Database : MEDLINE
Search on : hospitalization [Words]
References found : 168779 [refine]
Displaying: 1 .. 10   in format [Detailed]

page 1 of 16878 go to page                         

  1 / 168779 MEDLINE  
              next record last record
select
to print
Photocopy
Full text

[PMID]: 29524714
[Au] Autor:Ning GZ; Kan SL; Zhu RS; Feng SQ
[Ad] Address:Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China.
[Ti] Title:Comparison of Mobi-C Cervical Disc Arthroplasty versus Fusion for the Treatment of Symptomatic Cervical Degenerative Disc Disease.
[So] Source:World Neurosurg;, 2018 Mar 07.
[Is] ISSN:1878-8769
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Mobi-C cervical disc arthroplasty (MCDA) has been regarded as an alternative to anterior cervical discectomy and fusion (ACDF). In this study, the effectiveness and safety between MCDA and ACDF for symptomatic cervical degenerative disc disease was evaluated. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials. Studies were included based on the eligibility criteria. Risk of bias assessment and quality of evidence assessment were performed. RESULTS: Four studies with 785 patients were included. For clinical outcomes, MCDA were superior to ACDF considering fewer subsequent surgical intervention (P < 0.00001), lower neck pain scores (P = 0.01), lower incidences of adjacent segment degeneration (ASD) at both superior and inferior level (P = 0.0003 and P = 0.01, respectively), greater range of motion (ROM) of the operated segment (P < 0.0001), and higher patient satisfaction (P = 0.007). No substantial differences were observed between two groups regarding surgery time, blood loss, duration of hospitalization, neck disability index (NDI) scores and arm pain scores (P > 0.05). Subgroup analyses indicated that for patients with two-level CDDD, MCDA demonstrated lower NDI and arm pain scores, and higher patient satisfaction (P < 0.05) compared with ACDF. CONCLUSION: MCDA presented fewer subsequent surgical intervention, lower neck pain score, lower incidences of ASD at superior and inferior level, greater ROM and higher score of patient satisfaction than ACDF. However, considering the surgery time, blood loss, duration of hospitalization, NDI and neck pain scores, MCDA was similar with ACDF.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29524610
[Au] Autor:Anandappa M; Adjei Boakye E; Li W; Zeng W; Rebmann T; Chang JJ
[Ad] Address:Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
[Ti] Title:Racial disparities in vaccination for seasonal influenza in early childhood.
[So] Source:Public Health;158:1-8, 2018 Mar 07.
[Is] ISSN:1476-5616
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Influenza vaccination is the best protection against infection and severe complications of disease, such as hospitalization and death. Therefore, it is important to accurately estimate vaccination coverage and to evaluate the role of race/ethnicity. This study examines racial disparities in influenza vaccination among children using a nationally representative sample. STUDY DESIGN: This study used cross-sectional data from the 2009-2014 National Immunization Survey for children aged 19-35 months (n = 98,186) in the United States. METHODS: The outcome variable was receipt of influenza vaccination (yes/no) and exposure variable was race/ethnicity. Weighted multivariate logistic regression was used to estimate the odds ratio and 95% confidence intervals (CIs) for the effect of race/ethnicity on receipt of the influenza vaccine. RESULTS: The overall vaccination rates were 81.6% for non-Hispanic whites, 79.2% for Hispanics, 80.5% for non-Hispanic blacks, and 80.7% for non-Hispanic mixed/other. In the adjusted model, compared with non-Hispanic white children, Hispanic children were 13% less likely to receive influenza vaccination within the last 12 months (adjusted odds ratio [aOR] = 0.87; 95% CI: 0.80-0.94). In addition, children aged 24-29 months (aOR = 0.48; 95% CI: 0.44-0.52) and 30-35 months (aOR = 0.33; 95% CI: 0.30-0.36) were significantly less likely to receive influenza vaccination within the last 12 months compared with those who were 19-23 months old. CONCLUSIONS: There were differences in influenza vaccination rates among different racial groups. Hispanic children had the lowest vaccination rates. Findings from our study have significant implications for targeted interventions to increase the overall vaccination rate for children in the United States.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29515974
[Au] Autor:Ewan VC; Reid WDK; Shirley M; Simpson AJ; Rushton SP; Wade WG
[Ad] Address:South Tees Hospital, NHS Foundation Trust, Middlesbrough, United Kingdom.
[Ti] Title:Oropharyngeal Microbiota in Frail Older Patients Unaffected by Time in Hospital.
[So] Source:Front Cell Infect Microbiol;8:42, 2018.
[Is] ISSN:2235-2988
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Respiratory tract infections are the commonest nosocomial infections, and occur predominantly in frailer, older patients with multiple comorbidities. The oropharyngeal microbiota is the major reservoir of infection. This study explored the relative contributions of time in hospital and patient demographics to the community structure of the oropharyngeal microbiota in older patients with lower limb fracture. We collected 167 throat swabs from 53 patients (mean age 83) over 14 days after hospitalization, and analyzed these using 16S rRNA gene sequencing. We calculated frailty/comorbidity indices, undertook dental examinations and collected data on respiratory tract infections. We analyzed microbial community composition using correspondence (CA) and canonical correspondence analysis. Ten patients were treated for respiratory tract infection. Microbial community structure was related to frailty, number of teeth and comorbidity on admission, with comorbidity exerting the largest effect. Time in hospital neither significantly changed alpha ( = -0.910, = 0.365) nor beta diversity (CA1 = 0.022, = 0.982; CA2 = -0.513, = 0.609) of microbial communities in patient samples. Incidence of respiratory pathogens were not associated with time in hospital ( = -0.207, = 0.837), nor with alpha diversity of the oral microbiota ( = -1.599, = 0.113). Patient characteristics at admission, rather than time in hospital, influenced the community structure of the oral microbiota.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.3389/fcimb.2018.00042

