Design: Value-Based Medicine (Center for Value-Based Medicine, Flourtown, PA) 14-year, cost-utility analysis using patient preferences and 2012 United States real dollars. Participants: Published data from ATM/ATR tumor the identical Ranibizumab Injection in Subjects with Clinically Significant Macular Edema with Center Involvement Secondary to Diabetes Mellitus (RISE and RIDE) clinical trials. Methods:
An incremental cost-utility analysis was performed using societal and third-party insurer cost perspectives. Costs and outcomes were discounted with net present value analysis at 3% per annum. Main Outcome Measures: The incremental comparative effectiveness was measured in: (1) quality-adjusted life year (QALY) gain and (2) percent patient value (quality-of-life) gain. Cost effectiveness was quantified with the cost-utility ratio (CUR) measured as $/QALY. Results: The 14-year, incremental patient value gain conferred by intravitreal ranibizumab therapy for diabetic maculopathy was 0.9981 QALY, equating to an 11.6% improvement in quality of life. The direct, ophthalmic medical cost for ranibizumab therapy in 1 eye was $30 116, whereas for 2 eyes it was $56 336. The direct, nonophthalmic, medical costs saved from decreased depression, injury, skilled nursing facility admissions, nursing home admissions, and other vision-associated
selleck products costs totaled $51 758, resulting in an overall direct medical cost of $4578. The net mean societal cost for bilateral ranibizumab Proton Pump inhibitor therapy was -$30
807. Of this total, decreased caregiver costs accrued a $31 406 savings against the direct medical costs, whereas decreased wage losses accrued a $3978 savings. The third-party insurer CUR for bilateral ranibizumab therapy was $4587/QALY. The societal cost perspective for bilateral therapy was -$30 807/QALY, indicating that ranibizumab therapy dominated sham therapy because it conferred both a positive QALY gain of 0.9981 and a financial value gain (positive financial return on investment) of $30 807 referent to the direct ophthalmic medical costs expended. Conclusions: Intravitreal ranibizumab therapy for the treatment of DME confers considerable patient (human) value gain. It also accrues financial value to patients, public and private insurers, and society. (C) 2015 by the American Academy of Ophthalmology.”
“Modern sphincter-preserving surgery for ultralow rectal carcinoma has a comparable oncological radicality to abdomino-perineal extirpation (APE). The aim of this study was to assess the long-term morbidity of ultralow anterior resection (ULAR) and its impact on quality of life (QoL)\n\nThe medical records of 142 consecutive patients who underwent surgery for ultralow rectal carcinoma from January 1991 to December 2004 were reviewed retrospectively. The rate of rehospitalisation and rate of non-reversed temporary stomas (“failure” stoma) were analysed.
This indicates that the main function of ankle collateral ligaments is to sense joint speeds in motions.”
“PurposeThis review highlights AL3818 price the physiological mechanisms underlying the neural regulation of the kidney, normally to maintain
cardiovascular homeostasis, and in pathophysiological states of hypertension and renal disease. It is relevant because of the demonstration that bilateral renal denervation in different hypertensive groups causes a sustained reduction in blood pressure.Recent findingsThere are patients groups in whom their hypertension is resistant to antihypertensive drugs or with renal diseases in which they are contraindicated. Recently, medical devices have been developed to manipulate the sympathetic nervous system, for example, implantation of carotid sinus nerve stimulating electrodes and ablation of the renal innervation. These approaches have been relatively
successful but there remains a lack of understanding of the neural mechanisms impinging on the kidney that regulate long-term control of blood pressure.SummaryThe observation that bilateral renal nerve ablation can reduce blood pressure represents an important therapeutic milestone. Nonetheless, questions arise as to the underlying mechanisms, the long-term consequences, whether there may be re-innervation over a number of years, or whether some unknown consequence to the denervation may arise. This may point to the development of novel compounds targeted to the innervation of the kidney.”
