Open Access. Powered by Scholars. Published by Universities.®

Medicine and Health Sciences Commons

Open Access. Powered by Scholars. Published by Universities.®

Articles 1 - 30 of 194

Full-Text Articles in Medicine and Health Sciences

Higher Body Mass Index In Adolescence Predicts Cardiomyopathy Risk In Midlife: Long-Term Follow-Up Among Swedish Men, Josefina Robertson, Maria Schaufelberger, Martin Lindgren, Martin Adiels, Linus Schiöler, Kjell Torén, John J. V. Mcmurray, Naveed Sattar, Maria Åberg, Annika Rosengren Jan 2019

Higher Body Mass Index In Adolescence Predicts Cardiomyopathy Risk In Midlife: Long-Term Follow-Up Among Swedish Men, Josefina Robertson, Maria Schaufelberger, Martin Lindgren, Martin Adiels, Linus Schiöler, Kjell Torén, John J. V. Mcmurray, Naveed Sattar, Maria Åberg, Annika Rosengren

Faculty of Health Sciences Publications

Background: Modifiable lifestyle factors in relation to risk for cardiomyopathy, a common and increasing cause of heart failure in the young, have not been widely studied. We sought to investigate a potential link between obesity, a recognized predictor of early heart failure, in adolescence and being diagnosed with cardiomyopathy in adulthood. Methods: This was a nationwide register-based prospective cohort study of 1 668 893 adolescent men (mean age, 18.3 years; SD, 0.7 years) who enlisted for compulsory military service from 1969 to 2005. At baseline, body mass index (BMI), blood pressure, and medical disorders were registered, along with ...


Diagnostic Tests, Drug Prescriptions, And Follow-Up Patterns After Incident Heart Failure: A Cohort Study Of 93,000 Uk Patients, Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, Richard Hobbs, John G. Cleland, John J. V. Mcmurray, Kazem Rahimi Jan 2019

Diagnostic Tests, Drug Prescriptions, And Follow-Up Patterns After Incident Heart Failure: A Cohort Study Of 93,000 Uk Patients, Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, Richard Hobbs, John G. Cleland, John J. V. Mcmurray, Kazem Rahimi

Faculty of Health Sciences Publications

Background Effective management of heart failure is complex, and ensuring evidence-based practice presents a major challenge to health services worldwide. Over the past decade, the United Kingdom introduced a series of national initiatives to improve evidence-based heart failure management, including a landmark pay-for-performance scheme in primary care and a national audit in secondary care started in 2004 and 2007, respectively. Quality improvement efforts have been evaluated within individual clinical settings, but patterns of care across its continuum, although a critical component of chronic disease management, have not been studied. We have designed this study to investigate patients’ trajectories of care ...


Health Care Professionals’ Perceptions Of Home Telemonitoring In Heart Failure Care: Cross-Sectional Survey, Ina Thon Aamodt, Edita Lycholip, Jelena Celutkiene, Anna Strömberg, Dan Atar, Ragnhild Sørum Falk, Thomas G. Von Lueder, Ragnhild Hellesø, Tiny Jaarsma, Irene Lie Jan 2019

Health Care Professionals’ Perceptions Of Home Telemonitoring In Heart Failure Care: Cross-Sectional Survey, Ina Thon Aamodt, Edita Lycholip, Jelena Celutkiene, Anna Strömberg, Dan Atar, Ragnhild Sørum Falk, Thomas G. Von Lueder, Ragnhild Hellesø, Tiny Jaarsma, Irene Lie

Faculty of Health Sciences Publications

Background: Noninvasive telemonitoring (TM) can be used in heart failure (HF) patients to perform early detection of decompensation at home, prevent unnecessary health care utilization, and decrease health care costs. However, the evidence is not sufficient to be part of HF guidelines for follow-up care, and we have no knowledge of how TM is used in the Nordic Baltic region. Objective: The aim of this study was to describe health care professionals’ (HCPs) perception of and presumed experience with noninvasive TM in daily HF patient care, perspectives of the relevance of and reasons for applying noninvasive TM, and barriers to ...


Income Inequality And Outcomes In Heart Failure, Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, Joao Pedro Ferreira, Faiez Zannad, Li Shen, Lars Køber, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Milton Packer, Jean L. Rouleau, Scott D. Solomon, Karl Swedberg, Michael R. Zile, John J. V. Mcmurray Jan 2019

Income Inequality And Outcomes In Heart Failure, Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, Joao Pedro Ferreira, Faiez Zannad, Li Shen, Lars Køber, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Milton Packer, Jean L. Rouleau, Scott D. Solomon, Karl Swedberg, Michael R. Zile, John J. V. Mcmurray

Faculty of Health Sciences Publications

Objectives This study examined the relationship between income inequality and heart failure outcomes. Background The income inequality hypothesis postulates that population health is influenced by income distribution within a society, with greater inequality associated with worse outcomes. Methods This study analyzed heart failure outcomes in 2 large trials conducted in 54 countries. Countries were divided by tertiles of Gini coefficients (where 0% represented absolute income equality and 100% represented absolute income inequality), and heart failure outcomes were adjusted for standard prognostic variables, country per capita income, education index, hospital bed density, and health worker density. Results Of the 15,126 ...


