LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 9 of total 9

Search options

  1. Article ; Online: SARS-CoV-2 antibody seroprevalence after the first wave among workers at a community healthcare system in the Greater Boston area.

    Bruno-Murtha, Lou Ann / Osgood, Rebecca / Lan, Fan-Yun / Buley, Jane / Nathan, Neetha / Weiss, Michelle / MacDonald, Mary / Kales, Stefanos N / Sayah, Assaad J

    Pathogens and global health

    2021  Volume 115, Issue 5, Page(s) 331–334

    Abstract: SARS-CoV-2 antibody seroprevalence among health-care workers (HCW) can assess past exposure and possible immunity, which varies across different regions, populations and times. We investigated the seroprevalence among HCW in Massachusetts (a region ... ...

    Abstract SARS-CoV-2 antibody seroprevalence among health-care workers (HCW) can assess past exposure and possible immunity, which varies across different regions, populations and times. We investigated the seroprevalence among HCW in Massachusetts (a region suffering high COVID-19 mortality) at the end of first wave of the SARS-CoV-2 pandemic. All HCW at Cambridge Health Alliance were invited to participate in this cross-sectional survey in June 2020. Those who volunteered, consented and provided a blood sample were included. Dried blood specimens from finger-prick sampling collected either at home by each HCW or onsite by the study team were analyzed for anti-SARS-CoV-2 IgM and IgG to the virus' receptor binding domain, using an enzyme-linked immunosorbent assay. IgM and IgG antibody abundance were categorized based on the number of standard deviations above the cross-reacting levels found in existing, pre-pandemic blood samples previously obtained by the Ragon Institute and analyzed by the Broad Institute (Cambridge, MA). Seroprevalence estimates were made based on 'positive' IgM or IgG using 'low' (>6 SD), 'medium' (>4.5 SD), and 'high' prevalence cutoffs (>3 SD).A total of 433 out of 5,204 eligible HCWs consented and provided samples. Participating HCWs had a lower cumulative incidence (from the start of the pandemic up to the bloodspot collections) of SARS-CoV-2 RT-PCR positivity (1.85%) compared to non-participants (3.29%). The low, medium, and high seroprevalence estimates were 8.1%, 11.3%, and 14.5%, respectively. The weighted estimates based on past PCR positivity were 13.9%, 19.4%, and 24.9%, respectively, for the entire healthcare system population after accounting for participation bias.
    MeSH term(s) Boston ; COVID-19 ; Community Health Services ; Cross-Sectional Studies ; Delivery of Health Care ; Humans ; SARS-CoV-2 ; Seroepidemiologic Studies
    Language English
    Publishing date 2021-03-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2625162-0
    ISSN 2047-7732 ; 2047-7724
    ISSN (online) 2047-7732
    ISSN 2047-7724
    DOI 10.1080/20477724.2021.1901041
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ud II Zs.196: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article: The role of fibrinolytics in the prehospital treatment of ST-elevation myocardial infarction (STEMI).

    Sayah, Assaad J / Roe, Matthew T

    The Journal of emergency medicine

    2008  Volume 34, Issue 4, Page(s) 405–416

    Abstract: The efficacy of fibrinolytics in the treatment of ST-elevation myocardial infarction is directly related to the time of administration, with the first 2 h after symptom onset seen as a critical period for greatest improvement in cardiovascular parameters ...

    Abstract The efficacy of fibrinolytics in the treatment of ST-elevation myocardial infarction is directly related to the time of administration, with the first 2 h after symptom onset seen as a critical period for greatest improvement in cardiovascular parameters and mortality. The American College of Cardiology/American Heart Association recommends a medical contact to treatment time of 30 min for fibrinolysis in patients with ST-elevation myocardial infarction. In selected patients, reperfusion goals may be expedited with prehospital administration of fibrinolytics. In clinical trials, prehospital fibrinolysis markedly reduced the time from symptom onset to treatment, allowed earlier ST-segment resolution, and reduced short- and long-term mortality compared with in-hospital treatment. Prehospital fibrinolysis has become more feasible with the introduction of prehospital 12-lead electrocardiography, improved skills of emergency medical services personnel, improved communication with the Emergency Department, and the advent of bolus fibrinolysis. Rapid and accurate administration of a fibrinolytic is vital for the success of prehospital fibrinolysis.
    MeSH term(s) Angioplasty, Balloon, Coronary ; Emergency Medical Services/methods ; Emergency Medical Services/statistics & numerical data ; Evidence-Based Medicine ; Fibrinolytic Agents/therapeutic use ; Humans ; Myocardial Infarction/drug therapy ; Myocardial Infarction/mortality ; Myocardial Infarction/therapy ; Time Factors ; Treatment Outcome
    Chemical Substances Fibrinolytic Agents
    Language English
    Publishing date 2008-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 605559-x
    ISSN 0736-4679
    ISSN 0736-4679
    DOI 10.1016/j.jemermed.2007.02.068
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1895: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Effects of universal masking on Massachusetts healthcare workers' COVID-19 incidence

