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Measurement of Ejection Fraction After Myocardial Infarction in the Population: Characteristics Associated

Characteristics Associated With Testing To Measure LVEF Table 1 compares the characteristics of patients who underwent measurement of LVEF within 30 days after an incident MI between 1988 and 1998 to those who did not. Characteristics associated with greater likelihood of ejection fraction (EF) measurement included male sex, higher peak CK, cardiologist involved as a…

Measurement of Ejection Fraction After Myocardial Infarction in the Population: Results

Time Trends of Testing To Measure LVEF After MI Between 1979 and 1998, 2,317 subjects in Olmsted County were hospitalized with an incident MI. The percentage of patients undergoing testing for LVEF within 30 days after MI over time is shown in Figure 1. The use of testing increased from 22% in 1979 to 85%…

Measurement of Ejection Fraction After Myocardial Infarction in the Population: Statistical Analysis

The Mantel-Haenszel x2 test for trend was used to analyze the change in the proportion of patients tested for LVEF over time, and the Pearson x2 test was used to compare proportions. Logistic regression was used to examine the independent association between demographic and clinical variables, and testing for LVEF within 30 days after index…

Measurement of Ejection Fraction After Myocardial Infarction in the Population: Data Collection

The procedures used to assemble the MI incidence cohort have been reported in detail elsewhere. Briefly, all incident MIs between 1979 and 1998 were ascertained from indexes of medical diagnosis and hospital discharges using standardized epidemiologic criteria, relying on cardiac pain, creatine phos-phokinase enzyme values, and Minnesota coding of the ECG.

Measurement of Ejection Fraction After Myocardial Infarction in the Population: Materials and Methods

Study Setting This study was carried out within the boundaries of Olmsted County, MN. Epidemiologic research in the county is possible because it is relatively isolated from other urban centers, and nearly all medical care is delivered to local residents by few providers. With the exception of a higher proportion of the working population employed…

Measurement of Ejection Fraction After Myocardial Infarction in the Population

Knowledge of left ventricular ejection fraction (LVEF) after acute myocardial infarction (MI) helps stratify risk and guides the use of evidence-based treatment such as angiotensin-converting enzyme (ACE) inhibitors and (3-blockers and revascularization. Indeed, studies demonstrated positive associations between LVEF measurement and use of ACE inhibitor therapy after MI. Furthermore, data underscore the pivotal role of…

Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients – Discussion (4)

Once the decision to treat has been made, it is critical to define adequate therapy. Seven of our HIV-positive patients who received antituberculosis therapy survived, and none of those who died received antituberculosis therapy. Nevertheless, we cannot definitively prove that they died because of M gordonae disease, and not because of an additional infection (see…

Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients – Discussion (3)

Patient 12 had 1 positive sputum sample, but 5 blood cultures with centrifugation lysis, 12 sputa, the bronchoalveolar lavage, and the bone marrow aspiration and biopsy specimen did not reveal M gordonae. All these diagnostic procedures may expose the patient to potential complications. On the other hand, empirical treatment may induce unwanted side effects such…

Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients – Discussion (2)

Classic criteria for pathogenicity of MOTTs are major criteria with (1) repeated isolation (> than 4 episodes) of colonies in large numbers (>100) with clinical symptoms or (2) positive cultures with histopathologic changes. Minor criteria are (1) repeated discharge or large numbers of organisms, (2) positive cultures of secretions with clinical symptoms, (3) positive cultures…

Mycobacterium gordonae: A Treatable Disease in HIV-Positive Patients – Discussion (1)

Mycobacterium gordonae has been called tap water bacillus or M aquae and is commonly found in soil (gardeners may have a higher risk), nonpasteurized fresh milk, and water. In humans it can be found in sputum, gastric fluid, and urine as a saprophyte or colonizer. Nosocomial outbreaks (tap water, ice machine, bronchoscopies, laboratory contamination) have…

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