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[PMID]:29318276
[Au] Autor:Plevritis SK; Munoz D; Kurian AW; Stout NK; Alagoz O; Near AM; Lee SJ; van den Broek JJ; Huang X; Schechter CB; Sprague BL; Song J; de Koning HJ; Trentham-Dietz A; van Ravesteyn NT; Gangnon R; Chandler Y; Li Y; Xu C; Ergun MA; Huang H; Berry DA; Mandelblatt JS
[Ad] Endereço:Departments of Radiology and Biomedical Data Science, School of Medicine, Stanford University, Stanford, California.
[Ti] Título:Association of Screening and Treatment With Breast Cancer Mortality by Molecular Subtype in US Women, 2000-2012.
[So] Source:JAMA;319(2):154-164, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Given recent advances in screening mammography and adjuvant therapy (treatment), quantifying their separate and combined effects on US breast cancer mortality reductions by molecular subtype could guide future decisions to reduce disease burden. Objective: To evaluate the contributions associated with screening and treatment to breast cancer mortality reductions by molecular subtype based on estrogen-receptor (ER) and human epidermal growth factor receptor 2 (ERBB2, formerly HER2 or HER2/neu). Design, Setting, and Participants: Six Cancer Intervention and Surveillance Network (CISNET) models simulated US breast cancer mortality from 2000 to 2012 using national data on plain-film and digital mammography patterns and performance, dissemination and efficacy of ER/ERBB2-specific treatment, and competing mortality. Multiple US birth cohorts were simulated. Exposures: Screening mammography and treatment. Main Outcomes and Measures: The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment. Results: In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100 000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. In 2012, the estimated reduction in overall breast cancer mortality rate was 49% (model range, 39%-58%) relative to the estimated baseline rate in 2012 of 63 deaths (model range, 54-73) per 100 000 women: 37% (model range, 26%-51%) of this reduction was associated with screening and 63% (model range, 49%-74%) with treatment. Of the 63% associated with treatment, 31% (model range, 22%-37%) was associated with chemotherapy, 27% (model range, 18%-36%) with hormone therapy, and 4% (model range, 1%-6%) with trastuzumab. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2-, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER-/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER-/ERBB2-, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%). Conclusions and Relevance: In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype.
[Mh] Termos MeSH primário: Neoplasias da Mama/mortalidade
Detecção Precoce de Câncer
Mamografia
Modelos Estatísticos
[Mh] Termos MeSH secundário: Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/terapia
Feminino
Seres Humanos
Mamografia/métodos
Mortalidade/tendências
Receptor ErbB-2
Receptores Estrogênicos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Receptors, Estrogen); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19130


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[PMID]:29446583
[Au] Autor:Zaikova ZA; Burdukovskaya AV; Belykh AI
[Ti] Título:[Determination of priority unfavorable environmental factors].
[So] Source:Gig Sanit;95(12):1205-9, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:In the Irkutsk region there are recorded high indices of rates of morbidity, disability, mortality rate of the working-age population and low levels of life expectancy of the population, that is confirmed by ranking position levels among the all subjects of the Russian Federation. According to all mentioned indices of health the region is inside the top ten unfavorable regions of Russia. In relation to the problem in the state of health of the adult population the estimation of the causal relationships between environmental factors and certain health indices is actual. The list of studiedfactors included health indices that characterize the harmful working conditions of the working population and basic socioeconomic indices in the region. Estimation of causal-relationship relationships was performed with the use of methods of multivariate analysis - correlation and multiple linear regression. In the selection offactors for the construction of mathematical models of multiple regression there were used methods of the analysis of variables variability, pair correlation coefficients matrix and sequential switching covariates to eliminate the problems of multicollinearity, pre-standardization of indices for the elevation of the numerical stability of regression analysis algorithm. As a result of the execution of the analysis there were constructed statistical models for the dependence in the system variables "environment - public health", which allowed to identify the most informative regression models for the adult population health according to indices of primary disability of the population, the mortality rate and life expectancy of the working age population. According to results of the analysis there were identified priority factors affecting on the health of the adult population of the Irkutsk region. To these factors there are referred the proportion of workplaces failing to meet sanitary standards for vibration and 8 socio-economic indices of living standards of the population.
