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Use Of Do-Not-Resuscitate Orders In Patients With Kidney Disease Hospitalized With Acute Myocardial Infarction, Joline Chen, Jonathan Sosnov, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg 2010 Boston University

Use Of Do-Not-Resuscitate Orders In Patients With Kidney Disease Hospitalized With Acute Myocardial Infarction, Joline Chen, Jonathan Sosnov, Darleen Lessard, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Patients with kidney disease are at increased risk for adverse health outcomes in comparison to patients without kidney disease. Therefore, patients with kidney disease may have greater use of do-not-resuscitate (DNR) orders than patients without kidney disease in the setting of an acute illness. We examined the association between advanced kidney disease and use of DNR orders in patients admitted with an acute myocardial infarction (AMI) to all greater Worcester, MA, hospitals as part of an epidemiological study.

METHODS: Use of DNR orders in 4,033 Worcester residents hospitalized with AMI at 11 greater Worcester medical centers during 1997 ...


Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg 2010 McMaster University

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history ...


Excess Body Weight, Clinical Profile, Management Practices, And Hospital Prognosis In Men And Women After Acute Myocardial Infarction, Robert Goldberg, Jiang Cui, Barbara Olendzki, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore 2010 University of Massachusetts Medical School

Excess Body Weight, Clinical Profile, Management Practices, And Hospital Prognosis In Men And Women After Acute Myocardial Infarction, Robert Goldberg, Jiang Cui, Barbara Olendzki, Frederick Spencer, Jorge Yarzebski, Darleen Lessard, Joel Gore

Jorge L. Yarzebski

BACKGROUND: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction (AMI).

METHODS: Nonconcurrent prospective epidemiologic investigation of Worcester (Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003.

RESULTS: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41% of men and 29% of women were classified as ...


Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo 2010 Universidade de São Paulo

Validation Of A Stroke Symptom Questionnaire For Epidemiological Surveys., Paulo A. Lotufo

Paulo A Lotufo

CONTEXT AND OBJECTIVE:Stroke is a relevant issue within public health and requires epidemiological surveillance tools. The aim here was to validate a questionnaire for evaluating individuals with stroke symptoms in the Stroke Morbidity and Mortality Study (Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral, EMMA), São Paulo, Brazil.DESIGN AND SETTING:This was a cross-sectional study performed among a sample of the inhabitants of Butantã, an area in the western zone of the city of São Paulo.METHODS:For all households in the coverage area of a primary healthcare unit, household members over the age of 35 years ...


Randomized Trial Of A Pharmacist-Delivered Intervention For Improving Lipid-Lowering Medication Adherence Among Patients With Coronary Heart Disease, Yunsheng Ma, Ira S. Ockene, Milagros C. Rosal, Philip A. Merriam, Judith K. Ockene, Pritesh J. Gandhi 2010 University of Massachusetts Medical School

Randomized Trial Of A Pharmacist-Delivered Intervention For Improving Lipid-Lowering Medication Adherence Among Patients With Coronary Heart Disease, Yunsheng Ma, Ira S. Ockene, Milagros C. Rosal, Philip A. Merriam, Judith K. Ockene, Pritesh J. Gandhi

Preventive and Behavioral Medicine Publications

A randomized trial of a pharmacist-delivered intervention (PI) versus usual care (UC) was conducted; 689 subjects with known coronary heart disease were recruited from cardiac catheterization laboratories. Participants in the PI condition received 5 pharmacist-delivered telephone counseling calls post-hospital discharge. At one year, 65% in the PI condition and 60% in the UC condition achieved an LDL-C level <100 mg/dL (P=.29); mean statin adherence was 0.88 in the PI, and 0.90 in the UC (P=.51). The highest percentage of those who reached the LDL-C goal were participants who used statins as opposed to those who did not use statins (67% versus 58%, P=.05). However, only 53% and 56% of the patients in the UC and PI conditions, respectively, were using statins. We conclude that a pharmacist-delivered intervention aimed only at improving patient adherence is unlikely to positively affect outcomes. Efforts must be oriented towards influencing physicians to increase statin prescription rates.