    Lan, Fan-Yun / Christophi, Costas A / Buley, Jane / Iliaki, Eirini / Bruno-Murtha, Lou Ann / Sayah, Assaad J. / Kales, Stefanos N.

    medRxiv

    Abstract: Background: Healthcare workers (HCWs) and other essential workers are at risk for occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Particularly, evidence shows that universal masking can ... ...

    Abstract Background: Healthcare workers (HCWs) and other essential workers are at risk for occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Particularly, evidence shows that universal masking can mitigate COVID-19 infection, though existing research is limited by secular trend bias. Aims: To investigate the effect of hospital universal masking on COVID-19 incidence among HCWs compared to the general community population. Methods: We compared the 7-day averaged incidence rates between a Massachusetts (USA) healthcare system and Massachusetts residents statewide. The study period was from March 17 (the date of first incident case in the healthcare system) to May 6 (the date Massachusetts implemented public masking). The healthcare system implemented universal masking on March 26, we allotted a 5-day lag for effect onset, and peak COVID-19 incidence in Massachusetts was April 20. Thus, we categorized March 17-31 as the pre-intervention phase, April 1-20 the intervention phase, and April 21-May 6 the post-intervention phase. Temporal incidence trends (i.e. 7-day average slopes) were compared using standardized coefficients from linear regression models. Results: The standardized coefficients were similar between the healthcare system and the state in both the pre- and post-intervention phases. During the intervention phase, the healthcare system9s epidemic slope became negative (standardized β: -0.68, 95% CI: -1.06 to -0.31), while Massachusetts9 slope remained positive (standardized β: 0.99, 95% CI: 0.94 to 1.05). Conclusions: Universal masking at the healthcare system was associated with flattening the COVID-19 curve among HCWs, while the infection rate continued to rise in the surrounding community.
    Keywords covid19
    Language English
    Publishing date 2020-08-13
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2020.08.09.20171173
    Database COVID19

    Full text online

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  4. Article ; Online: Effects of universal masking on Massachusetts healthcare workers' COVID-19 incidence

    Lan, Fan-Yun / Christophi, Costas A / Buley, Jane / Iliaki, Eirini / Bruno-Murtha, Lou Ann / Sayah, Assaad J. / Kales, Stefanos N.

    Abstract: Background: Healthcare workers (HCWs) and other essential workers are at risk for occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Particularly, evidence shows that universal masking can ... ...

    Abstract Background: Healthcare workers (HCWs) and other essential workers are at risk for occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Particularly, evidence shows that universal masking can mitigate COVID-19 infection, though existing research is limited by secular trend bias. Aims: To investigate the effect of hospital universal masking on COVID-19 incidence among HCWs compared to the general community population. Methods: We compared the 7-day averaged incidence rates between a Massachusetts (USA) healthcare system and Massachusetts residents statewide. The study period was from March 17 (the date of first incident case in the healthcare system) to May 6 (the date Massachusetts implemented public masking). The healthcare system implemented universal masking on March 26, we allotted a 5-day lag for effect onset, and peak COVID-19 incidence in Massachusetts was April 20. Thus, we categorized March 17-31 as the pre-intervention phase, April 1-20 the intervention phase, and April 21-May 6 the post-intervention phase. Temporal incidence trends (i.e. 7-day average slopes) were compared using standardized coefficients from linear regression models. Results: The standardized coefficients were similar between the healthcare system and the state in both the pre- and post-intervention phases. During the intervention phase, the healthcare system's epidemic slope became negative (standardized {beta}: -0.68, 95% CI: -1.06 to -0.31), while Massachusetts' slope remained positive (standardized {beta}: 0.99, 95% CI: 0.94 to 1.05). Conclusions: Universal masking at the healthcare system was associated with flattening the COVID-19 curve among HCWs, while the infection rate continued to rise in the surrounding community.
    Keywords covid19
    Publisher MedRxiv; WHO
    Document type Article ; Online
    Note WHO #Covidence: #20171173
    DOI 10.1101/2020.08.09.20171173
    Database COVID19

