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Benefit of a Novel High-Resolution Mapping System for Ablation of Ventricular Arrhythmias in Challenging Mapping Conditions
Erscheinung:
/ Journal of Interventional Cardiac Electrophysiology
Die Studie beschreibt den Einsatz eines neuartigen hochauflösenden Mapping-Systems zur Katheterablation ventrikulärer Arrhythmien unter schwierigen Bedingungen. Das System ermöglicht eine präzisere Darstellung elektrischer Aktivierungsmuster und erleichtert dadurch die Identifikation arrhythmogener Substrate. Insbesondere in komplexen Fällen führte das Mapping zu einer effizienteren und erfolgreicheren Ablation.
Predictors of Freedom from Atrial Arrhythmia Recurrence after Cryoballoon Ablation for Persistent Atrial Fibrillation – A Multicenter Study
Erscheinung:
/ Journal of Cardiovascular Electrophysiology
Diese multizentrische Studie untersuchte klinische und prozedurale Prädiktoren für den langfristigen Erhalt des Sinusrhythmus nach Kryoballonablation bei Patient*innen mit persistierendem Vorhofflimmern. Insgesamt zeigten sich eine kürzere Dauer des Vorhofflimmerns vor der Ablation, ein kleinerer linker Vorhofdurchmesser und eine vollständig erreichte Pulmonalvenenisolation als unabhängige Prädiktoren für ein rezidivfreies Langzeitergebnis. Die Studie bestätigt die Wirksamkeit und Sicherheit der Kryoballonablation auch bei komplexeren AF-Formen.
Methamphetamine withdrawal and the restoration of cognitive functions – a study over a course of 6 months abstinence
Erscheinung:
/ Psychiatry Research
A continuously rising consumption of methamphetamine (MA) has been suggested to be associated with increasing cognitive dysfunction. The objective of this study was to investigate associations between cognitive functions and gender, drug using patterns and treatment-attending profiles of recently abstinent MA users over the course of six months abstinence. Data were collected from 108 participants in two inpatient rehabilitation centers. The mean duration of MA use was 11.5 years. Interviews and cognitive tests (cognitrone, Stroop, TMT, nback) were performed right after the withdrawal and again after approx. six months of abstinence. Comparisons and explorative analyses between the groups (gender, primary MA/ multidrug users, early dropouts/ completers) regarding cognitive variables were performed. At baseline a significant decline in general neuropsychological functioning and attention/concentration after ongoing years of consumption were found. After a period of six months abstinence, cognitive performances remained stable or improved significantly for cognitrone percentile and cognitive flexibility. Normal cognitive functions were measured in former MA users after acute withdrawal which remained stable and partly improved in those patients who refrained from substance abuse over six months. Continued long-term MA intake was the only identified indicator of poorer cognitive performance. These results point towards a regain of cognitive performance in patients abstinent from MA.
Associations between methamphetamine use, psychiatric comorbidities and treatment outcome in two inpatient rehabilitation centers
Erscheinung:
/ Psychiatry Research
The use of methamphetamine is spreading globally and provokes the need for effective treatment options. Previous research showed increased psychiatric comorbidities in methamphetamine users, but its impact on treatment success is still unclear. This study investigates data from two German addiction rehabilitation centers including 108 methamphetamine using individuals. The participants were tested and interviewed at the beginning of the addiction treatment program and at the end of treatment after about six months. In total, 95% of the participants had at least another psychiatric diagnosis. At admission, substance related comorbid diagnoses (meaning abuse or addiction of other substances than methamphetamine) showed a significant effect on treatment dropout. Within the substance related diagnoses, the majority of participants (62%) suffered from cannabinoid dependency. Non-substance related comorbidities and the total number of comorbid diagnoses did not have an impact on treatment outcome. The most frequent non substance specific diagnosis at admission was a depressive disorder (15%). Diagnoses patients had at discharge did not show any effects on the treatment completion. Comparing diagnoses at admission and discharge revealed slight differences, which may rise from a better assessment at discharge due to the fact that clinicians got to know the patients better during the therapeutic process.
Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy
Erscheinung:
/ Journal of Neurology
Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. It affects large numbers of patients and may cause major disability. So far, spasticity has merely been described as part of the upper motor neurone syndrome or defined in a narrowed neurophysiological sense. This consensus organised by IAB—Interdisciplinary Working Group Movement Disorders wants to provide a brief and practical new definition of spasticity—for the first time—based on its various forms of muscle hyperactivity as described in the current movement disorders terminology. We propose the following new definition system: Spasticity describes involuntary muscle hyperactivity in the presence of central paresis. The involuntary muscle hyperactivity can consist of various forms of muscle hyperactivity: spasticity sensu strictu describes involuntary muscle hyperactivity triggered by rapid passive joint movements, rigidity involuntary muscle hyperactivity triggered by slow passive joint movements, dystonia spontaneous involuntary muscle hyperactivity and spasmscomplex involuntary movements usually triggered by sensory or acoustic stimuli. Spasticity can be described by a documentation system grouped along clinical picture(axis 1), aetiology (axis 2), localisation (axis 3) and additional central nervous system deficits (axis 4). Our new definition allows distinction of spasticity components accessible to BT therapy and those inaccessible. The documentation sheet presented provides essential information for planning of BT therapy.