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1.
Nature ; 629(8012): 616-623, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38632405

RESUMO

In palaeontological studies, groups with consistent ecological and morphological traits across a clade's history (functional groups)1 afford different perspectives on biodiversity dynamics than do species and genera2,3, which are evolutionarily ephemeral. Here we analyse Triton, a global dataset of Cenozoic macroperforate planktonic foraminiferal occurrences4, to contextualize changes in latitudinal equitability gradients1, functional diversity, palaeolatitudinal specialization and community equitability. We identify: global morphological communities becoming less specialized preceding the richness increase after the Cretaceous-Palaeogene extinction; ecological specialization during the Early Eocene Climatic Optimum, suggesting inhibitive equatorial temperatures during the peak of the Cenozoic hothouse; increased specialization due to circulation changes across the Eocene-Oligocene transition, preceding the loss of morphological diversity; changes in morphological specialization and richness about 19 million years ago, coeval with pelagic shark extinctions5; delayed onset of changing functional group richness and specialization between hemispheres during the mid-Miocene plankton diversification. The detailed nature of the Triton dataset permits a unique spatiotemporal view of Cenozoic pelagic macroevolution, in which global biogeographic responses of functional communities and richness are decoupled during Cenozoic climate events. The global response of functional groups to similar abiotic selection pressures may depend on the background climatic state (greenhouse or icehouse) to which a group is adapted.


Assuntos
Organismos Aquáticos , Mudança Climática , Foraminíferos , Filogeografia , Plâncton , Animais , Organismos Aquáticos/fisiologia , Organismos Aquáticos/classificação , Biodiversidade , Evolução Biológica , Mudança Climática/história , Conjuntos de Dados como Assunto , Extinção Biológica , Foraminíferos/classificação , Foraminíferos/fisiologia , História Antiga , Plâncton/classificação , Plâncton/fisiologia , Análise Espaço-Temporal
2.
Nature ; 614(7949): 713-718, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36792824

RESUMO

The geographic ranges of marine organisms, including planktonic foraminifera1, diatoms, dinoflagellates2, copepods3 and fish4, are shifting polewards owing to anthropogenic climate change5. However, the extent to which species will move and whether these poleward range shifts represent precursor signals that lead to extinction is unclear6. Understanding the development of marine biodiversity patterns over geological time and the factors that influence them are key to contextualizing these current trends. The fossil record of the macroperforate planktonic foraminifera provides a rich and phylogenetically resolved dataset that provides unique opportunities for understanding marine biogeography dynamics and how species distributions have responded to ancient climate changes. Here we apply a bipartite network approach to quantify group diversity, latitudinal specialization and latitudinal equitability for planktonic foraminifera over the past eight million years using Triton, a recently developed high-resolution global dataset of planktonic foraminiferal occurrences7. The results depict a global, clade-wide shift towards the Equator in ecological and morphological community equitability over the past eight million years in response to temperature changes during the late Cenozoic bipolar ice sheet formation. Collectively, the Triton data indicate the presence of a latitudinal equitability gradient among planktonic foraminiferal functional groups which is coupled to the latitudinal biodiversity gradient only through the geologically recent past (the past two million years). Before this time, latitudinal equitability gradients indicate that higher latitudes promoted community equitability across ecological and morphological groups. Observed range shifts among marine planktonic microorganisms1,2,8 in the recent and geological past suggest substantial poleward expansion of marine communities even under the most conservative future global warming scenarios.


