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A phase II, sham-controlled, double-blinded study testing the safety and efficacy of the coronary sinus reducer in patients with refractory angina: study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature116297
Source
Trials. 2013;14:46
Publication Type
Article
Date
2013
Author
E Marc Jolicœur
Shmuel Banai
Timothy D Henry
Marc Schwartz
Serge Doucet
Christopher J White
Elazer Edelman
Stefan Verheye
Author Affiliation
Montreal Heart Institute, Université de Montréal, 5000 Bélanger Street East, Montréal, Québec Q H1T 1C8, Canada. marc.jolicoeur@icm-mhi.org
Source
Trials. 2013;14:46
Date
2013
Language
English
Publication Type
Article
Keywords
Angina, Stable - diagnosis - physiopathology - therapy
Canada
Cardiac Catheterization - adverse effects - instrumentation
Cardiac Catheters
Cardiovascular Agents - therapeutic use
Clinical Protocols
Coronary Angiography
Coronary Circulation
Coronary Sinus - physiopathology - radiography - radionuclide imaging - ultrasonography
Double-Blind Method
Drug resistance
Echocardiography, Stress
Equipment Design
Europe
Humans
Myocardial Perfusion Imaging - methods
Predictive value of tests
Prospective Studies
Questionnaires
Research Design
Stroke Volume
Time Factors
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Ventricular Function, Left
Abstract
A growing population of patients lives with severe coronary artery disease not amenable to coronary revascularization and with refractory angina despite optimal medical therapy. Percutaneous reduction of the coronary sinus is an emerging treatment for myocardial ischemia that increases coronary sinus pressure to promote a transcollateral redistribution of coronary artery in-flow from nonischemic to ischemic subendocardial territories. A first-in-man study has demonstrated that the percutaneous reduction of the coronary sinus can be performed safely in such patients. The COSIRA trial seeks to assess whether a percutaneous reduction of the coronary sinus can improve the symptoms of refractory angina in patients with limited revascularization options.
The COSIRA trial is a phase II double-blind, sham-controlled, randomized parallel trial comparing the percutaneously implanted coronary sinus Reducer (Neovasc Inc, Richmond, BC, Canada) to a sham implantation in 124 patients enrolled in Canada, Belgium, England, Scotland, Sweden and Denmark. All patients need to have stable Canadian Cardiovascular Society (CCS) class III or IV angina despite optimal medical therapy, with evidence of reversible ischemia related to disease in the left coronary artery, and a left ventricular ejection fraction >25%. Participants experiencing an improvement in their angina =2 CCS classes six months after the randomization will meet the primary efficacy endpoint. The secondary objective of this trial is to test whether coronary sinus Reducer implantation will improve left ventricular ischemia, as measured by the improvement in dobutamine echocardiogram wall motion score index and in time to 1 mm ST-segment depression from baseline to six-month post-implantation.
Based on previous observations, the COSIRA is expected to provide a significant positive result or an informative null result upon which rational development decisions can be based. Patient safety is a central concern and extensive monitoring should allow an appropriate investigation of the safety related to the coronary sinus Reducer.
ClinicalTrials.gov identifier - NCT01205893.
Notes
Cites: Ann Thorac Surg. 2000 Sep;70(3):961-311016343
Cites: J Am Coll Cardiol. 1995 Feb;25(2):333-417829785
Cites: J Am Med Assoc. 1954 Nov 27;156(13):1226-3313211223
Cites: J Am Med Assoc. 1956 Dec 29;162(18):1603-613376326
Cites: J Am Med Assoc. 1955 Nov 26;159(13):1264-7113271060
Cites: Acta Med Scand. 1963 Jul;174:93-814042469
Cites: N Engl J Med. 2007 Feb 22;356(8):830-4017314342
Cites: J Am Coll Cardiol. 2007 May 1;49(17):1783-917466229
Cites: Am Heart J. 2008 Mar;155(3):418-3418294474
Cites: Am Heart J. 2008 Mar;155(3):435-4418294475
Cites: Nat Clin Pract Cardiovasc Med. 2009 Mar;6(3):E319234494
Cites: Catheter Cardiovasc Interv. 2010 May 1;75(6):886-9120432394
Cites: Circ Res. 2011 Aug 5;109(4):428-3621737787
Cites: Can J Cardiol. 2012 Mar-Apr;28(2 Suppl):S20-4122424281
Cites: Can J Cardiol. 2012 Mar-Apr;28(2 Suppl):S50-922424284
Cites: Am J Cardiol. 1999 Sep 1;84(5):598-600, A810482164
Cites: Am J Physiol Heart Circ Physiol. 2001 Mar;280(3):H1361-711179085
Cites: Ann Intern Med. 2001 Apr 17;134(8):657-6211304106
Cites: BMJ. 2001 Nov 10;323(7321):1123-411701584
Cites: J Am Coll Cardiol. 2003 Jan 1;41(1):159-6812570960
Cites: J Postgrad Med. 2002 Oct-Dec;48(4):312-312571393
Cites: Adv Anat Embryol Cell Biol. 2003;168:I-VIII, 1-10412645157
Cites: Circulation. 2003 Nov 4;108(18):2219-2314557359
Cites: Thorax. 1967 Jan;22(1):34-74961992
Cites: Biometrics. 1991 Jun;47(2):523-331912259
Cites: J Am Coll Cardiol. 1995 Sep;26(3):585-937642847
PubMed ID
23413981 View in PubMed
Less detail

