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Doron Aronson, Varda Shalev, Rachel Katz, Gabriel Chodick, Diab Mutlak
PURPOSE:  We used a large real-world data from community settings to develop and validate a 10-year risk score for new-onset atrial fibrillation (AF) and calculate its net benefit performance. METHODS:  Multivariable Cox proportional hazards model was used to estimate effects of risk factors in the derivation cohort ( n  = 96,778) and to derive a risk equation. Measures of calibration and discrimination were calculated in the validation cohort ( n  = 48,404)...
August 13, 2018: Thrombosis and Haemostasis
Jörn A Karhausen, Wenjing Qi, Alan M Smeltz, Yi-Ju Li, Svati H Shah, William E Kraus, Joseph P Mathew, Mihai V Podgoreanu, Miklos D Kertai
INTRODUCTION:  Thrombocytopenia after cardiac surgery independently predicts stroke, acute kidney injury and death. To understand the underlying risks and mechanisms, we analysed genetic variations associated with thrombocytopenia in patients undergoing coronary artery bypass grafting (CABG) surgery. MATERIALS AND METHODS:  Study subjects underwent isolated on-pump CABG surgery at Duke University Medical Center. Post-operative thrombocytopenia was defined as platelet count < 100 × 109 /L...
August 13, 2018: Thrombosis and Haemostasis
Lisa Gross, Dietmar Trenk, Claudius Jacobshagen, Anne Krieg, Meinrad Gawaz, Steffen Massberg, Monika Baylacher, Daniel Aradi, Fabian Stimpfle, Julia Hromek, Anja Vogelgesang, Martin Hadamitzky, Dirk Sibbing, Tobias Geisler
BACKGROUND:  Phenotype-guided de-escalation (PGDE) of P2Y12 -inhibitor treatment with an early switch from prasugrel to clopidogrel was identified as an effective alternative treatment strategy in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The Testing Responsiveness to Platelet Inhibition on Chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Genotyping Substudy aimed to investigate whether CYP2C19 genotypes correlate with on-treatment platelet reactivity (PR) in ACS patients treated with clopidogrel or prasugrel and thus might be useful for guidance of early de-escalation of anti-platelet treatment...
August 13, 2018: Thrombosis and Haemostasis
Yinka Titilawo, Abiodun Adeniji, Mobolaji Adeniyi, Anthony Okoh
This study evaluated levels of heavy metals and macro-elements in ten major rivers in Osun State, Southwest Nigeria. Triplicate water samples collected from selected rivers were analyzed for metal pollutants by atomic absorption spectrophotometry. Concentrations were obtained as follows: iron: 60-960 μg L-1 ; manganese: ND - 3 μg L-1 ; chromium 0-2100 μg L-1 ; aluminium: 0-800 μg L-1 ; copper: 0-1350 μg L-1 ; zinc: 10-650 μg L-1 ; calcium: 6400-232000 μg L-1 and magnesium: 2000-71000 μg L-1 but lead was not detected...
August 1, 2018: Chemosphere
Martin Frank, Dorothee Marx, Vedran Nedelkovski, Julia-Theresa Fischer, Dieter H Pahr, Philipp J Thurner
Trabecular bone is located inside flat bones as well as in the epi- and metaphysis of long bones and plays a key role with respect to load transfer. Disorders, such as osteoporosis, weaken the structural integrity and may also cause changes in the mechanical properties of individual trabeculae, such as Young's modulus. Knowledge of mechanical tissue properties are necessary to assess risk of bone fracture with finite element analysis (FEA). However, such parameters are most often obtained from experiments on air-dried specimens which do not reflect the physiological conditions...
August 1, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Claudia J Coulton, Francisca G-C Richter, Jill Korbin, David Crampton, James C Spilsbury
This study examines how changes in the social and economic structure of neighborhoods relate to changes in child maltreatment report rates over an extended period. The panel study design allows us to partition the changes in child maltreatment report rates into a portion associated with how the levels of socio-economic risk factors have changed over time, and a portion related to how the relative importance of those factors in explaining maltreatment report rates has changed over time. Through the application of fixed effects panel models, the analysis is also able to control for unmeasured time-invariant characteristics of neighborhoods that may be a source of bias in cross-sectional studies...
August 10, 2018: Child Abuse & Neglect
Andreas Palm, Bengt Midgren, Jenny Theorell-Haglöw, Magnus Ekström, Mirjam Ljunggren, Christer Janson, Eva Lindberg
OBJECTIVES: Adherence to continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA) is crucial. Our aim was to identify protective and risk factors against the discontinuation of CPAP treatment in patients with OSA and to estimate the mortality risk in those who were non-adherent to CPAP therapy. METHODS: This was a registry-based cohort study from 37 centers across Sweden with OSA patients on CPAP in the Swedevox Swedish national registry between July 2010 and March 2017...
