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1. Policy Statement on Clinical Informatics Fellowships and the Future of Informatics-Driven Medicine.

Author

Kannry J, Smith J, Mohan V, Levy B, Finnell J, and Lehmann CU

Subjects
Aged, Fellowships and Scholarships, Humans, Medicare, Policy, United States, Medical Informatics, Medicine
Abstract

Board certified clinical informaticians provide expertise in leveraging health IT (HIT) and health data for patient care and quality improvement. Clinical Informatics experts possess the requisite skills and competencies to make systems-level improvements in care delivery using HIT, workflow and data analytics, knowledge acquisition, clinical decision support, data visualization, and related informatics tools. However, these physicians lack structured and sustained funding because they have no billing codes. The sustainability and growth of this new and promising medical subspecialty is threatened by outdated and inconsistent funding models that fail to support the education and professional growth of clinical informaticians. The Clinical Informatics Program Directors' Community is calling upon the Centers for Medicare and Medicaid Services to consider novel funding structures and programs through its Innovation Center for Clinical Informatics Fellowship training. Only through structural and sustained funding for Clinical Informatics fellows will be able to fully develop the potential of electronic health records to improve the quality, safety, and cost of clinical care., Competing Interests: C.U.L. reports that he is designated to be the Fellowship program director, UT Southwestern. J.S. reports that he was employed by the American Medical Informatics Association, which serves as the professional home for Clinical Informatics Fellows., (Thieme. All rights reserved.)

Published
2020
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2. Effect of Febuxostat versus Allopurinol on the Glomerular Filtration Rate and Hyperuricemia in Patients with Chronic Kidney Disease

Author

Shankar Prasad Nagaraju, Srinivas Vinayak Shenoy, Indu Rao, Ravindra Attur Prabhu, Dharshan Rangaswamy, Mohan V. Bhojaraja, and Vasudeva Guddattu

Subjects
Medicine
Abstract

Hyperuricemia is a risk factor for the progression of chronic kidney disease (CKD). We compared febuxostat versus allopurinol in the progression of CKD and hyperuricemia in 101 patients with Stage 3–4 CKD treated with febuxostat or allopurinol for at least 6 months for hyperuricemia (>7 mg/dL) between January 2012 and December 2016. Baseline characteristics, serum uric acid (SUA), serum creatinine, and estimated glomerular filtration rate (eGFR) at entry and 6 months were compared. The primary outcome was the decline in eGFR and the secondary outcomes were reductions in SUA and adverse events. Fifty-four were in the febuxostat group and 47 were in the allopurinol group. The baseline characteristics were comparable except for age. The mean dose of febuxostat and allopurinol was 43.70 ± 14.5 mg and 108.51 ± 40 mg, respectively. After 6 months, the median rate of decline in eGFR was 1.2 mL/min/1.73 m2 (IQR: 1.2, 5.5) in the febuxostat group and 3.1 mL/min/1.73 m2 (0.6, 6.2) in the allopurinol group, but this was not statistically significant (P = 0.136). The mean reduction in SUA was significantly better (P = 0.004) in the febuxostat group (3.9 ± 1.7 mg/dL) compared with the allopurinol group (2.1 ± 1.0 mg/dL). Both drugs had no serious adverse events. Febuxostat was better at reducing hyperuricemia than allopurinol, but there was no significant difference in the progression of CKD. Large randomized trials and long-term follow-up are necessary to see whether febuxostat has a favorable effect on the progression of CKD.

Published
2023
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3. Highly conductive anion exchange membranes based on polymer networks containing imidazolium functionalised side chains

Author

Ebrahim Abouzari-Lotf, Mohan V. Jacob, Hossein Ghassemi, Masoumeh Zakeri, Mohamed Mahmoud Nasef, Yadollah Abdolahi, Ali Abbasi, and Arshad Ahmad

Subjects
Medicine, Science
Abstract

Abstract Two novel types of anion exchange membranes (AEMs) having imidazolium-type functionalised nanofibrous substrates were prepared using the facile and potentially scalable method. The membranes’ precursors were prepared by graft copolymerization of vinylbenzyl chloride (VBC) onto syndiotactic polypropylene (syn-PP) and polyamide-66 (PA-66) nanofibrous networks followed by crosslinking with 1,8-octanediamine, thermal treatment and subsequent functionalisation of imidazolium groups. The obtained membranes displayed an ion exchange capacity (IEC) close to 1.9 mmol g–1 and ionic (OH-) conductivity as high as 130 mS cm–1 at 80 °C. This was coupled with a reasonable alkaline stability representing more than 70% of their original conductivity under accelerated degradation test in 1 M KOH at 80 °C for 360 h. The effect of ionomer binder on the performance of the membrane electrode assembly (MEA) in AEM fuel cell was evaluated with the optimum membrane. The MEA showed a power density of as high as 440 mW cm−2 at a current density is 910 mA cm−2 with diamine crosslinked quaternized polysulfone (DAPSF) binder at 80 °C with 90% humidified H2 and O2 gases. Such performance was 2.3 folds higher than the corresponding MEA performance with quaternary ammonium polysulfone (QAPS) binder at the same operating conditions. Overall, the newly developed membrane was found to possess not only an excellent combination of physico-chemical properties and a reasonable stability but also to have a facile preparation procedure and cheap ingredients making it a promising candidate for application in AEM fuel cell.

Published
2021
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4. Hospital outcomes in pediatric patients with Prader–Willi syndrome (PWS) undergoing orthopedic surgery: A 12-year analysis of national trends in surgical management and inpatient hospital outcomes

Author

Joseph C. Brinkman, Kade S. McQuivey, Andrew S. Chung, Mohan V. Belthur, Justin L. Makovicka, Zachary K. Christopher, and Michael R. Jones

Subjects
Pediatrics, medicine.medical_specialty, Acute blood loss anemia, Urinary system, medicine.medical_treatment, Diabetes mellitus, medicine, Humans, Orthopedics and Sports Medicine, Musculoskeletal Diseases, Child, Retrospective Studies, Inpatients, business.industry, Incidence (epidemiology), Retrospective cohort study, medicine.disease, medicine.icd_9_cm_classification, Hospitals, Spinal Fusion, Spinal fusion, Orthopedic surgery, Surgery, Orthopedic Procedures, business, Prader-Willi Syndrome
Abstract

Background The incidence of orthopedic disorders amongst patients with Prader–Willi Syndrome (PWS) is high when compared to the general pediatric population. The purpose of this retrospective study was to define the most commonly performed orthopedic procedures in pediatric patients with PWS and to characterize the peri-operative outcomes of these patients. Methods The Kids Inpatient Database (KID) was queried to collect data and identify all pediatric patients with PWS who underwent orthopedic procedures from 2001 to 2012. A total of 3684 patients with PWS were identified, 334 of who underwent an orthopedic procedure. Population demographics, comorbidities, and specific procedures undergone were defined. The incidences of postoperative complications and length of associated hospital stay were additionally evaluated. Results Mean age of patients in this sample was 10.33 years (SD 4.5). The most common comorbidities included obesity (18.1%), chronic pulmonary disease (14.1%), hypothyroidism (5.1%), hypertension (5.1%), and uncomplicated diabetes (4%). Common procedures were spinal fusion (165/334, 49%) and lower extremity procedures (50/334, 15%). Complications included acute blood loss anemia, device related complications, pneumonia, sepsis, and urinary tract infections. The overall complication rate was 35.6%. Average hospital lengths of stay for patients undergoing spinal fusion was 6.68 days (SD 4.13), lower extremity orthopedic procedure was 5.65 days (SD 7.4), and all other orthopedic procedures was 7.74 days (SD 16.3). Conclusions Orthopedic disorders are common in patients with PWS. Consequently, spinal fusions and lower extremity procedures are commonly performed in this patient population. Associated comorbid conditions may negatively impact surgical outcomes in these patients. This information should prove useful in the peri-operative management of patients with PWS undergoing orthopedic surgery and for shared decision making with families.

Published
2022

5. Prenatal diagnosis of Sprengel's deformity in a patient with Klippel-Feil Syndrome

Author

Luis F. Goncalves, Roy U. Bisht, Ian M. Singleton, and Mohan V. Belthur

Subjects
Fetal magnetic resonance imaging, medicine.medical_specialty, Klippel–Feil syndrome, Prenatal diagnosis, Ultrasonography, Prenatal, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Deformity, Humans, Radiology, Nuclear Medicine and imaging, Fetus, Shoulder Joint, business.industry, Ultrasound, Sprengel's deformity, medicine.disease, Scapula, medicine.anatomical_structure, Klippel-Feil Syndrome, 030220 oncology & carcinogenesis, Cervical Vertebrae, Female, Radiology, medicine.symptom, business, Cervical vertebrae
Abstract

We present a case of Klippel-Feil Syndrome, a congenital skeletal defect where multiple cervical vertebral bodies are fused. Klippel-Feil Syndrome has multiple associated anomalies, with a notable one being Sprengel's deformity. In this case, the patient was given a diagnosis of Klippel-Feil Syndrome prenatally after suspected cervical vertebrae fusion and Sprengel's deformity were seen on both fetal magnetic resonance imaging (MRI) and ultrasound. Prenatal diagnosis of Sprengel's deformity has been reported once in the literature. In this report, we present imaging findings of Sprengel's deformity seen in association with Klippel-Feil Syndrome using a combination of fetal ultrasound and MRI.

Published
2021

6. Sodium‐glucose cotransporter‐2 inhibitors and non‐steroidal mineralocorticoid receptor antagonists: Ushering in a new era of nephroprotection beyond renin‐angiotensin system blockade

Author

Ravindra Prabhu, Dharshan Rangaswamy, Shankar Prasad Nagaraju, Mohan V Bhojaraja, Indu Ramachandra Rao, and Srinivas Shenoy

Subjects
Drug, Nephrology, medicine.medical_specialty, media_common.quotation_subject, Angiotensin-Converting Enzyme Inhibitors, Kidney, urologic and male genital diseases, Bioinformatics, Renin-Angiotensin System, Diabetic nephropathy, Angiotensin Receptor Antagonists, chemistry.chemical_compound, Mineralocorticoid receptor, Internal medicine, Renin–angiotensin system, medicine, Animals, Humans, Diabetic Nephropathies, Renal Insufficiency, Chronic, Sodium-Glucose Transporter 2 Inhibitors, Mineralocorticoid Receptor Antagonists, media_common, Aldosterone, biology, business.industry, Angiotensin-converting enzyme, General Medicine, medicine.disease, female genital diseases and pregnancy complications, Treatment Outcome, chemistry, Disease Progression, biology.protein, business, Kidney disease
Abstract

The therapeutic options for preventing or slowing the progression of chronic kidney disease (CKD) have been thus far limited. While angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are, without a doubt, safe and effective drugs, a significant proportion of patients with CKD still progress to end-stage kidney disease. After decades of negative trials, nephrologists have finally found cause for optimism with the introduction of sodium-glucose cotransporter-2 (SGLT2) inhibitors and non-steroidal mineralocorticoid receptor antagonists (MRAs). Recent trials such as EMPA-REG OUTCOME and CREDENCE have provided evidence of the renal benefits of SGLT2 inhibitors, which have now found widespread acceptance as first-line agents for diabetic CKD, in addition to ACEi/ARBs. Considering results from the DAPA-CKD study, it is expected that their use will soon be expanded to other causes of albuminuric CKD as well, although confirmation from further trials, such as the EMPA-KIDNEY study is awaited. Likewise, although the role of mineralocorticoid receptor overactivation in CKD progression has been known for decades, it is only now with the FIDELIO-DKD study that we have evidence of benefits of MRAs on hard renal endpoints, specifically in patients with diabetic CKD. While further research is ongoing, given the evidence of synergism between the three drug classes, it is foreseeable that a combination of two or more of these drugs may soon become the standard of care for CKD, regardless of underlying aetiology. This review describes pathophysiologic mechanisms, current evidence and future perspectives on the use of SGLT2 inhibitors and novel MRAs in CKD.

Published
2021

7. Hospital outcomes of scoliosis surgery in children with Prader–Willi Syndrome: comparison with adolescent idiopathic scoliosis

Author

Joseph C. Brinkman, Matthew T. Gulbrandsen, Andrew S. Chung, Mohan V. Belthur, Kade S. McQuivey, Cory K Mayfield, and Joseph R. Sheridan

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, 030222 orthopedics, Pediatrics, medicine.medical_specialty, business.industry, Incidence (epidemiology), medicine.medical_treatment, nutritional and metabolic diseases, Idiopathic scoliosis, Scoliosis, medicine.disease, nervous system diseases, Scoliosis surgery, 03 medical and health sciences, Pneumonia, 0302 clinical medicine, Hospital outcomes, Spinal fusion, Orthopedic surgery, Medicine, Orthopedics and Sports Medicine, business, 030217 neurology & neurosurgery
Abstract

The purpose of this study was to evaluate the peri-operative outcomes of patients with Prader–Willi Syndrome (PWS) undergoing spinal deformity correction and compare the outcomes to patients with adolescent idiopathic scoliosis (AIS). A retrospective review of the Kid’s Inpatient Database was performed from 2000 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. Cohorts were created on the basis of PWS diagnosis and adolescent idiopathic scoliosis. Statistical analysis was performed for differences in post-operative outcomes between these two patient cohorts. Between 2000 and 2012, the number of spinal fusions performed increased by 24.6 and 32.2% in the PWS and adolescent idiopathic scoliosis populations, respectively. There was no difference between the incidence of major complications in PWS patients when compared to AIS (1.7% vs. 1.0% in idiopathic scoliosis; p = 0.362). Although there was no significant difference in the rate of overall minor complications, PWS patients were demonstrated to be more likely to experience post-operative pneumonia (p

Published
2021

8. Coronary artery vasculitis: a review of current literature

Author

Kartheek Garikapati, Shaun Khanna, Surjit Tarafdar, Mohan V. Bhojaraja, Phillip Lo, Kenneth Cho, and Daniel S. L. Goh

Subjects
medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Population, Takayasu's arteritis, Coronary Artery Disease, Review, Mucocutaneous Lymph Node Syndrome, 030204 cardiovascular system & hematology, Multimodal Imaging, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Cardiac magnetic resonance imaging, Internal medicine, Intravascular ultrasound, medicine, Humans, 030212 general & internal medicine, Arteritis, Coronary artery vasculitis, education, Giant cell arteritis, education.field_of_study, medicine.diagnostic_test, Polyarteritis nodosa, business.industry, Kawasaki’s disease, Takayasu’s arteritis, Prognosis, medicine.disease, Takayasu Arteritis, Cardiac Imaging Techniques, lcsh:RC666-701, Cardiology, cardiovascular system, Cardiology and Cardiovascular Medicine, Vasculitis, business
Abstract

Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki’s disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.

Published
2021

9. Comparative Study of Natural Terpenoid Precursors in Reactive Plasmas for Thin Film Deposition

Author

Andrew Michelmore, Daniel S. Grant, Kateryna Bazaka, Jakaria Ahmed, Mohan V. Jacob, Krasimir Vasilev, Jason D. Whittle, Grant, Daniel S, Ahmed, Jakaria, Whittle, Jason D, Michelmore, Andrew, Vasilev, Krasimir, Bazaka, Kateryna, and Jacob, Mohan V

Subjects
Staphylococcus aureus, Plasma Gases, Pharmaceutical Science, Organic chemistry, natural precursors, Article, Analytical Chemistry, chemistry.chemical_compound, QD241-441, Drug Discovery, medicine, Physical and Theoretical Chemistry, Thin film, tea tree oil, chemistry.chemical_classification, Biological Products, Terpenes, Chemistry, Tea tree oil, Cationic polymerization, plasma polymerisation, Adhesion, Polymer, Melaleuca, Terpenoid, Anti-Bacterial Agents, Monomer, Polymerization, Chemical engineering, thin films, Chemistry (miscellaneous), Molecular Medicine, medicine.drug
Abstract

If plasma polymer thin films are to be synthesised from sustainable and natural precursors of chemically heterogeneous composition, it is important to understand the extent to which this composition influences the mechanism of polymerisation. To this end, a well-studied monoterpene alcohol, terpinen-4-ol, has been targeted for a comparative study with the naturally occurring mix of terpenes (viz. Melaleuca alternifolia oil) from which it is commonly distilled. Positive ion mode mass spectra of both terpinen-4-ol and M. alternifolia oil showed a decrease in disparities between the type and abundance of cationic species formed in their respective plasma environments as applied plasma power was increased. Supplementary biological assay revealed the antibacterial action of both terpinen-4-ol and M. alternifolia derived coatings with respect to S. aureus bacteria, whilst cytocompatibility was demonstrated by comparable eukaryotic cell adhesion to both coatings. Elucidating the processes occurring within the reactive plasmas can enhance the economics of plasma polymer deposition by permitting use of the minimum power, time and precursor pre-processing required to control the extent of monomer fragmentation and fabricate a film of the desired thickness and functionality.

Published
2021

10. Determinants of caregiver satisfaction in pediatric orthopedics

Author

Rachel J. Garfinkel, Mohan V. Belthur, Jason B. Malone, M'hamed Temkit, and Ian M. Singleton

Subjects
Male, medicine.medical_specialty, media_common.quotation_subject, Empathy, Personal Satisfaction, Logistic regression, Literacy, Odds, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Surveys and Questionnaires, Humans, Medicine, Orthopedics and Sports Medicine, Child, media_common, 030222 orthopedics, business.industry, Odds ratio, Cross-Sectional Studies, Orthopedics, Caregivers, Caregiver satisfaction, Patient Satisfaction, Family medicine, Pediatrics, Perinatology and Child Health, Orthopedic surgery, Female, business, 030217 neurology & neurosurgery
Abstract

This study investigates determinants of pediatric orthopedic surgery patients' parent or guardian (caregiver) satisfaction with the physician in an outpatient office setting. This was a cross-sectional survey study of 200 English-speaking caregivers of pediatric patients that checked into the pediatric orthopedic clinic at the authors' institution from 1 March 2017 to 1 November 2018. Questionnaires given in clinic include the Newest Vital Sign and The Literacy in Musculoskeletal Problems survey to measure general and musculoskeletal health literacy, respectively, demographic information, expected/estimated wait time, Consultation and Relational Empathy Measure, and Consumer Assessment of Healthcare Providers and Systems Clinician and Group. After multivariate regression, only perceived physician empathy as measured by the Consultation and Relational Empathy Measure score was significantly correlated with caregiver satisfaction (P < 0.0001), accounting for 56% of the variability of caregiver satisfaction scores. The odds of a satisfaction score of at least 9 out of 10 were 21% higher for every unit increase of the Consultation and Relational Empathy Measure score [odds ratio = 1.21 (P < 0.0001)]. After logistic regression, the caregiver's gender was also correlated with patient satisfaction and the odds of a patient satisfaction score ≥9 for males was less than 1/4th that of females [odds ratio = 0.16 (P = 0.040)]. The most important determinant of caregiver satisfaction with the physician in an outpatient pediatric orthopedic setting is perceived physician empathy. This accounts for the majority of the caregiver's satisfaction. This is the first study to determine this relationship in pediatric orthopedic surgery.

Published
2020

11. Syndromic Scoliosis: National Trends in Surgical Management and Inpatient Hospital Outcomes

Author

Donovan B Lockwood, Mohan V. Belthur, Sean P. Renfree, Judson W. Karlen, and Andrew S. Chung

Subjects
Marfan syndrome, Down syndrome, Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Scoliosis, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Achondroplasia, Prospective cohort study, Retrospective Studies, 030222 orthopedics, business.industry, Retrospective cohort study, medicine.disease, Hospitalization, Spinal Fusion, Treatment Outcome, Spinal fusion, Neurology (clinical), business, Complication, 030217 neurology & neurosurgery
Abstract

STUDY DESIGN Retrospective cohort study. OBJECTIVE Evaluate the trends in management and inpatient outcomes in patients with syndromic scoliosis undergoing spinal deformity correction. SUMMARY OF BACKGROUND DATA Syndromic scoliosis (SS) refers to scoliosis that is most commonly associated with systemic disease including Ehler Danhlos syndrome (EDS), Marfan syndrome (MF), Down syndrome (DS), Achondroplasia (AP), and Prader-Willi syndrome (PWS). Limited data exist evaluating hospital outcomes in patients with SS undergoing spinal deformity correction. METHODS The Kids' Inpatient Database (KIDS) was queried from 2001 to 2012 to identify all pediatric patients with scoliosis undergoing spinal fusion. These patients were then sub-divided into two cohorts: (1) patients with idiopathic scoliosis (IS) and (2) patients with syndromic scoliosis. Trends in surgical management, and postoperative morbidity and mortality were assessed. Length of stay and total hospital charges were additionally analyzed. A sub-analysis to characterize outcomes in each syndrome was also performed. RESULTS An estimated 1071 patients with SS were identified and compared with 24,989 pediatric patients with IS. MF (36.8%), Down syndrome (16.0%), and PWS (14.9%) were the most common diagnoses among patients with SS. Between 2001 and 2012, there was a significant decline in the number of anterior procedures performed in both cohorts. Conversely, the number of posterior based procedures increased. SS was associated with increased major complications (2.7% compared with 1.0% in IS; P

Published
2019

12. Rare Case of Central Pontine Myelinolysis: Etiological Dilemma

Author

Vinayagamani Selvadasan, Mohan V. Sumedha Maturu, Sibasankar Dalai, and Aravind Varma Datla

Subjects
Pediatrics, medicine.medical_specialty, business.industry, brain magnetic resonance, General Engineering, distal renal tubular acidosis, hypokalaemia, medicine.disease, Allergy/Immunology, Dilemma, Neurology, sjogren's, Rare case, Etiology, medicine, Central pontine myelinolysis, Radiology, business, central pontine myelinolysis, anti-ssa antibody
Abstract

Central nervous system (CNS) involvement in Sjogren's syndrome (SS) has a broad spectrum of presentations. We present a 33-year-old with sudden onset, rapidly progressive quadriplegia, severe dysarthria, bilateral facial palsy, bulbar palsy, and hypernatremia. The MRI of the brain revealed hyperintensity in the central pons diffusion-weighted imaging, T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR) without abnormal contrast enhancement, consistent with central pontine myelinolysis. However, there was no antecedent history of hyponatremia with rapid correction. The patient responded excellently to sodium correction and pulse methylprednisolone therapy and was erroneously diagnosed as idiopathic hypernatremic osmotic demyelination. One year later, she presented with vague constitutional symptoms, renal tubular acidosis type-1 (distal), hypokalemia with associated myopathy. Subsequent testing for anti-Sjögren's-syndrome-related antigen A (SSA)/Ro autoantibodies and a biopsy of the minor salivary gland established the diagnosis of primary Sjogren syndrome (pSS). Remission was achieved with oral prednisolone after her discharge. Neurological signs can be the initial presentation that precedes the classical systemic manifestations of multisystem autoimmune disorders like pSS. In the event of osmotic demyelination, when antecedent hyponatremia with rapid correction is not there, we suggest evaluating for possible autoimmune etiology.

Published
2021

13. Fractional Excretion of Sodium and Urea in Differentiating Acute Kidney Injury Phenotypes in Decompensated Cirrhosis

Author

Priyadarshini John, Nitin Jagtap, Nagaraja P. Rao, Bhushan Bhaware, Rajesh Gupta, Mithun Sharma, Nageshwar D. Reddy, Manu Tandan, Mohan V. Turpati, Pramod Kumar, Anand V. Kulkarni, Yashavanth H.S. Gowda, Gujjarapudi Deepika, Mohan Ramchandani, and Arun Karyampudi

Subjects
medicine.medical_specialty, Fractional excretion of sodium, Hepatology, Receiver operating characteristic, urogenital system, business.industry, Urology, Acute kidney injury, Area under the curve, urologic and male genital diseases, medicine.disease, female genital diseases and pregnancy complications, Hepatorenal syndrome, Cohort, Medicine, Original Article, Derivation, business, Acute tubular necrosis
Abstract

BACKGROUND: Prerenal acute kidney injury (prerenal AKI), hepatorenal syndrome (HRS–AKI), and acute tubular necrosis (ATN–AKI) are the various phenotypes of acute kidney injury, which are described in decompensated cirrhosis. It has therapeutic and prognostic implications. We aimed to evaluate the diagnostic utility of fractional excretion of sodium and urea (FENa and FEUrea) for differentiating AKI phenotypes. METHODS: A prospective analysis was performed in 200 patients with decompensated cirrhosis with AKI to derive receiver operating curve, optimal cut-off, sensitivity, and specificity. These findings were validated in an independent cohort (n = 50) to differentiate ATN–AKI, HRS–AKI, and prerenal AKI. RESULTS: The incidence of prerenal AKI, HRS–AKI, and ATN–AKI were 37.5%, 34%, and 28.5% in the derivation cohort and 28%, 38%, and 34% in the validation cohort respectively. The median FENa was significantly different in various phenotypes of AKI in the derivation and validation cohort (P 0.001); FEUrea was significantly different in the derivation cohort (P 0.0001), not in the validation cohort (P 0.106). The AUC for FENa (cut-off, sensitivity/specificity) was 86.6% (0.567, 89/71) and for FEUrea was 60.3% (34.73, 70/58) for ATN–AKI vs. non-ATN–AKI. The area under the curve for FENa to differentiate between HRS–AKI vs. non-HRS–AKI was 74.5%. FEUrea could not differentiate HRS-AKI vs. non-HRS–AKI (AUC 60.4%) satisfactorily. FENa and FEUrea were unable to differentiate between prerenal AKI and HRS-AKI (AUC

Published
2021

14. Utility of 18F-FDG PET/CT in Management of Pancreatic and Periampullary Masses—Prospective Study from a Tertiary Care Center

Author

Venkatarami Reddy V, Krishna Mohan V. S, Narendra Hulikal, Ranadheer Gupta Manthri, Chandra Teja Reddy S, Sai Moulika Jeepalem, Tekchand Kalawat, and Vijaya Lakshmi Devi B

Subjects
medicine.medical_specialty, business.industry, Malignancy, medicine.disease, Tertiary care, people.cause_of_death, Oncology, Surgical oncology, medicine, Periampullary cancer, Etiology, Surgery, Fdg pet ct, Original Article, Radiology, people, Prospective cohort study, business, Pathological
Abstract

Characterizing a pancreatic or periampullary mass lesion as benign or malignant on conventional imaging is difficult due to overlapping morphological features. 18F-FDG PET/CT is a molecular imaging technique with reportedly higher sensitivity and specificity in the differentiation of benign and malignant pancreatic and periampullary masses. In this prospective study, we evaluated the utility of 18F-FDG PET/CT in patients with recently diagnosed pancreatic and periampullary masses. Based on FDG uptake pattern, diffuse or absent uptake was considered benign and focal increased uptake as malignant. Among the 32 patients included in the study, pathological examination confirmed 25 as positive for malignancy and the remaining 7 as benign etiology. Based on FDG uptake pattern, sensitivity, specificity, PPV, NPV, and accuracy of the study were 92%, 42.8%, 85.2%, 60%, and 81.3% respectively. 18F-FDG PET/CT had a statistically significant higher detection rate in the evaluation of regional lymph nodes and distant organ metastases compared to radiological imaging. In 7/25 (14%) malignant cases, 18F-FDG PET/CT detected additional distant metastases which were not detected by conventional imaging and thus resulting in change in management from curative resection to palliative therapy. To conculde, 18F-FDG PET/CT uptake pattern can characterize pancreatic and periampullary masses as benign or malignant with a relatively good accuracy. Using 18F-FDG PET/CT for initial staging of pancreatic and periampullary cancer helps in appropriate staging and optimal selection of treatment modality compared to conventional imaging techniques.

