9 months (range, 1445 months). HBV reactivation learn more was observed in three patients, one of whom required antiviral treatment. No HBV reactivation-related hepatitis was observed. In conclusion, prevention of HBV reactivation by monitoring of HBV viral load is cost-effective and may decrease the risk of developing drug resistance from routine anti-HBV prophylaxis

treatment. It can be considered as an alternative in psoriasis patients treated by TNF-a inhibitors, especially in areas with a high HBV burden and in hepatitis B e-antigen-negative patients who have a lower risk of viral reactivation.”
“Objectives: To examine the level of agreement between self-reported and hospital administration records of arthritis-related surgeries for two large samples of community-dwelling older women in Australia, born between 1921-1926 and 1946-1951.

Study Design and Setting: Self-report survey data from the Australian Longitudinal Study on Women’s Health was linked to inpatient hospital data from the New South Wales Admitted Patient Data Collection. Levels of agreement were compared using Cohen’s kappa, sensitivity, specificity,

and positive and negative predictive values. Reasons for false positives were AMN-107 examined.

Results: This study found good agreement (kappa >0.70; sensitivity ‘and specificity >0.80) between self-report and hospitalizations data for arthritis-related surgeries.

Conclusions: This study provides new evidence for good agreement between self-reported selleck compound health survey data and administrative records of arthritis-related joint procedures, and supports the use of self-report surveys in epidemiological studies of joint procedures where administrative data are either not available or not readily accessible, or where more extensive contextual information is needed. The use of health survey data in conjunction with administrative data has an important role to play in public health

planning and policy. (C) 2013 Elsevier Inc. All rights reserved.”
“Frail older adults have a high prevalence of chronic pain with major effects on function and quality of life. Many analgesics, including opioids, have adverse effects on older adults with multiple co-morbidities. Methadone has been increasingly used for analgesia in the last 10 years. However, a number of adverse events such as sleep-disordered breathing, methadone-induced torsades de pointes arrhythmias, as well as the “”addiction stigma,”" have made people reluctant to use this medication.

This article uses examples of five cases of pain in frail older adults living in a skilled nursing facility.

Safe and effective use of methadone is illustrated with these cases. The pharmacology of methadone in frail elders is reviewed to demonstrate the specific benefits of the drug in older adults and how adverse events can be minimized.

Methadone is an excellent choice for pain in frail older adults.

All preparations showed antioxidant activity, but the ethanolic one (EME) was significantly more active than the aqueous one (AME) as hydrogen or electron donors with

SC50 values between 1.45 to 6.31 mu g GAE/mL and 7.38 to 64.77 mu g GAE/mL, respectively. The aqueous extraction was significantly more active than EME on superoxide and hydroxyl radical scavenging. Polyphenols showed a dose-response relationship (R-2>0.90) with antioxidant capacity in the decoction and the alcoholic beverage. The maceration showed an inhibitory effect on lipoxygenase (LOX) activity with an inhibitory concentration (IC50) value of 183.80 BAY 57-1293 mouse mu g gallic acid equivalents (GAE)/mL but the decoction did not. On the other hand, extracts did not show any mutagenic effect. Therefore, mistol fruits consumption could be encouraged not only for its functional properties, but also because of the positive ecological impact of preserving biological diversity through the exploitation of native natural resources in a regional economy.

(C) 2011 Elsevier Ltd. All rights reserved.”
“BACKGROUND: Only about 15% of donor lungs are considered suitable for transplantation (LTx). Ex vivo lung perfusion (EVLP) has been developed as a method to reassess and repair damaged lungs. Selleckchem Avapritinib We report our experience with EVLP in non-acceptable donor lungs and evaluate its ability to recondition these lungs.

METHODS: We studied lungs from 16 brain-dead 8-Bromo-cAMP donors rejected for LTx. After harvesting, the lungs were stored at 4 degrees C for 10 hours and subjected to normothermic EVLP with Steen Solution (Vitro life, Goteborg, Sweden) for 60 minutes. For functional evaluation, the following variables were assessed: partial pressure of arterial oxygen (Pao(2)), pulmonary vascular resistance (PVR), and lung compliance (LC). For histologic assessment, lung biopsy was done before harvest and after EVLP. Tissue samples were examined under light microscopy. To detect and quantify apoptosis, terminal deoxynucleotide transferase-mediated deoxy uridine

triphosphate nick-end labeling assay was used.

