Annals of medicine
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Comparative Study
Use of antihypertensive medication after ischemic stroke in young adults and its association with long-term outcome.
Knowledge on the use of secondary preventive medication in young adults is limited. ⋯ Use of antihypertensives was suboptimal in one-third of patients in whom antihypertensives were initially prescribed. Users were at lower risk of mortality and recurrent stroke or TIA compared to non-users. Key Messages The use of antihypertensive medication is suboptimal in one-third of patients in whom antihypertensive medication was initially prescribed after ischemic stroke at young age. The risk of mortality and recurrent stroke or TIA is lower for users of antihypertensive medication after ischemic stroke at young age compared to non-users, after adjustment for relevant confounders including pre-existing hypertension and prior use of antihypertensive medication. Specific guidelines on antihypertensive medication use after ischemic stroke at young age are lacking. However, our results may motivate doctors and patients in gaining better usage of antihypertensive medication, since better usage was associated with more favorable outcome in this study.
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Comparative Study
A new prediction model for assessing the clinical outcomes of ICU patients with community-acquired pneumonia: a decision tree analysis.
We aimed to develop a new scoring index based on decision-tree analysis to predict clinical outcomes of patients with community-acquired pneumonia (CAP) admitted to the intensive care unit (ICU). ⋯ The new CART prediction model has higher specificity and better receiver operating characteristics (ROC) curves than CURB-65 and SOAR score indices although its accuracy and sensitivity are only moderately better than the other systems. Key messages The new CART prediction model has higher specificity and better ROC curves than CURB-65 and SOAR score indices. However, accuracy and sensitivity of the new CART prediction model are only moderately better than the other systems in predicting 30-day mortality in CAP patients.
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Comparative Study
Risk of preterm birth in primiparous women with exposure to antidepressant medication before pregnancy and/or during pregnancy - impact of body mass index.
Preterm birth is a major cause of infant mortality. It is unknown whether body mass index (BMI) influences the risk of preterm birth in women, who prenatally use antidepressants. ⋯ Primiparous women using antidepressants, who were underweight before conception should be closely monitored and provided tailored care in a maternity clinic to minimize the risk of preterm birth. Key messages In primiparous women, one in ten used antidepressant medications before pregnancy and/or during pregnancy. In primiparous women, the prevalence of preterm birth was 5%. Underweight primiparous women using antidepressants should be closely monitored and provided tailored care in a maternity clinic.
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High physical activity (PA) at old age indicates good functional capacity enabling independent living. We investigated how different disease conditions are associated with measured PA indicators in old women and men, and whether they recognize this association. ⋯ Chronic disease conditions are associated with low PA, which individuals may not always recognize. Shared genetic factors may explain part of the associations. Key messages Among community-dwelling older men and women one-fourth of the variation in objectively measured moderate-to-vigorous physical activity is accounted for by age, sex, body mass index and self-reported diseases. Occurrence of chronic diseases is associated with low physical activity and individuals do not always recognize this. Healthcare professionals should pay attention to the low physical activity and mobility of individuals with chronic disease conditions before these result in limitations in independent living.