Published
2021

15. Primary Bacterial Pyomyositis in Children: A Systematic Review

Author

Ashish Ranade, Neeraj Vij, Paul Kang, and Mohan V. Belthur

Subjects
Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Percutaneous, Pyomyositis, Limp, Medicine, Humans, Orthopedics and Sports Medicine, Child, Pelvis, Arthritis, Infectious, medicine.diagnostic_test, business.industry, Osteomyelitis, General Medicine, Staphylococcal Infections, medicine.disease, Surgery, Anti-Bacterial Agents, medicine.anatomical_structure, Erythrocyte sedimentation rate, Pediatrics, Perinatology and Child Health, Septic arthritis, medicine.symptom, Iliopsoas, business
Abstract

Background Tropical pyomyositis has had a recent increase in the United States, Europe, and other nontropical areas. The purpose of this study was to provide an accurate description of the demographics, presenting features, sites of involvement, microbiology, imaging modalities, medical and surgical management, complications, and predictors of clinical course. Methods We searched PubMed, Cochrane, Web of Science Collection, Scopus, and Embase databases yielding 156 studies. Of these, 23 articles were selected for statistical analysis. Results The average age at presentation was 8.4±1.9 years with males more commonly affected. Fever, painful limp, and localized pain were the most common presenting symptoms. Pelvis, lower extremity, trunk and spine, in descending order, were the most commonly affected locations. Iliopsoas, obturator musculature, and gluteus musculature were the most commonly affected muscle groups. The mean time to diagnosis was 6.6±3.05 days. Staphylococcus aureus was the most common offending organism. The mean length of hospital stay was 12.0±4.6 days. Medical management alone was successful in 40% of cases (143/361) with an average duration of 9.5±4.0 and 22.7±7.2 days of intravenous and oral antibiotics, respectively. Surgical management consisted of open drainage in 91.3% (199/218) or percutaneous drainage in 8.7% (19/218) of cases. Painful limp, fever, and larger values of white cell count and erythrocyte sedimentation rate were associated with an increased need for surgery. Obturator and calf muscle involvement were strongly associated with multifocal involvement. There were 42 complications in 41 patients (11.3%). Methicillin-resistant S. aureus was associated with an increased risk of complications. The most common complications were osteomyelitis, septicemia, and septic arthritis. Conclusions Primary pyomyositis should be considered in cases suggesting pediatric infection. Magnetic resonance imaging is the most commonly used imaging modality; however, ultrasound is useful given its accessibility and low cost. Medical management alone can be successful, but surgical treatment is often needed. The prognosis is favorable. Early diagnosis, appropriate medical management, and potential surgical drainage are required for effective treatment. Level of evidence Level IV-systematic review.

Published
2021

16. Diversity and Inclusion in an Orthopaedic Surgical Society: A Longitudinal Study

Author

Selina C Poon, Ian M. Singleton, Roy U. Bisht, Mohan V. Belthur, Francisco Lucio, and Neeraj Vij

Subjects
Longitudinal study, business.industry, education, Specialty, Ethnic group, General Medicine, Asian americans, Pediatrics, Perinatology and Child Health, Health care, Medicine, Orthopedics and Sports Medicine, business, Cultural competence, Inclusion (education), health care economics and organizations, Demography, Diversity (business)
Abstract

Background Diversity and inclusion are critical to providing the best possible health care. Previous studies have shown that diversity among physicians increases cultural competency, which in turn enhances the quality of care provided and increases minoritized patients' participation in decisions regarding their health care. However, physician diversity in both race and sex is lacking in orthopaedic surgery. This study seeks to determine the sex and racial diversity in the membership and leadership of the Pediatric Orthopaedic Society of North America (POSNA). Methods POSNA membership and leadership were reviewed for the years 2010, 2015, and 2020. This data was gathered from membership directories and committee reference books. All North American Active Members' race/ethnicity and sex were recorded for each year. The categories for race/ethnicity are Caucasian, East/South/Middle Eastern Asian American (Asian), Hispanic/Latin/South American (HLSA), and African American. Results From 2010 to 2020, Active Members of POSNA increased from 608 to 818, and the percentage of female (14.6% to 23.7%), Asian (7.4% to 11.2%), HLSA (2.5% to 2.9%), and African American membership (1.6% to 1.8%) increased. Male (85.4% to 76.3%) and Caucasian (88.5% to 84.0%) membership decreased. From 2010 to 2020, male leadership decreased on both the Board of Directors and Committee Chairs (89.5% to 81.8% and 86.4% to 64.7%, respectively), as did Caucasians (94.7% to 81.8% and 90.9% to 88.2%, respectively). The number of Asian members holding positions on both the Board of Directors and Committee Chairs increased (0% to 18.2% and 4.5% to 11.8%, respectively) as did the number of females (10.5% to 18.2% and 13.6% to 35.3%, respectively). HLSA and African American members were proportionally represented in leadership for the years 2010 and 2015. Conclusions Membership in POSNA has increased between 2010 to 2020 for every diversity category examined and POSNA membership exhibits significantly more diversity than the orthopaedic specialty as a whole. Leadership as a whole is more diverse in 2020 than it was in 2010. Level of evidence Level II-retrospective.

Published
2021

17. MO229PROFILE OF TUBERCULOSIS AND ITS MANAGEMENT IN CHRONIC KIDNEY DISEASE

Author

Shankar Prasad Nagaraju, Nisha Abdul Khader, Indu Ramachandra Rao, Srinivas Shenoy, Mohan V Bhojaraja, Ravindra Prabhu, and Divya Datta

Subjects
Transplantation, medicine.medical_specialty, Tuberculosis, business.industry, Human immunodeficiency virus (HIV), medicine.disease, medicine.disease_cause, medicine.anatomical_structure, Nephrology, Internal medicine, medicine, Abdomen, business, Kidney disease
Abstract

Background and Aims Estimates of Tuberculosis(TB) burden indicate an estimated incidence and mortality of 199 and 32 respectively per 100000 in our country. Risk factors for acquiring TB disease include HIV infection, Diabetes Mellitus, Tobacco consumption and undernutrition. We retrospectively studied profile of TB in Chronic Kidney disease(CKD) in our population. Method Retrospective case record based study of consecutive TB patients visiting a Tertiary care hospital attached to a Medical College diagnosed by standard methods to demonstrate TB bacilli in sputum or affected tissue. CKD was diagnosed based on estimated Glomerular filtration rate less than 60 ml/min/m2 for at least three months. Pattern of TB and adverse drug effects were studied. Statistical analysis was done on SPSS version 20 Results Over ten months, of 746 TB patients seen, 41(5.4%) had CKD, Stage 3b,4 and 5 in 7/41(17.1%), 11(26.8%), 23(56.1%) respectively. Among CKD 24(58.5%) had Diabetes Mellitus, 1(2.4%) HIV and 37(90.2%) hypertension. Pattern of TB is shown in table 1. Adverse drug reactions were significantly higher in CKD 24/41(54.5% vs 17% in non CKD, P < 0.05). Mortality in CKD was 3/41(7.3%) and not significantly higher on multivariable analysis than in those without CKD. Conclusion In this retrospective survey of TB patients CKD constituted 5.4%, was associated with more adverse drug reactions but did not impact on mortality. Pulmonary TB was the common pattern in CKD.

Published
2021

18. Increased risk of brain metastases in ovarian cancer patients with BRCA mutations

Author

Elena Ratner, Mohan V. Bala, Melinda Louie-Gao, Priscilla K. Brastianos, Ebru Aydin, and Sebastien Hazard

Subjects
0301 basic medicine, Oncology, medicine.medical_specialty, Databases, Factual, endocrine system diseases, Genes, BRCA2, Population, Genes, BRCA1, Kaplan-Meier Estimate, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, In patient, education, Aged, Retrospective Studies, Ovarian Neoplasms, education.field_of_study, Brain Neoplasms, business.industry, BRCA mutation, Hazard ratio, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, medicine.disease, female genital diseases and pregnancy complications, Confidence interval, 030104 developmental biology, Increased risk, 030220 oncology & carcinogenesis, Mutation, Female, Ovarian cancer, business
Abstract

To estimate the risk for brain metastases in patients with ovarian cancer using real-world data, and assess whether BRCA mutations increase that risk.This retrospective study included 4515 patients diagnosed with ovarian cancer between January 1, 2011, and January 31, 2018, from the Flatiron Health database, a longitudinal, demographically, and geographically diverse database derived from electronic health records in the United States.Forty-six (1%) patients were diagnosed with brain metastases after being diagnosed with ovarian cancer. Of 4515 patients with ovarian cancer, 10% had a known BRCA mutation, 37% had BRCA wildtype (BRCAwt), and the BRCA status of the remaining 51% was unknown/untested. Brain metastases were observed in 3% of patients with BRCA mutations compared with 0.6% of those with BRCAwt. The Kaplan-Meier estimate for the proportion of patients with brain metastases within 5 years of diagnosis was 5.7% in the population with BRCA mutations compared with 1.4% in those with BRCAwt (hazard ratio 4.44; 95% confidence interval, 1.97, 10.00; P 0.0001). These data demonstrate that patients with a BRCA mutation had a significantly higher risk for brain metastases than those without.Despite being a rare manifestation of ovarian cancer, the possibility of developing brain metastases should be considered in these patients, especially in patients with a BRCA mutation. The availability of new therapeutic options that may prolong overall survival and may not cross the blood-brain barrier could also lead to an increase in brain metastases in patients with ovarian cancer.

Published
2019

19. Correction of Bowleg Deformity in Achondroplasia through Combined Bony Realignment and Lateral Collateral Ligament Tightening

Author

James A. Fernandes, Stanley Jones, Binu T Kurian, S.N. Giles, and Mohan V. Belthur

Subjects
medicine.medical_specialty, education.field_of_study, External fixator, business.industry, Grade II PIN, Radiography, Genu varum, Population, medicine.disease, Ilizarov, Lateral collateral ligament, Surgery, Achondroplasia, Bowlegs, medicine.anatomical_structure, medicine, Deformity, Ligament, Orthopedics and Sports Medicine, Original Article, medicine.symptom, business, education
Abstract

Introduction Achondroplasia is one of the most common osteochondrodysplasias with an incidence of 1 in 26,000 live births. Bowing of lower limbs can cause significant morbidity in this population. The use of the Ilizarov external fixator to tighten collateral ligaments of the knee in children has not been reported in the literature. We report the technique and early results of lateral collateral ligament (LCL) tightening with correction of genu varum in children with achondroplasia. Materials and methods A retrospective review of children with achondroplasia presenting with bowleg deformity who were treated by corrective osteotomy and LCL tightening was conducted. Between 1998 and 2003, 12 patients (24 limb segments) underwent this procedure and were included in the study. All patients had grade III LCL laxity preoperatively. Pre- and postoperative anteroposterior standing mechanical axis radiographs were evaluated. The final outcome was graded using the grading system of Paley et al. Results All patients had bilateral corrections. The Ilizarov external fixator was used in 10 patients and the Orthofix limb reconstruction system in 2 patients. The bony realignment was achieved through monofocal or bifocal tibial osteotomies. The LCL was tightened in all limb segments using the Paley’s type II strategy. The final result was graded as excellent in 20 limb segments and good in 4 limb segments. One patient developed transient common peroneal nerve palsy, four developed grade II pin site infections, and there was premature consolidation of the tibial regenerate in one patient. How to cite this article Kurian BT, Belthur MV, Jones S, et al. Correction of Bowleg Deformity in Achondroplasia through Combined Bony Realignment and Lateral Collateral Ligament Tightening. Strategies Trauma Limb Reconstr 2019;14(3):132–138.

Published
2019

20. Acute Kidney Injury and Progressive Diabetic Kidney Disease: An Epidemiological Perspective

Author

Srinivas Shenoy, Indu Ramachandra Rao, Dharshan Rangaswamy, Mohan V Bhojaraja, Shankar Prasad Nagaraju, Ravindra Prabhu, Karan Saraf, Deepak Nayak M, Ashok Ramaswamy, and Sindhura Lakshmi Koulmane Laxminarayana

Subjects
Nephrology, medicine.medical_specialty, medicine.medical_treatment, International Journal of Nephrology and Renovascular Disease, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, urologic and male genital diseases, sepsis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Renal replacement therapy, Risk factor, Original Research, Proteinuria, business.industry, urogenital system, Acute kidney injury, medicine.disease, diabetic kidney disease, female genital diseases and pregnancy complications, acute kidney injury, GFR decline, proteinuria, medicine.symptom, business, Cohort study, Kidney disease
Abstract

Ravindra Attur Prabhu,1 Srinivas V Shenoy,1 Shankar Prasad Nagaraju,1 Dharshan Rangaswamy,1 Indu Ramachandra Rao,1 Mohan V Bhojaraja,1 Deepak Nayak M,2 Sindhura Lakshmi Koulmane Laxminarayana,2 Karan Saraf,1,3 Ashok Ramaswamy1,4 1Department of Nephrology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India; 2Department of Pathology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India; 3Department of Nephrology, Excelcare Hospitals, Guwahati, Assam, India; 4Department of Nephrology, Saveetha Medical College, Chennai, Tamil Nadu, IndiaCorrespondence: Srinivas V ShenoyDepartment of Nephrology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, IndiaTel +91 9844374705Email shenoy.srinivas@manipal.eduPurpose: Diabetic kidney disease (DKD) represents a unique subset of patients with chronic kidney disease (CKD). Acute kidney injury (AKI) is implicated in DKD progression; however, their interplay is not studied well. We studied risk factors for AKI and the effect of AKI on disease progression in a homogeneous group of patients with DKD.Patients and Methods: We conducted a retrospective open cohort study of patients with DKD at a single tertiary care centre between August 2016 – August 2019. Patients with a minimum follow-up of 2 years were included in the study. The incidence, etiology and risk factors for AKI were studied. The primary outcome studied was the effect of AKI on reduction in estimated glomerular filtration rate (eGFR) in DKD. Loss in eGFR by 50% and need for renal replacement therapy or reaching CKD stage V were studied as secondary outcomes.Results: Two hundred and ninety-two DKD patients meeting the study criteria with a follow-up of 29.57 (± 4.3) months were included. The incidence of AKI was 31.1%. Sepsis was the most common etiology (61%). Proteinuria was an independent risk factor for AKI after adjusting for covariates (adjusted OR - 1.158; 95% CI (1.018– 1.316); p=0.025). In patients with AKI, median decline in eGFR was 10.29 mL/min/1.73m2/year (IQR-5.58– 13.84) which was significantly higher compared to patients with no AKI [eGFR 7.25 (IQR 5.06– 11.38); p-0.014]. On subgroup analysis, sepsis-induced AKI (versus non-sepsis AKI; p< 0.001) and higher AKI stage (stage 2/3 versus stage 1; p=0.019) were associated with a faster decline in eGFR.Conclusion: AKI is common in patients with DKD with sepsis being the most common etiology. AKI in diabetic kidney disease is associated with a faster decline in eGFR. Baseline proteinuria is an independent risk factor for AKI.Keywords: diabetic kidney disease, acute kidney injury, GFR decline, proteinuria, sepsis

Published
2021

21. Outcomes and predictors of failure of arteriovenous fistulae for hemodialysis

Author

Indu Ramachandra Rao, Mohan V Bhojaraja, Shankar Prasad Nagaraju, Ravindra Prabhu, Arun Chawla, Siddharth Venkat Ramanan, and Srinivas Shenoy

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Adolescent, Urology, medicine.medical_treatment, 030232 urology & nephrology, Vascular access, Failure, Arteriovenous fistula, 030204 cardiovascular system & hematology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Arteriovenous Shunt, Surgical, Renal Dialysis, Internal medicine, medicine, Humans, Nephrology - Original Paper, In patient, Treatment Failure, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Hemodialysis, Female, business
Abstract

Purpose Arteriovenous fistula(AVF) is preferred vascular access for hemodialysis but has primary failure in 20–60%. Studying predictors of AVF failure would help plan appropriate management.We studied AVF outcomes, clinical and vascular factors predicting their failure in patients requiring hemodialysis. Methods Retrospective study of patients with AVF creation from January 2017 to December 2018. Outcomes studied were immediate ( Results Of 530 AVFs in 460 patients, DUS was done in 426/530 (80.4%), 349/460 (75.8%) were males, mean age was 53.10 ± 14.54 (18–91), 215/460(46.7%) had Diabetes mellitus(DM), 423/460(92%) hypertension. AVFs were radiocephalic in 79/530 (14.9%), brachiocephalic 418/530 (78.9%), brachiobasilic 33/530 (6.2%). AVF Immediate/Primary failure was seen in 64/530 (12.1%), 90/352 (25.6%); Patency at six months/one year in 253/352(71.8%),191/305 (62.6%), respectively. Older age had less immediate failures (AOR 0.97, CI 0.95–0.99, p 0.03). Feeding arterial diameter predicted immediate and primary failure on univariate analysis [OR 0.64 (95% CI 0.49–0.83), 0.62 (95% CI 0.47–0.89), respectively], but not multivariate. Artery diameter of > 4.0 mm had less failures [immediate (p 0.01), primary (p 0.02)], Conclusion AVF failure is 12.1%, immediately; 25.6% three months after construction, Patency at 6 months is 71.8%, one year 62.6%. Immediate failures decrease with age. Artery diameters > 4.0 mm had less

