scholarly journals Prognostic Implication of Longitudinal Changes in Cardiothoracic Ratio and Aortic Arch Calcification in Hemodialysis Patients

2021 ◽  
Vol 11 (8) ◽  
pp. 788
Author(s):  
Tung-Ling Chung ◽  
Yi-Hsueh Liu ◽  
Jiun-Chi Huang ◽  
Pei-Yu Wu ◽  
Hung-Pin Tu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Chest Radiography ◽  
Antiplatelet Agents ◽  
Older Age ◽  
X Rays ◽  
Cardiothoracic Ratio ◽  
Follow Up Study ◽  
Significant Difference ◽  
Aortic Arch Calcification

Patients with end-stage renal disease have a high prevalence of cardiovascular disease. Chest radiography can be used to assess cardiothoracic ratio (CTR) and aortic arch calcification (AoAC). The aims of this longitudinal follow-up study were to investigate factors associated with changes in CTR and AoAC and understand whether these changes are associated with overall and cardiovascular mortality in hemodialysis (HD) patients. We enrolled 260 patients undergoing HD who had at least two available chest X-rays from 2008 to 2015. CTR and AoAC were assessed in each patient using measurements from baseline and annual chest X-rays. The CTR increased from 49.05% to 51.86% and the AoAC score increased from 3.84 to 9.73 over 7 years. The estimated slopes were 0.24 (p < 0.0001) for CTR and 0.08 (p = 0.0441) for AoAC. Increased AoAC, older age, female sex, coronary artery disease, and decreased albumin were associated with an increase in CTR, and older age, cerebrovascular disease, decreased albumin, increased Kt/V, and the use of antiplatelet agents were associated with an increase in AoAC. During follow-up, 136 of the 260 (52.3%) patients died, of whom 72 died due to cardiovascular causes. The change in CTR was greater in those who died (p = 0.0125) than in those who survived. The AoAC score was also higher in those who died than in those who survived, although there was no significant difference in the change in AoAC between the two groups (p = 0.8035). CTR and AoAC increased significantly over time in the HD patients in this longitudinal follow-up study, and the change in CTR was greater in those who died than in those who survived. Chest radiography is a simple and useful tool to assess the progression of CTR and AoAC as a prognostic marker.

P109 PROGRESSION OF AORTIC ARCH CALCIFICATION AFTER KIDNEY TRANSPLANT AND ITS IMPORTANCE IN PREDICTING CARDIOVASCULAR RISK: SINGLE-CENTER 2-YEAR FOLLOW-UP STUDY

2017 ◽  
Vol 20 (C) ◽  
pp. 91
Author(s):  
Agne Laucyte-Cibulskiene ◽  
Evelina Boreikaite ◽  
Gediminas Aucina ◽  
Migle Gudynaite ◽  
Ilona Rudminiene ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Aortic Arch ◽  
Kidney Transplant ◽  
Single Center ◽  
Follow Up Study ◽  
Aortic Arch Calcification

scholarly journals Heritability of Cardiothoracic Ratio and Aortic Arch Calcification in Twins

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 421
Author(s):  
Zsofia Jokkel ◽  
Bianka Forgo ◽  
Christopher Hani-Gaius Ghattas ◽  
Marton Piroska ◽  
Helga Szabó ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Aortic Arch ◽  
Structural Equation ◽  
Cardiovascular Complications ◽  
X Rays ◽  
Cardiothoracic Ratio ◽  
South Korean ◽  
High Heritability ◽  
Genetic And Environmental Factors ◽  
Aortic Arch Calcification

Background and Objectives: Aortic arch calcification (AoAC) is associated with a variety of cardiovascular complications. The measurement and grading of AoAC using posteroanterior (PA) chest X-rays are well established. The cardiothoracic ratio (CTR) can be simultaneously measured with PA chest X-rays and used as an index of cardiomegaly. The genetic and environmental contributions to the degree of the AoAC and CTR are not well understood. The purpose of this study was to investigate the effect of genetics and environmental factors on the AoAC and CTR. Materials and Methods: A total of 684 twins from the South Korean twin registry (261 monozygotic, MZ and 81 dizygotic, DZ pairs; mean age 38.6 ± 7.9 years, male/female = 264/420) underwent PA chest X-rays. Cardiovascular risk factors and anthropometric data were also collected. The AoAC and CTR were measured and graded using a standardized method. A structural equation method was used to calculate the proportion of variance explained by genetic and environmental factors behind AoAC and CTR. Results: The within-pair differences were low regarding the grade of AoAC, with only a few twin pairs showing large intra-pair differences. We found that the thoracic width showed high heritability (0.67, 95% CI: 0.59–0.73, p = 1). Moderate heritability was detected regarding cardiac width (0.54, 95% CI: 0.45–0.62, p = 0.572) and CTR (0.54, 95% CI: 0.44–0.62, p = 0.701). Conclusions: The heritable component was significant regarding thoracic width, cardiac width, and the CTR.

