Prevalence and determinants of electrocardiographic abnormalities in sub-Saharan African individuals with type 2 diabetes.

AIM: This study assessed the prevalence and determinants of electrocardiographic abnormalities in a group of type 2 diabetes patients recruited from two referral centres in Cameroon. METHODS: A total of 420 patients (49% men) receiving chronic diabetes care at the Douala General and Yaoundé Central hospitals were included. Electrocardiographic abnormalities were investigated, identified and related to potential determinants, with logistic regressions. RESULTS: The mean age and median duration of diagnosis were 56.7 years and four years, respectively. The main electrocardiographic aberrations (prevalence %) were: T-wave abnormalities (20.9%), Cornell product left ventricular hypertrophy (16.4%), arrhythmia (16.2%), ischaemic heart disease (13.6%), conduction defects (11.9%), QTc prolongation (10.2%) and ectopic beats (4.8%). Blood pressure variables were consistently associated with all electrocardiographic abnormalities. Diabetes-specific factors were associated with some abnormalities only. CONCLUSIONS: Electrocardiographic aberrations in this population were dominated by repolarisation, conduction defects and left ventricular hypertrophy, and were more related to blood pressure than diabetes-specific factors.

Electrophysiological evidence for biased competition in V1 for fear expressions.

When multiple stimuli are concurrently displayed in the visual field, they must compete for neural representation at the processing expense of their contemporaries. This biased competition is thought to begin as early as primary visual cortex, and can be driven by salient low-level stimulus features. Stimuli important for an organism's survival, such as facial expressions signaling environmental threat, might be similarly prioritized at this early stage of visual processing. In the present study, we used ERP recordings from striate cortex to examine whether fear expressions can bias the competition for neural representation at the earliest stage of retinotopic visuo-cortical processing when in direct competition with concurrently presented visual information of neutral valence. We found that within 50 msec after stimulus onset, information processing in primary visual cortex is biased in favor of perceptual representations of fear at the expense of competing visual information (Experiment 1). Additional experiments confirmed that the facial display's emotional content rather than low-level features is responsible for this prioritization in V1 (Experiment 2), and that this competition is reliant on a face's upright canonical orientation (Experiment 3). These results suggest that complex stimuli important for an organism's survival can indeed be prioritized at the earliest stage of cortical processing at the expense of competing information, with competition possibly beginning before encoding in V1.

Motivationally significant stimuli show visual prior entry: evidence for attentional capture.

Previous studies that have found attentional capture effects for stimuli of motivational significance do not directly measure initial attentional deployment, leaving it unclear to what extent these items produce attentional capture. Visual prior entry, as measured by temporal order judgments (TOJs), rests on the premise that allocated attention accelerates perception, that is, stimuli that receive attention first are perceived first; thus, this method is a sensitive and direct measure of the time course of initial attentional deployment. The authors demonstrate, using a novel TOJ paradigm without cues, that displays of faces and facial threat show visual prior entry effects, that is, these stimuli are prioritized by the perceptual-attentional system over other stimuli competing for awareness. This study provides direct evidence of the extent to which motivationally significant stimuli capture attention over other concurrently displayed items in the visual array.

Outcome and prognostic factors of lung cancer patients admitted to the medical intensive care unit.

The aim of the present study was to assess the outcome of lung cancer patients who were admitted to a medical intensive care unit (MICU) and to identify the measurable predictors of their MICU outcome. The retrospective study took place at the MICUs of a university-affiliated medical centre and involved adult lung cancer patients admitted to the MICU between January 1998 and October 2005. A total of 139 lung cancer patients were included during the study period. The mean age+/-sd at MICU admission was 64.2+/-10.2 yrs (48% males, 52% females). In total, 96 (69%) patients had nonsmall cell lung cancer, 18 (13%) patients had small cell lung cancer, and one patient had mesothelioma. The MICU mortality was 22% (31 patients), while the in-hospital mortality was 40% (56 patients). Sixty-eight (49%) patients required mechanical ventilation (MV), with MICU mortality of 38% and in-hospital mortality of 53%. The independent predictors of poor MICU outcome were: the need for MV; Acute Physiology And Chronic Health Evaluation III and Simplified Acute Physiology Score III scores; the use of vasopressors; positive blood cultures; high serum lactate; two or more organ system failures; and the need for adult cardiac life support. On multivariate analysis, only the need for vasopressors and the presence of two or more organ system failures predicted poor MICU outcome. The present study shows that the medical intensive care unit outcome of lung cancer patients is better than previously reported. Intensive care and mechanical ventilation should not be considered futile care in this patient population. While there were no absolute predictors of mortality, the need for vasopressors and the presence of two or more organ system failures predicted poor medical intensive care unit care.