In patients with chronic heart failure (CHF), a beta-blocker is generally added to regimen containing an angiotensin-converting-enzyme (ACE) inhibitor. It unknown whether beta-blockade as initial therapy may be useful.We randomized 1010 mild moderate CHF and left ventricular ejection fraction < or =35%, who were not receiving ACE inhibitor, beta-blocker, angiotensin receptor blocker therapy, open-label monotherapy either bisoprolol (target dose 10 mg QD; n=505) enalapril BID; for 6 months,...

Abstract Objective : To investigate the cardiovascular autonomic function in pediatric obesity of different duration by using standard time domain, spectral heart rate variability (HRV), and nonlinear methods. Research Methods Procedures Fifty obese children (13.9 ± 1.7 years) were compared with 12 lean subjects (12.9 1.6 years). Obese classified as recent (ROB) (&lt;4 years), intermediate (IOB) (4 to 7 long‐term (OB) (&gt;7 In all participants, we performed blood pressure (BP) measurements,...

To assess the impact of a set interventions in reducing interruption/distraction rate during medication administration.Pre- and postintervention observational study nurses undertaking rounds.Acute Medical Admissions Unit (AMAU) 1000-bed teaching hospital.A measures previously proven successful interruptions (behaviour modification staff education; checklists; visible symbols form red vest; signage) were adapted introduced onto AMAU.Rate distractions pre- overall for each individual source...

For three cohorts (the elderly, socially deprived, and those with chronic disabling disease), the relationship between concentrations of particulate matter (PM10), sulphur dioxide (SO₂), or oxides nitrogen (NOx) at time hospital admission outcomes (30-day in-hospital mortality) were investigated All emergency admissions (90,423 episodes, recorded in 48,035 patients) 2002 2015 examined. PM10, SO₂, NOx daily levels from catchment area correlated for older cohort (>70 years), lower...

Traditionally, nitric oxide-mediated alteration in blood vessel tone has been inferred from changes flow response to physical and pharmacological interventions using plethysmographic or ultrasonic techniques. We hypothesized that pulsatile arterial function may represent a more sensitive measure detect monitor modulation of smooth muscle tone. Healthy male volunteers (n = 15) had radial artery pressure pulse waveforms recorded calibrated tonometer device. A computer-based assessment the...

We carried out a randomized double-blind controlled secondary-prevention trial of oxprenolol over seven years. Forty milligrams or placebo was given twice daily to 1103 men 35 65 years old who had an acute myocardial infarction between 1 and 90 months previously. Overall, there no difference in mortality cardiac events the groups. The major influence on prognosis time at which treatment started after infarction. In 417 patients whom within four increased six-year cumulative survival rate...

Aim: To develop and validate an in-hospital mortality risk prediction tool for unselected acutely ill medical patients using routinely collected physiological laboratory data. Design: Analysis of all emergency admitted to St James's Hospital (SJH), Dublin, between 1 January 2002 31 December 2007. Validation a dataset acute admissions from Nenagh 2000–04. Methods: Using vital signs findings, composite 5-day score, designated system (MARS), was developed iterative approach involving logistic...

The actual impact of emergency department (ED) 'wait' time on hospital mortality in patients admitted as a medical has often been debated. We have evaluated the such waits 30-day mortality, for all over 7-year period.All emergencies by ED between 2002 and 2008 were studied; we looked at to referral subsequent ward bed any inhospital death within 30 days. Significant univariate predictors outcome, including Charlson's comorbidity acute illness severity score, entered into multivariate...

A weekend emergency medical admission has been associated with a higher mortality. We have examined all admissions to St James' Hospital, Dublin between 2002 and 2009.We divided by weekday or (Saturday Sunday) presentation. utilised multivariate logistic model, determine whether was independently predictive of 30 day outcome.There were 49337 episodes recorded in 25883 patients; 30-day inhospital mortality at the (9.9% vs. 9.0%) had an unadjusted Odds Ratio 1.11 (95% CI 0.99, 1.23: p=0.057)....