[Mh] Termos MeSH primário: Exposição Ambiental
Saúde do Trabalhador
Saúde Pública
[Mh] Termos MeSH secundário: Exposição Ambiental/prevenção & controle
Exposição Ambiental/estatística & dados numéricos
Seres Humanos
Expectativa de Vida
Mortalidade
Saúde do Trabalhador/normas
Saúde do Trabalhador/estatística & dados numéricos
Saúde Pública/métodos
Saúde Pública/normas
Saúde Pública/estatística & dados numéricos
Fatores de Risco
Sibéria/epidemiologia
Fatores Socioeconômicos
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE


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[PMID]:29431340
[Au] Autor:Kenessaryiev UI; Yerzhanova AE; Kenessary DU; Kenessary AU
[Ti] Título:[Trends of change in demographic indices of population in the area of oil and gas deposits of the republic of Kazakhstan].
[So] Source:Gig Sanit;95(10):946-9, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:According to assured resources of hydrocarbons the Republic of Kazakhstan (RK) is among ten largest oil countries in the world, trailing only some states of the Middle East, Latin America, as well Russia and the USA. Public health state is the one of most important indices of social development, the manifestation of the economic and sanitaryhygienic welfare, as well as national defense capability and cultural potential of the state. In relation with the intensive development of oil and gas fields the problems of environmental protection and healthcare of the population in these regions occur critically. Therefore, it causes keen interest both from the side of researches and practical health care workers. Rapid development of the oil and gas industry leads to changes in a medical and demographic situation of given regions that is related both with the natural migration of the population and other migratory processes. According to data of the Ministry of Energetics and natural resources of RK, the Karachaganak oil-gas condensate deposit is considered to be the one of the largest in the world. For the next 40 years, the field is becoming the stable financial donor of the country. Currently Karachaganak field is considered to be the one of the largest investment projects in Kazakhstan. The studied oil and gas condensate field is located in the Burlin district of West Kazakhstan region, which is 140 km far from the city of Uralsk and 160 km far from the city of Orenburg. The field was discovered in 1984.
[Mh] Termos MeSH primário: Demografia/estatística & dados numéricos
Indústria de Petróleo e Gás/organização & administração
Saúde Pública
Regionalização/organização & administração
[Mh] Termos MeSH secundário: Conservação dos Recursos Naturais/métodos
Nível de Saúde
Seres Humanos
Desenvolvimento Industrial/estatística & dados numéricos
Cazaquistão/epidemiologia
Mortalidade
Campos de Petróleo e Gás
Dinâmica Populacional
Saúde Pública/métodos
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:28922781
[Au] Autor:Goldvaser H; Barnes TA; Seruga B; Cescon DW; Ocaña A; Ribnikar D; Amir E
[Ad] Endereço:Division of Medical Oncology, University of Toronto and Princess Margaret Cancer Centre, Toronto, Canada; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Research Unit, Albacete University Hospi
[Ti] Título:Toxicity of Extended Adjuvant Therapy With Aromatase Inhibitors in Early Breast Cancer: A Systematic Review and Meta-analysis.
[So] Source:J Natl Cancer Inst;110(1), 2018 Jan 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: A number of randomized controlled trials (RCTs) have reported improvement in breast cancer outcomes from extending treatment with aromatase inhibitors (AIs) beyond the initial five years after diagnosis. However, the toxicity profile of extended AIs is uncertain. Methods: We identified RCTs that compared extended AIs to placebo or no treatment using MEDLINE and a review of abstracts from key conferences between 2013 and 2016. Odds ratios (ORs), 95% confidence intervals (CIs), absolute risks, and the number needed to harm (NNH) were computed for prespecified safety and tolerability outcomes including cardiovascular events, bone fractures, second cancers (excluding new breast cancer), treatment discontinuation for adverse events, and death without recurrence. All statistical tests were two-sided. Results: Seven trials comprising 16 349 patients met the inclusion criteria. Longer treatment with AIs was associated with increased odds of cardiovascular events (OR = 1.18, 95% CI = 1.00 to 1.40, P = .05, NNH = 122), bone fractures (OR = 1.34, 95% CI = 1.16 to 1.55, P < .001, NNH = 72), and treatment discontinuation for adverse events (OR = 1.45, 95% CI = 1.25 to 1.68, P < .001, NNH = 21). Longer treatment with AIs did not influence the odds of either second malignancy (OR = 0.93, 95% CI = 0.73 to 1.18, P = .56) or deaths without breast cancer recurrence (OR = 1.11, 95% CI = 0.90 to 1.36, P = .34). Conclusions: Extended treatment with AIs is associated with an increased risk of cardiovascular events and bone fractures. There is no statistically significant increase in deaths without breast cancer recurrence among patients receiving longer treatment with AIs. These data should be taken into account when considering extended adjuvant AIs.
