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PubMed1998

Radiofrequency catheter ablation of septal accessory pathways within the triangle of Koch: importance of energy titration testing other than the local electrogram characteristics for identifying the successful target site.

Radiofrequency (RF) catheter ablation of accessory atrioventricular (AV) connections in the proximity of His bundle or AV node is at high risk of developing complete heart block. A safe and effective protocol has not been well established. Nineteen consecutive patients with 19 septal accessory pathways within the triangle of Koch underwent a protocol with power-titrated RF energy testing to identify the target site for successful catheter ablation. At every potential target site preselected by local electrogram characteristics, RF energy was started at 5 W for 10 seconds, with an increment of 5 W (duration remained at 10 s) until maximally 30 W or the observation of transient interruption of accessory pathway conduction. By this stepwise RF energy testing, we successfully localized and ablated 18 (94.7%) of the 19 septal accessory pathways, 10 close to His bundle (zone I) and 8 away from it (zone II). The test-effective RF power was 20 W or less in 9 of all 11 septal accessory pathways in zone I, and 5 of the 8 in zone II (P = 0.68). Meanwhile, the final RF power for successful ablation was 30 W or less in 9 of the 10 zone I and 6 of the 8 zone II septal accessory pathways (P = 0.83). One patient with an accessory pathway in zone I was complicated with complete AV block after final ablation at 30 W. None of the local electrogram characteristics except continuous electrical activity during retrograde mapping was helpful in the prediction of ablation outcome. Careful RF energy titration testing could effectively help identify the target site for successful RF catheter ablation of septal accessory pathways within the triangle of Koch. The dependence on local electrogram manifestations could be frustrated by a low probability of success.

Adult↗

PubMed2005

Predictors for successful angioplasty of chronic totally occluded coronary arteries.

AIMS: Reevaluation of clinical and angiographic predictors for percutaneous recanalization of coronary chronic total occlusion (CTO) using current techniques with conventional PTCA wires and balloons. METHODS AND RESULTS: We studied 253 consecutive patients with 283 lesions who underwent attempted PTCA of CTO (mean time since occlusion 33 months, range 3-150 month). Immediate procedural success rate was 84.8% (95% CI = 80.3%-88.6%). Multiple clinical and angiographic characteristics were evaluated as possible predictors of success/failure. Multiple logistic regression analysis revealed that a tapered morphology (P < 0.001, OR = 6.1; 95% CI = 2.1-18.2), </=45 degree of angulations of the target artery (P < 0.03, OR = 4.5; 95% CI = 1.2-17.2), length of occlusion <15 mm (P < 0.001, OR = 3.4; 95% CI = 1.6-7.0), and the presence of multiple lesions in the target artery (P < 0.03, OR = 2.2; 95% CI = 1.1-4.4) were statistically significant independent predictors of procedural success. According to absence or presence of the various identified determinants of outcome, predicted procedural success rates varied between 26 and 98%. CONCLUSIONS: Although the probability of immediate procedural success with percutaneous recanalization of coronary CTO using conventional PTCA is now high, a number of characteristics of the occlusive lesion represent significant modulators of success or failure. These factors should be utilized in the process of patients or lesions selection.

Angioplasty, Balloon, Coronary↗

PubMed1990

On my own terms: the redefinition of success in nursing.

Studies seeking predictors of success among professional women, including nurses, define "success" largely in extrinsic terms. In the findings of two studies of nurses (N = 200; N = 722), intrinsic forms of success emerge as more highly valued than externally measured achievements. Other studies of nurses and professional women show similar findings. This is argued to reflect realism about the structural obstacles and personal costs involved in vertical careers and the balancing of priorities important to women. Success defined as personal satisfaction is particularly appropriate in an economic climate where the success ethic is less viable and self-evaluation in extrinsic terms is psychologically risky.

Altruism↗

PubMed2004

Perceived parental beliefs about the causes of success in sport: relationship to athletes' achievement goals and personal beliefs.

