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Background: A reduction in duration of antibiotic therapy is crucial in minimizing the development of antimicrobial resistance, drug-related side effects and health care costs. The minimal effective duration of antimicrobial therapy for febrile urinary tract infections (fUTI) remains a topic of uncertainty, especially in male patients, those of older age or with comorbidities. Biomarkers have the potential to objectively identify the optimal moment for cessation of therapy.Methods: A secondary analysis of a randomized placebo-controlled trial among 35 primary care centers and 7 emergency departments of regional hospitals in the Netherlands. Women and men aged ≥18 years with a diagnosis of fUTI were randomly assigned to receive antibiotic treatment for 7 or 14 days. Patients indicated to receive antimicrobial treatment for more than 14 days were excluded from randomization. The biomarkers procalcitonin (PCT), mid-regional proadrenomedullin (MR-proADM), and C-reactive protein (CRP) were compared in their ability to predict clinical cure or failure through the 10-18 day post-treatment visit.Results: Biomarker concentrations were measured in 249 patients, with a clinical cure rate of 94% in the 165 randomized and 88% in the 84 non-randomized patients. PCT, MR-proADM and CRP concentrations did not differ between patients with clinical cure and treatment failure, and did not predict treatment outcome, irrespective of 7 or 14 day treatment duration (ROCAUC 0.521; 0.515; 0.512, respectively). PCT concentrations at presentation were positively correlated with bacteraemia (τ = 0.33, p < 0.001) and presence of shaking chills (τ = 0.25, p < 0.001), and MR-proADM levels with length of hospital stay (τ = 0.40, p < 0.001), bacteraemia (τ = 0.33, p < 0.001), initial intravenous treatment (τ = 0.22, p < 0.001) and time to defervescence (τ = 0.21, p < 0.001). CRP did not display any correlation to relevant clinical parameters.Conclusions: Although the biomarkers PCT and MR-proADM were correlated to clinical parameters indicating disease severity, they did not predict treatment outcome in patients with community acquired febrile urinary tract infection who were treated for either 7 or 14 days. CRP had no added value in the management of patients with fUTI.Trial Registration: The study was registered at ClinicalTrials.gov [ NCT00809913 ; December 16, 2008] and trialregister.nl [ NTR1583 ; December 19, 2008]. [ABSTRACT FROM AUTHOR]

This observational study investigated digital auscultation for the purpose of assessing the clinical feasibility of monitoring vascular sounds in pregnancy. The study was performed at the Regional Hospital Viborg, Denmark, and included 29 pregnant women, 10 non-pregnant women and 10 male participants. Digital auscultation was performed with an electronic stethoscope bilaterally near the uterine arteries and correlated to the clinical diagnosis of preeclampsia (PE), intrauterine growth restriction (IUGR) or normal pregnancy in the group of pregnant participants. In the group of non-pregnant participants, digital auscultation was performed as control measurements in the same anatomical positions. The auscultations displayed pulse waveforms comprising systolic and diastolic periods in 20 of the 29 pregnant participants. However, in the non-pregnant and male participants, the pulse waveforms were absent. The pulsatile patterns are thus likely to originate from the arteries in relation to the pregnant uterus. In the participants displaying pulse waveforms, the presence of a dicrotic notch appeared with a sensitivity of 89% and a specificity of 100% in the discrimination of normal pregnancies (n  =  11) from pregnancies with PE or IUGR (n  =  9), (p  <  0.001). This preliminary study shows the potential of identifying vascular complications during pregnancy such as preeclampsia and intrauterine growth restriction. The morphology of the derived pulse contour should be investigated and could be further developed to identify pathophysiology. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the correlation between the seismocardiogram and cardiorespiratory fitness. Cardiorespiratory fitness can be estimated as VO2 max using non-exercise algorithms, but the results can be inaccurate. Healthy subjects were recruited for this study. Seismocardiogram and electrocardiogram were recorded at rest. VO2 max was measured during a maximal effort cycle ergometer test. Amplitudes and timing intervals were extracted from the seismocardiogram and used in combination with demographic data in a non-exercise prediction model for VO2 max. 26 subjects were included, 17 females. Mean age: 38.3±9.1 years. The amplitude following the aortic valve closure derived from the seismocardiogram had a significant correlation of 0.80 (p<0.001) to VO2 max. This feature combined with age, sex and BMI in the prediction model, yields a correlation to VO2 max of 0.90 (p<0.001, 95% CI: 0.83–0.94) and a standard error of the estimate of 3.21 mL·kg−1 ·min−1. The seismocardiogram carries information about the cardiorespiratory fitness. When comparing to other non-exercise models the proposed model performs better, even after cross validation. The model is limited when tracking changes in VO2 max. The method could be used in the clinic for a more accurate estimation of VO2 max compared to current non-exercise methods. [ABSTRACT FROM AUTHOR]

