolator systems permits introduction of allogeneic cells to diabetic patients without the need for immunosuppression. Using TheraCyte™ immunoisolation devices, we investigated two rat models of type 1 diabetes mellitus (T1DM), BB rats and rats made diabetic by streptozotocin (STZ) treatment. We chose to implant islets after the onset of diabetes to mimic the probable treatment of children with T1DM as they are usually diagnosed after disease onset. We encapsulated 1000 rat islets and implanted them subcutaneously (SQ) into diabetic biobreeding (BB) rats and STZ‐induced diabetic rats, defined as two or more consecutive days of blood glucose >350 mg/dl. Rats were monitored for weight and blood glucose. Untreated BB rats rapidly lost weight and were euthanized at >20% weight loss that occurred between 4 and 10 days from implantation. For period of 30–40 days following islet implantation weights of treated rats remained steady or increased. Rapid weight loss occurred after surgical removal of devices that contained insulin positive islets. STZ‐treated rats that received encapsulated islets showed steady weight gain for up to 130 days, whereas untreated control rats showed steady weight loss that achieved >20% at around 55 days. Although islet implants did not normalize blood glucose, treated rats were apparently healthy and groomed normally. Autologous or allogeneic islets were equally effective in providing treatment. TheraCyte™ devices can sustain islets, protect allogeneic cells from immune attack and provide treatment for diabetic‐mediated weight loss in both BB rats and STZ‐induced diabetic rats.
Conditional knockdown of hMRS2 results in loss of mitochondrial Mg + uptake and cell death
Authors: Piskacek Martin , Zotova Ludmila , Zsurka Gábor , Schweyen Rudolf J. 
Published: March 2008

AbstractThe human gene MRS2L encodes a mitochondrial protein distantly related to CorA Mg2+ transport proteins. Constitutive shRNA‐mediated knockdown of hMRS2 in human HEK‐293 cell line was found here to cause death. To further study its role in Mg2+ transport, we have established stable cell lines with conditionally expressing shRNAs directed against hMRS2L. The cells expressing shRNA for several generations exhibited lower steady‐state levels of free mitochondrial Mg2+ ([Mg2+]m) and reduced capacity of mitochondrial Mg2+ uptake than control cells. Long‐term expression of shRNAs resulted in loss of mitochondrial respiratory complex I, decreased mitochondrial membrane potential and cell death. We conclude that hMrs2 is the major transport protein for Mg + uptake into mitochondria and that expression of hMrs2 is essential for the maintenance of respiratory complex I and cell viability.
The aging male – diagnosis and therapy of late‐onset hypogonadism
Authors: Schreiber Gerhard , Ziemer Mirjana 
Published: March 2008

SummaryManaging the clinical features of hormone insufficiency in aging men is an important field of activity for dermatologists and in particular for dermatologists specialized in andrology. Potential consequences of age‐associated decrease in plasma testosterone levels include long‐term changes in diverse organ systems including changes of bone architecture, body composition, muscular strength, cognitive functions, and mood as well as negative effects on skin and hair. Indications and contraindications for a hormone replacement therapy as well as therapy monitoring are well‐defined. Replacement of testosterone in the case of late‐onset hypogonadism is not a standardized therapy. Previous studies suggest that testosterone replacement therapy has positive clinical effects. Dermatologic effects of testosterone replacement therapy have not yet been investigated. Further research is required to identify potential benefits and risks of hormone replacement therapy in aging men.
Urticaria
Authors: Wedi Bettina 
Published: March 2008

SummaryUrticaria and angioedema are common and, if chronic, often persist for years with significant impact on quality of life and occupational ability. To achieve a better understanding of disease etiology and pathogenesis and to compare clinical trials, there is a clear need for cross‐specialty and international agreement of the nomenclature and diagnostic classification of urticaria and angioedema. At least in part this has been achieved by two recently published European guidelines.After the urticaria subtype is defined, potential triggers should be sought including persistent bacterial infections (Helicobacter pylori, streptococci, staphylococci, Yersinia, parasites) pseudoallergic reactions (acetylsalicylic acid, rarely food additives) and/or autoreactive mechanisms (autologous serum test). Identified trigger factors should be avoided or eradicated, as this is the most successful therapeutic approach.Treatment of most urticaria subtypes is difficult and besides H1 antihistamines neither standardized nor evidence‐based. Low‐sedating H1 antihistamines represent the mainstay of treatment, as they have a better therapeutic index and pharmacodynamic properties than older agents. In severe cases their dose has to be increased which is off‐label use. The evidence base for treatment alternatives is totally insufficient and the risk‐benefit profile of each off‐label used drug should be carefully considered.
Maternal depression is associated with mother–infant interaction in preterm infants
Authors: Korja Riikka , Savonlahti Elina , Ahlqvist‐Björkroth Sari , Stolt Suvi , Haataja Leena , Lapinleimu Helena , Piha Jorma , Lehtonen Liisa ,   the PIPARI study group
Published: March 2008

AbstractAim: The purpose of this study was to assess the prevalence and the background factors of maternal depressive symptoms and their relation to the quality of mother–infant interaction in a group of preterm infants and their mothers.Methods: The signs of maternal depression were evaluated in 125 mothers of very preterm infants (birth weight ≤ 1500 g or < 32 gestational weeks) at 6 months of infant's corrected age using Edinburgh Postnatal Depression Scale (EPDS). The association between maternal depressive symptoms and the quality of mother–infant interaction as assessed by the parent child early relational assessment method (PCERA) method was studied at 6 and 12 months of corrected age in 32 preterm infants who were their mothers' firstborn infants and singletons.Results: The prevalence of depression assessed by EPDS in mothers of very preterm infants was 12.6%. Most interestingly, the number of postnatal signs of depression associated negatively with the quality of the maternal interaction behaviour with their preterm infants.Conclusions: This study suggests that maternal depression may be a risk factor in the development of the mother–infant relationship between preterm infants and their mothers. Therefore, it would be important to identify signs of depression in mothers of preterm infants to offer early support.