41 research outputs found
A cost analysis of surgery for ruptured abdominal aortic aneurysm
AbstractObjective: this study compares our costs of salvaging patients with ruptured abdominal aortic aneurysms (AAA) with the costs for unruptured AAAs. Methods: details of all AAAs presenting over 18 months were obtained. Costs of repair were carefully calculated for each case and were based upon ITU and ward stay and the use of theatre, radiology and pathology services. We compared the costs in unruptured AAAs with both uncomplicated ruptures and ruptures with one or more system failure. Results: the mortality rate for ruptures undergoing repair was 18% and for elective repairs was 1.6%. The median cost for uncomplicated ruptures was £6427 (range £2012-13 756). For 12 complicated ruptures, it was £20 075 (range £13 864-166 446), and for 63 unruptured AAAs, was £4762 (range £2925-47 499). Conclusion: relatively low operative mortality rates for ruptured AAA repair can be achieved but this comes at substantial cost. On average, a ruptured AAA requiring system support costs four times as much as an elective repair.Eur J Vasc Endovasc Surg 26, 299-302 (2003
Avaliação do impacto da suplementação alimentar a gestantes no cotrole do baixo peso ao nascer no município de São Paulo, SP (Brasil)
A partir de estudo realizado em oito grandes maternidades do Município de São Paulo, SP (Brasil) que atendem clientela predominantemente de baixo nível sócio-econômico, objetivou-se analisar o impacto da suplementação alimentar durante a assistência pré-natal sobre a incidência de recém-nascidos de baixo peso ao nascer (peso < 2.500 g). Foram envolvidos no estudo 1.060 recém-nascidos de mães que receberam suplementação e 664 recém-nascidos de mães que não a receberam. Ã incidência de baixo peso ao nascer foi de cerca de 11%, considerada elevada e semelhante em ambos os grupos de recém-nascidos. A análise multivariada, realizada para controlar eventuais diferenças entre os grupos, que não a condição de suplementação, descartou qualquer associação significativa entre suplementação e peso ao nascer e revelou, por outro lado, que tabagismo e morbidade na gestação e determinadas características antropométricas e reprodutivas da mãe, prévias à gestação, são importantes fatores de risco para o baixo peso ao nascer. A aparente explicação para a ausência de impacto da suplementação alimentar na população estudada parece residir não na quantidade insuficiente da suplementação alimentar oferecida (370 Kcal/dia), mas no predomínio de fatores não alimentares na determinação do baixo peso ao nascer. São formuladas recomendações quanto ao controle do baixo peso ao nascer no contexto estudado
Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.
BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362
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Phacelia mutabilis E. GreeneChangeable phaceliabranch of Herring Creek about 2 miles northeast of PinecrestHillsid
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Satellite-based laser windsounder
This is the final report of a one-year, Laboratory-Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The project`s primary objective is to determine the technical feasibility of using satellite-based laser wind sensing systems for detailed study of winds, aerosols, and particulates around and downstream of suspected proliferation facilities. Extensive interactions with the relevant operational organization resulted in enthusiastic support and useful guidance with respect to measurement requirements and priorities. Four candidate wind sensing techniques were evaluated, and the incoherent Doppler technique was selected. A small satellite concept design study was completed to identify the technical issues inherent in a proof-of-concept small satellite mission. Use of a Mach-Zehnder interferometer instead of a Fabry-Perot would significantly simplify the optical train and could reduce weight, and possibly power, requirements with no loss of performance. A breadboard Mach-Zehnder interferometer-based system has been built to verify these predictions. Detailed plans were made for resolving other issues through construction and testing of a ground-based lidar system in collaboration with the University of Wisconsin, and through numerical lidar wind data assimilation studies
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Initial airborne CO{sub 2} DIAL measurements: Discussion of results and data analysis considerations
A detailed discussion of airborne CO{sub 2}, DIAL measurements obtained from the first joint N-ABLE field campaign at INEL is presented. System performance characteristics, including return signal strength, averaging statistics, and temporal correlation as well as multi-line DIAL spectral data are discussed. In particular, we review data acquisition and analysis strategies pertinent to chemical detection from a moving platform, such as range determination and correction, and return signal processing (waveform vs. box-car integration, baseline correction). We also report observed effects and variations due to near-field light scattering, pointing and tracking stability, and stack-release plume dynamics
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Time-resolved flourescence measurements of KrF emission produced by vacuum ultraviolet photolysis of KrF/sub 2/ mixtures
Vacuum ultraviolet (VUV) light radiation was used to produce electronically excited KrF excimers (in D-, B- and C-states) by the photolysis of KrF/sub 2/ and F/sub 2//Kr mixtures at various excitation wavelengths. The excited KrF photoproduct quantum yield was measured over the excitation wavelength range of 120 to 200 nm, and a quantum efficiency of 0.45 was estimated at the peak absorption wavelength of 159 nm for KrF/sub 2/. The collision-free fluorescence lifetime of the B-X transition near 248 nm was determined to be 9.9 /plus minus/ 0.6 ns when the KrF/sub 2/ was excited with the 159 nm light. Near gas kinetic rate constants were measured for the quenching of KrF B-X emission by KrF/sub 2/ and CO/sub 2/. Using the threshold energy needed for observing excited KrF photofragments, an upper bound for the bond dissociation energy of KrF/sub 2/ was determined to be 1.03 /plus minus/ 0.1 eV. 14 refs., 8 figs
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Atmospheric measurements using a scanning, solar-blind Raman Lidar
The study of the water cycle by Lidar has many applications. Because micro-scale structures can be identified by their water content, the technique offers new opportunities to visualize and study the phenomena. There are applications to many practical problems in agricultural and water management as well as at waste storage sites. Conventional point sensors are limited and are inappropriate for use in complex terrain or varied vegetation and cannot be extrapolated over even modest ranges. To this end, techniques must be developed to measure the variables associated with evapotranspirative processes over large areas and varied surface conditions. A scanning water-Raman Lidar is an ideal tool for this task in that it can measure the water vapor concentration rapidly with high spatial resolution without influencing the measurements by the presence of the sensor. 3 refs., 5 figs., 1 tab
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Observation of excited H/sup 0/ atoms produced by relativistic H/sup /minus// ions in carbon and formvar foils
We have measured the relative yield of several low-lying excited states of neutral hydrogen atoms produced by the passage of 226-MeV and 581-MeV H/sup /minus// ions through thin carbon foils and a tilted formvar foil. The relative yields of H/sup /minus///sub /asterisk//(n = 2,3, 4) were measured for 17 different carbon foils ranging in thickness from 662 /angstrom/ to 5386 /angstrom/ at 581 MeV. The relative yield of H/sup 0//sup /asterisk//(n = 2) was also measured for these carbon foils at 226 MeV. These data exhibit a significant deviation from a simple yield curve indicating that a more complex mechanism than has previously been thought is responsible for producing the excited states. The relative yields of H/sup 0//sup /asterisk//(n = 2,3) were measured for a tilting formvar foil at 226 MeV; unexplained dips appear at incidence angles of /theta/ /approx/ 12/degree/ and /theta/ /approx/ 15/degree/ in the yield of n=2 and n=3 states, respectively. 19 refs., 7 figs., 1 tab