Van alles m.b.t. het hart

Onderwerpen met wetenschappelijke, medische of algemene gezondheidsgerelateerde informatie en discussie dat niet specifiek betrekking heeft op de ziekte van Lyme.
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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Za 18 Jul 2009 12:22

Ik geef even een reactie hierop bij het topic over Vitamine D :

viewtopic.php?p=38649#p38649

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Wo 26 Aug 2009 12:20

http://www.nu.nl/gezondheid/2068024/koo ... anval.html

Koolhydraatarm eten verhoogt kans op hartaanval

JERUZALEM - Wie een dieet volgt waarbij weinig tot geen koolhydraten gegeten mogen worden, loopt kans op aderverkalking. Daardoor kan zo'n dieet de kans op hartaanvallen en beroertes verhogen.
Dat blijkt uit onderzoek van Israëlische wetenschappers op muizen, meldde de BBC dinsdag.

De onderzoekers voerden muizen drie soorten diëten: een zonder koolhydraten, een met veel vet en een menu van muizenvoer. De muizen die geen koolhydraten kregen, hadden weliswaar geen last van cholesterol, maar kampten wel met aderverkalking.



Na twaalf weken hadden deze muizen 15 procent meer aderverkalking dan de dieren die het muizenvoer aten. Het dieet met veel vet leidde tot 9 procent meer aderverkalking.

Beenmergcellen

De wetenschappers weten niet precies waardoor dit negatieve resultaat tot stand komt. Mogelijk zorgt een dieet met weinig koolhydraten ervoor dat beenmergcellen de aderen minder efficiënt schoonmaken. Ze adviseren een dieet te volgen dat een gebalanceerde mix is van alle soorten voedingsstoffen.

Diëten zonder koolhydraten waren vooral in de jaren negentig enorm populair. Duizenden mensen volgden diëten als Southbeach en Atkins, waar snel gewicht mee kan worden verloren.

Het is al langer bekend dat deze vorm van afvallen kan leiden tot schade aan de gezondheid. De Israëlische wetenschappers deden hun onderzoek omdat ze veel berichten hoorden over mensen die een dieet volgden en een hartaanval kregen

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Di 8 Sep 2009 10:53

http://www.medicalnewstoday.com/articles/162562.php

High Caffeine Intake Can Lead To Arrhythmias


Coffee is routinely consumed in countries within the Mediterranean basin. Coffee, an infusion of ground, roasted coffee beans, is the most widely consumed behaviourally active substance in the world. It contains several hundred different substances including, antioxidants, carbohydrates, lipids, vitamins, minerals, phenolic compounds and alkaloids. Nevertheless, the effects of coffee on the cardiovascular system have been mainly related to caffeine. Acute and chronic caffeine intake appears to have only minor negative consequence on health. However, high levels of caffeine intake have been related to ventricular arrhythmias

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Za 6 Feb 2010 17:45

Kruiden remedies kunnen het risico verhogen van gevaarlijke geneesmiddelen interacties bij hartpatiënten.

Veel van de populaire kruiden supplementen, waaronder St. Janskruid, Gingko Biloba, knoflook en zelfs grapefruitsap kunnen ernstige risico's opleveren voor mensen die medicijnen voor hart-en vaatziekten gebruiken, volgens een overzichtsartikel gepubliceerd in de februari, 9, 2010, nummer van het Journal van de American College of Cardiology


http://www.medicalnewstoday.com/articles/177871.php

Herbal Remedies May Increase Risk Of Dangerous Drug Interactions In Heart Patients

More and more Americans are turning to herbal remedies to help manage chronic conditions or promote general health and wellness. But many of today's popular herbal supplements, including St. John's wort, gingko biloba, garlic and even grapefruit juice can pose serious risks to people who are taking medications for heart disease, according to a review article published in the February, 9, 2010, issue of the Journal of the American College of Cardiology. The use of these products is especially concerning among elderly patients who typically have co-morbidities, take multiple medications and are already at greater risk of bleeding, according to authors.

"Many people have a false sense of security about these herbal products because they are seen as 'natural,'" Arshad Jahangir, M.D., Professor of Medicine and Consultant Cardiologist, Mayo Clinic Arizona, adding that more than 15 million Americans reportedly use herbal remedies or high-dose vitamins. "But 'natural' doesn't always mean they are safe. Every compound we consume has some effect on the body, which is, in essence, why people are taking these products to begin with."

