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Secondary impact syndrome

Maria Giner-Soriano, Gerard Sotorra Figuerola, Jordi Cortés, Helena Pera Pujadas, Ana Garcia-Sangenis, Rosa Morros
BACKGROUND: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, such as coronary heart disease (CHD), cerebrovascular disease, and peripheral artery disease. CVD is the leading threat to global health, whether measured by mortality, morbidity, or economic cost. Long-term administration of aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers improves survival in patients with stablished coronary heart disease...
March 9, 2018: JMIR Research Protocols
Amy C Arnold, Jessica Ng, Satish R Raj
Postural tachycardia syndrome (POTS) is a heterogeneous clinical syndrome that has gained increasing interest over the past few decades due to its increasing prevalence and clinical impact on health-related quality of life. POTS is clinically characterized by sustained excessive tachycardia upon standing that occurs in the absence of significant orthostatic hypotension and other medical conditions and or medications, and with chronic symptoms of orthostatic intolerance. POTS represents one of the most common presentations of syncope and presyncope secondary to autonomic dysfunction in emergency rooms and in cardiology, neurology, and primary care clinics...
February 28, 2018: Autonomic Neuroscience: Basic & Clinical
Vasanth Sathiyakumar, Jihwan Park, Renato Quispe, Mohamed B Elshazly, Erin D Michos, Maciej Banach, Peter P Toth, Seamus P Whelton, Roger S Blumenthal, Steven R Jones, Seth S Martin
Background -Selected dyslipidemia guidelines recommend non-high-density lipoprotein-cholesterol (non-HDL-C) and apolipoprotein B (apoB) as secondary targets to the primary target of low-density lipoprotein-cholesterol (LDL-C). We examined, after considering two LDL-C estimates that differ in accuracy: (1) how frequently non-HDL-C guideline targets could change management; and (2) utility of apoB targets after meeting LDL-C and non-HDL-C targets. Methods -We analyzed 2,518 adults representative of the U.S. population from the 2011-2012 National Health and Nutrition Examination Survey and 126,092 patients from the Very Large Database of Lipids study with apoB...
March 5, 2018: Circulation
Kodai Kawamura, Kazuya Ichikado, Makoto Takaki, Yoshitomo Eguchi, Keisuke Anan, Moritaka Suga
Effective pharmacological therapy has not been established for patients with acute respiratory distress syndrome (ARDS). Macrolides are antibiotics with potent immunomodulatory and anti-inflammatory effects that may be beneficial in ARDS treatment. The objective of this study was to determine the adjunctive effect of azithromycin on survival for patients with ARDS. This single-center, retrospective cohort evaluation of hospitalized patients with moderate or severe ARDS aimed to assess the impact of intravenous azithromycin on clinical outcomes using a propensity score analysis...
February 28, 2018: International Journal of Antimicrobial Agents
Jakob M Townsend, Brian T Andrews, Yi Feng, Jinxi Wang, Randolph J Nudo, Erik Van Kampen, Stevin H Gehrke, Cory J Berkland, Michael S Detamore
Traumatic brain injury (TBI) is a life-threatening condition defined by internal brain herniation. Severe TBI is commonly treated by a two-stage surgical intervention, where decompressive craniectomy is first conducted to remove a large portion of calvarial bone and allow unimpeded brain swelling. In the second surgery, spaced weeks to months after the first, cranioplasty is performed to restore the cranial bone. Hydrogels with paste-like precursor solutions for surgical placement may potentially revolutionize TBI treatment by permitting a single-stage surgical intervention, capable of being implanted with the initial surgery, remaining pliable during brain swelling, and tuned to regenerate calvarial bone after brain swelling has subsided...
February 26, 2018: Acta Biomaterialia
J Liu, W Wang, J Liu, Y Wang, Y Qi, J Y Sun, D Zhao
Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education)...