Cancer risk in systemic lupus: an updated international multi-centre cohort study.

https://arctichealth.org/en/permalink/ahliterature116317
Source
J Autoimmun. 2013 May;42:130-5
Publication Type
Article
Date
May-2013
Author
Sasha Bernatsky
Rosalind Ramsey-Goldman
Jeremy Labrecque
Lawrence Joseph
Jean-Francois Boivin
Michelle Petri
Asad Zoma
Susan Manzi
Murray B Urowitz
Dafna Gladman
Paul R Fortin
Ellen Ginzler
Edward Yelin
Sang-Cheol Bae
Daniel J Wallace
Steven Edworthy
Soren Jacobsen
Caroline Gordon
Mary Anne Dooley
Christine A Peschken
John G Hanly
Graciela S Alarcón
Ola Nived
Guillermo Ruiz-Irastorza
David Isenberg
Anisur Rahman
Torsten Witte
Cynthia Aranow
Diane L Kamen
Kristjan Steinsson
Anca Askanase
Susan Barr
Lindsey A Criswell
Gunnar Sturfelt
Neha M Patel
Jean-Luc Senécal
Michel Zummer
Janet E Pope
Stephanie Ensworth
Hani El-Gabalawy
Timothy McCarthy
Lene Dreyer
John Sibley
Yvan St Pierre
Ann E Clarke
Author Affiliation
McGill University Health Centre, 687 Pine Avenue, V Building, Montreal, Quebec H3A 1A1, Canada. sasha.bernatsky@mail.mcgill.ca
Source
J Autoimmun. 2013 May;42:130-5
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Asia - epidemiology
Breast Neoplasms - epidemiology
Canada - epidemiology
Cohort Studies
Europe - epidemiology
Female
Follow-Up Studies
Humans
Incidence
International Cooperation
Lupus Erythematosus, Systemic - epidemiology
Lymphoma, Non-Hodgkin - epidemiology
Male
Neoplasms - epidemiology
Ovarian Neoplasms - epidemiology
Risk
United States - epidemiology
Abstract
To update estimates of cancer risk in SLE relative to the general population.
A multisite international SLE cohort was linked with regional tumor registries. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers.
Across 30 centres, 16,409 patients were observed for 121,283 (average 7.4) person-years. In total, 644 cancers occurred. Some cancers, notably hematologic malignancies, were substantially increased (SIR 3.02, 95% confidence interval, CI, 2.48, 3.63), particularly non-Hodgkin's lymphoma, NHL (SIR 4.39, 95% CI 3.46, 5.49) and leukemia. In addition, increased risks of cancer of the vulva (SIR 3.78, 95% CI 1.52, 7.78), lung (SIR 1.30, 95% CI 1.04, 1.60), thyroid (SIR 1.76, 95% CI 1.13, 2.61) and possibly liver (SIR 1.87, 95% CI 0.97, 3.27) were suggested. However, a decreased risk was estimated for breast (SIR 0.73, 95% CI 0.61-0.88), endometrial (SIR 0.44, 95% CI 0.23-0.77), and possibly ovarian cancers (0.64, 95% CI 0.34-1.10). The variability of comparative rates across different cancers meant that only a small increased risk was estimated across all cancers (SIR 1.14, 95% CI 1.05, 1.23).
These data estimate only a small increased risk in SLE (versus the general population) for cancer over-all. However, there is clearly an increased risk of NHL, and cancers of the vulva, lung, thyroid, and possibly liver. It remains unclear to what extent the association with NHL is mediated by innate versus exogenous factors. Similarly, the etiology of the decreased breast, endometrial, and possibly ovarian cancer risk is uncertain, though investigations are ongoing.
Notes
Cites: J Intern Med. 2012 Feb;271(2):193-20321973261
Cites: J Rheumatol. 2011 Sep;38(9):1891-721724695
Cites: Ann Rheum Dis. 2008 Jan;67(1):74-917545189
Cites: Br J Cancer. 2002 Jul 1;87(1):49-5312085255
Cites: J Environ Pathol Toxicol Oncol. 2002;21(2):193-20112086406
Cites: J Rheumatol. 2002 Dec;29(12):2551-412465150
Cites: Lupus. 2004;13(6):469-7215303575
Cites: Ann Intern Med. 1978 Dec;89(6):888-92102228
Cites: Ann Rheum Dis. 1992 Apr;51(4):437-91586239
Cites: J Natl Cancer Inst. 1995 May 17;87(10):732-417563150
Cites: Arthritis Rheum. 1996 Jun;39(6):1050-48651970
Cites: Arthritis Rheum. 2005 May;52(5):1481-9015880596
Cites: Ann Rheum Dis. 2005 Oct;64(10):1507-916162903
Cites: Arthritis Rheum. 2005 Oct 15;53(5):781-416208671
Cites: Arch Intern Med. 2005 Nov 14;165(20):2337-4416287762
Cites: J Rheumatol. 2006 Jan;33(1):45-916331804
Cites: Arthritis Rheum. 2006 Aug;54(8):2550-716868977
Cites: Lung Cancer. 2007 Jun;56(3):303-617291624
Cites: Ann Rheum Dis. 2007 Jun;66(6):815-717204564
Cites: Clin Rev Allergy Immunol. 2007 Jun;32(3):265-7417992593
Cites: Arthritis Res Ther. 2008;10(2):R4518433475
Cites: J Clin Invest. 2008 Dec;118(12):3837-4019033653
Cites: Haematologica. 2008 Dec;93(12):1773-619050067
Cites: Anticancer Drugs. 2009 Sep;20(8):736-4519584707
Cites: J Clin Endocrinol Metab. 2010 Jan;95(1):314-819906791
Cites: Metabolism. 2010 Jun;59(6):896-90020005534
Cites: Endocr Pract. 2011 Mar-Apr;17(2):201-920841310
Cites: Br J Cancer. 2011 Apr 26;104(9):1478-8121487409
Cites: Nat Rev Rheumatol. 2011 Jun;7(6):360-821637317
Cites: Ann N Y Acad Sci. 2011 Jul;1229:176-8321793853
Cites: Ann Rheum Dis. 2013 May;72(5):659-6422589375
PubMed ID
23410586 View in PubMed
Less detail