The antipsychotic drug thioridazine has potential for treatment of multidrug-resistant microbes including tuberculosis but also causes cardiotoxic QT interval prolongation. Both thioridazine enantiomers have potent antimicrobial effects, but the neuroleptic effect primarily resides with (+)-thioridazine. In this study we for the first time investigate the cardiotoxicity of the isolated thioridazine enantiomers and show their effects on ventricular repolarization. The effects of (+)-thioridazine, (−)-thioridazine, and racemate on the rabbit ventricular action potential duration (APD) were investigated in a randomized controlled blinded experiment. Action potentials were measured in papillary muscles isolated from 21 female rabbits, and the drug effect on 90% APD in comparison with control (ΔΔ-APD 90 ) was evaluated. Increasing concentrations of (+)-thioridazine and the racemate caused significant dose-dependent ΔΔ-APD 90 prolongation, while (−)-thioridazine did not. At 0.5 and 2 Hz pacing, (+)-thioridazine caused 19.5% and 20.1% ΔΔ-APD 90 prolongation, the racemate caused 8.0% and 12.9%, and (−)-thioridazine caused 1.5% and 1.1%. The effect of (−)-thioridazine on APD 90 was significantly less than that of the other drugs at both pacing rates ( P <0.01 in all cases), and there was no significant difference between (−)-thioridazine and control. The results of this study indicate that the APD prolonging effect of thioridazine is primarily due to the (+)-thioridazine enantiomer. If these results are valid in humans, (−)-thioridazine may be a safer drug for treatment of multidrug-resistant tuberculosis and other microbes. [ABSTRACT FROM AUTHOR]

Competing Interests: Disclosures The authors have no conflicts of interest to disclose.

Objectives: Previous studies have observed an increase in low frequency diastolic heart sounds in patients with coronary artery disease (CAD). The aim was to develop and validate a diagnostic, computerized acoustic CAD-score based on heart sounds for the non-invasive detection of CAD., Methods: Prospective study enrolling 463 patients referred for elective coronary angiography. Pre-procedure non-invasive recordings of heart sounds were obtained using a novel acoustic sensor. A CAD-score was defined as the power ratio between the 10-90 Hz frequency spectrum and the 90-300 Hz frequency spectrum of the mid-diastolic heart sound. Quantitative coronary angiography analysis was performed by a blinded core laboratory and patients grouped according to the results: obstructive CAD defined by the presence of at least one ≥ 50% stenosis, non-obstructive CAD as patients with a maximal stenosis in the 25-50% interval and non-CAD as no coronary lesions exceeding 25%. We excluded patients with potential confounders or incomplete data (n = 245). To avoid over-fitting the final cohort of 218 patients was randomly divided into to a training group for development (n = 127) and a validation group (n = 91)., Results: In both the training and the validation group the CAD-score was significantly increased in CAD patients compared to non-CAD patients (p < 0.0001). In the validation group the area under the receiver-operating curve was 77% (95% CI 63-91%). Sensitivity was 71% (95% CI 59-82%) and specificity 64% (95% CI 45-83%)., Conclusion: The acoustic CAD-score is a new, inexpensive, non-invasive method to detect CAD, which may supplement clinical risk stratification and reduce the need for subsequent non-invasive and invasive testing., (© 2022. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Objective. Conduction-induced heart failure in patients with left bundle branch block (LBBB) can benefit from cardiac resynchronization therapy (CRT). However, some patients are non-responders to the therapy with one contributing factor being poor optimization of the atrioventricular (AV) pacing delay. In this study, we have investigated the pacing-induced changes in the seismocardiogram (SCG). Approach. 14 patients with heart failure, LBBB, and CRT were included. SCG was recorded with pacing turned on and off. Based on a mean SCG heartbeat from each patient, fiducial points were annotated, and cardiac timing intervals (CTI) and amplitudes were derived. These were compared between the CRT group and a group of healthy normal subjects ( n = 14). Echocardiography was also used to derive CTI. Intervals derived from the SCG and echocardiogram were correlated. Main results. The isovolumetric contraction time (IVCT) derived from SCG was significantly shorter in the CRT group when the pacemaker was turned on (63.2-52.6 ms, p = 0.027). The first peak-to-peak amplitude in the systolic complex was significantly larger with the pacemaker turned on ( p = 0.002), as well as the ∣max-min∣ amplitude in the systolic complex ( p = 0.003). Isovolumetric relaxation time and left ventricular ejection time (LVET) were not significantly different between pacemaker settings. Compared to normal subjects, IVCT was significantly prolonged with the pacemaker turned off. All amplitudes were significantly larger in the healthy subject group. IVCT and LVET derived from SCG were significantly correlated to the echocardiogram. Significance. IVCT shortened and SCG amplitudes increased in response to CRT, indicating a more efficient ventricular contraction. This demonstrates the possibility to detect cardio-mechanic changes in response to treatment with the SCG. However, for the patients the systolic part of the SCG was abnormal and difficult to characterize, raising concerns about the correct interpretation of the SCG., (© 2022 Institute of Physics and Engineering in Medicine.)

