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Syncope
Published in Henry J. Woodford, Essential Geriatrics, 2022
An implantable loop recorder is useful when symptoms are infrequent (intervals of greater than every two weeks) and a longer recording period is necessary. This device is placed under the skin much like a cardiac pacemaker. Similar to surface event recorders, it can be activated following a symptomatic episode. The advantage of the device being that it can be used reliably for periods of up to two years. The obvious disadvantages being the requirement for a minor surgical procedure and the financial cost involved. In case series of people without a diagnosis after assessment (total n = 223; mean age 64-71), 20–28% of people had a syncopal event associated with an episode of cardiac arrhythmia during a period of implantable loop recorder use.12–14
Systemic Lupus Erythematosus
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Maria A. Giraldo-Isaza, Bettina F. Cuneo
The risk of C-NLE is about 2% in mothers with positive anti-SSA or anti-SSA/SSB antibodies and no prior affected pregnancy. It increases to 10–15% if prior child with cutaneous lupus and 18% if prior child with cardiac–NL, but the risk does not decrease with a previously unaffected child. Anti-SSA or anti-SSA/SSB positive mothers with thyroid disease have a higher risk of NC-NLE as compared with mothers whose babies born in spring [108]. It is estimated that approximately 40% of patients with SLE have anti-Ro/SSA antibodies. C-NLE is most likely to occur between 18- and 24 weeks gestation and rarely after 26 weeks’ gestation [75, 80]. Third-degree AV block may be associated with congestive heart failure (hydrops), and in 18%, fetal or neonatal demise [77]. If third-degree AV block is associated with dilated cardiomyopathy, mortality is 50%. Poor prognostic factors in utero include diagnosis at <20 weeks’ gestation, hydrops, ventricular rate <50 bpm, left ventricular failure. A permanent cardiac pacemaker is needed in almost all survivors, and in 60–70% of affected children by 3 months of age [77]. In the current era, the 10-year survival rate of liveborns with normal cardiac function is 86% but falls to 23.1% if dilated cardiomyopathy is present at birth [109]. Cardiac transplant action occurs in 7–19% [98, 110].
The Use of Magnetic Resonance Imaging in Intrauterine Growth Retardation
Published in Asim Kurjak, John M. Beazley, Fetal Growth Retardation: Diagnosis and Treatment, 2020
There are some very practical hazards in the use of MRI. People (either patients or staff) with ferromagnetic aneurysm clips should not be placed in the magnetic field as there is a risk of the clips being displaced with fatal consequences. (Clips used by gynecologists for tubal occlusion are not usually ferromagnetic and so are not susceptible to this hazard!) Also, some cardiac pacemakers may be affected by the magnetic field, causing a malfunction. No one with a pacemaker in situ — particularly those programmed by magnetic fields — should be permitted in the vicinity of the magnet.
Relationship between the triglyceride–glucose index and coronary artery calcification in asymptomatic, non-diabetic patients undergoing maintenance hemodialysis
Published in Renal Failure, 2023
Hong Ding, Jinhua Zhu, Ying Tian, Li Xu, Lei Song, Ying Shi, Dongxing Mu, Ruoxin Chen, Hong Liu, Bicheng Liu
This was a cross-sectional, observational study. Patients who were undergoing regular hemodialysis at People’s Hospital of Yangzhong city were selected as study participants (Figure 1). The inclusion criteria were as follows: (a) age ≥18 years; (b) stable hemodialysis for >3 months; (c) regular hemodialysis 3 times/week for 4 h each time; (d) no history of CAD, cardiac pacemaker or defibrillator implantation, or suspected symptoms, such as chest pain and heart palpitations; and (e) agreement to undergo chest CT examination. The exclusion criteria were as follows: (a) diagnosis of diabetes mellitus by a doctor; (b) elevated triglyceride levels (≥ 500 mg/dL); (c) presence of malignant tumors, acute severe infection, connective tissue disease, severe metabolic diseases, decompensated chronic liver disease, hematologic diseases, or use of hormones in the past 3 months; (d) presence of severe cognitive impairment or mental illness; (e) pregnancy or lactation; and (f) lack of complete data.
The relationship between cardiorespiratory parameters, mobilisation and physical function following cardiac surgery
Published in European Journal of Physiotherapy, 2022
Matthew Giacchi, My-Thao Nguyen, James Gaudin, Miles Bergin, Olivia Collicoat, Bronte Armstrong, Sophie Jennings, Doa El-ansary, Annemarie L. Lee
The study population for this prospective, interventional study were patients undergoing emergent/elective cardiac surgery, specifically coronary artery bypass grafting (CABG) or valvular surgery, at a Metropolitan Hospital in Melbourne, Australia. Potential participants were identified following extubation in the intensive care unit (ICU). Patients were excluded if they are presented with longstanding cardiac arrhythmias prior to surgery, protracted stays in ICU for additional haemodynamic/respiratory support, had an implanted cardiac pacemaker or a physical inability to undertake exercise. Ethical approval was granted by Institutional Human Research Ethics committee, with all participants providing written, informed consent. The study is registered on the Australian and New Zealand clinical trials registry: ACTRN12619001351101.
Effects of mental imagery training combined electromyogram-triggered neuromuscular electrical stimulation on upper limb function and activities of daily living in patients with chronic stroke: a randomized controlled trial
Published in Disability and Rehabilitation, 2020
Seventy-nine participants were recruited from the local rehabilitation hospital in Korea. Among all the participants, 68 participants were finally selected as study subjects (Figure 1). The inclusion and exclusion criteria were derived from a previous study [13–17]. The inclusion criteria for the participants were as follows: (a) the participants with a first-time cerebral infarction or cerebral hemorrhage which had been ascertained by computer tomography or magnetic resonance imaging for at least 6 months, (b) the participants who were able to have an active wrist extension at least 10°, (c) Modified Ashworth Scale (MAS) grade on the muscles affecting on the wrist and fingers of affected upper limb ≤ 2, (d) intact general cognitive function as determined by the Korean version of Mini-Mental Examination score ≥ 24, and (e) a normal movement imagery ability as confirmed by the Vividness of Movement Imagery Questionnaire (VMIQ) average score ≤ 2.26. The exclusion criteria were as follows: (a) the participant with artificial cardiac pacemaker, (b) Medical Research Council (MRC) grade on the affected upper limb is 0, (c) the affected upper limb pain determined Visual Analogue Scale ≥ 5, and (d) the participant with skin lesions on the electrodes.