The safety of urban cycle tracks: a review of the literature.

https://arctichealth.org/en/permalink/ahliterature116459
Source
Accid Anal Prev. 2013 Mar;52:219-27
Publication Type
Article
Date
Mar-2013
Author
Beth Thomas
Michelle DeRobertis
Author Affiliation
Transportation Choices for Sustainable Communities Research and Policy Institute, Oakland, CA, USA. Bethomas1967@gmail.com
Source
Accid Anal Prev. 2013 Mar;52:219-27
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Bicycling - injuries - statistics & numerical data
Canada
Cities - statistics & numerical data
Environment Design
Europe
Humans
Injury Severity Score
Risk
Safety - statistics & numerical data
Abstract
Cycling has to be a safe activity, and perceived as such, if bicycle trips by all populations are to increase and the public health benefits are to be realized. A key characteristic of developed countries with a high cycling mode share is their provision of cycle tracks--separated bikeways along city streets--on major routes. This literature review therefore sought to examine studies of cycle tracks from different countries in order elucidate the safety of these facilities relative to cycling in the street and to point to areas where further research is needed. The review indicates that one-way cycle tracks are generally safer at intersections than two-way and that, when effective intersection treatments are employed, constructing cycle tracks on busy streets reduces collisions and injuries. The evidence also suggests that, when controlling for exposure and including all collision types, building one-way cycle tracks reduces injury severity even when such intersection treatments are not employed. However, the extent of this effect has not been well examined, as very few studies both look at severity and control for exposure. Future studies of the safety of cycle tracks and associated intersection treatments should focus foremost on examining injury severity, while controlling for exposure. In the U.S., where the obesity epidemic and its health consequences and costs are well documented, the benefits of increased cycling should be a focus of research and policy development in order to provide the infrastructure needed to attract people to cycling while minimizing injuries.
PubMed ID
23396201 View in PubMed
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DISC1 in adult ADHD patients: an association study in two European samples.

