scholarly journals Association between Cardiologist Consultation and Mortality of Stable Patients with Elevated Cardiac Troponin at Admission

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2229
Author(s):  
Ah Ran Oh ◽  
Jungchan Park ◽  
Sooyeon Lee ◽  
Kwangmo Yang ◽  
Jin-Ho Choi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Propensity Score ◽  
Cardiac Troponin ◽  
Primary Outcome ◽  
Management Strategies ◽  
First Year ◽  
Effective Management ◽  
Consultation Group ◽  
One Year ◽  
Outcome Mortality

Elevated cardiac troponin (cTn) showed associations with mortality even in stable patients, but management has not been established. We aimed to investigate whether consultation to cardiologists could reduce mortality of stable patients with cTn elevation at admission. We identified 1329 patients with elevated cTn level at hospitalization from outpatient clinic to any department other than cardiology or cardiac surgery between April 2010 and December 2018. The patients were divided into two groups according to cardiologist consultation at admission. For primary outcome, mortality during one year was compared in the crude and propensity-score-matched populations. In 1329 patients, 397 (29.9%) were consulted to cardiologists and 932 (70.1%) were not. Mortality during the first year was significantly lower in patients consulted to cardiologists compared with those who were not (9.8% vs. 14.2%; hazard ratio (HR), 0.50; 95% confidence interval (CI), 0.35–0.72; p < 0.001). After propensity-score matching, 324 patients were in the cardiologist consultation group and 560 patients were in the no cardiologist consultation group. One-year mortality was consistently lower in the cardiologist consultation group (10.5% vs. 14.6%; HR, 0.58; 95% CI, 0.39–0.86; p = 0.01). Cardiologist consultation may be associated with lower mortality in stable patients with cTn elevation at admission. Further studies are needed to identify effective management strategies for stable patients with elevated cTn.

Teething Symptoms in the First Year of Life and Associated Factors: A Cohort Study

2010 ◽  
Vol 34 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Carlos Alberto Feldens ◽  
Italo Medeiros Faraco Junior ◽  
Andréia Bertani Ottoni ◽  
Eliane Gerson Feldens ◽  
Márcia Regina Vítolo
Keyword(s):  
Associated Factors ◽  
Primary Outcome ◽  
First Year ◽  
Structured Interviews ◽  
Self Medication ◽  
Nuclear Families ◽  
Dental Examination ◽  
Pediatric Dentists ◽  
One Year ◽  
First Year Of Life

Objective: To investigate the occurrence and management of teething symptoms during the first year of life and associated factors. Study design: 500 children were recruited at birth. Research assessments including structured interviews, anthropometric measurements and dental examination were carried out after birth, at 6 months and at one-year of age. The primary outcome of this study was defined as the occurrence of one or more teething symptoms within the first year of life, as reported by the mother. Results: Teething symptoms were reported in 73% of the children analyzed (273/375). The symptoms most frequently reported were irritability (40.5%), fever (38.9%), diarrhoea (36.0%) and itching (33.6%). Dentists had little influence on the management of symptoms and self-medication to relieve them was a common practice. The risk of reporting teething symptoms was higher for children from nuclear families (p=0.040) and for children from families with higher income (p=0.040). Conclusions: Teething symptoms were highly reported in this population. Pediatric dentists should be accessible and provide adequate orientation when symptoms can be managed at home or immediate referral to health services when more serious diseases are suspected.

scholarly journals Effect of Continuous Intensive Cultivation on the Chemical and Microbiological Properties of Oxic Dystrandept Soils in the Western Highlands of Cameroon

2021 ◽  
Vol 9 (1) ◽  
pp. 17-26
Author(s):  
NTANGMO TSAFACK Honorine ◽  
Keyword(s):  
Soil Fertility ◽  
Crop Production ◽  
Cropping Systems ◽  
Management Strategies ◽  
Chemical Properties ◽  
Available Phosphorus ◽  
First Year ◽  
Soil Productivity ◽  
One Year ◽  
Microbiological Properties

