Aims: To investigate the prognostic value of T- wave abnormalities in patients with non- ST- segment elevation acute coronary syndromes(NSTE- ACS), and whether such ECG changes may predict benefit from an early corona...Aims: To investigate the prognostic value of T- wave abnormalities in patients with non- ST- segment elevation acute coronary syndromes(NSTE- ACS), and whether such ECG changes may predict benefit from an early coronary angiography. Although ST- segment changes are considered the most important ECG feature in NSTE- ACS, T- wave abnormalities are the most common ECG finding. We hypothesize that a new quantitative approach to T- wave analysis could improve the prognostic value of this ECG abnormality. Methods and results: Quantitative T- wave analysis was performed on the admission ECG in 1609 patients with NSTE- ACS. Nine different categories of T- wave abnormality were analysed for their prognostic value concerning clinical outcome in patients not randomized to early coronary angiography. Also, the presence of one category(i.e. T- wave abnormality in >6 leads)was analysed for its predictive value concerning benefit from early coronary angiography. The combined study endpoint was death or myocardial infarction at 1 year follow- up. Patients with >6 leads with abnormal T waves and concomitant ST- segment depression had a higher risk when not receiving early coronary angiography(24 vs. 12% , respectively; P=0.003), but could be brought to the same level of risk as the remaining patients with this treatment. For non- invasively treated patients five different categories of T- wave abnormality were significantly associated with an adverse outcome. Conclusion: New quantitative T- wave analysis of the admission ECG gives additional predictive information concerning clinical outcome and identifies patients who benefit from early coronary angiography.展开更多
Background & Aims: Although diabetes occurs frequently in pancreatic cancer, the value of new-onset diabetes as a marker of underlying pancreatic cancer is unknown. Methods: We assembled a population-based cohort ...Background & Aims: Although diabetes occurs frequently in pancreatic cancer, the value of new-onset diabetes as a marker of underlying pancreatic cancer is unknown. Methods: We assembled a population-based cohort of 2122 Rochester, Minnesota, residents age ≥ 50 years who first met standardized criteria for diabetes between January 1, 1950, and December 31, 1994, and identified those who developed pancreatic cancer within 3 years of meeting criteria for diabetes. We compared observed rates of pancreatic cancer with expected rates based on the Iowa Surveillance Epidemiology and End Results registry. In a nested case control study, we compared body mass index (BMI) and smoking status in diabetes subjects with and without pancreatic cancer. Results: Of 2122 diabetic subjects, 18 (0.85% ) were diagnosed with pancreatic cancer within 3 years of meeting criteria for diabetes; 10 of 18 (56% ) were diagnosed < 6 months after first meeting criteria for diabetes, and 3 were resected. The observed-to-expected ratio of pancreatic cancer in the cohort was 7.94 (95% CI, 4.70- 12.55). Compared with subjects without pancreatic cancer, diabetic subjects with pancreatic cancer were more likely to have met diabetes criteria after age 69 (OR = 4.52, 95% CI, 1.61- 12.74) years but did not differ significantly with respect to BMI values (29.2 ± 6.8 vs 26.5 ± 5.0, respectively). A larger proportion of those who developed pancreatic cancer were ever smokers (92% vs 69% , respectively), but this did not reach statistical significance. Conclusions: Approximately 1% of diabetes subjects aged < 50 yearswill be diagnosed with pancreatic cancer within 3 years of first meeting criteria for diabetes. The usefulness of new-onset diabetes as marker of early pancreatic cancer needs further evaluation.展开更多
