Symptom severity and quality of life in patients with atrial fibrillation: Psychological function outweighs clinical predictors.

Background: The key drivers of symptom severity and health-related quality of life (hr-QOL) in patients with atrial fibrillation (AF) remain unclear. We aimed to determine the relative contribution to symptom severity and hr-QOL of clinical factors including left ventricular (LV) diastolic function and ventricular rate control during AF and of psychological functioning.

Methods: Seventy-eight consecutive patients with symptomatic AF and preserved LV systolic function underwent detailed evaluation of i) AF symptom severity and hr-QOL; ii) clinical factors including left ventricular (LV) diastolic function, AF burden, and ventricular rate during AF and iii) state and trait aspects of psychological functioning.

Angiotensin converting enzyme 2 activity and human atrial fibrillation: increased plasma angiotensin converting enzyme 2 activity is associated with atrial fibrillation and more advanced left atrial structural remodelling.

Aim: Angiotensin converting enzyme 2 (ACE2) is an integral membrane protein whose main action is to degrade angiotensin II. Plasma ACE2 activity is increased in various cardiovascular diseases. We aimed to determine the relationship between plasma ACE2 activity and human atrial fibrillation (AF), and in particular its relationship to left atrial (LA) structural remodelling.

Progression of atrial remodeling in patients with high-burden atrial fibrillation: Implications for early ablative intervention.

Background: Advanced atrial remodeling predicts poor clinical outcomes in human atrial fibrillation (AF).

Objective: The purpose of this study was to define the magnitude and predictors of change in left atrial (LA) structural remodeling over 12 months of AF.

Methods: Thirty-eight patients with paroxysmal AF managed medically (group 1), 20 undergoing AF ablation (group 2), and 25 control patients with no AF history (group 3) prospectively underwent echocardiographic assessment of strain variables of LA reservoir function at baseline and at 4, 8, and 12 months.

Meconium ileus secondary to cystic fibrosis. The East London experience.

Meconium ileus (MI) affects 15% of neonates with cystic fibrosis (CF). The authors reviewed the management and outcome of 51 neonates presenting to a single institution between 1976 and 1995 with MI secondary to CF. Clinical presentation included abdominal distension (96%), bilious vomiting (49%), and delayed passage of meconium (36%).

Effect of hepatocyte proliferation and cellular DNA synthesis on hepatitis B virus replication.

Background & Aims: Interrelationship between hepatitis B virus (HBV) replication and the stage of hepatocyte proliferation and differentiation may play an important role in the pathogenesis of HBV infection. The aim of this study was to assess the effect of hepatocyte proliferation and/or cell arrest on HBV replication.

Methods: Hepatoblastoma cells transfected with HBV were subjected to serum deprivation or treatment with aphidicolin or camptothecin.

Induction of senescent cell-derived inhibitor of DNA synthesis gene, SDI1, in hepatoblastoma (HepG2) cells arrested in the G2-phase of the cell cycle by 9-nitrocamptothecin.

Background: Recent studies have demonstrated that the plant-derived alkaloid camptothecin (CPT) and its derivative, 9-nitro-CPT (9NC), are cytotoxic in tumorigenic cells but cytostatic in nontumorigenic cells in vitro and in vivo. Also, CPT induces differentiation of human leukemia cells in vitro along specific lineages. In this study, we have investigated the effects of 9NC on nontumorigenic HepG2 cells derived from human hepatoblastoma.

Hepatitis B virus DNA in peripheral-blood mononuclear cells in chronic hepatitis B after HBsAg clearance.

In this study, peripheral-blood mononuclear cells from patients with chronic hepatitis B and spontaneous or therapy-induced disappearance of HBsAg were examined for HBV DNA. Samples were evaluated by in situ hybridization and polymerase chain reaction both before and after clearance of HBsAg. By in situ hybridization, positive signals were observed in 2 of 13 samples collected after HBsAg loss, in 8 of 15 samples before HBsAg loss and in 0 of 4 control patients without serological markers of active or prior HBV infection.

Cows' milk sensitive enteropathy in cystic fibrosis.

Proximal small intestinal mucosal biopsies were carried out in children with cystic fibrosis who had diarrhoea and failed to thrive in spite of adequate treatment, including pancreatic supplements. Histological examination of eight of the 17 biopsies taken over a period of 12 years showed evidence of enteropathy, and accounted for one in 13 (8%) children with cystic fibrosis under 3 years of age attending our clinic. Seven responded to a cows' milk free diet; the diarrhoea stopped and weight gain increased.

