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Participants consented to a medical record review which included abstraction of total glycated hemoglobin levels obtained at the enrollment visit, completed a self-administered questionnaire and self-collected a vaginal swab.
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In British centres, patients with retinoblastoma were not included because they were the subject of a specific study (Hawkins et al, 1996).
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Methods: This study included all adult inpatients of St. Vincent s Hospital and Medical Center who had documented pneumococcal pneumonia between December 1998 and October 1999.
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The average cost per fraction of radiation therapy of $138 Canadian included the salaries and benefits of all staff involved in the radiation treatment programme, as well as the depreciation of radiotherapy equipment, the capital cost of the construction of the radiation treatment facilities and administrative costs (Earle et al, 1997).
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Anemia was defined as serum hemoglobin !130 g/L in men, and !120 g/L in women 21 . Albuminuria was defined as the presence of _0.3 g/L of albumin by urinary dipstick.
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All other discharges were classified as __ural._ Discharges were classified as __eaching_ if they occurred at a hospital listed as a primary or affiliated institution of an accredited internal medicine or family practice residency program according to the American Medical Association__ directory of postgraduate medical training programs (16).
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Patients were given 740 MBq of technetium-99m__abeled human serum albumin (Nihon Medi-Physics, Nishinomia, Japan).
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Then differences in the rate of septicemia between HD and PD patients were examined in multivariate analyses (Poisson regression) adjusting for age, gender, race, education, insurance status, region of the country (as defined by ESRD network), the presence of DM, serum albumin, hematocrit, and the presence of a neoplasm.
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Ischemia was defined as persistent ischemic chest pain after reperfusion therapy or recurrent symptoms with ST-segment changes, new heart failure, murmur or creatine kinase re-elevation.
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Prescription of beta-blocker, angiotensin-converting enzyme inhibitor, and statin therapy was determined at hospital discharge.
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Additional outcomes analyzed were clinical events (all-cause death [death], cardiac death, nonfatal MI and a composite end point of death or nonfatal MI).
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For example, if the index individual reported that the maternal grandmother of an index individual had died from breast cancer and this could not be verified in the cancer register, the mother and all siblings of the index individual were included in the analysis of high-risk women with one FDR or second-degree relative with breast cancer other than the index woman (Fig.
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We previously reported the influence of compliance on the reduction in coronary risk in subjects receiving pravastatin (12).
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Clinical characteristics include a primary diagnosis, the level of non-cardiac disability, and the patient__ ACC/AHA classification.
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Inpatient medication payments were contained within inpatient facility payments and could not be analyzed separately.
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Ascertainment and confirmation of end points Cases of nonfatal myocardial infarction were reported on questionnaires mailed to participants every six months.
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Nonfatal stroke was defined as a typical neurologic deficit, either sudden or rapid in onset, that lasted gt;24 h and was attributed to a cerebrovascular event.
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Over a 6-month period, each consecutive admission was included in the study.
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Patient confidentiality was ensured with removal of all patient identifiable information, including scrambled identifiers, after linkage.
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PLSS section boundary Residential parcels Almonds Grapes Apples Kiwi Pistachios Plums Field crops N 0 0.5 1 2 Miles 0 0.5 1 2 Kilometers Orchards and crops Shafter uncertainty, we decided to combine these crop categories into a class of field crops, assuming that for a reported pesticide application on a specific field, truck, grain, or pasture crop in a PLSS section, all areas with these crop designations were equally likely application sites.
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Predicting psychiatric admission rates.
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Gender differences and normal left ventricular anatomy in an adult population free of hypertension A cardiovascular magnetic resonance study of the Framingham Heart Study Offspring cohort
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Additional prespecified analyses were all-cause mortality and adherence to HF guidelines developed by the Agency for Health Care Policy and Research (16)and the American College of Cardiology and American Heart Association (17).
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Arterial hypertension was diagnosed according to the World Health Organization criteria, systolic blood pressure _160 mm Hg, and/or diastolic blood pressure _95 mm Hg, or if antihypertensive treatment was being prescribed.
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Outcome was considered __ad_ if the patient had died during hospitalization, was nonambulatory, or was discharged to a long-term care facility.
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Therefore, death by peritonitis was categorized as a __omplication of treatment_ and not as an __nfection._ Determinants of mortality.
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This group was scheduled to receive two doses at least 2 months apart.