July 17, 2018: Sleep Medicine
David Mou, Evan M Kleiman, Szymon Fedor, Stuart Beck, Jeff C Huffman, Matthew K Nock
Patients suffering from borderline personality disorder (BPD) are at elevated risk for suicidal thoughts and behaviors (STBs), but this well-described and clinically important association is not well-understood. Prior research suggests that STBs often function as an attempt to escape aversive affect, and that people with BPD experience stronger emotion reactivity and greater discomfort with emotion than those without BPD. Here, we tested whether negative affective states are more likely to predict suicidal thoughts among those with BPD than those without this disorder...
August 3, 2018: Journal of Psychiatric Research
Paul Welsh, Olia Papacosta, Sheena Ramsay, Peter Whincup, John McMurray, Goya Wannamethee, Naveed Sattar
AIM: To study the association of high sensitivity troponin T (hsTnT) with incident heart failure, and implications for its use in prediction models. METHODS AND RESULTS: The British Regional Heart Study of 3852 men aged 60-79 without baseline HF (3165 without baseline CHD) was followed up for a median of 12.6 years, during which 295 incident cases of HF occurred (7.7%). A 1 standard deviation increase in log-transformed hsTnT was associated with a higher risk of incident HF after adjusting for classical risk factors (HR 1...
August 10, 2018: Journal of Cardiac Failure
Michael S Koeckert, Eugene A Grossi, Patrick F Vining, Ramsey Abdallah, Mathew R Williams, Gary Kalkut, Didier F Loulmet, Elias A Zias, Michael Querijero, Aubrey C Galloway
OBJECTIVE: Medicare's Bundle Payment for Care Improvement(BPCI) Model 2 groups reimbursement for valve surgery into 90-day episodes of care(EOC) which include operative costs, inpatient stay, physician fees, post-acute care, and readmissions up to 90 days post-procedure. We analyzed our BPCI patients' 90-day outcomes to understand the late financial risks and implications of the bundle payment system for valve patients. METHODS: All BPCI valve patients from 10/2013 (start of risk-sharing phase) through 12/2015 were included...
August 10, 2018: Seminars in Thoracic and Cardiovascular Surgery
Elisabeth K Simmelink, Johan B Wempe, Jan H B Geertzen, Lucas H V van der Woude, Rienk Dekker
BACKGROUND: Physical fitness of patients with a lower limb amputation predicts their walking ability and may be improved by physical exercise and training. A maximal exercise test is recommended prior to training in order to determine cardiovascular risks and design exercise programs. A potentially suitable ergometer for maximal exercise testing in patients with a lower limb amputation is the combined arm-leg (Cruiser) ergometer. The aim of this study was to determine feasibility, safety, and reliability of (sub)maximal exercise testing on the Cruiser ergometer in subjects with a lower limb amputation...
2018: PloS One
Hualu Cui, Wenqing Geng, Hong Sun, Xiaoxu Han, Minghui An, Yongjun Jiang, Zining Zhang, Zhiwei Chen, Junjie Xu, Qinghai Hu, Bin Zhao, Bennan Zhou, Hong Shang
OBJECTIVE: CRF01_AE is the most prevalent human immunodeficiency virus-1 (HIV-1) subtype among men who have sex with men (MSM) in China. However, the characteristics and underlying mechanism of the accelerated CD4 T-cell decline in CRF01_AE-infected MSM remain incompletely understood. DESIGN: A long-term prospective follow-up study was conducted with 1338 MSM at risk of HIV-1 infection in Northeast China. MSM with primary HIV-1 CRF01_AE infection were identified and followed for 3-6 years to explore the determinants of rapid CD4 T-cell decline...
August 9, 2018: AIDS
Anthony J Rosellini, Murray B Stein, David M Benedek, Paul D Bliese, Wai Tat Chiu, Irving Hwang, John Monahan, Matthew K Nock, Nancy A Sampson, Amy E Street, Alan M Zaslavsky, Robert J Ursano, Ronald C Kessler
BACKGROUND: Preventing suicides, mental disorders, and noncombat-related interpersonal violence during deployment are priorities of the US Army. We used predeployment survey and administrative data to develop actuarial models to identify soldiers at high risk of these outcomes during combat deployment. METHODS: The models were developed in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) Pre-Post Deployment Study, a panel study of soldiers deployed to Afghanistan in 2012-2013...