This study examined the relationship between perceived parental beliefs and young athletes' achievement goal orientations and personal beliefs about the causes of success in sport. Participants were 183 male and female athletes, 11-18 years old, involved in team sports. Athletes completed the Task and Ego Orientation in Sport Questionnaire, the Beliefs about the Causes of Sport Success Questionnaire, and two modified versions of the latter inventory to assess their perceptions of their parents' beliefs. Canonical correlation analysis revealed that perceived parental beliefs were related to goal orientations and personal beliefs in a conceptually coherent fashion. Thus, the perceived parental belief that effort leads to success in sport was related to athletes' task orientation and personal belief that effort causes sport success. In contrast, the perceived parental beliefs that superior ability, external factors, and using deceptive tactics are precursors to success in sport corresponded to athletes' ego orientation and the same personal beliefs. The findings are discussed in terms of their implications for understanding the socialization experiences of young athletes.

Achievement↗

PubMed2000

Successful aging: implications for oral health.

The past few years have seen a growing emphasis in gerontology on the concept of "successful" or "robust" aging. This represents a major paradigm shift in the field from a focus on declines in physical and social functioning, assumptions of the aging process as a downward spiral, and studies on how to manage these declines. Leading the way toward this new perspective on aging, the MacArthur Studies of Successful Aging asked the fundamental question: "What genetic, biomedical, behavioral, and social factors are crucial to maintaining health and functional capacities in the later years?" These studies examined longitudinally a large cohort of independent elders on several physical, cognitive, emotional, and social parameters. Other researchers have focused on the theme of robust aging; however, common predictors have emerged, such as remaining active physically and cognitively, maintaining social contacts, and avoiding disease. This research is timely, given the expanding population of the oldest old, and with successive cohorts demonstrating the "compression of morbidity" phenomenon. Such a paradigm shift is critical in geriatric dentistry as well, where successful aging is evident in the growing number of older adults who have retained their natural dentition into advanced old age. This presentation draws parallels between successful aging at the systemic and oral health levels, with illustrations from epidemiologic studies that demonstrate trends in improved health and quality of life among newer cohorts of older adults.

Adult↗

PubMed1978

Sex differences in 'fear of success' among British students.

Using a measure derived from Horner's studies of 'fear of success', the attitudes of three groups of British undergraduates towards success and failure were investigated. The results indicate ambivalence towards success and failure among both sexes, but neither the numerical analysis nor the kinds of responses indicated much of the overt sex-stereotype-based 'fear of success' found in the earlier American studies. Both sexes indicated some disillusionment with the 'success ethic'. Males showed somewhat greater anxiety about failure.

Achievement↗

PubMed1984

Cynical boys, determined girls? Success and failure anxiety in British adolescents.

Fifteen-year-old British adolescents of both sexes were presented with success or failure story cues, in sex-appropriate and sex-inappropriate fields of endeavour. Responses were analysed to establish the extent and nature of 'motive to avoid success'. The effects of cue variables (sex appropriateness, success versus failure), sex-role attitude, locus of control, social class and maternal employment were explored. It was found that boys were generally more negative, predicting failure and demonstrating anxiety in various ways. Girls were generally more positive, more likely to predict success outcomes, and tended to treat the obstacles to girls' achievement as challenges to be overcome. They tended to show a realistic appreciation of the problems likely to be encountered rather than anxiety or a motive to avoid success.

Achievement↗

PubMed2005

Success with hydrostatic reduction of intussusception in relation to duration of symptoms.

BACKGROUND: It is widely believed that hydrostatic reduction of intussusception is less successful in children with prolonged symptoms prior to presentation. AIM: To prospectively evaluate success in relation to duration of symptoms. METHODS: Prospective study in which children, regardless of symptom duration, underwent an attempt at hydrostatic reduction. RESULTS: Of 113 children presenting with intussusception, 16 had peritonitis and required immediate laparotomy. A hydrostatic reduction was attempted in 97 and was successful in 77 (79%). There were 26 successful reductions with symptoms <12 hours (81%), 30 with symptoms for 12-24 hours (81%), and 21 with symptoms >24 hours (75%). CONCLUSION: The success rate with hydrostatic reduction was not significantly influenced by symptom duration.

Acute Disease↗

PubMed2005

Baseline IOP predicts selective laser trabeculoplasty success at 1 year post-treatment: results from a randomised clinical trial.

