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A 3-year follow-up study of preformed beta-quartz glass-ceramic insert restorations.

https://arctichealth.org/en/permalink/ahliterature195752
Source
Quintessence Int. 2000 Jan;31(1):25-31
Publication Type
Article
Date
Jan-2000
Author
G. Sjögren
S O Hedlund
C. Jonsson
A. Sandström
Author Affiliation
Department of Dental Materials Science, Umeå University, SE-901 87 Umeå, Sweden. Goran.Sjogren@odont.umu.se
Source
Quintessence Int. 2000 Jan;31(1):25-31
Date
Jan-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Bicuspid
Ceramics - chemistry
Color
Dental Caries - classification
Dental Marginal Adaptation
Dental Plaque - classification
Dental Restoration Failure
Dental Restoration, Permanent - classification
Female
Follow-Up Studies
Gingival Hemorrhage - classification
Glass - chemistry
Humans
Inlays - classification
Male
Middle Aged
Molar
Quartz - chemistry
Surface Properties
Survival Analysis
Time Factors
Treatment Outcome
Abstract
The purpose of this study was to evaluate the clinical performance of preformed beta-quartz glass-ceramic insert restorations.
Nine Class I and 30 Class II beta-quartz glass-ceramic insert restorations were placed in 16 patients who were seen regularly by personnel at Umeå University Dental School. The California Dental Association criteria were used to evaluate the restorations at baseline, 6 months, and 1, 2, and 3 years after luting. The occurrence of postoperative sensitivity, the time taken to manufacture each restoration, and certain periodontal conditions were also evaluated.
Sixty-nine percent of the restorations were rated satisfactory at the 3-year examination. During the follow-up period, 4 became loose and 7 were fractured or had flaking surfaces. Caries was registered in connection with 1 restoration. Excellent ratings were obtained for marginal integrity, anatomic form, surface, and color in 62%, 84%, 32%, and 44% of the restorations, respectively. There was no statistically significant difference in the occurrence of plaque and bleeding on probing in comparison with the controls. The mean overall time for placement was 38 minutes. The estimated survival rate (Kaplan-Meier) was 59% after 3.5 years.
The quality of the beta-quartz glass-ceramic restorations in the present study was inferior to that presented in most earlier studies of ceramic or resin composite posterior restorations placed in patients treated at university clinics. Both the technique and the beta-quartz glass-ceramic inserts have to be evaluated in more long-term studies to assess the possibility of their serving as an alternative restorative technique.
PubMed ID
11203902 View in PubMed
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8-Hydroxydeoxyguanosine: a new potential independent prognostic factor in breast cancer.

https://arctichealth.org/en/permalink/ahliterature97933
Source
Br J Cancer. 2010 Mar 16;102(6):1018-23
Publication Type
Article
Date
Mar-16-2010
Author
H. Sova
A. Jukkola-Vuorinen
U. Puistola
S. Kauppila
P. Karihtala
Author Affiliation
Department of Oncology and Radiotherapy, Oulu University Hospital, Finland. henrijuh@mail.student.oulu.fi
Source
Br J Cancer. 2010 Mar 16;102(6):1018-23
Date
Mar-16-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Breast Neoplasms - diagnosis - metabolism - mortality - pathology
Carcinoma, Ductal, Breast - diagnosis - metabolism - mortality - pathology
Deoxyguanosine - analogs & derivatives - blood - metabolism
Female
Humans
Immunohistochemistry
Middle Aged
Neoplasm Staging
Prognosis
Survival Analysis
Tumor Markers, Biological - analysis - metabolism
Abstract
BACKGROUND: 8-Hydroxydeoxyguanosine (8-oxodG) is the commonly used marker of oxidative stress-derived DNA damage. 8-OxodG formation is regulated by local antioxidant capacity and DNA repair enzyme activity. Earlier studies have reported contradictory data on the function of 8-oxodG as a prognostic factor in different cancer types. METHODS: We assessed pre-operative serum 8-oxodG levels with an enzyme-linked immunosorbent assay in a well-defined series of 173 breast cancer patients. 8-OxodG expression in the nuclei of cancer cells from 150 of these patients was examined by immunohistochemistry. RESULTS: The serum 8-oxodG levels and immunohistochemical 8-oxodG expression were in concordance with each other (P
PubMed ID
20179711 View in PubMed
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A 10-year retrospective study of interhospital patient transport using inhaled nitric oxide in Norway.

