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116 results on '"Hagglund"'

1. Does ventral mesh rectopexy at the time of sacrocolpopexy prevent subsequent posterior wall prolapse?

Author: Muhammad Faisal Aslam, Kyle R. Mackeya, Karen H. Hagglund, Michael Gerard Baracy, and Casey Richardsona
Subjects: medicine.medical_specialty, Mesh rectopexy, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Significant difference, Obstetrics and Gynecology, sacrocolpopexy, Retrospective cohort study, Pelvic organ prolapse, Surgery, multicompartmental prolapse, Posterior wall, Concomitant, Statistical significance, rectopexy, medicine, Urodynamic testing, business, minimally invasive surgery, Original Investigation
Abstract: Objective: To determine whether ventral mesh rectopexy at the time of sacrocolpopexy reduces the rate of future posterior wall prolapse. Material and Methods: This was a retrospective cohort study of women with pelvic organ prolapse (POP) who underwent sacrocolpopexy or without concomitant rectopexy at a single community hospital from December 1, 2015 to June 30, 2019. Preoperative pelvic organ prolapse quantification (POP-Q) and urodynamic testing was used in evaluation of POP. Patients were followed for 12-weeks postoperatively and a 12-week postoperative POP-Q assessment was completed. The incidence of new or recurrent posterior prolapse was compared between cohorts. Results: Women with POP (n=150) were recruited, of whom 41 (27.3%) underwent sacrocolpopexy while the remainder (n=109, 72.7%) did not receive rectopexy. Patient demographics did not statistically differ between cohorts. Post-surgical posterior wall prolapse was reduced in the robotic assisted sacrocolpopexy (RASC) + rectopexy group compared to RASC alone, however this did not reach statistical significance. There were no patients who underwent concomitant rectopexy and RASC that needed recurrent posterior wall prolapse surgery, compared to eight-percent of patients that underwent isolated RASC procedures. Conclusion: Our findings suggest a reduction in the need for subsequent posterior wall surgery when rectopexy is performed at the time of sacrocolpopexy. In our study, no future surgery for POP was found in the concomitant sacrocolpopexy and rectopexy group, while a small proportion of the RASC only group required future POP surgery. Our study, however, was underpowered to elucidate a statistically significant difference between groups. Future larger studies are needed to confirm a reduced risk of posterior wall prolapse in patients who undergo concomitant RASC and rectopexy.
Published: 2021
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2. Sex‐ and age‐related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long‐Term Registry

Author: Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M. G., Lund, L. H., Anker, S. D., Laroche, C., Ferrari, R., Coats, A. J. S., Mcdonagh, T., Filippatos, G., Maggioni, A. P., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J. -C., Yilmaz, M. B., Seferovic, P. M., Gale, C. P., Chair, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Mebazaa, A., Coats, A., A. Goda A. L., M. Diez A. R., A. Fernandez A. R., F. Fruhwald A. T., Fazlibegovic, E., P. Gatzov B. G., A. Kurlianskaya B. Y., R. Hullin C. H., T. Christodoulides C. Y., J. Hradec C. Z., O. Wendelboe Nielsen D. K., R. Nedjar D. Z., T. Uuetoa E. E., M. Hassanein E. G., J. F. Delgado Jimenez E. S., P. Harjola F. I., V, D. Logeart F. R., V. Chumburidze G. E., D. Tousoulis G. R., D. Milicic H. R., B. Merkely H. U., O'Donoghue IE, E., O. Amir I. L., A. Shotan I. L., D. Shafie I. R., M. Metra I. T., A. Matsumori J. P., E. Mirrakhimov K. G., A. Kavoliuniene L. T., A. Erglis L. V., Vataman, E., M. Otljanska M. K., E. Srbinovska Kostovska M. K., D. Cassar DeMarco M. T., J. Drozdz P. L., Fonseca, C., O. Chioncel R. O., M. Dekleva R. S., E. Shkolnik R. U., U. Dahlstrom S. E., M. Lainscak S. I., E. Goncalvesova S. K., A. Temizhan T. R., V. Estrago U. Y., G. Bajraktari X. K., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Gunes, H., Lainscak, M., Milinkovic, I., Polovina, M., Crespo-Leiro, M. G., Lund, L. H., Anker, S. D., Laroche, C., Ferrari, R., Coats, A. J. S., Mcdonagh, T., Filippatos, G., Maggioni, A. P., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Simic, D., Asanin, M., Eicher, J. -C., Yilmaz, M. B., Seferovic, P. M., Gale, C. P., Chair, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Mebazaa, A., Coats, A., A. Goda A., L., M. Diez A., R., A. Fernandez A., R., F. Fruhwald A., T., Fazlibegovic, E., P. Gatzov B., G., A. Kurlianskaya B., Y., R. Hullin C., H., T. Christodoulides C., Y., J. Hradec C., Z., O. Wendelboe Nielsen D., K., R. Nedjar D., Z., T. Uuetoa E., E., M. Hassanein E., G., J. F. Delgado Jimenez E., S., V-, P. Harjola F. I., D. Logeart F., R., V. Chumburidze G., E., D. Tousoulis G., R., D. Milicic H., R., B. Merkely H., U., O'Donoghue IE, E., O. Amir I., L., A. Shotan I., L., D. Shafie I., R., M. Metra I., T., A. Matsumori J., P., E. Mirrakhimov K., G., A. Kavoliuniene L., T., A. Erglis L., V., Vataman, E., M. Otljanska M., K., E. Srbinovska Kostovska M., K., D. Cassar DeMarco M., T., J. Drozdz P., L., Fonseca, C., O. Chioncel R., O., M. Dekleva R., S., E. Shkolnik R., U., U. Dahlstrom S., E., M. Lainscak S., I., E. Goncalvesova S., K., A. Temizhan T., R., V. Estrago U., Y., G. Bajraktari X., K., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Gunes, H., University of Zurich, and Seferović, Petar M
Subjects: Male, Registry, medicine.medical_specialty, Adverse outcomes, 610 Medicine & health, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Independent predictor, 2705 Cardiology and Cardiovascular Medicine, Ventricular Function, Left, 03 medical and health sciences, Age, 0302 clinical medicine, Internal medicine, Age related, Hospitalization, Mortality, Sex, medicine, Humans, Registries, Medical prescription, Aged, Heart Failure, Ejection fraction, business.industry, Stroke Volume, medicine.disease, Ageing, Heart failure, 10209 Clinic for Cardiology, Female, Angiotensin Receptor Blockers, Cardiology and Cardiovascular Medicine, business
Abstract: [Abstract] Aims. This study aimed to assess age‐ and sex‐related differences in management and 1‐year risk for all‐cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results. Of 16 354 patients included in the European Society of Cardiology Heart Failure Long‐Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline‐directed medical therapy (GDMT) were high (angiotensin‐converting enzyme inhibitors/angiotensin receptor blockers, beta‐blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1‐year follow‐up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all‐cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all‐cause hospitalization (21.9% vs. 27.3%; P < 0.001) and there were no differences in causes of death. All‐cause mortality and all‐cause hospitalization increased with greater age in both sexes. Sex was not an independent predictor of 1‐year all‐cause mortality (restricted to patients with LVEF ≤45%). Mortality risk was significantly lower in patients of younger age, compared to patients aged >75 years. Conclusions. There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all‐cause mortality in patients with LVEF ≤45%.
Published: 2019
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3. Opioid prescribing trends: Changes after focused hospital resident education and after subsequent adoption of new state regulations

Author: Sejul Chaudhary, Victoria Simmons, Elango Edhayan, Karen Hagglund, and R. David Hayward
Subjects: Adult, Pain, Postoperative, medicine.medical_specialty, business.industry, Psychological intervention, Internship and Residency, Retrospective cohort study, Resident education, General Medicine, Opioid prescribing, Analgesics, Opioid, Anesthesiology and Pain Medicine, Opioid, Intervention (counseling), Emergency medicine, medicine, Humans, Pharmacology (medical), Practice Patterns, Physicians', Medical prescription, Hospitals, Teaching, business, Laparoscopic cholecystectomy, Retrospective Studies, medicine.drug
Abstract: Objective: We examined changes in opioid prescriptions after outpatient laparoscopic cholecystectomy (LC) before and after (1) an educational intervention for surgical residents and (2) subsequent changes in state regulations for handling these prescriptions. Design: A single-institution retrospective review evaluated opioids prescribed on discharge in morphine milligram equivalents (MMEs) over three periods: Period 1, prior to educational intervention (October 1, 2017 to January 31, 2018); Period 2, after intervention and before regulation changes occurred (February 1, 2018 to May 31, 2018); and Period 3, after changes in regulations went into effect (June 1, 2018 to September 30, 2018). Setting: A large urban teaching hospital in Detroit, Michigan. Patients: All adults receiving outpatient LC during one of the study periods. Patients with a history of regular opioid use prior to surgery were excluded. There were 49 patients in Period 1, 57 in Period 2, and 51 in Period 3. Interventions: All general surgery residents participated in an education session focusing on problems related to opioid addiction, prescribing trends, and multimodal pain control options in February 2018. Main outcome measure: Mean MME per patient was compared between time periods. Results: Average MME was reduced from 87.11 in Period 1 to 65.96 in Period 2 to 51.80 in Period 3. Analysis of variance showed MME differed significantly among the periods. Scheffe post hoc t-tests showed MME prescribed during Periods 2 and 3 were each significantly lower than Period 1, whereas Periods 2 and 3 did not differ significantly. Conclusions: MME prescribed after outpatient LC significantly decreased after the educational intervention and remained low after state mandate went into effect.
Published: 2021
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4. Randomized clinical trial comparing skin closure with tissue adhesives vs subcuticular suture after robotic urogynecologic procedures

Author: Sunetris Fluellen, Kyle Mackey, Muhammad Faisal Aslam, and Karen H. Hagglund
Subjects: medicine.medical_specialty, Closure (topology), Clinical Trials Study, Skin closure in robotic surgery, 02 engineering and technology, Urogynecology, 01 natural sciences, law.invention, Randomized controlled trial, law, 0103 physical sciences, Medicine, Dermabond, 010303 astronomy & astrophysics, Closure time, integumentary system, business.industry, Tissue adhesives, technology, industry, and agriculture, Cosmesis, 021001 nanoscience & nanotechnology, Surgery, body regions, Subcuticular suture, 0210 nano-technology, business, human activities
Abstract: BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference. The optimum technique would theoretically be safe, rapid, inexpensive, and result in good cosmetic appearance. Cyanoacrylate tissue adhesive (Dermabond) may be a comparable and safe option for port site closure as compared with subcuticular suture. In this randomized clinical trial, we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures. AIM To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture. METHODS Fifty female subjects > 18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive (n = 25) or subcuticular suture (n = 25). All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon. Incisional closure time was recorded. Each subject was followed for 12-wk postoperatively. Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale. RESULTS A total of 47 subjects (cyanoacrylate group, n = 23; suture group, n = 24) completed the 12-wk postoperative evaluation. Closure time was significantly less (P < 0.0005) using cyanoacrylate tissue adhesive (5.4 ± 2.0 min) than subcuticular suture (24.9 ± 5.6 min). Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture (P = 0.025). No differences were found between bleeding, infection, or dehiscence (P = 1.00, P = 0.609, P = 0.234, respectively). No statistical demographical differences existed between the two study arms. CONCLUSION Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture. Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding, infection, or dehiscence.
Published: 2020

5. Unravelling the interplay between hyperkalaemia, renin-angiotensin-aldosterone inhibitor use and clinical outcomes. Data from 9222 chronic heart failure patients of the ESC-HFA-EORP Heart Failure Long-Term Registry

