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mortality - Top 30 Publications

MicroRNA-145 Aggravates Hypoxia-Induced Injury by Targeting Rac1 in H9c2 Cells.

Myocardial infarction (MI) is a leading cause of morbidity and mortality. Here, we sought to explore the potential role and underlying mechanism of miR-145 in MI.

Bladder Metastases from Breast Cancer: Managing the Unexpected. A Systematic Review.

Breast cancer (BrC) has the highest incidence among females world over and it is one of the most common causes of death from cancer overall. Its high mortality is mostly due to its propensity to rapidly spread to other organs through lymphatic and blood vessels in spite of proper treatment. Bladder metastases from BrC are rare, with 50 cases having been reported in the last 60 years. This review aims to discuss some critical points regarding this uncommon condition. First, we performed a systematic review of the literature in order to draw a clinical and pathological profile of this entity. On this basis, its features in terms of diagnostic issues, imaging techniques, and survival are critically examined. Most bladder metastases from BrC are secondary lobular carcinoma, which mimic very closely the rare variant of urothelial cancer with lobular carcinoma-like features (uniform cells with an uncohesive single-cell, diffusely invasive growth pattern); thus, immunohistochemistry is mandatory to arrive at a correct diagnosis. This article summarizes the current knowledge regarding the incidence, clinical presentation, diagnosis, prognosis, and treatment of bladder metastases in patients with BrC.

Analysis of the MELD Score Impact in the Outcome of Endovascular Portal Vein Reconstruction.

Endovascular therapy represents a less invasive alternative to open surgery for reconstruction of the portal vein (PV) and the spleno-mesenteric venous confluence to treat Portal hypertension. The objective of this study is to determine if the Model for End-Stage Liver Disease (MELD) score is a useful method to evaluate the risk of morbidity and mortality during endovascular approaches.

Hepatitis C and Its Metabolic Complications in Kidney Disease.

Evidence has been accumulated during the last decade showing that HCV infection plays an important activity at hepatic and extra-hepatic level. Chronic HCV is associated with a large spectrum of extra-hepatic manifestations including lympho-proliferative diseases and metabolic abnormalities (such as insulin resistance and fatty liver disease).

Burden of Chronic Viral Hepatitis and Liver Cirrhosis in Brazil - the Brazilian Global Burden of Disease Study.

Data on epidemiology of liver diseases in Brazil is scarce. This study aimed to estimate the burden of chronic viral hepatitis and liver cirrhosis in the country.

High risk of hepatocellular carcinoma and death in patients with immune-tolerant-phase chronic hepatitis B.

High serum HBV DNA levels are associated with high risks of hepatocellular carcinoma (HCC) and cirrhosis in patients with chronic hepatitis B (CHB). Although the immune-tolerant (IT) phase is characterised by high circulating HBV DNA levels, it remains unknown whether antiviral treatment reduces risks of HCC and mortality.

The pattern of paediatric blast injury in Afghanistan.

Between 2009 and 2015, 3746 children died, and 7904 were injured as a result of armed conflict within Afghanistan. Improvised explosive devices (IEDs) and explosive remnants of war accounted for 29% of child casualties in 2015. The aim of this study was to review the burden of paediatric blast injuries admitted to Camp Bastion, Afghanistan, and to investigate the hypothesis that children suffer proportionally more head injuries than adults.

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers.

The French nuclear worker cohort allows for the assessment of cancer risk associated with occupational radiation exposure, but workers are also exposed to medical and environmental radiation which can be of the same order of magnitude. This study aims to examine the impact of non-occupational radiation exposures on the dose-risk analysis between occupational radiation exposure and cancer mortality.

Prevalence and pathways of recovery from drug and alcohol problems in the United States population: Implications for practice, research, and policy.

Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision.

Tocopherol and selenite modulate the transplacental effects induced by sodium arsenite in hamsters.

Human studies suggest that in utero exposure to arsenic results in adverse pregnancy outcomes. The use of dietary supplements, such as sodium selenite (SS) or α-tocopherol succinate (α-TOS), is a reasonable approach to ameliorate such health effects. Sodium arsenite at 100ppm was administered via drinking water to female hamsters from gestational days 1 or 8 to the time of delivery. Viable fetuses, fetal resorptions and non-viable fetuses were recorded during and after pregnancy and total arsenic and its metabolites were characterized in pregnant animals, placentas and fetuses. Arsenic was found to accumulate in the placenta and fetus, increasing fetal mortality, non-viable fetuses and resorptions. Co-administration of SS and α-TOS significantly reduced the observed teratogenic effects. SS influenced arsenic biotransformation by reducing the MMA/InAs index and increasing the DMA/MMA, whereas α-TOS more likely exerts its protective effect through its potent antioxidant activity.

