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131.
Cessation of Driving is Rare in Older Drivers Seen in the Emergency Department After a Motor Vehicle Collision: A Prospective Cohort Study
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132.
Management of resistant hypertension: Aldosterone antagonists or intensification of diuretic therapy?
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133.
Michał Hawranek Marek Gierlotka Damian Pres Marian Zembala Mariusz Gąsior 《JACC: Cardiovascular Interventions》2018,11(18):1885-1893
Objectives
The authors sought to compare outcomes of patients with myocardial infarction and cardiogenic shock (CS) treated with percutaneous coronary intervention (PCI) with or without intra-aortic balloon pump (IABP) support according to final epicardial flow in the infarct-related artery.Background
A routine use of IABP is contraindicated in patients with myocardial infarction and CS. There are no data regarding the subpopulation of patients who may benefit from such support besides patients with mechanical complications of myocardial infarction.Methods
Prospective nationwide registry data of patients with myocardial infarction and CS treated with PCI between 2003 and 2014 were analyzed. Patients were initially stratified into 2 groups according to final infarct-related artery Thrombolysis In Myocardial Infarction (TIMI) flow grade after PCI: those with successful primary PCI (TIMI flow grades 2 or 3) and those with unsuccessful primary PCI (TIMI flow grades 0 or 1). Outcomes of patients with or without IABP treatment in each group were analyzed and compared.Results
In the unsuccessful PCI group, patients in whom IABP was applied had lower in-hospital, 30-day, and 12-month mortality. IABP support in this group of patients was an independent predictor of lower 30-day mortality (hazard ratio [HR]: 0.72; 95% confidence interval [CI]: 0.59 to 0.89; p = 0.002). Conversely, in patients with successful PCI, IABP was an independent predictor of higher 30-day mortality (HR: 1.18; 95% CI: 1.08 to 1.30; p = 0.0004).Conclusions
IABP is associated with a lower risk of 30-day mortality in patients with myocardial infarction complicated by CS, in whom primary PCI was unsuccessful. 相似文献134.
Barbara M Murphy Peter C Elliott Rosemary O Higgins Michael R Le Grande Marian U C Worcester Alan J Goble James Tatoulis 《European journal of cardiovascular prevention and rehabilitation》2008,15(4):434-440
BACKGROUND: To target interventions, patients at risk for poor outcomes after a cardiac event need to be identified. We investigated trajectories of anxiety and depression after coronary artery bypass graft surgery (CABGS) and identified patients at risk of persistent or worsening anxiety and depression. METHODS: A consecutive sample of 184 patients on the waiting list for CABGS at The Royal Melbourne Hospital completed self-report questionnaires before surgery, and at 2 and 6 months postsurgery. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Growth mixture modelling identified trajectories of anxiety and depression. RESULTS: Two possible trajectories emerged for anxiety, whereas three trajectories emerged for depression. Most patients (92%) followed a trajectory of minor presurgical anxiety that remitted in 6 months after CABGS, with the remainder (8%) following a trajectory of major anxiety that remitted in the same period. Minor remitted depression was also common (72% patients). Two less common depression trajectories indicated worsening or unresolved depression. One trajectory began with major presurgical depression that partially remitted by 6 months (14% patients) and the other began with minor presurgical depression that worsened by 6 months (14% patients). Unpartnered patients, smokers, those with presurgical anxiety, high cholesterol, angina, more severe disease or having repeat CABGS were at increased risk for a poor depression trajectory. CONCLUSION: Although initial anxiety and depression resolved or lessened for most patients, some patients experienced persistent or worsening depression after CABGS. Interventions can be targeted toward 'at risk' patients. 相似文献
135.
