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  • 1
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    Online Resource
    Abstract P163: Are Coronary Artery Disease and Type 2 Diabetes Causally Related to Age of Menopause?
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 133, No. suppl_1 ( 2016-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Background: Women who enter the menopause at a younger age, are at an increased risk of cardiovascular disease (CVD) and type 2 diabetes (T2D) in later life. However, we have previously reported that development of an unfavourable cardiovascular risk profile premenopausally accelerates the onset of menopause. Furthermore, we reported that women who were diagnosed with diabetes at a very young age also reached menopause earlier. Hence, the direction of the relationship between coronary heart disease (CHD), T2D and the onset of menopause is unclear, and whether the associations are causal is also unclear. Hypothesis: In this study we hypothesize that CHD and/or T2D are causally related to the age of menopause, and studied this using genetic risk scores for CHD and T2D. Methods: Single nucleotide polymorphisms which had previously reached genome-wide significance for CHD and T2D were, individually and as a genetic risk score, tested for an association with age at natural menopause in over 50,000 women from three large consortia: the ITMAT/Broad/CARe (IBC) consortium, the ReproGen consortium, and the EPIC-InterAct consortium. From these consortia all women with a known age at natural menopause between 40 and 60 years were included. We used the genotyping array of the IBC consortium for the selection of the SNPs. The IBC array is a gene-centric genotyping array developed for replication and fine mapping and incorporates about 50K SNPs that capture information on 2000 genetic regions related to cardiovascular, inflammatory, and metabolic regions. The selected SNPs were also requested for analyses in the other two consortia. A total of 18 single nucleotide polymorphisms for CHD and 28 for T2D were selected. In the EPIC-InterAct study we used these SNPs to calculate unweighted individual level genetic risk scores. Results: No statistically significant associations were found for any of the CHD SNPs, nor for the T2D SNPs, nor for the genetic risk scores. Conclusions: Previous findings that women with an increased risk of CHD or T2D also have an increased risk of entering the menopause at younger ages, could not be supported by our data. Furthermore, the association between cardiometabolic disease and earlier timing of menopause does not seem to be causal. However, this finding does not exclude the possibility that the reverse association can be causal.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.133.suppl_1.p163
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
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  • 2
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    Polyglutamine (CAG) Intermediate Repeat Expansions in ATXN2 is Associated with a More Aggressive Form of ALS Across Multiple Independent Cohorts (2094)
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurology Vol. 94, No. 15_supplement ( 2020-04-14)
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 94, No. 15_supplement ( 2020-04-14)
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.94.15_supplement.2094
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 3
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    Beneficial Effect of Prone Positioning During Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019*
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Critical Care Medicine Vol. 50, No. 2 ( 2022-02), p. 275-285
    Details
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 2 ( 2022-02), p. 275-285
    Abstract: The study investigated the impact of prone positioning during venovenous extracorporeal membrane oxygenation support for coronavirus disease 2019 acute respiratory failure on the patient outcome. DESIGN: An observational study of venovenous extracorporeal membrane oxygenation patients. We used a multistate survival model to compare the outcomes of patients treated with or without prone positioning during extracorporeal membrane oxygenation, which incorporates the dynamic nature of prone positioning and adjusts for potential confounders. SETTING: Seventy-two international institutions participating in the Coronavirus Disease 2019 Critical Care Consortium international registry. PATIENTS: Coronavirus disease 2019 patients who were supported by venovenous extracorporeal membrane oxygenation during the study period. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: There were 232 coronavirus disease 2019 patients at 72 participating institutions who were supported with venovenous extracorporeal membrane oxygenation during the study period from February 16, 2020, to October 31, 2020. Proning was used in 176 patients (76%) before initiation of extracorporeal membrane oxygenation and in 67 patients (29%) during extracorporeal membrane oxygenation. Survival to hospital discharge was 33% in the extracorporeal membrane oxygenation prone group versus 22% in the extracorporeal membrane oxygenation supine group. Prone positioning during extracorporeal membrane oxygenation support was associated with reduced mortality (hazard ratio, 0.31; 95% CI, 0.14–0.68). CONCLUSIONS: Our study highlights that prone positioning during venovenous extracorporeal membrane oxygenation support for refractory coronavirus disease 2019-related acute respiratory distress syndrome is associated with reduced mortality. Given the observational nature of the study, a randomized controlled trial of prone positioning on venovenous extracorporeal membrane oxygenation is needed to confirm these findings.