Assuntos
Organismos Aquáticos , Biodiversidade , Temperatura Baixa , Foraminíferos , Mapeamento Geográfico , Filogeografia , Plâncton , Análise Espaço-Temporal , Animais , Organismos Aquáticos/classificação , Organismos Aquáticos/isolamento & purificação , Conjuntos de Dados como Assunto , Foraminíferos/classificação , Foraminíferos/isolamento & purificação , Fósseis , História Antiga , Filogenia , Plâncton/classificação , Plâncton/isolamento & purificação , Fatores de Tempo , Hidrobiologia
3.
Nature ; 558(7709): 288-291, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29849143

RESUMO

The Cretaceous/Palaeogene mass extinction eradicated 76% of species on Earth1,2. It was caused by the impact of an asteroid3,4 on the Yucatán carbonate platform in the southern Gulf of Mexico 66 million years ago 5 , forming the Chicxulub impact crater6,7. After the mass extinction, the recovery of the global marine ecosystem-measured as primary productivity-was geographically heterogeneous 8 ; export production in the Gulf of Mexico and North Atlantic-western Tethys was slower than in most other regions8-11, taking 300 thousand years (kyr) to return to levels similar to those of the Late Cretaceous period. Delayed recovery of marine productivity closer to the crater implies an impact-related environmental control, such as toxic metal poisoning 12 , on recovery times. If no such geographic pattern exists, the best explanation for the observed heterogeneity is a combination of ecological factors-trophic interactions 13 , species incumbency and competitive exclusion by opportunists 14 -and 'chance'8,15,16. The question of whether the post-impact recovery of marine productivity was delayed closer to the crater has a bearing on the predictability of future patterns of recovery in anthropogenically perturbed ecosystems. If there is a relationship between the distance from the impact and the recovery of marine productivity, we would expect recovery rates to be slowest in the crater itself. Here we present a record of foraminifera, calcareous nannoplankton, trace fossils and elemental abundance data from within the Chicxulub crater, dated to approximately the first 200 kyr of the Palaeocene. We show that life reappeared in the basin just years after the impact and a high-productivity ecosystem was established within 30 kyr, which indicates that proximity to the impact did not delay recovery and that there was therefore no impact-related environmental control on recovery. Ecological processes probably controlled the recovery of productivity after the Cretaceous/Palaeogene mass extinction and are therefore likely to be important for the response of the ocean ecosystem to other rapid extinction events.


Assuntos
Biodiversidade , Extinção Biológica , Vida , Cálcio/metabolismo , Foraminíferos/isolamento & purificação , Fósseis , Golfo do México , História Antiga , Magnésio/metabolismo , Oxigênio/metabolismo , Plâncton/isolamento & purificação , Tamanho da Amostra , Especificidade da Espécie , Fatores de Tempo
4.
J Cardiovasc Electrophysiol ; 24(6): 649-54, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23397974

RESUMO

INTRODUCTION: While most ventricular arrhythmias (VA) can be ablated successfully using an endocardial (endo) approach, epicardial (epi) mapping and ablation is sometimes required. There may be suggestive clues on the surface electrocardiogram; however, identification of an epi origin of VA with certainty remains problematic. METHODS AND RESULTS: All patients referred for ablation of ventricular tachycardia or frequent ventricular ectopy from June 2007 to July 2011 were evaluated. Patients with completed endo and epi electroanatomical activation maps of an epi VA were included (n = 10). Bipolar electrograms (EGMs) in the area of earliest endo activation were analyzed and compared to the area of early epi activation. An EGM component was characterized as far field if it was monophasic and there was inability to capture. We identified 3 characteristics from endo mapping that consistently indicated need for epi ablation: (1) Diffusely early activation (>2 cm(2) region of sites with equally earliest activation within 10 milliseconds). (2) Sequence of a far-field EGM followed by a near-field EGM in the region of earliest endo activation. (3) Inability to capture the far-field component of the earliest EGM (stim-QRS < egm-QRS time) or reproduce morphological features of the VA complex with stimulation at the earliest endo site of activation. CONCLUSIONS: The presence of a diffusely early area of activation and inability to capture a far-field endo EGM indicates that epi ablation may be needed to eliminate a VA.