Sona Rivas-Tumanyan, Donna Spiegelman, Gary C. Curhan, John P. Forman, Kaumudi J. Joshipura. Am J Hypertens, 2012,25 （7） ： 770-776. 最近有研究表明，牙周病和高血压可能存在关联，但前瞻性的研究资料还不够充分。方法：...Sona Rivas-Tumanyan, Donna Spiegelman, Gary C. Curhan, John P. Forman, Kaumudi J. Joshipura. Am J Hypertens, 2012,25 （7） ： 770-776. 最近有研究表明，牙周病和高血压可能存在关联，但前瞻性的研究资料还不够充分。方法：医务人员随访研究（healthprofessionals’follow—upstudy，HPFS）为前瞻性研究，该研究入选HPFS的参与者31543人，基线年龄40～75岁，均无高血压病史，并有完整的口腔健康资料。每两年检查一次以了解牙周病、高血压以及混杂因素的存在情况。展开更多
文摘Aims: To investigate the prognostic value of T- wave abnormalities in patients with non- ST- segment elevation acute coronary syndromes(NSTE- ACS), and whether such ECG changes may predict benefit from an early coronary angiography. Although ST- segment changes are considered the most important ECG feature in NSTE- ACS, T- wave abnormalities are the most common ECG finding. We hypothesize that a new quantitative approach to T- wave analysis could improve the prognostic value of this ECG abnormality. Methods and results: Quantitative T- wave analysis was performed on the admission ECG in 1609 patients with NSTE- ACS. Nine different categories of T- wave abnormality were analysed for their prognostic value concerning clinical outcome in patients not randomized to early coronary angiography. Also, the presence of one category(i.e. T- wave abnormality in >6 leads)was analysed for its predictive value concerning benefit from early coronary angiography. The combined study endpoint was death or myocardial infarction at 1 year follow- up. Patients with >6 leads with abnormal T waves and concomitant ST- segment depression had a higher risk when not receiving early coronary angiography(24 vs. 12% , respectively; P=0.003), but could be brought to the same level of risk as the remaining patients with this treatment. For non- invasively treated patients five different categories of T- wave abnormality were significantly associated with an adverse outcome. Conclusion: New quantitative T- wave analysis of the admission ECG gives additional predictive information concerning clinical outcome and identifies patients who benefit from early coronary angiography.
文摘Background & Aims: Although diabetes occurs frequently in pancreatic cancer, the value of new-onset diabetes as a marker of underlying pancreatic cancer is unknown. Methods: We assembled a population-based cohort of 2122 Rochester, Minnesota, residents age ≥ 50 years who first met standardized criteria for diabetes between January 1, 1950, and December 31, 1994, and identified those who developed pancreatic cancer within 3 years of meeting criteria for diabetes. We compared observed rates of pancreatic cancer with expected rates based on the Iowa Surveillance Epidemiology and End Results registry. In a nested case control study, we compared body mass index (BMI) and smoking status in diabetes subjects with and without pancreatic cancer. Results: Of 2122 diabetic subjects, 18 (0.85% ) were diagnosed with pancreatic cancer within 3 years of meeting criteria for diabetes; 10 of 18 (56% ) were diagnosed < 6 months after first meeting criteria for diabetes, and 3 were resected. The observed-to-expected ratio of pancreatic cancer in the cohort was 7.94 (95% CI, 4.70- 12.55). Compared with subjects without pancreatic cancer, diabetic subjects with pancreatic cancer were more likely to have met diabetes criteria after age 69 (OR = 4.52, 95% CI, 1.61- 12.74) years but did not differ significantly with respect to BMI values (29.2 ± 6.8 vs 26.5 ± 5.0, respectively). A larger proportion of those who developed pancreatic cancer were ever smokers (92% vs 69% , respectively), but this did not reach statistical significance. Conclusions: Approximately 1% of diabetes subjects aged < 50 yearswill be diagnosed with pancreatic cancer within 3 years of first meeting criteria for diabetes. The usefulness of new-onset diabetes as marker of early pancreatic cancer needs further evaluation.
文摘Sona Rivas-Tumanyan, Donna Spiegelman, Gary C. Curhan, John P. Forman, Kaumudi J. Joshipura. Am J Hypertens, 2012,25 （7） ： 770-776. 最近有研究表明，牙周病和高血压可能存在关联，但前瞻性的研究资料还不够充分。方法：医务人员随访研究（healthprofessionals’follow—upstudy，HPFS）为前瞻性研究，该研究入选HPFS的参与者31543人，基线年龄40～75岁，均无高血压病史，并有完整的口腔健康资料。每两年检查一次以了解牙周病、高血压以及混杂因素的存在情况。
