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- Walfridsson, Håkan, et al.
(author)
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Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial
- 2015
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In: Europace. - : Oxford University Press (OUP): Policy B - Oxford Open Option B - CC-BY. - 1099-5129 .- 1532-2092. ; 17:2, s. 215-221
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Journal article (peer-reviewed)abstract
- Aims The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF. In this substudy, we evaluated the effect of these treatment modalities on the Health-Related Quality of Life (HRQoL) and symptom burden of patients at 12 and 24 months. Methods and results During the study period, 294 patients were enrolled in the MANTRA-PAF trial and randomized to receive AAD (N = 148) or RFA (N = 146). Two generic questionnaires were used to assess the HRQoL [Short Form-36 (SF-36) and EuroQol-five dimensions (EQ-5D)], and the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) was used to evaluate the symptoms appearing during the trial. All comparisons were made on an intention-to-treat basis. Both randomization groups showed significant improvements in assessments with both SF-36 and EQ-5D, at 24 months. Patients randomized to RFA showed significantly greater improvement in four physically related scales of the SF-36. The three most frequently reported symptoms were breathlessness during activity, pronounced tiredness, and worry/anxiety. In both groups, there was a significant reduction in ASTA symptom index and in the severity of seven of the eight symptoms over time. Conclusion Both AAD and RFA as first-line treatment resulted in substantial improvement of HRQoL and symptom burden in patients with PAF. Patients randomized to RFA showed greater improvement in physical scales (SF-36) and the EQ-visual analogue scale.
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- Davidsson, P, et al.
(author)
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DESIGN AND OPERATION OF A LOW-TEMPERATURE SCANNING TUNNELING MICROSCOPE SUITABLE FOR OPERATION BELOW 1-K
- 1992
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In: Ultramicroscopy. - 0304-3991 .- 1879-2723. ; 42-44, s. 1470-1475
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Journal article (peer-reviewed)abstract
- A scanning tunneling microscope suitable for very low temperatures has been designed, and preliminary testing has been carried out. In order to improve cooling and temperature uniformity the instrument is arranged for operation immersed in the 3He-4He mixture inside the mixing chamber of a small dilution refrigerator. A discussion of the specific problems present in the design of this kind of an instrument is given as well as a description of our design. Special attention is given to the vacuum sealing and vibration-damping solutions required.
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- Minja, Daniel T. R., et al.
(author)
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Reliability of rapid diagnostic tests in diagnosing pregnancy associated malaria in North Eastern Tanzania
- 2012
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In: Malaria Journal. - : Springer Science and Business Media LLC. - 1475-2875. ; 11, s. 211-
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Journal article (peer-reviewed)abstract
- Background: Accurate diagnosis and prompt treatment of pregnancy-associated malaria (PAM) are key aspects in averting adverse pregnancy outcomes. Microscopy is the gold standard in malaria diagnosis, but it has limited detection and availability. When used appropriately, rapid diagnostic tests (RDTs) could be an ideal diagnostic complement to microscopy, due to their ease of use and adequate sensitivity in detecting even sub-microscopic infections. Polymerase chain reaction (PCR) is even more sensitive, but it is mainly used for research purposes. The accuracy and reliability of RDTs in diagnosing PAM was evaluated using microscopy and PCR. Methods: A cohort of pregnant women in north-eastern Tanzania was followed throughout pregnancy for detection of plasmodial infection using venous and placental blood samples evaluated by histidine rich protein 2 (HRP-2) and parasite lactate dehydrogenase (pLDH) based RDTs (Parascreen (TM)) or HRP-2 only (Paracheck Pf (R) and ParaHIT (R) f), microscopy and nested Plasmodium species diagnostic PCR. Results: From a cohort of 924 pregnant women who completed the follow up, complete RDT and microscopy data was available for 5,555 blood samples and of these 442 samples were analysed by PCR. Of the 5,555 blood samples, 49 ((proportion and 95% confidence interval) 0.9% [0.7 - 1.1]) samples were positive by microscopy and 91 (1.6% [1.3-2.0]) by RDT. Forty-six (50.5% [40.5 - 60.6]) and 45 (49.5% [39.4 - 59.5]) of the RDT positive samples were positive and negative by microscopy, respectively, whereas nineteen (42.2% [29.0 - 56.7]) of the microscopy negative, but RDT positive, samples were positive by PCR. Three (0.05% [0.02 - 0.2]) samples were positive by microscopy but negative by RDT. 351 of the 5,461 samples negative by both RDT and microscopy were tested by PCR and found negative. There was no statistically significant difference between the performances of the different RDTs. Conclusions: Microscopy underestimated the real burden of malaria during pregnancy and RDTs performed better than microscopy in diagnosing PAM. In areas where intermittent preventive treatment during pregnancy may be abandoned due to low and decreasing malaria risk and instead replaced with active case management, screening with RDT is likely to identify most infections in pregnant women and out-performs microscopy as a diagnostic tool.