“Background: In a double-blind, H 89 concentration randomised phase III trial of advanced renal cell carcinoma patients, pazopanib 800 mg QD (n = 290) versus placebo (n = 145) significantly prolonged progression-free survival (hazard ratio (HR) = 0.46, 95% confidence interval [CI] 0.34-0.62, p-value < 0.0001), without important differences in health-related quality of life (HRQoL). This post-hoc analysis evaluated time to HRQoL deterioration and whether tumour response/stabilisation was associated with
HRQoL improvement.\n\nMethods: HRQoL was assessed using EORTC QLQ-C30 and EQ-5D. Effect of pazopanib on time to >= 20% decline from baseline in summary scores was estimated for all patients and by prior treatment. Analyses were conducted for different HRQoL deterioration selleck thresholds. HRQoL changes were stratified by benefit and compared: complete response (CR) or partial response (PR) versus progressive disease (PD); CR/PR versus stable disease (SD), and SD versus PD.\n\nResults: There was a trend for pazopanib patients to be less likely than placebo patients to experience P20% HRQoL deterioration in EORTC-QLQ-C-30 global health status/QOL scale (HR = 0.77; 95% CI 0.57-1.03, not significant). Results by prior treatment and different HRQoL deterioration thresholds were similar. Patients with CR/PR and SD experienced significantly less HRQoL deterioration than those with PD (p < 0.001, p = 0.
These results offer a new perspective for understanding seemingly paradoxical
traits in human populations. (c) 2013 Elsevier Inc. All rights reserved.”
“Allograft inflammatory factor-1 (AIF-1) is Selleckchem PD-L1 inhibitor a calcium-binding, scaffold-signalling protein expressed in vascular smooth muscle cells (VSMCs) in response to injury. The effects of AIF-1 attenuation on development of intimal hyperplasia are unknown, and the molecular mechanisms of these effects remain uncharacterized. The goals of the present study were to determine whether AIF-1 knockdown reduced VSMC proliferation, migration, and intimal hyperplasia, and determine AIF-1 effects on signal transduction in VSMCs.\n\nBalloon angioplasty-injured rat carotid arteries transduced with adenovirus to overexpress AIF-1 (AdAIF-1) significantly increased, and adenovirus to knock down AIF-1 (AdsiRNA) expression significantly decreased neointimal formation compared with green fluorescent protein (AdGFP) and Adscrambled controls (P < 0.05 and P < 0.01, n = 6). Primary
rat VSMCs transduced with AdAIF-1 displayed a significant increase in proliferation, and AdsiRNA-transduced VSMCs proliferated significantly more Selleckchem AZD8055 slowly than controls (P < 0.05). VSMCs transduced with AdAIF-1 show increased migration when compared with control VSMCs (P < 0.01). Rat VSMCs transduced with AdAIF-1 showed constitutive and prolonged activation
of the mitogen-activated protein kinase p38, whereas AdsiRNA-treated VSMCs showed decreased p38 activation compared with AdGFP (P < 0.05). Immunohistochemical analysis of AdAIF-1-transduced carotid arteries showed increased staining with a phospho-specific p38 antibody compared with AdGFP-transduced arteries. A specific p38 inhibitor abrogated buy STA-9090 AIF-1-induced VSMC proliferation, but not AIF-1-induced migration.\n\nTaken together, AIF-1 expression plays a key role in the development of neointimal hyperplasia. AIF-1 expression enhances the activation of p38 MAP kinase. AIF-1-enhanced proliferation is p38 kinase dependent, but AIF-1-enhanced VSMC migration is p38 independent.”
“The overexpression of the multidrug resistance gene (MDR-1) and its translational product p-glycoprotein (P-gp) may play an important role in pharmacoresistant epilepsy. We established the rat astrocyte model overexpressing P-gp induced by coriaria lactone and successfully nucleofected it with the siRNA-hairpin expression vector pSIREN-shuttle designed to target MDR-1B mRNA. The mRNA expression of MDR-1B gene was mostly knock down by 67.70% (p<0.01). The expression of P-gp in experimental group was significantly lower than that in negative control (p<0.05), and the rhodamine efflux ratio of experimental group (23.08%) was remarkably lower than that of negative control (78.35%, p<0.01).
001). The results of the Tukey honestly significant difference post hoc analyses revealed significant differences between groups 1 and 4 (P = 0.026), 2 and 4 (P = 0.007), PD-1/PD-L1 Inhibitor 3 inhibitor and 3 and 4 (P = 0.013) for training frequency. There were also significant differences between groups 1 and 2 (P < 0.001), 1 and 4 (P < 0.001), and 2 and 4 (P = 0.021) for body height. In sledge length, significant differences were observed between groups 1 and 2 (P < 0.001),
1 and 3 (P < 0.001), 1 and 4 (P = 0.016), and 2 and 4 (P = 0.028). There was no strong evidence to support disability group differences in game efficiency measures.\n\nConclusions: The results may confirm the lack of a need for additional classification in sledge hockey beyond minimum eligibility or may enhance PF-04929113 molecular weight the argument that a classification system may be needed because the lower functioning disabilities are not being represented in the sport.”