  4 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29506511
[Au] Autor:Seibt S; Gilchrist CA; Reed PW; Best EJ; Harnden A; Camargo CA; Grant CC
[Ad] Address:Paediatrics, Taranaki Base Hospital, New Plymouth, New Zealand.
[Ti] Title:Hospital readmissions with acute infectious diseases in New Zealand children < 2 years of age.
[So] Source:BMC Pediatr;18(1):98, 2018 Mar 05.
[Is] ISSN:1471-2431
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Infectious diseases are the leading cause of hospital admissions in young children. Hospitalisation with an infectious disease is a recurrent event for some children. Our objective was to describe risk factors for infectious disease readmission following hospital admission with an infectious disease in the first two years of life. METHODS: We performed a national cohort study of New Zealand children, born 2005-2009, with an infectious disease admission before age 24 months. Children readmitted with an infectious disease within 12 months of the first infectious disease admission were identified. Every infectious disease admission was categorised as a respiratory, enteric, skin and soft tissue, urinary or other infection. Independent associations of demographic and child health factors with infectious disease readmission were determined using multiple variable logistic regression. RESULTS: From 2005 to 2011, there were 69,902 infectious disease admissions for 46,657 children less than two years old. Of these 46,657 children, 10,205 (22%) had at least one infectious disease readmission within 12 months of their first admission. The first infectious disease admission was respiratory (54%), enteric (15%), skin or soft tissue (7%), urinary (4%) or other (20%). Risk of infectious disease readmission was increased if the first infectious disease admission was respiratory (OR = 1.87, 95% CI 1.78-1.95) but not if it was in any other infectious disease category. Risk factors for respiratory infectious disease readmission were male gender, Pacific or Maori ethnicity, greater household deprivation, presence of a complex chronic condition, or a first respiratory infectious disease admission during autumn or of ≥3 days duration. Fewer factors (younger age, male gender, presence of a complex chronic condition) were associated with enteric infection readmission. The presence of a complex chronic condition was the only factor associated with urinary tract infection readmission and none of the factors were associated with skin or soft tissue infection readmission. CONCLUSIONS: In children less than two years old, infectious disease readmission risk is increased if the first infectious disease admission is a respiratory infectious disease but not if it is another infectious disease category. Risk factors for respiratory infectious disease readmission are different from those for other infectious disease readmissions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1186/s12887-018-1079-x