BACKGROUND/AIMS: The efficacy and safety of selective laser trabeculoplasty (SLT) has been found to be equivalent to argon laser trabeculoplasty (ALT). Since SLT produces significantly less disturbance to the trabecular meshwork and is theoretically more repeatable than ALT, it has potential to replace ALT as the standard procedure to treat medically uncontrolled open angle glaucoma. This study's objective is to determine factors that predict successful SLT at 1 year post-treatment. METHODS: As part of a randomised clinical trial comparing the efficacy and safety of SLT to ALT, data on 72 SLT patients were collected, and successful SLT defined as having an SLT induced intraocular pressure (IOP) reduction of >or=20% at 1 year post-treatment follow up. RESULTS: 43 out of the 72 patients who had completed their 1 year follow up visit had an IOP reduction of >or=20% from baseline. No glaucoma risk factors studied predicted successful SLT. The amount of trabecular meshwork pigmentation was not a significant predictor. However, it was discovered that baseline IOP strongly predicted SLT success (odds ratio=1.16; p=0.0001). CONCLUSION: SLT success was significantly predicted by baseline IOP but not by age, sex, other glaucoma risk factors, type of open angle glaucoma, or by degree of trabecular meshwork pigmentation.

Adult↗

PubMed1983

Physiological and psychological correlates of success in track and field athletes.

Twenty-four collegiate distance runners and 20 power athletes (sprinters and jumpers) of various success levels were tested on a number of physiological and psychological parameters. Multiple regression analysis indicated that physiological factors could explain over 81% of the variance related to successful distance running while physiological and psychological factors could explain over 80% of the of the variance related to successful sprinting and jumping. Body weight, fibre type, low density lipoprotein-cholesterol, and hamstring strength were significant singular correlates to successful distance running. Year in school, percent body fat, quadriceps strength, and leg muscle balance were significant single correlates to successful sprinting and jumping performance.

Adolescent↗

PubMed1991

Determinants of successful transthoracic defibrillation and outcome in ventricular fibrillation.

OBJECTIVE: To examine factors determining defibrillation success and outcome in patients with ventricular fibrillation. DESIGN: Observational prospective study of age, sex, transthoracic impedance, site of cardiac arrest, ventricular fibrillation duration and amplitude, primary or secondary ventricular fibrillation, aetiology, number of shocks to correct ventricular fibrillation, and drug treatment. SETTING: A teaching hospital and a mobile coronary care unit with a physician. PATIENTS: 70 consecutive patients (50 male, 20 female) mean age 66.5 years. INTERVENTIONS: Before the first countershock was administered transthoracic impedance using a 30 kHz low amplitude AC current passed through 8 cm/12 cm self-adhesive defibrillator electrode pads applied in the anteroapical position was measured. The first two shocks were 200 J delivered energy (low energy) and further shocks of 360 J (high energy) were given if required. MAIN OUTCOME MEASURES: Countershock success and outcome from ventricular fibrillation. RESULTS AND CONCLUSIONS: First shock success was significantly greater in inhospital arrests (37/53) than in out-of-hospital arrests (5/17) and in those receiving antiarrhythmic treatment (13/15, 86.7%) v (27/51, 52.9%). Transthoracic impedance was similar in those who were successfully defibrillated with one or two 200 J shocks (98.7 (26) omega) and those who required one or more 360 J shocks (91.4 (23) omega). Success rates with two 200 J shocks were similar in those patients with "high" transthoracic impedance (that is, greater than 115 omega) and those with transthoracic impedance (less than or equal to 115 omega) (8/12 (67%) v 44/58 (76%]. Fine ventricular fibrillation was significantly more common in the patients with a transthoracic impedance of greater than 95 omega (41% (13/32] than in those with a transthoracic impedance less than or equal to 95 omega (13% (5/38]. Death during arrest was significantly more common in patients who needed high energy shocks (14/18 (78%] than in those who needed low energy shocks (16/52 (31%]. Multiple regression analysis identified ventricular fibrillation with an amplitude of greater than or equal to 0.5 mV, age less than or equal to 70 years, and arrests that needed less than or equal to two shocks for defibrillation, in rank order as independent predictors of survival to discharge.

Aged↗

PubMed1993

Determinants of success of coronary angioplasty in patients with a chronic total occlusion: a multiple logistic regression model to improve selection of patients.

