Association of time of occurrence of electrical heart storms with environmental physical activity.

AIM: Many publications in recent decades have reported a temporal link between medical events and environmental physical activity. The aim of this study was to analyze the time of occurrence of electrical heart storms against levels of cosmological parameters. METHODS: The sample included 82 patients (71 male) with ischemic cardiomyopathy treated with an implantable cardioverter defibrillator at a tertiary medical center in 1999-2012 (5,114 days). The time of occurrence of all electrical heart storms, defined as three or more events of ventricular tachycardia or ventricular fibrillation daily, was recorded from the defibrillator devices. Findings were analyzed against data on solar, geomagnetic, and cosmic ray (neutron) activity for the same time period obtained from space institutions in the United States and Russia. RESULTS: Electrical storms occurred in all months of the year, with a slight decrease in July, August, and September. Most events took place on days with lower-than-average levels of solar and geomagnetic activity and higher-than-average levels of cosmic ray (neutron) activity. There was a significant difference in mean daily cosmic ray activity between the whole observation period and the days of electrical storm activity (P = 0.0001). CONCLUSION: These data extend earlier findings on the association of the timing of cardiac events and space weather parameters to the most dangerous form of cardiac arrhythmia-electric storms. Further studies are needed to delineate the pathogenetic mechanism underlying this association.

The diversity of heart failure in a hospitalized population: the role of age.

BACKGROUND: The prevalence of heart failure (HF) among hospitalized elderly patients is high and steadily growing. However, because most studies have focused mostly on young patients, little is known about the clinical characteristics, echocardiographic measures, prognostic factors, and outcome of hospitalized elderly HF patients. METHODS AND RESULTS: We identified all HF patients aged ≥50 years who had undergone ≥1 echocardiography study and had been hospitalized during January 2000 to December 2009. A comparative analysis was performed between 3,897 "young" patients (aged 50-75 years) and 5,438 "elderly" patients (aged >75 years), followed for a mean 2.8 ± 2.6 years. Elderly HF patients were more often female (50% vs 35%; P < .0001) and had a higher prevalence of HF with preserved ejection fraction (64.8% vs 53%; P < .0001), more significant valvular disease (35.7% vs 32.5%; P < .0001), and lower rates of ischemic heart disease (65.5% vs 70.9%; P < .0001) and diabetes (34.4% vs 53.9%; P < .0001). Thirty-day and 1-year mortality rates were significantly higher among the elderly population (12.2% vs 6.9% [P < .0001] and 34.3% vs 21.2% [P < .0001], respectively). Prognostic markers differed significantly between age groups. Young-specific predictors were chronic renal failure, diastolic dysfunction, malignancy, and tricuspid regurgitation, whereas elderly-specific predictors were HF with reduced ejection fraction, chronic obstructive pulmonary disease, pulmonary hypertension, and mitral regurgitation. CONCLUSIONS: Hospitalized elderly, compared with young, HF patients differed in prevalence of cardiac and noncardiac comorbid conditions, echocardiographic parameters, and predictors of short- and intermediate-term mortality. Identifying unique features in the elderly population may render age-tailored therapeutics.

Birth month of patients with malignant neoplasms: links to longevity?

BACKGROUND: In 2001, the Proceedings of National Academy of Sciences (USA) published a study on the relationship between month of birth and longevity. Subsequent studies revealed differences in month of birth among patients with acute myocardial infarction, a major killer in industrialized countries. The aim of the present study was to analyze month of birth in patients with malignant neoplasms, another major fatal disease. METHODS: The study sample consisted of 44,487 patients (22,584 male) diagnosed with a malignant neoplasm at Rabin Medical Center in 1994-2011. The number of patients born in each month of the year was calculated for the whole group and by gender. Student's t-test was used to compare mean (standard deviation) monthly, quarterly and trimester values. RESULTS: There was a strong trend (p=0.06) for a higher mean number of births in the first trimester of the year than in the second and third trimesters. The difference was significant for male patients (p=0.03) but not female patients (p=0.13-0.15). CONCLUSIONS: Patients born in the first trimester of the year are more affected by malignancies, particularly males. The overall monthly birth distribution of oncology patients is in line with the paradigm linking birth month with longevity.

Acute myocardial infarction (AMI) (n-11026) on days of zero geomagnetic activity (GMA) and the following week: differences at months of maximal and minimal solar activity (SA) in solar cycles 23 and 24.