Co– And Post–Translational N–Linked Glycosylation Of Cardiac Potassium Channel Subunits: A Dissertation, Tuba Bas 2010 University of Massachusetts Medical School

Co– And Post–Translational N–Linked Glycosylation Of Cardiac Potassium Channel Subunits: A Dissertation, Tuba Bas

GSBS Dissertations and Theses

KCNE1 (E1) peptide is the founding member of the KCNE family (1-5), which is a class of type I transmembrane ß-subunits. KCNE1 peptides assemble with and modulate the gating, ion conducting properties and pharmacology of a variety of voltage-gated K+ channel a-subunits, including KCNQ1 (Q1). Mutations that interfere with the function of either E1 and/or Q1 and disrupt the assembly and trafficking of KCNE1- KCNQ1 channel complexes give rise to diseases such as Romano-Ward (RW) and Jervell Lange Nielsen Syndrome (JLNS), two different forms of Long QT Syndrome (LQTS).

Using enzymatic deglycosylation assays, immunofluorescence techniques and quantitative cell surface ...


Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo 2010 Universidade de São Paulo

Socioeconomic Status And Coronary Heart Disease Mortality In The City Of Sao Paulo, Brazil (1996 To 2007), Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Polyheart: Cardiovascular Disease Risk Assessment, Katherine Vaughan 2010 California Polytechnic State University - San Luis Obispo

Polyheart: Cardiovascular Disease Risk Assessment, Katherine Vaughan

Kinesiology

Cardiovascular disease (CVD) is the leading cause of death in ‘Western Civilization.’ Lifestyle modification (ie regular exercise and healthy diet) greatly reduces the risk for CVD. It is unclear whether faculty at Cal Poly, who are exposed to positive benefits of lifestyle modification are at risk for CVD. The purpose of this study was to assess Cal Poly’s faculties’ cardiovascular health status, as specified by the American College of Sports Medicine’s (ACSM) seven cardiovascular disease risk factors. Both the researchers and participants benefit from this study because awareness of CVD risk factors may help prevent progression of risk ...


Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez 2010 Dartmouth College

Cardiovascular Risk Assessment - From Individual Risk Prediction To Estimation Of Global Risk And Change In Risk In The Population, John A. Batsis, Francisco Lopez-Jimenez

Open Dartmouth: Faculty Open Access Articles

Cardiovascular disease is the most common cause of death and risk prediction formulae such as the Framingham Risk Score have been developed to easily identify patients at high risk that may require therapeutic interventions. Using cardiovascular risk formulae at a population level to estimate and compare average cardiovascular risk among groups has been recently proposed as a way to facilitate surveillance of net cardiovascular risk and target public health interventions. Risk prediction formulas may help to compare interventions that cause effects of different magnitudes and directions in several cardiovascular risk factors, because these formulas assess the net change in risk ...


Effect Of Calcium Supplements On Risk Of Myocardial Infarction And Cardiovascular Events: Meta-Analysis, Mark J. Bolland, Allison Avenell, John A. Baron, A. Grey 2010 University of Aukland

Effect Of Calcium Supplements On Risk Of Myocardial Infarction And Cardiovascular Events: Meta-Analysis, Mark J. Bolland, Allison Avenell, John A. Baron, A. Grey

Open Dartmouth: Faculty Open Access Articles

Objective: To investigate whether calcium supplements increase the risk of cardiovascular events.

Osteoporosis is a major cause of morbidity and mortality in older people. Calcium supplements margin- ally reduce the risk of fracture, and most guidelines recommend adequate calcium intake as an integral part of the prevention or treatment of osteoporosis. Consequently, calcium supplements are commonly used by people over the age of 50. Observational stu- dies suggest that high calcium intake might protect against vascular disease, and the findings are consis- tent with those of interventional studies of calcium sup- plements thatshow improvementin some vascular risk factors. In contrast ...


