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ARAKAKI, L., S. NGAI e D. WEISS. "Completeness ofNeisseria meningitidisreporting in New York City, 1989–2010". Epidemiology and Infection 144, n.º 11 (17 de março de 2016): 2374–81. http://dx.doi.org/10.1017/s0950268816000406.
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SUMMARYInvasive meningococcal disease (IMD) completeness of reporting has never been assessed in New York City (NYC). We conducted a capture–recapture study to assess completeness of reporting, comparing IMD reports made to the NYC Department of Health and Mental Hygiene (DOHMH) and records identified in the New York State hospital discharge database [Statewide Planning and Research Cooperative System (SPARCS)] by ICD-9 codes from 1989 to 2010. Reporting completeness estimates were calculated for the entire study period, and stratified by year, age group, clinical syndrome, and reporting system. A chart review of hospital medical records from 2008 to 2010 was conducted to validate hospital coding and to adjust completeness estimates. Overall, 2194 unique patients were identified from DOHMH (n= 1300) and SPARCS (n= 1525); 631 (29%) were present in both. Completeness of IMD reporting was 41% [95% confidence interval (CI) 40–43]. Differences in completeness were found by age, clinical syndrome, and reporting system. The chart review found 33% of hospital records from 2008 to 2010 had no documentation of IMD. Removal of those records improved completeness of reporting to 51% (95% CI 49–53). Our data showed a low concordance between what is reported to DOHMH and what is coded by hospitals as IMD. Additional guidance to clinicians on IMD reporting criteria may improve completeness of IMD reporting.
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Holloway, Ian W., Heidi E. Jones, David L. Bell e Carolyn L. Westhoff. "Men’s Preferences for Sexually Transmitted Infection Care Services in a Low-Income Community Clinic Setting in New York City". American Journal of Men's Health 5, n.º 3 (18 de maio de 2010): 208–15. http://dx.doi.org/10.1177/1557988310370359.
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A self-administered anonymous waiting room survey was used to evaluate men’s preferences on testing, notification, and treatment for sexually transmitted infections (STIs) in a community clinic in Upper Manhattan in 2007. Sixty-seven percent of eligible men ( n = 199) participated. Most were willing to collect a urine sample at home (71%, n = 140) or at the clinic (87%, n = 171). Respondents preferred learning of a positive STI test result by phone (67%, n = 123). However, men were willing to receive results by text (65%, n = 127) or e-mail (61%, n = 121). Most (83%, n = 162) reported they would be (very) likely to take STI medication brought to them by a partner. Twenty-one percent reported previous gonorrhea or Chlamydia infection ( n = 41). Of these, 39% ( n = 16) had received medication to bring their partner, and almost all ( n = 14/16) reported their partner took the medicine. Multiple options for STI testing, notification, and treatment are recommended to maximize service use among men, including providing patient-delivered partner therapy.
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BEFUS, M., D. V. MUKHERJEE, C. T. A. HERZIG, F. D. LOWY e E. LARSON. "Correspondence analysis to evaluate the transmission ofStaphylococcus aureusstrains in two New York State maximum-security prisons". Epidemiology and Infection 145, n.º 10 (16 de maio de 2017): 2161–65. http://dx.doi.org/10.1017/s0950268817000942.
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SUMMARYPrisons/jails are thought to amplify the transmission ofStaphylococcus aureus(SA) particularly methicillin-resistant SA infection and colonisation. Two independently pooled cross-sectional samples of detainees being admitted or discharged from two New York State maximum-security prisons were used to explore this concept. Private interviews of participants were conducted, during which the anterior nares and oropharynx were sampled and assessed for SA colonisation. Log-binomial regression and correspondence analysis (CA) were used to evaluate the prevalence of colonisation at entry as compared with discharge. Approximately 51% of admitted (N= 404) and 41% of discharged (N= 439) female detainees were colonised with SA. Among males, 59% of those admitted (N= 427) and 49% of those discharged (N= 393) were colonised. Females had a statistically significant higher prevalence (1·26:P= 0·003) whereas males showed no significant difference (1·06;P= 0·003) in SA prevalence between entry and discharge. CA demonstrated that some strains, such asspatypes t571 and t002, might have an affinity for certain mucosal sites. Contrary to our hypothesis, the prison setting did not amplify SA transmission, and CA proved to be a useful tool in describing the population structure of strains according to time and/or mucosal site.
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Parker, Albert, e Clifford Ollier. "Atlantic meridional overturning circulation stable over the last 150 years". Quaestiones Geographicae 38, n.º 3 (10 de setembro de 2019): 31–40. http://dx.doi.org/10.2478/quageo-2019-0026.
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Abstract The Atlantic Meridional Overturning Circulation (AMOC) describes the northward flow of warm, salty water in the upper layers, and the southward flow of colder water in the deep Atlantic layers. AMOC strength estimates at 41°N latitude based on satellite sea surface height (SSH), and ARGO ocean temperature, salinity and velocity, and finally the difference in between the absolute mean sea levels (MSL) of the tide gauges of The Battery, New York, 40.7°N latitude, and Brest, 48.3°N latitude. Results suggest that the AMOC has been minimally reducing but with a positive acceleration since 2002, has been marginally increasing but with a negative acceleration since 1993, and has not been reducing but only oscillating with clear periodicities up 18 years, 27 years and about 60 years since 1856.
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Priemer, David S., e Rebecca D. Folkerth. "Dementia in the Forensic Setting: Diagnoses Obtained Using a Condensed Protocol at the Office of Chief Medical Examiner, New York City". Journal of Neuropathology & Experimental Neurology 80, n.º 8 (1 de agosto de 2021): 724–30. http://dx.doi.org/10.1093/jnen/nlab059.
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Abstract Individuals with dementia may come to forensic autopsy, partly because of non-natural deaths (e.g. fall-related), and/or concerns of abuse/neglect. At the New York City Office of Chief Medical Examiner (NYC OCME), brains from such cases are submitted for neurodegenerative disease (ND) work-up. Seventy-eight sequential cases were evaluated using a recently published condensed protocol for the NIA-AA guidelines for the neuropathologic assessment of Alzheimer disease (AD), a cost-cutting innovation in diagnostic neuropathology. ND was identified in 74 (94.9%) brains; the most common were AD (n = 41 [52.5%]), primary age-related tauopathy (n = 26 [33.3%]), and Lewy body disease ([LBD], n = 25 [32.1%]). Others included age-related tau astrogliopathy, hippocampal sclerosis of aging, progressive supranuclear palsy, multiple system atrophy, amyotrophic lateral sclerosis, argyrophilic grain disease, and Creutzfeldt-Jakob disease. 26.8% of AD cases involved a non-natural, dementia-related death, versus 40.0% for LBD. Finally, 70 (89.7%) cases had chronic cerebrovascular disease, 53 (67.9%) being moderate-to-severe. We present a diverse distribution of NDs notable for a high rate of diagnoses associated with falls (e.g. LBD), a potential difference from the hospital neuropathology experience. We also report a high burden of cerebrovascular disease in demented individuals seen at the NYC OCME. Finally, we demonstrate that the aforementioned condensed protocol is applicable for a variety of ND diagnoses.
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Thomas, Sumi, Yaser Hussein, Sudeshna Bandyopadhyay, Michele Cote, Oudai Hassan, Eman Abdulfatah, Baraa Alosh, Hui Guan, Robert A. Soslow e Rouba Ali-Fehmi. "Interobserver Variability in the Diagnosis of Uterine High-Grade Endometrioid Carcinoma". Archives of Pathology & Laboratory Medicine 140, n.º 8 (3 de maio de 2016): 836–43. http://dx.doi.org/10.5858/arpa.2015-0220-oa.
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Context.—Low interobserver diagnostic agreement exists among high-grade endometrial carcinomas. Objective.—To evaluate diagnostic variability in International Federation of Gynecology and Obstetrics (FIGO) grade 3 endometrioid adenocarcinoma (G3EC) in 2 different sign-out practices. Design.—Sixty-six G3EC cases were identified from pathology archives of Wayne State University (WSU, Detroit, Michigan) (general surgical pathology sign-out) and 65 from Memorial Sloan Kettering Cancer Center (MSK, New York, New York) (gynecologic pathology focused sign-out). Each case was reviewed together by 2 gynecologic pathologists, one from each institution, and classified into the G3EC group or a reclassified group. Clinicopathologic parameters were compared. Results.—Twenty-five WSU cases (38%) were reclassified as undifferentiated (n = 2), serous (n = 4), mixed endometrioid and serous carcinomas (n = 12), and FIGO grade 2 endometrioid adenocarcinomas with focal marked nuclear atypia (n = 7). Eleven MSK cases (17%) were reclassified as undifferentiated (n = 5), serous (n = 1), mixed endometrioid and serous carcinomas (n = 4), and mixed endometrioid and clear cell carcinomas (n = 1). Agreement rate between original and review diagnosis was 83% (54 of 65) at MSK and 62% (41 of 66) at WSU (P = .01) with an overall rate of 73% (95 of 131). There were more undifferentiated carcinomas at MSK than there were at WSU (45% [5 of 11] versus 8% [2 of 25]; P = .02). There were more grade 2 endometrioid adenocarcinomas with focal, marked nuclear atypia at WSU (28%; 7 of 25) than there were at MSK (0%) (P = .03). Mixed endometrioid and serous carcinoma was the most common misclassified subtype (44%; 16 of 36). Conclusion.—Moderate interobserver variability exists in the diagnosis of G3EC with a significantly greater diagnostic agreement rate in gynecologic pathology–focused sign-out than in general sign-out practice.
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Rosenblum, Rachel E., Celina Ang, Sabrina A. Suckiel, Emily R. Soper, Meenakshi R. Sigireddi, Sinead Cullina, Gillian M. Belbin, Aimee L. Lucas, Eimear E. Kenny e Noura S. Abul-Husn. "Lynch Syndrome–Associated Variants and Cancer Rates in an Ancestrally Diverse Biobank". JCO Precision Oncology, n.º 4 (novembro de 2020): 1429–44. http://dx.doi.org/10.1200/po.20.00290.
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PURPOSE Limited data are available on the prevalence and clinical impact of Lynch syndrome (LS)–associated genomic variants in non-European ancestry populations. We identified and characterized individuals harboring LS-associated variants in the ancestrally diverse Bio Me Biobank in New York City. PATIENTS AND METHODS Exome sequence data from 30,223 adult Bio Me participants were evaluated for pathogenic, likely pathogenic, and predicted loss-of-function variants in MLH1, MSH2, MSH6, and PMS2. Survey and electronic health record data from variant-positive individuals were reviewed for personal and family cancer histories. RESULTS We identified 70 individuals (0.2%) harboring LS-associated variants in MLH1 (n = 12; 17%), MSH2 (n = 13; 19%), MSH6 (n = 16; 23%), and PMS2 (n = 29; 41%). The overall prevalence was 1 in 432, with higher prevalence among individuals of self-reported African ancestry (1 in 299) than among Hispanic/Latinx (1 in 654) or European (1 in 518) ancestries. Thirteen variant-positive individuals (19%) had a personal history, and 19 (27%) had a family history of an LS-related cancer. LS-related cancer rates were highest in individuals with MSH6 variants (31%) and lowest in those with PMS2 variants (7%). LS-associated variants were associated with increased risk of colorectal (odds ratio [OR], 5.0; P = .02) and endometrial (OR, 30.1; P = 8.5 × 10−9) cancers in Bio Me. Only 2 variant-positive individuals (3%) had a documented diagnosis of LS. CONCLUSION We found a higher prevalence of LS-associated variants among individuals of African ancestry in New York City. Although cancer risk is significantly increased among variant-positive individuals, the majority do not harbor a clinical diagnosis of LS, suggesting underrecognition of this disease.
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Wang, Wenyao, Haixia Guan, A. Martin Gerdes, Giorgio Iervasi, Yuejin Yang e Yi-Da Tang. "Thyroid Status, Cardiac Function, and Mortality in Patients With Idiopathic Dilated Cardiomyopathy". Journal of Clinical Endocrinology & Metabolism 100, n.º 8 (1 de agosto de 2015): 3210–18. http://dx.doi.org/10.1210/jc.2014-4159.
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Context: Previous studies claiming a relationship between thyroid dysfunction and poor prognosis of heart failure (HF) had a major limitation in that they included patients with different etiologies. Objective: With complete information of thyroid function profile from 458 consecutive patients with idiopathic dilated cardiomyopathy, we tested the hypothesis that thyroid status can independently influence mortality in patients with HF. Design, Patients, and Outcome Measure: The original cohort consisted of 572 consecutive patients with idiopathic dilated cardiomyopathy, and 458 patients remained at the end of follow-up. All patients took thyroid function tests and other regular examinations in hospital. The risk of mortality was evaluated based on free T3, TSH, and the whole thyroid function profile, respectively. Results: The most frequent thyroid dysfunction was subclinical hypothyroidism (n = 41), followed by subclinical hyperthyroidism (n = 35), low-T3 syndrome (n = 17), and hypothyroidism (n = 12). Logistic analysis showed log-TSH and free T3 as independent predictors of exacerbated cardiac function (New York Heart Association stages III–IV vs New York Heart Association stages I–II). During the follow-up (17 ± 8 mo), 111 cumulative deaths occurred. Hypothyroidism was the strongest predictor of mortality [hazard ratio (HR) 4.189; 95% confidence interval (CI) 2.118–8.283)], followed by low-T3 syndrome (HR 3.147; 95% CI 1.558–6.355) and subclinical hypothyroidism (HR 2.869; 95% CI 1.817–4.532). Subclinical hyperthyroidism showed no significant impact. Conclusions: We found a clear association between thyroid dysfunction and increased risk of mortality in idiopathic dilated cardiomyopathy with HF. These results suggest that monitoring thyroid function in HF patients is necessary, and further studies on the treatment of HF with thyroid dysfunction are needed.