Anti-diabetic potential of peptides: Future prospects as therapeutic agents.

Diabetes mellitus is a metabolic disorder in which the glucose level in blood exceeds beyond the normal level and its effective control is recognized as a global challenge for clinician. Persistent hyperglycemia leads to diabetes late complication and obviously account for a large number of morbidity and mortality worldwide. Numerous therapeutic options are available for the treatment of diabetes including insulin for type I and oral tablets for type II, but its effective management is still a dream. Several options are under investigation in various research laboratories for efficacious and safer agents. Of them, peptides are currently amongst the most widely investigated potential therapeutic agents whose design and optimal uses are under development. A number of natural and synthetic peptides were found with outstanding antidiabetic effect, mediated through diverse mechanisms. The applications of new emerging techniques and drug delivery systems further offer opportunities to achieve the desired target outcomes. We found some outstanding peptides in preclinical and clinical studies with better efficacy and safety profile. Further detail studies on these peptides may therefore lead to significant clinically useful antidiabetic agents.

Long-Term Outcomes With Transcatheter Aortic Valve Replacement in Women Compared With Men: Evidence From a Meta-Analysis.

This study sought to examine long-term outcomes with transcatheter aortic valve replacement (TAVR) in women versus men.

Remote Ischemic Preconditioning in High-risk Cardiovascular Surgery Patients: A Randomized-controlled Trial.

Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery. The intervention consisted of 3 cycles of RIPC on the upper limb for 5 minutes alternated with 5 minutes of rest. A sham intervention was performed on the control group. Patients were recruited who were undergoing (1) high-risk cardiac or vascular surgery or (2) cardiac or vascular surgery and were at high risk of ischemic complications. The primary end point was a composite outcome of mortality, myocardial infarction, stroke, renal failure, respiratory failure, and low cardiac output syndrome, and the secondary end points included the individual outcome parameters that made up this score, as well as troponin-I values. A total of 436 patients were randomized and analysis was performed on 215 patients in the control group and on 213 patients in the RIPC group. There were no differences in the composite outcome between the 2 groups (RIPC: 67 [32%] and control: 72 [34%], relative risk [0.94 {0.72-1.24}]) or in any of the individual components that made up the composite outcome. Additionally, we did not observe any differences between the groups in troponin-I values, the length of intensive care unit stay, or the total hospital stay. RIPC did not have a beneficial effect on clinical outcomes in patients who had cardiovascular surgery.

Impact of bariatric surgery on outcomes of patients with nonalcoholic fatty liver disease: a nationwide inpatient sample analysis, 2004-2012.

Bariatric surgery in eligible morbidly obese individuals may improve liver steatosis, inflammation, and fibrosis; however, population-based data on the clinical benefits of bariatric surgery in patients with nonalcoholic fatty liver disease (NAFLD) are lacking.

Bivalirudin versus heparin, without glycoprotein inhibition, in percutaneous coronary intervention: A comparison of ischemic and hemorrhagic outcomes over 10years.

The choice of antithrombotic agent used during percutaneous coronary intervention (PCI) is controversial. While earlier studies suggested a reduction in bleeding events with bivalirudin, these studies were confounded by the concomitant use of glycoprotein IIbIIIa inhibitors (GPI) in the heparin group. More recent studies have challenged the superiority of bivalirudin, pointing to an increased risk of stent thrombosis. Real-world data remains limited.

High serum soluble CD40L levels previously to liver transplantation in patients with hepatocellular carcinoma are associated with mortality at one year: Methodological issues.

Molecular detection and characterization of zoonotic Anaplasma species in domestic dogs in Lusaka, Zambia.

Although tick-borne pathogens, Anaplasma platys and Anaplasma phagocytophilum are recognized as zoonotic agents associated with appreciable morbidity and mortality in dogs and humans worldwide, there is limited information on these infections in many African countries, including Zambia. The purpose of this study was to detect, identify and phylogenetically characterize Anaplasma species from dogs in Chilanga District in Lusaka Province, Zambia. A total of 301 blood samples were collected from apparently healthy and semi-confined dogs. Initial screening by polymerase chain reaction with specific primers targeting the 16S rRNA gene of Anaplasma species revealed that 9% (27/301) of our samples were positive. Subsequent sequence and phylogenetic analysis of a longer fragment of the 16S rRNA and citrate synthase (gltA) genes of four positive samples showed the presence of A. platys and an Anaplasma species, which was closely related to those detected in dogs in South Africa. This is the first report on molecular identification and characterization of canine-associated zoonotic Anaplasma species in Zambia.

