Hartmuir2734

After endografts deployment, mean chimney graft flow at 60, 80 and 100 mmHg of pressure was 1053 ml/min (-45%), 1306 ml/min (-41%) and 1502 ml/min (-40%) for the left coronary and 1100 ml/min (-33%), 1460 ml/min (-28%) and 1626 ml/min (-31%) for the right coronary, respectively. CONCLUSIONS In this preliminary study, chimney grafts for transcatheter aortic root repair provided 830% of target flow in the right coronary (-31% of free flow) and 414% of target flow in the left coronary (-42% of free flow) which is more than sufficient for both coronaries in real-life conditions. The potential of this approach should be further explored with specifically designed endografts. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.OBJECTIVES To compare membranous lupus nephritis (MLN) and proliferative lupus nephritis (PLN) with respect to survival, demographic, clinical and laboratory characteristics; and to investigate predictors of renal and patient survival. METHODS Single-centre retrospective observational study. Patients with biopsy-proven PLN, MLN and mixed lupus nephritis were included. Groups were compared using appropriate statistical tests and survival was analysed through the Kaplan-Meier method. Cox regression analysis was performed to investigate predictors of renal and patient survival. RESULTS A total of 187 patients with biopsy-proven lupus nephritis (135 with PLN, 38 with MLN and 14 with mixed LN) were followed for up to 42 years (median 12 years). There was a higher proportion of MLN amongst Afro-Caribbeans than amongst Caucasians (31% vs 15%, P = 0.010). Patients with MLN had significantly lower anti-dsDNA antibodies (P = 0.001) and higher C3 levels (P = 0.018) at diagnosis. Cumulative renal survival rates at 5, 10, 15 and 20 years were 91, 81, 75 and 66% for PLN and 100, 97, 92 and 84% for MLN, respectively (P = 0.028). Cumulative patient survival at 5, 10, 15 and 20 years was 94, 86, 80 and 76%, with no difference between PLN and MLN. Urinary protein-creatinine ratio above 42 mg/mmol and eGFR below 76 ml/min/1.73 m2, one year after the diagnosis of LN, were the strongest predictors of progression to end-stage renal disease. eGFR below 77 ml/min/1.73 m2, at one year, development of end-stage renal disease and Afro-Caribbean ethnicity were associated with higher mortality. CONCLUSION Patients with MLN and PLN differ significantly regarding serological profiles and renal survival, suggesting different pathogenesis. Renal function at year one predicts renal and patient survival. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.BACKGROUND Greece experienced the largest reduction in its health care budget of any European country during the economic crisis of 2008-15. Here, we test the hypothesis that budget reductions worsened health system performance in Greece, using the concept of Amenable Mortality to capture deaths which should not occur in the presence of effective and timely health care. METHODS Amenable mortality was calculated from national mortality statistics, using age-standardized deaths from 34 conditions amenable to medical intervention in Greece during 2000-16, with further analysis by sex, age, region and cause. Mortality rate ratios and their 95% CI were also computed. Interrupted time series analyses were performed to compare trends prior to austerity measures (2001-10) with those after (2011-16), adjusting for historical trends. RESULTS Prior to austerity measures, amenable mortality rates were declining. After 2011, coinciding with the inception of budget reductions, the slope of decline diminished significantly. The average annual percent of change in standardized death rates was 2.65% in 2001-10, falling to 1.60% in 2011-6. In 10 of 34 conditions, the SDR increased significantly after the crisis onset, and in five more conditions the long-term decline reversed, to increasing after 2011. The age-specific mortality rates observed in 2011-16 were significantly higher than those expected at ages 0-4 and 65-74 but not significantly higher in all other age groups. CONCLUSIONS Health system performance in Greece worsened in association with austerity measures, leading to a deceleration of the decline in amenable mortality and increased mortality from several conditions amenable to medical interventions. © The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.BACKGROUND Post-traumatic stress (PTS) is prevalent among military personnel. Knowledge of the risk and protective factors associated with PTS in this population may assist with identifying personnel who would benefit from increased or targeted support. AIMS To examine factors associated with PTS among New Zealand military personnel. METHODS For this cross-sectional study, currently serving and retired military personnel were invited to complete a questionnaire. The questionnaire included a measure of PTS (the Military Post-traumatic Stress Disorder Checklist; PCL-M), where scores ≥30 indicate the experience of significant PTS symptoms and scores ≥45 indicate a presumptive clinical diagnosis of post-traumatic stress. Potential risk and protective factors associated with PTS were examined using logistic regression modelling. NCT-503 RESULTS 1817 military personnel completed the questionnaire. PCL-M scores were ≥30 for 549 (30%) participants and ≥45 for 179 (10%) participants. Factors associated with higher PCL-M scores were trauma exposure, older age, male sex, and Māori ethnicity. Factors associated with lower PCL-M scores were greater length of service, psychological flexibility, and better quality sleep. CONCLUSIONS PTS was found to be prevalent among New Zealand military personnel. The experience of trauma was strongly associated with PTS. However, factors such as psychological flexibility (the ability to adapt to changes in circumstances) and good sleep were protective, suggesting that these factors could be key targets for interventions designed to reduce PTS among military personnel in New Zealand.