Extensive Undertreatment Of Osteoporosis In Older Swedish Women, Mattias Lorentzon, A. G. Nilsson, Helena Johansson, John A. Kanis, Dan Mellström, D. Sundh Jan 2019

Extensive Undertreatment Of Osteoporosis In Older Swedish Women, Mattias Lorentzon, A. G. Nilsson, Helena Johansson, John A. Kanis, Dan Mellström, D. Sundh

Faculty of Health Sciences Publications

Summary In a population-based study of older Swedish women, we investigated the proportion of women treated with osteoporosis medication in relation to the proportion of women eligible for treatment according to national guidelines. We found that only a minority (22%) of those eligible for treatment were prescribed osteoporosis medication. Introduction Fracture rates increase markedly in old age and the incidence of hip fracture in Swedish women is among the highest in the world. Although effective pharmacological treatment is available, treatment rates remain low. Limited data are available regarding treatment rates in relation to fracture risk in a population-based setting in ...


Prognostic Implications Of Changes In Amino-Terminal Pro–B-Type Natriuretic Peptide In Acute Decompensated Heart Failure: Insights From Ascend-Hf [Accepted Manuscript], Justin L. Grodin, Max J. Liebo, Javed Butler, Marco Metra, G. Michael Felker, Adrian F. Hernandez, Adriaan A. Voors, John J. V. Mcmurray, Paul W. Armstrong, Christopher M. O'Connor, Randall C. Starling, Richard W. Troughton, W. H. Wilson Tang Jan 2019

Prognostic Implications Of Changes In Amino-Terminal Pro–B-Type Natriuretic Peptide In Acute Decompensated Heart Failure: Insights From Ascend-Hf [Accepted Manuscript], Justin L. Grodin, Max J. Liebo, Javed Butler, Marco Metra, G. Michael Felker, Adrian F. Hernandez, Adriaan A. Voors, John J. V. Mcmurray, Paul W. Armstrong, Christopher M. O'Connor, Randall C. Starling, Richard W. Troughton, W. H. Wilson Tang

Faculty of Health Sciences Publications

Background: Amino-terminal pro–B-type natriuretic peptide (NTproBNP) is closely associated with prognosis in acute decompensated heart failure (ADHF). As a result, there has been great interest measuring it during the course of treatment. The prognostic implications in both short-term and follow-up changes in NTproBNP need further clarification. Methods: Baseline, 48–72 hour, and 30-day NTproBNP levels were measured in 795 subjects in the ASCEND-HF trial. Multivariable logistic and Cox-proportional hazards models were used to test the association between static, relative, and absolute changes in NTproBNP with outcomes during and after ADHF. Results: The median NTproBNP at baseline was 5773 (2981 ...


The Effect Of Minimally Invasive Surgical Aortic Valve Replacement On Postoperative Pulmonary And Skeletal Muscle Function [Accepted Manuscript], Hajar Boujemaa, Alaaddin Yilmaz, Boris Robic, Katrien Koppo, Guido Claessen, Ines Frederix, Paul Dendale, Heinz Völler, Luc J. C. Van Loon, Dominique Hansen Jan 2019

The Effect Of Minimally Invasive Surgical Aortic Valve Replacement On Postoperative Pulmonary And Skeletal Muscle Function [Accepted Manuscript], Hajar Boujemaa, Alaaddin Yilmaz, Boris Robic, Katrien Koppo, Guido Claessen, Ines Frederix, Paul Dendale, Heinz Völler, Luc J. C. Van Loon, Dominique Hansen

Faculty of Health Sciences Publications

Suboptimal post‐operative improvements in functional capacity are often observed after minimally invasive aortic valve replacement (mini‐AVR). It remains to be studied how AVR affects the cardiopulmonary and skeletal muscle function during exercise to explain these clinical observations and to provide a basis for improved/tailored post‐operative rehabilitation. Twenty‐two patients with severe aortic stenosis (AS) (aortic valve area (AVA) <1.0 cm²) were pre‐operatively compared to 22 healthy controls during submaximal constant‐workload endurance‐type exercise for oxygen uptake (urn:x-wiley:09580670:media:eph12495:eph12495-math-0001), carbon dioxide output (urn:x-wiley:09580670:media:eph12495:eph12495-math-0002), respiratory gas exchange ratio, expiratory volume (urn:x-wiley:09580670:media:eph12495:eph12495-math-0003), ventilatory equivalents for O2 (urn:x-wiley:09580670:media:eph12495:eph12495-math-0004/urn:x-wiley:09580670:media:eph12495:eph12495-math-0005) and CO2 (urn:x-wiley:09580670:media:eph12495:eph12495-math-0006/urn:x-wiley:09580670:media:eph12495:eph12495-math-0007), respiratory rate (RR), tidal volume (Vt), heart rate (HR), oxygen pulse (urn:x-wiley:09580670:media:eph12495:eph12495-math-0008/HR), blood lactate, Borg ratings of perceived exertion (RPE) and exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0009 kinetics. These exercise tests were repeated at 5 and 21 days after AVR surgery (n = 14), along with echocardiographic examinations. Respiratory exchange ratio and ventilatory equivalents (urn:x-wiley:09580670:media:eph12495:eph12495-math-0010/urn:x-wiley:09580670:media:eph12495:eph12495-math-0011 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0012/urn:x-wiley:09580670:media:eph12495:eph12495-math-0013) were significantly elevated, urn:x-wiley:09580670:media:eph12495:eph12495-math-0014 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0015/HR were significantly lowered, and exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0016 kinetics were significantly slower in AS patients vs. healthy controls (P < 0.05). Although the AVA was restored by mini‐AVR in AS patients, urn:x-wiley:09580670:media:eph12495:eph12495-math-0017/urn:x-wiley:09580670:media:eph12495:eph12495-math-0018 and urn:x-wiley:09580670:media:eph12495:eph12495-math-0019/urn:x-wiley:09580670:media:eph12495:eph12495-math-0020 further worsened significantly within 5 days after surgery, accompanied by elevations in Borg RPE, urn:x-wiley:09580670:media:eph12495:eph12495-math-0021 and RR, and lowered Vt. At 21 days after mini‐AVR, exercise‐onset urn:x-wiley:09580670:media:eph12495:eph12495-math-0022 kinetics further slowed significantly (P < 0.05). A decline in pulmonary function was observed early after mini‐AVR surgery, which was followed by a decline in skeletal muscle function in the subsequent weeks of recovery. Therefore, a tailored rehabilitation programme should include training modalities for the respiratory and peripheral muscular system.