In addition to their direct effects on body function, these herbs can interact with medications used to treat heart disease, either reducing their effectiveness or increasing their potency, which may lead to bleeding or a greater risk for serious cardiac arrhythmias.

"We can see the effect of some of these herb-drug interactions - some of which can be life-threatening - on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram," Dr. Jahangir said.

According to the report, a major concern is that patients do not readily disclose their use of herbal remedies, and healthcare providers may not routinely ask about such use. In addition, because these herbs are regarded as food products, they are not subject to the same scrutiny and regulation as traditional medications.

"If patients aren't satisfied with their care today, many will turn to herbs because they believe these compounds can help them manage chronic conditions or improve health and prevent future disease," said Dr. Jahangir. "In fact, patients are willing to spend nearly the same or more on out-of-pocket expenses for herbal remedies than traditional medical care."

Two nationwide surveys conducted in 1990 and 1997 found that the number of visits to complementary and alternative providers increased from 427 million to 629 million, whereas the number of visits to primary care physicians remained basically unchanged.

Some examples of herbs and their adverse effect on heart disease management include:

- St. John's wort, which is typically used to treat depression, anxiety and sleep disorders among other problems, reduces the effectiveness of medications contributing to recurrences of arrhythmia, high blood pressure or increase in blood cholesterol levels and risk for future heart problems.


- Ginkgo biloba, which is supposedly used to improve circulation or sharpen the mind, increases bleeding risk in those taking warfarin or aspirin.


- Garlic, which supposedly helps boost the immune system and is commonly used for its cholesterol and blood pressure lowering properties, can also increase the risk of bleeding among those taking warfarin.

In addition to highlighting commonly used herbs and potential interactions with cardiovascular medications, the present review also outlines steps for improving their safe use and reducing harm among patients with heart disease.

"These herbs have been used for centuries - well before today's cardiovascular medications - and while they may have beneficial effects these need to be studied scientifically to better define their usefulness and, more importantly, identify their potential for harm when taken with medications that have proven benefit for patients with cardiovascular diseases," said Dr. Jahangir. "Patients, physicians, pharmacists and other healthcare providers need to know about the potential harm these herbs can have."

In addition to greater public education about the risks of using herbal products, patients and clinicians need to actively discuss the use of over-the-counter medications, supplements and herbal products in addition to prescription medications.

Dr. Jahanigir also urges the scientific community to commit to conducting studies to test manufacturers' claims and study the impact of these compounds on heart disease management. He reports no conflict of interest.

Source:
Amanda Jekowsky
American College of Cardiology

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Zo 2 Mei 2010 12:21

http://www.ntvg.nl/publicatie/Reumato%C ... s-mellitus

Reumatoïde artritis verhoogt het risico op hart- en vaatziekten even sterk als diabetes mellitus

Ned Tijdschr Geneeskd. 2010;154:A1469


Doel
De incidentie van hart- en vaatziekten (HVZ) bij patiënten met reumatoïde artritis (RA) vergelijken met de incidentie bij patiënten met diabetes mellitus type 2 (DM2) en bij de algemene bevolking.

Opzet
Prospectief beschrijvend cohortonderzoek.

Methode
In 2001-2002 werden in totaal 353 patiënten met RA geïncludeerd in een cohort. Alle patiënten werden na 3 jaar opnieuw gezien om de 3-jaarsincidentie van HVZ te bepalen. Deze werd met een cox-regressiemodel vergeleken met de 3-jaarsincidentie van HVZ in een cohort van 1852 personen uit de algemene bevolking, van wie 155 DM2 hadden. Fatale en niet-fatale HVZ werden geclassificeerd volgens ICD-9-criteria.

Resultaten
De 3-jaars incidentie van HVZ was 9,0% bij de RA-patiënten en 4,3% bij de algemene bevolking, wat overeenkomt met een incidentie van 3,30 per 100 patiëntjaren (95%-BI: 2,08-4,25) respectievelijk 1,51 per 100 persoonsjaren (95%-BI: 1,18-1,84). Vergeleken met de 1852 personen uit de algemene bevolking was de voor leeftijd en geslacht gecorrigeerde hazardratio (HR) voor HVZ bij RA-patiënten 1,94 (95%-BI: 1,24-3,05; p = 0.004). Dit risico bleef onveranderd na exclusie van patiënten die bij aanvang al HVZ hadden of na correctie voor de aanwezigheid van cardiovasculaire risicofactoren. Zowel RA-patiënten zonder DM2 als DM2-patiënten hadden een twee maal zo hoog cardiovasculair risico als personen uit de algemene bevolking zonder DM2, met een HR van 2,16 (95%-BI: 1,28-3,63) respectievelijk 2,04 (95%-BI: 1,12-3,67).