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  5. Article ; Online: Emergency medical service predictive instrument-aided diagnosis and treatment of acute coronary syndromes and ST-segment elevation myocardial infarction in the IMMEDIATE trial.

    Selker, Harry P / Beshansky, Joni R / Ruthazer, Robin / Sheehan, Patricia R / Sayah, Assaad J / Atkins, James M / Aufderheide, Tom P / Pirrallo, Ronald G / D'Agostino, Ralph B / Massaro, Joseph M / Griffith, John L

    Prehospital emergency care

    2011  Volume 15, Issue 2, Page(s) 139–148

    Abstract: Background: A challenge for emergency medical service (EMS) is accurate identification of acute coronary syndromes (ACS) and ST-segment elevation myocardial infarction (STEMI) for immediate treatment and transport. The electrocardiograph-based acute ... ...

    Abstract Background: A challenge for emergency medical service (EMS) is accurate identification of acute coronary syndromes (ACS) and ST-segment elevation myocardial infarction (STEMI) for immediate treatment and transport. The electrocardiograph-based acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) and the thrombolytic predictive instrument (TPI) have been shown to improve diagnosis and treatment in emergency departments (EDs), but their use by paramedics in the community has been less studied.
    Objective: To identify candidates for participation in the Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care (IMMEDIATE) Trial, we implemented EMS use of the ACI-TIPI and the TPI in out-of-hospital electrocardiographs and evaluated its impact on paramedic on-site identification of ACS and STEMI as a community-based approach to improving emergency cardiac care.
    Methods: Ambulances in the study municipalities were outfitted with electrocardiographs with ACI-TIPI and TPI software. Using a before-after quasi-experimental design, in Phase 1, for seven months, paramedics were provided with the ACI-TIPI/TPI continuous 0-100% predictions automatically printed on electrocardiogram (ECG) text headers to supplement their identification of ACS; in Phase 2, for 11 months, paramedics were told to identify ACS based on an ACI-TIPI cutoff probability of ACS ≥ 75% and/or TPI detection of STEMI. In Phase 3, this cutoff approach was used in seven additional municipalities. Confirmed diagnoses of ACS, acute myocardial infarction (AMI), and STEMI were made by blinded physician review for 100% of patients.
    Results: In Phase 1, paramedics identified 107 patients as having ACS; in Phase 2, 104. In Phase 1, 45.8% (49) of patients so identified had ACS confirmed, which increased to 76.0% (79) in Phase 2 (p < 0.001). Of those with ACS, 59.2% (29) had AMI in Phase 1 versus 84.8% (67) with AMI in Phase 2 (p < 0.01), and STEMI was confirmed in 40.8% (20) versus 68.4% (54), respectively (p < 0.01). In Phase 3, of 226 patients identified by paramedics as having ACS, 74.3% (168) had ACS confirmed, of whom 81.0% (136) had AMI and 65.5% (110) had STEMI. Among patients with ACS, the proportion who received percutaneous coronary intervention (PCI) was 30.6% (15) in Phase 1, increasing to 57.0% (45) in Phase 2 (p < 0.004) and 50.6% (85) in Phase 3, and the proportions of patients with STEMI receiving PCI rose from 75.0% (15) to 83.3% (45) (p < 0.4) and 82.7% (91).
    Conclusions: In a wide range of EMS systems, use of electrocardiographs with ACI-TIPI and TPI decision support using a 75% ACI-TIPI cutoff improves paramedic diagnostic performance for ACS, AMI, and STEMI and increases the proportions of patients who receive PCI.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/drug therapy ; Acute Coronary Syndrome/therapy ; Chest Pain ; Chi-Square Distribution ; Decision Support Systems, Clinical ; Diagnosis, Computer-Assisted/instrumentation ; Diagnosis, Computer-Assisted/methods ; Electrocardiography/instrumentation ; Electrocardiography/methods ; Emergency Medical Technicians/statistics & numerical data ; Emergency Service, Hospital/statistics & numerical data ; Female ; Health Status Indicators ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnosis ; Myocardial Infarction/drug therapy ; Myocardial Infarction/therapy ; Predictive Value of Tests ; Sensitivity and Specificity ; Software ; Time Factors
    Language English
    Publishing date 2011-03-02
    Publishing country England
    Document type Evaluation Study ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1461751-1
    ISSN 1545-0066 ; 1090-3127
    ISSN (online) 1545-0066
    ISSN 1090-3127
    DOI 10.3109/10903127.2010.545478
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 4762: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Improving use of prehospital 12-lead ECG for early identification and treatment of acute coronary syndrome and ST-elevation myocardial infarction.