RESULTS: Thirteen lima donors were refused for having impaired lung function. The mean Pao(2) obtained in the organ donor at the referring hospital was 193.7 mm Hg and rose to 489 mm Hg after EVLP. During EVLP, the mean PVR was 652.5 dynes/sec/cm(5) and the mean LC was 48 ml/cm H2O. There was no significant difference between the mean Lung Injury Score before harvest and after EVLP. There was a trend toward a reduction in the median number of apoptotic cells after EVLP.

CONCLUSIONS: EVLP improved lung function (oxygenation capacity) of organs considered unsuitable for transplantation. Lung tissue structure did not deteriorate even after 1 hour of normothermic perfusion. J Heart Lung Transplant 2012;31:305-9 (C) 2012 International Society for Heart and Lung Transplantation. All rights reserved.

The principle was first suggested approximately a century ago, but, although research has significantly increased, the field remains conceptually unstructured and no unambiguous definition exists. This has resulted in variable use of the term, making it difficult to formulate testable hypotheses that are comparable between studies, slowing down advancement in this field. Related to this, a range of studies do not effectively distinguish between disruption and other forms of camouflage. Here, we give a formal definition of disruptive coloration, reorganize

a range of subprinciples involved in camouflage and argue that LB-100 manufacturer five in particular are specifically related to disruption: differential blending; maximum disruptive contrast; disruption

of surface through false edges; disruptive marginal patterns; and coincident disruptive coloration. We discuss how disruptive I-BET-762 price coloration can be optimized, how it can relate to other forms of camouflage markings and where future work is particularly needed.”
“Parkinson’s disease (PD) is characterized by a triade of motor symptoms due to the degeneration of nigrostriatal pathway. In addition to these motor impairments, cognitive disturbances have been reported to occur in PD patients in the early stage of the disease. The 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin widely used to produce experimental models of PD. In a previous work, we showed that MPTP altered the expression of proteins involved in mTOR antiapoptotic and PKR apoptotic pathways of translational control (TC) in neuroblastoma cells. In the present Volasertib cost study, the results indicated that a subchronic MPTP intoxication in mice decreased the dopaminergic neuron number, produced an activation of PKR way and an inhibition of mTOR way of TC especially in striatum and frontal cortex associated with a great activation of PKR in hippocampus. Moreover, in parallel to biochemical analysis, the mnesic disturbances induced by MPTP were characterized in C57B1/6 mice, by testing their performance in three versions of the Morris Water Maze task. Behavioral results showed that the MPTP

lesion altered mice learning of a spatial working memory, of a cued version and of a spatial reference memory task in the water maze. Furthermore, we previously demonstrated that the neuropeptide pituitary adenylate cyclase activating polypeptide (PACAP) could counteract the MPTP toxicity on TC factors in neuroblastoma cells. Thus, the second objective of our study was to assess the PACAP effect on MPTP-induced TC impairment and cognitive deficit in mice. The pretreatment with PACAP27 by intravenous injections partially protected TH-positive neuron loss induced by MPTP, prevented the MPTP-induced protein synthesis control dysregulation and mnesic impairment of mice. Therefore, our results could indicate that PACAP may be a promising therapeutic agent in Parkinson’s disease.

Naturally existing edible varieties are, however, known to occur in Mexico. The toxic components of J. curcas seeds, the potential for plant breeding

to generate improved varieties, and the suitability of J. curcas oil as a feedstock for biodiesel production are discussed.”
“In this work, a detailed study on the surface recombination in InP/GaAsSb double heterojunction bipolar transistors (DHBTs) this website with an InP-InAlAs composite emitter was carried out. The experimental data clearly revealed that the surface recombination was effectively suppressed by using InP-InAlAs composite emitter in the devices. At a low collector current density J(C), a reduction in the normalized emitter periphery surface recombination current K-B_surf of by a factor of 50 was observed. The physical mechanisms responsible for the surface recombination in the InP/GaAsSb DHBTs with an InP-InAlAs composite emitter were examined by characterization of the temperature-dependent K-B_surf. The results demonstrate the great potential for aggressive scaling of GaAsSb DHBTs by using an InP-InAlAs composite emitter

