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Etingof, Pavel, Nate Harman e Viktor Ostrik. "$p$-adic dimensions in symmetric tensor categories in characteristic $p$". Quantum Topology 9, n.º 1 (1 de fevereiro de 2018): 119–40. http://dx.doi.org/10.4171/qt/104.
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Hunnicutt, Jennifer L., Chris M. Gregory, Michelle M. McLeod, Shane K. Woolf, Russell W. Chapin e Harris S. Slone. "Quadriceps Recovery After Anterior Cruciate Ligament Reconstruction With Quadriceps Tendon Versus Patellar Tendon Autografts". Orthopaedic Journal of Sports Medicine 7, n.º 4 (1 de abril de 2019): 232596711983978. http://dx.doi.org/10.1177/2325967119839786.
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Background: Quadriceps tendon (QT) autografts are being increasingly used for anterior cruciate ligament reconstruction (ACLR). A paucity of studies exist that compare QT autografts with alternative graft options. Additionally, concerns exist regarding quadriceps recovery after graft harvest insult to the quadriceps muscle-tendon unit. Purpose/Hypothesis: The purpose of this study was to compare quadriceps recovery and functional outcomes in patients with QT versus bone–patellar tendon–bone (BPTB) autografts. The hypothesis was that those with QT autografts would demonstrate superior outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Active patients with a history of primary, unilateral ACLR with soft tissue QT or BPTB autografts participated. Quadriceps recovery was quantified using variables of strength, muscle size, and activation. Knee extensor isometric and isokinetic strength was measured bilaterally with an isokinetic dynamometer and normalized to body weight. Quadriceps activation was measured with the superimposed burst technique. The maximal cross-sectional area of each quadriceps muscle was measured bilaterally using magnetic resonance imaging. Assessors of muscle size were blinded to the graft type and side of ACLR. Functional tests included hop tests and step length symmetry during walking, measured via spatiotemporal gait analysis. Self-reported function was determined with the International Knee Documentation Committee (IKDC) questionnaire. Neuromuscular and functional outcomes were expressed as limb symmetry indices (LSIs: [surgical limb/nonsurgical limb]*100%). Wilcoxon rank-sum tests were used to compare the LSIs and IKDC scores between groups. Results: There were 30 study participants (19 male, 11 female; median age, 22 years [range, 14-41 years]; median time since surgery, 8 months [range, 6-23 months]), with 15 patients in each group. There were no significant between-group differences in demographic variables or outcomes. LSIs were not significantly different between the QT versus BPTB group, respectively: knee extensor isokinetic strength at 60 deg/s (median, 70 [range, 41-120] vs 68 [range, 37-83]; P = .285), activation (median, 95 [range, 85-111] vs 92 [range, 82-105]; P = .148), cross-sectional area of the vastus medialis (median, 79 [range, 62-104] vs 77 [range, 62-95]; P = .425), single-leg hop test (median, 88 [range, 35-114] vs 77 [range, 49-100]; P = .156), and step length symmetry (median, 99 [range, 93-104] vs 98 [range, 92-103]; P = .653). The median IKDC scores between the QT and BPTB groups were also not significantly different: 82 (range, 67-94) versus 83 (range, 54-94); respectively ( P = .683). Conclusion: Patients with QT autografts demonstrated similar short-term quadriceps recovery and postsurgical outcomes compared with patients with BPTB autografts.
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Holmgren, David, Shiba Noory, Eva Moström, Hege Grindem, Anders Stålman e Tobias Wörner. "Weaker Quadriceps Muscle Strength With a Quadriceps Tendon Graft Compared With a Patellar or Hamstring Tendon Graft at 7 Months After Anterior Cruciate Ligament Reconstruction". American Journal of Sports Medicine 52, n.º 1 (janeiro de 2024): 69–76. http://dx.doi.org/10.1177/03635465231209442.
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Background: Impaired quadriceps muscle strength after anterior cruciate ligament reconstruction (ACLR) is associated with worse clinical outcomes and a risk of reinjuries. Yet, we know little about quadriceps muscle strength in patients reconstructed with a quadriceps tendon (QT) graft, which is increasing in popularity worldwide. Purpose: To describe and compare isokinetic quadriceps strength in patients undergoing ACLR with a QT, hamstring tendon (HT), or bone–patellar tendon–bone (BPTB) autograft. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We included patients with QT grafts (n = 104) and matched them to patients with HT (n = 104) and BPTB (n = 104) grafts based on age, sex, and associated meniscal surgery. Data were collected through clinical strength testing at a mean of 7 ± 1 months postoperatively. Isokinetic strength was measured at 90 deg/s, and quadriceps strength was expressed as the limb symmetry index (LSI) for peak torque, total work, torque at 30° of knee flexion, and time to peak torque. Results: Patients with QT grafts had the most impaired isokinetic quadriceps strength, with the LSI ranging between 67.5% and 75.1%, followed by those with BPTB grafts (74.4%-81.5%) and HT grafts (84.0%-89.0%). Patients with QT grafts had a significantly lower LSI for all variables compared with patients with HT grafts (mean difference: peak torque: −17.4% [95% CI, −21.7 to −13.2], P < .001; total work: −15.9% [95% CI, −20.6 to −11.1], P < .001; torque at 30° of knee flexion: −8.8% [95% CI, −14.7 to −2.9], P = .001; time to peak torque: −17.7% [95% CI, −25.8 to −9.6], P < .001). Compared with patients with BPTB grafts, patients with QT grafts had a significantly lower LSI for all variables (mean difference: peak torque: −6.9% [95% CI, −11.2 to −2.7], P < .001; total work: −7.7% [95% CI, −12.4 to −2.9], P < .001; torque at 30° of knee flexion: −6.3% [95% CI, −12.2 to −0.5], P = .03; time to peak torque: −8.8% [95% CI, −16.9 to −0.7], P = .03). None of the graft groups reached a mean LSI of >90% for peak torque (QT: 67.5% [95% CI, 64.8-70.1]; HT: 84.9% [95% CI, 82.4-87.4]; BPTB: 74.4% [95% CI, 72.0-76.9]). Conclusion: At 7 months after ACLR, patients with QT grafts had significantly worse isokinetic quadriceps strength than patients with HT and BPTB grafts. None of the 3 graft groups reached a mean LSI of >90% in quadriceps strength.
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Martinelli, Marianna, Chiara Giubbi, Laura Saderi, Rosario Musumeci, Federica Perdoni, Biagio Eugenio Leone, Robert Fruscio et al. "Evaluation of Human Papilloma Virus (HPV) Genotyping and Viral Load Determination as Diagnostic Biomarkers of Cervical Cancer Risk". International Journal of Molecular Sciences 24, n.º 2 (10 de janeiro de 2023): 1320. http://dx.doi.org/10.3390/ijms24021320.
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HPV testing in cervical cancer screening programs offers the possibility of introducing molecular standardized biomarkers for the triage of HPV-positive women. This study aimed to evaluate the role of HPV genotyping and viral load as possible diagnostic biomarkers of high-grade cervical lesions (CIN2+) by performing a preliminary evaluation of a new HPV test. Cervical specimens were obtained from 200 women referred for a colposcopy. Samples were tested using both Anyplex™ II HR-HPV as well as OncoPredict HPV® Screening (SCR) and quantitative typing (QT). Using a cycle threshold cutoff (Ct) of 36.8 for the SCR assay and 1.27 log10 (viral copies/104 cells) for the QT assay, relative clinical sensitivity for CIN2+ and relative clinical specificity for CIN2− as compared to Anyplex™ II HR-HPV were, respectively, 0.92 and 1.00 for SCR and 1.35 and 1.24 for QT. The distribution of high-risk HPV (HR-HPV) genotypes (p = 0.009) as well as the viral copy numbers (CIN2−: 3.7 log10 (viral copies/104 human cells); CIN2+: 4.3 log10 (viral copies/104 human cells); p = 0.047) were found to differ in women with high- and low-grade cervical lesions, suggesting a possible role of HPV genotyping and normalized viral load as potential biomarkers to identify women at increased risk of cervical lesions.
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Shao, Yan, Haitao Yu, Yan Yang, Min Li, Li Hang e Xinrong Xu. "A Solid Dispersion of Quercetin Shows Enhanced Nrf2 Activation and Protective Effects against Oxidative Injury in a Mouse Model of Dry Age-Related Macular Degeneration". Oxidative Medicine and Cellular Longevity 2019 (7 de novembro de 2019): 1–12. http://dx.doi.org/10.1155/2019/1479571.
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Age-related macular degeneration (AMD) represents a major reason for blindness in the elderly population. Oxidative stress is a predominant factor in the pathology of AMD. We previously evaluated the effects of phospholipid complex of quercetin (Q-PC) on oxidative injury in ARPE-19 cells, but the underlying mechanisms are not fully understood. Herein, the solid dispersion of quercetin-PC (Q-SD) was prepared with solubility being 235.54 μg/mL in water and 2.3×104 μg/mL in chloroform, which were significantly higher than that of quercetin (QT) and Q-PC. Q-SD also exhibited a considerably higher dissolution rate than QT and Q-PC. Additionally, Q-SD had Cmax of 4.143 μg/mL and AUC of 12.015 μg·h/mL in rats, suggesting better bioavailability than QT and Q-PC. Then, a mouse model of dry AMD (Nrf2 wild-type (WT) and Nrf2 knockout (KO)) was established for evaluating the effects of Q-SD in vivo. Q-SD more potently reduced retinal pigment epithelium sediments and Bruch’s membrane thickness than QT and Q-PC at 200 mg/kg in Nrf2 WT mice and did not work in Nrf2 KO mice at the same dosage. Additionally, Q-SD significantly decreased ROS and MDA contents and restored SOD, GSH-PX, and CAT activities of serum and retinal tissues in Nrf2 WT mice, but not in Nrf2 KO mice. Furthermore, Q-SD more potently increased Nrf2 mRNA expression and stimulated its nuclear translocation in retinal tissues of Nrf2 WT mice. Q-SD significantly increased the expression of Nrf2 target genes HO-1, HQO-1, and GCL of retinal tissues in Nrf2 WT mice, not in Nrf2 KO mice. Altogether, Q-SD had improved physicochemical and pharmacokinetic properties compared to QT and Q-PC and exhibited more potent protective effects on retina oxidative injury in vivo. These effects were associated with activation of Nrf2 signaling and upregulation of antioxidant enzymes.
