3%); dengue with warning signs, 107/181 (59.1%); and severe dengue, 29/181 (15.6%). Of the 150 patients classified as having dengue fever, 105 (70%) were reclassified as having dengue with warning Y-27632 research buy signs or severe dengue.

CONCLUSION: These data demonstrate that the revised classification system has greater discriminatory power for detecting patients at risk of progression to severe disease and those needing hospitalization.”
“The purpose of this study was to measure serum hepatocyte growth factor (HGF) and elucidate the relationship between HGF and protein-losing enteropathy (PLE) after Fontan operation (FO). Ten patients with PLE

(mean age 15.7 +/- A 8.7 years) who underwent FO were enrolled. Control group 1 comprised 20 patients without PLE after FO, and control group 2 comprised 10 patients with nephrotic syndrome (NS). Serum HGF, vascular endothelial growth factor, albumin, and random stool alpha-1 antitrypsin concentration were measured. Transthoracic echocardiography was completed. Serum

HGF level Bafilomycin A1 inhibitor was significantly greater in the PLE patients (0.61 +/- A 0.27 ng/ml) after FO than in the two control groups (0.41 +/- A 0.12 ng/ml [P = 0.024] for the Fontan group without PLE and 0.26 +/- A 0.12 ng/ml [P = 0.002] for the patients with NS). Serum albumin of patients with PLE (2.82 +/- A 0.96 g/dl) showed significantly lower levels compared with those of patients without PLE after FO (4.30 +/- A 0.37 g/dl, P < 0.001) but significantly greater levels compared with patients with NS (1.91 +/- A 0.33 g/dl, P = 0.019). Patients with greater serum HGF levels

showed significant correlation with lower serum albumin level (P = 0.006, r = -0.495). Because serum HGF levels were significantly greater in patients with PLE after FO, HGF may play a role in the development of PLE after FO.”
“Objective: To assess trends in mortality from 1999 to 2008 resulting VX-680 inhibitor from non-traumatic subarachnoid hemorrhage (SAH) in the Colombian population. Method: This population-based study analyzed all deaths by assuming a Poisson model. Results: Subarachnoid hemorrhage-related deaths showed a statistically significant increase of 1.6% per year (p<0.001). The age-standardized analysis demonstrated an increased mortality trend of 3.3% per year (p<0.001) in people older than 70 years, but a decreased mortality trend in people younger than 50. It remained stable in patients 50-69 years old. Conclusion: The overall SAH-related mortality rate in Colombia has increased because increased mortality among the elderly has been counterbalanced by reduced mortality rates in younger age groups. These disparities may reflect epidemiologic transition, treatment inequities, or a less favorable comorbid profile.”
“OBJECTIVES: To determine the awakening arterial blood concentration of desflurane and its relationship with the end-tidal concentration during emergence from various durations of general anesthesia.

The target population was 20-year-old health care workers and the main outcome measure was the incremental cost per QALY gained during

the lifetime, with an annual discount rate of 3%. The three strategies looked at for annual p38 MAP Kinase pathway HCW screening for TB were: a two-step TST followed by a chest X-ray, QFT followed by a chest X-ray, and a QFT-alone strategy. They concluded that the QFT-alone strategy is most cost-effective in BCG-vaccinated HCWs in Japan, and when the probability of having LTBI is over 0.463, the QFT/chest X-ray strategy may be more cost-effective than the QFT-alone strategy at a threshold of US$25 000/QALY gained during the lifetime.”
“Purpose The ergonomic problems for surgeons during spine surgery are an awkward body posture, repetitive movements, increased muscle activity, an overflexed spine, and a protracted time in a standing posture. The authors analyzed whole spine angles during discectomy. The objective of this study is to assess differences in surgeon whole spines angles according to operating table height and the methods used to visualize surgical field.

Materials and methods

A cohort of 12 experienced spine surgeons was enrolled. Twelve experienced spine surgeons performed discectomy using a spine surgery simulator. Three different methods were used to visualize the surgical field (naked eye, loupe, and out of loupe) and three different learn more operating table heights. Whole spine angles were compared for three different PD173074 views during discectomy simulation; midline, ipsilateral, and contralateral. A 16-camera optoelectronic motion analysis system was used, and 16 markers were placed from head to pelvis. Lumbar lordosis, thoracic kyphosis, cervical

lordosis, and occipital angle were compared at the different operating table heights, while using the three visualization methods, with natural standing position.

