996 resultados para Escore Grace


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General note: Title and date provided by Bettye Lane. Original date is incorrect.

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General note: Title and date provided by Bettye Lane.

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General note: Title and date provided by Bettye Lane.

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BACKGROUND: Risk assessment is fundamental in the management of acute coronary syndromes (ACS), enabling estimation of prognosis. AIMS: To evaluate whether the combined use of GRACE and CRUSADE risk stratification schemes in patients with myocardial infarction outperforms each of the scores individually in terms of mortality and haemorrhagic risk prediction. METHODS: Observational retrospective single-centre cohort study including 566 consecutive patients admitted for non-ST-segment elevation myocardial infarction. The CRUSADE model increased GRACE discriminatory performance in predicting all-cause mortality, ascertained by Cox regression, demonstrating CRUSADE independent and additive predictive value, which was sustained throughout follow-up. The cohort was divided into four different subgroups: G1 (GRACE<141; CRUSADE<41); G2 (GRACE<141; CRUSADE≥41); G3 (GRACE≥141; CRUSADE<41); G4 (GRACE≥141; CRUSADE≥41). RESULTS: Outcomes and variables estimating clinical severity, such as admission Killip-Kimbal class and left ventricular systolic dysfunction, deteriorated progressively throughout the subgroups (G1 to G4). Survival analysis differentiated three risk strata (G1, lowest risk; G2 and G3, intermediate risk; G4, highest risk). The GRACE+CRUSADE model revealed higher prognostic performance (area under the curve [AUC] 0.76) than GRACE alone (AUC 0.70) for mortality prediction, further confirmed by the integrated discrimination improvement index. Moreover, GRACE+CRUSADE combined risk assessment seemed to be valuable in delineating bleeding risk in this setting, identifying G4 as a very high-risk subgroup (hazard ratio 3.5; P<0.001). CONCLUSIONS: Combined risk stratification with GRACE and CRUSADE scores can improve the individual discriminatory power of GRACE and CRUSADE models in the prediction of all-cause mortality and bleeding. This combined assessment is a practical approach that is potentially advantageous in treatment decision-making.

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Comparatively few contemporary writers have accompanied American POWs home from Hanoi, been arrested on the White House Lawn, or been dragged off in shackles to serve time in the Greenwich Village Women's House of Detention. Paley's pacifist, socialist politics are also deeply rooted in a family past where memories were still fresh of Tsarist oppression - one uncle shot dead carrying the red flag, and parents who reached America only because the Tsar had a son and amnestied all political prisoners under the age of twenty-one. At this point, Paley's father (imprisoned in Archangel) and her mother (in exile) took their chances (and all their surviving relatives) and very sensibly ran for their lives. Her grandmother recalled family arguments around the table between Paley's father (Socialist), Uncle Grisha (Communist), Aunt Luba (Zionist), and Aunt Mira (also Communist). Paley's own street-wise adolescence involved the usual teenage gang fights, between adherents of the Third and Fourth Internationals. This article is copyright MHRA 2001, and is included in this repository with permission.

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Résumé : Les eaux souterraines ont un impact majeur sur la vie terrestre, les besoins domestiques et le climat. Elles sont aussi un maillon essentiel du cycle hydrologique. Au Canada par exemple, plus de 30 % de la population est tributaire des eaux souterraines pour leur alimentation en eau potable. Ces ressources subissent de nombreuses pressions sous l’influence de certains facteurs comme la salinisation, la contamination et l’épuisement. La variabilité du climat et la demande croissante sur ces ressources imposent l'amélioration de nos connaissances sur les eaux souterraines. L’objectif principal du projet de recherche est d’exploiter les données d’anomalies (TWS) de la mission Gravity Recovery And Climate Experiment (GRACE) pour localiser, quantifier et analyser les variations des eaux souterraines à travers les bassins versants du Bas-Mackenzie, du Saint-Laurent, du Nord-Québec et du Labrador. Il s’agit aussi d’analyser l’influence des cycles d’accumulation et de fonte de neige sur les variations du niveau des eaux souterraines. Pour estimer les variations des eaux souterraines, la connaissance des autres paramètres du bilan hydrologique est nécessaire. Ces paramètres sont estimés à l’aide des sorties du modèles de surface CLM du Système Global d’Assimilation des Données de la Terre (GLDAS). Les données GRACE qui ont été utilisées sont celles acquises durant la période allant de mars 2002 à août 2012. Les résultats ont été évalués à partir d’enregistrements de niveaux piézométriques provenant de 1841 puits localisés dans les aquifères libres du bassin des réseaux de suivi des eaux souterraines au Canada. Les valeurs de rendements spécifiques des différents types d’aquifères de chaque puits et celles des variations mensuelles du niveau d’eau dans ces puits ont été utilisées pour estimer les variations des anomalies des eaux souterraines in-situ. L’étude de corrélation entre les variations des anomalies des eaux souterraines estimées à partir de la combinaison GRACE-GLDAS et celles issues de données in-situ révèle des concordances significatives avec des valeurs de

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A Hipertensão Arterial e o Diabetes Mellitus são atualmente considerados problemas de saúde pública, sendo que as doenças cardiovasculares representam hoje no Brasil a maior causa de mortes. Trata-se de uma pesquisa de revisão integrativa realizada na Biblioteca Virtual de Saúde que objetivou descrever os trabalhos relacionados à utilização do Escore de Risco de Framingham publicados na literatura nacional nos anos de 2003 a 2013, em artigos científicos completos. A intenção deste trabalho é propor a utilização do Escore de Risco de Framingham para a abordagem, manejo e acompanhamento dos usuários de uma Estratégia de Saúde da Família. Foram utilizados os descritores: Hipertensão; Diabetes Mellitus e a palavra Framingham. Chegou-se aos seguintes resultados: todas as variáveis utilizadas pelo Escore de Framingham, sendo elas: sexo, idade, tabagismo, presença de diabetes, pressão arterial, colesterol total e HDL colesterol diminuído se mostraram associadas ao risco coronariano, ou seja, possuir estes fatores de risco aumentam as chances de infarto ou morte por doença coronariana nos próximos 10 anos. O Escore de Risco de Framingham tem utilidade na prevenção de doenças cardiovasculares pela proposta de intervir nos fatores de risco modificáveis e propor mudanças no estilo de vida, além de ser forma eficiente de abordagem das doenças pela possibilidade de garantir adequada adesão medicamentosa e ao tratamento propriamente dito, além de possibilitar acompanhamento e avaliação dos pacientes. De acordo com os resultados encontrados, pode-se concluir que a Estratégia da Saúde da Família é um dos locais apropriados para o acompanhamento e para o tratamento de hipertensos e diabéticos dentro do enfoque de risco, com a finalidade de estabelecer metas terapêuticas para o manejo e abordagem destes pacientes, visando a diminuição dos índices de morbimortalidade.