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32.
Effect of known history of heart disease on survival outcomes after out‐of‐hospital cardiac arrests 下载免费PDF全文
Magdalene HM Lee Stephanie Fook‐Chong Win Wah Sang Do Shin Tatsuya Nishiuchi Patrick Chow‐In Ko Ghulam Yasin Naroo Kwanhathai Darin Wong Ling Tiah Apichaya Monsomboon Fahad J Siddiqui Marcus EH Ong 《Emergency medicine Australasia : EMA》2018,30(1):67-76
Objective
We aimed to investigate the effect of known heart disease on post‐out‐of‐hospital cardiac arrest (OHCA) survival outcomes, and its association with factors influencing survival.Methods
This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009–2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non‐traumatic arrests for whom resuscitation was attempted and with known medical histories were included. Differences in demographics, arrest characteristics and survival between patients with and without known heart disease were analysed. Multivariate logistic regression was performed to identify factors influencing survival to discharge.Results
Of 19 044 eligible patients, 5687 had known heart disease. They were older (77 vs 72 years) and had more comorbidities like diabetes (40.9 vs 21.8%), hypertension (60.6 vs 36.0%) and previous stroke (15.2 vs 10.1%). However, they were not more likely to receive bystander cardiopulmonary resuscitation (P = 0.205) or automated external defibrillation (P = 0.980). On univariate analysis, known heart disease was associated with increased survival (unadjusted odds ratio 1.16, 95% confidence interval 1.03–1.30). However, on multivariate analysis, heart disease predicted poorer survival (adjusted odds ratio 0.76, 95% confidence interval 0.58–1.00). Other factors influencing survival corresponded with previous reports.Conclusions
Known heart disease independently predicted poorer post‐OHCA survival. This study may provide information to guide future prospective studies specifically looking at family education for patients with heart disease and the effect on OHCA outcomes. 相似文献33.
Previous studies on the association of ankylosing spondylitis and
abnormalities of the lung parenchyma have been based largely on plain
radiography and pulmonary function testing. This study, although
uncontrolled, is the first to use high-resolution computed tomography to
examine the entire lung parenchyma in ankylosing spondylitis patients, and
to correlate the findings with clinical assessment, plain radiography and
pulmonary function testing. The study population comprised 26 patients
meeting the New York criteria for idiopathic ankylosing spondylitis who
attended the out-patient department at our institution. High-resolution
computed tomography examination revealed abnormalities in 19 patients
(70%): these included interstitial lung disease (n = 4), bronchiectasis (n
= 6), emphysema (n = 4), apical fibrosis (n = 2), mycetoma (n = 1) and
non-specific interstitial lung disease (n = 12). Plain radiography was
abnormal in only four patients and failed to identify any patient with
interstitial lung disease. All patients with interstitial lung disease on
high-resolution computed tomography had respiratory symptoms and three of
the four had evidence of a restrictive process on pulmonary function
testing. This study raises, for the first time, the possible association
between interstitial lung disease and ankylosing spondylitis, and
highlights the use of high-resolution computed tomography in detecting such
disease in ankylosing spondylitis patients.
相似文献
34.
Chronic graft-versus-host disease in 52 patients: adverse natural course and successful treatment with combination immunosuppression 总被引:18,自引:26,他引:18
Sullivan KM; Shulman HM; Storb R; Weiden PL; Witherspoon RP; McDonald GB; Schubert MM; Atkinson K; Thomas ED 《Blood》1981,57(2):267-276
Fifty-two of 175 (30%) survivors of allogeneic marrow transplantation developed chronic graft-versus-hose diseases (GVHD). Five with limited chronic GVHD had an indolent clinical course with involvement of only the skin and liver. Forty-seven with extensive chronic GVHD had an unfavorable multiorgan disorder that resembled several autoimmune diseases. Thirteen patients with extensive disease (group I) were not treated and only 2 survive with Karnofsky scores >- 70%. Mortality resulted from infections and morbidity from sica syndrome, pulmonary and hepatic insufficiency, scleroderma-like skin disease, and contractures. Another 13 (group II) received a median of 8 mo prednisone and/or a brief course of antithymocyte globulin, and 3 survive without disability. The other 21 (group III) were treated with a combination of prednisone (1.0 mg/kg/q.o.d.) and either cyclophosphamide, procarbazine, or azathioprine (all 1.5 mg/kg/day) for a median of 13 mo. Combination therapy was well tolerated with only modest myelotoxicity. Fifteen in group III had a good and 4 a fair response to treatment while 2 with no response died. Azathioprine and prednisone was the most effective regimen. All therapy has been discontinued in 12 group III patients: GVHD returned in 5 (including 2 who died in spite of retreatment) while 7 remain free of GVHD for a median of 11 (range 6-30) mo observation. Only I group III survivor is disabled and 16 of the original 21 are alive 2-4 yr after transplant with Karnofsky scores of 70%-100%. Thus, combination immmunosuppression appears to favorably affect and, in some cases, premanently arrest the adverse natural course of extensive chronic GVHD. 相似文献
35.