    Type of Medium: Online Resource
    ISSN: 0090-3493
    URL: Article
    DOI: 10.1097/CCM.0000000000005296
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2034247-0
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  • 4
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    Reappraisal of Reported Genes for Sudden Arrhythmic Death : Evidence-Based Evaluation of Gene Validity for Brugada Syndrome
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Circulation Vol. 138, No. 12 ( 2018-09-18), p. 1195-1205
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 138, No. 12 ( 2018-09-18), p. 1195-1205
    Abstract: Implicit in the genetic evaluation of patients with suspected genetic diseases is the assumption that the genes evaluated are causative for the disease based on robust scientific and statistical evidence. However, in the past 20 years, considerable variability has existed in the study design and quality of evidence supporting reported gene-disease associations, raising concerns of the validity of many published disease-causing genes. Brugada syndrome (BrS) is an arrhythmia syndrome with a risk of sudden death. More than 20 genes have been reported to cause BrS and are assessed routinely on genetic testing panels in the absence of a systematic, evidence-based evaluation of the evidence supporting the causality of these genes. Methods: We evaluated the clinical validity of genes tested by diagnostic laboratories for BrS by assembling 3 gene curation teams. Using an evidence-based semiquantitative scoring system of genetic and experimental evidence for gene-disease associations, curation teams independently classified genes as demonstrating limited, moderate, strong, or definitive evidence for disease causation in BrS. The classification of curator teams was reviewed by a clinical domain expert panel that could modify the classifications based on their independent review and consensus. Results: Of 21 genes curated for clinical validity, biocurators classified only 1 gene ( SCN5A ) as definitive evidence, whereas all other genes were classified as limited evidence. After comprehensive review by the clinical domain Expert panel, all 20 genes classified as limited evidence were reclassified as disputed with regard to any assertions of disease causality for BrS. Conclusions: Our results contest the clinical validity of all but 1 gene clinically tested and reported to be associated with BrS. These findings warrant a systematic, evidence-based evaluation for reported gene-disease associations before use in patient care.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.118.035070
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1466401-X
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  • 5
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    Influence of Postconcussion Sleep Duration on Concussion Recovery in Collegiate Athletes
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Clinical Journal of Sport Medicine Vol. 30, No. 1 ( 2020-03), p. S29-S35
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 1 ( 2020-03), p. S29-S35
    Abstract: To determine whether decreased sleep duration postconcussion influences days to asymptomatic and assessment of performance throughout recovery. Design: Prospective. Setting: Institutional Clinical Research Laboratory. Patients: Four hundred twenty-three collegiate athletes were diagnosed with concussion. Interventions: Multidimensional concussion assessment battery was conducted at baseline, within 24 to 48 hours, daily [2-4 days postinjury (PI); symptoms only], once asymptomatic, and after return-to-play. The battery included the following: 22-item symptom checklist, Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and computerized neurocognitive test [Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)] . Main Outcome Measures: We subtracted baseline sleep duration from 24 to 48 hours postconcussion sleep duration and categorized athletes into the following groups: shorter sleep (≤−1 hour), no change ( 〉 −1 hour, 〈 +1 hour), and longer sleep (≥+1 hour). A 1-way analysis of variance (ANOVA) was conducted to compare days to asymptomatic and separate mixed-model ANOVAs to compare total symptom scores, SAC total scores, BESS total error scores, and ImPACT composite scores between sleep categories across time points (α = 0.05). Results: Sleep groups did not differ in days to asymptomatic. The shorter sleep group had greater symptom severity than no sleep change and longer sleep groups at 24 to 48 hours (shorter: 39.1 ± 20.7; no change: 25.1 ± 18.4, P = 0.007; longer: 25.7 ± 21.8, P = 0.004), and at 2 to 4 days PI (shorter: 21.8 ± 21.8; no change: 10.5 ± 10.8, P = 0.013; longer: 11.9 ± 14.2, P = 0.007), but did not differ at other time points (ie, asymptomatic and return-to-play). Participants with shorter sleep exhibited slower ImPACT reaction times at 24 to 48 hours (shorter: 0.68 ± 0.14; no change: 0.61 ± 0.09, P = 0.016; and longer: 0.62 ± 0.12, P = 0.028) and asymptomatic time points (shorter: 0.62 ± 0.11; no change: 0.56 ± 0.05; P = 0.015). Conclusion: Postinjury sleep declines may be associated with symptom severity and worsened reaction time during initial stages of recovery or may be the result of the concussion itself. Clinicians should be aware of alterations in sleep duration and manage appropriately to mitigate initial symptom burden postconcussion.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000000538
