1
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Chastant AJ, Long W, Carlson J. FD&C Yellow #6 hypersensitivity unveiled in a patient treated with ChloraPrep™ Hi-Lite Orange. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00538-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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2
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Penna GD, Carlson J. PEANUT COMPONENT TESTING: NOT THE ONLY COMPONENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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3
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Chastant A, Carlson J. FD&C YELLOW #6 HYPERSENSITIVITY UNVEILED IN A PATIENT TREATED WITH CHLORAPREP™ HI-LITE ORANGE. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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4
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Hein N, Carlson J. VENOM IMMUNOTHERAPY: SELECTIVE DESENSITIZATION. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Svensson A, Carlson J, Jensen HK, Dahlberg P, Bundgaard H, Christensen AH, Boonstra MJ, Svendsen JH, Cadrin Tourigny J, Te Riele ASJ, Platonov PG. Arrhythmogenic right ventricular cardiomyopathy – evolution of electrocardiographic markers during long-term follow-up prior to ascertainment of diagnosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are part of the diagnostic Task Force Criteria of 2010 (TFC2010) for arrhythmogenic right ventricular cardiomyopathy (ARVC). These abnormalities are thought to be progressive but have also been described as dynamic and sometimes reversible. Evolution of ECG abnormalities prior to clinical ARVC diagnosis is poorly studied.
Objective
To assess the evolution of ECG depolarization and repolarization characteristics in patients with ARVC prior to diagnosis and to identify markers of disease progression at a preclinical stage.
Methods
353 patients with definite ARVC from Sweden, Denmark, the Netherlands and Canada with at least one 12-lead digital ECG (65% males, 67% probands, 56% mutation carriers, median age at diagnosis 42 [IQR 29–53] years and median age at first ECG 44 [30–55] years) were included. Digital ECGs were extracted from regional ECG archives. ECGs with left bundle branch block, ventricular pacing or recorded either prior to 15 years of age or after heart transplantation were excluded. Remaining 6,871 ECGs were digitally processed and automatically analysed using the Glasgow algorithm. Median values for overall QRS duration, terminal activation delay (TAD) in lead V1 as well as amplitudes of QRS-T-components in precordial leads per patient per year were used for analyses and graphically represented using Lowess smoothing with cubic splines (Figure 1). Blue lines indicate smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 were fulfilled for definite diagnosis.
A database of 18,564 anonymized digital ECGs (58% males, median age at latest ECG 41 years [IQR 32–52]) who were in contact with health care during 2020–2021 was processed using the same exclusion criteria and signal-processing methodology as in the ARVC group and used as a reference (black line).
Results
TAD in lead V1 and overall QRS duration demonstrated a significant increase years before ARVC diagnosis, and significant reductions were seen in QRS-T voltages measured as R wave amplitude, QRS amplitude (the absolute sum of R wave and S wave), and T wave amplitude (Table 1 and Figure 1). The changes were seen in all precordial leads, not only the right-sided, and visually diverging from the controls.
Conclusion
Development of the ARVC ECG phenotype started several years before diagnosis and continued afterwards. QRS duration and TAD increased, QRS voltages decrease, and T wave amplitude decreased eventually leading to T wave inversion. These changes might be visually assessed but also measured with available ECG software. These findings may be clinically useful in the screening and follow-up of ARVC relatives.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Governmental funding of clinical research (ALF), Region Ostergotland, Sweden.The Swedish Heart-Lung Foundation.
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Affiliation(s)
- A Svensson
- Department of Cardiology, Department of Medical, Health and Caring Sciences, Linkoping University , Linkoping , Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
| | - H K Jensen
- Aarhus University Hospital, Department of Clinical Medicine, Aarhus University Hospital , Aarhus , Denmark
| | - P Dahlberg
- Institute of Medicine - Sahlgrenska Academy - University of Gothenburg , Gothenburg , Sweden
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - A H Christensen
- Gentofte University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - M J Boonstra
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Clinical Medicine University of Copenhagen , Copenhagen , Denmark
| | - J Cadrin Tourigny
- Cardiovascular Genetics Center, Montreal Heart Center, Montreal, Quebec, Canada , Montreal , Canada
| | - A S J Te Riele
- Division Heart & Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University , Utrecht , The Netherlands
| | - P G Platonov
- Arrhythmia Clinic, Skane University Hospital Lund and, Department of Cardiology, Clinical Sciences, Lund University , Lund , Sweden
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6
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Bolton E, Bezecny J, Han D, Carlson J, Mengden Koon S, Berry EG. Localized myxedema histologically mimicking spindle cell lipoma. Dermatol Online J 2022; 28. [DOI: 10.5070/d328357787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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Marinko S, Platonov PG, Carlson J, Borgquist R. Longer left ventricular activation time is associated with lower mortality and risk of heart failure hospitalization in CRT recipients. Europace 2022. [DOI: 10.1093/europace/euac053.497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): ALF Governmental Funding within the Swedish health care system
Introduction
Cardiac resynchronization therapy (CRT) is an established treatment for heart failure in selected patients. Longer QRS duration has been showed to correlate to clinical outcome, but measures global activation time, rather than the left ventricular dyssynchrony that CRT aims to correct. This study therefore evaluated the incremental value of using Left Ventricular Activation Time (LVAT) for prediction of outcome after CRT.
Methods
Medical records of 445 patients receiving CRT implants at a large-volume tertiary care center were retrospectively evaluated. Digital electrocardiograms (ECG) before and after CRT implantation were collected and ECG parameters were analysed in relation to a primary composite endpoint of time to heart failure hospitalisation or death from any cause. LVAT was defined as time from QRS onset to maximum positive deflection in lead V6 (Figure 1).
Results
Patients were followed for up to 6 years (median 2.7), during which 147 patients (33%) reached the primary endpoint (93 deaths and 103 heart failure hospitalisations). LVAT was measured pre-implant (median 71ms [58-88]) and post-implant (median 74ms [57-96]). There was no CRT-mediated reduction in LVAT (delta -2.3ms +/-31ms, p=0.27). When divided into quartiles, preoperative LVAT had a significant association with clinical outcome (HR 0.76 [0.64-0.90] per increasing quartile, p=0.001), also shown in a median-split Kaplan Meier curve (Figure 2, log rank p=0.001). Multivariate hazard ratio (adjusted for relevant clinical variables) was 0.83; [0.69-0.99]; p=0.047). There was an interaction between LVAT and ECG morphology (p=0.033), and when ECG groups were analysed separately, there was only a significant result for those with native left bundle branch block morphology. Post-implant LVAT, or change in LVAT, did not correlate with the primary endpoint (p=0.25 and p=0.38 respectively.
Conclusion
In CRT recipients, longer pre-implant LVAT was associated with lower risk of heart failure hospitalisation and death during a follow-up of up to 6 years. This association was mainly seen in patients with native LBBB prior to implant. No association was seen with post-CRT LVAT and clinical outcome. If confirmed in prospective trials, evaluation of preoperative LVAT may help optimise patient selection for CRT.
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Affiliation(s)
- S Marinko
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
| | - PG Platonov
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
| | - J Carlson
- Lund University, Cardiology, Lund, Sweden
| | - R Borgquist
- Lund University, Skane University Hospital, Department of Arrhythmias, Lund, Sweden
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8
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Le T, Hajirawala M, Carlson J. M018 A CASE OF RECURRENT ANAPHYLAXIS DURING METRONIDAZOLE DESENSITIZATION. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Hein N, Grieb H, Roddy T, Carlson J. M239 CHALLENGE CONFIRMED ATYPICAL FOOD PROTEIN-INDUCED ENTEROCOLITIS SYNDROME (FPIES) TO AVOCADO IN AN INFANT. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Baturova M, Demidova M, Carlson J, Erlinge D, Platonov P. Clinical risk factors and P wave indices in prediction of atrial fibrillation development during long-term follow-up after acute ST-segment elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
In patients with high thromboembolic risk detection of atrial fibrillation (AF) is crucial for implementation of proper anticoagulation therapy, which highlights the need for identification of patients at risk for AF. P wave indices reflect atrial structural abnormalities linked to AF development.
Purpose
We aimed to assess the value of clinical risk factors and P wave indices in prediction of incident AF after acute ST-segment elevation myocardial infarction (STEMI) in patients undergoing primary percutaneous intervention (PCI).
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission. Patients without known AF at discharge were included in the current study (n=1837, mean age 65±12 years, 30% females). AF in follow-up (median 9, interquartile range 25–75% (IQR) 7–10 years) was documented by linkage with the Swedish National Patient Register and Swedish Cause-of-Death Register. The closest available ECGs prior to STEMI (median 448, interquartile rate 25–75% 112–1390 days before STEMI) were extracted from the regional electronic ECG databases and automatically processed using Glasgow algorithm. P-wave duration, PR interval, P-wave frontal axis and P terminal force in lead V1 (PTF-V1) were assessed. PTF-V1 >40 mm*ms was considered abnormal.