Results Whole spine angles were significantly different for visualization methods. Lumbar lordosis, cervical lordosis, and occipital angle were closer to natural standing values when discectomy was performed with a loupe, but most measures differed from natural standing values when performed out of loupe. Thoracic kyphosis was also similar to the natural standing position during discectomy using a loupe, but differed from the natural standing position when performed with naked eye. Whole spine angles were also found to differ from the natural standing position according to operating table height, and became closer to natural standing position values as operating table height increased, when simulation was conducted with loupe.

Conclusion This study suggests that loupe use and a table height midpoint between the umbilicus and sternum are optimal for reducing surgeon musculoskeletal fatigue.”
“The tuberculin skin test is associated with exposure to TB, and conversion of a TST is associated with the risk of disease. A consistent number of TB cases occur over the years in persons with positive TSTs.

Resumption of menstruation at 12 months after end of chemotherapy was the primary outcome. Postchemotherapy hormonal and ultrasound changes were secondary outcomes.

RESULTS: Twelve months after termination of chemotherapy, there were no differences in menstruation resumption rates between GnRH-treated patients and control group individuals in either early (80% in arms I and II, risk ratio 1, 95% confidence interval 0.7-.32; P=1.00) or delayed chemotherapy groups (80% and VS-6063 cell line 84% in arms III and IV, risk ratio 0.95, 95% confidence interval 0.73-1.235; P=.71).

There were no differences in hormonal and ultrasound markers between GnRH analogue users and control group individuals. The use of GnRH analogue cotreatment did not predict independently the odds of menstruating at 12 months.

CONCLUSION: GnRH analogue cotreatment does not offer a significant protective effect on ovarian function in patients treated by cyclophosphamide-based chemotherapy.”
“Antimicrobial and hemolytic activity of ethanol extract of brown seaweed Laminaria cichorioides (Miyabe), its lipophilic fractions, various classes of substances of lipophilic fraction, such as chlorophylls, fucoxanthin, monogalactosyldiacylglycerols, digalactosyldiacylglycerols, sulfoquinovosyldiacylglycerols, and fatty buy FK228 acids were investigated. The antimicrobial activity was

studied by means of yeast cells Safale S-04 and Candida albicans KMM 455, fungi Aspergillus niger KMM 4634 and Fusarium oxysporum KMM 4639, Dibutyryl-cAMP bacteria Staphylococcus aureus ATCC 21027 (gram-positive) and Escherichia coli ATCC 15034 (gram-negative) which demonstrated selective sensitivity to the studied substances. Hemolytic activity was investigated at

concentrations of substances in the range of 0.2-200 mu g/ml at different pH of erythrocyte suspension. All investigated substances caused hemolysis. The dependence of hemolytic activity of substances on pH of media was determined.”
“OBJECTIVE: To evaluate the learning curve of robotic hysterectomy using objective, patient-centered outcomes and analytic methods proposed in the literature.

METHODS: All cases of robotic hysterectomy performed at Mayo Clinic, Rochester, Minnesota, from January 1, 2007, through December 31, 2009, were collected. Experience was analyzed in 6-month periods. Operative time, complications, and length of stay longer than 1 day were compared between periods for significant change. For learning curve analysis, standard and risk-adjusted cumulative summation charting was used for the two most experienced robotic surgeons (A and B). Outcomes of interest were intraoperative complications and intraoperative or postoperative complications within 6 weeks. Proficiency was defined as the point at which each surgeon’s curve crossed H-0 based on complication rates of abdominal hysterectomy. Cumulative summation parameters were p(0)=5.7% and p(1)=11.4% for outcome 1 and p(0)=36.0% and p(1)=550% for outcome 2.

Atrial surface geometry was identified and myofiber orientations were estimated throughout by eigen-analysis of the 3-D image structure tensor. Sinus node, crista terminalis, pectinate muscle, Bachman’s bundle, and pulmonary veins were segmented on the basis of anatomic characteristics. Heterogeneous electrical properties were assigned to this structure and electrical activation was simulated on it at 100 mu m(3) resolution, selleckchem using both biophysically-detailed and reduced-order cell activation models with spatially-varying membrane kinetics. We

confirmed that the model reproduced key features of the normal spread of atrial activation. Furthermore, we demonstrate that vulnerability to rhythm disturbance caused by structural heterogeneity in the posterior left atrium is exacerbated by spatial variation of repolarization kinetics across this region. These results provide insight into mechanisms that may sustain paroxysmal atrial fibrillation. We conclude that image-based computer models that incorporate realistic descriptions of atrial myofiber architecture and electrophysiologic properties have the potential to analyse and identify complex substrates for atrial fibrillation.”
“Over 20 years ago the term non-specific

low back pain became popular to convey the limitations of our knowledge of the pathological source of most people’s low back pain. Knowledge of underlying pathology has advanced little since then, despite limited improvements in outcomes for patients with low back pain.

