Do European GSM Mobile Cellular Phones Pose a Potential Risk to Pacemaker Patients?

BARBARO, V., et al .: Do European GSM Mobile Cellular Phones Pose a Potential Risk to Pacemaker Patients? A series of in vivo trials were carried out in order to verify whether the electromagnetic field radiated by GSM (Groupe Systemes Mobiles) mobile cellular phones might affect implanted pacemakers. Two European GSM phones of 2-watt power were tested and trials conducted on 101 pacemaker implanted outpatients attending day hospital for routine check-up, who volunteered for trials. Forty-three pacemaker models from 11 manufacturers were tested in all. When the sensing threshold of the pacemakers was set at a minimum and the antenna of the phone was in direct contact with the patient's chest, interference was detected for 26 implanted pacemakers. Specifically, pulse inhibition in 10 of 101 cases, ventricular triggering in 9 of 46 DDD-VDD pacemakers, and asynchronous pacing in 4 of 52 devices. Pulse inhibition was also observed combined with asynchronous pacing in 1 of 52 cases and with ventricular triggering in 2 of 46 cases. Minimum effect duration was ca. 3 seconds but in 6 cases effects continued as long as the interfering GSM signal was on. No permanent malfunctioning or changes in the programmed parameters were detected. Whenever interference was detected, trials were repeated to determine the maximum sensing threshold at which interference persisted (with the antenna in contact with the skin over the pacemaker). Then maximum distance between antenna and pacemaker at which interference occurred was determined at pacemaker maximum and minimum sensing threshold. Under our experimental conditions electromagnetic interference effects were detected at a maximum distance of 10 cm with the pacemaker programmed at its minimum sensing threshold. When the phone antenna was in direct contact with patient's skin over the implant, electromagnetic interference effects occurred at maximum ventricular and atrial sensing thresholds of 4 mV and 2.5 mV, respectively.     

Electromagnetic Interference of Analog Cellular Telephones with Pacemakers

The aim of this study was to verify whether there is a public health risk from the interference of analog cellular telephones with pacemakers. We used a human trunk simulator to reproduce an actual implant, and two cellular telephones working with the TACS (Total Access Communication System) standard. Results showed that the electromagnetic field radiated from the analog cellular telephones interfered with a large number of the pacemakers tested (10/25). When the telephone antenna was in close proximity to the pacemaker head, pacemaker desensitizing and sensitizing and pulse inhibition was detected at the moment of an incoming call and throughout ringing. In the worst case of pulse inhibition, the pacemaker skipped three nonconsecutive beats and then resumed its normal pacing, while the desensitizing and sensitizing phenomena persisted as long as the interfering signal was on. Pulse inhibition was also observed when the connection did not succeed. Maximum sensing threshold variation was about 186% (increase) and 62% (decrease) for desensitizing and sensitizing phenomena, respectively. It was also demonstrated that the signal emitted by analog cellular telephones during the crossing of contiguous cells could induce pacemaker pulse inhibition, but under our experimental conditions this event did not seem to pose a risk for the pacemaker patient.     

Prestretch potentiation of human skeletal muscle during ballistic movement

The conditions associated prior to and during the transition from prestretch to shortering may have considerable influence on the final performance of muscle. In the present study male subjects of good physical condition performed vertical jumps on the force-platform with and without preliminary counter movement. In the counter movement jump (CMJ) the amplitude of the knee bending, velocity of the prestretch and the force attained at end of prestretch were the primary parameters of interest. In addition the coupling time indicating the transition from the eccentric (prestretch) phase to the concentric phase was recorded from the angular displacement and reaction force curves. In the final calculation the mechanical performance parameters of CMJ were always compared with those of the jumps performed without counter movement. The results indicated in general first that CMJ enhanced the average concentric force and average mechanical power by 423 N (66%) and 1158 W (81%), respectively. This potentiation effect was the higher the higher was the force at end of prestretch (p<0.001). Similarly, the prestretch speed (p<0.001) and short coupling time (p<0.01) were associated with enhanced performance during the concentric phase. The average coupling time was 23 ms. The results are interpreted through changes in the prestretch conditions to modify the acto-myosin cross-bridge formation so that the storage and utilization of elastic energy is associated with high prestretch speed, high eccentric force and short coupling time. The role of the reflex potentiation is also suggested as additional enhancement of the final performance.     

Electromagnetic Interference of Digital and Analog Cellular Telephones with Implantable Cardioverter Defibrillators: In Vitro and In Vivo Studies

The present study examines the potential electromagnetic interference effects induced by cellular telephones on ICDs. We developed ad hoc protocols to conduct both in vitro and in vivo trials on most of the implantable cardioverter defibrillators available on the international market. Trials were conducted with three cellular telephones: two GSM (Global System for Mobile Communication) and one TACS (Total Access Communication System). A human trunk simulator was used to carry out in vitro observations on six ICDs from five manufacturers. In vivo tests were conducted on 13 informed patients with eight different ICD models. During the trials in air, GSM telephones induced interference effects on 4 out of the 6 cardioverter defibrillators tested. Specifically, pulse inhibition, reprogramming, false ventricular fibrillation, and ventricular tachycardia detections occurred, which would have entailed inappropriate therapy delivery had this been activated. Effects were circumscribed to the area closely surrounding the connectors. When the ICD was immersed in saline solution, no effects were observed. Three cases of just ventricular triggering with the interfering signal were observed in vivo.     

Intravenous drug users and AIDS: Knowledge, attitudes and behaviour in Calabria, Italy

Objective: the aim of this study was to evaluate the knowledge,attitudes and behaviour of Italian intravenous drug users (IVDUs)regarding AIDS. Design: cross-sectional survey. Setting: 4 publicdrug treatment centres in Calabria, Italy. Participants: 157IVDUs attending the clinics from March to October 1994 recruitedon a voluntary basis. Measurements and results: a self-administeredquestionnaire consisting of questions on demographics, knowledgeabout AIDS, injecting and sexual behaviour and attitudes ondrug-using and sexual activity was distributed to participants.Stepwise logistic regression was performed. Knowledge was significantlylower in married people (OR=0.22, 95% CI: 0.06–0.76) andin those with a lower income (OR=0.61, 95% Cl: 0.38–0.97),while it was higher in IVDUs with a longer history of addiction(OR=1.19, 95% Cl: 1.03–1.36). The ‘sharing’of injecting equipment was significantly higher as the frequencyof injection increased (OR=3.44, 95% Cl: 1.17–10.36).The routine use of condoms was significantly lower in marriedpeople (OR=0.04, 95% Cl: 0.01–0.43) and as the numberof partners in the previous year increased (OR=0.39, 95% Cl:0.18–0.83), while it was significantly more common inthose who considered that getting AIDS was a likely event intheir lives (OR=3.61, 95% CI: 1.20–10.84). Knowledge wassatisfactory in our population, except for methods of disinfection.The proportion of sharers in the previous 3 months (15.9%) waslow. The routine use of condoms was still low, confirming resistanceto seeking a safer sexual lifestyle. Conclusions: the resultsof our study confirm that changing sexually risky behaviourhas proven more difficult than changing drug injection riskbehaviour. Our findings suggest that an important target forAIDS prevention programmes may be the reduction of frequencyof injection and that intervention strategies should shift theiremphasis from drug use to sexual behaviour.