Results
In follow-up incident AF was documented in 285 patients (15.4%). In univariate Cox regression analysis age, hypertension, history of myocardial infarction, heart failure, history of stroke, smoking status, P wave duration >120 ms, PR interval and abnormal PTF-V1 predicted the AF development during follow-up (Table). In multivariate Cox regression analysis in which significantly associated variables were included only age (hazard ratio (HR) 1.07, 95% CI 1.05–1.08, p<0.001) and abnormal PTF-V1 (HR 1.49, 95% CI 1.08–2.05, p=0.015, Figure) remained independent predictors of incident AF.
Conclusion
In patients with acute STEMI incident AF developed during long-term follow-up after discharge from hospital was strongly associated with age and atrial structural abnormalities reflected as abnormal PTF-V1 on pre-STEMI ECG which might serve as a tool in risk stratification of STEMI patients in regard to AF development.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Scholarship grant from Swedish Institute. Table 1Figure 1
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Affiliation(s)
- M Baturova
- St Petersburg state university, St Petersburg, Russia and Lund University, Lund, Sweden
| | - M.M Demidova
- National Medical and Research Almazov Center, St Petersburg, Russia and Lund University, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Baturova M, Demidova MM, Carlson J, Erlinge D, Platonov PG. ECG markers of atrial abnormalities are not associated with new onset atrial fibrillation in patients with acute ST-segment elevation myocardial infarction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF is linked to atrial structural abnormalities or has different underlying mechanisms is not fully clarified.
Purpose
We aimed to assess the association of P wave indices as ECG markers of atrial structural abnormalities with new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI).
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF. The closest available ECGs prior to STEMI (median 448, interquartile rate 25–75% 112–1390 days before STEMI) were extracted from the regional electronic ECG databases and automatically processed using Glasgow algorithm. Patients with sinus rhythm ECGs were included in the current analysis (n=1481, mean age 68±12 years, 33% females). P-wave duration, PR interval, P-wave frontal axis and P terminal force in lead V1 (PTF-V1) were assessed. PTF-V1 >40 mm*ms was considered abnormal.
Results
Paroxysmal AF prior to STEMI was known in 77 patients (5.2%). Among patients without pre-existing AF (n=1404), new-onset AF during hospital admission was identified in 102 patients (6.9%). Patients with new-onset AF were older than those without AF history (74±9 vs 67±12 years, p<0.001), but did not differ in regard to other clinical characteristics. In univariate logistic regression analysis P wave duration as continuous variable, P wave duration >120 ms and PR interval were significantly associated with new onset AF (Table 1). However, after adjustment for age both, P wave duration >120 ms (odds ratio (OR) 1.20, 95% CI 0.77–1.89, p=0.418) and PR interval (OR 1.01, 95% CI 1.00–1.01, p=0.068), failed to demonstrate the significant association with new onset AF while age (OR 1.06, 95% CI 1.04–1.08, p<0.001) remained an independent risk factor for AF development.
Conclusion
In patients with acute STEMI new onset AF developed during hospital admission is common and strongly associated with age. P wave indices failed to demonstrate the significant association with new onset AF thus indicating that atrial structural abnormalities are unlikely the underlying cause of AF development in acute STEMI.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Scholarship grant from Swedish Institute. Table 1
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Affiliation(s)
- M Baturova
- St Petersburg state university, St Petersburg, Russia and Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - M M Demidova
- National Medical and Research Almazov Center, St Petersburg, Russia and Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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12
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13
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Van Steenkiste G, Carlson J, Decloedt A, Vera L, Buhl R, Platonov PG, van Loon G. Relationship between atrial fibrillatory rate based on analysis of a modified base-apex surface electrocardiogram analysis and the results of transvenous electrical cardioversion in horses with spontaneous atrial fibrillation. J Vet Cardiol 2021; 34:73-79. [PMID: 33611234 DOI: 10.1016/j.jvc.2021.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To compare the atrial fibrillatory rate (AFR) derived from a local right atrial intracardiac recording (RA-FR) and from a single-lead surface electrocardiogram (ECG) during atrial fibrillation (AF) and to evaluate the correlation with transvenous electrical cardioversion (TVEC) threshold (in Joules), number of shocks and cardioversion success rate in horses. ANIMALS ECGs and clinical records of horses with AF treated by TVEC. Horses were included if a simultaneous recording of the right atrial intracardiac electrogram and a modified base-apex ECG were available. MATERIALS AND METHODS Clinical records of horses with AF treated by TVEC were reviewed. Three-minute long episodes of simultaneous electrograms and surface ECG during AF were selected for analysis and compared using Bland-Altman analysis. The mean RA-FR was measured from the deflections on the intracardiac electrogram, while the AFR was extracted from the surface ECG using spatiotemporal QRS and T-wave cancellation. RESULTS Seventy-three horses satisfied the inclusion criteria. The mean difference between RA-FR and AFR was -13 fibrillations per minute (fpm), the 95% limits of agreement were between -66 and 40 fpm, and there was a moderate (ρ = 0.65) correlation between RA-FR and AFR (p < 0.001). Neither RA-FR nor AFR appeared to influence the TVEC cardioversion threshold or the number of TVEC shocks applied. CONCLUSIONS The AFR may allow non-invasive long-term monitoring of AF dynamics. Neither RA-FR nor AFR could be used to predict the minimal defibrillation threshold for TVEC.
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Affiliation(s)
- G Van Steenkiste
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - J Carlson
- Department of Cardiology, Lund University, 21185 Lund, Sweden
| | - A Decloedt
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L Vera
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - R Buhl
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Højbakkegaard Allé 5, 2630 Taastrup, Denmark
| | - P G Platonov
- Arrhythmia Clinic, Skåne University Hospital and Department of Cardiology, Clinical Sciences, Lund University, 21185 Lund, Sweden
| | - G van Loon
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Svensson A, Carlson J, Sherina V, Bundgaard H, Svendsen J, Platonov P. Progressive ECG changes over time in arrhythmogenic right ventricular cardiomyopathy precede diagnosis and continue – indices of disease substrate development? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Depolarization and repolarization abnormalities are common in arrhythmogenic right ventricular cardiomyopathy (ARVC), and are included in the diagnostic 2010 Task Force criteria (TFC2010). However, first ARVC symptoms commonly occur before ECG abnormalities reach the diagnostic thresholds and the time course of ECG abnormalities during initial phase of the disease remains obscure. Regional digital ECG archives allow computerized signal-processing and assessment of ECG phenotype during different disease phases, including the time prior to ascertainment of ARVC diagnosis.
Purpose
We aimed to assess the natural course of ECG characteristics associated with ARVC, hypothesizing that ARVC is a progressive disease and that ECG parameters progress over time due to disease substrate development.
Methods
Definite ARVC patients with at least one digital ECG recruited in three tertiary care hospitals in Sweden and Denmark were included (n=102, 66% males, 68% probands, 52% carrying a pathogenic genetic variant, 74% ICD carriers and 25% physically active >4 hours/week). Median age at diagnosis was 41 years (IQR 30–55). 12-lead digital ECGs were extracted from the regional ECG archives, containing all recordings in the hospital catchment areas since 1988. After excluding ECGs with heart rate <40 or >100/min, left bundle branch block or ventricular pacing, and those recorded prior to 14 years of age, the remaining 2067 ECGs were digitally processed and automatically analyzed using the Glasgow algorithm (median 3 [IQR 0–9] ECGs prior to diagnosis and 6 [IQR 2–14] ECGs during follow-up). Overall QRS duration as well as the right precordial lead indices exemplified by the lead V2 (terminal activation delay [TAD], area under the T-wave [T-wave area] and R-prime amplitude) were calculated and graphically represented using generalized additive model (GAM) with cubic splines (Figure 1). A median value for each measurement per patient per year was used for analysis. Blue line indicates smoothed conditional mean with 95% confidence interval (shadow). Time “0” (red line) indicates the time when TFC2010 criteria were fulfilled.
Results
Marked and consistent changes are seen in all studied depolarization and repolarization parameters over 10 years preceding ARVC diagnosis and continue afterwards. TAD demonstrates gradual increase, while T-wave area demonstrates consistent decrease over time before and after diagnosis indicating amplitude reduction and transition to T-wave inversion. The R-prime curve indicates that the terminal part of QRS complex demonstrate abnormalities first late in the course of the disease (Figure 1).
Conclusion
Electrocardiographic ARVC phenotype appears to become detectable long before the time of ARVC diagnosis indicating the progressive nature of ARVC and may explain arrhythmic events that may occur during the subclinical phase before ECG criteria are fulfilled.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Svensson
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
| | - V Sherina
- Research Statistics, Biostatistics, GSK, Upper Providence, PA, United States of America
| | - H Bundgaard
- Unit for Inherited Cardiac Diseases, the Heart Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J.H Svendsen
- Department of Cardiology, Rigshospitalet, University of Copenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P.G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Arrhythmia Clinic, Skane University Hospital, Lund, Sweden
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Baturova M, Demidova M, Carlson J, Erlinge D, Platonov P. Impact of new onset atrial fibrillation on long-term prognosis in patients with acute ST-segment elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF affects the long-term prognosis to the same extent as pre-existing AF is not fully clarified and prescription of oral anticoagulants (OAC) in patients with new-onset AF remains a matter of debates.