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Romanova, V. A., A. S. Goncharov, N. N. Terebilina e V. S. Moiseev. "Cardiac damage in liver cirrhosis in alcohol abusers". Terapevticheskii arkhiv 88, n.º 8 (15 de agosto de 2016): 99–104. http://dx.doi.org/10.17116/terarkh201688899-104.
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Aim. To estimate the contribution of liver cirrhosis (LC) to the development of heart diseases in alcohol abusers. Subjects and methods. The investigation included 80 patients with alcoholic LC without a history of cardiovascular and respiratory diseases and, as a control group, 32 alcohol abusers without a history of chronic diseases of the liver and cardiovascular and respiratory systems; 45 patients with alcoholic cardiomyopathy (ACM) and congestive heart failure without a history of coronary heart disease and valvular diseases, among whom 11 patients were found to have LC. In addition to standard clinical examination, all the patients underwent electrocardiography, by estimating the corrected QT interval (QTc), standard echocardiography; and those without ACM underwent estimation of left ventricular (LV) kinetics using speckle-tracking echocardiography. Results. The patients with alcoholic LC were found to have a higher LV ejection fraction and a more obvious impairment of LV global longitudinal deformity, and more commonly LV diastolic dysfunction. 16 of the 80 patients with LC were observed to have moderate pulmonary hypertension while the mean pulmonary artery pressure (MPAP) was within the normal range in all the patients without LC. A prolonged QTc interval was revealed in the patients with LC. The duration of QTc was directly correlated with the MELD severity of LC. The patients with chronic heart failure in the presence of ACM and CL showed a more obvious LV diastolic dysfunction, as estimated by E/E’, a greater LV mass index, and a higher MPAP than those with ACM without LC. Conclusion. The LC patients both with ACM and without a history of diseases of the heart were noted to have its more evident disorders as diastolic dysfunction and elevated MPAP. Those without ACM were observed to have impaired LV global deformity and a prolonged QTc interval.
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Yildiz, Alaattin, Vakur Akkaya, Sevgi Sahin, Tufan Tükek, Mine Besler, Semra Bozfakioglu e Ferruh Korkut. "Qt Dispersion and Signal-Averaged Electrocardiogram in Hemodialysis and Capd Patients". Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 21, n.º 2 (março de 2001): 186–94. http://dx.doi.org/10.1177/089686080102100213.
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Objective The aim of this study was to compare QT dispersion (QTd) and signal-averaged electrocardiogram (SA-ECG) parameters that may predict risk of malignant arrhythmias in patients on hemodialysis (HD), on continuous ambulatory peritoneal dialysis (CAPD), and in controls. Setting Controlled cross-sectional study in a tertiary- care setting. Patients 28 HD (M/F 18/10; mean age 32 ± 9 years), 29 CAPD (M/F 17/12; mean age 34 ± 10 years), and 29 healthy controls (M/F 17/12; mean age 32 ± 8 years) were included. Interventions On ECG, minimum (QTmin) and maximum (QTmax) QT duration and their difference (QTd) were measured. In SA-ECG, duration of filtered QRS, HFLA signals less than 40 μV, and RMS voltage (40 ms) were also measured. Results Higher serum Ca2+ and lower K+ levels were found in CAPD compared to HD. All QT parameters were increased in HD and CAPD compared to controls. QT dispersion was significantly prolonged in HD compared to CAPD. In HD, QTd was correlated with left ventricular (LV) mass index ( r = 0.53, p = 0.004), but not in CAPD ( r = -0.09, p = 0.63). QT dispersion was significantly prolonged in patients with LV hypertrophy compared to patients without hypertrophy on HD (68 ± 18 ms vs 49 ± 18 ms, p = 0.008). In the analysis of SA-ECG, 3 of the 28 (11%) HD and 2 of the 29 (7%) CAPD patients had abnormal late potentials. Patients on HD and CAPD had significantly higher filtered-QRS duration compared to controls (105 ± 15 ms and 104 ± 12 ms vs 95 ± 5 ms, respectively, p = 0.04). Patients with LV hypertrophy had higher filtered-QRS duration compared to patients without hypertrophy (109 ± 12 ms vs 95 ± 8 ms, p < 0.001). Conclusion Dialysis patients had prolonged QTd and increased filtered-QRS duration in SA-ECG compared to controls. Patients on HD had longer QTd than patients on CAPD. QTd has been correlated to LV mass index in HD, but not in CAPD. This difference might be due to the effect of different dialysis modalities on electrolytes, especially the higher serum Ca2+ levels.
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Saib, Anis, Walid Amara, Pascal Wang, Simon Cattan, Azeddine Dellal, Kais Regaieg, Stephane Nahon, Olivier Nallet e Lee S. Nguyen. "Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study". PLOS ONE 16, n.º 6 (9 de junho de 2021): e0252388. http://dx.doi.org/10.1371/journal.pone.0252388.
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Background Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical effects of HCQ/AZI, with a 28-days follow-up. Methods In a registry-study which included patients hospitalized for COVID-19 between March 15 and April 2, 2020, we compared patients who received HCQ/AZI to those who did not, regarding a composite outcome of mortality and mechanical ventilation with a 28-days follow-up. QT was monitored for patients treated with HCQ/AZI. Were excluded patients in intensive care units, palliative care and ventilated within 24 hours of admission. Three analyses were performed to adjust for selection bias: propensity score matching, multivariable survival, and inverse probability score weighting (IPSW) analyses. Results Overall, 203 patients were included: 60 patients treated by HCQ/AZI and 143 control patients. During the 28-days follow-up, 32 (16.3%) patients presented the primary outcome and 23 (12.3%) patients died. Propensity-score matching identified 52 unique pairs of patients with similar characteristics. In the matched cohort (n = 104), HCQ/AZI was not associated with the primary composite outcome (log-rank p-value = 0.16). In the overall cohort (n = 203), survival and IPSW analyses also found no benefit from HCQ/AZI. In the HCQ/AZI group, 11 (18.3%) patients prolonged QT interval duration, requiring treatment cessation. Conclusions HCQ/AZI combination therapy was not associated with lower in-hospital mortality and mechanical ventilation rate, with a 28-days follow-up. In the HCQ/AZI group, 18.3% of patients presented a prolonged QT interval requiring treatment cessation, however, control group was not monitored for this adverse event, making comparison impossible.
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Gao, Yuanfeng, Wenling Liu, Cuilan Li, Xiaoliang Qiu, Xuguang Qin, Baojing Guo, Xueqin Liu et al. "Common Genotypes of Long QT Syndrome in China and the Role of ECG Prediction". Cardiology 133, n.º 2 (24 de outubro de 2015): 73–78. http://dx.doi.org/10.1159/000440608.
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Objectives: Genetic testing, a gold standard for long QT syndrome (LQTS) diagnosis, is time-consuming and costly when all the 15 candidate genes are screened. Since genotype-specific ECG patterns are present in most LQT1-3 mutation carriers, we tested the utility of ECG-guided genotyping in a large cohort of Chinese LQTS patients. Methods and Results: We enrolled 230 patients (26 ± 17 years, 66% female) with a clinical diagnosis of LQTS. Genotypes were predicted as LQT1-3 based on the presence of ECG patterns typical for each genotype in 200 patients (85 LQT1, 110 LQT2 and 5 LQT3). Family-based genotype prediction was also conducted if gene-specific ECG patterns were found in other affected family members. Mutational screening identified 104 mutations (44% novel), i.e. 46 KCNQ1, 54 KCNH2 and 4 SCN5A mutations. The overall predictive accuracy of ECG-guided genotyping was 79% (157/200) and 79% (67/85), 78% (86/110) and 80% (4/5) for LQT1, LQT2 and LQT3, respectively. The predictive accuracy was 98% (42/43) when family-based ECG assessment was performed. Conclusions: From this large-scale genotyping study, we found that LQT2 is the most common genotype among the Chinese. Family-based ECG-guided genotyping is highly accurate. ECG-guided genotyping is time- and cost-effective. We therefore recommend it as an optimal approach for the genetic diagnosis of LQTS.
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Gur, Ali, e Zeynep Ulutas. "Characteristic Electrocardiography Findings of COVID-19 Patients". Archives of Iranian Medicine 24, n.º 9 (1 de setembro de 2021): 706–12. http://dx.doi.org/10.34172/aim.2021.103.
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Background: Determining a relationship between coronavirus disease 2019 (COVID-19) and the ECG findings of the patients with this disease can assist in early diagnosis and patient management based on these findings. This study aimed to investigate whether COVID-19 patients had characteristic ECG findings in the acute period. Methods: A total of 124 patients were divided into two groups as those diagnosed with COVID-19 and controls. The ECGs of these patients were evaluated in terms of rate, rhythm, presence of ST changes, PR interval, QRS width, QTc and QT interval, and presence of right and left bundle branch blocks. Results: On the ECG, the median heart rate of the COVID-19 patients was 104/min (IQR: 99–114), and there was a significant difference compared to the control group (P<0.001). The median PR interval was 157/ms, the QRS width was 86 ± 9/ms in the COVID-19 patients, with no significant difference compared to the controls (P = 0.161 and P = 0.631, respectively). The median QT interval of the COVID-19 patients was normal (400/ms), but a significant difference was detected compared to the controls (P = 0.005). The QTc, ST change, AF, and presence of right and left bundle branch blocks were not significantly different between the two groups. Conclusion: Considering the importance of ECG findings in order to diagnose COVID-19 disease early, we can state that sinus tachycardia is very common in COVID-19 patients, but there is no characteristic ECG finding for COVID-19, including tachycardia.
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Esmaeillou, Mahsa, Jalil Houshyar, Fariborz Akbarzadeh e Akbar Aliasgarzadeh. "Evaluation of autonomic neuropathy in newly diagnosed and chronic type 2 diabetic patients: A retrospective cross-sectional study". Journal of Research in Clinical Medicine 8, n.º 1 (23 de dezembro de 2020): 49. http://dx.doi.org/10.34172/jrcm.2020.049.
