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PubMed1984

Automatic tachycardia recognition.

A microcomputer algorithm for tachycardia identification, suitable for use in an implanted antitachycardia pacemaker, is described. The system employs an atrial and ventricular electrogram, detects a sustained fast rate in either chamber, and awakens the main program to perform detailed analysis of the tachycardia and its immediately preceding beats. The algorithm distinguishes atrial, ventricular, and AV nodal and re-entrant tachycardia from high rates due to sinus tachycardia. For testing of the program, we used a data base of twenty-two tape-recorded and documented arrhythmias provoked during electrophysiologic studies in which atrial and ventricular bipolar electrodes were in place; twenty-one were successfully detected. These included atrial fibrillation, atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, AV re-entrant tachycardia using an accessory pathway, and ventricular tachycardia with and without ventriculo-atrial conduction.

Atrial Fibrillation↗
PubMed1998

A morphometric analysis of the posed smile.

A fundamental goal of orthodontics is to improve the smile, but no objective criteria exist to assess the lip-teeth relationship, establish objectives of treatment or measure treatment outcome. Here we propose a method to digitally measure the smile characteristics of orthodontic patients. Specifically, the 'posed smile' is measured. By definition the posed smile is voluntary and not elicited by an emotion. It can be a learned greeting or a signal of appeasement and can be sustained. The posed smile is reliably repeatable. The multimedia computer program for smile measurement we developed was based on studies of the utility of the smile photograph and the assessment of the lip-teeth characteristics of the posed smile in treated and untreated patients. On the computer screen a grid, or smile mesh, employs horizontal and vertical lines to measure eleven attributes of a smile. Not all orthodontically 'well-treated' patients with exemplary plaster casts exhibit desirable anterior tooth display while smiling. We suggest that the photographic analysis of an unstrained posed smile might be a standard orthodontic record.

Child↗
PubMed1981

Spontaneous hypertension ion cross-suckled rats.

Genetically normotensive Sprague-Dawley rats nursed by spontaneously hypertensive foster mothers develop sustained high blood pressure. Some factor related to the genetically programmed hypertension of the foster mother is probably transmitted to the infant rats through her milk. Alternatively, the hyperkinetic behavior of the mother may activate a hypertensinogen in young having the proper constellation of genes.

Animal Population Groups↗
PubMed1998

Developing sustainable systems for nematode management.

Early researchers identified key concepts and developed tactics for multiple-option management of nematodes. Although the emphasis on integrated pest management over the past three decades has promoted strategies and tactics for nematode management, comprehensive studies on the related soil biology-ecology are relatively recent. Traditional management tactics include host resistance (where available), cultural tactics such as rotation with nonhosts, sanitation and avoidance, and destruction of residual crop roots, and the judicious use of nematicides. There have been advances in biological control of nematodes, but field-scale exploitation of this tactic remains to be realized. New technologies and resources are currently becoming central to the development of sustainable systems for nematode-pest-crop management: molecular diagnostics for nematode identification, genetic engineering for host resistance, and the elucidation and application of soil biology for general integrated cropping systems. The latter strategy includes the use of nematode-pest antagonistic cover crops, animal wastes, and limited tillage practices that favor growth-promoting rhizobacteria, earthworms, predatory mites, and other beneficial organisms while suppressing parasitic nematodes and other plant pathogens. Certain rhizobacteria may induce systemic host resistance to nematodes and, in some instances, to foliage pathogens. The systems focusing on soil biology hold great promise for sustainable crop-nematode management, but only a few research programs are currently involved in this labor-intensive endeavor.

Journal Article↗
PubMed1982

Electrophysiology of tiapamil in concealed accessory pathways.

The effect of 2 mg/kg intravenous tiapamil was studied by programmed stimulation of the heart in 6 patients. Before tiapamil, sustained tachycardias were initiated in 5, and only atrial echoes in 1. In all patients, the reentrant circuit involved an accessory pathway conducting only in the ventriculoatrial direction. When administered during tachycardia, tiapamil promptly terminated the arrhythmia in 5 cases. Tiapamil lengthened the atrio-His (A-H) interval and the effective refractory period of the A-V node. As a result of these changes, it was not possible to initiate the tachycardia in 1 patient. In 1 case, tiapamil permitted the induction of sustained tachycardia, while only echoes had been initiated before the drug. In 2 cases, the tachycardia zone narrowed, in 2 others it widened following tiapamil. The ability to sustain the arrhythmia was lost in 1 patient. Tiapamil may be useful for the termination of reentrant supraventricular tachycardia involving concealed accessory pathways. Whether tiapamil prevents or favors the initiation of tachycardia in these patients depends on the interplay between the prolongation of the effective A-V nodal refractory period and the prolongation of the transnodal conduction time in individual patients.