    Daudelin, Denise H / Sayah, Assaad J / Kwong, Manlik / Restuccia, Marc C / Porcaro, William A / Ruthazer, Robin / Goetz, Jessica D / Lane, William M / Beshansky, Joni R / Selker, Harry P

    Circulation. Cardiovascular quality and outcomes

    2010  Volume 3, Issue 3, Page(s) 316–323

    Abstract: Background: Performance of prehospital ECGs expedites identification of ST-elevation myocardial infarction and reduces door-to-balloon times for patients receiving reperfusion therapy. To fully realize this benefit, emergency medical service performance ...

    Abstract Background: Performance of prehospital ECGs expedites identification of ST-elevation myocardial infarction and reduces door-to-balloon times for patients receiving reperfusion therapy. To fully realize this benefit, emergency medical service performance must be measured and used in feedback reporting and quality improvement.
    Methods and results: This quasi-experimental design trial tested an approach to improving emergency medical service prehospital ECGs using feedback reporting and quality improvement interventions in 2 cities' emergency medical service agencies and receiving hospitals. All patients age > or =30 years, calling 9-1-1 with possible acute coronary syndrome, were included. In total, 6994 patients were included: 1589 patients in the baseline period without feedback and 5405 in the intervention period when there were feedback reports and quality improvement interventions. Mean age was 66+/-17 years, and women represented 51%. Feedback and quality improvement increased prehospital ECG performance for patients with acute coronary syndrome from 76% to 93% (P=<0.0001) and for patients with ST-elevation myocardial infarction from 77% to 99% (P=<0.0001). Aspirin administration increased from 75% to 82% (P=0.001), but the median total emergency medical service run time remained the same at 22 minutes. The proportion of patients with door-to-balloon times of < or =90 minutes increased from 27% to 67% (P=0.006).
    Conclusions: Feedback reports and quality improvement improved prehospital ECG performance for patients with acute coronary syndrome and ST-elevation myocardial infarction and increased aspirin administration without prehospital transport delays. Improvements in door-to-balloon times were also seen.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/epidemiology ; Acute Coronary Syndrome/therapy ; Aged ; Aged, 80 and over ; Aspirin/therapeutic use ; Early Diagnosis ; Electrocardiography/statistics & numerical data ; Emergency Medical Services ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Myocardial Infarction/therapy ; Myocardial Reperfusion ; Practice Guidelines as Topic ; Quality Assurance, Health Care
    Chemical Substances Aspirin (R16CO5Y76E)
    Language English
    Publishing date 2010-05-18
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.109.895045
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6744: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Study design for the Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care (IMMEDIATE) Trial: A double-blind randomized controlled trial of intravenous glucose, insulin, and potassium for acute coronary syndromes in emergency medical services.

    Selker, Harry P / Beshansky, Joni R / Griffith, John L / D'Agostino, Ralph B / Massaro, Joseph M / Udelson, James E / Rashba, Eric J / Ruthazer, Robin / Sheehan, Patricia R / Desvigne-Nickens, Patrice / Rosenberg, Yves D / Atkins, James M / Sayah, Assaad J / Aufderheide, Tom P / Rackley, Charles E / Opie, Lionel H / Lambrew, Costas T / Cobb, Leonard A / Macleod, Bruce A /
    Ingwall, Joanne S / Zalenski, Robert J / Apstein, Carl S

    American heart journal

    2012  Volume 163, Issue 3, Page(s) 315–322

    Abstract: Background: Experimental studies suggest that metabolic myocardial support by intravenous (IV) glucose, insulin, and potassium (GIK) reduces ischemia-induced arrhythmias, cardiac arrest, mortality, progression from unstable angina pectoris to acute ... ...

