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1.
Ilaria Cova Francesca Clerici Annalia Rossi Valentina Cucumo Roberta Ghiretti Laura Maggiore Simone Pomati Daniela Galimberti Elio Scarpini Claudio Mariani Barbara Caracciolo 《PloS one》2016,11(3)
Background
Weight loss is common in people with Alzheimer’s disease (AD) and it could be a marker of impending AD in Mild Cognitive Impairment (MCI) and improve prognostic accuracy, if accelerated progression to AD would be shown.Aims
To assess weight loss as a predictor of dementia and AD in MCI.Methods
One hundred twenty-five subjects with MCI (age 73.8 ± 7.1 years) were followed for an average of 4 years. Two weight measurements were carried out at a minimum time interval of one year. Dementia was defined according to DSM-IV criteria and AD according to NINCDS-ADRDA criteria. Weight loss was defined as a ≥4% decrease in baseline weight.Results
Fifty-three (42.4%) MCI progressed to dementia, which was of the AD-type in half of the cases. Weight loss was associated with a 3.4-fold increased risk of dementia (95% CI = 1.5–6.9) and a 3.2-fold increased risk of AD (95% CI = 1.4–8.3). In terms of years lived without disease, weight loss was associated to a 2.3 and 2.5 years earlier onset of dementia and AD.Conclusions
Accelerated progression towards dementia and AD is expected when weight loss is observed in MCI patients. Weight should be closely monitored in elderly with mild cognitive impairment. 相似文献2.
Background
The association between overtime work and depression is still unclear. This study examined the association between overtime work and the onset of a major depressive episode (MDE).Methodology/Principal Findings
Prospective cohort study with a baseline examination of working hours, psychological morbidity (an indicator of baseline depression) and depression risk factors in 1991–1993 and a follow-up of major depressive episode in 1997–1999 (mean follow-up 5.8 years) among British civil servants (the Whitehall II study; 1626 men, 497 women, mean age 47 years at baseline). Onset of 12-month MDE was assessed by the Composite International Diagnostic Interview (CIDI) at follow-up. In prospective analysis of participants with no psychological morbidity at baseline, the odds ratio for a subsequent major depressive episode was 2.43 (95% confidence interval 1.11 to 5.30) times higher for those working 11+ hours a day compared to employees working 7–8 hours a day, when adjusted for socio-demographic factors at baseline. Further adjustment for chronic physical disease, smoking, alcohol use, job strain and work-related social support had little effect on this association (odds ratio 2.52; 95% confidence interval 1.12 to 5.65).Conclusions/Significance
Data from middle-aged civil servants suggest that working long hours of overtime may predispose to major depressive episodes. 相似文献3.
Ling-Yun Fan Yu Sun Huey-Jane Lee Shu-Chien Yang Ta-Fu Chen Ker-Neng Lin Chung-Chi Lin Pei-Ning Wang Li-Yu Tang Ming-Jang Chiu 《PloS one》2015,10(9)
Background
Evidence of an association between lifestyle and marital status and risk of dementia is limited in Asia.Methods
In this nationwide population-based cross-sectional survey, participants were selected by computerized random sampling from all 19 counties in Taiwan. A total of 10432 residents were assessed by a door-to-door in-person survey, among whom 7035 were normal and 929 were diagnosed with dementia using the criteria recommended by National Institute on Aging-Alzheimer’s Association. Premorbid lifestyle habits and demographic data including marital status were compared between normal subjects and participants with dementia.Results
After adjustment for age, gender, education, body mass index, smoking, drinking, marital status, sleep habits, exercise, social engagement and co-morbidities including hypertension, diabetes and cerebrovascular diseases, an increased risk for dementia was found in people with widow or widower status (OR 1.42, 95% CI 1.15–1.77) and people who used to take a nap in the afternoon (OR 1.33, 95% CI 1.02–1.72). Decreased risk was found in people with the habit of regular exercise (OR 0.12, 95% CI 0.09–0.16), adequate night sleep (OR 0.55, 95% CI 0.39–0.76) and regular social engagement (OR 0.53, 95% CI 0.36–0.77).Conclusions
Our results provide preliminary evidence of possible risk-reduction effects for dementia, including regular exercise even in modest amounts, social engagement and adequate night sleep, whereas people with the widow/widower status or who used to take an afternoon nap might have increased risk of dementia. 相似文献4.
