Satisfaction with an exercise physiology consultation after treatment for childhood cancer: An opportunity for healthy lifestyle education David Mizrahi, Claire E Wakefield, Lauren Ha, Richard J Cohn, David Simar, Joanna E Fardell Heart and Mind 2019 3(3):77-106 Purpose: Many childhood cancer survivors are not engaging in sufficient physical activity despite high chronic disease incidence. We assessed satisfaction and acceptability of attending an exercise physiology consultation. Methods: An 8–18-year-old cancer survivor >1-year posttherapy were assessed by an exercise physiologist (T0). We assessed parents' and survivors' satisfaction and acceptability with the consultation and information received 1-month later (T1). Parents and survivors were asked whether they would see an exercise physiologist again and whether other survivors should be assessed. Results: We recruited 102 participants, with 70 unique families retained. Parents were more satisfied with information received about exercise from T0to T1 (43.4 ± 33.2 vs. 81.5 ± 17.6/100,P < 0.001). Parents reported high satisfaction from the consultation (94.7 ± 10.2/100). Most parents (96.6%) and survivors (95.9%) recommended other survivors see an exercise physiologist. Some parents (37.0%) wanted their child to be more active, while 47.8% of survivors wanted to be more active. Conclusions: There was support for an exercise physiology consultation from parents and survivors. Guidance from an exercise physiologist may be important to alter lifestyle behaviors, which can be potentially beneficial to cardiovascular and psychological well-being.

Enhancement of orbitofrontal and insular cortices responses to spicy perception increases high salt sensation: An event-related potentials study Qiang Li, Qiang Li, Fang Sun, Guoyi Yan, Hongmei Lang, Zhiming Zhu Heart and Mind 2019 3(3):107-112 Context: The interplay between taste perception and salt sensation is crucial for salt intake. Our hemodynamic neuroimaging research has shown that the administration of capsaicin (the major spicy component of chili peppers) enhances the metabolic activity of the insula and orbitofrontal cortex (OFC) in response to high salt intake. Aims: The aim is to study how the brain processes underlying salty taste and spicy perception within the first second after stimulation. Settings and Design: This electrophysiological study included 25 participants (10 males) who were recruited by advertisement flyers in Chongqing. Subjects and Methods: The present study investigated the responses of the OFC and insular to the interaction of spicy flavor and salty taste by recording the event-related potentials (ERPs). Two concentrations of sodium chloride solution (150 and 200 mmol/L) with or without 0.5 μM capsaicin were applied to the tongue of the study's participants. Statistical Analysis Used: One-way ANOVA with Games-Howell's multiple comparison post-hoc tests and linear regression analysis. Results: N1 amplitudes were positively correlated with participants' levels of salt intake and their salty preference scores. Source analysis performed on the ERP N1 wave in the 120–180 ms time window showed that the sources were located approximately in the insula and OFC. The amplitudes of the N1 and P2 components in the 200 mmol/L NaCl group were higher than those in 150 mmol/L NaCl group, but not significantly different than the group administered 150 mmol/L of NaCl and 0.5 μmol/L of capsaicin. Conclusions: The present study provides novel insights into the use of flavor or saltiness enhancers for salt reduction in humans through cortical responses to the spicy-salty interaction.

Psychosocial and medical predictors of 1-year functional outcome in male and female coronary bypass recipients Sandra Young, Wolfgang Linden, Andrew Ignaszewski, Andrea Con, Sonia Terhaag, Tavis Campbell Heart and Mind 2019 3(3):113-121 Background and Purpose: This study examines coronary artery bypass graft (CABG) patients, their baseline medical and psychosocial characteristics, and level of functioning after 1 year. Functioning was defined as ability to play their role in social, family, recreational, and occupational areas. Sex differences and the buffering effect of social support were also investigated. Methods: This prospective, observational study recruited 296 (42% female) post-CABG patients, of whom 234 (79%; 44% female) had complete data at 1-year follow-up. Clinical and demographic variables were collected following surgery via chart review and provincial database. Depressive symptoms, perceived social support, household responsibilities, marital status, pain, and role interference were assessed at baseline and 1 year later. Hierarchical linear regression examined relationships between baseline psychosocial variables and 1-year role interference controlling for potential medical confounding variables. Results: One-year role interference was partially predicted by baseline depression, social support, household responsibilities, and marital status (R2 = 0.20,P < 0.001), but not disease severity. Baseline depression predicted 1-year role interference only at mean (b = 0.15, 95% confidence interval [CI] [0.01, 0.31]) and high (b = 0.30, 95% CI [0.12, 0.48]) perceived social support. Baseline perceived social support predicted greater reduction in 1-year role interference in women compared to men (interaction b = 0.29; 95% CI [0.06, 0.52]) and reduced the association between high depression symptoms and role interference in women only (b = −0.25, 95% CI [−0.42, −0.09]). Conclusions: Long-term role interference in bypass graft recipients was not associated with disease severity, but was predicted by social variables and depressive symptoms. In women perceived social support moderated the association between depression and role interference.

Right atrial myxoma presenting as pyrexia of unknown origin Narendra Kumar, Madhan Kumar Ranganathan, Cyril James, Shaimaa Mustafa, Arun Kumar Jha, Ismail Aksoy, Manish Barman Heart and Mind 2019 3(3):122-124 Most cardiac tumors are benign and localized to the left atrium. Right atrial myxomas are rare and mostly discovered during symptomatic workup or as an incidental finding. Usually, right atrial myxomas are comparatively asymptomatic compared to their left atrial counterparts and do not embolize to systemic circulation unless associated with other anatomical defects. We report a rare case presenting with a history of fever and diagnosed by transthoracic echocardiography. The myxoma was successfully removed surgically, and the patient has significantly improved clinically since then.

On-table acute ischemic stroke during primary PCI-double intra-arterial thrombolysis in a young patient: Uncommon complication and “double-edged sword” management Pankaj Jariwala Heart and Mind 2019 3(3):125-128 Stroke is an unusual but possibly devastating complication of cardiac catheterization. We report a case where a patient developed transient hemiplegia secondary to the embolization of a thrombus following thromboaspiration in the setting of acute myocardial infarction. The recent American College of Cardiology/European Society of Cardiology guidelines have classified the routine use of thromboaspiration as a Class III indication, but in some special circumstances with large thrombus burden, can be executed with a caution. Preprocedure identification of the high-risk patient should be performed along with measures to avoid ischemic stroke. If stroke happens, the instant evaluation and intervention of the patient could minimize cerebral damage. Every catheterization laboratory should develop a predefined protocol for the management of periprocedural stroke. We have discussed the management of periprocedural stroke with its review of literature.

Treatment of nonsuicidal self-injury disorder with oral ketamine Brigitte C Vanle, Mitchell Fuller, Gabriella Hangiandreou, Stuart Silverman Heart and Mind 2019 3(3):129-131 Nonsuicidal self-injury disorder (NSSID) is the deliberate alteration or destruction of body tissue without conscious suicidal intent and for purposes not socially sanctioned. NSSID can cause significant morbidity and mortality, and despite being recognized as a clinical entity for many years, clear pharmacological guidelines on how to effectively treat these symptoms do not yet exist. Given the dearth of evidence regarding effective medication treatment of this condition, we present a case where remission of nonsuicidal self-injury was achieved through the use of oral ketamine.