Published
2021

22. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author

Zhou, B, Carrillo-Larco, Rm, Danaei, G, Riley, Lm, Paciorek, Cj, Stevens, Ga, Gregg, Ew, Bennett, Je, Solomon, B, Singleton, Rk, Sophiea, Mk, Iurilli, Mlc, Lhoste, Vpf, Cowan, Mj, Savin, S, Woodward, M, Balanova, Y, Cifkova, R, Damasceno, A, Elliott, P, Farzadfar, F, He, J, Ikeda, N, Kengne, Ap, Khang, Yh, Kim, Hc, Laxmaiah, A, Lin, Hh, Maira, Pm, Miranda, Jj, Neuhauser, H, Sundstrom, J, Varghese, C, Widyahening, Is, Zdrojewski, T, Ezzati, M, Abarca-Gomez, L, Abdeen, Za, Rahim, Hfa, Abu-Rmeileh, Nm, Acosta-Cazares, B, Adams, Rj, Aekplakorn, W, Afsana, K, Afzal, S, Agdeppa, Ia, Aghazadeh-Attari, J, Aguilar-Salinas, Ca, Agyemang, C, Ahmad, Na, Ahmadi, A, Ahmadi, N, Ahmadizar, F, Ahmed, Sh, Ahrens, W, Ajlouni, K, Al-Raddadi, R, Alarouj, M, Albuhairan, F, Aldhukair, S, Ali, Mm, Alkandari, A, Alkerwi, A, Allin, K, Aly, E, Amarapurkar, Dn, Amougou, N, Amouyel, P, Andersen, Lb, Anderssen, Sa, Anjana, Rm, Ansari-Moghaddam, A, Ansong, D, Aounallah-Skhiri, H, Araujo, J, Ariansen, I, Aris, T, Arku, Re, Arlappa, N, Aryal, Kk, Aspelund, T, Assah, Fk, Assuncao, Mcf, Auvinen, J, Avdicova, M, Azevedo, A, Azimi-Nezhad, M, Azizi, F, Azmin, M, Babu, Bv, Bahijri, S, Balakrishna, N, Bamoshmoosh, M, Banach, M, Banadinovic, M, Bandosz, P, Banegas, Jr, Baran, J, Barbagallo, Cm, Barcelo, A, Barkat, A, Barreto, M, Barros, Ajd, Barros, Mvg, Bartosiewicz, A, Basit, A, Bastos, Jld, Bata, I, Batieha, Am, Batyrbek, A, Baur, La, Beaglehole, R, Belavendra, A, Ben Romdhane, H, Benet, M, Benson, Ls, Berkinbayev, S, Bernabe-Ortiz, A, Bettiol, H, Bezerra, J, Bhagyalaxmi, A, Bhargava, Sk, Bia, D, Biasch, K, Lele, Ecb, Bikbov, Mm, Bista, B, Bjerregaard, P, Bjertness, E, Bjertness, Mb, Bjorkelund, C, Bloch, Kv, Blokstra, A, Bo, S, Bobak, M, Boeing, H, Boggia, Jg, Boissonnet, Cp, Bojesen, Se, Bongard, V, Bonilla-Vargas, A, Bopp, M, Borghs, H, Bovet, P, Boyer, Cb, Braeckman, L, Brajkovich, I, Branca, F, Breckenkamp, J, Brenner, H, Brewster, Lm, Briceno, Y, Brito, M, Bruno, G, Bueno-de-Mesquita, Hb, Bueno, G, Bugge, A, Burns, C, Bursztyn, M, de Leon, Ac, Cacciottolo, J, Cameron, C, Can, G, Candido, Apc, Capanzana, Mv, Capkova, N, Capuano, E, Capuano, V, Cardoso, Vc, Carlsson, Ac, Carvalho, J, Casanueva, Ff, Censi, L, Cervantes-Loaiza, M, Chadjigeorgiou, Ca, Chamukuttan, S, Chan, Aw, Chan, Q, Chaturvedi, Hk, Chaturvedi, N, Chee, Ml, Chen, Cj, Chen, Ff, Chen, Hs, Chen, Sh, Chen, Zm, Cheng, Cy, Cheraghian, B, Dekkaki, Ic, Chetrit, A, Chien, Kl, Chiolero, A, Chiou, St, Chirita-Emandi, A, Chirlaque, Md, Cho, B, Christensen, K, Christofaro, Dg, Chudek, J, Cinteza, E, Claessens, F, Clarke, J, Clays, E, Cohen, E, Concin, H, Cooper, C, Coppinger, Tc, Costanzo, S, Cottel, D, Cowell, C, Craig, Cl, Crampin, Ac, Crujeiras, Ab, Cruz, Jj, Csilla, S, Cui, Lf, Cureau, Fv, Cuschieri, S, D'Arrigo, G, D'Orsi, E, Dallongeville, J, Dankner, R, Dantoft, Tm, Dauchet, L, Davletov, K, De Backer, G, De Bacquer, D, De Curtis, A, de Gaetano, G, De Henauw, S, de Oliveira, Pd, De Ridder, D, De Smedt, D, Deepa, M, Deev, Ad, Degennaro, V, Delisle, H, Demarest, S, Dennison, E, Deschamps, V, Dhimal, M, Di Castelnuovo, Af, Dias-da-Costa, Js, Diaz, A, Dickerson, Tt, Dika, Z, Djalalinia, S, Htp, Do, Dobson, Aj, Donfrancesco, C, Donoso, Sp, Doring, A, Dorobantu, M, Dorr, M, Doua, K, Dragano, N, Drygas, W, Duante, Ca, Duboz, P, Duda, Rb, Dulskiene, V, Dushpanova, A, Dzakula, A, Dzerve, V, Dziankowska-Zaborszczyk, E, Eddie, R, Eftekhar, E, Eggertsen, R, Eghtesad, S, Eiben, G, Ekelund, U, El-Khateeb, M, El Ati, J, Eldemire-Shearer, D, Eliasen, M, Elosua, R, Erasmus, Rt, Erbel, R, Erem, C, Eriksen, L, Eriksson, Jg, Escobedo-de la Pena, J, Eslami, S, Esmaeili, A, Evans, A, Faeh, D, Fakhretdinova, Aa, Fall, Ch, Faramarzi, E, Farjam, M, Fattahi, Mr, Fawwad, A, Felix-Redondo, Fj, Felix, Sb, Ferguson, Ts, Fernandes, Ra, Fernandez-Berges, D, Ferrante, D, Ferrao, T, Ferrari, M, Ferrario, Mm, Ferreccio, C, Ferreira, Hs, Ferrer, E, Ferrieres, J, Figueiro, Th, Fink, G, Fischer, K, Foo, Lh, Forsner, M, Fouad, Hm, Francis, Dk, Grego, Franco, Frikke-Schmidt, R, Frontera, G, Fuchs, Fd, Fuchs, Sc, Fujita, Y, Fumihiko, M, Furdela, V, Furer, A, Furusawa, T, Gaciong, Z, Galbarczyk, A, Galenkamp, H, Galvano, F, Gao, Jl, Gao, P, Garcia-de-la-Hera, M, Garcia, P, Gareta, D, Garnett, Sp, Gaspoz, Jm, Gasull, M, Gazzinelli, A, Gehring, U, Geleijnse, Jm, George, R, Ghanbari, A, Ghasemi, E, Gheorghe-Fronea, Of, Ghimire, A, Gialluisi, A, Giampaoli, S, Gieger, C, Gill, Tk, Giovannelli, J, Gironella, G, Giwercman, A, Gkiouras, K, Goldberg, M, Goldsmith, Ra, Gomez, Lf, Gomula, A, da Silva, Bgc, Goncalves, H, Goncalves, M, Gonzalez-Chica, Da, Gonzalez-Gross, M, Gonzalez-Rivas, Jp, Gonzalez-Villalpando, C, Gonzalez-Villalpando, Me, Gonzalez, Ar, Gorbea, Mb, Gottrand, F, Graff-Iversen, S, Grafnetter, D, Grajda, A, Grammatikopoulou, Mg, Gregor, Rd, Grodzicki, T, Grosso, G, Gruden, G, Df, Gu, Guan, Op, Gudmundsson, Ef, Gudnason, V, Guerrero, R, Guessous, I, Guimaraes, Al, Gulliford, Mc, Gunnlaugsdottir, J, Gunter, Mj, Gupta, Pc, Gupta, R, Gureje, O, Gurzkowska, B, Gutierrez, L, Gutzwiller, F, Ha, S, Hadaegh, F, Haghshenas, R, Hakimi, H, Halkjaer, J, Hambleton, Ir, Hamzeh, B, Hange, D, Hanif, Aam, Hantunen, S, Hao, J, Hardman, Cm, Kumar, Rh, Hashemi-Shahri, Sm, Hata, J, Haugsgjerd, T, Hayes, Aj, Yn, He, Heier, M, Hendriks, Me, Henrique, Rd, Henriques, A, Cadena, Lh, Herrala, S, Heshmat, R, Hill, Ag, Sy, Ho, Sc, Ho, Hobbs, M, Holdsworth, M, Homayounfar, R, Dinc, Gh, Horimoto, Arvr, Hormiga, Cm, Horta, Bl, Houti, L, Howitt, C, Htay, Tt, Htet, As, Htike, Mmt, Yh, Hu, Huerta, Jm, Huhtaniemi, It, Huiart, L, Huisman, M, Husseini, As, Huybrechts, I, Hwalla, N, Iacoviello, L, Iannone, Ag, Ibrahim, Mm, Wong, Ni, Ikram, Ma, Iotova, V, Irazola, Ve, Ishida, T, Isiguzo, Gc, Islam, M, Islam, Sms, Iwasaki, M, Jackson, Rt, Jacobs, Jm, Jaddou, Hy, Jafar, T, James, K, Jamrozik, K, Janszky, I, Janus, E, Jarvelin, Mr, Jasienska, G, Jelakovic, A, Jelakovic, B, Jennings, G, Jha, Ak, Jiang, Cq, Jimenez, Ro, Jockel, Kh, Joffres, M, Johansson, M, Jokelainen, Jj, Jonas, Jb, Jorgensen, T, Joshi, P, Joukar, F, Jozwiak, J, Juolevi, A, Jurak, G, Juresa, V, Kaaks, R, Kafatos, A, Kajantie, Eo, Kalmatayeva, Z, Kalpourtzi, N, Kalter-Leibovici, O, Kampmann, Fb, Kannan, S, Karaglani, E, Karhus, Ll, Karki, Kb, Katibeh, M, Katz, J, Kauhanen, J, Kaur, P, Kavousi, M, Kazakbaeva, Gm, Keil, U, Boker, Lk, Keinanen-Kiukaanniemi, S, Kelishadi, R, Kemper, Hcg, Keramati, M, Kerimkulova, A, Kersting, M, Key, T, Khader, Ys, Khalili, D, Khaw, Kt, Kheiri, B, Kheradmand, M, Khosravi, A, Kiechl-Kohlendorfer, U, Kiechl, S, Killewo, J, Kim, Dw, Kim, J, Klakk, H, Klimek, M, Klumbiene, J, Knoflach, M, Kolle, E, Kolsteren, P, Kontto, Jp, Korpelainen, R, Korrovits, P, Kos, J, Koskinen, S, Kouda, K, Kowlessur, S, Koziel, S, Kratenova, J, Kriaucioniene, V, Kristensen, Pl, Krokstad, S, Kromhout, D, Kruger, Hs, Kubinova, R, Kuciene, R, Kujala, Um, Kulaga, Z, Kumar, Rk, Kurjata, P, Kusuma, Ys, Kutsenko, V, Kuulasmaa, K, Kyobutungi, C, Laatikainen, T, Lachat, C, Laid, Y, Lam, Th, Landrove, O, Lanska, V, Lappas, G, Larijani, B, Latt, Ts, Le Coroller, G, Bao, Kln, Le, THUY DUNG, Lee, J, Lehmann, N, Lehtimaki, T, Lemogoum, D, Levitt, Ns, Yp, Li, Lilly, Cl, Lim, Wy, Lima-Costa, Mf, Lin, X, Lin, Yt, Lind, L, Lingam, V, Linneberg, A, Lissner, L, Litwin, M, Wc, Lo, Loit, Hm, Lopez-Garcia, E, Lopez, T, Lotufo, Pa, Lozano, Je, Lovrencic, Il, Lukrafka, Jl, Luksiene, D, Lundqvist, A, Lundqvist, R, Lunet, N, Lustigova, M, Luszczki, E, Gs, Ma, Ma, J, Machado-Coelho, Gll, Machado-Rodrigues, Am, Macia, E, Macieira, Lm, Madar, Aa, Maggi, S, Magliano, Dj, Magriplis, E, Mahasampath, G, Maire, B, Majer, M, Makdisse, M, Malekzadeh, F, Malekzadeh, R, Malhotra, R, Mallikharjuna, K, Malyutina, Sk, Maniego, Lv, Manios, Y, Mann, Ji, Mansour-Ghanaei, F, Manzato, E, Marcil, A, Margozzini, P, Marild, Sb, Glavic, Mm, Marques-Vidal, P, Marques, Lp, Marrugat, J, Martorell, R, Mascarenhas, Lp, Matasin, M, Mathiesen, Eb, Mathur, P, Matijasevich, A, 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Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Clinicum, Research Programs Unit, Johan Eriksson / Principal Investigator, Department of General Practice and Primary Health Care, University of Helsinki, HUS Helsinki and Uusimaa Hospital District, Department of Public Health, Tampere University, Clinical Medicine, Department of Clinical Chemistry, Eye Centre, Wellcome Trust, Epidemiology, Radiology & Nuclear Medicine, Éco-Anthropologie (EA), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH - Personalized Medicine, Psychiatry, APH - Mental Health, Bin Zhou, Rodrigo M Carrillo-Larco, Goodarz Danaei, Leanne M Riley, Christopher J Paciorek, Gretchen A Stevens, Edward W Gregg, James E Bennett, Bethlehem Solomon, Rosie K Singleton, Marisa K Sophiea, Maria Lc Iurilli, Victor Pf Lhoste, Melanie J Cowan, Stefan Savin, Mark Woodward, Yulia Balanova, Renata Cifkova, Albertino Damasceno, Paul Elliott, Farshad Farzadfar, Jiang He, Nayu Ikeda, Andre P Kengne, Young-Ho Khang, Hyeon Chang Kim, Avula Laxmaiah, Hsien-Ho Lin, Paula Margozzini Maira, J Jaime Miranda, Hannelore Neuhauser, Johan Sundström, Cherian Varghese, Indah S Widyahening, Tomasz Zdrojewski, Leandra Abarca-Gómez, Ziad A Abdeen, Hanan F Abdul Rahim, Niveen M Abu-Rmeileh, Benjamin Acosta-Cazares, Robert J Adams, Wichai Aekplakorn, Kaosar Afsana, Shoaib Afzal, Imelda A Agdeppa, Javad Aghazadeh-Attari, Carlos A Aguilar-Salinas, Charles Agyemang, Noor Ani Ahmad, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadi, Fariba Ahmadizar, Soheir H Ahmed, Wolfgang Ahrens, Kamel Ajlouni, Rajaa Al-Raddadi, Monira Alarouj, Fadia AlBuhairan, Shahla AlDhukair, Mohamed M Ali, Abdullah Alkandari, Ala'a Alkerwi, Kristine Allin, Eman Aly, Deepak N Amarapurkar, Norbert Amougou, Philippe Amouyel, Lars Bo Andersen, Sigmund A Anderssen, Ranjit Mohan Anjana, Alireza Ansari-Moghaddam, Daniel Ansong, Hajer Aounallah-Skhiri, Joana Araújo, Inger Ariansen, Tahir Aris, Raphael E Arku, Nimmathota Arlappa, Krishna K Aryal, Thor Aspelund, Felix K Assah, Maria Cecília F Assunção, Juha Auvinen, Mária Avdićová, Ana Azevedo, Mohsen Azimi-Nezhad, Fereidoun Azizi, Mehrdad Azmin, Bontha V Babu, Suhad Bahijri, Nagalla Balakrishna, Mohamed Bamoshmoosh, Maciej Banach, Maja Banadinović, Piotr Bandosz, José R Banegas, Joanna Baran, Barbagallo Carlo Maria, Alberto Barceló, Amina Barkat, Marta Barreto, Aluisio Jd Barros, Mauro Virgílio Gomes Barros, Anna Bartosiewicz, Abdul Basit, Joao Luiz D Bastos, Iqbal Bata, Anwar M Batieha, Assembekov Batyrbek, Louise A Baur, Robert Beaglehole, Antonisamy Belavendra, Habiba Ben Romdhane, Mikhail Benet, Lowell S Benson, Salim Berkinbayev, Antonio Bernabe-Ortiz, Gailute Bernotiene, Heloísa Bettiol, Jorge Bezerra, Aroor Bhagyalaxmi, Santosh K Bhargava, Daniel Bia, Katia Biasch, Elysée Claude Bika Lele, Mukharram M Bikbov, Bihungum Bista, Peter Bjerregaard, Espen Bjertness, Marius B Bjertness, Cecilia Björkelund, Katia V Bloch, Anneke Blokstra, Simona Bo, Martin Bobak, Heiner Boeing, Jose G Boggia, Carlos P Boissonnet, Stig E Bojesen, Vanina Bongard, Alice Bonilla-Vargas, Matthias Bopp, Herman Borghs, Pascal Bovet, Christopher B Boyer, Lutgart Braeckman, Imperia Brajkovich, Francesco Branca, Juergen Breckenkamp, Hermann Brenner, Lizzy M Brewster, Yajaira Briceño, Miguel Brito, Graziella Bruno, H Bas Bueno-de-Mesquita, Gloria Bueno, Anna Bugge, Con Burns, Michael Bursztyn, Antonio Cabrera de León, Joseph Cacciottolo, Christine Cameron, Günay Can, Ana Paula C Cândido, Mario V Capanzana, Naděžda Čapková, Eduardo Capuano, Vincenzo Capuano, Viviane C Cardoso, Axel C Carlsson, Joana Carvalho, Felipe F Casanueva, Laura Censi, Marvin Cervantes-Loaiza, Charalambos A Chadjigeorgiou, Snehalatha Chamukuttan, Angelique W Chan, Queenie Chan, Himanshu K Chaturvedi, Nish Chaturvedi, Miao Li Chee, Chien-Jen Chen, Fangfang Chen, Huashuai Chen, Shuohua Chen, Zhengming Chen, Ching-Yu Cheng, Bahman Cheraghian, Imane Cherkaoui Dekkaki, Angela Chetrit, Kuo-Liong Chien, Arnaud Chiolero, Shu-Ti Chiou, Adela Chirita-Emandi, María-Dolores Chirlaque, Belong Cho, Kaare Christensen, Diego G Christofaro, Jerzy Chudek, Eliza Cinteza, Frank Claessens, Janine Clarke, Els Clays, Emmanuel Cohen, Hans Concin, Cyrus Cooper, Tara C Coppinger, Simona Costanzo, Dominique Cottel, Chris Cowell, Cora L Craig, Amelia C Crampin, Ana B Crujeiras, Juan J Cruz, Semánová Csilla, Liufu Cui, Felipe V Cureau, Sarah Cuschieri, Graziella D'Arrigo, Eleonora d'Orsi, Jean Dallongeville, Rachel Dankner, Thomas M Dantoft, Luc Dauchet, Kairat Davletov, Guy De Backer, Dirk De Bacquer, Amalia De Curtis, Giovanni de Gaetano, Stefaan De Henauw, Paula Duarte de Oliveira, David De Ridder, Delphine De Smedt, Mohan Deepa, Alexander D Deev, Vincent Jr DeGennaro, Hélène Delisle, Stefaan Demarest, Elaine Dennison, Valérie Deschamps, Meghnath Dhimal, Augusto F Di Castelnuovo, Juvenal Soares Dias-da-Costa, Alejandro Diaz, Ty T Dickerson, Zivka Dika, Shirin Djalalinia, Ha Tp Do, Annette J Dobson, Chiara Donfrancesco, Silvana P Donoso, Angela Döring, Maria Dorobantu, Marcus Dörr, Kouamelan Doua, Nico Dragano, Wojciech Drygas, Charmaine A Duante, Priscilla Duboz, Rosemary B Duda, Virginija Dulskiene, Anar Dushpanova, Aleksandar Džakula, Vilnis Dzerve, Elzbieta Dziankowska-Zaborszczyk, Ricky Eddie, Ebrahim Eftekhar, Robert Eggertsen, Sareh Eghtesad, Gabriele Eiben, Ulf Ekelund, Mohammad El-Khateeb, Jalila El Ati, Denise Eldemire-Shearer, Marie Eliasen, Roberto Elosua, Rajiv T Erasmus, Raimund Erbel, Cihangir Erem, Louise Eriksen, Johan G Eriksson, Jorge Escobedo-de la Peña, Saeid Eslami, Ali Esmaeili, Alun Evans, David Faeh, Albina A Fakhretdinova, Caroline H Fall, Elnaz Faramarzi, Mojtaba Farjam, Mohammad Reza Fattahi, Asher Fawwad, Francisco J Felix-Redondo, Stephan B Felix, Trevor S Ferguson, Romulo A Fernandes, Daniel Fernández-Bergés, Daniel Ferrante, Thomas Ferrao, Marika Ferrari, Marco M Ferrario, Catterina Ferreccio, Haroldo S Ferreira, Eldridge Ferrer, Jean Ferrieres, Thamara Hubler Figueiró, Günther Fink, Krista Fischer, Leng Huat Foo, Maria Forsner, Heba M Fouad, Damian K Francis, Maria do Carmo Franco, Ruth Frikke-Schmidt, Guillermo Frontera, Flavio D Fuchs, Sandra C Fuchs, Yuki Fujita, Matsuda Fumihiko, Viktoriya Furdela, Ariel Furer, Takuro Furusawa, Zbigniew Gaciong, Andrzej Galbarczyk, Henrike Galenkamp, Fabio Galvano, Jingli Gao, Pei Gao, Manoli Garcia-de-la-Hera, Pablo Garcia, Dickman Gareta, Sarah P Garnett, Jean-Michel Gaspoz, Magda Gasull, Andrea Gazzinelli, Ulrike Gehring, Johanna M Geleijnse, Ronnie George, Ali Ghanbari, Erfan Ghasemi, Oana-Florentina Gheorghe-Fronea, Anup Ghimire, Alessandro Gialluisi, Simona Giampaoli, Christian Gieger, Tiffany K Gill, Jonathan Giovannelli, Glen Gironella, Aleksander Giwercman, Konstantinos Gkiouras, Marcel Goldberg, Rebecca A Goldsmith, Luis F Gomez, Aleksandra Gomula, Helen Gonçalves, Mauer Gonçalves, Bruna Gonçalves Cordeiro da Silva, David A Gonzalez-Chica, Marcela Gonzalez-Gross, Juan P González-Rivas, Clicerio González-Villalpando, María-Elena González-Villalpando, Angel R Gonzalez, Mariano Bonet Gorbea, Frederic Gottrand, Sidsel Graff-Iversen, Dušan Grafnetter, Aneta Grajda, Maria G Grammatikopoulou, Ronald D Gregor, Tomasz Grodzicki, Giuseppe Grosso, Gabriella Gruden, Dongfeng Gu, Ong Peng Guan, Elias F Gudmundsson, Vilmundur Gudnason, Ramiro Guerrero, Idris Guessous, Andre L Guimaraes, Martin C Gulliford, Johanna Gunnlaugsdottir, Marc J Gunter, Prakash C Gupta, Rajeev Gupta, Oye Gureje, Beata Gurzkowska, Laura Gutierrez, Felix Gutzwiller, Seongjun Ha, Farzad Hadaegh, Rosa Haghshenas, Hamid Hakimi, Jytte Halkjær, Ian R Hambleton, Behrooz Hamzeh, Dominique Hange, Abu Am Hanif, Sari Hantunen, Jie Hao, Carla Menêses Hardman, Rachakulla Hari Kumar, Seyed Mohammad Hashemi-Shahri, Jun Hata, Teresa Haugsgjerd, Alison J Hayes, Yuna He, Margit Heier, Marleen Elisabeth Hendriks, Rafael Dos Santos Henrique, Ana Henriques, Leticia Hernandez Cadena, Herqutanto, Sauli Herrala, Ramin Heshmat, Allan G Hill, Sai Yin Ho, Suzanne C Ho, Michael Hobbs, Michelle Holdsworth, Reza Homayounfar, Gonul Horasan Dinc, Andrea Rvr Horimoto, Claudia M Hormiga, Bernardo L Horta, Leila Houti, Christina Howitt, Thein Thein Htay, Aung Soe Htet, Maung Maung Than Htike, Yonghua Hu, José María Huerta, Ilpo Tapani Huhtaniemi, Laetitia Huiart, Martijn Huisman, Abdullatif S Husseini, Inge Huybrechts, Nahla Hwalla, Licia Iacoviello, Anna G Iannone, Mohsen M Ibrahim, Norazizah Ibrahim Wong, M Arfan Ikram, Violeta Iotova, Vilma E Irazola, Takafumi Ishida, Godsent C Isiguzo, Muhammad Islam, Sheikh Mohammed Shariful Islam, Masanori Iwasaki, Rod T Jackson, Jeremy M Jacobs, Hashem Y Jaddou, Tazeen Jafar, Kenneth James, Konrad Jamrozik, Imre Janszky, Edward Janus, Marjo-Riitta Jarvelin, Grazyna Jasienska, Ana Jelaković, Bojan Jelaković, Garry Jennings, Anjani Kumar Jha, Chao Qiang Jiang, Ramon O Jimenez, Karl-Heinz Jöckel, Michel Joffres, Mattias Johansson, Jari J Jokelainen, Jost B Jonas, Torben Jørgensen, Pradeep Joshi, Farahnaz Joukar, Jacek Jóżwiak, Anne Juolevi, Gregor Jurak, Vesna Jureša, Rudolf Kaaks, Anthony Kafatos, Eero O Kajantie, Zhanna Kalmatayeva, Natasa Kalpourtzi, Ofra Kalter-Leibovici, Freja B Kampmann, Srinivasan Kannan, Eva Karaglani, Line L Kårhus, Khem B Karki, Marzieh Katibeh, Joanne Katz, Jussi Kauhanen, Prabhdeep Kaur, Maryam Kavousi, Gyulli M Kazakbaeva, Ulrich Keil, Lital Keinan Boker, Sirkka Keinänen-Kiukaanniemi, Roya Kelishadi, Han Cg Kemper, Maryam Keramati, Alina Kerimkulova, Mathilde Kersting, Timothy Key, Yousef Saleh Khader, Davood Khalili, Kay-Tee Khaw, Bahareh Kheiri, Motahareh Kheradmand, Alireza Khosravi, Ursula Kiechl-Kohlendorfer, Stefan Kiechl, Japhet Killewo, Dong Wook Kim, Jeongseon Kim, Heidi Klakk, Magdalena Klimek, Jurate Klumbiene, Michael Knoflach, Elin Kolle, Patrick Kolsteren, Jukka P Kontto, Raija Korpelainen, Paul Korrovits, Jelena Kos, Seppo Koskinen, Katsuyasu Kouda, Sudhir Kowlessur, Slawomir Koziel, Jana Kratenova, Vilma Kriaucioniene, Peter Lund Kristensen, Steiner Krokstad, Daan Kromhout, Herculina S Kruger, Ruzena Kubinova, Renata Kuciene, Urho M Kujala, Zbigniew Kulaga, R Krishna Kumar, Pawel Kurjata, Yadlapalli S Kusuma, Vladimir Kutsenko, Kari Kuulasmaa, Catherine Kyobutungi, Tiina Laatikainen, Carl Lachat, Youcef Laid, Tai Hing Lam, Orlando Landrove, Vera Lanska, Georg Lappas, Bagher Larijani, Tint Swe Latt, Gwenaëlle Le Coroller, Khanh Le Nguyen Bao, Tuyen D Le, Jeannette Lee, Jeonghee Lee, Nils Lehmann, Terho Lehtimäki, Daniel Lemogoum, Naomi S Levitt, Yanping Li, Christa L Lilly, Wei-Yen Lim, M Fernanda Lima-Costa, Xu Lin, Yi-Ting Lin, Lars Lind, Vijaya Lingam, Allan Linneberg, Lauren Lissner, Mieczyslaw Litwin, Wei-Cheng Lo, Helle-Mai Loit, Esther Lopez-Garcia, Tania Lopez, Paulo A Lotufo, José Eugenio Lozano, Iva Lukačević Lovrenčić, Janice L Lukrafka, Dalia Luksiene, Annamari Lundqvist, Robert Lundqvist, Nuno Lunet, Michala Lustigová, Edyta Luszczki, Guansheng Ma, Jun Ma, George Ll Machado-Coelho, Aristides M Machado-Rodrigues, Enguerran Macia, Luisa M Macieira, Ahmed A Madar, Stefania Maggi, Dianna J Magliano, Emmanuella Magriplis, Gowri Mahasampath, Bernard Maire, Marjeta Majer, Marcia Makdisse, Fatemeh Malekzadeh, Reza Malekzadeh, Rahul Malhotra, Kodavanti Mallikharjuna Rao, Sofia K Malyutina, Lynell V Maniego, Yannis Manios, Jim I Mann, Fariborz Mansour-Ghanaei, Enzo Manzato, Anie Marcil, Staffan B Mårild, Mihalea Marinović Glavić, Pedro Marques-Vidal, Larissa Pruner Marques, Jaume Marrugat, Reynaldo Martorell, Luis P Mascarenhas, Marija Matasin, Ellisiv B Mathiesen, Prashant Mathur, Alicia Matijasevich, Piotr Matlosz, Tandi E Matsha, Christina Mavrogianni, Jean Claude N Mbanya, Anselmo J Mc Donald Posso, Shelly R McFarlane, Stephen T McGarvey, Stela McLachlan, Rachael M McLean, Scott B McLean, Breige A McNulty, Sounnia Mediene Benchekor, Jurate Medzioniene, Parinaz Mehdipour, Kirsten Mehlig, Amir Houshang Mehrparvar, Aline Meirhaeghe, Christa Meisinger, Carlos Mendoza Montano, Ana Maria B Menezes, Geetha R Menon, Alibek Mereke, Indrapal I Meshram, Andres Metspalu, Haakon E Meyer, Jie Mi, Nathalie Michels, Kairit Mikkel, Karolina Milkowska, Jody C Miller, Cláudia S Minderico, G K Mini, Mohammad Reza Mirjalili, Erkin Mirrakhimov, Marjeta Mišigoj-Duraković, Pietro A Modesti, Sahar Saeedi Moghaddam, Bahram Mohajer, Mostafa K Mohamed, Shukri F Mohamed, Kazem Mohammad, Mohammad Reza Mohammadi, Zahra Mohammadi, Noushin Mohammadifard, Reza Mohammadpourhodki, Viswanathan Mohan, Salim Mohanna, Muhammad Fadhli Mohd Yusoff, Iraj Mohebbi, Farnam Mohebi, Marie Moitry, Line T Møllehave, Dénes Molnár, Amirabbas Momenan, Charles K Mondo, Eric Monterrubio-Flores, Kotsedi Daniel K Monyeki, Jin Soo Moon, Mahmood Moosazadeh, Leila B Moreira, Alain Morejon, Luis A Moreno, Karen Morgan, George Moschonis, Malgorzata Mossakowska, Aya Mostafa, Seyed-Ali Mostafavi, Jorge Mota, Mohammad Esmaeel Motlagh, Jorge Motta, Marcos André Moura-Dos-Santos, Malay K Mridha, Kelias P Msyamboza, Thet Thet Mu, Alfa J Muhihi, Maria L Muiesan, Martina Müller-Nurasyid, Neil Murphy, Jaakko Mursu, Kamarul Imran Musa, Sanja Musić Milanović, Vera Musil, Norlaila Mustafa, Iraj Nabipour, Shohreh Naderimagham, Gabriele Nagel, Balkish M Naidu, Farid Najafi, Harunobu Nakamura, Jana Námešná, Ei Ei K Nang, Vinay B Nangia, Sameer Narake, Ndeye Coumba Ndiaye, William A Neal, Azim Nejatizadeh, Ilona Nenko, Martin Neovius, Chung T Nguyen, Nguyen D Nguyen, Quang V Nguyen, Quang Ngoc Nguyen, Ramfis E Nieto-Martínez, Teemu J Niiranen, Yury P Nikitin, Toshiharu Ninomiya, Sania Nishtar, Marina A Njelekela, Marianna Noale, Oscar A Noboa, Ahmad Ali Noorbala, Teresa Norat, Maria Nordendahl, Børge G Nordestgaard, Noto Davide, Natalia Nowak-Szczepanska, Mohannad Al Nsour, Baltazar Nunes, Terence W O'Neill, Dermot O'Reilly, Caleb Ochimana, Eiji Oda, Augustine N Odili, Kyungwon Oh, Kumiko Ohara, Ryutaro Ohtsuka, Valérie Olié, Maria Teresa A Olinto, Isabel O Oliveira, Mohd Azahadi Omar, Altan Onat, Sok King Ong, Lariane M Ono, Pedro Ordunez, Rui Ornelas, Pedro J Ortiz, Clive Osmond, Sergej M Ostojic, Afshin Ostovar, Johanna A Otero, Kim Overvad, Ellis Owusu-Dabo, Fred Michel Paccaud, Cristina Padez, Elena Pahomova, Karina Mary de Paiva, Andrzej Pająk, Domenico Palli, Luigi Palmieri, Wen-Harn Pan, Songhomitra Panda-Jonas, Francesco Panza, Mariela Paoli, Dimitrios Papandreou, Soon-Woo Park, Suyeon Park, Winsome R Parnell, Mahboubeh Parsaeian, Patrick Pasquet, Nikhil D Patel, Halyna Pavlyshyn, Ivan Pećin, Mangesh S Pednekar, João M Pedro, Nasheeta Peer, Sergio Viana Peixoto, Markku Peltonen, Alexandre C Pereira, Karen Gda Peres, Marco A Peres, Annette Peters, Janina Petkeviciene, Niloofar Peykari, Son Thai Pham, Rafael N Pichardo, Iris Pigeot, Hynek Pikhart, Aida Pilav, Lorenza Pilotto, Freda Pitakaka, Aleksandra Piwonska, Andreia N Pizarro, Pedro Plans-Rubió, Ozren Polašek, Miquel Porta, Anil Poudyal, Farhad Pourfarzi, Akram Pourshams, Hossein Poustchi, Rajendra Pradeepa, Alison J Price, Jacqueline F Price, Rui Providencia, Soile E Puhakka, Maria Puiu, Margus Punab, Radwan F Qasrawi, Mostafa Qorbani, Daniel Queiroz, Tran Quoc Bao, Ivana Radić, Ricardas Radisauskas, Salar Rahimikazerooni, Mahfuzar Rahman, Olli Raitakari, Manu Raj, Ellina M Rakhimova, Sudha Ramachandra Rao, Ambady Ramachandran, Elisabete Ramos, Lekhraj Rampal, Sanjay Rampal, Daniel A Rangel Reina, Vayia Rarra, Cassiano Ricardo Rech, Josep Redon, Paul Ferdinand M Reganit, Valéria Regecová, Luis Revilla, Abbas Rezaianzadeh, Robespierre Ribeiro, Elio Riboli, Adrian Richter, Fernando Rigo, Tobias F Rinke de Wit, Raphael M Ritti-Dias, Cynthia Robitaille, Fernando Rodríguez-Artalejo, María Del Cristo Rodriguez-Perez, Laura A Rodríguez-Villamizar, Ulla Roggenbuck, Rosalba Rojas-Martinez, Dora Romaguera, Elisabetta L Romeo, Annika Rosengren, Joel Gr Roy, Adolfo Rubinstein, Jean-Bernard Ruidavets, Blanca Sandra Ruiz-Betancourt, Maria Ruiz-Castell, Iuliia A Rusakova, Paola Russo, Marcin Rutkowski, Charumathi Sabanayagam, Hamideh Sabbaghi, Harshpal S Sachdev, Alireza Sadjadi, Ali Reza Safarpour, Sare Safi, Saeid Safiri, Olfa Saidi, Sibel Sakarya, Nader Saki, Benoit Salanave, Eduardo Salazar Martinez, Diego Salmerón, Veikko Salomaa, Jukka T Salonen, Massimo Salvetti, Jose Sánchez-Abanto, Susana Sans, Diana A Santos, Ina S Santos, Lèlita C Santos, Maria Paula Santos, Rute Santos, Jouko L Saramies, Luis B Sardinha, Giselle Sarganas, Nizal Sarrafzadegan, Thirunavukkarasu Sathish, Kai-Uwe Saum, Savvas Savva, Norie Sawada, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Herman Schargrodsky, Sabine Schipf, Carsten O Schmidt, Peter Schnohr, Ben Schöttker, Sara Schramm, Constance Schultsz, Aletta E Schutte, Sylvain Sebert, Aye Aye Sein, Abhijit Sen, Idowu O Senbanjo, Sadaf G Sepanlou, Jennifer Servais, Svetlana A Shalnova, Teresa Shamah-Levy, Morteza Shamshirgaran, Coimbatore Subramaniam Shanthirani, Maryam Sharafkhah, Sanjib K Sharma, Jonathan E Shaw, Amaneh Shayanrad, Ali Akbar Shayesteh, Zumin Shi, Kenji Shibuya, Hana Shimizu-Furusawa, Dong Wook Shin, Majid Shirani, Rahman Shiri, Namuna Shrestha, Khairil Si-Ramlee, Alfonso Siani, Rosalynn Siantar, Abla M Sibai, Caroline Ramos de Moura Silva, Diego Augusto Santos Silva, Mary Simon, Judith Simons, Leon A Simons, Michael Sjöström, Jolanta Slowikowska-Hilczer, Przemyslaw Slusarczyk, Liam Smeeth, Hung-Kwan So, Fernanda Cunha Soares, Eugène Sobngwi, Stefan Söderberg, Agustinus Soemantri, Reecha Sofat, Vincenzo Solfrizzi, Mohammad Hossein Somi, Emily Sonestedt, Yi Song, Thorkild Ia Sørensen, Elin P Sørgjerd, Maroje Sorić, Charles Sossa Jérome, Aïcha Soumaré, Bente Sparboe-Nilsen, Karen Sparrenberger, Jan A Staessen, Gregor Starc, Bill Stavreski, Jostein Steene-Johannessen, Peter Stehle, Aryeh D Stein, George S Stergiou, Jochanan Stessman, Jutta Stieber, Doris Stöckl, Tanja Stocks, Jakub Stokwiszewski, Karien Stronks, Maria Wany Strufaldi, Machi Suka, Chien-An Sun, Yn-Tz Sung, Paibul Suriyawongpaisal, Rody G Sy, Holly E Syddall, René Charles Sylva, Moyses Szklo, E Shyong Tai, Mari-Liis Tammesoo, Abdonas Tamosiunas, Eng Joo Tan, Xun Tang, Frank Tanser, Yong Tao, Mohammed Rasoul Tarawneh, Carolina B Tarqui-Mamani, Anne Taylor, Julie Taylor, William R Tebar, Grethe S Tell, Tania Tello, Yih Chung Tham, K R Thankappan, Holger Theobald, Xenophon Theodoridis, Lutgarde Thijs, 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Yoshihara, San-Lin You, Novie O Younger-Coleman, Ahmad Faudzi Yusoff, Ahmad A Zainuddin, Seyed Rasoul Zakavi, Farhad Zamani, Sabina Zambon, Antonis Zampelas, Maria Elisa Zapata, Ko Ko Zaw, Kristyna Zejglicova, Tajana Zeljkovic Vrkic, Yi Zeng, Luxia Zhang, Zhen-Yu Zhang, Dong Zhao, Ming-Hui Zhao, Shiqi Zhen, Yingfeng Zheng, Bekbolat Zholdin, Dan Zhu, Marie Zins, Emanuel Zitt, Yanina Zocalo, Nada Zoghlami, Julio Zuñiga Cisneros, Majid Ezzati, Sakarya, Sibel (ORCID 0000-0002-9959-6240 & YÖK ID 172028), Zhou, Bin, Carrillo-Larco, Rodrigo M., Danaei, Goodarz, Riley, Leanne M., Paciorek, Christopher J., Stevens, Gretchen A., Gregg, Edward W., Bennett, James E., Solomon, Bethlehem, Singleton, Rosie K., Sophiea, Marisa K., Iurilli, Maria L. 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D. A., Peres, Marco A., Peters, Annette, Petkeviciene, Janina, Peykari, Niloofar, Son Thai Pham, Pichardo, Rafael N., Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia N., Plans-Rubio, Pedro, Polasek, Ozren, Porta, Miquel, Poudyal, Anil, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J., Price, Jacqueline F., Providencia, Rui, Puhakka, Soile E., Puiu, Maria, Punab, Margus, Qasrawi, Radwan F., Qorbani, Mostafa, Queiroz, Daniel, Tran Quoc Bao, Radic, Ivana, Radisauskas, Ricardas, Rahimikazerooni, Salar, Rahman, Mahfuzar, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina M., Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramos, Elisabete, Rampal, Lekhraj, Rampal, Sanjay, Rangel Reina, Daniel A., Rarra, Vayia, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M., Regecova, Valeria, Revilla, Luis, Rezaianzadeh, Abbas, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, de Wit, Tobias F. Rinke, Ritti-Dias, Raphael M., Robitaille, Cynthia, Rodriguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, Maria, Rodriguez-Villamizar, Laura A., Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Romaguera, Dora, Romeo, Elisabetta L., Rosengren, Annika, Roy, Joel G. R., Rubinstein, Adolfo, Ruidavets, Jean-Bernard, Sandra Ruiz-Betancourt, Blanca, Ruiz-Castell, Maria, Rusakova, Iuliia A., Russo, Paola, Rutkowski, Marcin, Sabanayagam, Charumathi, Sabbaghi, Hamideh, Sachdev, Harshpal S., Sadjadi, Alireza, Safarpour, Ali Reza, Safi, Sare, Safiri, Saeid, Saidi, Olfa, Saki, Nader, Salanave, Benoit, Salazar Martinez, Eduardo, Salmeron, Diego, Salomaa, Veikko, Salonen, Jukka T., Salvetti, Massimo, Sanchez-Abanto, Jose, Sans, Susana, Santos, Diana A., Santos, Ina S., Santos, Lelita C., Santos, Maria Paula, Santos, Rute, Saramies, Jouko L., Sardinha, Luis B., Sarganas, Giselle, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savvas, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D., Schargrodsky, Herman, Schipf, Sabine, Schmidt, Carsten O., Schnohr, Peter, Schoettker, Ben, Schramm, Sara, Schultsz, Constance, Schutte, Aletta E., Sebert, Sylvain, Sein, Aye Aye, Sen, Abhijit, Senbanjo, Idowu O., Sepanlou, Sadaf G., Servais, Jennifer, Shalnova, Svetlana A., Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K., Shaw, Jonathan E., Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M., de Moura Silva, Caroline Ramos, Santos Silva, Diego Augusto, Simon, Mary, Simons, Judith, Simons, Leon A., Sjostrom, Michael, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobngwi, Eugene, Soderberg, Stefan, Soemantri, Agustinus, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sorensen, Thorkild I. A., Sorgjerd, Elin P., Soric, Maroje, Jerome, Charles Sossa, Soumare, Aicha, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Staessen, Jan A., Starc, Gregor, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D., Stergiou, George S., Stessman, Jochanan, Stieber, Jutta, Stoeckl, Doris, Stocks, Tanja, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Suka, Machi, Sun, Chien-An, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G., Syddall, Holly E., Sylva, Rene Charles, Szklo, Moyses, Tai, E. Shyong, Tammesoo, Mari-Liis, Tamosiunas, Abdonas, Tan, Eng Joo, Tang, Xun, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B., Taylor, Anne, Taylor, Julie, Tebar, William R., Tell, Grethe S., Tello, Tania, Tham, Yih Chung, Thankappan, K. R., Theobald, Holger, Theodoridis, Xenophon, Thinggaard, Mikael, Thomas, Nihal, Thorand, Barbara, Thuesen, Betina H., Timmermans, Erik J., Tjandrarini, Dwi H., Tjonneland, Anne, Toft, Ulla, Tolonen, Hanna K., Tolstrup, Janne S., Topbas, Murat, Topor-Madry, Roman, Jose Tormo, Maria, Tornaritis, Michael J., Torrent, Maties, Torres-Collado, Laura, Touloumi, Giota, Traissac, Pierre, Triantafyllou, Areti, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Trinh, Oanh T. H., Trivedi, Atul, Tshepo, Lechaba, Tsugane, Shoichiro, Tuliakova, Azaliia M., Tulloch-Reid, Marshall K., Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L., Twig, Gilad, Tynelius, Per, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ulmer, Hanno, Uusitalo, Hannu M. T., Valdivia, Gonzalo, Valvi, Damaskini, van Dam, Rob M., van den Born, Bert-Jan, Van der Heyden, Johan, van der Schouw, Yvonne T., Van Herck, Koen, Hoang Van Minh, Van Schoor, Natasja M., van Valkengoed, Irene G. M., van Zutphen, Elisabeth M., Vanuzzo, Diego, Varbo, Anette, Vasan, Senthil K., Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, W. M. Monique, Verstraeten, Roosmarijn, Victora, Cesar G., Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesus, Virtanen, Jyrki K., Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Ari, Wade, Alisha N., Walton, Janette, Wambiya, Elvis O. A., Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, Wanderley Junior, Rildo de Souza, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S. Goya, Wareham, Nicholas, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H., Widhalm, Kurt, Wiecek, Andrzej, Wilks, Rainford J., Willeit, Johann, Willeit, Peter, Williams, Emmanuel A., Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A., Wong, Andrew, Wong, Tien Yin, Woo, Jean, Wu, Frederick C., Wu, Shouling, Wyszynska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K., Yoosefi, Moein, Yoshihara, Akihiro, You, San-Lin, Younger-Coleman, Novie O., Yusoff, Ahmad Faudzi, Zainuddin, Ahmad A., Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Elisa Zapata, Maria, Zaw, Ko Ko, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhao, Dong, Zhao, Ming-Hui, Zhen, Shiqi, Zheng, Yingfeng, Zholdin, Bekbolat, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Zoghlami, Nada, Zuniga Cisneros, Julio., School of Medicine, ACS - Diabetes & metabolism, APH - Global Health, Pulmonology, Medical Informatics, Adult Psychiatry, Global Health, APH - Quality of Care, APH - Methodology, Vascular Medicine, ACS - Atherosclerosis & ischemic syndromes, Anesthesiology, Graduate School, and ACS - Heart failure & arrhythmias

