Patient-Specific Sensor Registration for Electrical Source Imaging Using a Deformable Head Model.

Objective: Electrical source imaging of brain activity is most accurate when using individualized bioelectric head models. Constructing these models requires identifying electrode positions on the scalp surface. Current methods such as photogrammetry involve significant user interaction that limits integration in clinical workflows.

Strategies for Acing the Fundamentals and Mitigating Legal and Ethical Consequences of Poor Physician-Patient Communication.

This article explores how the absence of effective verbal and nonverbal communication in the physician-patient encounter can lead to poor outcomes for patients and physicians alike. The article discusses legal and ethical topics physicians should consider during a medical encounter and provides educational and practical suggestions for improving effective communication between physicians and their patients.

Promoting Access to School-Based Services for Children's Mental Health.

Mental health issues are widespread among children, but many never receive adequate treatment. One political solution proposed to address this disparity would be to fund mental health services through school-based programs and support collaboration among community and health organizations to address the needs of children. Regardless of whether this policy is implemented, health care professionals have a responsibility to promote access to care and patient health, which may include actively participating in the development of programs to provide services to children with mental health disorders.

A Helminth Protease Inhibitor Modulates the Lipopolysaccharide-Induced Proinflammatory Phenotype of Microglia in vitro.

Objective: The aim of this study was to examine whether the natural protease inhibitor Av-cystatin (rAv17) of the parasitic nematode Acanthocheilonema viteae exerts anti-inflammatory effects in an in vitro model of lipopolysaccharide (LPS)-activated microglia.

Methods: Primary microglia were harvested from the brains of 2-day-old Wistar rats and cultured with or without rAv17 (250 nM). After 6 and 24 h the release of nitric oxide (Griess reagent) and TNF-α (ELISA) was measured in the supernatant.

Usefulness of N-acetylcysteine or ascorbic acid versus placebo to prevent contrast-induced acute kidney injury in patients undergoing elective cardiac catheterization: a single-center, prospective, randomized, double-blind, placebo-controlled trial.

Background: Contrast-induced acute kidney injury (CI-AKI) is a serious complication of procedures requiring contrast media associated with rising costs, prolonged hospitalization, and increased mortality. The aim of this study was to assess whether prophylactic administration of standard dosages of intravenous N-acetylcysteine or ascorbic acid reduce the incidence of CI-AKI in patients with chronic renal insufficiency undergoing elective cardiac catheterization.

Methods: In a single-center, prospective, randomized, double-blind, placebo-controlled trial, the preventive effects of N-acetylcysteine and ascorbic acid were evaluated in 520 patients with chronically impaired renal function (serum creatinine ≥1.

Does the number of simultaneously activated electrodes during phased RF multielectrode ablation of atrial fibrillation influence the incidence of silent cerebral microembolism?

Background: Asymptomatic cerebral embolus (ACE) detected by diffusion-weighted magnetic resonance imaging (DW-MRI) following atrial fibrillation (AF) ablation has been reported at varying rates with different ablation techniques.

Objective: To evaluate the incidence of ACE after phased radiofrequency ablation for AF with procedural modifications that potentially reduce the embolic load.

Methods: One hundred twenty consecutive patients with AF underwent MRI before ablation, 24 hours after ablation, and at 4-6 weeks.

[Posthepatic obstructive jaundice caused by primary extragonadal germ-cell tumor in a patient with glucose-6-phosphatase dehydrogenase deficiency].

History And Admission Findings: In patients with glucose-6-phosphatase dehydrogenase (G6PD) deficiency (favism) jaundice is usually caused by hemolysis due to stress, infection or following the application of drugs. We report on a 74-year-old Italian with known G6PD deficiency complaining of jaundice, weight loss and abdominal pain. Physical examination revealed jaundice of the eyes.

Contemporary success and complication rates of percutaneous coronary intervention for chronic total coronary occlusions: results from the ALKK quality control registry of 2006.

Aims: Despite successful prevention of lesion recurrence by drug-eluting stents (DES), and the advancement in procedural techniques in the treatment of chronic total coronary occlusions (CTO), the number of CTOs treated by percutaneous coronary intervention (PCI) is still low as compared to their prevalence. This study aims to assess the outcome of PCI for CTOs in a contemporary survey of PCI in interventional centres in Germany.

Methods And Results: The basis of this analysis is the 2006 quality assessment database of PCI conducted by the ALKK (working group of cardiology centres).

Percutaneous transluminal dilatation of inadvertent partial or complete occlusion of the femoral artery caused by Angio-Seal deployment for puncture site closure after cardiac catheterization.