    Abstract Background: Experimental studies suggest that metabolic myocardial support by intravenous (IV) glucose, insulin, and potassium (GIK) reduces ischemia-induced arrhythmias, cardiac arrest, mortality, progression from unstable angina pectoris to acute myocardial infarction (AMI), and myocardial infarction size. However, trials of hospital administration of IV GIK to patients with ST-elevation myocardial infarction (STEMI) have generally not shown favorable effects possibly because of the GIK intervention taking place many hours after ischemic symptom onset. A trial of GIK used in the very first hours of ischemia has been needed, consistent with the timing of benefit seen in experimental studies.
    Objective: The IMMEDIATE Trial tested whether, if given very early, GIK could have the impact seen in experimental studies. Accordingly, distinct from prior trials, IMMEDIATE tested the impact of GIK (1) in patients with acute coronary syndromes (ACS), rather than only AMI or STEMI, and (2) administered in prehospital emergency medical service settings, rather than later, in hospitals, after emergency department evaluation.
    Design: The IMMEDIATE Trial was an emergency medical service-based randomized placebo-controlled clinical effectiveness trial conducted in 13 cities across the United States that enrolled 911 participants. Eligible were patients 30 years or older for whom a paramedic performed a 12-lead electrocardiogram to evaluate chest pain or other symptoms suggestive of ACS for whom electrocardiograph-based acute cardiac ischemia time-insensitive predictive instrument indicated a ≥75% probability of ACS, and/or the thrombolytic predictive instrument indicated the presence of a STEMI, or if local criteria for STEMI notification of receiving hospitals were met. Prehospital IV GIK or placebo was started immediately. Prespecified were the primary end point of progression of ACS to infarction and, as major secondary end points, the composite of cardiac arrest or in-hospital mortality, 30-day mortality, and the composite of cardiac arrest, 30-day mortality, or hospitalization for heart failure. Analyses were planned on an intent-to-treat basis, on a modified intent-to-treat group who were confirmed in emergency departments to have ACS, and for participants presenting with STEMI.
    Conclusion: The IMMEDIATE Trial tested whether GIK, when administered as early as possible in the course of ACS by paramedics using acute cardiac ischemia time-insensitive predictive instrument and thrombolytic predictive instrument decision support, would reduce progression to AMI, mortality, cardiac arrest, and heart failure. It also tested whether it would provide clinical and pathophysiologic information on GIK's biological mechanisms.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/drug therapy ; Acute Coronary Syndrome/mortality ; Adult ; Cardioplegic Solutions ; Dose-Response Relationship, Drug ; Double-Blind Method ; Electrocardiography ; Emergency Medical Services/methods ; Follow-Up Studies ; Glucose/administration & dosage ; Humans ; Infusions, Intravenous ; Insulin/administration & dosage ; Myocardium/metabolism ; Potassium/administration & dosage ; Survival Rate/trends ; Time Factors ; Tomography, Emission-Computed, Single-Photon ; Treatment Outcome ; United States/epidemiology
    Chemical Substances Cardioplegic Solutions ; Insulin ; glucose-insulin-potassium cardioplegic solution ; Glucose (IY9XDZ35W2) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2012-03-18
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 80026-0
    ISSN 1097-6744 ; 0002-8703
    ISSN (online) 1097-6744
    ISSN 0002-8703
    DOI 10.1016/j.ahj.2012.02.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ui IV Zs.15: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: One-year outcomes of out-of-hospital administration of intravenous glucose, insulin, and potassium (GIK) in patients with suspected acute coronary syndromes (from the IMMEDIATE [Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency Care] Trial).