Adult↗
PubMed1993

Adenosine-sensitive ventricular tachycardia. Clinical characteristics and response to catheter ablation.

BACKGROUND: Sustained ventricular tachycardia in the absence of structural heart disease may have diverse mechanisms. Termination of the tachycardia by adenosine suggests triggered automaticity as the etiology in many of these patients. We examined the clinical characteristics, electrophysiological responses, and results of catheter ablation in this patient subgroup. METHODS AND RESULTS: Intravenous adenosine terminated sustained ventricular tachycardia in seven of 14 consecutive patients without evidence of structural heart disease. In each of these patients, the tachycardia had a left bundle branch block, inferior-axis QRS configuration and occurred predominantly during stress or exertion. A morphologically similar sustained tachycardia was induced in six of seven patients during programmed ventricular stimulation, although day-to-day reproducibility was poor. Signal-averaged ECGs were normal in all patients. Imaging with 123I-metaiodobenzylguanidine did not reveal focal abnormalities in any of five patients. A discrete site of origin was identified in the free wall of the pulmonary infundibulum in all patients. Limited application of direct current shocks (two patients) or radiofrequency energy (five patients) resulted in long-term abolition of spontaneous and inducible ventricular tachycardia in all patients. CONCLUSIONS: Adenosine-sensitive ventricular tachycardia appears to arise from relatively discrete sites predominantly located in the free wall of the pulmonary infundibulum. The localized nature of this tachycardia renders it amenable to long-term cure by catheter ablation techniques.

Adenosine↗
PubMedDate not supplied

Integrating mental health services into primary HIV care for women: the Whole Life project.

The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, implementation strategies, effects of the service integration, and lessons learned. Funded by the Health Resources and Services Administration (HRSA) as a Special Program of National Significance (SPNS), Whole Life efforts have been sustained beyond the demonstration funding period as a result of the changes brought about in organizational structures, service delivery, and the providers' conceptualization of health for HIV-infected women.

Adolescent↗
PubMed2004

Induction of T-cell development from human cord blood hematopoietic stem cells by Delta-like 1 in vitro.

The Notch signaling pathway plays a key role at several stages of T-lymphocyte differentiation. However, it remained unclear whether signals induced by the Notch ligand Delta-like 1 could support full T-cell differentiation from a defined source of human hematopoietic stem cells (HSCs) in vitro. Here, we show that human cord blood-derived HSCs cultured on Delta-like 1-expressing OP9 stromal cells undergo efficient T-cell lineage commitment and sustained T-cell differentiation. A normal stage-specific program of T-cell development was observed, including the generation of CD4 and CD8 alpha beta-T-cell receptor (TCR)-bearing cells. Induction of T-cell differentiation was dependent on the expression of Delta-like 1 by the OP9 cells. Stimulation of the in vitro-differentiated T cells by TCR engagement induced the expression of T-cell activation markers and costimulatory receptors. These results establish an efficient in vitro coculture system for the generation of T cells from human HSCs, providing a new avenue for the study of early T-cell differentiation and function.

Animals↗
PubMed2002

Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate.

PURPOSE/OBJECTIVES: To examine the effect of exercise and methylphenidate on fatigue, functional ability, and cognitive function in patients with melanoma. DESIGN: Pilot study with comparison to historic controls. SETTING: University-based cancer center. SAMPLE: 12 patients with melanoma entered and completed the study. The mean age was 44 years. METHOD: Eligible patients were recruited before their first dose of interferon-a (IFN-a). Patients were instructed to take 20 mg sustained-release methylphenidate every morning and follow an aerobic exercise program four days a week for 15-30 minutes. Measures included a 12-minute walk, the Schwartz Cancer Fatigue Scale, Trail Maker Forms A and B, Medical Outcomes Study 36 Short Form, body weight, and daily logs. Fatigue scores were compared to usual care historical controls with melanoma receiving only IFN-a. MAIN RESEARCH VARIABLES: Fatigue, functional ability, and cognitive function. FINDINGS: 66% adhered to exercise and methylphenidate; all adhered to exercise. Fatigue was lower for the exercise and methylphenidate group than historic controls. Functional ability increased 6% for all patients and 9% for the exercise and methylphenidate group. Cognitive function was stable for the exercise and methylphenidate group. The exercise-only group showed marked cognitive slowing. CONCLUSION: The combination of aerobic exercise and methylphenidate may have a positive effect on fatigue, cognitive function, and functional ability. A larger sample size and randomized trial is needed to more rigorously evaluate the results of exercise and methylphenidate alone or in combination. IMPLICATIONS FOR NURSING: Although further study is needed, a combination of exercise and methylphenidate may be a practical intervention for patients receiving IFN-a for melanoma.