The use of access-site closure devices in interventional cardiology has expanded rapidly in the past several years. Initial reports indicated remarkable safety with these devices but there are a small number of major complications. This single-center, retrospective study was carried out to investigate the efficacy of percutaneous transluminal angioplasty (PTA) of inadvertent occlusion or severe stenosis of the femoral artery after deployment of the Angio-Seal closure device.

[Pneumoretroperitoneum and bilateral pneumothorax after endoscopic biliary sphincterotomy].

History And Admission Findings: A 39-year-old obese woman underwent endoscopic retrograde cholangiopancreatography with elective endoscopic biliary sphincterotomy (papillotomy) for symptomatic retained stones in the common bile duct which were extracted completely after added lithotripsy. Three hours later the patient developed profound subcutaneous emphysema of the face, neck and chest wall and shortness of breath, but had no abdominal pain. Physical examination revealed bilaterally diminished breath sounds and a distended and hyper-resonant abdomen, but no evidence of peritonitis.

Pulmonary vein isolation by duty-cycled bipolar and unipolar antrum ablation using a novel multielectrode ablation catheter system: first clinical results.

Background: The electrical disconnection of the pulmonary veins (PV) plays an important role in the ablation strategy of paroxysmal atrial fibrillation (PAF). Circumferential antral ablation with a conventional ablation technique using a steerable ablation catheter is sometimes difficult to perform and does not always result in isolation of the targeted PV.

Methods: Patients with symptomatic PAF were treated with a novel circular mapping/ablation catheter (PVAC).

A randomized comparison of transradial versus transfemoral approach for coronary angiography and angioplasty.

Objectives: The aim of the study was to evaluate the safety, feasibility, and procedural variables by the transradial approach compared with the transfemoral access in a standard population of patients undergoing coronary catheterization.

Background: Coronary catheterization is usually performed via the transfemoral approach. Transradial access may offer some advantages in comparison with transfemoral access especially under conditions of aggressive anticoagulation and antiplatelet treatment.

[Superior vena cava syndrome by cardiac tumor].

Case Report: A 59-year-old man with a 4-week history of dyspnea, coughing, and chest discomfort was referred to hospital for further evaluation. Moreover, he reported fever and fatigue. There were neither cardiovascular risk factors nor drug medication.

Incidence of coronary artery disease and necessity of revascularization in symptomatic patients requiring permanent pacemaker implantation.

Background And Purpose: The cause of severe cardiac conduction disturbances or sinus node dysfunction is often unknown. The objective of this study was to assess the incidence of coronary artery disease (CAD) and the necessity of revascularization in patients with symptomatic bradycardia requiring permanent pacemaker implantation and to try to find a causal association between the need for a pacemaker and the presence of CAD.

Patients And Methods: From January 2002 to December 2005, 507 pacemakers were implanted due to symptomatic bradycardia.

[Recurrent upper gastrointestinal bleeding in a 61 year-old man with infrarenal abdominal aortic aneurysm].

A 61-year-old man was admitted to hospital due to recurrent upper gastrointestinal bleeding. Four weeks ago, he had been treated with epinephrine and endoclips by endoscopy due to an arterial gastrointestinal bleeding. The patient had a history of coronary and peripheral artery disease, diabetes, and an abdominal aortic aneurysm.

Aortic valve stenosis due to alkaptonuria.

Cardiovascular disease is a less-well appreciated aspect of alkaptonuria. A 69-year-old man presented with shortness of breath and exertional chest pain. He had a previous diagnosis of alkaptonuria (endogenous ochronosis), confirmed on the basis of urine coloration, skin pigmentation and ochronotic arthropathy in the knees.

The late open infarct-related artery hypothesis: evidence-based medicine or not?

Randomized clinical trials have clearly shown that early reperfusion of coronary arteries is the established treatment of myocardial infarction preserving left ventricular function and reducing mortality. However, late patency of the infarct-related artery is an independent predictor of survival leading to the late open-artery hypothesis. This concept implies restoration of antegrade blood flow of the infarct-related artery in patients with myocardial infarction to improve survival by mechanisms less time-dependent or even time-independent.

Inferior vena cava approach to permanent pacemaker implantation.

A 89-year-old woman required permanent pacemaker implantation because of symptomatic bradyarrhythmia with multiple falls and repeated fractures. Because of the obstruction of the thoracic veins and infection of both groins, an alternative approach via directly punctured inferior vena cava was performed. At follow-up, the patient remained well with an excellent symptomatic response to pacing.