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Definitions __tent failure_ was defined as either death, myocardial infarction (MI) (episode of typical chest pain, new pathological Q waves or creatine kinase rise gt;3 times the upper limit of normal [gt;240 U/l] with concomitant increase of the MB isoenzyme) or angiographically documented stent vessel occlusion.
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Individuals whose EBT results triggered further cardiovascular testing, including functional testing or angiography, were excluded from the final analysis.
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We assessed the agreement between fetal echocardiographic definition of the great artery relationship to the underlying ventricular mass, the great artery orientation, the location of associated ventricular septal defects as well as the presence or absence of ventricular outflow tract obstructions with the other diagnostic modalities.
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All patients underwent a similar regimen of pulmonary rehabilitation at the Medical Center, beginning immediately following hospital discharge.
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An introductory letter was first sent explaining the study, followed by a telephone interview about a week later.
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Stroke Stroke was defined as transient or permanent neurologic impairment and disability due to vascular causes, including episodes lasting lt;24 h which were regarded as transient ischemic attacks (TIAs).
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Subjects and methods Patients admitted to the coronary care unit (CCU) with proven or suspected acute myocardial infarction were considered for the study if they developed ventricular tachyarrhythmias of one or more of the following types: i) > 5 ventricular premature contractions per minute; 2) paired ventricular premature contractions; 3) multifocal ventricular premature contractions; 4) R on T ventricular premature contractions; and 5) ventricular tachycardia defined as 3 or more ventricular premature contractions in sequence at a rate exceeding IOO a minute.
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During the procedure the anaesthetist noted on the data collection form, the patient s course and therapeutic regimen as well as any adverse events that may have occurred.
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Inclusion criteria and enrollment On admittance to hospital, patients presenting with a history and/or symptoms compatible with the diagnosis of advanced CHF were screened and registered prospectively by the attending investigator-physician and subsequently investigated by trained research nurses using a structured questionnaire.
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In addition, we noted any evidence of the nine somatic conditions most frequently cited in published studies of high primary care utilization in patients with emotional conditions, including insomnia, headaches, migraines, back pain, abdominal pain, vertigo, chest pain, excessive sweating, and excessive itching [19,20].
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Sepsis was considered to be present when positive blood cultures were documented with or without elevated temperature _ 38C and/or presence of hypotension.
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Azathioprine was given at 1 to 2 mg/kg/day after transplantation, with the dose adjusted to maintain a white blood cell count 4,000 to 6,000/mm3.
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The amount of hospitalization that could result from these chemotherapy complications was extracted from Statistics Canada s POD.
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Logistic regression was used to identify the characteristics associated with the use of oesophagectomy and the variables associated with perioperative mortality among those who underwent oesophagectomy.
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Blood gas analysis was performed using a Corning 278 pH/blood gas analyser (Medfield, MA, USA).
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Despite maximal medical management, all patients were markedly symptomatic.
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Renal disease was identified as a preoperative creati- nine level greater than 2.0 mg/dL.
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In this case, reduced systolic function was defined as LVEF lt;40% or a qualitative description of moderately or severely reduced systolic function.
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13 Strokes were defined as the presence of a clinical neurologic deficit beyond 24 hours.
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High blood cholesterol level was defined as a total cholesterol value equal to or more than 250 mg/dl.
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If no coagulation abnormality was found, anti__itamin K therapy was maintained for 6 months.
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We compared observational resource use and cost between two strategies: 1) use of direct catheterization to 2) initial stress myocardial perfusion imaging followed by selective catheterization in patients who were clinically high risk and those with evidence of ischemia on initial noninvasive imaging techniques.
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Cardiovascular events included myocardial infarction, unstable angina with concomitant ischemic ECG changes, coronary artery surgery or angioplasty, sudden cardiac death, congestive heart failure requiring hospitalization, stroke and transient ischemic attack.
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Therefore, children who were seen only once contributed only one data point, whereas children with repeat visits contributed two to four data points (mean 2.2).
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When a new drug enters the market, it is likely that the first patients to receive the medication are those not responding well to previously available drugs.
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Age (y) 80 Contralateral occlusion 66 MI lt;6 months 11 Reoperation 29 NYHA class III/IV angina 16 Neck radiation 3 Canadian class III/IV CHF 4 High lesion 53 Steroid/oxygen COPD 4 Creatinine level gt;3 13 NYHA, New York Heart Association; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease.
