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ECG Challenge Response

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https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#1
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29110883/linear-and-nonlinear-parameters-of-heart-rate-variability-in-ischemic-stroke-patients
#2
V Constantinescu, D Matei, V Costache, D Cuciureanu, C Arsenescu-Georgescu
INTRODUCTION: Cardiovascular system presents cortical modulation. Post-stroke outcome can be highly influenced by autonomic nervous system disruption. Heart rate variability (HRV) analysis is a simple non-invasive method to assess sympatho-vagal balance. OBJECTIVES: The purpose of this study was to investigate cardiac autonomic activity in ischemic stroke patients and to asses HRV nonlinear parameters beside linear ones. METHODS: We analyzed HRV parameters in 15 right and 15 left middle cerebral artery ischemic stroke patients, in rest condition and during challenge (standing and deep breathing)...
October 11, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29107952/hereditary-angioedema-assessing-the-hypothesis-for-underlying-autonomic-dysfunction
#3
Maddalena A Wu, Francesco Casella, Francesca Perego, Chiara Suffritti, Nada Afifi Afifi, Eleonora Tobaldini, Andrea Zanichelli, Chiara Cogliati, Nicola Montano, Marco Cicardi
BACKGROUND: Attacks of Hereditary Angioedema due to C1-inhibitor deficiency (C1-INH-HAE)are often triggered by stressful events/hormonal changes. OBJECTIVE: Our study evaluates the relationship between autonomic nervous system (ANS) and contact/complement system activation. METHODS: Twenty-three HAE patients (6 males, mean age 47.5±11.4 years) during remission and 24 healthy controls (8 males, mean age 45.3±10.6 years) were studied. ECG, beat-by-beat blood pressure, respiratory activity were continuously recorded during rest (10') and 75-degrees-head-up tilt (10')...
2017: PloS One
https://www.readbyqxmd.com/read/28949414/age-dependent-electrocardiographic-changes-in-pgc-1%C3%AE-deficient-murine-hearts
#4
Shiraz Ahmad, Haseeb Valli, Samantha C Salvage, Andrew A Grace, Kamalan Jeevaratnam, Christopher L-H Huang
Increasing evidence implicates chronic energetic dysfunction in human cardiac arrhythmias. Mitochondrial impairment through Pgc-1β knockout is known to produce a murine arrhythmic phenotype. However, the cumulative effect of this with advancing age and its electrocardiographic basis has not been previously studied. Young (12-16 weeks) and aged (>52 weeks), WT (n = 5 and 8) and Pgc-1β(-/-) (n = 9 and 6), mice were anaesthetised and used for electrocardiographic (ECG) recordings. Time intervals separating successive ECG deflections were analysed for differences between groups before and after β1-adrenergic (intraperitoneal dobutamine 3 mg/kg) challenge...
September 26, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28894151/the-effects-of-ageing-and-adrenergic-challenge-on-electrocardiographic-phenotypes-in-a-murine-model-of-long-qt-syndrome-type-3
#5
Karan R Chadda, Shiraz Ahmad, Haseeb Valli, Ingrid den Uijl, Ali Bak Al-Hadithi, Samantha C Salvage, Andrew A Grace, Christopher L-H Huang, Kamalan Jeevaratnam
Long QT Syndrome 3 (LQTS3) arises from gain-of-function Nav1.5 mutations, prolonging action potential repolarisation and electrocardiographic (ECG) QT interval, associated with increased age-dependent risk for major arrhythmic events, and paradoxical responses to β-adrenergic agents. We investigated for independent and interacting effects of age and Scn5a+/ΔKPQ genotype in anaesthetised mice modelling LQTS3 on ECG phenotypes before and following β-agonist challenge, and upon fibrotic change. Prolonged ventricular recovery was independently associated with Scn5a+/ΔKPQ and age...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28765984/-acute-chest-pain
#6
REVIEW
M Möckel, T Störk
Patients presenting with acute chest pain are a challenge for attending physicians in private practice and specialists for emergency and acute medicine in hospitals because a wide spectrum of diagnoses may be the cause, ranging from acute myocardial infarction (AMI) to harmless muscular tension. The evaluation of patients with acute chest pain follows basic principles independent of the setting: A thorough clinical investigation by the responsible physician including medical history and physical examination, followed by a 12-channel electrocardiogram (ECG) and further focused diagnostics...
