Association of Heart Rate With Troponin Levels Among Patients With Symptomatic Atrial Fibrillation

This cohort study investigates heart rate and cardiac troponin levels in patients admitted to the emergency department with symptomatic atrial fibrillation.Non peer reviewe

Relation between heart rate variability and spontaneous and induced ventricular arrhythmias in patients with coronary artery disease

AbstractObjectives. The aim of this study was to determine the relation between autonomic control of heart rate and the spontaneous occurrence and inducibility of ventricular arrhythmias in patients with coronary artery disease.Background. Low heart rate variability increases the risk of arrhythmic events. It is not known whether impaired autonomic heart rate control reflects alterations in functional factors that contribute to the initiation of spontaneous arrhythmias or whether it is the consequence of an anatomic substrate for reentrant tachyarrhythmias.Methods. Fifty-four patients with coronary artery disease with a history of sustained ventricular tachycardia (n = 25) or cardiac arrest (n = 29) were studied by 24-h ambulatory electrocardiographic recording and by programmed electrical stimulation. Heart rate variability was compared among the patients with and without spontaneous ventricular arrhythmias and with and without inducibility of sustained ventricular tachyarrhythmias.Results. Eight patients had a total of 21 episodes of sustained ventricular tachycardia on Holter recordings. Standard deviation of RR intervals and low frequency and very low frequency components of heart rate variability were significantly blunted in patients with sustained ventricular tachycardias compared with those without repetitive ventricular ectopic activity (p < 0.05, p < 0.01 and p < 0.05, respectively). However, no significant alterations were observed in heart rate variability before the onset of 21 episodes of sustained ventricular tachycardia. Heart rate variability did not differ between the patients with or without nonsustained episodes of ventricular tachycardia. In patients with frequent ventricular ectopic activity, low frequency and very low frequency power components were significantly blunted compared with those with infrequent ventricular ectopic activity (p < 0.01 and p < 0.001, respectively). Heart rate variability did not differ significantly between the patients with and without inducible sustained ventricular tachyarrhythmias.Conclusions. Impaired very low and low frequency oscillation of heart rate reflects susceptibility to the spontaneous occurrence of ventricular arrhythmias but may not reflect the instantaneous triggers for life-threatening arrhythmias or a specific marker of the arrhythmic substrate for ventricular tachyarrhythmias

"Suurin osa elämästä on menny siihen, että mun täytyis olla toisenlainen": Herkkyyden kokemuksia nyky-yhteiskunnassa

Artikkelissa tarkastellaan inhimillisten toimintamahdollisuuksien ilmenemistä yksilöllisissä herkkyyden kokemuksissa. Kulttuurinen konteksti on yhteydessä siihen, kuinka ihminen kokee itsensä yhteiskunnassa ja maailmassa. Tutkimuksen teoreettisena viitekehyksenä on filosofi Martha Nussbaumin toimintamahdollisuuksien lähestymistapa (capabilities approach), jossa toiminnan mahdollisuudet nähdään toimijuutta edistävinä etappeina kohti inhimillistä hyvinvointia. Kysymme, 1) millä tavoin herkkyyttä kuvaillaan kokemuksellisena ilmiönä ja 2) miten herkkyyden koetaan vaikuttaneen omiin toimintamahdollisuuksiin. Analysoitava aineistokokonaisuus koostui kirjoitetuista muistoista sekä muisteluryhmän tallennetuista ja litteroiduista ryhmäkeskusteluista. Aineistot analysoitiin sisällönanalyysin avulla. Tulosten perusteella herkkyys voi olla kokijalleen yhtäältä suuri elämän rikkaus ja voimavara, toisaalta tukahduttava kuormituksen ja jopa häpeän lähde. Yksilöllinen kokemusmaailma saattaa ajautua ristiriitaan ympäröivien sosiaalisten, kulttuuristen ja yhteiskunnallisten odotusten sekä vaatimusten kanssa ja johtaa toimijuutta ja hyvinvointia lamaavaan toimintamahdollisuuksien kaventumiseen. Tulokset avaavat näkymiä herkkyyden asemoitumiseen vallitsevissa yhteiskunnallisissa normikäsityksissä ja arvostuksissa sekä siihen, kuinka yksilölliseen herkkyyteen kytkeytyviä toimintavalmiuksia voidaan tukea.© 2023 Kirjoittajat. Tämä työ on lisensoitu Creative Commons Nimeä 4.0 Kansainvälinen Julkinen -lisenssillä.fi=vertaisarvioitu|en=peerReviewed

Difficulties in administration of oral medication formulations to pet cats: an e-survey of cat owners

The purpose here was to determine the problems cat owners encounter in medicating their cats with orally administered drugs at home. The study was carried out as an open e-questionnaire survey addressed to cat owners in which the authors focused on the oral administration route. A total of 46 completed questionnaires were included in the survey. In the study, 46 cats received 67 orally administered drugs. Approximately half of the drugs were registered for use in cats by the European Medicines Agency (54 per cent), and there were also off-label drugs registered for human (36 per cent) and canine medication (7.4 per cent) and an ex tempore drug (3.0 per cent). The owners were unable to give the doses as prescribed for their cats for one-fourth of the medications (16/67). Drugs that were registered for feline medication were significantly more palatable than drugs registered for other species (odds ratio (OR) 4.9), and liquid formulations were significantly more palatable than solid formulations (OR 4.8). However, most of the owners (22/38) preferred a solid dosage form, while few (4/38) chose a liquid formulation. The results indicate that there is still a need for more palatable and easily administered oral drugs for cats.Peer reviewe