There is interest in emergency medical admissions, the outcomes of major reconfigurations and development systems processes for Acute Medicine. We report on long-term an Medical Admissions Unit, using a database admissions to St James' Hospital, Dublin, from 2002 2012.All (67,971 episodes 37,828 patients) were tracked in-hospital mortality, length stay 'wait' numbers times summarized. examined generalized estimating equations, extension linear models that permitted adjustment correlated...

<h3>ABSTRACT</h3> The relationship between serum potassium levels and mortality in acute medical admissions is uncertain. In particular, the relevance of minor abnormalities level or variations within normal range remains to be determined. We performed a retrospective cohort study all emergency St James9s Hospital (Dublin, Ireland) 2002 2012. used stepwise logistic regression model predict in-hospital mortality, adjusting risk estimates for major predictor variables. There were 67,585 37,828...

Aim: To determine the impact of introduction an acute medical admission unit (AMAU) on all-cause hospital mortality in unselected patients undergoing to a teaching hospital. Design: Analysis data recorded in-patient enquiry (HIPE) system relating all emergency admitted St James's Hospital (SJH), Dublin between 1 January 2002 and 31 December 2006. Methods: The reference year was 2002, during which were variety wards under care named consultant physician. In 2003, two centrally located...

Beta-blocking drugs are increasingly prescribed in coronary heart disease, but controversy surrounds the hemodynamic relevance of their ancillary pharmacologic properties--cardioselectivity and intrinsic sympathomimetic activity. We therefore compared effects four intravenous beta-adrenoreceptor antagonists with different properties on left ventricular function 24 patients disease. All depressed relation between filling pressure cardiac output at rest during exercise. However, practolol...

Serum sodium has been shown to predict mortality in heart and liver failure.To determine whether serum independently predicts in-hospital during any emergency medical admission.An analysis was performed of all patients admitted St James's Hospital (SJH), Dublin between 1 January 2002 31 December 2006, using the hospital inpatient enquiry (HIPE) system, linked patient administration system laboratory datasets. obtained from a database 20 deaths occurring same period under physicians...

Background: The utility of risk stratification following an emergency medical admission has been debated. We have examined the predictability outcomes, from a database all admissions to St James’ Hospital, Dublin, over six year period (2005-2010). Methods: Analysis was performed using hospital in-patient enquiry system, linked patient administration system and laboratory data. fractional polynomial only model predict 30-day in-hospital mortality determined. Results: AUROC for parameters 30...

Journal Article Accepted manuscript Response to Correspondence Short and Long-Term Mortality Following Acute Medical Admission Get access Richard Conway, PhD, PhD Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland Search for other works by this author on: Oxford Academic PubMed Google Scholar Declan Byrne, MD, MD Deirdre O'Riordan, Bernard Silke, DSc Address correspondence to: Dr Ireland, email: [email protected] Ph: +353 1 416 2777, Fax: 410 3451 QJM: An International...

While many UK hospitals have introduced an acute medical admissions unit (AMAU) to facilitate efficient emergency admission process and reduce length of hospital stay (LOS), there is a lack such data in the Republic Ireland.To determine impact AMAU on department (ED) wait times for bed, consultant practice, LOS.Retrospective analysis recorded in-patient enquiry (HIPE) system.We studied all patients admitted St James' Hospital Dublin between 1 January 2002 31 December 2003. In 2002, were...

Concurrent with an extension in longevity, a prodrome of ill-health ('disability' identifiable by certain International Classification Disease (ICD) 9/ICD10 codes) predates the acute emergency presentation. To date, no study has assessed effect such 'disability' on outcomes medical admissions.To devise new method scoring burden and assess its relevance to hospital admissions.All admissions (67 971 episodes n = 37 828 patients) St James' Hospital, Dublin, Ireland over 11-year period...

Background: Deprivation in the general population predicts mortality. We have investigated its relevance to an acute medical admission, using a database of all emergency admissions St James' Hospital, Dublin, over 10-year period (2002–11). Methods: All admissions, based on geocoding residence, were allocated Small Area Health Research Unit division, with corresponding deprivation index. then examined this index as univariate (unadjusted) and independent (adjusted) predictor 30-day...