39 research outputs found
West Nile Virus Infection among the Homeless, Houston, Texas1
- Author
- Publication venue
- Centers for Disease Control and Prevention
- Publication date
- 01/10/2007
- Field of study
Among 397 homeless participants studied, the overall West Nile virus (WNV) seroprevalence was 6.8%. Risk factors for WNV infection included being homeless >1 year, spending >6 hours outside daily, regularly taking mosquito precautions, and current marijuana use. Public health interventions need to be directed toward this high-risk population
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
- Author
- Ab Majid MA
- Ab Rahman AS
- Ab Rahman R
- Abayasinghe C
- Abbott T
- Abdullah NH
- Abdur-Rahman L
- Abeloos J
- Abernethy C
- Abidin UN
- Abrunhosa A
- Absar M
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- Adenike O
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- Agarwal V
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- Aimoniotou-Georgiou E
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- Akring I
- Al 'Amri K
- Al Anizi M
- Al hussaini S
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- Zonneveldt H
- Zou X
- Zoulamoglou M
- Zsisku L
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2016
- Field of study
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial
- Author
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- Thirugnana-Chandran T
- Thomas AL
- Thomas C
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- Thomas L
- Thompson Jones H
- Thompson A
- Thompson J
- Thompson P
- Thomson A
- Thornthwaite S
- Thorpe K
- Tilbey S
- Tinsley S
- Tiwari D
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- Topia B
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- Trugeon-Smith T
- Tryambake D
- Tsang S-M
- Tucker S
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- Tysoe S
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- Ullah K
- Umasankar U
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- Van Wijck F
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- Vassallo J
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- Warinton R
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- Watson F
- Waugh D
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- Weinling M
- Weir N
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- Westcott J
- Westmoreland J
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- Wiggam I
- Wightman J
- Wijewardane A
- Wilkinson M
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- Willberry A
- Willcoxson P
- Williams C
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- Williams R
- Williams R
- Williams R
- Williams S
- Williams S
- Williams-Yesson B
- Williamson J
- Williamson S
- Willmot M
- Wills R
- Willson J
- Wilmshurst N
- Wilson D
- Wilson H
- Wilson J
- Wilson J
- Wilson J
- Wilson L
- Wiltshire A
- Withers V
- Wong J
- Wong S
- Wood D
- Wood D
- Wood E
- Wood L
- Wood P
- Wood P
- Woodford E
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- Wroath B
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- Yeomans A
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- Young E
- Young R
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- Zachariah G
- Zhang L
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Background
Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.
Methods
FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.
Findings
Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.
Interpretation
Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.
Funding
UK Stroke Association and NIHR Health Technology Assessment Programme
Effects of olfactory bulbectomy on NMDA receptor density in the rat brain: [3H] MK-801 binding assay
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- 'Elsevier BV'
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“I’m Not Gonna Run Around and Put a Condom on Every Dick I See”: Tensions in Safer Sex Activism Among Queer Communities in Montréal, Quebec
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Interactions of neurotensin with dopamine-containing neurons in the central nervous system
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- 'Elsevier BV'
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Verbal working memory and reading abilities among students with visual impairment
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- Abner
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- 'Elsevier BV'
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