OBJECTIVE: To study the determinants of success of coronary angioplasty in patients with chronic total occlusions, and to formulate a multiple logistic regression model to improve selection of patients. DESIGN: A retrospective analysis of clinical and angiographic data on a consecutive series of patients. PATIENTS: 312 patients (mean age 55, range 31 to 79 years, 86% men) who underwent coronary angioplasty procedure for a chronic total occlusion between 1981 and 1992. RESULTS: Procedural success was achieved in 191 lesions (61.2%). A major complication occurred in six patients (1.9%). Multiple stepwise logistic regression analysis identified the presence of bridging collaterals (p < 0.001), the absence of a tapered entry configuration (p < 0.001), estimated duration of occlusion of greater than three months (p = 0.001), and a vessel diameter of less than 3 mm (p = 0.003) as independent predictors of procedural failure. The logistic regression model was used to classify patients into groups of high, intermediate, and low probability of procedural success with cut off points of 70% and 30%. The predictive value for procedural success (probability > or = 70%) was 91% (95% confidence intervals (95% CI) 83% to 96%) and predictive value for procedural failure (probability < 30%) was 81% (95% CI 64% to 92%). CONCLUSIONS: Percutaneous transluminal coronary angioplasty of chronic total occlusions is associated with a low risk of acute complication. Procedural success is influenced by easily identifiable clinical and angiographic features and the multiple regression model described may help to improve selection of patients.

Adult↗

PubMed1995

Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success.

BACKGROUND: Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique. METHODS: Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one as successful (78%) or unsuccessful (22%) according to survival and to the need for endotracheal intubation. RESULTS: Pneumonia was the cause of acute respiratory failure in 38% of the unsuccessful episodes but only in 9% of the successful ones. Success with non-invasive mechanical ventilation was associated with less severely abnormal baseline clinical and functional parameters, and with less severe levels of acidosis assessed during an initial trial of non-invasive mechanical ventilation. CONCLUSIONS: The severity of the episode of acute respiratory failure as assessed by clinical and functional compromise, and the level of acidosis and hypercapnia during an initial trial of non-invasive mechanical ventilation, have an influence on the likelihood for success with non-invasive mechanical ventilation and may prove to be useful in deciding whether to continue with this treatment.

Aged↗

PubMed1983

Transcatheter vessel occlusion: angiographic results versus clinical success.

A review was made of 219 transcatheter vessel occlusion procedures performed over a ten-year period for control of hemorrhage, tumor palliation, or blood supply redistribution prior to intra-arterial chemotherapy. Complete angiographic success was obtained in 85% of the procedures, with partial success in 8%; complete clinical success was achieved in 53% of patients, with partial success in 23%. The most satisfactory clinical results were obtained with hemorrhagic gastritis and pelvic trauma. Embolizations for duodenal ulcer hemorrhage and transhepatic variceal occlusion were the least clinically successful, although isobutyl-cyanoacrylate appeared to be a significant improvement in angiographic therapy for duodenal ulcer. The overall complication rate was 13%, with one third of the complications clinically silent. These results indicate that transcatheter vessel occlusion is a relatively safe and effective method for control of hemorrhage or tumor infarction.

Abdomen↗

PubMed2003

Mechanistic inquiry into decrease in probability of defibrillation success with increase in complexity of preshock reentrant activity.

Energy requirements for successful antiarrhythmia shocks are arrhythmia specific. However, it remains unclear why the probability of shock success decreases with increasing arrhythmia complexity. The goal of this research was to determine whether a diminished probability of shock success results from an increased number of functional reentrant circuits in the myocardium, and if so, to identify the responsible mechanisms. To achieve this goal, we assessed shock efficacy in a bidomain defibrillation model of a 4-mm-thick slice of canine ventricles. Shocks were applied between a right ventricular cathode and a distant anode to terminate either a single scroll wave (SSW) or multiple scroll waves (MSWs). From the 160 simulations conducted, dose-response curves were constructed for shocks given to SSWs and MSWs. The shock strength that yielded a 50% probability of success (ED(50)) for SSWs was found to be 13% less than that for MSWs, which indicates that a larger number of functional reentries results in an increased defibrillation threshold. The results also demonstrate that an isoelectric window exists after both failed and successful shocks; however, shocks of strength near the ED(50) value that were given to SSWs resulted in 16.3% longer isoelectric window durations than the same shocks delivered to MSWs. Mechanistic inquiry into these findings reveals that the two main factors underlying the observed relationships are 1) smaller virtual electrode polarizations in the tissue depth, and 2) differences in preshock tissue state. As a result of these factors, intramural excitable pathways leading to delayed breakthrough on the surface were formed earlier after shocks given to MSWs compared with SSWs and thus resulted in a lower defibrillation threshold for shocks given to SSWs.

