Implantation of a completely subcutaneous ICD system: case report of a patient with Brugada syndrome and state of the art

Aims  

Complications of implantable cardioverter-defibrillator (ICD) therapy are often linked to transvenous lead insertion, lead failure, or infections. An entirely subcutaneous ICD system (S-ICD) avoids the need for the placement of electrodes within the heart and can provide clinical advantages.     

Reading disorders in a language with shallow orthography: A multiple single-case study in Italian

Background: This study aimed (i) to verify whether the classical word-naming models developed for English-speaking participants also account for the performance of patients who speak a shallow-orthography language such as Italian, and (ii) to study the effects of word frequency, concreteness, and grammatical class on word naming. Methods & Procedures: A total of 90 Italian aphasic patients participated in two reading tasks. The first task contained four sets of items: (i) concrete nouns (natural objects and artefacts), (ii) abstract nouns, (iii) function words, (iv) morphologically simple legal nonwords. The second task (trisyllabic words with unpredictable stress position) was designed to test reading ability along the lexical route (the position of the major word stress is the only opaque variable in the Italian reading system). The patients' performances on the two tasks were analysed for strong dissociations, and to test the effect of grammatical class, concreteness, word frequency, and item length. The effect of age of acquisition was tested in a subsequent analysis. Outcomes & Results: Reading scores were pathological for all patients. The present sample reflected the entire spectrum of reading impairments: phonological (49), surface (4), undifferentiated (32), and letter-by-letter (5) dyslexia, which is in line with data reported for English-speaking aphasic patients. Only one of the phonological dyslexic patients made semantic errors (a reading impairment compatible with the diagnosis of deep dyslexia). The vast majority of Broca's aphasic patients suffered from phonological dyslexia (76%), while fluent aphasic patients were distributed more evenly across dyslexia types; all four surface dyslexic patients belonged to the fluent aphasia group. Overall, grammatical class (concrete nouns vs function words) had a significant effect on 14 patients (15.6%), concreteness (concrete vs abstract nouns) on 15 (16.7%), and word frequency on 5 (5.6%). Grammatical class and concreteness affected the performance of phonological and undifferentiated dyslexic patients, and seemed not to influence the scores of the surface dyslexic patients. Age of acquisition turned out to have a highly significant effect and may account for most of the lexical effects emerging from the first analysis. Conclusions: The entire spectrum of reading impairments was observed in this group of Italian aphasic patients, thus confirming the validity of contemporary reading models also for shallow-orthography languages. Concreteness and grammatical class effects, present in deep dyslexia, also affected the performance of patients suffering from other types of dyslexia, although both phenomena might derive from a confounding effect of age of acquisition.     

Short- and long-term motor outcome of STN-DBS in Parkinson’s Disease: focus on sex differences

Neurological Sciences - Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for patients with Parkinson’s disease (PD) with motor complications; the contribution...     

The influence of preoperative teres minor muscle fatty degeneration on active external rotation following reverse total shoulder arthroplasty

BackgroundReverse total shoulder arthroplasty (rTSA) improves shoulder elevation in patients treated for cuff tear arthropathy (CTA) or irreparable massive cuff tears. Patient satisfaction can be limited by reduced active external rotation (AER). Rotator cuff muscles that externally rotate the shoulder are infraspinatus and teres minor (TM).AimThe purpose of this study was to assess the correlation between preoperative TM fatty degeneration and postoperative AER after rTSA performed for CTA or irreparable cuff tears.MethodsConstant scores and active range of motion were consecutively collected for 109 shoulders in 97 patients (mean: 75.73 ± 8.94 years; 31 male, 66 female) over a 10-year period. AER was evaluated with the humerus in adduction (AER1) and in abduction. TM muscle atrophy was scored according to Goutallier's classification, assessed on preoperative computed tomography scans.ResultsMultivariate analysis showed that TM fatty infiltration was a predictor of AER1. AER1 decreased by 4.9 degrees preoperatively and by 6.4 degrees at the final follow-up, for each increment in Goutallier grade (P = .02). Postoperatively, AER evaluated with humerus in abduction improved significantly (P < .001), but did not correlate with TM Goutallier grade. At a mean follow-up of 38 months (range: 24 to 96), mean Constant score improved from 20.5 ± 11.1 to 68.4 ± 14.9 (P < .001), as did shoulder active range of motion in all planes including AER1 (P < .001).ConclusionThis is the first study to quantify the inverse correlation between AER and TM Goutallier grade, both preoperatively and after rTSA; this information guides prognosis for patients with TM degeneration undergoing rTSA. Further studies are necessary to have a better understanding and find reliable solutions.Level of evidenceLevel III; Case Series     

Posterior box isolation as an adjunctive ablation strategy with the second-generation cryoballoon for paroxysmal atrial fibrillation: a comparison with standard cryoballoon pulmonary vein isolation

Journal of Interventional Cardiac Electrophysiology - The purpose of the study was to evaluate the impact of left atrial posterior wall isolation (LAPWI) in addition to pulmonary vein isolation...     

On social polarization and ordinal variables: the case of self-assessed health

Social polarization refers to the measurement of the distance between different social groups, defined on the basis of variables such as race, religion, or ethnicity. We propose two approaches to measuring social polarization in the case where the distance between groups is based on an ordinal variable, such as self-assessed health status. The first one, the ‘stratification approach’, amounts to assessing the degree of non-overlapping of the distributions of the ordinal variable between the different population subgroups that are distinguished. The second one, the ‘antipodal approach’, considers that the social polarization of an ordinal variable will be maximal if the individuals belonging to a given population subgroup are in the same health category, this category corresponding either to the lowest or to the highest health status. An empirical illustration is provided using the 2009 cross-sectional data of the European Union Statistics on Income and Living Conditions (EU-SILC). We find that Estonia, Latvia, and Ireland have the highest degree of social polarization when the ordinal variable under scrutiny refers to self-assessed health status and the (unordered) population subgroups to the citizenship of the respondent whereas Luxembourg is the country with the lowest degree of social polarization in health.