Author: Rossignol, P., Lainscak, M., Crespo-Leiro, M. G., Laroche, C., Piepoli, M. F., Filippatos, G., Rosano, G. M. C., Savarese, G., Anker, S. D., Seferovic, P. M., Ruschitzka, F., Coats, A. J. S., Mebazaa, A., Mcdonagh, T., Sahuquillo, A., Penco, M., Maggioni, A. P., Lund, L. H., Christopher Peter Gale, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Fazlibegovic, E., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Hassanein, M., Jimenez, J. F. D., Harjola, V. P., Logeart, D., Chumburidze, V., Tousoulis, D., Milicic, D., Merkely, B., O'Donoghue, E., Amir, O., Shotan, A., Shafie, D., Metra, M., Matsumori, A., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Vataman, E., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Chioncel, O., Dekleva, M., Shkolnik, E., Dahlstrom, U., Goncalvesova, E., Temizhan, A., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Fuhrmann, A. V., Romano, S., Marcon, S., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Modena, Mg, University of Zurich, Rossignol, Patrick, Rossignol, P., Lainscak, M., Crespo-Leiro, M. G., Laroche, C., Piepoli, M. F., Filippatos, G., Rosano, G. M. C., Savarese, G., Anker, S. D., Seferovic, P. M., Ruschitzka, F., Coats, A. J. S., Mebazaa, A., Mcdonagh, T., Sahuquillo, A., Penco, M., Maggioni, A. P., Lund, L. H., Christopher Peter Gale, G. B., Branko Beleslin, R. S., Andrzej Budaj, P. L., Ovidiu Chioncel, R. O., Nikolaos Dagres, D. E., Nicolas Danchin, F. R., David Erlinge, S. E., Jonathan Emberson, G. B., Michael Glikson, I. L., Alastair Gray, G. B., Meral Kayikcioglu, T. R., Aldo Maggioni, I. T., Klaudia Vivien Nagy, H. U., Aleksandr Nedoshivin, R. U., Anna-Sonia Petronio, I. T., Jolien Roos-Hesselink, N. L., Lars Wallentin, S. E., Uwe Zeymer, D. E., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Fazlibegovic, E., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Hassanein, M., Jimenez, J. F. D., Harjola, V. P., Logeart, D., Chumburidze, V., Tousoulis, D., Milicic, D., Merkely, B., O'Donoghue, E., Amir, O., Shotan, A., Shafie, D., Metra, M., Matsumori, A., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Vataman, E., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Chioncel, O., Dekleva, M., Shkolnik, E., Dahlstrom, U., Goncalvesova, E., Temizhan, A., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Fuhrmann, A. V., Romano, S., Marcon, S., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), University of Ljubljana, University of A Coruña (UDC), EURObservational Research Programme, European Society of Cardiology, Cardiac Department, G. da Saliceto Hospital, AUSL Piacenza, National and Kapodistrian University of Athens (NKUA), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS San Raffaele Pisana), Karolinska Institutet [Stockholm], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Berlin-Brandenburg Center for Regenerative Medicine [Berlin, Germany] (BCRT), University hospital of Zurich [Zurich], Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), King's College Hospital (KCH), Hospital de Manacor, Università degli Studi dell'Aquila (UNIVAQ), ANMCO Research Center, Firenze,Italy, Since the start of EORP, the following companies have supported the programme: Abbott Vascular Int. (2011-2021), Amgen Cardiovascular (2009-2018), AstraZeneca (2014-2021), Bayer AG (2009-2018), Boehringer Ingelheim (2009-2019), Boston Scientific (2009-2012), The Bristol Myers Squibb and Pfizer Alliance (2011-2019), Daiichi Sankyo Europe GmbH (2011-2020), The Alliance Daiichi Sankyo Europe GmbH and Eli Lilly and Company (2014-2017), Edwards (2016-2019), Gedeon Richter Plc. (2014-2016), Menarini Int. Op. (2009-2012), MSD-Merck & Co. (2011-2014), Novartis Pharma AG (2014-2020), ResMed (2014-2016), Sanofi (2009-2011), SERVIER (2009-2018), Vifor (2019-2022)., Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: medicine.medical_specialty, Angiotensin receptor, Angiotensins, Prognosi, Angiotensin-Converting Enzyme Inhibitors, Heart failure, 610 Medicine & health, 030204 cardiovascular system & hematology, Hyperkalaemia, Hypokalaemia, Mineralocorticoid receptor antagonists, Prognosis, Renin–angiotensin–aldosterone system inhibitors, 2705 Cardiology and Cardiovascular Medicine, Angiotensin Receptor Antagonists, 03 medical and health sciences, 0302 clinical medicine, Mineralocorticoid receptor, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Renin, Renin–angiotensin system, Humans, Medicine, Registries, cardiovascular diseases, Risk factor, Aldosterone, Ejection fraction, business.industry, Mineralocorticoid receptor antagonist, Renin-angiotensin-aldosterone system inhibitors, medicine.disease, 3. Good health, Discontinuation, Cardiology, 10209 Clinic for Cardiology, Hyperkalemia, Cardiology and Cardiovascular Medicine, business, Lower mortality
Abstract: [Abstract] Aims. We assessed the interplay between hyperkalaemia (HK) and renin–angiotensin–aldosterone system inhibitor (RAASi) use, dose and discontinuation, and their association with all‐cause or cardiovascular death in patients with chronic heart failure (HF). We hypothesized that HK‐associated increased death may be related to RAASi withdrawal. Methods and results. The ESC‐HFA‐EORP Heart Failure Long‐Term Registry was used. Among 9222 outpatients (HF with reduced ejection fraction: 60.6%, HF with mid‐range ejection fraction: 22.9%, HF with preserved ejection fraction: 16.5%) from 31 countries, 16.6% had HK (≥5.0 mmol/L) at baseline. Angiotensin‐converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) was used in 88.3%, a mineralocorticoid receptor antagonist (MRA) in 58.7%, or a combination in 53.2%; of these, at ≥50% of target dose in ACEi: 61.8%; ARB: 64.7%; and MRA: 90.3%. At a median follow‐up of 12.2 months, there were 789 deaths (8.6%). Both hypokalaemia and HK were independently associated with higher mortality, and ACEi/ARB prescription at baseline with lower mortality. MRA prescription was not retained in the model. In multivariable analyses, HK at baseline was independently associated with MRA non‐prescription at baseline and subsequent discontinuation. When considering subsequent discontinuation of RAASi (instead of baseline use), HK was no longer found associated with all‐cause deaths. Importantly, all RAASi (ACEi, ARB, or MRA) discontinuations were strongly associated with mortality. Conclusions. In HF, hyper‐ and hypokalaemia were associated with mortality. However, when adjusting for RAASi discontinuation, HK was no longer associated with mortality, suggesting that HK may be a risk marker for RAASi discontinuation rather than a risk factor for worse outcomes. Funding for open access charge: Universidad de Granada / CBUA. The work was funded by the Courel Mountains UGGp
Published: 2020
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6. The Tour of Africa. Containing a Concise Account of All the Contries in that Quarter of the Globe, Hitherto Visited by Europeans; With the Manners and Customs of the Inhabitants. Selected from the Best Authors, and Arranged by Catherine Hutton. Vol. II

Author: Betty Hagglund
Subjects: medicine.anatomical_structure, History, medicine, Globe, Ancient history, Quarter (Canadian coin)
Published: 2021
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7. When to Remove the Indwelling Catheter After Minimally Invasive Sacrocolpopexy? CARESS (CAtheter REmoval after Sacrocolpopexy Surgery)

Author: Ali Ahmad Bazzi, Blake Osmundsen, Karen H. Hagglund, and Muhammad Faisal Aslam
Subjects: medicine.medical_specialty, Urology, Urinary system, 030232 urology & nephrology, Urinary Catheters, law.invention, 03 medical and health sciences, Catheters, Indwelling, Gynecologic Surgical Procedures, 0302 clinical medicine, Patient satisfaction, Randomized controlled trial, law, Statistical significance, Indwelling catheter, medicine, Humans, Minimally Invasive Surgical Procedures, Catheter removal, Urinary catheter, Device Removal, Postoperative Care, Pain, Postoperative, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Middle Aged, Plastic Surgery Procedures, Surgery, Catheter, Outcome and Process Assessment, Health Care, Retreatment, Urinary Tract Infections, Female, Risk Adjustment, Urinary Catheterization, business
Abstract: Objective The aim of the study was to determine the best practice guidelines regarding the use of indwelling catheters after minimally invasive sacrocolpopexy. Methods Multicenter (3 sites) randomized control trial comparing the standard overnight indwelling urethral catheterization (group 2) with removal of catheter immediately after surgery (group 1). Our primary outcome is the need for recatheterization. Secondary outcomes include the number of patients discharged with a catheter, length of hospital stay, number of urinary tract infections, patient satisfaction/pain scores, and whether patients would use the same treatment again. Results There were 32 patients (43.8%) in group 1 and 41 patients (56.2%) in group 2. On average, patients in group 1 required straight catheterization 0.8 (SD = 0.9) times versus 0.6 (SD = 0.9) times for group 2 (P = 0.239). The number of days with a catheter between the 2 groups was not statistically significant. There was no statistical significance between group 1 and group 2 in terms of operative time, times to leave the operating room, and hospital. Zero patients in group 1 and 2 patients in group 2 had a urinary tract infection. After dividing the groups based on whether or not they underwent a transvaginal tape procedure, the final results were similar. Conclusions We did not observe a difference in the risk of recatheterization or discharge home with a urinary catheter between the 2 groups. Addition of transvaginal tape to sacrocolpopexy did not show a difference in the risk of recatheterization. One reason for the lack of difference between the 2 groups could be due to a lack of power in our study.
Published: 2020
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8. Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

Author: Kapelios, C. J., Laroche, C., Crespo-Leiro, M. G., Anker, S. D., Coats, A. J. S., Diaz-Molina, B., Filippatos, G., Lainscak, M., Maggioni, A. P., Mcdonagh, T., Mebazaa, A., Metra, M., Moura, B., Mullens, W., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Seferovic, P. M., Lund, L. H., Gale, C. P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A., Nagy, K. V., Nedoshivin, A., Petronio, A. -S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Jimenez, J. F. D., Harjola, V. -P., Logeart, D., Tousoulis, D., Milicic, D., Merkely, B., Amir, O., Shotan, A., Shafie, D., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Dekleva, M., Dahlstrom, U., Goncalvesova, E., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Kurteva, T., Kamenova, D., Antova, M., Krejci, J., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Saleh, A., Ebeid, H., Hanna, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Thevenin, S., Hagege, A., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Tsaknakis, T., Evangelou, S., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Fuhrmann, A. V., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Bosi, S., Schiavina, G., Squeri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Salvioni, E., Copelli, S., Modena, M. G., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Marino, P. N., Di Ruocco, M. V., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Rumbinaite, E., Brazyte-Ramanauskiene, R., Petraskiene, D., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kardaszewicz, P., Lazorko-Piega, M., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavaresaguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., Dejesus, I., Santos, R., Silva, P., Moreno, N., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveiraguimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Proenca, M., Araujo, I., Marques, F., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Peres, M., Marta, L., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljaninilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Letonja, M., Winkler, R., Melihen-Bartolic, C., Bartolic, A., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Gallegopage, J. C., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Paniagua-Martin, M. J., Barge-Caballero, E., Gonzalez-Gallarza, R. D., Salvadormontanes, O., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segoviacubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Cano, M. J. R., Sanchez, M. A. G., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Garcia-Escriva, D., Pellicer-Cabo, A., de laFuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Portoles-Ocampo, A., Melin, M., Hagglund, Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Kapelios, C. J., Laroche, C., Crespo-Leiro, M. G., Anker, S. D., Coats, A. J. S., Diaz-Molina, B., Filippatos, G., Lainscak, M., Maggioni, A. P., Mcdonagh, T., Mebazaa, A., Metra, M., Moura, B., Mullens, W., Piepoli, M. F., Rosano, G. M. C., Ruschitzka, F., Seferovic, P. M., Lund, L. H., Gale, C. P., Beleslin, B., Budaj, A., Chioncel, O., Dagres, N., Danchin, N., Erlinge, D., Emberson, J., Glikson, M., Gray, A., Kayikcioglu, M., Maggioni, A., Nagy, K. V., Nedoshivin, A., Petronio, A. -S., Roos-Hesselink, J., Wallentin, L., Zeymer, U., Crespo-Leiro, M., Anker, S., Coats, A., Ferrari, R., Goda, A., Diez, M., Fernandez, A., Fruhwald, F., Gatzov, P., Kurlianskaya, A., Hullin, R., Christodoulides, T., Hradec, J., Nielsen, O. W., Nedjar, R., Uuetoa, T., Jimenez, J. F. D., Harjola, V. -P., Logeart, D., Tousoulis, D., Milicic, D., Merkely, B., Amir, O., Shotan, A., Shafie, D., Mirrakhimov, E., Kavoliuniene, A., Erglis, A., Otljanska, M., Kostovska, E. S., Demarco, D. C., Drozdz, J., Fonseca, C., Dekleva, M., Dahlstrom, U., Goncalvesova, E., Estrago, V., Bajraktari, G., Auer, J., Ablasser, K., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Kurteva, T., Kamenova, D., Antova, M., Krejci, J., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Saleh, A., Ebeid, H., Hanna, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Thevenin, S., Hagege, A., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Tsaknakis, T., Evangelou, S., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Fuhrmann, A. V., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Bulgari, M., Quinzani, F., Bosi, S., Schiavina, G., Squeri, A., Di Tano, G., Pirelli, S., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Salvioni, E., Copelli, S., Modena, M. G., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Marino, P. N., Di Ruocco, M. V., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Rumbinaite, E., Brazyte-Ramanauskiene, R., Petraskiene, D., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kardaszewicz, P., Lazorko-Piega, M., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Huziuk, I., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavaresaguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., Dejesus, I., Santos, R., Silva, P., Moreno, N., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveiraguimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Proenca, M., Araujo, I., Marques, F., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Peres, M., Marta, L., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Christodorescu, R., Otasevic, P., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Simic, D., Asanin, M., Iric-Cupic, V., Jovic, M., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljaninilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Letonja, M., Winkler, R., Melihen-Bartolic, C., Bartolic, A., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Gallegopage, J. C., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Grille-Cancela, Z., Marzoa-Rivas, R., Paniagua-Martin, M. J., Barge-Caballero, E., Gonzalez-Gallarza, R. D., Salvadormontanes, O., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segoviacubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Cano, M. J. R., Sanchez, M. A. G., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Garcia-Escriva, D., Pellicer-Cabo, A., de laFuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Portoles-Ocampo, A., Melin, M., Hagglund, Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Afzelius, M., Karlstrom, P., Tengvall, L., Olsson, B., Kalayci, S., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., University of Zurich, and Kapelios, Chris J
Subjects: medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, 610 Medicine & health, 030204 cardiovascular system & hematology, 2705 Cardiology and Cardiovascular Medicine, Loop diuretics, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Furosemide, Internal medicine, medicine, Loop diuretic, Mortality, Ejection fraction, business.industry, Hazard ratio, medicine.disease, Prognosis, Chronic heart failure, 3. Good health, Blood pressure, Heart failure, Drug titration, 10209 Clinic for Cardiology, Cardiology, Diuretic, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: [Abstract] Aims. Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results. We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66±13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion. Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease.
Published: 2020