Aortic arch calcification is strongly associated with coronary artery calcification

VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Adem Adar ◽  
Hakan Erkan ◽  
Tayyar Gokdeniz ◽  
Aysegul Karadeniz ◽  
Ismail G. Cavusoglu ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Aortic Arch ◽  
Chest Radiography ◽  
Coronary Artery Calcification ◽  
Independent Predictor ◽  
Study Group ◽  
Discriminative Performance ◽  
Sensitivity Specificity ◽  
Aortic Arch Calcification

Background: We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low‐ and high‐risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Patients and methods: Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64‐slice MDCT scanner for the evaluation of CAC score. A four‐point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior‐anterior chest radiography images. Results: The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high‐risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively. Conclusions: AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low‐ and high‐risk CAC scores.

Student nurses’ unethical behavior, social media, and year of birth

2016 ◽  
Vol 23 (8) ◽  
pp. 910-918 ◽  
Author(s):  
Gloria Copeland Smith ◽  
Troy Keith Knudson
Keyword(s):  
Social Media ◽  
Nursing Students ◽  
Unethical Behavior ◽  
Ethics Education ◽  
Student Nurses ◽  
Clinical Cohort ◽  
Follow Up Study ◽  
Significant Difference ◽  
Use Of Social Media

Background: This study is the result of findings from a previous dissertation conducted by this author on Student Nurses’ Unethical Behavior, Boundaries, and Social Media. The use of social media can be detrimental to the nurse–patient relationship if used in an unethical manner. Method: A mixed method, using a quantitative approach based on research questions that explored differences in student nurses’ unethical behavior by age (millennial vs nonmillennial) and clinical cohort, the relationship of unethical behavior to the utilization of social media, and analysis on year of birth and unethical behavior. A qualitative approach was used based on a guided faculty interview and common themes of student nurses’ unethical behavior. Participants and Research Context: In total, 55 Associate Degree nursing students participated in the study; the research was conducted at Central Texas College. There were eight faculty-guided interviews. Ethical considerations: The main research instrument was an anonymous survey. All participants were assured of their right to an informed consent. All participants were informed of the right to withdraw from the study at any time. Findings: Findings indicate a significant correlation between student nurses’ unethical behavior and use of social media (p = 0.036) and a significant difference between student unethical conduct by generation (millennials vs nonmillennials (p = 0.033)) and by clinical cohort (p = 0.045). Further findings from the follow-up study on year of birth and student unethical behavior reveal a correlation coefficient of 0.384 with a significance level of 0.003. Discussion: Surprisingly, the study found that second-semester students had less unethical behavior than first-, third-, and fourth-semester students. The follow-up study found that this is because second-semester students were the oldest cohort. Conclusion: Implications for positive social change for nursing students include improved ethics education that may motivate ethical conduct throughout students’ careers nationally and globally for better understanding and promotion of ethics and behavior.

Impact of cardiac rehabilitation on 3 year outcomes amongst patients after acute coronary syndrome: (ACS) SNAPSHOT ACS follow-up study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Redfern ◽  
K Hyun ◽  
D Brieger ◽  
D Chew ◽  
J French ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Rehabilitation ◽  
Data Linkage ◽  
Research Network ◽  
Funding Source ◽  
Cardiovascular Research ◽  
Coronary Syndrome ◽  
Follow Up Study ◽  
Significant Difference

Abstract Background Cardiovascular disease is the leading cause of disease burden globally. With advancements in medical and surgical care more people are surviving initial acute coronary syndrome (ACS) and are in need of secondary prevention and cardiac rehabilitation (CR). Increasing availability of high quality individual-level data linkage provides robust estimates of outcomes long-term. Purpose To compare 3 year outcomes amongst ACS survivors who did and did not participate in Australian CR programs. Methods SNAPSHOT ACS follow-up study included 1806 patients admitted to 232 hospitals who were followed-up by data linkage (cross-jurisdictional morbidity, national death index, Pharmaceutical Benefit Schedule) at 6 and 36 months to compare those who did/not attend CR. Results In total, the cohort had a mean age of 65.8 (13.4) years, 60% were male, only 25% (461/1806) attended CR. During index admission, attendees were more likely to have had PCI (39% v 14%, p&lt;0.001), CABG (11% v 2%, p&lt;0.001) and a diagnosis of STEMI (21% v 5%, p&lt;0.001) than those who did not attend. However, there was no significant difference between CR attendees/non-attendees for risk factors (LDL-cholesterol, smoking, obesity). Only 19% of eligible women attended CR compared to 30% of men (p&lt;0.001). At 36 months, there were fewer deaths amongst CR attendees (19/461, 4.1%) than non-attendees (116/1345, 8.6%) (p=0.001). CR attendees were more likely to have repeat ACS, PCI, CABG at both 6 and 36 months (Table). At 36 months, CR attendees were more likely to have been prescribed antiplatelets (78% v 53%, p&lt;0.001), statins (91% 73%, p&lt;0.001), beta-blockers (11% v 13%, p=0.002) and ACEI/ARBs (72% v 61%, p&lt;0.001) than non-attendees. Conclusions Amongst Australian ACS survivors, participation in CR was associated with less likelihood of death and increased prescription of pharmacotherapy. However, attendance at CR was associated with higher rates of repeat ACS and revascularisation. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): New South Wales Cardiovascular Research Network, National Heart Foundation

