Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

Aims Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes.Methods and results Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes.Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002).Conclusions The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.Cardiolog

Design alternatives for the U.S. survey of income and program participation

SIGLEAvailable from British Library Document Supply Centre- DSC:9349.2264(ESF-ESNHPS-WP--63) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Indicators of Economic Status and Social Capital in South African Townships

This article proposes a set of non-monetary indicators of material and social resources characterizing the childrearing environments of families in South African black urban townships. The selected indicators include adequacy of food, quality of housing, financial assets, consumer goods and social resources. The study reported in the article was carried out between 1990 and 1996. Through factor analyses two dimensions of social and economic status (SES) - consumption and social/financial capital - were identified. High, moderate and low SES groups were formed based on the families' combined score on the two factors. SES was significantly predictive of a family's ability to meet basic needs and in its experience of material hardship. The results of the study are reported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66883/2/10.1177_0907568297004002005.pd