February 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Jang I Moon, Thomas D Schiano, Alyssa Burnham, Kwai Lam, Kishore R Iyer
BACKGROUND: The ideal donor in intestinal transplantation is generally considered to be 50 - 70% of recipient body weight. This may be due to concerns for "small for size" syndrome as seen in liver transplantation. We report our experience using smaller donors (donor-recipient weight ratio, DRWR < 50%) in intestinal transplantation (ITX) recipients. METHODS: We studied a group of ITX recipients with DRWR ≤ 50% to unmatched controls who received intestinal allografts with DRWR > 50%...
February 26, 2018: Transplantation
S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
February 22, 2018: International Journal of Colorectal Disease
Dong Hoon Suh, Miseon Kim, Kyung Hun Lee, Keun Yong Eom, Maj Kamille Kjeldsen, Mansoor Raza Mirza, Jae Weon Kim
In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer...
March 2018: Journal of Gynecologic Oncology
Luminita Ene
Introduction: Human immunodeficiency virus (HIV) enters the brain early, where it can persist, evolve, and become compartmentalized. Central nervous system (CNS) disease can be attributed to HIV alone or to the complex interplay between the virus and other neurotropic pathogens. Aim: The current review aims to describe the direct impact of HIV on the brain as well as its relationship with other pathogens from a practitioner's perspective, to provide a general clinical overview, brief workup, and, whenever possible, treatment guidance...
2018: Infectious Diseases
David J Gracie, P John Hamlin, Alexander C Ford
OBJECTIVES: The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. METHODS: Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of life were assessed using validated questionnaires...
February 16, 2018: American Journal of Gastroenterology
Ying-Chuan Hung, Yi-Chieh Lin, Hui-Min Hsieh, Chun-Jen Huang, Herng-Chia Chiu
OBJECTIVE: There has been a growing recognition that obstructive sleep apnea (OSA) could increase the propensity for type 2 diabetes the metabolic syndrome. However, studies concerning about the impact of non-apnea sleep disorders (NSD) on diabetes control and metabolic outcomes are relatively scarce. Our aim is to investigate the impact of non-apnea sleep disorders (NSD) on diabetic control and associated metabolic outcomes in patients with type 2 diabetes. METHODS: The data were obtained from two nationwide population-based databases for a period 2007 to 2012...
January 31, 2018: General Hospital Psychiatry
Susan D Shenkin, Christopher Fox, Mary Godfrey, Najma Siddiqi, Steve Goodacre, John Young, Atul Anand, Alasdair Gray, Joel Smith, Tracy Ryan, Janet Hanley, Allan MacRaild, Jill Steven, Polly L Black, Julia Boyd, Christopher J Weir, Alasdair Mj MacLullich
INTRODUCTION: Delirium is a severe neuropsychiatric syndrome of rapid onset, commonly precipitated by acute illness. It is common in older people in the emergency department (ED) and acute hospital, but greatly under-recognised in these and other settings. Delirium and other forms of cognitive impairment, particularly dementia, commonly coexist. There is a need for a rapid delirium screening tool that can be administered by a range of professional-level healthcare staff to patients with sensory or functional impairments in a busy clinical environment, which also incorporates general cognitive assessment...
February 10, 2018: BMJ Open
Shannon L Goddard, Gordon D Rubenfeld, Venika Manoharan, Shelly P Dev, John Laffey, Giacomo Bellani, Tai Pham, Eddy Fan
OBJECTIVES: Radiographic criteria for acute respiratory distress syndrome have been criticized for poor reliability. Our objective was to test an educational intervention to improve the radiographic identification of acute respiratory distress syndrome by participants in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study. DESIGN: Randomized controlled trial. SETTINGS: Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure study centers...
February 12, 2018: Critical Care Medicine
Lindsey A Sjaarda, Sunni L Mumford, Daniel L Kuhr, Tiffany L Holland, Robert M Silver, Torie C Plowden, Neil J Perkins, Enrique F Schisterman
OBJECTIVE: To examine whether higher T and/or antimüllerian hormone (AMH) was associated with anovulation, time to pregnancy (TTP), or pregnancy loss risk among healthy, fecund women without diagnosed polycystic ovary syndrome. DESIGN: Prospective cohort study conducted as a secondary analysis from the Effects of Aspirin in Gestation and Reproduction randomized trial. SETTING: University medical centers. PATIENT(S): A total of 1,198 healthy, eumenorrheic women aged 18-40 years attempting spontaneous pregnancy with one to two prior pregnancy losses were included...
