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1,873 full-text articles. Page 81 of 85.

Effects Of A Multicomponent Wellness Intervention On Dyslipidemia In An Overweight Adolescent Population, Olga T. Hardy, Jean Wiecha, Albert Kim, Carlos Salas, Rayna Bricenoc, Kwesi Moody, Joan Becker, Greer Glazer, Carol A. Ciccarelli, Ling Shi, Laura L. Hayman 2011 University of Massachusetts Medical School

Effects Of A Multicomponent Wellness Intervention On Dyslipidemia In An Overweight Adolescent Population, Olga T. Hardy, Jean Wiecha, Albert Kim, Carlos Salas, Rayna Bricenoc, Kwesi Moody, Joan Becker, Greer Glazer, Carol A. Ciccarelli, Ling Shi, Laura L. Hayman

UMass Center for Clinical and Translational Science Research Retreat

Epidemiologic studies suggest that atherosclerotic processes begin in childhood and are associated with abnormal lipid levels. Behavioral changes are the first line of treatment for dyslipidemia in adolescents but outcome data on the effectiveness of this approach are inconsistent. This study aimed to assess the effect of a 13-week multicomponent wellness intervention program on dyslipidemia in lean and overweight/obese adolescents enrolled at a public high school in Boston, Massachusetts. The intervention was conducted at a university-based youth fitness center where 9 overweight/obese adolescents (body mass index [BMI]≥85th percentile for age and sex) and 9 lean adolescents (BMIsex ...


Patterns Of Complex Comorbidity In Older Patients With Heart Failure, Jane S. Saczynski, Jerry H. Gurwitz, Sandhyasree Padmanabhan, Robert J. Goldberg, David J. Magid, David H. Smith, Sue Hee Sung, Alan S. Go 2011 University of Massachusetts Medical School

Patterns Of Complex Comorbidity In Older Patients With Heart Failure, Jane S. Saczynski, Jerry H. Gurwitz, Sandhyasree Padmanabhan, Robert J. Goldberg, David J. Magid, David H. Smith, Sue Hee Sung, Alan S. Go

UMass Center for Clinical and Translational Science Research Retreat

Background

Heart failure (HF) carries a high burden of comorbidity with approximately one half of patients with HF having at least one additional comorbid condition present. Rates of comorbidity in patients with HF have steadily increased over the past 2 decades.

Objective

To examine patterns of comorbidity among older patients with HF in the Cardiovascular Research Network PRESERVE cohort.

Methods

PRESERVE Cohort

Data are from the CVRN PRESERVE cohort which is a multicenter cohort of 37,054 patients [mean age = 74 years (SD = 12.4 yrs); 46% female] with HF diagnosed between 2005 and 2008 currently being conducted at 4 ...


Childhood Meat Eating And Inflammatory Markers: The Guangzhou Biobank Cohort Study, Mary Schooling, Chao Q. Jiang, Tai H. Lam, W. S. Zhang, Kar Keung Cheng, Gabriel M. Leung 2011 CUNY School of Public Health

Childhood Meat Eating And Inflammatory Markers: The Guangzhou Biobank Cohort Study, Mary Schooling, Chao Q. Jiang, Tai H. Lam, W. S. Zhang, Kar Keung Cheng, Gabriel M. Leung

Publications and Research

Background
We hypothesized that socio-economic development could, via nutritionally driven levels of pubertal sex-steroids, promote a pro-inflammatory state among men but not women in developing countries. We tested this hypothesis, using recalled childhood meat eating as a proxy for childhood nutrition, in southern China.

Methods
We used multivariable linear regression in the Guangzhou Biobank Cohort Study phase 3 (2006-8) to examine the adjusted associations of recalled childhood meat eating, <1/week (n = 5,023), about once per week (n = 3,592) and almost daily (n = 1,252), with white blood cell count and its differentials among older (≥50 years) men (n = 2,498) and women (n = 7,369).

Results
Adjusted for age, childhood socio-economic position, education and smoking, childhood meat eating had sex-specific associations with white blood cell count and lymphocyte count, but not granulocyte count. Men with childhood ...