BACKGROUND: Acute myocardial infarction (AMI) is one of most common cardiovascular pathologies in the industrial world. In addition to known risk factors, environmental physical activity factors such as solar activity (SA), geomagnetic activity (GMA), and cosmic ray activity (CRA) could be also involved in the timing of AMI. The aim of this study was to study AMI admissions at days of zero GMA, accompanied by high CRA, and the following week in the higher and lowest parts of solar cycles 23 and 24. METHODS: Patients admitted for AMI (n=11,026, 59.5% men) in years 2000-2009 at the Department of Cardiology of Lithuanian University of Medical Sciences were studied for all periods and separately for the higher part of the 11-year solar activity in cycles 23 and 24 (2000-2007) and its lowest part (2008-2009). Admissions at day of zero GMA as well as 1, 2, 6, and 7 days after zero-GMA day were compared. RESULTS: At high SA, zero-GMA days were rare and isolated (36 in years 2000-2007). They have been followed by significant increase in admissions on the following days. In the two lowest years of SA 2008-2009, there were 57 days of zero GMA, many of which were consecutive and in groups. For the whole solar cycle, there was a more gradual increase in AMI from 1 to 2 days after zero-GMA day, and there were significantly higher AMI admissions at 6 days after the first zero-GMA day (p=0.018). CONCLUSIONS: Zero-GMA/high-neutron activity is followed by increase in AMI admissions at the days that follow. The effects are different at high and low parts of the 11-year solar cycle.

Birth month and longevity - monthly birth distribution in acute coronary events provoked by atherothrombosis in patients treated with percutaneous coronary intervention (PCI).

BACKGROUND: Human homeostasis is time related. Environmental physical factors also play a role. Recent studies published by the National Academy of Sciences (USA) describe human longevity links with the month of birth. The aim of this study was to check monthly birth distribution in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) related to atherothrombosis - one of the main causes of morbidity and mortality in the industrial world. METHODS: A total of 4732 (3594 men) subjects were included in the study. Patients treated with PCI for AMI in the years 2000 to March 2010 were studied. The population registry specific to 1950 excluded 1024 patients, i.e., those registered as born on January 1 and they were replaced with patients with an average of births from January 2 to 31. A total of 3675 patients were finally studied (2839 men, 836 women). RESULTS: The average monthly birth number was 306±60.38. Significant monthly differences in birth number (q2=21.077, p<0.03) were observed. A higher birth rate in the first four months of the year was revealed, with the exception of February. The number of births in these months exceeded the following two four-month data (q2=20.57, p<0.024). March births exceeded the monthly average by more than two standard deviations (SD) - 462, with an analogical increase for both genders. In May-December births were below average. CONCLUSIONS: Patients with AMI treated with PCI show differences in the month of birth with the majority being born in the first four months of the year and of those most were born in March. Possible implications on pathogenetic clues of atherothrombosis can be assumed.

Left anterior descending/right coronary artery as culprit arteries in acute myocardial infarction (n=2011) in changing physical environment, percutaneous coronary intervention data, 2000-2010.

BACKGROUND: Percutaneous coronary intervention (PCI) is one of the principal treatments of acute coronary syndrome (ACS), including acute myocardial infarction (AMI). This treatment largely expanded our knowledge on the pathophysiology of AMI and related coronary pathologies. Recent studies found a significant relationship of the timing of ACS with environmental physical activity: solar (SA), geomagnetic (GMA) and cosmic ray (CRA) activity. The aim of this study was to examine if the interrelationship of two principal culprit arteries, left anterior descending (LAD) and right coronary artery (RCA), are involved in the pathogenesis of AMI in different daily levels of GMA and CRA. METHODS: Patients undergoing PCI for AMI on the day of symptoms of the disease (n=2011, 79.9% males) in the Rabin Medical Center in the years 2000-2010 were studied. The culprit arteries, LAD and RCA, correlated to AMI in zero and I0-IV0 of daily GMA and inversely to GMA related CRA (measured by neutron activity on the earth surface) and their ratio was compared. RESULTS: LAD (45.0%) and RCA (35.7%) were the main culprit arteries in AMI. LAD/RCA ratio increased inversely to GMA (zero=IV0, r=-0.94, p=0.017) and in correlation with daily neutron activity for LAD (r=0.97, p=0.03) and RCA (r=0.95, p=0.04). LAD/RCA ratio was 1 in IV0 of GMA (28% increase) and steadily increased to 1.62 (62% difference) at zero GMA (r=-0.94, p=0.0117), and increasing neutron activity was accompanied by increasing LAD involvement as a culprit artery in AMI. CONCLUSIONS: High daily neutron activity and low GMA are accompanied by increasing LAD as a culprit artery in AMI. The possible mechanisms of this finding are discussed.