9. Factors associated with lack of improvement in submaximal exercise capacity of patients with heart failure

Author: Jaarsma, T, Perkio Kato, N, Ben Gal, T, Back, M, Chiala, O, Evangelista, L, Martensson, J, Piepoli, Mf, Vellone, E, Klompstra, L, Stromberg, A, Ben Avraham, B, Boyne, J, Hagenow, A, and Hagglund, E
Subjects: Male, Submaximal exercise capacity, medicine.medical_specialty, Psychological intervention, Walk Test, Heart failure, Cardiorespiratory Medicine and Haematology, Cardiovascular, 6&nbsp, 6 min walk test, Physical activity, chemistry.chemical_compound, Clinical Research, medicine, Diseases of the circulatory (Cardiovascular) system, Humans, Aerobic exercise, Sjukgymnastik, Physiotherapy, Aged, Heart Failure, Creatinine, Exercise Tolerance, business.industry, 6 min walk test, HF-Wii study team, Cognition, Original Articles, Odds ratio, Prognosis, medicine.disease, Confidence interval, Exercise Therapy, Settore MED/45, Heart Disease, chemistry, RC666-701, Physical therapy, Anxiety, min walk test, Original Article, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Aims Improvement in exercise capacity is the primary goal of physical activity programmes for patients with heart failure (HF). Although activity programmes are effective for some patients, others do not benefit. Identifying factors related to a lack of improvement in submaximal exercise capacity may help us interpret findings and design new interventions. The aim of this study is to identify factors contributing to a lack of improvement in submaximal exercise capacity 3 months after physical activity advice or an exergame intervention in patients with HF. Additionally, we aimed to assess differences in lack of improvement in submaximal exercise capacity of patients whose baseline exercise capacity predicted a worse compared with better prognosis of HF. Methods and results This secondary analysis of the HF-Wii study analysed baseline and 3 month data of the 6 min walk test (6MWT) from 480 patients (mean age 67 years, 72% male). Data were analysed separately in patients with a pre-defined 6 min walking distance at baseline of = 300 m (n = 401). Among patients with a baseline 6MWT of >= 300 m, 18% had deteriorated submaximal exercise capacity. In the multiple logistic regression analysis, lower baseline levels of self-reported physical activity [odds ratio (OR) = 0.77, 95% confidence interval (CI) = 0.60-0.97], lower baseline levels of cognitive function (OR = 0.87, 95%CI = 0.79-0.96) were significantly associated with lack of improvement in exercise capacity at 3 months. Not randomized to exergaming (OR = 0.63, 95%CI = 0.37-1.09) was likely (P = 0.097) to be associated with lack of improvement in exercise capacity at 3 months. Among the 79 patients with baseline 6MWT of Funding Agencies|Swedish National Science Council [K2013-69X-22302-01-3, 2016-01390]; Swedish National Science Council/the Swedish Research Council for Health, Working Life and Welfare, VR-FORTE [2014-4100]; Swedish Heart and Lung AssociationSwedish Heart-Lung Foundation [E085/12]; Swedish Heart and Lung FoundationSwedish Heart-Lung Foundation [20130340, 20160439]; Vardal Foundation [2014-0018]; Medical Research Council of Southeast SwedenUK Research & Innovation (UKRI)Medical Research Council UK (MRC) [FORSS 474681]
Published: 2021

10. Acute heart failure congestion and perfusion status – impact of the clinical classification on in-hospital and long-term outcomes; insights from the ESC-EORP-HFA Heart Failure Long-Term Registry

Author: Chioncel, O., Mebazaa, A., Maggioni, A. P., Harjola, V. -P., Rosano, G., Laroche, C., Piepoli, M. F., Crespo-Leiro, M. G., Lainscak, M., Ponikowski, P., Filippatos, G., Ruschitzka, F., Seferovic, P., Coats, A. J. S., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Chioncel, O., Mebazaa, A., Maggioni, A. P., Harjola, V. -P., Rosano, G., Laroche, C., Piepoli, M. F., Crespo-Leiro, M. G., Lainscak, M., Ponikowski, P., Filippatos, G., Ruschitzka, F., Seferovic, P., Coats, A. J. S., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., and Gunes, H.
Subjects: Adult, Male, Registry, medicine.medical_specialty, New York Heart Association Class, Acute heart failure, Congestion, Forrester classification, Outcomes, Perfusion, Acute Disease, Aged, Blood Pressure, Coronary Circulation, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Humans, Long-Term Care, Middle Aged, Registries, Risk Factors, Treatment Outcome, Hospitalization, 030204 cardiovascular system & hematology, Lower risk, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Long term outcomes, Medicine, Outcome, business.industry, Hazard ratio, acute heart failure, congestion, forrester classification, outcomes, perfusion, registry, acute disease, adult, aged, blood pressure, coronary circulation, female, follow-up studies, heart failure, hospital mortality, humans, long-term care, male, middle aged, registries, risk factors, treatment outcome, hospitalization, medicine.disease, Confidence interval, 3. Good health, Heart failure, Emergency medicine, Cardiology and Cardiovascular Medicine, business
Abstract: [Abstract] Aims: Classification of acute heart failure (AHF) patients into four clinical profiles defined by evidence of congestion and perfusion is advocated by the 2016 European Society of Cardiology (ESC)guidelines. Based on the ESC-EORP-HFA Heart Failure Long-Term Registry, we compared differences in baseline characteristics, in-hospital management and outcomes among congestion/perfusion profiles using this classification. Methods and results: We included 7865 AHF patients classified at admission as: 'dry-warm' (9.9%), 'wet-warm' (69.9%), 'wet-cold' (19.8%) and 'dry-cold' (0.4%). These groups differed significantly in terms of baseline characteristics, in-hospital management and outcomes. In-hospital mortality was 2.0% in 'dry-warm', 3.8% in 'wet-warm', 9.1% in 'dry-cold' and 12.1% in 'wet-cold' patients. Based on clinical classification at admission, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: 'wet-warm' vs. 'dry-warm' 1.78 (1.43-2.21) and 'wet-cold' vs. 'wet-warm' 1.33 (1.19-1.48). For profiles resulting from discharge classification, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: 'wet-warm' vs. 'dry-warm' 1.46 (1.31-1.63) and 'wet-cold' vs. 'wet-warm' 2.20 (1.89-2.56). Among patients discharged alive, 30.9% had residual congestion, and these patients had higher 1-year mortality compared to patients discharged without congestion (28.0 vs. 18.5%). Tricuspid regurgitation, diabetes, anaemia and high New York Heart Association class were independently associated with higher risk of congestion at discharge, while beta-blockers at admission, de novo heart failure, or any cardiovascular procedure during hospitalization were associated with lower risk of residual congestion. Conclusion: Classification based on congestion/perfusion status provides clinically relevant information at hospital admission and discharge. A better understanding of the clinical course of the two entities could play an important role towards the implementation of targeted strategies that may improve outcomes.
Published: 2019

11. Sacubitril/valsartan eligibility and outcomes in the ESC-EORP-HFA Heart Failure Long-Term Registry: bridging between European Medicines Agency/Food and Drug Administration label, the PARADIGM-HF trial, ESC guidelines, and real world

