Results of this proof-of-concept study revealed that ranolazine improved measures of hemodynamics but that there was no improvement in relaxation parameters. (Ranolazine in Diastolic Heart Failure [RALI-DHF]; NCT01163734).

Pro-ANP plasma levels are independently and inversely related to anxiety. Even in severe CHF with severely compromised quality of life, anxiety tends to decrease with high pro-ANP levels. This might be part of a negative feedback loop limiting psychological distress and its adverse autonomic consequences in severe heart failure.

Although IBP monitoring is considered the 'gold standard', NIBP values showed good agreement with those obtained invasively irrespective of gestational age and birth weight. We conclude that NIBP monitoring constitutes an important parameter in the assessment of the cardiovascular status even in extremely low birth weight infants.

Pustule formation and conidia production of Erysiphe graminis f. sp. tritici were examined on wheat plants (Triticum aestivum) supplied with different amounts of nitrate in hydroponic culture. On first and fifth leaves of the cultivar Nandu inoculated with an incompatible race of powdery mildew, hypersensitive, specific resistance was not modified by nitrogen nutrition. On primary leaves of the compatible cultivar Syros. pustule numbers and conidia production were not altered by nitrogen supply. On fifth leaves of this cultivar. high nitrogen supply to the plants increased pustule numbers and sporulation per unit leaf area, compared lo a low disease intensity at low nitrogen level. Individual hydroxycinnamic acids (HCAs) were determined by HPLC in extracts from wheat plants cultivated at different levels of nitrogen. Ferulic acid, the predominant phenolic acid as well as p‐coumaric acid were detected in primary and fifth leaves in both unbound and bound forms. In primary leaves, nitrogen supply did not modify HCA concentration. Levels of bound and unbound HCAs in fifth leaves decreased greatly when nitrogen supply increased. In response to infection with a compatible race of powdery mildew, levels of bound and unbound HCAs slightly increased in leaves of the cv. Syros grown with low and medium nitrogen supply. Infection of the incompatible cv. Nandu with the same race led lo HCA accumulation, irrespective of nitrogen supply to the wheat plant. In primary and fifth leaves less than 5% of total alkali‐soluble unbound HCAs were unconjugated or present in glycosides. At low nitrogen supply, bound and unbound HCAs are likely involved in quantitative resistance of wheat to powdery mildew. Zusammenfassung Aniälligkeit gegenüber Erysiphe graminis f.sp tritici und Gehalt an Phenolsäuren von Weizen unter dem Einfluß unterschiedlicher Stickstoffdüngung Pustelbildung und Konidienproduktion von Erysiphe graminis f. sp. tritici wurden an Weizenpflanzen (Triticum aestivum) mit unterschiedlicher Nitratversorgung in Hydrokultur überprüft. An den ersten und fünften Blättern der Sorte Nandu wurde nach Inokulation mit einer imkompatiblen Mehltaurasse die hypersensitive, spezifische Resistenz durch die N‐Düngung nicht verändert. Auf Primärblättern der kompatiblen Sorte Syros wurden Pustelzahl und Konidienbildung nicht durch die N‐Versorgung beeinflußt. Auf den fünften Blättern dieser Sorte führten die höheren N‐Stufen zu einer höheren Pustelzahl und Konidienproduktion. verglichen mit einer geringeren Infektionsintensität bei geringer N‐Versorgung. Einzelne Hydroxyzimtsäuren (HCAs) wurden mit Hilfe der HPLC in Extrakten aus Weizenpflanzen. kultiviert bei unterschiedlicher N‐Versorgung. bestimmt. Ferulasäure. die dominierende Phenolsäure. sowie p‐Cumarsäure wurden in den ersten und fünften Blättern sowohl in ungebundener als auch in gebundener Form nachgewiesen. In den Primärblättern beeinflußte die N‐Versorgung die HCA‐Konzentration nicht. In den fünften Blättern wurden ungebundene und gebundene HCAs bei höherer N‐Versorgun...

