Pacemaker implantation in the extreme elderly.

Introduction: There are scant data for pacemaker implant complications and readmission rates in the extreme elderly (age ≥80 years) despite their common use in this population.

Methods: This is a retrospective chart review of consecutive patients (n = 149, age ≥80 years) who underwent pacemaker implantation at a community hospital electrophysiology program from July 2008 through June 2010. Single-, dual-, and biventricular-chamber pacemakers and generator changes were included for analysis; cardioverter-defibrillator devices, temporary pacemakers, and loop recorders were excluded.

Patient demographics, complications, and hospital utilization in 250 consecutive device implants in a new community hospital electrophysiology program--implications for 'niche' hospitals.

Background: Single-center reports on patient demographics and early (<6 weeks) device complication rates in academic hospitals are scant and non-existent for non-academic community hospital electrophysiology (EP) programs.

Objective: The objective of our study was to examine the demographics, complications, re-admissions, and accessibility of care in a community EP program to add to the body of knowledge of 'real-world' defibrillator implant complications.

Methods: Two hundred and fifty consecutive patients who underwent device implantation by a single electrophysiologist in a new non-academic community hospital EP program starting from its inception in July 2008 were included for analysis.

Intrahissian anisotropy and second degree type I block.

A 79 year old female presents for evaluation of multiple episodes of witnessed syncope. Invasive electrophysiologic evaluation revealed evidence of both intrahissian Wenckebach and anisotropy. This is the first report documenting both phenomena in the same patient.

Life, survival, and behavioral health in small closed communities: 10 years of studying isolated Antarctic groups.

In the late 1980s the Australian Antarctic Division collaborated with NASA to use the Australian National Antarctic Research Expeditions' (ANARE) stations to pursue research of benefit to both programs. This article outlines the data collection efforts, the development of analyses, and selected results, and describes some of the benefits for the aerospace, health, and environmental psychology communities. The Behavior and Performance Laboratory at Johnson Space Center developed a questionnaire to sample broadly the many aspects of life in extreme environments analogous to space missions.

Behavioral health in Antarctica: implications for long-duration space missions.

Ideally, evidence from long-duration spaceflight should be used to predict likely occurrences of behavioral health events and for planning management strategies for such events. With small numbers of space travelers, and limited long-duration missions of a year or more, Earth analogues and simulations must be used as the evidence base, despite such analogues lacking microgravity, radiation, rapidly altering photoperiodicity, and fidelity to space. Antarctic health data are reviewed and an assessment made of the likely frequency of behavioral health events.

Gender differences in leader and follower perceptions of social support in Antarctica.

The purpose of this study was to methodologically explore the links among social support, gender, age, prior experience, leader/follower status, and leadership effectiveness noted in previous accounts from Antarctic stations. Data for this study were collected from volunteers involved in Australian National Antarctic Research Expeditions conducted from 1996 to 2001. Multilevel analysis revealed that most of the variance in perceptions of social support was at the individual level (71%).

Epstein-Barr virus shedding by astronauts during space flight.

Patterns of Epstein-Barr virus (EBV) reactivation in 32 astronauts and 18 healthy age-matched control subjects were characterized by quantifying EBV shedding. Saliva samples were collected from astronauts before, during, and after 10 space shuttle missions of 5-14 days duration. At one time point or another, EBV was detected in saliva from each of the astronauts.

Team climate at Antarctic research stations 1996-2000: leadership matters.

Introduction: The popular assumption is that extreme environments induce a climate of hostility, incompatibility, and tension by intensifying differences and disagreements among team members. Team members' perceptions of team climate are likely to change over time in an extreme environment, and thus team climate should be considered as a dynamic outcome variable resulting from multiple factors. In order to explore team climate as a dynamic outcome, we explored whether variables at multiple levels of analysis contributed to team climate over time for teams living and working in Antarctica.

Cell mediated immunity and alcohol intake in Antarctic wintering personnel.

The relationship between cell-mediated immunity and alcohol intake was studied in an Antarctic wintering group. Cell-mediated immune responses have previously been shown to be significantly lowered on the Antarctic Continent. The cause for this is yet to be elucidated.

Trends in mucosal immunity in Antarctica during six Australian winter expeditions.

The mucosal immune status of Australian Antarctic personnel was monitored during six wintering expeditions at two Australian Antarctic Research Stations, Casey in 1992, 1993, 1994, and Mawson in 1992, 1995, 1996. Salivary immunoglobulin and albumin levels were examined for differences between stations and expeditions, and for monthly changes over the expedition year. Salivary IgA and IgM concentrations were on average higher for the 1993 Casey expeditioners, and all salivary protein levels were lower for 1996 Mawson expeditioners compared to levels of the other expeditions.

Suppression of human anti-inflammatory plasma cytokines IL-10 and IL-1RA with elevation of proinflammatory cytokine IFN-gamma during the isolation of the Antarctic winter.

Cellular immune function has been shown to be decreased and latent virus shedding to be increased in human beings isolated during the Antarctic winter, a model used for assessing some effects of space flight. However, the balance of proinflammatory (IFN-gamma) and anti-inflammatory (IL-10 and IL-1RA) cytokines has not previously been evaluated. We therefore sought to determine whether isolation during the Antarctic winter would alter the proinflammatory and anti-inflammatory cytokine balance.