  5 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29438721
[Au] Autor:Jentzer JC; Anavekar NS; Mankad SV; White RD; Kashani KB; Barsness GW; Rabinstein AA; Pislaru SV
[Ad] Address:Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester MN 55905, United states; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester MN 55905, United states. Electronic address: jentzer.jacob@mayo.e
[Ti] Title:Changes in left ventricular systolic and diastolic function on serial echocardiography after out-of-hospital cardiac arrest.
[So] Source:Resuscitation;126:1-6, 2018 Feb 10.
[Is] ISSN:1873-1570
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:AIM: Reversible myocardial dysfunction is common after out-of-hospital cardiac arrest (OHCA). The aim of this study was to determine if changes on serial transthoracic echocardiography (TTE) can predict long-term mortality in OHCA subjects. METHODS: This is a single-center historical cohort study of OHCA subjects undergoing targeted temperature management who received >1 TTE during hospitalization. Two-dimensional and Doppler parameters of systolic and diastolic function were compared between paired TTE. Univariate analysis was used to determine associations between TTE parameters and all-cause mortality. RESULTS: Fifty-nine patients were included; mean age was 59.4 ±â€¯11.2 years (75% male). Initial rhythm was shockable in 90%. Initial TTE was done a median of 10.4 h after admission and repeat TTE was done 5.7 ±â€¯4.1 days later. Between TTE studies, there were significant increases in left ventricular ejection fraction (LVEF, from 32% to 43%), cardiac output, stroke volume, and other Doppler-derived hemodynamic parameters, while systemic vascular resistance decreased (all p < 0.001). Systolic function and hemodynamic parameters on initial TTE were not associated with follow-up mortality. Patients who died during follow-up (n = 16, 27%) had smaller increases in LVEF and cardiac output-derived hemodynamic parameters than long-term survivors (p < 0.05). CONCLUSIONS: Significant changes in systolic function and hemodynamic parameters occur on serial Doppler TTE after OHCA, consistent with reversible post-arrest myocardial dysfunction. The magnitude of those changes is greater in long-term survivors, emphasizing that the degree of recovery from post-arrest myocardial dysfunction may be more important than its initial severity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  6 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Clinical Trials Registry
Full text

[PMID]: 29410163
[Au] Autor:Bledsoe J; Woller S; Stevens S; Aston V; Patten R; Allen T; Horne B; Dong L; Lloyd J; Snow G; Madsen T; Elliott G
[Ad] Address:Department of Emergency Medicine, Stanford University-Intermountain Medical Center, Salt Lake City, UT. Electronic address: Joseph.bledsoe@imail.org.
[Ti] Title:Management of Low-Risk Pulmonary Embolism Patients Without Hospitalization: The Low-Risk Pulmonary Embolism Prospective Management Study.
[So] Source:Chest;, 2018 Feb 02.
[Is] ISSN:1931-3543
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The efficacy and safety of managing patients with low-risk pulmonary embolism (PE) without hospitalization requires objective data from US medical centers. We sought to determine the 90-day composite rate of recurrent symptomatic VTE, major bleeding events, and all-cause mortality among consecutive patients diagnosed with acute low-risk PE managed without inpatient hospitalization; and to measure patient satisfaction. METHODS: We performed a prospective cohort single-arm management study conducted from January 2013 to October 2016 in five EDs. We enrolled 200 consecutive adults diagnosed with objectively confirmed acute PE and assessed to have a low risk for mortality using the Pulmonary Embolism Severity Index (PESI) score (< 86), echocardiography, and whole-leg compression ultrasound (CUS). The primary intervention was observation in the ED or hospital (observation status) for > 12 to < 24 h, followed by outpatient management with Food and Drug Administration-approved therapeutic anticoagulation. Patients were excluded for a PESI ≥ 86, echocardiographic signs of right heart strain, DVT proximal to the popliteal vein, hypoxia, hypotension, hepatic or renal failure, contraindication to therapeutic anticoagulation, or another condition requiring hospital admission. The primary outcome was 90-day composite rate of all-cause mortality, recurrent symptomatic VTE, and major bleeding. RESULTS: The composite outcome occurred in one of 200 patients (90-day composite rate = 0.5%; 95% CI, 0.02%-2.36%). No patient suffered recurrent VTE or died during the 90-day follow-up period. A major bleed occurred in one patient. Patients indicated a high level of satisfaction with their care. CONCLUSIONS: Treatment of carefully selected patients with acute PE and low risk by PESI < 86, echocardiography, and CUS without inpatient hospitalization is safe and acceptable to patients. Results must be viewed with caution because of the small sample size relative to the end point and the generalizability surrounding availability of emergent echocardiography. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT02355548; URL: www.clinicaltrials.gov.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[Cl] Clinical Trial:ClinicalTrial
[St] Status:Publisher

