218 results on '"C NR"'
Search Results
2. Hemodynamic Effects of Ketamine Versus Etomidate for Prehospital Rapid Sequence Intubation
- Author
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Stanke, Lucy, Nakajima, Steven, Zimmerman, Lisa Hall, Collopy, Kevin, Fales, Carrie, and Powers, William, IV
- Published
- 2021
- Full Text
- View/download PDF
3. Coordination polymers with Co(II) sulfate layers linked by alkanediamines of varying chain length
- Author
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Behera, J N and Rao, C NR
- Published
- 2005
4. Invasive group A streptococcal infections in adults, France (2006–2010)
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Plainvert, C., Doloy, A., Loubinoux, J., Lepoutre, A., Collobert, G., Touak, G., Bouvet, A., Trieu-Cuot, P., Poyart, C., Network, C. Nr-Strep, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre national de Référence des Streptocoques (CNR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département des maladies infectieuses, Institut de Veille Sanitaire (INVS), Biologie des Bactéries Pathogènes à Gram-positif, Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris] (IP), This study was partly funded by the Institut National de Veille Sanitaire (INVS), the Assistance Publique-Hôpitaux de Paris (AP-HP), INSERM, and by a grant from ANR in the frame of ERA-Net PathoGenoMics., ANR-06-PATH-0012,Systematic analyses of kinase and phosphatase function in morphological, environmental, and virulence responses of the human fungal pathogen Candida albicans,Systematic analyses of kinase and phosphatase function in morphological, environmental, and virulence responses of the human fungal pathogen Candida albicans(2006), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique ( CNRS ), and ANR-06-PATH-0012,Systematic analyses of kinase and phosphatase function in morphological, environmental, and virulence responses of the human fungal pathogen Candida albicans,Systematic analyses of kinase and phosphatase function in morphological, environmental, and virulence responses of the human fungal pathogen Candida albicans ( 2006 )
- Subjects
Male ,Antibiotic resistance ,Antibiotics ,Bacteremia ,[ SDV.MP.BAC ] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,medicine.disease_cause ,Epidemiology ,Case fatality rate ,Prevalence ,Fasciitis ,Aged, 80 and over ,0303 health sciences ,Pleuropneumonia ,General Medicine ,Middle Aged ,Shock, Septic ,Anti-Bacterial Agents ,3. Good health ,Infectious Diseases ,emm type ,invasive infections ,Female ,epidemiology ,France ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Streptococcus pyogenes ,medicine.drug_class ,Microbial Sensitivity Tests ,Biology ,Microbiology ,Young Adult ,03 medical and health sciences ,Streptococcal Infections ,Drug Resistance, Bacterial ,medicine ,Humans ,Fasciitis, Necrotizing ,Aged ,030304 developmental biology ,030306 microbiology ,group A streptococcus ,medicine.disease ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Molecular Typing ,Streptococcus agalactiae - Abstract
International audience; Severe invasive group A streptococcal diseases have re-emerged during the past 10-20 years. In order to provide a better insight into the current epidemiological situation in France, we analysed the questionnaires regarding all invasive strains received at the National Reference Center for Streptococci (CNR-Strep) between 2006 and 2010 from patients aged ≥18 and characterized them by emm typing, spe gene detection and antibiotic resistance. Among the 1542 invasive GAS strains studied, 78% (n = 1206) were from blood cultures, and a streptococcal toxic shock syndrome (STSS) was described in 22% (n = 340) of cases, mainly associated with necrotizing fasciitis (NF) and pleuro-pulmonary infections (p
- Published
- 2012
5. Scaling high-speed counter-current chromatography for preparative neodymium purification: Insights and challenges.
- Author
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Weberg AB, Dembowski M, Blad QK, Goff GS, Hanson SK, and May I
- Subjects
- Organophosphates, Countercurrent Distribution methods, Neodymium chemistry, Neodymium isolation & purification
- Abstract
Efficient rare earth element (REE) separations are becoming increasingly important to technologies ranging from renewable energy and high-performance magnets to applied radioisotope separations. These separations are made challenging by the extremely similar chemical and physical characteristics of the individual elements, which almost always occupy the 3+ oxidation state under ambient conditions. Herein, we discuss the development of a novel REE separation aimed at obtaining purified samples of neodymium (Nd) on a multi-milligram scale using high-speed counter-current chromatography (HSCCC). The method takes advantage of the subtle differences in ionic radii between neighboring REEs to tune elution rates in dilute acid through implementation of the di-(2-ethylhexyl)phosphoric acid (HDEHP)-infused stationary phase (SP) of the column. A La/Ce/Nd/Sm separation was demonstrated at a significantly higher metal loading than previously accomplished by HSCCC (15 mg, R
Nd/REE > 0.85), while the Pr/Nd separation was achieved at lower metal loadings (0.3 mg, RNd/Pr = 0.75 - 0.83). The challenges associated with scaling REE separations via HSCCC are presented and discussed within., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)- Published
- 2024
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6. A new method for quantifying 64 Cu in nuclear debris samples.
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Wren MS, Weberg AB, Salazar AA, Klosterman MR, Eaton SJ, Goehring TL, Herman SM, Pierson BD, Warzecha EJ, Dale GE, Fotiades N, May I, and Hanson SK
- Abstract
Quantifying
64 Cu in post-detonation nuclear debris samples can provide important diagnostic information regarding the structural materials used within a nuclear device. However, this task is challenging due to the weak gamma emissions associated with the decay of64 Cu, its short half-life (12.701 h), and the presence of interfering fission product radioisotopes. Large quantities of debris sample are generally needed to accurately quantify64 Cu, which can be problematic in sample-limited scenarios where other radiometric analyses are required. Herein, we present a new method for the separation of64 Cu from solutions of mixed fission products and demonstrate the quantification of its activity through use of gas-flow proportional beta counting. The new method was validated through a series of rigorous tests and was shown to improve the detection limit of64 Cu by over two orders of magnitude, from 2.5 × 106 to 1.3 × 104 atoms/sample for 100 min measurements., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier B.V.)- Published
- 2024
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7. Detecting Pu in U-bearing Particles by SEM/EDS for Nuclear Safeguards Applications.
- Author
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Wurth K, Tenner T, and Naes B
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- 2023
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8. High-precision measurement of U-Pu-Np-Am concentrations and isotope ratios in environmental reference materials by mass spectrometry.