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Vaghefi, Niloofar, Frank S. Hay, Julie R. Kikkert e Sarah J. Pethybridge. "Genotypic Diversity and Resistance to Azoxystrobin of Cercospora beticola on Processing Table Beet in New York". Plant Disease 100, n.º 7 (julho de 2016): 1466–73. http://dx.doi.org/10.1094/pdis-09-15-1014-re.
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Cercospora leaf spot (CLS), caused by Cercospora beticola, is one of the major diseases affecting productivity and profitability of beet production worldwide. Fungicides are critical for the control of this disease and one of the most commonly used products is the quinone outside inhibitor (QOI) azoxystrobin. In total, 150 C. beticola isolates were collected from two commercial processing table beet fields in Batavia, NY in 2014. The mating types of the entire population were determined, and genetic diversity of a subset of samples (n = 48) was assessed using five microsatellite loci. Sensitivity to azoxystrobin was tested using a spore germination assay. The cytochrome b gene was sequenced to check for the presence of point mutations known to confer QOI resistance in fungi. High allelic diversity (He = 0.50) and genotypic diversity (D* = 0.96), gametic equilibrium of the microsatellite loci, and equal ratios of mating types were suggestive of a mixed mode of reproduction for C. beticola. Resistance to azoxystrobin was prevalent because 41% of the isolates had values for effective concentrations reducing spore germination by 50% (EC50) > 0.2 μg/ml. The G143A mutation, known to cause QOI resistance in C. beticola, was found in isolates with EC50 values between 0.207 and 19.397 μg/ml. A single isolate with an EC50 of 0.272 μg/ml carried the F129L mutation, known to be associated with low levels of QOI resistance in fungi. This is the first report of the F129L mutation in C. beticola. The implications of these findings for the epidemiology and control of CLS in table beet fields in New York are discussed.
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Maenza-Gmelch, Terryanne E. "Late-glacial – early Holocene vegetation, climate, and fire at Sutherland Pond, Hudson Highlands, southeastern New York, U.S.A." Canadian Journal of Botany 75, n.º 3 (1 de março de 1997): 431–39. http://dx.doi.org/10.1139/b97-045.
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Accelerator mass spectrometry dated pollen, plant-macrofossil, and charcoal records from Sutherland Pond (41°23′29″N, 74°02′16″W), located in the Black Rock Forest, provide a detailed account of forest history during the late-glacial – Holocene transition in the Hudson Highlands, lower Hudson Valley, southeastern New York. Pollen assemblages dating more than 12 600 radiocarbon years before present (years BP) are dominated by herbaceous and shrub types (Salix, Betula, Alnus, Ericaceae, Cyperaceae, Gramineae, and Tubuliflorae), with some arboreal types (Pinus and Picea), apparently representing an open landscape possibly with scattered trees. At 12 600 years BP increased organic deposition and pollen influx and the first occurrence of macrofossils indicate dramatic environmental change. Mixed assemblages of boreal and temperate taxa (Picea, Abies, Betula papyrifera, Quercus, Ostrya – Carpinus, and Fraxinus) are evident from 12 600 to 11 200 years BP. Low charcoal influx suggests that fire was a minor component of early woodland development beginning around 12 600 years BP. A Picea–Abies–Alnus assemblage, suggesting a cool climatic episode, dominates between 11 200 and 10 120 years BP, with rapid onset and termination each occurring within 150 years. Fire activity is also low during this colder interval. Warmer conditions, reestablished by 10 120 years BP, are inferred from expansion of Pinus strobus and increasing Quercus and Ostrya–Carpinus, followed by replacement of B. papyrifera by Betula populifolia and increased charcoal influx. Key words: late glacial, pollen, plant macrofossils, fire, accelerator mass spectrometry radiocarbon dating, New York.
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Sutton, Desmond, Timothy Wen, Anna P. Staniczenko, Yongmei Huang, Maria Andrikopoulou, Mary D'Alton, Bruce B. Feinberg et al. "Clinical and Demographic Risk Factors for COVID-19 during Delivery Hospitalizations in New York City". American Journal of Perinatology 38, n.º 08 (20 de abril de 2021): 857–68. http://dx.doi.org/10.1055/s-0041-1727168.
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Objective This study was aimed to review 4 weeks of universal novel coronavirus disease 2019 (COVID-19) screening among delivery hospitalizations, at two hospitals in March and April 2020 in New York City, to compare outcomes between patients based on COVID-19 status and to determine whether demographic risk factors and symptoms predicted screening positive for COVID-19. Study Design This retrospective cohort study evaluated all patients admitted for delivery from March 22 to April 18, 2020, at two New York City hospitals. Obstetrical and neonatal outcomes were collected. The relationship between COVID-19 and demographic, clinical, and maternal and neonatal outcome data was evaluated. Demographic data included the number of COVID-19 cases ascertained by ZIP code of residence. Adjusted logistic regression models were performed to determine predictability of demographic risk factors for COVID-19. Results Of 454 women delivered, 79 (17%) had COVID-19. Of those, 27.9% (n = 22) had symptoms such as cough (13.9%), fever (10.1%), chest pain (5.1%), and myalgia (5.1%). While women with COVID-19 were more likely to live in the ZIP codes quartile with the most cases (47 vs. 41%) and less likely to live in the ZIP code quartile with the fewest cases (6 vs. 14%), these comparisons were not statistically significant (p = 0.18). Women with COVID-19 were less likely to have a vaginal delivery (55.2 vs. 51.9%, p = 0.04) and had a significantly longer postpartum length of stay with cesarean (2.00 vs. 2.67days, p < 0.01). COVID-19 was associated with higher risk for diagnoses of chorioamnionitis and pneumonia and fevers without a focal diagnosis. In adjusted analyses, including demographic factors, logistic regression demonstrated a c-statistic of 0.71 (95% confidence interval [CI]: 0.69, 0.80). Conclusion COVID-19 symptoms were present in a minority of COVID-19-positive women admitted for delivery. Significant differences in obstetrical outcomes were found. While demographic risk factors demonstrated acceptable discrimination, risk prediction does not capture a significant portion of COVID-19-positive patients. Key Points
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Giri, Paresh C., Gizelle J. Stevens, Jeanette Merrill-Henry, Udochukwu Oyoyo e Vijay P. Balasubramanian. "Participation in pulmonary hypertension support group improves patient-reported health quality outcomes: a patient and caregiver survey". Pulmonary Circulation 11, n.º 2 (abril de 2021): 204589402110132. http://dx.doi.org/10.1177/20458940211013258.
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Support group participation has been shown to be effective in many chronic medical conditions. The evidence for integrating support group into pulmonary hypertension care and its effect on quality of life, physical and psychological well-being is limited. We sought to assess the effect of support group participation on quality of life in patients diagnosed with pulmonary hypertension and their caregivers. The emPHasis-10 questionnaire (a tool validated for quality of life assessment in pulmonary hypertension) was used to evaluate the effect of support group participation. Additional demographic and health-related quality measures were examined. Results showed that 165 subjects were enrolled in the study; 122 (74.4%) were patients with pulmonary hypertension, 41 (25.0%) were their caregivers, and 2 (0.02%) did not respond. The cohort was predominantly female ( n = 128, 78%), Caucasian ( n = 10, 61%), and the principal self-reported classification of pulmonary hypertension was World Health Organization Group 1 ( n = 85, 51.8%) and the self-reported New York Heart Association Functional Class was II and III ( n = 43, 57.3%). Most participants ( n = 118, 71.5%) attended support groups and of them, a majority ( n = 107, 90.6%) stated it helped them. There was no difference in quality of life as assessed by emPHasis-10 scores with support group participation (median score 30 vs 32, p = 0.387). There was self-reported improvement in understanding condition better including procedures such as right heart catheterization, medication compliance, and confidence in self-care ( p < 0.05). Using multivariate logistic regression, baseline variables that were independently associated with emPHasis-10 scores for the entire cohort included knowledge of New York Heart Association Functional Class (odds ratio: 1.919, 95% CI: 1.004–3.67, p = 0.04) and greater distance traveled to visit pulmonary hypertension physician (odds ratio: 1.391, 95% CI: 0.998--1.94, p = 0.05). In conclusion, support group participation does not improve quality of life as assessed by emPHasis-10 scores but improves other meaningful health-related quality outcomes.
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Budhwani, Henna, e Ruoyan Sun. "Creating COVID-19 Stigma by Referencing the Novel Coronavirus as the “Chinese virus” on Twitter: Quantitative Analysis of Social Media Data". Journal of Medical Internet Research 22, n.º 5 (6 de maio de 2020): e19301. http://dx.doi.org/10.2196/19301.
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Background Stigma is the deleterious, structural force that devalues members of groups that hold undesirable characteristics. Since stigma is created and reinforced by society—through in-person and online social interactions—referencing the novel coronavirus as the “Chinese virus” or “China virus” has the potential to create and perpetuate stigma. Objective The aim of this study was to assess if there was an increase in the prevalence and frequency of the phrases “Chinese virus” and “China virus” on Twitter after the March 16, 2020, US presidential reference of this term. Methods Using the Sysomos software (Sysomos, Inc), we extracted tweets from the United States using a list of keywords that were derivatives of “Chinese virus.” We compared tweets at the national and state levels posted between March 9 and March 15 (preperiod) with those posted between March 19 and March 25 (postperiod). We used Stata 16 (StataCorp) for quantitative analysis, and Python (Python Software Foundation) to plot a state-level heat map. Results A total of 16,535 “Chinese virus” or “China virus” tweets were identified in the preperiod, and 177,327 tweets were identified in the postperiod, illustrating a nearly ten-fold increase at the national level. All 50 states witnessed an increase in the number of tweets exclusively mentioning “Chinese virus” or “China virus” instead of coronavirus disease (COVID-19) or coronavirus. On average, 0.38 tweets referencing “Chinese virus” or “China virus” were posted per 10,000 people at the state level in the preperiod, and 4.08 of these stigmatizing tweets were posted in the postperiod, also indicating a ten-fold increase. The 5 states with the highest number of postperiod “Chinese virus” tweets were Pennsylvania (n=5249), New York (n=11,754), Florida (n=13,070), Texas (n=14,861), and California (n=19,442). Adjusting for population size, the 5 states with the highest prevalence of postperiod “Chinese virus” tweets were Arizona (5.85), New York (6.04), Florida (6.09), Nevada (7.72), and Wyoming (8.76). The 5 states with the largest increase in pre- to postperiod “Chinese virus” tweets were Kansas (n=697/58, 1202%), South Dakota (n=185/15, 1233%), Mississippi (n=749/54, 1387%), New Hampshire (n=582/41, 1420%), and Idaho (n=670/46, 1457%). Conclusions The rise in tweets referencing “Chinese virus” or “China virus,” along with the content of these tweets, indicate that knowledge translation may be occurring online and COVID-19 stigma is likely being perpetuated on Twitter.
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Kowalik, Ewa, Beata Kuśmierczyk-Droszcz, Anna Klisiewicz, Aleksandra Wróbel, Anna Lutyńska, Monika Gawor, Julita Niewiadomska et al. "Galectin-3 plasma levels in adult congenital heart disease and the pressure overloaded right ventricle: reason matters". Biomarkers in Medicine 14, n.º 13 (setembro de 2020): 1197–205. http://dx.doi.org/10.2217/bmm-2020-0250.
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Aim: To assess galectin-3 (Gal-3) levels and their relationship with clinical status and right ventricular (RV) performance in adults with RV pressure overload of various mechanisms due to congenital heart disease. Materials & methods: A cross-sectional study was conducted. Patients underwent clinical examination, blood testing and transthoracic echocardiography. Results: The study included 63 patients with congenitally corrected transposition of the great arteries, 41 patients with Eisenmenger syndrome and 20 healthy controls. Gal-3 concentrations were higher in patients compared with controls (7.83 vs 6.11 ng/ml; p = 0.002). Biomarker levels correlated with age, New York Health Association class, N-terminal probrain natriuretic peptide and RV function only in congenitally corrected transposition of the great arteries patients. Conclusion: Gal-3 profile in congenital heart disease patients and pressure-overloaded RV differs according to the cause of pressure overload.
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Breck, Andrew, Jonathan H. Cantor e Brian Elbel. "Energy contribution of sugar-sweetened beverage refills at fast-food restaurants". Public Health Nutrition 20, n.º 13 (9 de maio de 2017): 2349–54. http://dx.doi.org/10.1017/s1368980017000611.
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AbstractObjectiveTo identify demographic and consumer characteristics associated with refilling a soft drink at fast-food restaurants and the estimated energy content and volume of those refills.DesignLogistic and linear regression with cross-sectional survey data.SettingData include fast-food restaurant receipts and consumer surveys collected from restaurants in New York City (all boroughs except Staten Island), and Newark and Jersey City, New Jersey, during 2013 and 2014.SubjectsFast-food restaurant customers (n 11795) from ninety-eight restaurants.ResultsThirty per cent of fast-food customers ordered a refillable soft drink. Nine per cent of fast-food customers with a refillable soft drink reported refilling their beverage (3 % of entire sample). Odds of having a beverage refill were higher among respondents with a refillable soft drink at restaurants with a self-serve refill kiosk (adjusted OR (aOR)=7·37, P<0·001) or who ate in the restaurant (aOR=4·45, P<0·001). KFC (aOR=2·18, P<0·001) and Wendy’s (aOR=0·41, P<0·001) customers had higher and lower odds, respectively, of obtaining a refill, compared with Burger King customers. Respondents from New Jersey (aOR=1·47, P<0·001) also had higher odds of refilling their beverage than New York City customers. Customers who got a refill obtained on average 29 more ‘beverage ounces’ (858 ml) and 250 more ‘beverage calories’ (1046 kJ) than customers who did not get a refill.ConclusionsRefilling a beverage was associated with having obtained more beverage calories and beverage ounces. Environmental cues, such as the placement and availability of self-serve beverage refills, may influence consumer beverage choice.
