急性冠脉综合征患者强化他汀治疗与心衰入院危险

目的:确定强化他汀治疗是否可以降低高危患者心衰(HF)的入院危险。背景:强化他汀治疗与缺血性事件的关系已被证实,但其与HF发生危险的关系还不确定。方法:PROVEIT-TIMI2(2ThePravastatinorAtorvastatinEvaluationandInfectionTrial-ThrombolysisInMyocardialInfarction,22帕伐他汀或阿托伐他汀评价与感染试验——心肌梗死溶栓22)研究将4162例患者进行随机分组,分别接强化他汀(阿托伐他汀80mg)或中度他汀(帕伐他汀40mg)治疗。在平均24个月的随访期中,因心住院发生在随机分组后的30多天。并测量基线的型利钠肽(BNP)水平。结果:阿…     

Esophageal Function in Diabetes Mellitus with Special Reference to Acid Studies and Relationship to Peripheral Neuropathy

Esophageal function in 20 subjects with diabetes mellitus was assessed using esophageal manometry, 24-hr ambulatory esophageal pH monitoring, and esophageal scintigraphy. Seven patients had abnormal esophageal manometric studies, and this abnormality was significantly associated with peripheral neuropathy. Almost half of the subjects studied demonstrated excessive gastroesophageal acid reflux, but there was no correlation between the likelihood of abnormal reflux and the presence of peripheral neuropathy. Esophageal scintigraphy was relatively insensitive in the detection of abnormal esophageal function in diabetics.     

Prevalence of high Epworth Sleepiness Scale scores in a rural population

BACKGROUND:

Increased daytime sleepiness is an important symptom of obstructive sleep apnea (OSA). OSA is frequently underdiagnosed, and the Epworth Sleepiness Scale (ESS) can be a useful tool in alerting physicians to a potential problem involving OSA.

OBJECTIVE:

To measure the prevalence and determinants of daytime sleepiness measured using the ESS in a rural community population.

METHODS:

A community survey was conducted to examine the risk factors associated with ESS in a rural population in 154 households comprising 283 adults. Questionnaire information was obtained regarding physical factors, social factors, general medical history, family medical history, ESS score, and self-reported height and weight. Multivariable binary logistic regression analysis based on the generalized estimating equations approach to account for clustering within households was used to predict the relationship between a binary ESS score outcome (normal or abnormal) and a set of explanatory variables.

RESULTS:

The population included 140 men (49.5%) and 143 women (50.5%) with an age range of 18 to 97 years (mean [± SD] 52.0±14.9 years). The data showed that 79.2% of the study participants had an ESS score in the normal range (0 to 10) and 20.8% had an ESS score >10, which is considered to be abnormal or high sleepiness. Multivariable regression analysis revealed that obesity was significantly associated with an abnormal or high sleepiness score on the ESS (OR 3.40 [95% CI 1.31 to 8.80).

CONCLUSION:

High levels of sleepiness in this population were common. Obesity was an important risk factor for high ESS score.     

Left ventricular function evaluation using radionuclide methods in the intensive coronary care unit

We describe an adapted first-transit (FT) technique to perform left ventricular ejection fraction (LVEF) measurements on patients with Swan-Ganz catheters in the intensive cardiac care unit (ICCU). The radionuclide is introduced directly into the right pulmonary artery through the catheter. High-quality images of the left ventricle are obtained owing to minimal activity in the right ventricle and left lung. LVEF measurements obtained by FT compared well with measurements obtained from gated blood pool studies (r = 0.91) but gave consistently lower values. The adapted FT method improves LVEF determination and left-ventricular wall motion evaluation in the ICCU patient.