Is it really so bad? A comparison of positive and negative experiences in Antarctic winter stations.

This study examined the range of positive and negative themes reported by 104 Australian Antarctic winter personnel at four stations during two austral winters. Reports from the expeditioners were subjected to a content analysis using the TextSmart software from SPSS, Inc. Results indicated that, although the list of negative experiences is lengthy, most events are relatively rare.

Space analogue studies in Antarctica.

Medical research has been carried out on the Australian National Antarctic Research Expeditions (ANARE) for 50 years. As an extension of this program collaborative Australian/United States research on immunology, microbiology, psychology and remote medicine has produced important data and insight on how humans adapt to the stress of extreme isolation, confinement and the harsh environment of Antarctica. An outstanding analogue for the isolation and confinement of space missions (especially planetary outposts), ANARE has been used as an international research platform by Australia and the United States since 1993.

Psychological changes in hundred-day remote Antarctic field groups.

Psychological adaptation to extreme environments has been examined from several perspectives. In this study, two Australian teams, each consisting of six male crew members, completed computer-administered questionnaires twice weekly during 100-day traverses around the Lambert Glacier Basin, Antarctica. Only small trends were noted when data were aggregated at the group level, which is consistent with the findings of others.

Antibody responses to bacteriophage phi X-174 in human subjects exposed to the antarctic winter-over model of spaceflight.

Background: It has been proposed that exposure to long-term spaceflight conditions (stress, isolation, sleep disruption, containment, microbial contamination, and solar radiation) or to ground-based models of spaceflight will alter human immune responses, but specific antibody responses have not been fully evaluated.

Objective: We sought to determine whether exposure to the 8-month Antarctic winter-over model of spaceflight would alter human antibody responses.

Methods: During the 1999 Australian National Antarctic Research Expeditions, 11 adult study subjects at Casey, Antarctica, and 7 control subjects at Macquarie Island, sub-Antarctica, received primary and secondary immunizations with the T cell-dependent neoantigen bacteriophage phi X-174.

One year in Antarctica: mucosal immunity at three Australian stations.

The effect of a year's isolation in Antarctica on the human mucosal immune system was assessed during the winter of 1992 at three Australian Antarctic stations: Casey, Davis and Mawson. Saliva samples were collected from each expeditioner prior to their departure from Australia and during each month in Antarctica. The concentrations of salivary immunoglobulins IgA and IgG were significantly different between the three stations, but there were no differences for salivary IgM and albumin.

Epstein-Barr virus reactivation associated with diminished cell-mediated immunity in antarctic expeditioners.

Epstein-Barr virus (EBV) reactivation and cell-mediated immune (CMI) responses were followed in 16 Antarctic expeditioners during winter-over isolation at 2 Australian National Antarctic Research Expedition stations. Delayed-type hypersensitivity (DTH) skin testing was used as an indicator of the CMI response, that was evaluated 2 times before winter isolation and 3 times during isolation. At all 5 evaluation times, 8 or more of the 16 subjects had a diminished CMI response.

Telemedicine: have technological advances improved health care to remote Antarctic populations?

Telemedicine has been used in remote areas for decades. In recent years the information superhighway has been a catalyst for the rapid growth of telemedicine; development of new technologies; and proliferation of subspecialties, journals and abstracts, and centers for telemedicine law. It has further promoted conferences of clinicians and managers planning telemedicine to advance remote health care, as well as the generation of revenue from business opportunities.

The measurement of solar ultraviolet radiation.

High skin cancer rates, stratospheric ozone depletion and increased public interest and concern have resulted in a strong demand for solar ultraviolet radiation measurements and information. The Australian Radiation Laboratory (ARL) has been involved since the mid-1980s in the measurement of solar ultraviolet radiation (UVR) using spectroradiometers (SRM) and a network of broadband detectors at 18 sites in Australia and Antarctica and in Singapore through a collaborative agreement with the Singapore Institute of Science and Forensic Medicine. Measurement locations range from equatorial (Singapore, 1.

Description of movement patterns of young adults moving supine from the foot to the head of the bed.

Background And Purpose: The purpose of this study was to describe the movement patterns (MPs) in young adults moving supine from the foot to the head of a bed.

Subjects: Thirty-six young adults, aged 19 through 44 years, participated in this study.

Methods: Subjects were videotaped performing 10 trial of moving in bed.

Antarctic isolation: immune and viral studies.

Stressful environmental conditions are a major determinant of immune reactivity. This effect is pronounced in Australian National Antarctic Research Expedition populations exposed to prolonged periods of isolation in the Antarctic. Alterations of T cell function, including depression of cutaneous delayed-type hypersensitivity responses and a peak 48.

Seasonal cutaneous immune responses in an Antarctic wintering group: no association with testosterone, vitamin D metabolite or anxiety score.

Immune function is modulated by a complex set of neuroendocrine factors including sex hormones, vitamin D metabolites and stress. Antarctic expeditioners exhibit reduced cell mediated immunity. Studies have also shown a reduction in testosterone levels in wintering expeditioners and suggested a correlation between levels of anxiety and reduced immune function in brief trip expeditioners.