Rationale, design and methodology of APPROACH-IS II: International study of patient-reported outcomes and frailty phenotyping in adults with congenital heart disease.

Background: In recent years, patient-reported outcomes (PROs) have received increasing prominence in cardiovascular research and clinical care. An understanding of the variability and global experience of PROs in adults with congenital heart disease (CHD), however, is still lacking. Moreover, information on epidemiological characteristics and the frailty phenotype of older adults with CHD is minimal.

Education as important predictor for successful employment in adults with congenital heart disease worldwide.

Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an important determinant for quality of life, we assessed this in a large international adult CHD cohort.

Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross-sectional APPROACH International Study.

Catheter closure of atrial septal defect in the elderly (≥65years). A worthwhile procedure.

Background: Secundum atrial septal defect (ASD2) is one of the most common cardiac malformations diagnosed in adult life. Catheter closure has made treatment possible even in patients of high age. However, published outcome data for elderly patients is limited.

Quality of Life of Adults With Congenital Heart Disease in 15 Countries: Evaluating Country-Specific Characteristics.

Background: Measuring quality of life (QOL) is fundamental to understanding the impact of disease and treatment on patients' lives.

Objectives: This study aimed to explore QOL in an international sample of adults with congenital heart disease (CHD), the association between patient characteristics and QOL, and international variation in QOL and its relationship to country-specific characteristics.

Methods: We enrolled 4,028 adults with CHD from 15 countries.

Comparison of participants and non-participants in patient-reported outcome surveys: the case of Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study.

Background: The last decade has seen a vast increase in the use of patient-reported outcomes. As patient-reported outcomes are used in order to capture patients' perspectives of their health and illness, it is a prerequisite for accurate patient-reported outcome evaluations to use representative samples. In order to evaluate representativeness, the present study focussed on the comparison between participants and non-participants in the Swedish branch of the international study APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study), regarding demographic, clinical, and health status characteristics.

Long-Term Outcome of Mustard/Senning Correction for Transposition of the Great Arteries in Sweden and Denmark.

Background: The atrial switch operation, the Mustard or Senning operation, for the transposition of the great arteries (TGA) was introduced in the late 1950s and was the preferred surgery for TGA until the early 1990s. The Mustard and Senning operation involves extensive surgery in the atria and leaves the right ventricle as the systemic ventricle. The Mustard and Senning cohort is now well into adulthood and we begin to see the long-term outcome.

Strategies and outcomes of periprocedural bridging therapy with low-molecular-weight heparin in patients with mechanical heart valves.

Patients with mechanical heart valves (MHV) undergoing invasive procedures often receive periprocedural bridging with low-molecular-weight heparin (LMWH). The bridging strategies used in real-life and the predictors for bleeding and thrombosis are not well studied. We retrospectively assessed patients with MHV that underwent invasive procedures requiring vitamin K antagonist interruption and LMWH bridging.

Functioning and quality of life in adults with mild-to-moderate osteogenesis imperfecta.

Purpose: The aim of this study was to describe physical activity, quality of and satisfaction with life, pain, joint mobility and muscle function in adults with mild-to-moderate osteogenesis imperfecta (OI) to form the basis of improved clinical care and physical therapy treatment.

Method: A total of 40 men and women aged between 21 and 71 years were identified and a prospective, cross-sectional study was performed on 29 (18 women) included participants. The participants had to be able to walk and to have a diagnosis of mild-to-moderate OI.

Clinical implications of azole resistance in Aspergillus fumigatus, The Netherlands, 2007-2009.

The prevalence and spread of azole resistance in clinical Aspergillus fumigatus isolates in the Netherlands are currently unknown. Therefore, we performed a prospective nationwide multicenter surveillance study to determine the effects of resistance on patient management strategies and public health. From June 2007 through January 2009, all clinical Aspergillus spp.

Left ventricular hypertrophy in incident dialysis patients randomized to treatment with hemofiltration or hemodialysis: results from the ProFil study.

Introduction: Left ventricular hypertrophy (LVH) is present in a majority of hemodialysis (HD) patients and is among the strongest risk factors for cardiovascular events and mortality. Hemofiltration (HF), a purely convective dialysis treatment, has been associated with enhanced hemodynamic stability compared with HD, possibly as a result of a more physiologic removal of fluid and solutes.

Methods: In a randomized controlled study conducted at ten dialysis centers in Sweden and Denmark, incident patients (HD <3 months) without clinical signs or history of cardiovascular disease were randomized to treatment with either online, predilution HF or low-flux HD.

Adolescents' perceptions of obesity treatment--an interview study.

Purpose: To describe adolescents' perceptions of obesity treatment in order to provide valuable information for design and development of treatment.

Method: A nominated sample of 18 obese adolescents (12 girls, 14-16 years, body mass index (BMI) 25-47.4 kg·m(-2)), recruited from a paediatric obesity clinic, participated in semi-structured interviews.

Glossopharyngeal pistoning for lung insufflation in children with spinal muscular atrophy type II.

Aim: To evaluate whether children with spinal muscular atrophy (SMA) type II were able to learn glossopharyngeal pistoning for lung insufflation (GI), and to evaluate the effects of GI on pulmonary function and chest expansion.

Methods: Eleven children with SMA type II were recruited. They performed 10 cycles of GI, four times per week, for 8 weeks.

Fear-avoidance beliefs and pain as predictors for low physical activity in patients with leg ulcer.

Background And Purpose: Previous studies have shown that patients with chronic venous insufficiency are deconditioned and physically inactive. The present study aimed to examine the occurrence of fear-avoidance beliefs in patients with chronic venous insufficiency, and to investigate the role of fear-avoidance beliefs and pain severity in predicting the low level of physical activity in these patients.