August 13, 2018: Depression and Anxiety
Sigmund Ytre-Hauge, Julie A Dybvik, Arvid Lundervold, Øyvind O Salvesen, Camilla Krakstad, Kristine E Fasmer, Henrica M Werner, Balaji Ganeshan, Erling Høivik, Line Bjørge, Jone Trovik, Ingfrid S Haldorsen
BACKGROUND: Improved methods for preoperative risk stratification in endometrial cancer are highly requested by gynecologists. Texture analysis is a method for quantification of heterogeneity in images, increasingly reported as a promising diagnostic tool in various cancer types, but largely unexplored in endometrial cancer. PURPOSE: To explore whether tumor texture parameters from preoperative MRI are related to known prognostic features (deep myometrial invasion, cervical stroma invasion, lymph node metastases, and high-risk histological subtype) and to outcome in endometrial cancer patients...
August 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
Yangyang Kan, Di Dong, Yuchen Zhang, Wenyan Jiang, Nannan Zhao, Lu Han, Mengjie Fang, Yali Zang, Chaoen Hu, Jie Tian, Chunming Li, Yahong Luo
BACKGROUND: Lymph node metastasis (LNM) is the principal risk factor for poor outcomes in early-stage cervical cancer. Radiomics may offer a noninvasive way for predicting the stage of LNM. PURPOSE: To evaluate a radiomic signature of LN involvement based on sagittal T1 contrast-enhanced (CE) and T2 MRI sequences. STUDY TYPE: Retrospective. POPULATION: In all, 143 patients were randomly divided into two primary and validation cohorts with 100 patients in the primary cohort and 43 patients in the validation cohort...
August 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
M Baré, L Mora, N Torà, M J Gil, I Barrio, P Collera, D Suárez, M Redondo, A Escobar, N Fernández de Larrea, J M Quintana
BACKGROUND: The aim of this study was to assess factors associated with outcomes after surgery for colorectal cancer and to design and internally validate a simple score for predicting perioperative mortality. METHODS: Patients undergoing surgery for primary invasive colorectal cancer in 22 centres in Spain between June 2010 and December 2012 were included. Clinical variables up to 30 days were collected prospectively. Multiple logistic regression techniques were applied and a risk score was developed...
August 13, 2018: British Journal of Surgery
F Crawford, G Cezard, M Chappell
AIMS: Diabetes guidelines recommend screening for the risk of foot ulceration but vary substantially in the underlying evidence base. Our purpose was to derive and validate a prognostic model of independent risk factors for foot ulceration in diabetes using all available individual patient data from cohort studies conducted worldwide. METHODS: We conducted a systematic review and meta-analysis of individual patient data from 10 cohort studies of risk factors in the prediction of foot ulceration in diabetes...
August 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Sarah V Strickland, Mara H Rendi, Rochelle L Garcia, Barbara S Norquist, Kathryn P Pennington, Mark R Kilgore
Intraoperative assessment (IA) of uteri is often used to help determine whether to perform lymphadenectomy in patients with endometrial carcinoma. We sought to perform a quality assurance review of the practice of IA at our institution. In a 1-yr period, 107 hysterectomies had an IA performed. Grade of neoplasm in preoperative endometrial biopsy, neoplasm size, depth of myometrial invasion at IA, operative management, and final histologic features were recorded. Operative reports were reviewed to assess the surgeon's interpretation of the IA and the effect on surgical management...
September 2018: International Journal of Gynecological Pathology
Jacqueline F Gould, Emily Hunt, Rachel M Roberts, Jennie Louise, Carmel T Collins, Maria Makrides
AIM: Infants born preterm (<37 weeks' gestation) are at risk of poor neurodevelopmental outcomes; hence, many neonatal centres routinely follow up infants using the Bayley Scales of Infant Development (BSID), although the predictive validity of the BSID for children born preterm is questionable. Our objective is to evaluate the predictive capacity of the BSID for behavioural functioning at school age of children born preterm. METHODS: Children (n = 657 children born <33 weeks' gestation) were enrolled at birth from five neonatal centres around Australia...
August 13, 2018: Journal of Paediatrics and Child Health
Masaru Hiki, Takatoshi Kasai, Shoichiro Yatsu, Azusa Murata, Hiroki Matsumoto, Takao Kato, Shoko Suda, Tetsuro Miyazaki, Atsutoshi Takagi, Hiroyuki Daida
Although hyponatremia during hospitalization for acute decompensated heart failure (ADHF) is reportedly related with poor prognosis, the available data regarding the impact of serum sodium level within the low-normal range at admission on clinical events in patients with ADHF is limited.We studied eligible patients admitted to our institution in 2007-2011. All the patients were categorized into 3 groups according to the admission serum sodium levels of < 135 mmol/L (hyponatremia), ≥ 135 and < 140 mmol/L (low-normal range), or ≥ 140 mmol/L (normal range)...
August 11, 2018: International Heart Journal
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