    Selker, Harry P / Udelson, James E / Massaro, Joseph M / Ruthazer, Robin / D'Agostino, Ralph B / Griffith, John L / Sheehan, Patricia R / Desvigne-Nickens, Patrice / Rosenberg, Yves / Tian, Xin / Vickery, Ellen M / Atkins, James M / Aufderheide, Tom P / Sayah, Assaad J / Pirrallo, Ronald G / Levy, Michael K / Richards, Michael E / Braude, Darren A / Doyle, Delanor D /
    Frascone, Ralph J / Kosiak, Donald J / Leaming, James M / Van Gelder, Carin M / Walter, Gert-Paul / Wayne, Marvin A / Woolard, Robert H / Beshansky, Joni R

    The American journal of cardiology

    2014  Volume 113, Issue 10, Page(s) 1599–1605

    Abstract: The Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care Trial of very early intravenous glucose-insulin-potassium (GIK) for acute coronary syndromes (ACS) in out-of-hospital emergency medical service (EMS) ...

    Abstract The Immediate Myocardial Metabolic Enhancement During Initial Assessment and Treatment in Emergency care Trial of very early intravenous glucose-insulin-potassium (GIK) for acute coronary syndromes (ACS) in out-of-hospital emergency medical service (EMS) settings showed 80% reduction in infarct size at 30 days, suggesting potential longer-term benefits. Here we report 1-year outcomes. Prespecified 1-year end points of this randomized, placebo-controlled, double-blind, effectiveness trial included all-cause mortality and composites including cardiac arrest, mortality, or hospitalization for heart failure (HF). Of 871 participants randomized to GIK versus placebo, death occurred within 1 year in 11.6% versus 13.5%, respectively (unadjusted hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.57 to 1.23, p = 0.36). The composite of cardiac arrest or 1-year mortality was 12.8% versus 17.0% (HR 0.71, 95% CI 0.50 to 1.02, p = 0.06). The composite of hospitalization for HF or mortality within 1 year was 17.2% versus 17.2% (HR 0.98, 95% CI 0.70 to 1.37, p = 0.92). The composite of mortality, cardiac arrest, or HF hospitalization within 1 year was 18.1% versus 20.4% (HR 0.85, 95% CI 0.62 to 1.16, p = 0.30). In patients presenting with suspected ST elevation myocardial infarction, HRs for 1-year mortality and the 3 composites were, respectively, 0.65 (95% CI 0.33 to 1.27, p = 0.21), 0.52 (95% CI 0.30 to 0.92, p = 0.03), 0.63 (95% CI 0.35 to 1.16, p = 0.14), and 0.51 (95% CI 0.30 to 0.87, p = 0.01). In patients with suspected acute coronary syndromes, serious end points generally were lower with GIK than placebo, but the differences were not statistically significant. However, in those with ST elevation myocardial infarction, the composites of cardiac arrest or 1-year mortality, and of cardiac arrest, mortality, or HF hospitalization within 1 year, were significantly reduced.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/drug therapy ; Acute Coronary Syndrome/mortality ; Adult ; After-Hours Care/methods ; Cardioplegic Solutions ; Cause of Death/trends ; Double-Blind Method ; Electrocardiography ; Female ; Follow-Up Studies ; Glucose/administration & dosage ; Heart Arrest/mortality ; Heart Arrest/prevention & control ; Humans ; Infusions, Intravenous ; Insulin/administration & dosage ; Male ; Middle Aged ; Myocardium/metabolism ; Outpatients ; Potassium/administration & dosage ; Retrospective Studies ; Survival Rate/trends ; Time Factors ; Treatment Outcome ; United States/epidemiology
    Chemical Substances Cardioplegic Solutions ; Insulin ; glucose-insulin-potassium cardioplegic solution ; Glucose (IY9XDZ35W2) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2014-03-01
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2014.02.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ui IV Zs.73: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Article ; Online: Out-of-hospital administration of intravenous glucose-insulin-potassium in patients with suspected acute coronary syndromes: the IMMEDIATE randomized controlled trial.

    Selker, Harry P / Beshansky, Joni R / Sheehan, Patricia R / Massaro, Joseph M / Griffith, John L / D'Agostino, Ralph B / Ruthazer, Robin / Atkins, James M / Sayah, Assaad J / Levy, Michael K / Richards, Michael E / Aufderheide, Tom P / Braude, Darren A / Pirrallo, Ronald G / Doyle, Delanor D / Frascone, Ralph J / Kosiak, Donald J / Leaming, James M / Van Gelder, Carin M /
    Walter, Gert-Paul / Wayne, Marvin A / Woolard, Robert H / Opie, Lionel H / Rackley, Charles E / Apstein, Carl S / Udelson, James E

    JAMA

    2012  Volume 307, Issue 18, Page(s) 1925–1933

    Abstract: Context: Laboratory studies suggest that in the setting of cardiac ischemia, immediate intravenous glucose-insulin-potassium (GIK) reduces ischemia-related arrhythmias and myocardial injury. Clinical trials have not consistently shown these benefits, ... ...