The Role Of Akt2 In Hepatic Lipid Metabolism, Karla F. Leavens 2010 Universiy of Pennsylvania

The Role Of Akt2 In Hepatic Lipid Metabolism, Karla F. Leavens

Publicly Accessible Penn Dissertations

Insulin drives the global anabolic response to nutrient ingestion, regulating both carbohydrate and lipid metabolism. When insulin resistance occurs in Type 2 Diabetes Mellitus, dysregulation of both of these processes ensues, resulting in hyperglycemia and lipid abnormalities. One of the most prevalent morbidities associated with insulin resistance is the abnormal accumulation of triglycerides in the liver, called hepatic steatosis, though the underlying pathogenesis of this accumulation remains unclear. There is certainly an inappropriate increase in de novo lipogenesis in the livers of individuals with hepatic steatosis, but the insulin signaling pathway involved in the control of normal, and therefore abnormal ...


Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo 2010 Universidade de São Paulo

Non-Inferiority Trials [In Portuguese], Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


Age And Sex Differences In Duration Of Pre-Hospital Delay, Hospital Treatment Practices, And Short-Term Outcomes In Patients Hospitalized With An Acute Coronary Syndrome/Acute Myocardial Infarction: A Dissertation, Hoa L. Nguyen 2010 University of Massachusetts Medical School

Age And Sex Differences In Duration Of Pre-Hospital Delay, Hospital Treatment Practices, And Short-Term Outcomes In Patients Hospitalized With An Acute Coronary Syndrome/Acute Myocardial Infarction: A Dissertation, Hoa L. Nguyen

GSBS Dissertations and Theses

Background
The prompt seeking of medical care after the onset of symptoms suggestive of acute coronary syndromes (ACS)/acute myocardial infarction (AMI) is associated with the receipt of coronary reperfusion therapy, and effective cardiac medications in patients with an ACS/AMI and is crucial to reducing mortality and the risk of serious clinical complications in these patients. Despite declines in important hospital complications and short-term death rates in patients hospitalized with an ACS/AMI, several patient groups remain at increased risk for these adverse outcomes, including women and the elderly. However, recent trends in age and sex differences in extent ...


Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo 2010 Universidade de São Paulo

Cardiovascular And Cancer Mortality In Brazil, Paulo A. Lotufo

Paulo A Lotufo

Cancer are not surpassing Cardiovascular Diseases. Here you have an evaluation of mortality in Brazil. The debate was ignited by paper from IARC (International Agency for Research on Cancer) that forecasts cancer deaths surpassing heart diseases rates during de 2020’s. There is no dispute about the fact that - at least in the US and other countries - the decline of mortality deaths for heart diseases presenting a faster pace compared to cancer death rates. It is an epidemiological evidence that must be analyzed and some headline fueling hype as “heart diseases as an old agenda of public health and medical ...


Smooth Muscle Hyperplasia Due To Acta2/Myh11 Mutations: Identification Of Novel Pathology And Pathways Leading To Aneurysms And Diverse Vascular Occlusive Diseases, Christina L. Papke 2010 University of Texas Graduate School of Biomedical Sciences at Houston

Smooth Muscle Hyperplasia Due To Acta2/Myh11 Mutations: Identification Of Novel Pathology And Pathways Leading To Aneurysms And Diverse Vascular Occlusive Diseases, Christina L. Papke

UT GSBS Dissertations and Theses (Open Access)

Missense mutations in smooth muscle cell (SMC) specific ACTA2 (á-actin) and MYH11 (â-myosin heavy chain) cause diffuse and diverse vascular diseases, including thoracic aortic aneurysms and dissections (TAAD) and early onset coronary artery disease and stroke. The mechanism by which these mutations lead to dilatation of some arteries but occlusion of others is unknown. We hypothesized that the mutations act through two distinct mechanisms to cause varied vascular diseases: a loss of function, leading to decreased SMC contraction and aneurysms, and a gain of function, leading to increased SMC proliferation and occlusive disease. To test this hypothesis, ACTA2 mutant SMCs ...