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Abstract Introduction: Diabetic autonomic neuropathy is one of the most important complications of diabetes mellitus (DM) that ultimately occurs in most patients. The purpose of this study was to screen and diagnose latent cases of autonomic neuropathy between patients who have a history of over 10 years DM and recently diagnosed diabetic patients. Methods: This cross-sectional study was performed on 104 patients (52 type 2 DM patients diagnosed in the last 6 months; and 52 type 2 DM patients with more than 10 years history) referred to outpatient Endocrine Clinic of Imam Reza Medical Center in Tabriz University of Medical Sciences between 2015-2016. Blood pressure, resting heart rate and corrected QT interval were evaluated according to standard methods. The history of gastrointestinal and urinary tract neuropathy was extracted from patients’ history and physical exam. Results: Of the 104 patients studied, 54 were male and 50 were female. Standing heart rate (p=0.02), resting (p<0.0002) and standing (p<0.0001) systolic blood pressure, and resting diastolic blood pressure (p=0.03) were significantly higher in chronic diabetic patients compared to newly diagnosed group. Additionally, blood glucose levels (p=0.03) and body mass index (BMI) (p<0.0001) were significantly higher in patients with neuropathy. Conclusion: Overall, the results of this study showed that in patients with type 2 DM, cardiac autonomic dysfunction is more common in patients with a longer history of DM.
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Pasero, Eros, Fiorenzo Gaita, Vincenzo Randazzo, Pierre Meynet, Sergio Cannata, Philippe Maury e Carla Giustetto. "Artificial Intelligence ECG Analysis in Patients with Short QT Syndrome to Predict Life-Threatening Arrhythmic Events". Sensors 23, n.º 21 (1 de novembro de 2023): 8900. http://dx.doi.org/10.3390/s23218900.
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Short QT syndrome (SQTS) is an inherited cardiac ion-channel disease related to an increased risk of sudden cardiac death (SCD) in young and otherwise healthy individuals. SCD is often the first clinical presentation in patients with SQTS. However, arrhythmia risk stratification is presently unsatisfactory in asymptomatic patients. In this context, artificial intelligence-based electrocardiogram (ECG) analysis has never been applied to refine risk stratification in patients with SQTS. The purpose of this study was to analyze ECGs from SQTS patients with the aid of different AI algorithms to evaluate their ability to discriminate between subjects with and without documented life-threatening arrhythmic events. The study group included 104 SQTS patients, 37 of whom had a documented major arrhythmic event at presentation and/or during follow-up. Thirteen ECG features were measured independently by three expert cardiologists; then, the dataset was randomly divided into three subsets (training, validation, and testing). Five shallow neural networks were trained, validated, and tested to predict subject-specific class (non-event/event) using different subsets of ECG features. Additionally, several deep learning and machine learning algorithms, such as Vision Transformer, Swin Transformer, MobileNetV3, EfficientNetV2, ConvNextTiny, Capsule Networks, and logistic regression were trained, validated, and tested directly on the scanned ECG images, without any manual feature extraction. Furthermore, a shallow neural network, a 1-D transformer classifier, and a 1-D CNN were trained, validated, and tested on ECG signals extracted from the aforementioned scanned images. Classification metrics were evaluated by means of sensitivity, specificity, positive and negative predictive values, accuracy, and area under the curve. Results prove that artificial intelligence can help clinicians in better stratifying risk of arrhythmia in patients with SQTS. In particular, shallow neural networks’ processing features showed the best performance in identifying patients that will not suffer from a potentially lethal event. This could pave the way for refined ECG-based risk stratification in this group of patients, potentially helping in saving the lives of young and otherwise healthy individuals.
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Ohe, Yuichiro, Terufumi Kato, Fumikazu Sakai, Masahiko Kusumoto, Masahiro Endo, Yoshinobu Saito, Tomohisa Baba et al. "Real-world use of osimertinib for epidermal growth factor receptor T790M-positive non-small cell lung cancer in Japan". Japanese Journal of Clinical Oncology 50, n.º 8 (17 de junho de 2020): 909–19. http://dx.doi.org/10.1093/jjco/hyaa067.
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Abstract Objective Adverse drug reactions (ADRs) during real-world osimertinib use were investigated in Japan. Methods Patients with epidermal growth factor receptor (EGFR) T790M-positive non-small cell lung cancer treated with second-line or later oral osimertinib per the Japanese package insert (80 mg once daily) were included. Data were collected between 28 March 2016 and 31 August 2018. Results The median observation period in the safety analysis population (n = 3578) was 343.0 days. ADRs (defined as adverse events whose causality to osimertinib could not be denied by the attending physicians or manufacturer) were reported in 58.1% (2079/3578) of patients. ADRs of interstitial lung disease events were reported in 6.8% (245/3578; Grade ≥ 3, 2.9% [104/3578]) of patients, of whom 29 (11.8%) died (0.8% of patients overall). ADRs of QT interval prolonged, liver disorder and haematotoxicity were reported in 1.3% (45/3578; Grade ≥ 3, 0.1% [5/3578]), 5.9% (212/3578; Grade ≥ 3, 1.0% [35/3578]) and 11.4% (409/3578; Grade ≥ 3, 2.9% [104/3578]) of patients, respectively. In the efficacy analysis population (n = 3563), 119 (3.3%) patients had complete responses, 2373 (66.6%) had partial responses and 598 (16.8%) had stable disease. The objective response rate was 69.9%; disease control rate was 86.7%; and median progression-free survival (PFS) was 12.3 months. At 6 and 12 months, PFS rates were 77.4% (95% confidence interval [CI], 75.9–78.9) and 53.2% (95% CI, 51.3–55.1) and overall survival rates were 88.3% (95% CI, 87.2–89.4) and 75.4% (95% CI, 73.8–77.0), respectively. Conclusions These data support the currently established benefit-risk assessment of osimertinib in this patient population.
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Diederichsen, Søren Zöga, Stine Darkner, Xu Chen, Arne Johannessen, Steen Pehrson, Jim Hansen e Jesper Hastrup Svendsen. "QT as a predictor of recurrence after atrial fibrillation ablation and the impact of amiodarone: results from the placebo-controlled AMIO-CAT trial". EP Europace 21, n.º 7 (6 de março de 2019): 1055–62. http://dx.doi.org/10.1093/europace/euz028.
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Aims Prolonged corrected QT interval (QTc) might be associated with arrhythmia recurrence after atrial fibrillation (AF) ablation. The effect of short-term amiodarone in this setting remains unknown. This study seeks to quantify short-term amiodarone’s impact on QTc, and to investigate QTc and amiodarone treatment as predictors of recurrence of arrhythmia after ablation. Methods and results The Short-term AMIOdarone treatment after CATheter ablation for atrial fibrillation (AMIO-CAT) trial randomized patients to 8 weeks of oral amiodarone or placebo following AF ablation. Scheduled and symptom-driven 12-lead electrocardiography and 3-day Holter-monitorings were performed. The endpoint was atrial fibrillation, atrial flutter or atrial tachycardia (AF/AT) lasting >30 s. The cut-off for prolonged QTc was 450 ms for men and 460 ms for women. A total of 212 patients were included, of which 108 were randomized to amiodarone and 104 to placebo. From baseline to 1 month QTc in the amiodarone group increased by 27 (±30) ms, while at 6 months QTc had normalized. After 3-months of blanking, new AF/AT recurrence was detected in 63% of patients with prolonged QTc vs. 41% of patients with normal QTc at baseline, and in multivariate Cox regression, prolonged QTc was associated with AF/AT recurrence [hazard ratio (HR) 2.19, P = 0.023]. Among patients with baseline QTc below median, amiodarone treatment decreased the rate of AF/AT recurrences (HR 0.43, P = 0.008). Conclusions Amiodarone increased QTc with 27 ms compared to placebo, and this effect decreased rapidly after drug discontinuation. Prolonged QTc at baseline independently predicted AF/AT recurrence, and baseline QTc identified patients who would possibly benefit from short-term amiodarone following ablation.
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Ершова, И. Б., Ю. В. Глушко, В. А. Рещиков, И. А. Лохматова e О. В. Петренко. "ОСОБЕННОСТИ НАРУШЕНИЙ СЕРДЕЧНОЙ ДЕЯТЕЛЬНОСТИ У ДЕТЕЙ ШКОЛЬНОГО ВОЗРАСТА, ПЕРЕНЕСШИХ СТРЕСС ВОЕННЫХ ДЕЙСТВИЙ". Университетская клиника, n.º 1(34) (28 de fevereiro de 2020): 19. http://dx.doi.org/10.26435/uc.v0i1(34).382.
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Влияние сильнейшего стрессового фактора на состояние здоровья детей, находившихся в эпицентре боевых действий в регионе Донбасса, в настоящее время является весьма актуальным и недостаточно изученным. Целью данного исследования явилась оценка психосоматического состояния здоровья детей 7-16 лет, в том числе деятельности сердечно-сосудистой системы. Обследовано 113 детей, проживающих в зоне военного конфликта. Проведено общее клиническое исследование состояния здоровья, включая психопатологические тесты и методики, адаптированные согласно возрасту, оценку физического развития (соматометрические и физиометрические данные), электрокардиографию, эхокардиографию и кардиоинтервалографию. В результате проведенного исследования выявлены психоэмоциональные нарушения (у 100%) и функциональные нарушения сердечно-сосудистой системы у 104 (92,04%) детей основной группы, с преобладанием жалоб на кардиалгии, сердцебиение, цефалгии, повышенную утомляемость, возбуждение, нарушения сна. Анализ электрокардиограмм выявил нарушения сердечного ритма в виде наджелудочковой тахикардии (34,51%), блокады правой ножки пучка Гиса (29,47%), атриовентрикулярной блокады и блокады левой ножки пучка Гиса (17,70%), миграции водителя ритма (9,73%), эктопических ритмов (6,19%), экстрасистолии (8,85%); изменения процессов деполяризации предсердий (51,33%) и реполяризации желудочков (64,60%); удлинение интервала QT (12,39%). Зарегистрировано снижение уровня физического развития в основной группе. У детей, длительно находившихся в стрессовой ситуации военного конфликта, значительно чаще встречалась соматическая патология, в частности патология нервной системы (89,38%) – расстройства вегетативной нервной системы и транзиторные тики; невротические, связанные со стрессом, и соматоформные расстройства – у 24,21% детей (реакция на тяжелый стресс и нарушения адаптации). У 58,41% детей выявлены хронические очаги инфекции носоглотки – хронические тонзиллиты; у 52,21% – заболевания органов пищеварения (дискинезия желчного пузыря и желчных путей, классифицируемые в МКБ-10 как «другие уточненные болезни желчного пузыря», а также функциональные расстройства кишечника в виде функциональных диарей); у 38,93% – нарушения костно-мышечной системы (деформирующие дорсопатии, а именно сколиозы, кифозы и лордозы); у 14,16% – болезни мочеполовой системы (циститы, острые тубулоинтерстициальные нефриты). Вегетативный гомеостаз характеризовался преобладанием симпатикотонического тонуса (48,67%) и гиперсимпатикотонической вегетативной реактивности. Длительное нахождение в зоне боевых действий значительно снизило адаптационные возможности детей, что привело к развитию дистресса.