Subjects
Male, Latin Americans, Nutrition and Disease, Epidemiology, [SDV]Life Sciences [q-bio], Medizin, BLOOD-PRESSURE, 030204 cardiovascular system & hematology, Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants, Hypertension, Prevalence, Control, Tretament, GUIDELINES, Global Health, Worldwide trends, 0302 clinical medicine, Hypertension prevalence, Voeding en Ziekte, Medicine and Health Sciences, kohonnut verenpaine, Medicine, 030212 general & internal medicine, Prevention and Control, 11 Medical and Health Sciences, ComputingMilieux_MISCELLANEOUS, education.field_of_study, food and beverages, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, Noncommunicable diseases, Period prevalence, Middle Aged, kansainvälinen vertailu, 3142 Public health care science, environmental and occupational health, 3. Good health, MIDDLE-INCOME, Pooled analysis, SYSTEMATIC ANALYSIS, INCOME COUNTRIES, ADULTS, PREVENTION, MANAGEMENT, ADHERENCE, DIAGNOSIS, Western europe, [SDE]Environmental Sciences, Hypertension/diagnosis, NCD Risk Factor Collaboration (NCD-RisC), Female, B990 Subjects Allied to Medicine not elsewhere classified, Life Sciences & Biomedicine, Adult, health-care, esiintyvyys, Central asia, Population, Nursing, 3121 Internal medicine, 03 medical and health sciences, Medicine, General & Internal, Drug Therapy, General & Internal Medicine, Life Science, Humans, ddc:610, education, Antihypertensive Agents, VLAG, Aged, Science & Technology, Antihypertensive Agents/therapeutic use, business.industry, Omvårdnad, fungi, General and internal medicine, Estados de Saúde e de Doença, Taking medication, Treatment, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Blood pressure, Faculdade de Ciências Sociais, 3121 General medicine, internal medicine and other clinical medicine, lääkehoito, 1182 Biochemistry, cell and molecular biology, business, Demography
Abstract

Background: hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods: we used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings: the number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings., British Heart Foundation Centre of Research Excellence Grant; World Health Organization (WHO); Abdul Latif Jameel Institute for Disease and Emergency Analytics Fellowship

Published
2021

23. Highly conductive anion exchange membranes based on polymer networks containing imidazolium functionalised side chains

Author

Mohamed Mahmoud Nasef, Hossein Ghassemi, Yadollah Abdolahi, Mohan V. Jacob, Arshad Ahmad, Ebrahim Abouzari-Lotf, Ali Abbasi, and Masoumeh Zakeri

Subjects
Technology, Materials science, Energy science and technology, Science, 02 engineering and technology, 010402 general chemistry, 01 natural sciences, Article, chemistry.chemical_compound, Nanoscience and technology, Diamine, Copolymer, Polysulfone, Ionomer, chemistry.chemical_classification, Multidisciplinary, Ion exchange, Membrane electrode assembly, Polymer, 021001 nanoscience & nanotechnology, 0104 chemical sciences, Chemistry, Membrane, chemistry, Chemical engineering, Medicine, 0210 nano-technology, ddc:600
Abstract

Two novel types of anion exchange membranes (AEMs) having imidazolium-type functionalised nanofibrous substrates were prepared using the facile and potentially scalable method. The membranes’ precursors were prepared by graft copolymerization of vinylbenzyl chloride (VBC) onto syndiotactic polypropylene (syn-PP) and polyamide-66 (PA-66) nanofibrous networks followed by crosslinking with 1,8-octanediamine, thermal treatment and subsequent functionalisation of imidazolium groups. The obtained membranes displayed an ion exchange capacity (IEC) close to 1.9 mmol g–1 and ionic (OH-) conductivity as high as 130 mS cm–1 at 80 °C. This was coupled with a reasonable alkaline stability representing more than 70% of their original conductivity under accelerated degradation test in 1 M KOH at 80 °C for 360 h. The effect of ionomer binder on the performance of the membrane electrode assembly (MEA) in AEM fuel cell was evaluated with the optimum membrane. The MEA showed a power density of as high as 440 mW cm−2 at a current density is 910 mA cm−2 with diamine crosslinked quaternized polysulfone (DAPSF) binder at 80 °C with 90% humidified H2 and O2 gases. Such performance was 2.3 folds higher than the corresponding MEA performance with quaternary ammonium polysulfone (QAPS) binder at the same operating conditions. Overall, the newly developed membrane was found to possess not only an excellent combination of physico-chemical properties and a reasonable stability but also to have a facile preparation procedure and cheap ingredients making it a promising candidate for application in AEM fuel cell.

Published
2021
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24. Tension-Sided Femoral Neck Stress Fracture in an Adolescent with Vitamin D Deficiency and Osteomalacia

Author

Supriya Gupte, Mohan V. Belthur, Neeraj Vij, Ashish Ranade, and Gauri A Oka

Subjects
medicine.medical_specialty, Adolescent, Fractures, Stress, Parathyroid hormone, vitamin D deficiency, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Displacement (orthopedic surgery), Femoral neck, 030222 orthopedics, Osteomalacia, Medical treatment, Groin, Femur Neck, business.industry, Vitamin D Deficiency, medicine.disease, Femoral Neck Fractures, Surgery, medicine.anatomical_structure, Fracture (geology), Female, business, 030217 neurology & neurosurgery
Abstract

Case An adolescent girl presented with groin pain without any history of trauma. Imaging showed a tension-sided stress fracture of the femoral neck. Vitamin D deficiency (VDD), and raised alkaline phosphatase and parathyroid hormone levels were found. Pain relief was not achieved with nonoperative treatment. Considering the risk of fracture progression and displacement, the fracture was fixed with cannulated cancellous screws. Fracture healed without any complications. Conclusion A tension-sided femoral neck stress fracture, with VDD and osteomalacia, is a rare cause of hip pain in an adolescent. Surgical fracture stabilization is necessary in addition to medical treatment.

Published
2021

25. Art and Pediatric Orthopaedics: Ribera, an Artist for the Downtrodden

Author

Mohan V. Belthur, Sean Youn, Timothy Schaub, and Melissa Esparza

Subjects
Male, Clubfoot, medicine.medical_specialty, Contracture, Medicine in the Arts, Lower limb, medicine, Humans, Orthopedics and Sports Medicine, Joint Contracture, Child, Muscle contracture, Arthrogryposis, business.industry, General surgery, General Medicine, medicine.disease, Orthopedics, Pediatrics, Perinatology and Child Health, Orthopedic surgery, Etiology, Paintings, medicine.symptom, business
Abstract

Jusepe de Ribera's most famous artistic works consisted of the bizarre such as mutilated bodies and social outcasts, with one being of a Neapolitan beggar boy with upper and lower limb joint contractures. Although the etiology of the boy's contractures in The Clubfoot has been debated, we present a case for arthrogryposis with a unilateral clubfoot as the most likely diagnosis.

Published
2021

26. A SEVERE CASE OF COVID-19 THAT DEVELOPED ENCEPHALITIS AND TREATED SUCCESFULLY WITH IV IMMUNOGLOBULINS

Author

Aravind Varma Datla, Srikanth Koyyana, Sibasankar Dalai, Anandamakula Sameera, Satya Rao Kolli, and Mohan V. Sumedha Maturu

Subjects
03 medical and health sciences, 0302 clinical medicine, IV Immunoglobulins, Coronavirus disease 2019 (COVID-19), business.industry, medicine, 030212 general & internal medicine, medicine.disease, business, Virology, 030217 neurology & neurosurgery, Encephalitis
Abstract

Neurologic manifestations of COVID-19 have attracted widespread attention. Though the respiratory system is the primary target of SARS-CoV2, it is now increasingly recognised as a neuropathogen. Clinical features range from mild lethargy to deep coma and evidence of focal or diffuse neurologic signs and symptoms. The majority of patients with encephalitis are in critical condition. We report here a case of COVID-19-related encephalitis who developed persistent drowsiness 11 days after admission. The patient recovered well upon treatment with intravenous immunoglobulins (IVIg).

Published
2021

27. Motion laboratory gait analysis and orthopedic resident education: preliminary results

Author

Mohan V. Belthur, Jason B. Malone, Jessica D. Burns, and Judson W. Karlen

Subjects
Adult, medicine.medical_specialty, Gait Disturbance, business.industry, Internship and Residency, Resident education, Gait, Motion (physics), Education, Medical, Graduate, Gait analysis, Pediatrics, Perinatology and Child Health, Orthopedic surgery, Physical therapy, medicine, Humans, Orthopedics and Sports Medicine, Clinical Competence, Prospective Studies, Prospective cohort study, business, Child, Gait Analysis, Laboratories, Curriculum
Abstract

Gait analysis in the pediatric and adult orthopedic patient populations can adjunct the diagnosis and treatment of a multitude of musculoskeletal conditions. Understanding of normal and abnormal gait biomechanics is an important aspect of orthopedic residency; yet, there is great variability in the time residency programs dedicate to gait analysis education. The purpose of this study was to investigate if formal gait analysis education during residency improves an orthopedic resident's understanding of normal and pathologic gait. Five residency programs consisting of 81 resident subjects were surveyed at the beginning of the 2016-2017 academic year. The residents were divided into those with formal gait analysis education (group A) and those without (group B). Each resident was sent an online survey with 11 questions from former orthopedic in-training exams (OITE) regarding gait pattern analysis. The average number of correct questions was compared between the two groups with Student's t-test. Fifty-three of the 81 surveys sent out were completed. There were 23 subjects in group A and 30 in group B. All five programs and all postgraduate years (PGYs) were represented (PGY1: 10, PGY2: 12, PGY3: 12, PGY4: 6, PGY5 12). The average score for all residents was 5.6 out of 11 correct (51%). The residents from group A averaged a significantly higher score (6.3) than group B (5.0) (P = 0.017). Understanding gait biomechanics is a critical skill for orthopedic surgeons, and residency training often lacks sufficient training in their curriculum. A good understanding of gait analysis allows orthopedic surgeons to analyze gait disturbances and develop patient-specific treatment plans in adult and pediatric populations. This study found improved knowledge of gait patterns amongst orthopedic residents with formal education. Even though the residents with formal education fared better than their counterparts, the overall percent correct was still low (51%). Evidence: Level 3: Prospective Cohort Study.

Published
2020

28. Hypochondrogenesis: A pictorial assay combining ultrasound, MRI and low-dose computerized tomography

Author

Mohan V. Belthur, Roy U. Bisht, Luis F. Goncalves, Ian M. Singleton, and Julia E. Solomon

Subjects
medicine.medical_specialty, Prenatal diagnosis, Osteochondrodysplasias, Ultrasonography, Prenatal, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Prenatal Diagnosis, medicine, Humans, Radiology, Nuclear Medicine and imaging, Ultrasonography, medicine.diagnostic_test, Achondrogenesis, business.industry, Ultrasound, Infant, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Fetal imaging, Dysplasia, 030220 oncology & carcinogenesis, Female, Tomography, Radiology, business, Tomography, X-Ray Computed, Hypochondrogenesis
Abstract

We present a case of hypochondrogenesis, a rare autosomal dominant skeletal dysplasia that often results in infant death shortly after birth. Hypochondrogenesis can present similarly to other skeletal dysplasia diseases, notably achondrogenesis type II. The diagnosis of hypochondrogenesis was given during the prenatal stage after fetal imaging was performed using ultrasound, magnetic resonance imaging (MRI), and low-dose computerized tomography (CT). To the best of our knowledge, this is the first known case that reported the use of low-dose CT to assist in the prenatal diagnosis of hypochondrogenesis.

Published
2020

29. P1310STUDY OF RISK FACTORS AND PREVALENCE OF PULMONARY HYPERTENSION IN CKD 5D PATIENTS ON HEMODIALYSIS

Author

Shankar Prasad Nagaraju, Ganesh Paramasivam, Ravindra Prabhu, Vasudeva Guddattu, Dharshan Rangaswamy, Srinivas Shenoy, Indu Ramachandra Rao, and Mohan V Bhojaraja

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Internal medicine, medicine.medical_treatment, Medicine, Hemodialysis, business, medicine.disease, Pulmonary hypertension
Abstract

Background and Aims Pulmonary hypertension (PH) in chronic kidney disease stage 5D (CKD5D) patients on haemodialysis (HD) is associated with increased morbidity and mortality. We studied the risk factors and prevalence of PH in patients on HD at our centre. We also studied its association with oxidative stress and markers of inflammation. Method After ethics committee clearance, we conducted a cross-sectional study on CKD5D patients at our centre from June 2016 to May 2017. Patients on maintenance HD for at least 3 months were included. Demographic, clinical, biochemical and trans-thoracic echocardiography details were collected. PH was defined as estimated mean pulmonary artery pressure (mPAP) greater than 25 mm Hg at rest. PH was further categorized into mild (mPAP b/w 25-40mmHg), moderate (mPAP b/w 40-60mmHg) and severe PH (mPAP > 60mmHg). Serum thiol and C Reactive protein (CRP) were studied as markers of oxidative stress and inflammation respectively. Data was analysed using SPSS version 16. Results Out of 52 patients, 28 (54%) had PH. Twenty four out of these patients had mild PH (Figure 1). None had severe PH. The baseline characteristics of patients with and without PH are shown in Figure 2. No clinical or biochemical factors (p>0.05) were found as significant risk factors in our study. CRP (p-0.76) (inflammatory marker) and Thiol levels (p-0.36) (oxidative stress marker) did not had any relationship with occurrence of PH. (Table 1). Conclusion CKD 5D patients on HD have high prevalence of PH. There were no identifiable risk factors. The prevalence of PH was not influenced by dialysis vintage, ultrafiltration, paratharmone levels, presence of co-morbidities, oxidative stress or inflammation.

Published
2020

30. P0574IS PERIPROCEDURAL BLOOD LOSS FOLLOWING PERCUTANEOUS CORONARY INTERVENTION A RISK FACTOR FOR CONTRAST-INDUCED ACUTE KIDNEY INJURY ?

