QT intervals and heart rate variability in hypertensive patients

Low heart rate variability and increased QT dispersion are risk factors for cardiac mortality in various patient populations. We studied dispersion of QT interval, i.e. an index of inhomogeneity of repolarization, and heart rate variability (HRV) i.e., a measure of cardiac autonomie modulation in 76 essential hypertension cases (45 women, 53.0 ± 11.1 years, body mass index: 25.1 ±1.4 kg/m2) and 70 healthy cases (42 women, 54.0 ±10.2 years, body mass index: 25.5 ±1.6 kg/m2,/? > 0.05). QT-corrected QT intervals and their dispersions were significantly higher in the hypertensive group (p 50 msec (p = 0.005), HRV triangular index (p - 0.007), the square root of the mean squared differences of successive RR intervals (p = 0.011), and the high frequency (HF, 0.16-0.40 Hz, p< 0.0001) part of the frequency domain measure of HRV were all decreased, whereas the low frequency (LF, 0.04-0.15 Hz, p = 0.013) part of the frequency domain measures and LF/HF ratio (p < 0.0001) were increased in hypertensive cases. Time domain and the HF part of frequency domain measures of heart rate variability showed an inverse relation with the increased levels of both systolic and diastolic blood pressures and Lown grading system of ventricular rhythm problems, whereas LF and LF / HF showed direct relations with high levels of systolic and diastolic blood pressures and high Lown grade ventricular rhythm problems. The measures of heart rate variability apart from LF and LF / HF were inversely related with the QT intervals and dispersions, whereas LF / HF was directly related with them. Therefore, we conclude that the levels of both systolic and diastolic blood pressures are related to the generation of ventricular rhythm problems either via increasing left ventricular mass which results in an increase in QT parameter measurements, or by altering heart rate variability measures indicating a disturbance in cardiac autonomie balance in essential hypertension

Coronary artery disease and infection with chlamydia pneumonia

The association between chlamydia pneumonia and coronary artery disease is well documented, however less is known about the correlation between chlamydia pneumonia infection and blood inflammatory markers or lipid levels. In 100 patients with proven coronary artery disease (25 females, 61.0 + 4.0 years old), and 60 healthy volunteer control cases (15 females, 60.6 ±3.4 years old), anti chlamydia pneumonia IgG, blood lipid, C-reactive protein and fibrinogen levels were detected. In cases with coronary artery disease seropositivity for IgG antibodies to chlamydia pneumonia (74% versus 34%, p < 0.0001 ), C-reactive protein (mg / /) (2.8 ±0.6 versus 1.4 ±0.6, p < 0.0001 ), fibrinogen (mg / d/) (317.4 ±38.2 versus 256.2 ±34.5, p < 0.0001 ), triglycéride (mg/dl) (217.5 ±39.0 versus 191.0 + 25.9, p <0.0001), LDL-cholesterol (mg /dl) (126.9+ 19.2 versus 110.6± 19.5, p< 0.0001) levels and total cholesterol / HDL-cholesterol ratio (7.7 ±1.8 versus 4.4 + 1.2, p < 0.0001) were higher but the level of HDL-cholesterol (mg/dl) (26.4±6.7 versus 47.0 ±11.2, p< 0.0001) was lower. The levels of total cholesterol did not differ between the two groups (/? = 0.9). Levels of triglycéride (r = 0.60, p< 0.00001), LDL-cholesterol (r = 0.27, p = 0.0004), C-reactive protein (r = 0.69, p < 0.00001), fibrinogen (r = 0.60, p<0.00001) and total cholesterol /HDLcholesterol ratio (r = 0.74, p< 0.00001) had a direct relation, but the level of HDL-cholesterol had a negative (r = -0.80, p< 0.00001) relation with the seropositivity for chlamydia pneumonia. As a result, seropositivity for IgG antibodies to chlamydia pneumonia is considered as a risk factor for coronary artery disease by its association with the atherogenic lipid profile and procoagulant activity

Forecasting Design Day Demand Using Extremal Quantile Regression

Extreme events occur rarely, making them difficult to predict. Extreme cold events strain natural gas systems to their limits. Natural gas distribution companies need to be prepared to satisfy demand on any given day that is at or warmer than an extreme cold threshold. The hypothetical day with temperature at this threshold is called the Design Day. To guarantee Design Day demand is satisfied, distribution companies need to determine the demand that is unlikely to be exceeded on the Design Day. We approach determining this demand as an extremal quantile regression problem. We review current methods for extremal quantile regression. We implement a quantile forecast to estimate the demand that has a minimal chance of being exceeded on the design day. We show extremal quantile regression to be more reliable than direct quantile estimation. We discuss the difficult task of evaluating a probabilistic forecast on rare events. Probabilistic forecasting is a quickly growing research topic in the field of energy forecasting. Our paper contributes to this field in three ways. First, we forecast quantiles during extreme cold events where data is sparse. Second, we forecast extremely high quantiles that have a very low probability of being exceeded. Finally, we provide a real world scenario on which to apply these techniques