configuration. (c) 2010 American Institute of Physics. [doi:10.1063/1.3374637]“
“In this work, a new polydimethylsiloxane (PDMS) membrane was synthesized and its sorption, diffusion, and permeation properties were investigated using H(2), N(2), O(2), CH(4), CO(2), and C(3)H(8) check details as a function of pressure at 35 degrees C. PDMS, as a rubbery membrane, was confirmed to be more permeable to more condensable gases such as C(3)H(8). The

synthesized PDMS membrane showed much better gas permeation performance than others reported in the literature. Based on the sorption data of this study and other researchers’ works, some valuable parameters such as Flory-Huggins (FH) interaction parameters, chi, etc., were calculated and discussed. The concentration-averaged FH interaction HKI-272 Protein Tyrosine Kinase inhibitor parameters of H(2), N(2), O(2), CH(4), CO(2), and C(3)H(8) in the synthesized PDMS membrane were estimated to be 2.196, 0.678, 0.165, 0.139, 0.418, and 0.247, respectively. Chemical similarity of O(2), CH(4), and C(3)H(8) with backbone structure of PDMS led to lower chi values or more favorable interactions with polymer matrix, particularly for CH(4). Regular solution theory was applied to verify correctness of evaluated interaction parameters. Local effective diffusion coefficient of C(3)H(8) and CO(2) increased with increasing penetrant concentration, which indicated the plasticization effect of these gases over the range of penetrant concentration studied. According to high C(3)H(8)/gas ideal selectivity values, the synthesized PDMS membrane is recommended as an efficient membrane for the separation of organic vapors from noncondensable gases. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 117: 33-48, 2010″
“Background: Takotsubo cardiomyopathy (TC) mimics acute myocardial infarction (AMI).

Molecular marker-supported

genotypic information at the identified QTLs then enables quick and accurate accumulation of desirable alleles in plant breeding programmes. Recent genetic mapping research in pearl millet has mapped several QTLs for grain yield and its components under terminal drought stress conditions. Most importantly, a major QTL associated with grain yield and for the drought tolerance of grain yield in drought stress environments has been identified on linkage group 2 (LG 2) which accounts for up to 32% of the phenotypic variation of grain yield in mapping population testcrosses. The effect of this QTL has been validated in two independent marker-assisted backcrossing programmes, where 30% improvement in grain yield general combining ability (GCA) expected of this QTL under terminal drought stress conditions was recovered

Copanlisib mouse in the QTL introgression lines. To transfer effectively favourable alleles of this QTL into pearl millet varieties that otherwise Capmatinib solubility dmso are high yielding and adapted to specific agricultural zones, efforts are currently underway to develop closely spaced gene-based markers within this drought tolerance (DT)-QTL. In this review, an overview is provided of information on the genetic maps developed in pearl millet for mapping drought tolerance traits and their applications in identifying and characterizing DT-QTLs. Bafilomycin A1 ic50 Marker-assisted transfer of desirable QTL alleles to elite parent backgrounds, and results from introgression line validation in multiple terminal drought stress environments are discussed. Current

efforts undertaken towards delimiting the interval of a major DT-QTL mapping to LG 2, and towards identifying candidate genes and physiologies underlying this QTL are presented. Highly specialized genetic stocks [QTL-near-isogenic lines (NILs), a high-resolution cross, and a germplasm population] and genomic resources (gene sequences, gene-based markers, and comparative genomics information) specifically developed for these purposes are discussed.”
“This study describes an effective way for the preparation of well-dispersed, high-loaded PVA/bentonite nanocomposites with improved properties, based on nanoscale interactions. To this end, a series of Poly(vinyl alcohol)- bentonite clay nanocomposites have been prepared via solvent casting technique and their properties were thoroughly investigated by atomic force microscopy, transmission electron microscopy, X-Ray diffraction, oxygen and water permeability, water sorption along with mechanical and thermal studies. Microscopic and XRD techniques revealed highly organized regions. Clay content up to 10% led to nanocomposites with high degree of exfoliation. In addition samples with increased filler content (20%) demonstrated also, apart from the delaminated, well-organized intercalated regions.

