Fragmented QRS complex in patients with implantable cardioverter defibrillator—Prevalence and predisposing factors

Background

Incidence of fragmented (fQRS) and predisposing factors in patients with implantable cardioverter-defibrillator (ICD) have not yet been established.AimTo examine incidence of fQRS, associated factors as well as predictive value in identifying site of coronary artery disease (CAD).

Is there a Rationale for Autologous Breast Reconstruction in Older Patients? A Retrospective Single Center Analysis of Quality of life,Complications and Comorbidities after DIEP or ms‐TRAM Flap Using the BREAST‐Q

Autologous breast reconstruction with the deep inferior epigastric perforator (DIEP) or muscle‐sparing transverse rectus abdominis myocutaneous (ms‐TRAM) flap is a common method in the majority of patients after mastectomy. Because of an increased perioperative risk profile the benefit in older patients is questionable. To assess the postoperative quality of life and peri‐ and post‐operative complications of older compared to younger patients is the aim of this retrospective study. In a retrospective analysis 39 older (i.e. >60 years) and 140 younger patients (i.e. <60 years) with autologous breast reconstruction in the Department of Plastic Surgery at the University Hospital of Erlangen‐Nuernberg were surveyed at least 6 month postoperative using the BREAST‐Q questionnaire. Correlations were generated between comorbidities and complications. Significant differences were observed regarding hospitalization, pre‐existing diseases and the choice of DIEP versus ms‐TRAM flaps. Parameters such as major and minor complications, bulging or hernia and risk factors (e.g. smoking or obesity) showed no significant differences. The results of the questionnaire parameters showed no significant difference between both groups, revealing high satisfaction with the aesthetic result and an improvement in quality of life independent of age. Autologous breast reconstruction after mastectomy generates a gain in quality of life and shows a good to excellent overall satisfaction in older as well as younger patients. Despite a longer hospitalization and a different risk profile there were no significant differences regarding minor and major complications in the postoperative course. Hence autologous breast reconstruction for older patients is justified and should be taken into consideration.     

The Role of Low Density Lipoprotein Apheresis in the Treatment of Familial Hypercholesterolemia

Abstract: The chief indication for low density lipoprotein (LDL) apheresis is the treatment of homozygous familial hypercholesterolemia (FH), a potentially fatal condition that responds poorly to conventional therapy. Dextran sulfate/cellulose adsorption columns (Kaneka) and on-line heparin precipitation (HELP) are the most popular systems used in LDL apheresis. Weekly or biweekly procedures plus concomitant drug therapy enable LDL cholesterol to be maintained at 30–50% of its untreated level, with regression of xanthomas, arrest of progression of coronary atherosclerosis, and improved life expectancy. However, aortic stenosis may progress despite apheresis and necessitate valve replacement. Better control of hypercholesterolemia results from combining apheresis with a new 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, atorvastatin. LDL apheresis can also be useful in treating drug-resistant FH heterozygotes with coronary disease. However, the FH Regression Study showed no evidence that reduction by apheresis of both LDL and lipoprotein(a), was more advantageous than reduction by combination drug therapy of LDL alone.     

Prognosis and first diagnostic ECG in STEMI patients referred to the emergency medical system for primary PCI

Background

Pathological Q waves (QWs) in the first ECG recorded at hospital admission has been found to correlate with myocardial damage and mortality in STEMI patients. We investigated the association between new QWs recorded in the pre-hospital setting and adverse outcome during the hospital stay.

A meta-analysis of the associations between the Q141K and Q126X ABCG2 gene variants and gout risk

Background: Gout is an inflammatory disease in which genetic factors play a role. ABCG2 is a urate transporter, and the Q141K and Q126X variants of ABCG2 have been associated with a risk of developing gout, though previous studies of these associations have been inconsistent. Therefore, we conducted a meta-analysis to explore the relationship between these genetic variants and gout. Methods: We examined 8 electronic literature databases. In total, 9 eligible articles on the associations between the Q141K (rs2231142) and Q126X (rs72552713) variants and gout risk, including 11 case-control studies were selected. We used odds ratios (OR) and 95% confidence intervals (CI) to assess the strength of these relationships in dominant, recessive, and co-dominant models. Results: This study included 6652 participants (2499 gout patients and 4153 controls). The Q141K variant was found to significantly increase the risk of gout in Asians (dominant model: OR=2.64, 95% CI=2.04-3.43, P=0.02 for heterogeneity; recessive model: OR=3.19, 95% CI=2.56-3.97, P=0.28 for heterogeneity; co-dominant model: OR=1.37, 95% CI=1.18-1.59, P=0.09 for heterogeneity) and other populations (dominant model: OR=1.85, 95% CI=1.20-2.85, P<0.0001 for heterogeneity; recessive model: OR=3.78, 95% CI=2.28-6.27, P=0.19 for heterogeneity; co-dominant model: OR=1.48, 95% CI=1.26-1.74, P=0.19 for heterogeneity). The Q126X variant also significantly increased the risk of gout in Asians (dominant model: OR=3.87, 95% CI=2.07-7.24, P=0.06 for heterogeneity). Conclusions: These results suggest associations between the rs2231142 and rs72552713 ABCG2 gene polymorphisms and gout risk, which led to unfavorable outcomes. However, studies with larger sample sizes and homogeneous populations should be performed to confirm these results.     

