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Used Early (used + early)

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Medical Sciences	75%

Selected Abstracts

Early Vasoactive Drugs Improve Heart Failure Outcomes

CONGESTIVE HEART FAILURE, Issue 6 2009
William Frank Peacock MD
Vasoactive therapy is often used to treat acute decompensated heart failure (ADHF). The authors sought to determine whether clinical outcomes are temporally associated with time to vasoactive therapy (vasoactive time) in ADHF. Using the Acute Decompensated Heart Failure (ADHERE) Registry, the authors examined the relationship between vasoactive time and inpatient mortality within 48 hours of hospitalization. Vasoactive agents were used early (defined as <6 hours) in 22,788 (63.8%) patients and late in 12,912 (36.2%). Median vasoactive time was 1.7 and 14.7 hours in the early and late groups, respectively. In-hospital mortality was significantly lower in the early group (odds ratio, 0.87; 95% confidence interval, 0.79,0.96; P=.006), and the adjusted odds of death increased 6.8% for every 6 hours of treatment delay (95% confidence interval, 4.2,9.6; P<.0001). Early vasoactive initiation is associated with improved outcomes in patients hospitalized for ADHF. [source]

Is it possible to identify early predictors of the future cost of chronic arthritis?

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2009
The VErA project
Abstract This study was conducted to identify early predictors of the total cost of inflammatory arthritis (IA). One hundred and eighty patients affected by undifferentiated arthritis (UA) or rheumatoid arthritis (RA) were included in the French Very Early rheumatoid Arthritis (VErA) cohort between 1998 and 2001. Health economic data for 2003 were collected using a patient self-questionnaire. Results were analysed in terms of direct, indirect and total costs in 2003 euros (2003,) for the population as a whole and in diagnostic subgroups. A payor perspective (the French National Health Insurance, in this case) was adopted. Multiple linear regression models were used to identify predictors of total cost from among the criteria assessed on recruitment. Results of the study showed that for the study population as a whole, the mean total cost was ,4700 per patient. The costs attributable to the RA and UA sub-groups were ,5928 and ,2424 per patient, respectively. In a univariate analysis, certain parameters were significantly correlated with a higher cost of illness. In the multivariate analysis, some of these parameters were further identified as being predictive of higher cost. Two strong significant, early predictors of total cost were identified: higher pain (P = 0.002) and the presence of rheumatoid factor (P = 0.004). In the RA sub-group, lower grip strength of the dominant hand (P = 0.039) was another predictor of the illness's subsequent economic impact. In conclusion, our data show that simple clinical and laboratory parameters can be used early in the course of IA to predict the condition's impact on healthcare budgets. [source]

The Persuasive Effects of Metaphor: A Meta-Analysis

HUMAN COMMUNICATION RESEARCH, Issue 3 2002
Pradeep Sopory
Empirical investigations of metaphor's persuasive effects have produced mixed results. In an effort to integrate the literature, we present a review and meta-analytic summary of existing studies. Six explanations for the potential suasory advantage of metaphor over literal language were reviewed: (a) pleasure or relief, (b) communicator credibility, (c) reduced counterarguments, (d) resource-matching, (e) stimulated elaboration, and (f) superior organization. Next, a meta-analysis was conducted and the impact of seven moderator variables was tested. The overall effect for the metaphor-literal comparison for attitude change was r = .07, which supported the claim that metaphors enhance persuasion. The effect rose to r = .42 under optimal conditions, when a single, nonextended metaphor was novel, had a familiar target, and was used early in a message. Metaphor appeared to exert a small effect on perceptions of source dynamism (r = .06), but showed no demonstrable impact on competence (r =,.01) or character (r =,.02). Of the six theories considered, the superior organization explanation of metaphor's persuasive impact was most supported by the results. [source]

Aspirin (100 mg) used for prevention of pre-eclampsia in nulliparous women: the Essai Régional Aspirine Mère,Enfant study (Part 1)

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2003
Damien Subtil
Objective To reduce the incidence of pre-eclampsia in nulliparous women, in accordance with the suggestion of a recent meta-analysis that low dose aspirin might decrease this incidence by more than half if used early enough in and at a sufficient dose during pregnancy (more than 75 mg). Design Multicentre randomised double-blinded placebo-controlled trial. Setting Twenty eight centres in Northern of France and one in Belgium. Population Three thousand and two hundred ninety-four nulliparous women recruited between 14 and 20 weeks. Methods Randomisation to either 100 mg aspirin or placebo daily from inclusion through 34 weeks. Main outcome measures Preeclampsia was defined as hypertension (,140 and or 90 mmHg) associated with proteinuria (,0.5 g/L). Results The aspirin (n= 1644) and placebo (n= 1650) groups did not differ significantly in the mothers' incidence of pre-eclampsia (28 of 1632 [1.7%] vs 26 of 1637 [1.6%]; relative risk, RR, 1.08, 95% CI 0.64,1.83), hypertension, HELLP syndrome or placental abruption, or in the children's incidence of perinatal deaths or birthweight below the 10th centile. The incidence of babies with birthweight below the third centile was significantly higher in the aspirin group, with no explanation. The incidence of maternal side effects was higher in the aspirin group, principally because of a significantly higher rate of haemorrhage. Conclusions Aspirin at a dose of 100 mg does not reduce the incidence of pre-eclampsia in nulliparous women. Aspirin (100 mg) is associated with an increase in bleeding complications. [source]