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Garfein, R. S., L. Liu, J. Cuevas-Mota, K. Collins, D. G. Catanzaro, F. Muñoz, K. Moser et al. "Evaluation of recorded video-observed therapy for anti-tuberculosis treatment". International Journal of Tuberculosis and Lung Disease 24, n.º 5 (1 de maio de 2020): 520–25. http://dx.doi.org/10.5588/ijtld.19.0456.
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BACKGROUND: Asynchronous video directly observed therapy (VDOT) may reduce tuberculosis (TB) program costs and the burden on patients. We compared VDOT performance across three cities in the United States, each of which have TB incidence rates above the national average.METHODS: Patients aged ≥18 years who are currently receiving directly observed anti-TB treatment were invited to use VDOT for monitoring treatment. Pre- and post-treatment interviews and medical records were used to assess site differences in treatment adherence and patient characteristics and perceptions.RESULTS: Participants were enrolled in New York City, NY (n = 48), San Diego, CA (n = 52) and San Francisco, CA, USA (n = 49). Overall, the mean age was 41 years (range 18–87); 59% were male; most were Asian (45%) or Hispanic/Latino (30%); and 77% were foreign-born. The median fraction of expected doses observed (FEDO) was 88% (IQR 76–96). At follow-up, 97% thought VDOT was “very or somewhat easy to use” and 95% would recommend VDOT to other TB patients. Age, race/ethnicity, annual income, and country of birth differed by city (P < 0.05), but FEDO and VDOT perceptions did not.CONCLUSIONS: TB programs in three large US cities observed a high FEDO using VDOT while minimizing staff time and travel. Similar findings across sites support VDOT adoption by other large, urban TB programs.
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Swearingen, Alyssa, Mary Gao, Pearl Ugwu-Dike, Avani Kolla Patel, Jenne P. Ingrassia, Suzanne Vang, Prince Adotama, Jennifer A. Stein, Soutrik Mandal e David Polsky. "Disparities in the initial presentation of melanoma across two socioeconomically diverse New York City neighborhoods." Journal of Clinical Oncology 42, n.º 16_suppl (1 de junho de 2024): 1593. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.1593.
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1593 Background: Disparities in stage at diagnosis among melanoma patients are often seen between urban and rural communities, with patients in rural areas being diagnosed with more advanced tumors. Factors contributing to the disparities include decreased access to dermatologists in rural areas, and lower socioeconomic status (SES). We investigated urban disparities in melanoma T stage at diagnosis among patients residing in 2 New York City (NYC) neighborhoods of differing SES and receiving care within the NYU Langone Health System. The neighborhoods were: Upper East Side (UES) and Brighton Beach/Coney Island (BB/CI). Methods: We conducted a retrospective chart review (NYU IRB 23-01020) of melanoma patients (N=243) diagnosed from 2018-2022 using ICD-10-CM codes: C43 (malignant melanoma of skin); D03 (melanoma in situ); and Z85.820 (personal history of malignant melanoma of skin). For community-level data we used the American Academy of Dermatology’s “Find a Dermatologist” search function to locate member-dermatologists; New York State Cancer Registry data (2016-2020) to determine annual melanoma incidence; and the United States Census Bureau Public Use Microdata Areas to determine the proportion of Non-Hispanic Whites (NHW), income levels, and educational attainment. The distribution of T stages was compared using a chi-square test. A two-sample test was used to assess equality of proportions. Results: In UES, the annual melanoma incidence was 30.2/100,000 (95% CI: 27.4-33.2); NHW comprised 74.6% of the population; the median household income was $135,820; 78% attained education higher than high school; and there are 190 dermatologists within a 0.5-mile radius. In BB/CI the annual melanoma incidence was 14/100,000 (95% CI: 11.6-16.9); NHW comprised 55.1% of the population; the median household income was $43,118; 46% attained education higher than high school; and there is 1 dermatologist within a 0.5-mile radius. There are 15 dermatologists within a 3.0-mile radius. 155 and 88 patients met inclusion criteria in UES and BB/CI respectively. The distribution of T stages (i.e. Tis to T4) was significantly different between UES and BB/CI with higher proportions of advanced stage tumors in BB/CI (p=0.0002). Specifically, the proportion of (T2+T3+T4) tumors/total melanomas was 35/155 (23%) in UES; and 41/88(47%) in BB/CI (p<0.0001). For reference, the proportion of T2+T3+T4 melanomas in the United States is 30%. Conclusions: We identified substantial disparities in the initial presentation of melanoma in 2 NYC neighborhoods, with proportionately more advanced stage tumors in the community of low educational attainment, less access to dermatologic services, and lesser household income. Neighborhood-based approaches to uncover melanoma disparities can identify areas for community outreach and engagement efforts to improve melanoma awareness and access to dermatologic care.
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Glaser, Allison, Emma Kaplan-Lewis, Ana Ventuneac, Wyley Gates, Michael Cruz, Joaquin Aracena, Diane Tider, Bianca Duah, Judith Aberg e Antonio Urbina. "860. Immediate Access to Post-Exposure Prophylaxis (PEP) Through a 24/7 New York City PEP Hotline". Open Forum Infectious Diseases 5, suppl_1 (novembro de 2018): S20—S21. http://dx.doi.org/10.1093/ofid/ofy209.045.
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Abstract Background Oral post-exposure prophylaxis (PEP) is effective in preventing HIV transmission. To minimize barriers to PEP for New York City (NYC) residents, the Institute for Advanced Medicine (IAM), Mount Sinai Health System, and the NYC Department of Health and Mental Health established a 24-hour 7-days PEP hotline to provide eligible callers with immediate access to PEP and follow-up clinical care. Methods Data from hotline callers (January to December 2017) was analyzed utilizing multivariable logistic regression to determine whether a call resulted in PEP access within 72 hours of exposure by sociodemographic variables and exposure characteristics. We describe transitions from PEP to PrEP (pre-exposure prophylaxis). Results The PEP hotline cohort (n = 1278) was 83% male, 11% female, 1% transgender; 66% LGBTQ and 20% heterosexual; 35% White, 15% Black, 9% Asian; 41% other/unknown; 25% Hispanic; mean age of 30 years (range 14–72). The majority of callers learned about the hotline by Internet search (59%). Mean exposure time prior to call was 31 hours with 57% within 24 hours. Exposures were 98% sexual; 73% anal sex (43% receptive; 30% insertive), 21% vaginal, and 6% other. 63% reported condomless sex and 29% condom failure. 15% of callers reported a partner with HIV. 35% of callers reported alcohol or recreational substances at the time of the exposure. Prior PEP and PrEP use was 20% and 9%, respectively. 91% of callers were eligible for PEP; 69% called afterhours and received a telephone PEP prescription, and 27% called during business hours and were directed to a clinic. Access to PEP within 72 hours of exposure occurred in 1,081 (93%) of eligible callers and within 36 hours in 68%. 90% of callers had confirmed follow-up clinic appointments. Of the 472 callers linked to care at the IAM, 89 (19%) transitioned to PrEP. Conclusion This unique program demonstrates a timely initiative to facilitate PEP access to a diverse cohort with the purpose of mitigating risk from potential exposure to HIV. Further investigation is needed to explore adherence to PEP, follow-up testing results, transitions to PrEP for prevention planning, and coordination of health care and substance use services. Disclosures E. Kaplan-Lewis, Viiv: Consultant, Consulting fee. J. Aberg, Gilead: Research Contractor, Research support. GSK: Research Contractor, Research support. ViiV: Research Contractor, Research support. A. Urbina, Theratechnologies: Scientific Advisor, Consulting fee. ViiV: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Gilead: Scientific Advisor, Consulting fee.
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Abralov, Khakimjon, e Amonjon Alimov. "Short-Term Results of Sinus of Valsalva Aneurysm Repair". World Journal for Pediatric and Congenital Heart Surgery 8, n.º 1 (29 de dezembro de 2016): 13–17. http://dx.doi.org/10.1177/2150135116673809.
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Background: We retrospectively analyzed 65 patients who underwent surgical repair of sinus of Valsalva aneurysm over the last 27 years. Methods: From January 1, 1988, to October 1, 2015, a total of 65 patients with sinus of Valsalva aneurysm underwent surgical repair in our hospital. There were 41 males (63%) and 24 females (37%), and their age ranged from 5 to 50 years (mean 23 ± 10 years, median 21 years). Out of the 65 patients, 45 (69%) had ruptured sinus of Valsalva aneurysm, 46 (70%) had a ventricular septal defect, and 22 (34%) had aortic valve insufficiency. The ruptured sinus of Valsalva was repaired with patch in 12 cases and direct suturing in 33 cases. The aortic valve was replaced in five patients and the aortic root was replaced in five patients. Results: Sixty patients (92%) survived the 30-day operative interval. At one year follow-up, only two patients had complications: infective endocarditis and sepsis, which lead to septic shock (n = 1) and paraprosthetic leakage and mitral valve regurgitation (n = 1). All the other patients were well and in New York Heart Association functional class I or II. Conclusion: In this relatively high-risk population, repair of SVA can be achieved with satisfactory early results.
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SoRelle, J. A., A. Clark, Z. Wang e J. Park. "Multiplex Fragment analysis detects all COVID-19 variants of concern". American Journal of Clinical Pathology 156, Supplement_1 (1 de outubro de 2021): S138. http://dx.doi.org/10.1093/ajcp/aqab191.294.
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Abstract Introduction/Objective The majority of tracking methods have employed whole genome sequencing, which can be very expensive and time consuming. An alternative method has been to use genotyping of specific mutations to identify variants. However, tracking SARS-CoV-2 variants by targeted methods has been a moving target. Most methods only multiplex four targets per reaction, but we have multiplexed 8 targets in a single tube using fragment analysis. Methods/Case Report Fluorescently labeled primers targeted a combination of insertion/ deletion mutations and single nucleotide mutations. The PCR amplified products, amplicons, were separated by capillary electrophoresis. Primers were designed to detect changes in size indicative of insertion or deletion mutations including: ORF1A:Del3675_3677, S:Del69_70, S:Del144, S:Del157_158, S:Del242_244, ORF8:Del119_120, and ORF8:ins28269-28273. Allele-specific primers were designed to detect both the wild-type and mutated versions of S:N501Y, S:E484K, and S:L452R. Residual nasopharyngeal and nasal specimens testing positive for SARS-CoV-2 by RT-PCR or isothermal amplification (IDnow) methods were selected from May 1- June 24, 2021. Variant analysis was performed by multiplex targeted PCR and whole genome sequencing in parallel on the same specimens to determine positive percent agreement. Results (if a Case Study enter NA) Variant analysis was performed on 250 specimens detecting each of the major variants of concern Alpha (B.1.1.7, U.K. origin, n= 108), Beta (B.1.351, South Africa origin, n=3), Gamma (P.1, Brazil origin, n=12), Delta (B.1.617.2, Indian origin, n=17), and Iota (B.1.526, New York, n=5). Some specimens with low viral load were detected by only PCR (n=18), only WGS (n=41), or neither (n=20). Overall positive percent agreement was 95% (163/171). Conclusion This adjustable method robustly and accurately identifies COVID-19 VOCs utilizing a platform amenable to multiple targets (20-40 targets ranging from 100-500b.p. across four fluorescent channels) using equipment commonly found in routine molecular pathology laboratories. Future directions include adjusting targets to detect new variants.
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Scholz, Christin, Elisa C. Baek, Matthew Brook O’Donnell, Hyun Suk Kim, Joseph N. Cappella e Emily B. Falk. "A neural model of valuation and information virality". Proceedings of the National Academy of Sciences 114, n.º 11 (27 de fevereiro de 2017): 2881–86. http://dx.doi.org/10.1073/pnas.1615259114.
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Information sharing is an integral part of human interaction that serves to build social relationships and affects attitudes and behaviors in individuals and large groups. We present a unifying neurocognitive framework of mechanisms underlying information sharing at scale (virality). We argue that expectations regarding self-related and social consequences of sharing (e.g., in the form of potential for self-enhancement or social approval) are integrated into a domain-general value signal that encodes the value of sharing a piece of information. This value signal translates into population-level virality. In two studies (n = 41 and 39 participants), we tested these hypotheses using functional neuroimaging. Neural activity in response to 80 New York Times articles was observed in theory-driven regions of interest associated with value, self, and social cognitions. This activity then was linked to objectively logged population-level data encompassing n = 117,611 internet shares of the articles. In both studies, activity in neural regions associated with self-related and social cognition was indirectly related to population-level sharing through increased neural activation in the brain's value system. Neural activity further predicted population-level outcomes over and above the variance explained by article characteristics and commonly used self-report measures of sharing intentions. This parsimonious framework may help advance theory, improve predictive models, and inform new approaches to effective intervention. More broadly, these data shed light on the core functions of sharing—to express ourselves in positive ways and to strengthen our social bonds.
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Satlin, Michael J., Christine J. Kubin, Jill S. Blumenthal, Andrew B. Cohen, E. Yoko Furuya, Stephen J. Wilson, Stephen G. Jenkins e David P. Calfee. "Comparative Effectiveness of Aminoglycosides, Polymyxin B, and Tigecycline for Clearance of Carbapenem-Resistant Klebsiella pneumoniae from Urine". Antimicrobial Agents and Chemotherapy 55, n.º 12 (3 de outubro de 2011): 5893–99. http://dx.doi.org/10.1128/aac.00387-11.