Purpose
We aimed to assess the impact of new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI) on outcome during long-term follow-up in comparison with pre-existing AF and to evaluate effect of OAC therapy in patients with new-onset AF on survival.
Methods
Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010 (age 66±12 years, 70% male). AF prior to STEMI was documented by record linkage with the Swedish National Patient Register and review of ECGs obtained from the digital archive containing ECGs recorded in the hospital catchment area since 1988. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF and OAC at discharge. All-cause mortality was assessed using the Swedish Cause-of-Death Register 8 years after discharge.
Results
AF prior to STEMI was documented in 177 patients (8%). Among patients without pre-existing AF (n=2100), new-onset AF was identified in 151 patients (7%). Patients with new-onset AF were older than those without AF history (74±9 vs 65±12 years, p<0.001), but did not differ in regard to other clinical characteristics. Among 2149 STEMI survivors discharged alive, 523 (24%) died during 8 years of follow-up. OAC was prescribed at discharge in 45 (32%) patients with new onset AF and in 49 (31%) patients with pre-existing AF, p=0.901. In a univariate analysis, both new-onset AF (HR 2.18, 95% CI 1.70–2.81, p<0.001) and pre-existing AF (HR 2.80, 95% CI 2.25–3.48, p<0.001) were associated with all-cause mortality, Figure 1. After adjustment for age, gender, cardiac failure, diabetes, BMI and smoking history, new-onset AF remained an independent predictor of all-cause mortality (HR 1.40, 95% CI 1.02–1.92, p=0.037). OAC prescribed at discharge in patients with new-onset AF was not significantly associated with survival (univariate HR 0.86, 95% CI 0.50–1.50, p=0.599).
Conclusion
New-onset AF developed during hospital admission with STEMI is common and independently predicts all-cause mortality during long-term follow-up after STEMI with risk estimates similar to pre-existing AF. The effect of OAC on survival in patients with new-onset AF is inconclusive as only one third of them received OAC therapy at discharge.
Kaplan-Meier survival curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M.A Baturova
- Saint-Petersburg state university, Saint Petersburg, Russian Federation
| | - M.M Demidova
- National Medical and Research Almazov Centre, Saint Petersburg, Russian Federation
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - D Erlinge
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Jacobsson J, Carlson J, Reitan C, Borgquist R, Platonov P. Interatrial Block Predicts Atrial Fibrillation and Total Mortality in Patients with Cardiac Resynchronization Therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Interatrial block (IAB) and abnormal P-wave terminal force in lead V1 (PTFV1) are electrocardiographic (ECG) abnormalities associated with new-onset atrial fibrillation (AF) and death. However, their prognostic importance has not been proven in CRT recipients with advanced heart failure (HF).
Purpose
To assess if IAB and abnormal PTFV1 are associated with new-onset AF or death in CRT recipients.
Methods
CRT recipients without AF history before CRT implantation were included (n=210, median age 67 years, 80% male, 55% ischemic heart disease, 70% NYHA Class III/IV, median LVEF 25%, 51% CRT-P). Automated analysis of P-wave duration (PWD) and morphology classified patients as having either No IAB (PWD <120ms), Partial IAB (pIAB: PWD ≥120 ms, positive P waves in leads II and aVF) or Advanced IAB (aIAB: PWD ≥120 ms and biphasic or negative P wave in leads II or aVF). PTFV1 >0.04 mm·s was considered abnormal. Cox regression analyses adjusted for age, NYHA Class, ischemic etiology of HF, LBBB, LVEF and CRT-P vs. CRT-D were performed to assess the impact of IAB and abnormal PTFV1 on the primary endpoint new-onset AF, death or heart transplant (HTx) and the secondary endpoint death or HTx at 5 years of follow up.
Results
IAB was found in 45% (34% pIAB and 11% aIAB) and was associated with both the primary (HR 1.9, 95% CI 1.2–2.9, p=0.004) and the secondary (HR 2.1, 95% CI 1.2–3.4, p=0.006) endpoints. Abnormal PTFV1 was not associated with outcome. See Forest plot for adjusted HRs for individual P-wave indices.
Conclusions
IAB is associated with new-onset AF and death in CRT recipients and may be helpful in risk stratification in the context of HF management. Abnormal PTFV1 did not demonstrate any prognostic value in the setting of CRT-treated patients with advanced HF.
Forest plot
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swedish Heart and Lung Foundation
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Affiliation(s)
- J Jacobsson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Reitan
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - R Borgquist
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P.G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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Demidova M, Ulfarsson A, Carlson J, Erlinge D, Platonov P. Early monomorphic ventricular tachycardia is associated with increased long-term mortality in STEMI. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Malignant ventricular arrhythmias occurring early during ST-elevation myocardial infarction (STEMI) are known to markedly contribute to increased in-hospital mortality, but not to influence the long-term prognosis. However recent data advocate differential approach to the type of arrhythmia and indicate long-term hazard of monomorphic ventricular tachycardia (VT).
Purpose
We aimed to evaluate the prognostic value of monomorphic VT compared to non-monomorphic VT or ventricular fibrillation (VF) during the first 48 hours of STEMI in non-selected cohort of STEMI patients admitted for primary PCI.
Methods
Consecutive STEMI patients admitted to a tertiary care hospital for primary PCI during 2007–2010 were included. The Swedish national SWEDEHEART registry was used for assessment of clinical characteristics and the presence of VT/VF during index admission. The occurrence and type of VT/VF during the first 48 hours from symptom onset were verified in medical records. Information on all-cause mortality endpoint 8 years after STEMI was obtained from the Swedish Cause of Death Register.
Results
In total, 2277 patients were included (age 66±12 years, 70% male). Early monomorphic VT during index STEMI was documented in 35 (1.5%) and non-monomorphic VT or VF – in 115 (5.1%) patients. Patients with monomorphic VT had similar clinical characteristics compared to those with non-monomorphic VT/VF with a trend of higher prevalence of history of myocardial infarction by index admission among those with monomorphic VT (31% vs 21%, p=0.256). In total, 22 (63%) patients with monomorphic VT and 43 (37%) with non-monomorphic VT/VF died by 8 years of follow up (p=0.011). Monomorphic VT was associated with a higher risk of all-cause mortality compared to non-monomorphic VT/VF in a univariate analysis (HR 2.03, 95% CI 1.21–3.39, p=0.007) and after adjustment for age and history of myocardial infarction (HR 1.74, 95% CI 1.02–2.97, p=0.041) (Figure).
Conclusion
Monomorphic VT during the first 48 hours of STEMI is associated with a higher risk of all-cause mortality compared to non-monomorphic VT/VF and deserves further studies in order to refine risk stratification strategies.
Survival after STEMI by VT/VF <48 hours
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Swedish Heart-Lung Foundation
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Affiliation(s)
- M Demidova
- Lund University, Lund, Sweden and National Medical Research Centre, Saint Petersburg, Russian Federation
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18
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Grieb A, Carlson J. M170 A POSTPARTUM PUZZLE OF RECURRENT URTICARIA. Ann Allergy Asthma Immunol 2020. [DOI: 10.1016/j.anai.2020.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Brown C, Kaji A, Fantegrossi A, Carlson J, April M, Kilgo R, Walls R. Video versus augmented direct laryngoscopy in adult emergency department intubations. Br J Anaesth 2020. [DOI: 10.1016/j.bja.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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20
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Dawkins WG, Carlson J, van Kolck U, Gezerlis A. Clustering of Four-Component Unitary Fermions. Phys Rev Lett 2020; 124:143402. [PMID: 32338952 DOI: 10.1103/physrevlett.124.143402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/13/2020] [Indexed: 06/11/2023]
Abstract
Ab initio nuclear physics tackles the problem of strongly interacting four-component fermions. The same setting could foreseeably be probed experimentally in ultracold atomic systems, where two- and three-component experiments have led to major breakthroughs in recent years. Both due to the problem's inherent interest and as a pathway to nuclear physics, in this Letter we study four-component fermions at unitarity via the use of quantum Monte Carlo methods. We explore novel forms of the trial wave function and find one which leads to a ground state of the eight-particle system whose energy is almost equal to that of two four-particle systems. We investigate the clustering properties involved and also extrapolate to the zero-range limit. In addition to being experimentally testable, our results impact the prospects of developing nuclear physics as a perturbation around the unitary limit.
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Affiliation(s)
- William G Dawkins
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
| | - J Carlson
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - U van Kolck
- Institut de Physique Nucléaire, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay, France
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
| | - Alexandros Gezerlis
- Department of Physics, University of Guelph, Guelph, Ontario N1G 2W1, Canada
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21
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Cruz A, Carlson J. M358 SUCCESSFUL OFF-LABEL USE OF OMALIZUMAB IN THE TREATMENT OF A PATIENT WITH SYSTEMIC MASTOCYTOSIS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Jacobsson JKD, Reitan C, Borgquist R, Carlson J, Platonov PP. P5683Incremental hazard associated with the degree of advanced intaratrial block in cardiac resynchronization therapy treated heart failure patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Advanced Inter Atrial Block (aIAB) reflects a disruption of the electrical signal between the atria and develops gradually. It has been predictive of atrial fibrillation and death in patients with Cardiac Resynchronization Therapy (CRT). A higher number of inferior ECG leads demonstrating biphasic P waves was proposed as a measure of aIAB severity, however its prognostic importance has not been proven.