Author: Kapelios C. J., Lainscak M., Savarese G., Laroche C., Seferovic P., Ruschitzka F., Coats A., Anker S. D., Crespo-Leiro M. G., Filippatos G., Piepoli M. F., Rosano G., Zanolla L., Aguiar C., Murin J., Leszek P., McDonagh T., Maggioni A. P., Lund L. H., Auer J., Ablasser K., Fruhwald F., Dolze T., Brandner K., Gstrein S., Poelzl G., Moertl D., Reiter S., Podczeck-Schweighofer A., Muslibegovic A., Vasilj M., Fazlibegovic E., Cesko M., Zelenika D., Palic B., Pravdic D., Cuk D., Vitlianova K., Katova T., Velikov T., Kurteva T., Gatzov P., Kamenova D., Antova M., Sirakova V., Krejci J., Mikolaskova M., Spinar J., Krupicka J., Malek F., Hegarova M., Lazarova M., Monhart Z., Hassanein M., Sobhy M., El Messiry F., El Shazly A. H., Elrakshy Y., Youssef A., Moneim A. A., Noamany M., Reda A., Abdel Dayem T. K., Farag N., Ibrahim Halawa S., Abdel Hamid M., Said K., Saleh A., Ebeid H., Hanna R., Aziz R., Louis O., Enen M. A., Ibrahim B. S., Nasr G., Elbahry A., Sobhy H., Ashmawy M., Gouda M., Aboleineen W., Bernard Y., Luporsi P., Meneveau N., Pillot M., Morel M., Seronde M. -F., Schiele F., Briand F., Delahaye F., Damy T., Eicher J. -C., de Groote P., Fertin M., Lamblin N., Isnard R., Lefol C., Thevenin S., Hagege A., Jondeau G., Logeart D., Le Marcis V., Ly J. -F., Coisne D., Lequeux B., Le Moal V., Mascle S., Lotton P., Behar N., Donal E., Thebault C., Ridard C., Reynaud A., Basquin A., Bauer F., Codjia R., Galinier M., Tourikis P., Stavroula M., Tousoulis D., Stefanadis C., Chrysohoou C., Kotrogiannis I., Matzaraki V., Dimitroula T., Karavidas A., Tsitsinakis G., Kapelios C., Nanas J., Kampouri H., Nana E., Kaldara E., Eugenidou A., Vardas P., Saloustros I., Patrianakos A., Tsaknakis T., Evangelou S., Nikoloulis N., Tziourganou H., Tsaroucha A., Papadopoulou A., Douras A., Polgar L., Merkely B., Kosztin A., Nyolczas N., Csaba Nagy A., Halmosi R., Elber J., Alony I., Shotan A., Vazan Fuhrmann A., Amir O., Romano S., Marcon S., Penco M., Di Mauro M., Lemme E., Carubelli V., Rovetta R., Metra M., Bulgari M., Quinzani F., Lombardi C., Bosi S., Schiavina G., Squeri A., Barbieri A., Di Tano G., Pirelli S., Ferrari R., Fucili A., Passero T., Musio S., Di Biase M., Correale M., Salvemini G., Brognoli S., Zanelli E., Giordano A., Agostoni P., Italiano G., Salvioni E., Copelli S., Modena M. G., Reggianini L., Valenti C., Olaru A., Bandino S., Deidda M., Mercuro G., Cadeddu Dessalvi C., Marino P. N., Di Ruocco M. V., Sartori C., Piccinino C., Parrinello G., Licata G., Torres D., Giambanco S., Busalacchi S., Arrotti S., Novo S., Inciardi R. M., Pieri P., Chirco P. R., Ausilia Galifi M., Teresi G., Buccheri D., Minacapelli A., Veniani M., Frisinghelli A., Priori S. G., Cattaneo S., Opasich C., Gualco A., Pagliaro M., Mancone M., Fedele F., Cinque A., Vellini M., Scarfo I., Romeo F., Ferraiuolo F., Sergi D., Anselmi M., Melandri F., Leci E., Iori E., Bovolo V., Pidello S., Frea S., Bergerone S., Botta M., Canavosio F. G., Gaita F., Merlo M., Cinquetti M., Sinagra G., Ramani F., Fabris E., Stolfo D., Artico J., Miani D., Fresco C., Daneluzzi C., Proclemer A., Cicoira M., Marchese G., Torelli F., Vassanelli C., Voronina N., Erglis A., Tamakauskas V., Smalinskas V., Karaliute R., Petraskiene I., Kazakauskaite E., Rumbinaite E., Kavoliuniene A., Vysniauskas V., Brazyte-Ramanauskiene R., Petraskiene D., Stankala S., Switala P., Juszczyk Z., Sinkiewicz W., Gilewski W., Pietrzak J., Orzel T., Kasztelowicz P., Kardaszewicz P., Lazorko-Piega M., Gabryel J., Mosakowska K., Bellwon J., Rynkiewicz A., Raczak G., Lewicka E., Dabrowska-Kugacka A., Bartkowiak R., Sosnowska-Pasiarska B., Wozakowska-Kaplon B., Krzeminski A., Zabojszcz M., Mirek-Bryniarska E., Grzegorzko A., Bury K., Nessler J., Zalewski J., Furman A., Broncel M., Poliwczak A., Bala A., Zycinski P., Rudzinska M., Jankowski L., Kasprzak J. D., Michalak L., Wojtczak Soska K., Drozdz J., Huziuk I., Retwinski A., Flis P., Weglarz J., Bodys A., Grajek S., Kaluzna-Oleksy M., Straburzynska-Migaj E., Dankowski R., Szymanowska K., Grabia J., Szyszka A., Nowicka A., Samcik M., Wolniewicz L., Baczynska K., Komorowska K., Poprawa I., Komorowska E., Sajnaga D., Zolbach A., Dudzik-Plocica A., Abdulkarim A. -F., Lauko-Rachocka A., Kaminski L., Kostka A., Cichy A., Ruszkowski P., Splawski M., Fitas G., Szymczyk A., Serwicka A., Fiega A., Zysko D., Krysiak W., Szabowski S., Skorek E., Pruszczyk P., Bienias P., Ciurzynski M., Welnicki M., Mamcarz A., Folga A., Zielinski T., Rywik T., Sobieszczanska-Malek M., Piotrowska M., Kozar-Kaminska K., Komuda K., Wisniewska J., Tarnowska A., Balsam P., Marchel M., Opolski G., Kaplon-Cieslicka A., Gil R. J., Mozenska O., Byczkowska K., Gil K., Pawlak A., Michalek A., Krzesinski P., Piotrowicz K., Uzieblo-Zyczkowska B., Stanczyk A., Skrobowski A., Ponikowski P., Jankowska E., Rozentryt P., Polonski L., Gadula-Gacek E., Nowalany-Kozielska E., Kuczaj A., Kalarus Z., Szulik M., Przybylska K., Klys J., Prokop-Lewicka G., Kleinrok A., Tavares Aguiar C., Ventosa A., Pereira S., Faria R., Chin J., De Jesus I., Santos R., Silva P., Moreno N., Queiros C., Lourenco C., Pereira A., Castro A., Andrade A., Oliveira Guimaraes T., Martins S., Placido R., Lima G., Brito D., Francisco A. R., Cardiga R., Proenca M., Araujo I., Marques F., Fonseca C., Moura B., Leite S., Campelo M., Silva-Cardoso J., Rodrigues J., Rangel I., Martins E., Sofia Correia A., Peres M., Marta L., Ferreira da Silva G., Severino D., Durao D., Leao S., Magalhaes P., Moreira I., Filipa Cordeiro A., Ferreira C., Araujo C., Ferreira A., Baptista A., Radoi M., Bicescu G., Vinereanu D., Sinescu C. -J., Macarie C., Popescu R., Daha I., Dan G. -A., Stanescu C., Dan A., Craiu E., Nechita E., Aursulesei V., Christodorescu R., Otasevic P., Seferovic P. M., Simeunovic D., Ristic A. D., Celic V., Pavlovic-Kleut M., Suzic Lazic J., Stojcevski B., Pencic B., Stevanovic A., Andric A., Iric-Cupic V., Jovic M., Davidovic G., Milanov S., Mitic V., Atanaskovic V., Antic S., Pavlovic M., Stanojevic D., Stoickov V., Ilic S., Deljanin Ilic M., Petrovic D., Stojsic S., Kecojevic S., Dodic S., Cemerlic Adic N., Cankovic M., Stojiljkovic J., Mihajlovic B., Radin A., Radovanovic S., Krotin M., Klabnik A., Goncalvesova E., Pernicky M., Kovar F., Kmec J., Semjanova H., Strasek M., Savnik Iskra M., Ravnikar T., Cernic Suligoj N., Komel J., Fras Z., Jug B., Glavic T., Losic R., Bombek M., Krajnc I., Krunic B., Horvat S., Kovac D., Rajtman D., Cencic V., Letonja M., Winkler R., Valentincic M., Melihen-Bartolic C., Bartolic A., Pusnik Vrckovnik M., Kladnik M., Slemenik Pusnik C., Marolt A., Klen J., Drnovsek B., Leskovar B., Fernandez Anguita M. J., Gallego Page J. C., Salmeron Martinez F. M., Andres J., Bayes-Genis A., Mirabet S., Mendez A., Garcia-Cosio L., Roig E., Leon V., Gonzalez-Costello J., Muntane G., Garay A., Alcade-Martinez V., Lopez Fernandez S., Rivera-Lopez R., Puga-Martinez M., Fernandez-Alvarez M., Serrano-Martinez J. L., Crespo-Leiro M., Grille-Cancela Z., Marzoa-Rivas R., Blanco-Canosa P., Paniagua-Martin M. J., Barge-Caballero E., Laynez Cerdena I., Famara Hernandez Baldomero I., Lara Padron A., Ofelia Rosillo S., Dalmau Gonzalez-Gallarza R., Salvador Montanes O., Iniesta Manjavacas A. M., Castro Conde A., Araujo A., Soria T., Garcia-Pavia P., Gomez-Bueno M., Cobo-Marcos M., Alonso-Pulpon L., Segovia Cubero J., Sayago I., Gonzalez-Segovia A., Briceno A., Escribano Subias P., Vicente Hernandez M., Ruiz Cano M. J., Gomez Sanchez M. A., Delgado Jimenez J. F., Barrios Garrido-Lestache E., Garcia Pinilla J. M., Garcia de la Villa B., Sahuquillo A., Bravo Marques R., Torres Calvo F., Perez-Martinez M. T., Gracia-Rodenas M. R., Garrido-Bravo I. P., Pastor-Perez F., Pascual-Figal D. A., Diaz Molina B., Orus J., Epelde Gonzalo F., Bertomeu V., Valero R., Martinez-Abellan R., Quiles J., Rodrigez-Ortega J. A., Mateo I., ElAmrani A., Fernandez-Vivancos C., Bierge Valero D., Almenar-Bonet L., Sanchez-Lazaro I. J., Marques-Sule E., Facila-Rubio L., Perez-Silvestre J., Garcia-Gonzalez P., Ridocci-Soriano F., Garcia-Escriva D., Pellicer-Cabo A., de la Fuente Galan L., Lopez Diaz J., Recio Platero A., Arias J. C., Blasco-Peiro T., Sanz Julve M., Sanchez-Insa E., Aured-Guallar C., Portoles-Ocampo A., Melin M., Hagglund E., Stenberg A., Lindahl I. -M., Asserlund B., Olsson L., Dahlstrom U., Afzelius M., Karlstrom P., Tengvall L., Wiklund P. -A., Olsson B., Kalayci S., Temizhan A., Cavusoglu Y., Gencer E., Yilmaz M. B., Gunes H., Kapelios, C. J., Lainscak, M., Savarese, G., Laroche, C., Seferovic, P., Ruschitzka, F., Coats, A., Anker, S. D., Crespo-Leiro, M. G., Filippatos, G., Piepoli, M. F., Rosano, G., Zanolla, L., Aguiar, C., Murin, J., Leszek, P., Mcdonagh, T., Maggioni, A. P., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Abdel Dayem, T. K., Farag, N., Ibrahim Halawa, S., Abdel Hamid, M., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Elber, J., Alony, I., Shotan, A., Vazan Fuhrmann, A., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Cadeddu Dessalvi, C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Ausilia Galifi, M., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Wojtczak Soska, K., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavares Aguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveira Guimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Sofia Correia, A., Peres, M., Marta, L., Ferreira da Silva, G., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Filipa Cordeiro, A., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Suzic Lazic, J., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljanin Ilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Cemerlic Adic, N., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Savnik Iskra, M., Ravnikar, T., Cernic Suligoj, N., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Pusnik Vrckovnik, M., Kladnik, M., Slemenik Pusnik, C., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Fernandez Anguita, M. J., Gallego Page, J. C., Salmeron Martinez, F. M., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Lopez Fernandez, S., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Laynez Cerdena, I., Famara Hernandez Baldomero, I., Lara Padron, A., Ofelia Rosillo, S., Dalmau Gonzalez-Gallarza, R., Salvador Montanes, O., Iniesta Manjavacas, A. M., Castro Conde, A., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segovia Cubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Escribano Subias, P., Vicente Hernandez, M., Ruiz Cano, M. J., Gomez Sanchez, M. A., Delgado Jimenez, J. F., Barrios Garrido-Lestache, E., Garcia Pinilla, J. M., Garcia de la Villa, B., Sahuquillo, A., Bravo Marques, R., Torres Calvo, F., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Diaz Molina, B., Orus, J., Epelde Gonzalo, F., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Bierge Valero, D., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Lopez Diaz, J., Recio Platero, A., Arias, J. C., Blasco-Peiro, T., Sanz Julve, M., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., and Gunes, H.
Subjects: medicine.medical_specialty, Registry, Prognosi, Tetrazoles, 030204 cardiovascular system & hematology, Angiotensin receptor, Sacubitril, 03 medical and health sciences, Angiotensin Receptor Antagonists, 0302 clinical medicine, Internal medicine, medicine, neprilysin inhibitor, Humans, LCZ696, Enalapril, Registries, Sacubitril/valsartan, New York Heart Association Class I, Heart Failure, Angiotensin receptor–neprilysin inhibitor, Eligibility, Ejection fraction, business.industry, United States Food and Drug Administration, Aminobutyrates, Biphenyl Compounds, Stroke Volume, Guideline, Prognosis, Neprilysin, United States, Valsartan, medicine.disease, 3. Good health, Drug Combinations, Heart failure, Cardiology and Cardiovascular Medicine, business, angiotensin receptor–neprilysin inhibitor, eligibility, lcz696, prognosis, registry, sacubitril/valsartan, aminobutyrates, angiotensin receptor antagonists, humans, neprilysin, registries, stroke volume, tetrazoles, united states, united states food and drug administration, valsartan, heart failure, Sacubitril, Valsartan, medicine.drug
Abstract: Aims To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM-HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes. Methods and results Outpatients with HFrEF in the ESC-EORP-HFA Long-Term Heart Failure (HF-LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM-HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM-HF and guideline criteria, respectively. Absent PARADIGM-HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub-optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%) and sub-optimal pharmacotherapy (82%); absent label criteria were absence of symptoms (New York Heart Association class I). When a daily requirement of ACEi/ARB >= 10mg enalapril (instead of >= 20 mg) was used, eligibility rose from 12% to 28% based on both PARADIGM-HF and guidelines. One-year heart failure hospitalization was higher (12% and 17% vs. 12%) and all-cause mortality lower (5.3% and 6.5% vs. 7.7%) in registry eligible patients compared to the enalapril arm of PARADIGM-HF. Conclusions Among outpatients with HFrEF in the ESC-EORP-HFA HF-LT Registry, 84% met label criteria, while only 12% and 28% met PARADIGM-HF and guideline criteria for LCZ696 if requiring >= 20 mg and >= 10mg enalapril, respectively. Registry patients eligible for LCZ696 had greater heart failure hospitalization but lower mortality rates than the PARADIGM-HF enalapril group.
Published: 2019

12. Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases

Author: Sharrack, B., Saccardi, R., Alexander, T., Badoglio, M., Burman, J., Farge, D., Greco, R., Jessop, H., Kazmi, M., Kirgizov, K., Labopin, M., Mancardi, G., Martin, R., Moore, J., Muraro, P.A., Rovira Tarrats, Montserrat, Sormani, M.P., Snowden, J.A., Snowden, J., McGrath, E., Bambi, F., Sanchez-Guijo, F., Worel, N., Badolglio, M., Abinun, M., Arnold, R., Brierley, C., Castilla-Llorente, C., Cooper, N., Daikeler, T., del Papa, N., Finke, J., Hagglund, H., Henes, J., Hiepe, F., Kiely, D., Marjanovic, Z., Martin, T., Ma, D., Miller, P., Muraro, P., Oliveira, M.C., Polushin, A., Onida, F., Simoes, B., Puyade, M., Resnick, I., Rovira, Montserrat, Saif, M., Sakellari, I., Snarski, E., Scherer, H.U., Sossa, C., de Vries-Bouwstra, J., Wulffraat, N., Zaccara, E., Universitat Autònoma de Barcelona, University of Zurich, and Snowden, John A
Subjects: Feature, medicine.medical_specialty, Multiple Sclerosis, Neurologi, Bone marrow transplantation, 2747 Transplantation, medicine.medical_treatment, Immunology, 2720 Hematology, Chronic inflammatory demyelinating polyneuropathy, 610 Medicine & health, Disease, Hematopoietic stem cell transplantation, Transplantation, Autologous, Accreditation, Autoimmune Diseases, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, European Society for Blood and Marrow Transplantation (EBMT) Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of the International Society for Cellular Therapy (ISCT) and EBMT (JACIE), Intensive care medicine, Peripheral neuropathies, Transplantation, Hematology, Neuromyelitis optica, business.industry, Multiple sclerosis, Hematopoietic Stem Cell Transplantation, 1103 Clinical Sciences, medicine.disease, 10040 Clinic for Neurology, Clinical trial, Europe, surgical procedures, operative, Neurology, business, 030217 neurology & neurosurgery, 030215 immunology
Abstract: These updated EBMT guidelines review the clinical evidence, registry activity and mechanisms of action of haematopoietic stem cell transplantation (HSCT) in multiple sclerosis (MS) and other immune-mediated neurological diseases and provide recommendations for patient selection, transplant technique, follow-up and future development. The major focus is on autologous HSCT (aHSCT), used in MS for over two decades and currently the fastest growing indication for this treatment in Europe, with increasing evidence to support its use in highly active relapsing remitting MS failing to respond to disease modifying therapies. aHSCT may have a potential role in the treatment of the progressive forms of MS with a significant inflammatory component and other immune-mediated neurological diseases, including chronic inflammatory demyelinating polyneuropathy, neuromyelitis optica, myasthenia gravis and stiff person syndrome. Allogeneic HSCT should only be considered where potential risks are justified. Compared with other immunomodulatory treatments, HSCT is associated with greater short-term risks and requires close interspeciality collaboration between transplant physicians and neurologists with a special interest in these neurological conditions before, during and after treatment in accredited HSCT centres. Other experimental cell therapies are developmental for these diseases and patients should only be treated on clinical trials.
Published: 2020

13. Role of extracellular trap release by macrophages during the development of chronic inflammation

Author: P. Hagglund, B. Rayner, M. Jensen, Y. Zhang, and C.L. Hawkins
Subjects: Trap (computing), Chemistry, Extracellular, medicine, Inflammation, medicine.symptom, Cardiology and Cardiovascular Medicine, Cell biology
Published: 2021
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14. Implementation and Evaluation of a Condom Availability Program on a College Campus: Lessons From the Field

Author: Sara B. Oswalt, Heather P. Eastman-Mueller, Jessica Gomez-Scott, Kristofer J. Hagglund, and Ae Kyung Jung
Subjects: Program evaluation, College health, 030505 public health, business.industry, education, Human sexuality, Education, law.invention, Likert scale, 03 medical and health sciences, 0302 clinical medicine, Health promotion, Condom, Nursing, law, Medicine, Residence, 030212 general & internal medicine, 0305 other medical science, business, Reproductive health
Abstract: The U.S. Centers for Disease Control and Prevention advocate access to condoms as a critical sexual health prevention strategy. The purpose of this article is to discuss the implementation and evaluation of a condom availability program using dispensing machines in residence halls at a Midwestern U.S. university. Undergraduate students (N = 337) living in on-campus housing participated in a survey about their utilization of condom dispensers at the beginning and end of three academic years (2008–2009, 2009–2010, and 2010–2011). Questions also addressed students' attitudes toward the condom dispensers and related sexual behavior. Results indicated that the presence of condom machines did not increase rates of sexual activity (a concern of university administrators), but there was also no improvement in rates of unprotected sex. Overall, students reported high levels of satisfaction with the condom availability program. Implementation challenges are discussed and recommendations for universities and...
Published: 2016
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15. Anatomical Outcomes Based on Suturing Technique During Vaginal Mesh Attachment in Robotic Sacrocolpopexy