[Mh] Termos MeSH primário: Inibidores da Aromatase/efeitos adversos
Neoplasias da Mama/tratamento farmacológico
Doenças Cardiovasculares/epidemiologia
Quimioterapia Adjuvante/efeitos adversos
Fraturas Ósseas/epidemiologia
Segunda Neoplasia Primária/epidemiologia
[Mh] Termos MeSH secundário: Inibidores da Aromatase/administração & dosagem
Neoplasias da Mama/cirurgia
Quimioterapia Adjuvante/métodos
Feminino
Seres Humanos
Mortalidade
Ensaios Clínicos Controlados Aleatórios como Assunto
Fatores de Tempo
Suspensão de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Aromatase Inhibitors)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx141


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[PMID]:28747462
[Au] Autor:Mistry EA; Mistry AM; Nakawah MO; Chitale RV; James RF; Volpi JJ; Fusco MR
[Ad] Endereço:From the Department of Neurology, University of Cincinnati, OH (E.A.M); Department of Neurology, Houston Methodist Neurological Institute, TX (M.O.N., J.J.V.); Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN (A.M.M., R.V.C., M.R.F.); and Department of Neurosurgery, Un
[Ti] Título:Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis.
[So] Source:Stroke;48(9):2450-2456, 2017 09.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Whether prior intravenous thrombolysis provides any additional benefits to the patients undergoing mechanical thrombectomy for large vessel, acute ischemic stroke remains unclear. METHODS: We conducted a meta-analysis of 13 studies obtained through PubMed and EMBASE database searches to determine whether functional outcome (modified Rankin Scale) at 90 days, successful recanalization rate, and symptomatic intracerebral hemorrhage rate differed between patients who underwent mechanical thrombectomy with (MT+IVT) and without (MT-IVT) pre-treatment with intravenous thrombolysis. RESULTS: MT+IVT patients compared with MT-IVT patients had better functional outcomes (modified Rankin Scale score, 0-2; summary odds ratio [OR], 1.27 [95% confidence interval (CI), 1.05-1.55]; =0.02; n=1769/1174), lower mortality (OR, 0.71 [95% CI, 0.55-0.91]; =0.006; n=1774/1202), and higher rate of successful recanalization (OR, 1.46 [95% CI, 1.09-1.96]; =0.01; n=1652/1216) without having increased odds of symptomatic intracerebral hemorrhage (OR, 1.11 [95% CI, 0.69-1.77]; =0.67; n=1471/1143). A greater number of MT+IVT patients required ≤2 passes with a neurothrombectomy device to achieve successful recanalization (OR, 2.06 [95% CI, 1.37-3.10]; =0.0005; n=316/231). CONCLUSIONS: Our results demonstrated that MT+IVT patients had better functional outcomes, lower mortality, higher rate of successful recanalization, requiring lower number of device passes, and equal odds of symptomatic intracerebral hemorrhage compared with MT-IVT patients. The results support the current guidelines of offering intravenous thrombolysis to eligible patients even if they are being considered for mechanical thrombectomy. Because the data are compiled from studies where the 2 groups differed based on eligibility for intravenous thrombolysis, randomized trials are necessary to accurately evaluate the added value of intravenous thrombolysis in patients treated with mechanical thrombectomy.
[Mh] Termos MeSH primário: Fibrinolíticos/uso terapêutico
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intravenosa
Hemorragia Cerebral/induzido quimicamente
Hemorragia Cerebral/epidemiologia
Terapia Combinada
Seres Humanos
Mortalidade
Razão de Chances
Complicações Pós-Operatórias/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017320


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[PMID]:28453819
[Au] Autor:Cheen MHH; Goon CP; Ong WC; Lim PS; Wan CN; Leong MY; Khee GY
[Ad] Endereço:Department of Pharmacy, Singapore General Hospital, Singapore.