Soil fertility indices are well documented as they are directly related to land use and productivity. However, the effect of continuous intensive cultivation on the evolution of soil fertility is still poorly documented. The aim of this study was thus to assess the effect of continuous intensive cultivation on the chemical and microbiological properties of Oxic Dystrandept soils in the Western Highlands of Cameroon. Composite soil samples were taken between 0-15 cm depths on farmlands that have been subjected to continuous intensive cultivation for one, five and ten years meanwhile samples from plots that have never been cultivated served as control. The main results revealed that the ammonium contents dropped abruptly (86%-wt) from the first year of cultivation. The organic carbon (OC) content decreased from 1.81 ± 0.14 %-dm (in control) to 1.69 ± 0.09 % after one year, 1.66 ± 0.10 % after 5 years and 1.58 ± 0.07 % after 10 years. Compared to the control, available phosphorus (P) showed a 13 %-wt drop after one year, 46 % after 5 years and 85 % after 10 years. Dehydrogenase activity showed a 42 % decrease after one year, 50 % after five years and 73 % after 10 years. The other parameters were not significantly different (P<0.05) amongst treatments. Decline of soil productivity was undoubtedly related to the decrease of OC, P, microbial activity and ammonium with continuous intensive cultivation. Thus, management strategies for improved crop production should include selection suitable cropping systems and chemical methods. Keywords: Continuous intensive cultivation, enzymatic activities, soil chemical properties, Oxic Dystrandept, Cameroon western highland

scholarly journals Adherence to Prescribed Acamprosate in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology

2021 ◽  
Vol 10 (10) ◽  
pp. 2102
Author(s):  
Serenella Tolomeo ◽  
Alex Baldacchino
Keyword(s):  
Alcohol Dependence ◽  
Health Informatics ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
First Year ◽  
Increased Risk ◽  
One Year ◽  
Mortality Hazard Ratio ◽  
Dispensing Data

Objectives: We tested the hypothesis that poor adherence is associated with a greater risk of alcohol-caused mortality and morbidities within the first year of discontinuing this medication. Materials and Methods: A retrospective cohort study of 3319 individuals who received acamprosate in the East of Scotland in a 10-year period was conducted using a health informatics approach with record linkage of dispensing data, hospital utilization (SMR) and General Register Office of Scotland (GROS) data. The primary outcome was adherence between one to six months after initiating acamprosate medication. The secondary outcome was all-cause morbidities and mortality. Results: Of the total 3319 individuals identified, a good adherence index of >80% was found in 59% of those prescribed acamprosate after three months and 6% after six months. There were significant linear trends of poorer adherence with increased risk of alcohol-caused mortality (Hazard Ratio, HR 1.2), medical morbidities especially neoplasm (HR 4.1) and poisoning (HR 1.4), and psychiatric morbidities especially stress (HR 35.1), psychotic (HR 5.6) and neurotic disorders, and directly alcohol induced conditions (7.4 HR) after adjustment for other factors within a one-year period of initiation of acamprosate treatment. Discussion and Conclusions: Further exploratory studies using this digitalized approach should be encouraged in order to capture role of compliance to acamprosate and other types of medication that are known to reduce relapse into alcohol dependence and its direct relationship to mortality and morbidities in this population.

scholarly journals Adherence to Prescribed Acamprosate® in Alcohol Dependence and 1-Year Morbidities and Mortality: Utilizing a Data Linkage Methodology

2021 ◽  
Author(s):  
Serenella Tolomeo ◽  
Alexander Mario Baldacchino
Keyword(s):  
Alcohol Dependence ◽  
Health Informatics ◽  
Primary Outcome ◽  
Data Linkage ◽  
Secondary Outcome ◽  
First Year ◽  
Increased Risk ◽  
One Year ◽  
Dispensing Data