Adult↗
PubMed2004

Sinus node function in patients with Brugada-type ECG.

BACKGROUND: Some studies have shown that patients with Brugada syndrome (BS) have atrioventricular conduction disturbance, but their sinus node function has not been evaluated. METHODS AND RESULTS: The patients group consisted of 59 male patients and 1 female patient with BS. Supraventricular and ventricular programmed electrical stimulation (PES) was performed. Ventricular fibrillation (VF) or sustained polymorphic ventricular tachycardia was induced by ventricular PES in 26 patients with BS (VF group), but was not induced in the other 34 patients (non-VF group). Sinus node function and conduction of the atrioventricular (AV) node in the control group, non-VF group and VF group were evaluated. Sinus node function was attenuated and the His - ventricle interval was prolonged in the VF group (corrected sinus node recovery time: 452+/-126 ms (VF group), 324+/-146 ms (non-VF group), Sino-atrial conduction time: 179+/-60 ms (VF group), 127+/-60 ms (non-VF group), His-ventricle interval: 41+/-9 ms (VF group), 35+/-8 ms (non-VF group)). CONCLUSION: The function of both the sinus node and AV node are attenuated in patients with PES-induced VF.

Adult↗
PubMed2006

Laboratory evaluation of the toxicity of systemic insecticides for Control of Anoplophora glabripennis and Plectrodera scalator (Coleoptera: Cerambycidae).

Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae) is one of the most serious nonnative invasive forest insects discovered in North America in recent years. A. glabripennis is regulated by federal quarantines in the United States and Canada and is the subject of eradication programs that involve locating, cutting, and chipping all infested trees. Other control methods are needed to aid in eradication and to form an integrated management program in the event eradication fails. We conducted laboratory bioassays to determine the toxicity of two systemic insecticides, azadirachtin and imidacloprid, for potential control of A. glabripennis and the cottonwood borer, Plectrodera scalator (F.) (Coleoptera: Cerambycidae), a closely related native cerambycid. Larvae of both cerambycid species were fed artificial diet with dilutions of azadirachtin or imidacloprid for 14 wk. Both insecticides exhibited strong antifeedant effects and some toxicity against A. glabripennis and P. scalator larvae. For A. glabripennis, the highest larval mortality at the end of the bioassay was 60% for larvae fed artificial diet treated with azadirachtin (50 ppm) or imidacloprid (1.6 ppm). For P. scalator, the highest larval mortality at the end of the bioassay was 100% for larvae fed artificial diet treated with azadirachtin (50 ppm) or imidacloprid (160 ppm). At 14 wk, the LC50 values for P. scalator were 1.58 and 1.78 ppm for azadirachtin and imidacloprid, respectively. Larvae of both species gained weight when fed diet treated with formulation blanks (inert ingredients) or the water control but lost weight when fed diet treated with increasing concentrations of either azadirachtin or imidacloprid. In a separate experiment, A. glabripennis adults were fed maple twigs treated with high and low concentrations of imidacloprid. A. glabripennis adult mortality reached 100% after 13 d on twigs treated with 150 ppm imidacloprid and after 20 d on twigs treated with 15 ppm imidacloprid. There was no visible feeding by A. glabripennis adults on twigs treated at the higher imidacloprid rate, and feeding was significantly reduced for adults placed on twigs treated at the low imidacloprid rate compared with adults on untreated twigs. In summary, imidacloprid and azadirachtin had both antifeedant and toxic effects against A. glabripennis and P. scalator and have potential for use in management programs. Based on our results, the delivery of high and sustained insecticide concentrations will be needed to overcome the antifeedant effects and lengthy lethal time for both larvae and adults exposed to these insecticides.

Acer↗
PubMed1994

Relapse prevention: an emerging technology for promoting long-term drug abstinence.

This article reviews relapse prevention strategies that can be applied after primary drug treatment. To sustain their own recovery, ex-addicts must learn a program of self-management to cope with drug cravings and social pressures to use drugs, become integrated into a new social network, learn to find pleasure in drug-free activities, and find new ways of responding to emotional stress and physical pain. While additional research is needed to identify the very best methods, there is now sufficient evaluation data to argue that practitioners should incorporate this approach as an integral part of their treatment services.