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Drosten, Christian, Marcus Panning, Jan Felix Drexler, Florian Hänsel, Celia Pedroso, Jane Yeats, Luciano Kleber de Souza Luna et al. "Ultrasensitive Monitoring of HIV-1 Viral Load by a Low-Cost Real-Time Reverse Transcription-PCR Assay with Internal Control for the 5′ Long Terminal Repeat Domain". Clinical Chemistry 52, n.º 7 (1 de julho de 2006): 1258–66. http://dx.doi.org/10.1373/clinchem.2006.066498.
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Abstract Background: Current HIV-1 viral-load assays are too expensive for resource-limited settings. In some countries, monitoring of antiretroviral therapy is now more expensive than treatment itself. In addition, some commercial assays have shown shortcomings in quantifying rare genotypes. Methods: We evaluated real-time reverse transcription-PCR with internal control targeting the conserved long terminal repeat (LTR) domain of HIV-1 on reference panels and patient samples from Brazil (n = 1186), South Africa (n = 130), India (n = 44), and Germany (n = 127). Results: The detection limit was 31.9 IU of HIV-1 RNA/mL of plasma (>95% probability of detection, Probit analysis). The internal control showed inhibition in 3.7% of samples (95% confidence interval, 2.32%–5.9%; n = 454; 40 different runs). Comparative qualitative testing yielded the following: Roche Amplicor vs LTR assay (n = 431 samples), 51.7% vs 65% positives; Amplicor Ultrasensitive vs LTR (n = 133), 81.2% vs 82.7%; BioMerieux NucliSens HIV-1 QT (n = 453), 60.5% vs 65.1%; Bayer Versant 3.0 (n = 433), 57.7% vs 55.4%; total (n = 1450), 59.0% vs 63.8% positives. Intra-/interassay variability at medium and near-negative concentrations was 18%–51%. The quantification range was 50–10 000 000 IU/mL. Viral loads for subtypes A–D, F–J, AE, and AG yielded mean differences of 0.31 log10 compared with Amplicor in the 103–104 IU/mL range. HIV-1 N and O were not detected by Amplicor, but yielded up to 180 180.00 IU/mL in the LTR assay. Viral loads in stored samples from all countries, compared with Amplicor, NucliSens, or Versant, yielded regression line slopes (SD) of 0.9 (0.13) (P <0.001 for all). Conclusions: This method offers all features of commercial assays and covers all relevant genotypes. It could allow general monitoring of antiretroviral therapy in resource-limited settings.
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Nag, Kaushik, Kaushik Tripura, Anjan Datta, Nabarun Karmakar, Manvi Singh, Meenu Singh, Kusum Singal e Pranita Pradhan. "Effect of Hydroxychloroquine and Azithromycin Combination Use in COVID-19 Patients – An Umbrella Review". Indian Journal of Community Medicine 49, n.º 1 (2024): 22–27. http://dx.doi.org/10.4103/ijcm.ijcm_983_22.
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Background: Hydroxychloroquine and Azithromycin combination was used rampantly in management of COVID-19 patients in different countries. Present review was conducted to evaluate the efficacy of Hydroxychloroquine and Azithromycin combination compared to the control (standard care) and any adverse effect following this combination use in COVID-19 patients if any. Material and Methods: We included all the systematic review with or without meta-analysis reporting the effect of Hydroxychloroquine (HCQ) and Azithromycin (AZM) combination use in COVID-19 patient using three databases namely PubMed, medline, CINHAL, Web of Science from July 2020 till Jan 2022. Results: The systematic search strategy has identified 104 studies in total, after removal of duplicates only 4 systematic reviews were included in the qualitative synthesis. The various tools for assessing and reporting the data in the reviews were PRISMA, ROBINS-I, Robs2, AMSTAR, MASTER checklists. Mortality among the hydroxychloroquine with azithromycin combination group was significantly higher than among the Standard Care group. The duration of hospital stay in days was shorter in the Standard Care group in comparison with the hydroxychloroquine group or the hydroxychloroquine and azithromycin combination group. Of the 4 systematic reviews included, 3 had low risk of bias and one had unclear risk of bias using the ROBIS tool. Chloroquine or Hydroxychloroquine combination did not shorten the duration of hospital stay. Conclusion: Rampant use of Chloroquine or Hydroxychloroquine alone or with Azithromycin combination caused adverse effects like QT prolongation. Finally, there is no evidence to support use of either Hydroxychloroquine with or without Azithromycin, for the treatment of COVID-19.
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Hanselman, Jonathan. "Splicing integer framed knot complements and bordered Heegaard Floer homology". Quantum Topology 8, n.º 4 (6 de dezembro de 2017): 715–48. http://dx.doi.org/10.4171/qt/100.
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Baseilhac, Stéphane, e Riccardo Benedetti. "Non ambiguous structures on 3-manifolds and quantum symmetry defects". Quantum Topology 8, n.º 4 (6 de dezembro de 2017): 749–846. http://dx.doi.org/10.4171/qt/101.
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Behrens, Stefan, e Marco Golla. "Heegaard Floer correction terms, with a twist". Quantum Topology 9, n.º 1 (1 de fevereiro de 2018): 1–37. http://dx.doi.org/10.4171/qt/102.
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Massuyeau, Gwénaël. "Formal descriptions of Turaev's loop operations". Quantum Topology 9, n.º 1 (1 de fevereiro de 2018): 39–117. http://dx.doi.org/10.4171/qt/103.
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De, Sandipan, e Vijay Kodiyalam. "Planar algebras, cabling and the Drinfeld double". Quantum Topology 9, n.º 1 (1 de fevereiro de 2018): 141–65. http://dx.doi.org/10.4171/qt/105.
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Scaduto, Christopher, e Matthew Stoffregen. "Two-fold quasi-alternating links, Khovanov homology and instanton homology". Quantum Topology 9, n.º 1 (1 de fevereiro de 2018): 167–205. http://dx.doi.org/10.4171/qt/106.
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Ramos, Vinicius Gripp Barros. "Absolute gradings on ECH and Heegaard Floer homology". Quantum Topology 9, n.º 2 (9 de fevereiro de 2018): 207–28. http://dx.doi.org/10.4171/qt/107.
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Juhász, András. "Defining and classifying TQFTs via surgery". Quantum Topology 9, n.º 2 (9 de fevereiro de 2018): 229–321. http://dx.doi.org/10.4171/qt/108.
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Queffelec, Hoel, e Antonio Sartori. "HOMFLY-PT and Alexander polynomials from a doubled Schur algebra". Quantum Topology 9, n.º 2 (9 de fevereiro de 2018): 323–47. http://dx.doi.org/10.4171/qt/109.
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Tkachyshyn, Oleksandr. "EVALUATION OF CARDIOVASCULAR DYSREGULATION IN PATIENTS AFTER HEMORRHAGIC STROKE AS A COMPLICATION OF ESSENTIAL HYPERTENSION". Ukrainian Scientific Medical Youth Journal 125, n.º 3 (30 de setembro de 2021): 32–43. http://dx.doi.org/10.32345/usmyj.3(125).2021.32-43.
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The aim of the study was to compare blood pressure and electrocardiogram indices, assessed by their daily monitoring, and anamnestic data on mild traumatic brain injury between a group of patients with essential hypertension ≥6 months after a hemorrhagic stroke and a group of patients with essential hypertension without complications. Materials and methods. The total number of examined patients was 198 people, who were divided into 2 groups: the main (n = 94; age – 54,4±8,8 years, M±σ years) and the control (n = 104; age – 53,7±8,9 years) one. Patients in the main group suffered a hemorrhagic stroke as a complication of essential hypertension ≥6 months ago. The control group included patients with essential hypertension, stage II. In both groups of patients, the parameters of 24-hour ambulatory blood pressure monitoring and electrocardiogram were determined. Results. The indices of 24-hour ambulatory blood pressure monitoring in the main group and the control group were the following ones, respectively: the mean daytime systolic blood pressure was 109,6±1,6 and 121,1±1,1 mm Hg, the minimal one was 74,4±2,0 mm Hg and 82,3±12,5 mm Hg, and the maximal one was 168,2±1,9 and 161,9±1,7 mm Hg, p<0,05. The daytime sigma systolic blood pressure (17,9±0,6) and its average real variability of (11,31±2,52 mm Hg) were bigger in the main group (p<0,05). The daytime index of the hyperbaric load of systolic blood pressure was bigger in the main group: it was 403,6±25,9 against 231,7±12,1 mm Hg×h in the comparison group (p<0,05). The mean, minimum and maximum heart rate at night were significantly lower in the main group (p<0,05). The QTcmin index was significantly lower in the main group in contrast to the control one – 286,28±43,34 and 336,69±22,55, and the QT variance was greater – 232,56±44,55 – in comparison to the control group (188,31±33,67) (p<0,05). From the anamnestic data of patients, a significantly higher prevalence of mild traumatic brain injury was found in 37,4% (35 patients out of 94) in the main group relative to the control one – 13,5% (14 out of 104), p<0,05. Conclusions: The results of the study indicate the larger ranges of blood pressure variability in patients with essential hypertension complicated with hemorrhagic stroke, which can be caused by impaired autoregulation according to the QTc interval data. In combination with the disturbances of cerebral circulation, caused by the injury of the brain due to the hemorrhagic stroke alone or in combination with mild traumatic brain injury episode, such a situation may lead to the development of recurrent stroke.