Michael Seyffert Pooja Lagisetty Jessica Landgraf Vineet Chopra Paul N. Pfeiffer Marisa L. Conte Mary A. M. Rogers 《PloS one》2016,11(2)
Background
Insomnia is of major public health importance. While cognitive behavioral therapy is beneficial, in-person treatment is often unavailable. We assessed the effectiveness of internet-delivered cognitive behavioral therapy for insomnia.Objectives
The primary objectives were to determine whether online cognitive behavioral therapy for insomnia could improve sleep efficiency and reduce the severity of insomnia in adults. Secondary outcomes included sleep quality, total sleep time, time in bed, sleep onset latency, wake time after sleep onset, and number of nocturnal awakenings.Data Sources
We searched PubMed/MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane Library, Embase, and the Web of Science for randomized trials.Methods
Studies were eligible if they were randomized controlled trials in adults that reported application of cognitive behavioral therapy for insomnia via internet delivery. Mean differences in improvement in sleep measures were calculated using the Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis.Results
We found 15 trials, all utilizing a pretest-posttest randomized control group design. Sleep efficiency was 72% at baseline and improved by 7.2% (95% CI: 5.1%, 9.3%; p<0.001) with internet-delivered cognitive behavioral therapy versus control. Internet-delivered cognitive behavioral therapy resulted in a decrease in the insomnia severity index by 4.3 points (95% CI: -7.1, -1.5; p = 0.017) compared to control. Total sleep time averaged 5.7 hours at baseline and increased by 20 minutes with internet-delivered therapy versus control (95% CI: 9, 31; p = 0.004). The severity of depression decreased by 2.3 points (95% CI: -2.9, -1.7; p = 0.013) in individuals who received internet-delivered cognitive behavioral therapy compared to control. Improvements in sleep efficiency, the insomnia severity index and depression scores with internet-delivered cognitive behavioral therapy were maintained from 4 to 48 weeks after post-treatment assessment. There were no statistically significant differences between sleep efficiency, total sleep time, and insomnia severity index for internet-delivered versus in-person therapy with a trained therapist.Conclusion
In conclusion, internet-delivered cognitive behavioral therapy is effective in improving sleep in adults with insomnia. Efforts should be made to educate the public and expand access to this therapy. Registration Number, Prospero: CRD42015017622 相似文献5.
Carolina P. B. Gracitelli Andrew J. Tatham Erwin R. Boer Ricardo Y. Abe Alberto Diniz-Filho Peter N. Rosen Felipe A. Medeiros 《PloS one》2015,10(10)
Purpose
To evaluate the ability of longitudinal Useful Field of View (UFOV) and simulated driving measurements to predict future occurrence of motor vehicle collision (MVC) in drivers with glaucoma.Design
Prospective observational cohort study.Participants
117 drivers with glaucoma followed for an average of 2.1 ± 0.5 years.Methods
All subjects had standard automated perimetry (SAP), UFOV, driving simulator, and cognitive assessment obtained at baseline and every 6 months during follow-up. The driving simulator evaluated reaction times to high and low contrast peripheral divided attention stimuli presented while negotiating a winding country road, with central driving task performance assessed as “curve coherence”. Drivers with MVC during follow-up were identified from Department of Motor Vehicle records.Main Outcome Measures
Survival models were used to evaluate the ability of driving simulator and UFOV to predict MVC over time, adjusting for potential confounding factors.Results
Mean age at baseline was 64.5 ± 12.6 years. 11 of 117 (9.4%) drivers had a MVC during follow-up. In the multivariable models, low contrast reaction time was significantly predictive of MVC, with a hazard ratio (HR) of 2.19 per 1 SD slower reaction time (95% CI, 1.30 to 3.69; P = 0.003). UFOV divided attention was also significantly predictive of MVC with a HR of 1.98 per 1 SD worse (95% CI, 1.10 to 3.57; P = 0.022). Global SAP visual field indices in the better or worse eye were not predictive of MVC. The longitudinal model including driving simulator performance was a better predictor of MVC compared to UFOV (R2 = 0.41 vs R2 = 0.18).Conclusions
Longitudinal divided attention metrics on the UFOV test and during simulated driving were significantly predictive of risk of MVC in glaucoma patients. These findings may help improve the understanding of factors associated with driving impairment related to glaucoma. 相似文献6.
