Statin Use in the Early Phase of ST-Segment Elevation Myocardial Infarction Is Associated With Decreased QTc Dispersion.

BACKGROUND: Although there is strong evidence supporting the use of statin therapy after myocardial infarction (MI), some mechanistic gaps exist regarding the benefits of this therapy at the very onset of MI. Among the potential beneficial mechanisms, statins may improve myocardial electrical stability and reduce life-threatening ventricular arrhythmia, as reported in stable clinical conditions. This study was designed to evaluate whether this mechanism could also occur during the acute phase of MI. METHODS: Consecutive patients with ST-segment elevation MI were treated without statin (n = 57) or with a simvastatin dose of 20 to 80 mg (n = 87) within the first 24 hours after MI symptom onset. Patients underwent digital electrocardiography within the first 24 hours and at the third and fifth days after MI. The QTC dispersion (QTcD) was measured both with and without the U waves. RESULTS: Although QTcD values were equivalent between the groups at the first day (80.6 ± 36.0 vs 80.0 ± 32.1; P = 0.36), they were shorter among individuals using simvastatin than in those receiving no statins on the third (90.4 ± 38.6 vs 86.5 ± 36.9; P = .036) and fifth days (73.1 ± 31 vs 69.2 ± 32.6; P = .049). We obtained similar results when analyzing the QTcD duration including the U wave. All values were adjusted by an ANCOVA model after propensity-score matching. CONCLUSIONS: Statins administered within 24 hours of ST-segment elevation MI reduced QTc dispersion, which may potentially attenuate the substrate for life-threatening ventricular arrhythmias.

Predictors of affective responses of mothers and fathers of children with cancer.

We investigated predictors of affective responses for 125 parents (77 mothers, 48 fathers) of children with various types of cancer who varied in time of diagnosis from newly diagnosed to 13 years following cancer treatment. The primary rationale of the investigation was to determine whether cognitive appraisals, perceived social supports, and caregivers' perceptions of children's behavior would predict affective responses differentially for mothers and fathers. We defined affectivity as self-reported depressive symptoms, and state and trait anxiety symptoms. Parents did not differ on any of the variables, including affective responses, although differential predictors of affective responses were revealed for mothers and fathers. Affiliation-related attributions were associated with affective responses for mothers, and achievement-related attributions and perceived social support were associated with affective responses for fathers.

Attributions, coping, and adjustment in children with cancer.

Assessed the influence of children's attribution style, coping style, social competence, parent coping, and demographic variables on the psychosocial adjustment of 86 pediatric oncology patients. Utilizing hierarchical multiple regression procedures, nearly one half of the variance in child depression was predicted by children's avoidance coping, depressive attributional style, and social competence. Child anxiety was predicted by a depressive attributional style, avoidance coping, and age at diagnosis. Child externalizing behavior was predicted by a depressive attributional style, parents' anxiety and SES. Implications for interventions and future research are discussed.

The use of scheduled awakenings to eliminate childhood sleepwalking.

Evaluated the use of scheduled awakenings to eliminate sleepwalking using a noncurrent multiple baseline design across three subjects with persistent sleep-walking. Treatment procedure involves having parents awaken children several hours after they go to sleep and just before the typical time of the sleepwalking episode. This intervention proved immediately successful in eliminating sleep-walking in all three children. Treatment effects were maintained at 3 and 6 months posttreatment. Implications for intervention and future research are discussed.

The Child-Adult Medical Procedure Interaction Scale-Revised: an assessment of validity.

Investigated the validity of the Child-Adult Medical Procedure Interaction Scale-Revised (CAMPIS-R) using multiple concurrent objective and subjective measures of child distress, approach-avoidance behavior, fear, pain, child cooperation, and parents' perceived ability to help their preschool children during routine immunizations. Parents', staffs', and children's behaviors in the treatment room were videotaped and coded. Results indicate that the validity of the CAMPIS-R codes of Child Coping and Distress, Parent Distress Promoting and Coping Promoting, and Staff Distress Promoting and Coping Promoting behavior were supported, with all significant correlations being in the predicted direction. An unanticipated finding was that the child, parent, and staff Neutral behaviors were inversely related to some measures of distress and positively related to some measures of coping. Interobserver reliability was high for each CAMPIS-R code.

Parent and staff behavior, previous child medical experience, and maternal anxiety as they relate to child procedural distress and coping.

Assessed the influence of adult in-session behavior and psychological variables on 77 preschool children's coping and distress during routine immunizations. Maternal anxiety was not related to the behavior of the parent, staff, or child. However, in-session behavior by one person was highly correlated with in-session behavior by the other people in the treatment room. The effects of parent and staff in-session behaviors, previous child medical experience, and maternal anxiety on child distress and coping was examined using hierarchical multiple regression procedures. Child coping was predicted by parent and staff behavior whereas child distress was predicted by parent behavior and by the level of the child's distress during previous medical and dental experiences. Implications for intervention and future research are discussed.