The interstellar medium towards the Ara OB1 region

We present high resolution (R ~ 4 km/s) absorption measurements of the interstellar NaI and CaII lines measured towards 14 early-type stars of distance 123 pc - 1650 pc, located in the direction of the Ara OB1 stellar cluster. The line profiles can broadly be split into four distinct groupings of absorption component velocity, and we have attempted to identify an origin and distance to each of these interstellar features. For gas with absorption covering the velocity range -10 km/s < V_helio < +10 km/s, we can identify the absorbing medium with local gas belonging to the Lupus-Norma interstellar cavity located between 100 and 485 pc in this galactic direction. Gas with velocities spanning the range -20 km/s < V_helio < +20 km/s is detected towards stars with distances of 570-800 pc. We identify a wide-spread interstellar feature at V_helio ~ -15 km/s with the expanding HI shell called GSH 337+00-05, which is now placed at a distance of ~530 pc.Comment: 12 pages, 5 figures, accepted for publication in Astrophysics & Space Scienc

Predictors of the incidence of all-cause mortality and deaths due to diabetes and renal diseases among patients newly prescribed antihypertensive agents: a cohort study

&lt;b&gt;Background&lt;/b&gt; Randomized trials have shown that the major antihypertensive drug classes are similarly effective to reduce mortality, but whether these drug class difference exists in clinical practice has been scarcely explored. This study evaluated the association between antihypertensive drug class, all-cause mortality and deaths due to diabetes or renal disease in real-life clinical settings.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; A clinical database in Hong Kong included all patients who were prescribed their first-ever antihypertensive agents between 2001 and 2005 from the public healthcare sector. All patients were followed up for five years, and grouped according to the initial antihypertensive prescription. The associations between antihypertensive drug class, all-cause mortality or combined diabetes and renal mortality, respectively, were evaluated by Cox proportional hazard models.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; From 218,047 eligible patients, 33,288 (15.3%) died within five years after their first-ever antihypertensive prescription and among which 1055 patients (0.48%) died of diabetes or renal disease. After adjusted for age, gender, socioeconomic status, service settings, district of residence, medication adherence, and the number of comorbidities, each drug class was similarly likely to be associated with mortality due to diabetes or renal disease [Adjusted Hazard Ratios (AHR) ranged from 0.92 to 1.73, p = 0.287–0.939] and all-cause mortality (AHR ranged from 0.83 to 1.02) except for beta-blockers (AHR = 0.815, 95% C.I. 0.68–0.87, p = 0.024) when ACEI was used as a reference group in propensity score-adjusted analysis.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; These findings provide real-life evidence reinforcing that any major antihypertensive drug class is suitable as a first-line agent for management of hypertension as recommended by international guidelines

Predictors of the incidence of all-cause mortality and deaths due to diabetes and renal diseases among patients newly prescribed antihypertensive agents: A cohort study

&lt;b&gt;Background&lt;/b&gt; Randomized trials have shown that the major antihypertensive drug classes are similarly effective to reduce mortality, but whether these drug class difference exists in clinical practice has been scarcely explored. This study evaluated the association between antihypertensive drug class, all-cause mortality and deaths due to diabetes or renal disease in real-life clinical settings.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; A clinical database in Hong Kong included all patients who were prescribed their first-ever antihypertensive agents between 2001 and 2005 from the public healthcare sector. All patients were followed up for five years, and grouped according to the initial antihypertensive prescription. The associations between antihypertensive drug class, all-cause mortality or combined diabetes and renal mortality, respectively, were evaluated by Cox proportional hazard models.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; From 218,047 eligible patients, 33,288 (15.3%) died within five years after their first-ever antihypertensive prescription and among which 1055 patients (0.48%) died of diabetes or renal disease. After adjusted for age, gender, socioeconomic status, service settings, district of residence, medication adherence, and the number of comorbidities, each drug class was similarly likely to be associated with mortality due to diabetes or renal disease [Adjusted Hazard Ratios (AHR) ranged from 0.92 to 1.73, p = 0.287–0.939] and all-cause mortality (AHR ranged from 0.83 to 1.02) except for beta-blockers (AHR = 0.815, 95% C.I. 0.68–0.87, p = 0.024) when ACEI was used as a reference group in propensity score-adjusted analysis.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; These findings provide real-life evidence reinforcing that any major antihypertensive drug class is suitable as a first-line agent for management of hypertension as recommended by international guidelines

Patient satisfaction with teledermatology is related to perceived quality of life

Background: There is a lack of good data about patient satisfaction with teledermatology and about its potential interaction with quality-of-life factors.Objectives: To assess the association between perceived skin-related quality of life and patient satisfaction with a nurse-led teledermatology service.Methods: In a mobile nurse-led teledermatology clinic located in four inner city general practices in Manchester, the teledermatology service used digital cameras to capture and store images of skin conditions for remote diagnosis by dermatologists. One hundred and twenty-three adult patients, non-urgent dermatology referrals from primary care, completed the Dermatology Life Quality Index (DLQI) and a 15-item patient satisfaction questionnaire.Results: In common with other studies of patient satisfaction, subjects reported highly favourable views of ‘hotel’ aspects of the service (93%) and found it ‘convenient’ (86%). However, 40% of patients would have preferred to have had a conventional face-to-face consultation with a dermatologist, and 17% felt unable to speak freely about their condition. Patient satisfaction with the service was related to quality of life. Patients reporting lower quality of life as measured by the DLQI were more likely to prefer a face-to-face encounter with a dermatologist (r = 0·216, P &lt; 0·05), and to evince anxiety about being photographed (r = 0·223, P &lt; 0·05).Conclusions:Patient acceptance and satisfaction with telemedicine services is complicated by patients' subjective health status. Telehealthcare providers need to recognize that patients with poor quality of life may want and benefit from face-to-face interaction with expert clinicians

