Poor R-wave progression as a predictor of sudden cardiac death in the general population and subjects with coronary artery disease

Publisher Copyright: © 2022 Heart Rhythm SocietyBackground: Poor R-wave progression (PRWP) is a common clinical finding on the standard 12-lead electrocardiogram (ECG), but its prognostic significance is unclear. Objective: The purpose of this study was to examine the prognosis associated with PRWP in terms of sudden cardiac death (SCD), cardiac death, and all-cause mortality in general population subjects with and without coronary artery disease (CAD). Methods: Data and 12-lead ECGs were collected from a Finnish general population health examination survey conducted during 1978–1980 with follow-up until 2011. The study population consisted of 6854 subjects. Main end points were SCD, cardiac death, and all-cause mortality. PRWP was defined as R-wave amplitude ≤ 0.3 mV in lead V3 and R-wave amplitude in lead V2 ≤ R-wave amplitude in lead V3. Results: PRWP occurred in 213 subjects (3.1%). During the follow-up period of 24.3 ± 10.4 years, 3723 subjects (54.3%) died. PRWP was associated with older age, higher prevalence of heart failure and CAD, and β-blocker medication. In multivariate analyses, PRWP was associated with SCD (hazard ratio [HR] 2.13; 95% confidence interval [CI] 1.34–3.39), cardiac death (HR 1.75; 95% CI 1.35–2.15), and all-cause mortality (HR 1.29; 95% CI 1.08–1.54). In the subgroup with CAD, PRWP had a stronger association with cardiac mortality (HR 1.71; 95% CI 1.19–2.46) than in the subgroup without CAD, while the association with SCD was significant only in the subgroup with CAD (HR 2.62; 95% CI 1.38–4.98). Conclusion: PRWP was associated with adverse prognosis in the general population and with SCD in subjects with CAD.Peer reviewe

Leave Me Alone With Your Symptoms! Social Exclusion at the Workplace Mediates the Relationship of Employee's Mental Illness and Sick Leave

Although a substantial part of employees suffers from a mental illness, the work situation of this population still is understudied. Previous research suggests that people with a mental illness experience discrimination in the workplace, which is known to have detrimental effects on health. Building on the stereotype content model and allostatic load theory, the present study investigated whether employees with a mental illness become socially excluded at the workplace and therefore show more days of sick leave. Overall, 86 employees diagnosed with a mental disorder were interviewed and completed online-surveys. Path analyses supported the hypotheses, yielding a serial mediation: The interview-rated severity of the mental disorder had an indirect effect on the days of sick leave, mediated by the symptomatic burden and the social exclusion at the workplace. In the light of the costs associated with absenteeism the present paper highlights the harmfulness of discrimination. Organizations and especially supervisors need to be attentive for signs of exclusion within their teams and try to counteract as early as possible

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

PNA microarrays for hybridisation of unlabelled DNA samples

Several strategies have been developed for the production of peptide nucleic acid (PNA) microarrays by parallel probe synthesis and selective coupling of full-length molecules. Such microarrays were used for direct detection of the hybridisation of unlabelled DNA by time-of-flight secondary ion mass spectrometry. PNAs were synthesised by an automated process on filter-bottom microtitre plates. The resulting molecules were released from the solid support and attached without any purification to microarray surfaces via the terminal amino group itself or via modifications, which had been chemically introduced during synthesis. Thus, only full-length PNA oligomers were attached whereas truncated molecules, produced during synthesis because of incomplete condensation reactions, did not bind. Different surface chemistries and fitting modifications of the PNA terminus were tested. For an examination of coupling selectivity, bound PNAs were cleaved off microarray surfaces and analysed by MALDI-TOF mass spectrometry. Additionally, hybridisation experiments were performed to compare the attachment chemistries, with fully acetylated PNAs spotted as controls. Upon hybridisation of unlabelled DNA to such microarrays, binding events could be detected by visualisation of phosphates, which are an integral part of nucleic acids but missing entirely in PNA probes. Overall best results in terms of selectivity and sensitivity were obtained with thiol-modified PNAs on maleimide surfaces

