Left atrial pump strain predicts long-term survival after transcatheter aortic valve implantation.

BACKGROUND: This study aims at investigating left atrial (LA) deformation by left atrial reservoir (LARS) and pump strain (LAPS) and its implications for long-term survival in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS: Speckle tracking echocardiography was performed in 198 patients with severe AS undergoing TAVI. Association of strain parameters with cardiovascular mortality was determined. RESULTS: Over a follow-up time of 5 years, 49 patients (24.7%) died. LAPS was more impaired in non-survivors than survivors (P = 0.010), whereas no difference was found for LARS (P = 0.114), LA ejection fraction (P = 0.241), and LA volume index (P = 0.292). Kaplan-Meier analyses yielded a reduced survival probability according to the optimal threshold for LAPS (P = 0.002). A more impaired LAPS was associated with increased mortality risk (HR 1.12 [95% CI 1.02-1.22]; P = 0.014) independent of LVEF, LAVI, age, and sex. Addition of LAPS improved multivariable echocardiographic (LVEF, LAVI) and clinical (age, sex) models with potential incremental value for mortality prediction (P = 0.013 and P = 0.031, respectively). In contrast, LARS and LAVI were not associated with mortality. CONCLUSIONS: In patients undergoing aortic valve replacement for severe AS, LAPS was impaired in patients dying during long-term follow-up after TAVI, differentiated survivors from non-survivors, was independently associated with long-term mortality, and yielded potential incremental value for survival prediction after TAVI. LAPS seems useful for risk stratification in severe AS and timely valve replacement.

Understanding SARS-CoV-2 Delta and Omicron variant transmission and vaccine impact in schools and child-care settings in Australia: a population-based study.

Background: Over 214 million students globally have been affected by school closures during the COVID-19 pandemic. To address knowledge gaps on transmission of SARS-CoV-2 delta (B.1.617.2) and omicron (B.1.1.529) variants in educational settings we examined virus transmission in schools and early childhood education and care settings (ECECs) in New South Wales (NSW), Australia in relation to mitigation measures, including COVID-19 vaccination. Methods: Secondary transmission from children and adults with laboratory-confirmed SARS-CoV-2 infection who attended a school (n = 3170) or ECECs (n = 5800) while infectious was investigated over two periods: 1) June 16 to September 18, 2021 (delta outbreak), and; 2) October 18 to December 18, 2021 (delta and omicron; schools only). Close contacts of cases underwent 14 days quarantine and SARS-CoV-2 nucleic acid testing. Secondary attack rates (SARs) were calculated and compared with state-wide notification data, school attendance, and vaccination status. Findings: 1187 schools and 300 ECECs had students (n = 1349) or staff (n = 440) attend while infectious. Of 24,277 contacts investigated, most (91.8%; 22,297/24,277) were tested and 912 secondary cases identified. The secondary attack rate (SAR) was 5.9% in 139 ECECs and 3.5% in 312 schools. The risk of becoming a secondary case was higher in unvaccinated school staff (OR 4.7; 95% CI: 1.7-13.3), particularly ECEC staff (OR 9.0; 95% CI: 3.6-22.7) and unvaccinated school students than in vaccinated school staff. SARs were similar for delta (4.9%) and omicron BA.1 (4.1%) in the unvaccinated and higher compared with vaccinated contacts (0.9% and 3.4%, respectively). Increasing school attendance rates raised case incursions and secondary case numbers, but not community-wide infection rates. Interpretation: Vaccination reduced SARS-CoV-2 transmission rates in schools, although less so for omicron than delta variants. Despite higher community-based transmission rates, in-school transmission remained low and stable with high attendance, suggesting that community restrictions, rather than school closures, best mitigated COVID-19 impacts. Funding: NSW Government Department of Health.

[Visual outcome after trabeculectomy - a retrospective study]. / Visusentwicklung nach Trabekulektomie - eine retrospektive Studie.

BACKGROUND: Trabeculectomy (TE) is the standard operation for glaucoma. An alternative interventional treatment of glaucoma is the cyclophotocoagulation (CPC). In a data analysis in 2012, a visual loss was found after transscleral CPC. The aim of this study was to investigate the outcome after TE. PATIENTS AND METHODS: 91 patients with pseudoexfoliation (n=38), open angle (n=22), normal tension (n=8), congenital (n=1) and secondary glaucoma (n=22) were included. The follow-up time was 24 months. Intraocular pressure (IOP), best corrected visual acuity (BCVA) and the total number of antiglaucoma drugs (AGD) were recorded. RESULTS: The mean age was 68.18±12.12 years. Mean IOP reduction after 24 months was 14.76±10.62 mmHg (-49%, p<0.001). On average, 2.34±1.17 (-85%, p<0.001) AGDs could be reduced. A mean BCVA decrease of 0.15 logMAR (±0.26, p<0.001) was found. CONCLUSION: TE is a successful method for lowering the IOD. However, postoperative visual loss is possible.