A Trial To Evaluate The Effect Of The Sodium-Glucose Co-Transporter 2 Inhibitor Dapagliflozin On Morbidity And Mortality In Patients With Heart Failure And Reduced Left Ventricular Ejection Fraction (Dapa-Hf), John J. V. Mcmurray, David L. Demets, Silvio E. Inzucchini, Lars Køber, Mikhail N. Kosiborod, Anna M. Langkilde, Felipe A. Martinez, Olof Bengtsson, Piotr P. Ponikowski, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon Jan 2019

A Trial To Evaluate The Effect Of The Sodium-Glucose Co-Transporter 2 Inhibitor Dapagliflozin On Morbidity And Mortality In Patients With Heart Failure And Reduced Left Ventricular Ejection Fraction (Dapa-Hf), John J. V. Mcmurray, David L. Demets, Silvio E. Inzucchini, Lars Køber, Mikhail N. Kosiborod, Anna M. Langkilde, Felipe A. Martinez, Olof Bengtsson, Piotr P. Ponikowski, Marc S. Sabatine, Mikaela Sjöstrand, Scott D. Solomon

Faculty of Health Sciences Publications

Background Sodium–glucose co‐transporter 2 (SGLT2) inhibitors have been shown to reduce the risk of incident heart failure hospitalization in individuals with type 2 diabetes who have, or are at high risk of, cardiovascular disease. Most patients in these trials did not have heart failure at baseline and the effect of SGLT2 inhibitors on outcomes in individuals with established heart failure (with or without diabetes) is unknown. Design and methods The Dapagliflozin And Prevention of Adverse‐outcomes in Heart Failure trial (DAPA‐HF) is an international, multicentre, parallel group, randomized, double‐blind, study in patients with chronic heart failure ...


Sacubitril/Valsartan In Asian Patients With Heart Failure With Reduced Ejection Fraction, Pooja Dewan, Kieran F. Docherty, John J. V. Mcmurray Jan 2019

Sacubitril/Valsartan In Asian Patients With Heart Failure With Reduced Ejection Fraction, Pooja Dewan, Kieran F. Docherty, John J. V. Mcmurray

Faculty of Health Sciences Publications

The Prospective comparison of Angiotensin Receptor-neprilysin inhibitor (ARNI) with Angiotensin converting enzyme inhibitor (ACEI) to Determine Impact on Global Mortality and morbidity in Heart Failure (HF) trial (PARADIGM-HF) showed that adding a neprilysin inhibitor (sacubitril) to a renin-angiotensin system blocker (and other standard therapy) reduced morbidity and mortality in ambulatory patients with chronic HF with reduced ejection fraction (HFrEF). In PARADIGM-HF, valsartan combined with sacubitril (a so-called ARNI) was superior to the current gold standard of an ACEI, specifically enalapril, reducing the risk of the primary composite outcome of cardiovascular (CV) death or first HF hospitalization by 20% and all-cause ...


Winter Peaks In Heart Failure: An Inevitable Or Preventable Consequence Of Seasonal Vulnerability?, Simon Stewart, Trine T. Moholdt, Louise M. Burrell, Karen Sliwa, Ana O. Mocumbi, John J. V. Mcmurray, Ashley K. Keates, John A. Hawley Jan 2019

Winter Peaks In Heart Failure: An Inevitable Or Preventable Consequence Of Seasonal Vulnerability?, Simon Stewart, Trine T. Moholdt, Louise M. Burrell, Karen Sliwa, Ana O. Mocumbi, John J. V. Mcmurray, Ashley K. Keates, John A. Hawley

Faculty of Health Sciences Publications

Climate change is a major contributor to annual winter peaks in cardiovascular events across the globe. However, given the paradoxical observation that cardiovascular seasonality is observed in relatively mild as well as cold climates, global warming may not be as positive for the syndrome of heart failure (HF) as some predict. In this article, we present our Model of Seasonal Flexibility to explain the spectrum of individual responses to climatic conditions. We have identified distinctive phenotypes of resilience and vulnerability to explain why winter peaks in HF occur. Moreover, we identify how better identification of climatic vulnerability and the use ...