https://arctichealth.org/en/permalink/ahliterature269280
Source
Acta Anaesthesiol Scand. 2015 May;59(5):648-53
Publication Type
Article
Date
May-2015
Author
C. Buskop
P P Bredmose
M. Sandberg
Source
Acta Anaesthesiol Scand. 2015 May;59(5):648-53
Date
May-2015
Language
English
Publication Type
Article
Keywords
Administration, Inhalation
Adolescent
Adult
Aged
Bronchodilator Agents - administration & dosage - adverse effects - therapeutic use
Child
Child, Preschool
Critical Care
Equipment Failure - statistics & numerical data
Extracorporeal Membrane Oxygenation
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Nitric Oxide - administration & dosage - adverse effects - therapeutic use
Norway
Respiratory Insufficiency - mortality - therapy
Retrospective Studies
Survival Analysis
Tertiary Care Centers
Transportation of Patients
Treatment Outcome
Young Adult
Abstract
Anaesthesiologists from Oslo University Hospital have transported patients with severe oxygenation failure with inhaled nitric oxide (usually 20?ppm) from other hospitals to a tertiary care centre since 2002 in an effort to reduce the number of patients that otherwise would require transport with ongoing extracorporeal membrane oxygenation. The aim of this study was to evaluate the patient safety during transport with inhaled nitric oxide.
All patient transports with ongoing nitric oxide treatment undertaken from 2003 to 2012 were identified in the transport database. The frequency of adverse events and their impact on patient safety were studied in addition to response to inhaled nitric oxide and adjusted intensive care treatment and time aspects of the transports. Information about in-hospital treatment and survival were extracted from the hospital patient records.
Adverse events were recorded in 12 of the 104 transports. Seven of the adverse events were due to malfunctioning technical equipment, three were related to medication other than the inhaled nitric oxide and two were related to ventilation. No adverse events resulted in permanent negative patient consequences or in discontinuation of the transport. Out of 104 patients, 79 responded to treatment with inhaled nitric oxide and other treatment changes by an increase in oxygen saturation of more than 5%. The 30-day mortality was 27% in the group transported with inhaled nitric oxide.
Transporting patients on inhaled nitric oxide is an alternative in selected patients who would otherwise require extracorporeal membrane oxygenation during transport.
PubMed ID
25782015 View in PubMed
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10-year survival and quality of life in patients with high-risk pN0 prostate cancer following definitive radiotherapy.

https://arctichealth.org/en/permalink/ahliterature94068
Source
Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1074-83
Publication Type
Article
Date
Nov-15-2007
Author
Berg Arne
Lilleby Wolfgang
Bruland Oyvind Sverre
Fosså Sophie Dorothea
Author Affiliation
Faculty of Medicine, University of Oslo, Oslo, Norway. arne.berg@radiumhospitalet.no
Source
Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1074-83
Date
Nov-15-2007
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analysis of Variance
Case-Control Studies
Disease Progression
Erectile Dysfunction - physiopathology
Follow-Up Studies
Health status
Health Surveys
Humans
Male
Middle Aged
Neoplasm Staging
Norway
Prostatic Neoplasms - mortality - pathology - radiotherapy
Quality of Life
Radiotherapy, Conformal
Survival Analysis
Urination Disorders - physiopathology
Abstract
PURPOSE: To evaluate long-term overall survival (OS), cancer-specific survival (CSS), clinical progression-free survival (cPFS), and health-related quality of life (HRQoL) following definitive radiotherapy (RT) given to T(1-4p)N(0)M(0) prostate cancer patients provided by a single institution between 1989 and 1996. METHODS AND MATERIALS: We assessed outcome among 203 patients who had completed three-dimensional conformal RT (66 Gy) without hormone treatment and in whom staging by lymphadenectomy had been performed. OS was compared with an age-matched control group from the general population. A cross-sectional, self-report survey of HRQoL was performed among surviving patients. RESULTS: Median observation time was 10 years (range, 1-16 years). Eighty-one percent had high-risk tumors defined as T(3-4) or Gleason score (GS) > or =7B (4+3). Among these, 10-year OS, CSS, and cPFS rates were 52%, 66%, and 39%, respectively. The corresponding fractions in low-risk patients (T(1-2) and GS or =7B.