We conclude that melatonin does not alter the quality of sleep EEG studies in children with epilepsy or suspected epilepsy. Melatonin does not increase the rate of successfully performed EEG studies in sleep-deprived children.

No abstract

IMPORTANCEIntraoperative handovers of anesthesia care are common. Handovers might improve care by reducing physician fatigue, but there is also an inherent risk of losing critical information. Large observational analyses report associations between handover of anesthesia care and adverse events, including higher mortality.OBJECTIVE To determine the effect of handovers of anesthesia care on postoperative morbidity and mortality. DESIGN, SETTING, AND PARTICIPANTSThis was a parallel-group, randomized clinical trial conducted in 12 German centers with patients enrolled between June 2019 and June 2021 (final follow-up, July 31, 2021). Eligible participants had an American Society of Anesthesiologists physical status 3 or 4 and were scheduled for major inpatient surgery expected to last at least 2 hours.INTERVENTIONS A total of 1817 participants were randomized to receive either a complete handover to receive anesthesia care by another clinician (n = 908) or no handover of anesthesia care (n = 909). None of the participating institutions used a standardized handover protocol. MAIN OUTCOMES AND MEASURESThe primary outcome was a 30-day composite of all-cause mortality, hospital readmission, or serious postoperative complications. There were 19 secondary outcomes, including the components of the primary composite, along with intensive care unit and hospital lengths of stay. RESULTS Among 1817 randomized patients, 1772 (98%; mean age, 66 [SD,12] years; 997 men [56%]; and 1717 [97%] with an American Society of Anesthesiologists physical status of 3) completed the trial. The median total duration of anesthesia was 267 minutes (IQR, 206-351 minutes), and the median time from start of anesthesia to first handover was 144 minutes in the handover group (IQR, 105-213 minutes). The composite primary outcome occurred in 268 of 891 patients (30%) in the handover group and in 284 of 881 (33%) in the no handover group (absolute risk difference [RD], −2.5%; 95% CI, −6.8% to 1.9%; odds ratio [OR], 0.89; 95% CI, 0.72 to 1.10; P = .27). Nineteen of 889 patients (2.1%) in the handover group and 30 of 873 (3.4%) in the no handover group experienced all-cause 30-day mortality (absolute RD, −1.3%; 95% CI, −2.8% to 0.2%; OR, 0.61; 95% CI, 0.34 to 1.10; P = .11); 115 of 888 (13%) vs 136 of 872 (16%) were readmitted to the hospital (absolute RD, −2.7%; 95% CI, −5.9% to 0.6%; OR, 0.80; 95% CI, 0.61 to 1.05; P = .12); and 195 of 890 (22%) vs 189 of 874 (22%) experienced serious postoperative complications (absolute RD, 0.3%; 95% CI, −3.6% to 4.1%; odds ratio, 1.02; 95% CI, 0.81 to 1.28; P = .91). None of the 19 prespecified secondary end points differed significantly.CONCLUSIONS AND RELEVANCE Among adults undergoing extended surgical procedures, there was no significant difference between the patients randomized to receive handover of anesthesia care from one clinician to another, compared with the no handover group, in the composite primary outcome of mortality, readmission, or serious postoperative complications within 30 days.

endocardium failed. Mapping of the great cardiac vein performed with an irrigated 3.5-mm ablation catheter (AC) showed the earliest activation in the epicardial area of LVS. A second 4-mm AC, which served as a return catheter (RC), was introduced into LV outflow tract to the area of earliest endocardial PVC activation, and was connected to the modified purpose-made switchbox in order to connect the tip electrode (instead of dispersive patch) to B ipolar radiofrequency catheter ablation (RFCA) is an emerging option for treatment of arrhythmias resistant to standard unipolar attempts. A 43-yearold man was referred for bipolar ablation after 2 previously unsuccessful RFCA for symptomatic premature ventricular complexes (PVC) originating from the left ventricular summit (LVS; Figure A). Previous RFCA from the distal coronary venous system and from the anatomically adjacent IMAGES IN CARDIOVASCULAR MEDICINEAdvance Publication by-J-STAGE