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  • Ovid Technologies (Wolters Kluwer Health)  (38)
  • 1
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    Online Resource
    Elevated Fos Expression in the Nucleus Tractus Solitarii Is Associated With Reduced Baroreflex Response in Spontaneously Hypertensive Rats
    Ovid Technologies (Wolters Kluwer Health) ; 1998
    In:  Hypertension Vol. 32, No. 5 ( 1998-11), p. 939-944
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 5 ( 1998-11), p. 939-944
    Abstract: Abstract —We delineated the functional role of Fos protein at the nucleus tractus solitarii in the manifestation of reduced baroreceptor reflex control of heart rate during hypertension, using spontaneously hypertensive rats (SHR), stroke-prone SHR, Wistar-Kyoto rats, or Sprague-Dawley rats. Microinjection into the bilateral nucleus tractus solitarii of an antisense oligonucleotide that targets against the initiation codon of c- fos mRNA significantly potentiated the baroreceptor reflex in response to 30 minutes of sustained increase in blood pressure. Of particular note was the restoration of both the impaired sensitivity and capacity of baroreceptor reflex in SHR and stroke-prone SHR to levels comparable to those in normotensive rats. Likewise, the number of Fos-immunoreactive nuclei evoked by the sustained increase in blood pressure in the caudal nucleus tractus solitarii of SHR and stroke-prone SHR was reduced, after this antisense c- fos treatment, to the basal level exhibited by the normotensive animals. Control treatment with the corresponding sense oligonucleotide, an antisense oligonucleotide that targets against a different portion of the coding sequence of the c- fos mRNA or artificial cerebrospinal fluid, on the other hand, elicited no discernible effect on either the baroreceptor reflex response or the induced expression of Fos protein in the nucleus tractus solitarii by baroreceptor activation. We also found that the basal level of Fos expression in the caudal nucleus tractus solitarii was significantly elevated in the SHR and stroke-prone SHR. Together, these novel findings suggest that an elevated expression of basal Fos protein in the NTS during hypertension may be associated with the dysfunction in baroreceptor reflex control of heart rate.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/01.HYP.32.5.939
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1998
    detail.hit.zdb_id: 2094210-2
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  • 2
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    Epidemiology and outcomes of hypertensive crisis in patients with chronic kidney disease: a nationwide analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Journal of Hypertension Vol. 40, No. 7 ( 2022-07), p. 1288-1293
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 7 ( 2022-07), p. 1288-1293
    Abstract: The epidemiology and outcomes of hypertensive crisis (HTN-C) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) have not been well studied. The objective of our study is to describe the incidence, clinical characteristics, and outcomes of emergency department (ED) visits for HTN-C in patients with CKD and ESRD. Methods: We performed a secondary analysis of Nationwide Emergency Department Sample databases for years 2016–2018 by identifying adult patients presenting to ED with hypertension related conditions as primary diagnosis using appropriate diagnosis codes. Results: There were 348 million adult ED visits during the study period. Of these, 680 333 (0.2%) ED visits were for HTN-C. Out of these, majority were in patients without renal dysfunction (82%), with 11.4 and 6.6% were in patients with CKD and ESRD, respectively. The CKD and ESRD groups had significantly higher percentages of hypertensive emergency (HTN-E) presentation than in the No-CKD group (38.9, 34.2 and 22.4%, respectively; P   〈  0.001). ED visits for HTN-C frequently resulted in hospital admission and these were significantly higher in patients with CKD and ESRD than in No-CKD (78.3 vs. 72.6 vs. 44.7%; P   〈  0.0001). In-hospital mortality was overall low but was higher in CKD and ESRD than in No-CKD group (0.3 vs. 0.2 vs. 0.1%; P   〈  0.0001), as was cost of care (USD 28 534, USD 29 465 and USD 26 394, respectively; P   〈  0.001). Conclusion: HTN-C constitutes a significant burden on patients with CKD and ESRD compared with those without CKD with a higher proportion of ED visits, incidence of HTN-E, hospitalization rate, in-hospital mortality and cost of care. Graphical abstract: http://links.lww.com/HJH/C22
    Type of Medium: Online Resource
    ISSN: 0263-6352 , 1473-5598
    URL: Article
    DOI: 10.1097/HJH.0000000000003136
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2017684-3
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  • 3
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    Abstract 10258: Do Statins Impact Long-term Mortality Peripheral Artery Disease Patients Who Have End Stage Renal Disease?