  7 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29362796
[Au] Autor:Bouillon K; Bertrand M; Bader G; Lucot JP; Dray-Spira R; Zureik M
[Ad] Address:Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety (ANSM), Saint-Denis, France.
[Ti] Title:Association of Hysteroscopic vs Laparoscopic Sterilization With Procedural, Gynecological, and Medical Outcomes.
[So] Source:JAMA;319(4):375-387, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Safety of hysteroscopic sterilization has been recently questioned following reports of general symptoms such as allergy, tiredness, and depression in addition to associated gynecological results such as pelvic pain, perforation of fallopian tubes or uterus, and unwanted pregnancy. Objective: To compare the risk of reported adverse events between hysteroscopic and laparoscopic sterilization. Design, Setting, and Participants: French nationwide cohort study using the national hospital discharge database linked to the health insurance claims database. Women aged 30 to 54 years receiving a first hysteroscopic or laparoscopic sterilization between 2010 and 2014 were included and were followed up through December 2015. Exposures: Hysteroscopic sterilization vs laparoscopic sterilization. Main Outcomes and Measures: Risks of procedural complications (surgical and medical) and of gynecological (sterilization failure that includes salpingectomy, second sterilization procedure, or pregnancy; pregnancy; reoperation) and medical outcomes (all types of allergy; autoimmune diseases; thyroid disorder; use of analgesics, antimigraines, antidepressants, benzodiazepines; outpatient visits; sickness absence; suicide attempts; death) that occurred within 1 and 3 years after sterilization were compared using inverse probability of treatment-weighted Cox models. Results: Of the 105 357 women included (95.5% of eligible participants; mean age, 41.3 years [SD, 3.7 years]), 71 303 (67.7% ) underwent hysteroscopic sterilization, and 34 054 (32.3%) underwent laparoscopic sterilization. During the hospitalization for sterilization, risk of surgical complications for hysteroscopic sterilization was lower: 0.13% for hysteroscopic sterilization vs 0.78% for laparoscopic sterilization (adjusted risk difference [RD], -0.64; 95% CI, -0.67 to -0.60) and was lower for medical complications: 0.06% vs 0.11% (adjusted RD, -0.05; 95% CI, -0.08 to -0.01). During the first year after sterilization, 4.83% of women who underwent hysteroscopic sterilization had a higher risk of sterilization failure than the 0.69% who underwent laparoscopic sterilization (adjusted hazard ratio [HR], 7.11; 95% CI, 5.92 to 8.54; adjusted RD, 4.23 per 100 person-years; 95% CI, 3.40 to 5.22). Additionally, 5.65% of women who underwent hysteroscopic sterilization required gynecological reoperation vs 1.76% of women who underwent laparoscopic sterilization (adjusted HR, 3.26; 95% CI, 2.90 to 3.67; adjusted RD, 4.63 per 100 person-years; 95% CI, 3.38 to 4.75); these differences persisted after 3 years, although attenuated. Hysteroscopic sterilization was associated with a lower risk of pregnancy within the first year of the procedure but was not significantly associated with a difference in risk of pregnancy by the third year (adjusted HR, 1.04; 95% CI, 0.83-1.30; adjusted RD, 0.01 per 100 person-years; 95% CI, -0.04 to 0.07). Risks of medical outcomes were not significantly increased with hysteroscopic sterilization compared with laparoscopic sterilization. Conclusions and Relevance: Among women undergoing first sterilization, the use of hysteroscopic sterilization was significantly associated with higher risk of gynecological complications over 1 year and over 3 years than was laparoscopic sterilization. Risk of medical outcomes was not significantly increased over 1 year or over 3 years. These findings do not support increased medical risks associated with hysteroscopic sterilization.
[Mh] MeSH terms primary: Hysteroscopy/adverse effects
Laparoscopy/adverse effects
Postoperative Complications/etiology
Sterilization, Tubal/methods
[Mh] MeSH terms secundary: Adult
Cohort Studies
Female
France
Humans
Middle Aged
Postoperative Complications/epidemiology
Pregnancy
Pregnancy, Unplanned
Reoperation/statistics & numerical data
Sterilization, Tubal/adverse effects
Treatment Failure
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Entry month:1801
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21269