Aims: Current early risk stratification of coronary artery disease (CAD) consists of pre-test probability scoring such as the 2019 ESC guidelines on chronic coronary syndromes (ESC2019), which has low specificity and thus rule-out capacity. A newer clinical risk factor model (risk factor-weighted clinical likelihood, RF-CL) showed significantly improved rule-out capacity over the ESC2019 model. The aim of the current study was to investigate if the addition of acoustic features to the RF-CL model could improve the rule-out potential of the best performing clinical risk factor models., Methods and Results: Four studies with heart sound recordings from 2222 patients were pooled and distributed into two data sets: training and test. From a feature bank of 40 acoustic features, a forward-selection technique was used to select three features that were added to the RF-CL model. Using a cutoff of 5% predicted risk of CAD, the developed acoustic-weighted clinical likelihood (A-CL) model showed significantly ( P < 0.05) higher specificity of 48.6% than the RF-CL model (specificity of 41.5%) and ESC 2019 model (specificity of 6.9%) while having the same sensitivity of 84.9% as the RF-CL model. Area under the curve of the receiver operating characteristic for the three models was 72.5% for ESC2019, 76.7% for RF-CL, and 79.5% for A-CL., Conclusion: The proposed A-CL model offers significantly improved rule-out capacity over the ESC2019 model and showed better overall performance than the RF-CL model. The addition of acoustic features to the RF-CL model was shown to significantly improve early risk stratification of symptomatic patients suspected of having stable CAD., Competing Interests: Conflict of interest: B.S.L. is an industrial PhD student at Acarix A/S and is also a minor shareholder in the company. S.E.S. is a minor shareholder in Acarix A/S and is also employed at the company as a part-time consultant., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Aims: Recent technological advances enable diagnosing of obstructive coronary artery disease (CAD) from heart sound analysis with a high negative predictive value. However, the prognostic impact of this approach remains unknown. To investigate the prognostic value of heart sound analysis as two scores, the Acoustic-score and the CAD-score, in patients with suspected CAD which is treated according to standard of care., Methods and Results: Consecutive patients with angina symptoms referred for coronary computed tomography angiography (CTA) were enrolled. The Acoustic-score was developed from eight acoustic CAD-related features. This score was combined with risk factors to generate the CAD-score. A cut-off score >20 was pre-specified for both scores to indicate disease. If coronary CTA raised suspicion of obstructive CAD, patients were referred to invasive angiography and revascularized when indicated. Of 1675 enrolled patients, 1464 (87.4%) were included in this substudy. The combined primary endpoint was all-cause mortality and myocardial infarction ( n  = 26). Follow-up was 3.1 (2.7-3.4) years. Of patients with primary endpoints, the Acoustic-score was >20 in 25 (96%); the CAD-score was >20 in 22 (85%). In an unadjusted Cox analysis of the primary endpoints, the hazard ratio for scores >20 under current standard clinical care was 12.6 (1.7-93.2) for the Acoustic-score and 5.4 (1.9-15.7) for the CAD-score. The CAD-score contained prognostic information even after adjusting for lipid-lowering therapy initiation, stenosis at CTA, and early revascularization., Conclusion: Heart sound analysis seems to carry prognostic information and may improve initial risk stratification of patients with suspected CAD., Clinicaltrialsorg Id: NCT02264717., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

