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8 ± 1.9 vs. 2.0 ± 1.3 Wood units) and lower stroke volume index (26 ± 9 vs. 37 ± 10 ml/m2) than patients with SR (p  less then  0.05 for all). Patients with AF and SR had a different mPAWP-left ventricular end-diastolic pressure (LVEDP) relationship with higher mPAWP in AF and higher LVEDP in SR. After a median follow-up of 49 (interquartile range, 35-64) months post-AVR patients with AF (p = 0.05) and patients with a larger difference between mPAWP and LVEDP (p = 0.005) had higher mortality. CONCLUSIONS Patients with severe AS and concomitant AF have a distinct and significantly worse hemodynamic profile compared to patients with SR associated with worse clinical outcome. BACKGROUND To investigate the contribution of individual and population factors to Coronary Heart Disease (CHD) mortality rates in Ireland between 2000 and 2015. METHODS The Irish IMPACT CHD model was utilized with CHD Deaths Prevented or Postponed (DPPs) as outcome. RESULTS CHD mortality rates in Ireland in those aged 25-84 years fell by 56% (63% in women vs. men 53%), with 4060 fewer deaths than expected in 2015. Improvements in CHD risk factors explained ~30% of the decline (785 DPPs in men; 425 in women) [population systolic blood pressure (+25% DPPs), mean cholesterol serum levels (+11%) and smoking prevalence (+5%)]. Additional deaths attributable to rises in diabetes prevalence (-6%), BMI (-4%) and physical inactivity (-2%) negatively impacted DPPs. Increased uptake of cardiology treatments explained ~60% of the decline (1620 DPPs in men; 825 in women), particularly secondary prevention and heart failure treatments. Some 10% was unexplained. CONCLUSION CHD mortality declined in Ireland between 2000 and 2015, with two-thirds attributable to increased uptake in cardiology treatments and only one-third to improvements in population risk factors, partly reflecting adverse trends in obesity, diabetes and physical inactivity. Additional investments in prevention policies and treatments will be necessary to reduce future CHD deaths. learn more V.INTRODUCTION Tibial nerve entrapment is highly prevalent in diabetic subjects, resulting in significantly more neuropathic complaints and concomitant sensory disturbances. The study aim was to assess the impact of tarsal tunnel syndrome (TTS) and sensory loss at baseline on incident diabetic foot ulceration (DFU) in diabetic patients, since decompressing the tibial nerve might change the natural history of the disease. METHODS In this study, 113 subjects with TTS (69 bilateral, 23 left-sided and 21 right-sided) participating in the prospective Rotterdam Diabetic Foot Study were compared to 303 diabetic controls without TTS, regarding incident DFU. Kaplan-Meier analysis and Cox's regression analysis were used to determine the independent hazard of baseline variables for new DFU. RESULTS The median observation period was 836.5 days (IQR, 459-1077.8). In bilateral TTS, 17.4% (95% CI 8.4-26.3%) of subjects experienced DFU versus 8.3% (95% CI 5.1-11.6%) in controls (left or right) during follow-up (p = 0.0036). In left-sided TTS, no subjects versus 6.2% (95% CI 3.4-9.0%) in controls had DFUs (p = 0.243). Incident ulceration was seen in 14.3% (95% CI -0.7% to -29.3%) of right-sided TTS subjects versus 4.1% (95% CI 1.5-6.3%) in controls (p = 0.034). Besides HbA1c, diminished sensation at the hallux independently increased the risk of ulceration, in patients with (HR 4.692, p = 0.003) and without (HR 2.307, p = 0.002) prior DFU. DISCUSSION Elevated sensory thresholds in TTS render diabetic patients at a higher risk for DFU. With effective surgery, TTS is likely to be an amenable factor to potentially prevent diabetic foot disease and thereby reduce amputation risk. LEVEL OF EVIDENCE II. BACKGROUND Congenital diaphragmatic hernia (CDH) is a common birth defect associated with significant mortality and morbidity. There is limited outcome data on CDH in the Southeast Asian region. Rapid accessibility to our CDH Perinatal Center, as a consequence of the small geographic size of our country and efficient land transportation system, has largely eliminated deaths of live outborn babies prior arrival at our center. We selected a study period when extracorporeal membrane oxygenation (ECMO) support was not available at our institution. The data will therefore be relevant in developing management guidelines and antenatal counselling for perinatal centers in this region managing CDH with limited resources, without ECMO facilities. METHODS A retrospective study of antenatally or postnatally diagnosed CDH infants born between January 2002 and June 2005 was performed. We selected this study period as ECMO support was not available over this period. We studied the demographics, clinical characteristics, posrt now with long-term survival outcome which will be valuable to the neonatology community. V.OBJECTIVE To determine the sources of protein and phosphorus levels from the food consumed by patients on dialysis. DESIGN AND METHODS This is a retrospective, secondary data analysis of the Comprehensive Dialysis Survey study participants who had a baseline food frequency questionnaire and baseline lab data (N = 358). We examined intake of protein, phosphorus, and 7 other key nutrients from a subcohort of the Comprehensive Dialysis Survey based on the published National Kidney Foundation Kidney Dialysis Outcome Quality Initiative's nutrition recommendations. We studied the relationship of dietary protein source (plant or animal) with phosphorus intake using self-reported data from food frequency questionnaires. Variables included in final analysis are demographic, lab variables (albumin and prealbumin, alpha-1 acid glycoprotein, and C-reactive protein), and nutrition variables (calorie density, protein density, total fat, saturated fat, cholesterol, carbohydrates, phosphorus, calcium, sodium, potassium, plant-based protein, animal-based protein, and daily protein intake). RESULTS Most of the patients had a lower than recommended consumption of calories, protein, phosphorus, and potassium while sodium, total, and saturated fats were overconsumed. Patients intake of dietary protein and calories was proportional to the amount of food consumed for both plant- and animal-based food. The levels of dietary protein and phosphorus were significantly (P  less then  .05) lower in patients who primarily consumed a plant-based diet than in those who mainly consumed an animal-based diet. CONCLUSIONS Consuming more plant-based protein as part of a varied diet could be nutritionally adequate while limiting intake of absorbable dietary phosphorus. More research in plant-based protein diets and their impact on patients with end-stage renal disease is needed.

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