Intervention Versus Observation in Symptomatic Patients With Normal Flow-Low Gradient Severe Aortic Stenosis.

To describe patients with severe symptomatic aortic stenosis with normal flow and low gradients and determine whether they benefit from intervention.

Pulmonary Arterial Hypertension With Abnormal V/Q Single-Photon Emission Computed Tomography.

This study aimed to evaluate the incidence and clinical outcomes of abnormal ventilation/perfusion (V/Q) single-photon emission computed tomography (SPECT) without thromboembolism, especially in patients with group I pulmonary arterial hypertension (PAH).

The RTS plus measurement of the RDW improves the prediction of 28-day mortality in trauma patients.

The relationship between fibrinogen and in-hospital mortality in patients with type A acute aortic dissection.

Fibrinogen plays an important role in hemostasis and thrombosis and is proven to have prognostic significance in patients with cardiovascular disease. We examined the utility of fibrinogen as a prognostic indicator for patients with type A acute aortic dissection (AAD).

Treatment of primary graft dysfunction after lung transplantation with orally inhaled AP301: A prospective, randomized pilot study.

Primary graft dysfunction (PGD) after lung transplantation (LTx) carries significant morbidity and mortality in the early post-operative period and is associated with the development of chronic lung allograft dysfunction. AP301, an activator of epithelial sodium channel-mediated Na(+) uptake represents a new concept for prevention and treatment of pulmonary edema and has shown promising results in the pre-clinical setting. This pilot study investigated the clinical effect of inhaled AP301 on patients with development of PGD > 1 according to International Society of Heart and Lung Transplantation criteria after primary LTx in a high-volume center and was conducted as a randomized, placebo-controlled, single-center pilot-study including 20 patients. All consecutive patients fulfilling inclusion criteria were screened for PGD at arrival on the intensive care unit (ICU) after LTx. After randomization, inhaled AP301 or placebo was administered by nebulizer twice daily for 7 days or until extubation. Otherwise, patients were treated according to routine clinical protocol. Partial pressure of arterial oxygen (Pao2)/fraction of inspired oxygen (Fio2) values were obtained until extubation and assessed as a primary outcome parameter. Patients were monitored for 30 days within the study protocol.

The phylogenetic group, antimicrobial susceptibility, and virulence genes of Escherichia coli from clinical bovine mastitis.

Bovine mastitis is still a central problem on dairy farms despite control programs, and Escherichia coli is a crucial pathogen during the development of bovine mastitis. The virulence genes, antimicrobial susceptibility, and mortality of mice infected with different E. coli isolates from bovine mastitis were determined in this study. According to the presence of the specific genes chuA, yjaA, and TspE4.C2, these isolates mainly belonged to 2 different groups: group A (47/79) and group B1 (22/79). The ompC gene was detected in all the isolates, followed by fimH (89.9%), ECs3703 (88.6%), and ompF (73.4%), whereas most of the virulence genes were not detected in these isolates. The results of the antimicrobial susceptibility tests indicated that the isolates were susceptible to the fluoroquinolones and aminoglycosides. An inverse relationship was shown between the expression level of ompF and antimicrobial resistance; additionally, the isolates that were nonsusceptible to at least 4 classes of antimicrobial agents showed a lower mortality to mice in comparison with the susceptible isolates. This study indicated that antibiotic resistance had emerged in E. coli from bovine mastitis in this area, and appropriate measures should be taken to avoid potential threats to humans and other animals.

Mortality during heatwaves 2003-2015 in Frankfurt-Main - the 2003 heatwave and its implications.

Heatwaves have always occurred, but they are expected to intensify in frequency, duration and intensity due to climate change. Germany (like most European countries) experienced a distinct heatwave in 2003. Afterwards local heat health action plans (HHAP) were implemented in numerous regions (for example in Hesse). This analysis was designed to compare the heat wave of 2003 with the following ones in 2006, 2010 and 2015. We discuss whether measures from the Hessian HHAP were effective in reducing mortality and identify specific characteristics of the 2003 heatwave which did not allow direct comparison. Mortality and temperature data from the city of Frankfurt collected between 2003 and 2015 was used to answer the question of whether the implemented HHAP were effective, or if the mortality in 2003, pre-HHAP implementation, was especially high due to other factors. Excess mortality in 2003 was considerably higher for the overall population than in the heatwaves of the following years (2003: 77.8%, 2006: 12%, 2010: 22.7%, 2015: 38.1%). Heatwaves did not result in a significant excess mortality at all in some years, e.g. in 2006. Aside from the mortality rate, the duration of the heatwave (2003: 12days; 2006: 5days; 2010: 5days; 2015: 5days) was the only differing characteristic, leading to the hypothesis that heatwave duration might be a better indicator of mortality during heatwaves, than other characteristics, alone or combined. In summary regarding the effectiveness of the HHAP remains inconclusive since the pre-HHAP heatwave of 2003 differed in certain characteristics (especially the longer duration). Furthermore, the activities representing the HHAP were diverse and were implemented stepwise over some years. The effects on mortality of individual activities cannot be evaluated. Further research should consider differences, e.g. between places (climate zones etc.) and heatwave definitions.