However, diffusion of resveratrol was not affected by the degradation of PLA. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 121: 970-978, 2011″
“Headache is a disorder that has a very

negative personal and social impact. This is an observational, cross-sectional, population-based study conducted in a subject sample (n = 904) that was representative of the town of Parma’s general population aged 18 and over. The aim of this study, which is a part of a larger project, was to assess the frequency of headache and the disease perception of subjects with headache during the past year (n = 387). The average number of headache days in the past year was 34.9 days and it was comparable in men and in women: 49.9% of subjects had 1-12 days of headache in the past year, 34.9% had 1-52 days, 11.9% had 53-180 days, and 3.4% had more than 180 days. Only AC220 price three subjects had headache every day during the past year. Only one-third

of the subjects with headache in the past year considered themselves headache sufferers. The analysis by gender showed differences between men and women: although the average number of headache days in the past year was comparable in the male and female populations, women considered their headache a disease more often than men did. In addition, the percentage of men who considered their headache a disease did not increase with the increase in the number of headache selleck compound days in the past year. More in-depth studies on

this important aspect are needed.”
“Background: In sub-Saharan Africa, the distributions of malaria and HIV widely overlap. Among pregnant and nonpregnant adults, HIV affects susceptibility to malaria, its clinical course and impairs antibody responses to malaria antigens. However, the relationship between the two diseases in childhood, when most deaths from malaria occur, is less clear. It was previously reported that HIV is associated with admission to hospital in rural Kenya with severe malaria among children, except in infancy. HIV-infected children with severe malaria were older, had higher parasite density and increased mortality, raising a hypothesis that HIV interferes with naturally acquired immunity to malaria, hence with little effect at younger ages (a shorter Sonidegib history of exposure). To test this hypothesis, levels of anti-merozoite and schizont extract antibodies were compared between HIV-infected and uninfected children who participated in the original study.

Methods: IgG responses to malaria antigens that are potential targets for immunity to malaria (AMA1, MSP2, MSP3 and schizont extract) were compared between 115 HIV-infected and 115 age-matched, HIV-uninfected children who presented with severe malaria. The children were classified as high and low responders for each antigen and assigned antibody-response breadth scores according to the number of antigens to which they were responsive.

Finite difference time domain simulations reveal that there is a strong enhancement of the electric field at the resonant frequency. The absorption properties of our resonator are described in terms of effective optical constants and reveal that the silicon microring is an electric resonator. Surface plasmon resonators are efficient terahertz absorbers and have potential applications in security imaging, biological analysis, spectroscopy and nondestructive testing. (C) 2011 American Institute of Physics.

[doi:10.1063/1.3553441]“
“Chronic hepatitis C virus (HCV) infection is associated with chronic inflammation of liver, which leads to the development of cirrhosis and hepatocellular carcinoma (HCC). Because of severe side

effects and only a 50-70% cure rate in genotype 1 HCV-infected patients upon current standard treatment with pegylated interferon-alpha plus ribavirin, new therapeutic regimens are still needed. selleckchem San-Huang-Xie-Xin-Tang (SHXT) is a transitional Chinese herbal formula, composed of Rhei rhizoma, Scutellaria radix and Coptidis rhizome, and possesses anti-inflammatory effect. Here, we describe a (+)-catechin-containing selleck fraction extracted from SHXT, referred as SHXT-frC, exhibited effective inhibition of HCV replication, with selectivity index value (SI; CC(50)/EC(50)) of 84, and displayed synergistic anti-HCV effects when combined with interferon-alpha, HCV protease

inhibitor telaprevir or polymerase inhibitor 2′-C-methylcytidine. The activation of factor-kappa B (NF-kappa B) and cyclooxygenase-2 (COX-2) signalling pathway has particular relevance to CX-4945 HCV-associated HCC. SHXT-frC treatment also caused a concentration-dependent decrease in the induction of COX-2 and NF-kappa B expression caused by either HCV replication or HCV NS5A protein. Collectively, SHXT-frC could be an adjuvant treatment for patients with HCV-induced liver diseases.”
“We describe hospitalization trends of invasive pneumococcal disease (IPD) among human immunodeficiency virus-infected individuals <25 years of age since the introduction of highly active antiretroviral therapy (HAART) and the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, using the Nationwide Inpatient Sample. We estimated national trends of IPD hospitalizations during 3 periods: 1994 to 1995 (pre-HAART and pre-PCV7 era); 1998 to 1999 (HAART and pre-PCV7 era); and 2004 to 2005 (HAART and early PCV7 era). The number of IPD hospitalizations among human immunodeficiency virus-infected children and youth <25 years in the United States declined by 78.7% between 1994/1995 and 2004/2005 (P = 0.03). This decrease was more pronounced among younger children.”
“Photoluminescence properties of size-controlled Si nanocrystals (NCs) formed by various annealings have been studied in detail.