Traffic accidents and environmental physical activity.

Environmental physical activity (EPA) is considered as one of main regulators of human homeostasis. Evidence is growing that components of this activity through the "human factor" (i.e., changing human physiological and psychological status) can affect the dynamics of traffic accidents (TA)-the modern life epidemic. This paper presents results of studies conducted in order to reveal the potential influence of EPA [solar (SA), geomagnetic (GMA) and cosmic ray (CRA) activities] on the number of TA and related casualties in the years of the maximum and declining phase of SA cycle 23 (2000-2005). We selected the 7,160 most severe TA and their related 7,558 deaths and 1,647 severe injuries, registered in the Grand Baku Area (Azerbaijan, middle latitudes), for analysis. A significant increase of TA and victims was observed during the whole year and also during the last months of the year. The monthly numbers of TA and victims were inversely related to SA (probability p = 0.0002), and non-significantly to background GMA, but were significantly affected by major geomagnetic disturbances and storms. A strong correlation between CRA variations (cosmic ray intensity measured by ground-based neutron monitors on the Earth's surface) and the number of TA (p = 0.001) has been observed. It was found that the number of TA which occur within a month depends significantly on the particular month of the year, the CRA, and the SA levels (inverse correlation). The increase of the number of TA is also significantly linked to geomagnetic storms, but not to steady GMA. These effects can be related to changes in human functional and behavioral markers provoked by EPA influences.

Dynamics of serum C-reactive protein (CRP) level and cosmophysical activity.

BACKGROUND: C-reactive protein (CRP), an acute phase reactant, plays an important part in the investigation of the role of inflammation in pathology. Many cardiovascular events show significant associations with various cosmophysical parameters. The aim of this study was to investigate the relationship between the level of CRP and the levels of solar, geomagnetic (GMA), and cosmic ray activity. METHODS: The results of 25,399 serum CRP tests carried out over a 3-year period were compared with the monthly and daily levels of solar, geomagnetic, and cosmic ray activity during the same period. The cosmophysical data were obtained from the National Oceanic Atmospheric Administration (NOAA) in the U.S. and from the Russian Academy of Science. RESULTS: On a monthly basis, CRP levels showed no correlation with GMA (n=36, r=0.258, p=0.13), but there was a significant inverse relationship with neutron activity (r=-0.35, p=0.03). For the daily comparisons, CRP levels were significantly correlated with GMA (n=1057, r=0.97, p=0.02), and there was a significant inverse relationship with neutron activity (r=-0.97, p=0.025). Daily neutron activity was higher on days with CRP levels of 0-1.0 mg/dl (n=289) and above1.0-1.5 mg/dl (n=1213) than on days with higher CRP values (>1.5; n=23,897; p<0.0001). CONCLUSION: The level of serum CRP, in addition to its association with inflammation, is related to the daily level of GMA and inversely to the level of neutron activity.

Monthly number of preterm births and environmental physical activity.

UNLABELLED: Recent studies have reported links between external physical factors and human homeostasis. OBJECTIVE: to determine whether the monthly values of specific physical environmental factors are associated with the monthly number of preterm births in a major medical center in Israel. METHODS: The sample included 1006 infants weighing less than 1500g born live to 774 mothers during 96 consecutive months (1995-2002) at a tertiary medical center in Israel. Monthly values of indices of solar, cosmic ray, and geomagnetic activity for the same period were obtained from national data monitoring facilities in the United States of America, Russia, and Finland. The findings were statistically correlated with the monthly number of preterm births. RESULTS: The number of preterm births correlated with the month of the year (1-12), with a progressive rise in the number of infants born as the year progressed (p = .02). The monthly number of preterm births showed a significant and direct correlation with solar activity indices (r = .32, p = .0016), and a significant and inverse correlation with cosmic ray activity indices (r = -0.3, p = .008). The relation was significant only for singelton births and for the whole group of preterm newborns, but not for multiple pregnancies. CONCLUSION: Our findings suggest that solar and cosmic ray activity may play a role in the timing of premature labor, however in multiple pregnancies additional factors are dominant.