The Relationship Of A Long-Term Exercise Program And Selected Coronary Risk Factors, Maryse Wells 2010 University of Nevada Las Vegas

The Relationship Of A Long-Term Exercise Program And Selected Coronary Risk Factors, Maryse Wells

UNLV Theses, Dissertations, Professional Papers, and Capstones

The purpose of this study was to investigate body composition and blood pressure as potential risk factors for coronary artery disease after 3 years of participation in a structured exercise program. The sample group was comprised of 21 male participants (66%) and 11 (34%) female participants with a mean age of 55 years who attended the exercise program and completed health and fitness testing annually. Participants did cardiovascular, strength, and flexibility training 5 days a week with an average attendance of 70%. After 3 years, BMI, waist circumference, and percent body fat increased significantly (p < .01); blood pressure levels did not change significantly (p > .05). Low control of diet ...


Does Cognitive Impairment Predict Poor Self-Care In Patients With Heart Failure?, Jan Cameron, Linda Worrall-Carter, Karen Page, Barbara Riegel, Sing Kai Lo, Simon Stewart 2010 University of Pennsylvania

Does Cognitive Impairment Predict Poor Self-Care In Patients With Heart Failure?, Jan Cameron, Linda Worrall-Carter, Karen Page, Barbara Riegel, Sing Kai Lo, Simon Stewart

School of Nursing Departmental Papers

Aims

Cognitive impairment occurs often in patients with chronic heart failure (CHF) and may contribute to sub‐optimal self‐care. This study aimed to test the impact of cognitive impairment on self‐care.

Methods and Results

In 93 consecutive patients hospitalized with CHF, self‐care (Self‐Care of Heart Failure Index) was assessed. Multiple regression analysis was used to test a model of variables hypothesized to predict self‐care maintenance, management, and confidence. Variables in the model were mild cognitive impairment (MCI; Mini‐Mental State Exam and Montreal Cognitive Assessment), depressive symptoms (Cardiac Depression Scale), age, gender, social isolation, education ...


Myostatin Is Upregulated Following Stress In An Erk-Dependent Manner And Negatively Regulates Cardiomyocyte Growth In Culture And In A Mouse Model, Lawrence T. Bish, Kevin J. Morine, Margaret M. Sleeper, H. Lee Sweeney 2010 University of Pennsylvania

Myostatin Is Upregulated Following Stress In An Erk-Dependent Manner And Negatively Regulates Cardiomyocyte Growth In Culture And In A Mouse Model, Lawrence T. Bish, Kevin J. Morine, Margaret M. Sleeper, H. Lee Sweeney

Departmental Papers (Vet)

Myostatin is well established as a negative regulator of skeletal muscle growth, but its role in the heart is controversial. Our goal in this study was to characterize myostatin regulation following cardiomyocyte stress and to examine the role of myostatin in the regulation of cardiomyocyte size. Neonatal cardiomyocytes were cultured and stressed with phenylephrine. Adenovirus was used to overexpress myostatin or dominant negative myostatin in culture. Adeno-associated virus was used to overexpress myostatin or dominant negative myostatin in mice. Myostatin is upregulated following cardiomyocyte stress in an Erk-dependent manner that is associated with increased nuclear translocation and DNA binding activity ...


Symptom Recognition In Elders With Heart Failure, Barbara Riegel, Victoria V. Dickson, Janette Cameron, Jerry C. Johnson, Stephen Bunker, Karen Page, Linda Worrall-Carter 2010 University of Pennsylvania

Symptom Recognition In Elders With Heart Failure, Barbara Riegel, Victoria V. Dickson, Janette Cameron, Jerry C. Johnson, Stephen Bunker, Karen Page, Linda Worrall-Carter

School of Nursing Departmental Papers

Purpose: Aging is associated with losses in hearing and vision. The objective of this study was to assess whether aging also is associated with less ability to detect and interpret afferent physiological information.

Design: A cross‐sectional mixed methods study was conducted with 29 persons with a confirmed diagnosis of chronic heart failure of at least 6 months duration. The sample was divided at the median to compare younger (<73 years) versus older (≥73 years) patients in the ability to detect and interpret their heart failure symptoms.

Methods: Shortness of breath was stimulated using a 6‐minute walk test (6MWT) and used to assess the ability of heart failure patients to detect shortness of breath using the Borg ...


Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo 2010 Universidade de São Paulo

Gender Differences Of Case-Fatality Rate In A Brazilian Stroke Registry, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.


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