August 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28762476/use-of-early-clinical-trial-data-to-support-thorough-qt-study-waiver-for-upadacitinib-and-utility-of-food-effect-to-demonstrate-ecg-assay-sensitivity
#7
Mohamed-Eslam F Mohamed, Jiewei Zeng, Ping Jiang, Balakrishna Hosmane, Ahmed A Othman
Exposure-response analyses of QT data from early-stage clinical studies represent a valuable tool to assess the QT prolongation potential for drugs in development in lieu of standalone thorough QT (TQT) studies. However, demonstrating adequate electrocardiogram assay sensitivity can be challenging in the absence of a positive pharmacological control. Upadacitinib is a Janus kinase 1 inhibitor currently being evaluated in phase III rheumatoid arthritis trials. Exposure-response analyses to evaluate the QT prolongation potential for upadacitinib from phase I trials and the utility of the effect of food on QTcF to demonstrate ECG assay sensitivity are presented...
August 1, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28657491/novel-noninvasive-method-of-cerebrovascular-blood-volume-assessment-using-brain-bioimpedance
#8
Mohamad H Tiba, Brendan M McCracken, Sardar Ansari, Ashwin Belle, Brandon C Cummings, Venkatakrishna Rajajee, Parag G Patil, Hasan B Alam, Kevin R Ward
Cerebrovascular autoregulation (CAR) is the ability of vessels to modulate their tone in response to changes in pressure. As an auto-protective mechanism, CAR is critical in preventing secondary brain injury post-trauma. Monitoring of changes in cerebral blood volume might be valuable in evaluating CAR and response to various therapies. In this study, we utilized an ocular-brain bioimpedance interface to assess real time changes in cerebral blood volume in response to a number of physiological challenges. We hypothesize that changes in brain bioimpedance (dz) would track changes in cerebral blood volume...
November 15, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28588014/different-approaches-for-catheter-ablation-of-para-hisian-accessory-pathways-implications-for-mapping-and-ablation
#9
Ming Liang, Zulu Wang, Yanchun Liang, Guitang Yang, Zhiqing Jin, Mingyu Sun, Yaling Han
BACKGROUND: Catheter ablation of para-Hisian accessory pathways (APs) can be challenging because of adjacent conduction tissue. Some different approaches for ablation, including the inferior vena cava approach (IVC-A), the noncoronary cusp approach (NCC-A), or the superior vena cava approach (SVC-A), have been reported. However, when should para-Hisian APs be mapped and ablated by the IVC-A, NCC-A, or SVC-A is not well established. METHODS AND RESULTS: This study included 55 consecutive patients (mean age, 53±11 years, 36 males) with para-Hisian APs...
June 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28479090/electrocardiogram-training-for-residents-a-curriculum-based-on-facebook-and-twitter
#10
Stanley S Liu, Sammy Zakaria, Dhananjay Vaidya, Mukta C Srivastava
BACKGROUND: We studied whether social media applications can serve as effective educational tools for teaching electrocardiogram (ECG) interpretation to medical residents. METHODS: 39 emergency, family, and internal medicine residents participated in the 33-week "ECG of the Week" curriculum via Facebook and Twitter. ECG skill was assessed before and after the study with a 10-ECG quiz. Outcomes of interest included predictors of participant response rates and post-study quiz performance...