The purpose of this study was to investigate the correlation between the seismocardiogram and cardiorespiratory fitness. Cardiorespiratory fitness can be estimated as VO 2 max using non-exercise algorithms, but the results can be inaccurate. Healthy subjects were recruited for this study. Seismocardiogram and electrocardiogram were recorded at rest. VO 2 max was measured during a maximal effort cycle ergometer test. Amplitudes and timing intervals were extracted from the seismocardiogram and used in combination with demographic data in a non-exercise prediction model for VO 2 max. 26 subjects were included, 17 females. Mean age: 38.3±9.1 years. The amplitude following the aortic valve closure derived from the seismocardiogram had a significant correlation of 0.80 (p<0.001) to VO 2 max. This feature combined with age, sex and BMI in the prediction model, yields a correlation to VO 2 max of 0.90 (p<0.001, 95% CI: 0.83-0.94) and a standard error of the estimate of 3.21 mL·kg -1 ·min -1  . The seismocardiogram carries information about the cardiorespiratory fitness. When comparing to other non-exercise models the proposed model performs better, even after cross validation. The model is limited when tracking changes in VO 2 max. The method could be used in the clinic for a more accurate estimation of VO 2 max compared to current non-exercise methods., Competing Interests: KS, SES, JJS and PS are shareholders in VentriJect ApS. The company uses a method similar to the one described in this article in a commercial product. The study was not financially supported by VentriJect ApS., (© Georg Thieme Verlag KG Stuttgart · New York.)

Plants manipulate their rhizosphere community in a species and even a plant life stage-dependent manner. In essence plants select, promote and (de)activate directly the local bacterial and fungal community, and indirectly representatives of the next trophic level, protists and nematodes. By doing so, plants enlarge the pool of bioavailable nutrients and maximize local disease suppressiveness within the boundaries set by the nature of the local microbial community. MiSeq sequencing of specific variable regions of the 16S or 18S ribosomal DNA (rDNA) is widely used to map microbial shifts. As current RNA extraction procedures are time-consuming and expensive, the rRNA-based characterization of the active microbial community is taken along less frequently. Recently, we developed a relatively fast and affordable protocol for the simultaneous extraction of rDNA and rRNA from soil. Here, we investigated the long-term impact of three type of soil management, two conventional and an organic regime, on soil biota in fields naturally infested with the Columbian root-knot nematode Meloidogyne chitwoodi with pea ( Pisum sativum ) as the main crop. For all soil samples, large differences were observed between resident (rDNA) and active (rRNA) microbial communities. Among the four organismal group under investigation, the bacterial community was most affected by the main crop, and unweighted and weighted UniFrac analyses (explaining respectively 16.4% and 51.3% of the observed variation) pointed at a quantitative rather than a qualitative shift. LEfSe analyses were employed for each of the four organismal groups to taxonomically pinpoint the effects of soil management. Concentrating on the bacterial community in the pea rhizosphere, organic soil management resulted in a remarkable activation of members of the Burkholderiaceae, Enterobacteriaceae, and Pseudomonadaceae. Prolonged organic soil management was also accompanied by significantly higher densities of bacterivorous nematodes, whereas levels of M. chitwoodi had dropped drastically. Though present and active in the fields under investigation Orbiliaceae, a family harboring numerous nematophagous fungi, was not associated with the M. chitwoodi decline. A closer look revealed that a local accumulation and activation of Pseudomonas, a genus that includes a number of nematode-suppressive species, paralleled the lower M. chitwoodi densities. This study underlines the relevance of taking along both resident and active fractions of multiple organismal groups while mapping the impact of e.g. crops and soil management regimes., (Copyright © 2020 Harkes, van Steenbrugge, van den Elsen, Suleiman, de Haan, Holterman and Helder.)