Tomas Rozbroj Anthony Lyons Marian Pitts Anne Mitchell Helen Christensen 《Journal of medical Internet research》2015,17(3)
BackgroundE-therapies for depression and anxiety rarely account for lesbian and gay users. This is despite lesbians and gay men being at heightened risk of mood disorders and likely to benefit from having access to tailored self-help resources.ObjectiveWe sought to determine how e-therapies for depression and anxiety could be improved to address the therapeutic needs of lesbians and gay men.MethodsWe conducted eight focus groups with lesbians and gay men aged 18 years and older. Focus groups were presented with key modules from the popular e-therapy “MoodGYM”. They were asked to evaluate the inclusiveness and relevance of these modules for lesbians and gay men and to think about ways that e-therapies in general could be modified. The focus groups were analyzed qualitatively using a thematic analysis approach to identify major themes.ResultsThe focus groups indicated that some but not all aspects of MoodGYM were suitable, and suggested ways of improving e-therapies for lesbian and gay users. Suggestions included avoiding language or examples that assumed or implied users were heterosexual, improving inclusiveness by representing non-heterosexual relationships, providing referrals to specialized support services and addressing stigma-related stress, such as “coming out” and experiences of discrimination and harassment. Focus group participants suggested that dedicated e-therapies for lesbians and gay men should be developed or general e-therapies be made more inclusive by using adaptive logic to deliver content appropriate for a user’s sexual identity.ConclusionsFindings from this study offer in-depth guidance for developing e-therapies that more effectively address mental health problems among lesbians and gay men. 相似文献
136.
Kaisa M. Kemppainen Alexandria N. Ardissone Austin G. Davis-Richardson Jennie R. Fagen Kelsey A. Gano Luis G. León-Novelo Kendra Vehik George Casella Olli Simell Anette G. Ziegler Marian J. Rewers ?ke Lernmark William Hagopian Jin-Xiong She Jeffrey P. Krischer Beena Akolkar Desmond A. Schatz Mark A. Atkinson Eric W. Triplett the TEDDY Study Group 《Diabetes care》2015,38(2):329-332
OBJECTIVE
Gut microbiome dysbiosis is associated with numerous diseases, including type 1 diabetes. This pilot study determines how geographical location affects the microbiome of infants at high risk for type 1 diabetes in a population of homogenous HLA class II genotypes.RESEARCH DESIGN AND METHODS
High-throughput 16S rRNA sequencing was performed on stool samples collected from 90 high-risk, nonautoimmune infants participating in The Environmental Determinants of Diabetes in the Young (TEDDY) study in the U.S., Germany, Sweden, and Finland.RESULTS
Study site–specific patterns of gut colonization share characteristics across continents. Finland and Colorado have a significantly lower bacterial diversity, while Sweden and Washington state are dominated by Bifidobacterium in early life. Bacterial community diversity over time is significantly different by geographical location.CONCLUSIONS
The microbiome of high-risk infants is associated with geographical location. Future studies aiming to identify the microbiome disease phenotype need to carefully consider the geographical origin of subjects. 相似文献137.
Katarzyna Kościelska-Kasprzak Dorota Bartoszek Marta Myszka Marcelina Żabińska Marian Klinger 《Archivum immunologiae et therapiae experimentalis》2014,62(1):47-57
Serum complement cascade, a part of innate immunity required for host protection against invading pathogens, is also a mediator of various forms of disease and injury. It is activated by classical, lectin, and alternative pathways that lead to activation of C3 component by C3 convertases, release of C3b opsonin, C5 conversion and eventually membrane attack complex formation. The tightly regulated activation process yields also C3a and C5a anaphylatoxins, which target a broad spectrum of immune and non-immune cells. The review discusses the involvement of the complement cascade in kidney disease pathogenesis and injury. The role of the complement pathways in autoantibody-mediated forms of glomerulonephritis (lupus nephritis, anti-glomerular basement membrane disease, anti-neutrophil cytoplasmic autoantibody-induced or membranoproliferative glomerulonephritis, membranous nephropathy), C3 glomerulopathy, atypical forms of hemolytic uremic syndrome, ischemic-reperfusion injury of transplanted kidney, and antibody-mediated renal allograft rejection are discussed. The disturbances in complement activation and regulation with underlying genetics are presented and related to observed pathology. Also promising strategies targeting the complement system in complement-related disorders are mentioned. 相似文献
138.
Siobhan O. Burns Vincent Plagnol Beatriz Morillo Gutierrez Daifulah Al Zahrani James Curtis Miguel Gaspar Amel Hassan Alison M. Jones Marian Malone Dyanne Rampling Alex McLatchie Rainer Doffinger Kimberly C. Gilmour Frances Henriquez Adrian J. Thrasher H. Bobby Gaspar Sergey Nejentsev 《The Journal of allergy and clinical immunology》2014
139.