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  • Article
    Nirmal D, Stojanovic N, Kishore A, Sivakumar S, Gorantla A, Chandrakumar H, Graham-Hill S, Budzikowski AS.
    Cureus. 2024 Mar;16(3):e55557.
    Brugada syndrome is an autosomal dominant channelopathy that usually affects healthy young males without apparent structural heart disease. It is associated with a spectrum of variable and dynamic clinical manifestations, high risk of life-threatening ventricular arrhythmias, and sudden cardiac death. Our patient demonstrated transient and dynamic EKG changes of both type 1 (coved) and type 2 (saddleback) ST elevation, suggestive of the Brugada pattern that was associated with physical chest trauma and stressful situations. While common triggers like fever and certain drugs are well-recognized, this case illustrates the potential for physical stress and trauma to unmask or aggravate Brugada syndrome, albeit without definitive evidence for a causal link. Ultimately, this report underscores the importance of considering a broad differential diagnosis, including Brugada syndrome, in patients presenting with unexplained syncope or characteristic EKG changes, even when traditional triggers are absent.
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  • Article
    Stattin EL, Hagström E, Dahl N, Strömsöe A, Delgado-Vega AM, Klar J, Svennblad B, Börjesson M, Wisten A.
    BMJ Open. 2022 05 10;12(5):e055557.
    PURPOSE: The rationale behind the SUDden cardiac Death in the Young (SUDDY) cohort was to provide a complete nationwide, high-quality platform with integrated multisource data, for clinical and genetic research on sudden cardiac death (SCD) in the young, with the ultimate goal to predict and prevent SCD.
    PARTICIPANTS: The cohort contains all SCD victims <36 years, in Sweden during the period 2000-2010. We assigned five population-based controls per case, together with parents of cases and controls, in total 15 633 individuals. Data of all individuals were extracted from multiple mandatory registries; the National Patient Registry, the Medical Birth Registry, the Prescribed Drug registry, the Cause of Death registry, the Multigeneration Registry, combined with socioeconomic data from Statistics Sweden. From SCD victims, the autopsy report, medical records, ECGs, parental information and biological samples were gathered.
    FINDINGS TO DATE: We identified 903 individuals diagnosed with SCD (67% men, 33% women). The cases comprised 236 infants <1 year of age (26%), 90 individuals aged 1-15 years (10%), 186 individuals aged 15-25 years (21%) and 391 aged 25-35 years (43%). Hospitalisations and outpatient clinic visits due to syncope were significantly more common among cases than controls. DNA obtained from dried blood spots tests (DBS) stored from birth was equally suitable as venous blood samples for high-throughput genetic analysis of SCD cases.
    FUTURE PLANS: We will explore the SUDDY cohort for symptoms and healthcare consumption, socioeconomic variables and family history of SCD. Furthermore, we will perform whole exome sequencing analysis on DNA of cases obtained from DBS or postmortem samples together with parental blood samples in search for gene variants associated with cardiac disease. The genetic analysis together with data compiled in the nationwide cohort is expected to improve current knowledge on the incidence, aetiology, clinical characteristics and family history of SCD.
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  • Article
    Müller N, Lorenz I, Langguth B, Weisz N.
    PLoS One. 2013;8(2):e55557.
    Chronic tinnitus, the continuous perception of a phantom sound, is a highly prevalent audiological symptom. A promising approach for the treatment of tinnitus is repetitive transcranial magnetic stimulation (rTMS) as this directly affects tinnitus-related brain activity. Several studies indeed show tinnitus relief after rTMS, however effects are moderate and vary strongly across patients. This may be due to a lack of knowledge regarding how rTMS affects oscillatory activity in tinnitus sufferers and which modulations are associated with tinnitus relief. In the present study we examined the effects of five different stimulation protocols (including sham) by measuring tinnitus loudness and tinnitus-related brain activity with Magnetoencephalography before and after rTMS. Changes in oscillatory activity were analysed for the stimulated auditory cortex as well as for the entire brain regarding certain frequency bands of interest (delta, theta, alpha, gamma). In line with the literature the effects of rTMS on tinnitus loudness varied strongly across patients. This variability was also reflected in the rTMS effects on oscillatory activity. Importantly, strong reductions in tinnitus loudness were associated with increases in alpha power in the stimulated auditory cortex, while an unspecific decrease in gamma and alpha power, particularly in left frontal regions, was linked to an increase in tinnitus loudness. The identification of alpha power increase as main correlate for tinnitus reduction sheds further light on the pathophysiology of tinnitus. This will hopefully stimulate the development of more effective therapy approaches.
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  • Article
    Fisher E, Venkatesan S, Benevides P, Bertrand E, Brum PS, El Baou C, Ferri CP, Fossey J, Jelen M, Laks J, Liu L, Mograbi DC, Natarajan N, Naylor R, Pantouli D, Ramanujam V, Rangaswamy T, Santos de Carvalho RL, Stoner C, Vaitheswaran S, Spector A.
    JMIR Aging. 2024 Jun 11;7:e55557.
    BACKGROUND: Cognitive stimulation therapy (CST) is an evidence-based, group psychosocial intervention for people with dementia, and it has a positive impact on cognition and quality of life. CST has been culturally adapted for use globally. It was developed as a face-to-face intervention but has recently been adapted for online delivery.
    OBJECTIVE: In this study, we aimed to explore the feasibility and acceptability of online or virtual CST (vCST) delivery in India and Brazil, emphasizing barriers and facilitators to implementation.