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Bakurey, Sergey, e Svetlana Senotova. "DEVELOPMENT OF MOBILE APPLICATIONS USING THE QT FRAMEWORK". Modern Technologies and Scientific and Technological Progress 2023, n.º 1 (4 de maio de 2023): 99–100. http://dx.doi.org/10.36629/2686-9896-2023-1-99-100.
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The paper discusses the process of developing a full-fledged mobile application (developing an interface using QML, using the functionality of the mobile platform using the QT Framework modules, building and testing the project, obtaining an APK file for distributing the application) using QT products such as "QT Creator" and "QT Framework", based on the C++
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Pereira, Roberta, Oscar Campuzano, Georgia Sarquella-Brugada, Sergi Cesar, Anna Iglesias, Josep Brugada, Fernando E. S. Cruz Filho e Ramon Brugada. "Short QT syndrome in pediatrics". Clinical Research in Cardiology 106, n.º 6 (16 de março de 2017): 393–400. http://dx.doi.org/10.1007/s00392-017-1094-1.
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Yunisova, A. S., e A. V. Smolensky. "QT interval variability and athlete's heart remodeling". Clinical Medicine (Russian Journal) 100, n.º 7-8 (31 de outubro de 2022): 377–81. http://dx.doi.org/10.30629/0023-2149-2022-100-7-8-377-381.
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At present, the prevention of sudden cardiac death in athletes is of great interest. A large amount of literature data concerning the correlation between the length of the QT interval and the proarrhythmic potential of the myocardium has been accumulated. However, new potential predictors of the fatal arrhythmias occurrence in athletes have emerged in recent years — an increase in the dispersion of the QT interval, as well as short-term variability in repolarization. This review provides detailed data on the diagnosis, prevalence, classifi cation, etiology of long QT as one of the manifestations of QT variance. The variety of causes leading to long QT syndrome (LQTS) causes diffi culties in the diff erential diagnosis of this condition and, and as a result, LQTS often remains outside the attention of practitioners. The data of recent studies of the athlete’s heart remodelling are presented as well.
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Orlov, P. S., D. E. Ivanoshchuk, A. M. Nesterets, A. A. Kuznetsov, A. A. Ivanova, S. K. Maliutina, D. V. Denisova, E. V. Striukova, V. N. Maksimov e S. V. Maksimova. "The results of next-generation sequencing in men with borderline QT interval prolongation (pilot study)". Complex Issues of Cardiovascular Diseases 11, n.º 2 (28 de abril de 2022): 98–106. http://dx.doi.org/10.17802/2306-1278-2022-11-2-98-106.
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Highlights. Probably causal mutations of QT interval prolongation in genes associated with LQTS were found in men of the Siberian population.Aim. To detect and study mutations in individuals with borderline prolongation of the QT interval in Siberian males.Methods. The study was conducted on the material of the international project HAPIEE in the period from 2003 to 2005 and screening of young people aged 25–44, performed in Novosibirsk. The total sample of men was 1353 people aged 25 to 69 years. From each age subgroup (25–29, 30–34, ..., 65–69 years old) 2–3 samples with the highest QT values were selected . The study group consisted of 30 men who subsequently underwent sequencing of a panel of genes. The search for mutations was carried out in genes associated with long QT syndrome (LQTS): KCNQ1, KCNH2, SCN5A, KCNE1, KCNE2, KCNJ2, CACNA1, SCN4B, KCNJ5, ANK2, CAV3, SNTA1, AKAP9, CALM1 and CALM2. All identified single nucleotide variants were verified by direct Sanger sequencing.Results. Three rare variants in the LQTS genes have been identified: p.P197L of the KCNQ1 gene, p.R176W, and p.D1003GfsX116 of the KCNH2 gene.Conclusion. In Caucasian men from the Novosibirsk population with borderline prolongation of the QT interval, probably causal substitutions in the LQTS genes – KCNH2 and KCNQ1, contributing to the prolongation of the QT interval, were found. To clarify the spectrum and frequency of occurrence of various mutations in genes, life-threatening arrhythmias in the population, additional studies are needed on extended samples.
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Takeuchi, Satoshi, Ryo Kanto, Benjamin Rothrauff, Kevin Byrne, Freddie Fu e Kentaro Onishi. "Morphological evaluation of the quadriceps tendon using preoperative ultrasound in anterior cruciate ligament injured knee (114)". Orthopaedic Journal of Sports Medicine 9, n.º 10_suppl5 (1 de outubro de 2021): 2325967121S0026. http://dx.doi.org/10.1177/2325967121s00264.
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Objectives: The quadriceps tendon (QT) is one of the potential autografts used for anterior cruciate ligament (ACL) reconstruction, and excellent clinical results have been reported using QT autograft with or without a patellar bone block. In the coronal plane, QT autografts are commonly harvested from the central 10 mm of the tendon. To adequately reconstruct the native length of the ACL with an additional 15-20 mm to fill each bone tunnel, 65-70 mm of QT length is typically required to use an all soft tissue graft. However, a previous study has reported the length of the QT to vary from 53.9-104.0 mm between individuals when assessed with 3D-MRI. Additionally, the minimum width of the QT 70 mm proximal to the superior pole of the patella was found to be just 9.6 mm. Due to such variability in morphology, the QT should be evaluated prior to surgery to avoid harvesting an inadequately sized graft. However, to the best of our knowledge, QT morphology has not been evaluated pre-operatively in ACL injured knees. Furthermore, 3D-MRI is not typically used in daily practice for ACL injury, and it is difficult to evaluate the entire QT using the standard MRI protocol for ACL injury. Ultrasound is a readily available imaging modality and has several advantages compared to MRI, such as decreased examination cost and time. Thus, we aimed to investigate the morphological characteristics of the QT using preoperative ultrasound in ACL injured knees. Methods: A total of 33 patients (17 males and 16 females, 17 right and 16 left knees), who were diagnosed with an ACL tear requiring ACL reconstruction were prospectively included. Preoperative ultrasonographic examination was performed by a fellowship-trained musculoskeletal ultrasound specialist using a 18-5 MHz linear ultrasound transducer (Aplio i800, Canon medical systems, Japan). Patients were positioned supine with 20˚ of knee flexion. The transducer was placed on the anterior aspect of the knee perpendicular to the longitudinal axis of the QT to visualize the QT in the short axis. Short axis images were acquired at 30, 50, 60, 70, 80, 90 and 100 mm proximal to the superior pole of the patella. The length of the QT was determined by the two contiguous images that did and did not contain rectus femoris muscle tissue (i.e., if the rectus femoris muscle could be seen from 90 mm proximal to the superior pole of the patella, the length was 80-90 mm). All images with rectus femoris muscle belly were excluded from further width, thickness and CSA assessment. For each image, the width of the superficial and narrowest part of the QT, and the thickness of the central and thickest part of the QT were assessed (Figure 1). In addition, the cross-sectional area (CSA) was assessed at the central 10 mm of the width of the QT to simulate intraoperative harvesting of the QT (Figure 2). Estimated intraoperative diameter of the QT autograft was calculated based on the formula [(intraoperative diameter of the QT autograft) = 6.818 + 0.045 × (QT CSA)] created through the linear regression analysis between the CSA of the QT and intraoperative diameter of the QT autograft in a previous study. All data of the width, thickness, and CSA of the QT were compared among all assessment locations using one-way ANOVA followed by post hoc pairwise comparison using a Tukey test. The QT length was classified into 7 groups of 0-30, 30-50, 50-60, 60-70, 70-80, 80-90, 90-100 and 100 < mm, and demographic data (age, sex, height, weight and BMI) was compared among these groups using a one-way ANOVA or a Fisher exact test to reveal the relationship between the QT length and demographic data. Statistical significance was set at P<0.05. Results: Mean age, height, weight, and body mass index were 26.0 ± 11.5 years, 173.8 ± 11.5 cm, 72.6 ± 14.5 kg, and 23.9 ± 3.2 kg/m2, respectively. The QT length was 50-60 mm in 4 patients, 60-70 mm in 11 patients, 70-80 mm in 10 patients, 80-90 mm in 6 patients, 90-100 mm in 1 patient, and longer than 100 mm in 1 patient. No significant relationship was observed between the QT length and all demographic data (P>0.05). The mean QT thickness, width, and CSA at each position were shown in Table 1. All of the width, thickness, and CSA of the QT were significantly greater at 30 mm than 70 mm proximal to the superior pole of the patella. The estimated intraoperative diameter of the QT autograft was 0.6-0.7 mm greater at 30 mm than that at 70 and 80 mm. Regarding the range of the width of the QT, the minimum width of the narrowest segment of the QT was less than 10 mm wide at 60, 70, 80, and 90 mm in 5 patients. The minimum width of the superficial part of the QT was less than 10 mm wide at 60 and 70 mm in 2 patients. Conclusions: The important finding of this study was that the length of the QT was less than 70 mm in 45.5% of patients (15/33). Moreover, minimum width of the narrowest QT was shorter than 10 mm in 5 patients. These results indicate that approximately half of the patients may have had inappropriate QT width or length to be harvested as an all soft tissue QT autograft. In addition, all of the QT width, thickness, CSA, and estimated intraoperative diameter of the QT autograft were significantly greater at 30 mm than 70 mm proximal to the superior pole of the patella. Since the intraoperative diameter of the graft is commonly measured using a graft sizing device with 0.5 mm increments, the difference of the estimated diameter can be considered as clinically meaningful difference. Therefore, the size of the proximal part of the QT autograft can be smaller than distal part if the QT autograft is harvested to 70 mm or more proximal to the superior pole of the patella. Thus, preoperative assessment of the morphological characteristics of the QT using ultrasound may help to avoid inadequately sized grafts and may determine if a patellar bone block is needed to extend the length of the QT autograft.
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Takeuchi, Satoshi, Kevin J. Byrne, Ryo Kanto, Kentaro Onishi e Freddie H. Fu. "Morphological Evaluation of the Quadriceps Tendon Using Preoperative Ultrasound in Anterior Cruciate Ligament Reconstruction". American Journal of Sports Medicine 50, n.º 1 (17 de novembro de 2021): 111–17. http://dx.doi.org/10.1177/03635465211054095.
