Very high pacing thresholds during long‐term follow‐up predicted by a combination of implant pacing threshold and impedance in leadless transcatheter pacemakers

2020 ◽  
Vol 31 (4) ◽  
pp. 868-874 ◽  
Author(s):  
José M. Tolosana ◽  
Eduard Guasch ◽  
Rodolfo San Antonio ◽  
Jose Apolo ◽  
Margarida Pujol‐López ◽  
...  
Keyword(s):  
Pacing Threshold ◽  
Long Term Follow Up ◽  
Very High

scholarly journals Long-Term Follow-up of Myeloablative Haploidentical (HID) Peripheral Blood Stem Cell Transplantation and Post-Transplant Cyclophosphamide (PTCy) Following Fludarabine and Total Body Irradiation (TBI)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3368-3368
Author(s):  
Scott R Solomon ◽  
Xu Zhang ◽  
Melhem Solh ◽  
Lawrence E Morris ◽  
H. Kent Holland ◽  
...  
Keyword(s):  
Total Body Irradiation ◽  
Graft Failure ◽  
Chronic Gvhd ◽  
Single Institution ◽  
Post Transplant ◽  
Long Term Follow Up ◽  
Total Body ◽  
Very High

Abstract Haploidentical donor (HID) transplant with post-transplant cyclophosphamide (PTCy) is being increasingly utilized worldwide. Although the original "Baltimore" protocol employed nonmyeloablative conditioning, there has been increasing interest in the use of myeloablative conditioning (MAC) in an attempt to decrease the risk of disease recurrence and graft failure. We present the long-term follow-up results of 82 consecutive patients receiving a MAC HID transplant at a single institution between 2011-2017, following a uniform protocol of Fludarabine/total body irradiation (TBI) 1200cGy conditioning, PTCy, tacrolimus and mycophenolate mofetil. PBSC was utilized as the graft source for all transplants and graft CD34 dose was capped at 5 x 106/kg. Median patient age was 42 (range 19-61) years. The most common diagnoses were AML (51%) and ALL (33%), and 39% were high/very high disease risk index (DRI). Donor was a child, sibling or parent in 35%, 43% and 22% respectively. Median follow-up time for surviving patients was 37 months. Primary engraftment occurred in all patients, with all patients achieving complete donor T cell and myeloid chimerism by day +30. There were no cases of late graft failure. The cumulative incidence of grade 3-4 acute graft-versus-host disease (GVHD) and moderate-to-severe chronic GVHD was 17% and 22%, respectively. Non-relapse mortality (NRM) was 7% at one year and 12% at three years post-transplant. Overall survival at 1, 2, and 3 years post-transplant was 85%, 72% and 66% respectively (figure 1). Estimated 3-year DFS, current GVHD-, relapse-free survival (CGRFS), conventional GRFS, and relapse was 67%, 62%, 43%, and 21% respectively. DFS at 3-yr was significantly improved in patients with low/intermediate vs high/very high DRI (79% vs. 48%, figure 2) due to a lower risk of relapse (12% vs. 36%). Infectious complications included CMV reactivation in 55% of patients (CMV disease - 2%) and BK virus infection in 38% (severe - 2%). There were no reported cases of EBV lymphoproliferative disease. This large single institution analysis with long-term follow-up confirms the feasibility of Fludarabine/TBI-based MAC HID transplant with PBSC/PTCy in younger adult patients. This is supported by both the high rate of engraftment, low NRM and a 3-yr CGRFS of 62% (suggesting freedom from relapse and need for long-term systemic immunosuppression for GVHD). The achievement of long term DFS in approximately 80% of low/intermediate DRI and half of high/very high DRI patients is promising. Disclosures Solh: ADC Therapeutics: Research Funding; Celgene: Speakers Bureau; Amgen: Speakers Bureau.

scholarly journals Twenty-Five and Thirty-Five Year Follow up of First Admissions to Mental Hospital

1968 ◽  
Vol 13 (3) ◽  
pp. 219-229 ◽  
Author(s):  
M. N. Beck
Keyword(s):  
Prince Edward Island ◽  
Mental Hospital ◽  
Long Term Effects ◽  
Nineteen Thirties ◽  
Needed Information ◽  
Nineteen Forties ◽  
Long Term Follow Up ◽  
Very High

This has been a report of a study designed to assess the feasibility of long-term follow-up studies on Prince Edward Island. Cohorts of patients first admitted to the Island's only mental hospital during the early nineteen-thirties and early nineteen-forties were followed in retrospect in order to determine, a) the course and outcome of the major disorders over periods ranging up to thirty-five years and, b) the long-term effects of these disorders upon the families of the patients. Needed information was gathered through a review of hospital records, a search for death records and community interviews. The results of the study suggest that lifetime prognosis in the absence of modern treatment methods may be even worse than believed by most professionals working in the field. As might be expected the outlook was found to be particularly grave for schizophrenia. Success in following up a very high proportion of the cases over several decades supports the belief that Prince Edward Island offers unusual opportunities for studies of this kind.

scholarly journals Long-Term Technical Performance of the Osypka QT-5® Ventricular Pacemaker Lead