中西医结合治疗冠心病动态心电图Q-Tcp延长的疗效观察

目的观察中西医结合治疗冠心病动态心电图Q-Tcp延长的临床疗效。方法选取2012年6月—2013年8月四川省广元市苍溪县第三人民医院内科收治的冠心病动态心电图检查中Q-Tcp延长患者60例,将其按照治疗方法不同分为对照组和治疗组,各30例。对照组采用常规西医治疗,治疗组在对照组治疗基础上加用中药汤剂,并按照中医分型进行辨证治疗,均以10 d为1个疗程,治疗3个疗程。结果治疗组总有效率为90.0%(27/30),高于对照组的60.0%(18/30)(P0.05)。治疗前两组患者最快心率、最快心率Q-Tc、最慢心率、最慢心率Q-Tc及Q-Tcp比较,差异均无统计学意义(P0.05);治疗后治疗组最快心率Q-Tc、最慢心率Q-Tc和Q-Tcp低于对照组(P0.05)。结论中西医结合治疗冠心病动态心电图Q-Tcp延长疗效显著,能够明显改善患者动态心电图QTc与Q-Tcp指标。     

唇腭裂患者家长寻求正畸治疗的Q方法调查

目的 探讨唇腭裂（cleft lip and/or palate,CLP）患儿家长的正畸治疗动机,为制定更加合理的治疗方案提供帮助。方法 采用Q方法对40例患儿家长进行调查,主要分为5部分— ①语句集合即收集所有关于CLP患儿家长寻求矫正的动机观点;② Q样本,由从语句集合中整理出的36条观点组成;③P样本,由40例寻求正畸治疗的CLP患儿家长组成;④Q排序,P样本被要求完成一张从“最同意”到“最不同意”的Q分布量表; ⑤分析,利用PQMethod 进行数据处理和分析。结果 根据参与者完成的Q分布处理分析,提取得到3个主要动机因素,将CLP患儿家长分为3种相应类型。类型1,“责任动力型”（13人）;类型2,“担忧型”（8人）;类型3,“混合功能型”（9人）。部分持分散观点的参与者不包括在以上3组内。结论 大多数参与者都能归类到以上3种类型中,结果有助于对CLP患儿制定更加合理的正畸治疗方案,提高家长及患儿的合作性,以期取得更满意的效果。     

转录因子FOXQ1和增殖指数Ki67在进展期胃癌组织中相关性研究

目的：研究进展期胃癌组织中叉头框Q1（FOXQ1）与细胞增殖指数Ki67表达的相关性,分析两者表达水平对治疗预后的影响。方法：进展期胃癌167例,运用免疫组化法检测癌组织中FOXQ1和 Ki67蛋白的表达水平。采用Pearson法对FOXQ1与Ki67表达进行相关性分析,采用χ2检验分析FOXQ1和Ki67表达与临床参数的关系,Kaplan-Meier生存曲线和Log-rank检验分析患者无复发生存期（RFS）,采用Cox比例风险回归分析影响RFS的因素。结果：FOXQ1在胃癌组织中高表达,并与Ki6表达水平呈正相关性（r=0.77,P＜0.001）。患者RFS与FOXQ1高表达（HR=2.962,P<0.001）、Ki67高表达（HR=2.416,P<0.001）有关。FOXQ1和Ki67高表达患者术后RFS生存率低于FOXQ1和Ki67表达阴性者,差异具有统计学意义（P＜0.05）。结论：进展期胃癌组织中FOXQ1和Ki67高表达,两者表达水平呈正相关,FOXQ1及Ki67高表达影响SOX化疗方案的效果,与患者术后复发及RFS缩短相关。