centrifugally cast 20Cr32Ni1Nb stainless steel manifold in service for 16 years at temperatures ranging from 1073 K to 1123 K (800 A degrees C to 850 A degrees C) has been characterized using scanning electron microscopy (SEM), electron probe micro-analysis (EPMA), auger electron spectroscopy (AES), and X-ray diffraction (XRD). Nb(C,N), M23C6, and the silicide G-phases (Ni16Nb6Si7) were all identified in a conventional SEM, while the nitride Z-phase (CrNbN) was observed only in AES. M23C6, Z-phase and Selleckchem Epigenetic inhibitor G-phase were characterized in XRD. Thermodynamic equilibrium calculations using ThermoCalc Version
S, with the TCS Steel and Fe-alloys Database (TCFE6), and Thermotech Ni-based Superalloys Database (TTNI8) were validated by comparing experimental phase fraction results obtained from both EPMA and AES. A computational study looking at variations in the chemical composition of the alloy, and how they affect phase equilibria, was investigated. Increasing the nitrogen concentration is shown to decrease G-phase formation, where it is replaced by other intermetallic phases such as Z-phase and pi-phase that do not experience liquation during pre-weld annealing treatments. Suppressing G-phase formation was ultimately determined to be a function of minimizing silicon content, and understabilizing the Nb/(C + 6/7N) ratio.”
“The aim of the present study was to evaluate the prevalence and correlates of right ventricular (RV) noncompaction (RVNC), RV systolic dysfunction, and RV myocardial fibrosis in patients with isolated left ventricular (LV) noncompaction (LVNC). For this purpose, cine and contrast-enhanced cardiac magnetic resonance imaging (MIRE) was used. A total of 56 consecutive patients with isolated LVNC were included in the study. The diagnosis of isolated LVNC was based on the presence of standard cardiac MRI and clinical criteria.
beta 2-M mediates this process by activating epithelial to mesenchymal transition (EMT) to promote lethal bone and soft tissue metastases in host mice. beta 2-M interacts with its receptor, hemochromatosis (HFE) protein,
to modulate iron responsive pathways in cancer cells. Inhibition of either beta 2-M or HFE results in reversion of EMT. These results demonstrate the role of beta 2-M in cancer metastasis and lethality. Thus, beta 2-M and its downstream signaling pathways are promising prognostic markers of cancer metastases and novel therapeutic targets for cancer therapy. Cancer Res; 71(7); 2600-10. (C)2011 ABT-263 AACR.”
“Purpose\n\nTo investigate the impact of prior-to-transplantation azacitidine (AZA) on patient outcome after allogeneic stem-cell transplantation (alloSCT) for myelodysplastic syndrome (MDS).\n\nPatients and Methods\n\nOf the 265 consecutive patients who underwent alloSCT for MDS between October 2005 and December 2009, 163 had received cytoreductive
treatment prior to transplantation, including induction chemotherapy (ICT) alone (ICT group; n = 98), AZA alone (AZA group; n = 48), or AZA preceded or followed by ICT (AZA-ICT group; n = 17). At diagnosis, 126 patients (77%) had an excess of marrow blasts, and 95 patients (58%) had intermediate-2 or high-risk MDS according to the International Prognostic Scoring System (IPSS). Progression to more advanced disease before alloSCT was recorded in 67 patients. Donors were sibling (n = 75) Luminespib or HLA-matched unrelated (10/10; n = 88). They received blood (n = 142) or marrow (n = 21) grafts following either myeloablative (n = 33) or reduced intensity (n = 130) conditioning.\n\nResults\n\nWith a median follow-up of 38.7 months, 3-year outcomes in the AZA, ICT, and AZA-ICT groups were 55%, 48%, and 32% (P=.07) for overall survival (OS); 42%, 44%, and 29% (P=.14) for event-free survival (EFS); 40%, 37%, and 36% (P=.86) for relapse; and 19%, 20%, and 35% (P=.24) for nonrelapse mortality (NRM), respectively. Multivariate analysis confirmed the absence of
statistical differences between the AZA and the ICT groups in terms of OS, EFS, relapse, and NRM.\n\nConclusion\n\nWith the goal of downstaging underlying disease before Selleck SYN-117 alloSCT, AZA alone led to outcomes similar to those for standard ICT. J Clin Oncol 30:4533-4540. (C) 2012 by American Society of Clinical Oncology”
“Background. Hereditary diffuse gastric cancer is associated with the E-cadherin germline mutations, but genetic determinants have not been identified for familial intestinal gastric carcinoma.. e guidelines for hereditary diffuse gastric cancer are clearly established; however, there are no defined recommendations for the management of familial intestinal gastric carcinoma. Methods. In this study we describe Pope John XXIII’s pedigree that harboured gastric cancer as well as six other family members.