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Goldstein SJ, Price AA, Hinrichs KA, Lamont SP, Nunn AJ, Amato RS, Cardon AM, and Gurganus DW
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- Mass Spectrometry, Plutonium analysis, Radiation Monitoring, Soil Pollutants, Radioactive analysis, Water Pollutants, Radioactive analysis
- Abstract
We report results of precise and sensitive mass spectrometric measurements of uranium, plutonium, neptunium, and americium concentrations and isotope ratios in a variety of environmental reference materials. Most of our work has been done on NIST SRM 4350b, River Sediment, but we also present results for NIST SRM 4354, Lake Sediment; NIST SRMs 4355 and 4355a, Peruvian Soil; NIST SRM 4357, Ocean Sediment; NIST SRM 1648a, Urban Particulate Material; NIST SRM 1649b, Urban Dust; IAEA CRM 385, Ocean Sediment; USGS BCR-2, Columbia River Basalt; and USGS BHVO-2, Hawaiian Volcanic Observatory Basalt. These materials reflect a wide range in long-lived actinide concentrations (e.g. 1E4 to 1E10 atoms
239 Pu/g) and isotope ratios. Measurements were performed in a clean laboratory by isotope dilution, multi-collector thermal ionization and multi-collector inductively coupled plasma mass spectrometry. In general, our results are in agreement with, but lower the uncertainty of, literature or certificate values for these reference materials. Our uranium results for the basalts also confirm previously reported high-precision mass spectrometric results from our laboratory. In many cases our measurements of U-Pu-Np-Am nuclides appear to be novel. Extensive results for NIST SRM 4350b, River Sediment, indicate that this material is heterogeneous for Pu-Np-Am concentrations and isotope ratios at a sample size of 5 g or lower. Pu-Np isotope ratios and a241 Pu-241 Am model age of 1954 reflect a mix of plutonium production operations at the nearby Hanford, Washington site, and global atmospheric fallout from nuclear weapons testing. Results for the oceanic sediment materials (NIST SRM 4357 and IAEA 385) collected near Sellafield, U.K. vary but are also indicative of local anthropogenic sources of varying Pu isotopic composition and a mean241 Pu-241 Am model age of 1964. Large environmental fractionation between Pu and Np is observed for the ocean, river, and lake sediment reference materials. Novel measurements for the two air particulate SRMs indicate high U, Pu and Np concentrations for these collections in 1976-1977 with an anomalous regional fallout Pu isotopic signature. Results for BHVO-2 and other Hawaiian basalts indicate that those which erupted before or during the period of abundant atmospheric nuclear weapons testing (1950-1970) contain significant levels of Pu (on the order of 1E7 atoms239 Pu/g) with a global fallout Pu isotopic composition, compared to more recent eruptions which incorporated less Pu. Hence, Hawaiian basalts may provide an integrated temporal record of anthropogenic actinide fallout deposition from the atmosphere since eruption., (Copyright © 2021 Elsevier Ltd. All rights reserved.)- Published
- 2021
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9. Blood Pressure Control in Canada: Through the Looking-Glass Into a Glass Half Empty?
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Padwal R and Campbell NR
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- Blood Pressure, Blood Pressure Determination, Canada, Humans, Prevalence, Hypertension
- Published
- 2017
- Full Text
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10. The science of salt: A regularly updated systematic review of salt and health outcomes (December 2015-March 2016).
- Author
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Wong MM, Arcand J, Leung AA, Thout SR, Campbell NR, and Webster J
- Subjects
- Adult, Aged, Blood Pressure physiology, Cardiovascular Diseases etiology, Child, Female, Humans, Hypertension etiology, Incidence, Kidney Diseases etiology, Male, Middle Aged, Non-alcoholic Fatty Liver Disease etiology, Obesity etiology, Prevalence, Sodium Chloride adverse effects, Sodium Chloride, Dietary administration & dosage, Cardiovascular Diseases complications, Diet, Sodium-Restricted adverse effects, Hypertension epidemiology, Kidney Diseases complications, Non-alcoholic Fatty Liver Disease complications, Obesity complications, Sodium Chloride supply & distribution, Sodium Chloride, Dietary adverse effects
- Abstract
The purpose of this review was to identify, summarize, and critically appraise studies on dietary salt relating to health outcomes that were published from December 2015 to March 2016. The search strategy was adapted from a previous systematic review on dietary salt and health. Overall, 13 studies were included in the review: one study assessed cardiovascular events, nine studies assessed prevalence or incidence of blood pressure or hypertension, one study assessed kidney disease, and two studies assessed other health outcomes (obesity and nonalcoholic fatty liver disease). Four studies were selected for detailed appraisal and commentary. One study met the minimum methodologic criteria and found an increased risk associated with lower sodium intake in patients with heart failure. All other studies identified in this review demonstrated positive associations between dietary salt and adverse health outcomes., (© 2017 Wiley Periodicals, Inc.)
- Published
- 2017
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11. Unravelling the Roles of Size, Ligands, and Pressure in the Piezochromic Properties of CdS Nanocrystals.
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Corsini NR, Hine ND, Haynes PD, and Molteni C
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- Crystallization, Ligands, Light, Particle Size, Pressure, Structure-Activity Relationship, Surface Properties, Thermodynamics, Cadmium Compounds chemistry, Nanoparticles chemistry, Sulfides chemistry
- Abstract
Understanding the effects of pressure-induced deformations on the optoelectronic properties of nanomaterials is important not only from the fundamental point of view but also for potential applications such as stress sensors and electromechanical devices. Here, we describe the novel insights into these piezochromic effects gained from using a linear-scaling density functional theory framework and an electronic enthalpy scheme, which allow us to accurately characterize the electronic structure of CdS nanocrystals with a zincblende-like core of experimentally relevant size. In particular, we focus on unravelling the complex interplay of size and surface (phenyl) ligands with pressure. We show that pressure-induced deformations are not simple isotropic scaling of the original structures and that the change in HOMO-LUMO gap with pressure results from two competing factors: (i) a bulk-like linear increase due to compression, which is offset by (ii) distortions and disorder and, to a lesser extent, orbital hybridization induced by ligands affecting the frontier orbitals. Moreover, we observe that the main peak in the optical absorption spectra is systematically red-shifted or blue-shifted, as pressure is increased up to 5 GPa, depending on the presence or absence of phenyl ligands. These heavily hybridize the frontier orbitals, causing a reduction in overlap and oscillator strength, so that at zero pressure, the lowest energy transition involves deeper hole orbitals than in the case of hydrogen-capped nanocrystals; the application of pressure induces greater delocalization over the whole nanocrystals bringing the frontier hole orbitals into play and resulting in an unexpected red shift for the phenyl-capped nanocrystals, in part caused by distortions. In response to a growing interest in relatively small nanocrystals that can be difficult to accurately characterize with experimental techniques, this work exemplifies the detailed understanding of structure-property relationships under pressure that can be obtained for realistic nanocrystals with state-of-the-art first-principles methods and used for the characterization and design of devices based on these and similar nanomaterials.
- Published
- 2017
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12. Population Dietary Salt Reduction and the Risk of Cardiovascular Disease: A Commentary on Recent Evidence.
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Cappuccio FP and Campbell NR
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- Cardiovascular Diseases, Diet, Sodium-Restricted, Humans, Sodium, Dietary, Hypertension, Sodium Chloride, Dietary
- Published
- 2017
- Full Text
- View/download PDF
13. Unfounded concerns about the use of automated office blood pressure measurement in SPRINT.
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Myers MG and Campbell NR
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- Blood Pressure Determination economics, Blood Pressure Determination instrumentation, Humans, Hypertension drug therapy, Middle Aged, Randomized Controlled Trials as Topic, Risk Factors, Sphygmomanometers economics, Blood Pressure, Blood Pressure Determination methods, Cardiovascular Diseases prevention & control, Hypertension diagnosis, White Coat Hypertension prevention & control
- Abstract
SPRINT reported significantly fewer cardiovascular events when patients with a higher cardiovascular risk were treated to a target systolic blood pressure (BP) of <120 versus <140 mm Hg. In SPRINT, BP was recorded using the automated office BP (AOBP) method, with multiple readings being taken automatically with the patient resting alone. This technique for BP measurement eliminates the white-coat effect and gives lower BP readings than conventional manual office BP. Critics have questioned if the readings were actually taken with the subject alone and have expressed concerns about the time taken to obtain the readings and the cost of automated sphygmomanometers. Others have suggested that the findings in SPRINT can be applied to current clinical practice if a correction factor is used to convert conventional BP readings to AOBP. This article responds to these criticisms and explains why current methods for recording BP in clinical practice should be changed to AOBP, the technique for BP measurement used in SPRINT., (Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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14. Cardiac Rehabilitation Delivery Model for Low-Resource Settings: An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement.