Effect Of Abaloparatide On Vertebral,Nonvertebral, Major Osteoporotic And Clinical Fractures In A Subset Of Postmenopausal Women At Increased Risk Of Fracture By Frax Probability, Eugene V. Mccloskey, Lorraine Fitzpatrick, M.-Y. Hu, G. Williams, John A. Kanis Jan 2019

Effect Of Abaloparatide On Vertebral,Nonvertebral, Major Osteoporotic And Clinical Fractures In A Subset Of Postmenopausal Women At Increased Risk Of Fracture By Frax Probability, Eugene V. Mccloskey, Lorraine Fitzpatrick, M.-Y. Hu, G. Williams, John A. Kanis

Faculty of Health Sciences Publications

Summary We evaluated the efficacy of abaloparatide in women who were at increased risk for fracture, based on CHMP recommended risk thresholds, at the Abaloparatide Comparator Trial In Vertebral Endpoints (ACTIVE) study baseline. Among patients at high risk based on FRAX probabilities, 18 months of abaloparatide significantly decreased risk for all fracture endpoints compared with placebo. Purpose Abaloparatide, a novel anabolic agent for the treatment of postmenopausal osteoporosis, significantly reduced the risk of vertebral and nonvertebral fractures in the ACTIVE study compared with placebo. In this post hoc analysis, we evaluated abaloparatide’s efficacy in a subset of women in ...


Increased Autophagy In Ephrinb2-Deficient Osteocytes Is Associated With Elevated Secondary Mineralization And Brittle Bone, Christina Vrahnas, Martha Blank, Toby A. Dite, Liliana Tatarczuch, Niloufar Ansari, Blessing Crimeen-Irwin, Huynh Nguyen, Mark R. Forwood, Yifang Hu, Mike Ikegame, Keith R. Bambery, Cyril Petibois, Eleanor J. Mackie, Mark J. Tobin, Gordon K. Smyth, Jonathan S. Oakhill, T. John Martin, Natalie A. Sims Jan 2019

Increased Autophagy In Ephrinb2-Deficient Osteocytes Is Associated With Elevated Secondary Mineralization And Brittle Bone, Christina Vrahnas, Martha Blank, Toby A. Dite, Liliana Tatarczuch, Niloufar Ansari, Blessing Crimeen-Irwin, Huynh Nguyen, Mark R. Forwood, Yifang Hu, Mike Ikegame, Keith R. Bambery, Cyril Petibois, Eleanor J. Mackie, Mark J. Tobin, Gordon K. Smyth, Jonathan S. Oakhill, T. John Martin, Natalie A. Sims

Faculty of Health Sciences Publications

Mineralized bone forms when collagen-containing osteoid accrues mineral crystals. This is initiated rapidly (primary mineralization), and continues slowly (secondary mineralization) until bone is remodeled. The interconnected osteocyte network within the bone matrix differentiates from bone-forming osteoblasts; although osteoblast differentiation requires EphrinB2, osteocytes retain its expression. Here we report brittle bones in mice with osteocyte-targeted EphrinB2 deletion. This is not caused by low bone mass, but by defective bone material. While osteoid mineralization is initiated at normal rate, mineral accrual is accelerated, indicating that EphrinB2 in osteocytes limits mineral accumulation. No known regulators of mineralization are modified in the brittle cortical ...


Urban Densification And 12-Year Changes In Cardiovascular Risk Markers, Manoj Chandrabose, Neville Owen, Billie Giles-Corti, Gavin Turrell, Alison Carver, Takemi Sugiyama Jan 2019

Urban Densification And 12-Year Changes In Cardiovascular Risk Markers, Manoj Chandrabose, Neville Owen, Billie Giles-Corti, Gavin Turrell, Alison Carver, Takemi Sugiyama

Faculty of Health Sciences Publications

Background Population densities of many cities are increasing rapidly, with the potential for impacts on cardiovascular health. This longitudinal study examined the potential impact of population‐density increases in urban areas (urban densification) on cardiovascular risk markers among Australian adults. Methods and Results Data were from the Australian Diabetes, Obesity and Lifestyle Study, in which adult participants’ cardiovascular risk markers were collected in 3 waves (in 1999–2000, 2004–2005, and 2011–2012). We included 2354 participants with a mean age of 51 years at baseline who did not change their residence during the study period. Outcomes were 12‐year ...


Efficacy Of An Implantable Cardioverter-Defibrillator In Patients With Diabetes And Heart Failure And Reduced Ejection Fraction, Rasmus Rørth, Pooja Dewan, Søren L. Kristensen, Pardeep S. Jhund, Mark C. Petrie, Lars Køber, John J. V. Mcmurray Jan 2019

Efficacy Of An Implantable Cardioverter-Defibrillator In Patients With Diabetes And Heart Failure And Reduced Ejection Fraction, Rasmus Rørth, Pooja Dewan, Søren L. Kristensen, Pardeep S. Jhund, Mark C. Petrie, Lars Køber, John J. V. Mcmurray

Faculty of Health Sciences Publications

Background The effect of implantable cardioverter-defibrillator (ICD) therapy in patients with heart failure with reduced ejection fraction (HFrEF) and diabetes is not fully elucidated. Methods We examined the effect of ICD therapy on sudden cardiac death, cardiovascular death and all-cause mortality, according to diabetes status at baseline in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). The outcomes were analyzed by use of cumulative incidence curves and Cox regressions models. Results Of the 1676 patients randomized to an ICD or placebo, 540 (32%) had diabetes at baseline. Patients with diabetes were slightly older (61 vs 58 years) and were ...