Assuntos
Eletrocardiografia , Taquicardia Ventricular/fisiopatologia , Adulto , Idoso , Endocárdio/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericárdio/fisiopatologia , Taquicardia Ventricular/cirurgia
5.
Pacing Clin Electrophysiol ; 36(1): 76-85, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23078144

RESUMO

BACKGROUND: Ventricular fibrillation (VF) can be abolished by targeting triggering ventricular ectopy, most often originating in the Purkinje network or right ventricular outflow tract (RVOT). This strategy relies upon the induction of premature ventricular complex (PVC) and/or VF. We sought to evaluate a VF ablation strategy that utilizes analysis of stored implantable cardioverter defibrillator (ICD) electrograms. METHODS: Eleven consecutive patients experiencing frequent VF episodes (≥three episodes in prior month) underwent electrophysiology study and ablation of VF triggers. PVC and VF induction was intentionally avoided or not possible in all of these patients. Pacemapping at likely sites for PVC triggers of VF using an analysis of the morphology and relative timing of the stored far- and near-field ICD electrograms of VF triggers was used to identify potential culprit locations. Radiofrequency energy was applied to these sites for ablation of the identified VF trigger. RESULTS: Areas targeted for ablation included the left posterior fascicle (six), left anterior fascicle (three), RVOT (three) and left ventricular outflow tract (one); two patients had two separate triggers. Ablation was completed successfully without any complications. With a mean follow-up of 288 days (range 45-649), 10 patients are free of VF. CONCLUSION: Ablation of VF triggers can be performed successfully with good short-term outcomes in patients with and without underlying heart disease. Use of stored ICD electrograms with a focus on likely target areas permit ablation without the need for PVC or VF induction. This can be useful when ectopy is not present for mapping and to avoid potentially dangerous initiation of multiple episodes of VF.


Assuntos
Ablação por Cateter/métodos , Desfibriladores Implantáveis , Eletrocardiografia Ambulatorial/métodos , Fibrilação Ventricular/diagnóstico , Fibrilação Ventricular/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
6.
Sci Rep ; 12(1): 11376, 2022 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-35790847

RESUMO

To fully assess the resilience and recovery of life in response to the Cretaceous-Paleogene (K-Pg) boundary mass extinction ~ 66 million years ago, it is paramount to understand biodiversity prior to the Chicxulub impact event. The peak ring of the Chicxulub impact structure offshore the Yucatán Peninsula (México) was recently drilled and extracted a ~ 100 m thick impact-generated, melt-bearing, polymict breccia (crater suevite), which preserved carbonate clasts with common biogenic structures. We pieced this information to reproduce for the first time the macrobenthic tracemaker community and marine paleoenvironment prior to a large impact event at the crater area by combining paleoichnology with micropaleontology. A variable macrobenthic tracemaker community was present prior to the impact (Cenomanian-Maastrichtian), which included soft bodied organisms such as annelids, crustaceans and bivalves, mainly colonizing softgrounds in marine oxygenated, nutrient rich, conditions. Trace fossil assemblage from these upper Cretaceous core lithologies, with dominant Planolites and frequent Chondrites, corresponds well with that in the overlying post-impact Paleogene sediments. This reveals that the K-Pg impact event had no significant effects (i.e., extinction) on the composition of the macroinvertebrate tracemaker community in the Chicxulub region.


Assuntos
Extinção Biológica , Meteoroides , Biodiversidade , Fósseis , México
7.
J Cardiovasc Electrophysiol ; 22(2): 210-3, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20561106

RESUMO

We describe the case of a 43-year-old male with cardiac sarcoidosis and ventricular tachycardia storm successfully treated with catheter ablation and immunosuppression. Antiarrhythmics alone, and in combination with immusuppressive agents, failed to successfully manage the ventricular tachycardia episodes. Catheter ablation in conjunction with immunosuppression proved to be the most successful treatment strategy. The reported efficacy of catheter ablation for ventricular tachycardia in cardiac sarcoidosis is variable.