Clinical cosmobiology: distribution of deaths during 180 months and cosmophysical activity. The Lithuanian study, 1990-2004. The role of cosmic rays.

UNLABELLED: The aim of this study is a next step of our previous, initial, publications--to explore the links between monthly death number (total, and for the major death causes and each gender) with levels of monthly cosmophysical activity in a long-term, big cohort observation. METHODS: Death number during 180 consecutive months from the National Registry of Lithuania for years 1990-2004 were studied. A total of 630,205 deaths were analyzed (333,035 males). For comparison, monthly indices of solar activity, geomagnetic activity, and cosmic ray activity and year and month (1-12) of the study were used. The cosmophysical data were obtained from space research centers in the USA, Russia, and Finland. Statistics. Pearson correlation coefficients (r) and their probabilities (P) between compared parameters were calculated. A multivariate model of prediction was designed. RESULTS: It was a significant correlation between total monthly death number and indices of cosmic ray activity and, inverse, of solar activity; in men stronger than in women. Monthly geomagnetic activity was significantly correlated with traffic accidents, ischemic heart disease/stroke ratio, suicide victim number. Deaths from stroke, noncardiovascular causes, suicide, traffic accidents were related with cosmic ray activity and, inverse, with solar activity. Relationship of ischemic heart disease/stroke ratio to year of observation showed additional evidence for the growing role of stroke in cardiovascular mortality. CONCLUSIONS: Monthly death number is linked to cosmic ray activity, and inverse, to solar activity. Central place of stroke-related deaths in cardiovascular mortality is emerging. Geomagnetic activity, in monthly account, plays a relatively minor role. We presume that forces antagonistic to cosmic ray activity, like solar activity and geomagnetic activity, can prevent some negative biologic effects of cosmic ray.

Monthly number of newborns and environmental physical activity.

UNLABELLED: In the last decades many studies have demonstrated the cosmophysical influences on human homeostasis. The aim of the study was to explore links between environmental physical activity--solar, geomagnetic, cosmic ray--and monthly number of newborns in general and, separately, for each gender. MATERIAL AND METHODS: The distribution of newborns' number (n=286,963) over 96 months in the Republic of Lithuania from 1995 to 2002 was compared with the monthly cosmophysical indices nine months before the month of delivery. For the comparison of gender ratio, other 52,289 newborns at the same time were studied in a big Israeli hospital. Pearson's correlation coefficients and their probabilities between the newborns' number and cosmophysical indices were established. RESULTS: A strong and significant inverse correlation of monthly newborns' number with monthly solar activity indices (r=-0.72, p<0.0001) and similar, but positive, with cosmic ray activity was shown (r=0.67, p<0.0001). CONCLUSIONS: The monthly number of newborns of both genders is strongly and significantly related to the level of monthly cosmic ray and, inverse, to solar activity indices nine months before the month of delivery. Geomagnetic activity was not significantly related to the monthly number of newborns. The subject and mechanism of these relationships needs further investigation.

Space weather and human deaths distribution: 25 years' observation (Lithuania, 1989-2013).

