GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Comparison of Frailty Measures as Predictors of Outcomes After Orthopedic Surgery
    Wiley ; 2016
    In:  Journal of the American Geriatrics Society Vol. 64, No. 12 ( 2016-12), p. 2464-2471
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 64, No. 12 ( 2016-12), p. 2464-2471
    Abstract: To apply the Frailty Phenotype ( FP ) and Frailty Index ( FI ) before major elective orthopedic surgery to categorize frailty status and assess associations with postoperative outcomes. Design Prospective cohort study. Setting Two tertiary hospitals in Boston, Massachusetts. Participants Individuals aged 70 and older undergoing scheduled orthopedic surgery enrolled in the Successful Aging after Elective Surgery ( SAGES ) Study (N = 415). Measurements Preoperative evaluation included assessment of frailty using the FP and FI . The weighted kappa statistic was used to determine concordance between the two frailty measures and multivariable modeling to determine associations between each measure and postoperative complications, postoperative length of stay ( LOS ) of longer than 5 days, discharge to postacute institutional care ( PAC ), and 300 day readmission. Results Frailty was highly prevalent ( FP , 35%; FI , 41%). There was moderate concordance between the FP and FI ( κ = 0.42, 95% confidence interval ( CI ) 0.36–0.49). When using the FP , being prefrail predicted greater risk of complications (relative risk ( RR ) = 1.6, 95% CI = 1.1–2.1) and discharge to PAC ( RR = 1.8, 95% CI = 1.2–2.9) than being robust, and being frail predicted more complications ( RR = 1.7, 95% CI = 1.1–2.1), LOS longer than 5 days ( RR = 3.1, 95% CI = 1.1–8.8), and discharge to PAC ( RR = 2.3 95% CI = 1.4–3.7). When using FI , being prefrail predicted LOS longer than 5 days ( RR = 2.1, 95% CI = 1.0–4.8) and discharge to PAC ( RR = 1.5, 95% CI = 1.4–2.1), as did being frail ( RR = 1.9, 95% CI = 1.4–2.5; RR = 3.1, 95% CI = 1.4–6.8, respectively). The other outcomes were not significantly associated with frailty status. Conclusion FP and FI predict postoperative outcomes after major elective orthopedic surgery and should be considered for preoperative risk stratification.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2016.64.issue-12
    DOI: 10.1111/jgs.14387
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2040494-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Circulating Markers of Inflammation Persist in Children and Adults With Giant Aneurysms After Kawasaki Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation: Genomic and Precision Medicine Vol. 12, No. 4 ( 2019-04)
    Details
    In: Circulation: Genomic and Precision Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 4 ( 2019-04)
    Abstract: The sequelae of Kawasaki disease (KD) vary widely with the greatest risk for future cardiovascular events among those who develop giant coronary artery aneurysms (CAA). We sought to define the molecular signature associated with different outcomes in pediatric and adult KD patients. Methods: Molecular profiling was conducted using mass spectrometry–based shotgun proteomics, transcriptomics, and glycomics methods on 8 pediatric KD patients at the acute, subacute, and convalescent time points. Shotgun proteomics was performed on 9 KD adults with giant CAA and matched healthy controls. Plasma calprotectin was measured by ELISA in 28 pediatric KD patients 1 year post-KD, 70 adult KD patients, and 86 healthy adult volunteers. Results: A characteristic molecular profile was seen in pediatric patients during the acute disease, which resolved at the subacute and convalescent periods in patients with no coronary artery sequelae but persisted in 2 patients who developed giant CAA. We, therefore, investigated persistence of inflammation in KD adults with giant CAA by shotgun proteomics that revealed a signature of active inflammation, immune regulation, and cell trafficking. Correlating results obtained using shotgun proteomics in the pediatric and adult KD cohorts identified elevated calprotectin levels in the plasma of patients with CAA. Investigation of expanded pediatric and adult KD cohorts revealed elevated levels of calprotectin in pediatric patients with giant CAA 1 year post-KD and in adult KD patients who developed giant CAA in childhood. Conclusions: Complex patterns of biomarkers of inflammation and cell trafficking can persist long after the acute phase of KD in patients with giant CAA. Elevated levels of plasma calprotectin months to decades after acute KD and infiltration of cells expressing S100A8 and A9 in vascular tissues suggest ongoing, subclinical inflammation. Calprotectin may serve as a biomarker to inform the management of KD patients following the acute illness.
