Functional Capacity of Patients with Pacemaker Due to Isolated Congenital Atrioventricular Block

Background:Isolated congenital atrioventricular block (CAVB) is a rare condition with multiple clinical outcomes. Ventricular remodeling can occur in approximately 10% of the patients after pacemaker (PM) implantation.Objectives:To assess the functional capacity of children and young adults with isolated CAVB and chronic pacing of the right ventricle (RV) and evaluate its correlation with predictors of ventricular remodeling.Methods:This cross-sectional study used a cohort of patients with isolated CAVB and RV pacing for over a year. The subjects underwent clinical and echocardiographic evaluation. Functional capacity was assessed using the six-minute walk test. Chi-square test, Fisher's exact test, and Pearson correlation coefficient were used, considering a significance level of 5%.Results:A total of 61 individuals were evaluated between March 2010 and December 2013, of which 67.2% were women, aged between 7 and 41 years, who were using PMs for 13.5 ± 6.3 years. The percentage of ventricular pacing was 97.9 ± 4.1%, and the duration of the paced QRS complex was 153.7 ± 19.1 ms. Majority of the subjects (95.1%) were asymptomatic and did not use any medication. The mean distance walked was 546.9 ± 76.2 meters and was strongly correlated with the predicted distance (r = 0.907, p = 0.001) but not with risk factors for ventricular remodeling. (Arq Bras Cardiol. 2014; [online].ahead print, PP.0-0)Conclusions:The functional capacity of isolated CAVB patients with chronic RV pacing was satisfactory but did not correlate with risk factors for ventricular remodeling.

Meta-Analysis of Ultrafiltration versus Diuretics Treatment Option for Overload Volume Reduction in Patients with Acute Decompensated Heart Failure

Introduction: Although diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF), inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF) as an alternative strategy for reducing volume overloads in patients with ADHF. Objective: The aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality) were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome. Results: A total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI): −2.65 to −0.91 kg; p < 0.001) more than those who received standard diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = −0.25 mg/dL; 95% CI: −0.56 to 0.06 mg/dL; p = 0.112). The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64–1.56; p = 0.993). Conclusion: Compared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.

Maternal Factors and Adverse Perinatal Outcomes in Women with Preeclampsia in Maceió, Alagoas

Abstract Background: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. Objective: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. Methods: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. Results: We evaluated 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP). A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000) and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040) were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907) were small for gestational age and 25.0% and 23.2% (p = 0.994) were large for gestational age. There was a predominance of cesarean delivery. Conclusion: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries.

Neuere Überlegungen zur Ätiologie des Entwicklungsstotterns

In diesem Beitrag wird auf dem Hintergrund neuerer Studien zum frühen Beginn und Verlauf des Entwicklungsstotterns (Yairi & Ambrose 2004; Reilly et. al. 2009; Felsenfeld et. al. 2010), zu Temperamentsmerkmalen und emotionalen Regulations- und Aufmerksamkeitsdefiziten bei stotternden Kindern (Karras et al. 2006; Eggers et al. 2010; Alm & Risberg 2007), sowie traumapsychologischer Konzepte (Van der Kolk & McFarlane 2000; Fischer & Riedesser 2003), die Frage nach der Bedeutung emotionaler Faktoren auch im Zusammenhang mit traumatischen Erlebnissen in der Genese des „idiopathischen“ Entwicklungsstotterns neu aufgeworfen und diskutiert. Es wird vorgeschlagen, die von Dehon & Scheeringa (2006) zusammengestellte CBCL (1 ½ - 5) traumasensitive Itemliste im Rahmen der Diagnostik und Therapieplanung bei beginnenden Stottern zu verwenden.

Motor and cognitive development of selected Egyptian and German primary school aged children : a cross-cultural study

Magdeburg, Univ., Fak. für Humanwiss., Diss., 2013

Psychische Belastungen in der Berufswelt : ihre Ursprünge, Folgen und betrieblichen Handlungsmöglichkeiten

[s.c.]

Familiäre Sexualkultur : die Bedeutung familiärer Sozialisationsbedingungen für die sexuelle Entwicklung Heranwachsender - Empirische Befunde und Folgerungen für erzieherische Hilfen

[s.c.]

Traumazentrierte Pädagogik in der stationären Kinder- und Jugendhilfe : eine Analyse in Bezug auf Durchführbarkeit und Realisierbarkeit

[s.c.]

Erarbeiten von Grundlagen für eine außerschulisch orientierte integrierte Medien- und Umweltpädagogik für Grundschüler

[s.c.]

Long-term Forecasting of Frame Alignment Losses for Circuit Emulation Implementation

The article provides a method for long-term forecast of frame alignment losses based on the bit-error rate monitoring for structure-agnostic circuit emulation service over Ethernet in a mobile backhaul network. The developed method with corresponding algorithm allows to detect instants of probable frame alignment losses in a long term perspective in order to give engineering personnel extra time to take some measures aimed at losses prevention. Moreover, long-term forecast of frame alignment losses allows to make a decision about the volume of TDM data encapsulated into a circuit emulation frame in order to increase utilization of the emulated circuit. The developed long-term forecast method formalized with the corresponding algorithm is recognized as cognitive and can act as a part of network predictive monitoring system.