Conclusie
RA gaat gepaard met een verhoogd cardiovasculair risico waarvan de grootte vergelijkbaar is met dat van DM2.

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Zo 4 Jul 2010 15:24

http://www.ntvg.nl/publicatie/Jichtmidd ... s/volledig

Ned Tijdschr Geneeskd. 2010;154:C614

Jichtmiddel nuttig bij stabiele angina pectoris

Het jichtmedicijn allopurinol is een goede en veilige anti-ischemische behandeling voor patiënten met stabiele angina pectoris. Het middel verbetert de inspanningstolerantie en zorgt voor later optredende ST-elevaties bij inspanning. Gerandomiseerd, dubbelblind, placebogecontroleerd onderzoek van Awsan Noman et al. van de universiteit van Dundee (Schotland) wijst dat uit (Lancet. 2010; doi:10.1016/S0140-6736(10)60391-1).

Allopurinol, een xanthineoxidaseremmer, lijkt de zuurstofbehoefte van het myocard bij hartfalen te verlagen. Noman en collega’s wilden weten of dit ook het geval is bij patiënten met chronische stabiele angina pectoris.

De onderzoekers wezen 65 patiënten met ten minste 2 maanden angina pectoris, coronaire vaatafwijkingen en een positieve inspanningstest toe aan een behandeling van 6 weken placebo of allopurinol (week 1: 100 mg 1 dd; week 2: 300 mg 1 dd; week 3-6: 300 mg 2 dd). Na 6 weken behandeling kreeg de placebogroep nog 6 weken allopurinol en de allopurinolgroep nog 6 weken placebo. De patiënten bleven ook hun eigen medicatie tegen angina pectoris gebruiken. Bij het begin van de studie en na beide behandelperioden ondergingen de patiënten een inspanningstest met ecg.

Met allopurinol hielden de patiënten het langer vol tijdens de inspanningstest, kregen ze minder snel pijnklachten en duurde het langer voordat er ST-elevaties op het ecg te zien waren. Bij aanvang was de mediane tijd tot ST-elevaties 232 s. Met placebo (en eigen medicatie) steeg dit tot 249 s, met allopurinol tot 298 s. Met allopurinol steeg de totale inspanningstijd van 301 s tot 393 s, met placebo tot 307 s. De tijd tot pijn op de borst steeg van 234 s naar 304 s met allopurinol en naar 272 s met placebo. In de allopurinolgroep vertoonde 85% van de patiënten verbetering in de tijd tot ST-elevatie, versus 58% in de placebogroep.

De precieze werking van allopurinol op de hartspier is niet bekend. Toch biedt het middel volgens de auteurs veel voordelen boven andere middelen: het is goedkoop en geeft minder bijwerkingen dan bètablokkers en nitraten. Ook verlaagt allopurinol hartslag en bloeddruk niet.

In een commentaar schrijven cardiologen Renjith Antony (VK) en Henry Dargie (Schotland) dat hoewel preventie van coronair vaatlijden belangrijk blijft, het beschermen van hartspiercellen tegen ischemie een logische en pragmatische aanpak is (Lancet. 2010; doi:10.1016/S0140-6736(10)60578-8).


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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Ma 26 Jul 2010 15:11

http://www.medicalnewstoday.com/articles/195252.php

Risk Of Coronary Heart Disease Indicated By Increased Waistline And High Triglyceride Levels

People with a larger waistline and high triglyceride levels are at increased risk of coronary heart disease, according to a research study published in CMAJ (Canadian Medical Association Journal.

The concept of a hypertriglyceridemic waist phenotype, defined by high triglyceride levels and an increased waistline, had been previously proposed as a marker of metabolic abnormalities that could help predict increased risk of coronary heart disease

The CMAJ study examined whether a hypertriglyceridemic waist type could be a useful, cost-effective screening tool to identify people at risk of type 2 diabetes and coronary heart disease. It looked at a group of 21 787 men and women aged 45 to 79 years living in Norfolk, United Kingdom involved in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study. Out of the total sample, 1295 men and 814 women developed coronary heart disease during the follow up period of up to 8 to 10 years.

In both men and women, increased waist circumference (even without higher triglyceride levels) and increased triglyceride levels (even without higher waist circumference) increased the risk of developing coronary heart disease. However, the key finding of the study was that the combined presence of increased waist circumference and increased triglyceride levels was associated with the highest risk of coronary heart disease.

