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[PMID]:29268641
[Au] Autor:Junge JH; Sieber T; Hugentobler-Campell B
[Ad] Endereço:1 Departement Anästhesie, Notfall, Intensiv, Rettung, Kantonsspital Graubünden, Chur.
[Ti] Título:Präklinische Notfallmedizin..
[So] Source:Ther Umsch;74(7):399-404, 2017.
[Is] ISSN:0040-5930
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Cuidados Críticos/métodos
Estado Terminal/terapia
Serviços Médicos de Emergência/métodos
Medicina de Emergência/métodos
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1024/0040-5930/a000932


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[PMID]:29211672
[Au] Autor:Stevens DL; Bryant AE
[Ad] Endereço:From the Veterans Affairs Medical Center, Boise, ID; and the University of Washington School of Medicine, Seattle.
[Ti] Título:Necrotizing Soft-Tissue Infections.
[So] Source:N Engl J Med;377(23):2253-2265, 2017 Dec 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Desbridamento
Fasciite Necrosante
[Mh] Termos MeSH secundário: Anti-Inflamatórios não Esteroides/efeitos adversos
Biomarcadores/sangue
Biópsia
Proteína C-Reativa/análise
Estado Terminal
Fasciite Necrosante/diagnóstico
Fasciite Necrosante/etiologia
Fasciite Necrosante/patologia
Fasciite Necrosante/terapia
Gangrena Gasosa
Seres Humanos
Oxigenação Hiperbárica
Imunoglobulinas Intravenosas/uso terapêutico
Infecções dos Tecidos Moles
Infecções Estreptocócicas/induzido quimicamente
Streptococcus pyogenes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Biomarkers); 0 (Immunoglobulins, Intravenous); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMra1600673


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[PMID]:27770828
[Au] Autor:Álvarez-Lerma F; Marín-Corral J; Vila C; Masclans JR; González de Molina FJ; Martín Loeches I; Barbadillo S; Rodríguez A; H1N1 GETGAG/SEMICYUC Study Group
[Ad] Endereço:Service of Intensive Care Medicine, Hospital del Mar, Passeig Marítim 25-29, E-08003, Barcelona, Spain. FAlvarez@parcdesalutmar.cat.
[Ti] Título:Delay in diagnosis of influenza A (H1N1)pdm09 virus infection in critically ill patients and impact on clinical outcome.
[So] Source:Crit Care;20(1):337, 2016 Oct 23.
[Is] ISSN:1466-609X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patients infected with influenza A (H1N1)pdm09 virus requiring admission to the ICU remain an important source of mortality during the influenza season. The objective of the study was to assess the impact of a delay in diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection on clinical outcome in critically ill patients admitted to the ICU. METHODS: A prospective multicenter observational cohort study was based on data from the GETGAG/SEMICYUC registry (2009-2015) collected by 148 Spanish ICUs. All patients admitted to the ICU in which diagnosis of influenza A (H1N1)pdm09 virus infection had been established within the first week of hospitalization were included. Patients were classified into two groups according to the time at which the diagnosis was made: early (within the first 2 days of hospital admission) and late (between the 3rd and 7th day of hospital admission). Factors associated with a delay in diagnosis were assessed by logistic regression analysis. RESULTS: In 2059 ICU patients diagnosed with influenza A (H1N1)pdm09 virus infection within the first 7 days of hospitalization, the diagnosis was established early in 1314 (63.8 %) patients and late in the remaining 745 (36.2 %). Independent variables related to a late diagnosis were: age (odds ratio (OR) = 1.02, 95 % confidence interval (CI) 1.01-1.03, P < 0.001); first seasonal period (2009-2012) (OR = 2.08, 95 % CI 1.64-2.63, P < 0.001); days of hospital stay before ICU admission (OR = 1.26, 95 % CI 1.17-1.35, P < 0.001); mechanical ventilation (OR = 1.58, 95 % CI 1.17-2.13, P = 0.002); and continuous venovenous hemofiltration (OR = 1.54, 95 % CI 1.08-2.18, P = 0.016). The intra-ICU mortality was significantly higher among patients with late diagnosis as compared with early diagnosis (26.9 % vs 17.1 %, P < 0.001). Diagnostic delay was one independent risk factor for mortality (OR = 1.36, 95 % CI 1.03-1.81, P < 0.001). CONCLUSIONS: Late diagnosis of community-acquired influenza A (H1N1)pdm09 virus infection is associated with a delay in ICU admission, greater possibilities of respiratory and renal failure, and higher mortality rate. Delay in diagnosis of flu is an independent variable related to death.