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Coronary heart disease was diagnosed by at least one of the following criteria: (1) previous admission for documented myocardial infarction, not later than three months before the study started (elevated creatine kinase level and electrocardiogram changes); (2) a clinical history of symptoms consistent with angina confirmed by a positive exercise stress test result; or (3) significant positive results on coronary angiograms (stenosisgt; 50% for 1 of the 3 major vessels) or on thallium scan (defining fixed or reversible perfusion defects).
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Total cholesterol and triglycerides were estimated by enzymatic methods (cholesterol oxidase/peroxidase-aminophenazone for cholesterol, glycerol phosphate oxidase/peroxidase-aminophenazone for triglycerides) on an automated system using standard kits (Boehringer Mannheim Gmbh).
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In addition to the comparisons of patients without operation or rupture, patients who underwent operation, and patients who had rupture, a forward-looking piecewise exponential model was also used to evaluate risk factors for rupture, as has been described in detail previously.
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The manufacturers lower limits for muscle injury for the CK MB and myoglobin assays were 5 m g litre_1 and 70 m g litre_1, respectively.
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Accesses were excluded when (1) the cephalic vein was transposed instead of the basilic vein, (2) an axillary artery was used, (3) dialysis was discontinued before access success could be evaluated (within 3 months), or (4) patients were lost to follow-up.
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Diabetes was defined on the basis of a nonfasting blood glucose level _11.1 mmol/liter, a fasting blood glucose level _7.8 mmol/liter, or the use of insulin or an oral hypoglycemic agent.
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Inclusion required a follow-up of each individual child of gt;1 year; shorter follow-up periods were only considered for inclusion in case the affected child had died.
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The kit included a cold pack to keep the specimens cool (but not frozen) until receipt at Channing Laboratory the following morning, when they were aliquoted and stored at _80C. During storage, no specimen thawed or warmed substantially.
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Inclusion criteria Male or nonpregnant, nonlactating female patients older than 18 years were eligible for study inclusion if they were scheduled to undergo elective PTFE grafting including at least one end-to-side anastomosis of a PTFE graft to the common femoral artery and could undergo heparinization during the period of arterial occlusion.
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Control subjects were randomly selected from participants who met the matching criteria of age (1 year), smoking habit (current, past or never smoker) and time from randomization in six-month intervals.
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Polysplenia syndrome was suspected when the patient hod sinfle-ventricle anatomy and one or more of the following types of cardiac defects: \) an interrupted inferior vena 1992 by Ihe Americar, College orCardiolagy cava with azygos vein continuation.
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Mortality through December 31, 1996 was determined by a probabilistic match of the regional registry to the National Death Index (US Department of Health and Human Services) (20,21)using some combination of name, social security number, date of birth, gender, date last known alive and state of last known residence.
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Assuming a 3-h paclitaxel infusion yields the same survival advantage as the 24h infusion did in the randomized trial, paclitaxel/cisplatin is a cost-effective improvement over standard etoposide/cisplatin for patients with advanced non-small cell lung cancer.
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Chronic renal insufficiency was defined as creatinine clearance less than 80 mL/min/1.73 m2.
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G-CSF was given at the dose of 5 Mug/kg-1 day-1 days 3-5 of each week.
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All inhabitants of a suburb of Rotterdam, aged 55 years and over, were invited (response 78%).
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The following were classified as high-risk criteria in the ET: 1) a positive clinical and/or ECG response at any time, with a heart rate lt;120 beats/min, or when the response occurred during the first two stages of the Bruce protocol; 2) ST-segment depression _1 mm, persisting _6 min in the recovery phase or present in five or more leads; 3) ST-segment depression _2 mm at any level of exercise; 4) ST-segment elevation (not in lead aVR) in the non__-wave leads; 5) a sustained decrease in systolic blood pressure during progressive exercise; 6) the presence of ventricular tachycardia; and 7) Duke index _10.
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Definitions Several definitions were used in this study: major bleeding was defined as any bleeding requiring a blood transfusion; major vascular events were defined as any vascular repair, arteriovenous (AV) fistula, pseudoaneurysm, femoral nerve injury or retroperitoneal hemorrhage; minor bleeding was defined as a decrease in hemoglobin concentration gt;3 g/dl, not requiring a blood transfusion; minor vascular injury was defined as a femoral hematoma gt;6 cm, not requiring transfusion or vascular repair.