This paper discusses potential misunderstandings related to diagnostic studies in Apoptosis inhibitor check details the field of low back pain and argues that future diagnostic studies should include and investigate pathological sources of low back pain.

Six potential misunderstandings are discussed. (1) Until diagnosis is shown

to improve outcomes it is not worth investigating; (2) without a gold standard it is not possible to investigate diagnosis of low back pain; (3) the presence of pathology in some people without low back pain means it is not important; (4) dismissal of the ability to diagnose low back pain in clinical guidelines is supported by the same level of evidence as recommendations for therapy; (5) suggesting use of a diagnostic test in research is misinterpreted as endorsing its use in current clinical practice; (6) we seem to have forgotten the ‘bio’ in biopsychosocial low back pain.

We believe the misunderstandings presented in this paper partly explain the lack of investigation into pathology as an important component of the low back pain experience. A better understanding of the biological component of low back pain in relation, and in addition, to psychosocial factors is important for a more rational approach to management of low back pain.”
“Aortic valve reconstruction with fixed pericardium may occasionally be very useful when treating children with aortic valve disease.

26, 95% CI 0.10.68). More pimecrolimus 1%-treated patients withdrew from the trials because of adverse events, compared with tacrolimus 0.03%-treated patients, regardless of age (RR 0.1, 95% CI 0.020.53). In conclusion, tacrolimus ointment has higher efficacy and better tolerance than pimecrolimus cream in treatment of AD.”
“Robotic technology has recently emerged in different surgical specialties, but the experience with robotic sleeve gastrectomy (RSG) is

scarce in the literature. The purpose of this study is to compare our preliminary experience with RSG versus the descriptive results of a systematic review of the laparoscopic approach.

Data from our RSG experience FK506 were retrospectively collected. Two surgeons performed all the cases in one single surgery center. Such information was compared with a systematic review of 22 selected studies that included 3,148 laparoscopic sleeve gastrectomy (LSG) cases. RSG were performed using the daVinciA (R) Surgical System.

This study included 134 RSG vs 3,148 LSG. Mean age and mean BMI was 43 +/- 12.6 vs 40.7 +/- 11.6 (p = 0.022), and 45 +/- 7.1 vs 43.6 +/-

8.1 (p = 0.043), respectively. Leaks were found in 0 RSG vs 1.97 % LSG (p = 0.101); strictures in 0 vs 0.43 % (p = 0.447); bleeding in 0.7 vs 1.21 % (p = 0.594); and mortality in 0 vs 0.1 % (p = 0.714), respectively. Mean surgical time was calculated in 106.6 +/- 48.8 vs 94.5 +/- 39.9 min (p = 0.006); and mean hospital length of stay was 2.2 +/- 0.6 vs 3.3 +/- 1.7 days (p = < 0.005), respectively. Four (2.9 %) complications were found in our robotic Selleckchem HDAC inhibitor series.

Our series shows that RSG is a safe alternative when used in bariatric surgery, showing similar results as the laparoscopic approach. Surgical time

is longer in the robotic approach, while hospital length of stay is lower. No leaks or strictures were found in the robotic cases. However, further studies with larger sample size and randomization are warranted.”
“Laparoscopic Roux-en-Y gastric bypass is one of the most commonly performed bariatric operation worldwide for the surgical management of obesity. Totally robotic Roux-en-Y gastric bypass (TR-RYGBP) has been considered to be a better approach S3I-201 mouse by some groups especially early in a surgeon’s experience. However, the learning curve associated with TR-RYGBP has been poorly evaluated yet. The aim of this study was to evaluate the learning curve of patients who underwent TR-RYGBP.

This is a prospective study of 154 first consecutive patients undergoing TR-RYGBP to analyze the influence of surgeon experience, bedside first assistant, and patient factors on operative time and postoperative complications. To give a comprehensive view of success related to the learning process, a single hybrid variable was generated. Multivariate analysis predicted the risk factors for complications and operative time. A risk-adjusted cumulative sum analysis estimated the learning curve.