    Type of Medium: Online Resource
    ISSN: 2574-8300
    URL: Article
    DOI: 10.1161/CIRCGEN.118.002433
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2927603-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Antipsychotic Use in Hospitalized Adults: Rates, Indications, and Predictors
    Wiley ; 2016
    In:  Journal of the American Geriatrics Society Vol. 64, No. 2 ( 2016-02), p. 299-305
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 64, No. 2 ( 2016-02), p. 299-305
    Abstract: To investigate patterns and predictors of use of antipsychotics in hospitalized adults. Design Retrospective cohort study. Setting Academic medical center. Participants Individuals aged 18 and older hospitalized from August 2012 to August 2013, excluding those admitted to obstetrics and gynecology or psychiatry or with a psychotic disorder. Measurements Use was ascertained from pharmacy charges. Potentially excessive dosing was defined using guidelines for long‐term care facilities. A review of 100 records was performed to determine reasons for use. Results The cohort included 17,775 admissions with a median age 64; individuals could have been admitted more than once during the study period. Antipsychotics were used in 9%, 55% of which were initiations. The most common reasons for initiation were delirium (53%) and probable delirium (12%). Potentially excessive dosing occurred in 16% of admissions exposed to an antipsychotic. Of admissions with antipsychotic initiation, 26% were discharged on these medications. Characteristics associated with initiation included age 75 and older (relative risk ( RR ) = 1.4, 95% confidence interval ( CI ) = 1.2–1.7), male sex ( RR  = 1.2, 95% CI  = 1.1–1.4), black race ( RR  = 0.8, 95% CI  = 0.6–0.96), delirium ( RR  = 4.8, 95% CI  = 4.2–5.7), dementia ( RR  = 2.1, 95% CI  = 1.7–2.6), admission to a medical service ( RR  = 1.2, 95% CI  = 1.1–1.4), intensive care unit stay ( RR  = 2.1, 95% CI  = 1.8–2.4), and mechanical ventilation ( RR  = 2.0, 95% CI  = 1.7–2.4). In individuals who were initiated on an antipsychotic, characteristics associated with discharge on antipsychotics were age 75 and older ( RR  = 0.6, 95% CI  = 0.4–0.7), discharge to any location other than home ( RR  = 2.5, 95% CI  = 1.8–3.3), and class of in‐hospital antipsychotic exposure ( RR  = 1.6, 95% CI  = 1.1–2.3 for atypical vs typical; RR  = 2.7, 95% CI  = 1.9–3.8 for both vs typical). Conclusion Antipsychotic initiation and use were common during hospitalization, most often for delirium, and individuals were frequently discharged on these medications. Several predictors of use on discharge were identified, suggesting potential targets for decision support tools that would be used to prompt consideration of ongoing necessity.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2016.64.issue-2
    DOI: 10.1111/jgs.13943
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2040494-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU
    Springer Science and Business Media LLC ; 2016
    In:  Journal of General Internal Medicine Vol. 31, No. 3 ( 2016-3), p. 297-303
    Details
    In: Journal of General Internal Medicine, Springer Science and Business Media LLC, Vol. 31, No. 3 ( 2016-3), p. 297-303
    Type of Medium: Online Resource
    ISSN: 0884-8734 , 1525-1497
    URL: Article
    DOI: 10.1007/s11606-015-3514-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2016
    detail.hit.zdb_id: 2006784-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    The Montreal Cognitive Assessment: Creating a Crosswalk with the Mini‐Mental State Examination
    Wiley ; 2015
    In:  Journal of the American Geriatrics Society Vol. 63, No. 11 ( 2015-11), p. 2370-2374
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 63, No. 11 ( 2015-11), p. 2370-2374
    Abstract: To establish Montreal Cognitive Assessment (Mo CA ) scores that correspond to well‐established cut‐points on the Mini‐Mental State Examination ( MMSE ). Design Cross‐sectional observational study. Setting General medical service of a large teaching hospital. Participants Individuals aged 75 and older (N = 199; mean age 84, 63% female). Measurements The Mo CA (range 0–30) and the MMSE (range 0–30) were administered within 2 hours of each other. The Abbreviated Mo CA (A‐Mo CA ; range 0–22) was calculated from the full Mo CA . Scores from the three tests were analyzed using equipercentile equating, a statistical method for determining comparable scores on different tests of a similar construct by estimating percentile equivalents. Results Mo CA scores were lower (mean 19.3 ± 5.8) than MMSE scored (mean 24.1 ± 6.6). Traditional MMSE cut‐points of 27 for mild cognitive impairment and 23 for dementia corresponded to Mo CA scores of 23 and 17, respectively. Conclusion Scores on the full and abbreviated versions of the Mo CA can be linked directly to the MMSE . The Mo CA may be more sensitive to changes in cognitive performance at higher levels of functioning.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2015.63.issue-11