Author

Tom Devasia, Mohan V B, Ravindra Prabhu, Dharshan Rangaswamy, Shankar Prasad Nagaraju, Ganesh Paramasivam, Indu Ramachandra Rao, and Srinivas Shenoy

Subjects
Transplantation, medicine.medical_specialty, Anemia, business.industry, medicine.medical_treatment, Acute kidney injury, Percutaneous coronary intervention, medicine.disease, Pulmonary edema, Blood loss, Nephrology, Internal medicine, Diabetes mellitus, medicine, Cardiology, Hemodialysis, Risk factor, business
Abstract

Background and Aims Contrast-induced acute kidney injury (CI-AKI) is a significant concern with the use of intraarterial contrast agents, especially in percutaneous coronary interventions (PCI) in which higher contrast volumes are used. Presence of anemia is a risk factor for CI-AKI and is a component of various risk-prediction models. However, the impact of periprocedural hemoglobin (Hb) drop following PCI on CI-AKI is not known, despite the fact that significant blood loss is fairly common in patients undergoing PCI. The aim of this study was to examine whether periprocedural Hb drop is a risk factor for development of CI-AKI following PCI. Method This was a single-center, retrospective study of patients admitted for elective or primary PCI at our center between January 2015 and December 2018. Patients with baseline eGFR Results A total of 6418 patients were included. Baseline characteristics of the study population are shown in table 1. Overall incidence of CI-AKI in our study was 7.6% (n=490), of which 3.9% (n=19) required dialysis. Higher incidence of CI-AKI was seen in those with baseline eGFR < 60 ml/min/1.73m2 (16.4%) and a pre-procedural Mehran score >11 (33%). Peri-PCI Hb drop was seen in 49.9% (n=3203), with a drop >2g/dL in 18.5% (n=1185). On multivariate logistic regression analysis (Table 2), it was found that periprocedural Hb drop >2g/dL was independently associated with CI-AKI (OR 1.49, 95% CI 1.18-1.88, P=0.001). Furthermore, in those with periprocedural blood loss, the risk of CI-AKI was increased by 1.3 times for each 1g/dL drop in Hb (OR 1.30, 95% CI 1.14-1.49, P Conclusion Periprocedural blood loss was associated with a higher risk of CI-AKI after PCI. Moreover, risk of CI-AKI increased with increasing severity of blood loss. Whether measures to minimize blood loss, like using a transradial approach, staging complex procedures and close monitoring of anticoagulation/antiplatelet regimens, will help reduce risk of CI-AKI needs to be studied.

Published
2020

31. LEAN SIX SIGMA TECHNIQUES TO IMPROVE OPHTHALMOLOGY CLINIC EFFICIENCY

Author

Amanda L. Hill, Yehya A. ElMaraghi, Eyas M. Hattab, Thomas A. Ciulla, Rehan M. Hussain, Julie M. Clary, and Mohan V. Tatikonda

Subjects
Pediatrics, medicine.medical_specialty, Eye Diseases, Staffing, Efficiency, Organizational, Ambulatory Care Facilities, Workflow, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, 0502 economics and business, Health care, Humans, Medicine, Outpatient clinic, Lean Six Sigma, Total quality management, business.industry, 05 social sciences, Six Sigma, Unithiol, General Medicine, medicine.disease, Ophthalmology, Patient Satisfaction, 030221 ophthalmology & optometry, Job satisfaction, Medical emergency, business, 050203 business & management, Total Quality Management
Abstract

Purpose Ophthalmologists serve an increasing volume of a growing elderly population undergoing increasingly complex outpatient medical care, including extensive diagnostic testing and treatment. The resulting prolonged patient visit times ("patient flow times") limit quality, patient and employee satisfaction, and represent waste. Lean Six Sigma process improvement was used in a vitreoretinal practice to decrease patient flow time, demonstrating that this approach can yield significant improvement in health care. Methods Process flow maps were created to determine the most common care pathways within clinic. Three months' visits from the electronic medical record system, which tracks patient task times at each process step in the office were collected. Care tasks and care pathways consuming the greatest time and variation were identified and modified. Follow-up analysis from 6 weeks' visits was conducted to assess improvement. Results Nearly all patients took one of five paths through the office. Patient flow was redesigned to reduce waiting room time by having staff members immediately start patients into one of those five paths; staffing was adjusted to address high demand tasks, and scheduling was optimized around derived predictors of patient flow times. Follow-up analysis revealed a statistically significant decline in mean patient flow time by 18% and inpatient flow time SD by 4.6%. Patient and employee satisfaction scores improved. Conclusion Manufacturing industry techniques, such as Lean and Six Sigma, can be used to improve patient care, minimize waste, and enhance patient and staff satisfaction in outpatient clinics.

Published
2018

32. Six Sigma Pre-history

Author

George K. Strodtbeck and Mohan V. Tatikonda

Subjects
medicine.medical_specialty, Internal medicine, medicine, Six Sigma, Mathematics
Published
2019

33. YouTube as an information source for clubfoot: a quality analysis of video content

Author

Gauri A Oka, Jason D Malone, Mohan V. Belthur, and Ashish Ranade

Subjects
Quality Control, Clubfoot, medicine.medical_specialty, media_common.quotation_subject, MEDLINE, Video Recording, English language, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Orthopedics and Sports Medicine, Quality (business), media_common, 030222 orthopedics, business.industry, Information Dissemination, Idiopathic clubfoot, Information quality, medicine.disease, Pediatrics, Perinatology and Child Health, Physical therapy, Information source, Diffusion of Innovation, business, Social Media, 030217 neurology & neurosurgery, Medical Informatics, Needs Assessment
Abstract

Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube. However, the quality of these videos remains unknown. Therefore, we decided to evaluate the quality of YouTube videos about clubfoot. We searched YouTube for clubfoot videos using appropriate keywords. English language videos with more than 10 000 views were included. Three fellowship trained pediatric orthopedic surgeons independently assessed the videos and classified them into corporate, hospital, education and private. The quality of information was assessed using the Modified DISCERN and JAMA benchmark scores. The search yielded 12 060 videos of which 42 were analyzed. There were 9 (21%) videos from corporate organizations, 12 (29%) from hospitals, 3 (7%) from educational organizations and 18 (43%) by private individuals. The mean Modified DISCERN score was 2.1 ± 1.07 (range 0.3-4) and mean JAMA benchmark score was 0.9 ± 0.65 (range 0-2). Educational videos had highest mean Modified DISCERN score (3.1 ± 0.85) and private videos, the least (1.43 ± 1). This difference was statistically significant (P = 0.004). Hospital videos had highest mean JAMA benchmark score of 1.3 ± 0.6 as compared with private videos which had the least mean score of 0.5 ± 0.6. This difference was also statistically significant (P = 0.001). The results of our study indicate that the quality of information on idiopathic clubfoot on YouTube needs improvement. Videos from educational and hospital sources should be preferred over private sources.

Published
2019

34. Inter- and Intraobserver Reliability of Pelvic Obliquity Measurement Methods in Patients With Cerebral Palsy

Author

Mohan V. Belthur, Gregory R. White, Emily M. Andrisevic, Carla Boan, William Wood, and M. Wade Shrader

Subjects
Intraclass correlation, Radiography, Scoliosis, Pelvis, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Reliability (statistics), Retrospective Studies, Observer Variation, Orthodontics, 030222 orthopedics, Pelvic girdle, business.industry, Cerebral Palsy, Reproducibility of Results, Gold standard (test), medicine.disease, Pearson product-moment correlation coefficient, Coronal plane, symbols, business, 030217 neurology & neurosurgery
Abstract

Study Design Retrospective, chart review. Objectives The identification and management of pelvic obliquity in neuromuscular scoliosis can be difficult; therefore, appropriate evaluation of this pathology is important. Variations in presentation have resulted in various methods of measurement, without a consensus or gold standard measurement. This study is the evaluation of reliability of five methods commonly used to determine pelvic obliquity in the frontal plane. Summary of Background Data Previous studies have used five different methods (ie, the Maloney method, the O'Brien method, the Osebold method, the Allen and Ferguson method, and the Lindseth method) to determine pelvic obliquity in the frontal plane. Methods Radiographic images of 50 patients with neuromuscular scoliosis involving the pelvic girdle were identified and evaluated by a team of 5 raters. Each rater was instructed to apply five commonly used methods of measuring pelvic obliquity. The same raters were asked to rate the same radiographs again after a minimum of one month. The interobserver reliability was assessed using the intraclass correlation coefficient (ICC) and the intraobserver analysis was assessed using the Pearson correlation. A rating greater than 0.8 was considered excellent reliability. Results The Maloney method showing the highest interobserver reliability of ICC of 0.965 and 0.964. The Lindseth method had the lowest ICC, but all the methods were considered highly reliable by the rating classification system. The Maloney method also showed the highest intraobserver reliability, ranging from 0.845 to 0.962. The Allen and Ferguson method had the lowest intraobserver reliability. Conclusions Many of the methods tested had excellent reliability in this study, but our data suggest the Maloney method is the most reliable method of measuring pelvic obliquity on a frontal view radiograph. Level of Evidence Level III, retrospective, comparative study.

Published
2018

35. Characteristics of Medical Professional Liability Claims in Pediatric Orthopedics

Author

M. Wade Shrader, Jessica Burns, Carla Boan, and Mohan V. Belthur

Subjects
Adult, medicine.medical_specialty, Leadership and Management, media_common.quotation_subject, Population, Medical malpractice, Indemnity, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Epidemiology, medicine, Humans, Registries, Child, education, health care economics and organizations, Retrospective Studies, media_common, education.field_of_study, business.industry, Malpractice, Liability, Public Health, Environmental and Occupational Health, Liability, Legal, Payment, United States, Orthopedics, 030220 oncology & carcinogenesis, Family medicine, Orthopedic surgery, 030211 gastroenterology & hepatology, business
Abstract

OBJECTIVES Medical malpractice is burdensome to the U.S. healthcare system. The following is an epidemiological analysis of the closed medical professional liability (MPL) claims in pediatric orthopedics using data maintained by the Physician Insurers Association of America. METHODS The Physician Insurers Association of America registry of MPL claims from 1985 to 2013 for all specialties included 286,021 closed claims in the United States. All closed MPL claims for orthopedic surgery in patients younger than 18 years were retrospectively reviewed (N = 2,671). The error categories, result of the claim, the most common procedures, severity of injury, and the most common presenting and resultant medical conditions were reported with the paid-to-close ratios, average indemnity payment, and average cost of litigation. The pediatric orthopedic population was compared with all orthopedics. The data were adjusted for inflation and trended for the 29-year period. RESULTS Of the 2671 pediatric orthopedic claims, 881 resulted in a payment and the average indemnity was U.S. $317,574 with adjustment for inflation - significantly higher than for all of orthopedics at U.S. $268,817 (P = 0.0013). The paid-to-close ratio was 33.0%, compared with 28.7% for all of orthopedics (P = 0.023). CONCLUSIONS Costs to defend individual medical malpractice claims and the average indemnity payment per claim have both increased over time, and pediatric (versus adult) orthopedic claims are more likely to result in payment and result in a higher payment. Knowledge of the details of liability claims should assist practicing general and pediatric orthopedic surgeons in improving patient safety and quality of care, reducing patient injury, and reducing the incidence of MPL claims.

Published
2018

36. Microwave pyrolysis of sewage biosolids: Dielectric properties, microwave susceptor role and its impact on biochar properties

Author

Philip A. Schneider, Elsa Antunes, Graham Brodie, and Mohan V. Jacob

Subjects
Materials science, Waste management, Biosolids, 020209 energy, chemistry.chemical_element, 02 engineering and technology, Dielectric, 010501 environmental sciences, 01 natural sciences, Analytical Chemistry, law.invention, Fuel Technology, Chemical engineering, chemistry, law, Biochar, 0202 electrical engineering, electronic engineering, information engineering, medicine, Carbon, Pyrolysis, Microwave, 0105 earth and related environmental sciences, Activated carbon, medicine.drug, Susceptor
Abstract

Microwave assisted pyrolysis (MWAP) is an alternative heating approach to convert biosolids into value-added products, such as biochar, biogas and bio-oil. Studying the dielectric properties of biosolids is fundamental to understand the behaviour of this material under microwave irradiation and to design microwave assisted pyrolysis systems. This study examined the dielectric properties of biosolids with changes in moisture content and applied microwave frequency. Results demonstrated that the dielectric constant decreases with decreasing moisture content and with increasing microwave frequency, but the dielectric loss factor of dry biosolids is almost zero. Simulations demonstrated that moisture content of biosolids impacts on the distribution and intensity of electromagnetic field. Because of the poor dielectric properties of dry biosolids, a microwave susceptor must be added to the biosolids to attract microwave energy so that the materials can reach temperatures required for pyrolysis. Therefore, this study also investigated the impact of four microwave susceptors (activated carbon, charcoal, biochar and glycerol) on biosolids pyrolysis and on biochar properties produced from biosolids via microwave assisted pyrolysis at 600 °C. The choice of microwave susceptor influences the heating rate of biosolids and the specific surface area of the resultant biochar. Results show that activated carbon favours the heating process, increases surface area, and the biochar produced with activated carbon has the highest carbon stability and energy value.

Published
2018

37. An independent assessment of reliability of the Melbourne Cerebral Palsy Hip Classification System

Author

Carla Boan, Miranda Falk, Mohan V. Belthur, A L Koenig, and M W Shrader

Subjects
medicine.medical_specialty, Intraclass correlation, Radiography, Cerebral palsy, 03 medical and health sciences, 0302 clinical medicine, Original Clinical Article, medicine, Orthopedics and Sports Medicine, In patient, migration percentage, neuromuscular hip dysplasia, Pelvis, Hip dysplasia, cerebral palsy, 030222 orthopedics, reliability, business.industry, medicine.disease, Institutional review board, Melbourne Cerebral Palsy Hip Classification System, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Physical therapy, business, 030217 neurology & neurosurgery, Paediatric population
Abstract

Purpose Neuromuscular (NM) hip dysplasia is common in patients with cerebral palsy (CP). Traditionally, migration percentage (MP) has been used to measure the severity of NM hip dysplasia; however, the MP has some limitations. The purpose of this study is to determine the intra- and inter-reliability of the Melbourne Cerebral Palsy Hip Classification System in the typical paediatric population of patients with CP. Methods A total of 65 anteroposterior pelvis radiographs in patients (age range 12 years to 21 years) with CP spanning all grades (I to VI) of the classification system were identified and collected for analysis in this institutional review board approved study. Four paediatric orthopaedic surgeons and one orthopaedic surgical resident classified each radiograph according to the Melbourne system. Then, at least four weeks later, the raters repeated the process with a re-randomised order of radiographs. Statistical analysis was performed using the intraclass correlation coefficient (ICC) where < 0 denotes poor agreement and > 0.8 indicates almost perfect agreement. Results The interobserver reliability was found to be excellent with the ICC of 0.853 (0.813 to 0.887) and 0.839 (0.795 to 0.877). The intraobserver reliability was also found to be excellent with the ICC in the range of 0.838 to 0.933 among the raters. Subgroup analysis indicated no differences in the reliability of observers based on clinical experience. Conclusion This study independently demonstrates that the Melbourne Cerebral Palsy Hip Classification System for NM hip dysplasia in patients with CP can be reliably used for communication among various healthcare providers and research and epidemiological purposes.

Published
2017

38. Correction to: Hospital outcomes of scoliosis surgery in children with Prader–Willi Syndrome: comparison with adolescent idiopathic scoliosis

Author

Kade S. McQuivey, Matthew T. Gulbrandsen, Cory K Mayfield, Mohan V. Belthur, Joseph R. Sheridan, Joseph C. Brinkman, and Andrew S. Chung

Subjects
Pediatrics, medicine.medical_specialty, Hospital outcomes, business.industry, Orthopedic surgery, MEDLINE, Medicine, Orthopedics and Sports Medicine, Idiopathic scoliosis, business, Scoliosis surgery
Published
2021

39. POS-770 'SLOW AND STEADY MAY NOT ALWAY WIN THE RACE ' –SHORT TERM OUTCOMES OF SLOW GRAFT FUNCTION POST RENAL TRANSPLANT - A SINGLE CENTRE EXPERIENCE

Author

D. Rangaswamy, Srinivas Shenoy, Mohan V Bhojaraja, Ravindra Prabhu, Shankar Prasad Nagaraju, and I. Rao

Subjects
medicine.medical_specialty, Race (biology), Single centre, Nephrology, Renal transplant, business.industry, medicine, RC870-923, business, Graft function, Diseases of the genitourinary system. Urology, Surgery, Term (time)
Published
2021

40. Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Author

Shupler, Matthew, Hystad, Perry, Gustafson, Paul, Rangarajan, Sumathy, Mushtaha, Maha, Jayachtria, KG, Mony, Prem K, Mohan, Deepa, Kumar, Parthiban, Lakshmi, PVM, Sagar, Vivek, Gupta, Rajeev, Mohan, Indu, Nair, Sanjeev, Varma, Ravi Prasad, Li, Wei, Hu, Bo, You, Kai, Ncube, Tatenda, Ncube, Brian, Chifamba, Jephat, West, Nicola, Yeates, Karen, Iqbal, Romaina, Khawaja, Rehman, Yusuf, Rita, Khan, Afreen, Seron, Pamela, Lanas, Fernando, Lopez-Jaramillo, Patricio, Camacho, Paul A, Puoane, Thandi, Yusuf, Salim, Brauer, Michael, Yusuf, S, Rangarajan, S, Teo, KK, Anand, SS, Chow, CK, O'Donnell, M, Mente, A, Leong, D, Smyth, A, Joseph, P, Duong, M, Kurmi, O, D'Souza, R, Walli-Attaei, M, Balaji, B, Naito, R, Islam, S, Hu, W, Ramasundarahettige, C, Sheridan, P, Bangdiwala, S, Dyal, L, Casanova, A, Dehghan, M, Lewis, G, Agapay, D, Aliberti, A, Aoucheva, N, Arshad, A, Reyes, A, Bideri, B, Buthool, R, Chin, S, Di Marino, M, Frances, R, Gopal, S, Jakymyshn, M, Kandy, N, Kay, I, Lindeman, J, McAlpine, G, McNeice, E, Mushtaha, M, Patel, R, Pattath, D, Ramacham, S, Ramezani, E, Rimac, J, Shifaly, F, Swallow, J, Trottier, M, Trottier, S, Solano, R, Zaki, A, Zhang, B, Zhang, V, Rahman, O, Yusuf, R, Ahmed, SAKS, Choudhury, T, Sintaha, M, Khan, A, Alam, O, Nayeem, N, Mitra, SN, Pasha, F, Lanas, F, Seron, P, Oliveros, MJ, Cazor, F, Palacios, Y, Wei, Li, Lisheng, Liu, Jian, Bo, Bo, Hu, Lu, Yin, Wenhua, Zhao, Hongye, Zhang, Xuan, Jia, Yi, Sun, Xingyu, Wang, Xiuwen, Zhao, Xinye, He, Tao, Chen, Hui, Chen, Xiaohong, Chang, Qing, Deng, Xiaoru, Cheng, Liya, Xie, Zhiguang, Liu, Juan, Li, Jian, Li, Xu, Liu, Bing, Ren, Wei, Wang, Yang, Wang, Jun, Yang, Yi, Zhai, Manlu, Zhu, Fanghong, Lu, Jianfang, Wu, Yindong, Li, Yan, Hou, Liangqing, Zhang, Baoxia, Guo, Xiaoyang, Liao, Shiying, Zhang, BianRongwen, Xiuzhen, Tian, Dong, Li, Di, Chen, Jianguo, Wu, Yize, Xiao, Tianlu, Liu, Peng, Zhang, Changlin, Dong, Ning, Li, Xiaolan, Ma, Yuqing, Yang, Rensheng, Lei, Minfan, Fu, Jing, He, Yu, Liu, Xiaojie, Xing, Qiang, Zhou, Lopez-Jaramillo, P, Camacho-Lopez, PA, Otero-Wandurraga, J, Molina, DI, Cure-Cure, C, Perez, M, Hernandez, E, Arcos, E, Narvaez, C, Sotomayor, A, Garcia, H, Sanchez, G, Cotes, F, Rico, A, Duran, M, Torres, C, Mony, P, Vaz, M, Swaminathan, S, Shankar, K, Kurpad, AV, Jayachitra, KG, Kumar, N, Hospital, HAL, Mohan, V, Deepa, M, Parthiban, K, Anitha, M, Hemavathy, S, Rahulashankiruthiyayan, T, Anitha, D, Anjana, RM, Dhanasekar, R, Sureshkumar, S, Sridevi, K, Gupta, R, Panwar, RB, Mohan, I, Rastogi, P, Rastogi, S, Bhargava, R, Kumar, R, Thakur, JS, Patro, B, Mahajan, R, Chaudary, P, Kutty, V Raman, Vijayakumar, K, Ajayan, K, Rajasree, G, Renjini, AR, Deepu, A, Sandhya, B, Asha, S, Soumya, HS, Kaur, M, Sagar, V, Iqbal, R, Khawaja, R, Azam, I, Kazmi, K, Kruger, L, Kruger, A, Bestra, P, Voster, HH, Schutte, AE, Wentzel-Viljoen, E, Eloff, FC, de Ridder, H, Moss, H, Potgieter, J, Roux, AA, Watson, M, de Wet, G, Olckers, A, Jerling, JC, Pieters, M, Hoekstra, T, Puoane, T, Swart, R, Igumbor, E, Tsolekile, L, Ndayi, K, Sanders, D, Naidoo, P, Steyn, N, Peer, N, Mayosi, B, Rayner, B, Lambert, V, Levitt, N, Kolbe-Alexander, T, Ntyintyane, L, Hughes, G, Fourie, J, Muzigaba, M, Xapa, S, Gobile, N, Jwili, B, Ndibaza, K, Egbujie, B, Yeates, K, Oresto, M, West, N, Chifamba, J, Ncube, T, Ncube, B, Chimhete, C, Neya, GK, Manenji, T, Gwaunza, L, Mapara, V, Terera, G, Mahachi, C, Murambiwa, P, Mapanga, R, Chinhara, A, Epidemiolo, Prospective Urban Rural, and Everest

Subjects
010504 meteorology & atmospheric sciences, Air pollution, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, Agricultural economics, Article, Country level, 11. Sustainability, medicine, Coal, Baseline (configuration management), 0105 earth and related environmental sciences, General Environmental Science, 2. Zero hunger, Kerosene, Renewable Energy, Sustainability and the Environment, business.industry, Multilevel model, 1. No poverty, Public Health, Environmental and Occupational Health, 13. Climate action, Environmental science, Survey data collection, Community setting, business
Abstract

Digital, Introduction. Switching from polluting (e.g. wood, crop waste, coal) to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions. While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods. We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study. We assessed household-level primary cooking fuel switching during a median of 10 years of follow up (∼2005–2015). We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households (12 369) reported changing their primary cooking fuels between baseline and follow up surveys. Of these, 61% (7582) switched from polluting (wood, dung, agricultural waste, charcoal, coal, kerosene) to clean (gas, electricity) fuels, 26% (3109) switched between different polluting fuels, 10% (1164) switched from clean to polluting fuels and 3% (522) switched between different clean fuels. Among the 17 830 households using polluting cooking fuels at baseline, household-level factors (e.g. larger household size, higher wealth, higher education level) were most strongly associated with switching from polluting to clean fuels in India; in all other countries, community-level factors (e.g. larger population density in 2010, larger increase in population density between 2005 and 2015) were the strongest predictors of polluting-to-clean fuel switching. Conclusions. The importance of community and sub-national factors relative to household characteristics in determining polluting-to-clean fuel switching varied dramatically across the nine countries examined. This highlights the potential importance of national and other contextual factors in shaping large-scale clean cooking transitions among rural communities in low- and middle-income countries., Ciencias Médicas y de la Salud