[Mh] Termos MeSH primário: Influenza Humana/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Distribuição de Qui-Quadrado
Estado Terminal/epidemiologia
Diagnóstico Tardio
Feminino
Mortalidade Hospitalar
Seres Humanos
Vírus da Influenza A Subtipo H1N1/patogenicidade
Unidades de Terapia Intensiva/organização & administração
Unidades de Terapia Intensiva/estatística & dados numéricos
Tempo de Internação
Modelos Logísticos
Masculino
Meia-Idade
Razão de Chances
Estudos Prospectivos
Fatores de Risco
Espanha/epidemiologia
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29256282
[Au] Autor:Csöndes J; Fábián I; Szabó B; Máthé Á; Vajdovich P
[Ad] Endereço:1 Department of Clinical Pathology and Oncology, University of Veterinary Medicine , István u. 2, H-1078 Budapest , Hungary.
[Ti] Título:Assessment of adrenocortical reserve capacity and inflammatory parameters in critically ill dogs.
[So] Source:Acta Vet Hung;65(4):475-486, 2017 12.
[Is] ISSN:0236-6290
[Cp] País de publicação:Hungary
[La] Idioma:eng
[Ab] Resumo:Inflammatory markers and adrenocorticotropic hormone (ACTH) stimulation test results may help us recognise critically ill dogs with poor disease outcome. Systemic inflammatory response syndrome (SIRS) criteria, the fast version of the Acute Patient Physiologic and Laboratory Evaluation Score (APPLE ), complete blood count, albumin and C-reactive protein (CRP) levels, baseline and stimulated cortisol levels and Δcortisol value were recorded in 50 client-owned dogs admitted to the Small Animal Hospital of the University of Veterinary Medicine Budapest with various inflammatory or neoplastic conditions. Increasing APPLE score was associated with a decreasing chance of survival (P = 0.0420). The Δcortisol value was significantly higher in SIRS dogs than in non-SIRS dogs (mean ± SD Δcortisol : 342.5 ± 273.96; mean ± SD Δcortisol : 175.3 ± 150.35; P = 0.0443). Elevated baseline or stimulated cortisol levels were associated with a higher chance of non-survival (P = 0.0135 and P = 0.0311, respectively). These data indicate that pathologically higher baseline and stimulated cortisol levels represent an exaggerated stress response in critically ill dogs, which is negatively associated with survival.
[Mh] Termos MeSH primário: Hormônio Adrenocorticotrópico/metabolismo
Estado Terminal
Doenças do Cão/metabolismo
Inflamação/veterinária
Síndrome de Resposta Inflamatória Sistêmica/veterinária
[Mh] Termos MeSH secundário: Hormônio Adrenocorticotrópico/sangue
Animais
Biomarcadores/sangue
Cães
Feminino
Hidrocortisona/sangue
Hidrocortisona/metabolismo
Inflamação/sangue
Inflamação/metabolismo
Masculino
Síndrome de Resposta Inflamatória Sistêmica/sangue
Síndrome de Resposta Inflamatória Sistêmica/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers); 9002-60-2 (Adrenocorticotropic Hormone); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1556/004.2017.045


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[PMID]:28468613
[Au] Autor:Ostermann M; Hall A; Crichton S
[Ad] Endereço:Department of Critical Care, King's College London, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road SE1 7 EH, London, UK. Marlies.Ostermann@gstt.nhs.uk.
[Ti] Título:Low mean perfusion pressure is a risk factor for progression of acute kidney injury in critically ill patients - A retrospective analysis.