[Ti] Título:Evaluation of a care transition program with pharmacist-provided home-based medication review for elderly Singaporeans at high risk of readmissions.
[So] Source:Int J Qual Health Care;29(2):200-205, 2017 Apr 01.
[Is] ISSN:1464-3677
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. Design: Retrospective cohort study. Setting: Patient's home. Participants: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included. Intervention: Pharmacist-provided HBMR. Main outcome measures: Primary outcome was readmission rate over 6 months after the first home visit. Secondary outcomes included emergency department (ED) visits, outpatient visits and mortality. Drug-related problems (DRPs) were reported for the HBMR group. Multivariate incidence rate ratios (IRR) and hazard ratio (HR) were calculated with adjustments for covariates. Results: The study included 499 patients (97 HBMR, 402 no HBMR). Pharmacist-provided HBMR reduced readmissions by 26% (IRR = 0.74, 95% CI: 0.59-0.92, P = 0.007), reduced ED visits by 20% (IRR = 0.80, 95% CI: 0.66-0.98, P = 0.030) and increased outpatient visits by 16% (IRR = 1.16, 95% CI: 0.95-1.41, P = 0.150). There were 8 and 44 deaths in the HBMR and no HBMR groups respectively (HR = 0.73, 95% CI: 0.29-1.81, P = 0.492). Pharmacists identified 464 DRPs, with 169 (36.4%) resolved within 1 month after the home visit. Conclusions: The study suggests that pharmacist-provided HBMR is effective in reducing readmissions and ED visits in the elderly. More studies in the Asian population are needed to determine its long term benefits and patient's acceptability.
[Mh] Termos MeSH primário: Reconciliação de Medicamentos/métodos
Alta do Paciente
Readmissão do Paciente/estatística & dados numéricos
Farmacêuticos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
Serviço Hospitalar de Emergência/utilização
Feminino
Seres Humanos
Masculino
Meia-Idade
Mortalidade
Serviço de Farmácia Hospitalar/métodos
Estudos Retrospectivos
Singapura
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/intqhc/mzw150


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[PMID]:28457023
[Au] Autor:Sankatsing VDV; van Ravesteyn NT; Heijnsdijk EAM; Looman CWN; van Luijt PA; Fracheboud J; den Heeten GJ; Broeders MJM; de Koning HJ
[Ad] Endereço:Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
[Ti] Título:The effect of population-based mammography screening in Dutch municipalities on breast cancer mortality: 20 years of follow-up.
[So] Source:Int J Cancer;141(4):671-677, 2017 08 15.
[Is] ISSN:1097-0215
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Long-term follow-up data on the effects of screening are scarce, and debate exists on the relative contribution of screening versus treatment to breast cancer mortality reduction. Our aim was therefore to assess the long-term effect of screening by age and time of implementation. We obtained data on 69,630 breast cancer deaths between 1980 and 2010 by municipality (N = 431) and age of death (40-79) in the Netherlands. Breast cancer mortality trends were analyzed by defining the municipality-specific calendar year of introduction of screening as Year 0. Additionally, log-linear Poisson regression was used to estimate the turning point in the trend after Year 0, per municipality, and the annual percentage change (APC) before and after this point. Twenty years after introduction of screening breast cancer mortality was reduced by 30% in women aged 55-74 and by 34% in women aged 75-79, compared to Year 0. A similar and significant decrease was present in municipalities that started early (1987-1992) and late (1995-1997) with screening, despite the difference in availability of effective adjuvant treatment. In the age groups 55-74 and 75-79, the turning point in the trend in breast cancer mortality was estimated in Years 2 and 6 after the introduction of screening, respectively, after which mortality decreased significantly by 1.9% and 2.6% annually. These findings show that the implementation of mammography screening in Dutch municipalities is associated with a significant decline in breast cancer mortality in women aged 55-79, irrespective of time of implementation.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico por imagem
Neoplasias da Mama/mortalidade
Mamografia/métodos
Programas de Rastreamento/métodos
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Idoso
Detecção Precoce de Câncer
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Mortalidade/tendências
Países Baixos/epidemiologia
Análise de Regressão
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1002/ijc.30754


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[PMID]:29289257
[Au] Autor:DeWaters AL; Chansard M; Anzueto A; Pugh MJ; Mortensen EM
[Ad] Endereço:VA North Texas Health Care System, Dallas, Texas; University of Texas Southwestern Medical Center, Dallas, Texas.