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2045233-0
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  • 6
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    Mobile Extracorporeal Membrane Oxygenation for Covid-19 Does Not Pose Extra Risk to Transport Team
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  ASAIO Journal Vol. 68, No. 2 ( 2022-02), p. 163-167
    Details
    In: ASAIO Journal, Ovid Technologies (Wolters Kluwer Health), Vol. 68, No. 2 ( 2022-02), p. 163-167
    Abstract: Previous experience has shown that transporting patients on extracorporeal membrane oxygenation (ECMO) is a safe and effective mode of transferring critically ill patients requiring maximum mechanical ventilator support to a quaternary care center. The coronavirus disease 2019 (COVID-19) pandemic posed new challenges. This is a multicenter, retrospective study of 113 patients with confirmed severe acute respiratory syndrome coronavirus 2, cannulated at an outside hospital and transported on ECMO to an ECMO center. This was performed by a multidisciplinary mobile ECMO team consisting of physicians for cannulation, critical care nurses, and an ECMO specialist or perfusionist, along with a driver or pilot. Teams practised strict airborne contact precautions with eyewear while caring for the patient and were in standard Personal Protective Equipment. The primary mode of transportation was ground. Ten patients were transported by air. The average distance traveled was 40 miles (SD ±56). The average duration of transport was 133 minutes (SD ±92). When stratified by mode of transport, the average distance traveled for ground transports was 36 miles (SD ±52) and duration was 136 minutes (SD ±93). For air, the average distance traveled was 66 miles (SD ±82) and duration was 104 minutes (SD ±70). There were no instances of transport-related adverse events including pump failures, cannulation complications at outside hospital, or accidental decannulations or dislodgements in transit. There were no instances of the transport team members contracting COVID-19 infection within 21 days after transport. By adhering to best practices and ACE precautions, patients with COVID-19 can be safely cannulated at an outside hospital and transported to a quaternary care center without increased risk to the transport team.
    Type of Medium: Online Resource
    ISSN: 1058-2916
    URL: Article
    DOI: 10.1097/MAT.0000000000001602
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2083312-X
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  • 7
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    Preinjury Measures Do Not Predict Future Concussion Among Collegiate Student-Athletes : Findings From the CARE Consortium
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  American Journal of Physical Medicine & Rehabilitation Vol. 102, No. 9 ( 2023-9), p. 823-828
    Details
    In: American Journal of Physical Medicine & Rehabilitation, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 9 ( 2023-9), p. 823-828
    Abstract: This prospective cohort study aimed to determine whether preinjury characteristics and performance on baseline concussion assessments predicted future concussions among collegiate student-athletes. Participant cases (concussed = 2529; control = 30,905) completed preinjury: demographic forms (sport, concussion history, sex), Immediate Post-Concussion Assessment and Cognitive Test, Balance Error Scoring System, Sport Concussion Assessment Tool symptom checklist, Standardized Assessment of Concussion, Brief Symptom Inventory–18 item, Wechsler Test of Adult Reading, and Brief Sensation Seeking Scale. We used machine-learning logistic regressions with area under the curve, sensitivity, and positive predictive values statistics for univariable and multivariable analyses. Primary sport was determined to be the strongest univariable predictor (area under the curve = 64.3% ± 1.4, sensitivity = 1.1% ± 1.4, positive predictive value = 4.9% ± 6.5). The all-predictor multivariable model was the strongest (area under the curve = 68.3% ± 1.6, sensitivity = 20.7% ± 2.7, positive predictive value = 16.5% ± 2.0). Despite a robust sample size and novel analytical approaches, accurate concussion prediction was not achieved regardless of modeling complexity. The strongest positive predictive value (16.5%) indicated only 17 of every 100 individuals flagged would experience a concussion. These findings suggest preinjury characteristics or baseline assessments have negligible utility for predicting subsequent concussion. Researchers, healthcare providers, and sporting organizations therefore should not use preinjury characteristics or baseline assessments for future concussion risk identification at this time.
