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Article ; Online: Surgery versus conservative care for Rathke's cleft cyst.

Truong, L U F / Bazin, C / Gomis, P / Decoudier, B / Delemer, B / Litré, C F

2021 Volume 67, Issue 2, Page(s) 104–111

Abstract: Background: Rathke's cleft cysts are benign cystic lesions of the sellar region, which may cause headache, pituitary deficiencies and visual disturbances from mass effect. Their management is not standardized yet. This study is about establishing a ... ...

Abstract	Background: Rathke's cleft cysts are benign cystic lesions of the sellar region, which may cause headache, pituitary deficiencies and visual disturbances from mass effect. Their management is not standardized yet. This study is about establishing a consensus for medical care of RCC. Material and methods: We performed a retrospective observational study of all patients that were diagnosed or followed for RCC between 2008 and 2018 (11 years), in the neurosurgical and the adult endocrine departments of our institution. The study's average time length of follow-up is 72.9 months (from 2 to 385 months). Results: The 57 included patients were divided into 2 groups: group A, which included 39 patients that were conservatively managed and group B, which included 18 surgically treated patients. Group A showed either an improvement or a spontaneous resolution of headaches in 56.1% of the cases (P<0.01); a resolution of hyperprolactinemia in 70% of the cases (P=0.21); and of hypogonadism, ACTH deficiency, growth hormone deficiency in 100% of the cases. There was no spontaneous improvement of visual disturbances (P<0.01) or diabetes insipidus (P=0.29) during follow-up. Regarding group B, surgery allowed improvement or complete resolution of headaches in 60% of the cases; visual troubles in 100% of the cases (P<0.01); and hyperprolactinemia in 100% of the cases. Pituitary deficiencies were not improved by surgery. Conclusions: This study offers guidance in decision-making regarding the management of RCC patients. Surgery is particularly suitable for treating visual disturbances caused by RCC. Regular follow-up is more appropriate than surgery concerning headaches, hyperprolactinemia, endocrine disruptions and diabetes insipidus.
MeSH term(s)	Adolescent ; Adrenal Insufficiency/diagnostic imaging ; Adrenal Insufficiency/surgery ; Adrenal Insufficiency/therapy ; Adult ; Aged ; Central Nervous System Cysts/diagnostic imaging ; Central Nervous System Cysts/surgery ; Central Nervous System Cysts/therapy ; Cohort Studies ; Conservative Treatment/methods ; Diabetes Insipidus/diagnostic imaging ; Diabetes Insipidus/surgery ; Diabetes Insipidus/therapy ; Female ; Follow-Up Studies ; Headache/diagnostic imaging ; Headache/surgery ; Headache/therapy ; Humans ; Hyperprolactinemia/diagnostic imaging ; Hyperprolactinemia/surgery ; Hyperprolactinemia/therapy ; Hypopituitarism/diagnostic imaging ; Hypopituitarism/surgery ; Hypopituitarism/therapy ; Male ; Middle Aged ; Neurosurgical Procedures/methods ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/surgery ; Pituitary Neoplasms/therapy ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2021-01-12
Publishing country	France
Document type	Comparative Study ; Journal Article ; Observational Study
ZDB-ID	207146-0
ISSN	1773-0619 ; 0028-3770 ; 0150-9586
ISSN (online)	1773-0619
ISSN	0028-3770 ; 0150-9586
DOI	10.1016/j.neuchi.2020.12.010
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Article ; Online: Weighted Time Warping Improves T-Wave Morphology Markers Clinical Significance.

Palmieri, Flavio / Gomis, Pedro / Ferreira, Dina / Pueyo, Esther / Martinez, Juan Pablo / Laguna, Pablo / Ramirez, Julia

IEEE transactions on bio-medical engineering

2022 Volume 69, Issue 9, Page(s) 2787–2796

Abstract: Background: T-wave (TW) morphology indices based on time-warping ( d: Methods: The WFs were proportional to (i) the reference TW ( T), and (ii) the absolute value of its derivative ( D). The index d: Results and discussion: The WFs led to a ... ...