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: Statins have shown mortality benefit in peripheral artery disease (PAD), their impact in end-stage renal disease (ESRD) patients with PAD is not well studied. Hypothesis: Does statin utilization have any impact on mortality in ESRD patients with PAD? Methods: We included ESRD Medicare beneficiaries from the United states Renal Database (Jan 1 st 2006 to May 31 st 2017) with PAD within 6 months of incident dialysis. Medicare part D claims were used to determine STU during the follow-up period. Fractional polynomial regression across varying % of STU was generated to predict 2-year mortality. Results: Out of 45,424 ESRD patients with PAD, 62.3% received no statins while the rest had at least some duration of STU. ST was bimodally distributed, with median utilization of 0% (IQR= 0-90%). Mortality was 41.7% over a median follow-up of 472 days. Univariate association of STU on mortality yielded odds ratio (OR) of 0.99 (95% CI = 0.992-0.993; p 〈 0.001). Model 1 including baseline demographics and comorbidities (age, sex, body mass index, hypertension, coronary artery disease, stroke, smoking, diabetes, and heart failure) an AUC of 0.65. The addition of STU (Model 2) resulted in only minimal improvement in the AUC (0.65 vs 0.67; p 〈 0.01). Conclusions: Statin utilization in ESRD patients is associated with only borderline statistically significant reduction in mortality (≈0.1%) of unclear clinical implications
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.10258
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 4
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    Trends and Outcomes of Cardiogenic Shock in Patients With End-Stage Renal Disease: Insights From USRDS Database
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Circulation: Heart Failure Vol. 16, No. 8 ( 2023-08)
    Details
    In: Circulation: Heart Failure, Ovid Technologies (Wolters Kluwer Health), Vol. 16, No. 8 ( 2023-08)
    Abstract: There is a paucity of data regarding epidemiology, temporal trends, and outcomes of patients with cardiogenic shock (CS) and end-stage renal disease (chronic kidney disease stage V on hemodialysis). METHODS: This is a retrospective cohort study using the United States Renal Data System database from January 1, 2006 to December 31, 2019. We analyzed trends of CS, percutaneous mechanical support (intraaortic balloon pump, percutaneous ventricular assist device [Impella and Tandemheart], and extracorporeal membrane oxygenation) utilization, index mortality, 30-day mortality, and 1-year all-cause mortality in end-stage renal disease patients. RESULTS: A total of 43 825 end-stage renal disease patients were hospitalized with CS (median age, 67.8 years [IQR, 59.4–75.8] and 59.1% men). From 2006 to 2019, the incidence of CS increased from 275 to 578 per 100 000 patients ( P trend 〈 0.001). The index mortality rate declined from 54.1% in 2006 to 40.8% in 2019 ( P trend =0.44), and the 1-year all-cause mortality decreased from 63% in 2006 to 61.8% in 2018 ( P trend =0.73), but neither trend was statistically significant. There was a significantly decreased utilization of intra-aortic balloon pumps from 17 832 to 7992 ( P trend 〈 0.001), increased utilization of percutaneous ventricular assist device from 137 to 5201 ( P trend 〈 0.001) and increase in extracorporeal membrane oxygenation use from 69 to 904 per 100 000 patients ( P trend 〈 0.001). After adjusting for covariates, there was no significant difference in index mortality between CS patients requiring percutaneous mechanical support versus those not requiring percutaneous mechanical support (odds ratio, 0.97 [CI, 0.91–1.02]; P =0.22). On multivariable regression analysis, older age, peripheral vascular disease, diabetes, and time on dialysis were independent predictors of higher index mortality. CONCLUSIONS: The incidence of CS in end-stage renal disease patients has doubled without significant change in the trend of index mortality despite the use of percutaneous mechanical support.