Author: Blake Osmundsen, Ali Ahmad Bazzi, Karen H. Hagglund, and Muhammad Faisal Aslam
Subjects: medicine.medical_specialty, Sacrum, Urology, Pelvic Organ Prolapse, Suture (anatomy), Robotic Surgical Procedures, medicine, Mesh erosion, Humans, Aged, Retrospective Studies, Pelvic organ, Sutures, business.industry, Suture Techniques, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, Surgical Mesh, Vaginal mesh, Surgery, Knot tying, Treatment Outcome, Barbed suture, Vagina, Female, business
Abstract: OBJECTIVES In this study, we assessed the difference in anatomical outcomes using the barbed, self-anchoring, delayed absorbable suture when compared with the traditional knot-tying interrupted suture technique during vaginal mesh attachment in robotic sacrocolpopexy. In addition, we compared the rates of mesh erosion with the 2 techniques. METHODS This is a retrospective cohort study of 131 women who underwent minimally invasive robotic sacrocolpopexy at 2 sites. There were 65 subjects at site 1 (barbed, self-anchoring, delayed absorbable suture) and 66 from site 2 (traditional knot-tying technique). The primary outcome was anatomical success (measured by all Pelvic Organ Prolapse Quantification System points
Published: 2019

16. Case cohort study of risk factors for post-thyroidectomy hemorrhage

Author: Scott Samona, Elango Edhayan, and Karen Hagglund
Subjects: Adult, Male, Reoperation, medicine.medical_specialty, medicine.medical_treatment, Operative Time, Postoperative Hemorrhage, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Humans, Medicine, Aged, Retrospective Studies, business.industry, Thyroid, Thyroidectomy, General Medicine, Middle Aged, Bleed, Surgery, Dissection, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Hypertension, Vomiting, Female, 030211 gastroenterology & hepatology, medicine.symptom, business, Complication, Postoperative Hypertension, Cohort study
Abstract: Background Post-thyroidectomy hemorrhage is a potentially life-threatening complication of thyroid surgery. The goal of our study was to determine potential risk factors for development of post-thyroidectomy hemorrhage. Methods A retrospective case cohort study of patients with post-thyroidectomy hemorrhage between December 2008 and August 2014 was performed. This group of patients was compared with a stratified randomized control group, and several parameters were assessed for association with post-thyroidectomy hemorrhage. Results Sixteen patients were identified in this time period as developing post-thyroidectomy hemorrhage requiring reoperation. Postoperative hypertension, vomiting and/or straining, longer operative times, and extent of surgical dissection were found to be statistically significant risk factors. Postoperative hypertension was found to be the most significant risk factor, resulting in a 20.3 times increased likelihood of developing post-thyroidectomy hemorrhage. Conclusions A number of risk factors for post-thyroidectomy hemorrhage were identified. The most significant was postoperative hypertension. Early control of modifiable risk factors could improve patient outcomes and satisfaction.
Published: 2016
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17. The association of resting state heart rate variability and 24-hour blood pressure variability in spinal cord injury

Author: Julian Koenig, Kristofer J. Hagglund, Annika Clamor, Julian F. Thayer, and John J. Sollers
Subjects: Adult, Male, medicine.medical_specialty, Blood Pressure, Baroreflex, Autonomic Nervous System, 01 natural sciences, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Internal medicine, 0103 physical sciences, Heart rate, medicine, Humans, Heart rate variability, 010306 general physics, Tetraplegia, Spinal cord injury, Spinal Cord Injuries, business.industry, VO2 max, medicine.disease, Autonomic nervous system, Blood pressure, Neurology, Cardiology, Physical therapy, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Patients with high cervical complete spinal cord injuries (tetraplegia) sustain damage to the autonomic neural pathways that influence cardiovascular functioning and produce variability in the heart rate (HR) and blood pressure (BP). In non-injured individuals, an inverse relationship exists between resting autonomic control of the heart (as evidenced by HR variability (HRV)) and BP variability (BPV). This study examined the relationship between HRV, BP and BPV in individuals with tetraplegic (n=10) and paraplegic (n=10) spinal cord injuries, and a group of healthy controls (n=14). Resting HRV at baseline and 24-hour ambulatory BP measurements were collected from electrocardiogram measures of each participant. HRV was quantified using time- and frequency-domain measures. The standard deviation of the BP measurements was used as an index of BPV. Multivariate analyses of variance were performed to examine group differences for laboratory-based and 24-h dependent variables. The MANOVAs for HRV parameters (λ(14,50)=.352, p=.010, η(2)=.407) and for BP indices and HR (λ(16,48)=.318, p=.013, η(2)=.436) were significant. Furthermore, in line with existing evidence, we found that vagally mediated HRV was inversely related to BPV in healthy controls. However, this relationship did not hold for the tetraplegia group (ρ|.42|), and mixed results were found for the paraplegia group (e.g., ρ|.29| for time domain HRV, ρ|.65| for low-frequency power). These results support the conclusion that the damage to the spinal sympathetic pathways to the heart found in people with tetraplegia causes a significant disruption in baroreflex control of BP.
Published: 2016
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18. Sense of Coherence in Persons with Dementia and Their Next of Kin—A Mixed-Method Study

Author: Hellzen Ove, Annika Kjallman Alm, Norbergh Karl-Gustaf, and Per Hagglund
Subjects: Next of kin, Sense of Coherence, Omvårdnad, Support Groups, Nursing, Disease, Mixed Method, medicine.disease, Mental health, Developmental psychology, Social support, Next of Kin, Scale (social sciences), Stress (linguistics), medicine, Dementia, Psychology, Everyday life
Abstract: Indications of dementia disease include deterioration of memory, thinking, behaviour, and the ability to perform everyday activities. Any of these symptoms can lead to stress and difficulties organizing everyday life. As a way to view factors that support human health and well-being despite stressful situations, Antonovsky introduced a salutogenic model. This model proposes that sense of coherence primarily determines physical and mental health i.e. psychological well-being. Having a sense of coherence in everyday life can reduce the impact of stress on the individual in everyday life. The study’s aim of this study was to explore how participants in existing support groups scored on the Sense of Coherence Scale (SOC), and what they perceived as contributory factors to a meaningful, manageable, and comprehensible everyday life in the presence of dementia using a mixed method. Persons with dementia had the highest scores on the SOC scale and their partners the lowest. Persons with dementia expressed that being with others who understood them made their everyday life comprehensible and manageable. Their partners expressed that learning about dementia was helpful in managing and comprehending everyday situations. The adult children expressed that it was meaningful to care for their parents and they scored slightly higher than the partners on the SOC scale. Long-term ongoing support supplemented with information and social support can contribute to the sense of coherence in persons with dementia and their next of kin.
Published: 2015
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19. Opioid Prescribing Trends: A Comparison of Focused Resident Intervention and State of Michigan Mandates

Author: Sejul Chaudhary, Elango Edhayan, Karen Hagglund, and Victoria Simmons
Subjects: medicine.medical_specialty, business.industry, Family medicine, Intervention (counseling), medicine, Surgery, business, Opioid prescribing
Published: 2019
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20. Grade and maximum tumor dimension as determinants of lymphadenectomy in patients with endometrioid endometrial cancer

Author: K. Hagglund, L. Fathallah, A.A. Bazzi, R. OHara, and A. Hamza
Subjects: Oncology, medicine.medical_specialty, business.industry, medicine.medical_treatment, Endometrial cancer, Obstetrics and Gynecology, medicine.disease, Dimension (vector space), Internal medicine, Medicine, Lymphadenectomy, In patient, business
Published: 2019
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21. Teaching surgical residents to evaluate scholarly articles: a constructivist approach

Author: Karen Hagglund, Elango Edhayan, and Tiffany Chichester
Subjects: Adult, Male, Educational measurement, Statistics as Topic, education, Lifelong learning, Constructivist teaching methods, Educational aid, Humans, Medicine, Analysis of Variance, Medical education, Evidence-Based Medicine, business.industry, Education theory, Internship and Residency, General Medicine, Evidence-based medicine, Literature evaluation, Education, Medical, Graduate, General Surgery, Female, Surgery, Clinical Competence, Educational Measurement, Periodicals as Topic, Journal club, business
Abstract: Background The ability to critically appraise scholarly journals is an essential skill for surgical residents in their journey to being lifelong learners. Methods to teach evaluation of scholarly articles are scant in the educational literature. Methods Residents completed a pre-test on evaluation of surgical literature. Two lectures on methodology and statistics followed. A board-certified surgeon and residents evaluated 7 articles using a scoring form. A post-test followed. Four additional sessions on evaluating surgical articles were held without the rating form. Residents completed a second post-test. Results Residents showed improved knowledge and skills on evaluating surgical literature on the first and second post-tests when compared with the pretest ( P Conclusions Surgical residents can be taught to evaluate literature using constructivist Educational theory. There was a significant improvement in knowledge and the skills of literature evaluation, which persisted after the educational aid was removed.
Published: 2013
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22. Educational advocacy among adoptive parents of adolescents with fetal alcohol spectrum disorder

Author: Emma J. Stodel, Stephanie Fullarton, Cheryll Duquette, and Karras Hagglund
Subjects: Information seeking, business.industry, Fetal alcohol syndrome, medicine.disease, Education, Access to information, Arts and Humanities (miscellaneous), Fetal Alcohol Spectrum Disorder, Consciousness raising, medicine, The Internet, Young adult, business, Psychology, Qualitative research, Clinical psychology
Abstract: The purpose of this qualitative study was to examine the educational advocacy experiences of 36 adoptive parents of adolescents and young adults with fetal alcohol spectrum disorder (FASD). The participants responded to a questionnaire and 29 of them also engaged in an in-depth individual interview. Data were analysed inductively. Emerging from the data were four dimensions of advocacy: awareness, information seeking, presenting the case and monitoring. It was also found that the Internet was an essential tool for parents to seek information and support from others, and that in some cases advocacy was a means for parents to obtain respect from educators and programmes and services for their children.
Published: 2012
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23. Geographic differences in traumatic brain injury and spinal cord injury rehabilitation

Author: Brick Johnstone, Micah O. Mazurek, Kristofer J. Hagglund, and Yuko Yamato
Subjects: medicine.medical_specialty, Spinal cord injury rehabilitation, Rehabilitation, Demographics, business.industry, Traumatic brain injury, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Functional Independence Measure, Physical medicine and rehabilitation, medicine, Physical therapy, Substance use, Rural area, business, Spinal cord injury
Abstract: Background/aims: To examine potential geographic differences among individuals with traumatic brain injury (TBI) and spinal cord injury (SCI) in demographics, rehabilitation services/costs, and outcomes at one year follow-up. Methods: 152 participants with TBI from the Missouri Model Brain Injury System and 149 participants with SCI from the Missouri Model Spinal Cord Injury System were enrolled at initial acute or rehabilitation hospitalization and followed for one year. Measures included demographics, rehabilitative services/costs, functional independence measure, residency at discharge, and substance use. Findings: Few differences in demographics or rehabilitation services were found when comparing rural and urban groups, and there were no differences in one year outcomes measured. Conclusions: The results suggest that, contrary to expectations, individuals with severe disabilities in rural areas do not necessarily experience worse outcomes than those in urban areas, indicating potential improvements in access to services in rural areas.
Published: 2011
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24. Challenges in the Treatment of Factitious Disorder: A Case Study

Author: Leigh A. Hagglund
Subjects: Adult, medicine.medical_specialty, Attitude of Health Personnel, Codependency, Psychological, MEDLINE, Psychiatric Nursing, Holistic Health, Holistic health, Models, Psychological, Nurse's Role, medicine, Humans, Nurse Practitioners, Models, Nursing, Psychoanalytic theory, Psychiatry, Patient Care Team, Motivation, Stereotyping, business.industry, Sick role, Sick Role, medicine.disease, Factitious disorder, Mental health, Factitious Disorders, Nursing Theory, Psychoanalytic Theory, Nursing theory, Codependency, Female, Pshychiatric Mental Health, Nurse Clinicians, Nurse-Patient Relations, business
Abstract: Factitious disorder is difficult to diagnose and effectively treat. It is often met with intense emotion by both the care provider(s) and the client when suspected. However, if missed or untreated, it can become a chronic syndrome that is expensive and potentially dangerous. This article examines barriers to successful treatment of factitious disorder as manifested by a woman who received services from an urban community mental health center over a 7-year period for the management of multiple mental health issues. The unique role of the advanced practice psychiatric nurse is discussed through application of the nursing theory modeling and role modeling.
Published: 2009
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25. The Challenge of Financing and Delivering Personal Assistant Services

Author: Kristofer J. Hagglund, Mary J. Clark, and Brian J. Stout
Subjects: Service (business), Finance, Medicare/medicaid, Health (social science), Policy making, business.industry, Multitude, Argument, Workforce, Medicine, Delivery system, business, Law, Medicaid
Abstract: Over the past several years, a multitude of factors have converged to make the financing and delivery of personal assistant services (PAS) two of the most critical issues in American disability policy making. This article chronicles the development of assistive services and examines some of the more noteworthy strategies designed to improve PAS policy making. The argument is made that PAS should be a mandatory benefit provided through Medicaid. This approach, although imperfect, holds the greatest potential for improving the PAS delivery system. Incorporating PAS as a Medicaid benefit offers advantages over the current system, including the opportunity for ongoing need and satisfaction assessment among program beneficiaries, the development of a platform for strengthening the personal assistant workforce, and the ability to generate evidenced-based recommendations for improved service outcomes and cost-effectiveness.
Published: 2008
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26. A longitudinal comparison of consumer-directed and agency-directed personal assistance service programmes among persons with physical disabilities