February 7, 2018: Fertility and Sterility
Deldar Morad Abdulah, Rasoul Sabri Piro
BACKGROUND: College students experience various types of sleep disorders that impact daily functioning. Previous studies have focused on the effect of one sleep disorder. OBJECTIVE: Examine factors that might relate to several sleep disorders and the impacts of sleep disorders on the daily functioning in medical students. DESIGN: Cross-sectional study. SETTING: Medical college. SUBJECTS AND METHODS: A random sample of medical students from a public university was invited to participate in a cross-sectional study using the structured SLEEP-50 self-reported questionnaire...
January 2018: Annals of Saudi Medicine
Purumeh Nam, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha
BACKGROUND AND AIMS: Myocardial bridge (MB) and coronary artery spasm (CAS) can induce a sustained chest pain, acute coronary syndrome (ACS) and even sudden cardiac death. The aim of this study is to evaluate the relationship between MB and CAS and its impact on long-term clinical outcomes. METHODS: A total of 812 patients with MB without significant coronary artery disease (CAD), who underwent acetylcholine (ACH) provocation test, were enrolled. Significant CAS was defined as ≥70% temporary narrowing by ACH test, and MB was defined as the characteristic phasic systolic compression of the coronary artery with a decrease of more than 30% in diameter on the angiogram after intracoronary nitroglycerin infusion...
February 2, 2018: Atherosclerosis
Niklas Schofer, Sebastian Ludwig, Nicole Rübsamen, Renate Schnabel, Karl J Lackner, Hans J Ruprecht, Christoph Bickel, Ulf Landmesser, Stefan Blankenberg, Tanja Zeller
BACKGROUND: IL-1β-mediated inflammation contributes to development and progression of coronary artery disease (CAD). We aimed to assess the prognostic impact of the inflammatory marker Interleukin-1 receptor antagonist (IL1-Ra), reflecting high IL-1β activity, in patients with documented CAD. METHODS: IL-1Ra levels were determined in 1337 subjects of the AtheroGene study, a prospective cardiovascular registry comprising patients with CAD as detected by coronary angiography presenting with acute coronary syndrome (ACS) or stable angina...
January 29, 2018: International Journal of Cardiology
Inna Belfer, Netanya I Pollock, Jodi L Martin, Katherine G Lim, Carolyn De La Cruz, Gijsberta Van Londen, Stephanie R Nunziato-Virga, Katherine Stranieri, Adam M Brufsky, Haibin Wang
Introduction: Chronic pain is a common and debilitating complication following breast surgery. One of the most challenging for treatment is the neuropathic pain condition, postmastectomy pain syndrome (PMPS). Gabapentin is a pharmacotherapy for neuropathic pain disorders; however, its once-daily, gastroretentive formulation, Gralise, has not been evaluated in PMPS. Objective: To evaluate the safety and effectiveness of Gralise in patients with moderate-to-severe PMPS...
May 2017: Pain Reports (Baltimore, Md.)
Rajkumar Chinnadurai, James Ritchie, Darren Green, Philip A Kalra
Background: Non-alcoholic fatty liver disease (NAFLD) is an independent risk factor associated with cardiovascular disease (CVD) and incidence of chronic kidney disease (CKD). NAFLD is threatening to become a major public health problem in association with the metabolic syndrome. The association of NAFLD with outcomes in patients with advanced CKD has not been evaluated. In this study, the prevalence of NAFLD and its impact on cardiovascular and renal outcomes and mortality were determined in a large secondary care CKD cohort...
January 30, 2018: Nephrology, Dialysis, Transplantation
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