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Episodes Lasting (episode + lasting)
Selected AbstractsPresence and Duration of Atrial Fibrillation Detected by Continuous Monitoring: Crucial Implications for the Risk of Thromboembolic EventsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 3 2009GIOVANNI L. BOTTO M.D. Introduction: Asymptomatic atrial fibrillation (AF) can expose patients to the risk of stroke. The primary objective of this study was to assess the incidence of thromboembolic events in relationship with CHADS2 (congestive heart failure, hypertension, age ,75 years, diabetes mellitus, and prior stroke, or transient ischemic attack) score and AF presence/duration. The secondary objective was to compare intermittent versus continuous monitoring strategies. Methods and Results: Data from patients with an implanted pacemaker and a history of AF were analyzed. Thromboembolic risk was quantified through CHADS2 score. Three AF groups were considered: patients with <5-minutes AF on 1 day (AF-free); patients with >5-minutes AF on 1 day but <24 hours (AF-5 minutes); patients with AF episodes >24 hours (AF-24 hours). Monitoring strategies involving 24-hour Holter, 1-week Holter, and 30-day Holter were simulated. Data from 568 patients continuously monitored for 1 year were analyzed: 171 (30%) had CHADS2 score = 0; 269 (47%) had CHADS2 score = 1; 111 (20%) had CHADS2 score = 2; and 17 (3%) had CHADS2 score , 3. During follow-up, 14 patients (2.5%) had an ischemic thromboembolic event. AF-24 hours patients numbered 223 (39.2%); AF-5 minutes, 179 (31.5%); and AF-free, 29.2%. By combining AF presence/duration with CHADS2 score, two subpopulations with markedly different risks of events (0.8% vs 5%, P = 0.035) were identified, the former corresponding to AF-free with CHADS2,2, or AF-5 minutes with CHADS2,1, or AF-24 hours with CHADS2= 0. The mean sensitivity in detecting an AF episode lasting >5 minutes was 44.4%, 50.4%, and 65.1% for 24-hour Holter, 1-week Holter, and 1-month Holter monitoring, respectively. Conclusion: In patients with recurrent AF episodes, risk stratification for thromboembolic events can be improved by combining CHADS2 score with AF presence/duration. [source] Effects of a combination of napping and bright light pulses on shift workers' sleepiness at the wheel: a pilot studyJOURNAL OF SLEEP RESEARCH, Issue 4 2009DAMIEN LEGER Summary To assess the effects of napping + bright light on shift work drivers sleepiness at the wheel, we performed a pilot study on nine shift workers on three shifts (morning, afternoon, night), driving on a private road circuit. Sleepiness at the wheel was measured by ambulatory polysomnography and assessed using 30-s segments of recordings with a percentage of theta electroencephalogram of at least 50% (15 s) of the period recorded. Sleepiness was also assessed by the Stanford Sleepiness Scale (SSS). Participants drove the same car on two similar 24-h periods of work, with three drivers in each shift (morning, afternoon, night), separated by 3 weeks. During the baseline period, the subjects were told to manage their rest as usual. During the second experimental period, they had to rest lying in a dark room with two naps of 20 min and then exposed to bright light (5000 lux) for 10 min. Subjects showed a significantly decreased sleepiness at the wheel with an average of 10.7 ± 6.7 episodes of theta sleep during the baseline (766 ± 425 s) versus 1.0 ± 1.0 episode lasting 166 ± 96 s during the second period (P = 0.016; P = 0.0109). The percentage of driving asleep was also significantly reduced (3.7% ± 1.9% versus 0.9% ± 0.6%, P = 0.0077). The average SSS score in the group decreased from 2.76 ± 1.27 to 2.28 ± 0.74 (P = 0.09). In this pilot and preliminary study, a combination of napping and bright light pulses was powerful in decreasing sleepiness at the wheel of shift work drivers. [source] Outcome after prolonged convulsive seizures in 186 children: low morbidity, no mortalityDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2004Piia Metsäranta BM Prolonged convulsive seizures are a common neurological emergency and a potential cause of neuronal damage and functional sequelae. We explored the role of seizure duration and various background factors for neurological sequelae in children with prolonged convulsive seizures. The population-base of this study was all children (age < 16 years) who had been admitted to the Tampere University Hospital, Finland between 1993 and 1999 with convulsive seizures lasting more than 5 minutes. Patients were followed up individually (mean length of follow-up 2 years 1 month, range 0 to 7 years 8 months). All available data on the prolonged seizure episodes and clinical follow-up were analyzed retrospectively by a detailed review of all medical charts and records. In 186 children (94 males, 92 females; mean age 4 years 5 months, SD 3 years 10 months, range 1 month to 15 years 4 months) there were 279 separate convulsive seizure episodes lasting over 5 minutes, yielding an annual incidence of 47.5 out of every 100000 episodes. Seizure aetiology was