  8 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29359231
[Au] Autor:Kiadaliri AA; Englund M
[Ad] Address:Lund University, Faculty of Medicine, Department of Clinical Sciences-Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden. aliasghar.ahmad_kiadaliri@med.lu.se.
[Ti] Title:Temporal trends and regional disparity in rheumatoid arthritis and gout hospitalizations in Sweden, 1998-2015.
[So] Source:Clin Rheumatol;37(3):825-830, 2018 Mar.
[Is] ISSN:1434-9949
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Hospitalization is an important component of rheumatoid arthritis (RA) and gout economic burden. This study aimed to assess temporal trends and regional disparities in RA and gout hospitalizations among people aged ≥ 20 years in Sweden during 1998-2015. Data on hospital admissions with a principal diagnosis of RA or gout were collected from the National Patient Register. Age-standardized hospitalization rates (ASHRs) were calculated by means of direct standardization. The absolute and relative regional disparities were assessed. The temporal trends in ASHR and proportion of RA and gout hospitalizations from all and musculoskeletal disorders hospitalizations were analyzed using joinpoint regression. Between 1998-2000 and 2013-2015, the ASHR for RA declined by 78.9% from 109.9 to 23.2 per 100,000 Swedish adults, while it almost doubled for gout (from 10.5 to 20.8 per 100,000 Swedish adults). While in 1998-2000, RA hospitalizations were 10.3 times more frequent than gout (0.54 vs 0.05% of all hospitalizations), this ratio declined to 1.1 in 2013-2015 (0.13 vs 0.11% of all hospitalizations). The joinpoint regression revealed that, on average, the ASHR for RA declined by 10.2% (95% CI: 9.3-11.1) per year whereas for gout, it rose by 4.3% (3.2-5.4) per year during 1998-2015. While the relative regional disparities were stable, the absolute regional disparity declined for RA and increased for gout over the study period. While substantial decline in RA hospitalization is encouraging, the substantial rise in gout hospitalization is of concern, reflecting potential increase in prevalence of gout and suboptimal management of the disease.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1007/s10067-018-3983-8

  9 / 168779 MEDLINE  
              first record previous record next record last record
select
to print
Photocopy
Full text

[PMID]: 29236988
[Au] Autor:Bravo PE; Bergmark BA; Vita T; Taqueti VR; Gupta A; Seidelmann S; Christensen TE; Osborne MT; Shah NR; Ghosh N; Hainer J; Bibbo CF; Harrington M; Costantino F; Mehra MR; Dorbala S; Blankstein R; Desai A; Stevenson L; Givertz MM; Di Carli MF
[Ad] Address:Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Cardiovascular Imaging Program, Heart and Vascular Center, Brigham and Women's Hospital and Harvard Medical School, ASB-L1 037-C, 75 Francis Street, Boston, MA 02115, USA.
[Ti] Title:Diagnostic and prognostic value of myocardial blood flow quantification as non-invasive indicator of cardiac allograft vasculopathy.
[So] Source:Eur Heart J;39(4):316-323, 2018 Jan 21.
[Is] ISSN:1522-9645
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Aims: Cardiac allograft vasculopathy (CAV) is a leading cause of death in orthotopic heart transplant (OHT) survivors. Effective non-invasive screening methods are needed. Our aim was to investigate the added diagnostic and prognostic value of myocardial blood flow (MBF) to standard myocardial perfusion imaging (MPI) with positron emission tomography (PET) for CAV detection. Methods and results: We studied 94 OHT recipients (prognostic cohort), including 66 who underwent invasive coronary angiography and PET within 1 year (diagnostic cohort). The ISHLT classification was used as standard definition for CAV. Positron emission tomography evaluation included semiquantitative MPI, quantitative MBF (mL/min/g), and left ventricular ejection fraction (LVEF). A PET CAV severity score (on a scale of 0-3) was modelled on the ISHLT criteria. Patients were followed for a median of 2.3 years for the occurrence of major adverse events (death, re-transplantation, acute coronary syndrome, and hospitalization for heart failure). Sensitivity, specificity, positive, and negative predictive value of semiquantitative PET perfusion alone for detecting moderate-severe CAV were 83% [52-98], 82% [69-91], 50% [27-73], and 96% [85-99], respectively {receiver operating characteristic (ROC area: 0.82 [0.70-0.95])}. These values improved to 83% [52-98], 93% [82-98], 71% [42-92], and 96% [97-99], respectively, when LVEF and stress MBF were added (ROC area: 0.88 [0.76-0.99]; P = 0.01). There were 20 major adverse events during follow-up. The annualized event rate was 5%, 9%, and 25% in patients with normal, mildly, and moderate-to-severely abnormal PET CAV grading (P < 0.001), respectively. Conclusion: Multiparametric cardiac PET evaluation including quantification of MBF provides improved detection and gradation of CAV severity over standard myocardial perfusion assessment and is predictive of major adverse events.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1093/eurheartj/ehx683

