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  1. Article ; Online: Peripartum and Long-Term Maternal Cardiovascular Health After Preeclampsia.

    Giorgione, Veronica / Jansen, Gwyneth / Kitt, Jamie / Ghossein-Doha, Chahinda / Leeson, Paul / Thilaganathan, Basky

    Hypertension (Dallas, Tex. : 1979)

    2022  Volume 80, Issue 2, Page(s) 231–241

    Abstract: There is widespread acceptance of the increased prevalence of cardiovascular diseases occurring within 1 to 2 decades in women following a preeclamptic pregnancy. More recent evidence suggests that the deranged biochemical and echocardiographic findings ... ...

    Abstract There is widespread acceptance of the increased prevalence of cardiovascular diseases occurring within 1 to 2 decades in women following a preeclamptic pregnancy. More recent evidence suggests that the deranged biochemical and echocardiographic findings in women do not resolve in the majority of preeclamptic women following giving birth. Many women continue to be hypertensive in the immediate postnatal period with some exhibiting occult signs of cardiac dysfunction. There is now promising evidence that with close monitoring and effective control of blood pressure control in the immediate postnatal period, women may have persistently lower blood pressures many years after stopping their medication. This review highlights the evidence that delivering effective medical care in the fourth trimester of pregnancy can improve the long-term cardiovascular health after a preeclamptic birth.
    MeSH term(s) Female ; Humans ; Pregnancy ; Cardiovascular Diseases/epidemiology ; Hypertension/epidemiology ; Peripartum Period ; Pre-Eclampsia/epidemiology
    Language English
    Publishing date 2022-07-29
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 423736-5
    ISSN 1524-4563 ; 0194-911X ; 0362-4323
    ISSN (online) 1524-4563
    ISSN 0194-911X ; 0362-4323
    DOI 10.1161/HYPERTENSIONAHA.122.18730
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1488: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: DEcreased Cognitive functiON, NEurovascular CorrelaTes and myocardial changes in women with a history of pre-eclampsia (DECONNECT): research protocol for a cross-sectional pilot study.

    Brandt, Yentl / Alers, Robert-Jan / Canjels, Lisanne P W / Jorissen, Laura M / Jansen, Gwyneth / Janssen, Emma B N J / van Kuijk, Sander / Went, Tamara Michelle / Koehn, Dennis / Gerretsen, Suzanne C / Jansen, Jacobus / Backes, Walter / Hurks, Petra P M / van de Ven, Vincent / Kooi, M Eline / Spaanderman, Marc E A / Ghossein-Doha, Chahinda

    BMJ open

    2024  Volume 14, Issue 3, Page(s) e077534

    Abstract: Introduction: Pre-eclampsia is a hypertensive disorder affecting up to 8% of pregnancies. After pre-eclampsia, women are at increased risk of cognitive problems, and cerebrovascular and cardiovascular disorders. These sequelae could result from ... ...

    Abstract Introduction: Pre-eclampsia is a hypertensive disorder affecting up to 8% of pregnancies. After pre-eclampsia, women are at increased risk of cognitive problems, and cerebrovascular and cardiovascular disorders. These sequelae could result from microvascular dysfunction persisting after pre-eclampsia. This study will explore differences in cerebral and myocardial microvascular function between women after pre-eclampsia and women after normotensive gestation. We hypothesise that pre-eclampsia alters cerebral and myocardial microvascular functions, which in turn are related to diminished cognitive and cardiac performance.
    Methods and analysis: The cross-sectional 'DEcreased Cognitive functiON, NEurovascular CorrelaTes and myocardial changes in women with a history of pre-eclampsia' (DECONNECT) pilot study includes women after pre-eclampsia and controls after normotensive pregnancy between 6 months and 20 years after gestation. We recruit women from the Queen of Hearts study, a study investigating subclinical heart failure after pre-eclampsia. Neuropsychological tests are employed to assess different cognitive domains, including attention, processing speed, and cognitive control. Cerebral images are recorded using a 7 Tesla MRI to assess blood-brain barrier integrity, perfusion, blood flow, functional and structural networks, and anatomical dimensions. Cardiac images are recorded using a 3 Tesla MRI to assess cardiac perfusion, strain, dimensions, mass, and degree of fibrosis. We assess the effect of a history of pre-eclampsia using multivariable regression analyses.
    Ethics and dissemination: This study is approved by the Ethics Committee of Maastricht University Medical Centre (METC azM/UM, NL47252.068.14). Knowledge dissemination will include scientific publications, presentations at conferences and public forums, and social media.
    Trial registration number: NCT02347540.
    MeSH term(s) Female ; Humans ; Pregnancy ; Cognition ; Cross-Sectional Studies ; Myocardium ; Pilot Projects ; Pre-Eclampsia
    Language English
    Publishing date 2024-03-04
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-077534
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Prevalence of a History of Metabolic or Hypertensive Pregnancy Disorder in Patients With Myocardial Infarction and Non-obstructive Coronary Arteries: An Observational Cohort Study.

    Pustjens, Tobias F S / Vranken, Nousjka P A / Jansen, Gwyneth / Winkler, Patty J C / Stein, Mera / Hoebers, Loes / Kietselaer, Bas / Spaanderman, Marc E A / Rasoul, Saman / Ghossein-Doha, Chahinda / van 't Hof, Arnoud W J

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 932799

    Abstract: Introduction: Myocardial infarction with non-obstructive coronary arteries (MINOCA) predominantly affects younger females. Women with a history of gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM) are subjected to ...