    DOI: 10.1111/jgs.13710
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2040494-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Derivation and Validation of a Severity Scoring Method for the 3‐Minute Diagnostic Interview for Confusion Assessment Method‐‐Defined Delirium
    Wiley ; 2016
    In:  Journal of the American Geriatrics Society Vol. 64, No. 8 ( 2016-08), p. 1684-1689
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 64, No. 8 ( 2016-08), p. 1684-1689
    Abstract: To derive and validate a method for scoring delirium severity using a recently validated, brief, structured diagnostic interview for Confusion Assessment Method ( CAM )‐defined delirium (3D‐ CAM ) and to demonstrate its agreement with the CAM Severity short form ( CAM ‐S SF ) as the reference standard. Design Derivation and validation analysis in a prospective cohort study. Setting Two academic medical centers. Participants Individuals aged 70 and older enrolled in the Successful Aging after Elective Surgery Study undergoing major elective noncardiac surgery (N = 566). Measurements The sample was randomly divided into a derivation dataset (n = 377) and an independent validation dataset (n = 189). These datasets were used to develop a severity scoring method using the 3D‐ CAM based on the four‐item CAM ‐S SF (3D‐ CAM ‐S) and evaluate agreement between the 3D‐ CAM ‐S and the traditional CAM ‐S SF using weighted kappa statistics. Results A method for scoring severity using 3D‐ CAM items was developed that achieved good agreement with the CAM ‐S SF in the derivation dataset (κ = 0.94, 95% confidence interval ( CI ) = 0.93–0.95). The 3D‐ CAM ‐S achieved nearly identical agreement in the independent validation dataset (κ = 0.93, 95% CI = 0.92–0.95), and 100% of 3D‐ CAM ‐S scores were within 1 point of the CAM ‐S SF score in both datasets. The 3D‐ CAM ‐S also strongly predicts clinical outcomes. Conclusion A newly developed method for scoring delirium severity using the 3D‐ CAM (the 3D‐ CAM ‐S) has excellent agreement with the CAM ‐S SF . This new methodology enables clinicians and researchers using the 3D‐ CAM for surveillance to measure delirium severity and monitor its course simultaneously by tracking changes over time. The 3D‐ CAM ‐S expands the utility of the 3D‐ CAM as an important tool for delirium recognition and management.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2016.64.issue-8
    DOI: 10.1111/jgs.14234
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2040494-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    M281, an anti-FcRn antibody, inhibits IgG transfer in a human ex vivo placental perfusion model
    Elsevier BV ; 2019
    In:  American Journal of Obstetrics and Gynecology Vol. 220, No. 5 ( 2019-05), p. 498.e1-498.e9
    Details
    In: American Journal of Obstetrics and Gynecology, Elsevier BV, Vol. 220, No. 5 ( 2019-05), p. 498.e1-498.e9
    Type of Medium: Online Resource
    ISSN: 0002-9378
    URL: Article
    DOI: 10.1016/j.ajog.2019.02.058
    RVK:
    XA 19400
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2003357-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Cytokines and Postoperative Delirium in Older Patients Undergoing Major Elective Surgery
    Oxford University Press (OUP) ; 2015
    In:  The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Vol. 70, No. 10 ( 2015-10), p. 1289-1295
    Details
    In: The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Oxford University Press (OUP), Vol. 70, No. 10 ( 2015-10), p. 1289-1295
    Type of Medium: Online Resource
    ISSN: 1079-5006 , 1758-535X
    URL: Article
    DOI: 10.1093/gerona/glv083
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2043927-1
    SSG: 12
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Necuparanib, A Multitargeting Heparan Sulfate Mimetic, Targets Tumor and Stromal Compartments in Pancreatic Cancer
    American Association for Cancer Research (AACR) ; 2019