https://arctichealth.org/en/permalink/ahliterature116513
Source
Am J Med Genet B Neuropsychiatr Genet. 2013 Apr;162B(3):227-34
Publication Type
Article
Date
Apr-2013
Author
Kaya K Jacobsen
Anne Halmøy
Cristina Sánchez-Mora
Josep Antoni Ramos-Quiroga
Bru Cormand
Jan Haavik
Stefan Johansson
Author Affiliation
Department of Biomedicine, University of Bergen, Bergen, Norway. kja098@biomed.uib.no
Source
Am J Med Genet B Neuropsychiatr Genet. 2013 Apr;162B(3):227-34
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attention Deficit Disorder with Hyperactivity - genetics
Europe
Exons
Female
Genetic Association Studies
Genetic Predisposition to Disease
Genotype
Humans
Male
Middle Aged
Nerve Tissue Proteins - genetics - physiology
Norway
Odds Ratio
Phenotype
Polymorphism, Single Nucleotide
Spain
Young Adult
Abstract
The DISC1 gene was named after its discovery in a Scottish pedigree with schizophrenia (SCZ) patients. However, subsequent studies have shown association of DISC1 variants with a range of different neurocognitive phenotypes and psychiatric disorders, including bipolar disorder (BPD), and major depression. Attention-deficit/hyperactivity disorder (ADHD) shares some symptoms with BPD and ADHD patients often suffer from comorbid affective disorders. We wanted to examine the role of DISC1 in ADHD, and with comorbid symptoms of mood disorders. Eleven single nucleotide polymorphisms (SNPs) previously implicated in SCZ and BPD, and a DISC1 duplication involving exon 1, were genotyped in 561 adult ADHD cases and 713 controls of Norwegian ancestry. The intronic SNP rs1538979 was associated with ADHD in the Norwegian sample [odds ratio (OR): 1.33, 95% confidence interval (CI) 1.03-1.73, P = 0.03] and replicated in a Spanish adult ADHD sample of 694 cases and 735 controls, using the tagging SNP rs11122330 (meta-analysis: P = 0.008, OR 1.25, 95% CI 1.06-1.47). In the Norwegian ADHD sample we also observed an association between the Phe607-variant of rs6675281 and a positive score on the Mood Disorder Questionnaire (MDQ; OR = 1.44, 95% CI 1.08-1.93, P = 0.01). To our knowledge, this is the first study to show an association between DISC1 variants and ADHD. Our study suggests that further studies are warranted to resolve if DISC1 variation is involved in several common neurodevelopmental disorders including ADHD.
PubMed ID
23389941 View in PubMed
Less detail

Hierarchical modeling identifies novel lung cancer susceptibility variants in inflammation pathways among 10,140 cases and 11,012 controls.

