Intracellular precipitation of hydroxyapatite mineral and implications for pathologic calcification.

In contrast to physiologic biomineralization occurring in bones, teeth and otoconia in vertebrates, calcification of soft tissues occurs in many pathologic conditions. Although similarities have been noted between the two processes, and despite the important clinical consequences of ectopic calcification, the molecular mechanisms regulating ectopic calcification are poorly understood. Although calcification is mainly extracellular, intracellular calcification has been reported and might indeed contribute to pathologic calcification of soft tissues.

Biomedical and psychosocial evaluation of "cured" adults with congenital heart disease.

As a result of significant advances in diagnostic, surgical, interventional, and pharmacological approaches, up to 95% of infants born with a congenital heart defect now survive into adulthood and there are at least 800,000 adult congenital heart disease patients living in the United States. Unfortunately, many of these individuals consider themselves "cured" or "fixed" and might have the misperception of a cure for a variety of reasons. The "cured" label is problematic and congenital heart disease is most accurately considered a chronic condition.

Psychological intervention following implantation of an implantable defibrillator: a review and future recommendations.

Background: The medical benefits of the implantable cardioverter defibrillator (ICD) are unequivocal, but a subgroup of patients experiences emotional difficulties following implantation. For this subgroup, some form of psychological intervention may be warranted. This review provides an overview of current evidence on the efficacy of psychological intervention in ICD patients and recommendations for future research.

Implantable cardioverter defibrillators and quality of life: results from the defibrillators in nonischemic cardiomyopathy treatment evaluation study.

Background: The Defibrillators in Nonischemic Cardiomyopathy Treatment Evaluation study demonstrated that implantable cardioverter defibrillators (ICDs) significantly reduce the risk of sudden cardiac death in patients with nonischemic cardiomyopathy and an ejection fraction of 35% or less, with no statistically significant decrease in overall mortality. The impact of ICD placement and shock on health-related quality of life (HRQL) in this population is unknown.

Methods: The 12-Item Medical Outcomes Short-Form Health Survey and the Minnesota Living with Heart Failure Questionnaire were administered to 458 patients with nonischemic cardiomyopathy, an ejection fraction of 35% or less, and either nonsustained ventricular tachycardia or 10 or more premature ventricular depolarizations per hour at baseline, 1 month after randomization, and every 3 months thereafter throughout the trial.

Depression, anxiety, and quality of life in patients with obstructive hypertrophic cardiomyopathy three months after alcohol septal ablation.

Patients with obstructive hypertrophic cardiomyopathy are presumed to have poor quality of life (QOL) and distress related to their cardiac symptoms and functional limitations. Alcohol septal ablation (ASA) is designed to improve heart function and reduce cardiac symptoms. The purpose of this study was to examine psychosocial factors and QOL in patients with obstructive hypertrophic cardiomyopathy before and 3 months after ASA.

Patient evaluation of ICD recall communication strategies: a vignette study.

Introduction: Communication about the unprecedented number of implantable cardioverter defibrillator (ICD) recalls has proved challenging. While initial studies have explored the psychological impact of recalls on patients, the optimal way to communicate recalls is not currently known. This study investigated the way communication of a recall can affect patients' responses.

Breaking the cycle of fear.

Two approaches to eradicating pervasive and chronic fear include viewing mistakes and errors as informative rather than cause for personal evaluation, and improving people's skills for confronting and resolving these crucial conversations.

What do I have to lose? Effects of a psycho-educational intervention on cancer patient preference for resuscitation.

This original empirical study examined effects of a psycho-educational intervention on cancer patients' knowledge, concern, and preferences for cardiopulmonary resuscitation (CPR). We examined message framing as one factor that might impact subsequent decision making. In addition, we examined personality and coping style as predictors and moderators of patients' reactions to an informational intervention.

The ICD shock and stress management program: a randomized trial of psychosocial treatment to optimize quality of life in ICD patients.

Background: Implantable cardioverter defibrillator (ICD) patients potentially face significant psychological distress because of their risk for life-threatening arrhythmias and the occurrence of ICD shock.

Methods: The purpose of this study was to test an ICD stress and shock management program delivered in either a six-week format or a one-day workshop format. This intervention was aimed at reducing psychological (anxiety) and physiological (salivary cortisol) markers of distress in ICD patients.

Anxiety and marital adjustment in patients with implantable cardioverter defibrillator and their spouses.

Purpose: Device-related fears are a pervasive psychosocial difficulty that patients with implantable cardioverter defibrillators (ICDs) experience. Spouses also encounter anxieties that may influence patient and spouse adjustment. This study examined anxiety and marital adjustment among ICD patients and spouses, as well as intersex differences between female and male patients.

Examination of research trends on patient factors in patients with implantable cardioverter defibrillators.

Background: The implantable cardioverter defibrillator (ICD) is the most effective treatment available for terminating potentially life-threatening ventricular tachycardia and ventricular fibrillation and reducing the risk of mortality. Despite its established health benefits, ICD therapy is accompanied by a unique array of patient and psychological factors meriting ample research attention. The purpose of this paper is to examine research trends and results regarding patient factors in cardiac and ICD research and to discuss key areas for future research.

Using computers to improve the psychosocial care of implantable cardioverter defibrillator recipients.

Person-to-person psychosocial interventions (e.g., psychological, social) enhance the well-being of implantable cardioverter defibrillator (ICD) patients.

Managing congestive heart failure patient factors in the device era.