Background: Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of unrecognised cardiac disease. ECG abnormalities encountered in primary care settings may be warning signs of OHCA., Objective: We examined the association between common ECG abnormalities and OHCA in a primary care setting., Methods: We cross-linked individuals who had an ECG recording between 2001 and 2011 in a primary care setting with the Danish Cardiac Arrest Registry and identified OHCAs of presumed cardiac cause., Results: A total of 326 227 individuals were included and 2667 (0,8%) suffered an OHCA. In Cox regression analyses, adjusted for age and sex, the following ECG findings were strongly associated with OHCA: ST-depression without concomitant atrial fibrillation (HR 2.79; 95% CI 2.45 to 3.18), left bundle branch block (LBBB; HR 3.44; 95% CI 2.85 to 4.14) and non-specific intraventricular block (NSIB; HR 3.15; 95% CI 2.58 to 3.83). Also associated with OHCA were atrial fibrillation (HR 1.89; 95% CI 1.63 to 2.18), Q-wave (HR 1.75; 95% CI 1.57 to 1.95), Cornell and Sokolow-Lyon criteria for left ventricular hypertrophy (HR 1.56; 95% CI 1.33 to 1.82 and HR 1.27; 95% CI 1.12 to 1.45, respectively), ST-elevation (HR 1.40; 95% CI 1.09 to 1.54) and right bundle branch block (HR 1.29; 95% CI 1.09 to 1.54). The association between ST-depression and OHCA diminished with concomitant atrial fibrillation (HR 1.79; 95% CI 1.42 to 2.24, p < 0.01 for interaction). Among patients suffering from OHCA, without a known cardiac disease at the time of the cardiac arrest, 14.2 % had LBBB, NSIB or ST-depression., Conclusions: Several common ECG findings obtained from a primary care setting are associated with OHCA., Competing Interests: Competing interests: SMH is supported by an unrestricted grant from The Danish foundation TrygFonden and the Danish Heart Foundation. KK reports having received grants from the Danish Heart Foundation, The Fund of Herta Christensen and the Laerdal Foundation. FKL reports having an unrestricted research grants from The Danish foundation TrygFonden and the Laerdal Foundation. CT-P reported serving as a consultant for Cardiome, Merck, Sanofi, Daiichi, and Bristol-Myers Squibb and receiving grants or grants pending from Bristol-Myers Squibb. Dr Holst is an employee of Novo Nordisk. JHS reported serving as a consultant for Medtronic, receiving speaker fee from Medtronic, JHS also reported receiving research grants from Medtronic and Gilead. LK reports personal fees from Novartis and Sanofi.

Objectives: Febrile urinary tract infections (fUTI) can often be treated safely with oral antimicrobials in an outpatient setting. However, a minority of patients develop complications that may progress into septic shock. An accurate assessment of disease severity upon emergency department (ED) presentation is therefore crucial in order to guide the most appropriate triage and treatment decisions., Methods: Consecutive patients were enrolled with presumptive fUTI across 7 EDs in the Netherlands. The biomarkers mid-regional proadrenomedullin (MR-proADM), procalcitonin (PCT), C-reactive protein (CRP), and a clinical score (PRACTICE), were compared in their ability to predict a clinically severe course of fUTI, initial hospital admission and subsequent readmission using area under the receiver operating characteristic (AUROC) curves., Results: Biomarker concentrations were measured in 313 patients, with 259 (83%) hospitalized upon ED presentation, and 54 (17%) treated as outpatients. Of these outpatients, 12 (22%) were later hospitalized. MR-proADM had the highest diagnostic accuracy for predicting a complicated fUTI (AUROC [95% CI]: 0.86 [0.79-0.92]), followed by PCT (AUROC [95% CI]: 0.69 [0.58-0.80]). MR-proADM concentrations were unique in being significantly elevated in patients directly admitted and in outpatients requiring subsequent hospitalization, compared to those completing treatment at home. A virtual triage algorithm with an MR-proADM cut-off of 0.80  nmol/L resulted in a hospitalization rate of 66%, with only 2% secondary admissions., Conclusion: MR-proADM could accurately predict a severe course in patients with fUTI, and identify greater patient numbers who could be safely managed as outpatients. An initial assessment on ED presentation may focus resources to patients with highest disease severities., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Because of ambiguous reports in the literature, we aimed to investigate the association between PR interval and the risk of all-cause and cardiovascular death, heart failure, and pacemaker implantation, allowing for a nonlinear relationship., Methods: We included 293,111 individuals, corresponding to one-third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram recorded in a general practitioner's core facility from 2001-2011. Data on drug use, comorbidities, and outcomes were collected from Danish registries. We divided the population into 7 groups based on the population PR interval distribution. Cox models were used, with reference to a PR interval between 152 and 161 ms (40th to < 60th percentile)., Results: During follow-up, we identified 34,783 deaths from all