435032 research outputs found
Sort by
Reduced Vascular Complications After Catheter Ablation Applying Sonography‐Guidance and Modified Postprocedural Care
No full textBackground: Vascular access and postprocedural access site management remain the leading causes for postprocedural complications following interventional electrophysiological (EP) procedures. Method: Patients were consecutively included in a prospective registry (TRUST, NCT05521451). Two vascular access and groin‐site management protocols that changed as an institutional standard at a cut‐off date (August 15, 2022) were compared. Group I used conventional access with an 8‐h pressure bandage and bed rest. Group II utilized ultrasound‐guided access, figure‐of‐8 suture, a 2‐h pressure bandage, and 6 h total bed rest. Minor complications included hematoma, bleeding, AV fistula, or pseudoaneurysm not requiring intervention. Major complications involved any incident necessitating intervention (transfusion, surgery, interventional therapy) or retroperitoneal hematoma. Results: A total of 1672 procedures in 1501 patients (median age 65 (IQR 56.74) years, 38% female) were analyzed. Clinical features were balanced with the exception of a higher body mass index (median 27 [24;31] vs. 26 [24;30], p = 0.011) and more frequent arterial hypertension (63% vs. 56%, p = 0.003) in Group I. Total vascular complication rate was 9% (69/780 procedures) for Group I, and 4% (40/892 procedures) for Group II (OR 0.48 [95% CI: 0.32–0.73], p < 0.001). Major complications occurred in 30/109 (28%) cases, of which 20/780 (3%) occurred in Group I and 10/892 (1%) in Group II (OR 0.43 [95% CI: 0.18–0.97], p = 0.042). Hematomata were most frequently observed in both groups (Group I: 46/69, 67%; Group II: 30/40, 75%). Conclusion: Vascular complication rates in EP‐procedures were significantly reduced by implementing a novel institutional groin‐site management standard including ultrasound‐guided vascular access and modified post‐interventional care
Affective Instability and Regular Cannabis Use During Adolescence and Subsequent Risk for Psychosis in Early Adulthood:A Longitudinal Birth Cohort Study
No full textBackground and HypothesisAffective instability (AffI) is associated with psychosis, and cannabis use is a known risk factor for psychosis. Previous evidence suggests that AffI may itself be a risk factor for cannabis use. This study aimed to investigate the longitudinal relationship between AffI and cannabis use during adolescence and the development of psychosis in early adulthood.Study DesignData from the Avon Longitudinal Study of Parents and Children were analyzed to estimate the prevalence of AffI at age 12 and cannabis use frequency at ages 13, 14, 15, 17, 20, and 22. Psychotic experiences (PEs) and psychotic disorder (PD) were measured at age 24 using the Psychosis-like Symptoms Interview. Latent class growth analysis identified cannabis use trajectories and odds ratios (OR) were calculated to assess associations between adolescent AffI, different cannabis use patterns and psychotic outcomes. Path analysis was used to examine cannabis use as a mediator between AffI and psychotic outcomes.Study ResultsIndividuals with AffI were significantly more likely to develop psychotic outcomes at age 24 [PEs: OR = 4.08 (2.35–7.08); PD: OR = 4.74 (2.00–11.27)]. Regular cannabis users from ages 13 to 22 had an increased likelihood of developing psychotic outcomes compared with non-users [PEs: OR = 4.40 (2.79–6.92); PD: OR = 3.13 (1.25–7.88)]. Regular cannabis use partially mediated the relationship between AffI and both PEs and PD.ConclusionsAdolescents with AffI are at a higher risk of developing psychosis in early adulthood. Regular cannabis use mediates this risk, suggesting the potential benefit of targeted prevention strategies for at-risk youth
Data sources:
Access Repository Dashboard
Do you manage Open Research Online? Become a CORE Member to access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard! 👇