This report describes the case of a woman with Chagas' cardiomyopathy with severe left ventricular dysfunction and persistent left superior vena cava who presented with episodes of syncope without prodromes and who was referred for cardiac resynchronization therapy. Despite this venous anomaly, electrodes were safely positioned in suitable locations. (
Level of Difficulty: Intermediate.
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Figure 3 Atypical atrioventricular nodal reentrant tachycardia alternating atrioventricular and ventriculoatrial block. A: An alternating infra-Hisian and upper common pathway (UCP) block at each every other cycle is shown. B: Green and red arrows represent fast and slow pathway activation, respectively. AVN 5 atrioventricular node; HB 5 His bundle; LCP 5 lower common pathway.
The Portuguese government launched U-Bike, a nationwide program that aims to encourage university students, faculties and staff to switch to cycling, by providing a long-term bicycle rental scheme. This study aims to analyze the potential of adoption of U-Bike based on a cross-sectional online survey applied to a university campus in Lisbon, where the 1406 responses obtained adequately represent students, faculties, and staff. To minimize unrealistic forecasts striving from socially-desirable responses and unfamiliarity with cycling, stated willingness of U-Bike adoption was compared to the estimated likelihood to regularly cycling to campus. The assessment of realistic and unrealistic options is based on revealed mobility habits and housing constraints that are scrutinized and accounted for with a rule-based methodology, informed by the literature, in which respondents are assigned to five qualitative profiles ordered from "not realistic" to "meet all criteria". The stated interest and willingness to adopt U-Bike discloses an optimism bias of nearly 50% of those who fall in the profiles of not realistic and very unlikely options. The results suggest that 10% of the campuscommunity would most likely adopt the program, having interest and being realistic, and another 7% are interested in the program but do not meet all the mobility and housing requirements to commute by bike to campus, still being a very likely option. The results contribute to estimate bike loan fleet sizes through stated preferences surveys and inform decision-makers when planning for bike loan programs in university campuses.
Hypertensive patients have high blood pressure and poor cardiovascular health and it is known that hypertension negatively affects people's health-related quality of life. Meta-analyses have shown that isometric handgrip training (IHT) reduces blood pressure in hypertensives, but the effects of IHT on health-related quality of life is unknown. Therefore, we tested the hypotheses that the IHT improves health-related quality of life in hypertensives. In this randomized controlled trial, 48 hypertensive individuals were randomly assigned to two groups: IHT and control. IHT was completed thrice weekly (4 × 2 min at 30% of maximal voluntary contraction). Before and after 12 weeks health-related quality of life was assessment through Medical Outcomes Study Questionnaire Short Form 36 (SF36). No signi?cant effect was observed for physical function (IHT: 85.6±4.6 vs. 81.1±7.2; Control: 78.6±76.7±4.9), physical problems (IHT: 71.4±10.1vs. 83.9±8.1; Control: 73.8±8.2 vs. 64.3±8.0), general health (IHT: 56.1±3.7 vs. 57.1±1.9; Control: 54.3±1.6 vs. 57.6±2.1), pain (IHT: 23.6±4.6 vs. 30.7±5.8; Control: 32.9±4.5 vs. 31.9±4.3), social aspects (IHT: 46.4±3.6 vs. 50.0±2.3; Control: 48.8±2.7 vs. 48.8±1.7), emotional problems (IHT: 85.7±8.4 vs. 92.9±5.2; Control: 79.4±7.8 vs. 71.4±6.6), mental health (IHT: 61.7±2.8 vs. 58.0±2.5; Control: 54.5±2.4 ± 55.6±1.9), and vitality (IHT: 60.0±4.3 vs. 58.6±4.0; Control: 50.7±2.9 vs. 53.6±3.0) after 12-weeks of supervised IHT (p>0.05 for all). In conclusion, 12-weeks of IHT does not improve health-related quality of life in hypertensives. Therefore, in order to improve quality of life, other exercises should be an indicator for hypertensive patients.
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