Purpose. The purpose of this in vitro study was to
evaluate the influence of digitizing techniques on the fit of implant-retained crowns with 2 antirotational features. Material and Methods. An experimental working cast housing a tissue-level dental implant was created. Resin-retained abutments with different antirotational features were connected to the implant. Optical impressions of 2 abutment types were obtained separately with 1 chairside and 2 laboratory approaches. Alumina silicate restorations were milled from chairside optical impressions, and ceramic oxide cores were milled from laboratory optical impressions. Restoration fit was evaluated from axial sections of restorations with silicone materials representing the Bromosporine marginal and axial gaps. find more Axial and marginal fits were measured on digital photographs of the sectioned specimens with a computer program. Two-way ANOVA was used to compare differences between abutments with 2 different antirotational features and digitizing techniques separately for the marginal and axial fits of single implant-retained crowns. A post hoc least significant difference test was used to compare digitizing techniques
(alpha=.05). Results. Significant differences in the marginal fit of single-implant-retained crowns were found among digitizing techniques (P=.011) and between antirotational features (P smaller than .001). No significant difference in the axial fit of single-implant-retained crowns was found among digitizing techniques (P=.905) or between antirotational features (P=.075). Conclusions. Within the limitations of this in vitro study,
the marginal fit of single-implant-retained crowns was affected by antirotational abutment features. Furthermore, digitizing techniques were found to play an important role in the marginal fit of single-implant-retained restorations.”
“Recently, nanomaterials have been utilized in various fields. In particular, amorphous nanosilica particles are increasingly being used in a range of applications, including cosmetics, GSK621 food technology, and medical diagnostics. However, there is concern that the unique characteristics of nanomaterials might induce undesirable effects. The roles played by the physical characteristics of nanomaterials in cellular responses have not yet been elucidated precisely. Here, by using nanosilica particles (nSPs) with a diameter of 70 nm whose surface was either unmodified (nSP70) or modified with amine (nSP70-N) or carboxyl groups (nSP70-C), we examined the relationship between the surface properties of nSPs and cellular responses such as cytotoxicity, reactive oxygen species (ROS) generation, and DNA damage. To compare the cytotoxicity of nSP70, nSP70-N, or nSP70-N, we examined in vitro cell viability after nSP treatment.
Data collection ended when patients were ready for surgery, or if ephedrine was given to increase mean arterial pressure.\n\nMain Results: 21 patients had hypotension. Baseline blood pressure variability low-frequency band power (BPV LF) >8 mmHg(2) and near-infrared spectroscopy (NIRS) reduction >= 5% had high sensitivity (0.73 and 0.90, respectively) and specificity (0.78 and 0.64, respectively), and were significantly associated with the development of hypotension. Conclusions: Only NIRS and BPV Napabucasin LF Could significantly predict hypotension
among the elderly. (c) 2009 Elsevier Inc. All rights reserved.”
“Cessation of traditional mowing management has been the main threat to fen biodiversity for many decades; shrubs and trees expand and target plant and animal species decline. In Biebrza National Park (BNP), the EU’s HKI-272 largest conservation area of alkaline fens, abandonment has affected more than 300 km(2). To combat unwanted succession, tracked mowers were developed based on snow grooming vehicles and are increasingly used in BNP and some other
European fens. While effects on bird populations seemed promising, the impact on botanical diversity remained yet unknown. We assessed the effects of this management on vegetation by comparing 12 pairs of mown and unmown plots (percentage cover recorded from 4 m(2) for all species and 25 m(2) for rare species) spread over several km(2). We found that tracked vehicles suppressed some species, this website which are likely to facilitate others by providing shelters above groundwater level (hummock mosses, tussock sedges and shrubs) and enhanced species with effective clonal spread
and high specific leaf area. An even stronger increase was observed in forbs, which share effective clonal spread and flood tolerance (high Ellenberg F value). Analysis of functional diversity indices based on all measured traits showed a decrease of functional divergence due to mowing (indicating convergence of traits) and no response of functional richness, evenness and functional dispersion. Mowing has also decreased the number of rare species. We associate these changes with the reduction of micro-topography by caterpillar tracks. Tracked mowers should therefore be avoided in those fens, in which microtopography contributes to unique botanical diversity. (C) 2013 Elsevier Ltd. All rights reserved.”
