Rush University Medical Center

About: Rush University Medical Center is a healthcare organization based out in Chicago, Illinois, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 13915 authors who have published 29027 publications receiving 1379216 citations. The organization is also known as: Rush Presbyterian St. Luke's Medical Center.

Vasa Vasorum and Plaque Neovascularization on Contrast-Enhanced Carotid Ultrasound Imaging Correlates With Cardiovascular Disease and Past Cardiovascular Events

Abstract: Background and Purpose— Histological data associate proliferation of adventitial vasa vasorum and intraplaque neovascularization with vulnerable plaques represented by symptomatic vascular disease. In this observational study, the presence of carotid intraplaque neovascularization and adventitial vasa vasorum were correlated with the presence and occurrence of cardiovascular disease (CVD) and events (CVE). Methods— The contrast-enhanced carotid ultrasound examinations of 147 subjects (mean age 64±11 years, 61% male) were analyzed for the presence of intraluminal plaque, plaque neovascularization (Grade 1=absent; Grade 2=present), and degree of adventitial vasa vasorum (Grade 1=absent, Grade 2=present). These observations were correlated with preexisting cardiovascular risk factors, presence of CVD, and history of CVE (myocardial infarction and transient ischemic attack/stroke). Results— The presence of intraluminal carotid plaque was directly correlated to cardiovascular risk factors, CVD, and CVE (P<0.05...

Effect of cilostazol on treadmill walking, community-based walking ability, and health-related quality of life in patients with intermittent claudication due to peripheral arterial disease: meta-analysis of six randomized controlled trials.

Abstract: Objectives To assess whether cilostazol, a phosphodiesterase III inhibitor, improves treadmill and community-based walking ability and health-related quality of life (HQL) in patients with intermittent claudication resulting from peripheral arterial disease (PAD). Design Retrospective meta-analysis of data pooled from six Phase 3, multicenter, double-blind, placebo-controlled, parallel-group, randomized studies. Setting Patients were recruited from outpatient ambulatory medical care facilities. Participants Patients' (n = 1,751) mean age +/- standard deviation was 65 +/- 9, and they had a history of PAD for 6 months or longer and an ankle brachial index (ABI) of 0.90 or less. Intervention Cilostazol 50 mg bid or 100 mg bid for 12, 16, or 24 weeks. Measurements ABI; maximal walking distance (MWD); pain-free walking distance on a graded and constant-load treadmill; and HQL, measured using the Walking Impairment Questionnaire (WIQ) and the Medical Outcomes Study Short Form-36 (SF-36). Results Maximal treadmill walking distance improved more in both cilostazol groups than in the placebo group (both P Conclusions Treatment with cilostazol was associated with greater improvements in community-based walking ability and HQL in patients with intermittent claudication than treatment with placebo. These improvements correlated with increased MWD. This analysis of effects of cilostazol on improving walking ability in persons with claudication is the first cilostazol study focused on community-based measures of functional status and HQL. Questionnaires assessing walking ability and HQL provide important patient-based information about clinical outcomes of claudication therapy.

The cost effectiveness of surgical versus nonoperative treatment for lumbar disc herniation over two years: evidence from the Spine Patient Outcomes Research Trial (SPORT).

Abstract: Lumbar discectomy is the most common surgical procedure performed in the US for patients with back pain and leg symptoms due to intervertebral disc herniation (IDH) 1, Disc herniation most frequently occurs among persons between 33 and 55 years of age; however, rates of spine surgery in the Medicare population--those 65 and older--rose dramatically in the United States over the period 1992 through 2003, with total Medicare spending on lumbar discectomy/laminectomy estimated at $306 million.2. While recent clinical evidence shows a health benefit for those undergoing surgery,3,4 the cost-effectiveness of operative intervention compared with non-operative care remains poorly characterized. One study reported moderate cost-effectiveness for surgical treatment of IDH,5 but had several important limitations. First, cost and health outcome data came from different populations. Second, transitions between health states were not observed with prospectively collected data appropriate for estimating impact on quality-adjusted life years (QALYs), but were modeled using decision analysis. Third, the effect of surgery on worker productivity (i.e., indirect costs) was not addressed. The results from the Maine Lumbar Spine Study suggest that indirect costs are important to evaluate because, although spine surgery was associated with pain reduction, it was not associated with increased labor force participation.6 A recent Swedish study suggested that surgery for IDH may be cost-saving when lost productivity due to permanent disability is considered.7 To comprehensively address the economic value of surgery for treatment of IDH, the multicenter Spine Patient Outcomes Research Trial (SPORT), included patients with confirmed diagnosis of IDH and tracked the impact of treatment on QALYs using a validated instrument (EQ-5D), resource utilization, and indirect costs .8 Reports of the SPORT primary outcomes among 1,244 patients with IDH suggest that both surgically and non-operatively treated patients improve over time 3,4 In this paper, we report on the cost-effectiveness of surgery for IDH using SPORT two-year cost and outcomes data.