September 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28436550/epicardial-brugada-syndrome-ablation-unmasking-inferior-j-waves
#11
Adam Lee, Heidi Kohler, Daniel Wright, Haris M Haqqani
Patients with Brugada syndrome are at risk of life-threatening ventricular arrhythmias. Epicardial substrate ablation for Brugada syndrome has been described as a means of controlling these arrhythmias and recent reports describe elimination of the Brugada phenotype with ablation. We describe a unique case in which a patient developed inferior J waves with an early repolarization-type electrocardiogram following successful epicardial infundibular substrate ablation (which eliminated the Brugada syndrome electrocardiogram on ajmaline challenge)...
November 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28383399/poststroke-alterations-in-heart-rate-variability-during-orthostatic-challenge
#12
Joel Rodriguez, Andrew Philip Blaber, Markus Kneihsl, Irhad Trozic, Rebecca Ruedl, David A Green, James Broadbent, Da Xu, Andreas Rössler, Helmut Hinghofer-Szalkay, Franz Fazekas, Nandu Goswami
Older adults following recovery from ischemic stroke have a higher incidence of orthostatic hypotension, syncope, and fall risk, which may be related to impaired autonomic responses limiting the ability to maintain cerebral blood flow. Thus, we investigated cerebrovascular and cardiovascular regulation in 23 adults ≥55 years of age, 10 diagnosed with ischemic stroke, and 13 age-matched healthy controls when sitting at rest and upon standing to compare differences of autonomic variables at ∼7 months (218 ± 41 days) poststroke...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28078546/postoperative-real-time-electrocardiography-monitoring-detects-myocardial-ischemia-a-case-report
#13
Homer Yang, Ashraf Fayad, Alan Chaput, Stuart Oake, Adrian D C Chan, Mary Lou Crossan
PURPOSE: This case report outlines the utility and challenges of remote continuous postoperative electrocardiography ECG) monitoring, which is routed through a secure smartphone to provide real-time detection and management of myocardial ischemia. CLINICAL FEATURES: A 42-yr-old male with previous myocardial infarction and angioplasty underwent a radical prostatectomy. At three hours and 45 min postoperatively, remote real-time ECG monitoring was initiated upon the patient's arrival on a regular surgical ward...
April 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27909532/ajmaline-challenge-to-unmask-infrahisian-disease-in-patients-with-recurrent-and-unexplained-syncope-preserved-ejection-fraction-with-or-without-conduction-abnormalities-on-surface-ecg
#14
Francesco Pentimalli, Luca Bacino, Matteo Ghione, Siri Giambattista, Massimo Gazzarata, Paolo Bellotti
Background: Pharmacological challenge with class I antiarrhythmic drug is a recommended diagnostic test in patients with unexplained syncope only in the presence of bundle branch block, when non-invasive tests have failed to make the diagnosis. Its role in patients with minor or no conduction disturbances on 12-leads ECG has not been evaluated yet. It is also not clear which are the values of His-Ventricular interval to be considered diagnostic. We sought to evaluate the role of ajmaline challenge in unmasking the presence of an infrahisian disease in patients with recurrent and unexplained syncope, regardless of the existence of conduction disturbances on surface ECG...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27803673/electrophysiological-mechanisms-of-brugada-syndrome-insights-from-pre-clinical-and-clinical-studies
#15
REVIEW
Gary Tse, Tong Liu, Ka H C Li, Victoria Laxton, Yin W F Chan, Wendy Keung, Ronald A Li, Bryan P Yan
Brugada syndrome (BrS), is a primary electrical disorder predisposing affected individuals to sudden cardiac death via the development of ventricular tachycardia and fibrillation (VT/VF). Originally, BrS was linked to mutations in the SCN5A, which encodes for the cardiac Na(+) channel. To date, variants in 19 genes have been implicated in this condition, with 11, 5, 3, and 1 genes affecting the Na(+), K(+), Ca(2+), and funny currents, respectively. Diagnosis of BrS is based on ECG criteria of coved- or saddle-shaped ST segment elevation and/or T-wave inversion with or without drug challenge...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27761167/genetics-of-brugada-syndrome
#16
REVIEW
Jyh-Ming Jimmy Juang, Minoru Horie
In 1992, the Brugada syndrome (BrS) was recognized as a disease responsible for sudden cardiac death, characterized by a right bundle-branch block with ST segment elevation in the leads V1 and V2. This syndrome is highly associated with sudden cardiac death, especially in young males. BrS is currently diagnosed in patients with ST-segment elevation showing type 1 morphology ≥ 2 mm in ≥1 leads among the right precordial leads V1 or V2 positioned in the 2nd, 3rd, or 4th intercostal space, and occurring either spontaneously or after a provocative drug test by the intravenous administration of Class I antiarrhythmic drugs...