BACKGROUND: Human health is affected by space weather component [solar (SA), geomagnetic (GMA), cosmic ray (CRA) - neutrons, space proton flux] activity levels. The aim of this study was to check possible links between timing of human (both genders) monthly deaths distribution and space weather activity. METHODS: Human deaths distribution in the Republic of Lithuania from 1989 to 2013 (25 years, i.e., 300 consecutive months) was studied, which included 1,050,503 deaths (549,764 male, 500,739 female). Pearson correlation coefficients (r) and their probabilities (p) were obtained for years: months 1-12, sunspot number, smoothed sunspot number, solar flux (2800 MGH, 10.7 cm), adjusted solar flux for SA; A, C indices of GMA; neutron activity at the earth's surface (imp/min) for CRA. The cosmophysical data were obtained from space science institutions in the USA, Russia and Finland. The mentioned physical parameters were compared with the total number of deaths, deaths from ischemic heart disease (n=376,074), stroke (n=132,020), non-cardiovascular causes (n=542,409), accidents (n=98,805), traffic accidents (n=21,261), oncology (n=193,017), diabetes mellitus (n=6631) and suicide (n=33,072). RESULTS: Space factors were interrelated as follows for the considered period: CRA was inversely related to SA and GMA, CRA/SA (r=-0.86, p>0.0001), CRA/GMA (r=-0.70, p<0.0001); SA and GMA were correlated (r=0.50, p<0.0001). The total deaths distribution was inversely related to SA (r=-0.31, p<0.0001) and correlated with CRA (neutron) activity (r=0.234, p<0.0001). Ischemic heart disease (IHD) deaths (most at home) show a drop yearly (r=-0.2551), more for men. It was correlated with GMA for the total IHD population and men. Stroke deaths were inversely related to SA (r=-0.38, p<0.0001) and correlated with CRA (r=0.41, p<0.0001) and year (r=0.49, p<0.0001), showing a steady rise. The IHD/stroke deaths ratio was negatively correlated with the years of observation (r=-0.754, p=0.0001). Non-cardiovascular deaths were inversely related to SA (r=-039, p<0.0001) and correlated with CRA (r=0.263, p<0.0001). Oncology deaths that now are dominating in many places were inversely related to SA (r=-0.475, p<0.0001) and correlated with CRA (r=0.426, p<0.0001). Suicide showed a drop with years (r=-0.29, p<0.0001), possibly related to excessive immigration of young population (18-34 years) in the last decade and correlated with two of three GMA indices. Traffic accidents were correlated with SA and GMA (r=0.392-0.461, p<0.0001) and inversely related to CRA (r=-0.436). CONCLUSIONS: Most groups of deaths are related to space weather component activity. Extreme levels of activities of both groups (SA, GMA, and opposite CRA - neutron) are related to some health risks. In the considered period, there were relatively few GMA storms and low GMA was dominating, accompanied by higher CRA (neutron) activity. The ways of action of the components of space weather on the human body need additional studies. There is a special need for the prevention of rising cerebral vascular accidents and oncology malignancies as the causes of death.

Sudden cardiac death and geomagnetic activity: links to age, gender and agony time.

BACKGROUND: In previous studies, we analyzed sudden cardiac death (SCD) of shorter and longer agony time with geomagnetic activity (GMA) levels, with controversial results. The goals of the present study were (1) to study SCD at ages below 65 and 65 and older for each gender on days of low (Io) and higher (IIo-IVo) GMA; (2) to compare links between SCD and GMA with death at 1 h and from 1 to 24 h. METHODS: We studied 1327 SCD, 392 (29.5%) females and 935 (70.5%) males, from the Kaunas Registry (part of the MONICA Study): 785 deaths during 1826 consecutive days (1994-1998) at ages 25 to 64 years and 524 deaths at ages 65 and older during 732 consecutive days (1996-1997). Of these, 261 SCD occurred at 1 h, 1076 between 1 h and 24 h without prodromes. GMA data were obtained from the National Geophysical Data Center and the National Space Services Center, USA. Student t-test and its probabilities for daily SCD at Io and IIo-IVo GMA were compared. RESULTS: The daily number of SCD was significantly different for most of the compared groups at lowest and higher GMA levels. For all SCD, both at age <65 and at >65, the frequency was significantly higher on days of IIo-IVo GMA than on days of Io GMA (p=0.00067-0.03). A strong trend for more SCD on days of Io GMA was seen in males aged <65 who died within 1 h (p=0.06); females aged <65 who died within >1 h to 24 h (p=0.06), and females >65 who died within 1 h (p=0.0267). Females below the age of 65 who died in less than 1 h showed a trend toward higher SCD frequency at IIo-IVo GMA that did not achieve significance (p=0.057). CONCLUSIONS: The distribution of SCD, with short (< or =1h) and longer (1-24 h) time of death, on days of lowest (Io) GMA differs from that on days of unsettled, active, or stormy (IIo-IVo) GMA. Despite the general trend to higher SCD frequency at IIo-IVo GMA, certain rapidly dying groups (< 65 y males, > 65 y females) showed a strong trend toward higher numbers of SCD at the lowest GMA.

Link between monthly rates of four subtypes of acute myocardial infarction and their corresponding cosmophysical activity parameters.