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ABSTRACTCarbapenem-resistantKlebsiella pneumoniae(CRKP) is an increasingly common cause of health care-associated urinary tract infections. Antimicrobials within vitroactivity against CRKP are typically limited to polymyxins, tigecycline, and often, aminoglycosides. We conducted a retrospective cohort study of cases of CRKP bacteriuria at New York-Presbyterian Hospital from January 2005 through June 2010 to compare microbiologic clearance rates based on the use of polymyxin B, tigecycline, or an aminoglycoside. We constructed three active antimicrobial cohorts based on the active agent used and an untreated cohort of cases that did not receive antimicrobial therapy with Gram-negative activity. Microbiologic clearance was defined as having a follow-up urine culture that did not yield CRKP. Cases without an appropriate follow-up culture or that received multiple active agents or less than 3 days of the active agent were excluded. Eighty-seven cases were included in the active antimicrobial cohorts, and 69 were included in the untreated cohort. The microbiologic clearance rate was 88% in the aminoglycoside cohort (n= 41), compared to 64% in the polymyxin B (P= 0.02;n= 25), 43% in the tigecycline (P< 0.001;n= 21), and 36% in the untreated (P< 0.001;n= 69) cohorts. Using multivariate analysis, the odds of clearance were lower for the polymyxin B (odds ratio [OR], 0.10;P= 0.003), tigecycline (OR, 0.08;P= 0.001), and untreated (OR, 0.14;P= 0.003) cohorts than for the aminoglycoside cohort. Treatment with an aminoglycoside, when activein vitro, was associated with a significantly higher rate of microbiologic clearance of CRKP bacteriuria than treatment with either polymyxin B or tigecycline.
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Harvey, Ben-Gary, Yael Strulovici-Barel, Robert J. Kaner, Abraham Sanders, Thomas L. Vincent, Jason G. Mezey e Ronald G. Crystal. "Risk of COPD with obstruction in active smokers with normal spirometry and reduced diffusion capacity". European Respiratory Journal 46, n.º 6 (5 de novembro de 2015): 1589–97. http://dx.doi.org/10.1183/13993003.02377-2014.
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Smokers are assessed for chronic obstructive pulmonary disease (COPD) using spirometry, with COPD defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as airflow limitation that is not fully reversible with bronchodilators. There is a subset of smokers with normal spirometry (by GOLD criteria), who have a low diffusing capacity of the lung for carbon monoxide (DLCO), a parameter linked to emphysema and small airway disease. The natural history of these “normal spirometry/low DLCO” smokers is unknown.From a cohort of 1570 smokers in the New York City metropolitian area, all of whom had normal spirometry, two groups were randomly selected for lung function follow-up: smokers with normal spirometry/normal DLCO (n=59) and smokers with normal spirometry/low DLCO (n=46). All had normal history, physical examination, complete blood count, urinalysis, HIV status, α1-antitrypsin level, chest radiography, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio and total lung capacity. Throughout the study, all continued to be active smokers.In the normal spirometry/normal DLCO group assessed over 45±20 months, 3% developed GOLD-defined COPD. In contrast, in the normal spirometry/low DLCO group, followed over 41±31 months, 22% developed GOLD-defined COPD.Despite appearing “normal” according to GOLD, smokers with normal spirometry but low DLCO are at significant risk of developing COPD with obstruction to airflow.
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Refaai, Majed A., Kelly F. Henrichs, Joanna M. Heal, Amy E. Schmidt, Jason H. Mendler, Scott A. Kirkley, Christopher Aquina, Debra Masel, Jane Liesveld e Neil Blumberg. "ABO Identical and Washed Transfusions Are Candidate Strategies to Reduce Early Mortality in Acute Promyelocytic Leukemia (APL)". Blood 128, n.º 22 (2 de dezembro de 2016): 4011. http://dx.doi.org/10.1182/blood.v128.22.4011.4011.
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Abstract Background: Despite dramatically improved long term outcomes seen with all-trans retinoic acid therapy in APL, early mortality remains a substantial challenge. Recent data from a single center (Haematologica 2012; 97:133) and the Surveillance, Epidemiology and End Results (SEER) registry (Blood 2011; 118: 1248) report 30 day mortality rates of 26% (n = 18 of 70) and 17% (n = 238 of 1400), respectively. Early deaths are predominately due to hemorrhage. Patients with APL invariably have abnormal laboratory hemostasis tests. The standard of practice is to prophylactically transfuse platelets, plasma and cryoprecipitate to mitigate abnormal platelet counts, PT/PTT and fibrinogen levels. Standard blood bank practice is to transfuse platelets, plasma and cryoprecipitate either without regard to ABO blood group (platelets, cryoprecipitate), or, in some centers, transfusing non-identical universal donor group AB plasma. Evidence from observational studies demonstrate that use of ABO non-identical blood components is associated with increased bleeding. Formation of immune complexes containing ABO antibody, soluble and cellular antigens causes derangement of in vitro measures of platelet function and whole blood clotting. We hypothesized that use of ABO identical blood components and saline washed transfusions (red cells and platelets) would be associated with reduced early mortality in APL by avoidance of transfusion induced hemostatic dysfunction. Methods: This is a single center cohort study of APL patients treated in an 800 bed university community and referral hospital. Novel approaches to transfusion support, based upon randomized trials, have included implementation of ABO identical platelet transfusions for all patients with acute leukemia in 1990, use of only ABO identical cryoprecipitate in 2005, and washed transfusions of red cells and platelets for all patients with acute leukemia <50 years of age beginning in 2006. Plasma transfusion has always been ABO identical. Two comparison populations were recent literature reports and the New York State Cancer Registry. We characterized 30 day mortality in APL patients seen in our institution since 2000 as a convenience sample comparable to literature reports, beginning roughly when ATRA therapy became uniform for induction therapy. Only patients receiving their induction therapy in our hospital were included. Results: Of 41 patients we had 2 early (30 day) deaths (5%; a 71-81% reduction from expected). Early mortality at 100 days was 7% (n = 3). The 30 day mortality in the younger cohort <50 years of age (n = 16) receiving washed transfusions was 0%. Restricting the analysis to patients treated since 2006 (ABO identical transfusions; mostly washed) (n=27; mean age: 43 years; median: 41 years; range: 12 to 79), the early mortality rate at 30 days was 3.7%. Long-term survival (5 years) of our APL patients was similar to New York State Cancer Registry and literature reports (80-83%). Discussion: Patients treated with transfusion regimens including ABO identical blood components, with or without washing, experienced early mortality at 30 days that was strikingly better (reduced by 71% to 86%) than that reported in the recent literature (3.7% to 5% vs. 17% to 26%). If these observed reductions in early mortality are causal, the avoidance of ABO immune complex induced derangements in hemostasis are a plausible contributing mechanism. These promising results provide a rationale for randomized trials of relatively simple and inexpensive approaches to reducing early hemorrhagic mortality in APL: use of ABO identical transfusions and washing to remove supernatant plasma. Disclosures Blumberg: Biomet/Citra Labs: Consultancy, Honoraria.
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Gammie, James S., Krzysztof Bartus, Andrzej Gackowski, Piotr Szymanski, Agata Bilewska, Mariusz Kusmierczyk, Boguslaw Kapelak et al. "Safety and performance of a novel transventricular beating heart mitral valve repair system: 1-year outcomes". European Journal of Cardio-Thoracic Surgery 59, n.º 1 (10 de outubro de 2020): 199–206. http://dx.doi.org/10.1093/ejcts/ezaa256.
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Abstract OBJECTIVES The objective of this study was to evaluate the safety and performance of a novel, beating heart procedure that enables echocardiographic-guided beating heart implantation of expanded polytetrafluoroethylene (ePTFE) artificial cords on the posterior mitral leaflet of patients with degenerative mitral regurgitation. METHODS Two prospective multicentre studies enrolled 13 (first-in-human) and 52 subjects, respectively. Patients were treated with the HARPOON beating heart mitral valve repair system. The primary (30-day) end point was successful implantation of cord(s) with mitral regurgitation reduction to ≤moderate. An independent core laboratory analysed echocardiograms. RESULTS Of 65 patients enrolled, 62 (95%) achieved technical success, 2 patients required conversion to open surgery and 1 procedure was terminated. The primary end point was met in 59/65 (91%) patients. Among the 62 treated patients, the mean procedural time was 2.1 ± 0.5 h. Through discharge, there were no deaths, strokes or renal failure events. At 1 year, 2 of the 62 patients died (3%) and 8 (13%) others required reoperations. At 1 year, 98% of the patients with HARPOON cords were in New York Heart Association class I or II, and mitral regurgitation was none/trace in 52% (n = 27), mild in 23% (n = 12), moderate in 23% (n = 12) and severe in 2% (n = 1). Favourable cardiac remodelling outcomes at 1 year included decreased end-diastolic left ventricular volume (153 ± 41 to 119 ± 28 ml) and diameter (53 ± 5 to 47 ± 6 mm), and the mean transmitral gradient was 1.4 ± 0.7 mmHg. CONCLUSIONS This initial clinical experience with the HARPOON beating heart mitral valve repair system demonstrates encouraging early safety and performance. Clinical registration numbers NCT02432196 and NCT02768870.
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Olayinka, Olaniyi, Ayotomide Oyelakin, Karthik Cherukupally, Inderpreet Virk, Chiedozie Ojimba, Susmita Khadka, Alexander Maksymenko et al. "Use of Long-Acting Injectable Antipsychotic in an Inpatient Unit of a Community Teaching Hospital". Psychiatry Journal 2019 (13 de junho de 2019): 1–5. http://dx.doi.org/10.1155/2019/8629030.
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Background. Individuals with Schizophrenia Spectrum Disorders (SSD) often experience significant impairment in educational, occupational, and psychosocial functioning. The clinical benefit of long-acting injectable antipsychotics (LAIs) in the management of patients with SSD is well established. SSD patients who are nonadherent to treatment have lower disease relapse and readmission rates when prescribed a LAI, compared to oral antipsychotics. Despite the reported advantages of LAIs, their prescription rates in clinical settings remain low. This pilot study aimed to determine the pattern of LAI prescription in psychiatric inpatients of a teaching community hospital in Brooklyn, New York. Methods. A retrospective review of the charts of patients discharged from the psychiatric units of the hospital from September 1, 2017, through September 30, 2017, was conducted. Frequencies and proportions for demographic and disease-related characteristics were calculated. Pertinent continuous variables were recoded into categorical variables. Chi-square-tests or Fisher’s exact tests were performed for categorical variables. The one-sample Shapiro-Wilk test (for sample size < 50) was used to check for the normality of distribution of continuous variables. Statistical significance was defined as p ≤ 0.05. Results. Forty-three (70%) of the patients discharged from the inpatient unit during the study period had SSD and were eligible for a LAI. Their ages ranged from 20 to 71 years (mean = 41 years), and more than two-thirds were male. Less than half of the eligible patients (n = 19; 44%) were prescribed a LAI, most of whom were male (n=16; 84%). An association between age group (patients aged 41 years or younger) and LAI use was observed (p < 0.05), while gender, employment status, living arrangement, length of hospital stay, recent hospitalization, and cooccurring substance use disorder were not. Conclusion. LAI prescription rate at the inpatient psychiatric unit of the hospital was marginally higher than those reported in most studies. Age appears to influence LAI use during the study period. Initiatives that increase LAI prescription rate for all eligible patients admitted to inpatient psychiatric unit should be encouraged.
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Mdivani, M. O., e E. V. Lidskaya. "The Russian Version of the Short Gender Role Beliefs Scale (GRBS)". Social Psychology and Society 11, n.º 3 (2020): 185–95. http://dx.doi.org/10.17759/sps.2020110312.
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Objective. Translation, adaptation and psychometric verification of the 10-item Gender Role Beliefs Scale for Russian-speaking respondents. Background. A short version of GRBS was developed in 2012 by American psychologists M. Brown and N. Gladstone from New York University. The basis was the popular questionnaire of gender roles, de¬veloped in 1996. M. Brown and N. Gladstone reduced it to 10 items and tested it for reliability and validity. Study design. The study was conducted on the Internet based on self-selected Web surveys and subsequent sampling. Participants. The sample included 400 respondents (41% of men and 59% of women). Half of the respondents were middle-aged Russians, from 26 to 35 years old, 66% of the respondents had higher education. Measurements. For data processing, factor and descriptive analysis and suitability analysis of the scale (a Cronbach) were used. For statistical data processing, the IBM SPSS Statistics 22 program was used. Results. The results showed an identity of the factor structure with the original and sufficient consistency of the Russian version of the scale. The Russian version also showed a sufficient level of construct validity. Conclusions. A short scale of gender role beliefs can be used in the study of traditional ideology about the roles of men and women existing in modern society. The shortness of the scale allows to include it in a series of other questionnaires and conduct online research on large samples.
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Rankin, J. Scott, Domenico Mazzitelli, Theodor Fischlein, Yeong-Hoon Choi, Jan Pirk, Steffen Pfeiffer, Lawrence M. Wei e Vinay Badhwar. "Geometric Ring Annuloplasty for Aortic Valve Repair during Aortic Aneurysm Surgery". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 13, n.º 4 (julho de 2018): 248–53. http://dx.doi.org/10.1097/imi.0000000000000539.
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Objective An aortic annuloplasty ring could be useful for aortic valve repair. This trial evaluated intermediate-term outcomes of internal geometric ring annuloplasty for repair of trileaflet and bicuspid aortic insufficiency associated with ascending aortic and/or aortic root aneurysms. Methods Under regulatory supervision, 47 patients with aortic insufficiency and ascending aortic (n = 22) and/or aortic root (n = 25) aneurysms were managed with aortic valve repair and aneurysm resection. Valve repair was performed using trileaflet (n = 40) or bicuspid (n = 7) internal geometric rings, together with leaflet reconstruction. Ascending aortic and/or remodeling root replacements were accomplished with Dacron grafts 5 to 7 mm larger than the rings. An Echo Core Lab provided independent echocardiographic assessments, and changes over time were evaluated by Friedman tests. Results Mean ± SD age was 60 ± 14 years, 57% (27/47) were male, 15% (7/47) had bicuspid valves, 87% (41/47) had moderate-to-severe aortic insufficiency, and 13% (6/47) had mild aortic insufficiency. All patients had annular dilatation, with a mean ± SD of 26.5 ± 2.6 mm before repair, and mean ± SD ring sizes were 21.7 ± 1.7 mm. Follow-up was 42 months (mean = 27 months). No operative mortality or valve-related complications occurred. Two patients died beyond 1 year from nonvalve-related causes. One patient required valve replacement for repair failure. Survival free of complications or valve replacement was 94% at 2 years. Significant reduction in aortic insufficiency and New York Heart Association class were observed ( P < 0.0001), and valve gradients remained low. No heart block or direct ring complications occurred. Conclusions In preliminary regulatory studies, aortic ring annuloplasty seemed safe and effective during aortic aneurysm surgery. This approach could help standardize aortic valve repair.