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Grace SL, Turk-Adawi KI, Contractor A, Atrey A, Campbell NR, Derman W, Ghisi GL, Sarkar BK, Yeo TJ, Lopez-Jimenez F, Buckley J, Hu D, and Sarrafzadegan N
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- Global Health, Humans, Secondary Prevention organization & administration, Cardiac Rehabilitation methods, Cardiovascular Diseases epidemiology, Cardiovascular Diseases prevention & control, International Cooperation
- Abstract
Cardiovascular disease (CVD) is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be efficacious and cost-effective for secondary prevention in high-income countries. Given its affordability, CR should be more broadly implemented in middle-income countries as well. Hence, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) convened a writing panel to recommend strategies to deliver all core CR components in low-resource settings, namely: (1) initial assessment, (2) lifestyle risk factor management (i.e., diet, tobacco, mental health), (3) medical risk factor management (lipids, blood pressure), (4) education for self-management; (5) return to work; and (6) outcome evaluation. Approaches to delivering these components in alternative, arguably lower-cost settings, such as the home, community and primary care, are provided. Recommendations on delivering each of these components where the most-responsible CR provider is a non-physician, such as an allied healthcare professional or community health care worker, are also provided., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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15. Pay-for-performance remuneration for pharmacist prescribers' management of hypertension: A substudy of the RxACTION trial.
- Author
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Houle SK, Charrois TL, McAlister FA, Kolber MR, Rosenthal MM, Lewanczuk R, Campbell NR, and Tsuyuki RT
- Abstract
Background: To be sustainable, pharmacists providing direct patient care must receive appropriate payment for these services. This prespecified substudy of the RxACTION trial (a randomized trial of pharmacist prescribing vs usual care in patients with above-target blood pressure [BP]) aimed to determine if BP reduction achieved differed between patients whose pharmacist was paid by pay-for-performance (P4P) vs fee-for-service (FFS)., Methods: Within RxACTION, patients with elevated BP assigned to the pharmacist prescribing group were further randomized to P4P or FFS payment for the pharmacist. In FFS, pharmacists received $150 for the initial visit and $75 for follow-up visits. P4P included FFS payments plus incentives of $125 and $250 for each patient who reached 50% and 100% of the BP target, respectively. The primary outcome was difference in change in systolic BP between P4P and FFS groups., Results: A total of 89 patients were randomized to P4P and 92 to the FFS group. Patients' average (SD) age was 63.0 (13.2) years, 49% were male and 76% were on antihypertensive drug therapy at baseline, taking a median of 2 (interquartile range = 1) medications. Mean systolic BP reductions in the P4P and FFS groups were 19.7 (SD = 18.4) vs 17.0 (SD = 16.4) mmHg, respectively ( p = 0.47 for the comparison of deltas and p = 0.29 after multivariate adjustment)., Conclusions: This trial of pharmacist prescribing found substantial reductions in systolic BP among poorly controlled hypertensive individuals but with no appreciable difference when pharmacists were paid by P4P vs FFS., Competing Interests: Declaration of Conflicting Interests:The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
- Published
- 2016
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16. 2016 Dietary Salt Fact Sheet and Call to Action: The World Hypertension League, International Society of Hypertension, and the International Council of Cardiovascular Prevention and Rehabilitation.
- Author
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Campbell NR, Lackland DT, Niebylski ML, Orias M, Redburn KA, Nilsson PM, Zhang XH, Burrell L, Horiuchi M, Poulter NR, Prabhakaran D, Ramirez AJ, Schiffrin EL, Schutte AE, Touyz RM, Wang JG, and Weber MA
- Subjects
- Humans, Sodium, Dietary, Hypertension diet therapy, Sodium Chloride, Dietary
- Published
- 2016
- Full Text
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17. The Science of Salt: A Regularly Updated Systematic Review of Salt and Health Outcomes (August to November 2015).
- Author
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Wong MM, Arcand J, Leung AA, Raj TS, Trieu K, Santos JA, and Campbell NR
- Subjects
- Body Weight, Clinical Studies as Topic, Humans, Nutrition Assessment, Sodium Chloride, Dietary adverse effects, Cardiovascular Diseases epidemiology, Hypertension epidemiology, Kidney Diseases etiology, Sodium Chloride, Dietary administration & dosage
- Abstract
The purpose of this review was to systematically identify, summarize, and critically appraise studies on dietary salt relating to health outcomes that were published from August to November 2015. The search strategy was adapted from a previous systematic review on dietary salt and health. Overall, 15 studies were included in the review: one study assessed cardiovascular events, five studies assessed blood pressure or hypertension incidence, six studies assessed surrogate outcomes for cardiovascular or kidney diseases, and three studies assessed other outcomes (age-related cataracts, rheumatoid arthritis, and bone mineral density, respectively). Four studies were selected for detailed appraisal and commentary., (©2016 Wiley Periodicals, Inc.)
- Published
- 2016
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18. Influence of unhealthy food and beverage marketing on children's dietary intake and preference: a systematic review and meta-analysis of randomized trials.
- Author
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Sadeghirad B, Duhaney T, Motaghipisheh S, Campbell NR, and Johnston BC
- Subjects
- Advertising, Beverages adverse effects, Child, Child Nutritional Physiological Phenomena, Cues, Energy Intake, Fast Foods adverse effects, Humans, Nutritive Value, Pediatric Obesity prevention & control, Pediatric Obesity psychology, Randomized Controlled Trials as Topic, Television, Child Behavior psychology, Consumer Behavior statistics & numerical data, Diet adverse effects, Food Preferences psychology, Marketing methods, Pediatric Obesity etiology
- Abstract
Marketing of foods and beverages high in fat, sugar and salt are suggested to contribute to poor dietary behaviours in children and diet-related diseases later in life. This systematic review and meta-analysis of randomized trials aimed to assess the effects of unhealthy food and beverage marketing on dietary intake (grams or kilocalories) and dietary preference (preference score or percentage of participants who selected specific foods/beverages) among children 2 to 18 years of age. We searched MEDLINE, EMBASE and PsycINFO up to January 2015 for terms related to advertising, unhealthy foods or beverages among children. Randomized trials that assessed the effects of unhealthy food and beverage marketing compared with non-dietary advertisement or no advertisement in children were considered eligible. Two authors independently extracted information on study characteristics and outcomes of interest and assessed risk of bias and the overall quality of evidence using grade methodology. Meta-analysis was conducted separately for dietary intake and preference using a random-effects model. We identified 29 eligible studies, of which 17 studies were included for meta-analysis of dietary preference and nine for meta-analysis of dietary intake. Almost half of the studies were at high risk of bias. Our meta-analysis showed that in children exposed to unhealthy dietary marketing, dietary intake significantly increased (mean difference [MD] = 30.4 kcal, 95% confidence interval [CI] 2.9 to 57.9, and MD = 4.8 g, 95%CI 0.8 to 8.8) during or shortly after exposure to advertisements. Similarly, children exposed to the unhealthy dietary marketing had a higher risk of selecting the advertised foods or beverages (relative risk = 1.1, 95%CI 1.0 to 1.2; P = 0.052). The evidence indicates that unhealthy food and beverage marketing increases dietary intake (moderate quality evidence) and preference (moderate to low quality evidence) for energy-dense, low-nutrition food and beverage. Unhealthy food and beverage marketing increased dietary intake and influenced dietary preference in children during or shortly after exposure to advertisements. © 2016 World Obesity., (© 2016 World Obesity.)
