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Costs of surgical ablation of atrial fibrillation in Ontario, Canada from 2006 to 2017
ConclusionOntario taxpayers spend significant financial resources on surgical ablation of AF, a procedure lacking high ‐quality evidence demonstrating benefit in reducing mortality or stroke. Further large prospective studies examining clinically important outcomes are needed to justify its routine use in patient care and to guide allocation of healthcare funds.
Source: Journal of Cardiac Surgery - September 27, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Justin Y. Chow, Graham McClure, Emilie P. Belley ‐Côté, William F. McIntyre, Rohit K. Singal, Richard P. Whitlock Tags: ORIGINAL ARTICLE Source Type: research

Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial
This study is registered at ClinicalTrials.gov, number NCT01891058.FindingsBetween July 18, 2013, and Oct 17, 2018, we enrolled 396 patients, and none were lost to follow-up. In the drug–shock group (n=204), conversion to sinus rhythm occurred in 196 (96%) patients and in the shock-only group (n=192), conversion occurred in 176 (92%) patients (absolute difference 4%; 95% CI 0–9; p=0·07). The proportion of patients discharged home was 97% (n=198) versus 95% (n=183; p=0·60). 106 (52%) patients in the drug–shock group converted after drug infusion only. No patients had serious adverse events in follow-up. The differen...
Source: The Lancet - January 31, 2020 Category: General Medicine Source Type: research

Academic outcome in pediatric ischemic stroke.
Abstract An important cause of acquired brain injury in children, pediatric ischemic stroke can cause sequelae across a wide range of cognitive domains, including verbal reasoning and processing speed. As a result, survivors are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Despite this knowledge, pediatric stroke remains an understudied neurological condition, and its impact on school functioning poorly understood. The present clinical study addressed academic outcome in this population using a multifaceted approach. Patients were recruited for participation fr...
Source: Child Neuropsychology - January 8, 2020 Category: Child Development Authors: Champigny CM, Deotto A, Westmacott R, Dlamini N, Desrocher M Tags: Child Neuropsychol Source Type: research

Adagio Gives Afib Cold Treatment in Hot Market
Adagio Medical is vying to get its treatment for persistent atrial fibrillation treatment on the market. The Laguna Hills, CA-based company made significant progress toward the goal this week and announced it received an IDE from FDA. The firm is developing a catheter procedure involving an energy source that freezes tissue. Adagio said its intelligent continuous lesion ablation system (iCLAS) encompasses the One- Shot+ catheter, a corresponding console, and a protective esophageal balloon to mitigate the effects of the cold beyond the localized area of ablation. The anatomical approach requires a single transseptal punctu...
Source: MDDI - August 20, 2019 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Business Source Type: news

Value of routine echocardiography in the management of stroke.
Abstract BACKGROUND: Transthoracic echocardiography is routinely performed in patients with stroke or transient ischemic attack (TIA) to help plan secondary stroke management, but recent data evaluating its usefulness in this context are lacking. We sought to evaluate the value of echocardiography for identifying clinically actionable findings for secondary stroke prevention. METHODS: We conducted a multicentre cohort study of patients admitted to hospital with stroke or TIA between 2010 and 2015 at 2 academic hospitals in Toronto, Ontario, Canada. Clinically actionable echocardiographic findings for secondar...
Source: cmaj - August 5, 2019 Category: General Medicine Authors: Fralick M, Goldberg N, Rohailla S, Guo Y, Burke MJ, Lapointe-Shaw L, Kwan JL, Weinerman AS, Rawal S, Tang T, Razak F, Verma AA Tags: CMAJ Source Type: research

Sex Difference of Radiation Response in Occupational and Accidental Exposure
Conclusion and Outlook This review summarizes the data from major human studies on the health risks of radiation exposure and shows that sex can potentially influence the prolonged response to radiation exposure (Figure 1 and Tables 1, 2). These data suggest that long-term radiosensitivity in females is higher than that in males who receive a comparable dose of radiation. Our analysis of the literature agrees with the conclusions of the recent report on the Biological effects of ionizing radiation (BEIR VII) published in 2006 by the National Academy of Sciences (NAS), United States (National Research Council, 2006). The B...
Source: Frontiers in Genetics - May 2, 2019 Category: Genetics & Stem Cells Source Type: research

Reduction of Leukocyte Microvascular Adherence and Preservation of Blood-Brain Barrier Function by Superoxide-Lowering Therapies in a Piglet Model of Neonatal Asphyxia
Conclusion: Using three different strategies to either prevent formation or enhance elimination of O2⋅_ during the post-asphyxial period, we saw both reduced leukocyte adherence and preserved BBB function with treatment. These findings suggest that agents which lower O2⋅_ in brain may be attractive new therapeutic interventions for the protection of the neonatal brain following asphyxia. Introduction Asphyxia is a relatively common source of neonatal brain damage (1), affecting ~2 in every 1,000 births (2). The hypoxic ischemia resulting from this oxygen deprivation can produ...
Source: Frontiers in Neurology - April 30, 2019 Category: Neurology Source Type: research

