Hyperdominant left anterior descending artery continuing across left ventricular apex as posterior descending artery coexistent with aortic stenosis

We describe, in a 61 year old man, with coexistent aortic stenosis, the anomalous origin of posterior descending artery (PDA) from a stenotic left anterior descending (LAD) artery, as its continuation across the left ventricular apex, in the presence of a normally arising and atretic proximal right coronary artery. The patient underwent mechanical aortic valve replacement and triple coronary artery bypass grafting and made an uneventful recovery. To the best of our knowledge, origin of PDA as a continuation of LAD across the left ventricular apex in the presence of a normally arising but atretic proximal right coronary artery has never been described in literature before. There is one previous case report of continuation of LAD as PDA across the left ventricular apex in a patient with single left coronary coronary artery with an absent right coronary ostium. As the blood supply to the entire interventricular septum is derived from this "hyperdominant" LAD system, stenosis of LAD can be catastrophic. A review of literature of the anomalies of right coronary artery and, in particular, of its anomalous origin from LAD and its coexistence with aortic stenosis, is presented

Determinants of representational and behavioral hyperactivity in patients with fibromyalgia syndrome

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How fatigued do you currently feel? Convergent and discriminant validity of a single-item fatigue measure

Contains fulltext : 56229.pdf (publisher's version ) (Open Access)How Fatigued Do You Currently Feel? Convergent and Discriminant Validity of a Single-Item Fatigue Measure: Madelon L.M. VAN HOOFF, et al. Department of Work and Organizational Psychology, Radboud University Nijmegen, The Netherlands-The main aim of this study was to establish the convergent and discriminant validity of a single-item measure of daily fatigue ("How fatigued do you currently feel?") in a daily diary context. Convergent validity of our measure was examined by relating it to a validated multiple-item measure of fatigue (Profile of Mood States; McNair, Lorr, & Droppelman, 1971) and to other daily (work-home interference, sleep complaints, work-related effort) and global (fatigue, health complaints, work-home interference, job pressure) measures that are conceptually related to fatigue. Discriminant validity was assessed by relating the single-item fatigue measure to daily (work pleasure) and global (job control, social support, motivation to learn) measures that are conceptually distinct from fatigue. Data were collected among 120 academic staff members, who completed a general questionnaire (tapping the global measures under study) and who took part in a 9-d daily diary study (3 measurements daily). Correlation patterns and multilevel analyses revealed strong and significant associations between the single-item fatigue measure and the variables incorporated to assess convergent validity (especially with the POMS: r=0.80), thus supporting the convergent validity of our measure. Relations with variables included to examine discriminant validity were weak or insignificant, supporting the discriminant validity of the single-item fatigue measure. Despite this study's limitations (i.e., exclusive use of self-reporting, specific sample) we conclude that this single-item fatigue measure offers a valid way to assess daily fatigue.11 p

Fatigue, emotional exhaustion and perceived health complaints associated with work-related characteristics in employees with and without chronic diseases.

Contains fulltext : 52162.pdf (publisher's version ) (Closed access)OBJECTIVES: Ageing of the Dutch working force and increasingly more stringent restrictions regarding early retirement and disability benefits are leading to higher numbers of workers with ill health. Until now, only a few studies have explored how employees with ill health perceive their work. This study investigated possible differences in scores on fatigue, emotional exhaustion, perceived health complaints and various work-related characteristics between chronically ill (CIWs) and non-chronically ill workers (NCIWs), as well as differences in associations between work- and health-related characteristics. METHODS: A questionnaire was sent to all employees of a Dutch university to collect data on perceived work-related and health-related characteristics (response 49.1%). Differences in various scores were analysed using chi (2)-tests and the general linear model. Associations between the work- and the health-related characteristics were determined by multiple linear regression analyses in the CIWs (n = 444) and NCIWs (n = 1,347) separately. Interaction terms were included to detect differences between the two groups. RESULTS: The results indicated that the CIWs had less favourable scores on the three health-related characteristics. Also, the CIWs scored less favourably than the NCIWs on almost all the work-related characteristics. In the two groups, negative work-related aspects, such as higher work pressure, contributed most to explaining the variance in the health-related characteristics. However, in the CIWs, fatigue was not explained by the work-related aspects as much as in the NCIWs. In the CIWs, the association between unpleasant treatment and the health-related characteristics was stronger than in the NCIWs, but there were indications that autonomy, possibilities for learning and social support from superiors also played an important role. CONCLUSIONS: CIWs perceived more fatigue, emotional exhaustion and health complaints than NCIWs. There were different patterns of associations between work- and health-related characteristics in the NCIWs and CIWs. Future studies on associations between work-related characteristics and health should take the presence of chronic disease into account