    Type of Medium: Online Resource
    ISSN: 1537-7385 , 0894-9115
    URL: Article
    DOI: 10.1097/PHM.0000000000002302
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2272463-1
    detail.hit.zdb_id: 2049617-5
    SSG: 31
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  • 8
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    Optimizing Components of the Sport Concussion Assessment Tool for Acute Concussion Assessment
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurosurgery Vol. 87, No. 5 ( 2020-11), p. 971-981
    Details
    In: Neurosurgery, Ovid Technologies (Wolters Kluwer Health), Vol. 87, No. 5 ( 2020-11), p. 971-981
    Type of Medium: Online Resource
    ISSN: 0148-396X , 1524-4040
    URL: Article
    DOI: 10.1093/neuros/nyaa150
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1491894-8
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  • 9
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    Optimizing Components of the Sport Concussion Assessment Tool for Acute Concussion Assessment
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Neurosurgery Vol. 89, No. Supplement_2 ( 2021-11-18), p. S34-S34
    Details
    In: Neurosurgery, Ovid Technologies (Wolters Kluwer Health), Vol. 89, No. Supplement_2 ( 2021-11-18), p. S34-S34
    Type of Medium: Online Resource
    ISSN: 0148-396X , 1524-4040
    URL: Article
    DOI: 10.1093/neuros/nyaa150_S034
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1491894-8
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  • 10
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    Epidemiology and Outcomes of Acute Decompensated Heart Failure in Children
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation: Heart Failure Vol. 13, No. 4 ( 2020-04)
    Details
    In: Circulation: Heart Failure, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 4 ( 2020-04)
    Abstract: Acute decompensated heart failure (ADHF) is a highly morbid condition among adults. Little is known about outcomes in children with ADHF. We analyzed the Pediatric Cardiac Critical Care Consortium registry to determine the epidemiology, contemporary treatments, and predictors of mortality in critically ill children with ADHF. Methods: Cardiac intensive care unit (CICU) patients ≤18 years of age meeting Pediatric Cardiac Critical Care Consortium criteria for ADHF were included. ADHF was defined as systolic or diastolic dysfunction requiring continuous vasoactive or diuretic infusion, respiratory support, or mechanical circulatory support. Demographics, diagnosis, therapies, complications, and mortality are described for the cohort. Predictors of CICU mortality were identified using logistic regression. Results: Among 26 294 consecutive admissions (23 centers), 1494 (6%) met criteria for analysis. Median age was 0.93 years (interquartile range, 0.1–9.3 years). Patients with congenital heart disease (CHD) comprised 57% of the cohort. Common therapies included the following: vasoactive infusions (88%), central venous catheters (86%), mechanical ventilation (59%), and high flow nasal cannula (46%). Common complications were arrhythmias (19%), cardiac arrest (10%), sepsis (7%), and acute renal failure requiring dialysis (3%). Median length of CICU stay was 7.9 days (interquartile range, 3–18 days) and the CICU readmission rate was 22%. Overall, CICU mortality was 15% although higher for patients with CHD versus non-CHD (19% versus 11%; P 〈 0.001). Independent risk factors associated with CICU mortality included age 〈 30 days, CHD, vasoactive infusions, ventricular tachycardia, mechanical ventilation, sepsis, pulmonary hypertension, extracorporeal membrane oxygenation, and cardiac arrest. Conclusions: ADHF in children is characterized by comorbidities, high mortality rates, and frequent readmission, especially among patients with CHD. Opportunities exist to determine best practices around appropriate use of mechanical support, cardiac arrest prevention, and optimal heart transplantation candidacy to improve outcomes for these patients.
    Type of Medium: Online Resource
    ISSN: 1941-3289 , 1941-3297
    URL: Article
    DOI: 10.1161/CIRCHEARTFAILURE.119.006101
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2428100-1
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