“Object. Patients with moyamoya who are younger than 2 years of age represent a therapeutic challenge because of their frequent neurological instability and concomitant anesthetic risks. The authors report their experience with pial synangiosis revascularization in this population.\n\nMethods. The authors reviewed the clinical and radiographic records of all patients with moyamoya in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution.\n\nResults.
Reperfusion of an ischemic heart maybe harmful, but it is an essential process for myocardial survival. One of the major adverse consequences of reperfusion is the occurrence of ventricular fibrillation (VF). In the present study, we investigated the possible connection between autophagy and VF. Isolated mouse hearts
Angiogenesis inhibitor were subjected to ischemia/reperfusion (I/R) and divided into two groups based on the development of VF at the beginning of reperfusion. Western blot analysis was conducted for autophagy-associated proteins LC3B, ATG-5, ATG-7, ATG-12, Bcl-2 and Beclin-1 proteins. Significantly higher level of Beclin-1 and LC3B-II/LC3B-I ratio (both definitive autophagy biomarkers) was observed in the fibrillated myocardium, versus tissue from the nonfibrillated hearts. Interestingly, although Bcl-2 is a major regulator of Beclin-1, level of this protein was not significantly altered in tissue from fibrillated, versus non-fibrillated hearts. Moreover, Atg7 expression showed a trend, albeit nonsignificant, towards elevation Nutlin-3 mouse in fibrillated versus non-fibrillated hearts. Results of the
present investigation demonstrate a possible link between VF and autophagy. Studies by authors of this report to evaluate potential etiologic relationships between the two processes are ongoing.”
“A new class of photonucleases, 1-aryl/heteroaryl-4-substituted-1,2,4-triazolo[4,3-a]quinoxalines (4) was synthesized in a facile and efficient manner via copper(II) chloride mediated oxidative intramolecular cyclization of 2-(arylidenehydrazino)-3-substituted-quinoxalines (3). DNA cleavage potency of compounds 4a-d (40 mu g each) was quantitatively evaluated on supercoiled plasmid Phi X174 under UV irradiation (312 nm, 15 W) without any additive. Compound 4c was found to be the most efficient DNA photocleaver which had converted supercoiled
www.selleckchem.com/products/YM155.html DNA (form I) into the relaxed DNA (form II) at 30 jig and the DNA photocleavage activity increases with increase in concentration of 4c. (C) 2011 Elsevier Masson SAS. All rights reserved.”
“Background: Raltegravir (RAL) constitutes the first available integrase strand transfer inhibitor (INSTI) available in clinical practice. Three independent pathways have been described to confer resistance to RAL. Secondary mutations with little effect on INSTI susceptibility and additional substitutions with an uncertain role have also been described especially in HIV-1 non-B variants. Methods: We evaluated the prevalence of primary, secondary, and additional resistance mutations to INSTIs in patients naive to RAL or elvitegravir (EGV) carrying different HIV-1 variants. Results: A total of 83 patients infected by B HIV-1 subtype (64%) or non-B HIV-1 variants (36%) were evaluated. No primary mutations to RAL or EGV were found in the integrase sequences analyzed. Secondary mutations were detected in only 5 patients.
(C) 2014 Elsevier B.V. All rights reserved.”
“In Saccharomyces cerevisiae, transcription of ARO9 and ARO10 genes, involved in the catabolism of aromatic amino acids, is activated by Aro80 transcription factor in response to aromatic amino acids. Here we show that the transcription of ARO9 and ARO10 is also induced by heat shock in an Aro80-dependent manner. However, heat shock-related signaling pathways including PKA, PKC, and HOG pathways are not involved
in the heat shock activation of Aro80. We elucidate that heat-induced increase in aromatic amino acid influx can lead to the inducer-dependent activation of Aro80 upon heat shock. Known aromatic amino acid permeases play an insignificant role in the heat-induced expression of ARO9 and ARO10, suggesting that an increase in plasma membrane fluidity might be Selleck FK506 responsible for the influx of aromatic amino acids during heat shock stress. (C) 2013 Elsevier PRIMA-1MET Inc. All rights reserved.”