[So] Source:BMC Nephrol;18(1):151, 2017 May 03.
[Is] ISSN:1471-2369
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I. We compared patients with a MPP above and below the median value in the first 12 h of diagnosis of AKI. Multivariable logistic regression analyses were performed to identify independent risk factors for progression to AKI III, to explore the impact of MAP and CVP separately, and to investigate the impact of MPP in pre-defined sub-groups. RESULTS: Among 2118 ICU patients, 790 patients (37%) developed AKI I of whom 205 underwent advanced haemodynamic monitoring within 12 h of AKI stage I. Their median MPP was 59 mmHg. AKI I patients with a MPP ≤59 mmHg had a significantly higher risk of progressing to AKI stage III (48.6% versus 34%, respectively; p = 0.0034). This association was stronger in patients with ischemic heart disease, congestive cardiac failure or without pre-existing hypertension and in patients with a MAP <65 mmHg for >1 h. As individual components, a raised CVP was independently associated with progression to AKI stage III but MAP alone was not an independent risk factor for AKI progression. CONCLUSION: MPP <60 mmHg was independently associated with AKI progression. CVP was the key component of MPP.
[Mh] Termos MeSH primário: Lesão Renal Aguda/diagnóstico
Lesão Renal Aguda/epidemiologia
Pressão Sanguínea
Pressão Venosa Central
Estado Terminal/mortalidade
Progressão da Doença
[Mh] Termos MeSH secundário: Lesão Renal Aguda/fisiopatologia
Idoso
Comorbidade
Feminino
Cardiopatias
Seres Humanos
Londres/epidemiologia
Masculino
Meia-Idade
Prevalência
Estudos Retrospectivos
Fatores de Risco
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s12882-017-0568-8


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:29466591
[Au] Autor:van den Boogaard M; Slooter AJC; Brüggemann RJM; Schoonhoven L; Beishuizen A; Vermeijden JW; Pretorius D; de Koning J; Simons KS; Dennesen PJW; Van der Voort PHJ; Houterman S; van der Hoeven JG; Pickkers P; REDUCE Study Investigators
[Ad] Endereço:Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
[Ti] Título:Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial.
[So] Source:JAMA;319(7):680-690, 2018 02 20.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. Objective: To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands. Patients without delirium whose expected ICU stay was at least a day were included. Recruitment was from July 2013 to December 2016 and follow-up was conducted at 90 days with the final follow-up on March 1, 2017. Interventions: Patients received prophylactic treatment 3 times daily intravenously either 1 mg (n = 350) or 2 mg (n = 732) of haloperidol or placebo (n = 707), consisting of 0.9% sodium chloride. Main Outcome and Measures: The primary outcome was the number of days that patients survived in 28 days. There were 15 secondary outcomes, including delirium incidence, 28-day delirium-free and coma-free days, duration of mechanical ventilation, and ICU and hospital length of stay. Results: All 1789 randomized patients (mean, age 66.6 years [SD, 12.6]; 1099 men [61.4%]) completed the study. The 1-mg haloperidol group was prematurely stopped because of futility. There was no difference in the median days patients survived in 28 days, 28 days in the 2-mg haloperidol group vs 28 days in the placebo group, for a difference of 0 days (95% CI, 0-0; P = .93) and a hazard ratio of 1.003 (95% CI, 0.78-1.30, P=.82). All of the 15 secondary outcomes were not statistically different. These included delirium incidence (mean difference, 1.5%, 95% CI, -3.6% to 6.7%), delirium-free and coma-free days (mean difference, 0 days, 95% CI, 0-0 days), and duration of mechanical ventilation, ICU, and hospital length of stay (mean difference, 0 days, 95% CI, 0-0 days for all 3 measures). The number of reported adverse effects did not differ between groups (2 [0.3%] for the 2-mg haloperidol group vs 1 [0.1%] for the placebo group). Conclusions and Relevance: Among critically ill adults at high risk of delirium, the use of prophylactic haloperidol compared with placebo did not improve survival at 28 days. These findings do not support the use of prophylactic haloperidol for reducing mortality in critically ill adults. Trial Registration: clinicaltrials.gov Identifier: NCT01785290.