DESIGN: Comparative case series.

METHODS: This prospective Protein Tyrosine Kinase inhibitor randomized double-masked study comprised patients scheduled for phacoemulsification cataract surgery. At the beginning of the procedure, patients

received an intracameral injection of 0.15 mL of phenylephrine 0.15, 0.5, 1.5, 5.0, 15.0, or 30.0 mg/mL. To assess the mydriatic response, the pupil size was registered over 60 seconds using digital video recording. Then, the surgery was performed in the standard manner.

RESULTS: The study evaluated 42 patients. The mydriatic response was almost identical at the 4 lower phenylephrine concentrations (0.15 to 5.00 mg/mL; 0.015% to 0.500%), with final pupil sizes of approximately 4.3 mm. The 2 higher concentrations

gave significantly larger pupils as follows: mean 5.80 mm +/- 0.79 (SD) for 15.0 mg/mL (1.5%) and 6.65 mm +/- 0.57 for 30.0 mg/mL (3.0%).

CONCLUSIONS: Results show that phenylephrine injected intracamerally does not have a linear mydriatic dose-response relationship PF-04929113 manufacturer in humans. At very high concentrations, phenylephrine may bind to and stimulate receptors other than the alpha(1)-receptor, explaining this phenomenon.”
“Background: The prevalence of drug resistance amongst the human malaria Plasmodium species has most commonly been associated with genomic mutation within the parasites. This phenomenon necessitates evolutionary predictive studies of possible resistance mutations, which may occur when a new drug is introduced. Therefore, identification of possible new Plasmodium falciparum dihydrofolate reductase (PfDHFR) mutants that confer resistance to antifolate drugs is essential in the process of antifolate anti-malarial drug development.

Methods: A system to identify mutations in Pfdhfr gene that confer

antifolate drug resistance using an animal Plasmodium parasite model was developed. By using error-prone PCR and Plasmodium transfection technologies, libraries of Pfdhfr mutant were generated and then episomally transfected to Plasmodium berghei parasites, from which pyrimethamine-resistant Cl-amidine inhibitor PfDHFR mutants were selected.

Results: The principal mutation found from this experiment was S108N, coincident with the first pyrimethamine-resistance mutation isolated from the field. A transgenic P. berghei, in which endogenous Pbdhfr allele was replaced with the mutant Pfdhfr(S108N), was generated and confirmed to have normal growth rate comparing to parental non-transgenic parasite and also confer resistance to pyrimethamine.

Conclusion: This study demonstrated the power of the transgenic P. berghei system to predict drug-resistant Pfdhfr mutations in an in vivo parasite/host setting. The system could be utilized for identification of possible novel drug-resistant mutants that could arise against new antifolate compounds and for prediction the evolution of resistance mutations.

Escherichia coli, Trueperella pyogenes (Arcanobacterium pyogenes), Fusobacterium necrophorum and Prevotella melaninogenicus are recognized as major pathogens associated with uterine endometrial lesions. The objective of this study was to identify these pathogens using the polymerase chain reaction (PCR) as a culture-independent sensitive method. A total of 172 cows were examined 25-35days post-partum,

and 128 cows were examined at 2weeks later (39-49days post-partum). Uterine discharges were collected by covered plastic infusion pipettes. The prevalence of endometritis was greater in the first examination than the second (35.5% vs. 16%). E.coli was detected in eight of the samples, T.pyogenes was detected in 13 of the samples and F.necrophorum was detected in 11 of the samples. There was no positive sample of P.melaninogenicus. LY2835219 mw Uterine contamination by T.pyogenes

and F.necrophorum in the first examination was higher than the second examination. T.pyogenes affected as a tendency the prevalence of clinical endometritis in first examination. Primiparous cows showed 4.02 times higher odds of clinical endometritis compared with second-parity cows in first examination. A multiplex PCR protocol as a simple, less expensive, fast assay was introduced to identify E.coli, T.pyogenes and F.necrophorum.”
“Contents Follicular wave emergence was synchronized by treating camels with GnRH when a dominant follicle (DF) was present in the ovaries. Animals were scanned twice a day from day 0 (day of GnRH treatment) to day 10, to characterize CA3 cell line emergence and deviation of follicles during the development of the follicular wave. Follicle deviation in individual animals was determined by graphical method. Single DFs were found in 16, double click here DFs in 9 and triple DFs in two