RELATIONSHIP OF ELEVATED BLOOD TYROSINE TO THE ULTIMATE INTELLECTUAL PERFORMANCE OF PREMATURE INFANTS

PEDIATRICS ◽  
1972 ◽  
Vol 49 (2) ◽  
pp. 218-224 ◽  
Author(s):  
John H. Menkes ◽  
Doris W. Welcher ◽  
Helene S. Levi ◽  
Joseph Dallas ◽  
Neil E. Gretsky
Keyword(s):  
Birth Weight ◽  
Premature Infants ◽  
Maximum Level ◽  
Intellectual Performance ◽  
Wide Range Achievement Test ◽  
Follow Up Study ◽  
Wide Range ◽  
Significant Difference ◽  
Picture Completion

Blood tyrosine concentrations were followed from birth to nursery discharge in 71 premature infants fed a high protein formula supplemented by 60 mg/day of ascorbic acid. In 89% of infants blood tyrosine concentrations were abnormal, and in 38% of infants the maximum level observed was 15.0 mg/100 ml or higher. Maximum blood tyrosine levels correlated significantly with gestational age (p = &lt; 0.05) but not with birth weight. In a follow-up study performed at 15 months of age, infants with high tyrosine levels had no increase in the incidence of neurological abnormalities. Between 7 and 8 years of age a second follow-up study was performed on 62 children. This included a WISC, a Wide-Range Achievement Test (WRAT), and tests for psychomotor and language maturity. Two children had died in the interval, and five of the 62 were retarded for full testing. The full scale WISC I.Q. of all children correlated with birth weight at the 10% confidence level (p = &lt; 0.1). The mean WISC I.Q. of high and low tyrosine subjects was 82.9 and 81.6 respectively. When infants were grouped by birth weight, a significant difference was detected in subjects weighing 2,000 gm or more. High tyrosine infants had a significantly lower performance I.Q. than low tyrosine infants (82.4 and 97.8 respectively; p = &lt; 0.02). Significant differences were recorded in the scores on Object Assembly, Picture Assembly, and Picture Completion of the WISC. Significant differences were also seen on the Spelling subtest of the WRAT (p = &lt; 0.02). We observed no adverse effect of high tyrosine levels on the intellectual performance of smaller premature infants, who on the whole have a greater risk for other complications of prematurity.

scholarly journals A Seven-year Follow-up Study of Patient Satisfaction with Three-implant-retained Mandibular Overdentures

2021 ◽  
Vol 9 (D) ◽  
pp. 103-107
Author(s):  
Hisham Samir ElGabry
Keyword(s):  
Long Term Results ◽  
Complete Dentures ◽  
Patients Satisfaction ◽  
Follow Up Study ◽  
Group I ◽  
Significant Difference ◽  
Male Patients ◽  
Group Ii ◽  
Anterior Mandible

PURPOSE: This study aimed to compare patients’ satisfaction with mandibular overdentures retained by three-splinted implants versus conventional complete denture wearers during a 7-year follow-up study period. MATERIALS AND METHODS: Thirty edentulous male patients (mean age: 60 years) were carefully selected and divided into two equal groups. All patients received a new set of complete dentures. Group I patients received three implants in the anterior mandible and were connected after 3 months with bars, clips, and loaded. Group II patients received conventional complete dentures. Patients’ satisfaction was recorded for both groups at 3 weeks (baseline) and after 1, 3, 5, and 7 years. Patients were then asked to grade their overdentures/dentures on a visual analog scale and written questionnaire to evaluate their overall satisfaction. RESULTS: Satisfaction scores of Group I patients were found to be statistically significantly higher than that of Group II patients (p < 0.05) at 3, 5, and 7 years follow-up, meanwhile, no statistically significant difference was found at baseline or after 12 months. CONCLUSION: The long-term results suggest that three-implant-retained mandibular overdenture with a clip-bar attachment appears to be a successful rehabilitation strategy which is superior to conventional dentures for patients with advanced ridge resorption.