Outcomes for thoracoscopic versus open repair of small to moderate congenital diaphragmatic hernias.

Indications for thoracoscopic versus open approaches to repair congenital diaphragmatic hernia (CDH) are unclear as the variability in defect size, disease severity and patient characteristics pose a challenge. Few studies use a patient and disease-matched comparison of techniques. We aimed to compare the clinical outcomes of open versus thoracoscopic repairs of small to moderate sized hernia defects in a low risk population.

Elevated cardiovascular risk factors in multiple sclerosis.

Multiple sclerosis (MS) is associated with elevated cardiovascular mortality. To prevent this a better understanding of their CVD risk factors and interrelations is necessary.

Chasing the top quartile of cross-sectional data: Is it possible with resistance training?

Resistance exercise is believed to be important for improving several biomarkers of health and contributing to decreased all-cause mortality. However, a careful examination of the literature reveals a growing body of cross-sectional studies finding stronger associations between strength independent of physical activity on these various outcomes and biomarkers (i.e., C - reactive protein, homocysteine, total cholesterol) of health. Considering that engagement in resistance type exercise is associated with an increase in strength, such cross-sectional data is often used to promote engagement in resistance training. When one examines the cross-sectional studies together with the experimental work, however, this relationship becomes less clear. For example, being in a higher tertile or quartile for grip strength may be associated with more favorable biomarkers or health outcomes, yet, experimental work shows that grip strength does not change with traditional resistance exercise. This seems to suggest that our interpretation and application of this literature may be incorrect. It is our opinion that much of the cross-sectional work may more accurately illustrate inherent differences between individuals who are "weak" and individuals who are "strong". In addition, there is conflicting experimental evidence and a lack of longitudinal support that resistance exercise may have a meaningful effect on long-term health outcomes. Using this evidence, we present our "human baseline hypothesis", which proposes that the baseline value of strength that a person possesses prior to training may be a more appropriate indicator regarding long-term health outcomes than the act of training itself.

How Hepatitis B virus causes cirrhosis and liver cancer.

Hepatitis B virus is a major pathogen infecting the liver, causing high morbidity and mortality worldwide, particularly in developing countries. The mechanism underlying progression from infections of Hepatitis B virus to cirrhosis and liver cancer is not fully determined. Here we propose that the HBV X protein traps protons and Cl(-), and induces the expression of collagen in the liver, which forms potent hydrogen bonds with trapped protons. The presence of collagen in the liver marks the progression to fibrosis. The X protein and collagen concertedly build up HCl locally, triggering disease advances to liver cancer in some patients with liver cirrhosis. The hypothesis can be tested in Hepatitis B primate model with the administration of calcium and weak acids to ascertain physiological changes and monitor tumorigenesis rate. The experiments will pave the way for better intervention of human infections with Hepatitis B virus.

Tumor-associated immune aggregates in oral cancer: Their cellular composition and potential prognostic significance.

There is growing evidence supporting the importance of immune microenvironment in cancer development and progression, especially with the rapid development of immunotherapy. Presence of immune cell aggregates in solid tumors has been associated with clinical outcomes, but little is known about the immune microenvironment in oral squamous cell carcinoma (OSCC), which has high morbidity and mortality. Based on our preliminary observation, we hypothesize that there is the presence of tumor-associated immune aggregates (TaIAs) during oral cancer development. Adapting to the dynamic change of the composition of cellular membership and co-evolving with the tumor at invasion fronts, these TaIAs, either pro-inflammatory or immune suppressive, are associated with clinical consequences. With the unique access to a set of prospectively collected, highly annotated OSCC surgical samples and the use of multi-color immunostaining of key immune cells, the confirmation of our hypothesis may shed light of the underlying biology related to OSCC and the knowledge learned can potentially be used to identify prognostic markers, response predictive markers for immunotherapies, as well as novel therapeutic targets.

Trends in incidence and associated risk factors of suicide mortality among breast cancer patients.

Breast cancer patients are associated with an increased risk for committing suicide. The purpose of this study is to study the trends in the incidence of suicide mortality and identify pertinent risk factors among patients with breast cancer.