https://arctichealth.org/en/permalink/ahliterature116704
Source
Hum Genet. 2013 May;132(5):579-89
Publication Type
Article
Date
May-2013
Author
Darren R Brenner
Paul Brennan
Paolo Boffetta
Christopher I Amos
Margaret R Spitz
Chu Chen
Gary Goodman
Joachim Heinrich
Heike Bickeböller
Albert Rosenberger
Angela Risch
Thomas Muley
John R McLaughlin
Simone Benhamou
Christine Bouchardy
Juan Pablo Lewinger
John S Witte
Gary Chen
Shelley Bull
Rayjean J Hung
Author Affiliation
International Agency for Research on Cancer, Lyon, France. brenner.darren@gmail.com
Source
Hum Genet. 2013 May;132(5):579-89
Date
May-2013
Language
English
Publication Type
Article
Keywords
Alleles
Canada - epidemiology
Case-Control Studies
Europe - epidemiology
European Continental Ancestry Group - genetics
Female
Gene Frequency
Genetic Predisposition to Disease
Genetic Variation - genetics
Genome-Wide Association Study
Genotype
Humans
Inflammation - genetics
Likelihood Functions
Lung Neoplasms - epidemiology - genetics
Male
Middle Aged
Models, Statistical
Polymorphism, Single Nucleotide - genetics
Risk
United States - epidemiology
Abstract
Recent evidence suggests that inflammation plays a pivotal role in the development of lung cancer. In this study, we used a two-stage approach to investigate associations between genetic variants in inflammation pathways and lung cancer risk based on genome-wide association study (GWAS) data. A total of 7,650 sequence variants from 720 genes relevant to inflammation pathways were identified using keyword and pathway searches from Gene Cards and Gene Ontology databases. In Stage 1, six GWAS datasets from the International Lung Cancer Consortium were pooled (4,441 cases and 5,094 controls of European ancestry), and a hierarchical modeling (HM) approach was used to incorporate prior information for each of the variants into the analysis. The prior matrix was constructed using (1) role of genes in the inflammation and immune pathways; (2) physical properties of the variants including the location of the variants, their conservation scores and amino acid coding; (3) LD with other functional variants and (4) measures of heterogeneity across the studies. HM affected the priority ranking of variants particularly among those having low prior weights, imprecise estimates and/or heterogeneity across studies. In Stage 2, we used an independent NCI lung cancer GWAS study (5,699 cases and 5,818 controls) for in silico replication. We identified one novel variant at the level corrected for multiple comparisons (rs2741354 in EPHX2 at 8q21.1 with p value = 7.4 × 10(-6)), and confirmed the associations between TERT (rs2736100) and the HLA region and lung cancer risk. HM allows for prior knowledge such as from bioinformatic sources to be incorporated into the analysis systematically, and it represents a complementary analytical approach to the conventional GWAS analysis.
Notes
Cites: Aging Cell. 2004 Dec;3(6):399-41115569357
Cites: Genet Epidemiol. 1997;14(6):1137-429433637
Cites: Cancer Res. 2005 Oct 1;65(19):8583-616204020
Cites: Am J Epidemiol. 2006 Dec 15;164(12):1233-4117032696
Cites: N Engl J Med. 2007 Mar 29;356(13):1317-2617392301
Cites: Nat Biotechnol. 2008 Mar;26(3):25618327223
Cites: Nature. 2008 Apr 3;452(7187):633-718385738
Cites: Expert Rev Anticancer Ther. 2008 Apr;8(4):605-1518402527
Cites: Genet Epidemiol. 2008 May;32(4):361-918271029
Cites: Nat Genet. 2008 May;40(5):616-2218385676
Cites: Cancer Epidemiol Biomarkers Prev. 2008 May;17(5):1127-3518483334
Cites: Cancer Causes Control. 2008 Oct;19(8):887-9418386139
Cites: Cancer Causes Control. 2008 Dec;19(10):1413-418575952
Cites: Arch Intern Med. 2008 Nov 24;168(21):2326-32; discussion 233219029496
Cites: Nat Genet. 2008 Dec;40(12):1407-918978787
Cites: Nat Genet. 2008 Dec;40(12):1404-618978790
Cites: Bioinformatics. 2008 Dec 15;24(24):2938-918974171
Cites: Am J Hum Genet. 2009 Nov;85(5):679-9119836008
Cites: Am J Hum Genet. 2010 Jan;86(1):6-2220074509
Cites: BMC Cancer. 2010;10:28520546590
Cites: Nat Rev Genet. 2010 Dec;11(12):843-5421085203
Cites: PLoS One. 2011;6(3):e1747921483846
Cites: Brief Bioinform. 2011 May;12(3):259-6921546449
Cites: Biostatistics. 2011 Jul;12(3):445-6121252078
Cites: Eur J Hum Genet. 2011 Aug;19(8):908-1421448233
Cites: Cancer Discov. 2012 Feb;2(2):131-922585858
Cites: Cancer Epidemiol Biomarkers Prev. 2012 Jul;21(7):1213-2122573796
Cites: Cancer Res. 2007 Jul 1;67(13):6520-717596594
Cites: Am J Hum Genet. 2007 Aug;81(2):397-40417668389
Cites: Am J Hum Genet. 2007 Sep;81(3):559-7517701901
Cites: Genet Epidemiol. 2007 Dec;31(8):871-8217654612
Cites: Cancer Epidemiol Biomarkers Prev. 2007 Dec;16(12):2736-4418086781
Cites: Circ Res. 2001 Oct 26;89(9):793-811679409
Cites: Biomarkers. 2002 May-Jun;7(3):230-4112141066
Cites: Nature. 2003 Dec 18;426(6968):789-9614685227
Cites: Am J Hum Genet. 2004 Sep;75(3):460-7415272417
Cites: N Engl J Med. 1980 Dec 25;303(26):1514-76776404
Cites: Hum Exp Toxicol. 1992 Mar;11(2):99-1031349227
Cites: Control Clin Trials. 1993 Aug;14(4):308-248365195
Cites: Stat Med. 1996 Jun 15;15(11):1161-708804145
Cites: Cancer Epidemiol Biomarkers Prev. 1997 May;6(5):307-149149889
Cites: Bioinformatics. 2005 Mar 1;21(5):650-915388519
PubMed ID
23370545 View in PubMed
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Atrial fibrillation guidelines across the Atlantic: a comparison of the current recommendations of the European Society of Cardiology/European Heart Rhythm Association/European Association of Cardiothoracic Surgeons, the American College of Cardiology Foundation/American Heart Association/Heart Rhythm Society, and the Canadian Cardiovascular Society.