Heart Failure With Reduced Ejection Fraction: Comparison Of Patient Characteristics And Clinical Outcomes Within Asia And Between Asia, Europe And The Americas, Pooja Dewan, Pardeep S. Jhund, Li Shen, Mark C. Petrie, William T. Abraham, M. Atif Ali, Chen-Huan Chen, Akshay S. Desai, Kenneth Dickstein, Jun Huang, Songsak Kiatchoosakun, Kee-Sik Kim, Lars Køber, Wen-Ter Lai, Yuhua Liao, Ulrik M. Mogensen, Byung-Hee Oh, Milton Packer, Jean L. Rouleau, Victor C. Shi, Antonio S. Sibulo, Scott D. Solomon, Piyamitr Sritara, Karl Swedberg, Hiroyuki Tsutsui, Michael R. Zile, John J. V. Mcmurray Jan 2019

Heart Failure With Reduced Ejection Fraction: Comparison Of Patient Characteristics And Clinical Outcomes Within Asia And Between Asia, Europe And The Americas, Pooja Dewan, Pardeep S. Jhund, Li Shen, Mark C. Petrie, William T. Abraham, M. Atif Ali, Chen-Huan Chen, Akshay S. Desai, Kenneth Dickstein, Jun Huang, Songsak Kiatchoosakun, Kee-Sik Kim, Lars Køber, Wen-Ter Lai, Yuhua Liao, Ulrik M. Mogensen, Byung-Hee Oh, Milton Packer, Jean L. Rouleau, Victor C. Shi, Antonio S. Sibulo, Scott D. Solomon, Piyamitr Sritara, Karl Swedberg, Hiroyuki Tsutsui, Michael R. Zile, John J. V. Mcmurray

Faculty of Health Sciences Publications

Aims Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world. Methods and results We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110). Asian patients were younger (55.0–63.9 years) than in Western Europe (67 ...


High Versus Low Dietary Protein Intake And Bone Health In Older Adults: A Systematic Review And Meta-Analysis, Inge Groenendijk, Laura Den Boeft, J. C. Van Loon, Lisette C. P. G. M. De Groot Jan 2019

High Versus Low Dietary Protein Intake And Bone Health In Older Adults: A Systematic Review And Meta-Analysis, Inge Groenendijk, Laura Den Boeft, J. C. Van Loon, Lisette C. P. G. M. De Groot

Faculty of Health Sciences Publications

Protein may play a beneficial role in the prevention of bone loss and in slowing down osteoporosis. The effect of dietary protein may be different in older adults compared to younger adults, since this population has a greater need for protein. The aim of this systematic review and meta-analysis was to investigate the impact of a dietary protein intake above the Recommended Dietary Allowance (RDA) of 0.8 g/kg body weight/day from any source on Bone Mineral Density (BMD)/Bone Mineral Content (BMC), bone turnover markers, and fracture risk in older adults compared to a lower dietary protein ...


Increased Cortical Porosity And Reduced Trabecular Density Are Not Necessarily Synonymous With Bone Loss And Microstructural Deterioration, Roger M. Zebaze, Elizabeth J. Atkinson, Yu Peng, Minh Bui, Ali Ghasem-Zadeh, Sundeep Khosla, Ego Seeman Jan 2019

Increased Cortical Porosity And Reduced Trabecular Density Are Not Necessarily Synonymous With Bone Loss And Microstructural Deterioration, Roger M. Zebaze, Elizabeth J. Atkinson, Yu Peng, Minh Bui, Ali Ghasem-Zadeh, Sundeep Khosla, Ego Seeman

Faculty of Health Sciences Publications

Absolute values of cortical porosity and trabecular density are used to estimate fracture risk, but these values are the net result of their growth‐related assembly and age‐related deterioration. Because bone loss affects both cortical and trabecular bone, we hypothesized that a surrogate measure of bone fragility should capture the age‐related deterioration of both traits, and should do so independently of their peak values. Accordingly, we developed a structural fragility score (SFS), which quantifies the increment in distal radial cortical porosity and decrement in trabecular density relative to their premenopausal mean values in 99 postmenopausal women with forearm ...


Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer Jan 2019

Metformin Use And Cardiovascular Events In Patients With Type 2 Diabetes And Chronic Kidney Disease [Accepted Manuscript], David M. Charytan, Scott D. Solomon, Peter Ivanovich, Giuseppe Remuzzi, Mark E. Cooper, Janet B. Mcgill, Hans-Henrik Parving, Patrick Parfrey, Ajay K. Singh, Emmanuel A. Burdmann, Andrew S. Levey, Kai-Uwe Eckardt, John J. V. Mcmurray, Larry A. Weinrauch, Jiankang Liu, Brian L. Claggett, Eldrin F. Lewis, Marc A. Pfeffer

Faculty of Health Sciences Publications

Aims Metformin could have benefits on cardiovascular disease and kidney disease progression but is often withheld from individuals with diabetes and chronic kidney disease (CKD) because of a concern that it may increase the risk of lactic acidosis. Materials and methods All‐cause mortality, cardiovascular death, cardiovascular events (death, hospitalization for heart failure, myocardial infarction, stroke or myocardial ischemia), end stage renal disease (ESRD) and the kidney disease composite (ESRD or death) were compared in metformin users and non‐users with diabetes and CKD enrolled in the Trial to Reduce Cardiovascular Events with Aranesp (darbepoeitin‐alfa) Therapy (TREAT) (NCT00093015). Outcomes ...