camels. The incidence of codominant (double and triple DFs) follicles was 41%. The interval from GnRH treatment to wave emergence, wave emergence to deviation, diameter and growth rate of F1 follicle before or after deviation did not differ between the animals with single and double DFs. The size difference between future DF(s) and the largest subordinate follicle (SF) was apparent from the day of wave emergence in single and double DFs. Overall, interval from GnRH treatment to wave emergence and wave emergence to the beginning of follicle deviation was 70.6 +/- 1.4 and 58.6 +/- 2.7h, respectively. Mean size of the DF and largest SF at the beginning of deviation was 7.4 +/- 0.2 and 6.3 +/- 0.1mm, respectively. In conclusion, the characteristics of follicle deviation are similar between the animals that developed single or double DFs.”
“Objectives. We aimed to quantify children’s levels of pain and fear during needle puncture procedures in a context where intravenous sedation-analgesia seems to be effective for pain and anxiety relief.

(C) 2010 Elsevier Inc. All rights reserved.”
“The need to develop treatments and/or programs specific to a disease requires the analysis of outcomes to be specific to that disease. Such endpoints as heart failure, death due to a specific disease, or control of local disease in cancer may become impossible to observe due to a prior occurrence of a different type of event ( such as death from another cause). The event which hinders or changes the possibility of observing the event of interest is called a JNK-IN-8 competing risk.

The usual techniques for time-to-event analysis applied in the presence of competing risks give biased or uninterpretable results.

The estimation of the probability of the event therefore needs to be calculated using specific techniques such as the cumulative incidence function introduced by Kalbfleisch and Prentice. The model introduced by Fine and Gray can be applied to test a covariate when competing risks are present. Using

specific techniques for the analysis of competing risks will ensure that the results are unbiased and can be correctly interpreted. (C) 2011 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S. L. All rights reserved.”
“Twenty-one isolates of Rhizoctonia solani Tariquidar Transmembrane Transporters inhibitor were categorized into three anastomosis groups consisting of AG-4-HG-I (eight isolates), AG-2-2 (nine isolates) and AG-5 (four isolates). Their pathogenic capacities were tested on cotton cultivar Giza 86. Pre-emergence damping-off varied in response to the different isolates; however, the differences were not significant. Soluble proteins of the fungal isolates were electrophoresed using SDS-PAGE and gel electrophoreses. A dendrogram of the protein banding patterns by the UPGMA of arithmetic means placed the fungal isolates into distinct groups. There was no evidence of a relationship between learn more protein dendrogram, anastomosis grouping or level of virulence or geographic origin. The dendrogram

generated from these isolates based on PCR analysis with five RAPD-PCR primers showed high levels of genetic similarity among the isolates from the same geographical locations. There was partially relationship between the genetic similarity and AGs or level of virulence or geographic origin based on RAPD dendrogram. These results demonstrate that RAPD technique is a useful tool in determining the genetic characterization among isolates of R. solani.”
“The fundamental relationship between blood disorders and the cardiovascular system originates within multiple points of interface, ranging from the heart and its structural constituents to include heart chambers, valves, coronary arteries, coronary veins, and the cerebrovascular and peripheral vasculature.

A significant pain reduction was achieved in 59.4%. Significantly, after a double-level operation, more patients suffered persisting neck pain (P = 0.002) high throughput screening compounds compared with all patients being operated.

Conclusions.

Zygapophysial joints are a possible source of postoperative pain after anterior cervical spine surgery. Persistent and therapy-resistant neck pain occurs more often in patients after double-level operation. Radiofrequency neurotomy can provide an effective treatment for persistent neck pain after ventral cervical spine surgery.”
“Unna and Miescher nevi show

very different morphologic features. The main difference is that melanocytes involve mainly the papillary dermis in Unna nevi, whereas they widely penetrate the reticular dermis in Miescher nevi. The reason for this behavior is not totally understood, but anatomical location might play a role, since because Unna nevi are mainly found on the trunk, whereas Miescher nevi are mainly found on the face. We decided to test this hypothesis in relative easy way: dermis from the frontal, temporal, maxillary, and mandibullary regions derives

from the neural crest, whereas the dermis of the parietal/occipital regions originates from the paraxial mesoderm (somites and somitomeres). Therefore, we studied the morphology of 137 acquired melanocytic GSK621 datasheet nevi from the head and neck and classified their locations in 7 areas: occipital, temporal, parietal, frontal, face, high neck, and low neck. From such areas, we distinguished 4 groups: area A (parietal + occipital + low neck); area B (face + temporal + frontal