PubMed ID
17703896 View in PubMed
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14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections (BSI). Comorbidity - An Independent Risk Factor for Both BSI and Mortality.

https://arctichealth.org/en/permalink/ahliterature283680
Source
PLoS One. 2016;11(11):e0166527
Publication Type
Article
Date
2016
Author
Martin Holmbom
Christian G Giske
Mats Fredrikson
Åse Östholm Balkhed
Carina Claesson
Lennart E Nilsson
Mikael Hoffmann
Håkan Hanberger
Source
PLoS One. 2016;11(11):e0166527
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Bacteremia - drug therapy - epidemiology - microbiology - mortality
Candidiasis - drug therapy - epidemiology - microbiology - mortality
Community-Acquired Infections
Comorbidity
Cross Infection - epidemiology - microbiology
Female
Fungemia - drug therapy - epidemiology - microbiology - mortality
Gram-Negative Bacterial Infections - drug therapy - epidemiology - microbiology - mortality
Gram-Positive Bacterial Infections - drug therapy - epidemiology - microbiology - mortality
Health Surveys
Humans
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk factors
Survival Analysis
Sweden - epidemiology
Abstract
we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000-2013) in a Swedish county.
retrospective cohort study on culture confirmed BSI among patients in the county of Östergötland, Sweden, with approximately 440,000 inhabitants. A BSI was defined as either community-onset BSI (CO-BSI) or hospital-acquired BSI (HA-BSI).
of a total of 11,480 BSIs, 67% were CO-BSI and 33% HA-BSI. The incidence of BSI increased by 64% from 945 to 1,546 per 100,000 hospital admissions per year during the study period. The most prominent increase, 83% was observed within the CO-BSI cohort whilst HA-BSI increased by 32%. Prescriptions of antibiotics in outpatient care decreased with 24% from 422 to 322 prescriptions dispensed/1,000 inhabitants/year, whereas antibiotics prescribed in hospital increased by 67% (from 424 to 709 DDD per 1,000 days of care). The overall 30-day mortality for HA-BSIs was 17.2%, compared to 10.6% for CO-BSIs, with an average yearly increase per 100,000 hospital admissions of 2 and 5% respectively. The proportion of patients with one or more comorbidities, increased from 20.8 to 55.3%. In multivariate analyses, risk factors for mortality within 30 days were: HA-BSI (2.22); two or more comorbidities (1.89); single comorbidity (1.56); CO-BSI (1.21); male (1.05); and high age (1.04).
this survey revealed an alarming increase in the incidence of BSI over the 14-year study period. Interventions to decrease BSI in general should be considered together with robust antibiotic stewardship programmes to avoid both over- and underuse of antibiotics.
Notes
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PubMed ID
27835663 View in PubMed
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18F-FDG PET imaging of myocardial viability in an experienced center with access to 18F-FDG and integration with clinical management teams: the Ottawa-FIVE substudy of the PARR 2 trial.