Outcomes And Effect Of Treatment According To Etiology In Hfref: An Analysis Of Paradigm-Hf, Craig Balmforth, Joanne Simpson, Li Shen, Pardeep S. Jhund, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Scott D. Solomon, Karl Swedberg, Michael R. Zile, Milton Packer, John J. V. Mcmurray Jan 2019

Outcomes And Effect Of Treatment According To Etiology In Hfref: An Analysis Of Paradigm-Hf, Craig Balmforth, Joanne Simpson, Li Shen, Pardeep S. Jhund, Martin P. Lefkowitz, Adel R. Rizkala, Jean L. Rouleau, Victor C. Shi, Scott D. Solomon, Karl Swedberg, Michael R. Zile, Milton Packer, John J. V. Mcmurray

Faculty of Health Sciences Publications

Objectives The purpose of this study was to compare outcomes (and the effect of sacubitril/valsartan) according to etiology in the PARADIGM-HF (Prospective comparison of angiotensin-receptor-neprilysin inhibitor [ARNI] with angiotensin-converting-enzyme inhibitor [ACEI] to Determine Impact on Global Mortality and morbidity in Heart Failure) trial. Background Etiology of heart failure (HF) has changed over time in more developed countries and is also evolving in non-Western societies. Outcomes may vary according to etiology, as may the effects of therapy. Methods We examined outcomes and the effect of sacubtril/valsartan according to investigator-reported etiology in PARADIGM-HF. The outcomes analyzed were the primary composite ...


Peripartum Cardiomyopathy: Disease Or Syndrome?, Lucia Baris, Jérôme Cornette, Mark R. Johnson, Karen Sliwa, Jolien W. Roos-Hesselink Jan 2019

Peripartum Cardiomyopathy: Disease Or Syndrome?, Lucia Baris, Jérôme Cornette, Mark R. Johnson, Karen Sliwa, Jolien W. Roos-Hesselink

Faculty of Health Sciences Publications

Peripartum cardiomyopathy (PPCM) is a rare form of pregnancy-associated heart failure and is considered to be a diagnosis of exclusion. There are many hypotheses on the aetiology of PPCM; however, the exact pathophysiological mechanism remains unknown. It shows many resemblances to other conditions, such as familial dilated cardiomyopathy or myocarditis, and therefore it can be hard to make a definite diagnosis. We describe four cases of peripartum-onset heart failure in women who were suspected of having PPCM. We discuss the differential diagnosis, pathophysiological mechanisms and various diagnostic modalities.


Reduced Loop Diuretic Use In Patients Taking Sacubitril/Valsartan Compared With Enelapril: The Paradigm-Hf Trial, Orly Vardeny, Brian L. Claggett, Jessica Kachadourian, Akshay S. Desai, Milton Packer, Jean L. Rouleau, Michael R. Zile, Karl Swedberg, Martin P. Lefkowitz, Victor C. Shi, John J. V. Mcmurray, Scott D. Solomon Jan 2019

Reduced Loop Diuretic Use In Patients Taking Sacubitril/Valsartan Compared With Enelapril: The Paradigm-Hf Trial, Orly Vardeny, Brian L. Claggett, Jessica Kachadourian, Akshay S. Desai, Milton Packer, Jean L. Rouleau, Michael R. Zile, Karl Swedberg, Martin P. Lefkowitz, Victor C. Shi, John J. V. Mcmurray, Scott D. Solomon

Faculty of Health Sciences Publications

Aims To assess differences in diuretic dose requirements in patients treated with sacubitril/valsartan compared with enalapril in the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM‐HF) trial. Methods and results Overall, 8399 patients with New York Heart Association class II–IV heart failure and reduced LVEF were randomized to sacubitril/valsartan 200 mg bid or enalapril 10 mg twice daily. Loop diuretic doses were assessed at baseline, 6, 12, and 24 months, and furosemide dose equivalents were calculated via multiplication factors (2x for torsemide and 40x for bumetanide ...


Statins In The Prevention And Treatment Of Heart Failure: A Review Of The Evidence, Matthew M. Y. Lee, Naveed Sattar, John J. V. Mcmurray, Chris J. Packard Jan 2019

Statins In The Prevention And Treatment Of Heart Failure: A Review Of The Evidence, Matthew M. Y. Lee, Naveed Sattar, John J. V. Mcmurray, Chris J. Packard

Faculty of Health Sciences Publications

Purpose of Review We summarize the best evidence for statins in the prevention and treatment of heart failure. Recent Findings In patients with cardiovascular risk factors or established atherosclerotic cardiovascular disease (but without heart failure), statins reduce the risk of incident heart failure—mainly by preventing myocardial infarction although an additional benefit from reducing myocardial ischemia cannot be excluded. However, in patients with established heart failure, statins do not reduce the risk of cardiovascular death, which is mainly caused by pump failure and ventricular arrhythmias. Retrospective analyses, however, suggest that statins may reduce the rate of heart failure hospitalization and ...