- Published
- 2016
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19. The Science of Salt: A Systematic Review of Quality Clinical Salt Outcome Studies June 2014 to May 2015.
- Author
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Johnson C, Raj TS, Trieu K, Arcand J, Wong MM, McLean R, Leung A, Campbell NR, and Webster J
- Subjects
- Blood Pressure Determination, Headache chemically induced, Humans, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Risk Assessment, Sodium Chloride, Dietary pharmacology, Blood Pressure drug effects, Cardiovascular Diseases mortality, Headache epidemiology, Sodium Chloride, Dietary adverse effects
- Abstract
Studies identified from an updated systematic review (from June 2014 to May 2015) on the impact of dietary salt intake on clinical and population health are reviewed. Randomized controlled trials, cohort studies, and meta-analyses of these study types on the effect of sodium intake on blood pressure, or any substantive adverse health outcomes were identified from MEDLINE searches and quality indicators were used to select studies that were relevant to clinical and public health. From 6920 studies identified in the literature search, 144 studies were selected for review, of which only three (n=233,680) met inclusion criteria. Between them, the three studies demonstrated a harmful association between excess dietary salt and all-cause mortality, noncardiovascular and cardiovascular disease mortality, and headache. None of the included studies found harm from lowering dietary salt. The findings of this systematic review are consistent with the large body of research supportive of efforts to reduce population salt intake and congruent with our last annual review from June 2013 to May 2014., (© 2016 Wiley Periodicals, Inc.)
- Published
- 2016
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20. Influence of Using Different Databases and 'Look Back' Intervals to Define Comorbidity Profiles for Patients with Newly Diagnosed Hypertension: Implications for Health Services Researchers.
- Author
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Chen G, Lix L, Tu K, Hemmelgarn BR, Campbell NR, McAlister FA, and Quan H
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- Aged, Comorbidity, Female, Humans, Hypertension therapy, Male, Middle Aged, Retrospective Studies, Time Factors, Databases, Factual, Health Services, Hypertension diagnosis, Hypertension epidemiology, Medical Informatics methods, Patient Discharge statistics & numerical data, Research
- Abstract
Objective: To determine the data sources and 'look back' intervals to define comorbidities., Data Sources: Hospital discharge abstracts database (DAD), physician claims, population registry and death registry from April 1, 1994 to March 31, 2010 in Alberta, Canada., Study Design: Newly-diagnosed hypertension cases from 1997 to 2008 fiscal years were identified and followed up to 12 years. We defined comorbidities using data sources and duration of retrospective observation (6 months, 1 year, 2 years, and 3 years). The C-statistics for logistic regression and concordance index (CI) for Cox model of mortality and cardiovascular disease hospitalization were used to evaluate discrimination performance for each approach of defining comorbidities., Principal Findings: The comorbidities prevalence became higher with a longer duration. Using DAD alone underestimated the prevalence by about 75%, compared to using both DAD and physician claims. The C-statistic and CI were highest when both DAD and physician claims were used, and model performance improved when observation duration increased from 6 months to one year or longer., Conclusion: The comorbidities prevalence is greatly impacted by the data source and duration of retrospective observation. A combination of DAD and physicians claims with at least one year observation duration improves predictions for cardiovascular disease and one-year mortality outcome model performance., Competing Interests: Salary support for H.Q. and F.M. is from Alberta Innovates – Health Solutions. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials.
- Published
- 2016
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21. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities.
- Author
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Abreu A, Tovar AP, Castellanos R, Valenzuela A, Giraldo CM, Pinedo AC, Guerrero DP, Barrera CA, Franco HI, Ribeiro-Oliveira A Jr, Vilar L, Jallad RS, Duarte FG, Gadelha M, Boguszewski CL, Abucham J, Naves LA, Musolino NR, de Faria ME, Rossato C, and Bronstein MD
- Subjects
- Adenoma complications, Adenoma epidemiology, Adenoma therapy, Cardiovascular Diseases epidemiology, Carpal Tunnel Syndrome epidemiology, Comorbidity, Diabetes Mellitus epidemiology, Disease Management, Growth Hormone-Secreting Pituitary Adenoma complications, Growth Hormone-Secreting Pituitary Adenoma epidemiology, Growth Hormone-Secreting Pituitary Adenoma therapy, Headache etiology, Heart Failure epidemiology, Humans, Hypertension epidemiology, Hypertrophy, Left Ventricular epidemiology, Macroglossia epidemiology, Osteoarthritis epidemiology, Prognosis, Sleep Apnea Syndromes epidemiology, Vision Disorders etiology, Adenoma diagnosis, Growth Hormone-Secreting Pituitary Adenoma diagnosis
- Abstract
Introduction: Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life., Methods: We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment., Findings and Conclusions: Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management.
- Published
- 2016
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22. A review on the diagnosis and treatment of patients with clinically nonfunctioning pituitary adenoma by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism.
- Author
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Vieira L Neto, Boguszewski CL, Araújo LA, Bronstein MD, Miranda PA, Musolino NR, Naves LA, Vilar L, Ribeiro-Oliveira A Júnior, and Gadelha MR
- Subjects
- Antineoplastic Agents therapeutic use, Brazil, Early Diagnosis, Female, Humans, Magnetic Resonance Imaging, Male, Risk Factors, Societies, Medical, Adenoma diagnosis, Adenoma therapy, Neuroendocrinology, Pituitary Neoplasms diagnosis, Pituitary Neoplasms therapy
- Abstract
Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease. Thus, the majority of patients seek medical attention for signs and symptoms resulting from mass effect, such as neuro-ophthalmologic symptoms and hypopituitarism. Other presentations include pituitary apoplexy or an incidental finding on imaging studies. Mass effect and hypopituitarism impose high morbidity and mortality. However, early diagnosis and effective treatment minimizes morbidity and mortality. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism is to provide a review of the diagnosis and treatment of patients with NFPA, emphasizing that the treatment should be performed in reference centers. This review is based on data published in the literature and the authors' experience. Arch Endocrinol Metab. 2016;60(4):374-90.
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- 2016
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23. The Science of Salt: A Regularly Updated Systematic Review of the Implementation of Salt Reduction Interventions (June-October 2015).
- Author
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Trieu K, McLean R, Johnson C, Santos JA, Angell B, Arcand J, Raj TS, Campbell NR, Wong MM, Leung AA, Neal B, and Webster J
- Subjects
- Humans, Sodium Chloride, Hypertension diet therapy, Sodium Chloride, Dietary
- Published
- 2016
- Full Text
- View/download PDF
24. Reducing deaths by diet: Call to action for a public policy agenda for chronic disease prevention.
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Kaczorowski J, Campbell NR, Duhaney T, Mang E, and Gelfer M
- Subjects
- Canada, Health Policy, Humans, Physicians, Family, Risk Factors, World Health Organization, Chronic Disease prevention & control, Diet, Healthy, Health Promotion methods
- Published
- 2016
25. The Impact of Using Different Methods to Assess Completeness of 24-Hour Urine Collection on Estimating Dietary Sodium.