Published
2019

41. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes

Author

Green JB, Bethel MA, Armstrong PW, Buse JB, Engel SS, Garg J, Josse R, Kaufman KD, Koglin J, Korn S, Lachin JM, McGuire DK, Pencina MJ, Standl E, Stein PP, Suryawanshi S, Van de Werf F, Peterson ED, Holman RR, Josse RG, Califf RM, Goldstein BJ, Shapiro DR, Silverman R, Bethel A, Green J, Hayden S, Hannan K, Quintero K, Rorick T, Berdan L, Leloudis D, Califf S, Wilson M, McFarron D, Trollinger K, Pesarchick J, Eskenazi L, Campbell C, Townes O, Tolsma D, Keenan J, Milton J, Athwal R, Darbyshire J, Doran Z, Kennedy I, Gregory V, Lokhnygina Y, Prather K, Wolfley A, Usman M, Tajjar A, Gray R, Pfeffer MA, Gerstein HC, Groop L, McMurray JJ, Pocock SJ, Clayton T, Sinay I, Brieger D, Stranks S, Scheen A, Lopes R, Tankova T, Hramiak I, Grado CR, Wenying Y, Ge J, Aschner P, Skrha J, Ambos A, Strandberg T, Travert F, Hanefeld M, Riefflin A, Chan JC, Ofner P, Reddy NK, Christopher J, Mathur A, Arambam P, Mittal S, Manchanda M, Wainstein J, Ambrosio G, Pirags V, Jakuboniene N, Mohamed M, Scott R, White H, Cornel J, Halvorsen S, Tykarski A, Veresiu IA, Dreval AV, Misinkova I, Tai E, Krahulec B, Distiller L, Park Y, Rovira A, Alversson M, Chuang LM, Delibasi T, Adler A, Rodbard HW, Marre M, Goff D, Chacra A, DeVore A, Beaven A, Shah B, Hirsch B, Batch B, Bushnell C, Patel C, Melloni C, Henshaw C, Kong D, Bernecki G, Tillman H, Kang HJ, Hawes J, Strickler J, Piccini J, Wilder J, Alexander K, Mahaffey K, Patel K, Hyland K, Newby K, Jackson L, Cooper L, Armaganijan L, Szczeh L, Koshizaka M, Roe M, Morse M, Guimaraes P, Hess P, Tricoci P, Mehta R, Mathews R, Kociol R, Harrison R, Mentz R, Pokorney S, Leblanc T, Lazzarini V, Eapen Z, Truffa A, Fosbol E, Brito F, Katz M, Bahit M, Santos M, Barros P, Bernardez S, Alvarisqueta AF, Arias P, Cagide AL, Calella PR, Cantero MC, Canella JP, Cipullo MA, de Loredo L, Gelersztein ES, Gorban de Lapertosa SB, Klyver MI, Maffei LE, Maldonado N, Oviedo AI, Piskorz DL, Ridruejo MC, Saavedra SS, Sessa HA, Sinay IR, Sposetti GD, Ulla MR, Vico ML, Waitman JN, Binnekamp M, Carroll P, Cheung W, Colman P, Davis T, De Looze F, dEmden M, Fulcher G, Gerstman M, Hamilton A, Lehman S, Moses R, Proietto J, Roberts A, Shaw J, Simpson R, Sinha A, Tan Y, Topliss D, Vora P, Waites J, Crenier L, Descamps O, Keymeulen B, Mathieu C, Nobels F, Van den Bruel A, Van Gaal L, Borges JL, Costa e Forti A, Eliaschewitz FG, Felício JS, Griz LH, Hissa MN, Leite S, Panarotto D, Pimentel Filho P, Rassi N, Saraiva JK, Sgarbi JA, Silva RP, Tambascia M, Weber Silva DM, Bobeva R, Bostandzhieva R, Cinlikov I, Georgieva M, Iliev D, Ilieva E, Kovacheva S, Liubenova L, Nikitov Z, SHeinikova G, Slavcheva A, Spasova V, Temelkova-Kurktschiev T, Velichka D, Yakov A, Carpentier A, Chiasson JL, Constance C, Dumas R, Filteau P, Garceau C, Huynh T, Kaiser S, Kornder J, Leiter L, Mereu L, Miller D, Pandey S, Punthakee Z, Rabasa-Lhoret R, Robitaille Y, Saunders K, Sigal R, Sigalas J, Vizel S, Weisnagel S, Woo V, Yale JF, Yared K, Zinman B, Bunster Balocchi LB, Escobar Cerda EE, Garces Flores EE, Lanas Zanetti FT, Larrazabal Miranda Adel P, Morales Alvarado JM, Olivares Cañon CM, Potthoff Cárdenas SH, Raffo Grado CA, Rodriguez Venegas ME, Saavedra Gajardo VA, Westerberg Maldonado BH, Chen LL, Dong J, Guo X, Li QM, Shi B, Tang XL, Yang T, Yang WY, Zheng SX, Aschner Montoya P, Botero Lopez R, Coronel Arroyo JA, Cure CA, Gómez Medina AM, Molina DI, Perez Amador GA, Reyes Rincon A, Urina Triana MA, Valenzuela Rincon A, Vélez Pelaez S, Yupanqui Lozno H, Brabec T, Brychta T, Hasalova Zapletalova J, Havelkova J, Hejnicova K, Hola O, Hornackova M, Hrdina T, Kafkova D, Kellnerova I, Krystl T, Kutejova V, Mikulkova I, Nevrla J, Pantlikova C, Petr M, Racicka E, Sarbochova R, Smolenakova K, Turcinek R, Urbancova K, Vejvodova J, Vondrakova M, Zachoval R, Alt I, Kaasik Ü, Kiiroja K, Lanno R, Märtsin K, Past M, Vides H, Viitas L, Kantola I, Nieminen S, Perhonen M, Strand J, Valle T, Clergeot A, Couffinhal T, Courreges JP, Gouet D, Moulin P, Ziegler O, Badenhoop K, Behnke T, Bender G, Braun M, Dshabrailov J, Hamann A, Himpel-Boenninghoff A, Kamke W, Kasperk C, Luedemann J, Mayr P, Merkel M, Oerter EM, Ohlow MA, Ott P, Overhoff U, Paschen B, Remppis R, Rose L, Schumm-Draeger PM, Segiet T, Strotmann HJ, Stuchlik G, Stürmer W, Thinesse-Mallwitz M, Tytko A, Wendisch U, Wurziger J, Ho AY, Kam G, Kong AP, Lam YY, Lau EY, Lee S, Siu SC, Tomlinson B, Tsang CC, Yeung VT, Dezső E, Dudás M, Földesi I, Fülöp T, Késmárki N, Koranyi L, Nagy K, Oroszlán T, Pécsvárady Z, Ples Z, Taller A, Agarwal P, Ambulkar S, Aravind S, Balaji V, Kalra S, Kesavadev J, Kudalkar H, Kumar A, Misra A, Mithal A, Mohan V, Pitale S, Ramu M, Reddy N, Shah S, Shamanna P, Sharda A, Sharma A, Shunmugavelu M, Srikanta S, Suryaprakash G, Abramov G, Adawi F, Bashkin A, Darawsha M, Fuchs S, Harman-Boehm I, Hayek T, Jaffe A, Knobler H, Minuchin O, Mosseri M, Shechter M, Shimon I, Stern N, Tsur A, Vishlitzky V, Alfonsi F, Cavalot F, Del Vecchio L, Frisinghelli A, Gambardella S, Lauro D, Lembo G, Leotta S, Mondillo S, Novo S, Pedrinelli R, Piatti P, Salvioni A, Tritto I, Zavaroni DZ, Ahn KJ, Choi KM, Chung C, Han SJ, Kim DM, Kim IJ, Kim MH, Lee IK, Nam M, Park IeB, Park KS, Park TS, Rhee EJ, Yoo SJ, Andersone I, Balode A, Eglite R, Gersamija A, Kakurina N, Jegere B, Leitane I, Pastare S, Stalte V, Teterovska D, Baltramonaitiene K, Barsiene L, Ceponis J, Lasiene J, Levinger A, Sirutaviciene A, Sulskiene M, Urbanaviciene L, Valius L, Varanauskiene E, Velickiene D, Mahendran KA, Abu Hassan MR, Aziz NA, Hussein Z, Ismail IS, Kamaruddin NA, Nordin Z, Nayar SK, Ramanathan GR, Sothiratnam R, Beijerbacht H, Breedveld R, Cornel JH, Den Hartog F, Hermans W, Kietselaer B, Kooy A, Lenderink T, Nierop P, Remmen J, Rojas Lingan G, Ronner E, Van der Heijden R, Van Hessen M, van Kempen W, Voors-Pette C, Westendorp I, Baker J, Benatar J, Cutfield R, Krebs J, Leikis R, Lunt H, Manning P, Williams M, Birkeland K, Claudi T, Istad H, Karlsson T, Ossum Gronert J, Arciszewska M, Artemiuk E, Blach E, 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DAgostino R, Davies M, Dayamani P, De Lemos J, De Meireles M, Dean J, DeHart D, Detweiler R, Donovan D, Dugano-Daphnis P, Dulin M, Dunn F, Eaton C, Erickson B, Estevez R, Feinglos M, Fonseca V, Force R, Forker A, Fox D, Gabriel J, Garcia R, Garvey T, Gaudiani L, Getaneh A, Goff D, Goldberg A, Goldman S, Hairston K, Harris R, Haught W, Hidalgo H Jr, Higgins A, Houchin V, Ison R, Jacobs G, Jaffrani N, Jafry B, Kapsner P, Kaye W, Labroo A, Levinson L, Lewis S, Lillestol M, Luttrell L, Madu I, McNeill R, Merrick B, Metzger F, Nadar V, Nagelberg S, Nash S, Oparil S, Osei K, Papademetriou V, Patel N, Pedley C, Prentiss A, Radbill M, Raisinghani A, Rassouli N, Reddy R, Rees P, Rendell M, Robbins D, Rodbard H, Rohlf J, Roseman H, Rudolph L, Sadler L, Schnall A, Schramm R, Schubart U, Seneviratne T, Shanik M, Snyder H, Sorli C, Stich M, Sweeney ME, Tsao J, Ukwade P, Viswanath D, Vo A, Vogel C, Voyce S, Weintraub H, White J, Wood M, Wu P, Wysham C, Zimmerman R

Subjects
Oral, medicine.medical_specialty, Heart diseases, Glycosylated, Administration, Oral, heart failure, Type 2 diabetes, Dipeptidyl peptidase-4 inhibitor, Kaplan-Meier Estimate, Placebo, Sitagliptin Phosphate, Sitagliptin, Cardiovascular Outcomes, chemistry.chemical_compound, Drug Therapy, Double-Blind Method, Internal medicine, Diabetes Mellitus, medicine, Humans, Hypoglycemic Agents, Glycated Hemoglobin, Hemoglobin A, Glycosylated, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Follow-Up Studies, Heart Diseases, Heart Failure, Hospitalization, Pyrazines, Triazoles, Medicine (all), business.industry, Semaglutide, Hemoglobin A, General Medicine, ta3121, medicine.disease, Surgery, Cardiovascular diseases, chemistry, Sitagliptin, Administration, Combination, Glycated hemoglobin, business, Type 2, Alogliptin, medicine.drug
Abstract

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to-0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P

Published
2015

42. Liraglutide and Renal Outcomes in Type 2 Diabetes

Author

Mann JFE, Ørsted DD, Brown-Frandsen K, Marso SP, Poulter NR, Rasmussen S, Tornøe K, Zinman B, Buse JB, LEADER Steering Committee and Investigators. Bergenstal R, Daniels G, Moses AC, Nauck M, Nissen S, Pocock S, Steinberg W, Stockner M, Kristensen P, Ravn LS, Zychma M, Flyvbjerg A, Ford I, Kloos RT, Schactman MJ, Sleight P, Swedberg K, Tenner SM, Akalın S, Arechavaleta R, Bain S, Babkowski MC, Benroubi M, Berard L, Comlekci A, Czupryniak L, Eliasson B, Eriksson M, Fonseca V, Franek E, Gross J, Hafidh K, Haluzik M, Hayes F, Huang YY, Jacob S, Kaddaha G, Khalil A, Kilhovd B, Laakso M, Leiter L, Lalic N, Ji L, Luedemann J, Mannucci E, Marre M, Masmiquel L, Mota M, Omar M, O’Shea D, Pan C, Petrie J, Pieber T, Pratley R, Raz I, Rea R, Rutten G, Satman I, Shestakova M, Simpson R, Smith D, Tack C, Tarnow L, Thomas N, Van Gaal L, Travert F, Vidal J, Warren M, Yoon KH, Tuttle RM, Sheerman SI, Hegedüs L, Baerwald H, Bergenstal M, Celik S, Dias C, Eder M, Fitzgibbons S, Irvhage L, Kloluckova J, Kriulianski R, McDuffie R, Moen S, Paster A, Saalfeld RM, Sankar K, Shehaj E, Swierzewska P, Tiktin M, Tovey S, Gibson CM, Chakrabarti AK, Dashe JF, 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E, Martinez G, Martinez-Miss S, Marx P, Massara L, Mastoor M, Matfin G, Maturu A, Maurides P, May M, Mayfield R, Maynard B, Mazza A, McCann K, McCoy J, McCoy T, McCullen MK, McDaniel C, McDaniel AM, McDermott M, McDonald A, McMasters B, McMurray C, Medlin T, Meinel M, Mendez I, Menefee J, Meredith M, Merriweather M, Mersey J, Messino C, Meyer S, Meyers L, Michael D, Midyett C, Miklius A, Milford E, Miller B, Miller H, Milligan M, Minor A, Miranda-Palma B, Mirarchi N, Mittadodla S, Mittle J, Moffat A, Mohaupt S, Mohiuddin K, Mokshagundam S, Monaco S, Monsaert R, Montano-Pereira C, Montgomery A, Moody K, Moon M, Moore D, Moore L, Morawski E, Moreau C, Morin D, Moscoa C, Motzkin C, Mueller R, Munoz C, Munoz M, Myneni A, Naderi B, Nagireddy P, Naidu J, Naidu R, Naik S, Naimark R, Nardicchi M, Ndukwu I, Neller C, Netten-Foster L, Neumiller J, New T, Newman S, Newton T, Nguyen B, Nicol B, Nicol P, Ninivaggi L, Niswender K, Norman L, Noworatzky G, Nyenwe E, O'Brien H, O'Connell T, Oden W, Odugbesan A, Oliver M, Oliver T, Olmeda C, O'Neil C, Oremus R, Ortega T, Ortiz-Santos S, Osborn T, Padmanabhan S, Papacostea O, Park I, Parker A, Parker K, Parker R, Patel C, Patel M, Patel R, Patino M, Patterson S, Paulson K, Paz A, Pemba R, Pepe C, Perez J, Perez T, Perry D, Phillips B, Phillips J, Pickett A, Pinson M, Pitzer R, Poduri M, Poehls J, Poteat T, Powell L, Prasad S, Prevost J, Price E, Priest D, Prieto L, Purewal T, Purighalla R, Purighalla U, Quadrel M, Qureshi A, Radhamma R, Rafla E, Rajab H, Ramalingam R, Ramirez A, Ramirez J, Ramirez K, Ramirez M, Randall M, Rangaraj U, Rao V, Rasmussen P, Rasouli N, Ray A, Reed J, Rems L, Renaud K, Reno M, Resnick M, Reusch J, Reynolds L, Rhoton K, Rhudy J, Ricci C, Rice L, Richardson A, Richardson L, Rickard H, Rickels M, Riff D, Rightenour N, Risser J, Rizvi A, Robertson J, Robinson A, Robinson R, Rockwell M, Rodriguez JP, Rodriguez M, Rojas M, Rojas W, Rooker-Morris L, Root C, Rose M, Rosenberg R, Rosenstock J, Roth M, Ruby R, Sachson R, Sack P, Sadler RK, Sahai S, Salazar J, Salgam M, Samal A, Samson A, Sanagorski R, Sanchez A, Sandberg J, Sanderson M, Sandoval J, Santiago E, Sapp T, Saunders J, Schill J, Schott C, Schreiman R, Schu D, Schuh K, Schutta M, Schwartz J, Schweppe L, Scofield H, Scribner A, Seal J, Sealock J, Seaton B, Sedlak-Hanslik T, Seekins K, Segal M, Seggelke S, Semenza S, Sentman P, Serra M, Seshadri P, Sevilla E, Shah S, Shaheen K, Shanik M, Shaw J, Sheets M, Shellabarger C, Sher J, Shippey J, Shivaswamy V, Shomali M, Shore D, Shroff P, Siddiqui T, Siegwald A, Silver R, Simmons D, Simons R, Sinan A, Singh M, Sirinvaravong S, Skero J, Slover-Zipf J, Small S, Smith B, Smith K, Smith M, Sohl J, Solarz SH, Soler D, Sood A, Sora N, Souchet A, Soule J, Sparks J, Spector L, Speicher R, Spillers L, Spivey T, Springer N, Sprouse H, St John J, Stacey A, Stacey H, Stafford M, Stagner E, Staples K, Steadman E, Steed R, Steeves G, Steinberg H, Stell C, Stirman E, Straub K, Strock E, Sue M, Suris O, Sutton T, Tabbah I, Talsania M, Tang R, Tapia J, Taylor K, Taylor-Hancher R, Teator R, Tekateka M, Temple B, Temple K, Teodori M, Tharp P, Thethi T, Theuma P, Thomas S, Thottan A, Thrasher J, Thrasher L, Tiemeyer M, Tinney I, Tobin T, Toma S, Tovar M, Townsend J, Trantow C, Traylor H, Trevino M, Troy M, Trumper D, Tryggestad J, Tucker C, Turner J, Turney R, Tuten C, Tyzack J, Ullo L, Underkofler C, Unger J, Urdanetta R, Valdivia V, Valenti S, Vanderheiden A, Vanderlinde-Wood M, Varma C, Vasquez E, Vazquez M, Vickery D, Villafuerte B, Villegas C, Vivar J, Vivekananthan K, Vo G, Vukojicic K, Wachter A, Wahl D, Waitmann J, Walker D, Walsh J, Walsh K, Walton A, Wang A, Wardell K, Watkins S, Watkinson J, Watts M, Watwe V, Weaver N, Weber R, Wedick C, Weeks D, Weeks L, Weindorff K, Weinstein R, Weiss S, Wenger K, Wentworth M, Werner A, West M, Whelan S, White B, White J, Whitmire M, Whittington R, Wical J, Wigley C, Wilkins F, Will K, Williams A, Wilson LE, Wince M, Wine S, Winkle P, Winner C, Wise J, Witte M, Wittenmyer J, Wood C, Wood R, Woodruff C, Worthington B, Wynn D, Wysham C, Xavier P, Yela S, Yenoby L, Young L, Younus N, Yourell V, Zaid M, Zubair I., Mann, Jfe, Ørsted, Dd, Brown-Frandsen, K, Marso, Sp, Poulter, Nr, Rasmussen, S, Tornøe, K, Zinman, B, Buse, Jb, Bergenstal R, LEADER Steering Committee and Investigators., Daniels, G, Moses, Ac, Nauck, M, Nissen, S, Pocock, S, Steinberg, W, Stockner, M, Kristensen, P, Ravn, L, Zychma, M, Flyvbjerg, A, Ford, I, Kloos, Rt, Schactman, Mj, Sleight, P, Swedberg, K, Tenner, Sm, Akalın, S, Arechavaleta, R, Bain, S, Babkowski, Mc, Benroubi, M, Berard, L, Comlekci, A, Czupryniak, L, Eliasson, B, Eriksson, M, Fonseca, V, Franek, E, Gross, J, Hafidh, K, Haluzik, M, Hayes, F, Huang, Yy, Jacob, S, Kaddaha, G, Khalil, A, Kilhovd, B, Laakso, M, Leiter, L, Lalic, N, Ji, L, Luedemann, J, Mannucci, E, Marre, M, Masmiquel, L, Mota, M, Omar, M, O’Shea, D, Pan, C, Petrie, J, Pieber, T, Pratley, R, Raz, I, Rea, R, Rutten, G, Satman, I, 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Naidu, J, Naidu, R, Naik, S, Naimark, R, Nardicchi, M, Ndukwu, I, Neller, C, Netten-Foster, L, Neumiller, J, New, T, Newman, S, Newton, T, Nguyen, B, Nicol, B, Nicol, P, Ninivaggi, L, Niswender, K, Norman, L, Noworatzky, G, Nyenwe, E, O'Brien, H, O'Connell, T, Oden, W, Odugbesan, A, Oliver, M, Oliver, T, Olmeda, C, O'Neil, C, Oremus, R, Ortega, T, Ortiz-Santos, S, Osborn, T, Padmanabhan, S, Papacostea, O, Park, I, Parker, A, Parker, K, Parker, R, Patel, C, Patel, M, Patel, R, Patino, M, Patterson, S, Paulson, K, Paz, A, Pemba, R, Pepe, C, Perez, J, Perez, T, Perry, D, Phillips, B, Phillips, J, Pickett, A, Pinson, M, Pitzer, R, Poduri, M, Poehls, J, Poteat, T, Powell, L, Prasad, S, Prevost, J, Price, E, Priest, D, Prieto, L, Purewal, T, Purighalla, R, Purighalla, U, Quadrel, M, Qureshi, A, Radhamma, R, Rafla, E, Rajab, H, Ramalingam, R, Ramirez, A, J, Ramirez, Ramirez, K, Ramirez, M, Randall, M, Rangaraj, U, Rao, V, Rasmussen, P, Rasouli, N, Ray, A, Reed, J, Rems, L, Renaud, K, Reno, M, Resnick, M, Reusch, J, Reynolds, L, Rhoton, K, Rhudy, J, Ricci, C, Rice, L, Richardson, A, Richardson, L, Rickard, H, Rickels, M, Riff, D, Rightenour, N, Risser, J, Rizvi, A, Robertson, J, Robinson, A, Robinson, R, Rockwell, M, Rodriguez, Jp, Rodriguez, M, Rojas, M, Rojas, W, Rooker-Morris, L, Root, C, Rose, M, Rosenberg, R, Rosenstock, J, Roth, M, Ruby, R, Sachson, R, Sack, P, Sadler, Rk, Sahai, S, J, Salazar, Salgam, M, Samal, A, Samson, A, Sanagorski, R, Sanchez, A, Sandberg, J, Sanderson, M, Sandoval, J, Santiago, E, Sapp, T, Saunders, J, Schill, J, Schott, C, Schreiman, R, Schu, D, Schuh, K, Schutta, M, Schwartz, J, Schweppe, L, Scofield, H, Scribner, A, Seal, J, Sealock, J, Seaton, B, Sedlak-Hanslik, T, Seekins, K, Segal, M, Seggelke, S, Semenza, S, Sentman, P, Serra, M, Seshadri, P, Sevilla, E, Shah, S, Shaheen, K, Shanik, M, Shaw, J, Sheets, M, Shellabarger, C, Sher, J, Shippey, J, Shivaswamy, V, Shomali, M, Shore, D, Shroff, P, Siddiqui, T, Siegwald, A, Silver, R, Simmons, D, Simons, R, Sinan, A, Singh, M, Sirinvaravong, S, Skero, J, Slover-Zipf, J, Small, S, Smith, B, Smith, K, Smith, M, Sohl, J, Solarz, Sh, Soler, D, Sood, A, Sora, N, Souchet, A, Soule, J, Sparks, J, Spector, L, Speicher, R, Spillers, L, Spivey, T, Springer, N, Sprouse, H, St John, J, Stacey, A, Stacey, H, Stafford, M, Stagner, E, Staples, K, Steadman, E, Steed, R, Steeves, G, Steinberg, H, Stell, C, Stirman, E, Straub, K, Strock, E, Sue, M, Suris, O, Sutton, T, Tabbah, I, Talsania, M, Tang, R, Tapia, J, Taylor, K, Taylor-Hancher, R, Teator, R, Tekateka, M, Temple, B, Temple, K, Teodori, M, Tharp, P, Thethi, T, Theuma, P, Thomas, S, Thottan, A, Thrasher, J, Thrasher, L, Tiemeyer, M, Tinney, I, Tobin, T, Toma, S, Tovar, M, Townsend, J, Trantow, C, Traylor, H, Trevino, M, Troy, M, Trumper, D, Tryggestad, J, Tucker, C, Turner, J, Turney, R, Tuten, C, Tyzack, J, Ullo, L, Underkofler, C, Unger, J, Urdanetta, R, Valdivia, V, Valenti, S, Vanderheiden, A, Vanderlinde-Wood, M, Varma, C, Vasquez, E, Vazquez, M, Vickery, D, Villafuerte, B, Villegas, C, Vivar, J, Vivekananthan, K, Vo, G, Vukojicic, K, Wachter, A, Wahl, D, Waitmann, J, Walker, D, Walsh, J, Walsh, K, Walton, A, Wang, A, Wardell, K, Watkins, S, Watkinson, J, Watts, M, Watwe, V, Weaver, N, Weber, R, Wedick, C, Weeks, D, Weeks, L, Weindorff, K, Weinstein, R, Weiss, S, Wenger, K, Wentworth, M, Werner, A, West, M, Whelan, S, White, B, White, J, Whitmire, M, Whittington, R, Wical, J, Wigley, C, Wilkins, F, Will, K, Williams, A, Wilson, Le, Wince, M, Wine, S, Winkle, P, Winner, C, Wise, J, Witte, M, Wittenmyer, J, Wood, C, Wood, R, Woodruff, C, Worthington, B, Wynn, D, Wysham, C, Xavier, P, Yela, S, Yenoby, L, Young, L, Younus, N, Yourell, V, Zaid, M, Zubair, I., Mann J.F.E., Orsted D.D., Brown-Frandsen K., Marso S.P., Poulter N.R., Rasmussen S., Tornoe K., Zinman B., Buse J.B., and Buscemi S.

Subjects
Male, Settore MED/09 - Medicina Interna, Acute Kidney Injury, Aged, Albuminuria, Creatinine, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Female, Follow-Up Studies, Glomerular Filtration Rate, Glucagon-Like Peptide 1, Humans, Hypoglycemic Agents, Intention to Treat Analysis, Kidney Failure, Chronic, Liraglutide, Middle Aged, Type 2 diabetes, 030204 cardiovascular system & hematology, urologic and male genital diseases, GLOMERULAR-FILTRATION-RATE, KIDNEY-FUNCTION, DISEASE, law.invention, Kidney Failure, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Medicine, Settore MED/49 - Scienze Tecniche Dietetiche Applicate, Chronic, RISK, Kidney, Acute kidney injury, 11 Medical And Health Sciences, General Medicine, medicine.anatomical_structure, TRIAL, liraglutide, randomized controlled trial, type 2 diabetes, renal outcomes, Life Sciences & Biomedicine, Type 2, medicine.drug, medicine.medical_specialty, Renal function, 030209 endocrinology & metabolism, CARDIOVASCULAR OUTCOMES, Follow-Up Studie, 03 medical and health sciences, Medicine, General & Internal, General & Internal Medicine, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Intensive care medicine, Science & Technology, business.industry, MORTALITY, medicine.disease, INTENSIVE GLUCOSE CONTROL, INDIVIDUALS, chemistry, Diabetic Nephropathie, LEADER Steering Committee and Investigators, business
Abstract

BACKGROUND: In a randomized, controlled trial that compared liraglutide, a glucagon-like peptide 1 analogue, with placebo in patients with type 2 diabetes and high cardiovascular risk who were receiving usual care, we found that liraglutide resulted in lower risks of the primary end point (nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes) and death. However, the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes are unknown. METHODS: We report the prespecified secondary renal outcomes of that randomized, controlled trial in which patients were assigned to receive liraglutide or placebo. The secondary renal outcome was a composite of new-onset persistent macroalbuminuria, persistent doubling of the serum creatinine level, end-stage renal disease, or death due to renal disease. The risk of renal outcomes was determined with the use of time-to-event analyses with an intention-to-treat approach. Changes in the estimated glomerular filtration rate and albuminuria were also analyzed. RESULTS: A total of 9340 patients underwent randomization, and the median follow-up of the patients was 3.84 years. The renal outcome occurred in fewer participants in the liraglutide group than in the placebo group (268 of 4668 patients vs. 337 of 4672; hazard ratio, 0.78; 95% confidence interval [CI], 0.67 to 0.92; P=0.003). This result was driven primarily by the new onset of persistent macroalbuminuria, which occurred in fewer participants in the liraglutide group than in the placebo group (161 vs. 215 patients; hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P=0.004). The rates of renal adverse events were similar in the liraglutide group and the placebo group (15.1 events and 16.5 events per 1000 patient-years), including the rate of acute kidney injury (7.1 and 6.2 events per 1000 patient-years, respectively). CONCLUSIONS: This prespecified secondary analysis shows that, when added to usual care, liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo. (Funded by Novo Nordisk and the National Institutes of Health; LEADER ClinicalTrials.gov number, NCT01179048 .).

