Among patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of less than 70 mg per deciliter (1.81 mmol per liter), there was no incremental clinical benefit from the addition of niacin to statin therapy during a 36-month follow-up period, despite significant improvements in HDL cholesterol and triglyceride levels. (Funded by the National Heart, Lung, and Blood Institute and Abbott Laboratories; AIM-HIGH ClinicalTrials.gov number, NCT00120289.).
Objectives-To identify variation in patient, event, and scene characteristics of out-of-hospital cardiac arrest (OOHCA) patients assessed by emergency medical services (EMS), and to investigate variation in transport practices in relation to documented prehospital return of spontaneous circulation (ROSC) within eight regional clinical centers participating in the Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest.Methods-OOHCA patient, event, and scene characteristics were compared to identify variation in treatment and transport practices across sites. Findings were adjusted for site and standard Utstein covariates. Using logistic regression, these covariates were modeled to identify factors related to the initiation of transport without documented prehospital ROSC as well as survival in these patients. Setting: Eight US and Canadian sites participating in the ROC Epistry-Cardiac Arrest. Population: Persons ≥ 20 years with OOHCA who a) received compressions or shock by EMS providers and/or received bystander AED shock or b) were pulseless but received no EMS compressions or shock between December 2005 and May 2007.Results-23,233 OOHCA cases were assessed by EMS in the defined period. Resuscitation (treatment) was initiated by EMS in 13,518 cases (58%, site range: 36-69%, p<0.0001). Of treated cases, 59% were transported (site range: 49-88%, p<0.0001). Transport was initiated in the Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Author ManuscriptResuscitation. Author manuscript; available in PMC 2012 March 1.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript absence of documented ROSC for 58% of transported cases (site range: 14-95%, p<0.0001). Of these transported cases, 8% achieved ROSC before hospital arrival (site range: 5-21%, p<0.0001) and 4% survived to hospital discharge (site range: 1-21%, p<0.0001). In cases with transport from the scene initiated after documented ROSC, 28% survived to hospital discharge (site range: 18-44%, p<0.0001).Conclusion-Initiation of resuscitation and transport of OOHCA and the reporting of ROSC prior to transport markedly varies among ROC sites. This variation may help clarify reported differences in survival rates among sites and provide a target for identifying EMS practices most likely to enhance survival from OOHCA.
Our initial results suggest low dose CT images reconstructed with ASIR may have lower measured noise, similar image quality, yet significantly less radiation dose compared with higher dose images reconstructed with FBP.
Viewing dual-energy CT images may result in the greatest subjective lesion conspicuity and measured contrast-to-noise ratio at 50 keV with equal detection of hyperenhancing liver lesions compared with viewing 77-keV images alone. In addition, the radiation doses of dual-energy CT may be similar to those of single-energy CT.
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