Abstract	Background: T-wave (TW) morphology indices based on time-warping ( d Methods: The WFs were proportional to (i) the reference TW ( T), and (ii) the absolute value of its derivative ( D). The index d Results and discussion: The WFs led to a reduced sensitivity ( R) of d Conclusions and significance: The proposed WFs, with T showing the best performance, increased the robustness of time-warping based markers against TW location errors preserving their physiological information content and boosting their SCD risk stratification value. Results from this work support the use of T when deriving d
MeSH term(s)	Arrhythmias, Cardiac ; Biomarkers ; Death, Sudden, Cardiac ; Electrocardiography/methods ; Heart Failure ; Heart Ventricles ; Humans ; Risk Factors
Chemical Substances	Biomarkers
Language	English
Publishing date	2022-08-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	160429-6
ISSN	1558-2531 ; 0018-9294
ISSN (online)	1558-2531
ISSN	0018-9294
DOI	10.1109/TBME.2022.3153791
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Article ; Online: Evaluation of very low amplitude intra-QRS potentials during the initial minutes of acute transmural myocardial ischemia.

Gomis, Pedro / Caminal, Pere

Journal of electrocardiology

2014 Volume 47, Issue 4, Page(s) 512–519

Abstract: Introduction: Low-level electrocardiographic changes from depolarization wavefront may accompany acute myocardial ischemia. The purpose of this study was to assess the changes of microvolt amplitude intra-QRS potentials induced by elective percutaneous ... ...

Abstract	Introduction: Low-level electrocardiographic changes from depolarization wavefront may accompany acute myocardial ischemia. The purpose of this study was to assess the changes of microvolt amplitude intra-QRS potentials induced by elective percutaneous coronary interventions (PCI). Methods: Fifty-seven patients with balloon inflation periods ranging from 3.1 to 7.3 minutes (4.9±0.7 min) were studied. Nine leads continuous high-resolution ECG before and during PCI were recorded and signal-averaged. Abnormal intra-QRS at microvolt level (μAIQP) were obtained using a signal modeling approach. μAIQP, R-wave amplitude and QRS duration were measured in the processed ECG during baseline and PCI episodes. Results: The mean μAIQP amplitude significantly decreased for each of the standard 12 leads at the PCI event respect to baseline. Left anterior descending artery (LAD) occlusion resulted in a decrease μAIQP in both the precordial leads and the limb leads, while right coronary (RCA) and left circumflex (LCx) arteries occlusions mainly affected limb leads. R-wave amplitude increased during PCI in RCA and LCx groups in lead III but decreased in the precordial leads, while the amplitude decreased in the LAD group in lead III. The average duration of the QRS augmented in groups RCA and LCx but not in the LAD group. Conclusions: Abnormal intra-QRS potentials at the level of μV provide an excellent tool to characterize the very-low amplitude fragmentation of the QRS complex and its changes due to ischemic injuries. μAIQP shows promise as a new ECG index to measure electrophysiologic changes associated with acute myocardial ischemia.
MeSH term(s)	Acute Disease ; Angioplasty, Balloon, Coronary ; Diagnosis, Computer-Assisted/methods ; Electrocardiography/methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/surgery ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome
Language	English
Publishing date	2014-07
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	410286-1
ISSN	1532-8430 ; 0022-0736
ISSN (online)	1532-8430
ISSN	0022-0736
DOI	10.1016/j.jelectrocard.2014.04.014
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Article ; Online: Organisational Impact of a Remote Patient Monitoring System for Heart Failure Management: The Experience of 29 Cardiology Departments in France.

Alami, Sarah / Courouve, Laurène / Lancman, Guila / Gomis, Pierrette / Al-Hamoud, Gisele / Laurelli, Corinne / Pasche, Hélène / Chatellier, Gilles / Mercier, Grégoire / Roubille, François / Delval, Cécile / Durand-Zaleski, Isabelle

International journal of environmental research and public health

2023 Volume 20, Issue 5

Abstract: Remote patient monitoring (RPM) for the management of patients with chronic heart failure (CHF) has been widely studied from clinical and health-economic points of view. In contrast, data on the organisational impact of this type of RPM are scarce. The ... ...

