TY  - JOUR
A1  - Reibis, Rona Katharina
A1  - Jannowitz, Christina
A1  - Halle, Martin
A1  - Pittrow, David
A1  - Gitt, Anselm
A1  - Völler, Heinz
T1  - Management and outcomes of patients with reduced ejection fraction after acute myocardial infarction in cardiac rehabilitation centers
JF  - Current medical research and opinion
N2  - Background:
 We aimed to describe the contemporary management of patients with systolic chronic heart failure (CHF) during a cardiac rehabilitation (CR) stay and present outcomes with focus on lipids, blood pressure, exercise capacity, and clinical events.
 Methods:
 Comparison of 3199 patients with moderately or severely impaired left ventricular ejection fraction (low EF, 13.3%) and 20,913 patients with slightly reduced or normal LVEF (normal EF, 86.7%) who underwent an inpatient CR period of about 3 weeks in 2009-2010.
 Results:
 Patients with low EF compared to those with normal EF were somewhat older (65.1 vs. 63.0 years, p<0.0001), and more often had risk factors such as diabetes mellitus (39.7% vs. 32.0%, p<0.0001) or other comorbidities. The overall rate of patients with regular physical activity of at least 90 minutes per week prior to CR was low overall (54.4%), and reduced in patients with low EF compared to those with normal EF (47.7% vs. 55.5%, p<0.0001). The rate of patients that achieved lower LDL cholesterol (5100 mg/dl), total cholesterol (<200 mg/dl) and triglyceride (<150 mg/dl) values at discharge increased compared to baseline. Mean blood pressure was substantially lower in the low EF group compared to the normal EF group both at baseline (124/75 vs. 130/78 mmHg, p<0.0001) and at discharge (119/72 vs. 124/74 mmHg, p<0.0001). Maximum exercise improved substantially in both groups (at baseline 71 vs. 91 Watts, p<0.0001; at discharge 85 vs. 105 Watts, p<0.0001). Event rates during CR were low, and only 0.3% in the low EF group died. As limitations to this study, information on brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-pro BNP) and/or cardiac troponin were not documented, and no long-term information was collected beyond the 3-week CR stay.
 Conclusions:
 Patients with CHF account for a considerable proportion of patients in CR. Also patients with moderate/severe EF benefited from participation in CR, as their lipid profile and physical fitness improved.
KW  - Acute myocardial infarction
KW  - Cardiac rehabilitation Chronic heart failure
KW  - Control rates
KW  - Dyslipidemia
KW  - Lipid profile
KW  - Observational
KW  - Risk factor
Y1  - 2015
U6  - https://doi.org/10.1185/03007995.2014.977854
SN  - 0300-7995
SN  - 1473-4877
VL  - 31
IS  - 2
SP  - 211
EP  - 219
PB  - Taylor & Francis Group
CY  - London
ER  - 
TY  - JOUR
A1  - Fromm, Sabine
A1  - Beisswanger, Elena
A1  - Kaebohrer, Annemarie
A1  - Tenhagen, Bernd-Alois
T1  - Risk factors for MRSA in fattening pig herds - A meta-analysis using pooled data
JF  - Preventive veterinary medicine : an international journal on research and development in veterinary epidemiology, animal disease prevention and control, and animal health economics
N2  - The importance of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) as an infectious agent for humans has increased in recent years in Germany. Although it is well known that the prevalence of MRSA in pig farms is high, risk factors for the presence of MRSA in herds of fattening pigs are still poorly understood. The aim of this study was to evaluate available data from previous studies on MRSA in fattening pigs in a meta-analysis to answer the question: What are the factors associated with the occurrence of MRSA in fattening pig herds?
 The studies on MRSA in pigs that were identified by literature research were heterogeneous with respect to the risk factors investigated and the type of herds focused on. Therefore we decided to carry out a pooling analysis on herd level rather than a typical meta-analysis. Eligible herd data were identified based on the published literature and communication with the authors. The final data set covered 400 fattening pig herds from 10 different studies and 12 risk factors. The prevalence of MRSA in the 400 fattening pig herds was 53.5%.
 Data were analyzed using generalized estimating equations (GEE). The resulting multi-variate model confirmed previously identified risk factors for MRSA in pig herds (herd size and herd type). It also identified further risk factors: group treatment of fattening pigs with antimicrobial drugs (OR=1.79) and housing fattening pig herds on at least partially slatted floors (OR=2.39) compared to plain floor. In contrast, according to the model, fattening pig herds on farms keeping other livestock along with pigs were less likely to harbor MRSA (OR=0.54).
 The results underline the benefits from a pooling analysis and cooperative re-evaluation of published data. (C) 2014 The Authors. Published by Elsevier B.V.
KW  - Fattening pigs
KW  - Swine
KW  - MRSA
KW  - Methicillin resistant Staphylococcus aureus
KW  - Risk factor
KW  - Meta-analysis
KW  - Pooling analysis
KW  - Herd size
KW  - Herd type
KW  - Antimicrobial drugs
KW  - Slatted floor
KW  - Other livestock
KW  - Zoonoses
Y1  - 2014
U6  - https://doi.org/10.1016/j.prevetmed.2014.08.014
SN  - 0167-5877
SN  - 1873-1716
VL  - 117
IS  - 1
SP  - 180
EP  - 188
PB  - Elsevier
CY  - Amsterdam
ER  -