"Among individuals classified at low coronary heart disease risk based on the absence of traditional risk factors, the presence of the hypertriglyceridemic waist is predictive of a substantially increased risk of coronary heart disease," write Drs. Benoît Arsenault and Jean-Pierre Després, Laval University, Quebec City, who have collaborated with investigators from the Netherlands and from the United Kingdom to conduct this study. "Although hypertriglyceridemic waist is a marker of excess intra-abdominal adiposity, it cannot be used on its own to properly assess coronary heart disease risk."

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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Za 31 Jul 2010 11:02

http://www.bmj.com/cgi/content/abstract ... 29_1/c3691

Calcium Supplements May Increase Risk Of Heart Attacks

Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis

Objective To investigate whether calcium supplements increase the risk of cardiovascular events.
Design Patient level and trial level meta-analyses.

Data sources Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic database searches repeated in March 2010.

Study selection Eligible studies were randomised, placebo controlled trials of calcium supplements (500 mg/day), with 100 or more participants of mean age more than 40 years and study duration more than one year. The lead authors of eligible trials supplied data. Cardiovascular outcomes were obtained from self reports, hospital admissions, and death certificates.

Results 15 trials were eligible for inclusion, five with patient level data (8151 participants, median follow-up 3.6 years, interquartile range 2.7-4.3 years) and 11 with trial level data (11 921 participants, mean duration 4.0 years). In the five studies contributing patient level data, 143 people allocated to calcium had a myocardial infarction compared with 111 allocated to placebo (hazard ratio 1.31, 95% confidence interval 1.02 to 1.67, P=0.035). Non-significant increases occurred in the incidence of stroke (1.20, 0.96 to 1.50, P=0.11), the composite end point of myocardial infarction, stroke, or sudden death (1.18, 1.00 to 1.39, P=0.057), and death (1.09, 0.96 to 1.23, P=0.18). The meta-analysis of trial level data showed similar results: 296 people had a myocardial infarction (166 allocated to calcium, 130 to placebo), with an increased incidence of myocardial infarction in those allocated to calcium (pooled relative risk 1.27, 95% confidence interval 1.01 to 1.59, P=0.038).

Conclusions

Calcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.

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vonneke
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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Wo 11 Aug 2010 15:10

Disrupting Body Clock Could Keep Triglycerides High, Raising Risk Of Heart Disease :

http://www.medicalnewstoday.com/articles/196972.php

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Re: Van alles m.b.t. het hart

Berichtdoor vonneke » Za 21 Aug 2010 13:20

http://www.medicalnewstoday.com/articles/198315.php

Boosting Speed And Accuracy In Treatment Of Heart Rhythm Disorder

Researchers at the University of Maryland School of Medicine in Baltimore have developed a novel 3-D imaging approach that may improve the accuracy of treatment for ventricular tachycardia, a potentially life-threatening heart rhythm disorder that causes the heart to beat too fast. The new approach couples CT (computed tomography) images with conventional ablation techniques to eliminate erratic electrical circuits in the heart that produce arrhythmias. The results of a feasibility study have been published online in Circulation: Arrhythmia and Electrophysiology, a journal of the American Heart Association

Electrical signals control how frequently the heart beats and how the heart muscle contracts to move blood through the body. Following a heart attack, irregularly shaped sections of dead scar tissue may form in the heart and block the electrical flow or cause a short circuit. The researchers say a growing number of people who have survived severe heart attacks go on to face a weak, erratic heartbeat, and that has prompted the search for more effective ways to treat these electrical disturbances.

Current ablation procedures, which use high-energy radio waves to treat certain types of serious arrhythmias, have only 50-60 percent long-term success. The research team theorized that with the aid of sophisticated 3-D CT imaging, treatment may be more precise and take less time.

According to the study's senior author, Timm-Michael L. Dickfeld, M.D., Ph.D., associate professor of medicine at the University of Maryland School of Medicine, "We can use 3-D CT imaging to guide us more rapidly to areas of the heart that may cause the electrical abnormalities responsible for ventricular tachycardia, and move away from parts of the heart that do not contribute to the abnormalities." Dr. Dickfeld is a cardiologist at the University of Maryland Medical Center and chief of electrophysiology at the Baltimore VA Medical Center.