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Background: An evaluation of quadriceps tendon (QT) morphology preoperatively is an important step when selecting an individually appropriate autograft for anterior cruciate ligament (ACL) reconstruction. However, to our knowledge, there are no studies that have assessed the morphology of the entire QT in an ACL-injured knee preoperatively using ultrasound. Purpose: We aimed to investigate the morphological characteristics of the QT using preoperative ultrasound in ACL-injured knees. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 33 patients (mean age, 26.0 ± 11.5 years) with a diagnosed ACL tear undergoing primary ACL reconstruction were prospectively included. Using ultrasound, short-axis images of the QT were acquired in 10-mm increments from 30 to 100 mm proximal to the superior pole of the patella. The length of the QT was determined by 2 contiguous images that did and did not contain the rectus femoris muscle belly. The width of the superficial and narrowest parts of the QT, the thickness of the central and thickest parts of the QT, and the cross-sectional area at the central 10 mm of the superficial QT width were measured at each assessment location. The estimated intraoperative diameter of the QT autograft was calculated using a formula provided in a previous study. Results: There were no significant relationships between QT morphology and any of the demographic data collected. The length of the QT was less than 70 mm in 45.5% of patients (15/33). The width, thickness, cross-sectional area, and estimated intraoperative diameter of the QT autograft were significantly greater at 30 mm than at 70 mm proximal to the superior pole of the patella. Conclusion: Preoperative ultrasound may identify a QT that is too small for an all–soft tissue autograft in ACL reconstruction. Furthermore, harvesting a QT with a fixed width may result in autografts that are smaller proximally than they are distally. Assessing the morphology of the QT preoperatively using ultrasound may help surgeons to adequately reconstruct the native length and diameter of the ACL with a QT autograft.
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Wang, Qian, e Ping Zhu. "High Doses of Moternal Lymphocyte Infusions to Treat EBV-Associated Lymphoma in Pediatric Patients." Blood 114, n.º 22 (20 de novembro de 2009): 785. http://dx.doi.org/10.1182/blood.v114.22.785.785.
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Abstract Abstract 785 Introduction: The ability of allogeneic T cells to effect anti tumor responses had greatly improved the outcome of malignant EBV-associated lymphoproliferations. But high doses of DLI (donor lymphocyte infusion) could arise severe GVHD (graft versus host disease), and affect clinical outcomes. Recently, we successfully treated four EBV-associated lymphoma children with high doses of DLI from their IPA (inherited paternal antigens)-positive mothers, with no obvious GVHD occurred, which indicated that high doses of maternal leukocytes infusions could be an effective and safe therapy for EBV-associated lymphoma. Epstein-Barr virus (EBV) associated lymphoproliferative disorders(LPD) or hemophagocyticlymphohistiocytosis(EBV-HLH) in pediatric patients is classified into malignant lymphoma due to 2008 WHO International Working Formulation for lymphoma classification. In pediatric patients, cure is rarely get through conventional therapy such as chemotherapy. Approaches using adoptive immunotherapies offer very attractive alternative options for this subgroup of patients. The rationale for this strategy was that most EBV seropositive individuals have a high frequency of EBV specific precursors so that transfer of unmanipulated donor lymphocyte populations should be able to restore the immune response to EBV. However, these products may also contain a high frequency of alloreactive T cells so there is a significant risk of GVHD. Reciprocal cell traffic between mother and fetus during pregnancy gives rise to long-term postpartum fetal–maternal lympho-hematopoietic microchimerism (MC). Recent experimental evidence have suggested the association of MC with acquired immunologic hyporesponsiveness, which would benefit solid organ and hematopoietic stem cell transplantation. Some research have showed that mother-to-child transplantations involved significantly less GVHD and better outcome than father-to-child transplantations. Based on this fetal-maternal tolerance theory, we treated four EBV-associated lymphoma children with high doses of DLI from their mothers. Material and methods: Our four patients were all developed with fever over than 6 months, accompanied with lymphadenopathy, hepatosplenomegaly, two of them with skin lesion. The diagnosis were confirmed by skin or lymphnode biopsies. EBV-DNA is positive in all of the patients' plasma at the quantitation of >1×104 copies /ml. One of the patient had accepted chemotherapy in the past but got no remission. Using sex determining region Y chromosome (SRY) gene and insertion-deletion (InDel) polymorphism as fetal markers, child's DNA (IPAs) were detected through nested PCR and QT-PCR technology in all of the four mothers' blood at the level of 1: 104-105. With the approval of Ethics Committee, we treated these patients with infusions of unmanipulated leukocytes from their HLA-haploidentical, EBV-seropositive mothers. First at the doses below 107 PBNC cells/kg, while no side effects occurred, we began infusing high doses of mother's PBMC at above 108 PBNC cells /kg per time. Results: Clinical remissions were achieved in all of the patients within 3 to 10 days after the infusions, with remarkable reduction of the lymphnode and spleen, the EBV-DNA were undetectable in the patients' plasma. The remissions were sustained without further therapy for 5-10 months except one patient who got recurrance of lymphadenopathy and fever about two months after each infusion. We had monitored the quantitation of his mother's lymphocyte in the child's blood and found no detectable maternal MC a week after the infusion. During the process, none of our patients developed obvious GVHD. Conclusions: High doses of maternal lymphocyte infusions could be an effective and safe treatment for EBV-associated lymphoma. Further research is needed to improve the sustained effect. Disclosures: No relevant conflicts of interest to declare.
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Brennecka, Celeste R., Mark C. Preul, Timothy A. Becker e Brent L. Vernon. "In vivo embolization of lateral wall aneurysms in canines using the liquid-to-solid gelling PPODA-QT polymer system: 6-month pilot study". Journal of Neurosurgery 119, n.º 1 (julho de 2013): 228–38. http://dx.doi.org/10.3171/2013.3.jns121865.
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Object Over the past 20 years, endovascular embolization has become the preferred method of treating cerebral aneurysms. While there are many embolic devices on the market, none is ideal. In this study the authors investigated the use of a liquid-to-solid gelling polymer system—that is, poly(propylene glycol) diacrylate and pentaerythritol tetrakis (3-mercaptopropionate) (PPODA-QT)—to embolize in vivo aneurysms over a 6-month period. Methods Experimental aneurysms were created in the carotid arteries of 9 canines. Aneurysms were embolized with the polymer only (PPODA-QT, 3 dogs), filled with PPODA-QT after placement of a “framing” platinum coil (coil + PPODA-QT, 3 dogs), or packed with platinum coils (coils only, 3 dogs). Aneurysm occlusion was angiographically monitored immediately and 6 months after embolization. After 6 months, the ostial regions of explanted aneurysms were assessed macroscopically and histologically. Results All aneurysms showed 100% angiographic occlusion at 6 months, but turbulent blood flow was observed in 1 coils-only sample. Ostial regions of explanted coils-only aneurysms showed neointimal tissue surrounding individual coils but no continuous tissue layer over the aneurysm neck. All PPODA-QT aneurysms displayed smooth ostial surfaces, but 2 of 3 coil + PPODA-QT aneurysms showed polymer (unassociated with the coil) protruding into the vessel lumen, contributing to rough ostial surfaces. Neointimal tissue was present in PPODA-QT and coil + PPODA-QT aneurysms and covered smooth ostial surfaces more completely than in coils-only aneurysms. Conclusions This study compared neointimal tissue overgrowth in the ostium of experimental aneurysms embolized with PPODA-QT, PPODA-QT plus a framing coil, or coils alone. The coils-only and coil + PPODA-QT groups showed rough and discontinuous ostial surfaces, which hindered neointimal tissue coverage. The PPODA-QT aneurysms consistently produced smooth ostial surfaces that facilitated more complete neointimal tissue coverage over aneurysm necks.
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Laptev, Dmitriy Nikitich. "Аrterial stiffness and cardiovascular autonomic neuropathy relationship in children and adolescents with type 1 diabetes mellitus". Diabetes mellitus 18, n.º 1 (18 de março de 2015): 94–100. http://dx.doi.org/10.14341/dm2015194-100.
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Aim. To evolve the association between cardiac autonomic function and arterial stiffness in children and adolescents with type 1 diabetes mellitus (T1DM). Materials and methods. 72 T1DM patients aged 7?18 years without history of macrovascular complications or renal disease, including microalbuminuria, were involved in the study. Cardiac function was assessed by the cardiovascular tests and 24-hour ECG monitoring with automatic calculation of QT interval and heart rate variability (HRV) parameters. Artery stiffness was assessed by measurement of pulse wave velocity (PWV) and augmentation index (AI) obtained from arterial blood pressure monitoring for 24 hours. Results. Estimated prevalence of cardiovascular autonomic neuropathy (CAN) was 31,9%. CAN+ patients had significantly higher PWV and AI than those without CAN. A negative correlation between PWV and AI with some cardiovascular tests and HRV parameters was observed. In multivariable analysis, AI was independent predictor of autonomic dysfunction defined as number of positive cardiovascular tests, HRV parameters below normal values and prolongation of QT interval (?. =0,18; p=0,035). Conclusion. Cardiac autonomic function is an independent predictor of arterial stiffness, in children and adolescents with T1D without macrovascular and renal complications. The presence of cardiovascular risk factors and arterial stiffness in children and adolescents with T1DM may contribute to the increased cardiovascular morbidity and mortality in adulthood in patients with CAN.
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Pelchovitz, Daniel J., Jason Ng, Alexandru B. Chicos, Daniel W. Bergner e Jeffrey J. Goldberger. "QT-RR hysteresis is caused by differential autonomic states during exercise and recovery". American Journal of Physiology-Heart and Circulatory Physiology 302, n.º 12 (15 de junho de 2012): H2567—H2573. http://dx.doi.org/10.1152/ajpheart.00041.2012.