Time-course of left ventricle function during mild therapeutic hypothermia in out-of-hospital cardiac arrest patients

Peer reviewe

Towards chemical identification in atomic-resolution noncontact AFM imaging with silicon tips

In this study we use ab initio calculations and a pure silicon tip to study the tip-surface interaction with four characteristic insulating surfaces: (i) the narrow gap TiO2 (110) surface, (ii) the classic oxide MgO (001) surface, (iii) the ionic solid CaCO3 (101¯4) surface with molecular anion, and (iv) the wide gap CaF2 (111) surface. Generally we find that the tip-surface interaction strongly depends on the surface electronic structure due to the dominance of covalent bond formation with the silicon tip. However, we also find that in every case the strongest interaction is with the highest anion of the surface. This result suggests that, if the original silicon tip can be carefully controlled, it should be possible to immediately identify the species seen as bright in images of insulating surfaces. In order to provide a more complete picture we also compare these results to those for contaminated tips and suggest how applied voltage could also be used to probe chemical identity.Peer reviewe

Adverse events and survival with postpericardiotomy syndrome after surgical aortic valve replacement

Peer reviewe

Late incidence and recurrence of new-onset atrial fibrillation after isolated surgical aortic valve replacement

Publisher Copyright: © 2021 The AuthorsObjectives: Atrial fibrillation (AF) is a common complication after cardiac surgery. More knowledge is needed about long-term AF recurrence and adverse outcomes related to new-onset AF (NOAF) during the index hospitalization. Methods: A total of 1073 patients underwent isolated surgical aortic valve replacement at the 4 participating hospitals (2002-2014). After the exclusion of patients with a history of any preoperative AF, the final study population included 529 patients in the bioprosthetic and 253 patients in the mechanical valve prosthesis cohort. Median follow-up time was 5.4 (interquartile range, 3.4-8.2) years in the combined cohort. Results: Altogether 333 (42.6%) patients had in-hospital NOAF and 250 (32.0%) AF after hospital discharge. In the mechanical cohort, 64 (25.3%) experienced in-hospital NOAF and 74 (29.2%) AF after hospital discharge, whereas in the bioprosthetic cohort, 269 (50.9%) patients had in-hospital NOAF and 176 (33.3%) AF after hospital discharge. Patients with NOAF during the index hospital stay had a multifold risk of AF after hospital discharge in the combined cohort (hazard ratio [HR], 3.68; 95% confidence interval [CI], 2.82-4.81; P <.0001) as well as in both cohorts separately (bioprosthetic: HR, 4.35; 95% CI, 3.05-6.22; P <.001; mechanical: HR, 2.54; 95% CI, 1.59-4.03; P <.001). Patients with an in-hospital NOAF also had a significantly higher adjusted risk of death during the follow-up in the mechanical (HR, 2.05; 95% CI, 1.10-3.82; P =.025) and bioprosthetic (HR, 1.63; 95% CI, 1.17-2.28; P =.004) valve prosthesis cohorts. Conclusions: NOAF during the index hospitalization is associated with a 2- to 4-fold risk of later AF and 1.6- to 2.0-fold risk of all-cause mortality after mechanical and bioprosthetic surgical aortic valve replacement.Peer reviewe

Red blood cell transfusion induces abnormal HIF-1 alpha response to cytokine storm after adult cardiac surgery

Patients undergoing cardiac surgery develop a marked postoperative systemic inflammatory response. Blood transfusion may contribute to disruption of homeostasis in these patients. We sought to evaluate the impact of blood transfusion on serum interleukin-6 (IL-6), hypoxia induced factor-1 alpha (HIF-1 alpha) levels as well as adverse outcomes in patients undergoing adult cardiac surgery. We prospectively enrolled 282 patients undergoing adult cardiac surgery. Serum IL-6 and HIF-1 alpha levels were measured preoperatively and on the first postoperative day. Packed red blood cells were transfused in 26.3% of patients (mean 2.93 +/- 3.05 units) by the time of postoperative sampling. Postoperative IL-6 levels increased over 30-fold and were similar in both groups (p = 0.115), whilst HIF-1 alpha levels (0.377 pg/mL vs. 0.784 pg/mL, p = 0.002) decreased significantly in patients who received red blood cell transfusion. Moreover, greater decrease in HIF-1 alpha levels predicted worse in-hospital and 3mo adverse outcome. Red blood cell transfusion was associated with higher risk of major adverse outcomes (stroke, pneumonia, all-cause mortality) during the index hospitalization. Red blood cell transfusion induces blunting of postoperative HIF-1 alpha response and is associated with higher risk of adverse thrombotic and pulmonary adverse events after cardiac surgery.Peer reviewe