Alison Rushton Nicola R. Heneghan Melanie Calvert Alison Heap Louise White Peter C. Goodwin 《PloS one》2015,10(11)
Objectives
To evaluate: acceptability and feasibility of trial procedures; distribution of scores on the Roland Morris Disability Questionnaire (RMDQ, planned primary outcome); and efficient working of trial components.Design and Setting
A feasibility and external pilot randomised controlled trial (ISRCTN33808269, assigned 10/12/2012) was conducted across 2 UK secondary care outpatient physiotherapy departments associated with regional spinal surgery centres.Participants
Consecutive consenting patients aged >18 years; post primary, single level, lumbar discectomy.Interventions
Participants were randomised to either 1:1 physiotherapy outpatient management including patient leaflet, or patient leaflet alone.Main Outcome Measures
Blinded assessments were made at 4 weeks post surgery (baseline) and 12 weeks post baseline (proposed primary end point). Secondary outcomes included: Global Perceived Effect, back/leg pain, straight leg raise, return to work/function, quality of life, fear avoidance, range of movement, medication, re-operation.Results
At discharge, 110 (44%) eligible patients gave consent to be contacted. 59 (54%) patients were recruited. Loss to follow up was 39% at 12 weeks, with one site contributing 83% losses. Mean (SD) RMDQ was 10.07 (5.58) leaflet and 10.52 (5.94) physiotherapy/leaflet at baseline; and 5.37 (4.91) leaflet and 5.53 (4.49) physiotherapy/leaflet at 12 weeks. 5.1% zero scores at 12 weeks illustrated no floor effect. Sensitivity to change was assessed at 12 weeks with mean (SD) change -4.53 (6.41), 95%CI -7.61 to -1.44 for leaflet; and -6.18 (5.59), 95%CI -9.01 to -3.30 for physiotherapy/leaflet. RMDQ mean difference (95%CI) between change from baseline to twelve weeks was 1.65(-2.46 to 5.75). Mean difference (95%CI) between groups at 12 weeks was -0.16 (-3.36 to 3.04). Participant adherence with treatment was good. No adverse events were reported.Conclusions
Both interventions were acceptable, and it is promising that they both demonstrated a trend in reducing disability in this population. A randomised controlled trial, using a different trial design, is needed to ascertain the effectiveness of combining the interventions into a stepped care intervention and comparing to a no intervention arm. Findings will guide design changes for an adequately powered randomised controlled trial, using RMDQ as the primary outcome.Trial Registration
ISRCTN registry 33808269 相似文献7.
Background
A growing body of research has confirmed that workplace bullying is a source of distress and poor mental health. Here we summarize the cross-sectional and longitudinal literature on these associations.Methods
Systematic review and meta-analyses on the relation between workplace bullying and mental health.Results
The cross-sectional data (65 effect sizes, N = 115.783) showed positive associations between workplace bullying and symptoms of depression (r = .28, 95% CI = .23–.34), anxiety (r = .34, 95% CI = .29–.40) and stress-related psychological complaints (r = .37, 95% CI = .30–.44). Pooling the literature that investigated longitudinal relationships (26 effect sizes, N = 54.450) showed that workplace bullying was related to mental health complaints over time (r = 0.21, 95% CI = 0.13–0.21). Interestingly, baseline mental health problems were associated with subsequent exposure to workplace bullying (r = 0.18, 95% CI = 0.10–0.27; 11 effect sizes, N = 27.028).Limitations
All data were self-reported, raising the possibility of reporting- and response set bias.Conclusions
Workplace bullying is consistently, and in a bi-directional manner, associated with reduced mental health. This may call for intervention strategies against bullying at work. 相似文献8.