2021 ◽  
Vol 10 (4) ◽  
pp. 639 ◽  
Author(s):  
Georg Semmler ◽  
Fabian Barbieri ◽  
Karin Thudt ◽  
Paul Vock ◽  
Deddo Mörtl ◽  
...  
Keyword(s):  
High Rate ◽  
Pacing Threshold ◽  
Technical Performance ◽  
Cardiac Implantable Electronic Devices ◽  
Kaplan Meier ◽  
Ventricular Lead ◽  
Long Term Follow Up ◽  
Technical Issues

Background: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. Methods: All patients undergoing implantation of the Osypka QT-5® ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed (n = 211). Clinical data including pacemaker follow-up examinations and the need for lead revisions were assessed. Kaplan–Meier analysis to estimate the rate of lead dysfunction during long-term follow-up was conducted. Results: Patients were followed for a median of 5.2 years (interquartile range (IQR) 2.0–8.7). R-wave sensing properties at implantation, compared to last follow-up, remained basically unchanged: 9.9 mV (IQR 6.8–13.4) and 9.6 mV (IQR 5.6–12.0), respectively). Ventricular pacing threshold significantly increased between implantation (0.5 V at 0.4 ms; IQR 0.5–0.8) and the first follow-up visit (1.0 V at 0.4 ms; IQR 0.8–1.3; p < 0.001) and this increase persisted throughout to the last check-up (0.9 V at 0.4 ms; IQR 0.8–1.2). Impedance significantly declined from 1142 Ω (IQR 955–1285) at implantation to 814 Ω (IQR 701–949; p < 0.001) at the first check-up, followed by a further decrease to 450 Ω (IQR 289–652; p < 0.001) at the last check-up. Overall, the Osypka QT-5® ventricular lead was replaced in 36 patients (17.1%). Conclusions: This report shows an unexpected high rate of technical issues of the Osypka QT-5® ventricular lead during long-term follow-up.

Adrenal medullary hyperplasia mimicking pheochromocytoma

2020 ◽  
Vol 13 (9) ◽  
pp. e236209
Author(s):  
Annalisa Montebello ◽  
Michelle Ann Ceci ◽  
Sandro Vella
Keyword(s):  
Adrenal Mass ◽  
Adrenal Lesion ◽  
Adrenal Medullary Hyperplasia ◽  
Long Term Follow Up ◽  
Rare Diagnosis ◽  
Very High

A 59-year-old woman, a known case of hypertension, was incidentally diagnosed with a large right-sided adrenal mass. Investigations for a functional adrenal lesion resulted in very high preoperative norepinephrine levels. A right adrenalectomy was performed. Histology showed adrenal medullary hyperplasia (AMH). AMH is a rare diagnosis and its incidence is poorly documented in the literature. This is a benign entity which resembles pheochromocytoma (PCC) in both clinical and biochemical manner. AMH is usually bilateral and may occur in isolation or in association with PCC. In fact, some authors consider it to be a precursor to PCC. Thus, these patients need long-term follow-up in view of the risk of development of PCC later.

scholarly journals A Long-Term Follow-Up Study of Slash Bundling in Fast-Growing Eucalypt Plantations

Forests ◽  
2021 ◽  
Vol 12 (11) ◽  
pp. 1548
Author(s):  
Raffaele Spinelli ◽  
Natascia Magagnotti ◽  
Alberto Assirelli ◽  
João Pedro Martins ◽  
Matevž Mihelič
Keyword(s):  
Fast Growing ◽  
Follow Up Study ◽  
Eucalypt Plantations ◽  
Bioenergy Generation ◽  
Long Term Follow Up ◽  
The Cost ◽  
Ideal Technique ◽  
Very High

The Authors conducted a long-term follow-up study of a John Deere 1490 forwarder-mounted bundler owned by a Portuguese company and used for bundling logging residues from fast-growing eucalypt plantations located in Portugal and Spain. The study spanned 7 years, from 2011 to 2016. During this time, the machine clocked over 11,500 h and produced more than 200,000 bundles or 75,000 green tons of biomass. Bundle length was commonly 2.4 m, and bundle mass averaged 350 kg. Overall, the database contained 1752 daily records. Bundling productivity averaged 19 bundles per productive machine hour (meter hour, excluding all major delays). Mechanical availability was very high and averaged 93%. Utilization commonly ranged between 65% and 75%. Use and productivity showed a predictable seasonal trend and a slight decline over time. The latter might be due to wear, but also due to the increasingly challenging conditions faced by the company as the average worksite size sharply decreased from 2011 onwards. While almost extinct elsewhere, bundling seems to thrive in the Iberian plantations, possibly due to the industrial character of both eucalypt farming and bioenergy generation in the region. That allows the reaping of all integration benefits offered by bundling, while the cost of setting up a parallel biomass chain is minimized. Furthermore, bundling seems the ideal technique for efficient residue recovery where slash yields are low and roadside storage space is limited: these are the typical constraints of industrial eucalypt plantations, where planted area is maximized (=little landing space) and the largest possible proportion of the tree mass is turned into pulpwood (=relatively low residue yield).

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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