Purpose
To assess if aIAB is associated with poor prognosis in CRT recipients and to see if there is a dose-response relationship between the aIAB severity and the outcome.
Methods
CRT recipients with sinus rhythm on digitally stored preoperative ECG were included (n=565, median age 70 years, 82% male, 55% ischemic heart failure [HF] etiology, 54% CRT-P, 70% left bundle branch block [LBBB]). Automated analysis of P-wave duration [PWD] and morphology in leads II, aVF and III assessed as positive, negative or biphasic +/− was performed and patients classified as having either No IAB (PWD <120ms), Partial IAB (pIAB, PWD ≥120 ms, positive P-waves in inferior leads), aIAB (PWD ≥120 ms and biphasic p-waves in one of the inferior leads). aIAB patients were further stratified by the presence of biphasic P waves in only one (aIAB-1) or more (aIAB-2) inferior leads. Extreme aIAB was defined as biphasic P waves in lead II and negative in leads III and aVF. Cox regression analyses adjusted for age, gender, NYHA class, ischemic HF etiology, left ventricular ejection fraction, LBBB, CRT-P versus CRT-D and PWD were performed to assess the impact of aIAB and its types on the endpoint hospitalization for HF or death at 5 years of follow up.
Results
Advanced IAB was observed in 65 patients (10 with aIAB-1, 53 with aIAB-2 and 2 with extreme aIAB) and pIAB in 151. No clinically relevant significant differences in baseline characteristics were observed between groups. Compared to the NoIAB group, aIAB-2 and extreme aIAB independently predicted the combined endpoint with adjusted HR=1.82 (95% CI 1.14–2.90, p-value 0.012) and HR=4.70 (95% CI 1.10–20.16, p-value 0.037), respectively.
Conclusion
Advanced IAB is associated with HF admissions or death from any cause in HF patients treated with CRT. Our findings indicate dose-response relationship between the severity of aIAB and the outcome.
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Affiliation(s)
| | - C Reitan
- Lund University, Department of Cardiology, Lund, Sweden
| | - R Borgquist
- Lund University, Department of Cardiology, Lund, Sweden
| | - J Carlson
- Lund University, Department of Cardiology, Lund, Sweden
| | - P P Platonov
- Lund University, Department of Cardiology, Lund, Sweden
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23
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Demidova MM, Carlson J, Erlinge D, Platonov PG. P2661Ventricular fibrillation during acute STEMI is not associated with early repolarization pattern on ECG recorded prior to the index ischemic episode. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Generally considered as benign, ECG early repolarization (ER) pattern was recently claimed to be an indicator of increased susceptibility to fatal arrhythmias during acute ischemia. The victims of sudden cardiac death have been reported to have high prevalence of ER comparing with survivors of acute coronary event.
We aimed to test the association between the ER pattern on resting ECG recorded prior to ST-elevation myocardial infarction (STEMI) and the risk of ventricular fibrillation (VF) during acute phase of STEMI in non-selected population of STEMI patients.
Methods
For STEMI patients admitted to a tertiary care hospital for primary PCI during 2007–2010 (n=2286), all ECGs recorded prior to the date of admission with STEMI were extracted from a digital archive. The latest ECG recorded prior to the index STEMI was used for analysis.
After excluding ECGs with paced rhythm and intraventricular blocks with QRS duration ≥120ms, the remaining ECGs were processed using the Glasgow algorithm allowing automatic ER detection. The association between ER-pattern on historical ECG and VF during the first 48 hours of STEMI was tested using logistic regression.
Results
Historical ECGs were available for 1584 patients; 124 of them were excluded due to a paced rhythm or wide QRS, leaving 1460 patients available for analysis (age 68±12 years, 67% male). The time from historical ECG to STEMI was 16 (IQR 4–49) months. ER pattern was present on historical ECG in 272 of 1460 (18.6%) (ER+ group), among them in 90 (33%) – in inferior leads, in 116 (43%) – in lateral leads, in 66 (24%) – both in inferior and lateral leads.
ER+ patients were younger both at the time of historical ECG (64±13 vs 66±19; p=0.041) and at the time of STEMI (67±12 vs 68±12; p=0.033), and had lower heart rate on historical ECG (68±12 vs 73±15; p<0.001) than ER- patients. ER+ and ER- groups did not differ regarding clinical characteristics and conventional ECG measurements. The course of STEMI was complicated by VF in 106 patients (17 of them from ER+ group). The occurrence of VF during STEMI was not associated with ER-pattern on historical ECG (OR 0.875 95% CI 0.518–1.479; p=0.618). There was no association of ER pattern with VF before reperfusion (OR 0.54 95% CI 0.25–1.21; p=0.135) or reperfusion VF (OR 1.28 95% CI 0.55–3.01; p=0.569). No association was observed with regard to localization (inferior or lateral) of ER-pattern either.
Conclusion
In a non-selected population of STEMI patients the presence of ER-pattern on ECG recorded prior to the acute coronary event was not associated with VF during the first 48 hours of STEMI.
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Affiliation(s)
- M M Demidova
- Lund University, Lund, Sweden and National Medical Research Centre, Saint Petersburg, Russian Federation
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24
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Baturova MA, Svensson A, Svendsen JH, Bundgaard H, Carlson J, Meurling C, Astrom Aneq M, Platonov PG. P5653Atrial fibrillation in arrhythmogenic right ventricular cardiomyopathy and its association with left atrial volume index. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies in arrhythmogenic right ventricular cardiomyopathy (ARVC) support atrial involvement in the disease progression and consider atrial fibrillation (AF) as one of the primary manifestations of ARVC. We aimed to assess clinical factors, components of 2010 Task Force criteria (TFC2010) and echocardiographic characteristics of atria associated with AF in the Scandinavian cohort of ARVC patients.
Methods
Study sample comprised of 106 definite ARVC patients by TFC2010 from three tertiary care centers participating in the Nordic ARVC Registry (33% females, median age at ARVC diagnosis 41 years [IQR 30–54 years]). No concomitant diseases were observed in 90 patients (85%) while 16 patients had one or more comorbidities: hypertension (n=6), diabetes mellitus (n=5), coronary artery disease (n=5) or congestive heart failure (n=9). AF was included in the registry protocol as a pre-specified clinical event and verified by processing of the electronic ECG databases which contains all ECG recordings from the involved hospitals catchment areas (earliest ECG from 1988). Left (LA) and right atrial (RA) dimensions were obtained by revisiting cardiac ultrasound examinations performed at the time of ARVC diagnosis. Association between AF and clinical characteristics was assessed using multivariable logistic regression analysis adjusted for age and gender.
Results
AF was diagnosed in 29 patients (27%) at a median age of 53 (IQR 38–63) years, 7 females (24%). Median time from ARVC diagnosis to AF onset was 8 (IQR 2–12) years. AF was univariately associated with right ventricular structural abnormalities meeting the definition of major imaging criterion by 2010TFC, ventricular tachycardia (VT) with superior axis (major criterion) and LA volume index. Significantly associated variables were included in a multivariate model, in which LA volume index (OR=1.07, 95% CI 1.01–1.14, p=0.021) and superior axis VT (OR=7.45, 95% CI 1.82–30.55, p=0.005) remained independently associated with AF. In receiver operating characteristic (ROC) curve analysis, LA volume index was significantly associated with AF (AUC=0.703, p=0.005) and with superior axis VT (AUC=0.703, p=0.021). AF was not associated with either RA volume index (univariate OR=1.03, 95% CI 0.99–1.06, p=0.203) or left ventricular ejection fraction (OR=0.97, 95% CI 0.92–1.03, p=0.299).
Conclusion
In patients with ARVC,AF is primarily associated with LA structural abnormalities without indication of RA involvement and is strongly associated with ventricular arrhythmias thus indicating parallel development of atrial and ventricular arrhythmic substrate.
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Affiliation(s)
- M A Baturova
- Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden, Research Park, St.Petersburg State University, St.Petersburg, Russian Federation
| | - A Svensson
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - H Bundgaard
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, The Heart Centre, Copenhagen, Denmark
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - C Meurling
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - M Astrom Aneq
- Linkoping University, Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - P G Platonov
- Lund University, Department of cardiology, Clinical Sciences, Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden
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25
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Platonov PG, Carlson J, Castrini I, Svensson A, Christiansen MK, Gilljam T, Madsen T, Hansen J, Astrom MA, Haagua K, Jensen HK, Edvardsen T, Svendsen JH. P2247Pregnancies and childbirth in women with arrhythmogenic right ventricular cardiomyopathy are associated with low risk of ventricular arrhythmias. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with a risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD). Even though female patients with ARVC are considered to be at lower risk of VA, the impact of pregnancy and child birth on the arrhythmic risk and development of arrhythmic substrate in the context of ARVC remains insufficiently studied.