“In the present study, we employ a longitudinal design and a generalizability framework to examine the sources of variance in the diurnal rhythm of salivary alpha-amylase (sAA). The sample consisted of 122 first-year law students (55% male, mean age = 23.9 years), who collected five saliva samples on each of three consecutive days at each of five data collection waves. In total, over 6900 saliva samples
were collected, which allowed us to examine the properties of diurnal variation in sAA in great detail. Selleck KPT-8602 Systematic individual differences accounted for 15-29% of the variability in the awakening response and diurnal slope, and for 61-65% of the variation in overall daily levels (i.e., diurnal mean, area under the curve with respect to ground [AUCg]). Although less than 1% of the variation was due to differences between waves and between days, the generalizability analyses revealed that between
16% and 17% of the variance in the diurnal mean, slope and AUCg is due to person by wave interactions, indicating that individuals vary in their biological sensitivity to environmental influences. In sum, this study documents sufficient stability and variation in diurnal sAA to warrant future studies on the origins and consequences of alterations in the diurnal rhythm of sAA worthwhile, and proposes guidelines on obtaining reliable measures. (C) 2012 Elsevier Ltd. All rights reserved.”
“Downregulation of anterior pituitary GnRH-receptors by application of a slow release GnRH-implant offers an effective and reversible alternative to surgical castration of the male dog.\n\nAim of the present study was to test the efficacy and the underlying mechanisms of a new non-biodegradable control led-release device implant (Gonazon (R), Intervet, containing 18.5 mg of the GnRH-agonist Azagly-Nafarelin). Eight male beagle dogs were implanted s.c. at the para-umbilical region. In four dogs implant removal was after 180 days (group 1), in the other four dogs after 365 days (group 2).
We evaluated the association between socioeconomic status and the incidence of sudden cardiac arrest, a condition that accounts for a substantial proportion of cardiovascular-related deaths, in seven large North American urban populations.\n\nMethods: Using a population-based registry, we collected data on out-of-hospital sudden cardiac arrests occurring at home or at a residential institution from Apr. 1, 2006, to Mar. 31, 2007. We limited the analysis to cardiac arrests in seven metropolitan areas in the United States (Dallas, Texas; Pittsburgh, Pennsylvania;
Portland, Oregon; and Seattle-King County, Washington) and Canada (Ottawa and Toronto, Ontario; and Vancouver, British Columbia). Each incident was linked to a census tract; tracts were classified into quartiles of median household income.\n\nResults: A total of 9235 sudden cardiac arrests were included in the analysis. For all PXD101 sites combined, the incidence of sudden cardiac arrest in the lowest socioeconomic quartile was nearly double that in the highest quartile (incidence rate ratio [IRR] 1.9, 95% confidence interval [CI] 1.8-2.0). This disparity was greater among people less than 65 years old (IRR 2.7, 95% CI 2.5-3.0) than among those 65 or older (IRR 1.3, 95% CI 1.2-1.4). After adjustment for study site and for population age structure of each census
tract, the disparity across socio economic quartiles for all ages combined was greater in the United States (IRR 2.0, 95% CI 1.9-2.2)
than in Canada (IRR https://www.selleckchem.com/products/emricasan-idn-6556-pf-03491390.html 1.8, 95% CI 1.6-2.0) (p < 0.001 for interaction).\n\nInterpretation: The incidence of sudden cardiac arrest at home or at a residential institution was higher in poorer neighbourhoods of the US and Canadian sites studied, GSK461364 although the association was attenuated in Canada. The disparity across socioeconomic quartiles was greatest among people younger than 65. The association be tween socio economic status and incidence of sudden cardiac arrest merits consideration in the development of strategies to improve survival from sudden cardiac arrest, and possibly to identify opportunities for prevention.”
“Background: Therapeutic hypothermia (TH, 30 degrees C) protects the brain from hypoxic injury. However, TH may potentiate the occurrence of lethal ventricular fibrillation (VF), although the mechanism remains unclear. The present study explored the hypothesis that TH enhances wavebreaks during VF and Si pacing, facilitates pacing-induced spatially discordant alternans (SDA), and increases the vulnerability of pacing-induced VF\n\nMethods and Results: Using an optical mapping system, epicardial activations of VF were studied in 7 Langendorff-perfused isolated rabbit hearts at baseline (37 degrees C), TH (30 degrees C), and rewarming (37 degrees C). Action potential duration (APD)/conduction velocity (CV) restitution and APD alternans (n=6 hearts) were determined by S1 pacing at these 3 stages.