Ernährungsmedizinische Kontrolle des Körpergewichts: Individuelle Einstellung zu verschiedenen Verfahren der Gewichtsreduktion bei Patienten mit Diabetes mellitus

Die ernährungsmedizinische Kontrolle des Körpergewichts bei Patienten mit Typ 1- und Typ 2-Diabetes stand im Vordergrund dieser Studie. Untersucht wurde dabei die individuelle Einstellung der beiden Typen zu verschiedenen Verfahren der Gewichtsreduktion. Es wurden Daten von je 60 Patienten mit Typ 1- und Typ 2-Diabetes für die Studie erhoben. Ausgeschlossen wurden Patienten mit schwerwiegenden Herzschwächen mit Luftnot bei geringen körperlichen Anstrengungen oder ausgeprägter Wassereinlagerung (Ödembildung), schwerwiegende, chronische Infektionserkrankungen mit Fieber, Sepsis, ausgeprägten Entzündungsreaktion, fortgeschrittene Lebererkrankungen und Funktionseinbußen der Nieren, die eine Nierenersatztherapie notwendig macht. Nicht teilnehmen sollten auch Patienten, die dauerhaft systemisch Glukocortikoide nehmen, deren Energiehaushalt durch eine hochgradige Einschränkung ihrer Bewegungsfähigkeit z.B. stark beeinflusst wird oder Patienten des Diabetes Typ 1 oder Typ 2 während einer Schwangerschaft. Die Teilnehmer mit Typ 2-Diabetes fühlen sich signifikant unwohler mit ihrem Körpergewicht und schätzten es auch als zu hoch ein als die Teilnehmer mit Typ 1-Diabetes. Passend zu dem hohen eingeschätzten Krankheitswert des Übergewichts beim Typ 2-Diabetes, assoziierten diese Patienten das Körpergewicht mit früheren wie auch zukünftigen gesundheitlichen Problemen. Obwohl Typ 2-Diabetiker eher Gewichtsabnahmen begannen, waren diese in der Vergangenheit nur mäßig erfolgreich gewesen. Die Änderungsbereitschaft das Gewicht zu reduzieren, bleibt dennoch bei den Teilnehmern mit Typ 2-Diabetes bestehen und zeigte sich ausgeprägter bei diesen Teilnehmern. Hingegen waren die Gewichtsreduktionsversuche bei den Teilnehmern mit Typ 1-Diabetes öfter von Erfolg gekrönt als bei den Teilnehmern mit (...)

Fairness under uncertainty with indivisibilities

I analyze an economy with uncertainty in which a set of indivisible objects and a certain amount of money is to be distributed among agents. The set of intertemporally fair social choice functions based on envy-freeness and Pareto efficiency is characterized. I give a necessary and sufficient condition for its non-emptiness and propose a mechanism that implements the set of intertemporally fair allocations in Bayes-Nash equilibrium. Implementation at the ex ante stage is considered, too. I also generalize the existence result obtained with envy-freeness using a broader fairness concept, introducing the aspiration function.

Infinite index subgroups and finiteness properties of intersections of geometrically finite groups

We explore which types of finiteness properties are possible for intersections of geometrically finite groups of isometries in negatively curved symmetric rank one spaces. Our main tool is a twist construction which takes as input a geometrically finite group containing a normal subgroup of infinite index with given finiteness properties and infinite Abelian quotient, and produces a pair of geometrically finite groups whose intersection is isomorphic to the normal subgroup.

Programa nacional de mejora de trigo duro

El trigo duro es una especie relevante para la agricultura de nuestro país ya que es uno de los cereales más cultivados. En la última campaña el trigo duro ha ocupado una superficie de 907.094 ha, con una producción record de 2,8 M t. El consumo de pasta y sémola se ha estimado en 4,2 kg por habitante y año. Además España exporta grano de trigo duro a la UE y sémola a otros países, principalmente Argelia. En 2003 la producción utilizable fue de 2,1 M t y el volumen de exportaciones ascendió a 1,5 M t. Las condiciones climatológicas prevalentes en las zonas de cultivo de trigo duro en nuestro país son idóneas para la producción de grano de alta calidad y podemos aumentar las exportaciones sobre todo a la UE, pero para ello resulta imprescindible ofertar un producto de alta calidad industrial. Sin embargo el panorama varietal muestra que muchas de las variedades cultivadas actualmente no poseen una alta calidad, son sensibles a enfermedades y además son de origen foráneo, ya que los esfuerzos que se han dedicado hasta ahora a la mejora del trigo duro en nuestro país han sido muy limitados. Por otro lado la importancia del cultivo y la obligatoriedad de usar semilla certificada para percibir las ayudas de la UE ha hecho que aumente la demanda de variedades de alta calidad, resistentes a enfermedades y con buena productividad. Por todo ello en 2001 se solicitó este proyecto cuyo objetivo último era unificar los esfuerzos que se llevaban a cabo en ese momento en el campo de la mejora genética de trigo duro en España mediante la constitución del Programa Nacional de Trigo Duro.

In situ evaluation of single-cell lysis by cytosol extraction observation through fluorescence decay and dielectrophoretic trapping time

We present a new method for lysis of single cells in continuous flow, where cells are sequentially trapped, lysed and released in an automatic process. Using optimized frequencies, dielectrophoretic trapping allows exposing cells in a reproducible way to high electrical fields for long durations, thereby giving good control on the lysis parameters. In situ evaluation of cytosol extraction on single cells has been studied for Chinese hamster ovary (CHO) cells through out-diffusion of fluorescent molecules for different voltage amplitudes. A diffusion model is proposed to correlate this out-diffusion to the total area of the created pores, which is dependent on the potential drop across the cell membrane and enables evaluation of the total pore area in the membrane. The dielectrophoretic trapping is no longer effective after lysis because of the reduced conductivity inside the cells, leading to cell release. The trapping time is linked to the time required for cytosol extraction and can thus provide additional validation of the effective cytosol extraction for non-fluorescent cells. Furthermore, the application of one single voltage for both trapping and lysis provides a fully automatic process including cell trapping, lysis, and release, allowing operating the device in continuous flow without human intervention.