Predictor Of pH Research Articles

Perceptions and predictors of health-related quality of life among aging adults who stutter: a first glimpse

ABSTRACT Quality of life among adults who stutter (AWS) is well-studied but little is known about health-related quality of life, an index of successful aging. The study’s aim was to begin documenting perceptions and predictors of physical and mental health quality of life (PH-, MH-QoL) among aging AWS. Forty AWS (50-84 years old) in the United States completed the SF-36 survey of PH- and MH-QoL, and were surveyed on potential explanatory variables including resilience, social resources, health-promoting behavior, socioeconomic status, perceptions of aging, social risk, identity management, neuroticism, stuttering severity, and difficulty communicating. The prevalence of very low PH- and MH-QoL scores was compared against age- and gender-graded population norms. Finally, PH- and MH-QoL scores were regressed onto explanatory variables. Relatively few aging AWS had very low PH-QoL scores. A non-trivial subset of aging AWS had very low MH-QoL scores. Greater awareness of aging-related loss predicted lower PH- and MH-QoL. Greater neuroticism also predicted lower MH-QoL. Greater resilience predicted better MH-QoL. If replicable, results would suggest few aging AWS are at-risk for very low PH-QoL while more aging AWS are at-risk for very low MH-QoL. Predictors of PH- and MH-QoL may inform strategies for successful aging among AWS.

Clinical characteristics and predictors of pulmonary hypertension in chronic obstructive pulmonary disease at different altitudes

BackgroundPulmonary hypertension (PH) is a common complication in patients with chronic obstructive pulmonary disease (COPD) and is closely associated with poor prognosis. However, studies on the predictors of PH in COPD patients are limited, especially in populations living at high altitude (HA).ObjectivesTo investigate the differences in the clinical characteristics and predictors of patients with COPD/COPD and PH (COPD-PH) from low altitude (LA, 600 m) and HA (2200 m).MethodsWe performed a cross-sectional survey of 228 COPD patients of Han nationality admitted to the respiratory department of Qinghai People’s Hospital (N = 113) and West China Hospital of Sichuan University (N = 115) between March 2019 and June 2021. PH was defined as a pulmonary arterial systolic pressure (PASP) > 36 mmHg measured using transthoracic echocardiography (TTE).ResultsThe proportion of PH in COPD patients living at HA was higher than that in patients living at LA (60.2% vs. 31.3%). COPD-PH patients from HA showed significantly different in baseline characteristics, laboratory tests and pulmonary function test. Multivariate logistic regression analysis indicated that the predictors of PH in COPD patients were different between the HA and LA groups.ConclusionsThe COPD patients living at HA had a higher proportion of PH than those living at LA. At LA, increased B-type natriuretic peptide (BNP) and direct bilirubin (DB) were predictors for PH in COPD patients. However, at HA, increased DB was a predictor of PH in COPD patients.

Study of Pulmonary Hypertension and Its Predictors in Patients with Chronic Obstructive Pulmonary Disease

Abstract Background Pulmonary hypertension (PH) is one of the most common complications of chronic obstructive pulmonary disease (COPD). PH in COPD is caused by many factors mainly hypoxia. Aim The aim was to assess prevalence and predictors of PH in COPD patients. Patients and methods A prospective, observational study was carried out on 100 patients diagnosed with COPD admitted at chest department of Alexandria university hospitals and Al. Mamoura chest hospital. All patients were subjected to complete medical history taking (Age, sex, smoking index, history of previous hospital admission for COPD exacerbation and history of previous ICU admission for the same reason), routine laboratory investigations including complete blood count (CBC), arterial blood gases (ABG), pulmonary function test (FEV1, FVC, FEV1/FVC ratio), Body mass index(BMI), six minute walk test, COPD assessment test (CAT) score, dyspnea assessment by modified Medical Research Council(m MRC) and Echocardiography relevant data (right atrial area, left atrial size, ejection fraction, valvular heart disease, PH, right ventricular function TAPSE (Tricuspid annular plane systolic excursion), systolic pulmonary artery pressure (SPAP) and tricuspid regurge velocity if present. Results A total of 100 COPD patients were included in the study 88 (88%) were males and 12 (12%) were females. Among patients with pulmonary hypertension 32 (94.1%) were males and 2 (5.9%) were females. On the other hand, 84.8%(n = 56) of patients without PH were males and 15.2%(n = 10) were females. Mean ± SD age of the patients was 60.12 ± 8.59 years. Mean ±SD age of the patients with pulmonary hypertension was 61.26±7.97 years, and for patients without PH mean± SD was 59.53 ± 8.88 years. With no statistically significant difference between the two groups. PH was diagnosed in 34 (34%) of patients, m PAP ≥25mmHg, of whom11 (32.4%) showed severe PH m PAP ≥40mmHg, 23 (67.6%) mild, moderate PH. Conclusion Although, the most important factors predicting PH in COPD patients were FEV1 and EF, respectively, but in COPD patients with severe PH was FEV1.

