1,720,968 research outputs found
Thirty day post discharge BNP levels predict outcomes better than discharge levels - Italian RED study
No full textIntroduction: Heart failure (HF) patients often relapse into acute decompensation and consequent rehospitalization resulting in social and economic burdens. BNP has been previously shown to be prognostic at hospital discharge, but it has not been well characterized at time points after discharge from the emergency department (ED). Hypothesis: To determine the prognostic utility of BNP levels and changes in the emergency department (ED) and follow-up time-points. Methods: 276 HF patients were enrolled from 8 centers in Italy. The primary endpoints were cardiac associated rehospitalizations and deaths. Results: The Mean/Median BNP concentration at ED presentation was (mean±SE) 707.94±23.44pg/ml. Changes in BNP levels from presentation to 24h: –549.54±26.91pg/ml (p<0.001); to 72h: –426.57±26.91pg/ml (p<0.001); and at discharge: –323.59±29.51pg/ml (p<0.001). The mean/median BNP levels at follow-up time-points were 407.38±24.54 at 30 days, 363.07±29.51 at 60 days and 281.83±26.91pg/ml at 180 days. The BNP level at the 30 day follow-up was found to be highly predictive for events up to 180 days with an Area Under Curve (AUC) of 0.716 (p< 0.008) with a cut-point of 355pg/ml BNP and a hazard ratio of 8.56 (p = .014). The other considered BNP measurements did not significantly contribute to the prediction of the outcome. The discharge BNP level failed to significantly predict short term (within 30 days) outcomes (AUC: 0.647; p=0.054), and shows similar prognostic ability for long term (180 days) (AUC: 0.605; p<0.039).Conclusions: Tracking BNP levels post-discharge from the hospital may be equally important as the discharge BNP. Our results suggest that an increase in BNP at 30 days from the discharge BNP can be highly prognostic and may be a useful tool to discriminate between patients at higher risk for future events. This time period may be a crucial window to monitor BNP stability in the outpatient setting
Usefulness of Serial Assessment of Natriuretic Peptides in the Emergency Department for patients with Acute Decompensated Heart failure
No full textThe value of natriuretic peptides, both B-type natriuretic peptide (BNP) and
N-terminal prohormone brain natriuretic peptide (NTproBNP), for determining
diagnosis, severity, and prognosis of emergency department (ED) patients with
acute decompensated heart failure (ADHF) has been well documented. Emerging
data support the hypothesis that repeated natriuretic peptide determinations in
the acute phase of ADHF may assist in confirming the diagnosis, monitoring drug
therapy, and evaluating the adequacy of patient stabilization. Data from the
authors’ group demonstrate that in patients admitted to the ED for acute dyspnea,
serial NTproBNP measurement at admission and 4, 12, and 24 hours later was
useful in confirming the diagnosis of ADHF compared with patients with chronic
obstructive pulmonary disease. Moreover, in the same patients receiving intensive
intravenous diuretic therapy, there was a progressive reduction of NTproBNP
blood levels from hospitalization to discharge (P<.001), accompanied by clinical
improvement and stabilization of heart failure. More recently, the authors also demonstrated
that in ADHF patients improving with diuretics, a progressive reduction
in BNP levels was observed, starting 24 hours after ED admission and continuing
until discharge. Comparing BNP and NTproBNP, there was a significant correlation
between NTproBNP and BNP levels but not between NTproBNP’s and BNP’s
percent variation compared with baseline. In ADHF, serial ED measurements of
BNP are useful for monitoring the effects of treatment. A reduction in BNP from
admission to discharge is indicative of clinical improvement
IL-18 stimulates B-type natriuretic peptide synthesis by cardiomyocytes in vitro and its plasma levels correlate with B-type natriuretic peptide in non-overloaded acute heart failure patients
No full textBackground: An altered IL-18 pathway in heart failure (HF) has recently been described and this cytokine was shown tobe of clinical and prognostic utility. Cardiomyocytes are a target of this cytokine which exerts inflammatory, hypertrophic,and profibrotic activities. B-type natriuretic peptide is a cardiac hormone produced in response to cardiac filling to regulatecardiovascular homeostasis. The aim of the study was to verify the ability of IL-18 to induce B-type natriuretic peptidesynthesis in vitro and to analyse the relationship between these two molecules in plasma in vivo from acute HF patients.Methods and Results: We demonstrated the ability of IL-18 to directly stimulate a murine cardiomyocyte cell line toexpress the B-type natriuretic peptide gene, synthesize the relative protein through a PI3K-AKT-dependent transduction,and induce a cell secretory phenotype with B-type natriuretic peptide release. A correlation between IL-18 and B-typenatriuretic peptide plasma levels was found in non-overloaded acute HF patients, and in subgroups of acute HF patientswith diabetes and coronary artery disease. Acute HF patients with renal failure had significantly higher IL-18 plasma levelsthan patients without. IL-18 plasma levels were correlated with C-reactive protein plasma levels.Conclusions: This study provides the first evidence of the ability of IL-18 to induce B-type natriuretic peptide synthesisin vitro and outlines the relationship between the two molecules in acute HF patients with an ongoing inflammatory status
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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