UNLABELLED: The aim of this study was (1) to examine the relation between the monthly rate of acute myocardial infarction (AMI) and three cosmophysical activity parameters: solar activity (SA), geomagnetic activity (GMA), and cosmic rays activity (CRA) levels; (2) to study whether different subtypes of AMI: ST-elevation MI (STEMI), non-ST-elevation (NSTEMI), Q-wave (Q-waveMI) and non-Q-wave (NQ-wave MI) are linked with monthly cosmophysical indices or with the daily level (I degrees-IV degrees) of GMA. METHODS: For the first question, we studied for 204 consecutive months (1983-1999) 16,683 patients (including 10405 males) with AMI who were included in the Kaunas Registry and for the second, 3824 AMI patients (2342 males), 72-month data. Cosmophysical data were obtained from the Apatity Neutron Monitoring Station of the Russian Academy of Science. RESULTS: According to neutron monitoring data, total AMI and all its subtypes significantly correlated with monthly levels of CRA and inversely correlated with SA and GMA indices (r = 0.32-0.45; p = 0.0007-0.0001). No significant correlation was found between AMI subtypes and the daily level (I degrees-IV degrees) of GMA. All cosmophysical parameters were stronger in female patients. CONCLUSION: The monthly rates of all subtypes of AMI were significantly correlated with CRA and inversely correlated with SA and GMA, more strongly in female patients. We presume that the environmental factors studied here affect the general patho-physiological components of AMI, and that different subtypes are a consequence of the localization and extent of the process.

Temporal distribution of death among oncology patients: environmental links.

BACKGROUND: The natural history of terminal oncologic disease is death from cardiopulmonary arrest. The goal of this study was to determine whether the temporal distribution of death among oncology patients is related to levels of environmental physical activity-solar, geomagnetic, and cosmic rays and high energy space proton flux, as previously shown for other situations like accidents, suicide, and the occurrence of acute myocardial infarction. EXPERIMENTAL: Deaths of oncology patients, n = 102604, in 168 consecutive months were compared with-monthly indices of solar, geomagnetic, cosmic rays activity (sunspot number, solar flux, Ap, Cp, Am), and indices of magnetic and cosmic rays activity according to neutron monitor data). In addition, oncology patients monthly death numbers were compared with numbers of deaths from ischemic heart disease (IHD), stroke, sudden cardiac death (SCD), accidents, road accidents, non cardiovascular death (total deaths - [IHD + stroke]). The National Data of the Republic of Lithuania was used, excluding SCD and myocardial infarction in Kaunas--the second largest city in Lithuania Monica study register was used for SCD at age 25-64, and all data of AMI. Pearson correlation coefficients and their probabilities were obtained between the numbers of oncology patient monthly deaths and (1) cosmo-physical indices and (2) the number of deaths from other causes and the occurrence of AMI. RESULTS: The number of oncology patient deaths was inversely correlated with solar and geomagnetic activity indices and positively correlated with cosmic rays activity. The number of oncology patient deaths was correlated with monthly number of deaths from non-cardiovascular courses, stroke, suicide, at trend level with SCD, but not with deaths from IHD, accidents, road accidents. Oncology patient deaths showed a significant correlation with the number of AMI. CONCLUSION: The monthly death number of oncology patients is significantly related with environmental physical activity and shows similarity with deaths distribution by time of some other groups of death--stroke, SCD, suicide, and occurrence of AMI. The inverse correlation with solar and geomagnetic activity and positive links with cosmic rays activity level are remarkable.

Birth month and longevity: birth month of victims of sudden (SCD, ≤1 h) and rapid (RCD, ≤24 h) cardiac deaths.

BACKGROUND: After a publication of a study in the Proceedings of the National Academy of Sciences USA in 2001, we published three studies related to birth month and morbidity of patients that can affect longevity. The aim of this study is to check two groups of cardiac deaths, consisting of more than 50% of cardiovascular mortality in the industrial world, to examine this paradigm. METHODS: Patients suffering rapid cardiac death (RCD) (≤24 h) and sudden cardiac death (SCD) (≤1 h) in Lithuanian Medical Science University hospital, a tertiary 3000-bed facility, in 2000-2010 were studied. In total, 1239 RCDs and 324 SCDs were included in this study. Monthly, quarterly, trimester and half-year comparisons of the patients' birth month population were studied. RESULTS: A difference in birth month distribution of the study patients was observed. For RCDs (≤24 h), the highest numbers were found for January (11.0%) and May (10.3%), whereas for the SCDs (≤1 h), April (13.3%) and January (10.5%) dominated. The least numbers were in November (SCD, 5.6%; RCD, 6.2%) and December (5.2-6.1%). Those born in the first and second quarter and first trimester were significantly more than those born in the fourth quarter (I/IV, p=0.0023; I/III, p=0.0074; II/IV, p=0.047) or trimester [I/II, p=0.09 (trend); I/III p=0.014; II/III, p=0.079 (trend)]. In another study at the same location (number of newborns n=286,963), significant correlation between monthly newborn number and month of the year was not found. possible environmental effects related to the different monthly birth distributions of the studied group are discussed. CONCLUSIONS: Victims of SCD and RCD are unequally distributed according to month of birth. The highest numbers were found for January and March to May. The numbers are higher for the first and second quarter and first trimester in comparison with the months at the end of the year. The lowest numbers of study patients were born in November, December and October. This is in accord with the birth months of American centenarians (100-112 years old) found by colleagues from the University of Chicago. Possible mechanisms for predisposition to SCD and RCD need further elucidation. Our findings support the paradigm linking birth month and longevity.