Objective
To assess the risk of VA in relation to childbirth in women with ARVC and the impact of multiple pregnancies on progression of arrhythmic manifestations of the disease.
Methods
The study included 186 females with definite ARVC (n=107, 70 probands) or unaffected mutation-carriers (n=79) with median age at the end of follow up of 48 (IQR 34–60) years. Seventeen women had 1, 59 had 2 and 29 had ≥3 child births by the age of 40 years. VA was defined as ventricular tachycardia, appropriate ICD therapy, aborted cardiac arrest or SCD. Proportions of patients who experienced VA by the age of 40 years were compared between nulliparous women (n=81) and those with reported child births (n=105). VA-free survival after accomplished pregnancies was assessed for women ≥40 years of age (n=119). Cumulative probability of VA for each pregnancy (n=230) was assessed from conception through 2 years after child birth and compared between those that occurred before ARVC diagnosis (Pre-Ds, n=164), after it (Post-Ds, n=11) and in unaffected mutation carriers (No-Ds, n=55).
Results
The nulliparous women had lower age at ARVC diagnosis (37 vs 44, p=0.023) and more often had VA before the age of 40 (31% vs 13%, p=0.003) while the number of child births was not related to the prevalence of VA (18% among women with 1 childbirth, 12% in those with 2 and 14% in those with 3 or more, ns). Three women suffered SCD before the age of 40. VA-free survival after 40 years did not differ between nulliparous and those who gave birth (Figure A). Only four pregnancy-related events were documented (Figure B): 1 in the Post-Ds group and three in the Pre-Ds group. No pregnancy-related events were reported in the unaffected mutation carriers.
Conclusion
In this Scandinavian cohort of women with ARVC we observed no indication of an increased VA risk either associated with pregnancies or during long-term follow up after the last child birth.
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Affiliation(s)
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | | | | | | | - T Gilljam
- Sahlgrenska Academy, Gothenburg, Sweden
| | - T Madsen
- Aalborg University Hospital, Aalborg, Denmark
| | - J Hansen
- Gentofte University Hospital, Gentofte, Denmark
| | | | - K Haagua
- University of Oslo, Oslo, Norway
| | - H K Jensen
- Aarhus University Hospital, Aarhus, Denmark
| | | | - J H Svendsen
- Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
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26
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Eranti A, Carlson J, Kentta TV, Holmqvist F, Holkeri A, Haukilahti MA, Kerola T, Aro AL, Rissanen H, Noponen K, Seppanen T, Knekt P, Huikuri HV, Junttila MJ, Platonov PG. 3056Orthogonal P wave morphology, traditional P wave indices, and the risk of atrial fibrillation in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A substantial portion of the risk of atrial fibrillation (AF) remains unexplained by the established risk markers. However, accurate assessment of AF risk would be beneficial, especially among stroke patients and subjects with symptoms attributable to arrhythmia.
Purpose
To study the associations of P-wave indices with AF risk in the general population.
Methods
Electrocardiograms, including orthogonal leads, of 7217 Finnish subjects aged over 30 years who took part in the baseline examinations of the Mini-Finland Health Survey in 1978–80, were digitized. P-wave duration, third-degree interatrial block (IAB), and P terminal force (PTF) were assessed manually. PTF was considered abnormal when the amplitude of the negative terminal part of the P wave in lead V1 was ≥0.1mV and duration ≥40ms. Third-degree IAB was defined as P-wave duration ≥120ms and the presence of ≥2 +/− biphasic P-waves in the inferior leads. Orthogonal P-wave morphology, which is related to left atrial breakthrough site and affected by atrial fibrosis (1 being considered benign, 2 borderline, and 3 shown to be associated with adverse events), was assessed with an automated algorithm, and ascertained manually. Subjects were followed 10 years for AF hospitalization and mortality. The risk of AF associated with P wave parameters was assessed using Cox proportional hazards models. Model discrimination improvement was quantified by the change in C index, integrated discrimination improvement (IDI), and continuous net reclassification improvement (cNRI).
Results
There were 5489 subjects (47.8% male, mean age 50.5 years) with a readable ECG, sinus rhythm, no missing data, and a predefined orthogonal P-wave morphology. Type 3 orthogonal P morphology (n=216, multivariate adjusted HR [maHR] 3.01, 95% confidence interval [CI] 1.66–5.45, p<0.001), P-wave duration ≥120ms (n=752, maHR 1.67, 95% CI 1.06–2.64, p=0.027), and third-degree IAB (n=103, maHR 3.18, 95% CI 1.66–6.13, p=0.001) were independently associated with the risk of AF in separate models. PTF did not independently predict AF. Subjects presenting with both Type 1 orthogonal P-wave morphology and P-wave duration <110ms (n=2074) were at low risk of AF (maHR 0.46, 95% CI 0.26–0.83, p=0.006) when compared to the rest of the subjects. The inclusion of variables combining orthogonal P-wave morphology and P-wave duration to a multivariate model including conventional AF risk factors improved C index from 0.815 to 0.832 (change 0.017, 95% CI 0.001–0.033), IDI was 0.012 (95% CI 0.006–0.051), and cNRI was 0.220 (95% CI 0.048–0.357).
Conclusions
P-wave indices and orthogonal P-wave morphology can be used to identify subjects at high and low risk for AF and possibly direct extensive AF screening protocols towards high-risk subjects in the general population in order to decrease the risk of cardioembolic stroke. However, more research is needed in this topic.
Acknowledgement/Funding
Finnish Medical Foundation, Onni and Hilja Tuovinen's Foundation, Orion Research Foundation, Paavo Nurmi's Foundation, Veritas Foundation
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Affiliation(s)
- A Eranti
- North Karelia Central Hospital, Heart Center, Joensuu, Finland
| | - J Carlson
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
| | - T V Kentta
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - F Holmqvist
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
| | - A Holkeri
- Helsinki University Central Hospital, Heart and Lung Center, Division of Cardiology, Helsinki, Finland
| | - M A Haukilahti
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - T Kerola
- Paijat-Hame Central Hospital, Department of Internal Medicine, Lahti, Finland
| | - A L Aro
- Helsinki University Central Hospital, Heart and Lung Center, Division of Cardiology, Helsinki, Finland
| | - H Rissanen
- National Institute for Health and Welfare (THL), Department of Public Health Solutions, Helsinki, Finland
| | - K Noponen
- University of Oulu, Center for Machine Vision and Signal Analysis, Oulu, Finland
| | - T Seppanen
- University of Oulu, Center for Machine Vision and Signal Analysis, Oulu, Finland
| | - P Knekt
- National Institute for Health and Welfare (THL), Department of Public Health Solutions, Helsinki, Finland
| | - H V Huikuri
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - M J Junttila
- Medical Research Center Oulu, Research Unit of Internal Medicine, Oulu, Finland
| | - P G Platonov
- Lund University, Clinical Sciences, Department of Cardiology, Lund, Sweden
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Verner E, Johnston A, Pati N, Hawkes E, Lee H, Cochrane T, Cheah C, Filshie R, Purtill D, Enjeti A, Brown C, Murphy N, Curnow J, Cake S, Carlson J, Butcher B, Trotman J. SAFETY ANALYSIS OF AUSTRALASIAN LEUKAEMIA & LYMPHOMA GROUP NHL29: A PHASE II STUDY OF IBRUTINIB, RITUXIMAB AND MINI-CHOP IN VERY ELDERLY PATIENTS WITH NEWLY DIAGNOSED DLBCL. Hematol Oncol 2019. [DOI: 10.1002/hon.63_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- E.K. Verner
- Haematology; Concord Repatriation General Hospital; Concord Australia
| | | | - N. Pati
- Haematology; Canberra Hospital; Canberra Australia
| | - E. Hawkes
- Medical Oncology; Eastern Health; Box Hill Australia
| | - H. Lee
- Haematology; Flinders Medical Centre; Adelaide Australia
| | - T. Cochrane
- Haematology; Gold Coast University Hospital; Southport Australia
| | - C.Y. Cheah
- Haematology; Sir Charles Gairdner Hospital; Perth Australia
| | - R. Filshie
- Haematology; St Vincent's Hospital; Fitzroy Australia
| | - D. Purtill
- Haematology; Fiona Stanley Hospital; Murdoch Australia
| | - A.K. Enjeti
- Haematology; Calvary Mater Hospital; Newcastle Australia
| | - C. Brown
- Haematology; Royal Prince Alfred Hospital; Camperdown Australia
| | - N. Murphy
- Haematology; Royal Hobart Hospital; Hobart Australia
| | - J. Curnow
- Haematology; Westmead Hospital; Westmead Australia
| | - S. Cake
- Trial Centre; Australasian Leukaemia and Lymphoma Group; Richmond Australia
| | - J. Carlson
- Trial Centre; Australasian Leukaemia and Lymphoma Group; Richmond Australia
| | - B.E. Butcher
- Biostatistics & Medical Writing; WriteSource Medical Pty Ltd; Lane Cove Australia
| | - J. Trotman
- Medicine; University of Sydney; Camperdown Australia
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Barajas A, Pelaez T, González O, Usall J, Iniesta R, Arteaga M, Jackson C, Baños I, Sánchez B, Dolz M, Obiols JE, Haro JM, Ochoa S, Arranz B, Arteaga M, Asensio R, Autonell J, Baños I, Bañuelos M, Barajas A, Barceló M, Blanc M, Borrás M, Busquets E, Carlson J, Carral V, Castro M, Corbacho C, Coromina M, Dachs I, De Miquel L, Dolz M, Domenech MD, Elias M, Espezel I, Falo E, Fargas A, Foix A, Fusté M, Godrid M, Gómez D, González O, Granell L, Gumà L, Haro JM, Herrera S, Huerta E, Lacasa F, Mas N, Martí L, Martínez R, Matalí J, Miñambres A, Muñoz D, Muñoz V, Nogueroles R, Ochoa S, Ortiz J, Pardo M, Planella M, Pelaez T, Peruzzi S, Rivero S, Rodriguez MJ, Rubio E, Sammut S, Sánchez M, Sánchez B, Serrano E, Solís C, Stephanotto C, Tabuenca P, Teba S, Torres A, Urbano D, Usall J, Vilaplana M, Villalta V. Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset. Early Interv Psychiatry 2019; 13:414-424. [PMID: 29116670 DOI: 10.1111/eip.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension. AIM To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis. METHODS Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed. RESULTS Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained. CONCLUSION In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.,Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Trinidad Pelaez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Olga González