Background/Objectives
Recently, a body shape index (ABSI) was reported to predict all-cause mortality independently of body mass index (BMI) in Americans. This study aimed to evaluate whether ABSI is applicable to Japanese adults as a predictor for development of diabetes, hypertension, and dyslipidemia.Subjects/Methods
We evaluated the predictive power of ABSI in a retrospective cohort study using annual health examination data from Chiba City Hall in Japan, for the period 2008 to 2012. Subjects included 37,581 without diabetes, 23,090 without hypertension, and 20,776 without dyslipidemia at baseline who were monitored for disease incidence for 4 years. We examined the associations of standardized ABSI, BMI, and waist circumference (WC) at baseline with disease incidence by logistic regression analyses. Furthermore, we conducted a case-matched study using the propensity score matching method.Results
Elevated BMI, WC, and ABSI increased the risks of diabetes and dyslipidemia [BMI-diabetes: odds ratio (OR) = 1.26, 95% confidence interval (95%CI) = 1.20−1.32; BMI-dyslipidemia: OR = 1.15, 95%CI = 1.12−1.19; WC-diabetes: OR = 1.24, 95%CI = 1.18−1.31; WC-dyslipidemia: OR = 1.15, 95%CI = 1.11−1.19; ABSI-diabetes: OR = 1.06, 95%CI = 1.01−1.11; ABSI-dyslipidemia: OR = 1.04, 95%CI = 1.01−1.07]. Elevated BMI and WC, but not higher ABSI, also increased the risk of hypertension [BMI: OR = 1.32, 95%CI = 1.27−1.37; WC: OR = 1.22, 95%CI = 1.18−1.26; ABSI: OR = 1.00, 95%CI = 0.97−1.02]. Areas under the curve (AUCs) in regression models with ABSI were significantly smaller than in models with BMI or WC for all three diseases. In case-matched subgroups, the power of ABSI was weaker than that of BMI and WC for predicting the incidence of diabetes, hypertension, and dyslipidemia.Conclusions
Compared with BMI or WC, ABSI was not a better predictor of diabetes, hypertension, and dyslipidemia in Japanese adults. 相似文献9.
Dongliang Li Xueying Yang Zheng Zhang Zixin Wang Xiao Qi Yuhua Ruan Yunhua Zhou Chunrong Li Fengji Luo Joseph T. F. Lau 《PloS one》2016,11(1)
Background
The HIV-epidemic among MSM in China has worsened. In this key population, prevalence of HSV-2 and syphilis infection and co-infection with HIV is high.Methods
A longitudinal study was conducted (n = 962) in Beijing, China, with three overlapping cohorts (n = 857, 757 and 760) consisting of MSM that were free from pairs of infections of concern (i.e. HIV-HSV-2, HIV-syphilis, HSV-2-syphilis) at baseline to estimate incidence of HIV, HSV-2, syphilis, and those of co-infection.Results
The incidence of HIV, HSV-2 and syphilis in the overall cohort was 3.90 (95% CI = 2.37, 5.43), 7.87 (95% CI = 5.74, 10.00) and 6.06 (95% CI = 4.18, 7.94) cases per 100 person-years (PYs), respectively. The incidence of HIV-HSV-2, HIV-Syphilis and HSV-2-Syphilis co-infections was 0.30 (95% CI = 0.29, 0.88), 1.02 (95% CI = 0.13, 2.17) and 1.41 (95% CI: 0.04, 2.78) cases per 100 PYs, respectively, in the three sub-cohorts constructed for this study.Conclusions
The incidence of HIV, HSV-2 and syphilis was very high and those of their co-infections were relatively high. Such co-infections have negative impacts on the HIV/STI epidemics. Prevention practices need to take such co-infections into account. 相似文献10.
Yangbo Sun Chao Qiang Jiang Kar Keung Cheng Wei Sen Zhang Gabriel M. Leung Tai Hing Lam C. Mary Schooling 《PloS one》2015,10(9)
Objectives
In Western contexts nut consumption is associated with better health. We examined the associations of nut consumption with cardiovascular disease risk in the non-Western setting of Southern China.Methods
In the Guangzhou Biobank Cohort Study we used multivariable linear regression to examine the associations of baseline nut (mainly peanuts) consumption (none (n = 6688), <3 portions/week (n = 2596) and ≥3 portions/week (n = 2444)) with follow-up assessment of Framingham cardiovascular disease score (excluding smoking) and its components in older Chinese (≥50 years) (follow-up 57.8%).Results
Nut consumption was not associated with Framingham score (≥3 portions/week compared to none: 0.02 95% confidence interval (CI) -0.11 to 0.15), systolic blood pressure (-0.66 mmHg 95% CI -1.94, 0.62), diastolic blood pressure (-0.69 mmHg 95% CI -1.44, 0.07), HDL-cholesterol (-0.01 mmol/L 95% CI -0.02, 0.005), LDL-cholesterol (-0.01 mmol/L 95% CI -0.05, 0.02) or fasting glucose (0.04 mmol/L 95% CI -0.02, 0.09), adjusted for baseline values, energy intake, age, sex, phase of recruitment, socio-economic position, lifestyle and baseline health status.Conclusions
Observations concerning the benefits of nut consumption may be contextually specific, perhaps depending on the type of nut consumed. 相似文献11.