Gender-related differences in hospitalized heart failure patients.

AIMS: The burden of heart failure (HF)-related hospitalization and mortality of female patients with HF is substantial. Currently, several gender-specific distinctions have been recognized amongst HF patients, but their relationships to outcomes have not been fully elucidated. Accordingly, in the current work, we aimed to explore gender-specific clinical and echocardiographic measures and to assess their potential impact on outcome. METHODS AND RESULTS: We studied all consecutive HF patients, aged 50 or older, who had been hospitalized between January 2000 and December 2009, and had undergone at least one echocardiography study. A comparative analysis of clinical and echocardiographic findings was performed between 5228 males and 4107 females. Patients were followed for a mean of 2.8 ± 2.6 years. Females compared with males had less ischaemic heart disease, prior stroke, chronic renal failure, and COPD, and higher rates of hypertension, AF, obesity, valvular abnormalities, and pulmonary hypertension. Unadjusted 30-day and 1-year mortality rates were higher among women, while age-adjusted rates were similar. Predictors of outcomes varied between genders. Female-specific predictors of mortality included aortic stenosis, pulmonary hypertension, and malignancy, whereas diastolic dysfunction and chronic renal failure were found to be male-specific predictors. CONCLUSIONS: Age-adjusted mortality rates of male and female hospitalized HF patients are similarly high. Predictors of mortality, however, are gender distinctive, and these measures may allow a better identification of high-risk HF patients.

Predictors for anaerobic bacteraemia beyond the source of infection: retrospective, nested, case-control study.

In a retrospective case-control study, adults with anaerobic bacteraemia (ANB) were matched to patients with aerobic bacteraemia based on source of infection (1:3), date and age. We identified diabetes mellitus as a significant risk factor for ANB when the source of the bacteraemia was unknown, OR 2.29 (95% CI 1.22-4.29).

Congenital heart disease: correlation with fluctuations in cosmophysical activity, 1995-2005.

BACKGROUND: Environmental physical activity is known to be associated with many factors of human homeostasis, such as fetal development, birth number, and some genetic abnormalities. This study sought to investigate possible temporal links between the occurrence of congenital heart disease and solar, geomagnetic, and cosmic ray activities. PATIENTS AND METHODS: The study sample include 79,085 infants born live at a tertiary medical center in central Israel from 1995 to 2005, of whom 1739 were diagnosed with congenital heart disease, including 309 with patent ductus arteriosus (PDA). The number of infants with congenital heart disease (total and excluding PDA) was analyzed against the values of the physical parameters, as derived from international indices, by year of birth and 1 year before and by month of birth and 9 months before. Pearson correlation coefficients and their probabilities were calculated. RESULTS: The number of cases of infantile congenital heart disease over the 132-month study period significantly correlated with solar activity (r=0.5, p<0.0001) and with cosmic ray activity (r=-0.45, p<0.0001). On analysis by year, correlations were as follows: with solar activity 1 year before delivery, r=0.71, p=0.014, n=11, and at time of delivery, r=0.66, p=0.026; with cosmic ray activity, 1 year before delivery, r=-0.66, p=0.03, and at time of delivery, r=-0.61, p=0.047, n=11. The levels of correlation and probability were higher for solar activity indices at conception (9 months or 1 year before delivery) than at birth. Significance was maintained when cases of PDA were excluded. CONCLUSION: The monthly number of infants born with congenital heart disease is directly correlated with the level of solar activity and inversely correlated with the level of cosmic ray activity during pregnancy, predominantly in the month of conception. The mechanism underlying the possible effect of solar activity on the occurrence of congenital heart disease warrants additional studies.