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Raquel Iniesta
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Maria Arteaga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Chris Jackson
- Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Iris Baños
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi E Obiols
- Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep M Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Baturova MA, Lindgren A, Shubik YV, Carlson J, Platonov PG. Interatrial block in prediction of all-cause mortality after first-ever ischemic stroke. BMC Cardiovasc Disord 2019; 19:37. [PMID: 30744701 PMCID: PMC6371419 DOI: 10.1186/s12872-019-1015-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/04/2019] [Indexed: 12/25/2022] Open
Abstract
Background Interatrial block (IAB) is an ECG indicator of atrial fibrosis related to atrial remodeling and thrombus formation thus leading to embolic stroke and increasing mortality. We aimed to assess weather IAB predicted all-cause mortality during 10 years after ischemic stroke. Methods The study sample comprised 235 patients (median age 74 (interquartile range 25–75% 65–81) years, 95 female) included in the Lund Stroke Register in 2001–2002, who had sinus rhythm ECGs at stroke admission. IAB was defined as a P-wave duration ≥120 ms without = partial IAB (n = 56) or with = advanced IAB (n = 41) biphasic morphology (±) in the inferior ECG leads. All-cause mortality was assessed via linkage with the Swedish Causes of Death Register. Results During follow-up 126 patients died (54%). Advanced IAB, but not partial, was associated with all-cause mortality in univariate Cox regression analysis (hazard ratio (HR) 1.98, 95% CI 1.27–3.09, p = 0.003). After adjustment for age, gender, severity of stroke measured by NIHSS scale and smoking status in patients without additional comorbidities advanced IAB independently predicted all-cause mortality (HR 7.89, 95% CI 2.01–30.98, p = 0.003), while in patients with comorbidities it did not (HR 1.01 95% CI 0.59–1.72, p = 0.966). Conclusion Advanced IAB predicted all-cause mortality after ischemic stroke, but mostly in patients without additional cardiovascular comorbidities.
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Affiliation(s)
- M A Baturova
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden. .,Research Park, St Petersburg State University, Peterhof, Botanicheskaya, 17, St Petersburg, Russia.
| | - A Lindgren
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Y V Shubik
- Cardiology research, clinical and educational center, St. Petersburg State University, Universitetskaya Embankment, 7/9, St. Petersburg, Russia
| | - J Carlson
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden
| | - P G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, SE-221 85, Lund, Sweden.,Arrythmia Clinic, Skåne University Hospital, SE-221 85, Lund, Sweden
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30
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Cruz A, Montelibano L, Carlson J, Aung T. CHLORHEXIDINE: AN INCREASINGLY RECOGNIZED CAUSE OF PERI-OPERATIVE ANAPHYLAXIS. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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31
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Devlin V, Carlson J. HYPEREOSINOPHILIC SYNDROME: EXPLORING DIAGNOSTIC DILEMMA. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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32
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Carlson B, Jones K, Carlson J, Craft M, Benbrook D, Coleman-Jackson R, Hershey L. CEREBRAL OXYGENATION AND SLEEP DISORDERED BREATHING IN ADULTS WITH MILD COGNITIVE IMPAIRMENT. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Carlson
- Fran and Earl Ziegler College of Nursing and Donald W. Reynolds Center for Geriatric Nursing Excellence, University of Oklahoma Health Sciences Center
| | - K Jones
- Department of Pulmonary, Critical Care, and Sleep Medicine, College of Medicine, The University of Oklahoma Health Sciences Center
| | - J Carlson
- Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center
| | - M Craft
- The Fran and Earl Ziegler College of Nursing and Donald W. Reynolds Center for Geriatric Nursing Excellence, The University of Oklahoma Health Sciences Center
| | - D Benbrook
- Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, The University of Oklahoma Health Sciences Center
| | - R Coleman-Jackson
- Department of Neurology, University of Oklahoma Health Sciences Center
| | - L Hershey
- Department of Neurology, University of Oklahoma Health Sciences Center
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Demidova MM, Carlson J, Erlinge D, Azarov JE, Platonov PG. P3685Prolonged Tpeak-Tend interval is associated with ventricular fibrillation during reperfusion in ST-elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M M Demidova
- National Medical Research Center, St.Petersburg, Russia and Lund University, Lund, Sweden
| | | | | | - J E Azarov
- Institute of Physiology, Komi Science Center, Ural Branch, Russia and Lund University, Lund, Sweden
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Baturova MA, Svensson A, Svendsen JH, Bundgaard H, Sherina V, Carlson J, Platonov PG. P2506Long-term evolution of P wave indices in arrhythmogenic right ventricular cardiomyopathy indicates atrial involvement. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M A Baturova
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - A Svensson
- Linkoping University, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden
| | - J H Svendsen
- University of Copenhagen, Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark
| | - H Bundgaard
- University of Copenhagen, Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen, Denmark
| | - V Sherina
- University of Rochester, Department of Biostatistics and computational biology, Rochester, United States of America
| | - J Carlson
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
| | - P G Platonov
- Lund University, Department of Cardiology, Clinical Sciences, Lund, Sweden
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35
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Lonardoni D, Carlson J, Gandolfi S, Lynn JE, Schmidt KE, Schwenk A, Wang XB. Properties of Nuclei up to A=16 using Local Chiral Interactions. Phys Rev Lett 2018; 120:122502. [PMID: 29694099 DOI: 10.1103/physrevlett.120.122502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/29/2018] [Indexed: 06/08/2023]
Abstract
We report accurate quantum Monte Carlo calculations of nuclei up to A=16 based on local chiral two- and three-nucleon interactions up to next-to-next-to-leading order. We examine the theoretical uncertainties associated with the chiral expansion and the cutoff in the theory, as well as the associated operator choices in the three-nucleon interactions. While in light nuclei the cutoff variation and systematic uncertainties are rather small, in ^{16}O these can be significant for large coordinate-space cutoffs. Overall, we show that chiral interactions constructed to reproduce properties of very light systems and nucleon-nucleon scattering give an excellent description of binding energies, charge radii, and form factors for all these nuclei, including open-shell systems in A=6 and 12.
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Affiliation(s)
- D Lonardoni
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Carlson
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Gandolfi
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J E Lynn
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - K E Schmidt
- Department of Physics, Arizona State University, Tempe, Arizona 85287, USA
| | - A Schwenk
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
- ExtreMe Matter Institute EMMI, GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - X B Wang
- School of Science, Huzhou University, Huzhou 313000, China
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Carlson J, Gandolfi S, van Kolck U, Vitiello SA. Ground-State Properties of Unitary Bosons: From Clusters to Matter. Phys Rev Lett 2017; 119:223002. [PMID: 29286794 DOI: 10.1103/physrevlett.119.223002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Indexed: 06/07/2023]
Abstract
The properties of cold Bose gases at unitarity have been extensively investigated in the last few years both theoretically and experimentally. In this Letter we use a family of interactions tuned to two-body unitarity and very weak three-body binding to demonstrate the universal properties of both clusters and matter. We determine the universal properties of finite clusters up to 60 particles and, for the first time, explicitly demonstrate the saturation of energy and density with particle number and compare with bulk properties. At saturation in the bulk we determine the energy, density, two- and three-body contacts, and the condensate fraction. We find that uniform matter is more bound than three-body clusters by nearly 2 orders of magnitude, the two-body contact is very large in absolute terms, and yet the condensate fraction is also very large, greater than 90%. Equilibrium properties of these systems may be experimentally accessible through rapid quenching of weakly interacting boson superfluids.