To Live A Life With Copd: The Consequences Of Symptom Burden, Helena Johansson, Carina Berterö, Katarina Berg, Lise-Lotte Jonasson Jan 2019

To Live A Life With Copd: The Consequences Of Symptom Burden, Helena Johansson, Carina Berterö, Katarina Berg, Lise-Lotte Jonasson

Faculty of Health Sciences Publications

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent illness that, due to its symptoms and treatment, entails a significant burden for the affected person, and his/her family, health care and private finances. Today, knowledge and understanding are sparse regarding COPD-affected persons’ own lived experiences and about the symptom burden and its effect on their daily life. Due to this knowledge gap the aim of this study was to identify and describe the symptom burden and its effect on daily life in people with COPD, based on their own lived experiences. Subject and method: Eleven males and 14 females ...


Traffic Related Air Pollution And The Burden Of Childhood Asthma In The Contiguous United States In 2000 And 2010, Raed Alotaibi, Mathew Bechle, Julian D. Marshall, Tara Ramani, Josias Zietsman, Mark J. Nieuwenhuijsen, Haneen Khreis Jan 2019

Traffic Related Air Pollution And The Burden Of Childhood Asthma In The Contiguous United States In 2000 And 2010, Raed Alotaibi, Mathew Bechle, Julian D. Marshall, Tara Ramani, Josias Zietsman, Mark J. Nieuwenhuijsen, Haneen Khreis

Faculty of Health Sciences Publications

Background Asthma is one of the leading chronic airway diseases among children in the United States (US). Emerging evidence indicates that Traffic Related Air Pollution (TRAP), as opposed to ambient air pollution, leads to the onset of childhood asthma. We estimated the number of incident asthma cases among children attributable to TRAP in the contiguous US, for the years 2000 and 2010. Methods The number of incident childhood asthma cases and percentage due to TRAP were estimated using standard burden of disease assessment methods. We combined children (<18 years) counts and pollutant exposures at populated US census blocks with a national asthma incidence rate and meta-analysis derived concentration response functions (CRF). NO2, PM2.5 and PM10 were used as surrogates of TRAP exposures, with NO2 being most specific. Annual average concentrations were obtained from previously validated land-use regression (LUR) models. Asthma incidence rate and a CRF for each pollutant were obtained from the literature. Estimates were stratified by urban or rural living and by median household income. We also estimated the number of preventable cases among blocks that exceeded the limit for two counterfactual scenarios. The first scenario used the recommended air quality annual averages from the World Health Organization (WHO) as a limit. The second scenario used the minimum modeled concentration for each pollutant, in either year, as a limit. Results Average concentrations in 2000 and 2010, respectively, were 20.6 and 13.2 μg/m3 for NO2, 12.1 and 9 μg/m3 for PM2.5 and 21.5 and 17.9 μg/m3 for PM10. Attributable number of cases ranged between 209,100–331,200 for the year 2000 and 141,900–286,500 for 2010, depending on the pollutant. Asthma incident cases due to TRAP represented 27%–42% of all cases in 2000 and 18%–36% in 2010. Percentage of cases due to TRAP were higher (1) in urban areas than rural areas, and (2) in block groups with lowest median household income. Online open-access interactive maps and tables summarizing findings at the county level and 498 major US cities, are available at [https://carteehdata.org/l/s/TRAP-burden-of-childhood-asthma]. Assuming that pollutants did not exceed WHO air quality recommendations, the number of incident cases that could have been prevented ranged between 300 and 53,400, depending on the pollutant and year. Assuming that pollutant levels were limited to the minimum modeled concentration, the number of childhood asthma incident cases that could have been prevented ranged between 127,700 and 317,600, depending on the pollutant and year. Conclusion This is the first study to estimate the burden of incident childhood asthma attributable to TRAP at a national scale in the US. The attributable burden of childhood asthma dropped by 33% between 2000 and 2010. However, a significant proportion of cases can be prevented.


Heart Failure In Sub-Saharan Africa, Okechukwu Ogah, Adewole Adebiyi, Karen Sliwa-Hahnle Jan 2019

Heart Failure In Sub-Saharan Africa, Okechukwu Ogah, Adewole Adebiyi, Karen Sliwa-Hahnle

Faculty of Health Sciences Publications

Sub-Saharan Africa (SSA) is currently experiencing multiple burden of disease as a result of demographic and epidemiologic transition. This is occasioned rapid urbanization, unhealthy diets rich in fats and salt, western lifestyle and sedentary living. Heart failure (HF) has become a global public health issue. It is associated with high morbidity and mortality, frequent hospitalization and high economic cost. In SSA, HF is a disease of young and middle-aged adults with the attendant high disability-adjusted life years. This is unlike to the clinical profile and pattern of HF in high-income countries of North America, Western Europe and Japan where HF ...