Effect of insulin resistance on left ventricular structural changes in hypertensive patients

Both left ventricular (LV) hypertrophy and insulin resistance (IR) have often been demonstrated in patients with essential hypertension (EH). Insulin may exert a direct growth promoting effect on cardiomyocytes rather than affecting the LV internal diameter. The purpose of this study was to examine the effect of IR on LV geometry. We enrolled 105 patients (71 females, mean age, 49.2 ± 13.6 years) with recently diagnosed and untreated hypertension (blood press > 140 and/or 90 mmHg, fasting glucose < 110 mg/dL), and grouped them as normal (N) (39 patients, 26 females, mean age, 48.5 ± 14.7 years) if all M-mode echocardiographic measurements were within normal limits, concentric remodeling (CR) (22 patients, 15 females, mean age, 50.5 ± 14.8 years) if relative wall thickness was increased but left ventricular mass index (LVMI) was normal, concentric hypertrophy (CH) (13 patients, 9 females, mean age, 50.3 ± 10.8 years) if both ventricular thicknesses and the LVMI were increased, and eccentric hypertrophy (EH) (31 patients, 21 females, mean age, 48.6 ± 12.9 years) if ventricular thicknesses were normal, but LVMI was increased. Transthoracic echocardiography was performed in all subjects, and interventricular septal thickness (IVS), posterior wall thickness (PWT), sum of wall thickness (SWT), left ventricular end-diastolic internal diameter (LVED), relative wall thickness (RWT), and LVMI were recorded. Blood samples for routine biochemical examination and fasting insulin levels were obtained and then the homeostasis model assessment (HOMA) index was calculated by the formula: HOMA Index = Fasting Blood Glucose (mg/dL) × Immunoreactive Insulin (μU/mL)/405, for the assessment of IR. There were no significant differences among the groups with respect to age, blood pressure (BP) levels, fasting blood glucose (FBG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), total cholesterol (TC), or triglyceride (TG) levels. Insulin levels were significantly higher in the CR and CH groups in comparison with the N group (P = 0.004), and the HOMA index was higher in the CH group compared to the N group (P = 0.024). In Pearson's correlation analysis, insulin was found to be directly correlated with IVS (r = 0.29, P = 0.002), SWT (r = 0.25, P = 0.009), and RWT (r = 0.33, P = 0.0001). The HOMA index was also directly correlated with IVS (r = 0.33, P = 0.001), SWT (r = 0.29, P = 0.002), and RWT (r = 0.29, P = 0.003). Cardiac changes in hypertensive patients include increased LVMI and altered LV geometry. The concentric LV geometry seen in hypertensive patients might be mediated, at least in part, by increased insulin levels and the HOMA index. Copyright © 2006 by the International Heart Journal Association

Jugend und Arbeit: zur sozialistischen Persönlichkeitsentwicklung von Lehrlingen und jungen Arbeitern

"Arbeitseinstellungen gehören zu den grundlegenden Komponenten der Persönlichkeit und zu den wesentlichen Determinanten der Leistungsmotivation." Die vorliegende Studie referiert die Ergebnisse einer empirischen Untersuchung zur klassenbewußten Erziehung der Arbeiterjugend seit dem VIII. Parteitag der SED und zeigt gleichzeitig die Bedingungen auf, die bei der Erziehung der Jugendlichen zu sozialistischen Facharbeitern, zu bewußten Angehörigen der Arbeiterklasse beachtet werden sollten. Erhebungszeitraum, Stichprobengröße und Art der Erhebung sind aus den vorliegenden Daten nicht zu ermitteln. (pmb

Die Teilnahme der Arbeiterjugend am sozialistischen Wettbewerb: Parlamentsstudie 1975 ; Teilbericht II.2

Die Studie, basierend auf einer schriftlichen Befragung von ca. 7400 jungen Werktätigen in der DDR im Frühjahr 1975, dient der ideologisch-theoretischen Vorbereitung des 10. Parlaments der FDJ. Ihr Ziel besteht in der Analyse der Ergebnisse der sozialistischen Jugendpolitik auf der Grundlage der Beschlüsse des 8. Parteitags des SED, insbesondere bei der Entwicklung des sozialistischen Klassenbewußtseins der Jugend, in der Bestimmung der für diese Entwicklung wichtigen Prozesse sowie in der Erarbeitung von Empfehlungen für die vom 10. Parlament der FDJ zu beschließenden Dokumente zur kommunistischen Erziehung der Jugend. Die Teilnahme der Arbeiterjugend am sozialistischen Wettbewerb wird auf drei Ebenen untersucht: (1) Einsatz der werktätigen Jugend für volle Ausnutzung der Arbeitszeit, hohe Qualität der Arbeit und sparsamen Umgang mit Material und Energie; (2) Teilnahme der Arbeiterjugend an volkswirtschaftlichen Initiativen und an der Qualifizierung; (3) Informiertheit der Arbeiterjugend über grundlegende ökonomische Sachverhalte und Zielstellungen. (ICE

