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Ensuing Years (ensuing + year)
Selected AbstractsOne-year Outcomes Following Coronary Computerized Tomographic Angiography for Evaluation of Emergency Department Patients with Potential Acute Coronary SyndromeACADEMIC EMERGENCY MEDICINE, Issue 8 2009Judd E. Hollander MD Abstract Objectives:, Coronary computerized tomographic angiography (CTA) has high correlation with cardiac catheterization and has been shown to be safe and cost-effective when used for rapid evaluation of low-risk chest pain patients from the emergency department (ED). The long-term outcome of patients discharged from the ED with negative coronary CTA has not been well studied. Methods:, The authors prospectively evaluated consecutive low- to intermediate-risk patients who received coronary CTA in the ED for evaluation of a potential acute coronary syndrome (ACS). Patients with cocaine use, known cancer, and significant comorbidity reducing life expectancy and those found to have significant disease (stenosis , 50% or ejection fraction < 30%) were excluded. Demographics, medical and cardiac history, labs, and electrocardiogram (ECG) results were collected. Patients were followed by telephone contact and record review for 1 year. The main outcome was 1-year cardiovascular death or nonfatal acute myocardial infarction (AMI). Results:, Of 588 patients who received coronary CTA in the ED, 481 met study criteria. They had a mean (±SD) age of 46.1 (±8.8) years, 63% were black or African American, and 60% were female. There were 53 patients (11%) rehospitalized and 51 patients (11%) who received further diagnostic testing (stress or catheterization) over the subsequent year. There was one death (0.2%; 95% confidence interval [CI] = 0.01% to 1.15%) with unclear etiology, no AMI (0%; 95% CI = 0 to 0.76%), and no revascularization procedures (0%; 95% CI = 0 to 0.76%) during this time period. Conclusions:, Low- to intermediate-risk patients with a Thrombosis In Myocardial Infarction (TIMI) score of 0 to 2 who present to the ED with potential ACS and have a negative coronary CTA have a very low likelihood of cardiovascular events over the ensuing year. [source] Interferon-regulated chemokines as biomarkers of systemic lupus erythematosus disease activity: A validation studyARTHRITIS & RHEUMATISM, Issue 10 2009Jason W. Bauer Objective Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by unpredictable flares of disease activity and irreversible damage to multiple organ systems. An earlier study showed that SLE patients carrying an interferon (IFN) gene expression signature in blood have elevated serum levels of IFN-regulated chemokines. These chemokines were associated with more-severe and active disease and showed promise as SLE disease activity biomarkers. This study was designed to validate IFN-regulated chemokines as biomarkers of SLE disease activity in 267 SLE patients followed up longitudinally. Methods To validate the potential utility of serum chemokine levels as biomarkers of disease activity, we measured serum levels of CXCL10 (IFN,-inducible 10-kd protein), CCL2 (monocyte chemotactic protein 1), and CCL19 (macrophage inflammatory protein 3,) in an independent cohort of 267 SLE patients followed up longitudinally over 1 year (1,166 total clinic visits). Results Serum chemokine levels correlated with lupus activity at the current visit (P = 2 × 10,10), rising at the time of SLE flare (P = 2 × 10,3) and decreasing as disease remitted (P = 1 × 10,3); they also performed better than the currently available laboratory tests. Chemokine levels measured at a single baseline visit in patients with a Systemic Lupus Erythematosus Disease Activity Index of ,4 were predictive of lupus flare over the ensuing year (P = 1 × 10,4). Conclusion Monitoring serum chemokine levels in SLE may improve the assessment of current disease activity, the prediction of future disease flares, and the overall clinical decision-making. [source] Ischemic Preconditioning: Fact or Fantasy?JOURNAL OF CARDIAC SURGERY, Issue 6 2002Christopher D. Raeburn M.D. In the ensuing years, surgeons have learned to discriminate a biochemical/metabolic/functional spectrum of cardiac states ranging from healthy myocardium to "stunned" or "hibernating" heart to the modes of "apoptotic" or "necrotic" cardiomyocyte death. It is now clear that "protective cardiac preconditioning" influences all of these cardiac states. The cellular mechanisms of preconditioning (PC) are now sufficiently understood to permit clinical application. Ligation of adrenergic, adenosine, bradykinin or opioid receptors involves signaling via both tyrosine and calcium-dependent protein kinases (PKC), which activate mitochondrial ATP-dependent potassium channels. Subsequently, the release of oxygen radicals induces nuclear translocation of transcriptional regulators, which transform the cardiomyocyte into a more resilient cell. Although preconditioning was initially recognized as protecting only against infarction, PC also limits postischemic dysrhythmias and enhances contractile function. Phase I (safety) and phase II (efficacy) clinical trials now persuasively support pharmacological preconditioning