Abstract	Remote patient monitoring (RPM) for the management of patients with chronic heart failure (CHF) has been widely studied from clinical and health-economic points of view. In contrast, data on the organisational impact of this type of RPM are scarce. The objective of the present study of cardiology departments (CDs) in France was to describe the organisational impact of the Chronic Care Connect
MeSH term(s)	Humans ; Monitoring, Physiologic/methods ; Emergency Service, Hospital ; Chronic Disease ; France ; Heart Failure ; Cardiology
Language	English
Publishing date	2023-02-28
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20054366
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Book ; Online: Analysis of dysautonomia in patients with Chagas Cardiomyopathy

Vizcardo, Miguel / Ravelo, Antonio / Gomis, Pedro

2019

Abstract: Chagas disease American trypanosomiasis is caused by a flagellated parasite: trypanosoma cruzi, transmitted by an insect of the genus Triatoma and also by blood transfusions. In Latin America the number of infected people is approximately 6 million, with ...

Abstract	Chagas disease American trypanosomiasis is caused by a flagellated parasite: trypanosoma cruzi, transmitted by an insect of the genus Triatoma and also by blood transfusions. In Latin America the number of infected people is approximately 6 million, with a population exposed to the risk of infection of 550000. It is our interest to develop a non-invasive, low-cost methodology, capable of detecting any alteration early on cardiaca produced by T. cruzi. We analyzed the 24 hour RR records in patients with ECG abnormalities (CH2), patients without ECG alterations (CH1) who had positive serological findings for Chagas disease and healthy (Control) matched by sex and age. We found significant differences between the Control, CH1 and CH2 groups that show dysautonomy and enervation of the autonomic nervous system. Comment: 6 pages, 6 figures
Keywords	Quantitative Biology - Quantitative Methods
Publishing date	2019-12-05
Publishing country	us
Document type	Book ; Online
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Article ; Online: Heart rate differences between symptomatic and asymptomatic Brugada syndrome patients at night.

Calvo, M / Le Rolle, V / Romero, D / Béhar, N / Gomis, P / Mabo, P / Hernández, A I

Physiological measurement

2018 Volume 39, Issue 6, Page(s) 65002

Abstract: Objective: Ventricular arrhythmias in Brugada syndrome (BS) mainly occur at rest, especially during nighttime, suggesting that parasympathetic activity at night may play an important role in the arrhythmogenesis of the disease. This study examined and ... ...

Abstract	Objective: Ventricular arrhythmias in Brugada syndrome (BS) mainly occur at rest, especially during nighttime, suggesting that parasympathetic activity at night may play an important role in the arrhythmogenesis of the disease. This study examined and compared the autonomic function of symptomatic and asymptomatic BS patients overnight. Approach: We analyzed various heart rate variability (HRV) and heart rate complexity (HRC) markers in a clinical series including 87 BS patients, where 23 were symptomatic. Main results: Statistically significant differences were found in markers MIRR, SDNN, SDANN, [Formula: see text] and SampEn, suggesting that symptomatic patients may be related to lower heart rate variability and complexity values, as well as to greater circadian fluctuations overnight. Significance: The results provide further evidence for the role of autonomic imbalance in the pathophysiology of BS, highlighting the relevance of nighttime analysis to the unmasking of significant ANS changes. Based on these outcomes, the role of HRV and HRC assessment at night could be a step forward towards the understanding of BS and the risk for the occurrence of symptoms in these patients, with a potential future impact on therapeutic strategies.
MeSH term(s)	Asymptomatic Diseases ; Brugada Syndrome/physiopathology ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Signal-To-Noise Ratio ; Time Factors
Language	English
Publishing date	2018-06-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1149545-5
ISSN	1361-6579 ; 0967-3334
ISSN (online)	1361-6579
ISSN	0967-3334
DOI	10.1088/1361-6579/aac550
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Article ; Online: Nonlinear T-Wave Time Warping-Based Sensing Model for Non-Invasive Personalised Blood Potassium Monitoring in Hemodialysis Patients: A Pilot Study.

Palmieri, Flavio / Gomis, Pedro / Ruiz, José Esteban / Ferreira, Dina / Martín-Yebra, Alba / Pueyo, Esther / Martínez, Juan Pablo / Ramírez, Julia / Laguna, Pablo

Sensors (Basel, Switzerland)

2021 Volume 21, Issue 8

Abstract: Background: End-stage renal disease patients undergoing hemodialysis (ESRD-HD) therapy are highly susceptible to malignant ventricular arrhythmias caused by undetected potassium concentration ([K+]) variations (Δ[K+]) out of normal ranges. Therefore, a ... ...