Assuntos
Cardiomiopatias/terapia , Ablação por Cateter/métodos , Imunossupressores/uso terapêutico , Sarcoidose/complicações , Taquicardia Ventricular/complicações , Taquicardia Ventricular/terapia , Adulto , Cardiomiopatias/complicações , Terapia Combinada , Humanos , Masculino , Sarcoidose/terapia , Resultado do Tratamento
8.
Pacing Clin Electrophysiol ; 34(2): 186-92, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21039640

RESUMO

BACKGROUND: Implantable cardioverter-defibrillators (ICDs) can provide life-saving therapies for ventricular arrhythmias. Arrhythmia induction and defibrillation threshold testing is often performed at implantation and postoperatively during long-term follow-up to ensure proper device function. METHODS: We sought to evaluate the prevalence and predictors of occult device malfunction at follow-up defibrillation testing in asymptomatic individuals. A cohort of 853 patients underwent 1,578 defibrillation tests during the 13-year study period. Defibrillation efficacy was evaluated primarily by the two-shock (2S) method, with an adequate safety margin ≥ 10 joules (J) less than the maximum energy delivered by the ICD. RESULTS: A total of 38 testing failures requiring intervention were discovered during testing (2.4% of all tests). There were 11 ICD system failures resulting in failure to defibrillate, six with underdetection of ventricular fibrillation, and 21 clinically significant increases in defibrillation threshold. There was a higher incidence of failure in older ICD systems (1996-2002) compared to newer ICD systems (2003-2009), reaching statistical significance (3.6% vs 1.0%; P < 0.01). There were 178 subjects (20.8%) with a >20-J safety margin on previous testing, detected R waves >7.0 mV, and all system components implanted after 2003 at the time of testing who did not have any testing failures (0% vs 5.6%; P < 0.01). CONCLUSION: Postoperative defibrillation testing identifies a small number of ICD malfunctions in asymptomatic individuals. ICD testing failure is seen more frequently in older systems and in those with borderline results from prior interrogation or testing. These findings suggest that serial postoperative defibrillation testing is not indicated in asymptomatic patients without suspicion for specific problems.


Assuntos
Desfibriladores Implantáveis/estatística & dados numéricos , Análise de Falha de Equipamento/estatística & dados numéricos , Falha de Equipamento/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Fibrilação Ventricular/epidemiologia , Fibrilação Ventricular/prevenção & controle , Adulto , Idoso , Colorado/epidemiologia , Análise de Falha de Equipamento/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/estatística & dados numéricos , Prevalência
9.
Ann Noninvasive Electrocardiol ; 16(3): 308-10, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21762260

RESUMO

BACKGROUND: Heart block can occur at multiple levels in patients with prior cardiac transplant. This diagnosis is usually ascertained using the surface electrocardiogram. RESULTS: A 24-year-old man with prior cardiac transplant presented with apparent complete atrioventricular nodal block and junctional escape on the surface ECG. During pacemaker implantation, we demonstrated sinus rhythm in the recipient atrium, block across the atrioatrial anastomosis, and sinus arrest with intact AV nodal conduction in the donor atrium. CONCLUSION: This case illustrates an unusual presentation of sinus arrest occurring 2 years after heart transplantation that appeared to be complete heart block.


Assuntos
Bloqueio Atrioventricular/etiologia , Eletrocardiografia/métodos , Rejeição de Enxerto , Parada Cardíaca/etiologia , Transplante de Coração , Bloqueio Atrioventricular/fisiopatologia , Estimulação Cardíaca Artificial , Parada Cardíaca/fisiopatologia , Humanos , Masculino , Adulto Jovem
10.
Ann Noninvasive Electrocardiol ; 16(1): 70-6, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21251137