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Maurer, Susanne J., Lorena Moosholzer, Claudia Pujol, Nicole Nagdyman, Peter Ewert e Oktay Tutarel. "Complete Atrioventricular Septal Defects after the Age of 40 Years". Journal of Clinical Medicine 10, n.º 16 (19 de agosto de 2021): 3665. http://dx.doi.org/10.3390/jcm10163665.
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Background: There is an increasing number of adults with complete atrioventricular septal defects (cAVSD). However, data regarding older adults are lacking. The aim of this study is to analyze the outcome of adults with cAVSD over the age of 40 years. Methods: Patients with cAVSD who were ≥40 years of age at any point between 2005 until 2018 were included retrospectively. Data were retrieved from hospital records. The primary endpoint was a combination of death from any cause and unplanned hospitalizations due to cardiac reasons. Results: 43 patients (60.5% female, mean age 43.7 ± 6.0 years, genetic syndrome 58.1%) were included. At begin of follow-up, the majority of patients (n = 41, 95.3%) was in New York Heart Association (NYHA) class I or II. Out of the whole cohort 26 (60.5%) had undergone cardiac surgery. At baseline, at least one extracardiac comorbidity was present in 40 patients (93.0%). Median follow-up was 1.7 years (IQR 0.3–4.6). On univariate Cox analysis, NYHA class at begin of follow-up (hazard ratio: 1.96, CI 95%: 1.04–3.72, p < 0.05) was the only predictor for the primary endpoint. Conclusions: Significant morbidity and mortality is present in cAVSD patients over the age of 40 years. NYHA class is predictive for a worse outcome.
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Frankenstein, Lutz, Andrew Remppis, Joerdis Frankenstein, Georg Hess, Dietmar Zdunek, Karen Slottje, Hugo A. Katus e Christian Zugck. "Variability of N-Terminal Probrain Natriuretic Peptide in Stable Chronic Heart Failure and Its Relation to Changes in Clinical Variables". Clinical Chemistry 55, n.º 5 (1 de maio de 2009): 923–29. http://dx.doi.org/10.1373/clinchem.2008.112052.
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Abstract Background: We investigated the variability of N-terminal probrain natriuretic peptide (NT-proBNP) and its relation to known confounding variables in patients with stable chronic heart failure who were on a stable optimized medication regimen. Methods: At 4 sampling intervals (14-day, 1-month, 2-month, and 3-month) the results for NT-proBNP measurements and several clinical variables were measured in samples from 41 patients with chronic systolic dysfunction who met 21 prespecified criteria for stability. Results: Mean within-person NT-proBNP variabilities expressed as percentage CV were 17.6%, 18.9%, 15.5%, and 16.2% at 14-day, 1-month, 2-month, and 3-month follow-up, respectively, and the corresponding reference change values were 34.6%, 52.5%, 43.1%, and 45.0%, respectively. Within-person variability of NT-proBNP was not found to be associated with renal function, weight, or waist circumference. Likewise, age, sex, baseline NT-proBNP, New York Heart Association functional class, and ejection fraction did not influence variability of NT-proBNP. The index of individuality ranged from 0.07–0.15 depending on the time interval between test results. Conclusions: Although other reported studies have revealed variations in the range of 80%, in this prespecified stable heart-failure population variation of NT-proBNP at 14-day, 1-month, 2-month, and 3-month follow-up was lower and was not related to renal function or weight. In view of the low index of individuality we observed, within-person variation is quite low compared to between-person variation. Consideration of these facts is important for the interpretation of clinical trials and the use of NT-proBNP in monitoring patients with heart failure.
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Demus, Dietrich. "Ettore Majorana International Science Series, Physical Sciences, Vol. 41 Progress in Microemulsions. Herausgegeben von S. Martellucci, A. N. Chester; New York, London, Plenum Press, 1989; 290 Seiten; 75,- $; ISBN 0-306-43212-9". Zeitschrift für Chemie 30, n.º 5 (31 de agosto de 2010): 191. http://dx.doi.org/10.1002/zfch.19900300528.
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Sakata, Yasuhiko, Satoshi Miyata, Kotaro Nochioka, Masanobu Miura, Takashi Shiroto e Hiroaki Shimokawa. "Sex Differences in Patients With Chronic Heart Failure With Reference to Left Ventricular Ejection Fraction". Gender and the Genome 2, n.º 1 (janeiro de 2018): 27–42. http://dx.doi.org/10.1177/2470289718787115.
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Background: Data on sex differences in heart failure (HF) with reference to left ventricular ejection fraction (LVEF) are limited. Methods and Materials: We examined 4683 consecutive patients (mean 69 years) with HF in the CHART-2 study. Results: Compared to men (N = 3188), women with HF (N = 1495) were older and had a lower prevalence of ischemic heart disease and cancer, received less implementation of evidence-based treatment, and were characterized by more severe HF in terms of higher New York Heart Association (NYHA) functional class and increased brain natriuretic peptide (BNP) levels, despite greater preservation of LVEF. During the median 6.3-year follow-up, all-cause mortality was comparable between women and men (32.8% vs 33.2%, P = .816), while women had higher cardiovascular mortality, particularly among those with LVEF ≥50%. Although no sex differences existed in cause of death among patients with LVEF ≤ 40% and 41% to 49%, women had a higher proportion of cardiovascular death and lower proportion of noncardiovascular death than men among those with LVEF ≥ 50%. Multivariable Cox regression models showed that women with HF had reduced risk of both cardiovascular and noncardiovascular death, regardless of LVEF category. Beta-blockers were associated with improved mortality in women but not men with LVEF ≤ 40%, while renin–angiotensin system inhibitors were not associated with improved mortality in women with LVEF ≥ 50% but were in men. Conclusion: In addition to sex-specific differences in the age of onset, etiology and response to treatment, women with heart failure and preserved left ventricular ejection fraction (LVEF ≥ 50%) have higher cardiovascular mortality than men. Sex-related management of congestive heart failure should include a consideration of LVEF.
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LaNatra, N., H. Hochster, F. Muggia, S. V. Blank, J. Curtin, D. Fishman, I. E. Shapira, G. L. Goldberg, S. Parise e A. Tiersten. "Oxaliplatin plus continuous infusion topotecan: First stage of an ongoing phase II study for recurrent ovarian cancer: A New York Cancer Consortium study (#N01-CM62204)". Journal of Clinical Oncology 27, n.º 15_suppl (20 de maio de 2009): 5556. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.5556.
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5556 Background: Topoisomerase-1 inhibitors and platinums are active in ovarian cancer. Our prior series described infusional topotecan as less myelosuppressive than bolus and more easily combined with oxaliplatin than cisplatin. An NYU phase I study of the combination in previously treated ovarian cancer patients (pts) showed promising activity and good tolerability (Hochster H, Gynecol Oncol 2008). Methods: Ovarian cancer pts treated with 1–2 prior regimens (1 platinum/taxane regimen, no topotecan) were treated with oxaliplatin 85 mg/m2 day 1, 15 and topotecan (0.4 mg/m2/day) continuous infusion x 14 days every 4 weeks (wks). Platinum resistant (stratum I = 10) and sensitive (stratum II = 17) pts are included in this two-stage trial (n = 52) to evaluate overall response rate (ORR) and toxicities. Results: From January 2006 to November 2008, 27 pts entered. Median age was 61 (37–79). Fifteen pts had 1 prior regimen and 12 pts had 2. Five pts discontinued before 2 cycles (3 for predefined toxicity, 2 by pt/physician choice). 102 cycles of chemotherapy were given (median 4, [1–6]). Grade 3/4 toxicities included thrombocytopenia (37% grade 3, 19% grade 4), neutropenia (37% grade 3, 11% grade 4), anemia (15% grade 3), neuropathy (7% grade 3), diarrhea (4% grade 3), transaminitis (4% grade 3), and fatigue (7% grade 3). Twenty-one pts had day 15 oxaliplatin held, 10 pts required dose reductions, and 21 pts had treatment delays mainly from thrombocytopenia. No pts had neutropenic fever. Twenty-one pts are now evaluable. Stratum I had 1 complete and no partial responses, 5 pts with stable disease and 2 with progressive disease. Stratum II had 3 complete and 6 partial responses, 4 pts with stable disease and none progressed. Median response duration is 41 wks (17–62); median duration of stable disease is 17 wks (4–70). Conclusions: Excluding thrombocytopenia, tolerance to this regimen confirms phase I results. In pts with creatinine clearances (CrCl) < 60 ml/min, the incidence of grade 3/4 thrombocytopenia was 75% versus 35 % for pts with CrCl > 60 ml/min. Pts with CrCl of 40–60 ml/min will now start topotecan 0.3 mg/m2/day x 14 days. Reaching our predefined ORR of at least 30% for stratum II and 20% for stratum I, the second stage of accrual has begun. [Table: see text]
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Rodríguez, Yésica. "Kierkegaard y Kant: educación para la ética". Trilhas Filosóficas 11, n.º 1 (26 de junho de 2018): 125–54. http://dx.doi.org/10.25244/tf.v11i1.3036.