Early Mortality among Patients with Head and Neck Cancer Diagnosed in Thuringia, Germany, between 1996 and 2016—A Population-Based Study

Simple Summary When we consider the outcome of cancer treatment, we mostly focus on overall survival: studies on early mortality in head and neck cancer (HNC) are sparse. This retrospective population-based study investigated early mortality of HNC and the influence of patients’ tumor and treatment characteristics. All 8288 patients with primary HNC of the German federal state Thuringia from 1996 to 2016 were included. Statistics were performed to identify independent factors for 30-day, 90-day, and 180-day mortality. The 30-, 90-, and 180-day mortality risks were 1.8%, 5.1%, and 9.6%, respectively. Male sex, increasing age, larger tumor size, and distant metastasis, tumors of the cavity of mouth, oropharynx, and hypopharynx had a significantly greater 180-day mortality. Surgery, radiotherapy, and multimodal therapy were associated with decreased 180-day mortality. Typical factors associated with worse overall survival had the most important impact on early mortality in HNC patients in a population-based setting. Abstract Population-based studies on early mortality in head and neck cancer (HNC) are sparse. This retrospective population-based study investigated early mortality of HNC and the influence of patients’ tumor and treatment characteristics. All 8288 patients with primary HNC of the German federal state Thuringia from 1996 to 2016 were included. Univariate and multivariate analysis were performed to identify independent factors for 30-day, 90-day, and 180-day mortality. The 30-, 90-, and 180-day mortality risks were 1.8%, 5.1%, and 9.6%, respectively. In multivariable analysis, male sex (odds ratio (OR) 1.41; 95% confidence interval (CI) 1.08–1.84), increasing age (OR 1.81; CI 1.49–2.19), higher T (T4: OR 3.09; CI 1.96–4.88) and M1 classification (OR 1.97; CI 1.43–2.73), advanced stage (IV: OR 3.97; CI 1.97–8.00), tumors of the cavity of mouth (OR 3.47; CI 1.23–9.75), oropharynx (OR 3.01; CI 1.06–8.51), and hypopharynx (OR 3.27; CI 1.14–9.40) had a significantly greater 180-day mortality. Surgery (OR 0.51; CI 0.36–0.73), radiotherapy (OR 0.37; CI 0.25–0.53), and multimodal therapy (OR 0.10; CI 0.07–0.13) were associated with decreased 180-day mortality. Typical factors associated with worse overall survival had the most important impact on early mortality in a population-based setting

Role of Intraparotid and Neck Lymph Node Metastasis in Primary Parotid Cancer Surgery: A Population-Based Analysis

Simple Summary The prognostic role of intraparotid (PAR) and cervical lymph node (LN) metastasis on overall survival (OS) of primary parotid cancer is unclear. All 345 Thuringian patients with parotid cancer from 1996 to 2016 were included in a population-based study. OS was assessed in relation to the total number of removed PAR and cervical LN, number of positive intraparotid (PAR+), positive cervical LN, LN ratio, log odds of positive LN (LODDS), as well as including the PAR as LODDS-PAR. PAR was assessed in 42% of the patients (22% of these PAR+). T and N classification were not independent predictors of OS. When combining T with LODDS instead of N, higher T became a strong prognosticator, but not LODDS. When combining T classification with LODDS-PAR, both higher T classification and the classification with LODDS-PAR became independent predictors of worse OS. LODDS-PAR seems to be an optimal prognosticator for OS in primary parotid cancer. Abstract This population-based study investigated the prognostic role of intraparotid (PAR) and cervical lymph node (LN) metastasis on overall survival (OS) of primary parotid cancer. All 345 patients (median age: 66 years; 43% female, 49% N+, 31% stage IV) of the Thuringian cancer registries with parotid cancer from 1996 to 2016 were included. OS was assessed in relation to the total number of removed PAR and cervical LN, number of positive intraparotid (PAR+), positive cervical LN, LN ratio, log odds of positive LN (LODDS), as well as including the PAR as LODDS-PAR. PAR was assessed in 42% of the patients (22% of these PAR+). T and N classification were not independent predictors of OS. When combining T with LODDS instead of N, higher T (T3/T4) became a prognosticator (hazard ratio (HR) = 2.588; CI = 1.329–5.040; p = 0.005) but not LODDS ( p > 0.05). When combining T classification with LODDS-PAR, both higher T classification (HR = 2.256; CI = 1.288–3.950; p = 0.004) and the alternative classification with LODDS-PAR (≥median −1.11; HR 2.078; CI = 1.155–3.739; p = 0.015) became independent predictors of worse OS. LODDS-PAR was the only independent prognosticator out of the LN assessment for primary parotid cancer

Do female patients with metabolic syndrome have masked left ventricular dysfunction?

