870 research outputs found

    Method and apparatus for guiding ablative therapy of abnormal biological electrical excitation

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    This invention involves method and apparatus for guiding ablative therapy of abnormal biological electrical excitation. In particular, it is designed for treatment of cardiac arrhythmias. In the method of this invention electrical signals are acquired from passive electrodes, and an inverse dipole method is used to identify the site of origin of an arrhytmia. The location of the tip of the ablation catheter is similarly localized from signals acquired from the passive electrodes while electrical energy is delivered to the tip of the catheter. The catheter tip is then guided to the site of origin of the arrhythmia, and ablative radio frequency energy is delivered to its tip to ablate the site

    Neuroimaging of a pilocytic astrocytoma with anaplastic features and diffusion tensor imaging characteristics

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    We report the magnetic resonance imaging findings of an adult patient with a biopsy-proven pilocytic astrocytoma with anaplastic features. Pilocytic astrocytomas rarely occur in adults, and presentation with anaplastic features such as rapid mitotic activity, hypercellularity, and atypia is particularly uncommon. Accurate neuroimaging diagnosis is essential, but differentiation from more malignant neoplastic lesions may be challenging. Diffusion tensor imaging may potentially provide information on cell proliferation, vascularity, and fiber destruction, which can have implications for treatment and prognosis. In this case, tractography and fractional anisotropy maps demonstrated displacement of adjacent parenchyma and relatively intact fractional anisotropy, which is more suggestive of a pilocytic rather than an anaplastic astrocytoma. However, in the presence of focal anaplasia, long-term monitoring will be necessary, since pilocytic astrocytomas with anaplastic features frequently recur

    Low prevalence of valvular heart disease in 226 phentermine-fenfluramine protocol subjects prospectively followed for up to 30 months

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    AbstractOBJECTIVESThis investigation sought to determine the effect of phentermine-fenfluramine (phen-fen) on the prevalence of valvular heart disease in 226 obese subjects enrolled in a prospective, strict weight loss, research protocol.BACKGROUNDEarly reports have suggested that the use of phen-fen for weight loss may be associated with increased valvular heart disease. Such reports were based on small numbers of patients, limited data on dose and duration of phen-fen therapy, and no correlation with matched controls.METHODSAll subjects underwent transthoracic echocardiography for significant valvular lesions within a mean of 97 days from the manufacturer’s announcement of the voluntary withdrawal of fenfluramine and dexfenfluramine. All echocardiograms were interpreted by two independent readers.RESULTSThe study population included 183 women and 43 men with a mean age of 46.9 ± 8.9 years and mean starting body mass index of 39.8 ± 7.7 kg/m2. Using the Food and Drug Administration criteria, significant aortic regurgitation was detected in 15 subjects (6.6%) and mitral regurgitation in 3 subjects (1.3%). Only one patient had significant regurgitation of both aortic and mitral valves. No valves had severe regurgitation. Significant valvular disease did not correlate with the dose or duration of phen-fen therapy. Furthermore, the prevalence of valvular regurgitation is comparable to the normal offspring in the Framingham Heart Study, who are similar in age, gender, and geographical location.CONCLUSIONSPhen-fen therapy is associated with a low prevalence of significant valvular regurgitation. Valvular regurgitation in our subjects may reflect age-related degenerative changes

    Comparing recruitment strategies in a study of acupuncture for chronic back pain

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    <p>Abstract</p> <p>Background</p> <p>Meeting recruitment goals is challenging for many clinical trials conducted in primary care populations. Little is known about how the use of different recruitment strategies affects the types of individuals choosing to participate or the conclusions of the study.</p> <p>Methods</p> <p>A secondary analysis was performed using data from participants recruited to a clinical trial evaluating acupuncture for chronic back pain among primary care patients in a large integrated health care organization. We used two recruitment methods: mailed letters of invitation and an advertisement in the health plan's magazine. For these two recruitment methods, we compared recruitment success (% randomized, treatment completers, drop outs and losses to follow-up), participant characteristics, and primary clinical outcomes. A linear regression model was used to test for interaction between treatment group and recruitment method.</p> <p>Results</p> <p>Participants recruited via mailed letters closely resembled those responding to the advertisement in terms of demographic characteristics, most aspects of their back pain history and current episode and beliefs and expectations about acupuncture. No interaction between method of recruitment and treatment group was seen, suggesting that study outcomes were not affected by recruitment strategy.</p> <p>Conclusion</p> <p>In this trial, the two recruitment strategies yielded similar estimates of treatment effectiveness. However, because this finding may not apply to other recruitment strategies or trial circumstances, trials employing multiple recruitment strategies should evaluate the effect of recruitment strategy on outcome.</p> <p>Trial registration</p> <p>Clinical Trials.gov NCT00065585.</p

    Personality\u27s Relationship to Instagram Photo Characteristics and Themes

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    This study examined the relationship of personality, narcissism, and academic achievement to social media usage among 210 participants (35% Male, 65% Female). Findings demonstrate several relationships between person characteristics and the self- and other-rated behavioral and situational characteristics of posts on Instagram. Overall, personality predicts social media usage and content

    Characteristics of patients with chronic back pain who benefit from acupuncture

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    <p>Abstract</p> <p>Background</p> <p>Although many clinicians believe there are clinically important subgroups of persons with "non-specific" low back pain, such subgroups have not yet been clearly identified. As part of a large trial evaluating acupuncture for chronic low back pain, we sought to identify subgroups of participants that were particularly responsive to acupuncture.</p> <p>Methods</p> <p>We performed a secondary analysis of data for the 638 participants in our clinical trial comparing different types of acupuncture to usual care to identify baseline characteristics that predicted responses to individualized, standardized, or simulated acupuncture treatments. After identifying factors that predicted improvements in back-related function or symptoms, we determined if these factors were more likely to predict improvement for those receiving the acupuncture treatments than for those receiving usual care. This was accomplished by testing for an interaction between the prognostic factors and treatment group in four models: functional outcomes (measured by the Roland-Morris Disability Scale) at 8 and 52 weeks post-randomization and symptom outcomes (measured with a numerical rating scale) at 8 and 52 weeks.</p> <p>Results</p> <p>Overall, the strongest predictors of improvement in back function and symptoms were higher baseline levels of these measures, receipt of an acupuncture treatment, and non-use of narcotic analgesics. Benefit from acupuncture compared to usual care was greater with worse pre-treatment levels of back dysfunction (interaction p < 0.004 for the functional outcome, Roland Morris Disability Scale at 8 weeks). No other consistent interactions were observed.</p> <p>Conclusion</p> <p>This secondary analysis found little evidence for the existence of subgroups of patients with chronic back pain that would be especially likely to benefit from acupuncture. However, persons with chronic low back pain who had more severe baseline dysfunction had the most short-term benefit from acupuncture.</p
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