RESUMO

INTRODUCTION: Cardiac sarcoidosis (CS) occurs in up to 25% of patients with pulmonary involvement. Early diagnosis is critical because sudden death from ventricular arrhythmias can be the initial presentation. We sought to evaluate the diagnostic utility of signal-averaged ECG (SAECG) for detection of cardiac involvement of sarcoidosis. METHODS: Subjects with biopsy proven sarcoidosis and symptoms suggestive of possible cardiac involvement were included in the cohort. Standard criteria for SAECG were used. Subjects were considered to have CS if they met criteria established by the Japanese Ministry of Health and Welfare modified to include cardiac MRI. RESULTS: Of the 88 patients in the cohort 27 had evidence of CS independent of the SAECG results. The SAECG was abnormal in 14 of these 27 patients and 11 of the 61 of the subjects without cardiac involvement (P < 0.01). The sensitivity of SAECG detection of CS was 52% with a specificity of 82%. For the entire cohort, SAECG had a positive predictive value (PPV) of 0.56 and a negative predictive value (NPV) of 0.79. Within a subgroup of 67 patients with an unfiltered QRS duration of <100 ms, the specificity for diagnosing cardiac sarcoidosis improves to 100% with a reduced sensitivity of 36.8. Of the SAECG parameters, LAS40 was significantly associated with the diagnosis of cardiac sarcoidosis for the entire cohort (P < 0.01) and among the subgroup of patients with an unfiltered QRS duration of <100 ms (P < 0.01). CONCLUSIONS: SAECG is a useful screening tool in the evaluation of sarcoidosis for detection of cardiac involvement.


Assuntos
Cardiomiopatias/diagnóstico , Cardiopatias/diagnóstico , Sarcoidose/diagnóstico , Adulto , Idoso , Feminino , Sistema de Condução Cardíaco/fisiopatologia , Cardiopatias/complicações , Cardiopatias/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Sarcoidose/complicações , Sarcoidose/fisiopatologia , Sarcoidose Pulmonar/complicações , Sensibilidade e Especificidade , Taquicardia Ventricular/diagnóstico
11.
Sci Adv ; 7(9)2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33627429

RESUMO

The Cretaceous-Paleogene (K-Pg) mass extinction is marked globally by elevated concentrations of iridium, emplaced by a hypervelocity impact event 66 million years ago. Here, we report new data from four independent laboratories that reveal a positive iridium anomaly within the peak-ring sequence of the Chicxulub impact structure, in drill core recovered by IODP-ICDP Expedition 364. The highest concentration of ultrafine meteoritic matter occurs in the post-impact sediments that cover the crater peak ring, just below the lowermost Danian pelagic limestone. Within years to decades after the impact event, this part of the Chicxulub impact basin returned to a relatively low-energy depositional environment, recording in unprecedented detail the recovery of life during the succeeding millennia. The iridium layer provides a key temporal horizon precisely linking Chicxulub to K-Pg boundary sections worldwide.

12.
J Card Fail ; 16(4): 327-31, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20350700

RESUMO

BACKGROUND: The left ventricular assist device (LVAD) is a therapy for patients with end-stage heart failure, many of whom have a preexisting implantable cardioverter-defibrillator (ICD). We investigated whether the implantation of a LVAD affects ICD function. METHODS AND RESULTS: Patients implanted with a LVAD between September 2000 and February 2009 were studied. Right ventricular (RV), right atrial, and left ventricular lead impedance, sensing, and capture thresholds were recorded before and after LVAD placement and subsequent lead-related interventions were noted. Of the 61 patients receiving a LVAD, data were collected from 30 patients who had preexisting ICDs. Significant pre-post differences were noted for all RV lead parameters: sensing amplitude decreased from 9.2+/-3.1 to 5.7+/-3.6 millivolts (P < .001); impedance decreased from 479+/-118 to 418+/-94 ohms (P=.008); and threshold increased from 4.3+/-6.7 to 11.0+/-16.8 microjoules (P=.021). As a result of alterations in lead parameters, 4 patients (13%) required lead revisions and 6 patients (20%) required ICD testing. CONCLUSIONS: Differences in ICD lead function were observed after LVAD placement resulting in clinically significant interventions. These data suggest that ICD interrogation be performed post-LVAD placement and that patients be counseled for the potential need for lead revisions and ICD testing when consented for a LVAD.


