Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies

Atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men: systematic review and meta-analysis of cohort studies

Abstract

Objective To determine whether atrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men.

Design Meta-analysis of cohort studies.

Data sources Studies published between January 1966 and March 2015, identified through a systematic search of Medline and Embase and review of references.

Eligibility for selecting studies Cohort studies with a minimum of 50 participants with and 50 without atrial fibrillation that reported sex specific associations between atrial fibrillation and all cause mortality, cardiovascular mortality, stroke, cardiac events (cardiac death and non-fatal myocardial infarction), and heart failure.

Data extraction Two independent reviewers extracted study characteristics and maximally adjusted sex specific relative risks. Inverse variance weighted random effects meta-analysis was used to pool sex specific relative risks and their ratio.

Results 30 studies with 4 371 714 participants were identified. Atrial fibrillation was associated with a higher risk of all cause mortality in women (ratio of relative risks for women compared with men 1.12, 95% confidence interval 1.07 to 1.17) and a significantly stronger risk of stroke (1.99, 1.46 to 2.71), cardiovascular mortality (1.93, 1.44 to 2.60), cardiac events (1.55, 1.15 to 2.08), and heart failure (1.16, 1.07 to 1.27). Results were broadly consistent in sensitivity analyses.

Conclusion Atrial fibrillation is a stronger risk factor for cardiovascular disease and death in women compared with men, though further research would be needed to determine any causality.

 

Connor A Emdin, DPhil; Christopher X Wong; Allan J Hsiao; Douglas G Altman; Sanne AE Peters; Mark Woodward; Ayodele A Odutayo

BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.h7013 (Published 19 January 2016)

 

Posted in Atrial Fibrillation, Cardiology, Hot Topics in Research, March

Zebrafish Reel in Phenotypic Suppressors of Autism

Zebrafish Reel in Phenotypic Suppressors of Autism

Chemical genetics can help decipher novel pathways underlying neurodevelopmental psychiatric impairments. Hoffman et al. (2016) utilized behavioral profiling of psychoactive compounds in zebrafish and identified estrogens as suppressors of a phenotype resulting from loss of an autism risk gene.

Neuron, Volume 89, Issue 4, 17 February 2016, Pages 673–675

Posted in Brain, Hot Topics in Research, March Tagged with:

Mental Health of Transgender Children Who Are Supported in Their Identities

Mental Health of Transgender Children Who Are Supported in Their Identities

OBJECTIVE: Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children.

METHODS: A community-based national sample of transgender, prepubescent children (n= 73, aged 3–12 years), along with control groups of nontransgender children in the same age range (n = 73 age- and gender-matched community controls; n = 49 sibling of transgender participants), were recruited as part of the TransYouth Project. Parents completed anxiety and depression measures.

RESULTS: Transgender children showed no elevations in depression and slightly elevated anxiety relative to population averages. They did not differ from the control groups on depression symptoms and had only marginally higher anxiety symptoms.

CONCLUSIONS: Socially transitioned transgender children who are supported in their gender identity have developmentally normative levels of depression and only minimal elevations in anxiety, suggesting that psychopathology is not inevitable within this group. Especially striking is the comparison with reports of children with GID; socially transitioned transgender children have notably lower rates of internalizing psychopathology than previously reported among children with GID living as their natal sex.

 

Kristina R. Olson, Lily Durwood, Madeleine DeMeules, Katie A. McLaughlin

Copyright © 2016 by the American Academy of Pediatrics

March 2016, VOLUME 137 / ISSUE 3

Posted in Hot Topics in Research, March, Pediatrics

Wise-MD Trial Access (MedU Surgery Module)

WISE-MD is a series of 35 web-based modules created to enhance the surgical education of medical students and health care professionals by providing high quality content on common surgical conditions. The modules address topics typically taught during the surgical clerkship such as appendicitis, biliary tract disease, breast cancer, thyroid disease, hernia and more.

Most of the modules have self-assessment questions. Modules are illustrated with video and animation.

Currently 115 medical and osteopathic schools currently use WISE-MD as part of their clerkship curriculum. Reports are available for clerkship directors regarding usage of the modules by individual students.

Students can self register for MedU using their pcom.edu email address and will automatically get access to WISE-MD. See MedU Registration Instructions.

Instructors who want access to WISE-MD will need to register and request access for approval.

Did you find this resource useful? Please send comments to library@pcom.edu.

Posted in Front Page, Library News, New Resources

Thieme eNeurosurgery

Thanks to all who responded and provided feedback!  Thieme eNeurosurgery has been added to the PCOM Libary Collection!