Published
2017

44. Plant Secondary Metabolite-Derived Polymers: A Potential Approach to Develop Antimicrobial Films

Author

Avishek Kumar, Ahmed Al-Jumaili, Mohan V. Jacob, and Kateryna Bazaka

Subjects
0301 basic medicine, Polymers and Plastics, 030106 microbiology, 02 engineering and technology, Review, Secondary metabolite, Biofouling, lcsh:QD241-441, 03 medical and health sciences, lcsh:Organic chemistry, medicine, Fungal colonization, chemistry.chemical_classification, plasma-assisted technique, General Chemistry, Polymer, 021001 nanoscience & nanotechnology, Antimicrobial, Combinatorial chemistry, plant secondary metabolites, chemistry, volatile renewable resources, Surface modification, microbial infection, biologically-active polymers, 0210 nano-technology, Antibacterial activity, Polymer thin films, antimicrobial essential oils, medicine.drug
Abstract

The persistent issue of bacterial and fungal colonization of artificial implantable materials and the decreasing efficacy of conventional systemic antibiotics used to treat implant-associated infections has led to the development of a wide range of antifouling and antibacterial strategies. This article reviews one such strategy where inherently biologically active renewable resources, i.e., plant secondary metabolites (PSMs) and their naturally occurring combinations (i.e., essential oils) are used for surface functionalization and synthesis of polymer thin films. With a distinct mode of antibacterial activity, broad spectrum of action, and diversity of available chemistries, plant secondary metabolites present an attractive alternative to conventional antibiotics. However, their conversion from liquid to solid phase without a significant loss of activity is not trivial. Using selected examples, this article shows how plasma techniques provide a sufficiently flexible and chemically reactive environment to enable the synthesis of biologically-active polymer coatings from volatile renewable resources.

Published
2018

45. Empagliflozin and Kidney Function Decline in Patients with Type 2 Diabetes: A Slope Analysis from the EMPA-REG OUTCOME Trial

Author

Wanner, Christoph, Heerspink, Hiddo J. L., Zinman, Bernard, Inzucchi, Silvio E., Koitka-Weber, Audrey, Mattheus, Michaela, Hantel, Stefan, Woerle, Hans-Juergen, Broedl, Uli C., von Eynatten, Maximilian, Groop, Per-Henrik, Aizenberg, D., Ulla, M., Waitman, J., De Loredo, L., Farias, J., Fideleff, H., Lagrutta, M., Maldonado, N., Colombo, H., Ferre Pacora, F., Wasserman, A., Maffei, L., Lehman, R., Selvanayagam, J., d'Emden, M., Fasching, P., Paulweber, B., Toplak, H., Luger, A., Drexel, H., Prager, R., Schnack, C., Schernthaner, G., Fliesser-Goerzer, E., Kaser, S., Scheen, A., Van Gaal, Luc, Hollanders, G., Kockaerts, Y., Capiau, L., Chachati, A., Persu, A., Hermans, M., Vantroyen, D., Vercammen, C., Van de Borne, P., Mathieu, C., Benhalima, Katrien, Lienart, F., Mortelmans, J., Strivay, M., Vereecken, G., Keymeulen, B., Lamkanfi, F., Chacra, A., Eliaschewitz, F., Zanella, M., Faludi, A., Bertolami, M., Hayashida, C., Nunes Salles, J., Monte, O., Dinato, M., Manenti, E., Rassi, N., Halpern, A., Lima Filho, M., Ayoub, J., Felicio, J., Borges, J., Gross, J., Sgarbi, J., Betti, R., Tiburcio, A., Purisch, S., Schmid, H., Takahashi, M., Castro, M., Rea, R., Hissa, M., Geloneze Neto, B., Saraiva, J., Henein, S., Lochnan, H., Imran, S. A., Clayton, D., Bayly, K., Berlingieri, J., Boucher, P., Chan, Y., Gupta, M., Chehayeb, R., Ouellett, A., Ur, E., Woo, V., Zinman, B., St Amour, E., Terront Lozano, M., Yupanqui Lozno, H., Urina, M., Lopez Jaramillo, P., Jaramillo, N., Sanchez, G., Perez, G., Tusek, S., Mirosevic, G., Goldoni, V., Jurisic-Erzen, D., Balasko, A., Balic, S., Drvodelic-Sunic, E., Varzic, S. Canecki, Machkova, M., Weiner, P., Lastuvka, J., Olsovsky, J., Krarup, T., Ridderstrale, M., Tarnow, L., Boesgaard, T. Wellov, Lihn, A. Saetre, Christensen, P., Juhl, H., Urhammer, S., Lund, P., Adojaan, B., Jakovlev, U., Lanno, R., Lubi, M., Marandi, T., Gouet, D., Courreges, J., Zaoui, P., Choukroun, G., Petit, C., Formagne, L., Estour, B., Mabire, P., Daugenet, C., Lemarie, B., Clavel, S., Aure, P., Remaud, P., Halimi, J., Hadjadj, S., Couffinhal, T., Glonti, S., Metreveli, D., Lominadze, Z., Giorgadze, E., Burtchuladze, T., Javashvili, L., Kurashvili, G., Kurashvili, R., Virsaladze, D., Nadareishvili, L., Khomasuridze, A., Cahill, T., Green, F., MacRury, S., Waldron, M., Middleton, A., McKnight, J., Pearson, E., Butler, M., Choksi, M., Caldwell, I., Farmer, I., Wyatt, N., Patrick, J., O'Brien, I., Devers, M., Bousboulas, S., Pappas, S., Piaditis, G., Vryonidou, A., Tentolouris, N., Karamitsos, K., Manes, C., Benroubi, M., Avramidis, I., Ozaki, R., Tan, K., Siu, S., Tsang, C., Dudas, M., Nagy, K., Salamon, C., Ip, T., Geroo, L., Patkay, J., Tabak, A., Juhasz, F., Szentpeteri, I., Tamas, G., Ghaisas, N., Bantwal, G., Mohan, V., Gupta, J., Sadhu, N., Kulkarni, A., Garg, N., Reddy, S., Deshpande, N., Gutlapalli, K., Pillai, M., Premchand, R., Badgandi, M., Jain, S., Aravind, S., Shamanna, P., Pandey, A., Gupta, S., Pramono, B., Saksono, H. Dante, Agung, P., Wahono, S. Djoko, Suastika, K., Tanggo, Y., Juwana, Y., Siswanto, B., Adawi, F., Efrati, S., Mazen, E., Bashkin, A., Herskovits, T., Jaffe, A., Schiff, E., Wainstein, J., Taddei, S., Aiello, A., Arca, M., Calabro, P., Cignarelli, M., Fioretto, P., Reggiani, G. Marchesini, Gnasso, A., Marchionni, N., Marsilii, A., Bucci, M., Mezzetti, A., Pozzilli, P., Colivicchi, F., Santini, M., Moro, E., Toscano, V., Fucili, A., Semplicini, A., Monno, S., Furui, K., Higashiue, S., Hiramatsu, N., Kawamitsu, K., Takenaka, T., Takahashi, H., Hojo, F., Onishi, Y., Izumino, K., Okubo, M., Wakida, Y., Kondo, Y., Hieshima, K., Jinnouchi, H., Suzuki, A., Ito, M., Park, S., Kim, Y., Hong, T., Park, H., Gwon, H., Kim, H., Kang, K., Jeong, M., Seung, K., Lim, D., Rha, S., Tahk, S., Yang, J., Yoon, J., Shin, M., Kim, D., Jeong, J., Ahmad, N. Nik, Mustafa, N., Mohamed, W. Wan, Fung, Y., Ghani, R. Abdul, Chandramouli, A., Chee, K., Kadir, K. Abdul, Ling, K., Abu Hassan, M., Foo, S., Lee, S., Garcia Hernandez, P., Aguilar-Salinas, C., Vidrio Velazquez, M., Flores, F., Alpizar Salazar, M., Micher Escalante, D., Garcia Soria, M., Cardona Munoz, E., Storms, G., Schaper, N., Kooy, A., Krekels, M., van Bemmel, T., Verhoeven, R., Mulder, H., Oldenburg-Ligtenberg, P., Gonkel, F., de Jong, A., van Soest, J., Viergever, P., Mevissen, H., Lochorn, G., Zwiers, G., Hoogslag, P., Ronner, E., Nierop, P., Al-Windy, N., Kragten, J., Dekelver, P., Benatar, J., Krebs, J., Scott, R., Heggen, E., Berz, A., Fossum, C., Hurtig, U., Langslet, G., Baranowski, M., Sparby, J., Karlsson, T., Karlsson, Thomas, Delgado Torres, C., Rodriguez Escudero, A., Lisson, R., Allemant Maldonado, A., Gallardo Rojas, W., Gonzales Bravo, L., Lema Osores, J., Farfan, J., Zapata, L., Godoy Junchaya, J., Roldan Concha, Y., Urquiaga Calderon, J., Sy, R., Tan, G., Aquitania, G., De Los Santos, G., Panelo, A., Roderos, O., Rosales, R., Toledo, R., Liwag, A., Ramoncito, H., Skokowska, E., Krzyzagorska, E., Ogorek, M., Wojnowski, L., Spyra, J., Konieczny, M., Piesiewicz, W., Kus, W., Ocicka-Kozakiewicz, A., Orlowska-Kunikowska, E., Zmuda, W., Duarte, S., Leitao, A., Monteiro, P., Rita, H., Salgado, V., Pinto, L., Queiros, J., Teixeira, J., Rogado, C., Duarte, R., Sobral do Rosario, F., Silva, A., Andrade, L., Velez, M., Brazao, M., Istratoaie, O., Lichiardopol, R., Catrinoiu, D., Militaru, C., Zetu, C., Barbonta, D., Cosma, D., Crisan, C., Pop, L., Esip, V., Khetagurova, F., Petrov, A., Arutyunov, G., Boyarkin, M., Agafyina, A., Vorokhobina, N., Petunina, N., Libov, I., Zalevskaya, A., Nikolaev, K., Barbarash, O., Potemkin, V., Bystrova, A., Krasilnikova, E., Barbarich, V., Chumakova, G., Tarasov, N., Meleshkevich, T., Zateyshchikov, D., Lantseva, O., Belenkiy, D., Obrezan, A., Rossolko, L., Fillipova, E., Yakhontova, P., Khokhlov, A., Tan, R., Sum, C., Chang, H., Distiller, L., Pretorius, M., Nortje, H., Mitha, E., Burgess, L., Blignaut, S., Venter, T., Moodley, R., Lombaard, J., Govind, U., Naidoo, V., Mookadam, M., Engelbrecht, J., Omar, M., Jurgens, J., Podgorski, G., Vawda, H., Naidoo, D., Emanuel, S., Roodt, A., Amod, A., Van Zyl, L., Segura, J., Brito, M., Fernandez-Cruz, A., Artola, S., Iglesias, R., Toural, E., Garcia-Ortiz, L., Saban, J., Mesa, J., Vidal, J., Linares, J., del Canizo, F., Rigla, M., Suarez, C., Llorente, I., Moreno, B., Antoli, A., Gomez Peralta, F., Iglesias, M., Pereg, V., de Teresa, L., Camafort, M., Trescoli, C., Satarasinghe, R., Somasundaram, N., Siyambalapitiya, S., Antonypillai, C., Bulugahapitiya, D., Medagama, U., Huang, C., Lu, Y., Hwang, J., Chiang, C., Wen, M., Chen, J., Lai, W., Chang, K., Wang, J., Yeh, H., Kriangsak, P., Deerochanawong, C., Suwanwalaikorn, S., Mangklabruks, A., Kaewsuwanna, P., Piyayotai, D., Iabluchanskyi, M., Samoylov, O., Godlevska, O., Kovalyova, O., Voloshyna, O., Tseluyko, V., Zotov, S., Vykhovanyuk, I., Dulgeroff, A., Mayfield, R., Zaniewski-Singh, M., Ullal, J., Aloi, J., De La Rosa, R., Mosely, J., Wittmer, B., Aronoff, S., Rosenfeld, J., Seidner, M., Warren, M., Fishman, N., Weiss, R., Arif, A., Sandberg, M., Lewis, D., Ball, E., Graf, R., Breton, C., Tamayo, R., Richards, R., Cefalu, W., Uwaifo, G., Zayour, D., Hoffman, J., Fitz-Patrick, D., Khan, B., Blaze, K., Bressler, P., Halpern, S., Chappell, D., Bergenstal, R., Cuddihy, R., Matfin, G., Freedman, Z., Gonzalez-Campoy, J., Lerman, S., Rendell, M., Sitar, S., Reeves, M., Howard, T., Soufer, J., Miranda-Palma, B., Laliotis, A., Shomali, M., Teltser, M., Hurley, D., Morawski, E., Cherlin, R., Houchin, V., Welch, M., Goytia-Leos, D., Syed, M., Kowaloff, E., Weinrauch, L., Peniston, J., Brockmyre, A., First, B., Feld, L., Huffman, D., Nassim, O., Gottschlich, G., Patel, A., Knopke, C., Hernandez, M., Diaz, J., Giugliano, G., Nicasio, J., Eagerton, D., Huntley, R., Reed, J., Magee, M., Hippert, R., Sofley, C., Alzohaili, O., Levins, P., Anspach, R., Shah, S., Brusco, O., Naidu, J., Lindenbaum, J., Jacks, R., Hammond, G., Arena, C., Saxman, K., Mach, M., Kerstein, H., Kereiakes, D., Wahlen, J., Wehmeier, K., Chaykin, L., Rothman, J., Fogelfeld, L., Stroger, John H., Bittar, N., Rosenstock, J., Kayne, D., Navarro, J., Colfer, H., Mokshagundam, S., Shandilya, L., Connery, L., Wysham, C., Dela Llana, A., Jardula, M., MacAdams, M., Flippo, G., Heurich, E., Curtis, C., Sanders, D., Rawls, R., Velazquez, F., Osea, E., Mahood, K., Feldman, G., Eder, F., Riley, E., Fowler, W., Jain, M., Shepard, M., Schear, M., Barker, B., Strout, C., Obiekwe, O., Shanik, M., Green, C., Blakney, E., Roberson, K., Bretton, E., Pish, R., Kaveh, K., Maynard, B., Barager, W., Soldyshev, R., Austin, B., Parmar, P., Simpson, R., Chauhan, A., Kasper, J., Burr, R., Patel, N., Mariano, H., Pluto, T., Bratcher, C., Juarez, M., Levinson, L., Awad, A., Longshaw, K., Hoffman, K., Richwine, R., Molter, D., Boscia, J., Kowalyk, S., Lemis, P., Liss, J., Orr, R., Riser, J., Wood, J., Ubani, A., Paine, W., Hassani, F., Miranda, F., Hansen, V., Hansen, Val R., Farris, N., Bowden, R., Ajani, D., Maw, K., Andersen, J., Bergman, B., Dunmyer, S., Brandon, D., Anderson, M., Bononi, P., Prawer, J., Seidman, B., Cruz, H., Wilks, K., DiSanto, L., Buynak, R., Christensen, T., Denker, P., Koppel, W., Stedman, M., Lewy-Alterbaum, L., Karim, S., Shapiro, J., Gardner, T., Oskin, T., Gabra, N., Malano, J., Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Groningen Kidney Center (GKC), Methods in Medicines evaluation & Outcomes research (M2O), and EMPA-REG OUTCOME Investigators

Subjects
Male, Placebo-controlled study, PROGRESSION, Type 2 diabetes, 030204 cardiovascular system & hematology, PLACEBO-CONTROLLED TRIAL, GLOMERULAR-FILTRATION-RATE, HYPERFILTRATION, law.invention, ESTABLISHED CARDIOVASCULAR-DISEASE, Cohort Studies, MELLITUS, 0302 clinical medicine, Randomized controlled trial, Glucosides, law, Medicine, Diabetic Nephropathies, GFR DECLINE, General Medicine, Middle Aged, Nephrology, diabetes mellitus, randomized controlled trials, Disease Progression, Female, Glomerular Filtration Rate, medicine.medical_specialty, Urology, Renal function, 030209 endocrinology & metabolism, Placebo, 03 medical and health sciences, Double-Blind Method, Clinical Research, Diabetes mellitus, BASE-LINE CHARACTERISTICS, END-POINTS, Empagliflozin, Humans, Benzhydryl Compounds, Sodium-Glucose Transporter 2 Inhibitors, Aged, COTRANSPORTER 2 INHIBITION, Models, Statistical, Dose-Response Relationship, Drug, business.industry, chronic kidney disease, medicine.disease, Confidence interval, Diabetes Mellitus, Type 2, Human medicine, business
Abstract

BACKGROUND: Empagliflozin slowed the progression of CKD in patients with type 2 diabetes and cardiovascular disease in the EMPA-REG OUTCOME Trial. In a prespecified statistical approach, we assessed treatment differences in kidney function by analyzing slopes of eGFR changes.METHODS: Participants (n=7020) were randomized (1:1:1) to empagliflozin 10 mg/d, empagliflozin 25 mg/d, or placebo added to standard of care. We calculated eGFR slopes using random-intercept/random-coefficient models for prespecified study periods: treatment initiation (baseline to week 4), chronic maintenance treatment (week 4 to last value on treatment), and post-treatment (last value on treatment to follow-up).RESULTS: Compared with placebo, empagliflozin was associated with uniform shifts in individual eGFR slopes across all periods. On treatment initiation, adjusted mean slope (eGFR change per week, ml/min per 1.73 m2) decreased with empagliflozin (-0.77; 95% confidence interval, -0.83 to -0.71; placebo: 0.01; 95% confidence interval, -0.08 to 0.10; PCONCLUSIONS: The hemodynamic effects of empagliflozin, associated with reduction in intraglomerular pressure, may contribute to long-term preservation of kidney function.

Published
2018

46. Factors Associated with Severe Sepsis or Septic Shock in Patients with Gram Negative Bacteraemia: An Observational Cohort Study

Author

Vasudeva Guddattu, Mohan V Sumedha Maturu, Vandana Kalwaje Eshwara, and Chandrashekar Udyavara Kudru

Subjects
medicine.medical_specialty, business.industry, Septic shock, gram-negative bacilli, Mortality rate, lcsh:R, Clinical Biochemistry, lcsh:Medicine, General Medicine, Disease, Chronic liver disease, medicine.disease, Sepsis, Internal medicine, Diabetes mellitus, medicine, risk factors, business, Severe sepsis, pitt bacteraemia score, Cohort study
Abstract

Introduction: Sepsis is a systemic, host response to infection that progresses from sepsis to severe sepsis to septic shock. Severe sepsis carries significant morbidity and mortality. In the presence of individual risk factors such as old age, diabetes mellitus, chronic liver and renal disease, the death rate remains high despite treatment with antimicrobial agents. Aim: To determine the factors associated with severe sepsis or septic shock and to identify the factors influencing the mortality among patients with gram-negative bacteraemia. Materials and Methods: In this observational cohort study, 219 patients with gram-negative bacteraemia were screened for the presence of sepsis, severe sepsis and septic shock and detailed characteristics of the patients were analysed using independent sample t-test, chi-square test and logistic regression. Results: Among 219 patients with gram-negative bacteraemia, 43 (19.6%) were classified as severe sepsis, 69 (31.5%) as septic shock and the remaining 107 (48.9%) as only sepsis according to clinical criteria. Diabetes mellitus (p-value=0.006), chronic liver disease (p-value=0.001), presence of urinary catheter (p-value4 was significant (p-value

Published
2018

47. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, Gm, Carnahan, E, Stevens, Ga, Cowan, Mj, Farzadfar, F, Lin, Jk, Finucane, Mm, Rao, M, Khang, Yh, Riley, Lm, Mozaffarian, D, Lim, Ss, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, Na, Rahim, Hf, Addo, J, Aekplakorn, W, Afifi, Mm, Agabiti Rosei, E, Salinas, Ca, Agyemang, C, Ali, Mk, Ali, Mm, Al Nsour, M, Al Nuaim AR, Ambady, R, Di Angelantonio, E, Aro, P, Azizi, F, Babu, Bv, Bahalim, An, Barbagallo, Cm, Barbieri, Ma, Barceló, A, Barreto, Sm, Barros, H, Bautista, Le, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, Enzo, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León AC, Campos, H, Cappuccio, Fp, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, Cj, Chaouki, N, Chatterji, S, Chen, Cj, Chen, Z, Choi, Js, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Corsi, Am, Costanza, Mc, Craig, Cl, Dankner, Rs, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, Gh, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, Ch, Fan, Jg, Ferreccio, C, Fezeu, L, Firmo, Jo, Florez, Hj, Fornés, Ns, Fowkes, Fg, Franceschini, G, Frisk, F, Fuchs, Fd, Fuller, El, Getz, L, Giampaoli, S, Gómez, Lf, Gomez Zumaquero JM, Graff Iversen, S, Grant, Jf, Carvajal, Rg, Gulliford, Mc, Gupta, R, Gupta, Pc, Gureje, O, Gutierrez, Hr, Hansen, Tw, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, Wh, Herrera, Vm, Ho, S, Holdsworth, M, Frisman, Gh, Hopman, Wm, Hussain, A, Husseini, A, Ibrahim, Mm, Ikeda, N, Jacobsen, Bk, Jaddou, Hy, Jafar, Th, Janghorbani, M, Jasienska, G, Joffres, Mr, Jonas, Jb, Kadiki, Oa, Kalter Leibovici, O, Kamadjeu, Rm, Kaptoge, S, Karalis, I, Kastarinen, Mj, Katz, J, Keinan Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, Kw, Kiyohara, Y, Kobayashi, J, Krause, Mp, Kubínová, R, Kurjata, P, Kusuma, Ys, Lam, Th, Langhammer, A, Lawes, Cm, Le, C, Lee, J, Lévy Marchal, C, Lewington, S, Li, Y, Lim, To, Lin, X, Lin, Cc, Lin, Hh, Lind, L, Lissner, L, Liu, X, Lopez Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, Dr, Maggi, S, Magliano, Dj, Makdisse, M, Mancia, G, Mannami, T, Marques Vidal, P, Mbanya, Jc, McFarlane Anderson, N, Miccoli, R, Miettola, J, Minh, Hv, Miquel, Jf, Miranda, Jj, Mohamed, Mk, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, Wf, Morales, Dd, Morgan, K, Muiesan, Lm, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, Ka, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, Sw, Ohkubo, T, Olivieri, Oliviero, Önal, Ae, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, Wh, Panagiotakos, Db, Panza, F, Park, Y, Passos, Vm, Pednekar, Ms, Pelizzari, Pm, Peres, Ma, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, Ot, Ramos, Lr, Rampal, S, Rampal, L, Rasmussen, F, Reddy, Kk, Redon, J, Revilla, L, Reyes García, V, Roaeid, Rb, Robinson, Ca, Rodriguez Artalejo, F, Rojas Martinez, R, Ronkainen, K, Rosero Bixby, L, Roth, Ga, Sachdev, Hs, Sánchez, Jr, Sanisoglu, Sy, Sans, S, Sarraf Zadegan, N, Scazufca, M, Schaan, Bd, Schapochnik, N, Schelleman, H, Schneider, Ij, Schooling, Cm, Schwarz, B, Sekuri, C, Sereday, Ms, Serra Majem, L, Shaw, J, Shera, As, Shi, Z, Shiri, R, Shu, Xo, Silva, Da, Silva, E, Simons, La, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, Ad, Stergiou, Gs, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, Ab, Tai, Es, Tambs, K, Tesfaye, F, Thomas, Gn, Thorogood, M, Tilvis, Rs, Tobias, M, Torheim, Le, Trenkwalder, P, Tuomilehto, Jo, Tur, Ja, Tzourio, C, Uhernik, Ai, Ukoli, Fa, Unwin, N, Hoorn, Sv, Vanderpump, Mp, Varo, Jj, Veierød, Mb, Velásquez Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Yx, Ward, M, Waspadji, S, Welin, Lx, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, Xavier, Aj, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, Lc, Yoon, Js, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Ward, M., Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration, Danaei, G., Lu, Y., Singh, G.M., Carnahan, E., Stevens, G.A., Cowan, M.J., Farzadfar, F., Lin, J.K., Finucane, M.M., Rao, M., Khang, Y.H., Riley, L.M., Mozaffarian, D., Lim, S.S., Ezzati, M., Aamodt, G., Abdeen, Z., Abdella, N.A., Rahim, H.F., Addo, J., Aekplakorn, W., Afifi, M.M., Agabiti-Rosei, E., Salinas, C.A., Agyemang, C., Ali, M.K., Ali, M.M., Al-Nsour, M., Al-Nuaim, A.R., Ambady, R., Di Angelantonio, E., Aro, P., Azizi, F., Babu, B.V., Bahalim, A.N., Barbagallo, C.M., Barbieri, M.A., Barceló, A., Barreto, S.M., Barros, H., Bautista, L.E., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Botana, M.A., Bovet, P., Breckenkamp, J., Breteler, M.M., Broda, G., Brown, I.J., Bursztyn, M., de León, A.C., Campos, H., Cappuccio, F.P., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C.J., Chaouki, N., Chatterji, S., Chen, C.J., Chen, Z., Choi, J.S., Chua, L., Cífková, R., Cobiac, L.J., Cooper, R.S., Corsi, A.M., Costanza, M.C., Craig, C.L., Dankner, R.S., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G.H., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, R., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C.H., Fan, J.G., Ferreccio, C., Fezeu, L., Firmo, J.O., Florez, H.J., Fornés, N.S., Fowkes, F.G., Franceschini, G., Frisk, F., Fuchs, F.D., Fuller, E.L., Getz, L., Giampaoli, S., Gómez, L.F., Gomez-Zumaquero, J.M., Graff-Iversen, S., Grant, J.F., Carvajal, R.G., Gulliford, M.C., Gupta, R., Gupta, P.C., Gureje, O., Gutierrez, H.R., Hansen, T.W., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W.H., Herrera, V.M., Ho, S., Holdsworth, M., Frisman, G.H., Hopman, W.M., Hussain, A., Husseini, A., Ibrahim, M.M., Ikeda, N., Jacobsen, B.K., Jaddou, H.Y., Jafar, T.H., Janghorbani, M., Jasienska, G., Joffres, M.R., Jonas, J.B., Kadiki, O.A., Kalter-Leibovici, O., Kamadjeu, R.M., Kaptoge, S., Karalis, I., Kastarinen, M.J., Katz, J., Keinan-Boker, L., Kelly, P., Khalilzadeh, O., Kiechl, S., Kim, K.W., Kiyohara, Y., Kobayashi, J., Krause, M.P., Kubínová, R., Kurjata, P., Kusuma, Y.S., Lam, T.H., Langhammer, A., Lawes, C.M., Le, C., Lee, J., Lévy-Marchal, C., Lewington, S., Li, Y., Lim, T.O., Lin, X., Lin, C.C., Lin, H.H., Lind, L., Lissner, L., Liu, X., Lopez-Jaramillo, P., Lorbeer, R., Ma, G., Ma, S., Macià, F., MacLean, D.R., Maggi, S., Magliano, D.J., Makdisse, M., Mancia, G., Mannami, T., Marques-Vidal, P., Mbanya, J.C., McFarlane-Anderson, N., Miccoli, R., Miettola, J., Minh, H.V., Miquel, J.F., Miranda, J.J., Mohamed, M.K., Mohan, V., Mohanna, S., Mokdad, A., Mollentze, W.F., Morales, D.D., Morgan, K., Muiesan, L.M., Muntoni, S., Nabipour, I., Nakagami, T., Nangia, V., Nemesure, B., Neovius, M., Nerhus, K.A., Nervi, F., Neuhauser, H., Nguyen, M., Ninomiya, T., Noale, M., Oh, S.W., Ohkubo, T., Olivieri, O., Önal, A.E., Onat, A., Oróstegui, M., Ouedraogo, H., Pan, W.H., Panagiotakos, D.B., Panza, F., Park, Y., Passos, V.M., Pednekar, M.S., Pelizzari, P.M., Peres, M.A., Pérez, C., Pérez-Fernández, R., Pichardo, R., Phua, H.P., Pistelli, F., Plans, P., Polakowska, M., Poulter, N., Prabhakaran, D., Qiao, Q., Rafiei, M., Raitakari, O.T., Ramos, L.R., Rampal, S., Rampal, L., Rasmussen, F., Reddy, K.K., Redon, J., Revilla, L., Reyes-García, V., Roaeid, R.B., Robinson, C.A., Rodriguez-Artalejo, F., Rojas-Martinez, R., Ronkainen, K., Rosero-Bixby, L., Roth, G.A., Sachdev, H.S., Sánchez, J.R., Sanisoglu, S.Y., Sans, S., Sarraf-Zadegan, N., Scazufca, M., Schaan, B.D., Schapochnik, N., Schelleman, H., Schneider, I.J., Schooling, C.M., Schwarz, B., Sekuri, C., Sereday, M.S., Serra-Majem, L., Shaw, J., Shera, A.S., Shi, Z., Shiri, R., Shu, X.O., Silva, D.A., Silva, E., Simons, L.A., Smith, M., Söderberg, S., Soebardi, S., Solfrizzi, V., Sonestedt, E., Soysal, A., Stattin, P., Stein, A.D., Stergiou, G.S., Stessman, J., Sudo, A., Suka, M., Sundh, V., Sundquist, K., Sundström, J., Swai, A.B., Tai, E.S., Tambs, K., Tesfaye, F., Thomas, G.N., Thorogood, M., Tilvis, R.S., Tobias, M., Torheim, L.E., Trenkwalder, P., Tuomilehto, J.O., Tur, J.A., Tzourio, C., Uhernik, A.I., Ukoli, F.A., Unwin, N., Hoorn, S.V., Vanderpump, M.P., Varo, J.J., Veierød, M.B., Velásquez-Meléndez, G., Verschuren, M., Viet, L., Villalpando, S., Vioque, J., Vollenweider, P., Volpato, S., Wang, N., Wang, Y.X., Ward, M., Waspadji, S., Welin, L.X., Whitlock, G., Wilhelmsen, L., Willeit, J., Woodward, M., Wormser, D., Xavier, A.J., Xu, F., Xu, L., Yamamoto, A., Yang, G., Yang, X., Yeh, L.C., Yoon, J.S., You, Q., Yu, Z., Zhang, J., Zhang, L., Zheng, W., Zhou, M., ACS - Amsterdam Cardiovascular Sciences, APH - Amsterdam Public Health, Public and occupational health, Danaei G, Lu Y, Singh GM, Stevens GA, Cowan MJ, Farzadfar F, Lin JK, Finucane MM, Rao M, Khang Y-H, Riley LM, Mozaffarian D, Lim SS, Ezzati M, Aamodt G, Abdeen Z, Abdella NA, Abdul Rahim HF, Addo J, Aekplakorn W, Afi fi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MK, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Di Angelantonio E, Aro P, Azizi F, Babu BV, Bahalim AN, Barbagallo CM, Barbieri MA, Barcelo A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Bjorkelund C, Bo S, Bobak M, Bonora E, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de Leon A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang C-J, Chaouki N, Chatterji S, Chen C-J, Chen Z, Choi J-S, Chua L, Cifkova R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong G-H, Dorsi E, Dragano N, Drewnowski A, Eggertsen R, Elliott P, Anders Engeland, Erem C, Esteghamati A, Fall CHD, Fan J-G, Ferreccio C, Fezeu L, Firmo JO, Florez HF, Fornes NF, Fowkes FGR, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gomez LF, Gomez-Zumaquero JM, Graff –Iversen S, Grant JF, Guerrero Carvajal R, Gulliford MC, Gupta R, Gupta PC, Gureje O, Gutierrez HR, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Hollman Frisman G, Hopman WM, Hussain A, Husseini A, Ibrahim MM, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Kaptoge S, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Kiechl S, Woong Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubinova R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CMM, Le C, Lee J, Levy-Marchal C, Lewington S, Li Y, Lim TO, Lin X, Lin C-C, Lin H-H, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Ma G, Ma S, Macia F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JCN, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, J Miranda JJ, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Onal AE, Onat A, Orostegui M, Ouedraogo H, Pan W-A, Panagiotakos DB, Panza F, Park Y, Passos VMA, Pednekar MS, Pelizzari PM, Peres MA, Perez C, Perez-Fernandez R, Pichardo R, Hwee Pin Phua, Francesco Pistelli, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KKR, Josep Redon J, Revilla L, Reyes-GarciaV, Roaeid RB, Robinson CA, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sanchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJC, Schooling CM, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Santos Silva DA, Silva E, Simons LA, Smith M, Soderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, StattinP, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundstrom J, Swai AB, Tai ES, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik A, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierod MB, Velasquez-Melendez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Whitlock G, Wilhelmsen L, Willeit J, Woodward M, Wormser D, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh L-C, Yoon J-S, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, and Zhou, M