Objectives We tested the hypothesis that poor adherence is associated with a greater risk of alcohol-caused mortality and morbidities within the first year of discontinuing this medication. Materials and Methods Retrospective cohort study of 3319 individuals who received Acamprosate&reg; in the East of Scotland in a 10-year period using a health informatics approach with record linkage of dispensing data, hospital utilization (SMR) and General Register Office of Scotland (GROS) data. Primary outcome was adherence between one to six months of initiating Acamprosate&reg; medication. Secondary outcome was all cause morbidities and mortality. Results Of the total 3319 individuals identified, good adherence index of &gt;80% was found in 59% of those prescribed Acamprosate&reg; after three months and 6% after six months. There were significant linear trends of poorer adherence with increased risk of alcohol-caused mortality (HR1.2), medical morbidities especially neoplasm (HR 4.1|) and poisoning (HR 1.4) and psychiatric morbidities especially stress (HR 35.1), psychotic (HR 5.6) and neurotic disorders and directly alcohol induced conditions (7.4 HR) after adjustment for other factors within a one-year period of initiation of Acamprosate&reg; treatment. Discussion and Conclusions Further exploratory studies using this digitalized approach should be encouraged in order to capture role of compliance to Acamprosate&reg; and other types of medication that are known to reduce relapse into alcohol dependence and its direct relationship to mortality and morbidities in this population.

scholarly journals Treatment with a DPP-4 inhibitor at time of hospital admission for COVID-19 is not associated with improved clinical outcomes: data from the COVID-PREDICT cohort study in The Netherlands

2021 ◽  
Author(s):  
Rick I. Meijer ◽  
Trynke Hoekstra ◽  
Niels C. Gritters van den Oever ◽  
Suat Simsek ◽  
Joop P. van den Bergh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Primary Outcome ◽  
Infectious Complications ◽  
Glucose Lowering ◽  
Diabetes Severity ◽  
Outcome Mortality

Abstract Purpose Inhibition of dipeptidyl peptidase (DPP-)4 could reduce coronavirus disease 2019 (COVID-19) severity by reducing inflammation and enhancing tissue repair beyond glucose lowering. We aimed to assess this in a prospective cohort study. Methods We studied in 565 patients with type 2 diabetes in the CovidPredict Clinical Course Cohort whether use of a DPP-4 inhibitor prior to hospital admission due to COVID-19 was associated with improved clinical outcomes. Using crude analyses and propensity score matching (on age, sex and BMI), 28 patients using a DPP-4 inhibitor were identified and compared to non-users. Results No differences were found in the primary outcome mortality (matched-analysis = odds-ratio: 0,94 [95% confidence interval: 0,69 – 1,28], p-value: 0,689) or any of the secondary outcomes (ICU admission, invasive ventilation, thrombotic events or infectious complications). Additional analyses comparing users of DPP-4 inhibitors with subgroups of non-users (subgroup 1: users of metformin and sulphonylurea; subgroup 2: users of any insulin combination), allowing to correct for diabetes severity, did not yield different results. Conclusions We conclude that outpatient use of a DPP-4 inhibitor does not affect the clinical outcomes of patients with type 2 diabetes who are hospitalized because of COVID-19 infection.

scholarly journals Cardiovascular risk factors associated with acute myocardial infarction and stroke in the MADIABETES cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. A. Salinero-Fort ◽  
F. J. San Andrés-Rebollo ◽  
J. Cárdenas-Valladolid ◽  
M. Méndez-Bailón ◽  
R. M. Chico-Moraleja ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Antihypertensive Drugs ◽  
Hdl Cholesterol ◽  
First Year ◽  
Backward Elimination ◽  
One Year ◽  
Time Varying Covariates