Cardiovascular Risk Scores Do Not Account For The Effect Of Treatment: A Review, Su May Liew, Jenny Doust, Paul Glasziou 2011 University of Oxford

Cardiovascular Risk Scores Do Not Account For The Effect Of Treatment: A Review, Su May Liew, Jenny Doust, Paul Glasziou

Paul Glasziou

Objective - To compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease.Design - Review of cardiovascular risk scores.Data sources - Medline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords ‘cardiovascular’, ‘risk prediction’ and ‘cohort studies’.Eligibility - criteria for selecting studies A study was eligible if it fulfilled the following criteria: (1) it was a cohort study of adults in the general population with no prior history of cardiovascular disease and not restricted by a disease condition; (2) the primary objective was ...


Cardiovascular Risk Scores Do Not Account For The Effect Of Treatment: A Review, Su May Liew, Jenny Doust, Paul Glasziou 2011 University of Oxford

Cardiovascular Risk Scores Do Not Account For The Effect Of Treatment: A Review, Su May Liew, Jenny Doust, Paul Glasziou

Jenny Doust

Objective - To compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease.Design - Review of cardiovascular risk scores.Data sources - Medline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords ‘cardiovascular’, ‘risk prediction’ and ‘cohort studies’.Eligibility - criteria for selecting studies A study was eligible if it fulfilled the following criteria: (1) it was a cohort study of adults in the general population with no prior history of cardiovascular disease and not restricted by a disease condition; (2) the primary objective was ...


Diagnosis Of Heart Failure In Primary Care, F. D. R. Hobbs, Jenny Doust, Jonathan Mant, Martin R. Cowie 2011 University of Birmingham

Diagnosis Of Heart Failure In Primary Care, F. D. R. Hobbs, Jenny Doust, Jonathan Mant, Martin R. Cowie

Jenny Doust

Extract: Heart failure is a syndrome resulting from a structural or functional cardiac disorder. For a diagnosis of heart failure to be made, there should be symptoms or signs, such as breathlessness, effort intolerance or fluid retention, together with objective evidence of cardiac dysfunction. Heart failure is an increasingly important chronic disease syndrome, associated with poor prognosis, poor quality of life for patients, and high healthcare costs. In the general population, where all grades of heart failure are represented, 5 year mortality is around 42%; however, where the diagnosis is established during a hospital admission, 5 year mortality is between ...


A Qualitative Meta-Analysis Of Heart Failure Self-Care Practices Among Individuals With Multiple Comorbid Conditions, Victoria V. Dickson, Harleah G. Buck, Barbara Riegel 2011 University of Pennsylvania

A Qualitative Meta-Analysis Of Heart Failure Self-Care Practices Among Individuals With Multiple Comorbid Conditions, Victoria V. Dickson, Harleah G. Buck, Barbara Riegel

School of Nursing Departmental Papers

Background

Most heart failure (HF) patients have other comorbid conditions. HF self-care requires medication and diet adherence, daily weight monitoring, and a thoughtful response to symptoms when they occur. Self-care is complicated when other chronic conditions have additional self-care requirements. The purpose of this study is to explore how comorbidity influences HF self-care.

Methods

Using qualitative descriptive meta-analysis techniques, transcripts from 3 mixed methods studies (n = 99) were reexamined to yield themes about perceptions about HF and self-care and to explore the influence on HF self-care. The Charlson Comorbidity Index identified comorbid conditions.

Results

The sample was 74% Caucasian, 66 ...


Evaluation Of Recurrence Risks For Left-Sided Cardiac Lesions, Sarah Swain 2011 University of Texas Graduate School of Biomedical Sciences at Houston

Evaluation Of Recurrence Risks For Left-Sided Cardiac Lesions, Sarah Swain

The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Dissertations and Theses (Open Access)

It is widely accepted that hypoplastic left heart syndrome (HLHS), aortic valve stenosis with or without bicuspid aortic valve (AS/BAV) and coarctation of the aorta (CoA) occur in families more commonly with each other than with any other congenital heart defect (CHD). Genetic counseling for CHDs is currently based on empiric risk estimates derived from data collected on all types of CHDs between 1968 and 1990. Additionally, for the specific group of defects described above, termed left-sided lesions, estimates are available for sibling recurrence. Utilizing family history data from 757 probands recruited between 1997 and 2007 from The Children ...


Evaluation Of Kawasaki Disease Risk-Scoring Systems For Intravenous Immunoglobulin Resistance., Lynn A. Sleeper, L Luann Minich, Brian M. McCrindle, Jennifer S. Li, Wilbert Mason, Steven D. Colan, Andrew M. Atz, Beth F. Printz, Annette Baker, Victoria L. Vetter, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali 2011 Children's Mercy Hospital

Evaluation Of Kawasaki Disease Risk-Scoring Systems For Intravenous Immunoglobulin Resistance., Lynn A. Sleeper, L Luann Minich, Brian M. Mccrindle, Jennifer S. Li, Wilbert Mason, Steven D. Colan, Andrew M. Atz, Beth F. Printz, Annette Baker, Victoria L. Vetter, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To assess the performance of 3 risk scores from Japan that were developed to predict, in children with Kawasaki disease, resistance to intravenous immunoglobulin (IVIG) treatment.