Subjects
Male, Settore MED/09 - Medicina Interna, kidney disease, Endocrinology, Diabetes and Metabolism, humanos, coste de las enfermedades, Disease, Global Health, Cohort Studies, Endocrinology, Cost of Illness, cardiovascular disease, Health Transition, Risk Factors, transición sanitaria, estudios prospectivos, Renal Insufficiency, Chronic -- complications -- epidemiology -- mortality, evaluación de riesgos, Renal Insufficiency, Prospective Studies, Chronic, estudios de cohortes, Metabolic Syndrome, education.field_of_study, diabetes, Mortality rate, Age Factors, Cardiovascular Diseases, Diabetes Complications, Female, Health Surveys, Humans, Metabolic Syndrome X, Renal Insufficiency, Chronic, Risk Assessment, Sex Factors, Spatio-Temporal Analysis, Internal Medicine, Cardiovascular Diseases -- complications -- epidemiology -- mortality, Cardiovascular disease,Diabetes Mellitus, chronic kidney disease, Diabetes Complications -- epidemiology -- mortality, Sciences bio-médicales et agricoles, Diabetes and Metabolism, encuestas de salud, análisis temporoespacial, Risk assessment, complicaciones de la diabetes, insuficiencia renal, medicine.medical_specialty, Cardiovascular disease, diabetes mortality, Population, enfermedades cardiovasculares, Metabolic Syndrome X -- complications -- epidemiology -- mortality, Article, chronic kidney disease, mortality, Internal medicine, Environmental health, Diabetes mellitus, medicine, factores de riesgo, Risk factor, education, business.industry, medicine.disease, Relative risk, Cardiovascular Diseases/complications, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Diabetes Complications/epidemiology, Diabetes Complications/mortality, Metabolic Syndrome X/complications, Metabolic Syndrome X/epidemiology, Metabolic Syndrome X/mortality, Renal Insufficiency, Chronic/complications, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/mortality, business, Kidney disease
Abstract

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010., 0, info:eu-repo/semantics/published

Published
2014

48. Empagliflozin and Cerebrovascular Events in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk

Author

Zinman, Bernard, Inzucchi, Silvio E., Lachin, John M., Wanner, Christoph, Fitchett, David, Kohler, Sven, Mattheus, Michaela, Biomath, Dipl, Woerle, Hans J., Broedl, Uli C., Johansen, Odd Erik, Albers, Gregory W., Diener, Hans Christoph, Aizenberg, D., Ulla, M., Waitman, J., De Loredo, L., Farias, J., Fideleff, H., Lagrutta, M., Maldonado, N., Colombo, H., Ferre Pacora, F., Wasserman, A., Maffei, L., Lehman, R., Selvanayagam, J., d'Emden, M., Fasching, P., Paulweber, B., Toplak, H., Luger, A., Drexel, H., Prager, R., Schnack, C., Schernthaner, G., Fliesser-Goerzer, E., Kaser, S., Scheen, A., Van Gaal, L., Hollanders, G., Kockaerts, Y., Capiau, L., Chachati, A., Persu, A., Hermans, M., Vantroyen, D., Vercammen, C., Van de Borne, P., Mathieu, C., Benhalima, K., Lienart, F., Mortelmans, J., Strivay, M., Vereecken, G., Keymeulen, B., Lamkanfi, F., Chacra, A., Eliaschewitz, F., Zanella, M., Faludi, A., Bertolami, M., Hayashida, C., Nunes Salles, J., Monte, O., Dinato, M., Manenti, E., Rassi, N., Halpern, A., Lima Filho, M., Ayoub, J., Felicio, J., Borges, J., Gross, J., Sgarbi, J., Betti, R., Tiburcio, A., Purisch, S., Schmid, H., Takahashi, M., Castro, M., Rea, R., Hissa, M., Geloneze Neto, B., Saraiva, J., Henein, S., Lochnan, H., Imran, S. A., Clayton, D., Bayly, K., Berlingieri, J., Boucher, P., Chan, Y., Gupta, M., Chehayeb, R., Ouellett, A., Ur, E., Woo, V., Zinman, B., St Amour, E., Terront Lozano, M., Yupanqui Lozno, H., Urina, M., Lopez Jaramillo, P., Jaramillo, N., Sanchez, G., Perez, G., Tusek, S., Mirosevic, G., Goldoni, V., Jurisic-Erzen, D., Balasko, A., Balic, S., Drvodelic-Sunic, E., Varzic, S. Canecki, Machkova, M., Weiner, P., Lastuvka, J., Olsovsky, J., Krarup, T., Ridderstrale, M., Tarnow, L., Boesgaard, T. Wellov, Lihn, A. Saetre, Christensen, P., Juhl, H., Urhammer, S., Lund, P., Adojaan, B., Jakovlev, U., Lanno, R., Lubi, M., Marandi, T., Gouet, D., Courreges, J., Zaoui, P., Choukroun, G., Petit, C., Formagne, L., Estour, B., Mabire, P., Daugenet, C., Lemarie, B., Clavel, S., Aure, P., Remaud, P., Halimi, J., Hadjadj, S., Couffinhal, T., Glonti, S., Metreveli, D., Lominadze, Z., Giorgadze, E., Burtchuladze, T., Javashvili, L., Kurashvili, G., Kurashvili, R., Virsaladze, D., Nadareishvili, L., Khomasuridze, A., Cahill, T., Green, F., MacRury, S., Waldron, M., Middleton, A., McKnight, J., Pearson, E., Butler, M., Choksi, M., Caldwell, I., Farmer, I., Wyatt, N., Patrick, J., O'Brien, I., Devers, M., Bousboulas, S., Pappas, S., Piaditis, G., Vryonidou, A., Tentolouris, N., Karamitsos, K., Manes, C., Benroubi, M., Avramidis, I., Ozaki, R., Tan, K., Siu, S., Tsang, C., Dudas, M., Nagy, K., Salamon, C., Ip, T., Geroo, L., Patkay, J., Tabak, A., Juhasz, F., Szentpeteri, I., Tamas, G., Ghaisas, N., Bantwal, G., Mohan, V., Gupta, J., Sadhu, N., Kulkarni, A., Garg, N., Reddy, S., Deshpande, N., Gutlapalli, K., Pillai, M., Premchand, R., Badgandi, M., Jain, S., Aravind, S., Shamanna, P., Pandey, A., Gupta, S., Pramono, B., Saksono, H. Dante, Agung, P., Wahono, S. Djoko, Suastika, K., Tanggo, Y., Juwana, Y., Siswanto, B., Adawi, F., Efrati, S., Mazen, E., Bashkin, A., Herskovits, T., Jaffe, A., Schiff, E., Wainstein, J., Taddei, S., Aiello, A., Arca, M., Calabro, P., Cignarelli, M., Fioretto, P., Reggiani, G. Marchesini, Gnasso, A., Marchionni, N., Marsilii, A., Bucci, M., Mezzetti, A., Pozzilli, P., Colivicchi, F., Santini, M., Moro, E., Toscano, V., Fucili, A., Semplicini, A., Monno, S., Furui, K., Higashiue, S., Hiramatsu, N., Kawamitsu, K., Takenaka, T., Takahashi, H., Hojo, F., Onishi, Y., Izumino, K., Okubo, M., Wakida, Y., Kondo, Y., Hieshima, K., Jinnouchi, H., Suzuki, A., Ito, M., Park, S., Kim, Y., Hong, T., Park, H., Gwon, H., Kim, H., Kang, K., Jeong, M., Seung, K., Lim, D., Rha, S., Tahk, S., Yang, J., Yoon, J., Shin, M., Kim, D., Jeong, J., Ahmad, N. Nik, Mustafa, N., Mohamed, W. Wan, Fung, Y., Ghani, R. Abdul, Chandramouli, A., Chee, K., Kadir, K. Abdul, Ling, K., Abu Hassan, M., Foo, S., Lee, S., Garcia Hernandez, P., Aguilar-Salinas, C., Vidrio Velazquez, M., Flores, F., Alpizar Salazar, M., Micher Escalante, D., Garcia Soria, M., Cardona Munoz, E., Storms, G., Schaper, N., Kooy, A., Krekels, M., van Bemmel, T., Verhoeven, R., Mulder, H., Oldenburg-Ligtenberg, P., Gonkel, F., de Jong, A., van Soest, J., Viergever, P., Mevissen, H., Lochorn, G., Zwiers, G., Hoogslag, P., Ronner, E., Nierop, P., Al-Windy, N., Kragten, J., Dekelver, P., Benatar, J., Krebs, J., Scott, R., Heggen, E., Berz, A., Fossum, C., Hurtig, U., Langslet, G., Baranowski, M., Sparby, J., Karlsson, T., Karlsson, Thomas, Delgado Torres, C., Rodriguez Escudero, A., Lisson, R., Allemant Maldonado, A., Gallardo Rojas, W., Gonzales Bravo, L., Lema Osores, J., Farfan, J., Zapata, L., Godoy Junchaya, J., Roldan Concha, Y., Urquiaga Calderon, J., Sy, R., Tan, G., Aquitania, G., De Los Santos, G., Panelo, A., Roderos, O., Rosales, R., Toledo, R., Liwag, A., Ramoncito, H., Skokowska, E., Krzyzagorska, E., Ogorek, M., Wojnowski, L., Spyra, J., Konieczny, M., Piesiewicz, W., Kus, W., Ocicka-Kozakiewicz, A., Orlowska-Kunikowska, E., Zmuda, W., Duarte, S., Leitao, A., Monteiro, P., Rita, H., Salgado, V., Pinto, L., Queiros, J., Teixeira, J., Rogado, C., Duarte, R., Sobral do Rosario, F., Silva, A., Andrade, L., Velez, M., Brazao, M., Istratoaie, O., Lichiardopol, R., Catrinoiu, D., Militaru, C., Zetu, C., Barbonta, D., Cosma, D., Crisan, C., Pop, L., Esip, V., Khetagurova, F., Petrov, A., Arutyunov, G., Boyarkin, M., Agafyina, A., Vorokhobina, N., Petunina, N., Libov, I., Zalevskaya, A., Nikolaev, K., Barbarash, O., Potemkin, V., Bystrova, A., Krasilnikova, E., Barbarich, V., Chumakova, G., Tarasov, N., Meleshkevich, T., Zateyshchikov, D., Lantseva, O., Belenkiy, D., Obrezan, A., Rossolko, L., Fillipova, E., Yakhontova, P., Khokhlov, A., Tan, R., Sum, C., Chang, H., Distiller, L., Pretorius, M., Nortje, H., Mitha, E., Burgess, L., Blignaut, S., Venter, T., Moodley, R., Lombaard, J., Govind, U., Naidoo, V., Mookadam, M., Engelbrecht, J., Omar, M., Jurgens, J., Podgorski, G., Vawda, H., Naidoo, D., Emanuel, S., Roodt, A., Amod, A., Van Zyl, L., Segura, J., Brito, M., Fernandez-Cruz, A., Artola, S., Iglesias, R., Toural, E., Garcia-Ortiz, L., Saban, J., Mesa, J., Vidal, J., Linares, J., del Canizo, F., Rigla, M., Suarez, C., Llorente, I., Moreno, B., Antoli, A., Gomez Peralta, F., Iglesias, M., Pereg, V., de Teresa, L., Camafort, M., Trescoli, C., Satarasinghe, R., Somasundaram, N., Siyambalapitiya, S., Antonypillai, C., Bulugahapitiya, D., Medagama, U., Huang, C., Lu, Y., Hwang, J., Chiang, C., Wen, M., Chen, J., Lai, W., Chang, K., Wang, J., Yeh, H., Kriangsak, P., Deerochanawong, C., Suwanwalaikorn, S., Mangklabruks, A., Kaewsuwanna, P., Piyayotai, D., Iabluchanskyi, M., Samoylov, O., Godlevska, O., Kovalyova, O., Voloshyna, O., Tseluyko, V., Zotov, S., Vykhovanyuk, I., Dulgeroff, A., Mayfield, R., Zaniewski-Singh, M., Ullal, J., Aloi, J., De La Rosa, R., Mosely, J., Wittmer, B., Aronoff, S., Rosenfeld, J., Seidner, M., Warren, M., Fishman, N., Weiss, R., Arif, A., Sandberg, M., Lewis, D., Ball, E., Graf, R., Breton, C., Tamayo, R., Richards, R., Cefalu, W., Uwaifo, G., Zayour, D., Hoffman, J., Fitz-Patrick, D., Khan, B., Blaze, K., Bressler, P., Halpern, S., Chappell, D., Bergenstal, R., Cuddihy, R., Matfin, G., Freedman, Z., Gonzalez-Campoy, J., Lerman, S., Rendell, M., Sitar, S., Reeves, M., Howard, T., Soufer, J., Miranda-Palma, B., Laliotis, A., Shomali, M., Teltser, M., Hurley, D., Morawski, E., Cherlin, R., Houchin, V., Welch, M., Goytia-Leos, D., Syed, M., Kowaloff, E., Weinrauch, L., Peniston, J., Brockmyre, A., First, B., Feld, L., Huffman, D., Nassim, O., Gottschlich, G., Patel, A., Knopke, C., Hernandez, M., Diaz, J., Giugliano, G., Nicasio, J., Eagerton, D., Huntley, R., Reed, J., III, Magee, M., Hippert, R., Sofley, C., Jr., Alzohaili, O., Levins, P., Anspach, R., Shah, S., Brusco, O., Naidu, J., Lindenbaum, J., Jacks, R., Hammond, G., Arena, C., Saxman, K., Mach, M., Kerstein, H., Kereiakes, D., Wahlen, J., Wehmeier, K., Chaykin, L., Rothman, J., Fogelfeld, L., Stroger, John H., Jr., Bittar, N., Rosenstock, J., Kayne, D., Navarro, J., Colfer, H., Mokshagundam, S., Shandilya, L., Connery, L., Wysham, C., Dela Llana, A., Jardula, M., MacAdams, M., Flippo, G., Heurich, E., Curtis, C., Sanders, D., Rawls, R., Velazquez, F., Osea, E., Mahood, K., Feldman, G., Eder, F., Riley, E., Fowler, W., Jain, M., Shepard, M., Schear, M., Barker, B., Strout, C., Obiekwe, O., Shanik, M., Green, C., Blakney, E., Roberson, K., Bretton, E., Pish, R., Kaveh, K., Maynard, B., Barager, W., Soldyshev, R., Austin, B., Parmar, P., Simpson, R., Chauhan, A., Kasper, J., Burr, R., Patel, N., Mariano, H., Pluto, T., Bratcher, C., Juarez, M., Levinson, L., Awad, A., Longshaw, K., Hoffman, K., Richwine, R., Molter, D., Boscia, J., III, Kowalyk, S., Lemis, P., Liss, J., Orr, R., Riser, J., Wood, J., Ubani, A., Paine, W., Hassani, F., Miranda, F., Hansen, V., Hansen, Val R., Farris, N., Bowden, R., Ajani, D., Maw, K., Andersen, J., Bergman, B., Dunmyer, S., Brandon, D., Anderson, M., Bononi, P., Prawer, J., Seidman, B., Cruz, H., Wilks, K., DiSanto, L., Buynak, R., Christensen, T., Denker, P., Koppel, W., Stedman, M., Lewy-Alterbaum, L., Karim, S., Shapiro, J., Gardner, T., Oskin, T., Gabra, N., Malano, J., and EMPA REG OUTCOME Investigators

Subjects
riesgo, compuestos de bencidrilo, type 2 diabetes mellitus, Original Contributions, humanos, Medizin, 030204 cardiovascular system & hematology, blood pressure, cardiovascular diseases, hematocrit, stroke, 0302 clinical medicine, Glucosides, glucósidos, 030212 general & internal medicine, Myocardial infarction, Stroke, mediana edad, anciano, OUTCOMES, Hazard ratio, Middle Aged, ISCHEMIC-STROKE, Anesthesia, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Cardiology, TRIAL, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, Risk, medicine.medical_specialty, Clinical Sciences, enfermedades cardiovasculares, Clinical Neurology, Placebo, 03 medical and health sciences, Outcome Assessment (Health Care), Internal medicine, medicine, Empagliflozin, Diabetes Mellitus, Humans, Hypoglycemic Agents, accidente cerebrovascular, Benzhydryl Compounds, METAANALYSIS, Aged, Advanced and Specialized Nursing, Science & Technology, business.industry, MORTALITY, Type 2 Diabetes Mellitus, medicine.disease, Confidence interval, Blood pressure, hipoglicemiantes, Peripheral Vascular Disease, evaluación de resultados (asistencia sanitaria), Cardiovascular System & Cardiology, Neurology (clinical), Neurosciences & Neurology, business, FOLLOW-UP
Abstract

Supplemental Digital Content is available in the text., Background and Purpose— In the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), empagliflozin added to standard of care in patients with type 2 diabetes mellitus and high cardiovascular risk reduced the risk of 3-point major adverse cardiovascular events, driven by a reduction in cardiovascular mortality, with no significant difference between empagliflozin and placebo in risk of myocardial infarction or stroke. In a modified intent-to-treat analysis, the hazard ratio for stroke was 1.18 (95% confidence interval, 0.89–1.56; P=0.26). We further investigated cerebrovascular events. Methods— Patients were randomized to empagliflozin 10 mg, empagliflozin 25 mg, or placebo; 7020 patients were treated. Median observation time was 3.1 years. Results— The numeric difference in stroke between empagliflozin and placebo in the modified intent-to-treat analysis was primarily because of 18 patients in the empagliflozin group with a first event >90 days after last intake of study drug (versus 3 on placebo). In a sensitivity analysis based on events during treatment or ≤90 days after last dose of drug, the hazard ratio for stroke with empagliflozin versus placebo was 1.08 (95% confidence interval, 0.81–1.45; P=0.60). There were no differences in risk of recurrent, fatal, or disabling strokes, or transient ischemic attack, with empagliflozin versus placebo. Patients with the largest increases in hematocrit or largest decreases in systolic blood pressure did not have an increased risk of stroke. Conclusions— In patients with type 2 diabetes mellitus and high cardiovascular risk, there was no significant difference in the risk of cerebrovascular events with empagliflozin versus placebo. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01131676.

Published
2017

49. Low Dose Dexmedetomidine Attenuates Hemodynamic Response to Skull Pin Holder Application

Author

Vinayak Seenappa Pujari, Yatish Bevinguddaiah, Shwethashri Ramaprasannakumar Kondavagilu, and Mohan V. R. Chadalawada

Subjects
Mean arterial pressure, medicine.medical_specialty, Haemodynamic response, medicine.medical_treatment, Hemodynamics, 03 medical and health sciences, 0302 clinical medicine, Bolus (medicine), 030202 anesthesiology, Heart rate, Materials Chemistry, medicine, Intubation, neurosurgery, Dexmedetomidine, Saline, business.industry, dexmedetomidine, skull pin head holder, Surgery, Anesthesia, Original Article, business, hemodynamic response, 030217 neurology & neurosurgery, Craniotomy, neuroanesthesia, medicine.drug
Abstract

Background: The application of skull pin holder elicits an adverse hemodynamic response that can be deleterious; there are many drugs that have been used to attenuate this response. We have conducted this study to evaluate the efficacy of intravenous (i.v.) dexmedetomidine on attenuation of hemodynamic responses to skull pin head holder application and to compare the effectiveness of two doses of i.v. dexmedetomidine (1 μg/kg and 0.5 μg/kg bolus). Materials and Methods: Ninety American Society of Anesthesiologists physical Status I–III patients undergoing craniotomy were randomized into three groups of thirty each. After intubation, patients in Group A received 1 μg/kg of i.v. dexmedetomidine, Group B received 0.5 μg/kg of i.v. dexmedetomidine, whereas Group C received an equivalent quantity of normal saline. Hemodynamic parameters were monitored regularly after skull pin insertion. Results: There was no significant difference in the monitored hemodynamic parameters among the three groups from baseline until intubation. Heart rate (HR) and mean arterial pressure (MAP) increased significantly at skull pin insertion and subsequent points in Group C, whereas the values decreased in Groups A and B (P < 0.05). Patients in Group A showed a higher and sustained attenuation of MAP. Patients in Group C had a higher incidence of tachycardia and hypertension requiring additional measures to attenuate the response. Conclusions: Dexmedetomidine in either dosage (1 μg/kg or 0.5 μg/kg) was effective in attenuating hemodynamic response to skull pin insertion. Dexmedetomidine in doses of 0.5 μg/kg was as effective in attenuating the HR and MAP response to skull pin insertion as compared to a dose of 1 μg/kg.

Published
2017

50. SP451DIABETIC NEPHROPATHY IN TYPE 2 DIABETES MELLITUS- ARE INDIANS RAPID PROGRESSORS?

Author

Srinivas Shenoy, Indu Rao, Attur Ravindra Prabhu, Shankar Nagaraju, Darshan Rangaswamy, Karan Saraf, Mohan V B, Ashok Ram, and Anil Kumar

Subjects
Diabetic nephropathy, Nephrology, Transplantation, medicine.medical_specialty, business.industry, Internal medicine, medicine, Type 2 Diabetes Mellitus, medicine.disease, business
Published
2018

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