[Mh] Termos MeSH primário: Antipsicóticos/administração & dosagem
Estado Terminal/mortalidade
Delírio/prevenção & controle
Haloperidol/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Antipsicóticos/efeitos adversos
Relação Dose-Resposta a Droga
Método Duplo-Cego
Feminino
Haloperidol/efeitos adversos
Seres Humanos
Unidades de Terapia Intensiva
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Fatores de Risco
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antipsychotic Agents); J6292F8L3D (Haloperidol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0160


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[PMID]:29406045
[Au] Autor:Jalil B; Thompson P; Cavallazzi R; Marik P; Mann J; El-Kersh K; Guardiola J; Saad M
[Ad] Endereço:Division of Pulmonary, Department of Medicine, Critical Care and Sleep Disorders Medicine, University of Louisville, Louisville, Kentucky. Electronic address: bilaljalil@gmail.com.
[Ti] Título:Comparing Changes in Carotid Flow Time and Stroke Volume Induced by Passive Leg Raising.
[So] Source:Am J Med Sci;355(2):168-173, 2018 Feb.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Determining volume responsiveness in critically ill patients is challenging. We sought to determine if passive leg raise (PLR) induced changes in pulsed wave Doppler of the carotid artery flow time could predict fluid responsiveness in critically ill patients. MATERIALS AND METHODS: Medical intensive care unit patients ≥18 years old with a radial arterial line and FloTrac/Vigileo monitor in place were enrolled. Pulsed wave Doppler of the carotid artery was performed to measure the change in carotid flow time (CFT ) in response to a PLR. Patients were categorized as fluid responders if stroke volume increased by ≥15% on a Vigileo monitor. The main outcome measure was the accuracy of CFT to detect a change in response to a PLR. We also calculated the percentage increase in CFT that could predict fluid responsiveness. RESULTS: We enrolled 22 patients. Using an increase of ≥24.6% in the CFT in response to PLR to predict fluid responsiveness there was a sensitivity of 60%, specificity of 92%, positive likelihood ratio of 7.2, negative likelihood ratio of 0.4, positive predictive value of 86%, negative predictive value of 73% and receiver operating characteristic of 0.75 (95% CI: 0.54-0.96). CONCLUSIONS: CFT performs well compared to stroke volume measurements on a Vigileo monitor. The use of CFT is highlighted in resource-limited environments and when time limits the use of other methods. CFTc should be validated in a larger study with more operators against a variety of hemodynamic monitors.
[Mh] Termos MeSH primário: Artérias Carótidas/diagnóstico por imagem
Artérias Carótidas/fisiopatologia
Unidades de Terapia Intensiva
Postura
Volume Sistólico
Ultrassonografia Doppler de Pulso
[Mh] Termos MeSH secundário: Idoso
Velocidade do Fluxo Sanguíneo
Estado Terminal
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29298779
[Au] Autor:Colantuoni E; Scharfstein DO; Wang C; Hashem MD; Leroux A; Needham DM; Girard TD
[Ad] Endereço:Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA ejohnso2@jhmi.edu.
[Ti] Título:Statistical methods to compare functional outcomes in randomized controlled trials with high mortality.
[So] Source:BMJ;360:j5748, 2018 01 03.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Estado Terminal/mortalidade
Estado Terminal/terapia
Interpretação Estatística de Dados
Ensaios Clínicos Controlados Aleatórios como Assunto
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Seres Humanos
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5748


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[PMID]:28468953
[Au] Autor:Randhawa MS; Reed GW; Grafmiller K; Gornik HL; Shishehbor MH
[Ad] Endereço:From the Department of Cardiovascular Medicine, Cleveland Clinic, OH; and School of Medicine, Case Western Reserve University, Cleveland, OH.
[Ti] Título:Prevalence of Tibial Artery and Pedal Arch Patency by Angiography in Patients With Critical Limb Ischemia and Noncompressible Ankle Brachial Index.