Assuntos
Desfibriladores Implantáveis , Coração Auxiliar , Disfunção Ventricular Esquerda/terapia , Adulto , Idoso , Estudos de Coortes , Desfibriladores Implantáveis/normas , Feminino , Seguimentos , Coração Auxiliar/normas , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular Esquerda/cirurgia
13.
Sci Adv ; 6(22): eaaz3053, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32523986

RESUMO

The ~180-km-diameter Chicxulub peak-ring crater and ~240-km multiring basin, produced by the impact that terminated the Cretaceous, is the largest remaining intact impact basin on Earth. International Ocean Discovery Program (IODP) and International Continental Scientific Drilling Program (ICDP) Expedition 364 drilled to a depth of 1335 m below the sea floor into the peak ring, providing a unique opportunity to study the thermal and chemical modification of Earth's crust caused by the impact. The recovered core shows the crater hosted a spatially extensive hydrothermal system that chemically and mineralogically modified ~1.4 × 105 km3 of Earth's crust, a volume more than nine times that of the Yellowstone Caldera system. Initially, high temperatures of 300° to 400°C and an independent geomagnetic polarity clock indicate the hydrothermal system was long lived, in excess of 106 years.

14.
Nat Ecol Evol ; 3(6): 900-904, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30962557

RESUMO

Highly resolved palaeontological records can address a key question about our current climate crisis: how long will it be before the biosphere rebounds from our actions? There are many ways to conceptualize the recovery of the biosphere; here, we focus on the global recovery of species diversity. Mass extinction may be expected to be followed by rapid speciation, but the fossil record contains many instances where speciation is delayed-a phenomenon about which we have a poor understanding. A probable explanation for this delay is that extinctions eliminate morphospace as they curtail diversity, and the delay in diversification is a result of the time needed for new innovations to rebuild morphospace, which can then be filled out by new species. Here, we test this morphospace reconstruction hypothesis using the morphological complexity of planktic foraminifer tests after the Cretaceous-Palaeogene mass extinction. We show that increases in complexity precede changes in diversity, indicating that plankton are colonizing new morphospace, then slowly filling it in. Preliminary diversification is associated with a rapid increase in the complexity of groups refilling relict Cretaceous ecospace. Subsequent jumps in complexity are driven by evolutionary innovations (development of spines and photosymbionts), which open new niche space. The recovery of diversity is paced by the construction of new morphospace, implying a fundamental speed limit on diversification after an extinction event.


Assuntos
Extinção Biológica , Fósseis , Evolução Biológica , Clima , Paleontologia
15.
Heart Rhythm ; 5(2): 248-52, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18242549

RESUMO

BACKGROUND: Transient VA block can be created in the AV node (AVN) when an atrial extrastimulus is delivered at the AVN effective refractory period (ERP) due to anterograde concealed conduction. OBJECTIVE: We hypothesized that ventricular stimulation during pacing-induced AVN refractoriness could identify concealed accessory pathways (APs) that remain hidden with standard maneuvers. METHODS: Patients undergoing electrophysiological study for supraventricular tachycardia were screened for presence of an AP using standard pacing maneuvers and/or V pacing during adenosine infusion. The dual-chamber sequential extrastimulation maneuver consisted of an 8-beat drive train of simultaneous AV pacing at 600 msec, followed by an A2 delivered at AVN ERP, followed by a V2 delivered at the drive train cycle length (600 msec). Repeat drives were then performed with decrements of 10 msec for V2 until VA block was seen. Retrograde AVN and AP ERP were recorded with standard (V1, V2) and dual-chamber extrastimulation (A1/V1, A2, V2). Patients with an AP identified with standard pacing, manifest pre-excitation, or A ERP < AVN ERP were excluded. RESULTS: Fourteen patients with and 19 patients without an AP were studied. In all patients with an AP, exclusive VA conduction over the AP, without fusion, was seen with the described pacing maneuver. In patients without an AP, retrograde AV nodal ERP was extended by a mean of 138 +/- 46 msec (range 50 to 210 msec) with the A2. Anterograde concealed conduction into the AP was also seen in some patients who showed AP conduction during standard V1V2 pacing (mean retrograde extension of ERP 12 +/- 8 msec, range 0 to 20 msec). CONCLUSION: Dual-chamber sequential extrastimulation is a useful maneuver for identifying slowly conducting APs not revealed with standard pacing maneuvers because of an ERP and conduction time similar to the AVN. The maneuver uses anterograde concealed conduction to prolong AVN refractoriness much more than that of a concealed AP, thereby allowing the AP to become manifest with the V2.