- Author
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Wielgosz A, Robinson C, Mao Y, Jiang Y, Campbell NR, Muthuri S, and Morrison H
- Subjects
- 4-Aminobenzoic Acid urine, Adult, Aged, Female, Humans, Male, Middle Aged, Population Surveillance, Time Factors, 4-Aminobenzoic Acid administration & dosage, Sodium, Dietary urine, Urine Specimen Collection methods
- Abstract
The standard for population-based surveillance of dietary sodium intake is 24-hour urine testing; however, this may be affected by incomplete urine collection. The impact of different indirect methods of assessing completeness of collection on estimated sodium ingestion has not been established. The authors enlisted 507 participants from an existing community study in 2009 to collect 24-hour urine samples. Several methods of assessing completeness of urine collection were tested. Mean sodium intake varied between 3648 mg/24 h and 7210 mg/24 h depending on the method used. Excluding urine samples collected for longer or shorter than 24 hours increased the estimated urine sodium excretion, even when corrections for the variation in timed collections were applied. Until an accurate method of indirectly assessing completeness of urine collection is identified, the gold standard of administering para-aminobenzoic acid is recommended. Efforts to ensure participants collect complete urine samples are also warranted., (©2015 Wiley Periodicals, Inc.)
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- 2016
- Full Text
- View/download PDF
26. [Réduire la mortalité par l'alimentation: Revendication de politiques publiques pour prévenir les maladies chroniques].
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Kaczorowski J, Campbell NR, Duhaney T, Mang E, and Gelfer M
- Published
- 2016
27. Hypertension in Canada and the Global Context. The Wine Is Vintage and the Glass Is Two-Thirds Full, but Is the Bottle Empty?
- Author
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Campbell NR and Feldman RD
- Subjects
- Canada, Humans, Hypertension, Wine
- Published
- 2016
- Full Text
- View/download PDF
28. The Science of Salt: A Regularly Updated Systematic Review of Salt and Health Outcomes (June and July 2015).
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Arcand J, Wong MM, Trieu K, Leung AA, Campbell NR, Webster J, Johnson C, Raj TS, McLean R, and Neal B
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Clinical Studies as Topic, Cross-Sectional Studies, Female, Health Status Indicators, Heart Function Tests statistics & numerical data, Humans, Hypertension epidemiology, Mental Health statistics & numerical data, Nutrition Assessment, Recommended Dietary Allowances, World Health Organization organization & administration, Cardiovascular Diseases epidemiology, Hypertension diet therapy, Hypertension prevention & control, Kidney Diseases epidemiology, Sodium Chloride, Dietary administration & dosage, Sodium Chloride, Dietary adverse effects
- Published
- 2016
- Full Text
- View/download PDF
29. Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.
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Leung AA, Nerenberg K, Daskalopoulou SS, McBrien K, Zarnke KB, Dasgupta K, Cloutier L, Gelfer M, Lamarre-Cliche M, Milot A, Bolli P, Tremblay G, McLean D, Tobe SW, Ruzicka M, Burns KD, Vallée M, Prasad GV, Lebel M, Feldman RD, Selby P, Pipe A, Schiffrin EL, McFarlane PA, Oh P, Hegele RA, Khara M, Wilson TW, Penner SB, Burgess E, Herman RJ, Bacon SL, Rabkin SW, Gilbert RE, Campbell TS, Grover S, Honos G, Lindsay P, Hill MD, Coutts SB, Gubitz G, Campbell NR, Moe GW, Howlett JG, Boulanger JM, Prebtani A, Larochelle P, Leiter LA, Jones C, Ogilvie RI, Woo V, Kaczorowski J, Trudeau L, Petrella RJ, Hiremath S, Drouin D, Lavoie KL, Hamet P, Fodor G, Grégoire JC, Lewanczuk R, Dresser GK, Sharma M, Reid D, Lear SA, Moullec G, Gupta M, Magee LA, Logan AG, Harris KC, Dionne J, Fournier A, Benoit G, Feber J, Poirier L, Padwal RS, and Rabi DM
- Subjects
- Canada, Evidence-Based Medicine, Health Education, Humans, Hyperaldosteronism drug therapy, Risk Assessment, Risk Factors, Antihypertensive Agents therapeutic use, Blood Pressure Determination methods, Hypertension diagnosis, Hypertension drug therapy, Hypertension prevention & control
- Abstract
Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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- View/download PDF
30. A Call to Regulate Manufacture and Marketing of Blood Pressure Devices and Cuffs: A Position Statement From the World Hypertension League, International Society of Hypertension and Supporting Hypertension Organizations.
- Author
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Campbell NR, Gelfer M, Stergiou GS, Alpert BS, Myers MG, Rakotz MK, Padwal R, Schutte AE, O'Brien E, Lackland DT, Niebylski ML, Nilsson PM, Redburn KA, Zhang XH, Burrell L, Horiuchi M, Poulter NR, Prabhakaran D, Ramirez AJ, Schiffrin EL, Touyz RM, Wang JG, and Weber MA
- Subjects
- Blood Pressure physiology, Blood Pressure Monitors trends, Government Regulation, Humans, Organizations, Blood Pressure Determination instrumentation, Blood Pressure Monitors standards, Hypertension epidemiology, International Agencies organization & administration, Marketing legislation & jurisprudence
- Published
- 2016
- Full Text
- View/download PDF
31. Epidemiology of Hypertension in Canada: An Update.
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Padwal RS, Bienek A, McAlister FA, and Campbell NR
- Subjects
- Adult, Aged, Antihypertensive Agents economics, Body Mass Index, Canada epidemiology, Cross-Sectional Studies, Diabetes Mellitus epidemiology, Female, Humans, Hypertension diagnosis, Hypertension economics, Independent Living statistics & numerical data, Male, Middle Aged, Prevalence, Risk Factors, Antihypertensive Agents therapeutic use, Hypertension drug therapy, Hypertension epidemiology
- Abstract
Background: High blood pressure (BP) is the leading cause of death and disability in the world. The objective of this analysis was to perform a detailed update of the epidemiology of hypertension in Canada., Methods: Five population-based data sources were analyzed. We used the Canadian Health Measures Survey to determine the latest directly measured prevalence, awareness, and control estimates (2012-2013); the National Population Health Survey, and Canadian Community Health Survey to assess crude and age-standardized self-reported prevalence (1994-2013); the Canadian Chronic Disease Surveillance System to assess administrative data-ascertained prevalence and mortality trends (1998-2010); and Intercontinental Medical Statistics Health data to examine antihypertensive drug-prescribing trends and costs (2007-2014)., Results: In 2012-2013, the prevalence of hypertension (defined as drug treatment for high BP or BP ≥ 140/90 mm Hg) in Canadian adults was 22.6%, and the proportion of disease controlled was 68.1%. In Canadians with diabetes, the prevalence (defined as drug treatment or BP ≥ 130/80 mm Hg) was 67.1%, and 60.1% of cases were controlled. Self-reported hypertension prevalence has increased by approximately 2-fold over nearly 2 decades. Age-standardized mortality rates are falling in hypertensive Canadians (from 9.4 to 7.9 deaths per 1000 individuals), but to a lesser extent than in nonhypertensive individuals. Total antihypertensive drug prescription volume has increased steadily since 2007 amid falling drug costs., Conclusions: Hypertension prevalence in Canada continues to rise. Increased use of antihypertensive drugs and improvements in control are apparent. Coordinated efforts to further improve the treatment and control of hypertension in Canada are needed., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