October 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27733384/interactive-effects-of-maternal-cigarette-smoke-heat-stress-hypoxia-and-lipopolysaccharide-on-neonatal-cardiorespiratory-and-cytokine-responses
#17
Fiona B McDonald, Kumaran Chandrasekharan, Richard J A Wilson, Shabih U Hasan
Maternal cigarette smoke (CS) exposure exhibits a strong epidemiological association with Sudden Infant Death Syndrome, but other environmental stressors, including infection, hyperthermia, and hypoxia, have also been postulated as important risk factors. This study examines whether maternal CS exposure causes maladaptations within homeostatic control networks by influencing the response to lipopolysaccharide, heat stress, and/or hypoxia in neonatal rats. Pregnant dams were exposed to CS or parallel sham treatments daily for the length of gestation...
December 1, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27626806/optimizing-estimates-of-instantaneous-heart-rate-from-pulse-wave-signals-with-the-synchrosqueezing-transform
#18
Hau-Tieng Wu, Gregory F Lewis, Maria I Davila, Ingrid Daubechies, Stephen W Porges
BACKGROUND: With recent advances in sensor and computer technologies, the ability to monitor peripheral pulse activity is no longer limited to the laboratory and clinic. Now inexpensive sensors, which interface with smartphones or other computer-based devices, are expanding into the consumer market. When appropriate algorithms are applied, these new technologies enable ambulatory monitoring of dynamic physiological responses outside the clinic in a variety of applications including monitoring fatigue, health, workload, fitness, and rehabilitation...
October 17, 2016: Methods of Information in Medicine
https://www.readbyqxmd.com/read/27474416/reduced-npy-y1-receptor-hippocampal-expression-and-signs-of-decreased-vagal-modulation-of-heart-rate-in-mice
#19
Rosario Statello, Luca Carnevali, Silvia Paterlini, Laura Gioiosa, Ilaria Bertocchi, Alessandra Oberto, Carola Eva, Paola Palanza, Andrea Sgoifo
Central neuropeptide Y (NPY) signaling participates in the regulation of cardiac autonomic outflow, particularly via activation of NPY-Y1 receptors (Y1Rs). However, the specific brain areas and neural pathways involved have not been completely identified yet. Here, we evaluate the role of hippocampal Y1Rs in the modulation of the autonomic control of cardiac function using a conditional knockout mouse model. Radiotelemetric transmitters were implanted in 4-month-old male mice exhibiting reduced forebrain expression (rfb) of the Y1R (Npy1r(rfb), n=10) and their corresponding controls (Npy1r(2lox), n=8)...
April 1, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/27452149/-depressive-symptoms-during-anorexia-nervosa-state-of-the-art-and-consequences-for-an-appropriate-use-of-antidepressants
#20
REVIEW
N Leblé, L Radon, M Rabot, N Godart
OBJECTIVE: Depressive comorbidity is often associated with anorexia nervosa (AN), and antidepressant medication is widely used although it does not rely on any convincing data in the scientific literature. Our objectives were: to summarize the epidemiological, physiological, psychopathological literature about the relation between AN and manifestations of depression, and to focus on the clinical trial data assessing the use of antidepressant medication in AN in order to clarify the strategy for the use of antidepressant in AN during adolescence...
February 2017: L'Encéphale
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