Sex Differences in Sex Hormone Profiles and Prediction of Consciousness Recovery After Severe Traumatic Brain Injury
Conclusion: These findings indicate that TBI differentially affects the levels of sex-steroid hormones in men and women patients. Plasma levels of testosterone could be a good candidate blood marker to predict recovery from unconsciousness after sTBI for male patients. Introduction Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is increasing in incidence (1). Patients with acute severe TBI (sTBI) often develop severe disorders of consciousness, i.e., coma, minimally conscious state or vegetative state. Although many patients may regain consciousness during the 1-month post-TBI p...
Source: Frontiers in Endocrinology - April 25, 2019 Category: Endocrinology Source Type: research

Associations of Anemia With Outcomes in Patients With Spontaneous Intracerebral Hemorrhage: A Meta-Analysis
Conclusions: Anemia on admission was associated with higher mortality and an increased risk of poor outcome in patients with ICH. However, the results were limited by the high heterogeneity of included studies. Prospective, multi-center or population-based, large sample cohort studies are needed in the future. Introduction Intracerebral hemorrhage (ICH) is the second most common cause of stroke and a highly lethal disease (1), which still lacks effective therapeutic interventions (2, 3). Although age, baseline ICH volume and neurological status on admission are well-known predictors of outcome of ICH (4), none of t...
Source: Frontiers in Neurology - April 24, 2019 Category: Neurology Source Type: research

Influence of Combined Transcranial Direct Current Stimulation and Motor Training on Corticospinal Excitability in Children With Unilateral Cerebral Palsy
Conclusion This proof-of-principle study evaluated the influence of cathodal contralesional tDCS on corticospinal excitability in pediatric participants with UCP. A hypothesized decrease in contralesional excitability was noted in participants in the Active+CIMT group, however, the efficacy of tDCS to modulate corticospinal excitability was not statistically different than the Sham+CIMT group. A more detailed understanding of how tDCS impacts M1 neurophysiology will be essential to inform future clinical trials on the optimal dosing parameters, based on individual brain circuitry, to explore the potential functional benef...
Source: Frontiers in Human Neuroscience - April 23, 2019 Category: Neuroscience Source Type: research

A Novel Variant in Non-coding Region of GJB1 Is Associated With X-Linked Charcot-Marie-Tooth Disease Type 1 and Transient CNS Symptoms
Conclusion A novel GJB1 variant of c.-170T>G in non-coding region was found in this big Chinese CMTX1 pedigree. This is the first report of variant in non-coding DNA sequence associated with transient CNS symptoms. Thyroid malfunction may contribute to the CNS symptoms in this case. Ethics Statement This study has been reviewed and approved by the Ethics Committee of the China-Japan Union Hospital of Jilin University. Each member of the family provided written informed consent to the participation in the study, the genetic test, and authorized to publish the study including the photos in accordance with the Decl...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Compensation of Respiratory-Related Postural Perturbation Is Achieved by Maintenance of Head-to-Pelvis Alignment in Healthy Humans
Conclusion Extreme lung volume variations over vital capacity is associated with changes of thoracic curvature bringing it outside the normal range, which would theoretically compromise verticality. This is however fully compensated by adaptations of the cervical curvature and pelvic tilt to preserve adequate head-to-pelvis verticality and horizontal gaze alignment. Lung volume related postural perturbations increase with age, but age did not affect head-to-pelvis alignment. Future studies are needed to investigate potential postural dysfunction in chronic respiratory diseases that induce changes of lung volume or chest g...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Ambient Conditions Prior to Tokyo 2020 Olympic and Paralympic Games: Considerations for Acclimation or Acclimatization Strategies
This study was supported by ZonMw (Project: Thermo Tokyo: Beat the heat), Netherlands Organisation for Scientific Research (NWO) (Project: Citius, Altius, Sanius), and Heatshield, under EU Horizon 2020 grant agreement No 668786. Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgments The authors thank Dr. Tatsuro Amano (Niigata University, Japan) for his assistance with translating the Japanese Meteorological Agency website. Footnotes ^ https://rdrr.io/g...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1 β Deficient Murine Hearts
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health pro...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Blood Flow Restriction Exercise Attenuates the Exercise-Induced Endothelial Progenitor Cell Response in Healthy, Young Men
Conclusion In summary, this is the first study to show that BFR exercise did not augment EPC response to exercise, and in fact blunted the EPC response to low load unilateral KE exercise in young, healthy males. Ethics Statement This study was carried out in accordance with the recommendations of Edinburgh Napier University Research and Ethics Governance Committee. The study was ethically approved by Edinburgh Napier University Research and Ethics Governance Committee. All participants gave written informed consent in accordance with the Declaration of Helsinki. Author Contributions MR, RM, AP, CW, GF-J designed the s...
Source: Frontiers in Physiology - April 16, 2019 Category: Physiology Source Type: research

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