简介：Sarcoidosisisarareconditionofgranulomatousinfiltrationofmanytissuesofthebody,includingtheheart.Cardiacsarcoidosishasbeenchallengingtostudy,asitisoftenasymptomatic,althoughtheinitialpresentationcanbesuddencardiacdeath.Theincidenceandprevalencerateshavebeendifficulttoestablishandnoexpertagreeduponguidelinesfordiagnosisandmanagementofcardiacsarcoidosisexist,andclinicalmanifestationsarevaried.Thepathophysiologyofgranulomaformationinthemyocardiumaswellasothertissuesisgovernedbyimmuneresponsetosomeenvironmentalantigen.Geneticsisalsothoughttoplayarole,althoughgenealterationshavenotbeenextensivelystudied,andnospecificsetofgeneticmutationshasbeenidentifiedtoaidinidentificationofindividualsatriskofdevelopingdisease.Epigeneticfactorslikelyplayasignificantroleinmodulationofgeneexpressionwithrespecttoimmuneresponse.Thereisnostandardizedscreeningtoolfortheidentificationofcardiacsarcoidosis.Thepresenceofsystemicsarcoidosisandnew-onsetthird-degreeheartblockorventriculararrhythmiaswarrantsfurtherinvestigationforcardiacsarcoidosis.MRIandPETareusefulinhelpingtoidentifycardiacsarcoidosisbutarenotstand-alonetests.Endomyocardialbiopsyisthegoldstandardbuthasalowyieldowingtothepatchynatureofgranulomaformationinthemyocardium.Therapyshouldbeinstitutedearlyandinvolvesimmunosuppressivetherapywithpredominantuseofcorticosteroids.Arrhythmias,eitherventricularorhigh-gradeheartblocks,aremanagedwithdevicetherapy.Clinicalpresentationmaywarrantuseofantiarrhythmicagentsand/orcatheterablation.Survivalanddiseaseprognosisaredependentonearlydiagnosisandtreatment.Thisreviewdetailsthecurrentunderstandingofcardiacsarcoidosisandhighlightsdiagnosticstrategiesandtreatmentwiththeaimofguidingthecliniciantoearlyidentificationofpatientsandimplementationofappropriatemanagementinthisraredi

简介：Purpose:Acuteexercisehasbeenlinkedtothefacilitationofexecutivefunction,butlittleisknownregardingexecutivefunctionassessedbytheWisconsinCardSortingTest(WCST).ThepresentresearchconsistedoftwoexperimentsaimedtodeterminewhetheracuteaerobicexerciseinfluencessuccessiveWCSTperformance.Methods:InStudy1,27youngadultswererandomlyassignedtotheexerciseorreadingcontrolgroupandtheninstructedtoperformtheWCSTbeforeandafterassignedtreatment.Inexercisegroup,participantscompletedasingleboutaerobicexercisewithmoderateintensityfor20minonastationarybike.AsimilarexperimentalprotocolwasreplicatedinStudy2with24latemiddle-agedadultstolookforagedifferencesduringadulthoodandcontrolforapotentialceilingeffectatyoungadultage.Results:Althoughasignificanttimeeffectwasobservedinyoungadults,bothstudiesrevealedthattherewasnomaineffectfortreatmentoraninteractionbetweentreatmentandtimeonanyoftheWCSTindices.Conclusion:AcuteaerobicexercisefailedtoinfluenceexecutivefunctionasassessedbytheWCST,revealingthatthisclassicalneuropsychologicaltesttappingexecutivefunctionmaynotbesensitivetoacuteexercise.Ourfindingssuggestthatacuteexercisedoesnotbroadlyaffecttheentirefamilyofexecutivefunctions,oritseffectonaspecificaspectofexecutivefunctionmaybetask-dependent,asproposedbyEtnierandChang(2009).