Abstract	Background: End-stage renal disease patients undergoing hemodialysis (ESRD-HD) therapy are highly susceptible to malignant ventricular arrhythmias caused by undetected potassium concentration ([K+]) variations (Δ[K+]) out of normal ranges. Therefore, a reliable method for continuous, noninvasive monitoring of [K+] is crucial. The morphology of the T-wave in the electrocardiogram (ECG) reflects Δ[K+] and two time-warping-based T-wave morphological parameters, dw and its heart-rate corrected version dw,c, have been shown to reliably track Δ[K+] from the ECG. The aim of this study is to derive polynomial models relating dw and dw,c with Δ[K+], and to test their ability to reliably sense and quantify Δ[K+] values. Methods: 48-hour Holter ECGs and [K+] values from six blood samples were collected from 29 ESRD-HD patients. For every patient, dw and dw,c were computed, and linear, quadratic, and cubic fitting models were derived from them. Then, Spearman's (ρ) and Pearson's ( Results and discussions: Nonlinear models were the most suitable for Δ[K+] estimation, rendering higher Pearson's correlation (median 0.77 ≤r≤ 0.92) and smaller estimation error (median 0.20 ≤ed≤ 0.43) than the linear model (median 0.76 ≤r≤ 0.86 and 0.30 ≤ed≤ 0.40), even if similar Spearman's ρ were found across models (median 0.77 ≤ρ≤ 0.83). Conclusion: Results support the use of nonlinear T-wave-based models as Δ[K+] sensors in ESRD-HD patients.
MeSH term(s)	Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Nonlinear Dynamics ; Pilot Projects ; Potassium ; Renal Dialysis
Chemical Substances	Potassium (RWP5GA015D)
Language	English
Publishing date	2021-04-12
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2052857-7
ISSN	1424-8220 ; 1424-8220
ISSN (online)	1424-8220
ISSN	1424-8220
DOI	10.3390/s21082710
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Article ; Online: Complexity of the autonomic heart rate control in coronary artery occlusion in patients with and without prior myocardial infarction.

Magrans, R / Gomis, P / Caminal, P / Wagner, G S

Medical engineering & physics

2013 Volume 35, Issue 8, Page(s) 1070–1078

Abstract: Autonomic nervous system (ANS) is governed by complex interactions arising from feedback loops of nonlinear systems that operate over a wide range of temporal and spatial scales, enabling the organism to adapt to stress, metabolic changes and diseases. ... ...

Abstract	Autonomic nervous system (ANS) is governed by complex interactions arising from feedback loops of nonlinear systems that operate over a wide range of temporal and spatial scales, enabling the organism to adapt to stress, metabolic changes and diseases. This study is aimed to assess multifractal and nonlinear characteristics of the ANS during ischemic events provoked by a prolonged percutaneous coronary intervention (PCI) procedure. Eighty-seven patients from the STAFF III database were used. Patients were classified into 2 groups: (1) with prior myocardial infarction (MI) and (2) without MI (noMI). R-R signals during three 3-min stages of the procedures were analyzed using multifractal and surrogate data techniques. Multifractal indices increased significantly from the pre-inflation stage to the post-deflation stage. These variations were more marked for the noMI group. Multifractal changes significantly correlated with both the decreased parasympathetic and the increased sympathetic modulations accounted by classical linear indices. Multifractal measures resulted to be a more powerful indicator than linear HRV indices in quantifying the ischemia-induced changes. Right coronary artery (RCA) occlusions provoke greater multifractal reactions throughout the PCI procedure. Our findings suggest reduced complex multifractal and nonlinear reactions of ANS activity in patients with prior MI in comparison to the noMI group, possibly due to degradation in the complexity of control mechanism of heart rate generation.
MeSH term(s)	Aged ; Autonomic Nervous System/physiopathology ; Computer Simulation ; Coronary Stenosis/complications ; Coronary Stenosis/physiopathology ; Coronary Stenosis/surgery ; Feedback, Physiological ; Female ; Fractals ; Heart Rate ; Humans ; Male ; Middle Aged ; Models, Cardiovascular ; Myocardial Infarction/complications ; Myocardial Infarction/physiopathology ; Myocardial Infarction/surgery ; Percutaneous Coronary Intervention
Language	English
Publishing date	2013-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1181080-4
ISSN	1873-4030 ; 1350-4533
ISSN (online)	1873-4030
ISSN	1350-4533
DOI	10.1016/j.medengphy.2012.11.004
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Article ; Online: Multifractal and nonlinear assessment of autonomous nervous system response during transient myocardial ischaemia.