idiopathic in 26.2% of episodes, febrile in 41.9%, remote symptomatic in 28%, and acute symptomatic in 3.9% of episodes. Mean duration of all seizure episodes was 42.5 minutes (SD 46.1 minutes) and was significantly correlated with the aetiology: shortest in the febrile group (mean 35.4 minutes) and longest in the acute symptomatic group (mean 88.6 minutes; p < 0.001). There was no mortality related directly to these acute seizure episodes. The most common sequela was an onset of epilepsy in 40 children (22%). Permanent neurological sequelae were noted in only four patients (2.2%; mean seizure duration 16 minutes) and non-permanent sequelae in six patients (3.2%; mean seizure duration 38 minutes). Neurological sequelae of prolonged convulsive seizures in children are rare and are related to aetiological factors rather than the duration of a single seizure. The role of acute seizures in the evolution of epilepsy in children remains obscure. [source] Multi-annual dry episodes in Australian climatic variabilityINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 12 2009B. G. Hunt Abstract The output from a 10 000-year simulation with the CSIRO Mark 2 coupled global climatic model has been analysed to investigate the occurrence of multi-year dry episodes for three selected regions of Australia, specifically, the northeast, southeast and southwest of the continent. Results are presented for dry episodes lasting for 8 or more years. An episode is defined as a time interval having consecutive negative rainfall anomalies, but not necessarily a major drought, for each year of the episode. The hydrological consequences of such an episode can persist for over a century. Typically about 30 episodes are found over the 10 000 years of the simulation for each of the three regions. There is little synchronicity between the regions in the occurrence of the dry episodes. While there is an El Nino/Southern Oscillation (ENSO) influence associated with these episodes, it is not continuous over the duration of an episode. Composites of sea surface temperature anomalies over an episode highlight the limited presence of ENSO events. The occurrence of the dry episodes for all three regions is essentially random, with multi-centennial periods without an episode, and episodes at multi-decadal frequency at other times. Following a discussion of possible mechanistic influences, it is concluded that stochastic forcing is responsible for the occurrence of dry episodes. This implies that there is no predictability associated with the initiation, duration or termination of individual dry episodes. This also suggests that the 2000,2007 dry episodes occurring over much of Australia may not be caused by the greenhouse effect. Such an episode has a return period of between 200 and 300 years based on the mean frequency of occurrence in the present simulation. Copyright © 2008 Royal Meteorological Society [source] Demographic analysis of dormancy and survival in the terrestrial orchid Cypripedium reginaeJOURNAL OF ECOLOGY, Issue 4 2004MARC KÉRY Summary 1We use capture-recapture models to estimate the fraction of dormant ramets, survival and state transition rates, and to identify factors affecting these rates, for the terrestrial orchid Cypripedium reginae. We studied two populations in West Virginia, USA, for 11 years and investigated relationships between grazing and demography. Abe Run's population was small, with moderate herbivory by deer and relatively constant population size. The population at Big Draft was of medium size, with heavy deer grazing, and a sharply declining number of flowering plants up to the spring before our study started, when the population was fenced. 2We observed dormant episodes lasting from 1 to 4 years. At Abe Run and Big Draft, 32.5% and 7.4% of ramets, respectively, were dormant at least once during the study period for an average of 1.6 and 1.3 years, respectively. We estimated the annual fraction of ramets in the dormant state at 12.3% (95% CI 9.5,15.8%) at Abe Run and at 1.8% (95% CI 1.2,2.6%) at Big Draft. Transition rates between the dormant, vegetative and flowering life-states did not vary between years in either population. Most surviving ramets remained in the same state from one year to the next. Survival rates were constant at Abe Run (0.96, 95% CI 0.93,0.97), but varied between years at Big Draft (0.89,0.99, mean 0.95). 3At Big Draft, we found neither a temporal trend in survival after cessation of grazing, nor relationships between survival and the number of spring frost days or cumulative precipitation during the current or the previous 12 months. However, analysis of precipitation on a 3-month basis revealed a positive relationship between survival and precipitation during the spring (March,May) of the previous year. 4Relationship between climate and the population dynamics of orchids may have to be studied with a fine temporal resolution, and considering possible time lags. Capture-recapture modelling provides a comprehensive and flexible framework for demographic analysis of plants with dormancy. [source] | ||||||||||