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QT-RR hysteresis is characterized by longer QT intervals at a given RR interval while heart rates are increasing during exercise and shorter QT intervals at the same RR interval while heart rates are decreasing during recovery. It has been attributed to a lagging QT response to different directional changes in RR interval during exercise and recovery. Twenty control subjects (8 males, age 51 ± 6 yr), 16 subjects with type 2 diabetes (12 males, age 56 ± 8 yr), 71 subjects with coronary artery disease (CAD) and preserved left ventricular ejection fraction (LVEF) (≥50%) (51 males, age 59 ± 12 yr), and 17 CAD subjects with depressed LVEF (<50%) (13 males, age 57 ± 10 yr) underwent two 16-min exercise tests followed by recovery. In session 2, parasympathetic blockade with atropine (0.04 mg/kg) was achieved at end exercise. QT-RR hysteresis was quantified as: 1) the area bounded by the QT-RR relationships for exercise and recovery in the range of the minimum RR interval at peak exercise to the minimum RR interval + 100 ms and 2) the difference in QT interval duration between exercise and recovery at the minimum RR interval achieved during peak exercise plus 50 ms (ΔQT). The effect of parasympathetic blockade was assessed by substituting the QT-RR relationship after parasympathetic blockade. QT-RR hysteresis was positive in all groups at baseline and reversed by parasympathetic blockade ( P < 0.01). We conclude that QT-RR hysteresis is not caused by different directional changes in RR interval during exercise and recovery. Instead, it is predominantly mediated by differential autonomic nervous system effects as the heart rate increases during exercise vs. as it decreases during recovery.
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Malik, Marek, Katerina Hnatkova, Tomas Novotny e Georg Schmidt. "Subject-specific profiles of QT/RR hysteresis". American Journal of Physiology-Heart and Circulatory Physiology 295, n.º 6 (dezembro de 2008): H2356—H2363. http://dx.doi.org/10.1152/ajpheart.00625.2008.
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The time lag of the QT interval adaptation to heart rate changes (QT/RR hysteresis) was studied in 40 healthy subjects (18 females; mean age, 30.4 ± 8.1 yr) with 3 separate daytime (>13 h) 12-lead electrocardiograms (ECG) in each subject. In each recording, 330 individual 10-s ECG segments were measured, including 100 segments preceded by 2 min of heart rate varying greater than ±2 beats/min. Other segments were preceded by a stable heart rate. In segments preceded by variable rate, QT/RR hysteresis was characterized by λ parameters of the exponential decay models. The intrasubject SDs of λ values were compared with the intersubject SD of the individual means. The λ values were also correlated to individually optimized parameters of heart rate correction. Intrasubject SDs of λ were substantially smaller than the population SD of individual means (0.390 ± 0.197 vs. 0.711, P < 0.0001). The λ values were unrelated to the QT/RR correction parameters. When compared with the corrected QT (QTc) for averaged RR intervals in 10-s ECGs and with the averaged RR intervals in 2-min history, QTc for QT/RR hysteresis led to a substantially smaller SD of QTc values (11.4 ± 2.00, 6.33 ± 1.31, and 4.66 ± 0.85 ms, respectively, P < 0.0001). Thus the speed with which the QT interval adapts to heart rate changes is highly individual with intrasubject stability and intersubject variability. QT/RR hysteresis is independent of the static QT/RR relationship and should be considered as a separate physiological process. The combination of individual heart rate correction with individual hysteresis correction of the QT interval is likely to lead to substantial improvements of cardiac repolarization studies.
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Stock, Eileen M., John E. Zeber, Catherine J. McNeal, Javier E. Banchs e Laurel A. Copeland. "Psychotropic Pharmacotherapy Associated With QT Prolongation Among Veterans With Posttraumatic Stress Disorder". Annals of Pharmacotherapy 52, n.º 9 (11 de abril de 2018): 838–48. http://dx.doi.org/10.1177/1060028018769425.
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Background: In 2012, the Food and Drug Administration issued Drug Safety Communications on several drugs associated with QT prolongation and fatal ventricular arrhythmias. Among these was citalopram, a selective serotonin reuptake inhibitor (SSRI) approved for depression and commonly used for posttraumatic stress disorder (PTSD). Evaluation of the risk for QT prolongation among other psychotropic drugs for individuals with PTSD remains limited. Objective: Explore psychotropic drugs associated with QT prolongation among veterans with PTSD. Methods: Patients in the Veterans Health Administration in 2006-2009 with PTSD and QT prolongation (176 cases) were matched 1:4 on age, gender, visit date and setting, and physical comorbidity. Classification trees assessed QT prolongation risk among prescribed medications (n=880). Results: Receipt of any drug with known risk of QT prolongation varied by group (23% QT cases vs 15% control, p<0.01). Psychotropic medications conferring significant risks included ziprasidone (3% vs 1%, p=0.02) and buspirone (6% vs 2%, p=0.01). Increased risk was not observed for the SSRIs, citalopram and fluoxetine. Classification trees found that sotalol and amitriptyline carried greater risk among cardiac patients and methadone, especially if prescribed with quetiapine, among noncardiac patients. Per adjusted survival model, patients with QT prolongation were at increased risk for death (hazard ratio=1.60; 95% CI=1.04-2.44). Conclusions: Decision models are particularly advantageous when exploring nonlinear relationships or nonadditive interactions. These findings may potentially affect clinical decision-making concerning treatment for PTSD. For patients at higher risk of QT prolongation, antidepressants other than amitriptyline should be considered. Medications for comorbid conditions should also be closely monitored for heightened QT prolongation risk.
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Ozbay, Yılmaz, e Şeyda Yavuzkir. "PP-102 The Effect of Pregnancy on QT Dispersion". American Journal of Cardiology 115 (março de 2015): S142—S143. http://dx.doi.org/10.1016/j.amjcard.2015.01.459.
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Faria, Sergio L., Juvenal A. Oliveira Fo, Alice R. Garcia, Christiane Amalfi, Julia M. B. Spirandeli e Eliane C. de Campos. "Quimioterapia Concomitante à Radioterapia no Tratamento Adjuvante do Câncer da Mama Localizado". Revista Brasileira de Cancerologia 47, n.º 2 (29 de junho de 2001): 153–58. http://dx.doi.org/10.32635/2176-9745.rbc.2001v47n2.2323.
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Introdução: O tratamento adjuvante do câncer da mama com freqüência envolve o uso de radio (RT) e quimioterapia (QT). A seqüência ideal desta combinação ainda não foi estabelecida. O atraso da RT pode permitir falha local; o atraso da QT pode permitir falha sistêmica. Um tratamento não deve prejudicar o outro. Este artigo relata nossa experiência com RT+QT concomitantes. Material e Métodos: Foi feita análise retrospectiva de pacientes com câncer da mama que receberam RT+QT ao mesmo tempo, após a cirurgia (conservadora ou radical), tratadas entre jan/89 e jan/99. A RT não incluiu mamária interna e axila, e teve dose total de 50Gy. Durante a RT pacientes receberam 1 ou 2 ciclos de ciclofosfamida, methotrexate e 5 fluouracil (CMF). Foram avaliadas mudanças de dose, toxicidade, tolerância. Resultados: Idade média de 44 anos; seguimento mediano de 33 meses. Cirurgia conservadora: 62 pts; mastectomia: 41 pts. Todas receberam o tratamento sem mudança de dose ou interrupção da RT. Quanto à QT, 10/103 pts receberam 10%-20% menos dose de QT. Não houve evidência de mudança em resultados cosméticos. Conclusão: Resultados sobre demora no início de RT ou QT vêm de estudos retrospectivos e são conflitantes. Enquanto a seqüência ideal do uso de RT e QT está para ser definida, temos feito ambos os tratamentos ao mesmo tempo, com uso de CMF como esquema de QT, sem maiores mudanças de dose ou toxicidade de nenhum dos tratamentos. A idéia é não atrasar nenhum dos dois tratamentos, mas está para ser provado se esta alternativa traz benefícios significativos.
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Rádi, József, Domonkos Stéger, Aurél Marton e Rita Földényi. "Interactions of 2,2′-bipyridine herbicide intermediate with humic acid". Green Processing and Synthesis 3, n.º 2 (1 de abril de 2014): 155–61. http://dx.doi.org/10.1515/gps-2014-0008.
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Abstract The binding of the neutral 2,2′-bipyridine (BP) molecule to solid humic acid (HA) was studied in the presence of CaCl2 background electrolyte (10-2 mol/l), at pH=6.1–6.3. To investigate the binding, two different methods were used: the well-established static adsorption equilibrium measurements and the technique of equilibrium dialysis (ED). The obtained isotherms were fitted by the Langmuir equation, yielding values for the total binding capacity (qT) and the Langmuir constant (K). The values obtained from the batch experiment were: qT=3.3×10-4 mol/gHA, K=4.1×102 l/mol and from the ED experiment were: qT=5.7×10-4 mol/gHA, K=2.8×102 l/mol. From the linear range of the isotherm, the value of the distribution coefficient KD was calculated as 3.3×102 l/kgHA (by both methods). This parameter was used to calculate the value of KOC: 6.6×102 l/kgOC, indicating that BP is a slightly mobile pollutant in the HA dominated soil.
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Rayhan, Mohammad Zannatul, M. Rokib Sadi, Prosad Kumer Sarker, M. Asif Hossain e Most Mehenaz Alam. "QT interval prolongation in people treated with bedaquiline for drug-resistant tuberculosis". International Journal of Research in Medical Sciences 12, n.º 5 (30 de abril de 2024): 1430–37. http://dx.doi.org/10.18203/2320-6012.ijrms20241223.
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Background: Bedaquiline (BDQ) is indeed recommended for treating multidrug-resistant tuberculosis (MDR-TB). However, it's essential to monitor patients receiving bedaquiline therapy closely because it has been associated with prolongation of the QTc interval. This study aimed to assess the association of bedaquiline to QT interval prolongation in DR-TB patients. Methods: This was an observational longitudinal study conducted in the Department of Respiratory Medicine in Chest Disease Hospital, Rajshahi, from August 2020 to February 2023. A total of 44 MDR-TB patients were included in the study. Data analyses were done by using Statistical Package for Social Sciences (SPSS) version 25.0. Results: Out of 44 patients the majority 30(68.2%) patients belonged to age >40 years with a mean age of 49.3±15.6 years, and all patients were male. All MDR patients were detected by sputum Gene-Xpert, 44 (100%), and sputum for AFB culture was done in all patients, 44 (100%). QT level and QT changes were statistically significant for baseline and 24 weeks. Only one patient died in 2 weeks of follow-up (Table 3). Changes of QT >60 ms was found in 6 (13.6%) and ≤60 ms was 38 (86.4%). Age, sex, marital status, residence, educational status, occupational status, monthly income, chief complaints, co-morbidities, and using drug-causing QT prolongation were not statistically significant (p>0.05). Conclusions: Prolonged QT interval is in DR-TB patients who receive treatment using the bedaquiline regimen. We observed that with a moderate prolongation of QTc, there were no arrhythmias recorded and 1 death occurred due to acute MI.