Assuntos
Bloqueio Atrioventricular/fisiopatologia , Estimulação Cardíaca Artificial , Ablação por Cateter , Sistema de Condução Cardíaco/fisiopatologia , Taquicardia Supraventricular/terapia , Adulto , Eletrocardiografia , Eletrofisiologia , Feminino , Sistema de Condução Cardíaco/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Taquicardia Supraventricular/fisiopatologia , Taquicardia Supraventricular/cirurgia , Fatores de Tempo
17.
Pharmacotherapy ; 25(11): 1523-9, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16232014

RESUMO

STUDY OBJECTIVE: To evaluate the effects of methadone on QT-interval dispersion. DESIGN: Single-center, prospective, cohort study. SETTING: Methadone maintenance treatment facility. PATIENTS: One hundred eighteen patients who were newly admitted to the facility. Intervention. Twelve-lead electrocardiograms (ECGs) were performed in patients at both baseline and 6 months after the start of methadone therapy. MEASUREMENTS AND MAIN RESULTS: The ECGs were manually interpreted, and investigators were blinded to time interval and methadone dose. At least eight discernible ECG leads were required for study inclusion. Mean differences between baseline and follow-up rate-corrected QT (QTc) interval and QT dispersion were compared. Multivariate associations between clinical characteristics and magnitude of change in QT dispersion were assessed using linear regression. Mean +/- SD baseline QT dispersion was 32.9 +/- 12 msec, which increased to 42.4 +/- 15 msec (+9.5 +/- 18.6 msec, p<0.0001) after 6 months of therapy. The QTc increased by a similar magnitude (+14.1 msec, p<0.0001). No QT dispersion value exceeded 100 msec. The only variable associated with a greater increase in QT dispersion was antidepressant therapy (20 vs 8.5 msec, p=0.04). CONCLUSION: Methadone modestly increased both QTc interval and QT dispersion. Increased QT dispersion reflects heterogeneous cardiac repolarization and occurs with nonantiarrhythmic agents, such as synthetic opioids. However, the magnitude of this effect appears to be substantially less with methadone than with antiarrhythmic drugs.


Assuntos
Eletrocardiografia/efeitos dos fármacos , Metadona/farmacologia , Adulto , Antiarrítmicos/farmacologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
19.
Psychol Rep ; 91(2): 607-17, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12416855

RESUMO

Previous research which has established a relationship between organizational citizenship behavior and job satisfaction has involved primarily white collar workers. This study extends the prior research to a different sample--blue collar workers--and investigates the relations of organizational citizenship behavior to the various facets of job satisfaction as measured by the Job Descriptive Index. We also examine the relative effects of organizational commitment and job satisfaction on citizenship behaviors. Analysis of responses from a sample of 91 machine operators employed by a clothing manufacturer in the southeastern United States indicates that citizenship behaviors of blue collar workers are related to satisfaction with coworkers, satisfaction with supervision, and satisfaction with pay, but not satisfaction with opportunities for advancement, satisfaction with the work itself, or organizational commitment.


Assuntos
Satisfação no Emprego , Cultura Organizacional , Política Organizacional , Local de Trabalho , Adulto , Feminino , Humanos , Masculino , Comportamento Social , Inquéritos e Questionários
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