as a safe mode of preventing postcardiac surgical complications. Indeed, preconditioning is currently being proposed as adjunctive to hypothermic perfusates in protecting against the obligate organ ischemia during transplantation. [source] Anatomical Markers of Activity in Neuroendocrine Systems: Are we all ,Fos-ed out'?JOURNAL OF NEUROENDOCRINOLOGY, Issue 4 2002G. E. Hoffman Abstract It has now been nearly 15 years since the immediate early gene, c -fos, and its protein product, Fos, were introduced as tools for determining activity changes within neurones of the nervous system. In the ensuing years, this approach was applied to neuroendocrine study with success. With it have come advances in our understanding of which neuroendocrine neurones respond to various stimuli and how other central nervous system components interact with neuroendocrine neurones. Use of combined tract-tracing approaches, as well as double-labelling for Fos and transmitter markers, have added to characterization of neuroendocrine circuits. The delineation of the signal transduction cascades that induce Fos expression has led to establishment of the relationship between neurone firing and Fos expression. Importantly, we can now appreciate that Fos expression is often, but not always, associated with increased neuronal firing and vice versa. There are remaining gaps in our understanding of Fos in the nervous system. To date, knowledge of what Fos does after it is expressed is still limited. The transience of Fos expression after stimulation (especially if the stimulus is persistent) complicates design of experiments to assess the function of Fos and makes Fos of little value as a marker for long-term changes in neurone activity. In this regard, alternative approaches must be sought. Useful alternative approaches employed to date to monitor neuronal changes in activity include examination of (i) signal transduction intermediates (e.g. phosphorylated CREB); (ii) transcriptional/translational intermediates (e.g. heteronuclear RNA, messenger RNA (mRNA), prohormones); and (iii) receptor translocation. Another capitalizes on the fact that many neuroendocrine systems show striking stimulus-transcription coupling in the regulation of their transmitter or its synthetic enzymes. Together, as we move into the 21st Century, the use of multiple approaches to study activity within neuroendocrine systems will further our understanding of these important systems. [source] Research Methods in the Leading Small Business,Entrepreneurship Journals: A Critical Review with Recommendations for Future Research,JOURNAL OF SMALL BUSINESS MANAGEMENT, Issue 3 2009Michael R. Mullen Small business and entrepreneurship scholars have made significant progress toward advancing the field and gaining recognition as an important domain of scientific inquiry. However, the authors suggest that a strong methodological foundation built on state-of-the-art research technologies is necessary to support further paradigmatic growth and maturation. Using Chandler and Lyon's study as a benchmark for research methods through the 1990s, the study critiques research methodologies used by small business and entrepreneurship researchers over the ensuing years. The analysis includes all 665 papers published between 2001 and February of 2008 in the Journal of Small Business Management, Journal of Business Venturing, and Entrepreneurship Theory and Practice. The research outlines key methodological issues, assesses recent methodological practice, identifies current trends, and offers recommendations for researchers in adopting existing and emerging research technologies. [source] The American-Soviet Walks: Large-Scale Citizen Diplomacy at Glasnost's OutsetPEACE & CHANGE, Issue 4 2010Steve Brigham Nineteen eighty-seven was a watershed year in the Soviet Union, as Premier Gorbachev's glasnost and perestroika initiatives began to change the face of this closed society. On the citizen diplomacy front, the year featured one of the largest-ever initiatives between American and Soviet citizens, the American,Soviet Walk, the first of numerous walks of that scale to take place in the ensuing years. The five-week walk not only pushed the limits of this fledgling openness and democratization but also tread well beyond the traditional, safe conventions of small-scale citizen exchange. This article explores what made these walks unique, from an unexpectedly large peace rally in Novgorod, to an illegal peace demonstration in Red Square, to public meetings with dissidents. It concludes by exploring the deep cultural differences among the citizen representatives from both countries and whether the walks provide a model for future citizen diplomacy when tensions are high between rival countries. [source] Prefabricating Memory Lane: Whatever Happened to Systems?ARCHITECTURAL DESIGN, Issue 1 2006John McKean Abstract Three decades after his first involvement with an issue of 4 on systems buildings, John McKean, Professor of Architecture at the University of Brighton, revisits the subject. He concludes that, despite the ensuing years, architects still have much to learn about the mass production of buildings. [source] | ||||||||||