Prevalence of postural hypotension in primary, community and institutional care: a systematic review and meta-analysis

BackgroundPostural hypotension (PH), the reduction in blood pressure when rising from sitting or lying 0to standing, is a risk factor for falls, cognitive decline and mortality. However, it is not often tested for in primary care. PH prevalence varies according to definition, population, care setting and measurement method. The aim of this study was to determine the prevalence of PH across different care settings and disease subgroups.MethodsSystematic review, meta-analyses and meta-regression. We searched Medline and Embase to October 2019 for studies based in primary, community or institutional care settings reporting PH prevalence. Data and study level demographics were extracted independently by two reviewers. Pooled estimates for mean PH prevalence were compared between care settings and disease subgroups using random effects meta-analyses. Predictors of PH were explored using meta-regression. Quality assessment was undertaken using an adapted Newcastle-Ottawa Scale.ResultsOne thousand eight hundred sixteen studies were identified; 61 contributed to analyses. Pooled prevalences for PH using the consensus definition were 17% (95% CI, 14–20%; I2 = 99%) for 34 community cohorts, 19% (15–25%; I2 = 98%) for 23 primary care cohorts and 31% (15–50%; I2 = 0%) for 3 residential care or nursing homes cohorts (P = 0.16 between groups). By condition, prevalences were 20% (16–23%; I2 = 98%) with hypertension (20 cohorts), 21% (16–26%; I2 = 92%) with diabetes (4 cohorts), 25% (18–33%; I2 = 88%) with Parkinson’s disease (7 cohorts) and 29% (25–33%, I2 = 0%) with dementia (3 cohorts), compared to 14% (12–17%, I2 = 99%) without these conditions (P < 0.01 between groups). Multivariable meta-regression modelling identified increasing age and diabetes as predictors of PH (P < 0.01, P = 0.13, respectively; R2 = 36%). PH prevalence was not affected by blood pressure measurement device (P = 0.65) or sitting or supine resting position (P = 0.24), however, when the definition of PH did not fulfil the consensus description, but fell within its parameters, prevalence was underestimated (P = 0.01) irrespective of study quality (P = 0.04).ConclusionsPH prevalence in populations relevant to primary care is substantial and the definition of PH used is important. Our findings emphasise the importance of considering checking for PH, particularly in vulnerable populations, to enable interventions to manage it. These data should contribute to future guidelines relevant to the detection and treatment of PH.PROSPERO:CRD42017075423.

Clinical Characteristics and Outcome of Patients With Hemorrhagic Transformation After Intravenous Thrombolysis in the WAKE-UP Trial.