    Abstract Context: Laboratory studies suggest that in the setting of cardiac ischemia, immediate intravenous glucose-insulin-potassium (GIK) reduces ischemia-related arrhythmias and myocardial injury. Clinical trials have not consistently shown these benefits, possibly due to delayed administration.
    Objective: To test out-of hospital emergency medical service (EMS) administration of GIK in the first hours of suspected acute coronary syndromes (ACS).
    Design, setting, and participants: Randomized, placebo-controlled, double-blind effectiveness trial in 13 US cities (36 EMS agencies), from December 2006 through July 31, 2011, in which paramedics, aided by electrocardiograph (ECG)-based decision support, randomized 911 (871 enrolled) patients (mean age, 63.6 years; 71.0% men) with high probability of ACS.
    Intervention: Intravenous GIK solution (n = 411) or identical-appearing 5% glucose placebo (n = 460) administered by paramedics in the out-of-hospital setting and continued for 12 hours.
    Main outcome measures: The prespecified primary end point was progression of ACS to myocardial infarction (MI) within 24 hours, as assessed by biomarkers and ECG evidence. Prespecified secondary end points included survival at 30 days and a composite of prehospital or in-hospital cardiac arrest or in-hospital mortality, analyzed by intent-to-treat and by presentation with ST-segment elevation.
    Results: There was no significant difference in the rate of progression to MI among patients who received GIK (n = 200; 48.7%) vs those who received placebo (n = 242; 52.6%) (odds ratio [OR], 0.88; 95% CI, 0.66-1.13; P = .28). Thirty-day mortality was 4.4% with GIK vs 6.1% with placebo (hazard ratio [HR], 0.72; 95% CI, 0.40-1.29; P = .27). The composite of cardiac arrest or in-hospital mortality occurred in 4.4% with GIK vs 8.7% with placebo (OR, 0.48; 95% CI, 0.27-0.85; P = .01). Among patients with ST-segment elevation (163 with GIK and 194 with placebo), progression to MI was 85.3% with GIK vs 88.7% with placebo (OR, 0.74; 95% CI, 0.40-1.38; P = .34); 30-day mortality was 4.9% with GIK vs 7.7% with placebo (HR, 0.63; 95% CI, 0.27-1.49; P = .29). The composite outcome of cardiac arrest or in-hospital mortality was 6.1% with GIK vs 14.4% with placebo (OR, 0.39; 95% CI, 0.18-0.82; P = .01). Serious adverse events occurred in 6.8% (n = 28) with GIK vs 8.9% (n = 41) with placebo (P = .26).
    Conclusions: Among patients with suspected ACS, out-of-hospital administration of intravenous GIK, compared with glucose placebo, did not reduce progression to MI. Compared with placebo, GIK administration was not associated with improvement in 30-day survival but was associated with lower rates of the composite outcome of cardiac arrest or in-hospital mortality.
    Trial registration: clinicaltrials.gov Identifier: NCT00091507.
    MeSH term(s) Acute Coronary Syndrome/drug therapy ; Acute Coronary Syndrome/mortality ; Aged ; Allied Health Personnel ; Angina, Unstable/complications ; Angina, Unstable/drug therapy ; Cardioplegic Solutions/therapeutic use ; Decision Support Techniques ; Double-Blind Method ; Electrocardiography ; Emergency Medical Services ; Female ; Glucose/therapeutic use ; Heart Arrest/prevention & control ; Hospital Mortality ; Humans ; Insulin/therapeutic use ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Myocardial Infarction/prevention & control ; Odds Ratio ; Potassium/therapeutic use ; Survival Analysis ; Treatment Outcome
    Chemical Substances Cardioplegic Solutions ; Insulin ; glucose-insulin-potassium cardioplegic solution ; Glucose (IY9XDZ35W2) ; Potassium (RWP5GA015D)
    Language English
    Publishing date 2012-03-27
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2012.426
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ua VI Zs.88: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top