Pacemaker therapy in patients with neurally mediated syncope and documented asystole: Third International Study on Syncope of Uncertain Etiology (ISSUE-3): a randomized trial.

BACKGROUND: The efficacy of cardiac pacing for prevention of syncopal recurrences in patients with neurally mediated syncope is controversial. We wanted to determine whether pacing therapy reduces syncopal recurrences in patients with severe asystolic neurally mediated syncope. METHODS AND RESULTS: Double-blind, randomized placebo-controlled study conducted in 29 centers in the Third International Study on Syncope of Uncertain Etiology (ISSUE-3) trial. Patients were ≥40 years, had experienced ≥3 syncopal episodes in the previous 2 years. Initially, 511 patients, received an implantable loop recorder; 89 of these had documentation of syncope with ≥3 s asystole or ≥6 s asystole without syncope within 12 ± 10 months and met criteria for pacemaker implantation; 77 of 89 patients were randomly assigned to dual-chamber pacing with rate drop response or to sensing only. The data were analyzed on intention-to-treat principle. There was syncope recurrence during follow-up in 27 patients, 19 of whom had been assigned to pacemaker OFF and 8 to pacemaker ON. The 2-year estimated syncope recurrence rate was 57% (95% CI, 40-74) with pacemaker OFF and 25% (95% CI, 13-45) with pacemaker ON (log rank: P=0.039 at the threshold of statistical significance of 0.04). The risk of recurrence was reduced by 57% (95% CI, 4-81). Five patients had procedural complications: lead dislodgment in 4 requiring correction and subclavian vein thrombosis in 1 patient. CONCLUSIONS: Dual-chamber permanent pacing is effective in reducing recurrence of syncope in patients ≥40 years with severe asystolic neurally mediated syncope. The observed 32% absolute and 57% relative reduction in syncope recurrence support this invasive treatment for the relatively benign neurally mediated syncope. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00359203.

Quality of life following third molar removal under conscious sedation

Aim: The aim of this study was to assess quality of life (QoL) and degree of satisfaction among outpatients subjected to surgical extraction of all four third molars under conscious sedation. A second objective was to describe the evolution of self-reported pain measured in a visual analogue scale (VAS) in the 7 days after extraction. Study design: Fifty patients received a questionnaire assessing social isolation, working isolation, eating and speaking ability, diet modifications, sleep impairment, changes in physical appearance, discomfort at suture removal and overall satisfaction at days 4 and 7 after surgery. Pain was recorded by patients on a 100-mm pain visual analogue scale (VAS) every day after extraction until day 7. Results: Thirty-nine patients fulfilled correctly the questionnaire. Postoperative pain values suffered small fluctuations until day 5 (range: 23 to 33 mm in a 100-mm VAS), when dicreased significantly. A positive association was observed between difficult ranked surgeries and higher postoperative pain levels. The average number of days for which the patient stopped working was 4.9. Conclusion: The removal of all third molars in a single appointment causes an important deterioration of the patient"s QoL during the first postoperative week, especially due to local pain and eating discomfort.

The role of epilepsy in early language development in a child with a congenital lesion in the right hemisphere

Early epilepsy is known to worsen the developmental prognosis of young children with a congenital focal brain lesion, but its direct role is often very difficult to delineate from the other variables. This requires prolonged periods of follow-up with simultaneous serial electrophysiological and developmental assessments which are rarely obtained. We studied a male infant with a right prenatal infarct in the territory of the right middle cerebral artery resulting in a left spastic hemiparesis, and an epileptic disorder (infantile spasms with transient right hemihypsarrhythmia and focal seizures) from the age of 7 months until the age of 4 years. Pregnancy and delivery were normal. A dissociated delay of early language acquisition affecting mainly comprehension without any autistic features was documented. This delay was much more severe than usually expected in children with early focal lesions, and its evolution, with catch-up to normal, was correlated with the active phase of the epilepsy. We postulate that the epilepsy specifically amplified a pattern of delayed language emergence, mainly affecting lexical comprehension, reported in children with early right hemisphere damage.

Weeds in spring cereal fields in Finland - a third survey

Selostus: Kolmas kevätviljapeltojen rikkakasvikartoitus

New Iowa materials : a supplement to the third edition of Iowa and some Iowans, 1990

This bibliography is an update to the publication Iowa and Some Iowans, 1988. It includes literature and history with elementary and secondary interests.

Isolated disturbance of written language-acquisition as an initial symptom of epileptic aphasia in a 7-year-old child - a 3-year follow-up-study

A 7-year-old right-handed girl developed partial complex seizures with a left-sided onset. A brief period of post-ictal aphasia of the conduction type was documented before seizure control and complete normalization of oral language were obtained. We also found that she had a history of previous unexplained difficulty with written language acquisition that had occurred prior to the clinically recognized epilepsy and a subsequent loss of this ability. This rapidly improved with control of the epilepsy. The evolution of written language were been followed for 3 years, and continued improvement has occurred with fluctuations related to her epilepsy. This observation adds support to the growing body of data indicating that specific cognitive disturbances can be due to epilepsy in young children. It shows the vulnerability of skills which are in a period of active development, and the possibility that oral/written language can be differentially involved by cerebral dysfunction in the young child.