Distinct Skeletal Muscle Molecular Responses To Pulmonary Rehabilitation In Chronic Obstructive Pulmonary Disease: A Cluster Analysis, Anita E. M. Kneppers, Roy A. M. Haast, Ramon C. J. Langen, Lex B. Verdijk, Pieter A. Leermakers, Harry R. Gosker, Luc J. C. Van Loon, Mitja Lainscak, Annemie M. W. J. Schols Jan 2019

Distinct Skeletal Muscle Molecular Responses To Pulmonary Rehabilitation In Chronic Obstructive Pulmonary Disease: A Cluster Analysis, Anita E. M. Kneppers, Roy A. M. Haast, Ramon C. J. Langen, Lex B. Verdijk, Pieter A. Leermakers, Harry R. Gosker, Luc J. C. Van Loon, Mitja Lainscak, Annemie M. W. J. Schols

Faculty of Health Sciences Publications

Background Pulmonary rehabilitation (PR) is a cornerstone in the management of chronic obstructive pulmonary disease (COPD), targeting skeletal muscle to improve functional performance. However, there is substantial inter‐individual variability in the effect of PR on functional performance, which cannot be fully accounted for by generic phenotypic factors. We performed an unbiased integrative analysis of the skeletal muscle molecular responses to PR in COPD patients and comprehensively characterized their baseline pulmonary and physical function, body composition, blood profile, comorbidities, and medication use. Methods Musculus vastus lateralis biopsies were obtained from 51 COPD patients (age 64 ± 1 years, sex 73% men ...


Personalized Medicine And Hospitalization For Heart Failure: If We Understand It, We May Be Successful In Treating It, Faheem A. Ahmad, Mark C. Petrie, John J. V. Mcmurray, Ninian N. Lang Jan 2019

Personalized Medicine And Hospitalization For Heart Failure: If We Understand It, We May Be Successful In Treating It, Faheem A. Ahmad, Mark C. Petrie, John J. V. Mcmurray, Ninian N. Lang

Faculty of Health Sciences Publications

Randomized trials in patients with hospitalized heart failure (HHF) continue to frustrate the cardiology community. Promising haemodynamic, structural and biomarker findings from phase 2 studies consistently fail to deliver substantive benefits in larger outcome trials. What underlies these recurrent failures? Why are persistently high readmission and post‐discharge mortality rates not being reduced? Challenging any pre‐conceived ideas about the existence of a ‘typical’ acutely decompensated heart failure patient is fundamental, as is the adoption of a carefully personalized approach. These individuals come from a remarkably heterogeneous group. Surely precise phenotyping should translate to a more successful therapeutic approach?


Efficacy Of Treatments For Demodex Blepharitis: A Systematic Review And Meta-Analysis, Valentin Navel, Aurélien Mulliez, Cédric Benoist D'Azy, Julien S. Baker, Jean Malecaze, Frédéric Chiambaretta, Frederic Dutheil Jan 2019

Efficacy Of Treatments For Demodex Blepharitis: A Systematic Review And Meta-Analysis, Valentin Navel, Aurélien Mulliez, Cédric Benoist D'Azy, Julien S. Baker, Jean Malecaze, Frédéric Chiambaretta, Frederic Dutheil

Faculty of Health Sciences Publications

Purpose We conducted a systematic review and meta-analysis to evaluate the efficacy of different treatment for Demodex blepharitis. Parameters studied were mites count, improvement of symptoms and mites’ eradication, stratified on type of treatments and mode of delivery of treatments (local or systemic). Method The PubMed, Cochrane Library, Embase, ClinicalTrials.gov, Google scholar and Science Direct databases were searched for studies reporting an efficacy of treatments for Demodex blepharitis. Results We included 19 studies (14 observational and 5 randomized clinical trials), for a total of 934 patients, 1741 eyes, and 13 different treatments. For mites count, eradication rate, and symptoms ...


Gait Characteristics And Falls In Parkinson's Disease: A Systematic Review And Meta-Analysis [Accepted Manuscript], Mark W. Creaby, Michael H. Cole Dec 2018

Gait Characteristics And Falls In Parkinson's Disease: A Systematic Review And Meta-Analysis [Accepted Manuscript], Mark W. Creaby, Michael H. Cole

Faculty of Health Sciences Publications

Introduction: Given the high rate of falls during walking in people with idiopathic Parkinson's disease (PD), identifying at risk individuals and developing targeted interventions to reduce falls incidence is paramount. Numerous studies have investigated gait-related risk factors for falls in PD, however findings are inconsistent across studies, and thus a synthesis of the current evidence is needed to guide clinical practice and the development of interventions to reduce falls risk. The objective of this study was to systematically review the literature regarding the association between walking biomechanics and falls in people with PD, and where possible, perform meta-analyses. Methods ...


Improving Screening And Physiotherapy Management Of Vestibular Disorders In The Hospital Setting, Vicky Stewart Jun 2018

Improving Screening And Physiotherapy Management Of Vestibular Disorders In The Hospital Setting, Vicky Stewart

Theses

Vestibular disorders significantly impact a person’s quality of life and daily function with symptoms such as dizziness, vertigo, visual disturbances and balance impairment. Vestibular disorders commonly cause hospital presentations and are often under diagnosed and therefore mis-managed in the emergency department (ED) and acute medical environment (AME). There is a lack of research assisting clinicians in identifying and managing vestibular disorders in these settings. There is also limited evidence concerning the effectiveness of a physiotherapy vestibular service in the acute hospital setting for managing non-emergent vestibular disorders (non-life threatening).

The primary aim of this thesis was to improve the ...