Background: Hemorrhagic transformation (HT) is an important complication of intravenous thrombolysis with alteplase. HT can show a wide range from petechiae to parenchymal hematoma with mass effect with varying clinical impact. We studied clinical and imaging characteristics of patients with HT and evaluated whether different types of HT are associated with functional outcome.Methods: We performed a post-hoc analysis of WAKE-UP, a multicenter, randomized, placebo-controlled trial of MRI-guided intravenous alteplase in unknown onset stroke. HT was assessed on follow-up MRI or CT and diagnosed as hemorrhagic infarction type 1 and type 2 (HI1 and HI2, combined as HI), and parenchymal hemorrhage type 1 and type 2 (PH1 and PH2, combined as PH). Severity of stroke symptoms was assessed using the National Institutes of Health Stroke Scale (NIHSS) at baseline. Stroke lesion volume was measured on baseline diffusion weighted imaging (DWI). Primary endpoint was a favorable outcome defined as a modified Rankin Scale score 0–1 at 90 days.Results: Of 483 patients included in the analysis, 95 (19.7%) showed HI and 21 (4.4%) had PH. Multiple logistic regression analysis identified treatment with alteplase (OR, 2.08 [95% CI, 1.28–3.40]), baseline NIHSS score (OR, 1.11 [95% CI, 1.05–1.17]), DWI lesion volume (OR, 1.03 [95% CI, 1.01–1.05]), baseline glucose levels (OR, 1.01 [95% CI, 1.00–1.01]) and atrial fibrillation (OR, 3.02 [95% CI, 1.57–5.80]) as predictors of any HT. The same parameters predicted HI. Predictors of PH were baseline NIHSS score (OR, 1.11 [95% CI, 1.01–1.22]) and as a trend treatment with alteplase (OR, 2.40 [95% CI, 0.93–6.96]). PH was associated with lower odds of favorable outcome (OR 0.25, 95% [CI 0.05–0.86]), while HI was not.Conclusion: Our results indicate that HI is associated with stroke severity, cardiovascular risk factors and thrombolysis. PH is a rare complication, more frequent in severe stroke and with thrombolysis. In contrast to HI, PH is associated with worse functional outcome. The impact of HT after MRI-guided intravenous alteplase for unknown onset stroke on clinical outcome is similar as in the trials of stroke thrombolysis within a known early time-window.

Evaluation of Right Ventricular Function on Cardiac Magnetic Resonance Imaging and Correlation With Hemodynamics in Patients With Chronic Thromboembolic Pulmonary Hypertension

Background: Balloon pulmonary angioplasty (BPA) is an alternative therapy for chronic thromboembolic pulmonary hypertension (CTEPH). Right heart catheterization (RHC) is essential to evaluate the efficacy of BPA. Cardiac magnetic resonance imaging (CMR) is also now used to assess the structure and function of the right heart non-invasively. The aim of this study was to correlate improvement in CMR with that on RHC, and compared with improvement in other non-invasive findings after BPA.Methods and Results: Forty-two patients underwent BPA between July 2012 and March 2015, and CMR, electrocardiography (ECG), and echocardiography were performed at the same time before and 6 months after BPA. Median pulmonary vascular resistance (PVR) was improved from 5.7 Wood units (IQR, 3.1–7.9 Wood units) to 2.7 Wood units (IQR, 1.6–3.9 Wood units; P<0.001). Changes in PVR were correlated with the changes in 5 CMR, 9 ECG, and 5 echocardiography parameters. On logistic analysis to identify the indicators of improving PH (i.e., PVR <3 Wood units), 4 CMR parameters were independently correlated with PVR change, one of which was median septal inversion ratio (SIR; 0.59; IQR, 0.54–0.63 to 0.54; IQR, 0.50–0.58, P<0.0001). SIR was the best predictor of PH (OR, 1.27; P<0.05).Conclusions: CMR can be used to estimate hemodynamic changes after BPA, and SIR is useful to predict alleviation of PH.

Abstract WP34: The Relationship Between Reperfusion and Intracranial Hemorrhage After Thrombectomy

Introduction: Symptomatic intracerebral hemorrhage (sICH) is a devastating complication after endovascular thrombectomy (EVT). Prior reports have demonstrated that TICI ≥2b reperfusion is protective against sICH. We aimed to further examine the relationship between reperfusion grade and sICH, to elucidate whether a difference between TICI 2b and 3 exists, and to determine whether this relationship holds true for patients undergoing delayed thrombectomy (6-24 hours). Methods: We performed a single-center retrospective review of prospectively-recorded data for patients undergoing EVT for large vessel occlusion (LVO) between January 2015 and February 2018. Multivariable logistic regression analyses were performed to identify predictors of PH and sICH (NINDS, SITS-MOST, ECASS III criteria) and to identify the role of reperfusion grade. This analysis was repeated for delayed thrombectomy patients. Results: Five-hundred-and-twenty-eight patients were included. Mean age was 71.5 and 43% were male. Median NIHSS and TLSW to treatment were 17 and 4.8 hours, respectively. Successful recanalization was achieved in 94%. On multivariable analyses, ASPECTS was a predictor of PH [p=0.002, OR-0.7 (0.57-0.87)] for patients achieving any reperfusion grade. For patients achieving successful reperfusion, lower ASPECTS was a predictor of PH [p=0.005, OR-0.72 (0.58-0.89)]) and of sICH (ECASS III) [p=0.04, OR-0.67 (0.45-0.98)]; in addition, TICI 2b as compared to TICI 3 was a predictor of PH [p=0.04, OR-2.1 (1-4.4)] and of sICH (NINDS) [p=0.05, OR-7.5 (1-57)]. TLSW to treatment was not an independent predictor of PH or sICH. Conclusion: Higher baseline ASPECTS and higher degree of reperfusion following EVT is associated with reduced likelihood of PH and sICH.

