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Comparison Of Inappropriate Shocks And Other Health Outcomes Between Single- And Dual-Chamber Implantable Cardioverter-Defibrillators For Primary Prevention Of Sudden Cardiac Death: Results From The Cardiovascular Research Network Longitudinal Study Of Implantable Cardioverter-Defibrillators, Pamela N. Peterson, Robert T. Greenlee, Alan S. Go, David J. Magid, Andrea E. Cassidy-Bushrow, Romel Garcia-Montilla, Karen A. Glenn, Jerry H. Gurwitz, Stephen C. Hammill, John Hayes, Alan Kadish, Kristi Reynolds, Param Sharma, David H. Smith, Paul D. Varosy, Humberto Vidaillet, Chan X. Zeng, Sharon-Lise T. Normand, Frederick A. Masoudi

Public Health Sciences Articles

BACKGROUND: In US clinical practice, many patients who undergo placement of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death receive dual-chamber devices. The superiority of dual-chamber over single-chamber devices in reducing the risk of inappropriate ICD shocks in clinical practice has not been established. The objective of this study was to compare risk of adverse outcomes, including inappropriate shocks, between single- and dual-chamber ICDs for primary prevention.

METHODS AND RESULTS: We identified patients receiving a single- or dual-chamber ICD for primary prevention who did not have an indication for pacing from 15 hospitals within 7 integrated health …

A Point System To Forecast Hepatocellular Carcinoma Risk Before And After Treatment Among Persons With Chronic Hepatitis C, Jian Xing, Philip R. Spradling, Anne C. Moorman, Scott D. Holmberg, Eyasu H. Teshale, Loralee B. Rupp, Stuart C. Gordon, Mei Lu, Joseph A. Boscarino, Mark A. Schmidt, Connie M. Trinacty, Fujie Xu

Gastroenterology Articles

BACKGROUND: Risk of hepatocellular carcinoma (HCC) may be difficult to determine in the clinical setting.

AIM: Develop a scoring system to forecast HCC risk among patients with chronic hepatitis C.

METHODS: Using data from the Chronic Hepatitis Cohort Study collected during 2005-2014, we derived HCC risk scores for males and females using an extended Cox model with aspartate aminotransferase-to-platelet ratio index (APRI) as a time-dependent variables and mean Kaplan-Meier survival functions from patient data at two study sites, and used data collected at two separate sites for external validation. For model calibration, we used the Greenwood-Nam-D'Agostino goodness-of-fit statistic to examine …

Local Therapy Improves Survival In Metastatic Prostate Cancer, Sami-Ramzi Leyh-Bannurah, Stéphanie Gazdovich, Lars Budäus, Emanuele Zaffuto, Alberto Briganti, Firas Abdollah, Francesco Montorsi, Jonas Schiffmann, Mani Menon, Shahrokh F. Shariat, Margit Fisch, Felix Chun, Thomas Steuber, Hartwig Huland, Markus Graefen, Pierre I. Karakiewicz

Urology Articles

BACKGROUND: Treatment of the primary, termed local therapy (LT), may improve survival in metastatic prostate cancer (mPCa) versus no local therapy (NLT).

OBJECTIVE: To assess cancer-specific mortality (CSM) after LT versus NLT in mPCa.

DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance, Epidemiology and End Results database (2004-2013), 13 692 mPCa patients were treated with LT (radical prostatectomy [RP] or radiation therapy [RT]) or NLT.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable competing risk regression analyses (MVA CRR) tested CSM after propensity score matching (PSM) in two analyses, (1) NLT versus LT and (2) RP versus RT, and were complemented with interaction, …

The Aki Clinic For Fragile Patients, Jerry Yee, Ruth C. Campbell

Nephrology Articles

No abstract provided.

A Mathematical Formula For Institutional Gme Program Support, Kimberly Baker-Genaw, Crystal Gyiraszin

Graduate Medical Education Articles

No abstract provided.

Potential Deaths Averted And Serious Adverse Events Incurred From Adoption Of The Sprint (Systolic Blood Pressure Intervention Trial) Intensive Blood Pressure Regimen In The United States: Projections From Nhanes (National Health And Nutrition Examination Survey), Adam P. Bress, Holly Kramer, Rasha Khatib, Srinivasan Beddhu, Alfred K. Cheung, Rachel Hess, Vinod K. Bansal, Guichan Cao, Jerry Yee, Andrew E. Moran, Ramon Durazo-Arvizu, Paul Muntner, Richard S. Cooper

Nephrology Articles

BACKGROUND: SPRINT (Systolic Blood Pressure Intervention Trial) demonstrated a 27% reduction in all-cause mortality with a systolic blood pressure (SBP) goal ofmellitus, stroke, or heart failure. To quantify the potential benefits and risks of SPRINT intensive goal implementation, we estimated the deaths prevented and excess serious adverse events incurred if the SPRINT intensive SBP treatment goal were implemented in all eligible US adults.

METHODS: SPRINT eligibility criteria were applied to the 1999 to 2006 National Health and Nutrition Examination Survey and linked with the National Death Index through December 2011. SPRINT eligibility included age ≥50 years, SBP of 130 to …

Uspstf Recommendation For Obstructive Sleep Apnea Screening In Adults, Kathleen Yaremchuk

Otolaryngology Articles

No abstract provided.

Improving Uniformity In Brain Death Determination Policies Over Time, Hilary H. Wang, Panayiotis N. Varelas, Galen V. Henderson, Eelco Fm Wijdicks, David M. Greer

Neurology Articles

OBJECTIVE: To demonstrate that progress has been made in unifying brain death determination guidelines in the last decade by directly comparing the policies of the US News and World Report's top 50 ranked neurologic institutions from 2006 and 2015.

METHODS: We solicited official hospital guidelines in 2015 from these top 50 institutions, generated summary statistics of their criteria as benchmarked against the American Academy of Neurology Practice Parameters (AANPP) and the comparison 2006 cohort in 5 key categories, and statistically compared the 2 cohorts' compliance with the AANPP.

RESULTS: From 2008 to 2015, hospital policies exhibited significant improvement (p = …

Trends In Outcomes, Financial Burden, And Mortality For Acute Exacerbation Of Chronic Obstructive Pulmonary Disease (Copd) In The United States From 2002 To 2010, Chetna Jinjuvadia, Raxitkumar Jinjuvadia, Chaitanya Mandapakala, Navin Durairajan, Suthat Liangpunsakul, Ayman O. Soubani

Gastroenterology Articles

Chronic obstructive pulmonary disease (COPD) is the cause of substantial economic and social burden. We evaluated the temporal trends of hospitalizations from acute exacerbation of COPD and determined its outcome and financial impact using the National (Nationwide) Inpatient Sample (NIS) databases (2002-2010). Individuals aged ≥ 18 years were included. Subjects who were hospitalized with primary diagnosis of COPD exacerbation and those who were admitted for other causes but had underlying acute exacerbation of COPD (secondary diagnosis) were captured by International Classification of Diseases-Ninth Revision (ICD-9) codes. The hospital outcomes and length of stay were determined. Multivariate logistic regression was used …

Relationship Between Stress Rankings And The Overall Hospital Star Ratings: An Analysis Of 150 Cities In The United States, Jianhui Hu, David R. Nerenz

Center for Health Policy and Health Services Research Articles

No abstract provided.