AbstractWe aimed to develop two models to estimate first AMI and stroke/TIA, respectively, in type 2 diabetes mellitus patients, by applying backward elimination to the following variables: age, sex, duration of diabetes, smoking, BMI, and use of antihyperglycemic drugs, statins, and aspirin. As time-varying covariates, we analyzed blood pressure, albuminuria, lipid profile, HbA1c, retinopathy, neuropathy, and atrial fibrillation (only in stroke/TIA model). Both models were stratified by antihypertensive drugs. We evaluated 2980 patients (52.8% women; 67.3 ± 11.2 years) with 24,159 person-years of follow-up. We recorded 114 cases of AMI and 185 cases of stroke/TIA. The factors that were independently associated with first AMI were age (≥ 75 years vs. < 75 years) (p = 0.019), higher HbA1c (> 64 mmol/mol vs. < 53 mmol/mol) (p = 0.003), HDL-cholesterol (0.90–1.81 mmol/L vs. < 0.90 mmol/L) (p = 0.002), and diastolic blood pressure (65–85 mmHg vs. < 65 mmHg) (p < 0.001). The factors that were independently associated with first stroke/TIA were age (≥ 75 years vs. < 60 years) (p < 0.001), atrial fibrillation (first year after the diagnosis vs. more than one year) (p = 0.001), glomerular filtration rate (per each 15 mL/min/1.73 m2 decrease) (p < 0.001), total cholesterol (3.88–6.46 mmol/L vs. < 3.88 mmol/L) (p < 0.001), triglycerides (per each increment of 1.13 mmol/L) (p = 0.031), albuminuria (p < 0.001), neuropathy (p = 0.01), and retinopathy (p = 0.023).

scholarly journals Mortality in older adults following a fragility fracture: real-world retrospective matched-cohort study in Ontario

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jacques P. Brown ◽  
Jonathan D. Adachi ◽  
Emil Schemitsch ◽  
Jean-Eric Tarride ◽  
Vivien Brown ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Fragility Fracture ◽  
Mortality Risk ◽  
Real World ◽  
First Year ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Fracture Cohort ◽  
One Year

Abstract Background Recent studies are lacking reports on mortality after non-hip fractures in adults aged > 65. Methods This retrospective, matched-cohort study used de-identified health services data from the publicly funded healthcare system in Ontario, Canada, contained in the ICES Data Repository. Patients aged 66 years and older with an index fragility fracture occurring at any osteoporotic site between 2011 and 2015 were identified from acute hospital admissions, emergency and ambulatory care using International Classification of Diseases (ICD)-10 codes and data were analyzed until 2017. Thus, follow-up ranged from 2 years to 6 years. Patients were excluded if they presented with an index fracture occurring at a non-osteoporotic fracture site, their index fracture was associated with a trauma code, or they experienced a previous fracture within 5 years prior to their index fracture. This fracture cohort was matched 1:1 to controls within a non-fracture cohort by date, sex, age, geography and comorbidities. All-cause mortality risk was assessed. Results The survival probability for up to 6 years post-fracture was significantly reduced for the fracture cohort vs matched non-fracture controls (p < 0.0001; n = 101,773 per cohort), with the sharpest decline occurring within the first-year post-fracture. Crude relative risk of mortality (95% confidence interval) within 1-year post-fracture was 2.47 (2.38–2.56) in women and 3.22 (3.06–3.40) in men. In the fracture vs non-fracture cohort, the absolute mortality risk within one year after a fragility fracture occurring at any site was 12.5% vs 5.1% in women and 19.5% vs 6.0% in men. The absolute mortality risk within one year after a fragility fracture occurring at a non-hip vs hip site was 9.4% vs 21.5% in women and 14.4% vs 32.3% in men. Conclusions In this real-world cohort aged > 65 years, a fragility fracture occurring at any site was associated with reduced survival for up to 6 years post-fracture. The greatest reduction in survival occurred within the first-year post-fracture, where mortality risk more than doubled and deaths were observed in 1 in 11 women and 1 in 7 men following a non-hip fracture and in 1 in 5 women and 1 in 3 men following a hip fracture.

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