    METHODS: A single-group, multisite, mixed methods, feasibility study was conducted, with nested qualitative interviews. Primary feasibility outcomes were recruitment rate, attendance, attrition, acceptability, and outcome measure completion. Exploratory pre- and postintervention measures, including cognition and quality of life, were assessed. Qualitative interviews were conducted with people with dementia, family caregivers, and group and organizational leaders following intervention delivery, and the data were analyzed using the Consolidated Framework for Implementation Research.
    RESULTS: A total of 17 vCST group sessions with 59 participants were conducted for 7 weeks, with 53% (31/59) of participants attending all 14 sessions. Attrition rate was 7% (4/59), and outcome measure completion rate at follow-up was 68% (40/59). Interviews took place with 36 stakeholders. vCST was acceptable to participants and group leaders and enabled vital access to services during pandemic restrictions. While online services broadened geographic access, challenges emerged concerning inadequate computer literacy, poor technology access, and establishing interpersonal connections online. Exploratory, uncontrolled analyses indicated positive trends in quality of life but negative trends in cognition and activities of daily living, but these results were not statistically significant.
    CONCLUSIONS: vCST demonstrated feasibility and acceptability, serving as a crucial resource during the pandemic but raised challenges related to technology access, computer literacy, and long-term implementation. The study highlights the potential of vCST while emphasizing ongoing development and solutions to address implementation challenges.
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  • Article
    Lu X, Luo T, Li X, Wang Y, Ma Y, Wang B.
    Environ Sci Pollut Res Int. 2023 Apr;30(19):55557-55568.
    The combination technique of pre-ozonation and bioaugmentation is promising for remediating benzo[a]pyrene (BaP)-contaminated soil. However, little is known about the effect of coupling remediation on the soil biotoxicity, soil respiration, enzyme activity, microbial community structure, and microbial in the process of remediation. This study developed two coupling remediation strategies (pre-ozonation coupled with bioaugmentation by addition of polycyclic aromatic hydrocarbons (PAHs) specific degrading bacteria or activated sludge), compared with sole ozonation and sole bioaugmentation, to improve degradation of BaP and recovery of soil microbial activity and community structure. Results showed that the higher removal efficiency of BaP (92.69-93.19%) was found in coupling remediation, compared with sole bioaugmentation (17.71-23.28%). Meanwhile, coupling remediation significantly reduced the soil biological toxicity, promoted the rebound of microbial counts and activity, and recovered the species numbers and microbial community diversity, compared with sole ozonation and sole bioaugmentation. Besides, it was feasible to replace microbial screening with activated sludge, and coupling remediation by addition of activated sludge was more conducive to the recovery of soil microbial communities and diversity. This work provides a strategy of pre-ozonation coupled with bioaugmentation to further degrade BaP in soil by promoting the rebound of microbial counts and activity, as well as the recovery of species numbers and microbial community diversity.
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  • Book
    Bruce E. Jarrell, Stephen M. Kavicc, Eric D. Strauch.
    Summary: "The cases in this book represent how surgeons think and make decisions about clinical problems. We have attempted to write it in a way that allows us to "talk to you" as you read it, so that the book will be the next best thing to teaching in person. The cases are organized by systems address the common presentations of clinical problems. The history and physical examination clues, radiologic images, and other figures help you formulate a differential and ultimately a diagnosis. Case variations are also presented to help you consider the appropriate treatment of patients with various complications and coexisting conditions"-- Provided by publisher. "Lippincott® Connect Featured TitlePurchase the new print edition of this Lippincott® Connect title includes lifetime access to the digital version of the book, plus related materials such as videos and multiple-choice Q&A and self-assessments.Ideal as a stand-alone review or as a perfect companion to NMS Surgery, Seventh Edition, this leading casebook for the surgical rotation presents a series of surgical cases that begin with a clinical scenario and progress step by step through the decision-making process of patient management. Concise and portable, NSM Surgery Casebook, Third Edition fits in a lab coat pocket-ideal for review on the wards.Retaining the structured subject review, practice questions for the USMLE Step 2 exam, and focus on helping students work through clinical cases with a unique "what next" approach to decision making, this third edition offers a new full-color design, new study aids, and key updates throughout.A unique, case-based surgical review, with case variations, teaches effective surgical approach and allows students to practice real-world clinical decision making and prepare for exams.New and updated cases reflect modern surgical practice.Revised Cutting to the Chase feature at the beginning of each chapter presents a high-yield overview of important concepts.New Critical Surgical Associations from NMS Surgery cover associations and important sequences in a highly visual way.All-new radiographic images are easier to read and interpret.Easy-to-spot Digging Deep boxes provide high-yield information in an easily accessible way.An extensive illustration program provides opportunities to make patient management decisions based on visual cues.Lippincott® Connect features: Lifetime access to the digital version of the book with the ability to highlight and take notes on key passages for a more personal, efficient study experience.Carefully curated resources, including interactive diagrams, video tutorials, flashcards, organ sounds, and self-assessment, all designed to facilitate further comprehension.Lippincott® Connect also allows users to create Study Collections to further personalize the study experience. With Study Collections you can: Pool content from books across your entire library into self-created Study Collections based on discipline, procedure, organ, concept or other topics.Display related text passages, video clips and self-assessment questions from each book (if available) for efficient absorption of material.Annotate and highlight key content for easy access later.Navigate seamlessly between book chapters, sections, self-assessments, notes and highlights in a single view/page"-- Provided by publisher.
    Digital Access LWW Health Library [2022]