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Resumen: El presente artículo pretende realizar una aproximación entre los pensamientos éticos de Kant y Kierkegaard concentrándonos en los conceptos de educación y libertad. Para ello pondremos foco en el pensamiento práctico desarrollado por el filósofo alemán en el año 1790, al cual denominamos la segunda ética kantiana, y en la primera autoría kierkegaardiana, es decir, O lo uno o lo otro (1843) y El concepto de angustia (1844). Consideramos que estos dos periodos, en ambos autores, nos brindan la posibilidad de encontrar puntos de contactos que nos permiten sostener que la ética que Kierkegaard tiene en mente para estas obras es el pensamiento moral desarrollado por Kant en este periodo.Palabras claves: Kant. Kierkegaard. Libertad. Educación. ÉticaAbstract: The present article intends to make an approximation between the ethical thoughts of Kant and Kierkegaard concentrating on the concepts of education and freedom. For this we will focus on the practical thought developed by the German philosopher in the year 1790, which we call the second Kantian ethic, and in the first Kierkegaardian authorship, that is, Either/Or (1843) and The Concept of Anxiety (1844). We consider that these two periods, in both authors, give us the possibility of finding points of contact that allow us to maintain that the ethics that Kierkegaard has in mind for these works is the moral thought developed by Kant in this period.Keywords: Kant. Kierkegaard. Freedom. Education. Ethics Resumo: O presente artigo pretende fazer uma aproximação entre os pensamentos éticos de Kant e Kierkegaard concentrando-se nos conceitos de educação e liberdade. Para isso, vamos nos concentrar no pensamento prático desenvolvido pelo filósofo alemão no ano de 1790, que chamamos a segunda ética kantiana, e na primeira autoria de kierkegaardiana, ou seja, Ou/Ou (1843) e O conceito de Angústia (1844). Consideramos que esses dois períodos, em ambos os autores, nos darão a possibilidade de encontrar pontos de contato que nos permitam sustentar que a ética que Kierkegaard tem em mente para essas obras é o pensamento moral desenvolvido por Kant nesse período.Palavras-chave: Kant. Kierkegaard. Liberdade. Educação. Ética REFERENCIASALLISON, Henry. Kant's Theory of Freedom. Cambridge: Cambridge University Press, 1995.ASSISTER, Alison. Kant and Kierkegaard on Freedom and Evil. In: International Journal for Philosophy of Religion, Vol. 72 (April 1996), pp 275-296.DI GIOVANNI, George. Freedom and religion in Kant and his immediate successors: The vocation of mankind, 1774–1800. Cambridge: Cambridge University Press, 2005.DIP, Patricia. Judge William: the Limits of the ethical. In: Kierkegaard Research: Sources, Reception and Resources, Volume 17, Katalin Nun,Jon Stewart (Eds.), London-New York, Routledge, 2016.FOUCAULT, Michel. Una lectura de Kant: Introducción a la antropología en sentido pragmático. Traducción Ariel Dilon. Buenos Aires: Siglo veintiuno, 2013.FREMSTEDAL, Roe. Kierkegaard and Kant on Radical Evil and the Highest Good. Virtue, Happiness, and the kingdom of God, New York: Palgrave Macmillan , 2014._______. The concept of the highest good in Kierkegaard and Kant. Int J Philos Relig (2011) 69:155–171._______. The moral argument for the existence of God and immorality. Kierkegaard and Kant. Journal of Religious Ethics, Inc, JRE 41. (2013), pp. 50–78._______. The Moral Makeup of the World: Kierkegaard and Kant on the Relation between Virtue and Happiness in this World. Kierkegaard Studies Yearbook. N° 1 (2012), pp. 25-47.FRIEDMAN, R. Kant and Kierkegaard: the limits of the Reason and the cunning of faith. International Journal for Philosophy of Religion, 19:3-22, pp. 3-22. _______. Kierkegaard: First Existentialist or last Kantian?. Religious Studies, Cambridge University Press, Vol. 18, Nº 2 (1982), pp. 159-170.FRIERSON, Patrick. R. Freedom and anthropology in Kant’s moral philosophy. Cambridge: Cambridge University Press, 2003.GOUWENS, David. Kierkegaard as religious thinker. Cambridge: University Press, USA, 1996.GREEN, Ronald. Kant und Kierkegaard.The Hidden Debt. New York: State University New York Press, 1992.HELLER, Ágnes. Crítica a la Ilustración. Traducción Gustau Muñoz y José Ignacio López Soria. Barcelona: Ediciones Península, 1999.HEIDEGGER, Martin. Kant y el problema de la metafísica. Traducción Gred Ibscher Roth. México: Fondo de cultura económica, 2013.KANT, Immanuel. Antropología en sentido pragmático. Traducción José Gaos. México: Fondo de Cultura Económica, 2014._______. La metafísica de las Costumbres. Traducción Adela Cortina Orts y Jesús Cornill Sancho. Madrid: Tecnos, 1994._______. Pedagogía. Traducción Lorenzo Luzuriaga y José Luis Pascal, Madrid: Akal, 2003.KIERKEGAARD, Soren. O lo uno o lo otro I. Traducción Bogonya Saez Tajafuerce y Darío González. Madrid: Trotta, 2006._______. O lo uno o lo otro II. Traducción Darío González. Madrid: Trotta, 2007._______. El concepto de angustia. Traducción Darío González y Óscar Parcero. Madrid: Trotta, 2013._______. En la espera de la fe, Traducción Luis Guerrero Martínez y Leticia Valadez. México: Universidad Iberoamericana, 2005.KNAPPE, Ulrich. Theory and practice in Kant and Kierkegaard. (Kierkegaard studies. Monograph serie; 9), Copenhagen: Søren Kierkegaard Research Centre, 2004.KOSCH, Michelle. Freedom And Reason in Kant, Schelling and Kierkegaard. New York: Oxford University Press, 2006._______. Choosing Evil: Schelling, Kierkegaard, and the legacy of Kant's conception of Freedom. (Dissertation Philosophy). New York: Columbia University, 1999.LÖWITH, Karl. De Hegel a Nietzsche: La quiebra revolucionaria del pensamiento en el siglo XIX. Trad. Emilio Estiú. Buenos Aires: Katz, 2012.MOONEY, Edward. On Soren Kierkegaard, Dialogue, polemics, Lost Intimacy, and Time. Syracusa, Ashgate, 2007.MUENCH, Paul. Kierkegaard’s Socratic Task. (Dissertation). University of Pittsburgh, 2006.MUÑOZ FONNEGRA, Sergio. La elección ética. Sobre la crítica de Kierkegaard a la filosofía moral de Kant. Estudios filosóficos, Universidad de Antioquia, n. 41, pp. 81-109, 2010.NAES, Arnes. Kierkegaard and the values of education: Contribution to the Kierkegaard Conference of the International Institute of Philosophy, Copenhagen, 1966.NEGT, Oskar. Kant y Marx. Un diálogo entre épocas. Traducción Alejandro del Río. Madrid: Trotta, 2004.OLIVARES-BØGESKOV, Benjamín. El concepto de felicidad en las obras de Søren Kierkegaard: principios psicológicos en los estadios estéticos, ético y religioso. México: Universidad Iberoamericana, 2015._______. El concepto de felicidad en el estadio ético. La integración de la estética en la vida ética. La Mirada Kierkegaardiana. Nº 0, pp. 43-64, 2008.PECK, William. On Autonomy: The Primacy of the Subject in Kant and Kierkegaard. (Ph. D. Dissertation). Connecticut: Yale University, 1974.RODRÍGUEZ, Pablo. El descubrimiento de la libertad infinita. Kierkegaard y el pecado. El títere y el enano. Revista de Teología Crítica, Vol. 1, ISSN N°: 1853 – 0702, pp. 207-216, 2010.RODRÍGUEZ, Yésica; RODRÍGUEZ, Pablo; PEÑA ARROYAVE, Alejandro. El concepto de aburrimiento en Kierkegaard. Revista de Filosofía. Universidad Iberoamericana. Año 49, N° 142, ISSN: 0185-3481, pp. 97-118, 2017.RODRÍGUEZ, Yésica. Kierkegaard y Kant. Una interpretación del sí mismo a partir de la segunda ética kantiana. In: DIP, Patricia., RODRÍGUEZ, Pablo (Coord.) Orígenes y significado de la filosofía Poshegeliana. Buenos Aires, Gorla, 2017, pp. 113-139.STACK, George. Kierkegaard's Existential Ethics. Alabama: University of Alabama Press, 1977.TORRALBA, Francesc. Poética de la libertad: Lectura de Kierkegaard. Madrid, Caparrós Editores, 1998.
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Aykanian, Amanda, e Emmy Tiderington. "Health service use after moving on from permanent supportive housing". Housing, Care and Support 26, n.º 2 (17 de agosto de 2023): 53–64. http://dx.doi.org/10.1108/hcs-08-2022-0021.
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Purpose Studies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers’ health service use changes post-move. This paper aims to explore physical and mental health service use over time for participants in New York City’s MOI program. Design/methodology/approach This paper uses data collected at baseline, 12-months post move and 24-months post move to explore patterns in mental and physical health service use and their association with mental and physical health status for participants (N = 41). Health status was measured with the Medical Outcomes Study Short Form Survey Instrument. Findings Three mental health service use patterns emerged: service use at all time points, inconsistent service use across time points and no service use at any time point. Significant group differences in mental health were found at baseline and 12 months. Two physical health service use patterns emerged: service use at all three time points and inconsistent service use across time points. Significant group differences were found in mental health at 12 and 24 months. Originality/value This study showed that physical and mental health service use varied slightly over time for participants, with the majority of service use being for outpatient/non-acute care. The findings also point to possible relationships between service use and mental health status. Positive and negative implications of these findings are framed within the broader context of PSH and MOI goals.
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Guidry, Albert, Ali Fattom, Atul Patel, Celia O'Brien, Sara Shepherd e Jos Lohuis. "Serotyping scheme for Staphylococcus aureus isolated from cows with mastitis". American Journal of Veterinary Research 59, n.º 12 (1 de dezembro de 1998): 1537. http://dx.doi.org/10.2460/ajvr.1998.59.12.1537.
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Abstract Objective To identify the Staphylococcus aureus capsular serotypes that are not typable, using capsular serotypes 5 and 8, which are currently used to type Saureus isolated from cows with mastitis. Sample Population Milk samples (n = 273) from cows with mastitis in 178 dairy herds in California, Wisconsin, Michigan, Texas, and New York that were collected by state diagnostic laboratories and S aureus-positive milk samples collected by Veterinary Health Services in the United Kingdom (15), France (22), The Netherlands (36), and Germany (21). Procedure Capsular serotyping of coded isolates was performed by use of direct cell agglutination and immunoprecipitation of cell extracts with antisera specific for capsular types 5 and 8 and a newly developed S aureus serotyping antiserum 336. Results In the United States, S aureus capsular types 5 and 8 accounted for 18 and 23% of the isolates, respectively, and type 336 accounted for 59%. Percentage of capsular serotypes in European samples were as follows: type 5 = 34%, type 8 = 34%, type 336 = 30%, and nontypable = 2%. Conclusions Serotypes 5 and 8 accounted for only 41% of S aureus isolates from US milk samples, but accounted for 70% of isolates from European milk samples. Addition of the newly developed serotyping antiserum 336 to the typing scheme accounted for 100% of US samples and 98% of European samples and will enable development of a more comprehensive S aureus vaccine. (Am J Vet Res 1998; 59:1537-1539)
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Brewer, William D. "Maureen N. McLane. Romanticism and the Human Sciences: Poetry, Population, and the Discourse of the Species. (Cambridge Studies in Romanticism 41.) New York: Cambridge University Press. 2000. Pp. x, 282. $54.95. ISBN 0-521-77348-2." Albion 34, n.º 1 (2002): 122–23. http://dx.doi.org/10.2307/4053475.
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Shasha, Daniel, Dorothy Boo, Leora Perlow, Robert Salant e Louis Benjamin Harrison. "Biochemical and functional outcomes of brachytherapy for young men (≤50) with prostate cancer." Journal of Clinical Oncology 31, n.º 6_suppl (20 de fevereiro de 2013): 245. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.245.
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245 Background: NCCN guidelines endorse prognostic risk grouping to select therapy, and lend equal support to surgery and radiation therapy (RT). Despite this, the optimal treatment of prostate cancer in young men remains contentious, with the majority treated surgically. This may be because there are few reports of RT outcomes with long follow-up (FU) in this cohort. Thus, we report long-term biochemical and functional outcomes after prostate brachytherapy (BT) +/- supplemental therapies in men ≤ 50 years old. Methods: With IRB approval we analyzed outcomes of 47 patients ≤ 50 yrs old (median 48, range 48-50) implanted with curative intent by a single physician (DS) at Beth Israel Medical Center (New York City) between 2000-2009. Supplemental external beam therapy (45-50.4 Gy) was delivered to patients with NCCN intermediate risk (IR) and high risk (HR) disease, and to select patients with high volume low risk (LR) disease. Androgen deprivation therapy (ADT) was used in all HR patients, for pre-implant prostate downsizing, and for biopsy demonstrating very high volume disease. Biochemical failure (BF) was defined as “nadir +2.” Genitourinary (GU), gastrointestinal (GI) and erectile functional outcomes are included. Results: Median follow up (FU) was 5.2 yrs (range: 2-11). Only 1 patient experienced BF, thus, overall freedom from BF was 97.9%. Grade 2 acute and late 2 GU toxicity were reported in 10.6 % (n = 5) and 8.5% (n = 4), respectively. Grade 2 proctitis was seen 4.3 % (n=2). Erectile function was preserved in 41 of 47 men (87.2 %) with or without phosphodiesterase-5 inhibitors. Conclusions: With median FU of 5.2 years, excellent biochemical control with minimal toxicity was achieved in men ≤ 50 years old. The finding of only a single patient exhibiting BF over the 11 years of FU in this study is highly encouraging. Erectile preservation rates were high, and acute and late GI and GU toxicity were low. These results support prostate BT as an excellent option for patients in this age group.
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Ylvisaker, Mark, Timothy Feeney e Melissa Capo. "Long-Term Community Supports for Individuals With Co-Occurring Disabilities After Traumatic Brain Injury: Cost Effectiveness and Project-Based Intervention". Brain Impairment 8, n.º 3 (1 de dezembro de 2007): 276–92. http://dx.doi.org/10.1375/brim.8.3.276.
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AbstractOutcome studies have established that successful community living is compromised in the population of individuals with traumatic brain injury and chronic behavioural difficulties along with a co-occurring diagnosis of substance abuse and/or mental health disorder. Two studies are presented. The first was aimed at describing long-term outcome of a sample of individuals (N = 51) served by the New York State Department of Health TBI Medicaid Waiver Program. Each of the participants was diagnosed with TBI plus either substance abuse or a mental health disorder, or both. Because of significant behavioural challenges, all of the participants were in a restrictive living setting the year before enrolment in the waiver program (e.g., nursing or correctional facility). Data on community living arrangement, self-reported community integration experiences, and costs are presented. Results indicate that most of the participants (41 of the 46 who were alive and living in state) continued to live in the community 8 to 9 years after commencement of community support services. The participants' community integration responses were generally positive and cost data demonstrate substantial savings to the state for this cohort. Comparing prewaiver costs in residential settings with most recent (2005) costs for community supports, there was an average daily cost savings of US$137 per person for the 1996 cohort and US$144 per person for the 1997 cohort. The second study explored the use of project-oriented interventions and supports in an agency that provides community support services to this dual diagnosis population. Project-oriented services are described as meeting many needs common to this dual-diagnosis population. Clinical staff (N = 11) and a sample of waiver participants (N = 7) were surveyed. Results suggest that the use of personally meaningful projects can become a clinical habit for staff and that projects are generally judged by participants to be a meaningful use of time, and significant in giving them an opportunity to play an expert role and to help others.
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Kuiper, Rowan, Sophie L. Corthals, Payman Hanifi-Moghaddam, Yvonne de Knegt, Henk Lokhorst, Hartmut Goldschmidt, Brian G. M. Durie et al. "Developing a SNP Classifier for Predicting Peripheral Neuropathy by Bortezomib in Multiple Myeloma Patients." Blood 114, n.º 22 (20 de novembro de 2009): 1800. http://dx.doi.org/10.1182/blood.v114.22.1800.1800.