https://arctichealth.org/en/permalink/ahliterature116839
Source
Eur Heart J. 2013 May;34(20):1471-4
Publication Type
Article
Date
May-2013
Author
Paulus Kirchhof
Anne B Curtis
Allan C Skanes
Anne M Gillis
L. Samuel Wann
A. John Camm
Author Affiliation
University of Birmingham Centre for Cardiovascular Sciences, Institute for Biomedical Research, Birmingham, UK. p.kirchhof@bham.ac.uk
Source
Eur Heart J. 2013 May;34(20):1471-4
Date
May-2013
Language
English
Publication Type
Article
Keywords
Anti-Arrhythmia Agents - therapeutic use
Atrial Fibrillation - therapy
Canada
Decision Trees
Europe
Foundations
Humans
Practice Guidelines as Topic
Societies, Medical
United States
PubMed ID
23355653 View in PubMed
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The Transfusion Alternatives Preoperatively in Sickle Cell Disease (TAPS) study: a randomised, controlled, multicentre clinical trial.

https://arctichealth.org/en/permalink/ahliterature116861
Source
Lancet. 2013 Mar 16;381(9870):930-8
Publication Type
Article
Date
Mar-16-2013
Author
Jo Howard
Moira Malfroy
Charlotte Llewelyn
Louise Choo
Renate Hodge
Tony Johnson
Shilpi Purohit
David C Rees
Louise Tillyer
Isabeau Walker
Karin Fijnvandraat
Melanie Kirby-Allen
Eldon Spackman
Sally C Davies
Lorna M Williamson
Author Affiliation
Department of Haematology, Guy's and St Thomas' Hospital, London, UK. jo.howard@gstt.nhs.uk
Source
Lancet. 2013 Mar 16;381(9870):930-8
Date
Mar-16-2013
Language
English
Publication Type
Article
Keywords
Acute Chest Syndrome - etiology - prevention & control
Adolescent
Adult
Anemia, Sickle Cell - blood - complications - therapy
Blood Transfusion
Canada
Child
Child, Preschool
Europe
Female
Hemoglobin, Sickle - metabolism
Humans
Infant
Male
Odds Ratio
Perioperative Period
Postoperative Complications - prevention & control
Surgical Procedures, Operative - adverse effects
Treatment Outcome
beta-Thalassemia - therapy
Abstract
No consensus exists on whether preoperative blood transfusions are beneficial in patients with sickle-cell disease. We assessed whether perioperative complication rates would be altered by preoperative transfusion.
We did a multicentre, randomised trial. Eligible patients were aged at least 1 year, had haemoglobin SS or Sß(0)thalassaemia sickle-cell-disease subtypes, and were scheduled for low-risk or medium-risk operations. Patients were randomly assigned no transfusion or transfusion no more than 10 days before surgery. The primary outcome was the proportion of clinically important complications between randomisation and 30 days after surgery. Analysis was by intention to treat.
67 (96%) of 70 enrolled patients-33 no preoperative transfusion and 34 preoperative transfusion-were assessed. 65 (97%) of 67 patients had the haemoglobin SS subtype and 54 (81%) were scheduled to undergo medium-risk surgery. 13 (39%) of 33 patients in the no-preoperative-transfusion group had clinically important complications, compared with five (15%) in the preoperative-transfusion group (p=0.023). Of these, 10 (30%) and one (3%), respectively, had serious adverse events. The unadjusted odds ratio of clinically important complications was 3.8 (95% CI 1.2-12.2, p=0.027). 10 (91%) of 11 serious adverse events were acute chest syndrome (nine in the no-preoperative-transfusion group and one in the preoperative-transfusion group). Duration of hospital stay and readmission rates did not differ between study groups.
Preoperative transfusion was associated with decreased perioperative complications in patients with sickle-cell disease in this trial. This approach could, therefore, be beneficial for patients with the haemoglobin SS subtype who are scheduled to undergo low-risk and medium-risk surgeries.
NHS Blood and Transplant.
Notes
Comment In: Lancet. 2013 Mar 16;381(9870):886-823352053
PubMed ID
23352054 View in PubMed
Less detail

