Durhamproctor8183

ibed drug classes accounting for most ADRs.

dementia is associated with an excess risk of death but mortality after chronic subdural hematoma (CSDH) evacuation in older people with dementia is unknown. We assessed the association between dementia and 1-year case-fatality in older persons undergoing CSDH evacuation.

we conducted a nationwide Finnish cohort study including all older persons (≥60years) undergoing CSDH evacuation during 1997-2014 (referred to as cases). We identified controls, without a diagnosis of CSDH, that were matched for age, sex and year of first hospitalisation with a new dementia diagnosis. We identified cases and controls with a pre-existing diagnosis of dementia. Outcome was 12-month mortality. Mortality was compared in case-only and case-control analyses.

of 7,621 included cases, 885 (12%) had a pre-existing diagnosis of dementia. The proportion of cases increased from 9.7% in 1997-2002 to 12.2% in 2012-2014 (P = 0.038 for trend). In the case-analysis, dementia independently associated with 1-year case-fatality (dementia vs. no dementia odds ratio [OR] 1.50, 95% confidence interval [CI] 1.26-1.78). Sensitivity analysis suggested the association to be strongest for those 60-69years old (OR 3.21, 95% CI 1.59-6.47). In the case-control matched analysis, 1-year mortality was 26% in the dementia CSDH surgery group compared to 16% in the dementia non-CSDH controls (P < 0.001).

dementia is a significant risk factor for 1-year mortality after CSDH surgery in older people. The proportion of older CSDH patients having a pre-existing diagnosis of dementia is increasing. Thus, there is a need for improved evidence regarding the indications and benefits of CSDH evacuation among older persons.

dementia is a significant risk factor for 1-year mortality after CSDH surgery in older people. The proportion of older CSDH patients having a pre-existing diagnosis of dementia is increasing. Thus, there is a need for improved evidence regarding the indications and benefits of CSDH evacuation among older persons.

Newly available, smartphone-enabled carbon monoxide (CO) monitors are lower in cost than traditional stand-alone monitors and represent a marked advancement for smoking research. New products are promising, but data are needed to compare breath CO readings between smartphone-enabled and stand-alone monitors. The purpose of this study was to (1) determine the agreement between the mobile iCO (Bedfont Scientific Ltd) with two other monitors from the same manufacturer (Micro+ pro and Micro+ basic) and (2) determine optimal, monitor-specific, cotinine-confirmed abstinence cutoff values.

Adult (≥18) smokers (n = 26) and nonsmokers (n = 21) provided three breath CO samples (using three different monitors) in each of 10 sessions, and urine cotinine was measured for gold standard determination of abstinence. CO comparisons (N = 437) were analyzed using regression-based Bland-Altman Analysis of Agreement; receiver operating characteristics curves were used to determine optimal abstinence cutoffs.

Bland-Altman anbstinence vs confirming smoking status for study inclusion). Optimal CO cutoffs recommended for determining abstinence on Micro+ and iCO monitors are at <3 and <6 ppm, respectively.

Results from this study indicate that CO values from the smartphone-enabled iCO should not be used interchangeably with the stand-alone Micro+ pro and Micro+ basic, particularly when lower CO values ( less then 10 ppm) are critical (ie, determination of abstinence vs confirming smoking status for study inclusion). Optimal CO cutoffs recommended for determining abstinence on Micro+ and iCO monitors are at less then 3 and less then 6 ppm, respectively.

Epistaxis is the greatest cause of morbidity in patients with hereditary hemorrhagic telangiectasia (HHT); because of this, a validated epistaxis-specific quality-of-life instrument for HHT should be made available.

To develop and validate an epistaxis-specific quality-of-life patient-reported outcome measure for HHT.

This survey study focused on the development and validation of the Nasal Outcome Score for Epistaxis (NOSE) in HTT (NOSE HHT) outcome measure with data prospectively collected from December 10, 2019, to March 15, 2020. A total of 401 patients were recruited from within the Cure Hemorrhagic Telangiectasia online patient advocacy social media network, the Washington University HHT Center of Excellence, and a randomized clinical trial investigating an intranasal timolol gel for HHT-associated epistaxis.

Face and content validity, factor analysis, internal consistency as measured through Cronbach α, construct validity, responsiveness to change, and minimal clinically important difference.

or the total NOSE HHT score was 0.46.

Evaluation of the consistency, reliability, and responsiveness of the NOSE HHT survey found it to be a valid instrument to assess severity and change in epistaxis. Study results suggest that the NOSE HHT survey is clinically applicable and useful as an outcome measure of future HHT-associated epistaxis trials.

Evaluation of the consistency, reliability, and responsiveness of the NOSE HHT survey found it to be a valid instrument to assess severity and change in epistaxis. Study results suggest that the NOSE HHT survey is clinically applicable and useful as an outcome measure of future HHT-associated epistaxis trials.

The aim of this study was to define clusters of activity in a population-based cohort during the first 5 years after diagnosis in children with ulcerative colitis [UC] and to identify early prognostic risk factors.