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Affiliation(s)
- J Carlson
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Gandolfi
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - U van Kolck
- Institut de Physique Nucléaire, CNRS/IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay, France
- Department of Physics, University of Arizona, Tucson, Arizona 85721, USA
| | - S A Vitiello
- Instituto de Física Gleb Wataghin, Universidade Estadual de Campinas, 13083-859 Campinas SP, Brazil
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Carlson J, Zani L, Schwaiger T, Nurmoja I, Viltrop A, Vilem A, Beer M, Blome S. Simplifying sampling for African swine fever surveillance: Assessment of antibody and pathogen detection from blood swabs. Transbound Emerg Dis 2017; 65:e165-e172. [DOI: 10.1111/tbed.12706] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Indexed: 02/06/2023]
Affiliation(s)
- J. Carlson
- Institute of Diagnostic Virology; Friedrich-Loeffler-Institut; Greifswald - Insel Riems Germany
| | - L. Zani
- Institute of Diagnostic Virology; Friedrich-Loeffler-Institut; Greifswald - Insel Riems Germany
| | - T. Schwaiger
- Institute of Diagnostic Virology; Friedrich-Loeffler-Institut; Greifswald - Insel Riems Germany
| | - I. Nurmoja
- Estonian Veterinary and Food Laboratory; Tartu Estonia
- Institute of Veterinary Medicine and Animal Sciences; Estonian University of Life Sciences; Tartu Estonia
| | - A. Viltrop
- Institute of Veterinary Medicine and Animal Sciences; Estonian University of Life Sciences; Tartu Estonia
| | - A. Vilem
- Estonian Veterinary and Food Laboratory; Tartu Estonia
| | - M. Beer
- Institute of Diagnostic Virology; Friedrich-Loeffler-Institut; Greifswald - Insel Riems Germany
| | - S. Blome
- Institute of Diagnostic Virology; Friedrich-Loeffler-Institut; Greifswald - Insel Riems Germany
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Cortez D, Svensson A, Carlson J, Platonov P. P797In which non-ischemic cardiomyopathies can the VCG identify those at risk for sustained ventricular tachycardia? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Platonov P, Carlson J, Kutyifa V, McNitt S, Polonsky B, Couderc J, Zareba W. 5115Prognostic impact of electrocardiographic left atrial abnormality in patients with congestive heart failure treated with resynchronization therapy: experience from MADIT-CRT trial. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Baturova M, Lindgren A, Carlson J, Shubik Y, Olsson S, Platonov P. P1724Advanced interatrial block on electrocardiogram predicts new-onset atrial fibrillation during long term follow-up. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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41
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Svensson A, Carlson J, Fluur C, Lundin C, Platonov P. P1599Low sensitivity of conventional electrocardiographic criteria for arrhythmogenic right ventricular cardiomyopathy at symptom onset: emerging role of inferior T-wave inversion. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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42
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Bradshaw AC, Tell LA, Ernest HB, Bahan S, Carlson J, Sehgal RNM. Detection and prevalence of Haemoproteus archilochus (Haemosporida, Haemoproteidae) in two species of California hummingbirds. Parasitol Res 2017; 116:1879-1885. [PMID: 28534106 DOI: 10.1007/s00436-017-5463-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
Haemosporidian blood parasites are transmitted to a wide range of avian hosts via blood-sucking dipteran vectors. Microscopy has revealed an impressive diversity of avian haemosporidia with more than 250 species described. Moreover, PCR and subsequent sequence analyses have suggested a much greater diversity of haemosporidia than morphological analyses alone. Given the importance of these parasites, very few studies have focused on the charismatic hummingbirds. To date, three Haemoproteus species (Haemoproteus archilochus, Haemoproteus trochili, and Haemoproteus witti) and one Leucocytozoon species (Leucocytozoon quynzae) have been described in blood samples taken from hummingbirds (Trochilidae). Unconfirmed Plasmodium lineages have also been detected in hummingbirds. Here, we report the detection of H. archilochus in two hummingbird species (Calypte anna and Archilochus alexandri) sampled in Northern California and perform a phylogenetic analysis of mitochondrial cytochrome b (cyt b) gene lineages. A total of 261 hummingbirds (157 C. anna, 104 A. alexandri) were sampled and screened for blood parasites using PCR and microscopy techniques. Combining both methods, 4 (2.55%) haemosporidian infections were detected in C. anna and 18 (17.31%) haemosporidian infections were detected in A. alexandri. Molecular analyses revealed four distinct H. archilocus cyt b lineages, which clustered as a monophyletic clade. No species of Plasmodium or Leucocytozoon were detected in this study, raising the possibility of specific vector associations with hummingbirds. These results provide resources for future studies of haemosporidian prevalence, diversity, and pathogenicity in California hummingbird populations.
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Affiliation(s)
- A C Bradshaw
- Department of Biology, San Francisco State University, San Francisco, CA, USA
| | - L A Tell
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California at Davis, 1 Shields Avenue, Davis, CA, USA
| | - H B Ernest
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, 1 Shields Avenue, Davis, CA, USA.,Department of Veterinary Sciences, University of Wyoming, Laramie, WY, USA
| | - S Bahan
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, 1 Shields Avenue, Davis, CA, USA
| | - J Carlson
- Department of Entomology, University of California at Davis, 1 Shields Avenue, Davis, CA, USA
| | - R N M Sehgal
- Department of Biology, San Francisco State University, San Francisco, CA, USA.
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Perez LG, Carlson J, Slymen DJ, Patrick K, Kerr J, Godbole S, Elder JP, Ayala GX, Arredondo EM. Does the social environment moderate associations of the built environment with Latinas' objectively-measured neighborhood outdoor physical activity? Prev Med Rep 2016; 4:551-557. [PMID: 27818913 PMCID: PMC5094267 DOI: 10.1016/j.pmedr.2016.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/14/2016] [Accepted: 10/18/2016] [Indexed: 02/07/2023] Open
Abstract
Favorable perceptions of the built and social neighborhood environment may promote outdoor physical activity (PA). However, little is known about their independent and interactive effects on neighborhood-specific outdoor PA. We examined associations of perceived built and social neighborhood environment factors, and their interactions, with objectively-measured neighborhood outdoor moderate-to-vigorous physical activity (MVPA) among a sample of Latina women in San Diego, CA. Analyses included baseline data collected in 2011-2013 from 86 Latinas with ≥ 2 days of combined accelerometer and global positioning system data and complete survey measures. We examined objective neighborhood outdoor MVPA within 500-meter home buffers. Generalized linear mixed models examined associations of 3 perceived built (e.g., sidewalk maintenance) and 3 social environmental (e.g., safety from crime) factors with engaging in any daily neighborhood outdoor MVPA. Models tested interactions between the built and social environmental factors. Although the perceived neighborhood environmental factors were not significantly related to daily neighborhood outdoor MVPA, we found 2 significant interactions: perceived sidewalk maintenance x safety from crime (p = 0.05) and neighborhood aesthetics x neighborhood social cohesion (p = 0.03). Sidewalk maintenance was positively related to daily neighborhood outdoor MVPA only among Latinas that reported low levels of safety from crime. Neighborhood aesthetics was positively related to daily neighborhood outdoor MVPA only among Latinas with high neighborhood social cohesion. Findings suggest several built and social environmental factors interact to influence Latinas' neighborhood outdoor MVPA. Interventions are needed targeting both built and social neighborhood environmental factors favorable to outdoor PA in the neighborhood.
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Affiliation(s)
- L G Perez
- Joint Doctoral Program in Public Health, University of California, San Diego/San Diego State University, San Diego, CA 92182, USA; Institute for Behavioral and Community Health, San Diego, CA 92123, USA
| | - J Carlson
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
| | - D J Slymen
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182, USA
| | - K Patrick
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA; Center for Wireless and Population Health Systems, The Qualcomm Institute/Calit2, University of California, San Diego, La Jolla, CA 92093, USA
| | - J Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
| | - S Godbole
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA 92093, USA
| | - J P Elder
- Institute for Behavioral and Community Health, San Diego, CA 92123, USA; Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA 92182, USA
| | - G X Ayala
- Institute for Behavioral and Community Health, San Diego, CA 92123, USA; Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA 92182, USA; College of Health and Human Services, San Diego State University, San Diego, CA 92182, USA
| | - E M Arredondo
- Institute for Behavioral and Community Health, San Diego, CA 92123, USA; Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA 92182, USA
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Abstract
Psychosocial assessment of transplant candidates is a challenging task. Securing adequate information is made more difficult when patients present with fulminant hepatic failure. When the patient cannot be interviewed and the family is reluctant to provide vital information, a comprehensive pretransplant psychosocial evaluation is virtually impossible. However, even the most difficult cases have the potential for a positive result when a good psychosocial profile of the patient is obtained after transplantation, a team treatment plan is developed and carried out which addresses current and anticipated problems, and the patient obtains mental health treatment.