causes, 9867 cardiovascular deaths, 9526 cases of incident heart failure, and 1805 pacemaker implantations. A short PR interval (< 125 ms; hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.08-1.41; P = 0.001) as well as a long PR interval (> 200 ms; HR, 1.23; 95% CI, 1.14-1.32; P < 0.001) was associated with an increased risk of cardiovascular death after multivariable adjustment. A long PR interval conferred an increased risk of heart failure (> 200 ms; HR, 1.31; 95% CI, 1.22-1.42; P < 0.001). An increasing PR interval conferred an increased risk of pacemaker implantation, in a dose-response manner, with the highest risk associated with a PR interval > 200 ms (HR, 3.49; 95% CI, 2.96-4.11; P < 0.001)., Conclusions: PR interval was significantly associated with the risk of the adverse outcomes investigated. The nonlinear relationships, in combination with relatively weak associations, could contribute to previously reported conflicting results on the subject., (Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Optimizing risk assessment may reduce use of advanced diagnostic testing in patients with symptoms suggestive of stable coronary artery disease (CAD). Detection of diastolic murmurs from post-stenotic coronary turbulence with an acoustic sensor placed on the chest wall can serve as an easy, safe, and low-cost supplement to assist in the diagnosis of CAD. The aim of this study was to evaluate the diagnostic accuracy of an acoustic test (CAD-score) to detect CAD and compare it to clinical risk stratification and coronary artery calcium score (CACS). We prospectively enrolled patients with symptoms of CAD referred to either coronary computed tomography or invasive coronary angiography (ICA). All patients were tested with the CAD-score system. Obstructive CAD was defined as more than 50 % diameter stenosis diagnosed by quantitative analysis of the ICA. In total, 255 patients were included and obstructive CAD was diagnosed in 63 patients (28 %). Diagnostic accuracy evaluated by receiver operating characteristic curves was 72 % for the CAD-score, which was similar to the Diamond-Forrester clinical risk stratification score, 79 % (p = 0.12), but lower than CACS, 86 % (p < 0.01). Combining the CAD-score and Diamond-Forrester score, AUC increased to 82 %, which was significantly higher than the standalone CAD-score (p < 0.01) and Diamond-Forrester score (p < 0.05). Addition of the CAD-score to the Diamond-Forrester score increased correct reclassification, categorical net-reclassification index = 0.31 (p < 0.01). This study demonstrates the potential use of an acoustic system to identify CAD. The combination of clinical risk scores and an acoustic test seems to optimize patient selection for diagnostic investigation.

Background: Prolongation of the PR interval has been associated with an increased risk of incident atrial fibrillation (AF)., Objective: To determine if there was a nonlinear relation between PR interval duration and the risk of AF., Methods: We included 288,181 individuals, corresponding to one third of the population in the greater region of Copenhagen. These individuals had a digital electrocardiogram (ECG) recorded in a general practitioner's core facility from 2001 to 2010. Data on drug use, comorbidity, and outcomes were collected from Danish registries., Results: During a median follow-up period of 5.7 years, 11,087 developed AF. Having a PR interval ≥95th percentile (≥196 ms for women, ≥204 ms for men) was associated with an increased risk of AF as evidenced by a multivariable-adjusted hazard ratio (HR) of 1.18 (95% confidence interval [CI] 1.06-1.30, P = .001) for women and 1.30 (1.17-1.44, P < .001) for men compared with the respective reference groups (PR interval between 40th and 60th percentile). Having a short PR interval <5th percentile (≤121 ms for women, ≤129 ms for men) was also associated with an increased risk of AF for women (HR 1.32, 95% CI 1.12-1.56, P = .001), but this was not significant for men (HR 1.09, 95% CI 0.92-1.29, P = .33)., Conclusion: In this large ECG study, we found an increased risk of AF for longer PR intervals for both women and men. With respect to short PR intervals, we also observed an increased risk of AF for women., (Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Renal Artery Stenosis (RAS) is the most common cause of secondary hypertension, and early diagnosis is important since correct and timely treatment may cure hypertension and prevent loss of renal function. This study investigates a new approach to diagnosing renal artery stenosis by computer analysis of the phonogram recorded with an electronic stethoscope. Phonograms recorded from five positions over the renal arteries were obtained, three from patients with confirmed RAS and 15 from healthy subjects. Two features describing the power ratios between the systolic and diastolic periods in two different frequency bands were extracted. It was possible to discriminate all three RAS subjects from the healthy subjects in the frequency band 0.4-1.1 kHz. However, the number of subjects is insufficient to draw statistically significant conclusions about the performance of the system.