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- 2016
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- View/download PDF
32. Restructuring Hypertension Congresses and Scientific Meetings for Improved Hypertension Prevention and Control.
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Campbell NR, Redburn KA, Niebylski ML, Drouin D, Zhang XH, Lisheng L, Nilsson P, and Lackland DT
- Subjects
- Disease Management, Humans, Congresses as Topic organization & administration, Hypertension prevention & control
- Published
- 2016
- Full Text
- View/download PDF
33. Hypertension in Canada: Past, Present, and Future.
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Schiffrin EL, Campbell NR, Feldman RD, Kaczorowski J, Lewanczuk R, Padwal R, and Tobe SW
- Subjects
- Blood Pressure physiology, Blood Pressure Determination, Canada epidemiology, Cardiovascular Diseases epidemiology, Humans, Hypertension prevention & control, Risk Factors, Blood Pressure immunology, Hypertension epidemiology, Quality of Life
- Abstract
Canada has an extremely successful hypertension detection and treatment program. The aim of this review was to highlight the historic and current infrastructure and initiatives that have led to this success, and the outlook moving forward into the future. We discuss the evolution of hypertension awareness and control in Canada; contributions made by organizations such as the Canadian Hypertension Society, Blood Pressure Canada, and the Canadian Hypertension Education Program; the amalgamation of these organizations into Hypertension Canada; and the impact that Hypertension Canada has had on hypertension care in Canada. The important contribution that public policy and advocacy can have on prevention and control of blood pressure in Canada is described. We also highlight the importance of population-based strategies, health care access and organization, and accurate blood pressure measurement (including ambulatory, home, and automated office modalities) in optimizing hypertension prevention and management. We end by discussing how Hypertension Canada will move forward in the near and longer term to address the unmet residual risk attributable to hypertension and associated cardiovascular risk factors. Hypertension Canada will continue to strive to enhance hypertension prevention and control rates, thereby improving the quality of life and cardiovascular outcomes of Canadians, while at the same time creating a hypertension care model that can be emulated across the world., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
34. Announcing "Up to Date in the Science of Sodium".
- Author
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Arcand J, Webster J, Johnson C, Raj TS, Neal B, McLean R, Trieu K, Wong MM, Leung AA, and Campbell NR
- Subjects
- Health Knowledge, Attitudes, Practice, Humans, Nutritional Requirements, Outcome Assessment, Health Care, Blood Pressure physiology, Clinical Studies as Topic methods, Clinical Studies as Topic standards, Sodium, Dietary metabolism, Water-Electrolyte Balance physiology
- Published
- 2016
- Full Text
- View/download PDF
35. Implementation of World Health Organization Package of Essential Noncommunicable Disease Interventions (WHO PEN) for Primary Health Care in Low-Resource Settings: A Policy Statement From the World Hypertension League.
- Author
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Zhang XH, Lisheng L, Campbell NR, Niebylski ML, Nilsson P, and Lackland DT
- Subjects
- Cost-Benefit Analysis, Feasibility Studies, Health Plan Implementation economics, Health Resources, Humans, Hypertension economics, Hypertension epidemiology, Mortality, Premature, Practice Guidelines as Topic, Health Plan Implementation methods, Hypertension prevention & control, Primary Health Care methods, World Health Organization organization & administration
- Published
- 2016
- Full Text
- View/download PDF
36. World Hypertension League Position on Public Use of Blood Pressure Kiosks.
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Campbell NR, Niebylski ML, Redburn K, Lisheng L, Nilsson P, Zhang XH, and Lackland DT
- Subjects
- Humans, International Agencies, Blood Pressure physiology, Blood Pressure Determination instrumentation, Hypertension diagnosis
- Published
- 2015
- Full Text
- View/download PDF
37. Pressure-Induced Amorphization and a New High Density Amorphous Metallic Phase in Matrix-Free Ge Nanoparticles.
- Author
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Corsini NR, Zhang Y, Little WR, Karatutlu A, Ersoy O, Haynes PD, Molteni C, Hine ND, Hernandez I, Gonzalez J, Rodriguez F, Brazhkin VV, and Sapelkin A
- Abstract
Over the last two decades, it has been demonstrated that size effects have significant consequences for the atomic arrangements and phase behavior of matter under extreme pressure. Furthermore, it has been shown that an understanding of how size affects critical pressure-temperature conditions provides vital guidance in the search for materials with novel properties. Here, we report on the remarkable behavior of small (under ~5 nm) matrix-free Ge nanoparticles under hydrostatic compression that is drastically different from both larger nanoparticles and bulk Ge. We discover that the application of pressure drives surface-induced amorphization leading to Ge-Ge bond overcompression and eventually to a polyamorphic semiconductor-to-metal transformation. A combination of spectroscopic techniques together with ab initio simulations were employed to reveal the details of the transformation mechanism into a new high density phase-amorphous metallic Ge.
- Published
- 2015
- Full Text
- View/download PDF
38. A Needs Assessment of Sub-Sahara African National Hypertension Organizations for Hypertension Prevention and Control Programs.
- Author
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Khalsa TK, Campbell NR, Redburn KA, Lemogoum D, and Niebylski ML
- Subjects
- Africa South of the Sahara epidemiology, Cross-Sectional Studies, Epidemics, Health Services Accessibility, Humans, Hypertension epidemiology, Hypertension mortality, Needs Assessment, Risk Factors, Health Maintenance Organizations organization & administration, Hypertension prevention & control, Societies, Medical organization & administration
- Published
- 2015
- Full Text
- View/download PDF
39. High Blood Pressure in Sub-Saharan Africa: Why Prevention, Detection, and Control are Urgent and Important.
- Author
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Campbell NR, Bovet P, Schutte AE, Lemogoum D, and Nkwescheu AS
- Subjects
- Africa South of the Sahara epidemiology, Delivery of Health Care, Humans, Hypertension epidemiology, Prevalence, Public Health methods, Risk Assessment, Risk Reduction Behavior, Hypertension diagnosis, Hypertension prevention & control
- Published
- 2015
- Full Text
- View/download PDF
40. Death by food: Why pharmacists should care.
- Author
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Al Hamarneh YN, Tsuyuki RT, and Campbell NR