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Abstract Abstract 1800 Poster Board I-826 Background The prevalence of peripheral neuropathy (PNP) during the treatment of MM with Bortezomib is high. About 20% of patients develop a grade 3-4 PNP due to this treatment, and as a result Bortezomib treatment is stopped or a reduced dose is given. Therefore, there is a strong need to find markers which predict the susceptibility of a patient to develop Bortezomib related PNP. Materials and methods: Bortezomib treated patients from the Dutch/German Hovon 65 GMMG-HD4 trial and the French IFM-2005/01 trial were used for this analysis. In both trials, the efficacy of Bortezomib as induction treatment prior to high-dose therapy is evaluated and PNP status was recorded. Samples were genotyped using a custom-built molecular inversion probe (MIP)-based single nucleotide polymorphism (SNP) chip containing 3404 SNPs (Bank on a Cure program; Van Ness et al., 2008). In total, 232 patients who did not develop PNP were compared to 210 PNP cases (grade 1, n=82; grade 2 n=86, grade 3, n=31, grade 4, n=11). Results The data were processed on the basis of the following criteria. First, SNPs genotyped in less than 75% of the samples were removed (n=155). This resulted in elimination of 59% of the data with unknown genotype while only 1% of the genotyped data were lost. The remaining 41% of the missing data were imputed using BIMBAM (Guan et al., PLoS Genet. 4:e1000279, 2008). As reference panels, the data sets of the BOAC chips from this study, 500 random samples from the Rotterdam ERGO study (Köttgen et al., Nat. Genet. 41, 712–717, 2009) and 60 phased CEU HAPMAP samples were used. Secondly, SNPs were excluded which did not show any genotype variance and which were not in Hardy Weinberg equilibrium. As a last step the data was adjusted for stratification using Eigenstrat (Price et al., Nat. Genet. 38: 904–909, 2006). By removing 21 SNPs and 14 samples the variance between the IFM and Hovon was reduced to an acceptable level (p = 0.011). The resulting combined IFM/Hovon dataset now contained 2764 SNP and 428 samples. The data set was divided in 6/7 (n=367) part as a learning set and 1/7 (n=61) as a validation set. Possibly informative SNPs were selected using information gain as a feature selection method (Cover et al., Elements of information theory. New York, John Wiley, 1991). 66 SNPs with an information gain in allele and genotype frequency were selected (p value < 0.05 after permutation test (n=10000)). Classifiers generated by Partial C4.5 decision tree (PART), support vector machine (SVM) and Random forest learned on this set reached a better than random performance. Sensitivity, specificity, positive predictive value and negative predictive value were respectively 55%, 70%, 60%, and 66% for the PART classifier. Conclusion Preliminary classifiers generated by this dataset suggest that building a classifier with clinically relevant performance may be within reach. To this end, we will report on the outcome of different combinations of existing classifier methods and feature selection methods. Van Ness, B, Ramos, C, Haznadar, M, Hoering, A,Haessler, J, Crowley, J, Jacobus, S, Oken, M, Rajkumar, V, Greipp, P, Barlogie, B, Durie, B, Katz, M, Atluri, G, Ganf, G, Gupta, R, Steinbach, M, Kumar, V, Mushlin, R, Johnson, D, and Morgan, G. (2008). Genomic Variation in Myeloma: Design, content, and initial application of the Bank On A Cure SNP Panel to analysis of survival. BMC Medicine. 6:26. Disclosures Hanifi-Moghaddam: Skyline Diagnostics: Employment.
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Konareva, T. I., Yu P. Malyshev e V. V. Golubtsov. "Intensive Care Outcomes and Differences Between Survivors and Deceased Patients in a Terminal Coma: A Retrospective Observational Study". Kuban Scientific Medical Bulletin 29, n.º 6 (10 de dezembro de 2022): 41–52. http://dx.doi.org/10.25207/1608-6228-2022-29-6-41-52.
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Background. Early prognosis for the outcome of a coma-induced critical condition is central to selecting an optimal tactic for patient management. This question remains insufficiently studied, thus justifying the task of identifying significant criteria for differences in terminal coma patients (stage III, irreversible) who died and those recovered to different levels of consciousness.Objectives. To analyze the intensive care outcomes for patients in a terminal coma and to establish differences between the initial state of patients who have died and those who have recovered to different levels of consciousness.Methods. A retrospective observational study was conducted on 210 patients aged 21 to 65 hospitalized in the Anesthesiology and Resuscitation Unit of Ochapovsky Regional Clinical Hospital No. 1 (Krasnodarsky Krai) with a diagnosis of terminal coma in the period from 2010 to 2015. The study did not include patients with pregnancy, histologically-confirmed malignancies, cardiovascular diseases (NYHA classes III-IV, according to the New York Heart Association Functional Classification), terminal liver cirrhosis and chronic kidney disease at the stage of hemodialysis. Depending on the critical condition outcome, the admitted patients were divided into groups: group 1 (n = 101) — patients with adverse outcomes; group 2 (n = 109) — patients with relatively favorable outcomes (recovery to a level of consciousness at score 4 and higher, according to The Glasgow Coma Scale). The condition was assessed with referring to available clinical data. Statistical processing of the obtained study results was carried out via nonparametric techniques using Microsoft Excel 10 (Microsoft, USA) and Statistica 6.0 (StatSoft, USA).Results. The mortality structure against the background of a terminal coma in the following diagnosis: polytrauma — 54%, hemorrhagic stroke — 56%, isolated traumatic brain injury — 37%, acute cerebrovascular accidents (ischemic type) — 33% and acute posthypoxic dyscirculatory encephalopathy — 11%. Intergroup differences between the deceased and survivors were obtained in the following parameters: age (older with unfavorable outcome); base deficit — by 52%; glucose — by 47.6%; troponin — by 47.1%; potassium — by 13.7% and daily diuresis — by 27.5%.Conclusion. The obtained results are likely to be used in a combination of clinical, instrumental and laboratory examinations in order to provide early detection of the risk group with an adverse outcome.
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Zhang, Yu, Qiang Xing, Jiang-Hua Zhang, Wei-Feng Jiang, Mu Qin e Xu Liu. "Long-Term Effect of Different Optimizing Methods for Cardiac Resynchronization Therapy in Patients with Heart Failure: A Randomized and Controlled Pilot Study". Cardiology 142, n.º 3 (2019): 158–66. http://dx.doi.org/10.1159/000499502.
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Aim: During cardiac resynchronization therapy (CRT), optimized programming of the atrioventricular (AV) delay and ventricular-to-ventricular (VV) interval can lead to improved hemodynamics, symptomatic response, and left ventricular systolic function. Currently, however, there is no recommendation for the best optimization method. This study aimed to compare the long-term clinical outcomes of 4 different CRT optimization methods. Methods: One hundred and twenty-four consecutive CRT patients with severe heart failure and left bundle-branch block configuration were randomly assigned into four groups to undergo AV/VV delay optimization through echocardiogram (ECHO; n = 30), electrocardiogram (ECG; n = 32), QuickOpt algorithm (n = 28), and nominal AV/VV (n = 36) groups. Patients were followed up and underwent examinations, including New York Heart Association (NYHA) cardiac functional classification, 6-min walking distance (6MWD), and echocardiography, at 6, 12, 24, 36, and 48 months, respectively. The patients’ survival and clinical outcomes were compared among the four groups. Results: Kaplan-Meier survival analyses showed that the median survival was the same in the 4 groups: ECHO, 43 months; ECG, 44 months; QuickOpt, 44 months, and nominal, 41 months. At the 6-month follow-up, the reduction in left ventricular end diastolic diameter (LVEDD) was significantly less in the nominal group (–1.91 ± 2.58 mm) than that in the other three groups (ECHO: –3.70 ± 2.78 mm, p = 0.012; ECG: –3.53 ± 3.14 mm, p = 0.020; QuickOpt: –3.46 ± 2.65 mm, p = 0.032); 6MWD was significantly shorter in the nominal group (87.88 ± 34.76 m) than that in the other three groups (ECHO: 120.63 ± 56.93 m, p = 0.006; ECG: 114.97 ± 54.95 m, p = 0.020; QuickOpt: 114.57 ± 35.41 m, p = 0.027). Left ventricular ejection fraction (LVEF) significantly increased in ECHO (7.23 ± 2.76%, p = 0.010), ECG (8.50 ± 3.17%, p < 0.001), and QuickOpt (8.39 ± 2.90%, p < 0.001) compared with the nominal group (5.35 ± 2.59%). There were no significant differences among the groups in the aforementioned parameters at 24, 36, and 48 months, respectively. Conclusion: While LVEDD, LVEF, 6MWD, and NYHA were significantly improved in ECHO, ECG, and QuickOpt at 6 months, there were no significant improvements in any of the groups at 12, 24, and 48 months. These findings suggested that the long-term effect of the four CRT methods for heart failure was not significantly different.
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Shasha, Daniel, Brock John Debenham, Robert Salant e Louis Benjamin Harrison. "PSA outcomes in patients with adenocarcinoma of the prostate with presenting PSA > 20 ng/ml." Journal of Clinical Oncology 31, n.º 6_suppl (20 de fevereiro de 2013): 241. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.241.
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241 Background: Optimal treatment of prostate cancer with presenting PSA >20 ng/mL is debated within and between specialties, as reflected by variable PSA outcomes reported. We present our clinical outcomes in irradiated patients for this population. Methods: With IRB approval, we analyzed patient, disease, treatment, and PSA data of 149 patients with presenting PSA > 20 ng/mL radiated with curative intent 1997-2012 by a single physician (DS) at Beth Israel Medical Center (New York City). External beam radiation therapy (EBRT) was delivered first to prostate, seminal vesicles (SV) and draining pelvic lymph nodes to 45 Gy, then 5.4 Gy cone down, then a boost with either brachytherapy (BT) or 30.6 Gy conformal EBRT. BT was withheld in large volume of SV invasion by either DRE or by MRI. Hormonal therapy (HT) consisted of LHRH agonist +/- antiandrogen therapy. PSA was checked every 6 mos. Biochemical Failure (BF) was defined as post-treatment PSA nadir + 2 ng/mL. Results: 41% of patients were African American, 27% Hispanic, 21% Caucasian, and 6% Asian. The median patient age, Gleason score (GS), PSA, and T stage were 68 yrs (range 42-87), 30 ng/mL (range 20–280), 7 (range 5-10) and stage II (8% Tx, 29% T1, 32% T2, 22% T3a/b, 8% T3c). Combined EBRT and BT (CMT) were used in 70% (N=104); EBRT alone in 28% (N=42); BT alone in 2% (N=3). HT was given to 87% (N=129), (median duration 25 mos). Of CMT patients, 77% (N=81) had I-125 permanent seed implant, 22% (N=23) had Pd-103 implant, and 1% (N=1) had HDR temporary Ir-192 implant. With a minimum follow-up (FU) 2 years and median FU 4.9 years (range 2.0-14.1), overall BF was 18% (N=27), and median time to failure was 4 yrs (range 0.4–9.3). Of failures, median age was 64 (range 48-83), and 40% were African American; median pre-treatment PSA was 40 ng/mL (range 20–238), median stage was 3. BF occurred in 17/104 (16.3%) CMT patients (13/17 I-125 and 3/17 Pd-103), 9/42 (21.4%) EBRT patients, and 1/3 (33%) BT alone patients (1/1 I-125). All patients who failed received HT. Conclusions: Excellent overall biochemical outcomes in patients with presenting PSA > 20 ng/ml are reported, with only approximately 18% experiencing BF at a median FU of 4.9 years. Of all treatments analyzed, CMT yielded superior biochemical control.
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Delamar José Volpato Dutra. "aborto em Dworkin, Habermas e Rawls". Logeion: Filosofia da Informação 9 (27 de junho de 2023): 15–25. http://dx.doi.org/10.21728/logeion.2023v9nesp.p15-25.
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ALEXY, Robert. The Argument from Injustice. A Reply to Legal Positivism. [B. L. Paulson and S. L. Paulson: Begriff und Geltung des Rechts]. Oxford: Clardeon Press, 2002.
BEAUCHAMP, Tom L., CHILDRESS, James F. Principles of Biomedical Ethics. 5. ed., Oxford: Oxford University Press, 2001.
BECKENKAMP, Joãosinho. Direito como exterioridade na legislação prática em Kant. Ethic@. V. 2, n. 2, 2003. p. 151-171. [http://www.cfh.ufsc.br/ethic@].
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CODIGNOLA, Maria Moneti. From Generation to Production: How the Meaning of “Coming to the World” Changes in the Era of Reproductive Techniques. ethic@. Florianópolis, v.3, n.2, 2004. p. 99-106.
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HABERMAS, Jürgen. Die Zukunft der menschlichen Natur. Auf dem Weg zu einer liberalen Eugenik? Frankfurt a. M.: Suhrkamp, 2001.
HABERMAS, Jürgen. Direito e democracia: entre faticidade e validade. [v. I]. [Trad. F. B. Siebeneichler: Faktizität und Geltung: Beiträge zur Diskurstheorie des Rechts und des demokratischen Rechtsstaats]. Rio de Janeiro: Tempo Brasileiro, 1997.
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DeFaria Yeh, Doreen, Ada C. Stefanescu Schmidt, Aaron S. Eisman, John D. Serfas, Mariam Naqvi, Mohamed A. Youniss, Aaron D. Ryfa et al. "Impaired right ventricular reserve predicts adverse cardiac outcomes in adults with congenital right heart disease". Heart 104, n.º 24 (20 de julho de 2018): 2044–50. http://dx.doi.org/10.1136/heartjnl-2017-312572.
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ObjectiveThe prevalence of heart failure (HF) among adult patients with congenital heart disease (ACHD) is rising. Right ventricle (RV) exercise reserve and its relationship to outcomes have not been characterised. We aim to evaluate the prognostic impact of impaired RV reserve in an ACHD population referred for cardiopulmonary exercise testing (CPET).MethodsThis retrospective study evaluates patients with ACHD who underwent CPET (n=147) with first-pass radionuclide ventriculography at a single tertiary care centre. RV reserve was categorised as normal, mild to moderately or severely impaired. The primary composite clinical outcome included clinical right HF, arrhythmia, transplantation or death.ResultsPatients were median age 41±13 years, 50% were female and median follow-up was 1.1 (IQR: 0.7–2.0) years. Exercise RV reserve was impaired in 103 patients (70%), of whom 32% were asymptomatic. Resting RV systolic function poorly predicted RV reserve, with 52% of patients with severe impairment having a qualitatively normal echocardiographic assessment. The severely impaired reserve group had lower peak oxygen consumption (VO2)(17.2 vs 22.5 mL/kg/min, p<0.0001) compared with the normal reserve group, and was more likely to develop the composite outcome (48% vs 9%, log-rank p<0.001). Severely impaired RV reserve predicted event-free survival after adjusting for peak VO2, age, sex, RV pathology, QRS duration, New York Heart Association class, resting RV ejection fraction and RV dilation by echocardiography or MRI (HR 3.7, 95% CI 1.1 to 13.0, p=0.039).ConclusionImpaired RV reserve, occurred in asymptomatic patients, was not well predicted by resting systolic function assessment, and strongly predicted adverse cardiovascular outcomes.
