Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Association between Initiation of Pulmonary Rehabilitation and Rehospitalizations in Patients Hospitalized with Chronic Obstructive Pulmonary Disease.

Abstract: Rationale: Although clinical trials have found that pulmonary rehabilitation (PR) can reduce the risk of readmissions after hospitalization for a chronic obstructive pulmonary disease (COPD) exacer...

Cardiac surgery in the very elderly.

Abstract: OBJECTIVE To determine the results of cardiac surgery in the very elderly. DESIGN AND SUBJECTS A retrospective study of 56 very elderly patients (mean age 82 years, range 79-89 years) undergoing open heart surgery between 1988 and 1991. Thirty-three patients had coronary artery bypass grafting, 12 had valve replacement alone and 11 had valve replacement with an associated procedure. SETTING St Francis Xavier Cabrini Hospital, Melbourne--a large private hospital. RESULTS There were four in-hospital deaths (7%). The one-year actuarial survival rate was 88%. Of the 49 survivors, 92% were in New York Heart Association (NYHA) Class III or IV before operation, whereas 96% were in NYHA Class I or II a mean of 15 months after operation. CONCLUSION In very elderly patients with medically refractory cardiac symptoms, cardiac surgery has a tolerable mortality and provides excellent relief of symptoms.

Real world validation of the nonhyperemic index of coronary artery stenosis severity-Resting full-cycle ratio-RE-VALIDATE.

Abstract: OBJECTIVE The primary objective was to demonstrate diagnostic equivalence between RFR and iFR in clinical practice. BACKGROUND The instantaneous wave-free ratio (iFR), a nonhyperemic pressure ratio (NHPR), has been shown to be noninferior to fractional flow reserve (FFR) in determining coronary artery stenosis severity in intermediate lesions. However, iFR has a number of inherent limitations, including sensitive landmarking of the pressure waveform and the assumption that maximal flow and minimal microcirculatory resistance occur during a fixed period within diastole. The resting full-cycle ratio (RFR) is a novel NHPR which evaluates the entire cardiac cycle independent of the ECG, landmark identification, and timing within the cardiac cycle. METHODS RE-VALIDATE RFR was designed to determine the diagnostic utility of RFR for the physiological assessment of coronary artery disease in clinical practice compared to iFR. RFR was also tested for equivalence (1% margin), diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), areas under the receiver operated characteristic curve (AUC), and correlations compared to calculated iFR (iFRcalc ). RESULTS From two centers, 501 blinded rest- and hyperemic pressure recordings from 431 patients were suitable for analysis according to a core laboratory. The mean FFR, RFR, and iFRcalc were 0.80 ± 0.09, 0.90 ± 0.08, and 0.90 ± 0.08, respectively. Based on a binary cut-off approach (RFR/iFR ≤0.89), RFR demonstrated equivalence with iFRcalc (95% confidence interval: 0.025-0.019) with overall diagnostic accuracy 97.8%, sensitivity 97.8%, specificity 97.8%, PPV 96.2%, NPV 98.7%, and AUC 0.96 (0.94-0.97, p < .001). RFR had a mean bias 0.003 (95% limits of agreement: 0.019, -0.025). CONCLUSIONS RFR was equivalent to iFR in clinical practice. RFR is an alternative NHPR, avoiding the need for hyperemic agents, thus potentially reducing side effects, procedural time and cost compared to FFR.