https://arctichealth.org/en/permalink/ahliterature144812
Source
J Nucl Med. 2010 Apr;51(4):567-74
Publication Type
Article
Date
Apr-2010
Author
Arun Abraham
Graham Nichol
Kathryn A Williams
Ann Guo
Robert A deKemp
Linda Garrard
Ross A Davies
Lloyd Duchesne
Haissam Haddad
Benjamin Chow
Jean DaSilva
Rob S B Beanlands
Author Affiliation
National Cardiac PET Centre and Division of Cardiology, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Source
J Nucl Med. 2010 Apr;51(4):567-74
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Canada
Coronary Artery Disease - physiopathology - radionuclide imaging
Female
Fluorodeoxyglucose F18 - diagnostic use
Heart - physiopathology - radionuclide imaging
Heart Failure - physiopathology - radionuclide imaging
Humans
Male
Middle Aged
Myocardial Revascularization
Patient care team
Positron-Emission Tomography
Professional Competence
Radiopharmaceuticals - diagnostic use
Randomized Controlled Trials as Topic
Survival Analysis
Tissue Survival
Ventricular Dysfunction, Left - physiopathology - radionuclide imaging
Abstract
(18)F-FDG PET may assist decision making in ischemic cardiomyopathy. The PET and Recovery Following Revascularization (PARR 2) trial demonstrated a trend toward beneficial outcomes with PET-assisted management. The substudy of PARR 2 that we call Ottawa-FIVE, described here, was a post hoc analysis to determine the benefit of PET in a center with experience, ready access to (18)F-FDG, and integration with clinical teams.
Included were patients with left ventricular dysfunction and suspected coronary artery disease being considered for revascularization. The patients had been randomized in PARR 2 to PET-assisted management (group 1) or standard care (group 2) and had been enrolled in Ottawa after August 1, 2002 (the date that on-site (18)F-FDG was initiated) (n = 111). The primary outcome was the composite endpoint of cardiac death, myocardial infarction, or cardiac rehospitalization within 1 y. Data were compared with the rest of PARR 2 (PET-assisted management [group 3] or standard care [group 4]).
In the Ottawa-FIVE subgroup of PARR 2, the cumulative proportion of patients experiencing the composite event was 19% (group 1), versus 41% (group 2). Multivariable Cox proportional hazards regression showed a benefit for the PET-assisted strategy (hazard ratio, 0.34; 95% confidence interval, 0.16-0.72; P = 0.005). Compared with other patients in PARR 2, Ottawa-FIVE patients had a lower ejection fraction (25% +/- 7% vs. 27% +/- 8%, P = 0.04), were more often female (24% vs. 13%, P = 0.006), tended to be older (64 +/- 10 y vs. 62 +/- 10 y, P = 0.07), and had less previous coronary artery bypass grafting (13% vs. 21%, P = 0.07). For patients in the rest of PARR 2, there was no significant difference in events between groups 3 and 4. The observed effect of (18)F-FDG PET-assisted management in the 4 groups in the context of adjusted survival curves demonstrated a significant interaction (P = 0.016). Comparisons of the 2 arms in Ottawa-FIVE to the 2 arms in the rest of PARR 2 demonstrated a trend toward significance (standard care, P = 0.145; PET-assisted management, P = 0.057).
In this post hoc group analysis, a significant reduction in cardiac events was observed in patients with (18)F-FDG PET-assisted management, compared with patients who received standard care. The results suggest that outcome may be benefited using (18)F-FDG PET in an experienced center with ready access to (18)F-FDG and integration with imaging, heart failure, and revascularization teams.
Notes
Comment In: J Nucl Med. 2010 Apr;51(4):505-620237024
PubMed ID
20237039 View in PubMed
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21 year trends in incidence of myocardial infarction and mortality from coronary disease in middle-age.

https://arctichealth.org/en/permalink/ahliterature210947
Source
Eur Heart J. 1996 Oct;17(10):1495-502
Publication Type
Article
Date
Oct-1996
Author
P. Immonen-Räihä
M. Arstila
J. Tuomilehto
M. Haikio
A. Mononen
T. Vuorenmaa
J. Torppa
I. Parvinen
Author Affiliation
Health Office City of Turku, Finland.