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Soeters, Heidi, Amy Blain, How-Yi Chang, Melissa Whaley e Jessica Macneil. "Current Epidemiology of Serogroup W Meningococcal Disease—United States, 2010–2015". Open Forum Infectious Diseases 4, suppl_1 (2017): S7. http://dx.doi.org/10.1093/ofid/ofx162.017.
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Abstract Background Serogroup W (NmW) meningococcal disease is a rare but severe infection. Following an NmW outbreak after the Hajj in 2000, NmW disease, predominantly caused by sequence type (ST)-11 clonal complex (cc), rapidly increased in South Africa, South America, and the UK. We describe NmW meningococcal disease epidemiology in the USA during 2010–2015. Methods Data were collected from the National Notifiable Diseases Surveillance System, Active Bacterial Core surveillance, and state health departments. Isolates were serogrouped via slide agglutination and real-time polymerase chain reaction. For cases lacking a serogroup result at CDC, the state result was used. Case-fatality ratios (CFR) were calculated using the proportion of cases with known outcomes as the denominator. cc and ST were determined using multilocus sequence typing (MLST). Results From 2010 to 2015, 3,504 meningococcal disease cases were reported to CDC; 2,976 (85%) had a serogroup result, of which 290 (10%) were NmW. Although the number of NmW cases reported annually remained fairly stable (range: 40–57), the total number of reported meningococcal disease cases decreased by 60%, and the proportion of cases due to NmW increased from 6% (42/830) in 2010 to 12% (40/332) in 2015. The majority of NmW cases were reported from five states: Florida (n = 106), California (n = 31), New York (n = 25), Georgia (n = 19), and Oregon (n = 11). Half of people with NmW disease were male, 185 (64%) were white, and 84 (29%) were Hispanic. The median age was 51 years (interquartile range: 26–70). Overall, 20% (52/259) of NmW cases were fatal, compared with CFRs for serogroups B (15%), Y (18%), or C (24%). NmW CFR was highest among adults aged 50–59 years (38%). MLST results were available for 119 (41%) of NmW cases: 76 (64%) were cc11, 40 (34%) were cc22, and 1 each were cc23, cc32, and an unassigned cc. cc appeared to be geographically associated: cc11 was concentrated in Florida and Georgia, while cc22 predominated on the West coast. Within cc11, the majority of isolates (86%) were ST-11, and within cc22 the majority (73%) were ST-22. Conclusion A rapid increase in NmW disease has not been observed in the USA. Most NmW cases were reported in a limited number of states, with geographic differences in clonal complex. Disclosures All authors: No reported disclosures.
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Sandal Uzun, G., İ. Y. Çakir, E. Bilgin, B. Farisogullari, G. Ayan, Z. Özsoy, M. Ekici et al. "AB0954 IMPACT OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH AS USING BIOLOGIC AGENTS". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 1695.1–1695. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1943.
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BackgroundAlthough renal involvement is an rare extra-articular involvement in patients with ankylosing spondylitis (AS), medications and accopamyning comorbidities may adversly affect renal functions [1].ObjectivesTo determine the frequency and impact of CKD in patients with AS using biologic disease modyfying anti-rheumatic drugs (bDMARDs).MethodsBetween 2005 and November 2021, 3207 patients diagnosed with AS according to the modified New York criteria were enrolled in the Hacettepe University biological database (HUR-BIO). The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) guideline was used for the definition of CKD to evaluate the renal function of patients. Glomerular filtration rate (GFR) was calculated with the MDRD (modified Modification of Diet in Renal Disease) formula, taking into account the creatinine value, age and gender parameters of the patients [2]. CKD was detected in 39 (1,2%) patients. Age-sex matched 41 non-CKD AS patients were selected as the control group. Demographic and clinical characteristics and mortality rates of AS patients with and without CKD were compared.ResultsOf 39 AS-CKD patients, 25 (64.1%) had CKD before the initation of bDMARD and and 14 (35.8%) developed CKD during follow-up after treatment was started. Patients with AS-CKD had longer duration of symptoms and disease (Table 1). Comorbidities such as hypertension, coronary artery disease and amyloidosis were more prevalent in patients with AS-CKD. At a median follow-up of 2.48(0.1-20.1) years, mortality was observed in 11(28.2%) patients in the AS-CKD group, while no mortality was observed in the age-sex matched AS-nonCKD group (p<0.001, Figure 1). The mortality rate in patients with AS-CKD was 12.6 per 1000 patient-years, and 4 (10.2%) of deaths were during the COVID-19 pandemia.Figure 1.Table 1.AS-CKD group(n=39)AS-nonCKDgroup (n=41)PTotal AS patients,(n=3207)Age, mean(SD), years68.2 (12.0)58.8(12.6)-47.9±(11.2)Male, n(%)27 (69.2)27(65.9)-1716(53.5)53.1)Symptom duration, yearsmedian (min-max)20 (5-42)11(2-30)0.0110(1-44)Disease duration, yearsmedian (min-max)14,5(5-42)7(1-29)0.046(1-37)HLA-B27 positivity, n(%)13(33.3)12(29.2)0.5826/2014(41.0)Uveitis, n(%)6/354/360.2339/2946(11.5)Inflammatory bowel disease, n(%)4/353/360.4135/2946(4.58)Smoking, ever, n(%)22/34 (64.7)20/36(55.5)0.31781/2942(60.5)BMI (kg/m2), mean(SD)28 (6.08)28.2(5.01)0.828.1(5.5)Amiloidosis, n(%)14/36(38.9)1(2.4)<0.00133/2949(1.11)Comotbidities n(%)• Diabetes Mellitus,7/34(20.6)4/36(11.1)0.2199/2949(6.7)• Hypertension27/34(79.4)9/36(25)<0.001442/2949(14.9)• CAD8/21(38.1)1/25(4)0.005110/1882(5.8)• COPD5/21(23.8)0/240.004117/1774(6.59)CRP, med(min-max)1.6(0.4-12.4)1.77(0.1-23.6)0.81.07(0.1-45)• at the initiation of bDMARDs, at the last visit,0.7(0.16-14)0.55(0.1-7.5)0.30.5(0.1-14)ESR, med(min-max)• at the initiation of bDMARDs,48(12-140)30(2-96)0.119(1-140)• at the last visit, med(min-max)25(3-93)15(2-70)0.113(1-110)BASDAI, mean (SD)• At the initiation of bDMARDs4.5(±2.1)5.46(±2.07)0.55.7(±2.04)• At the last vizit3.94(±2.35)2.95(±2.33)0.093.69(±2.5)CAD: Coronary artery disease, COPD: Chronic Obstructive pulmonary disease, BMI: Body mass index, BASDAI: Bath AS Disease Activity IndexConclusionBoth comorbid disease burden and mortality seem to be increased in patients with AS-CKD. Increased mortality was more pronounced during the COVID-19 pandemia.References[1]Coşkun, B.N., et al.,Anti-TNF treatment in ankylosing spondylitis patients with chronic kidney disease: Is it effective and safe?Eur J Rheumatol, 2022.9(2): p. 68-74.[2]Stevens, P.E. and A. Levin,Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline.Ann Intern Med, 2013.158(11): p. 825-30.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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De Craemer, A. S., M. De Hooge, T. Renson, L. Deroo, G. Varkas, L. Van Praet, R. Joos et al. "POS0672 RHEUMATOLOGISTS OVERCALL SACROILIITIS ON X-RAY AND MRI IN AXIAL SPONDYLOARTHRITIS PATIENTS: DATA FROM THE BELGIAN INFLAMMATORY ARTHRITIS AND SPONDYLITIS COHORT (BE-GIANT)". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 617.2–618. http://dx.doi.org/10.1136/annrheumdis-2023-eular.2231.
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BackgroundImaging of the sacroiliac joints, especially with magnetic resonance imaging (MRI), is an important tool for early diagnosis of axial spondyloarthritis (axSpA). Interpretation of sacroiliac joint imaging can vary according to readers’ experience, but it is currently unknown if and how imaging assessment differs between academic hospitals and community based rheumatological care.ObjectivesTo investigate (1) agreement between local and central reading of sacroiliac joint images (X-ray and MRI) from axSpA patients, and (2) to explore potential differences between patients diagnosed in an academic hospital compared to community centres.MethodsThe BelGian Inflammatory Arthritis and spoNdylitis cohort (Be-GIANT) includes newly diagnosed biological-naïve axSpA patients, that fulfil the ASAS classification criteria, at the outpatient clinic of an academic hospital and eight community centres in Flanders. X-ray and MRI of the sacroiliac joints (SIJ) of patients enrolled between November 2010 and August 2020 were assessed by the local rheumatologist (‘local reading’) and two calibrated central readers (‘central reading’) for definite radiographic sacroiliitis according to the modified New York criteria (X-SIJ) and active sacroiliitis according to the ASAS/OMERACT definition of a positive MRI (MRI-SIJ). Central readers resolved discrepant cases by consensus. Inter-reader reliability was assessed with Cohen’s Kappa, and % overall, positive and negative agreement.ResultsAmong the 271 included patients (n=205 academic hospital, n=66 community hospital), 231 X-SIJ and 208 MRI-SIJ were available for central reading (Table 1). Central readers disagreed with local readers on 30/231 (13%) X-SIJ images (κ=0.44, moderate); 4/231 (1.7%) were reclassified as radiographic sacroiliitis and 26/231 (11.3%) as not showing radiographic sacroiliitis. Overall agreement was higher between central readers and academic rheumatologists compared to community rheumatologists (90.5% vs. 70.7%, p<0.001). 53/208 (25.4%) MRI-SIJ images were reclassified by central readers (κ=0.36, fair); the majority as negative for active sacroiliitis (51/208, 24.5%). Central readers agreed on the assessment of MRI-SIJ in a higher proportion with academic rheumatologists versus community rheumatologists (77.2% vs. 63.4%, p=0.07).ConclusionIn newly diagnosed axSpA patients, the prevalence of radiographic sacroiliitis is low. Sacroiliitis on MRI is overcalled by rheumatologists both in academic and non-academic settings, underscoring the need for continuous educational trainings.Table 1.Agreement between local and central readers on X-SIJ and MRI-SIJ of axSpA patients in academic and community centers.All axSpA patientsAcademic hospitalCommunity centresLocal readingCentral readingLocal readingCentral readingLocal readingCentral readingX-SIJ (N=231)X-SIJ +41 (18%)19 (8%)30 (16%)14 (7%)11 (27%)5 (12%)X-SIJ -190 (82%)212 (92%)160 (84%)176 (93%)30 (73%)36 (88%)Overall agreementPositive agreementNegative agreementKappa (95% CI)87.0%50.0%92.5%0.44 (0.28 – 0.60)90.5%59.1%94.6%0.55 (0.37 – 0.72)70.7%25.0%81.8%0.10 (-0.20,0.40)MRI-SIJ (N=208)MRI-SIJ +181 (87%)132 (63%)151 (90%)115 (69%)30 (73%)17 (41%)MRI-SIJ -27 (13%)76 (37%)16 (10%)52 (31%)11 (27%)24 (59%)Overall agreementPositive agreementNegative agreementKappa (95% CI)74.5%83.1%48.5%0.36 (0.25 – 0.48)77.2%85.7%44.1%0.35 (0.20 – 0.49)63.4%68.1%57.1%0.32 (0.10 – 0.55)REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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Rdolph, P. "B. N. Roy. Crystal Growth from Melts. Applications to Growth of Groups 1 and 2 Crystals. John Wiley & Sons; Chichester — New York — Brisbane — Toronto — Singapore 1992, 322 Seiten, 138 Abbildungen, 41 Tabellen, £ 65.00, ISBN: 0–471–93–109–8". Crystal Research and Technology 27, n.º 6 (1992): 824. http://dx.doi.org/10.1002/crat.2170270615.
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Baggen, Vivan J. M., Annemien E. van den Bosch, Jannet A. Eindhoven, Myrthe E. Menting, Maarten Witsenburg, Judith A. A. E. Cuypers, Eric Boersma e Jolien W. Roos-Hesselink. "Prognostic value of galectin-3 in adults with congenital heart disease". Heart 104, n.º 5 (23 de setembro de 2017): 394–400. http://dx.doi.org/10.1136/heartjnl-2017-312070.
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ObjectiveGalectin-3 is an emerging biomarker for risk stratification in patients with heart failure. This study aims to investigate the release of galectin-3 and its association with cardiovascular events in patients with adult congenital heart disease (ACHD).MethodsIn this prospective cohort study, 602 consecutive patients with ACHD who routinely visited the outpatient clinic were enrolled between 2011 and 2013. Galectin-3 was measured in thaw serum by batch analysis. The association between galectin-3 and a primary endpoint of all-cause mortality, heart failure, hospitalisation, arrhythmia, thromboembolic events and cardiac interventions was investigated using multivariable Cox models. Reference values and reproducibility were established by duplicate galectin-3 measurements in 143 healthy controls.ResultsGalectin-3 was measured in 591 (98%) patients (median age 33 (25–41) years, 58% male, 90% New York Heart Association (NYHA) class I). Median galectin-3 was 12.7 (range 4.2–45.7) ng/mL and was elevated in 7% of patients. Galectin-3 positively correlated with age, cardiac medication use, NYHA class, loss of sinus rhythm, cardiac dysfunction and N-terminal pro-B-type natriuretic peptide (NT-proBNP). During a median follow-up of 4.4 (IQR 3.9–4.8) years, the primary endpoint occurred in 195 patients (33%). Galectin-3 was significantly associated with the primary endpoint in the univariable analysis (HR per twofold higher value 2.05; 95% CI 1.44 to 2.93, p<0.001). This association was negated after adjustment for NT-proBNP (HR 1.04; 95% CI 0.72 to 1.49, p=0.848).ConclusionsGalectin-3 is significantly associated with functional capacity, cardiac function and adverse cardiovascular events in patients with ACHD. Nevertheless, the additive value of galectin-3 to a more conventional risk marker such as NT-proBNP seems to be limited.