Uranium in Larval Shells As a Barometer of Molluscan Ocean Acidification Exposure

As the ocean undergoes acidification, marine organisms will become increasingly exposed to reduced pH, yet variability in many coastal settings complicates our ability to accurately estimate pH exposure for those organisms that are difficult to track. Here we present shell-based geochemical proxies that reflect pH exposure from laboratory and field settings in larvae of the mussels Mytilus californianus and M. galloprovincialis. Laboratory-based proxies were generated from shells precipitated at pH 7.51 to 8.04. U/Ca, Sr/Ca, and multielemental signatures represented as principal components varied with pH for both species. Of these, U/Ca was the best predictor of pH and did not vary with larval size, with semidiurnal pH fluctuations, or with oxygen concentration. Field applications of U/Ca were tested with mussel larvae reared in situ at both known and unknown pH conditions. Larval shells precipitated in a region of greater upwelling had higher U/Ca, and these U/Ca values corresponded well with the laboratory-derived U/Ca-pH proxy. Retention of the larval shell after settlement in molluscs allows use of this geochemical proxy to assess ocean acidification effects on marine populations.

18 Does Geographic Distance From a Pulmonary Hypertension Center Delay Diagnosis and Treatment? A REVEAL Registry Analysis

monary function parameters and functional capacity as explanatory and predictive variables in univariate and multiple regression analysis. Results: The mean age at evaluation was 54.2 7.1 years (61% women). All patients were in NYHA function class III-IV with FEV1 22.8 7.1% and TLC 126 21% of predicted. The pulmonary pressure showed a unimodal normal distribution with a mean (mPAP) of 24.9 6.7 mmHg. One hundred ninety nine patients (49%) had PH (mPAP 25 mmHg), 141 (71%) of which had pulmonary capillary wedge pressure (PCWP) 15 mm Hg. Predictors of PH were confined to pO2 and pCO2, while static and dynamic lung volumes were unrelated to the pulmonary pressure. Conclusions: Half of the patients with end-stage COPD had pulmonary hypertension, usually of mild degree, one quarter of which had a postcapillary component probably due to left ventricular diastolic dysfunction. Hypoxemia and hypercapnia were associated with PH, while static lung volumes were unrelated to pulmonary hypertension in end-stage COPD.

Natural and anthropogenic acidity sources for Finnish Lakes

The headwater lakes in peat-rich areas in Finland commonly have high organic matter concentrations and are surrounded by soils and bedrock poor in bases. As a result the organic acid load on the watercourses is generally high. The significance of the organic vs anthropogenic acidity in 78 moderately acid lakes (pH range 4.3 to 7.1, TOC range 0.6 to 33.9 mg L−1) was evaluated in areas receiving different levels of acid deposition. The lakes were sampled during autumn overturn, and their water quality (mean TOC = 10.9 mg L−1, mean pH = 5.9) represents rather well the average water quality in small lakes in Finland. According to the correlation and regression analyses, TOC is a better predictor of pH than non-marine sulfate. Base cation concentrations are important in determining the sensitivity of the lakes to organic and anthropogenic acidity. The highest minerogenic acid contribution is found in high-deposition areas, while the percent organic acid contribution is greater in low deposition areas although TOC levels are comparable in both areas. It would appear that the pH of humic lakes is determined to a greater extent by individual watershed characteristics than by their geographical location at the present atmospheric loadings received in Finland.