URL: http://eneurosurgery.thieme.com

Thieme eNeurosurgery is the world’s most comprehensive resource for neurological and spine surgery online, providing access to:

  • Thieme’s entire neurosurgical E-Book library of 161 books including CORE TEXTS for residency programs and board exam preparation
  • Over 410 illustrated surgical procedures, original to Thieme eNeurosurgery, providing step-by-step instruction on core techniques and approaches
  • 225 cases with associated Q&A
  • Author-narrated videos, embedded into the text and available to search independently
  • More than 50,000 images for download and use in other applications, with legends and links to original sources
  • Simultaneous search across the neurosurgery titles in Thieme’s E-Journal platform, as well as across all journals indexed in PubMed, with results given to the abstract level

 

Posted in Front Page, Library News, New Resources

VisualDx update

ON TUESDAY, MARCH 1, the VisualDx experience will change.

visualDX

Double the diagnoses. From 1,300 to 2,700 diagnoses, VisualDx will provide a more holistic decision support.

NEW The Sympticon™. Look for these symptom icons to visually demonstrate symptoms of disease.

NEW More Images. The world’s best medical image library has expanded to include more photos, x-rays, and now the Sympticons.

NEW Guided Questionnaires. Choose to be guided with a questionnaire and/or type in additional findings. VisualDx can help you remember which questions are relevant to a particular symptom or complaint.

SAME GREAT FEATURES:

  • Concise expert content and therapy guidelines for use at the point of care.
  • Patient handouts for key diagnoses.
  • Integrated into the workflow: mobile, electronic health record, UpToDate.
  • Earn CME
Posted in Front Page, Library News

Treatments That Work Trial

The Treatments That Work series represents the gold standard of behavioral healthcare interventions. Featuring Therapists Guides and Workbooks, this series communicates evidence-based interventions in mental health and behavioral medicine to clinicians on the front lines of practice.

Led by a prestigious scientific advisory board, all programs have been rigorously tested in clinical trials and are backed by years of research. Reliable and effective, the titles in the Treatments That Work series provide clinicians with the information they need to provide the best possible care.

Now available online for the first time via Oxford Clinical Psychology, titles from the Treatments That Work series can be easily accessed and searched on one easy-to-use platform.

Did you find this resource useful? Please send comments to library@pcom.edu.

Posted in Front Page, Library News, New Resources

Disseminating Justified, Well-Designed, and Well-Executed Studies Despite Nonsignificant Tests

Disseminating Justified, Well-Designed, and Well-Executed Studies Despite Nonsignificant Tests

To the Editor

In her editorial1 published in JAMA Psychiatry, Dr Kraemer gives important insights into using covariates, thereby adding to her large body of highly valuable publications…

 

Gunther Meinlschmidt, PhD; Jan K. Woike, PhD; Marion Tegethoff, PhD
JAMA Psychiatry. 2016;73(1):88-89. doi:10.1001/jamapsychiatry.2015.2259.
Posted in February, Hot Topics in Research, Research Commentary

Disseminating Justified, Well-Designed, and Well-Executed Studies With Nonsignificant Tests—Reply

Disseminating Justified, Well-Designed, and Well-Executed Studies With Nonsignificant Tests—Reply

In Reply I wholeheartedly agree with the main point made by Meinlschmidt et al that well-justified, well-designed, and well-executed (non–poorly justified, designed, or executed [PJDE]) randomized clinical trials warrant dissemination—statistically significant or not. Crucial is whether a randomized clinical trial advances knowledge…

 

Helena Chmura Kraemer, PhD1

JAMA Psychiatry. 2016;73(1):89-90. doi:10.1001/jamapsychiatry.2015.2301.

Posted in February, Hot Topics in Research, Research Commentary

Paradoxical Motor Recovery From a First Stroke After Induction of a Second Stroke: Reopening a Postischemic Sensitive Period

Paradoxical Motor Recovery From a First Stroke After Induction of a Second Stroke: Reopening a Postischemic Sensitive Period

Abstract Background and objective. Prior studies have suggested that after stroke there is a time-limited period of increased responsiveness to training as a result of heightened plasticity—a sensitive period thought to be induced by ischemia itself. Using a mouse model, we have previously shown that most training-associated recovery after a caudal forelimb area (CFA) stroke occurs in the first week and is attributable to reorganization in a medial premotor area (AGm). The existence of a stroke-induced sensitive period leads to the counterintuitive prediction that a second stroke should reopen this window and promote full recovery from the first stroke. To test this prediction, we induced a second stroke in the AGm of mice with incomplete recovery after a first stroke in CFA. Methods. Mice were trained to perform a skilled prehension (reachto-grasp) task to an asymptotic level of performance, after which they underwent photocoagulation-induced stroke in CFA. After a 7-day poststroke delay, the mice were then retrained to asymptote. We then induced a second stroke in the AGm, and after only a 1-day delay, retrained the mice. Results. Recovery of prehension was incomplete when training was started after a 7-day poststroke delay and continued for 19 days. However, a second focal stroke in the AGm led to a dramatic response to 9 days of training, with full recovery to normal levels of performance. Conclusions. New ischemia can reopen a sensitive period of heightened responsiveness to training and mediate full recovery from a previous stroke.

 

Steven R. Zeiler, MD, PhD , Robert Hubbard , Ellen M. Gibson , Tony Zheng , Kwan Ng, MD, PhD , Richard O’Brien, MD, PhD , and John W. Krakauer, MD

Posted in Brain, Cardiology, February, Hot Topics in Research Tagged with: , ,

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