+ high neck); area 1 (parietal and occipital); and area 2 (temporal and frontal). In region A, 97.30% of the nevi were of Unna type. In region B, 89.00% were of Miescher AZD6244 type. Region A had 76.60% of Unna type nevi, whereas region B had 98.89% of Miescher nevi. In area 1, 100% of the nevi were of Miescher type. In area 2, 86.67% of the nevi were of Unna type. Region 1 had 86.67% of the cranial Unna nevi, whereas region 2 had 100% of the cranial Miescher nevi. Moreover, 90.9% of the nevi from the low neck were of Unna type. In the high neck, 20% of nevi were of Unna type. Finally, 90.90% of Unna nevi were in the low neck, whereas 80% of Miescher nevi were in the high neck. We concluded that these findings supported the hypothesis that the embryologic differences of these areas of head and neck might play a role in the morphology of Unna and Miescher nevi.”
“Background.

Lumbar spinal stenosis is a common condition that causes axial low back pain, radicular pain, and neurogenic claudication. Epidural steroid injections are commonly used for the treatment of radicular symptoms and neurogenic claudication associated with symptomatic lumbar spinal stenosis. No prior study has evaluated whether transforaminal or interlaminar epidural steroid injections produce better clinical outcomes.

Design.

Retrospective case control study.

Methods.

[doi:10.1063/1.3563571]“
“Background: Best practice for cardiac resynchronization therapy (CRT) device optimization is not established. This study compared Tissue Doppler Imaging (TDI) to study left ventricular (LV) synchrony and left ventricular outflow tract

velocity-time integral (LVOT VTI) to assess hemodynamic performance.

Methods: LVOT VTI and LV synchrony were tested in 50 patients at three interventricular (VV) delays (LV preactivation at -30 ms, simultaneous biventricular pacing, and right ventricular selleck screening library preactivation at +30 ms), selecting the highest VTI and the greatest degree of superposition of the displacement curves, respectively, as the optimum VV delay.

Results: In 39 patients (81%), both techniques agreed (Kappa = 0.65, p < 0.0001) on the optimum VV delay. LV preactivation (VV – 30) was the interval most frequently chosen.

Conclusions: Both TDI and LVOT VTI are useful CRT programming methods for VV optimization. The best hemodynamic response correlates with the best synchrony. In most patients, the optimum check details VV interval is LV preactivation. (PACE 2011;34:984-990)”
“6,13 Pentacenequinone (PQ) ultrathin films (3 and 5 nm nominal thickness) have been grown by means of ultrahigh vacuum deposition onto 100 nm thick SiO2/Si(100). The structure and morphology of the thin films have been

studied with field emission-scanning electron microscopy, tapping mode atomic force microscopy, and x-ray diffraction. The growth begins with PQ molecules standing almost upright (with respect to the substrate) and selleck kinase inhibitor aggregating into two-dimensional 3.62 nm thick pseudodendritic islands. The islands are characterized by two preferential growth directions (at 117 degrees), a clear evidence of a chiral growth. The thickness of the islands and the angle formed by the two directions of preferential

growth, allow a straightforward assignment to a PQ initial growth in the “”bulk”" phase. Above the critical thickness of 3.62 nm the PQ growth proceeds in a Stranski-Krastanov mode, with the formation of “”bulk”" and “”thin-film”" phase crystallites. (C) 2011 American Institute of Physics. [doi:10.1063/1.3549833]“
“Introduction: Depression predicts mortality in patients with coronary artery disease and heart failure. However, its effect on patient outcome in the presence of an implantable cardioverter defibrillator (ICD) has not been investigated.

Methods: A total of 236 ICD patients (76 females, 58.6 +/- 14.0 years) were screened for depressive symptoms using the Hospital Anxiety and Depression Scale (HADS). The outcome measure was all-cause mortality and the prognostic effect of depression was evaluated with Cox proportional hazards regression analysis.

Results: Fifty (21%) patients reported depressive symptoms (HADS score >= 8). Renal failure (odds ratio [OR] = 4.0, 95% confidence intervals [CI] = 1.47-10.87, P = 0.007), prior angina (OR = 2.1, 95% CI = 1.07-4.12, P = 0.