STUDY DESIGN: We used data from a randomized trial of pulsed steroids for primary treatment of Kawasaki disease to assess operating characteristics of the 3 risk scores, and we examined whether steroid therapy lowers the risk of coronary artery abnormalities in patients prospectively classified as IVIG resistant.

RESULTS: For comparability with published cohorts, we analyzed the data of 99 patients who were not treated with steroids (16% IVIG-retreated) and identified male sex, lower ...


Strategies To Reduce Disease Burden From Diabetes And Hypertension In Developing World, Waris Qidwai 2011 Aga Khan University

Strategies To Reduce Disease Burden From Diabetes And Hypertension In Developing World, Waris Qidwai

Department of Family Medicine

No abstract provided.


Excessive Daytime Sleepiness Is Associated With Poor Medication Adherence In Adults With Heart Failure, Barbara Riegel, Stephen T. Moelter, Sarah J. Ratcliffe, Susan J. Pressler, Sabina De Geest, Sheryl Potashnik, Desiree Fleck, Daohang Sha, Steven L. Sayers, William S. Weintraub, Terri E. Weaver, Lee R. Goldberg 2011 University of Pennsylvania

Excessive Daytime Sleepiness Is Associated With Poor Medication Adherence In Adults With Heart Failure, Barbara Riegel, Stephen T. Moelter, Sarah J. Ratcliffe, Susan J. Pressler, Sabina De Geest, Sheryl Potashnik, Desiree Fleck, Daohang Sha, Steven L. Sayers, William S. Weintraub, Terri E. Weaver, Lee R. Goldberg

School of Nursing Departmental Papers

Background

A relationship between excessive daytime sleepiness (EDS) and poor treatment adherence has been suspected but not confirmed. We hypothesized that medication adherence would be poorer in adults with heart failure (HF) and EDS and that cognitive status would be the mechanism of effect.

Methods and Results

A sample of 280 adults with chronic HF were enrolled into a prospective cohort comparison study. We identified a cohort with EDS and a control group without EDS and further divided both groups into those with and without mild cognitive decline. Data on medication adherence were obtained at baseline and 3 and 6 ...


“So I Just Took Over”: African American Daughters Caregiving For Parents With Heart Failure, Nancy Thornton, Faith Pratt Hopp 2011 Wayne State University

“So I Just Took Over”: African American Daughters Caregiving For Parents With Heart Failure, Nancy Thornton, Faith Pratt Hopp

Social Work Faculty Publications

This article examines the experiences of African American women who are caring for a parent with heart failure. Seven adult daughter caregivers completed in-depth, qualitative interviews, and a phenomenological approach was used for data analysis. Results suggest the presence of caregiving stressors, including heart failure symptoms and comorbidity, caregiving duties, social–emotional stressors, and distrust of the health system. Relevant coping strategies included valuing the caregiving role, coordinating care with siblings, taking charge, and spirituality. Social workers can play a critical role in supporting and advocating for caregivers of persons with heart failure, helping them to cope with stressors associated ...


Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik 2011 St Michael's Hospital, University of Toronto

Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.


Aneurysm Of Sinus Of Valsalva, Fateh Ali Tipoo Sultan, Nageeb Basir, Saulat H. Fatimi 2011 Aga Khan University

Aneurysm Of Sinus Of Valsalva, Fateh Ali Tipoo Sultan, Nageeb Basir, Saulat H. Fatimi

Section of Cardiology

Aneurysm of sinus of Valsalva is a rare cardiac abnormality with congenital origin in most of the cases. If it is located in the right coronary sinus, it usually ruptures into a right heart chamber and frequently a ventricular septal defect (VSD) coexists with this condition. Early diagnosis and immediate surgical treatment can save the patient’s life in most cases. All the 3 cases reported in this series had aneurysm of right sinus of Valsalva with associated VSD and mild degree of aortic regurgitation (AR). Two of the cases ruptured aneurysm into the right ventricle. Trans-esophageal echocardiography was used ...


Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik 2011 St Michael's Hospital, University of Toronto

Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik

Gustavo Saposnik

Stroke is a leading cause of death and adult disability. The ability to estimate prognosis in acute stroke patients directly affects treatment decisions for patients. It may also guide supportive care plans, facilitate patient and/or family counseling or discussions pertaining to end-of-life decisions. At the population level, prognostic estimations may assist policymakers in conducting fair comparisons when evaluating stroke fatality among different facilities for hospital outcomes and performance assessment. Clinicians usually rely on their own personal experience or average mortality reported in observational studies, which do not account for valuable information available at the time of the hospital presentation ...


30-Year Trends In Heart Failure In Patients Hospitalized With Acute Myocardial Infarction, David McManus, Marcello Chinali, Jane Saczynski, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg 2011 University of Massachusetts Medical School

30-Year Trends In Heart Failure In Patients Hospitalized With Acute Myocardial Infarction, David Mcmanus, Marcello Chinali, Jane Saczynski, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Despite significant advances in its treatment, acute myocardial infarction (AMI) remains an important cause of heart failure (HF). Contemporary data remain lacking, however, describing long-term trends in incidence rates, demographic and clinical profiles, and outcomes of patients who develop HF as a complication of AMI. Our study sample consisted of 11,061 residents of the Worcester (Massachusetts) metropolitan area hospitalized with AMI at all greater Worcester hospitals in 15 annual study periods from 1975 to 2005. Overall, 32.4% of patients (n = 3,582) with AMI developed new-onset HF during their acute hospitalization. Patients who developed HF were generally older ...


Recent Trends In The Incidence, Treatment, And Outcomes Of Patients With Stemi And Nstemi, David McManus, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg 2011 University of Massachusetts Medical School

Recent Trends In The Incidence, Treatment, And Outcomes Of Patients With Stemi And Nstemi, David Mcmanus, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: despite the widespread use of electrocardiographic changes to characterize patients presenting with acute myocardial infarction, little is known about recent trends in the incidence rates, treatment, and outcomes of patients admitted for acute myocardial infarction further classified according to the presence of ST-segment elevation. The objectives of this population-based study were to examine recent trends in the incidence and death rates associated with the 2 major types of acute myocardial infarction in residents of a large central Massachusetts metropolitan area. METHODS: We reviewed the medical records of 5383 residents of the Worcester (MA) metropolitan area hospitalized for either ST-segment ...


Declining Length Of Stay For Patients Hospitalized With Ami: Impact On Mortality And Readmissions, Jane Saczynski, Darleen Lessard, Frederick Spencer, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg 2011 University of Massachusetts Medical School

Declining Length Of Stay For Patients Hospitalized With Ami: Impact On Mortality And Readmissions, Jane Saczynski, Darleen Lessard, Frederick Spencer, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Length of hospital stay after acute myocardial infarction decreased significantly in the 1980s and 1990s. Whether length of stay has continued to decrease during the 2000s, and the impact of decreasing length of stay on rehospitalization and mortality, is unclear. We describe decade-long (1995-2005) trends in length of stay after acute myocardial infarction, and examine whether declining length of stay has impacted early rehospitalization and postdischarge mortality in a population-based sample of hospitalized patients.

METHODS: The study sample consisted of 4184 patients hospitalized with acute myocardial infarction in a central New England metropolitan area during 6 annual periods (1995 ...


Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David McManus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg 2011 University of Massachusetts Medical School

Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David Mcmanus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission. RESULTS: Patients with chronic kidney disease ...


Event-Free Survival In Adults With Heart Failure Who Engage In Self-Care Management, Christopher S. Lee, Debra K. Moser, Terry A. Lennie, Barbara Riegel 2011 University of Pennsylvania

Event-Free Survival In Adults With Heart Failure Who Engage In Self-Care Management, Christopher S. Lee, Debra K. Moser, Terry A. Lennie, Barbara Riegel

School of Nursing Departmental Papers

Background

Self-care management in heart failure (HF) involves decision-making to evaluate, and actions to ameliorate symptoms when they occur. This study sought to compare the risks of all-cause mortality, hospitalization, or emergency-room admission among HF patients who practice above-average self-care management, those who practice below-average self-care management, and those who are symptom-free.

Methods

A secondary analysis was conducted of data collected on 195 HF patients. A Cox proportional hazards model was used to examine the association between self-care management and event risk.

Results

The sample consisted of older (mean ± standard deviation = 61.3 ± 11 years), predominantly male (64.6%) adults ...


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