Cystic fibrosis in adolescents and adults.

Three hundred and sixteen patients with cystic fibrosis were seen at the Brompton Hospital during 1965-83; 178 (56.3%) of them were male and 136 female, and their ages ranged from 12 to 51 years. Most patients presented in infancy with respiratory symptoms and malabsorption, but 19 (6%) were diagnosed in adult life, three in their 30s.

Symptomatic vitamin E deficiency in cystic fibrosis.

A girl with cystic fibrosis who developed a neurological syndrome probably secondary to vitamin E deficiency at the age of 10 years is described. The severity of the deficiency and the early development of neurological features probably result from reduced intraluminal bile salt concentrations in addition to the pancreatic insufficiency.

Endotoxaemia in cystic fibrosis: response to antibiotics.

In a study of 6 children with cystic fibrosis receiving intravenous antibiotics for pseudomonas lung infection, serum endotoxin values were monitored by a modification of the limulus lysate technique. The values fell with treatment, reflecting a response that was not always apparent on clinical assessment. Endotoxin concentrations may offer a more precise way of monitoring the effects of antibiotic treatment in CF patients.

Relationship between the chest radiograph, regional lung function studies, exercise tolerance, and clinical condition in cystic fibrosis.

This study evaluated the accuracy of the interpretation of the chest film in delineating localised abnormalities of ventilation and perfusion, as well as the overall severity of airways obstruction, exercise tolerance, and clinical condition in children with cystic fibrosis. Radiographic findings in various regions of the chest film were compared with the functional values obtained with regional lung function tests which evaluated the arrival and disappearance of boluses of radioactive nitrogen given by inhalation and infusion. While the more severely affected areas on the chest radiograph were found to correlate with similar regions on the lung function tests, as did overall scores, errors occurred in some cases if the x-ray film alone was used as a judge of regional physiological derangement.

The role of nutritional status, airway obstruction, hypoxia, and abnormalities in serum lipid composition in limiting exercise tolerance in children with cystic fibrosis.

Previous work has shown that impaired exercise tolerance in children with cystic fibrosis (C.F.) is related to the severity of airway obstruction without elucidating the possible roles of hypoxia or malnutrition.

Serial lung function studies in cystic fibrosis in the first 5 years of life.

Lung mechanics were studied in 8 infants with cystic fibrosis at 6 months of life and radiosotopic lung function was measured in 5 of them at 5 years of age. The children who were initially asymptomatic had normal lung mechanics in infancy but the 2 restudied later had abnormal radioisotopic lung function. The symptomatic children showed abnormalities in infancy and more marked changes later.

Meconium ileus equivalent in adults with cystic fibrosis of pancreas: a report of six cases.

Eleven episodes of "meconium ileus equivalent" have been seen in six adults with cystic fibrosis of the pancreas. Three patients were initially treated surgically; one died and the other two developed serious postoperative chest infections. Six episodes were successfully treated medically with acetylcysteine orally and by enema, nasogastric suction, and intravenous fluids.

Cystic fibrosis in adolescents and adults.

Forty-five patients (25 male and 20 female) over 12 years of age with cystic fibrosis have been studied clinically, radiologically and physiologically. Their mean age at the first visit was 17 years; they were followed for a mean period of 4 years and attended at least every six months. The first symptom which developed before the age of five in 42 of the 45 patients was respiratory.

Prevalence of atopy and exercise-induced bronchial lability in relatives of patients with cystic fibrosis.

Skin tests and exercise tests were performed on children with cystic fibrosis (CF) and first-degree relatives of CF children. Positive skin tests were found in 56% of patients and 19% of relatives, but the prevalence of atopy in CF patients bore no relationship to its prevalence in their relatives. Increased 0ronchial lability, mainly due to bronchoconstriction, was present in 54% of patients and 27% of relatives.

Patterns of lung and heart growth as determined from serial radiographs of 76 children with cystic fibrosis.

, , 537-546. Chest radiographs of 76 children with cystic fibrosis were taken each year to determine lung length, lung width, and heart diameter. These measurements were plotted on standard charts against age and studied in relation to the initial clinical status.

Bronchial lability in cystic fibrosis.

Bronchial lability was studied in 52 children with cystic fibrosis (CF) and assessed by changes in the peak expiratory flow measured before, during, and after running. The findings are discussed in relation to the severity of pulmonary involvement assessed clinically and radiologically, and with those found in asthmatic children and those with a history of wheezy bronchitis in early childhood. In patients with CF, bronchial lability was found even in those with minimal pulmonary involvement.