    Type of Medium: Online Resource
    ISSN: 1941-3289 , 1941-3297
    URL: Article
    DOI: 10.1161/CIRCHEARTFAILURE.122.010462
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2428100-1
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  • 5
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    Burden of Hypertensive Crisis in Patients With End-Stage Kidney Disease on Maintenance Dialysis: Insights From United States Renal Data System Database
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension Vol. 80, No. 4 ( 2023-04)
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 4 ( 2023-04)
    Abstract: There is paucity of information on the incidence, clinical characteristics, admission trends, and outcomes of hypertensive crisis (HTN-C) in patients with end-stage kidney disease (ESKD) who are on maintenance dialysis. Methods: We conducted a retrospective observational study of HTN-C admissions in patients with end-stage kidney disease using the United States Renal Data System. We identified patients with end-stage kidney disease aged ≥18 years on dialysis and were hospitalized for HTN-C from January 2006 to August 2015. Results: A total of 54 483 patients with end-stage kidney disease were hospitalized for HTN-C during the study period. After study exclusions, 37 214 patients were included in the analysis. A majority of patients were Black, there were more women than men and the South region of the country accounted for a great majority of patients. During the study period, hospitalization rates increased from 1060 per 100 000 beneficiary years to 1821 ( P trend 〈 0.0001). Overall, in-hospital mortality, 30-day, and 1-year mortality were 0.6%, 2.3%, and 21.8%, respectively, and 30-day readmission rate was 31.1%. During the study period, most study outcomes showed a significant decreasing trend (in-hospital mortality 0.6%–0.5%, 30-day mortality 2.4%–1.9%, 1-year mortality 23.9%–19.7%, P trend 〈 0.0001 for all). Conclusions: Hospitalizations for HTN-C have increased consistently during the decade studied. Although temporal trends showed improving mortality and readmission rates, the absolute rates were still high with 1 in 3 patients readmitted within 30 days and 1 in 5 patients dying within 1 year of index hospitalization.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.122.20546
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 6
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    Impact of Evidence‐Based Stroke Care on Patient Outcomes: A Multilevel Analysis of an International Study
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of the American Heart Association Vol. 8, No. 13 ( 2019-07-02)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 13 ( 2019-07-02)
    Abstract: The uptake of proven stroke treatments varies widely. We aimed to determine the association of evidence‐based processes of care for acute ischemic stroke ( AIS ) and clinical outcome of patients who participated in the HEADPOST (Head Positioning in Acute Stroke Trial), a multicenter cluster crossover trial of lying flat versus sitting up, head positioning in acute stroke. Methods and Results Use of 8 AIS processes of care were considered: reperfusion therapy in eligible patients; acute stroke unit care; antihypertensive, antiplatelet, statin, and anticoagulation for atrial fibrillation; dysphagia assessment; and physiotherapist review. Hierarchical, mixed, logistic regression models were performed to determine associations with good outcome (modified Rankin Scale scores 0–2) at 90 days, adjusted for patient and hospital variables. Among 9485 patients with AIS, implementation of all processes of care in eligible patients, or “defect‐free” care, was associated with improved outcome (odds ratio, 1.40; 95% CI, 1.18–1.65) and better survival (odds ratio, 2.23; 95% CI , 1.62–3.09). Defect‐free stroke care was also significantly associated with excellent outcome (modified Rankin Scale score 0–1) (odds ratio, 1.22; 95% CI , 1.04–1.43). No hospital characteristic was independently predictive of outcome. Only 1445 (15%) of eligible patients with AIS received all processes of care, with significant regional variations in overall and individual rates. Conclusions Use of evidence‐based care is associated with improved clinical outcome in AIS . Strategies are required to address regional variation in the use of proven AIS treatments. Clinical Trial Registration URL : https://www.clinicaltrials.gov . Unique Identifier: NCT 02162017.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.119.012640
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 7
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    V14-03 TRANSPERINEAL MICROWAVE NEEDLE THERMOABLATION OF PROSTATE CANCER GUIDED BY MRI ULTRASOUND FUSION AND ORGAN BASED TRACKING TECHNOLOGY
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of Urology Vol. 203, No. Supplement 4 ( 2020-04)
    Details
    In: Journal of Urology, Ovid Technologies (Wolters Kluwer Health), Vol. 203, No. Supplement 4 ( 2020-04)
    Type of Medium: Online Resource
    ISSN: 0022-5347 , 1527-3792
    URL: Article
    DOI: 10.1097/JU.0000000000000982.03
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 8
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    PD44-02 NOCTURIA: A RED ALARM FOR CARDIOVASCULAR EVENTS MEDIATED BY CENTRAL ARTERIAL STIFFNESS?