Device-based care such as implantable cardioverter-defibrillators and cardiac resynchronization therapy extends congestive heart failure (CHF) care into a new era. The purpose of this paper is 2-fold: (1) to review the development of device-based CHF management and the implications from a medical and patient management perspective, and (2) to provide assessment and treatment approaches on how to clinically manage patient outcomes optimally. Quality of life, depression, and anxiety are targeted as concerns for patients with CHF and cardiac resynchronization therapy/implantable cardioverter-defibrillators.

A hospital outbreak of diarrhea due to an emerging epidemic strain of Clostridium difficile.

Background: Increased Clostridium difficile-associated disease (CDAD) in a hospital and an affiliated long-term care facility continued despite infection control measures. We investigated this outbreak to determine risk factors and transmission settings.

Methods: The CDAD cases were compared according to where the disease was likely acquired based on health care exposure and characterization of isolates from case patients, asymptomatic carriers, and the environment.

Internet-based behavioral change and psychosocial care for patients with cardiovascular disease: a review of cardiac disease-specific applications.

Background: Web-based interventions (WBIs) seem to be an efficacious method of addressing behavioral and psychosocial maladjustment among patients with chronic illness (eg, diabetes), behavioral concerns (eg, smoking cessation), and psychologic maladjustment (eg, panic disorder). Cardiology seems particularly well suited to the application of WBIs given its strong association with behavioral (eg, lifestyle) and cognitive (eg, stress and coping) factors. To date, few studies have been published that explore the use of WBIs on psychosocial and quality of life variables among populations with cardiac disease.

The role of the psychologist in adult congenital heart disease.

In addition to monitoring and treating the cardiac disease, patients benefit from health professionals recognizing and managing the potential psychosocial consequences of growing up with congenital heart disease. Working groups from Europe and North America have emphasized the benefit of inclusion of specialized mental health care for adult congenital heart disease (ACHD) patients. This article reviews the evidence that ACHD patients have special and unique psychosocial needs and outlines ways in which psychologists can be integrated into multidisciplinary ACHD care teams.

Device implant technique and consideration of body image: specific procedures for implantable cardioverter defibrillators in female patients.

Objectives: The purpose of this paper is to describe the psychological effects of implantable cardioverter defibrillator (ICD) implantation in female patients and to make clinical recommendations for providers to optimize health outcomes for women.

Background: Traditional ICD implantation produces visible scarring. Changes in physical appearance affect body image in all ICD recipients but may be more onerous in female ICD recipients.

Psychological aspects of cardiac devices and recalls in patients with implantable cardioverter defibrillators.

The product recall of an implantable cardioverter defibrillator (ICD) creates a potentially stressful event for patients. This study briefly describes the psychological adjustment of patients with implantable devices and makes recommendations for the management of device recalls and adverse outcomes to minimize psychological distress. Because the occurrence of ICD-specific fears and symptoms of anxiety are the most common psychological symptoms experienced by ICD recipients, a comprehensive care plan to attend to recall procedures and patient distress is needed.

Comparative study of nanoscale surface structures of calcite microcrystals using FE-SEM, AFM, and TEM.

The bulk morphology and surface features that developed upon precipitation on micrometer-size calcite powders and millimeter-size cleavage fragments were imaged by three different microscopic techniques: field-emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM) of Pt-C replicas, and atomic force microscopy (AFM). Each technique can resolve some nanoscale surface features, but they offer different ranges of magnification and dimensional resolutions. Because sample preparation and imaging is not constrained by crystal orientation, FE-SEM and TEM of Pt-C replicas are best suited to image the overall morphology of microcrystals.

Implantable cardioverter defibrillator implant-explant-implant case study: addressing the psychological adjustment to multiple shocks.

This case study details the multidisciplinary approach to a patient who underwent implantable cardioverter defibrillator (ICD) explantation for psychological reasons. The patient was unable to manage the stress associated with multiple shocks. He had a class I indication for an ICD but initially refused to undergo reimplantation.

Quality of death: implantable cardioverter defibrillators and proactive care.

Objectives: The purpose of this paper is to discuss quality of death (QOD) among patients with congestive heart failure (CHF) and implantable cardioverter defibrillators. We outline recommendations that enhance QOD from the device patient and specialty cardiology perspectives.

Background: Contemporary treatment of CHF patients routinely includes both pharmacologic therapy and the use of cardiac devices.

Measurement of patient fears about implantable cardioverter defibrillator shock: an initial evaluation of the Florida Shock Anxiety Scale.

Background: Psychological distress is both a precipitant and a consequence of ICD shock. Therefore, the assessment of patient anxiety and concerns related to receiving an ICD shock may prompt appropriate psychological referrals and treatment.

Methods: The purpose of this study is to assess the initial validity and clinical utility of the Florida Shock Anxiety Scale (FSAS).

Psychosocial and cultural influences on cardiovascular health and quality of life among Hispanic cardiac patients in South Florida.

This study examined whether psychosocial and cultural factors were related to four dimensions of cardiac-related quality of life (global, physical, emotional, and social functioning) in 120 Hispanic coronary heart disease (CHD) outpatients in south Florida. Survey data were collected on sociodemographic (age, gender, socioeconomic status), psychosocial (depression, social support), and cultural factors (acculturation, familism, fatalism), and quality of life. Medical data on CHD severity (New York Heart Association class, time since diagnosis) were obtained from patients' clinic records.

Clustering of solitons in weakly correlated wavefronts.

We demonstrate theoretically and experimentally the spontaneous clustering of solitons in partially coherent wavefronts during the final stages of pattern formation initiated by modulation instability and noise.