Method: Data were collected by a postal questionnaire sent to 146 patients with chronic venous insufficiency and current or previous venous leg ulcer.

Six-minute walk test in obese children and adolescents: reproducibility and validity.

Background And Purpose: The six-minute walk test (6MWT) is increasingly used in clinical practice. The aims of this study were to determine the reproducibility of the 6MWT in obese children and adolescents, to describe walking capacity in this population and compare the results with values from normal-weight children (known group validity), and, finally, to describe the correlation between distance walked and estimated maximum oxygen uptake (VO(2)max).

Methods: Reproducibility was determined by a test-retest design and known group validity by a comparative design.

Urinary incontinence in very young and mostly nulliparous women with a history of regular organised high-impact trampoline training: occurrence and risk factors.

The aim of this study was to examine the occurrence of urinary incontinence (UI) in mostly nulliparous women with a history of regular organised trampoline training as adolescents and to identify possible predictors. Female trampolinists in Sweden with licence for trampolining between 1995--1999 (n = 305), with a median age of 21 (range 18-44) years answered retrospectively a validated questionnaire. Competition with double somersaults had been performed by 85 women, the "competition group" (CG), while 220 women comprised the "recreational group" (RG).

Staphylococcal peptidoglycan initiates an inflammatory response and procoagulant activity in human vascular endothelial cells: a comparison with highly purified lipoteichoic acid and TSST-1.

Staphylococcus aureus is one of the most significant pathogens in human sepsis and endocarditis. A hallmark of these endovascular S. aureus infections is that the coagulation system is triggered by a tissue factor (TF)-dependent pathway.

Effects of glossopharyngeal pistoning for lung insufflation on vital capacity in healthy women.

Objectives: To determine whether healthy women could be trained to perform glossopharyngeal pistoning (GP) to insufflate the lungs to volumes exceeding maximum inspiratory capacity (IC), whether such insufflation caused discomfort, and the immediate and long-term effects on vital capacity (VC).

Design: A randomized controlled trial. Twenty-six healthy women were randomly assigned to a training group (TG, n = 17) or to a control group (CG, n = 9).

Edge-to-edge mitral repair without annuloplasty in combination with surgical ventricular restoration.

Background: Functional mitral regurgitation is common in ischemic dilated cardiomyopathy. Edge-to-edge repair is an option for correction and can be performed through the ventriculotomy during surgical ventricular restoration (SVR). This report describes the durability of the edge-to-edge repair without annuloplasty in combination with SVR.

Urinary incontinence in women with low back pain.

Urinary incontinence (UI) is a common female dysfunction, affecting women in all ages. Experienced physiotherapists and experts on low back pain (LBP) have since long observed and discussed the empirical association between LBP and UI. The aim of this study was to describe the occurrence of UI in women with LBP and to compare this group with a reference group of comparable age, language, culture and parity.

Six-minute walk test in adults with cerebral palsy. A study of reliability.

Objective: To determine the reliability of a six-minute walk test in adults with cerebral palsy.

Design: Four repeated walk tests during two weeks.

Setting: The tests were conducted in a 40-m-long corridor at a rehabilitation centre for outpatients.

Physical activity and self-perception in school children assessed with the Children and Youth--Physical Self-Perception Profile.

Aim: This study validated the Swedish translation of the Children and Youth--Physical Self-Perception Profile (CY-PSPP) scale and examined the relation between physical self-perception and daily physical activity as well as the relationship between physical self-perception and body mass index (BMI) among Swedish school children.

Methods: Forty-eight children aged 11-12 years completed the CY-PSPP twice with 2 weeks in between. Test-retest reliability, concurrent and content validity were calculated.

Highly purified lipoteichoic acid from Staphylococcus aureus induces procoagulant activity and tissue factor expression in human monocytes but is a weak inducer in whole blood: comparison with peptidoglycan.

Lipoteichoic acid from Staphylococcus aureus was a potent inducer of procoagulant activity in isolated mononuclear cells but not in whole blood. In contrast, staphylococcal peptidoglycan showed equal levels of potency in isolated mononuclear cells and whole blood, suggesting that peptidoglycan is an important inducer of procoagulant activity in severe sepsis involving gram-positive bacteria.

Low antibody levels against cell wall-attached proteins of Streptococcus pyogenes predispose for severe invasive disease.

Acute-phase serum samples from 70 patients with group A streptococcal (GAS) invasive disease were analyzed for IgG antibodies against 6 recently characterized GAS virulence factors (SclA, SclB, GRAB, MtsA, EndoS, and IdeS) and SpeB. Antibody levels against the cell wall-attached GAS antigens SclA, SclB, and GRAB were significantly lower in patients with severe invasive disease (streptococcal toxic shock syndrome [STSS] and/or necrotizing fasciitis [NF]; n=35), compared with levels in patients with nonsevere GAS bacteremia (n=35). Among patients with severe invasive disease, significantly lower antibody levels against GRAB were found in patients with STSS (n=10) than in patients with NF (n=17).

Peptidoglycan induces mobilization of the surface marker for activation marker CD66b in human neutrophils but not in eosinophils.

Peptidoglycan from Staphylococcus aureus mobilized CD66b in human neutrophils but did not upregulate surface activation markers in eosinophils. In addition, Toll-like receptor 2, implicated in the recognition of peptidoglycan, was detected on the surface of resting neutrophils but not on eosinophils. These findings suggest roles for neutrophils but not eosinophils in innate recognition of peptidoglycan.