Animals↗

PubMed1999

Emergency cervical cerclage: relation between its success, preoperative serum level of C-reactive protein and WBC count, and degree of cervical dilatation.

OBJECTIVE: To assess the relation between the preoperative serum level of C-reactive protein (CRP) and the WBC count and the efficacy of emergency cervical cerclage. STUDY DESIGN: We retrospectively reviewed the medical records of 17 women (16 singleton pregnancies and 1 twin pregnancy) who underwent emergency cervical cerclage (McDonald technique) between 21 and 26 weeks of gestation. The uterine cervix was dilated >/=3.0 cm and the intact (not ruptured) fetal membranes were visible or protruded into the vagina in all patients. The serum level of CRP and the WBC count were determined preoperatively and postoperatively. Emergency cervical cerclage was considered successful if delivery occurred >/=14 days after the procedure. RESULTS: Emergency cervical cerclage was successful in 12 women, including the woman with a twin pregnancy, but failed in 5 women. The preoperative serum level of CRP and the WBC count were significantly lower and dilatation of the cervix was significantly less in the success group than in the failure group. Cerclage was successful in all eight patients with cervical dilatation </=4.0 cm, but in only 4 of 9 patients with cervical dilatation >4.0 cm (p < 0. 05). Cerclage was successful in all 11 women with a preoperative serum level of CRP </=4.0 mg/dl and a WBC count </=14,000/ microl compared with 1 of 6 women with either a CRP level >4.0 mg/dl or a WBC count >14,000/ microl (p < 0.01). CONCLUSION: A preoperative CRP value </=4.0 mg/dl, a WBC count </=14,000/ microl, and cervical dilatation </=4.0 cm were significantly associated with prolongation of pregnancy after emergency cervical cerclage.

Adult↗

PubMed2006

Operative failure during ureteroscopic pneumatic lithotripsy: factors affecting successful outcome.

AIM: We aimed to evaluate the predictive factors that would in turn indicate stone migration and the effects of these factors on the ultimate success of the intervention. METHOD: Patients were divided into two groups with respect to the migration of the stone treated. Group I: patients demonstrating stone migration during manipulation; group II: no migration of the stones noted. In the second phase of the study, the results of ureteroscopic management in 433 patients were evaluated with respect to the success rates obtained. Parameters such as stone size, stone burden, experience of the surgeon, length of the ureter proximal to the stone treated, and lastly transverse diameter of the ureter were noted in all patients as possible risk factors for stone migration. RESULTS: Statistical analysis of ureteroscopic success in all patients revealed that there was a meaningful correlation with respect to the length of the proximal ureteral portion (p < 0.0001) and surgeon's experience (p = 0.004). p value for the correlation between stone burden and operative success was 0.056. There was no significant correlation between stone size (p = 0.51), ureter diameter (p = 0.78), and operative success. CONCLUSION: Stones that are close to the renal pelvis and treated by inexperienced physicians are the ones most likely to migrate to the renal pelvis during manipulation with pneumatic lithotripsy.

Adolescent↗

PubMed2006

Successful verbal retrieval in elderly subjects is related to concurrent hippocampal and posterior cingulate activation.

OBJECTIVE: Memory decline and hippocampal atrophy are two major aspects of Alzheimer's disease. Using a response-related fMRI design, we investigated the relationship between successful verbal retrieval and concurrent cerebral activation in elderly subjects in different stages of cognitive decline. We chose a correlational over the more traditional categorical approach to increase the power of detecting relevant activations. METHODS: Eleven subjects with Alzheimer's disease, 21 elderly subjects with mild cognitive impairment, and 29 age-matched cognitively unimpaired subjects learned 180 nouns. While measuring brain activation with fMRI, the subjects had to classify these 180 learned plus 180 new distractor words as known or new. Response-related fMRI analysis was used to identify cerebral activation by correctly remembered words (hits) that correlated with retrieval success in the whole group. RESULTS: Successful verbal retrieval was significantly correlated with concurrent activation of the left hippocampus and posterior cingulate gyrus. CONCLUSION: The study confirms the importance of adequate hippocampal function for successful verbal retrieval in the elderly. In addition, our study supports connectivity studies indicating a functional relationship between the hippocampus and the posterior cingulate gyrus during successful verbal retrieval in the elderly in different stages of cognitive decline.

Aged↗