[Ti] Título:The Association Between Major Depressive Disorder and Outcomes in Older Veterans Hospitalized With Pneumonia.
[So] Source:Am J Med Sci;355(1):21-26, 2018 01.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Major depressive disorder ("depression") has been identified as an independent risk factor for mortality for many comorbid conditions, including heart failure, cancer and stroke. Major depressive disorder has also been linked to immune suppression by generating a chronic inflammatory state. However, the association between major depression and pneumonia has not been examined. The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in Veterans hospitalized with pneumonia. MATERIALS AND METHODS: We conducted a retrospective national study using administrative data of patients hospitalized at any Veterans Administration acute care hospital. We included patients ≥65 years old hospitalized with pneumonia from 2002-2012. Depressed patients were further analyzed based on whether they were receiving medications to treat depression. We used generalized linear mixed effect models to examine the association of depression with the outcomes of interest after controlling for potential confounders. RESULTS: Patients with depression had a significantly higher 90-day mortality (odds ratio 1.12, 95% confidence interval 1.07-1.17) compared to patients without depression. Patients with untreated depression had a significantly higher 30-day (1.11, 1.04-1.20) and 90-day (1.20, 1.13-1.28) mortality, as well as significantly higher intensive care unit admission rates (1.12, 1.03-1.21), compared to patients with treated depression. CONCLUSION: For older veterans hospitalized with pneumonia, a concurrent diagnosis of major depressive disorder, and especially untreated depression, was associated with higher mortality. This highlights that untreated major depressive disorder is an independent risk factor for mortality for patients with pneumonia.
[Mh] Termos MeSH primário: Transtorno Depressivo Maior/diagnóstico
Transtorno Depressivo Maior/mortalidade
Hospitalização/tendências
Pneumonia/diagnóstico
Pneumonia/mortalidade
Veteranos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Bases de Dados Factuais/tendências
Transtorno Depressivo Maior/psicologia
Feminino
Seres Humanos
Masculino
Mortalidade/tendências
Pneumonia/psicologia
Estudos Retrospectivos
Fatores de Risco
Estados Unidos/epidemiologia
United States Department of Veterans Affairs/tendências
Veteranos/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[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:180101
[St] Status:MEDLINE


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[PMID]:29191321
[Au] Autor:Tsujimoto T; Kajio H
[Ad] Endereço:Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan. Electronic address: ttsujimoto@hosp.ncgm.go.jp.
[Ti] Título:Abdominal Obesity Is Associated With an Increased Risk of All-Cause Mortality in Patients With HFpEF.
[So] Source:J Am Coll Cardiol;70(22):2739-2749, 2017 Dec 05.
[Is] ISSN:1558-3597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is a lack of studies that evaluate the association between abdominal obesity and subsequent outcomes in patients with heart failure with preserved ejection fraction (HFpEF). OBJECTIVES: The present study aimed to assess the association between abdominal obesity and risk of all-cause mortality in patients with HFpEF. METHODS: The present study used data from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. The primary outcome was all-cause mortality. We analyzed and compared the hazard ratios (HRs) in patients with abdominal obesity and those without abdominal obesity using multivariable Cox proportional hazard models. Abdominal obesity was defined as a waist circumference of ≥102 cm in men and ≥88 cm in women. RESULTS: The present study included 3,310 patients with HFpEF: 2,413 patients with abdominal obesity and 897 without abdominal obesity. The mean follow-up was 3.4 ± 1.7 years. During follow-up, 500 patients died. All-cause mortality rates in patients with and without abdominal obesity were 46.1 and 40.7 events per 1,000 person-years, respectively. After multivariable adjustment, the risk of all-cause mortality was significantly higher in patients with abdominal obesity than in those without abdominal obesity (adjusted HR: 1.52; 95% confidence interval [CI]: 1.16 to 1.99; p = 0.002). The risk of cardiovascular and noncardiovascular mortality was also significantly higher in patients with abdominal obesity than in those without abdominal obesity (adjusted HR: 1.50; 95% CI: 1.08 to 2.08; p = 0.01 and adjusted HR: 1.58; 95% CI: 1.00 to 2.51; p = 0.04, respectively). CONCLUSIONS: The risk of all-cause mortality was significantly higher in patients with HFpEF with abdominal obesity than in those without abdominal obesity.