国内六大行政区域六城市中老年人群膝关节骨性关节炎患病危险因素比较 总被引:8,自引:3,他引:8
目的:了解中国不同地区间中老年人群膝关节骨性关节炎患病危险因素。方法:调查时间为2005—07/08。①从中国六大行政区(西北,华北,华东。中南,东北,西南)选出六城市(西安,石家庄,上海。广州,哈尔滨市,成都),用分层多阶段整群抽样方法,抽取6218名40岁及以上具有正式户口常住男女人群进行膝关节骨性关节炎的流行病学问卷调查(包括一般情况、现病史、既往史、体格检查、X射线片检查情况和疾病诊断6个方面,共计94个问题141个变量指标),并对其中4808名有症状者进行X射线平片膝正侧位投照。②膝关节骨性关节炎诊断标准为临床症状阳性加X射线Kellgren & Lawrence分级二级及以上者。③计算患病率,并采用Epilnf06.0和SPSS 10.0软件对其中83个变量进行多因素非条件Logistfc回归分析,表示疾病与暴露因素之间联系强度的指标用比值比(OR),若OR〉1,说明疾病发生危险性增加,与暴露因素呈正关联;若OR〈1,说明疾病发生危险性减少,与暴露因素呈负关联。
结果:①六城市膝关节骨性关节炎总患病率为15.6%,其中西安7.7%,石家庄11.2%,上海9.8%。广州30.5%,哈尔滨16.9%,成都17.5%,各城市患病率比较差异显著(P〈0.01)。②Logistic回归分析膝关节骨性关节炎在大部分城市有共同的危险因素如年龄大(OR=1.032—1.181),使用蹲坑排便年限长(OR=1.021-1.077),体质量高(OR=1.048—1.073),和开始饮酒年龄大(OR=1.008~1.028);而从事专职体育运动(OR=1.651,西安),骨质疏松病史(OR=3.311,石家庄),吸烟(OR=2.654,石家庄),类风湿关节炎病史(OR=4.964,上海),文化程度高(OR=2.593,上海),女性(OR=2.510,广州),姐妹骨关节炎史(OR=13.251,哈尔滨),母亲骨关节炎史(OR=5.683,成都)等危险因素分别在不同地区出现.
结论:年龄大、使用蹲坑排便年限长、体质量高和开始饮酒年龄大是中国六地区膝关节骨性关节炎患病的共同危险因素,同时,不同地区主要危险因素又有一定差异。 相似文献
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Background
Physical activity has been associated with a decreased risk for breast cancer. The biological mechanismn(s) underlying the association between physical activity and breast cancer is not clear. Most prominent hypothesis is that physical activity may protect against breast cancer through reduced lifetime exposure to endogenous hormones either direct, or indirect by preventing overweight and abdominal adiposity. In order to get more insight in the causal pathway between physical activity and breast cancer risk, we designed the Sex Hormones and Physical Exercise (SHAPE) study. Purpose of SHAPE study is to examine the effects of a 1-year moderate-to-vigorous intensity exercise programme on endogenous hormone levels associated with breast cancer among sedentary postmenopausal women and whether the amount of total body fat or abdominal fat mediates the effects. 相似文献39.
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