A CT scanner, which takes multiple X-ray images in a matter of seconds as it rapidly spirals around the body, yields three significant types of information about the heart; abnormal cardiac anatomy, blood flow and heart muscle contraction. After two years of testing and customizing software, the research team has succeeded in combining all of these factors into a three-dimensional imaging format that can work accurately with existing equipment in an electrophysiology laboratory, where ablation procedures are performed.

This project builds on the team's earlier work that studied how well a combination of PET (positron emission tomography) and CT technology would provide advanced imaging. Study co-author Jean Jeudy, M.D., a radiologist at the University of Maryland Medical Center and assistant professor of diagnostic radiology and nuclear medicine at the University of Maryland School of Medicine, says information from imaging technologies such as CT and PET has been used independently, up till now. "Each modality has advantages in imaging, but our idea is to pool their strengths to create a synergism that results in the best and safest therapies for patients."

Study design and results

Eleven men with ventricular tachycardia were evaluated in the study. Each had had a heart attack and required an implantable cardioverter-defibrillator to correct problems with their heartbeat. The participants were scanned for a total of 10-15 seconds with a 64-slice CT system. The scan data was reconstructed into 3-D images and compared to the clinical electrical mapping system routinely used to determine where to apply ablations.

The study's principal investigator, Jing Tian, B.M., Ph.D., says CT imaging was used only as a supplement to find the location of scars. To assess the potential value of this novel technology, the research team compared data from the 3-D imaging with the clinical data after ablations were performed on the patients in the study. "We found that the 3-D scar reconstruction from CT imaging predicted areas of abnormal electrical activity in 81.7 percent of heart segments analyzed. The imaging also correctly displayed the location and extent of cardiac scar tissue, determined by voltage mapping - the gold standard for scar definition in current clinical practice," says Dr. Tian, a research associate at the University of Maryland School of Medicine. "Curative ablations were located within tissue that CT had identified as abnormal in 82 percent of the cases."

In order to clarify the utility of the 3-D imaging technology, Dr. Tian says there would have to be a randomized, controlled trial to quantify how much time can be saved, how much less radiation it requires, and the impact on patient care. "Such a trial would be the next step," she adds.

Ventricular tachycardia

A healthy heart beats about 60 to 100 beats per minute, and may beat faster with exercise or during stress or fever. In ventricular tachycardia, the heart routinely beats more than 100 times a minute. This rapid heartbeat can lead to dizziness or lightheadedness, fainting and shortness of breath, and may set the stage for sudden cardiac arrest.

Some patients respond well to medications that restore normal heartbeat, while others require a shock from an implantable cardioverter-defibrillator (ICD) to restore normal rhythm. The medications have side effects and the electrical disturbances in some people are so frequent that the ICD must fire multiple corrective shocks each day to prevent sudden cardiac arrest. The shocks are painful, causing many patients to fear their next shock. The goal of ablation is to burn a barrier around the scars to end the electrical disturbance and restore normal heart rhythm. For some patients, the procedure reduces the number of corrective shocks and eliminates the need for medication.

"Advances in cardiac care and the availability of defibrillators have helped many people with weakened hearts live longer," says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. "Nevertheless, the devices create their own set of problems, especially for people who have received multiple shocks. If this CT research yields quicker, more accurate ablations that are more widely available, it will go a long way toward improving the quality of life for these patients."

Electrical mapping

During electrical or voltage mapping, an electrophysiologist inserts a catheter with an electrode into an artery through the groin and guides it to the beating heart. Fluoroscopic imaging shows the placement of the electrode. The probe detects variations in electrical signals as it is moved a small distance at a time. High voltage indicates normal cardiac tissue. Low or no voltage is associated with dead scar tissue. A computer compiles the data into a map which shows where to apply ablation to eliminate cardiac tissue in and near the scars.

Electrical mapping is laborious and not error-free. Since the probe is moved only small distances, such as five to 15 millimeters at a time for each reading while the heart continues to beat, it may take up to several hours to complete the mapping process and extend the time that the patient is exposed to fluoroscopic X-rays. A scar section that is missed by just a few millimeters during ablation could be the source of additional electrical disturbances. Also, it is possible to get a false electrical reading if the probe does not actually make contact with the heart muscle.

Notes:
Tian J, Jeudy J, Smith MF, Jimenez A, Yin X, Bruce PA, Lei P, Tergeman A, Abbo A, Shekhar R, Saba M, Shorofsky S, Dickfeld T. "Three dimensional contrast enhanced multi-detector CT for anatomic, dynamic and perfusion characterization of abnormal myocardium to guide VT ablations." Circulation: Arrhythmia and Electrophysiology. Published online July 24, 2010

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