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Kalatsei, L. V., e V. A. Snezhitskiy. "METHODOLOGICAL APPROACHES TO MEASURING AND ESTIMATING THE DURATION OF QT INTERVAL OF A STANDARD ELECTROCARDIOGRAM". Journal of the Grodno State Medical University 17, n.º 1 (2019): 99–105. http://dx.doi.org/10.25298/2221-8785-2019-17-1-99-105.
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Segondy, Michel, Thoai-Duong Ly, Martine Lapeyre e Brigitte Montes. "Evaluation of the Nuclisens HIV-1 QT Assay for Quantitation of Human Immunodeficiency Virus Type 1 RNA Levels in Plasma". Journal of Clinical Microbiology 36, n.º 11 (1998): 3372–74. http://dx.doi.org/10.1128/jcm.36.11.3372-3374.1998.
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Nuclisens HIV-1 QT is a new version of the NASBA HIV-1 QT assay for quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in plasma. The specificity of this assay was 100% in one laboratory and 99%—with nonrepeatability of the initial false positive—in another. The test was linear between 2.0 and 6.0 log RNA copies per ml. According to the input HIV-1 RNA concentration, accuracy varied from −0.11 to +0.10 log RNA copy per ml and precision varied from 0.66 to 0.14 log RNA copy per ml. Reproducibility decreased when the HIV-1 RNA level was near the lower limit of quantitation of the test. HIV-1 RNA could be quantitated by Nuclisens HIV-1 QT in 36% (laboratory 1) and 24% (laboratory 2) of clinical samples with HIV-1 RNA levels lower than the lower limit of quantitation by NASBA HIV-1 QT. Nuclisens HIV-1 QT was not suitable for measurement of RNA from clade G and group O HIV-1 strains.
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Kayali, Seyma, e Fadime Demir. "The effects of cigarette smoking on ventricular repolarization in adolescents". Einstein (São Paulo) 15, n.º 3 (setembro de 2017): 251–55. http://dx.doi.org/10.1590/s1679-45082017ao3945.
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ABSTRACT Objective To assess the association between cigarette smoking and ventricular arrhythmias in adolescents. Novel electrocardiographic parameters –Tp-e interval, as well as Tpe/QT and Tpe/QTc ratios – were used to make this assessment. Methods The study population consisted of 87 subjects aged between 16-19 years. Fifty-one adolescent smokers with no risk of arrhythmia comprised the Smoker Group, and 36 adolescents who had never smoked cigarettes comprised the Control Group. Smokers were defined as patients smoking more than three cigarettes per day, for at least 1 year. Body mass index, systolic, diastolic and mean blood pressures were measured, and electrocardiograms were performed on all subjects. Heart rate, PR and Tp-e intervals, and Tpe/QT, Tpe/QTc ratio were digitally measured. Results Adolescents in Smoker Group had smoked cigarettes for 2.9±1.4 years (range 1 to 6 years). The mean age at starting smoking was 13.8±1.4 years. There were no differences between smokers and Control Group as to baseline clinical variables (p>0.05). The PR, QT and QTc intervals were similar in all groups. Tp-e interval (98.4±12.7ms and 78.3±6.9 ms; p<0.001), Tpe/QT (0.28±0.04 and 22±0.03; p<0.01), Tpe/QTc (0.24±0.03 and 0.19±0.01; p<0.001) ratios were significantly higher in Smoker Group. There were no correlations between years of smoking, number of cigarettes per day, Tpe interval, Tpe/QT or Tpe/QTc ratios. Conclusion Cigarette smoking is associated with risk of ventricular arrhytmogenesis with prolonged Tp-e interval and increased Tpe/QT and Tpe/QTc ratios in adolescents.
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Eroglu, Talip E., Marieke T. Blom, Patrick C. Souverein, Anthonius de Boer e Hanno L. Tan. "Multiple categories of non-cardiac QT-prolonging drugs are associated with increased risk of out-of-hospital cardiac arrest: real-world data from a population-based study". EP Europace 24, n.º 4 (18 de outubro de 2021): 630–38. http://dx.doi.org/10.1093/europace/euab251.
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Abstract Aim Drugs causing QT-prolongation as off-target effect [non-cardiac QT-prolonging drugs (QT-drugs)] increase the risk of out-of-hospital cardiac arrest (OHCA). Such drugs are categorized in multiple clinically widely used CredibleMeds.org lists. Category 1 (‘known risk of Torsade de Pointes’) and category 2 (‘possible risk of Torsade de Pointes’) are of particular clinical relevance. However, a category-stratified analysis of OHCA-risk is presently unavailable. Methods and results We conducted a case–control study with OHCA-cases from presumed cardiac causes included from the ARREST registry in the Netherlands (2009–2018) that was specifically designed to study OHCA, and age/sex/OHCA-date matched non-OHCA-controls. Adjusted odds ratios for OHCA (ORadj) of QT-drugs from categories 1 or 2 were calculated, using conditional logistic regression. Stratified analysis was performed according to sex, age, and presence of cardiovascular drugs (proxy for cardiovascular disease). We included 5473 OHCA-cases (68.8 years, 69.9% men) and matched them to 20 866 non-OHCA-controls. Compared with no use of non-cardiac QT-drugs, drugs of both categories were associated with increased OHCA-risk, but seemingly weaker for category 2 {category 1: case 3.2%, control 1.4%, ORadj 1.7 [95% confidence interval (CI): 1.3–2.1]}; [category 2: case 7.3%, control 4.0%, ORadj 1.4 (95% CI: 1.2–1.6)]. The increased risk occurred in men and women, at all ages (highest in patients aged ≤50 years), and both in the presence or absence of cardiovascular drug use. Conclusion Both category 1 and category 2 QT-drugs are associated with increased OHCA-risk in both sexes, at all ages, and in patients taking or not taking cardiovascular drugs.
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Schwartz, P. J., e E. Locati. "The Idiopathic Long QT Syndrome: Pathogenetic Mechanisms and Therapy". European Heart Journal 6, suppl D (2 de novembro de 1985): 103–14. http://dx.doi.org/10.1093/eurheartj/6.suppl_d.103.
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Hepsen, Sema, Davut Sakiz, Hilal Erken Pamukcu, Ismail Emre Arslan, Hakan Duger, Pinar Akhanli, Muhammed Erkam Sencar et al. "The Assessment of Ventricular Arrhythmia Indicators Based on Electrocardiography in Patients With Differentiated Thyroid Cancer Followed Up With Levothyroxine Suppression". Angiology 72, n.º 7 (9 de fevereiro de 2021): 657–63. http://dx.doi.org/10.1177/0003319721993343.
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Levothyroxine suppression therapy (LST) can cause some unfavorable effects on the cardiovascular system in patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate ventricular arrhythmia predictors based on electrocardiography (ECG) in patients with DTC with LST. The ECG parameters including QT, corrected QT (QTc), Tp-e intervals, Tp-e/QT, and Tp-e/QTC ratios of 265 patients with DTC who met the inclusion criteria were compared with 100 controls. No difference was observed in the number of patients with DTC and controls with prolonged and borderline QTc interval ( P = .273). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients ( P = .002, P = .02, P = .003; respectively). Linear regression analysis suggested that male gender was a predictor of higher Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios (β = 4.322, R 2 = 0.024, P = .042; β = 0.016, R 2 = 0.048, P = .005; β = 0.015, R 2 = 0.044, P = .006, respectively). A higher serum fT4 level was found to be associated with a higher Tp-e/QT ratio (β = 0.018, R 2 = 0.089, P = .007). Ventricular arrhythmia indicators were found to be higher in patients with DTC with LST. Defining ventricular arrhythmia predictors through ECG, an easily accessible cardiac diagnostic tool, can be potentially useful in raising awareness of the possible cardiac harm of LST.
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Yiannakopoulos, Christos K., Georgios Theotokatos, Iakovos Vlastos, Nikolaos Platon Sachinis, Elina Gianzina, Georgios Kalinterakis e Olympia Papakonstantinou. "Morphometric MRI Evaluation of Three Autografts Used in Anterior Cruciate Ligament Reconstruction in Athletes". Journal of Functional Morphology and Kinesiology 8, n.º 1 (23 de janeiro de 2023): 14. http://dx.doi.org/10.3390/jfmk8010014.
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The purpose of the present study was to quantify the morphometric characteristics of three tendon autografts (hamstring tendons (HT), quadriceps tendon (QT), and patellar tendon (PT)) used in anterior cruciate ligament (ACL) reconstruction. For this purpose, knee magnetic resonance imaging (MRI) was obtained in 100 consecutive patients (50 males and 50 females) with an acute, isolated ACL tear without any other knee pathology were used. The level of the physical activity of the participants was determined using the Tegner scale. Measurements of the tendons’ dimensions (PT and QT tendon length, perimeter, cross-sectional area (CSA), and maximum mediolateral and anteroposterior dimensions) were performed perpendicular to their long axes. Higher values were recorded as regards the mean perimeter and CSA of the QT in comparison with the PT and the HT (perimeter QT: 96.52 ± 30.43 mm vs. PT: 63.87 ± 8.45 mm, HT: 28.01 ± 3.73 mm, F = 404.629, p < 0.001; CSA QT: 231.88 ± 92.82 mm2 vs. PT: 108.35 ± 28.98 mm2, HT: 26.42 ± 7.15 mm2, F = 342.415, p < 0.001). The length of the PT was shorter in comparison with the QT (53.1 ± 7.8 vs. 71.7 ± 8.6 mm, respectively, t = −11.243, p < 0.001). The three tendons showed significant differences in relation to sex, tendon type, and position as regards the perimeter, CSA, and the mediolateral dimensions but not for the maximum anteroposterior dimension.