Publications by authors named "Dominic P"

Sudden unexpected death in epilepsy (SUDEP) is a devastating complication of epilepsy with possible sex-specific risk factors, although the exact relationship between sex and SUDEP remains unclear. To investigate this, we studied Kcna1 knockout (Kcna1) mice, which lack voltage-gated Kv1.1 channel subunits and are widely used as a SUDEP model that mirrors key features in humans.

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  • Patients with chronic kidney disease (CKD) on renal replacement therapy (RRT) face a high risk of infections from cardiovascular implantable electronic devices (CIED), but device extraction, the usual way to manage these infections, is often avoided due to high procedural risks.
  • A study analyzed data from CKD patients with CIED infections, finding that 30% underwent device extraction, which significantly improved one-year survival rates (59.2% vs. 48.8% for no extraction).
  • Despite the survival benefits, the low rate of device extraction among these patients highlights a need for better management strategies in this high-risk group.
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  • - Breast cancer is a significant public health issue globally, with treatment decision-making critical for patient outcomes, especially in Tanzania where information on this topic is limited.
  • - The study utilized a qualitative approach and interviews with 14 female patients to identify both facilitators, like understanding treatment options and support from healthcare providers, and barriers such as treatment costs and reliance on religious healing.
  • - The findings highlight the ongoing challenges in making treatment decisions for breast cancer patients and suggest that improving patient education and healthcare support, along with advocating for insurance coverage, could enhance decision-making processes.
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Background: Catheter Ablation (CA) is an effective treatment for atrial fibrillation (AF). However, frail elderly patients have been understudied due to their exclusion from landmark trials.

Objectives: Our study aims to evaluate outcomes in this population.

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Importance: Atrial fibrillation and obesity are common, and both are increasing in prevalence. Obesity is associated with failure of cardioversion of atrial fibrillation using a standard single set of defibrillator pads, even at high output.

Objective: To compare the efficacy and safety of dual direct-current cardioversion (DCCV) using 2 sets of pads, with each pair simultaneously delivering 200 J, with traditional single 200-J DCCV using 1 set of pads in patients with obesity and atrial fibrillation.

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Hydropersulfide and hydropolysulfide metabolites are increasingly important reactive sulfur species (RSS) regulating numerous cellular redox dependent functions. Intracellular production of these species is known to occur through RSS interactions or through translational mechanisms involving cysteinyl t-RNA synthetases. However, regulation of these species under cell stress conditions, such as hypoxia, that are known to modulate RSS remain poorly understood.

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Syncope is a common complaint in clinical practice. The etiologies and mechanisms can be multiple and complex. Syncope caused by a mediastinal mass compressing the vagus nerve is rare.

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Dextroposition is a rare cardiac malformation defined as heart shift to right of midline. ECG findings vary with degree of displacement within the chest cavity. We report the second known case of dextroposition with accessory pathway (posteroseptal in our patient), presenting as pre-excited atrial tachycardia.

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  • The review investigates the mechanisms, electrocardiographic changes, and treatment methods related to cardiac arrhythmias that may occur after COVID-19 vaccination.
  • A global survey indicates that 18.27% of hospitalized COVID-19 patients experience arrhythmias, with myocarditis being the most common cardiac adverse event post-vaccination.
  • Potential causes of these arrhythmias include direct viral effects, inflammatory responses, electrolyte imbalances, and myocardial damage, prompting a need for standard treatment strategies for vaccination-induced arrhythmias.
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  • * A study analyzing data from 2016 to 2019 found that out of nearly 48,000 CA procedures, cancer patients had higher in-hospital mortality, lower chances of being discharged home, and increased risks of complications like major bleeding and pulmonary embolism.
  • * The findings suggest that while CA can be effective, cancer patients face notable risks, highlighting the need for larger studies to confirm these results and explore safer treatment options.
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Introduction: Sacubitril/valsartan reduces all-cause mortality in heart failure (HF) patients compared to angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). ACEIs/ARBs have been shown to decrease the incidence of atrial fibrillation (AF). We hypothesized sacubitril-valsartan decreases the incidence of AF compared to ACEis/ARBs.

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Background: Recent single-center reports have suggested that community-acquired bacteremic co-infection in the context of Coronavirus disease 2019 (COVID-19) may be an important driver of mortality; however, these reports have not been validated with a multicenter, demographically diverse, cohort study with data spanning the pandemic.

Methods: In this multicenter, retrospective cohort study, inpatient encounters were assessed for COVID-19 with community-acquired bacteremic co-infection using 48-h post-admission blood cultures and grouped by: (1) confirmed co-infection [recovery of bacterial pathogen], (2) suspected co-infection [negative culture with ≥ 2 antimicrobials administered], and (3) no evidence of co-infection [no culture]. The primary outcomes were in-hospital mortality, ICU admission, and mechanical ventilation.

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Introduction: Current guidelines for cardiac resynchronization therapy (CRT) device implant are the same across both sexes however women have been traditionally underrepresented in randomized controlled trials (RCTs). We aimed to identify if the number of women included in CRT trials is representative of the real-world burden of heart failure (HF) in women.

Methods: RCTs evaluating the benefit of CRT in HF patients referenced in the 2012 EHRA/HRS expert consensus statement on CRT in HF were included.

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Methamphetamine (METH) is an addictive illicit drug used worldwide that causes significant damage to blood vessels resulting in cardiovascular dysfunction. Recent studies highlight increased prevalence of cardiovascular disease (CVD) and associated complications including hypertension, vasospasm, left ventricular hypertrophy, and coronary artery disease in younger populations due to METH use. Here we report that METH administration in a mouse model of 'binge and crash' decreases cardiovascular function via cystathionine gamma lyase (CSE), hydrogen sulfide (HS), nitric oxide (NO) (CSE/HS/NO) dependent pathway.

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Introduction: Heart failure (HF) is a major cause of morbidity and mortality, with nearly half of all HF-related deaths resulting from sudden cardiac death (SCD), most often from an arrhythmic event. The pathophysiologic changes that occur in response to the hemodynamic stress of HF may lead to increased arrhythmogenesis. Theoretically, medications that block these arrhythmogenic substrates would decrease the risk of SCD.

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Hydrogen sulfide (HS) has emerged as a gaseous signalling molecule with crucial implications for cardiovascular health. HS is involved in many biological functions, including interactions with nitric oxide, activation of molecular signalling cascades, post-translational modifications and redox regulation. Various preclinical and clinical studies have shown that HS and its synthesizing enzymes - cystathionine γ-lyase, cystathionine β-synthase and 3-mercaptosulfotransferase - can protect against cardiovascular pathologies, including arrhythmias, atherosclerosis, heart failure, myocardial infarction and ischaemia-reperfusion injury.

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