“
“Background. Left ventricular hypertrophy (LVH) is an independent risk factor for morbidity/mortality in patients with

end stage renal disease (ESRD). Our study aimed to identify prevalence as well as independent risk factors that contribute to the development of LV geometric remodeling in our HD patients. Methods. The left ventricles of 116 HD patients were classified echocardiographically into four different geometric patterns on the basis of LV mass and relative wall thickness. Furthermore, p38 MAPK cancer we measured inferior vena cava (IVC) diameter and its collapsibility index (CI) by echocardiography. Finally, we modeled a stepwise multiple regression analysis to determine the predictors of LV geometry. Results. Our study provides evidence that HD patients had a prevalence of abnormal LV geometry in 92% and LVH in 81%. We found all four geometric models of LV. Most dominant were eccentric LVH. Concentric LVH was observed in 37, normal geometry (NG) in 9, and concentric remodeling (CR) in 13 of HD patients. Mean arterial blood pressure was significantly higher in the cL VII group (95 +/- 10 mmHg) than in the NG and CR groups (81.6 +/- 12.3 and 80 +/- 11.8, respectively, p < 0.001). The cL VH and eCL VH groups had significantly lower mean hemoglobin Emricasan mw (10.3 +/- 1.4g/dL and 10.6 +/- 1g/dL, respectively) compared

with the NG group (11.9 +/- 1.4g/dL), p < 0.001. Furthermore, interdialytic weight gain (kg) was significantly higher in eCL

VII group (3.13 +/- 0.8) than in NG group (2.3 +/- 1.1), p < 0.001. Mean IVC index of the eL VH group (10.83 +/- 2.07 mm/m(2)) was significantly higher than corresponding indexes of NG (10.83 +/- 2.07 mm/m2), CR (8.31 ALK mutation +/- 1.32 mm/m(2)) and cL VH (8.12 +/- 2.06 mm/m(2)) groups (p < 0.001 for each comparisons). Conclusion. Mean arterial pressure, hemoglobin, IVC index, and interdialytic weight gain were found to be independent predictors of LV geometry (R(2) = 0.147; p < 0.001) in HD patients.”
“Novel phenolic type of thermoset resins were synthesized, and their mechanical and toughness properties were evaluated. Phenol Formaldehyde (PF) phenolic resins were modified to broaden their applications for modern composite structures. A first modification consisted of copolymerization of Phenol with Cardanol during the synthesis of resole phenolic (CPF) resins. The modified phenolic resins (CPF) were prepared at various molar ratios of total Phenol to Formaldehyde (F : P ratio) and with different weight ratios of Phenol to Cardanol. CPF resins with a maximum content of 40 wt % of Cardanol were synthesized and used. The CPF resins were applied as a plasticizer and toughening agent to the base PF resins. Both resins (CPF/PF) were mixed in different proportions, and their thermal and mechanical properties were then established. A full miscibility of the two resins was observed with the formation of a single-phase system.

In nine patients with the modified protocol, with asynchronized and arrested pinopodes, simultaneous transfer of embryos of different ages was fulfilled. The implantation, pregnancy and take-home-baby Savolitinib research buy rates for the modified and standard protocols were 28.0% versus 6.0%, 52.4% versus 12.0% and 47.6% versus 12.0%, respectively. Detection of inappropriately timed pinopode formation with subsequent synchronization of embryonic development and endometrial maturation allowed improvements in the effectiveness

of programmes using frozen-thawed embryos in women with multiple implantation failure. (C) 2011, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“Lumbar laminectomy affects spinal stability in shear loading. However, the effects of laminectomy on torsion biomechanics are unknown. The purpose of this study was to investigate the effect of laminectomy on

torsion stiffness and torsion strength of lumbar spinal segments following SB202190 laminectomy and whether these biomechanical parameters are affected by disc degeneration and bone mineral density (BMD).

