Innlandet Hospital Trust

About: Innlandet Hospital Trust is a healthcare organization based out in Brumunddal, Norway. It is known for research contribution in the topics: Population & Dementia. The organization has 387 authors who have published 1302 publications receiving 37753 citations.

ESC guidelines adherence is associated with improved survival in patients from the Norwegian Heart Failure Registry.

Abstract: Aims To assess the adherence to heart failure (HF) guidelines for angiotensin-converting enzyme-I (ACE-I), angiotensin II receptor blockers (ARB), and β-blockers and the possible association of ACE-I or ARB, β-blockers, and statins with survival in the large contemporary Norwegian Heart Failure Registry . Methods and results The study included 5761 outpatients who were diagnosed with HF of any aetiology (mean left ventricular ejection fraction 32% ± 11%) from January 2000 to January 2010 and followed up until death or February 2010. Adherence to treatment according to the guidelines was high. Cox regression analysis to identify risk factors for all-cause mortality, after adjustment for many factors, showed that ACE-I ≥ 50% of target dose, use of beta-blockers, and statins were significantly related to improved survival ( P = 0.003, P < 0.001, and P < 0.001, respectively). Propensity scoring showed the same benefit for these variables. Conclusions Both multivariable and propensity scoring analyses showed survival benefits with β-blockers, statins, and adequate doses of ACE-I in this contemporary HF cohort. This study stresses the importance of guidelines adherence, even in the context of high levels of adherence to guidelines. Moreover, respecting the recommended target doses of ACE-I appears to have a crucial role in survival improvement and, in the multivariate Cox regression analysis, ARB treatment was not significantly associated with a lower all-cause mortality. [10.1093/ehjcvp/pvu015][1] [1]: /lookup/doi/10.1093/ehjcvp/pvu015

Right ventricular function in long-term adult survivors of childhood lymphoma and acute lymphoblastic leukaemia.

Abstract: Aims Little is known about right ventricular (RV) function in survivors of childhood cancer, although both anthracyclines and radiotherapy represent potentially cardiotoxic treatment. We hypothesized that adult survivors of childhood malignant lymphoma or acute lymphoblastic leukaemia would have impaired RV function. Methods and results We examined RV dimensions and function by echocardiography in 246 survivors, mean 21.7 years after diagnosis, and in 211 matched controls. Of the survivors, 84% had been exposed to anthracyclines, mediastinal radiotherapy, or both. Compared with controls, all mean measures of RV function were lower in the survivor group: fractional area change (44.5 vs. 48.6%, P < 0.001), tricuspid annular plane systolic excursion (2.24 vs. 2.49 cm, P < 0.001), peak systolic tricuspid annular velocity (12.1 vs. 13.0 cm/s, P < 0.001), and free wall strain (−26.5 vs. −28.4%, P < 0.001). In contrast, there were little differences in RV diastolic dimensions. Lower measures of RV function were found in all survivor subgroups having received cardiotoxic treatment, but not in the 16% of survivors unexposed to anthracyclines or mediastinal radiotherapy. Signs of RV systolic dysfunction were found in 30% of the survivors, and more than 3 times more often in survivors with left ventricular dysfunction. Conclusion Long-term survivors of childhood lymphoma or acute lymphoblastic leukaemia frequently have impaired RV function compared with controls. As this is associated with increased risk of heart failure and death in many other conditions, we recommend increased attention to RV function in childhood survivors. Whether RV dysfunction impairs prognosis in this patient group should be examined in longitudinal studies.

A 36-month follow-up of decline in activities of daily living in individuals receiving domiciliary care

Abstract: There have been few studies of how personal and instrumental activities of daily living (P-ADL and I-ADL) develop over time in older people receiving domiciliary care. This study aimed at assessing variables associated with the development of P-ADL and I-ADL functioning over a 36-month follow-up period, with a particular focus on cognitive functioning. In all, 1001 older people (≥70 years) receiving domiciliary care were included in a longitudinal study with three assessments of P-ADL and I-ADL functioning during 36 months. P-ADL and I-ADL were assessed using the Lawton and Brody’s Physical Self-Maintenance Scale and Instrumental Activities of Daily Living Scale, respectively. Mini Mental State Examination (MMSE), diagnosis of dementia and MCI, neuropsychiatric symptoms and use of psychotropic medication were also evaluated during the three assessments. Baseline demographic and general medical health information and information of being a nursing home resident at follow-up were recorded. Linear mixed models were estimated. There was a significant decline in P-ADL and I-ADL functioning throughout the follow-up. A lower MMSE sum-score, diagnosed MCI and dementia, a higher level of neuropsychiatric symptoms and the use of antipsychotics and antidepressants recorded at each assessment were associated with a decline in both P-ADL and I-ADL functioning. Furthermore, a decline in P-ADL and I-ADL functioning at follow-ups was associated with being male, a higher baseline age and in poorer medical health as well as residing in a nursing home at follow-up. P-ADL and I-ADL functioning in older people worsened over time. The worsening was associated with lower MMSE sum-score, diagnosed MCI and dementia, poorer medical health, neuropsychiatric symptoms, use of psychotropic medication and being transferred to nursing home care. Clinicians should pay close attention to the assessment and treatment of these factors to help older people maintain their level of functioning for as long as possible.