Source
Eur Heart J. 1996 Oct;17(10):1495-502
Date
Oct-1996
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Cholesterol - blood
Coronary Disease - mortality - prevention & control
Cross-Sectional Studies
Female
Finland
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - mortality - prevention & control
Registries - statistics & numerical data
Survival Analysis
Urban Population - statistics & numerical data
Abstract
The aim of this study is to describe the 21 year trends in myocardial infarction among middle-aged inhabitants in the city of Turku, in southwestern Finland. Since 1972 the coronary register in Turku has monitored acute coronary events leading to hospital admission or death, first according to the methods of the World Health Organization Heart Attack Register Study, and since 1982 according to the methods of the WHO MONICA. From 1972 to 1992 we registered 7374 events of suspected myocardial infarction, of which 6045 events occurring in inhabitants of Turku aged 35-64 years, fulfilled the criteria for myocardial infarction. Within 28 days, 2266 coronary events proved fatal. During the 21-year period, the incidence of definite myocardial infarction fell by 55% in men and by 62% in women, and coronary mortality fell by 66 and 81%, respectively. From 1972 to 1982, total mortality and coronary mortality decreased in parallel. Later on, the decrease in total mortality levelled off, even though coronary mortality fell still steeper, because mortality from external causes of death increased. The favourable long-term trends reflect favourable changes in total cholesterol and blood pressure in the middle-aged population, and the improvement in the treatment of myocardial infarction. Further efforts are needed to enhance this trend, but also to reduce total mortality among middle-aged people.
Notes
Comment In: Eur Heart J. 1996 Oct;17(10):1455-68909894
PubMed ID
8909905 View in PubMed
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30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

https://arctichealth.org/en/permalink/ahliterature273361
Source
PLoS One. 2015;10(9):e0136547
Publication Type
Article
Date
2015
Author
Sahar Hassani
Anja Schou Lindman
Doris Tove Kristoffersen
Oliver Tomic
Jon Helgeland
Source
PLoS One. 2015;10(9):e0136547
Date
2015
Language
English
Publication Type
Article
Keywords
Comorbidity
Diagnosis-Related Groups
Episode of Care
Hospital Mortality
Hospital records
Hospitals - standards - statistics & numerical data
Humans
Length of Stay
Norway - epidemiology
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient transfer
Probability
Quality Improvement
Quality Indicators, Health Care
Survival Analysis
Abstract
The Norwegian Knowledge Centre for the Health Services (NOKC) reports 30-day survival as a quality indicator for Norwegian hospitals. The indicators have been published annually since 2011 on the website of the Norwegian Directorate of Health (www.helsenorge.no), as part of the Norwegian Quality Indicator System authorized by the Ministry of Health. Openness regarding calculation of quality indicators is important, as it provides the opportunity to critically review and discuss the method. The purpose of this article is to describe the data collection, data pre-processing, and data analyses, as carried out by NOKC, for the calculation of 30-day risk-adjusted survival probability as a quality indicator.
Three diagnosis-specific 30-day survival indicators (first time acute myocardial infarction (AMI), stroke and hip fracture) are estimated based on all-cause deaths, occurring in-hospital or out-of-hospital, within 30 days counting from the first day of hospitalization. Furthermore, a hospital-wide (i.e. overall) 30-day survival indicator is calculated. Patient administrative data from all Norwegian hospitals and information from the Norwegian Population Register are retrieved annually, and linked to datasets for previous years. The outcome (alive/death within 30 days) is attributed to every hospital by the fraction of time spent in each hospital. A logistic regression followed by a hierarchical Bayesian analysis is used for the estimation of risk-adjusted survival probabilities. A multiple testing procedure with a false discovery rate of 5% is used to identify hospitals, hospital trusts and regional health authorities with significantly higher/lower survival than the reference. In addition, estimated risk-adjusted survival probabilities are published per hospital, hospital trust and regional health authority. The variation in risk-adjusted survival probabilities across hospitals for AMI shows a decreasing trend over time: estimated survival probabilities for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival) to 91.7% (in the hospital with highest estimated survival), whereas it ranged from 83.8% to 91.2% in 2013.
Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.
Notes
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PubMed ID
26352600 View in PubMed
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40 years after the first atrial switch procedure in patients with transposition of the great arteries: long-term results in Toronto and Zurich.

