Objective: To investigate whether parathyroidectomy (PTx) reverses risk factors for arrhythmias related to the QT dynamic changes evaluated during bicycle ergometry exercise test (ET). Methods: Twenty-four postmenopausal women with primary hyperparathyroidism (PHPT) (mean age 60.0G8.4 years) and 30 sex-and age-matched controls underwent ET, echocardiography, and biochemical evaluation. The following stages were considered during ET: rest, peak exercise, and recovery. The patients were randomized to two groups: 12 underwent PTx (group A) and 12 were followed-up conservatively (group B). After 6 months, the patients were studied again. Results: Groups A and B showed no differences in mean baseline biochemical values, echocardiographic parameters, and QTc interval. PHPT patients showed an increased occurrence of ventricular premature beats (VPBs) during ET compared with controls (37.0 vs 6.6%, PZ0.03). Serum calcium level was a predictor of VPBs (PZ0.05). Mean value of QTc was in the normal range at baseline (group A: 401G16.9; group B: 402.25G13.5 ms) but significantly lower than controls (417.8G25.1 ms, P!0.01). A negative correlation was found between QTc and calcium values (PZ0.03). Physiological reduction of QTc interval from rest to peak exercise was not observed in PHPT patients before surgery. After PTx, group A had a significant reduction in VPBs compared with baseline (at baseline, 5 of 12 vs none of 12 patients after PTx, PZ0.03) and a restored normal QT adaptation during ET. Group B showed no significant changes after a 6-month period. Conclusions: PTx reduces the occurrence of VPBs and restored the QTc adaptation during ET.
The past decade has witnessed an expanded accessibility and popularity of gambling worldwide, and in Italy the phenomenon significantly increased. Nevertheless, little is known about the role of gambling cognitions among Italian individuals, and few scales assessing problem gambling have been validated. The purpose of the present study was to examine and validate the Gambling Related Cognitions Scale-Italian version (GRCS-I), based on the 23-item Gambling Related Cognitions Scale (GRCS). Two-tailed t tests, ANOVA, MANOVA, Pearson's correlation, and multiple regression analyses were used for continuous variables, while χ(2) tests with Yates's correction for categorical variables. Cronbach's α was utilized to determine the internal consistency, and logistic regression analysis and the receiver operating characteristic curve analysis to determine discriminant validity. Principal axis factoring with Oblimin rotation was applied, and then confirmatory factor analysis was used to cross-validate the factor structures. We extracted a five-factor solution that accounted for 60 % of variance. All 23 items had communalities and factor loadings were satisfactory, and the factor structures were similar to the original version of the measure. The Cronbach's α coefficients were adequate, and concurrent and discriminant validities of the GRCS were also confirmed. GRCS-I presented good psychometric properties and it demonstrated good validity and reliability, providing a valid and suitable tool for the assessment of gambling related cognitions among Italian individuals.
Spectral analysis of heart rate sequences is commonly used to investigate neuroauthonomic control of heart rate by means of two indexes, the low and the high frequency power. For tilt test data of normal subjects we compare the spectral indexes with new indexes defined within the framework of symbolic analysis. We define two classes of binary words of length 4: the first class is related to "acceleration" of heart rate and the second class to "stationary behavior." The new indexes measure the change in frequency of the two classes before and after the tilt. Data analysis of 13 normal subjects shows that the behavior of the new indexes is in agreement with that of spectral ones.
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