scholarly journals Effectiveness of Online Training and Supervisor Feedback on Safe Eating and Drinking Practices for Individuals With Developmental Disabilities

2020 ◽  
Vol 58 (2) ◽  
pp. 111-125
Author(s):  
Emaley McCulloch ◽  
Audra Cuckler ◽  
Elise Valdes ◽  
M. Courtney Hughes
Keyword(s):  
Pilot Study ◽  
Developmental Disabilities ◽  
Online Training ◽  
Direct Care ◽  
Follow Up Study ◽  
Significant Difference ◽  
The Impact

Abstract Dysphagia is common in individuals with developmental disabilities. Little research exists on the impact of trainings aimed at improving Direct Care Staff's (DCS) use of safe eating and drinking practices. This article presents two studies using pre-and postexperimental design, evaluating online training to improve DCSs' knowledge and ability to identify nonadherence to diet orders. A pilot study (n = 18) informed improvements to the intervention. The follow-up study (n = 64) compared those receiving training with those receiving training plus supervisor feedback. There was no significant difference between groups after training. Both groups increased in knowledge and identification of nonadherence to diet orders. Online training may be an effective tool for training DCS in safe eating and drinking practices.

Psychosocial adjustment among women with breast cancer stages I and II: six-year follow-up of consecutive patients.

1994 ◽  
Vol 12 (9) ◽  
pp. 1778-1782 ◽  
Author(s):  
M Omne-Pontén ◽  
L Holmberg ◽  
P O Sjödén
Keyword(s):  
Breast Cancer ◽  
Psychosocial Adjustment ◽  
Social Adjustment ◽  
Negative Experience ◽  
Follow Up Study ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
The Impact

PURPOSE To evaluate, in a long-term follow-up study of consecutive patients (N = 99), the impact of surgery--breast-conserving treatment (BCT) versus mastectomy (MT)--on psychosocial adjustment among women with breast cancer, pTNM stage I/II. PATIENTS AND METHODS Semistructured interviews were conducted at a median of 6 years (range, 5.8 to 8.1) after primary surgery. Sixty-six women were available for the long-term follow-up study. Twenty-six women had been treated with BCT and 40 with MT. RESULTS No statistically significant differences were found between the two groups concerning psychosocial adjustment, as measured by the Social adjustment Scale (SAS). In general, the levels of maladjustment were lower than at 13 months postoperatively, but 10% still showed maladjustment. Sixty percent of the women were unwilling to show themselves naked, and 22% felt that they had become less attractive because of the surgical treatment. In an explorative part of the interview, 68% of the women complained about how they had been informed of the diagnosis. A tendency toward a significant difference was found in the relation between previous maladjustment and a negative experience at the time of diagnosis (P = .07). CONCLUSION Few data are available on long-term follow-up results with regard to psychosocial adjustment among women after breast cancer surgery. This study provides the important information that there are no differences in patient psychosocial adjustment that can be ascribed to the type of surgery at 6-year follow-up evaluation.

scholarly journals A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results

2014 ◽  
Vol 72 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aluizio Augusto Arantes Júnior ◽  
Geraldo Alves da Silva Junior ◽  
José Augusto Malheiros ◽  
Fernando Flavio Gonçalves ◽  
Marcelo Magaldi ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Radiographic Evaluation ◽  
Follow Up Study ◽  
Post Surgery ◽  
Technical Report ◽  
Significant Difference ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Multilevel Cervical Spondylotic Myelopathy

The laminoplasty technique was devised by Hirabayashi in 1978 for patients diagnosed with multilevel cervical spondylotic myelopathy. Objective: To describe an easy modification of Hirabayashi’s method and present the clinical and radiological results from a five-year follow-up study. Method and Results: Eighty patients had 5 levels of decompression (C3-C7), 3 patients had 6 levels of decompression (C2-T1) and 3 patients had 4 levels of decompression (C3-C6). Foraminotomies were performed in 23 cases (27%). Following Nurick`s scale, 76 patients (88%) improved, 9 (11%) had the same Nurick grade, and one patient worsened and was advised to undergo another surgical procedure. No deaths were observed. The mean surgery time was 122 min. Radiographic evaluation showed an increase in the mean sagittal diameter from 11.2 mm at pretreatment to 17.3 mm post surgery. There was no significant difference between pretreatment and post-surgery C2-C7 angles. Conclusions: This two-open-doors laminoplasty technique is safe, easy and effective and can be used as an alternative treatment for cases of multilevel cervical spondylotic myelopathy without instability.

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