Author: Kristofer J. Hagglund, Mary J. Clark, and Ashley K. Sherman
Subjects: Adult, Male, medicine.medical_specialty, Longitudinal study, Activities of daily living, Ethnic group, Interviews as Topic, Patient satisfaction, Nursing, Activities of Daily Living, Agency (sociology), Home Care Agencies, medicine, Humans, Disabled Persons, Longitudinal Studies, Service (business), business.industry, Rehabilitation, Home Health Aides, Middle Aged, Long-term care, Patient Satisfaction, Models, Organizational, Family medicine, Female, Functional status, business
Abstract: Purpose. To compare outcomes for persons who were enrolled in an agency-directed personal assistance services (PAS) programme and then changed to a consumer-directed PAS programme.Method. A convenience sample was used for this longitudinal study. In-home interviews were conducted by a trained data collector from April 2000 to December 2001.Results. Participants reported more satisfaction and safety with personal assistance, and fewer unmet needs after receiving consumer-directed services than after receiving agency-directed services. Other variables related to outcomes included race and ethnicity, employment, functional status, unmet needs, and the level of confidence in obtaining help if assistance is unavailable. Participants (74%) also reported high rates of unmet needs in the past month.Conclusions. Consumer-directed PAS enhances outcomes for many persons with disabilities. Self-reported outcomes are affected by many factors that could be addressed in PAS program development.
Published: 2008
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27. Secondary school experiences of individuals with foetal alcohol spectrum disorder: perspectives of parents and their children

Author: Stephanie Fullarton, Karras Hagglund, Emma J. Stodel, and Cheryll Duquette
Subjects: Persistence (psychology), education, Fetal alcohol syndrome, Foetal Alcohol Spectrum Disorder, medicine.disease, female genital diseases and pregnancy complications, Education, Developmental psychology, Social integration, Arts and Humanities (miscellaneous), medicine, Attention deficit hyperactivity disorder, Psychology, reproductive and urinary physiology, Social influence
Abstract: The purpose of this study was to examine persistence in school among students with Foetal Alcohol Spectrum Disorder (FASD) from the perspectives of the students themselves and their parents. Tinto’...
Published: 2007
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28. Life activities among individuals with spinal cord injury living in the community: Perceived choice and perceived barriers

Author: Kristofer J. Hagglund, Mary J. Clark, Brian J. Stout, David B. Gray, Ashley K. Sherman, Laura H. Schopp, and Mike Boninger
Subjects: Gerontology, Psychiatry and Mental health, Clinical Psychology, medicine.medical_specialty, Activities of daily living, business.industry, Rehabilitation, Alternative medicine, Medicine, Physical Therapy, Sports Therapy and Rehabilitation, business, medicine.disease, Spinal cord injury
Published: 2007
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29. Teaching Students with Developmental Disabilities: Tips from Teens and Young Adults with Fetal Alcohol Spectrum Disorder

Author: Karras Hagglund, Emma J. Stodel, Stephanie Fullarton, and Cheryll Duquette
Subjects: Teaching method, 05 social sciences, Fetal alcohol syndrome, 050301 education, 030229 sport sciences, medicine.disease, Education, Developmental psychology, 03 medical and health sciences, 0302 clinical medicine, Fetal Alcohol Spectrum Disorder, Learning disability, Developmental and Educational Psychology, medicine, Attention deficit hyperactivity disorder, Young adult, medicine.symptom, Psychology, 0503 education, Graduation, Clinical psychology
Published: 2006
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30. Selegiline slows the progression of the symptoms of Parkinson disease

Author: O. Maki-Ikola, R. Palm, E. H. Heinonen, J. Hagglund, S. Palhagen, and Toomas Kaugesaar
Subjects: Male, Levodopa, medicine.medical_specialty, Time Factors, Combination therapy, Placebo, Drug Administration Schedule, law.invention, Antiparkinson Agents, Central nervous system disease, Pharmacotherapy, Double-Blind Method, Randomized controlled trial, law, Internal medicine, Activities of Daily Living, Selegiline, Humans, Medicine, Aged, business.industry, Hazard ratio, Parkinson Disease, Middle Aged, medicine.disease, Surgery, Disease Progression, Drug Therapy, Combination, Female, Neurology (clinical), business, medicine.drug
Abstract: Objective: To study the long-term effects of selegiline in monotherapy and in combination with levodopa in the early phase of Parkinson disease (PD). Methods: One hundred fifty-seven de novo PD patients were randomized in a double-blind, placebo-controlled study of 7 years' duration. In the monotherapy part, selegiline significantly delayed the initiation of levodopa therapy vs placebo. The authors now report the results from the combination part of the study, in which 140 patients received selegiline or placebo in addition to individually tailored levodopa therapy. Results: Compared with placebo, selegiline slowed the progression of disease disability as measured by the Unified Parkinson Disease Rating Scale (UPDRS) total score (p = 0.003) or by motor (p = 0.002) and Activities of Daily Living (p = 0.0002) subscores. After 5 years in combination therapy, the mean difference in the UPDRS total score was nearly 10 points, with patients receiving placebo having 35% higher scores. Simultaneously, patients receiving placebo needed progressively higher doses of levodopa than patients receiving selegiline, after 5 years, the mean dosage of levodopa was 19% higher with placebo than with selegiline (p = 0.0002). Considering the entire (monotherapy and combination therapy) 7-year study time, there was a trend for selegiline to delay the start of wearing-off fluctuations (hazard ratio 0.55, p = 0.08). In both phases of the study, selegiline was safe and well tolerated. Conclusions: The results of this long-term study confirm earlier findings indicating that selegiline delays the progression of the signs and symptoms of Parkinson disease. Copyright © 2006 by AAN Enterprises, Inc.
Published: 2006
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31. Access to Healthcare Services Among Persons with Osteoarthritis and Rheumatoid Arthritis

Author: Kristofer J. Hagglund, James E Hewett, Mary J. Clark, and Shelley A Hilton
Subjects: Male, Mental Health Services, musculoskeletal diseases, medicine.medical_specialty, Alternative medicine, Arthritis, Physical Therapy, Sports Therapy and Rehabilitation, Osteoarthritis, Drug Prescriptions, Health Services Accessibility, Insurance Coverage, Arthritis, Rheumatoid, Health care, Humans, Medicine, skin and connective tissue diseases, Health Services Needs and Demand, Primary Health Care, business.industry, Rehabilitation, Age Factors, Middle Aged, medicine.disease, United States, Health Care Surveys, Rheumatoid arthritis, Physical therapy, Regression Analysis, Female, business, Specialization
Abstract: Persons with osteoarthritis and rheumatoid arthritis frequently require access to a broad range of healthcare services. The purpose of the current study was to examine the healthcare access experiences of these two populations.Mail surveys were completed by 409 adults with self-reported osteoarthritis or rheumatoid arthritis who were recruited through a variety of recruitment strategies such as advertisements placed in arthritis publications, internet sources, and physician referrals.Participants self-reported not obtaining needed health care at high rates for several service domains, including mental health services (42%) and rehabilitation therapies (39%). The most frequent reasons for not obtaining services included lack of service coverage by the health plan and high costs. Type of arthritis was predictive of the ability to obtain primary doctor services.The United States healthcare system continues to focus on treating acute disorders and has yet to adapt to the growing prevalence of chronic illness and disability. Changes will be needed in both healthcare financing and delivery structures to promote access to specialized services such as mental health services and rehabilitation therapies for persons with osteoarthritis and rheumatoid arthritis.
Published: 2005
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32. Consumer-Assistant Education to Reduce the Occurrence of Urinary Tract Infections Among Persons with Spinal Cord Injury

Author: Michael Acuff, Laura Schopp, Kristofer J. Hagglund, Ashley K. Sherman, and Mary J. Clark
Subjects: medicine.medical_specialty, Future studies, business.industry, Incidence (epidemiology), Urinary system, Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Intervention (counseling), Emergency medicine, medicine, Physical therapy, Neurology (clinical), business, Spinal cord injury
Abstract: Urinary tract infections (UTIs) have been identified as one of the most common secondary conditions among individuals with spinal cord injury (SCI). This article describes the outcomes of an educational intervention to reduce UTI incidence. Persons with SCI who attended an in-person educational workshop reported a decrease in the occurrence of UTIs over a 6-month period, compared to persons not attending the workshop (p .02). Future studies should include oversampling for those persons at greatest risk, including minorities and those with poor health status, with few social supports, and with high cervical level injuries who rely more extensively on personal assistant services.
Published: 2005
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33. Job Experiences of Personal Assistants Employed in a Consumer-Directed Personal Assistance Services Programs

Author: Mary J. Clark, Brian J. Stout, and Kristofer J. Hagglund
Subjects: Adult, Consumer Advocacy, Employment, Medical education, business.industry, media_common.quotation_subject, Rehabilitation, Home Health Aides, Pilot Projects, Physical Therapy, Sports Therapy and Rehabilitation, General Medicine, Job Satisfaction, Independence, Work (electrical), Nursing, Humans, Medicine, Job satisfaction, Personal experience, business, General Nursing, media_common
Abstract: The demand for personal assistants for persons with disabilities is outpacing the supply. The objective of this pilot project was to describe the training and supervision needs of personal assistants, the nature of the assistant-consumer relationship, and the job satisfaction associated with being employed as a personal assistant. Telephone interviews were conducted with 24 personal assistants. All of the participants reported being competent and well trained in their work and 79% of the participants reported being very satisfied with their work as a personal assistant. All also reported they had an opportunity to accomplish something worthwhile in their jobs. Participants reported high levels of satisfaction with their relationship with their employers and with their jobs in general, despite dissatisfaction with low wages. Further research is needed to identify strategies for increasing the supply of personal assistants, who are pivotal to helping consumers maintain their independence.
Published: 2004
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34. Mo1053 Feeding Tube Placement: Do We Need to Take It Down a PEG? Identifying Risk Factors for Adverse Outcomes After PEG Tube Placement

Author: Jeanne Lewandowski, Mohammed I. Ali, Daniel Hassumani, Elango Edhayan, Karen Hagglund, and Varun Kapur
Subjects: medicine.medical_specialty, Adverse outcomes, business.industry, PEG ratio, Gastroenterology, Tube placement, medicine, Radiology, Nuclear Medicine and imaging, Intensive care medicine, business, Feeding tube, Surgery
Published: 2016
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35. HerpesSimplex Virus 1 Mutant in Which the ICP0 HUL-1 E3 Ubiquitin Ligase SiteIs Disrupted Stabilizes cdc34 but Degrades D-Type Cyclins andExhibits DiminishedNeurotoxicity

Author: Ryan Hagglund and Bernard Roizman
Subjects: Ubiquitin-Protein Ligases, viruses, Immunology, Mutant, Herpesvirus 1, Human, medicine.disease_cause, Microbiology, Anaphase-Promoting Complex-Cyclosome, Immediate early protein, Cell Line, Immediate-Early Proteins, Mice, Ubiquitin, Cyclins, Virology, Ring finger, medicine, Animals, Humans, Cyclin D1, Cyclin D3, Cyclin, Brain Diseases, Mutation, Virulence, biology, Ubiquitin-Protein Ligase Complexes, Herpes Simplex, biochemical phenomena, metabolism, and nutrition, Molecular biology, Virus-Cell Interactions, Ubiquitin ligase, RING finger domain, medicine.anatomical_structure, Insect Science, Ubiquitin-Conjugating Enzymes, Mice, Inbred CBA, biology.protein, Gene Deletion
Abstract: Herpes simplex virus type 1 (HSV-1) infected cell protein 0 (ICP0) is a multifunctional protein that functions as a promiscuous transactivator and promotes the degradation of multiple cellular proteins. In vitro studies indicated that it encodes two physically separated functional E3 ubiquitin ligase domains. One, designated herpesvirus ubiquitin ligase 1 (HUL-1), maps to a region encoded by exon 3 and is contained between residues 543 and 680. Deletion of amino acids 621 to 625 abolishes this activity. The second, designated HUL-2, maps to the RING finger domain present in ICP0 encoded by exon 2. Earlier studies have shown that ICP0 stabilizes cyclins D1 and D3, and several lines of investigation led to the hypothesis that this function of ICP0 is the consequence of degradation of the E2 enzyme cdc34, known to be involved in the proteasome-dependent degradation of D-type cyclins. Consistent with this hypothesis, we have previously shown that cdc34 physically interacts with ICP0 at or near aspartate 199 and at amino acids 621 to 625 and that the former site is required for effective ubiquitylation and degradation of cdc34. Furthermore, the ICP0 HUL-1 domain promotes the polyubiquitination of cdc34 in vitro. If the mechanism by which D-type cyclins are salvaged in wild-type-infected cells is dependent on polyubiquitination and consequent destruction of cdc34, than the mutant virus R6701, which was constructed for these studies and lacks ICP0 residues 621 to 625, should destabilize the D cyclins and preclude the degradation of cdc34. We report that ICP0 residues 621 to 625 are essential for degradation of cdc34 in infected cells and for the ICP0-mediated stabilization of D-type cyclins, that a mutation that specifically disrupted the ring finger domain of the HUL-2 site had no effect on the degradation of cdc34 in infected cells, and that deletion of ICP0 residues 621 to 625 decreased the replicative capacity of the virus in growth-arrested but not in dividing cells and resulted in diminished pathogenicity on intracerebral inoculation of mice. We conclude that the ICP0 HUL-1 domain acts in infected cells to degrade cdc34 and that this function requires the interaction of cdc34 with sequences in exons 2 and 3 but does not involve the HUL-2 RING finger E3 domain.
Published: 2003
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36. Access to health care services among people with chronic or disabling conditions: patterns and predictors 11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated

Author: Melinda T. Neri, Kristofer J. Hagglund, Mary J. Clark, Shelley A Hilton, Kelley R. Dhont, and Phillip W. Beatty
Subjects: Service (business), medicine.medical_specialty, business.industry, Rehabilitation, Psychological intervention, Specialty, Physical Therapy, Sports Therapy and Rehabilitation, Family medicine, Health care, Epidemiology, Needs assessment, medicine, Physical therapy, Managed care, Medical prescription, business
Abstract: Beatty PW, Hagglund KJ, Neri MT, Dhont KR, Clark MJ, Hilton SA. Access to health care services among people with chronic or disabling conditions: patterns and predictors. Arch Phys Med Rehabil 2003;84:1417–25. Objective To examine patterns of access to a variety of specific health care services among people with chronic or disabling conditions, focusing on factors that predict access to services. Design National survey of 800 adults with cerebral palsy (CP), multiple sclerosis (MS), spinal cord injury (SCI), or arthritis. Setting Respondents were surveyed in the general community. Participants National convenience sample of adults with CP, MS, SCI, or arthritis. Interventions Not applicable. Main outcomes measures Access to services from primary care doctors, services from specialists, rehabilitative services, assistive equipment, and prescription medications. Cross tabulations and logistic regression analyses were performed on survey data to examine patterns and predictors of access to health care services. Results Only half of all respondents received needed rehabilitative services. Respondents covered by fee-for-service health plans were more likely than those covered by managed care organizations to receive needed services from specialists. Respondents with the poorest health and with the lowest incomes were the least likely to receive all health services examined. Conclusions People with chronic or disabling conditions often require a comprehensive array of health care services. Reform of the current health care payment and delivery structures is needed so that health care is more responsive to those with the greatest service needs.
Published: 2003
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37. Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty

Author: H. E. Muoneke, T. H. Dunningham, A. M. Khan, E. Hagglund, and K. A. Giannikas
Subjects: musculoskeletal diseases, medicine.medical_specialty, business.industry, Radiography, medicine.medical_treatment, Anterior knee pain, Total knee replacement, Anatomy, musculoskeletal system, Prosthesis, Arthroplasty, Knee score, Surgery, Radiological weapon, medicine, Orthopedics and Sports Medicine, Patella, business, human activities
Abstract: Out of a total of 623 patients who, over a ten-year period, underwent primary total knee replacement (TKR) without patellar resurfacing, 20 underwent secondary resurfacing for chronic anterior knee pain. They were evaluated pre- and postoperatively using the clinical and radiological American Knee Society score. The mean follow-up was 36.1 months (12 to 104). The mean knee score improved from 46.7 to 62.2 points and the mean functional score from 44.7 to 52.2 points. Only 44.4% of the patients, however, reported some improvement; the remainder reported no change or deterioration. The radiographic alignment of the TKR did not influence the outcome of secondary resurfacing of the patella. Complications were noted in six of the 20 patients including fracture and instability of the patella and loss of movement. Anterior knee pain after TKR remains difficult to manage. Secondary resurfacing of the patella is not advocated in all patients since it may increase patient dissatisfaction and hasten revision.
Published: 2003
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38. Gazing into the Crystal Ball: Health Care, Health Policy, and Rehabilitation for Spinal Cord Injury

Author: Kristofer J. Hagglund, Brian J. Stout, and Robert G. Frank
Subjects: Rehabilitation, Prescription drug, business.industry, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Long-term care, Nursing, Health care, Medicine, Neurology (clinical), Prospective payment system, Medical emergency, business, Medicaid, health care economics and organizations, Health policy, Reimbursement
Abstract: The US Congress faces a host of health issues that demand immediate attention. Many of these issues are of considerable importance to those persons with spinal cord injury (SCI), including the rising cost of health care and health insurance, the current budget shortfalls facing state governments, and the need for a Medicare prescription drug program. Persons with disabilities are becoming increasingly dependent on public forms of insurance, like Medicare and Medicaid, and are bearing a disproportionate share of service curtailment. Other issues relevant to persons with disabilities and health care providers are prospective payment reimbursement implementation for rehabilitation, the reauthorization of the Rehabilitation Act, and the New Freedom Initiative. Considering the political climate and the importance of such issues, the need for advocacy among professionals and consumers is greater than ever.
Published: 2003
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39. Characterization of the novel E3 ubiquitin ligase encoded in exon 3 of herpes simplex virus-1-infected cell protein 0

Author: Bernard Roizman and Ryan Hagglund
Subjects: Swine, Recombinant Fusion Proteins, Ubiquitin-Protein Ligases, Restriction Mapping, Herpesvirus 1, Human, Ubiquitin-conjugating enzyme, medicine.disease_cause, Anaphase-Promoting Complex-Cyclosome, Immediate early protein, Immediate-Early Proteins, Ligases, DDB1, Ubiquitin, medicine, Animals, Humans, Codon, Creatine Kinase, Glutathione Transferase, chemistry.chemical_classification, DNA ligase, Binding Sites, Multidisciplinary, biology, Ubiquitin-Protein Ligase Complexes, Exons, Biological Sciences, Molecular biology, Ubiquitin ligase, RING finger domain, Herpes simplex virus, chemistry, Ethylmaleimide, Ubiquitin-Conjugating Enzymes, Mutagenesis, Site-Directed, biology.protein, Plasmids
Abstract: Infected cell protein 0 (ICP0) of herpes simplex virus-1 is a 775-aa residue multifunctional protein that acts as a promiscuous transactivator linked to the degradation of several proteins. ICP0 is the only protein known which encodes two physically separated E3 ubiquitin (Ub) ligase domains, one, designated herpes virus Ub ligase 1 (HUL-1) located in a domain encoded in exon 3 and one designated herpes virus Ub ligase 2 (HUL-2) associated with the really interesting new gene (RING) finger domain encoded by exon 2. We report the following: ( i ) ICP0 residues 543–680 are sufficient for HUL-1 E3 activity and necessary determinants are encoded between residues 616 and 680. ( ii ) In substrate independent in vitro ubiquitylation reactions, a chimeric protein containing the HUL-1 domain promotes the ubiquitylation of itself and the ubiquitin conjugating enzyme (E2) cdc34 and interacts with cdc34. ( iii ) The mechanism of HUL-1 E3 function does not involve formation of a thioester between the HUL-1 domain and Ub. ( iv ) Residues 621–625 are essential for in vitro HUL-1 E3 activity and interaction between the HUL-1 domain and cdc34, suggesting that this interaction is required for HUL-1 E3 function.
Published: 2002
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40. REMOVING SERVICE BARRIERS FOR WOMEN WITH PHYSICAL DISABILITIES: PROMOTING ACCESSIBILITY IN THE GYNECOLOGIC CARE SETTING

Author: Laura H. Schopp, Tiffany C. Sanford, Kristofer J. Hagglund, John W. Gay, and Mary Ann Coatney
Subjects: Attitude of Health Personnel, Population, Poison control, Suicide prevention, Health Services Accessibility, Occupational safety and health, Nursing, Maternity and Midwifery, Injury prevention, Health care, Humans, Medicine, Disabled Persons, education, Spinal Cord Injuries, Cervical cancer, education.field_of_study, business.industry, Communication Barriers, Obstetrics and Gynecology, Human factors and ergonomics, Architectural Accessibility, medicine.disease, United States, Women's Health Services, Gynecology, Female, business
Abstract: Although women with disabilities constitute a substantial segment of the population, their gynecologic health care needs often go unrecognized or untreated. Women with disabilities encounter a variety of obstacles to receiving health services including attitudinal, environmental, economic, and informational barriers. Standard screening and preventive services, such as pelvic examinations and mammograms, can be especially difficult to obtain, potentially placing women with disabilities at greater risk for diseases such as breast cancer and cervical cancer. This article reviews the current status of gynecologic care for women with disabilities and provides strategies for women's health care providers seeking to increase the accessibility of their practice settings.
Published: 2002
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41. Vaccine Safety and Efficacy Evaluation of a Recombinant Bovine Respiratory Syncytial Virus (BRSV) with Deletion of the SH Gene and Subunit Vaccines Based On Recombinant Human RSV Proteins: N-nanorings, P and M2-1, in Calves with Maternal Antibodies

Author: Blodorn, Krister, Hagglund, Sara, Fix, Jenna, Dubuquoy, Catherine, Makabi-Panzu, Boby, Thom, Michelle, Karlsson, Per, Roque, Jean-Louis, Karlstam, Erika, Pringle, John, Eleouet, Jean Francois, Riffault, Sabine, Taylor, Geraldine, Valarcher, Jean Francois, Department of Clinical Sciences, Host Pathogen Interaction Group, Swedish University of Agricultural Sciences (SLU), Unité de recherche Virologie et Immunologie Moléculaires (VIM (UR 0892)), Institut National de la Recherche Agronomique (INRA), Pirbright Institute, National Veterinary Institute, Clinique Vétérinaire, National Veterinary Institute [Uppsala] (SVA), Swedish Research Council (Formas, Sweden), Biotechnology and Biological Sciences Research Council (BBSRC, UK), and L'Agence Nationale de la Recherche (ANR, France), through EMIDA ERA NET [87]
Subjects: vaccin, Viral Diseases, Genes, Viral, [SDV]Life Sciences [q-bio], Veterinary Microbiology, Respiratory Syncytial Virus, Bovine, Antibodies, Viral, White Blood Cells, Epitopes, Animal Cells, Medicine and Health Sciences, Lymphocytes, Lung, Vaccines, Virulence, T Cells, Vaccination, immunisation, Viral Load, Vaccination and Immunization, Infectious Diseases, Veterinary Diseases, Vaccines, Subunit, anticorps, Medicine, Cellular Types, Research Article, Veterinary Medicine, Infectious Disease Control, Science, Immune Cells, réponse immunitaire, Immunology, Molecular Sequence Data, Respiratory Syncytial Virus Infections, Veterinary Immunology, Immunomodulation, Immune Activation, Viral Proteins, adjuvant, Species Specificity, Vaccine Development, Respiratory Syncytial Virus Vaccines, Animals, Humans, Amino Acid Sequence, Immunity to Infections, Respiratory Syncytial Virus Infection, Blood Cells, Immunity, Biology and Life Sciences, Cell Biology, Veterinary Virology, Acquired Immune System, Immune System, Respiratory Syncytial Virus, Human, Humoral Immunity, Clinical Immunology, Veterinary Science, Cattle, protéine recombinante, Lymph Nodes, vaccin recombinant, Gene Deletion
Abstract: International audience; The development of safe and effective vaccines against both bovine and human respiratory syncytial viruses (BRSV, HRSV) to be used in the presence of RSV-specific maternally-derived antibodies (MDA) remains a high priority in human and veterinary medicine. Herein, we present safety and efficacy results from a virulent BRSV challenge of calves with MDA, which were immunized with one of three vaccine candidates that allow serological differentiation of infected from vaccinated animals (DIVA): an SH gene-deleted recombinant BRSV (Delta SHrBRSV), and two subunit (SU) formulations based on HRSV-P, -M2- 1, and -N recombinant proteins displaying BRSV-F and -G epitopes, adjuvanted by either oil emulsion (Montanide ISA71(VG), SUMont) or immunostimulating complex matrices (AbISCO-300, SUAbis). Whereas all control animals developed severe respiratory disease and shed high levels of virus following BRSV challenge, Delta SHrBRSV-immunized calves demonstrated almost complete clinical and virological protection five weeks after a single intranasal vaccination. Although mucosal vaccination with DSHrBRSV failed to induce a detectable immunological response, there was a rapid and strong anamnestic mucosal BRSV-specific IgA, virus neutralizing antibody and local T cell response following challenge with virulent BRSV. Calves immunized twice intramuscularly, three weeks apart with SUMont were also well protected two weeks after boost. The protection was not as pronounced as that in Delta SHrBRSV-immunized animals, but superior to those immunized twice subcutaneously three weeks apart with SUAbis. Antibody responses induced by the subunit vaccines were non-neutralizing and not directed against BRSV F or G proteins. When formulated as SUMont but not as SUAbis, the HRSV N, P and M2-1 proteins induced strong systemic cross-protective cell-mediated immune responses detectable already after priming. Delta SHrBRSV and SUMont are two promising DIVA-compatible vaccines, apparently inducing protection by different immune responses that were influenced by vaccine-composition, immunization route and regimen.
Published: 2014
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42. Paramyxovirus Fusion (F) Protein: A Conformational Change on Cleavage Activation

Author: Rebecca Ellis Dutch, Margaret A. Nagel, Robert A. Lamb, Reay G. Paterson, and Ryan N. Hagglund
Subjects: Repetitive Sequences, Amino Acid, Conformational change, Protein Conformation, medicine.drug_class, Stereochemistry, Recombinant Fusion Proteins, Succinimides, Biology, Antibodies, Viral, Monoclonal antibody, Cleavage (embryo), Membrane Fusion, Respirovirus, Cell Line, 03 medical and health sciences, Protein structure, Antibody Specificity, Virology, Papain, medicine, Animals, Humans, Trypsin, Disulfides, 030304 developmental biology, 0303 health sciences, Immune Sera, 030302 biochemistry & molecular biology, Antibodies, Monoclonal, Lipid bilayer fusion, Flow Cytometry, Precipitin Tests, Peptide Fragments, Molecular Weight, Heptad repeat, Cross-Linking Reagents, Biochemistry, Cell culture, Mutation, biology.protein, Antibody, Dimerization, Viral Fusion Proteins, HeLa Cells
Abstract: The fusion (F) protein of the paramyxovirus SV5 promotes both virus-cell and cell-cell fusion. Recently, the atomic structure at 1.4 A of an extremely thermostable six-helix bundle core complex consisting of two heptad repeat regions of the F protein has been described (K. A. Baker, R. E. Dutch, R. A. Lamb, and T. S Jardetsky, Mol. Cell 3, 309-319, 1999). To analyze the conformations of the F protein at various stages of the membrane fusion process and to understand further the role of formation of the six-helix bundle core complex in promotion of membrane fusion, antibodies to peptides corresponding to regions of the F protein were obtained. Major changes in F protein antibody recognition were found after cleavage of the precursor protein F(0) to the fusogenically active disulfide-linked heterodimer, F(1) + F(2), and antibodies directed against the heptad repeat regions recognized only the uncleaved form. A monoclonal antibody directed against the F protein showed increased recognition at the cell surface of the cleaved form of the F protein as compared to uncleaved F protein, again indicating changes in conformation between the uncleaved and cleaved forms of the F protein. Anti-peptide antibodies specific for the heptad repeat regions were unable to precipitate a synthetic protein that consisted of the heptad repeat regions separated only by a small spacer, suggesting that the antibodies are unable to recognize their target regions when the heptad repeats are present in the six-helix bundle core complex. Taken together, these data indicate that the six-helix bundle core complex is not present in the precursor molecule F(0) and that significant conformational changes occur subsequent to cleavage of the F protein.
Published: 2001
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43. Depression measures in outcomes research