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- Pehrson, S M, et al.
(author)
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Clinical value of transesophageal atrial stimulation and recording in patients with arrhythmia-related symptoms or documented supraventricular tachycardia--correlation to clinical history and invasive studies
- 1994
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In: Clinical Cardiology. - : Wiley. - 0160-9289 .- 1932-8737. ; 17:10, s. 528-534
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Journal article (peer-reviewed)abstract
- The main objective of the present study was to evaluate the clinical applicability of transesophageal atrial stimulation (TAS) and recording with regard to inducibility of supraventricular tachycardia (SVT) in patients with either an ECG-documented paroxysmal SVT or a clinical history of palpitations suggesting this disease. A further objective was to assess the inducibility of SVT and to compare the inducibility by TAS with that obtained by an invasive electrophysiologic study (EPS). A total of 64 patients (aged 13-74 years) with ECG-documented paroxysmal SVT (n = 50) or only a history of palpitations (n = 14) was referred for TAS. Preexcitation was present in 35 patients. The study protocol included single and double extrastimuli delivered at a basic paced interval of 500 ms, and incremental atrial stimulation until a cycle length of 275 ms or a second-degree AV block appeared. In 10 patients atropine intravenously was required for induction. The same protocol was used in 34 of the patients who also underwent invasive EPS. TAS was completed in 56 of 64 patients (88%). In this group SVT was induced during TAS in 84% (47/56). Of patients with ECG-documented tachycardia, clinical tachycardia was induced in 90% (35/39) with ECG-documented regular paroxysmal SVT and in 67% of patients (4/6) with ECG-documented atrial fibrillation. In patients without ECG-documented tachycardia, clinically relevant arrhythmia was induced in 73% (8/11). In 30 of 32 patients (94%) with an inducible tachycardia during invasive EPS, it was also possible to induce the tachycardia by TAS. We concluded that TAS is a simple and noninvasive diagnostic tool for evaluation of clinical arrhythmia in patients with documented or suspected paroxysmal SVT. The inducibility of SVT seems comparable to that obtained by invasive EPS.
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- Spyridonis, F., et al.
(author)
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A study on the state-of-the-art of e-infrastructures uptake in Africa
- 2015
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In: Palgrave Communications. - : Palgrave Macmillan Ltd.. - 2055-1045. ; 1
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Journal article (peer-reviewed)abstract
- e-Science is a pioneering method that uses integrated collections of Information and Communication Technologies (ICTs), or e-Infrastructures, to enable scientists across the world to collaboratively work on more and more ambitious projects. Have advances and access to ICTs enabled African e-Infrastructure development? This paper aims to understand the current state of e-Infrastructure uptake in Africa and present some of these initiatives across the African continent by exploring the current landscape emerging from a survey of early consumers. These initiatives are discussed in terms of key projects and user communities that they are addressing. In line with wider perceptions that e-Infrastructures will re-shape the ways research is performed, this study yielded 34 current or planned e-Infrastructure projects across 13 African countries addressing a range of research domains, and identified 7 user communities across these disciplines. Our findings suggest that the African research community is increasingly interested and involved in e-Infrastructure development activities in response to the issue of limited access to dedicated global research and education resources. The study can contribute to the ongoing discussion on how e-Infrastructures can positively promote the research, technological development and innovation potential of developing countries.
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| 15. |
- Yuan, S, et al.
(author)
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Localization of cardiac arrhythmias : conventional noninvasive methods
- 1991
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In: International Journal of Cardiac Imaging. - 0167-9899. ; 7:3-4, s. 193-205
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Journal article (peer-reviewed)abstract
- Noninvasive localization of the accessory pathway (AP) in patients with the Wolff-Parkinson-White syndrome and of the site of origin of ventricular tachycardia (VT) is reviewed. 12-lead electrocardiography (ECG) is the most readily available method for localization of both the AP and the site of VT origin. Many published ECG criteria are introduced. The application of body surface potential mapping, vectorcardiography, nuclear phase imaging, echocardiography, computed tomography, nuclear magnetic resonance, and signal-averaged ECG in the localization of these arrhythmogenic substrates is also described. We believe that ECG is the most sensitive noninvasive method for AP localization as well as being convenient and simple; it may be used as the only noninvasive method for the initial evaluation. The left lateral AP, which occurs with an incidence of more than 40%, could be localized preoperatively by noninvasive methods only. For localization of the site of VT origin, none of the noninvasive methods is accurate enough for guiding the surgical and catheter-mediated ablative therapies so far.
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