    In:  Molecular Cancer Therapeutics Vol. 18, No. 2 ( 2019-02-01), p. 245-256
    Details
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 18, No. 2 ( 2019-02-01), p. 245-256
    Abstract: Pancreatic cancer has an abysmal 5-year survival rate of 8%, making it a deadly disease with a need for novel therapies. Here we describe a multitargeting heparin-based mimetic, necuparanib, and its antitumor activity in both in vitro and in vivo models of pancreatic cancer. Necuparanib reduced tumor cell proliferation and invasion in a three-dimensional (3D) culture model; in vivo, it extended survival and reduced metastasis. Furthermore, proteomic analysis demonstrated that necuparanib altered the expression levels of multiple proteins involved in cancer-driving pathways including organ development, angiogenesis, proliferation, genomic stability, cellular energetics, and invasion and metastasis. One protein family known to be involved in invasion and metastasis and altered by necuparanib treatment was the matrix metalloprotease (MMP) family. Necuparanib reduced metalloproteinase 1 (MMP1) and increased tissue inhibitor of metalloproteinase 3 (TIMP3) protein levels and was found to increase RNA expression of TIMP3. MMP enzymatic activity was also found to be reduced in the 3D model. Finally, we confirmed necuparanib's in vivo activity by analyzing plasma samples of patients enrolled in a phase I/II study in patients with metastatic pancreatic cancer; treatment with necuparanib plus standard of care significantly increased TIMP3 plasma protein levels. Together, these results demonstrate necuparanib acts as a broad multitargeting therapeutic with in vitro and in vivo anti-invasive and antimetastatic activity.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    URL: Article
    DOI: 10.1158/1535-7163.MCT-18-0417
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2019
    detail.hit.zdb_id: 2062135-8
    SSG: 12
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Antipsychotic medication utilization in nonpsychiatric hospitalizations
    Wiley ; 2016
    In:  Journal of Hospital Medicine Vol. 11, No. 8 ( 2016-08), p. 543-549
    Details
    In: Journal of Hospital Medicine, Wiley, Vol. 11, No. 8 ( 2016-08), p. 543-549
    Abstract: Although antipsychotics are used for treatment of delirium/agitation in hospitalized patients, their scope of use has not been investigated in a large, multicenter cohort. OBJECTIVE To determine rates of use and hospital variation in use of antipsychotics in nonpsychiatric admissions. DESIGN, SETTING, PATIENTS Cohort study of adult, nonpsychiatric admissions to 300 US hospitals contributing data to the Premier database, from July 1, 2009 to June 30, 2010. MEASUREMENTS Antipsychotic exposure defined using pharmacy charges. Potentially excessive dosing defined using guidelines for long‐term care facilities. RESULTS Our cohort included 2,695,081 admissions (median age, 63 years; 56% female). Antipsychotic exposure occurred in 160,773 (6%) admissions; 102,148 (64%) received atypical antipsychotics, 76,979 (48%) received typical, and 18,354 (11%) received both. Among exposed admissions, 47% received ≥1 potentially excessive daily dose. Among the variables we analyzed, the strongest predictors of antipsychotic receipt were delirium (relative risk [RR]: 2.93, 95% CI: 2.88‐2.98) and dementia (RR: 2.78, 95% CI: 2.72‐2.83). After adjustment for patient characteristics, patients admitted to hospitals in the highest antipsychotic prescribing quintile were more than twice as likely to be exposed compared to patients admitted to hospitals in the lowest prescribing quintile (RR: 2.56, 95% CI: 2.50‐2.61). This relationship was similar across subgroups of admissions with delirium and dementia. CONCLUSIONS Antipsychotic medication exposure is common in nonpsychiatric admissions to US hospitals. The observed variation in antipsychotic prescribing was not fully explained by measured patient characteristics, suggesting the possibility of differing hospital prescribing cultures. Additional research and guidelines are necessary to define appropriate use of these potentially harmful medications in the hospital setting. Journal of Hospital Medicine 2016;11:543–549. © 2016 Society of Hospital Medicine
    Type of Medium: Online Resource
    ISSN: 1553-5592 , 1553-5606
    URL: Issue
    URL: Article
    DOI: 10.1002/jhm.v11.8
    DOI: 10.1002/jhm.2596
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2221544-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...