Author: Victoria J. Vahle, Kristofer J. Hagglund, and Elena M. Andresen
Subjects: Gerontology, Psychological Tests, medicine.medical_specialty, Rehabilitation, Psychometrics, Depression, medicine.medical_treatment, MEDLINE, Physical Therapy, Sports Therapy and Rehabilitation, Scale (social sciences), Outcome Assessment, Health Care, Respondent, medicine, Humans, Disabled Persons, Psychological testing, Outcomes research, Psychology, Depression (differential diagnoses), Face validity
Abstract: Vahle VJ, Andresen EM, Hagglund KJ. Depression measures in outcomes research. Arch Phys Med Rehabil 2000;81 Suppl 2:S53-S62. Objective: To review critically the measures used to screen for depression for disability outcomes research and to recommend measures and needed research. Date Sources: Review of literature pertaining to the development, testing, and use of depression measures for outcomes research. Study Selection: English language literature from scientists from a broad range of disciplines and research settings, focusing mainly on the Brief Symptom Inventory and the Center for Epidemiology Study–Depression scale. Data Extraction: A literature review was completed through MEDLINE. Based on the review, instruments were selected according to their use among people with disability and the reliability and validity of the instrument. Two instruments were selected for a complete review, and 5 instruments were selected for a brief review. Data Synthesis: A critical review of measures that have been and may be used to measure depressive symptomatology among people with disability. Conclusions: Screening measures of depression are easy to administer and score. Almost all have low respondent burden and good face validity, thereby contributing to a high participation rate for most studies. Some problems exist with the application of these instruments to people with disability (ie, overlap of symptoms of depression and indicators of physical impairment). © 2000 by the American Congress of Rehabilitation Medicine
Published: 2000
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44. EX VIVO EXPANSION OF CANINE DENDRITIC CELLS FROM CD34+ BONE MARROW PROGENITOR CELLS1

Author: Rainer Storb, George E. Sale, George E. Georges, M. John Gass, Peter A. McSweeney, Hans G. Hagglund, Richard A. Nash, Peter F Moore, George Mathioudakis, and Benedetto Bruno
Subjects: Transplantation, Pathology, medicine.medical_specialty, Cellular differentiation, CD34, Dendritic cell, Biology, Molecular biology, medicine.anatomical_structure, Antigen, Cell culture, medicine, Bone marrow, Stem cell, Ex vivo
Abstract: Background. The aims of this study were to ex vivo expand canine dendritic cells and determine their phenotype and functional characteristics. Methods. CD34 + -selected cells and CD34 + -depleted canine bone marrow (BM) cells were cultured in Iscove's modified medium for 14 days. Cytokines added to the cultures included human granylocyte/ macrophage colony-stimulating factor 5 ng/ml, hFlt3 ligand 200 ng/ml, and human tumor necrosis factor-a 10 ng/ml. Cultured cells and purified subpopulations were assessed for cell surface antigen expression, morphology, and function by flow cytometric analysis, electron microscopy, and an allogeneic mixed lymphocyte reaction at day 14. Results. Two main cell populations were identified, DR ++ (bright)/CD14 -- and DR + (dim)/CD14 + . Ex vivo expanded CD34 + -selected cells showed increased allostimulatory activity compared to both cultured CD34 + -depleted cells and mononuclear cells. In contrast, ex vivo expansion from CD34 + -depleted cells was unsuccessful. After sorting cells from the ex vivo expanded CD34 + -selected bone marrow to enrich for DR ++ /CD14 -- cells, a 42-fold increase (median) of allostimulatory activity was observed as compared with sorted DR + /CD14 + cells (P=0.02). Conclusions. Cells with dentric cell-like phenotypes and functions can be cultured from canine CD34 + -selected bone marrow cells. Future studies will address the roles of these cells in engraftment, graft versus host reactions and graft-host tolerance in a canine hematogoietic stem cell transplantaton model.
Published: 2000
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45. Medicaid's not-so-'quiet revolution': A call to action for psychologists

Author: Robert G. Frank, Kristofer J. Hagglund, Mary J. Clark, Cheryl L. Shigaki, and Donna Checkett
Subjects: medicine.medical_specialty, business.industry, Health care delivery, Call to action, Nursing, Ambulatory care, Family medicine, QUIET, Health care, medicine, Self care, business, Psychology, Medicaid, General Psychology, Health policy
Published: 1999
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46. Comparison of Health Status, Socioeconomic Characteristics, and Knowledge and Use of HIV-Related Resources Between HIV-Infected Women and Men

Author: David L. Cohn, Arthur J. Davidson, Bonnie B. Hagglund, Cornelis A. Rietmeijer, Dennis C. Lezotte, William M. Marine, and Suzanne L. Bertram
Subjects: Adult, Male, Health Knowledge, Attitudes, Practice, Colorado, Adolescent, Health Status, Matched-Pair Analysis, HIV Infections, Disease, Hospitals, General, Sex Factors, Acquired immunodeficiency syndrome (AIDS), Health care, medicine, Humans, Substance Abuse, Intravenous, Socioeconomics, Socioeconomic status, Insurance, Health, Social work, business.industry, Public Health, Environmental and Occupational Health, Community Health Centers, medicine.disease, Mental health, Outreach, Socioeconomic Factors, Health Resources, Female, business, Medicaid, Demography
Abstract: OBJECTIVES The authors compared socioeconomic characteristics, and knowledge and use of human immunodeficiency virus (HIV)-related resources and health status measures between HIV-infected women and men registered within the Denver Health and Hospitals health care system. METHODS Data collected through two Centers for Disease Control-funded surveillance initiatives (Adult Spectrum of Disease and Supplement to HIV/AIDS Surveillance) were linked. Health status measures were obtained using the Medical Outcomes Study (MOS-20) questionnaire. To compare health status measures between genders, men were matched to women based on disease stage, intravenous drug use, race, years of education, employment status, and age. RESULTS Among all patients interviewed (n = 419), women (n = 52) were more likely to be minority, uneducated, intravenous drug users, and at earlier stages of HIV-disease than men (n = 367). Employment status was not significantly different. Knowledge of available services was generally good among both genders. Women received public assistance and had health insurance (Medicaid) more often than men. Women used support services, social work, and shelter assistance less often than men. The matched pairs analysis (n = 46 pairs) showed no significant differences between genders in physical and social function, mental health, pain, or general health perceptions; however, role function was better in women than in men (P
Published: 1998
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47. Community Reintegration for Persons with Spinal Cord Injury Living in Rural America

Author: Daniel L. Clay, Kristofer J. Hagglund, and Michael Acuff
Subjects: Rehabilitation, business.industry, medicine.medical_treatment, Physical Therapy, Sports Therapy and Rehabilitation, Telehealth, medicine.disease, Outreach, Quality of life (healthcare), Nursing, Health care, medicine, Neurology (clinical), Rural area, business, Spinal cord injury, Independent living
Abstract: Despite the Americans with Disabilities Act (ADA), physical, transportation, information, and health care barriers continue to impede full community reintegration for rural-living persons with spinal cord injury (SCI). Lack of a health care policy that recognizes the unique needs of rural populations is particularly problematic. Innovative enterprises, such as AgrAbility, telehealth, and collaborative programs with independent living centers are few but show promise for overcoming obstacles to community reintegration and full participation among people with SCI in rural areas. Rehabilitation professionals can facilitate this process by participating in advocacy efforts, collaborating with state surveillance systems, developing innovative outreach models, and participating in research to identify and remove barriers to community reintegration.
Published: 1998
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48. Selegiline delays the onset of disability in de novo parkinsonian patients

Author: O Mäki-Ikola, J Turunen, H Kontants, J. Hagglund, E H Heinonen, S. Palhagen, R. Palm, and T Kaugesaar
Subjects: Chemotherapy, medicine.medical_specialty, Levodopa, Randomization, medicine.medical_treatment, Selegiline, Placebo, law.invention, Surgery, Clinical trial, Pharmacotherapy, Randomized controlled trial, law, Anesthesia, medicine, Neurology (clinical), Psychology, medicine.drug
Abstract: Objective: The objective of this study was to investigate the effect of selegiline first as monotherapy and then in combination with levodopa in the early phase of PD.Methods: A total of 157 de novo PD patients were randomized to receive either selegiline or placebo in a double-blind study until levodopa therapy became necessary. Thereafter, the drugs were withdrawn for an 8-week washout period to evaluate the possible symptomatic effect of selegiline.Results: Analysis of Kaplan-Meier survival curves for each group showed that selegiline delayed significantly the need for levodopa therapy (p= 0.028). The semiannual rate of disability progression was slowed down significantly in the selegiline group analyzed with the Unified Parkinson's Disease Rating Scale (total and motor scores; p < 0.001). Selegiline had a "wash-in" effect (i.e., an initial symptomatic amelioration of PD at 6 weeks and 3 months). However, after the 8-week washout period, no significant differences in the deterioration of disability between the groups was revealed in any of the scales, suggesting that besides having a slight symptomatic effect, selegiline may also have neuroprotective effects. Similarly, the progression of symptoms from baseline to the end of the washout period was significantly slower (p = 0.033) in the selegiline group when the progression was adjusted by the time to reach the end point. Selegiline was well tolerated.Conclusions: Selegiline delayed significantly the need to start levodopa in early PD. After a 2-month washout period (before the start of levodopa therapy) no significant symptomatic effect of selegiline was seen in comparison with the placebo group, supporting the concept of neuroprotective properties of the drug.
Published: 1998
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49. The Use and Failure Rates of Protective Equipment to Prevent Blood and Bodily Fluid Contamination in the Obstetric Health Care Worker

Author: Karen H. Hagglund, Susan J. Sherman, and Faris K. Ahmad
Subjects: medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Medical staff, business.industry, Health Personnel, Protective Devices, Forceps, Frequency of use, Specialty, Obstetrics and Gynecology, General Medicine, medicine.disease, Body Fluids, Surgery, Obstetrics, Blood, Universal precautions, Occupational Exposure, Health care, medicine, Humans, Equipment Failure, Prospective Studies, Medical emergency, business
Abstract: Objective: To determine the frequency of use and the failure rate of protective equipment by obstetric staff during common obstetric procedures. Methods: A prospective observational study was conducted of multiple obstetric procedures. The presence, area of specialty, level of training, and gender of each team member were recorded along with the use of protective equipment (cap, mask, eyewear, gown, gloves, and shoe protection). These observations were recorded by two trained observers. Blood and bodily fluid contamination of the protective equipment was quantified and recorded for each person. A forensic medicine reagent (Luminol; Cluefinders Inc., Tampa, FL) was used to detect trace amounts of blood on the inner surface of a selected subset of gowns that had gross external contamination but no obvious penetration. Results: Two hundred forty-one obstetric procedures were observed involving 1022 medical personnel. The use of at least one piece of protective equipment was noted 88% of the time. Compliance with universal precautions by attending and resident physicians in all deliveries (vaginal, forceps, vacuum, cesarean) was observed in 65 (25.2%) medical personnel. The use of protective equipment varied by the type of procedure, area of specialty, and level of training of the team member. In the gowns examined with the forensic medicine reagent, 44% of the cases demonstrated laboratory evidence of penetration. The frequency of gown failure varied with the type of surgical gown used. Conclusion: Despite the mandate in the medical community for universal precautions, the rate of compliance remains low. However, even among the compliant medical staff, protective equipment labeled as impenetrable has a high failure rate.
Published: 1998
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50. Disease and family contributors to adaptation in juvenile rheumatoid arthritis and juvenile diabetes

Author: Kristofer J. Hagglund, David E. Goldstein, Niels C. Beck, Daniel L. Clay, John M. Chaney, James T. Cassidy, Jane C. Johnson, Javad H. Kashani, Julian F. Thayer, Angela Z. Vieth, Robert G. Frank, Laura H. Schopp, and John E. Hewett
Subjects: Adult, Male, Coping (psychology), medicine.medical_specialty, Adolescent, Psychometrics, Immunology, Psychological intervention, Disease, Models, Psychological, Rheumatology, Surveys and Questionnaires, Diabetes mellitus, Adaptation, Psychological, Humans, Immunology and Allergy, Medicine, Family, Pharmacology (medical), Child, Depression, business.industry, Infant, medicine.disease, Arthritis, Juvenile, Distress, Diabetes Mellitus, Type 1, El Niño, Case-Control Studies, Child, Preschool, Physical therapy, Female, business, Stress, Psychological, Juvenile rheumatoid arthritis, Clinical psychology
Abstract: Objective. Research in the areas of pediatric rheumatology and pediatric chronic illness has emphasized comprehensive models of adaptation involving risk and resistance factors. This study examined adaptation, within this framework, among a large sample of children with chronic illness and children without chronic illness. Methods. A comprehensive battery of adaptation measures was administered to a sample of 107 children with juvenile rheumatoid arthritis, 114 children with insulin-dependent diabetes mellitus, and 88 healthy controls. Results. Medical diagnosis was associated with mothers' depression and a composite measure of parental (mother and father) distress and passive coping. Children's emotional and behavioral functioning was not related to medical diagnosis, but mothers' depression and parental distress were associated with child behavior problems. Conclusion. Because parental distress was associated with child functioning, interventions to ameliorate parental distress may have beneficial effects on the children's behavior and on parents' reactions to their children.
Published: 1998
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