Magrans, R / Gomis, P / Caminal, P / Wagner, G

Physiological measurement

2010 Volume 31, Issue 4, Page(s) 565–580

Abstract: We assess autonomic nervous system response during prolonged percutaneous transluminal coronary angioplasty (PTCA) using heart rate variability analysis with multifractal indices. These indices are used to evaluate the effects of the PTCA procedures at ... ...

Abstract	We assess autonomic nervous system response during prolonged percutaneous transluminal coronary angioplasty (PTCA) using heart rate variability analysis with multifractal indices. These indices are used to evaluate the effects of the PTCA procedures at different arteries and locations. A total of 55 patients from the Staff3 database, with no prior history of myocardial infarction, were included in the study. The indices increased significantly during the transient ischaemia and reperfusion periods, indicating an increase in nonlinear multifractal characteristics and a change in temporal correlations in heartbeat fluctuations. This indicates that significant multifractal and nonlinear complex reactions in the autonomic control of the heart rate occurred during coronary artery occlusions and suggests that the multifractal indices may be a promising nonlinear technique for evaluating autonomic nervous system response in the presence of transient myocardial ischaemia.
MeSH term(s)	Autonomic Nervous System/physiopathology ; Computer Simulation ; Fractals ; Heart/innervation ; Heart/physiopathology ; Heart Rate ; Humans ; Models, Cardiovascular ; Myocardial Ischemia/physiopathology ; Nonlinear Dynamics
Language	English
Publishing date	2010-04
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1149545-5
ISSN	1361-6579 ; 0967-3334
ISSN (online)	1361-6579
ISSN	0967-3334
DOI	10.1088/0967-3334/31/4/008
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Article ; Online: Heart rate complexity analysis in Brugada syndrome during physical stress testing.

Calvo, M / Gomis, P / Romero, D / Le Rolle, V / Béhar, N / Mabo, P / Hernández, A

Physiological measurement

2017 Volume 38, Issue 2, Page(s) 387–396

Abstract: Symptoms such as ventricular arrhythmias in Brugada syndrome (BS) typically occur at rest, especially during sleep, suggesting that the autonomic nervous system (ANS) function may be relevant in the arrhythmogenesis of the disease. The aim of this work ... ...

Abstract	Symptoms such as ventricular arrhythmias in Brugada syndrome (BS) typically occur at rest, especially during sleep, suggesting that the autonomic nervous system (ANS) function may be relevant in the arrhythmogenesis of the disease. The aim of this work was to assess the ANS response captured by nonlinear heart rate variability (HRV) measures in 69 patients diagnosed with BS, who underwent a standardized physical stress test. Heart rate complexity (HRC) was evaluated by the power-law scaling analysis (β slope) during rest, exercise, recovery and rest post-recovery, in order to discriminate between symptomatic and asymptomatic BS patients. Symptomatic patients showed a significant reduction in HRC in comparison to asymptomatic subjects, after exertion (p = 0.015); during the whole recovery period (p = 0.023), and in particular within the passive recovery phase (p = 0.025), as well as during rest post-recovery (p = 0.022). Based on these results, symptoms could be associated with a lower ANS complexity during the stress test stages where parasympathetic activity is predominant. Therefore, the proposed HRV indicators could be of help in the risk stratification of asymptomatic patients.
MeSH term(s)	Adult ; Aged ; Asymptomatic Diseases ; Autonomic Nervous System/physiopathology ; Brugada Syndrome/diagnosis ; Brugada Syndrome/physiopathology ; Exercise Test ; Female ; Heart/physiopathology ; Heart Rate ; Humans ; Male ; Middle Aged ; Signal Processing, Computer-Assisted ; Young Adult
Language	English
Publishing date	2017-01-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1149545-5
ISSN	1361-6579 ; 0967-3334
ISSN (online)	1361-6579
ISSN	0967-3334
DOI	10.1088/1361-6579/aa513c
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