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Table I High-risk criteria NASCET/ACAS exclusion 10,11,13 ARCHeR inclusion Anatomic Prior carotid endorterectomy Prior carotid endorterectomy Radiation therapy to neck Radiation therapy to neck High lesion Spinal immobility Stoma Contralateral recurrent laryngeal nerve paralysis Medical Age greater than 80 y Contralateral CEA within 4 mo Contralateral occlusion Two or more of the following: Uncorrected gt;2-vessel coronary artery disease Unstable angina Unstable angina Surgery needed within 30 d Myocardial infarction within 6 mo of visit Myocardial infarction within 30 d Symptomatic congestive heart failure Severe left ventricle dysfunction (ejection fraction lt;30%) Significant valve disease Lung, liver, or renal failure Undergoing dialysis Listed for organ transplantation Uncontrolled hypertension or diabetes mellitus Uncontrolled diabetes mellitus Protocol Tandem lesion higher than bifurcation Stenosis less than 30% or artery occluded Unable to consent Other lesion that could cause symptoms Previous cerebrovascular accident with profound deficit Contralateral symptoms within 45 d Nonhemispheric symptoms Major surgery within 1 mo Atrial fibrillation Cancer with lt;50% 5-y survival Aspirin allergy or active ulcer Warfarin sodium use High-risk factors defined by variables that would have excluded patients from NASCET or ACAS or included patients in ARCHeR (see text).
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Time course of respiratory decompensation in chronic obstructive pulmonary disease: a prospective, double-blind study of peak flow changes prior to emergency department visits
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Patients were eligible for inclusion if they were greater than 18 years of age, planned to be continuously enrolled in HD therapy at the same dialysis clinic throughout the duration of the study, and agreed to participate with monthly pharmacist visits.
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Children are less prone to bacteremia, and exclusion of children gives a more homogeneous age distribution.
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Influence of partides or other associated air pollutants on fetal growth in early gestation is one of several possible expl anions ofthese results.
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The location and scope of health care services provided over a 90-day period were used to define three levels of relapse management.
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For F1+2 and TAT measurement, 9 mL venous blood was mixed carefully with 1 mL sodium citrate solution (0.11 mol/liter).
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Three hundred and three subjects had received 745 psychotropics prescriptions and 56 cases of hip fracture were found.
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MATERIALS AND METHODS All patients admitted and treated in Chang Gung Memorial Hospital and Children s Hospital between April 1, 2000 and March 31, 2001 with invasive infections (meningitis, bacteremia, pneumonia, septic arthritis, cellulites, peritonitis, and so forth) attributable to S. pneumoniae were included in this study.
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Perinatal drug exposure was confirmed with a positive toxicology report in the child s medical chart, the mother s admission, or the referring physician s or agency s report.
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Our laboratory has confirmed that the cut-off value for cTnI in the diagnosis of myocardial muscle cell injury is 0.1 m g litre_1.
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(n) (n) radiotherapy Typea of fractions Mean radiation dose in Gy DosimetryDosimetry rx low Cobalt rx high e-(n) Cible Brain Thyroid BreastsDigestive not possible energy (n) energy volume tract possible (n) (n) (n) (tumour) (n) Ewing s sarcoma 141 1 26 114 4 89 30 17 26 74 1.8 2.8 5.6 7.1 Bone sarcoma 74 0 10 64 0 53 12 3 23 67 0.3 2.7 8.0 5.4 Soft tissue sarcoma 390 51 41 298 40 207 38 55 20 62 5.4 5.7 3.1 6.2 Neuroblastoma 317 0 15 302 66 168 29 54 16 34 2.3 3.5 5.5 8.4 Wilm s tumour 599 1 19 579 135 373 105 7 19 35 0.6 2.7 7.2 11.9 Central nervous system 604 9 19 576 86 383 145 89 29 74 25.3 6.2 2.0 3.9 Bilateral retinoblastoma 79 8 2 69 3 18 23 34 21 52 10.1 0.9 0.7 0.5 Unilateral retinoblastoma 36 2 1 33 5 12 1 16 24 49 8.6 2.2 1.6 1.4 Hodgkin s disease 342 1 19 322 24 147 179 31 24 61 3.3 23.4 11.1 13.4 Non-Hodgkin s lymphoma 274 2 8 264 25 204 46 19 17 42 14.6 7.0 3.1 5.1 Others 253 21 22 210 29 153 46 24 23 66 5.1 9.4 4.9 12.2 Total 3109 96 182 2831 417 1807 654 349 22 55 8.6 7.0 5.1 8.1 aPatients may have been treated with more than one type of machine.