- Published
- 2015
- Full Text
- View/download PDF
41. Healthcare Costs Attributable to Hypertension: Canadian Population-Based Cohort Study.
- Author
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Weaver CG, Clement FM, Campbell NR, James MT, Klarenbach SW, Hemmelgarn BR, Tonelli M, and McBrien KA
- Subjects
- Adult, Aged, Canada epidemiology, Cohort Studies, Cost-Benefit Analysis, Female, Humans, Hypertension epidemiology, Male, Middle Aged, Cost of Illness, Health Care Costs, Hypertension economics
- Abstract
Accurately documenting the current and future costs of hypertension is required to fully understand the potential economic impact of currently available and future interventions to prevent and treat hypertension. The objective of this work was to calculate the healthcare costs attributable to hypertension in Canada and to project these costs to 2020. Using population-based administrative data for the province of Alberta, Canada (>3 million residents) from 2002 to 2010, we identified individuals with and without diagnosed hypertension. We calculated their total healthcare costs and estimated costs attributable to hypertension using a regression model adjusting for comorbidities and sociodemographic factors. We then extrapolated hypertension-attributable costs to the rest of Canada and projected costs to the year 2020. Twenty-one percent of adults in Alberta had diagnosed hypertension in 2010, with a projected increase to 27% by 2020. The average individual with hypertension had annual healthcare costs of $5768, of which $2341 (41%) were attributed to hypertension. In Alberta, the healthcare costs attributable to hypertension were $1.4 billion in 2010. In Canada, the hypertension-attributable costs were estimated to be $13.9 billion in 2010, rising to $20.5 billion by 2020. The increase was ascribed to demographic changes (52%), increasing prevalence (16%), and increasing per-patient costs (32%). Hypertension accounts for a significant proportion of healthcare spending (10.2% of the Canadian healthcare budget) and is projected to rise even further. Interventions to prevent and treat hypertension may play a role in limiting this cost growth., (© 2015 American Heart Association, Inc.)
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- 2015
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- View/download PDF
42. Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community: The Alberta Clinical Trial in Optimizing Hypertension (RxACTION).
- Author
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Tsuyuki RT, Houle SK, Charrois TL, Kolber MR, Rosenthal MM, Lewanczuk R, Campbell NR, Cooney D, and McAlister FA
- Subjects
- Aged, Alberta epidemiology, Blood Pressure physiology, Drug Prescriptions, Female, Follow-Up Studies, Humans, Hypertension diagnosis, Hypertension epidemiology, Male, Middle Aged, Treatment Outcome, Antihypertensive Agents therapeutic use, Blood Pressure drug effects, Hypertension drug therapy, Pharmacists statistics & numerical data, Professional Role, Residence Characteristics
- Abstract
Background: Hypertension control rates remain suboptimal. Pharmacists' scope of practice is evolving, and their position in the community may be ideal for improving hypertension care. We aimed to study the impact of pharmacist prescribing on blood pressure (BP) control in community-dwelling patients., Methods and Results: We designed a patient-level, randomized, controlled trial, enrolling adults with above-target BP (as defined by Canadian guidelines) through community pharmacies, hospitals, or primary care teams in 23 communities in Alberta. Intervention group patients received an assessment of BP and cardiovascular risk, education on hypertension, prescribing of antihypertensive medications, laboratory monitoring, and monthly follow-up visits for 6 months (all by their pharmacist). Control group patients received a wallet card for BP recording, written hypertension information, and usual care from their pharmacist and physician. Primary outcome was the change in systolic BP at 6 months. A total of 248 patients (mean age, 64 years; 49% male) were enrolled. Baseline mean±SD systolic/diastolic BP was 150±14/84±11 mm Hg. The intervention group had a mean±SE reduction in systolic BP at 6 months of 18.3±1.2 compared with 11.8±1.9 mm Hg in the control group, an adjusted difference of 6.6±1.9 mm Hg (P=0.0006). The adjusted odds of patients achieving BP targets was 2.32 (95% confidence interval, 1.17-4.15 in favor of the intervention)., Conclusions: Pharmacist prescribing for patients with hypertension resulted in a clinically important and statistically significant reduction in BP. Policy makers should consider an expanded role for pharmacists, including prescribing, to address the burden of hypertension., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00878566., (© 2015 American Heart Association, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
43. Hypertension in sub-Saharan Africa: a massive and increasing health disaster awaiting solution.
- Author
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Campbell NR and Lemogoum D
- Subjects
- Humans, Antihypertensive Agents therapeutic use, Hypertension drug therapy, Medication Adherence, Poverty, Primary Health Care
- Published
- 2015
44. The World Hypertension League: where now and where to in salt reduction.
- Author
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Campbell NR, Lackland DT, Lisheng L, Zhang XH, Nilsson PM, and Niebylski ML
- Abstract
High dietary salt is a leading risk for death and disability largely by causing increased blood pressure. Other associated health risks include gastric and renal cell cancers, osteoporosis, renal stones, and increased disease activity in multiple sclerosis, headache, increased body fat and Meniere's disease. The World Hypertension League (WHL) has prioritized advocacy for salt reduction. WHL resources and actions include a non-governmental organization policy statement, dietary salt fact sheet, development of standardized nomenclature, call for quality research, collaboration in a weekly salt science update, development of a process to set recommended dietary salt research standards and regular literature reviews, development of adoptable power point slide sets to support WHL positions and resources, and critic of weak research studies on dietary salt. The WHL plans to continue to work with multiple governmental and non-governmental organizations to promote dietary salt reduction towards the World Health Organization (WHO) recommendations.
- Published
- 2015
- Full Text
- View/download PDF
45. The World Hypertension League challenges hypertension and cardiovascular organizations to develop strategic plans for the prevention and control of hypertension.
- Author
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Campbell NR, Lackland DT, Lisheng L, Zhang XH, Nilsson PM, Redburn KA, and Niebylski ML
- Subjects
- Global Health education, Humans, International Agencies organization & administration, Cardiovascular Diseases prevention & control, Hypertension prevention & control, Societies, Medical organization & administration
- Published
- 2015
- Full Text
- View/download PDF
46. The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension.
- Author
-
Daskalopoulou SS, Rabi DM, Zarnke KB, Dasgupta K, Nerenberg K, Cloutier L, Gelfer M, Lamarre-Cliche M, Milot A, Bolli P, McKay DW, Tremblay G, McLean D, Tobe SW, Ruzicka M, Burns KD, Vallée M, Ramesh Prasad GV, Lebel M, Feldman RD, Selby P, Pipe A, Schiffrin EL, McFarlane PA, Oh P, Hegele RA, Khara M, Wilson TW, Brian Penner S, Burgess E, Herman RJ, Bacon SL, Rabkin SW, Gilbert RE, Campbell TS, Grover S, Honos G, Lindsay P, Hill MD, Coutts SB, Gubitz G, Campbell NR, Moe GW, Howlett JG, Boulanger JM, Prebtani A, Larochelle P, Leiter LA, Jones C, Ogilvie RI, Woo V, Kaczorowski J, Trudeau L, Petrella RJ, Hiremath S, Stone JA, Drouin D, Lavoie KL, Hamet P, Fodor G, Grégoire JC, Fournier A, Lewanczuk R, Dresser GK, Sharma M, Reid D, Benoit G, Feber J, Harris KC, Poirier L, and Padwal RS
- Subjects
- Antihypertensive Agents therapeutic use, Blood Pressure Monitoring, Ambulatory standards, Canada, Education, Medical, Continuing standards, Female, Humans, Hypertension prevention & control, Male, Risk Assessment, Blood Pressure Determination standards, Hypertension diagnosis, Hypertension drug therapy, Practice Guidelines as Topic, Primary Prevention standards
- Abstract
The Canadian Hypertension Education Program reviews the hypertension literature annually and provides detailed recommendations regarding hypertension diagnosis, assessment, prevention, and treatment. This report provides the updated evidence-based recommendations for 2015. This year, 4 new recommendations were added and 2 existing recommendations were modified. A revised algorithm for the diagnosis of hypertension is presented. Two major changes are proposed: (1) measurement using validated electronic (oscillometric) upper arm devices is preferred over auscultation for accurate office blood pressure measurement; (2) if the visit 1 mean blood pressure is increased but < 180/110 mm Hg, out-of-office blood pressure measurements using ambulatory blood pressure monitoring (preferably) or home blood pressure monitoring should be performed before visit 2 to rule out white coat hypertension, for which pharmacologic treatment is not recommended. A standardized ambulatory blood pressure monitoring protocol and an update on automated office blood pressure are also presented. Several other recommendations on accurate measurement of blood pressure and criteria for diagnosis of hypertension have been reorganized. Two other new recommendations refer to smoking cessation: (1) tobacco use status should be updated regularly and advice to quit smoking should be provided; and (2) advice in combination with pharmacotherapy for smoking cessation should be offered to all smokers. The following recommendations were modified: (1) renal artery stenosis should be primarily managed medically; and (2) renal artery angioplasty and stenting could be considered for patients with renal artery stenosis and complicated, uncontrolled hypertension. The rationale for these recommendation changes is discussed., (Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
47. Impact of the emergence and re-emergence of different dengue viruses' serotypes in Rio de Janeiro, Brazil, 2010 to 2012.