    Abstract Introduction: Myocardial infarction with non-obstructive coronary arteries (MINOCA) predominantly affects younger females. Women with a history of gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM) are subjected to an elevated lifetime risk of cardiovascular disease. However, data on the potential association between these obstetric complications and MINOCA is lacking. Therefore, the current study aimed to provide insight in the prevalence of metabolic and hypertensive pregnancy disorders (MHPD) in MINOCA patients and their clinical characteristics.
    Methods: In this observational cohort study conducted at the Zuyderland Medical Center and Maastricht University Medical Center in the Netherlands, patients were enrolled if they were identified as having MINOCA. Data on individual patient characteristics, laboratory results, electrocardiography as well as (non-)invasive imaging procedures were derived from the electronic health record system. Patients were asked to complete a questionnaire about prior MHPD including GDM, GH, and PE. Patients were grouped into those with MHPD and those with prior uncomplicated normotensive pregnancy (or pregnancies; NP).
    Results: After excluding patients without 1-year follow-up (
    Conclusion: A history of metabolic and hypertensive pregnancy disorders occurred in one-third of female MINOCA patients. In these patients, conventional cardiovascular risk factors were more prevalent compared to NP patients. In most MHPD patients, the specific cause for MINOCA remained unclear.
    Language English
    Publishing date 2022-07-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.932799
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Short-stay admissions at an inner city hospital: a cross-sectional analysis.

    Pope, Ian / Ismail, Sharif / Bloom, Benjamin / Jansen, Gwyneth / Burn, Helen / McCoy, David / Harris, Tim

    Emergency medicine journal : EMJ

    2018  Volume 35, Issue 4, Page(s) 238–246

    Abstract: Objective: To investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs).: Method: This is a retrospective analysis of attendance and discharge data from an inner-city ED ... ...

    Abstract Objective: To investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs).
    Method: This is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU. Variables included: age, gender, ethnicity, deprivation score, arrival date and time, arrival method, admission outcome and discharge diagnosis. Analysis was performed by cross-tabulation followed by binary logistic regression in three models using the outcome measures above and seeking to identify factors associated with short-stay admission.
    Results: There were 2119 (24%) admissions during the study period and 458 were admitted for less than 24 hours. Those who were admitted in the middle of the week or with ambulatory care sensitive conditions (ACSCs) were significantly more likely to experience short-stays. Older patients and those who arrived by ambulance were significantly more likely to have a longer hospital stay. There was no association of length of inpatient stay with being admitted in the last 10 min of a 4 hours ED stay.
    Conclusion: Only a few factors were independently predictive of short stays. Patients with ACSCs were more likely to have short stays, regardless of whether they were admitted to CDU or an inpatient ward. This may be a group of patients that could be targeted for dedicated outpatient management pathways or CDU if they need admission.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Decision Support Techniques ; England ; Female ; Hospitalization/statistics & numerical data ; Hospitals, Urban/organization & administration ; Hospitals, Urban/statistics & numerical data ; Humans ; Length of Stay/statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; State Medicine/organization & administration ; State Medicine/statistics & numerical data ; Time Factors
    Language English
    Publishing date 2018-01-05
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2016-205803
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1941: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: (with research data) Risk factors for admission at three urban emergency departments in England: a cross-sectional analysis of attendances over 1 month.

    Ismail, Sharif A / Pope, Ian / Bloom, Benjamin / Catalao, Raquel / Green, Emilie / Longbottom, Rebecca E / Jansen, Gwyneth / McCoy, David / Harris, Tim

    BMJ open

    2017  Volume 7, Issue 6, Page(s) e011547

    Abstract: Objective: To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England.: Design and setting: Cross-sectional analysis of attendance data for patients from three ... ...

    Abstract Objective: To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England.
    Design and setting: Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome. Coding inconsistencies in routine ED data used for this study meant that diagnosis could not be included.
    Outcome measure: The primary outcome for the study was unscheduled admission.
    Participants: All adults aged 16 and older attending the three inner London EDs in December 2013. Data on 19 734 unique patient attendances were gathered.
    Results: Outcome data were available for 19 721 attendances (>99%), of whom 6263 (32%) were admitted to hospital. Site 1 was set as the baseline site for analysis of admission risk. Risk of admission was significantly greater at sites 2 and 3 (adjusted OR (AOR) relative to site 1 for site 2 was 1.89, 95% CI 1.74 to 2.05, p<0.001) and for patients of black or black British ethnicity (AOR 1.29, 1.16 to 1.44, p<0.001). Deprivation was strongly associated with admission. Analysis of departmental and hospital-wide workload pressures gave conflicting results, but proximity to the "4-hour target" (a rule that limits patient stays in EDs to 4 hours in the National Health Service in England) emerged as a strong driver for admission in this analysis (AOR 3.61, 95% CI 3.30 to 3.95, p<0.001).
    Conclusion: This study found statistically significant variations in odds of admission between hospital sites when adjusting for various patient demographic and presentation factors, suggesting important variations in ED-level and clinician-level behaviour relating to admission decisions. The 4-hour target is a strong driver for emergency admission.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Emergency Service, Hospital/statistics & numerical data ; England ; Female ; Hospitals/statistics & numerical data ; Humans ; Logistic Models ; Male ; Middle Aged ; Patient Acceptance of Health Care/statistics & numerical data ; Patient Admission/statistics & numerical data ; Referral and Consultation ; Risk Assessment ; Risk Factors ; Time Factors ; Workload ; Young Adult
    Language English
    Publishing date 2017-06-22
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2747269-3
    ISSN 2044-6055 ; 2044-6055 ; 2053-3624
    ISSN (online) 2044-6055
    ISSN 2044-6055 ; 2053-3624
    DOI 10.1136/bmjopen-2016-011547
    Database MEDical Literature Analysis and Retrieval System OnLINE

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