[Transscleral cyclophotocoagulation as primary surgical intervention in glaucoma]. / Transsklerale Zyklophotokoagulation als primäre antiglaukomatöse Operation.

BACKGROUND: The gold standard of surgical interventions in medically uncontrolled glaucoma is trabeculectomy. Cyclophotocoagulation is often performed only as a secondary/tertiary surgery. Since trabeculectomy demands a high degree of postsurgical compliance to achieve satisfying results, some patients do not qualify for trabeculectomy. PATIENTS AND METHODS: During cyclophotocoagulation, the ciliary processes were coagulated using a transscleral diode laser. 49 eyes of 47 patients (25 women and 22 men) were included in our study. Patients were regularly followed up for 24 months. During follow-up, IOP, best corrected visual acuity and number of antiglaucoma drugs were recorded. RESULTS: The mean age was 69.27 ± 14.45 years. The diagnosis was open-angle glaucoma in 15 eyes, pseudoexfoliative glaucoma in 12 eyes, secondary rubeotic glaucoma in 7 eyes and secondary glaucoma without further specification in 15 eyes. On average, cyclophotocoagulation reduced intraocular pressure by 14.45 ± 11.77 mmHg (-42.7%, p < 0.001). Medication could be reduced by 1.31 ± 1.27 (-52%, p < 0.001). On average, visual acuity deteriorated by 0.383 LogMAR (± 0.848, p = 0.004). CONCLUSION: For selected glaucoma patients, cyclophotocoagulation could be an option as primary surgical intervention to lower intraocular pressure.

Memory control in post-traumatic stress disorder: evidence from item method directed forgetting in civil war victims in Northern Uganda.

BACKGROUND: Traumatized individuals and particularly post-traumatic stress disorder (PTSD) patients are characterized by memory disturbances that suggest altered memory control. The present study investigated the issue using an item method, directed forgetting (DF) paradigm in 51 civil war victims in Uganda. All participants had been exposed to severe traumatic stress and 26 additionally suffered from PTSD. METHOD: In an item cued, DF paradigm photographs were presented, each followed by an instruction to either remember or forget it. A recognition test for all initially presented photographs and thematically similar distracters followed. DF patterns were compared between the non-PTSD and the PTSD groups. Post-experimental ratings of picture valence and arousal were collected and correlated with DF. RESULTS: Results revealed DF, that is, reduced recognition for 'to-be-forgotten' items in the non-PTSD but not in the PTSD group. Moreover, in the non-PTSD, but not in the PTSD group, false alarms were reduced for 'to-be-remembered' items. Finally, DF was reduced in those participants who rated the pictures as more arousing, the PTSD group giving, on average, higher arousal ratings. CONCLUSIONS: Data indicate that DF is reduced in PTSD and that the reduction is related to stimulus arousal. Furthermore, individuals with PTSD are characterized by a more global encoding style than individuals without PTSD, reflected in a higher false alarm rate. In sum, traumatized individuals with (but not without) PTSD are impaired in their ability to selectively control episodic memory encoding. This impairment may contribute to clinical features of the disorder such as intrusions and flashbacks.

Lipoid proteinosis (Urbach-Wiethe disease).

The aim of this study has been to assess the clinical presentation and biochemical profile of lipoid proteinosis within a defined pedigree. Glycoprotein analysis was compared to normal values in an attempt to define a biochemical phenotype. Six affected family members were identified with variable degrees of disease expression. The most likely mode of inheritance is autosomal recessive due to consanguinity. Routine laboratory investigations were normal in all family members tested. The total content of mucopolysaccharides, sialic acid and hexosamine in biopsed tissue was significantly lower than normal. Our findings demonstrate that a defect in glycoprotein synthesis, possibly enzymatic, may be the cause of lipid proteinosis and its protean clinical manifestations.

Habitual long-distance running does not enhance urinary excretion of 8-hydroxydeoxyguanosine.

The energy demand during physical exercise causes an increased oxygen uptake and supply to active tissues, which may increase the rate of free oxygen radical production and thereby affect the capacity of endogenous cellular defense systems. This could result in DNA base modifications, among which 8-hydroxydeoxyguanosine (8OHdG) is one of the most important and has widely been used as a biomarker of in vivo oxidative lesions. Therefore, we examined the effect of regular running exercise on the urinary levels of 8OHdG in 32 long-distance runners and in a group of untrained healthy subjects. The range of 8OHdG in urine was 0.12-6.45 mumol/mol creatinine in both groups, and no significant difference in the mean excretion levels between runners and control probands was observed. This gives no reason to believe that physical exercise in trained individuals may induce a disturbance of the oxidant-to-antioxidant balance.

The ability of bacteria to use Na-hyaluronate as a nutrient.