Stephen R. Knight Gabriel C. Oniscu Luke Devey Kenneth J. Simpson Stephen J. Wigmore Ewen M. Harrison 《PloS one》2016,11(3)
Introduction
Acute kidney injury is associated with a poor prognosis in acute liver failure but little is known of outcomes in patients undergoing transplantation for acute liver failure who require renal replacement therapy.Methods
A retrospective analysis of the United Kingdom Transplant Registry was performed (1 January 2001–31 December 2011) with patient and graft survival determined using Kaplan-Meier methods. Cox proportional hazards models were used together with propensity-score based full matching on renal replacement therapy use.Results
Three-year patient and graft survival for patients receiving renal replacement therapy were 77.7% and 72.6% compared with 85.1% and 79.4% for those not requiring renal replacement therapy (P<0.001 and P = 0.009 respectively, n = 725). In a Cox proportional hazards model, renal replacement therapy was a predictor of both patient death (hazard ratio (HR) 1.59, 95% CI 1.01–2.50, P = 0.044) but not graft loss (HR 1.39, 95% CI 0.92–2.10, P = 0.114). In groups fully matched on baseline covariates, those not receiving renal replacement therapy with a serum creatinine greater than 175μmol/L had a significantly worse risk of graft failure than those receiving renal replacement therapy.Conclusion
In patients being transplanted for acute liver failure, use of renal replacement therapy is a strong predictor of patient death and graft loss. Those not receiving renal replacement therapy with an elevated serum creatinine may be at greater risk of early graft failure than those receiving renal replacement therapy. A low threshold for instituting renal replacement therapy may therefore be beneficial. 相似文献12.
Objective
Osteoarthritis pain has become a leading cause of decreased productivity and work disability in older workers, a major concern in primary care. How osteoarthritis pain leads to decreased productivity at work is unclear; the aim of this study was to elucidate causal mechanisms and thus identify potential opportunities for intervention.Methods
Population-based prospective cohort study of primary care consulters with osteoarthritis. Path analysis was used to test proposed mechanisms by examining the association between pain at baseline, and onset of work productivity loss at three years for mediation by physical limitation, depression, poor sleep and poor coping mechanisms.Results
High pain intensity was associated with onset of work productivity loss (Adjusted Odds Ratio 2.5; 95%CI 1.3, 4.8). About half of the effect of pain on work productivity was a direct effect, and half was mediated by the impact of pain on physical function. Depression, poor sleep quality and poor coping did not mediate the association between high pain intensity and onset of work productivity loss.Conclusions
As pain is a major cause of work productivity loss, results suggest that decreasing pain should be a major focus. However, successfully improving function may have an indirect effect by decreasing the impact of pain on work productivity, especially important as significant pain reduction is often difficult to achieve. Although depression, sleep problems, and coping strategies may be directly related to work productivity loss, addressing these issues may not have much effect on the significant impact of pain on work productivity. 相似文献13.
Dhayana Dallmeier Michael J. Pencina Iris Rajman Wolfgang Koenig Dietrich Rothenbacher Hermann Brenner 《PloS one》2015,10(1)
Objective
To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease.Methods
NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline.Results
Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33–2.05] vs. HR 1.41 [95% CI 1.12–1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002–0.194] compared to NRI of 0.047 [95% CI −0.0004–0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12–1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10–5.95] compared to those with the highest 12-months reduction.Conclusions
Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. 相似文献14.
