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Yoav Michowitz Anat Milman Antoine Andorin Georgia Sarquella-Brugada M. Cecilia Gonzalez Corcia Jean-Baptiste Gourraud Giulio Conte Frederic Sacher Jimmy J.M. Juang Sung-Hwan Kim Eran Leshem Philippe Mabo Pieter G. Postema Aviram Hochstadt Yanushi D. Wijeyeratne Isabelle Denjoy Carla Giustetto Yuka Mizusawa Bernard Belhassen 《Journal of the American College of Cardiology》2019,73(14):1756-1765
Background
Information on young patients with Brugada syndrome (BrS) and arrhythmic events (AEs) is limited.Objectives
The purpose of this study was to describe their characteristics and management as well as risk factors for AE recurrence.Methods
A total of 57 patients (age ≤20 years), all with BrS and AEs, were divided into pediatric (age ≤12 years; n = 26) and adolescents (age 13 to 20 years; n = 31).Results
Patients’ median age at time of first AE was 14 years, with a majority of males (74%), Caucasians (70%), and probands (79%) who presented as aborted cardiac arrest (84%). A significant proportion of patients (28%) exhibited fever-related AE. Family history of sudden cardiac death (SCD), prior syncope, spontaneous type 1 Brugada electrocardiogram (ECG), inducible ventricular fibrillation at electrophysiological study, and SCN5A mutations were present in 26%, 49%, 65%, 28%, and 58% of patients, respectively. The pediatric group differed from the adolescents, with a greater proportion of females, Caucasians, fever-related AEs, and spontaneous type-1 ECG. During follow-up, 68% of pediatric and 64% of adolescents had recurrent AE, with median time of 9.9 and 27.0 months, respectively. Approximately one-third of recurrent AEs occurred on quinidine therapy, and among the pediatric group, 60% of recurrent AEs were fever-related. Risk factors for recurrent AE included sinus node dysfunction, atrial arrhythmias, intraventricular conduction delay, or large S-wave on ECG lead I in the pediatric group and the presence of SCN5A mutation among adolescents.Conclusions
Young BrS patients with AE represent a very arrhythmogenic group. Current management after first arrhythmia episode is associated with high recurrence rate. Alternative therapies, besides defibrillator implantation, should be considered. 相似文献46.
Maria Papaioannou Georgia Pitsiou Katerina Manika Paschalina Kontou Pavlos Zarogoulidis Lazaros Sichletidis 《COPD》2014,11(5):489-495
The COPD assessment test (CAT) is a short questionnaire designed to assess the impairment in health status of COPD patients. We aimed to determine the change of the CAT in COPD patients after 1 year of treatment and test the association between the score and clinical and lung function variables. Methods A cohort of 111 newly diagnosed COPD patients in primary care was evaluated at baseline and one year after the implementation of the recommended treatment according to the Global Initiative for the management of COPD (GOLD). Results Most of the patients (82%) were diagnosed with mild to moderate airflow limitation (mean FEV1 72 ± 21.5% predicted) and the CAT score increased in proportion with the GOLD stage of severity. The CAT significantly correlated with the number of exacerbations, visits to general practitioners and days of hospitalization both at the beginning and at 1 year follow-up. A strong negative correlation between the CAT score and FEV1 predicted was also observed. The CAT was responsive to the application of treatment with a significant improvement in the mean score (95% confidence interval) following 12 months of treatment by –2.4 (–2.9, –1.9) despite the small decline in lung function indices. The number of exacerbations in the preceding year and FEV1 were independent predictors of the CAT score in the general linear model. Conclusion The CAT questionnaire may serve as a simple, measurable tool complementary to spirometry in the assessment of severity and of response to treatment in unselected COPD patients in primary care. 相似文献
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Evangelos C. Karademas Georgia Dimitraki Christoforos Thomadakis Zoe Giannousi 《Journal of psychosocial oncology》2019,37(2):145-159
AbstractThe central role of spouses/partners in patients’ adaptation to cancer is well-established, but few studies have examined how partners facilitate adaptation. The Common Sense Model posits that a representation of illness as more controllable and less threatening promotes adaptive coping, but this has not been examined in a dyadic context. This cross-sectional study examined the relations of spouse illness representations of personal and treatment control, and emotional representations to recently diagnosed cancer patients’ coping behaviors, through patient illness representations. One hundred forty-nine heterosexual couples (39.60% female patients; 77.18% dealing with early stage cancer) participated in the study. Structural Equation Modeling showed that spouse illness representations were related to patient coping directly and indirectly through patient illness representations. Both partners’ representations of control were related to greater patient adaptive coping, and both partners’ emotional representations were related to greater dysfunctional coping. These findings highlight the importance of partner illness representations in patients’ adaptation to cancer. They also suggest that early intervention programs that address both partners’ illness representations may enhance patients’ adaptation to cancer. 相似文献
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Georgia Robins Sadler Paula R. Beerman Kathy Lee Jenny Hung Helene Nguyen Janet Cho Wennie Huang 《Journal of cancer education》2012,27(4):612-617
Asian American women's historically low breast cancer mortality rate has remained constant as rates decreased for all other races. From 2000 to 2004, a randomized controlled trial explored the Asian grocery store-based breast cancer education program's impact on Chinese, Filipino, Korean, and Vietnamese women (n?=?1,540). Women aged 40 and older and non-adherent for annual screening mammograms were more likely to schedule a mammogram after receiving the breast cancer education program than women randomized to the prostate cancer program (X 2?=?3.85, p?=?0.05). With the right program ingredients, late adopters of breast cancer screening can be prompted to change. 相似文献