Adaptation, Psychological↗
PubMed1995

Vestibular rehabilitation with graded occupations.

These three case reports are examples of the use of graded, purposeful activities in remediating the symptoms of vestibular disorders. Therapists can design individualized treatment plans for each patient by incorporating activities of interest to the patient. The treatment activities must include the particular head movements and positions that elicit vertigo during assessment. Additionally, activities must be interesting to the individual patient. Use of interesting activities may sustain the patient's interest and motivation for the treatment program and enable the patient to relate the learning process to real life experience. The principle that graded, repetitive head movement exercise is efficacious in reducing vertigo and disequilibrium in patients with vestibular disorders is now well accepted among physicians and therapists who treat these patients. The principle of adding meaning or purpose to otherwise rote exercise is well accepted among occupational therapists and is supported by evidence from the empirical literature (Heck, 1988; Kircher, 1984; Yoder, Nelson, & Smith, 1989). This concept of adding purpose to repetitive exercise may now be extended to the treatment of patients with peripheral vestibular disorders.

Activities of Daily Living↗
PubMed1999

Recurrent aneurysms: late complication for patients previously submitted to graft replacement for abdominal aortic aneurysm.

BACKGROUND: The possibility to perform easy and cheap ultrasonographic examinations of the abdomen allows us to face the problem of possible development of new paraanastomotic aneurysms or aneurysms on native arteries in subjects already submitted to endoaneurysmectomy of the abdominal aorta. The idea of planning accurate programs of ultrasonographic follow-up of operated patients is sustained by the hypothesis that the aortic aneurysm is an expression of a systemic disease due to a connectival defect of genetic nature. METHODS: Two different follow-up experiences are described: the first was a simple follow-up based only on clinical evaluation of patients previously submitted to aortic surgery in the last ten years at the Department of General and Cardiovascular Surgery of the University of Milan, and the second experience a planned follow-up programme based on instrumental evaluation of the patients. RESULTS: Thirty-one cases of recurrent aneurysms of native arteries in 13 subjects already operated for AAA from 3 to 13 years before are described. Despite the patients were evenly inserted in a clinical follow-up, as a matter of fact, 25 of these lesions were detected during occasional investigations performed for other reasons or for rupture, while during the last two years, the planned ultrasonographic follow-up of 95 patients detected 6 new aneurysms. CONCLUSIONS: Incidental detections of new paraanastomotic true aneurysms or ectasia of native arteries far from the graft are more and more frequent in patients already submitted to aortic replacement for abdominal aneurysm. In the international literature only few papers have been published about perspective studies based on instrumental follow-up of operated patients. The planning of such controls is mandatory, at present, also in order to evaluate the clinical development of aneurysmatic disease.

Aged↗
PubMed2001

[A study of the risk of melanoma in 3,695 primary school students in Liege].

An epidemiological survey was performed in pupils from primary schools of Liège in order to better identify risk factors for photobiological alterations prone to induce cutaneous melanoma in adult life. Phenotypic and behavioral factors facing up to sun exposure were considered. In a 4-level risk scale, about half of the Liège children showed a high to severe risk at photobiological alterations. Thus melanoma prevention requires a sustained effort in the Mosan region, particularly by health education programs at school.

Belgium↗
PubMed2002

[Cancer genetics. A review of oncological molecular biology seen in relation to the human genome].

Genetic changes are associated with the neoplastic process, when a normal cell is transformed into a cancer cell. Cell growth and differentiation are regulated by complicated interactions between growth promoting and inhibiting signals. Oncogenes are examples of growth promoting genes and tumour suppressor genes (gatekeepers and caretakers) are examples of growth inhibiting genes. Binding of a growth factor to its membrane receptor induces a cascade of intracellular signals resulting in proliferation. Regulation of proliferation is tightly correlated to the regulation of cell cycle, and many of the growth regulating genes also regulate cell cycle, and vice versa. The malignant transformation also includes evasion of programmed cell death (apoptosis), limitless replicative potential (evasion of senescence), sustained angiogenesis, and tissue invasion and metastasis. A rough sketch of the human genome has recently been published, and it brings hope of new potentials in cancer diagnostics, treatment, and choice of treatment, but also in revealing the molecular mechanisms behind cancer predisposition and environmental interactions. It is to be hoped that this will result in possibilities of cancer prophylaxis.

Apoptosis↗