[Mh] Termos MeSH primário: Insuficiência Cardíaca
Antagonistas de Receptores de Mineralocorticoides/uso terapêutico
Obesidade Abdominal
[Mh] Termos MeSH secundário: Idoso
Método Duplo-Cego
Feminino
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/tratamento farmacológico
Insuficiência Cardíaca/mortalidade
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Mortalidade
Obesidade Abdominal/complicações
Obesidade Abdominal/diagnóstico
Obesidade Abdominal/epidemiologia
Modelos de Riscos Proporcionais
Medição de Risco
Fatores de Risco
Volume Sistólico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Mineralocorticoid Receptor Antagonists)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE


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[PMID]:29391014
[Au] Autor:Torsein M; Lindberg A; Svensson C; Jensen SK; Berg C; Waller KP
[Ad] Endereço:Farm & Animal Health, Uddetorp Röda huset, 532 96, Skara, Sweden. maria.torsein@gardochdjurhalsan.se.
[Ti] Título:α-Tocopherol and ß-carotene concentrations in feed, colostrum, cow and calf serum in Swedish dairy herds with high or low calf mortality.
[So] Source:Acta Vet Scand;60(1):7, 2018 Feb 01.
[Is] ISSN:1751-0147
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A study of herd-level risk factors for calf mortality in large Swedish dairy herds showed low serum concentrations of α-tocopherol and ß-carotene in 1-7 day old calves to be more common in high mortality herds. Therefore, we aimed to investigate if calf mortality risk at herd level is associated with concentrations of α-tocopherol and/or ß-carotene at individual level in feed, colostrum, cow and calf serum, while controlling for herd level covariates. Inclusion criteria were affiliation to the Swedish official milk recording scheme, herd size of ≥ 120 milking cows/year, calf mortality risk (day 1-90) of at least 6% (high mortality; HM) or less than 1% (low mortality; LM) and located within one of two regions in southern Sweden. This cross-sectional study was performed in 2010 in 19 (n = 9; n = 10) dairy herds. Questionnaires were used to collect information about feed and routines for colostrum feeding. Feed (n = 57), colostrum (n = 162), cow serum (n = 189) and calf serum samples (n = 187) were collected and analysed for α-tocopherol and ß-carotene. Other analyses e.g. total serum protein, fat content, and total solids in colostrum were also performed. Linear regression models with vitamin concentrations in feed, colostrum, cow and calf serum as outcome were performed. RESULTS: Calves in HM herds had lower concentrations of α-tocopherol in serum than calves in LM herds, but the effect depended on total protein status in serum of the calf (P = 0.036). Calves from herds that fed transition milk for 3 days or more had higher α-tocopherol concentrations in serum than calves from herds feeding transition milk up to 2 days (P = 0.013). Fat percentage in colostrum was positively associated with α-tocopherol (P < 0.001) and ß-carotene concentrations in colostrum (P < 0.001). A diet containing ≥ 20% (in kg dry matter) maize silage of the total ration was negatively associated with ß-carotene concentration in cow serum (P = 0.001). CONCLUSIONS: High calf mortality risks were associated with lower concentrations of α-tocopherol in calf serum for calves with failure of passive transfer. Feeding transition milk longer was associated with higher concentrations of α-tocopherol in calf serum. In HM herds, evaluation of the calves' α-tocopherol status is recommended.
[Mh] Termos MeSH primário: Ração Animal
Colostro/química
Indústria de Laticínios/estatística & dados numéricos
Mortalidade
alfa-Tocoferol/análise
beta Caroteno/análise
[Mh] Termos MeSH secundário: Ração Animal/análise
Animais
Bovinos/sangue
Bovinos/metabolismo
Estudos Transversais
Feminino
Modelos Lineares
Suécia
alfa-Tocoferol/sangue
beta Caroteno/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
01YAE03M7J (beta Carotene); H4N855PNZ1 (alpha-Tocopherol)
[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:180203
[St] Status:MEDLINE
[do] DOI:10.1186/s13028-018-0361-0



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