Epidemiology and eradication strategy for hepatitis B in Europe. The European Regional Study Group.

https://arctichealth.org/en/permalink/ahliterature229525
Source
Vaccine. 1990 Mar;8 Suppl:S113-6; discussion S134-8
Publication Type
Article
Date
Mar-1990
Author
A. Goudeau
Author Affiliation
Laboratoire de Virologie, CHU Bretonneau, Tours, France.
Source
Vaccine. 1990 Mar;8 Suppl:S113-6; discussion S134-8
Date
Mar-1990
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Carrier State - epidemiology
Child
Europe - epidemiology
Female
Hepatitis B - epidemiology - prevention & control
Humans
Infant
Male
Pregnancy
Prevalence
Risk factors
Vaccination
Abstract
In Europe, only approximately 1% of the general population are chronic carriers of the hepatitis B surface antigen (HBsAg) but hepatitis B is unevenly distributed in the region. Based on the prevalence of HBsAg, the region may be divided into three hepatitis B epidemiological patterns: the UK and the Scandinavian countries (less than 0.1%); most countries in Western Europe (0.1-0.5%); and countries situated along the Mediterranean Sea and in Eastern Europe (1-5%). Existing screening and vaccination programmes depend on such factors as the carrier rate of the indigenous population and the influx of immigrants from highly endemic areas. Vaccination of health care workers is, in general, advised but not required. The accent has been placed, in most countries, on the screening of pregnant women for the presence of HBsAg and the vaccination of newborns of carrier mothers. Education programmes are needed to enhance awareness of general practitioners regarding these risk groups. The institution of mass vaccination will depend upon the cost of vaccine, although the cost factor is less important in Europe than in developing countries.
PubMed ID
2327149 View in PubMed
Less detail

Incidence of hip fracture in Saskatchewan, Canada, 1976-1985.

https://arctichealth.org/en/permalink/ahliterature229548
Source
Am J Epidemiol. 1990 Mar;131(3):502-9
Publication Type
Article
Date
Mar-1990
Author
W A Ray
M R Griffin
R. West
L. Strand
L J Melton
Author Affiliation
Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN.
Source
Am J Epidemiol. 1990 Mar;131(3):502-9
Date
Mar-1990
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Epidemiologic Methods
Europe
Female
Hip Fractures - epidemiology
Humans
Male
Medical Records
Saskatchewan
Sex Factors
United States
Urban health
Abstract
The authors ascertained the incidence of hip fracture in Saskatchewan, Canada, residents aged 65 years or older for the 10 years 1976-1985 from computerized hospital discharge records and compared it with rates for several other populations in Northern Europe and the United States. In Saskatchewan, the average annual incidence was 5.5 per 1,000 person-years. The incidence in women was twice that in men, the incidence in urban areas was 27% greater than that in nonurban areas, and there was no secular trend of increasing rates. The incidence of hip fracture in Saskatchewan was lower than that for populations in Scandinavia and the United States but was comparable to rates in English populations. Further study is needed to elucidate the genetic, environmental, and behavioral factors responsible for this variation.
PubMed ID
2301358 View in PubMed
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