Initial Antihypertensive Prescription and Switching: A 5 Year Cohort Study from 250,851 Patients

10.1371/journal.pone.0053625PLoS ONE81e5362

Duration of initial antihypertensive prescription and medication adherence: A cohort study among 203,259 newly diagnosed hypertensive patients

Background: Optimal adherence with antihypertensive medications is crucial to prevent hypertension-related complications. This study evaluated whether the duration of initial antihypertensive prescription is associated with better medication adherence in a large sample of Chinese hypertensive patients. Methods and results: From a validated clinical database which consists of all patients in the public healthcare sector in Hong Kong, all patients on their first-ever antihypertensive agent from 2001 to 2005 (N = 203,259) were included and followed-up for 12 months (and up to 5 years in separate analyses). The average age was 58.7 years (SD 17.3), and the overall rate of optimal adherence (as measured by having the Proportion of Days Covered ≥ 0.80) was 32.4%. The proportion of patients whose initial prescriptions lasted for ≤ 6 days; 7–14 days; 15–28 days and ≥ 29 days was 23.7%, 24.3%, 15.1% and 37.0%, respectively. The corresponding proportion of optimal adherence was 18.1%, 20.1%, 31.0% and 50.3%. The binary logistic regression analysis showed that after controlling for age, sex, socioeconomic status, service type, drug class, and district of residence, those whose initial prescription was 7–14 days (adjusted odds ratio [AOR] = 1.17, 95% C.I. 1.12–1.22); 15–28 days (AOR = 1.90, 95% C.I. 1.82–1.99) and ≥ 29 days (AOR = 4.13, 95% C.I. 3.96–4.31) were significantly more likely to be adherent than those who were prescribed for ≤ 6 days (all p &lt; 0.001). These findings remained significant in separate analyses where the period of follow-up was extended to 5 years. Conclusions: Shorter duration of first antihypertensive prescriptions was associated with poorer medication adherence, and this practice should be avoided if possible

The incidence of cancer deaths among hypertensive patients in a large Chinese population: a cohort study

Current evidence is mixed regarding the association between antihypertensive prescriptions and cancer mortality. We evaluated this association in a large Chinese hypertensive population. We followed for five years all patients who were prescribed their first-ever antihypertensive agents between 2001 and 2005 in a public healthcare sector of Hong Kong. The association between antihypertensive drug class and cancer mortality was evaluated by Cox proportional hazard models with propensity score matching. Age, gender, socioeconomic status, service settings, district of residence, proportion of days covered reflecting medication adherence, and the number of comorbidities were adjusted. From 217,910 eligible patients, 9500 (4.4%) died from cancer within five years after their first-ever antihypertensive prescription. Most cancer deaths occurred in the digestive (38.9%) and respiratory system (30.4%); the breast (6.2%); and the lympho-hematopoietic tissues (5.3%). The proportion of patients who died from cancer was the highest in the calcium channel blocker (CCB) group (6.5%), followed by thiazide diuretics (4.4%), angiotensin converting enzyme inhibitors (4.2%) and β-blockers (2.6%). When compared with β-blockers, patients prescribed CCBs (Adjusted Hazard Ratio [AHR] = 1.406, 95% C.I. 1.334–1.482, p &lt; 0.001) were more likely to die from cancer. Thiazide users were also more likely to suffer from cancer deaths (AHR = 1.364, 95% C.I. 1.255–1.483, p &lt; 0.001), but became insignificant in stratified analysis. The association between cancer mortality and use of CCB, and perhaps thaizide, may alert physicians to the need for more meticulous and comprehensive care of these patients in clinical practice. We recommend prospective studies to evaluate cause-and-effect relationships of these associations

Drug adherence and the incidence of coronary heart disease- and stroke-specific mortality among 218,047 patients newly prescribed an antihypertensive medication: a five-year cohort study

Background: Randomized trials have shown that optimal adherence to antihypertensive agents could protect against cardiovascular diseases, but whether adherence reduces cardiovascular deaths in community settings has not been explored so fully. This study evaluates the association between antihypertensive adherence and cardiovascular (coronary heart disease and stroke) mortality in the primary care settings. Methods: From a territory-wide database in Hong Kong, we included all patients who were prescribed their first-ever antihypertensive agents in the years between 2001 and 2005 from the public healthcare sector. All patients were followed up for five years, and assigned as having poor (Proportion of Days Covered [PDC] &lt; 40%), intermediate (40–79%), and high (≥ 80%) adherence to antihypertensive agents. The association between antihypertensive adherence and cardiovascular mortality was evaluated by using the Cox proportional hazard models. Results: From a total of 218,047 eligible patients, 3825 patients (1.75%) died of cardiovascular disease within five years after having received their first-ever antihypertensive agents. The proportions of patients having poor, intermediate, and high medication adherence were 32.9%, 12.1%, and 55.0%, respectively. Higher adherence levels at PDC 40%–79% (HR = 0.46, 95% C.I. 0.41–0.52, p &lt; 0.001) and ≥ 80% (HR = 0.91, 95% C.I. 0.85–0.98, p = 0.012) were significantly less likely to be associated with mortality than the poor adherence (PDC0.040) group. Conclusions: Better antihypertensive adherence was associated with lower cardiovascular mortality. This highlights the need to promote adherence through strategies which have been proved to be effective in clinical settings