Objective: Metabolic syndrome (MS) is a condition, which is recognized as raising the risk of cardiovascular disease. The aim of our study is to estimate the left ventricular functions by atrioventricular plane displacement (AVPD), myocardial performance index (MPI) and conventional methods in patients with MS who were diagnosed according to NCEP (ATP III) criteria. Methods: Fifty-three female patients with MS (mean age 53.1 ± 6.9 years) and 30 healthy female subjects (mean age 52.8 ± 6.3 years, p>0.05) underwent complete echocardiographic assessment. All of the subjects had no heart and pulmonary diseases. The systolic mitral AVPD was recorded at 4 sites (septal, lateral, anterior, and posterior) by M-mode echocardiography and left ventricle ejection fraction (LVEF) was calculated from the AVPD-mean (EF-AVPD). The LVEF was also established by biplane Simpson's (EF-2D) and Teichholz's methods (EF-T). Left ventricular MPI was calculated as (isovolumic contraction time + isovolumic relaxation time) / aortic ejection time by Doppler echocardiography. Results: Patients with MS showed mild left ventricular diastolic dysfunction (DD) in comparison to healthy subjects. The EF-2D and EF-T in patients with MS and healthy subjects were not different significantly and were within normal limits. Patients with MS showed LV global dysfunctions compared to healthy subjects (MPI: 0.56±0.12 and 0.46±0.11 respectively, p<0.01). Both the septal, anterior, lateral and posterior part of the atrioventricular plane values and also AVPD-mean during systole were statistically lower in patients with MS (12.85±1.76 mm) as compared with controls (14.65±2.19 mm, p<0.05). The EF-AVPD in patients with MS was statistically lower (65.58±11.95%) as compared with healthy subjects (74.45±11.07%, p<0.01). Conclusion: Female patients with MS had both left ventricular DD and a global dysfunction with an increased MPI. The EF-2D and EF-T were not different significantly between patients and controls, but patients with MS had a relatively reduced EF-AVPD. The AVPD method may indicate a systolic dysfunction with a relatively lower AVPD-mean and relatively lower EF-AVPD. The presence of global dysfunction in patients with MS may lead to heart failure

Evaluation of heart rate variability in patients with coronary artery ectasia and coronary artery disease

Objective: The present study compared heart rate variability (HRV) parameters in patients with coronary artery ectasia (CAE) and coronary artery disease (CAD). Methods: The study population consisted of 60 consecutive patients with CAE (14 women; mean age 51.63±7.44 years), 60 consecutive patients with CA (15 women; mean age 53.67±9.31 years), and 59 healthy individuals (13 women; mean age 52.85±8.19 years). Electrocardiograms, 24-hour Holter analyses, and routine biochemical tests were performed, and clinical characteristics were evaluated. Coronary angiography images were analyzed. Time-domain HRV parameters, including the standard deviation (SD) of normal-to-normal intervals (SDNN) and the root mean square of difference in successive normal-tonormal intervals (RMSSD) were evaluated, as were frequencydomain HRV parameters including low-frequency (LF), very lowfrequency (VLF), high-frequency (HF), the proportion derived by dividing low- and high-frequency (LF/HF), and total power (TP). Results: SDNN was lower in both the CAE and CAD groups, compared to the healthy group (140.85±44.21, 96.51±31.28, and 181.05±48.67, respectively). A significant difference in RMSSD values among the groups was determined (p=0.004). Significantly decreased VLF and HF values were found in the CAE group, compared with the healthy group (VLF p<0.001; HF, p=0.007). TP, VLF, and HF values were significantly lower (p<0.001, p<0.001, and p<0.001, respectively), but LF and LF/ HF values were significantly higher (p<0.001 for both) in the CAD group than in the healthy group. TP values were significantly higher (p<0.001), and LF and LF/HF values were lower in the CAE group, compared with the CAD group (p<0.001 for both). Conclusion: A decrease in vagal modulation or an increase in sympathetic activity of cardiac function, assessed by HRV analysis, is worse in patients with CAD than in patients with CAE. © 2016 Turkish Society of Cardiology