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of Urology Vol. 203, No. Supplement 4 ( 2020-04)
    Details
    In: Journal of Urology, Ovid Technologies (Wolters Kluwer Health), Vol. 203, No. Supplement 4 ( 2020-04)
    Type of Medium: Online Resource
    ISSN: 0022-5347 , 1527-3792
    URL: Article
    DOI: 10.1097/JU.0000000000000931.02
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 9
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    Transmission of Rat Hepatitis E Virus Infection to Humans in Hong Kong: A Clinical and Epidemiological Analysis
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Hepatology Vol. 73, No. 1 ( 2021-01), p. 10-22
    Details
    In: Hepatology, Ovid Technologies (Wolters Kluwer Health), Vol. 73, No. 1 ( 2021-01), p. 10-22
    Abstract: Hepatitis E virus (HEV) variants causing human infection predominantly belong to HEV species A (HEV‐A). HEV species C genotype 1 (HEV‐C1) circulates in rats and is highly divergent from HEV‐A. It was previously considered unable to infect humans, but the first case of human HEV‐C1 infection was recently discovered in Hong Kong. The aim of this study is to further describe the features of this zoonosis in Hong Kong. Approach and Results We conducted a territory‐wide prospective screening study for HEV‐C1 infection over a 31‐month period. Blood samples from 2,860 patients with abnormal liver function (n = 2,201) or immunosuppressive conditions (n = 659) were screened for HEV‐C1 RNA. In addition, 186 captured commensal rats were screened for HEV‐C1 RNA. Sequences of human‐derived and rat‐derived HEV‐C1 isolates were compared. Epidemiological and clinical features of HEV‐C1 infection were analyzed. HEV‐C1 RNA was detected in 6/2,201 (0.27%) patients with hepatitis and 1/659 (0.15%) immunocompromised persons. Including the previously reported case, eight HEV‐C1 infections were identified, including five in patients who were immunosuppressed. Three patients had acute hepatitis, four had persistent hepatitis, and one had subclinical infection without hepatitis. One patient died of meningoencephalitis, and HEV‐C1 was detected in cerebrospinal fluid. HEV‐C1 hepatitis was generally milder than HEV‐A hepatitis. HEV‐C1 RNA was detected in 7/186 (3.76%) rats. One HEV‐C1 isolate obtained from a rat captured near the residences of patients was closely related to the major outbreak strain. Conclusions HEV‐C1 is a cause of hepatitis E in humans in Hong Kong. Immunosuppressed individuals are susceptible to persistent HEV‐C1 infection and extrahepatic manifestations. Subclinical HEV‐C1 infection threatens blood safety. Tests for HEV‐C1 are required in clinical laboratories.
    Type of Medium: Online Resource
    ISSN: 0270-9139 , 1527-3350
    URL: Article
    DOI: 10.1002/hep.31138
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1472120-X
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  • 10
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    Predictors and Correlates of Maternal Role Competence and Satisfaction
    Ovid Technologies (Wolters Kluwer Health) ; 2010
    In:  Nursing Research Vol. 59, No. 3 ( 2010-05), p. 185-193
    Details
    In: Nursing Research, Ovid Technologies (Wolters Kluwer Health), Vol. 59, No. 3 ( 2010-05), p. 185-193
    Type of Medium: Online Resource
    ISSN: 0029-6562
    URL: Article
    DOI: 10.1097/NNR.0b013e3181dbb9ee
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2010
    detail.hit.zdb_id: 1480527-3
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