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Affiliation(s)
- J Carlson
- Nazih Zuhdi Transplantation Institute, Oklahoma City, Okla., USA
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Carlson J, Slavin J. Health benefits of fibre, prebiotics and probiotics: a review of intestinal health and related health claims. Quality Assurance and Safety of Crops & Foods 2016. [DOI: 10.3920/qas2015.0791] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- J. Carlson
- Department of Food Science and Nutrition, University of Minnesota, Twin Cities 1334 Eckles Avenue, St. Paul, MN 55108, USA
| | - J. Slavin
- Department of Food Science and Nutrition, University of Minnesota, Twin Cities 1334 Eckles Avenue, St. Paul, MN 55108, USA
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Hartvigson P, Gensheimer M, Evans K, Carlson J, Ford E. Indicators of Safety-Critical Events in Radiation Oncology Derived From the Oncology Information System. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tsai MH, Muenchhoff M, Adland E, Carlqvist A, Roider J, Cole DK, Sewell AK, Carlson J, Ndung'u T, Goulder PJR. Paediatric non-progression following grandmother-to-child HIV transmission. Retrovirology 2016; 13:65. [PMID: 27608713 PMCID: PMC5016918 DOI: 10.1186/s12977-016-0300-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/23/2016] [Indexed: 11/15/2022] Open
Abstract
Background In contrast to adult HIV infection, where slow disease progression is strongly linked to immune control of HIV mediated by protective HLA class I molecules such as HLA-B*81:01, the mechanisms by which a minority of HIV-infected children maintain normal-for-age CD4 counts and remain clinically healthy appear to be HLA class I-independent and are largely unknown. To better understand these mechanisms, we here studied a HIV-infected South African female, who remained a non-progressor throughout childhood.
Results
Phylogenetic analysis of viral sequences in the HIV-infected family members, together with the history of grand-maternal breast-feeding, indicated that, unusually, the non-progressor child had been infected via grandmother-to-child transmission. Although HLA-B*81:01 was expressed by both grandmother and grand-daughter, autologous virus in each subject encoded an escape mutation L188F within the immunodominant HLA-B*81:01-restricted Gag-specific epitope TL9 (TPQDLNTML, Gag 180–188). Since the transmitted virus can influence paediatric and adult HIV disease progression, we investigated the impact of the L188F mutant on replicative capacity. When this variant was introduced into three distinct HIV clones in vitro, viral replicative capacity was abrogated altogether. However, a virus constructed using the gag sequence of the non-progressor child replicated as efficiently as wildtype virus. Conclusion These findings suggest alternative sequences of events: the transmission of the uncompensated low fitness L188F to both children, potentially contributing to slow progression in both, consistent with previous studies indicating that disease progression in children can be influenced by the replicative capacity of the transmitted virus; or the transmission of fully compensated virus, and slow progression here principally the result of HLA-independent host-specific factors, yet to be defined.
Electronic supplementary material The online version of this article (doi:10.1186/s12977-016-0300-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M-H Tsai
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - M Muenchhoff
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - E Adland
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - A Carlqvist
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - J Roider
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK
| | - D K Cole
- Cardiff University School of Medicine, Heath Park, Cardiff, UK
| | - A K Sewell
- Cardiff University School of Medicine, Heath Park, Cardiff, UK
| | - J Carlson
- Microsoft Research, eScience Group, Los Angeles, CA, USA
| | - T Ndung'u
- HIV Pathogenesis Program, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.,Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA.,Max Planck Institute for Infection Biology, Berlin, Germany
| | - P J R Goulder
- Department of Paediatrics, University of Oxford, Peter Medawar Building for Pathogen Research, South Parks Road, Oxford, OX1 3SY, UK. .,HIV Pathogenesis Program, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.
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Lovato A, Gandolfi S, Carlson J, Pieper SC, Schiavilla R. Electromagnetic Response of ^{12}C: A First-Principles Calculation. Phys Rev Lett 2016; 117:082501. [PMID: 27588850 DOI: 10.1103/physrevlett.117.082501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Indexed: 06/06/2023]
Abstract
The longitudinal and transverse electromagnetic response functions of ^{12}C are computed in a "first-principles" Green's function Monte Carlo calculation, based on realistic two- and three-nucleon interactions and associated one- and two-body currents. We find excellent agreement between theory and experiment and, in particular, no evidence for the quenching of the measured versus calculated longitudinal response. This is further corroborated by a reanalysis of the Coulomb sum rule, in which the contributions from the low-lying J^{π}=2^{+}, 0_{2}^{+} (Hoyle), and 4^{+} states in ^{12}C are accounted for explicitly in evaluating the total inelastic strength.
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Affiliation(s)
- A Lovato
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - S Gandolfi
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J Carlson
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Steven C Pieper
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - R Schiavilla
- Theory Center, Jefferson Lab, Newport News, Virginia 23606, USA
- Department of Physics, Old Dominion University, Norfolk, Virginia 23529, USA
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Fernlund E, Liuba P, Carlson J, Platonov P, Schlegel T. MYBPC3 hypertrophic cardiomyopathy can be detected by using advanced ECG in children and young adults. J Electrocardiol 2016; 49:392-400. [DOI: 10.1016/j.jelectrocard.2016.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Indexed: 12/17/2022]
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50
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Birge RB, Boeltz S, Kumar S, Carlson J, Wanderley J, Calianese D, Barcinski M, Brekken RA, Huang X, Hutchins JT, Freimark B, Empig C, Mercer J, Schroit AJ, Schett G, Herrmann M. Phosphatidylserine is a global immunosuppressive signal in efferocytosis, infectious disease, and cancer. Cell Death Differ 2016; 23:962-78. [PMID: 26915293 PMCID: PMC4987730 DOI: 10.1038/cdd.2016.11] [Citation(s) in RCA: 442] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 02/06/2023] Open
Abstract
Apoptosis is an evolutionarily conserved and tightly regulated cell death modality. It serves important roles in physiology by sculpting complex tissues during embryogenesis and by removing effete cells that have reached advanced age or whose genomes have been irreparably damaged. Apoptosis culminates in the rapid and decisive removal of cell corpses by efferocytosis, a term used to distinguish the engulfment of apoptotic cells from other phagocytic processes. Over the past decades, the molecular and cell biological events associated with efferocytosis have been rigorously studied, and many eat-me signals and receptors have been identified. The externalization of phosphatidylserine (PS) is arguably the most emblematic eat-me signal that is in turn bound by a large number of serum proteins and opsonins that facilitate efferocytosis. Under physiological conditions, externalized PS functions as a dominant and evolutionarily conserved immunosuppressive signal that promotes tolerance and prevents local and systemic immune activation. Pathologically, the innate immunosuppressive effect of externalized PS has been hijacked by numerous viruses, microorganisms, and parasites to facilitate infection, and in many cases, establish infection latency. PS is also profoundly dysregulated in the tumor microenvironment and antagonizes the development of tumor immunity. In this review, we discuss the biology of PS with respect to its role as a global immunosuppressive signal and how PS is exploited to drive diverse pathological processes such as infection and cancer. Finally, we outline the rationale that agents targeting PS could have significant value in cancer and infectious disease therapeutics.
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Affiliation(s)
- R B Birge
- Department of Microbiology, Biochemistry and Molecular Genetics, Cancer Center, Rutgers New Jersey Medical School, 205 South Orange Ave, Newark, NJ 07103, USA
| | - S Boeltz
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, 91054 Erlangen, Germany
| | - S Kumar
- Department of Microbiology, Biochemistry and Molecular Genetics, Cancer Center, Rutgers New Jersey Medical School, 205 South Orange Ave, Newark, NJ 07103, USA
| | - J Carlson
- Peregrine Pharmaceuticals, 14282 Franklin Avenue, Tustin, CA 92780, USA
| | - J Wanderley
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - D Calianese
- Department of Microbiology, Biochemistry and Molecular Genetics, Cancer Center, Rutgers New Jersey Medical School, 205 South Orange Ave, Newark, NJ 07103, USA
| | - M Barcinski
- Laboratório de Biologia Celular, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil
| | - R A Brekken
- Division of Surgical Oncology, Department of Surgery, Hamon Center for Therapeutic Oncology Research, Dallas, TX 75390-8593, USA.,Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8593, USA
| | - X Huang
- Division of Surgical Oncology, Department of Surgery, Hamon Center for Therapeutic Oncology Research, Dallas, TX 75390-8593, USA.,Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX 75390-8593, USA
| | - J T Hutchins
- Peregrine Pharmaceuticals, 14282 Franklin Avenue, Tustin, CA 92780, USA
| | - B Freimark
- Peregrine Pharmaceuticals, 14282 Franklin Avenue, Tustin, CA 92780, USA
| | - C Empig
- Peregrine Pharmaceuticals, 14282 Franklin Avenue, Tustin, CA 92780, USA
| | - J Mercer
- Medical Research Council Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK
| | - A J Schroit
- Simmons Cancer Center and the Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX 75390 USA
| | - G Schett
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, 91054 Erlangen, Germany
| | - M Herrmann
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, 91054 Erlangen, Germany
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