The objective of this study was to test bacteria ability to use Na-hyaluronate as a nutrient in vitro. Thirteen bacteria strains were tested in three different media: specific culture medium, agar-Healon medium and agar-Healon GV medium. The bacterial growth criteria were determined by counting the number of new colonies appearing at each observation time (0, 24, 48 and 72 h). The results were expressed as the percentage of growth in agar-Na-hyaluronate compared to each corresponding specific culture medium. After 24 h in the medium containing agar-Healon, S. aureus, S. epidermidis, S. pyogenes and S. viridans grew using hyaluronic acid as a nutrient. The percentage of growth of these species remained constant over the follow-up period. The other bacteria strains tested were unable to use Healon as a nutrient. After 24 h of incubation in the medium containing agar-Healon GV, S. aureus, S. epidermidis, S. pyogenes, and S. viridans exhibited about 20% growth. Subsequently, this percentage slowly increased to about 50%. The other bacteria stains tested were unable to employ Healon GV as a nutrient. With the exception of Staphylococci and Streptococci, the other species do not synthesize the necessary enzymes to break glucosidic bonds, therefore neither concentration of hyaluronic acid can be utilized as a source of carbohydrate for their survival in culture media.

Effect of oral bromocriptine administration on intraocular pressure in normotensive and glaucomatous human subjects.

PURPOSE: The authors have verified the effect of orally administered bromocriptine on intraocular pressure in normotensive and glaucomatous human subjects. METHOD: Fifteen healthy volunteers and 15 glaucomatous patients were studied. Intraocular pressure, pupil diameter, total outflow facility, systolic arterial pressure, diastolic arterial pressure, and heart rate were recorded at baseline and at 1-h intervals for 12 h after oral administration of 2. 5 mg bromocriptine or placebo, given in a randomized, double-masked, cross-over fashion. The alternate regimen was given a week later. RESULTS: In all subjects bromocriptine significantly reduced intraocular pressure, whereas no variations in pupil diameter, systolic and diastolic arterial pressures, and heart rate were recorded. Moreover, total outflow facility, measured by conventional tonography, increased significantly both in normotensive and glaucomatous eyes. CONCLUSIONS: These findings indicate that oral bromocriptine administration could represent a new therapy to reduce intraocular pressure in humans.

[An alternative to alcohol at the work site. General practice test of an electrolyte beverage in hot work environments]. / Alternative zu Alkohol am Arbeitsplatz. Praxistest eines Elektrolytgetränkes auf Hitzearbeitsplätzen.

A survey was performed in 1989 by the Institute of Social Medicine and the Austrian Workers Compensation Board(AUVA) to investigated the alcohol problem in 277 factories in which the workers were exposed to hot and dusty atmospheres. As a result of the findings, a further study was undertaken by the same research team to investigate one possible solution to the problem of alcohol consumption at work in a paper-producing factory, predominantly under hot and dusty conditions. The study was well prepared by many activities in the field of health promotion. In this trial, an electrolyte drink especially suited for heat-burdened work places, was introduced for three months as alternative drink to alcohol. Before and after this period the employees answered a questionnaire regarding their alcohol consumption and any changes in consumption habits. One of the main results of the study was the significant increase in electrolyte drink consumption and decrease in wine consumption although that of beer remained practically unchanged. The offered electrolyte drink was accepted as alternative drink by many workers and represents a practical example of health promotion at the place of work. This study should encourage other factories and businesses to experiment with electrolyte drinks especially suited to their particular conditions in an attempt to overcome the problem of alcohol consumption during working hours.

Statistical evaluation of admission criteria for a radiography program.

The admission process of a radiography program was analyzed. The criteria used were summarized in a weighted score. A measurable difference was found between applicants offered appointment and those not, and the weighted score was found to be a statistically significant predictor of subsequent student performance.

Use of the posteroanterior projection: a method of reducing x-ray exposure to specific radiosensitive organs.

The posteroanterior projection was studied to determine if it could be a substitute for the commonly used anteroposterior projection as a method of reducing x-ray exposure to specific radiosensitive organs during intracranial tomography and scoliosis radiography. The use of the posteroanterior projection resulted in a reduction of 95% in exposure to the lens of the eye during intracranial tomography and of more than 90% to the thyroid, sternum, and breasts during scoliosis radiography. In addition to the major reduction in radiation exposure, the diagnostic capability of the examination was not reduced and comfort in most patients was not affected.

Evaluation of pH monitoring as a method of processor control.

Sensitometry and pH values of the developer solution were compared in controlled over-replenishment, developer depletion, fixer contamination experiments, and on a daily quality control basis. The purpose of these comparisons was to evaluate the potential of pH monitoring as a method of processor control, or a supplement to sensitometry as a method of quality control. Reasonable correlation was found between pH values and film density in two of the three experiments but little or no correlation was found in the third experiment and on a day-to-day basis. The conclusion drawn from these comparisons is that pH monitoring has several limitations which render it unsuitable as a method of daily processor quality control as either a primary or supplementary technique. Sensitometry takes into account all the variables encountered in film processing and is the clear method of choice for processor quality control.