[So] Source:Circ Cardiovasc Interv;10(5), 2017 May.
[Is] ISSN:1941-7632
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Approximately 20% of patients undergoing ankle brachial index testing for critical limb ischemia have noncompressible vessels because of tibial artery calcification. This represents a clinical challenge in determining tibial artery patency. We sought to identify the prevalence of tibial artery and pedal arch patency by angiography in these patients. METHODS AND RESULTS: One hundred twenty-five limbs (of 89 patients) with critical limb ischemia and ankle brachial index ≥1.4 who underwent lower extremity angiograms within 1 year were included. Reviewers of angiography were blinded to results of physiological testing. Tibial artery vessels were classified as completely occluded, significantly stenosed (≥50%), or patent (<50% stenosis). The sensitivity of toe brachial index and pulse volume recording to predict tibial artery disease was also determined. Of 125 limbs with noncompressible ankle brachial index, 72 (57.6%) anterior tibial and 80 (64%) posterior tibial arteries were occluded. Another 23 (18.4%) anterior tibial and 13 (10.4%) posterior tibial arteries had ≥50% stenosis. Pulse volume recording was moderate to severely dampened in 54 of 119 (45.4%) limbs. Toe brachial index <0.7 was found in 75 of 83 (90.4%) limbs. Moderate to severe pulse volume recording dampening was 43.6% sensitive, whereas toe brachial index <0.7 was 89.7% sensitive in diagnosing occluded or significantly stenotic tibial artery disease. The pedal arch was absent or incomplete in 86 of 103 (83.5%) limbs. CONCLUSIONS: Among patients with critical limb ischemia and noncompressible ankle brachial index results, the prevalence of occlusive tibial and pedal arch disease is very high. Toe brachial index <0.7 is more sensitive in diagnosing occluded and significantly stenotic tibial artery disease in these patients compared with ankle pulse volume recording.
[Mh] Termos MeSH primário: Angiografia
Índice Tornozelo-Braço
Isquemia/diagnóstico
Doença Arterial Periférica/diagnóstico
Artérias da Tíbia/diagnóstico por imagem
Calcificação Vascular/diagnóstico
Grau de Desobstrução Vascular
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Constrição Patológica
Estado Terminal
Feminino
Seres Humanos
Isquemia/diagnóstico por imagem
Isquemia/epidemiologia
Isquemia/fisiopatologia
Masculino
Meia-Idade
Ohio/epidemiologia
Doença Arterial Periférica/diagnóstico por imagem
Doença Arterial Periférica/epidemiologia
Doença Arterial Periférica/fisiopatologia
Valor Preditivo dos Testes
Prevalência
Estudos Retrospectivos
Índice de Gravidade de Doença
Artérias da Tíbia/fisiopatologia
Ultrassonografia Doppler
Calcificação Vascular/diagnóstico por imagem
Calcificação Vascular/epidemiologia
Calcificação Vascular/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:29320302
[Au] Autor:Joffe S; Lynch HF
[Ad] Endereço:From the Department of Medical Ethics and Health Policy, Perelman School of Medicine, and the Leonard Davis Institute of Health Economics, University of Pennsylvania (S.J., H.F.L.), and the Children's Hospital of Philadelphia (S.J.) - all in Philadelphia.
[Ti] Título:Federal Right-to-Try Legislation - Threatening the FDA's Public Health Mission.
[So] Source:N Engl J Med;378(8):695-697, 2018 Feb 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aprovação de Drogas/legislação & jurisprudência
Drogas em Investigação
Regulamentação Governamental
Acesso aos Serviços de Saúde/legislação & jurisprudência
Legislação de Medicamentos
Segurança do Paciente/legislação & jurisprudência
United States Food and Drug Administration/legislação & jurisprudência
[Mh] Termos MeSH secundário: Ensaios Clínicos Fase I como Assunto
Estado Terminal
Avaliação de Medicamentos/legislação & jurisprudência
Indústria Farmacêutica/legislação & jurisprudência
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Seres Humanos
Responsabilidade Legal
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Drugs, Investigational)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1714054



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