Predicting Early Mortality Among Implantable Defibrillator Patients Treated With Cardiac Resynchronization Therapy

Background: The beneficial effects of a cardiac resynchronization defibrillator (CRT-D) in patients with heart failure, low left ventricular ejection fraction (LVEF), and wide QRS have clearly been established. Nevertheless, mortality r

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Themes and variations: A discussion of some parallels between Western music and Chinese scroll painting

No abstract available

Emotional dysregulation in psychosis – proof of concept in healthy controls

Objectives: Psychosis symptoms occur in around 1-2% of the population during their lifetime. Various psychosis symptoms relate to a disturbed perception and regulation of emotions. Previous research indicates that emotional dysregulation may form a distinct psychosis symptom dimension that is linked to aberrant function and structure of the limbic system and its cortico-basal ganglia and cortico-cortical connections. However, the nature of emotional dysregulation in psychosis has not been studied extensively yet. Therefore, we aim to investigate affect as a dimension and its association with neural activation in limbic brain structures in psychosis patients as well as in healthy subjects. As a first step, we analysed preliminary data to investigate our self-developed task. Methods Neural activation patterns were investigated using functional magnetic resonance imaging (fMRI) from 12 healthy controls. During fMRI examination, we used a specifically developed face perception task. The presented stimuli were short animations of faces that varied in certain characteristics: gender (male, female), aesthetic (high, low), head movement (up, down) and gaze direction (direct, averted). Subsequently, all face stimuli were rated with regard to gender, health, trustworthiness, friendliness, attractiveness & dominance. Results/Conclusion: During the perception of the face animation, there was predominantly increased activity in face processing areas (i.e. fusiform gyrus) and decreased activity in other face processing areas (i.e. lingual gyrus, superior temporal gyrus) and limbic areas (i.e. posterior cingulate). More data and further investigations are required to investigate the affect domain in detail. Furthermore, comparison with psychosis patients might help find the underlying psychopathology of psychosis and therefore improve future prevention, diagnostic and treatment options

Neural Correlates of Semantic Priming in Psychosis

Psychoses are aetiologically complex disorders that affect about 1 − 2% of the population during their lifetime. Psychotic symptoms are thought to represent disturbances in higher-order brain functions that can be grouped according to their dysfunction in one or more of the following three neural brain circuitries: language, affect, motor function. Dysfunction of the neural language brain circuitry has already been linked to disturbances in expressive speech and formal thought disorders. However, it remains currently unknown if the language brain circuitry is only disturbed in psychosis, or if already individuals at familial or clinical high-risk show some extend of aberrancy. To examine the whole spectrum form health to psychosis, four different subject groups are being examined: healthy controls (HC), first-degree relatives of psychosis patients (REL), a clinical high-risk group (CHR) and psychosis patients (PAT). In total, 120 subjects (30 per group) will complete a lexical priming task during electroencephalography and functional magnetic resonance imaging. On a behavioural level, we expect to find subtle language dysfunction in the REL and CHR group. Furthermore, we hypothesize that aberrant neural activation patterns are present during the language task in PAT, CHR and REL groups in comparison to HC individuals. Finally, we aim to depict that aberrant neural activation in language - related brain areas is most pronounced in the PAT group and to a lesser extend present in the REL group. With this study, we hope to improve diagnostic strategies, treatments and outcome predictions