Background: The aim was to investigate whether 2 subgroups of Hodgkin lymphoma (Epstein-Barr virus-positive and Epstein-Barr virus-negative) are associated with smoking or alcohol. Methods: Patients ...with lymphoma diagnosed between age 16 and 69 years in geographically defined areas of England were recruited between 1998 and 2003. One control, matched to each lymphoma case on sex, date of birth, and area of residence, was randomly selected from population registers. Self-reported histories of tobacco and alcohol use were collected during face-to-face interviews with cases and controls. Results: Compared with lifelong nonsmokers, ever-smokers were at increased risk of Hodgkin lymphoma (odds ratio = 1.4; 95% confidence interval = 1.1-1.9). This excess was among current smokers, defined as smoking 2 years before diagnosis (1.7; 1.2-2.3). An increasing trend was observed with rising numbers of years smoked. Risks fell as the number of years stopped smoking increased, becoming equivalent to that of a nonsmoker 10 or more years after quitting. Associations were suggested for Epstein-Barr virus-positive Hodgkin lymphoma, but less so for Epstein-Barr negative Hodgkin lymphoma. No associations between Hodgkin lymphoma and alcohol consumption were observed. Conclusions: The association between smoking and Hodgkin lymphoma in general, and Epstein-Barr-positive Hodgkin lymphoma in particular, is consistent with previous studies. Further exploration of the relationship between Hodgkin lymphoma and smoking and of the potential mechanisms by which smoking could interact with Epstein-Barr virus status to increase Hodgkin lymphoma risk are required.
A Perioperative Acuity Measurement System MOSS, MAE TAYLOR; OʼCONNOR, SHEILA A; WINDLE, PAMELA E
Nursing management,
1994-November, Letnik:
25, Številka:
11
Journal Article
Recenzirano
Odprti dostop
An integrative acuity measurement system has been developed to increase efficiency and effectiveness of care delivery. Patients are classified into groups on the basis of nursing care required, thus ...facilitating both determination of actual nursing cost and accurate projection of staffing needs. It provides a universal language among perioperative departments for measuring similar outcomes.
An integrative acuity measurement system has been developed to increase efficiency and effectiveness of care delivery. Patients are classified into groups on the basis of nursing care required, thus ...facilitating both determination of actual nursing cost and accurate projection of staffing needs. It provides a universal language among perioperative departments for measuring similar outcomes.
Integrated conservation and development projects (ICDPs) moved from an untested concept in biodiversity conservation to conventional wisdom in a handful of years, despite a lack of convincing ...evidence that they were working effectively. Now, barely a decade after gathering momentum, ICDPs have been widely criticized for failing to meet expectations, and there are signs of their abandonment in favor of other, even less tested approaches.
Some conservation staff from the very same organizations that led the charge into ICDPs now claim to have turned away from this approach. While even a cursory examination of current field activities undermines these claims,
A 21-year-old female reports an 18-month history of light-headedness on standing. This is often associated with palpitations and a feeling of intense anxiety. She has had two black-outs in the past ...12 months. She is not taking any regular medications. Her supine blood pressure was 126/84 mmHg with a heart rate of 76 bpm, and her upright blood pressure was 122/80 mmHg with a heart rate of 114 bpm. A full system examination was otherwise normal. She had a 12-lead electrocardiogram performed which was unremarkable. She was referred for head-up tilt testing. She was symptomatic during the test and lost consciousness at 16 min. Figure
1
summarizes her blood pressure and heart rate response to tilting. A diagnosis of postural orthostatic tachycardia syndrome with overlapping vasovagal syncope was made.
IntroductionBleeding and thrombotic complication affect between 25-40% of left ventricular assist device (LVAD) recipients. Measures of thrombogenicity such as maximum platelet-fibrin clot strength ...(MAKH), endogenous thrombin potential (ETP) and platelet reactivity may indicate thrombotic and bleeding risk in patients on LVAD support and may vary after LVAD implantation.MethodsWe prospectively assessed thrombogenicity using the novel point-of-care (TEG-6S) with PlateletMapping and the calibrated automated thrombogram (CAT) in 31 patients before and serially after LVAD implantation (HeartWare HVAD, n = 17; Heartmate II, n = 14). All LVAD patients were on aspirin 325mg/daily and warfarin (INR 2.0 to 2.5) therapy. Standard hematologic and hemolysis laboratories were compared.ResultsMarkers of thrombogenicity were highly variable post-LVAD. Overall, in the acute phase, MAKH, and maximum ADP-, and arachidonic acid (AA)-induced clot strength increased (p < 0.05, Table) and returned to near baseline by ≥3 months. Despite target INR values at ≥ 3 months (2.0±0.3) and antiplatelet therapy, the R-time (7.1±1.8min) remained within the normal range. Hypercoagulable patients (MAKH≥69mm) had higher endogenous thrombin potential, peak thrombin generation, WBC count, and LDH (p≤0.05).ConclusionsA state of heightened thrombogenicity indicated by high MAKH and high platelet reactivity are present in the acute phase after LVAD implantation and in selected patient during the chronic phase despite therapy with warfarin/aspirin. These findings suggest that intensification of antithrombotic therapy in a personalized fashion based on sensitive thrombogenicity testing, rather than INR should be investigated to mitigate adverse events.
101Mass and the Dangers of Syncope Costello, Maria; Egan, Aisling; Leahy, Aoife ...
Age and ageing,
09/2018, Letnik:
47, Številka:
suppl_5
Journal Article
The U.S. Army initiated an investigation in response to observations of a possible increase in HIV incidence among soldiers deployed to combat. Human immunodeficiency virus (HIV)-infected U.S. Army ...soldiers are not eligible to deploy. Combat presents a health hazard to HIV-infected soldiers and they pose a threat to the safety of the battlefield blood supply and their contacts. All soldiers are routinely screened for HIV every 2 years and those who deploy are also screened both prior to and after deployment. Seroconversion rates were estimated for all soldiers who deployed to Afghanistan or Iraq in the period 2001-2007 and all active duty soldiers who did not. Seroconverters with an estimated date of infection, based on calculation of the midpoint between the last seronegative and first seropositive test date, that was either before or during deployment were eligible for inclusion. Confidential interviews and medical record reviews were conducted to determine the most likely time, geographic location, and mode of infection. Reposed predeployment samples were tested for HIV ribonucleic acid. The HIV seroconversion rate among all soldiers who deployed was less than the rate among those who did not deploy: 1.04 and 1.42 per 10,000 person-years, respectively. Among 48 cases, most were determined to have been infected in the United States or Germany and prior to deployment (n=20, 42%) or during rest and relaxation leave (n=13, 27%). Seven seronegative acute infections were identified in the predeployment period. Subtype was determined for 40 individuals; all were subtype B infections. All were acquired through sexual contact. These findings can inform development of preventive interventions and refinement of existing screening policy to further reduce HIV-infected deployed soldier person time.
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