Ten human cadaveric lumbar spines were obtained (age 75.5, range 59-88). Disc degeneration (MRI) and BMD (DXA) were assessed. Disc degeneration was classified according to Pfirrmann and dichotomized in mild or severe. BMD was defined as high BMD (a parts per thousand yenmedian BMD) or low BMD (< median BMD). Laminectomy was performed either on L2 (5x) or L4 (5x). Twenty motion segments (L2-L3 and L4-L5) were isolated. The effects of laminectomy, disc degeneration and BMD on torsion stiffness (TS) and torsion moments to failure (TMF) were studied.

Load-displacement curves showed a typical bi-phasic pattern with an early torsion stiffness (ETS), late torsion stiffness (LTS) and a TMF. Following laminectomy, ETS decreased

34.1 % (p < 0.001), LTS decreased 30.1 % (p = 0.027) and TMF decreased 17.6 % (p = 0.041). Disc degeneration (p < 0.001) and its interaction with laminectomy (p < Peptide 17 clinical trial 0.031) did significantly affect ETS. In the mildly degenerated group, ETS decreased 19.7 % from 7.6 Nm/degree (6.4-8.4) to 6.1 Nm/degree (1.5-10.3) following laminectomy. In the severely degenerated group, ETS decreased 22.3 % from 12.1 Nm/degree (4.6-21.9) to 9.4 Nm/degree (5.6-14.3) following laminectomy. In segments with low BMD, TMF was 40.7 % (p < 0.001) lower than segments with high BMD [34.9 Nm (range 23.7-51.2) versus 58.9 Nm (range 43.8-79.2)].

Laminectomy affects both torsion stiffness and torsion load to failure. In addition, torsional strength is strongly affected by BMD whereas disc degeneration affects torsional stiffness. Assessment of disc degeneration and BMD pre-operatively improves the understanding of the biomechanical effects of a lumbar laminectomy.

(Endocr Pract. 2012;18: 567-578)”
“Chorangiosis is microscopically designated as more than ten terminal capillaries within the villous stroma of the placenta and is mostly related to chronic fetal hypoxia. However, the histogenetic relationship between increased number of terminal villous capillaries and chronic hypoxia has not yet been clarified. Of 665 placentas histologically examined at Saitama Medical University from 2003 to 2010, chorangiosis was found in 58 cases (8.7 %), which were mostly more than 35 gestational

weeks. In addition, low birth weight (less than 2,500 g) infants (74.1 %) and those who suffered from cardiac anomalies, chromosome anomalies, Crenigacestat supplier and single umbilical artery comprised 32.7 % of cases. Placental lesions were associated with chorangiosis involved in infarct (46.6 %), intervillous thrombosis (20.7 %), and marginal hemorrhages MEK inhibitor review (22.4 %). Scanning electron microscopic studies showed narrowing of vessel ostium and disorders of endothelium in the umbilical cord vessel complicated by chorangiosis. Furthermore, in transmission electron microscopic observation, not only the chorionic villi had multiple enlarged vessels within the villous stroma, but we also found

that new capillaries were formed by angiogenesis with endothelial cells derived from fibroblasts under the chronic hypoxic state.”
“Implantable cardioverter defibrillators (ICDs) are being used with increasing frequency in children and young adults. Our aim was to examine the appropriateness and frequency of ICD discharges in children and young adults, to compare the effectiveness of ICDs when placed for primary or secondary prevention, and to provide time-dependent analysis OH-FMK Caspase Inhibitor VI mouse of ICD discharges. Data were collected from seven institutions on 210 patients < 30 years of age

who underwent ICD implantation from October 1992 to January 2007. Median age at implant was 15.4 years with a follow-up average of 3.3 years. Heart disease was categorized as electrical (n = 90, 42%), cardiomyopathic (n = 62, 30%), or congenital heart disease (n = 58, 28%). ICDs are increasingly placed for primary prevention. There are increased appropriate ICD discharges for ICDs placed for secondary prevention (52%) versus primary prevention (14%) at 5 years. There is no difference in the risk of inappropriate discharges between primary and secondary prevention indications. There is an increased risk for inappropriate therapy in the congenital heart disease population. An increasing number of ICDs are being placed for primary prevention in young patients, a marked shift in practice during the last two decades. The benefits of ICDs remain greater in secondary than in primary-prevention patients.