- Author
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Heringer M, Nogueira RM, de Filippis AM, Lima MR, Faria NR, Nunes PC, Nogueira FB, and dos Santos FB
- Subjects
- Adolescent, Adult, Brazil epidemiology, Child, Child, Preschool, Dengue immunology, Dengue transmission, Dengue Virus immunology, Disease Outbreaks, Enzyme-Linked Immunosorbent Assay, Female, Humans, Immunoglobulin G immunology, Immunoglobulin M immunology, Male, Polymerase Chain Reaction, Antibodies, Viral immunology, Dengue epidemiology, Dengue Virus isolation & purification, Public Health Surveillance
- Abstract
Background: Rio de Janeiro (RJ) has been of major importance for the epidemiology of dengue viruses (DENVs) in Brazil. After the DENV 1-4 introductions in 1986, 1990, 2000 and 2011, respectively, the state has suffered explosive epidemics. We aimed to describe laboratorial, epidemiological and clinical aspects due to the emergence and re-emergence of distinct DENV in a 2-year period., Methods: Suspected dengue cases (n=2833), including 190 fatal cases, were submitted to virus isolation, RT-PCR and non-structural 1 (NS1) antigen capture ELISA, IgM antibody-capture (MAC)-ELISA and IgG-ELISA., Results: Case confirmation was 47.5%. MAC-ELISA confirmed 32.6% of the cases, RT-PCR confirmed 56.3%; DENV was recovered in 33.1% of samples inoculated and NS1 ELISA confirmed 27.5% of the cases. DENV-2 was prevalent in 2010, DENV-1 in 2011 and DENV-4 in 2012. Individuals infected by DENV-3 and over 65 years-old, and children 15 years-old and under infected by DENV-2 had a significantly higher risk of developing a severe disease. Fatal cases confirmed (n=67) were due to DENV-1 (26.8%), DENV-2 (14.9%), DENV-3 (2.9%) and DENV-4 (7.4%)., Conclusions: It has been shown here that viral emergences or re-emergences may play different roles in the disease epidemiology, especially when many serotypes co-circulate., (© The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2015
- Full Text
- View/download PDF
48. Proposed nomenclature for salt intake and for reductions in dietary salt.
- Author
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Campbell NR, Correa-Rotter R, Cappuccio FP, Webster J, Lackland DT, Neal B, and MacGregor GA
- Subjects
- Humans, Hypertension prevention & control, Blood Pressure physiology, Diet, Sodium-Restricted, Hypertension etiology, Sodium Chloride, Dietary administration & dosage, Terminology as Topic
- Abstract
There is considerable confusion about what ranges of dietary salt(a) could be considered low, normal, or high and also what ranges of reduction in dietary salt are small or large. The World Hypertension League with other organizations involved in dietary salt reduction have proposed a standardized nomenclature based on normal ancestral levels of salt intake and also on ranges of reduction in salt intake in clinical and population interventions. Low daily salt (sodium) intake where harm due to deficiency would be expected to occur is recommended to remain undefined because of inadequate research but likely <0.25 g (100 mg), normal (physiological) intake <2.5 g (1000 mg), recommended intake <5.0 g (2000 mg), high ≥5.0 g (2000 mg), very high >10 to 15 g (4000-6000 mg), and extremely high >15 g (6000 mg). Reductions in daily salt (sodium) intake are recommended to be called small if <2.5 g (1000 mg), moderate if 2.5 to 5.0 g (1000-2000 mg) and large if >5.0 g (2000 mg). Use of this nomenclature is likely to result in less confusion about salt intake and interventions to reduce dietary sodium., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
49. MEthods of ASsessing blood pressUre: identifying thReshold and target valuEs (MeasureBP): a review & study protocol.
- Author
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Blom KC, Farina S, Gomez YH, Campbell NR, Hemmelgarn BR, Cloutier L, McKay DW, Dawes M, Tobe SW, Bolli P, Gelfer M, McLean D, Bartlett G, Joseph L, Featherstone R, Schiffrin EL, and Daskalopoulou SS
- Subjects
- Animals, Blood Pressure physiology, Humans, Hypertension physiopathology, Reproducibility of Results, Systematic Reviews as Topic, Blood Pressure Determination methods
- Abstract
Despite progress in automated blood pressure measurement (BPM) technology, there is limited research linking hard outcomes to automated office BPM (OBPM) treatment targets and thresholds. Equivalences for automated BPM devices have been estimated from approximations of standardized manual measurements of 140/90 mmHg. Until outcome-driven targets and thresholds become available for automated measurement methods, deriving evidence-based equivalences between automated methods and standardized manual OBPM is the next best solution. The MeasureBP study group was initiated by the Canadian Hypertension Education Program to close this critical knowledge gap. MeasureBP aims to define evidence-based equivalent values between standardized manual OBPM and automated BPM methods by synthesizing available evidence using a systematic review and individual subject-level data meta-analyses. This manuscript provides a review of the literature and MeasureBP study protocol. These results will lay the evidenced-based foundation to resolve uncertainties within blood pressure guidelines which, in turn, will improve the management of hypertension.
- Published
- 2015
- Full Text
- View/download PDF
50. Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League.
- Author
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Campbell NR, Lackland DT, Lisheng L, Niebylski ML, Nilsson PM, and Zhang XH
- Subjects
- Algorithms, Global Health, Humans, Hypertension etiology, International Agencies, Program Development, Risk Factors, Sodium Chloride, Dietary adverse effects, World Health Organization, Cost of Illness, Databases, Factual statistics & numerical data, Diet, Sodium-Restricted, Hypertension epidemiology, Hypertension prevention & control, International Cooperation
- Abstract
Increased blood pressure and high dietary salt are leading risks for death and disability globally. Reducing the burden of both health risks are United Nations' targets for reducing noncommunicable disease. Nongovernmental organizations and individuals can assist by ensuring widespread dissemination of the best available facts and recommended interventions for both health risks. Simple but impactful fact sheets can be useful for informing the public, healthcare professionals, and policy makers. The World Hypertension League has developed fact sheets on dietary salt and hypertension but in many circumstances the greatest impact would be obtained from national-level fact sheets. This manuscript provides instructions and a template for developing fact sheets based on the Global Burden of Disease study and national survey data., (©2015 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
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