https://arctichealth.org/en/permalink/ahliterature197150
Source
Thorac Cardiovasc Surg. 2000 Aug;48(4):233-7
Publication Type
Article
Date
Aug-2000
Author
E. Oechslin
R. Jenni
Author Affiliation
Division of Cardiology, University Hospital, Zurich, Switzerland. erwin.oechslin@dim.usz.ch
Source
Thorac Cardiovasc Surg. 2000 Aug;48(4):233-7
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Actuarial Analysis
Adolescent
Adult
Analysis of Variance
Arrhythmias, Cardiac - etiology
Cause of Death
Death, Sudden, Cardiac - epidemiology - etiology
Echocardiography
Follow-Up Studies
Heart Failure - etiology - mortality
Humans
Ontario - epidemiology
Proportional Hazards Models
Quality of Life
Reoperation - statistics & numerical data
Severity of Illness Index
Survival Analysis
Switzerland - epidemiology
Time Factors
Transposition of Great Vessels - complications - mortality - psychology - surgery
Treatment Outcome
Ventricular Dysfunction, Right - etiology - mortality
Abstract
The atrial switch procedure dramatically improved the prognosis of children with complete transposition of the great arteries (TGA). Overall actuarial survival was approximately 75% after 25 years and was better in patients with simple TGA than in those with complex TGA. Mortality by any cause (16%) and cardiovascular mortality (12% and 13%) were comparable in both centers. Progressive congestive heart failure and sudden death were the principal modes of death. Most of the survivors denied any symptoms or had mild limitations in their daily activities. However, long-term problems in this growing population of adults are challenging and include late arrhythmias (up to two thirds of the patients), systemic ventricular (SV) failure, systemic atrioventricular valve regurgitation and reoperations, such as baffle reconstruction, being the most frequent. Objective assessment of SV function obtained by echocardiography is difficult. It may include fractional area change and tricuspid annular motion. Survivors after an atrial switch procedure are unique and have a good quality of life. However, the definitive and true history of the RV supporting the systemic circulation is not as yet known.
PubMed ID
11005599 View in PubMed
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The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.

https://arctichealth.org/en/permalink/ahliterature178142
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Publication Type
Article
Date
Sep-2004
Author
Paul W Armstrong
Peter Bogaty
Christopher E Buller
Paul Dorian
Blair J O'Neill
Author Affiliation
VIGOUR Centre, University of Alberta, Edmonton. paul.armstrong@ualberta.ca
Source
Can J Cardiol. 2004 Sep;20(11):1075-9
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Canada
Defibrillators, Implantable - standards
Electrocardiography
Emergency Medical Services - standards
Emergency Service, Hospital - standards
Female
Guideline Adherence
Humans
Male
Myocardial Infarction - diagnosis - therapy
Myocardial Reperfusion - standards
Severity of Illness Index
Survival Analysis
Treatment Outcome
Abstract
Major changes in acute ST elevation myocardial infarction (STEMI) management prompted a comprehensive rewriting of the American College of Cardiology/American Heart Association Guidelines. The Canadian Cardiovascular Society (CCS) participated in both the writing process and the external review. Subsequently, a Canadian Working Group (CWG), formed under the auspices of the CCS, developed a perspective and adaptation for Canada. Herein, accounting for specific realities of the Canadian cardiovascular health system, is a discussion of the implications for prehospital care and transport, optimal reperfusion therapy and an approach to decision making regarding reperfusion options and invasive therapy following fibrinolytic therapy. Major recent developments regarding indications for implantable cardioverter defibrillator(s) (ICDs) also prompted a review of indications for ICDs and the optimal timing of implantation given the potential for recovery of left ventricular function. At least a 40-day, preferably a 12-week, waiting period was judged to be optimal to evaluate left ventricular function post-STEMI. A recommended algorithm for the insertion of an ICD is provided. Implementation of the new STEMI guidelines has substantial implications for resources, organization and priorities of the Canadian health care system. While on the one hand, the necessary incremental funding to provide tertiary and quaternary care and to support revascularization and device implantation capability is desirable, it is equally or more important to develop enhanced prehospital care, including the capacity for early recognition, risk assessment, fibrinolytic therapy and/or triage to a tertiary care centre as part of an enlightened approach to improving cardiac care.
PubMed ID
15457302 View in PubMed
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3483 records – page 1 of 349.