All UC patients from the SIGENP IBD registry with a complete follow-up of at least 5 years were included. Active disease was defined every 6 months in the presence of at least one of the following clinical activity [Paediatric Ulcerative Colitis Activity Index ≥ 35]; endoscopic activity [Mayo score ≥ 1]; faecal calprotectin > 250 µg/g; hospitalization; surgery; or treatment escalation. Formula-based clusters were generated based on four published questionnaire-based activity patterns in adults, plus one additional cluster.

In total, 226 patients were identified. Forty-two [19%] had moderate-severe chronically active disease, 31 [14%] chronic-intermittent, 75 [33%] quiescent, 54 [24%] active disease in the first 2 years after the diagnosis, then sustained remission, and 24 [11%] a remission. Interestingly, after initial treatment, one-third of patients have well-controlled disease throughout.The American Burn Association has developed comprehensive referral criteria to determine which burn injured patient should be transferred to burn centers. This was a retrospective analysis of burn injuries using Illinois inpatient and outpatient hospital data from 2010 to 2015. Multivariable logistic and linear regression models were developed to evaluate ABA burn center referral criteria adherence and to compare treatment outcomes among those treated in verified burn center (VB), non-verified burn center (NVB) and other facilities (OF). In this study, 66% of those treated in facilities without specialized burn teams met the ABA referral criteria. Patients who were over age of 40 years, lived farther from burn units, and were originally treated in level-1 trauma center without burn units were less likely to be transferred to burn centers. Those transported and treated in burn centers had overall better treatment outcomes including fewer infection complications (VB vs OF aOR 0.5, 95% CI 0.4-0.6, NVB vs OF aOR 0.5, 95% CI 0.4-0.6), fewer patients requiring additional care in skilled nursing/rehabilitation facilities (VB vs OF aOR 0.5, 95% CI 0.4-0.6, NVB vs OF aOR 0.7, 95% CI 0.6-0.9), shorter length of hospitalization (VB vs OF β-0.4, p less then 0.001, NVB vs OF β-0.8, p less then 0.001) and comparable in-hospital mortality (VB vs OF aOR 1.3, 95% CI 0.97-1.7, NVB vs OF aOR 1.01, 95% CI 0.7-1.5). While verified and unverified burn centers demonstrated better treatment outcomes, the data demonstrated a need to understand the barriers of adhering ABA criteria and an improved regional burn center referral guidelines education.A major challenge in modern biology is understanding how the effects of short-term biological responses influence long-term evolutionary adaptation, defined as a genetically determined increase in fitness to novel environments. This is particularly important in globally important microbes experiencing rapid global change, due to their influence on food webs, biogeochemical cycles, and climate. Epigenetic modifications like methylation have been demonstrated to influence short-term plastic responses, which ultimately impact long-term adaptive responses to environmental change. However, there remains a paucity of empirical research examining long-term methylation dynamics during environmental adaptation in nonmodel, ecologically important microbes. Here, we show the first empirical evidence in a marine prokaryote for long-term m5C methylome modifications correlated with phenotypic adaptation to CO2, using a 7-year evolution experiment (1,000+ generations) with the biogeochemically important marine cyanobacterium Trichodesmium. We identify m5C methylated sites that rapidly changed in response to high (750 µatm) CO2 exposure and were maintained for at least 4.5 years of CO2 selection. After 7 years of CO2 selection, however, m5C methylation levels that initially responded to high-CO2 returned to ancestral, ambient CO2 levels. Concurrently, high-CO2 adapted growth and N2 fixation rates remained significantly higher than those of ambient CO2 adapted cell lines irrespective of CO2 concentration, a trend consistent with genetic assimilation theory. These data demonstrate the maintenance of CO2-responsive m5C methylation for 4.5 years alongside phenotypic adaptation before returning to ancestral methylation levels. These observations in a globally distributed marine prokaryote provide critical evolutionary insights into biogeochemically important traits under global change.An automated platform for cytogenetic biodosimetry, the "Rapid Automated Biodosimetry Tool II (RABiT-II)," adapts the dicentric chromosome assay (DCA) for high-throughput mass-screening of the population after a large-scale radiological event. To validate this test, the U.S. Federal Drug Administration (FDA) recommends demonstrating that the high-throughput biodosimetric assay in question correctly reports the dose in an in vivo model. Here we describe the use of rhesus macaques (Macaca mulatta) to augment human studies and validate the accuracy of the high-throughput version of the DCA. To perform analysis, we developed the 17/22-mer peptide nucleic acid (PNA) probes that bind to the rhesus macaque's centromeres. To our knowledge, these are the first custom PNA probes with high specificity that can be used for chromosome analysis in M. mulatta. The accuracy of fully-automated chromosome analysis was improved by optimizing a low-temperature telomere PNA FISH staining in multiwell plates and adding the telomere detection feature to our custom chromosome detection software, FluorQuantDic V4. The dicentric frequencies estimated from in vitro irradiated rhesus macaque samples were compared to human blood samples of individuals subjected to the same ex vivo irradiation conditions. The results of the RABiT-II DCA analysis suggest that, in the lymphocyte system, the dose responses to gamma radiation in the rhesus macaques were similar to those in humans, with small but statistically significant differences between these two model systems.