Der GKV-Arzneimittelmarkt

Die vorliegende differenzierte Beschreibung des GKV-Arzneimittelmarktes gibt einen umfangreichen Einblick in das Verordnungsgeschehen und beleuchtet die Hinter-gründe der aktuellen Marktentwicklungen. Neben dem Geschehen im Gesamtmarkt werden die zentralen Marktsegmente der Patentarzneimittel, Biologika und Biosimilars sowie der Orphan Drugs differenziert dargestellt. Auch die Liefersicherheit von Arz-neimitteln, die Auswirkungen der Arzneimittelrabattverträge, die Zusammensetzung der Distributionskosten und die Marktdaten pharmazeutischer Hersteller werden be-handelt. Der Bericht wird ergänzt durch umfangreiches statistisches Material zum Arzneimittel-markt 2019, das auf unserer Webseite zum kostenfreien Download angeboten wird. Dieses umfasst unter anderem detaillierte Ergebnisse der Komponentenzerlegung des Umsatzes, mit deren Hilfe die Bewegungen im Arzneimittelmarkt im Jahr 2019 analy-siert werden können. Dazu kommen Übersichten über Arzneiverordnungen nach Fach-arztgruppen sowie nach Altersgruppen und Geschlecht der Versicherten, die einen dif-ferenzierten Einblick in das Verordnungsgeschehen des Jahres 2019 geben. Darüber hinaus werden die methodische Herangehensweise und die verschiedenen Klassifika-tionen erläutert

Der GKV-Arzneimittelmarkt

Die vorliegende differenzierte Beschreibung des GKV-Arzneimittelmarktes gibt einen umfangreichen Einblick in das Verordnungsgeschehen und beleuchtet die Hinter-gründe der aktuellen Marktentwicklungen. Neben dem Geschehen im Gesamtmarkt werden die zentralen Marktsegmente der Patentarzneimittel, Biologika und Biosimilars sowie der Orphan Drugs differenziert dargestellt. Auch die Liefersicherheit von Arz-neimitteln, die Auswirkungen der Arzneimittelrabattverträge, die Zusammensetzung der Distributionskosten und die Marktdaten pharmazeutischer Hersteller werden be-handelt. Der Bericht wird ergänzt durch umfangreiches statistisches Material zum Arzneimittel-markt 2019, das auf unserer Webseite zum kostenfreien Download angeboten wird. Dieses umfasst unter anderem detaillierte Ergebnisse der Komponentenzerlegung des Umsatzes, mit deren Hilfe die Bewegungen im Arzneimittelmarkt im Jahr 2019 analy-siert werden können. Dazu kommen Übersichten über Arzneiverordnungen nach Fach-arztgruppen sowie nach Altersgruppen und Geschlecht der Versicherten, die einen dif-ferenzierten Einblick in das Verordnungsgeschehen des Jahres 2019 geben. Darüber hinaus werden die methodische Herangehensweise und die verschiedenen Klassifika-tionen erläutert

Poor R-wave progression as a predictor of sudden cardiac death in the general population and subjects with coronary artery disease

Abstract Background: Poor R-wave progression (PRWP) is a common clinical finding on the standard 12-lead electrocardiogram (ECG), but its prognostic significance is unclear. Objective: The purpose of this study was to examine the prognosis associated with PRWP in terms of sudden cardiac death (SCD), cardiac death, and all-cause mortality in general population subjects with and without coronary artery disease (CAD). Methods: Data and 12-lead ECGs were collected from a Finnish general population health examination survey conducted during 1978–1980 with follow-up until 2011. The study population consisted of 6854 subjects. Main end points were SCD, cardiac death, and all-cause mortality. PRWP was defined as R-wave amplitude ≤ 0.3 mV in lead V₃ and R-wave amplitude in lead V₂ ≤ R-wave amplitude in lead V₃. Results: PRWP occurred in 213 subjects (3.1%). During the follow-up period of 24.3 ± 10.4 years, 3723 subjects (54.3%) died. PRWP was associated with older age, higher prevalence of heart failure and CAD, and β-blocker medication. In multivariate analyses, PRWP was associated with SCD (hazard ratio [HR] 2.13; 95% confidence interval [CI] 1.34–3.39), cardiac death (HR 1.75; 95% CI 1.35–2.15), and all-cause mortality (HR 1.29; 95% CI 1.08–1.54). In the subgroup with CAD, PRWP had a stronger association with cardiac mortality (HR 1.71; 95% CI 1.19–2.46) than in the subgroup without CAD, while the association with SCD was significant only in the subgroup with CAD (HR 2.62; 95% CI 1.38–4.98). Conclusions: PRWP was associated with adverse prognosis in the general population and with SCD in subjects with CAD