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Preterm births (lt; 37 weeks gestation) were excluded from analysis because of the differences in factors affecting fetal growth (16).
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(3) Late deceleration _ a visually apparent gradual decrease (defined as onset of deceleration to nadir _30 s) in the fetal heart rate with return to baseline associated with a uterine contraction.
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The hypertensive groups in stages II and III were merged, and thus four groups were considered: low BP (lt;119.4 mm Hg), reference group (119.4 to 139 mm Hg), high BP stage I (140 to 159 mm Hg), and high BP stages II and III (_160 mm Hg).
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Two hundred and eight patients who were being considered for orthotopic liver transplantation were excluded, as were 12 patients who died from noncardiac causes while hospitalized, two patients who had orthotopic heart transplantations, and 13 patients who had a PTCA within the six months prior to dobutamine stress testing.
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The screening test was provided free of charge by primary care physicians over a 4-month period, then posted to persons who had not consulted a general practitioner during this period, with a reminder letter after a month to non-responders.
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A stenosis was deemed significant if the gradient across the lesion was 10 mm Hg at rest, if the gradient across the lesion was 15 mm Hg after the administration of 30 mg of papaverine, or if the angiographic catheter caused occlusion or near occlusion of the artery as it crossed the lesion.
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Comparisons among treatment groups of the proportion of subjects hospitalized were made using chi-square statistics and corresponding confidence intervals (CI) for risk ratios.
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Our analysis includes only female breast cancers which are invasive (not in situ) and assumes that there are no major differences in the therapeutic approaches used for different tumour Diagnostic and therapeutic approaches for nonmetastatic breast cancer in Canada, and their associated costs BP Will1, C Le Petit1, J-M Berthelot1, EM Tomiak2, S Verma2 and WK Evans2 1The Health Analysis and Modelling Group, Statistics Canada, 24-Q, R. H. Coats Building, Ottawa, Ontario, K1A OT6, Canada; and 2The Ottawa Regional Cancer Centre, Cancer Care Ontario and the University of Ottawa, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada Summary In an era of fiscal restraint, it is important to evaluate the resources required to diagnose and treat serious illnesses.
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A _2-fold increase in CK-MB above the upper limit of normal (10 ng/ml) irrespective of total CK in the absence of new Q waves in the electrocardiogram was considered to indicate a non__-wave infarction.
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1 Estimated survival free from valve-related morbidity 10 years after aortic valve replacement with the CE or SJ prostheses as a function of patient age (year).
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Readmission for CHF was determined by searching the same data set for subsequent hospitalizations occurring before December 31, 1995 for each individual who qualified for inclusion in the study.
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Other comparisons of follow-up data in the various outcome groups are shown in Table I. Table I Follow-up of 50 patients with chronic type B dissection No rupture or operation (n = 31) Rupture (n = 9) Operation (n = 10) All patients (n = 50) Time (mo) Median Range Median Range Median Range Median Range From acute dissection until first follow-up CT scan 8.3 2.1-90.6 8.6 4.9-74.2 5.9 2.8-13.1 8.2 2.1-90.6 From acute dissection until last CT scan* 45.1 3.7-117.1 37.4 4.9-87.3 13.9 2.8-88.9 37.4 2.8-117.1 From last CT scan until last follow-up_ 12.5 2.9-74.3 7.0 2.0-14.8 2.3 0.4-23.6 10.2 0.4-74.3 From first follow-up CT scan until last follow-up 46.9 12.9-112.1 26.8 3.9-57.4 12.2 0.9-106.5 39.5 0.9-112.1 *Last CT scan refers to last CT scan in this study.
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Risk associated with pregnancy in hypertrophic cardiomyopathy
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The DC General Hospital pediatrics department provides a gamut of outpatient services through its pediatric emergency room; medical, well baby, and adolescent clinics; and various subspecialty clinics.
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Because we were interested in septicemia acquired in the outpatient setting, we limited the outcome variable to patients with a primary diagnosis code of septicemia.
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The variables included in the USRDS standard analysis files (SAFs), as well as data collection methods and validation studies, are listed at the USRDS web site, under Researcher s Guide to the USRDS Database, Section E, Contents of all the SAFs (Standard Analysis Files), and published in the USRDS (http://www.usrds.org).
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Patients who died during their index admission were excluded from this analysis.
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