  10 / 168779 MEDLINE  
              first record previous record
select
to print
Photocopy
Full text

[PMID]: 29204655
[Au] Autor:Delgado J; Bowman K; Ble A; Masoli J; Han Y; Henley W; Welsh S; Kuchel GA; Ferrucci L; Melzer D
[Ad] Address:Epidemiology and Public Health, Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, United Kingdom.
[Ti] Title:Blood Pressure Trajectories in the 20 Years Before Death.
[So] Source:JAMA Intern Med;178(1):93-99, 2018 Jan 01.
[Is] ISSN:2168-6114
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: There is mixed evidence that blood pressure (BP) stabilizes or decreases in later life. It is also unclear whether BP trajectories reflect advancing age, proximity to end of life, or selective survival of persons free from hypertension. Objective: To estimate individual patient BP for each of the 20 years before death and identify potential mechanisms that may explain trajectories. Design, Study, and Participants: We analyzed population-based Clinical Practice Research Datalink primary care and linked hospitalization electronic medical records from the United Kingdom, using retrospective cohort approaches with generalized linear mixed-effects modeling. Participants were all available individuals with BP measures over 20 years, yielding 46 634 participants dying aged at least 60 years, from 2010 to 2014. We also compared BP slopes from 10 to 3 years before death for 20 207 participants who died, plus 20 207 birth-year and sex-matched participants surviving longer than 9 years. Main Outcomes and Measures: Clinically recorded individual patient repeated systolic BP (SBP) and diastolic BP (DBP). Results: In 46 634 participants (51.7% female; mean [SD] age at death, 82.4 [9.0] years), SBPs and DBPs peaked 18 to 14 years before death and then decreased progressively. Mean changes in SBP from peak values ranged from -8.5 mm Hg (95% CI, -9.4 to -7.7) for those dying aged 60 to 69 years to -22.0 mm Hg (95% CI, -22.6 to -21.4) for those dying at 90 years or older; overall, 64.0% of individuals had SBP changes of greater than -10 mm Hg. Decreases in BP appeared linear from 10 to 3 years before death, with steeper decreases in the last 2 years of life. Decreases in SBP from 10 to 3 years before death were present in individuals not treated with antihypertensive medications, but mean yearly changes were steepest in patients with hypertension (-1.58; 95% CI, -1.56 to -1.60 mm Hg vs -0.70; 95% CI, -0.65 to -0.76 mm Hg), dementia (-1.81; 95% CI, -1.77 to -1.87 mm Hg vs -1.41; 95% CI, -1.38 to -1.43 mm Hg), heart failure (-1.66; 95% CI, -1.62 to -1.69 mm Hg vs -1.37; 95% CI, -1.34 to -1.39 mm Hg), and late-life weight loss. Conclusions and Relevance: Mean SBP and DBP decreased for more than a decade before death in patients dying at 60 years and older. These BP decreases are not simply attributable to age, treatment of hypertension, or better survival without hypertension. Late-life BP decreases may have implications for risk estimation, treatment monitoring, and trial design.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.1001/jamainternmed.2017.7023


page 1 of 16878 go to page                         
   


Refine the search
  Database : MEDLINE Advanced form   

    Search in field  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/PAHO/WHO - Latin American and Caribbean Center on Health Sciences Information