La traducción y los textos bilingües (japonés-inglés) para estudiantes de japonés: análisis de las antologías de relatos cortos y de las revistas de idioma

El treball estudia els dos tipus de textos bilingües japonès-anglès (llibres i revistes) que existeixen per a estudiants de japonès. La primera part analitza quatre antologies des de la perspectiva de la paratextualitat i de la teoria funcionalista de Christiane Nord (1997). A continuació, s'estudien les tècniques de traducció, a partir dels desenvolupaments teòrics d'Amparo Hurtado i Lucía Molina (2002), en el conte «The Third Night» de Natsume Sôseki. A la segona part s'investiguen dues revistes d'idiomes mensuals, Nihongo Journal i Hiragana Times. Es tracta d’analitzar la influència del propòsit pedagògic en les traduccions. Se segueix el procediment ja emprat a la primera part, exceptuant l'anàlisi de les tècniques

Interoperability and Technology for a Language Resources Factory

This document describes some of the technological aspects of a project devoted to the creation of a factory for language resources. The project’s objectives are explained, as well as the idea to create a distributed infrastructure of web services. This document focuses on two main topics of the factory: (1) the technological approaches chosen to develop the factory, i.e. software, protocols, servers, etc. (2) and Interoperability as the main challenge is to permit different NLP tools work together in the factory. This document explains why XCES and GrAF are chosen as the main formats used for the linguistic data exchange.

Language Resources Factory: case study on the acquisition of Translation Memories

This paper demonstrates a novel distributed architecture to facilitate the acquisition of Language Resources. We build a factory that automates the stages involved in the acquisition, production, updating and maintenance of these resources. The factory is designed as a platform where functionalities are deployed as web services, which can be combined in complex acquisition chains using workflows. We show a case study, which acquires a Translation Memory for a given pair of languages and a domain using web services for crawling, sentence alignment and conversion to TMX.

Sorafenib as third- or fourth-line treatment of advanced gastrointestinal stromal tumour and pretreatment including both imatinib and sunitinib, and nilotinib: A retrospective analysis.

BACKGROUND: Tyrosine kinase inhibitors (TKI) improve the outcome of patients with advanced gastrointestinal stromal tumour (GIST), but treatment failure is frequent, and prognosis then bleak. Smaller trials in this setting suggested activity for sorafenib, a multikinase inhibitor of receptor tyrosine kinases and RAF serine/threonine kinases. PATIENTS AND METHODS: We retrospectively evaluated the efficacy of sorafenib, starting dose 400mg twice daily, in a large community-based cohort of 124 patients treated in 12 European and one United States (U.S.) cancer centre. All but one patient had a WHO performance score 0-2. All had failed both imatinib and sunitinib, 68 patients nilotinib and 26 had failed investigational therapy, too. RESULTS: Twelve (10%) patients responded to sorafenib and 70 (57%) patients achieved disease stabilisation. Sorafenib was moderately tolerated, and toxicity reported in 56% of the patients. Rash, hand-foot-syndrome and diarrhea occurred frequently. Sorafenib dosage was reduced in a third of patients, but this did not have an impact on progression-free survival (PFS) (p=0.15). Median PFS was 6.4months (95% confidence interval [CI], 4.6-8.0months) and median overall survival (OS) 13.5months (95% CI, 10.0-21.0months). Patients with a good performance status and those who responded to sorafenib had a significant better PFS. CONCLUSION: We conclude that sorafenib is active in GIST resistant to imatinib, sunitinib and nilotinib. These results warrant further investigation of sorafenib or similar molecules in GIST.

Experiències poètiques de qualitat a la infància

La poesia és un gènere literari, massa sovint, oblidat a les escoles. No obstant, està demostrat que es pot treballar amb persones de totes les edats, des d’infants ben petits, fins a persones adultes, sempre i quan, les metodologies i les tècniques utilitzades siguin adequades als receptors. Aquest gènere no implica només comprensió del vocabulari i del missatge final, sinó també comporta gaudir del joc de les paraules, dels sons, de la melodia, del ritme... Es pot dir, doncs, que poesia i música, són dues arts que estan estretament relacionades. Quins elements provoquen que una experiència de poesia tingui qualitat? En primer lloc, el “què”, quin tipus de poesia oferim als infants. Així doncs, els podem proporcionar poesia escrita per a infants, però també poesia , en un inici, pensada per a adults. I és que el poema que és bo per a nens/es també ho és per a gent més gran, i a l’inrevés. A més a més, la poesia ha de ser rítmica, melòdica i que busqui constantment el joc sonor de les paraules. En segon lloc, el “qui”, és a dir, quines condicions ha de tenir la persona que escriu i recita poesia, per fer-ho amb la màxima qualitat possible. L’escriptor ha de ser una persona culta, amb un profund lligam artístic. No tothom serveix per a ser un bon escriptor, ja que comporta una gran tasca . Pel que fa a l’art de recitar, és una habilitat que tothom pot adquirir, amb pràctica, voluntat i constància. En tercer i últim lloc, el “com”, la metodologia adequada per presentar la poesia als infants. Aquest gènere literari s’ha de presentar de forma vivencial. El primer que han de fer els infants és estar en contacte amb la llengua i viure la poesia. Només així aprendran a estimar aquest gènere i a creure en ell i en les seves possibilitats.