Background
Several studies have assessed the effects of computer-based cognitive programs (CCP) in the management of age-related cognitive decline, but the role of CCP remains controversial. Therefore, this systematic review evaluated the evidence on the efficacy of CCP for age-related cognitive decline in healthy older adults.Methods
Six electronic databases (through October 2014) were searched. The risk of bias was assessed using the Cochrane Collaboration tool. The standardized mean difference (SMD) and 95% confidence intervals (CI) of a random-effects model were calculated. The heterogeneity was assessed using the Cochran Q statistic and quantified with the I2 index.Results
Twelve studies were included in the current review and were considered as moderate to high methodological quality. The aggregated results indicate that CCP improves memory performance (SMD, 0.31; 95% CI 0.16 to 0.45; p < 0.0001) and processing speed (SMD, 0.50; 95% CI 0.14 to 0.87; p = 0.007) but not executive function (SMD, -0.12; 95% CI -0.33 to 0.09; p = 0.27). Furthermore, there were long-term gains in memory performance (SMD, 0.59; 95% CI 0.13 to 1.05; p = 0.01).Conclusion
CCP may be a valid complementary and alternative therapy for age-related cognitive decline, especially for memory performance and processing speed. However, more studies with longer follow-ups are warranted to confirm the current findings. 相似文献15.
Adam Csordas Fabian Nietlispach Philipp Schuetz Andreas Huber Beat Müller Francesco Maisano Maurizio Taramasso Igal Moarof Slayman Obeid Barbara E. St?hli Martin Cahenzly Ronald K. Binder Christoph Liebetrau Helge M?llmann Won-Keun Kim Christian Hamm Thomas F. Lüscher 《PloS one》2015,10(12)
Background
Conventional surgical risk scores lack accuracy in risk stratification of patients undergoing transcatheter aortic valve replacement (TAVR).Elevated levels of midregional proadrenomedullin (MR-proADM) levels are associated with adverse outcome not only in patients with manifest chronic disease states, but also in the general population.Objectives
We investigated the predictive value of MR-proADM for mortality in an unselected contemporary TAVR population.Methods
We prospectively included 153 patients suffering from severe aortic stenosis who underwent TAVR from September 2013 to August 2014. This population was compared to an external validation cohort of 205 patients with severe aortic stenosis undergoing TAVR. The primary endpoint was all cause mortality.Results
During a median follow-up of 258 days, 17 out of 153 patients who underwent TAVR died (11%). Patients with MR-proADM levels above the 75th percentile (≥ 1.3 nmol/l) had higher mortality (31% vs. 4%, HR 8.9, 95% CI 3.0–26.0, P < 0.01), whereas patients with EuroSCORE II scores above the 75th percentile (> 6.8) only showed a trend towards higher mortality (18% vs. 9%, HR 2.1, 95% CI 0.8–5.6, P = 0.13). The Harrell’s C-statistic was 0.58 (95% CI 0.45–0.82) for the EuroSCORE II, and consideration of baseline MR-proADM levels significantly improved discrimination (AUC = 0.84, 95% CI 0.71–0.92, P = 0.01). In bivariate analysis adjusted for EuroSCORE II, MR-proADM levels ≥1.3 nmol/l persisted as an independent predictor of mortality (HR 9.9, 95% CI (3.1–31.3), P <0.01) and improved the model’s net reclassification index (0.89, 95% CI (0.28–1.59). These results were confirmed in the independent validation cohort.Conclusions
Our study identified MR-proADM as a novel predictor of mortality in patients undergoing TAVR. In the future, MR-proADM should be added to the commonly used EuroSCORE II for better risk stratification of patients suffering from severe aortic stenosis. 相似文献16.
Karlijn J. Barnhoorn J. Bart Staal Robert T. M. van Dongen Jan Paul M. Fr?lke Frank P. Klomp Henk van de Meent Han Samwel Maria W. G. Nijhuis-van der Sanden 《PloS one》2015,10(4)
Objective
To investigate whether pain-related fears are mediators for reducing disability and pain in patients with Complex Regional Pain Syndrome type 1 when treating with Pain Exposure Physical Therapy.Design
An explorative secondary analysis of a randomised controlled trial.Participants
Fifty-six patients with Complex Regional Pain Syndrome type 1.Interventions
The experimental group received Pain Exposure Physical Therapy in a maximum of five treatment sessions; the control group received conventional treatment following the Dutch multidisciplinary guideline.Outcome measures
Levels of disability, pain, and pain-related fears (fear-avoidance beliefs, pain catastrophizing, and kinesiophobia) were measured at baseline and after 3, 6, and 9 months follow-up.Results
The experimental group had a significantly larger decrease in disability of 7.77 points (95% CI 1.09 to 14.45) and in pain of 1.83 points (95% CI 0.44 to 3.23) over nine months than the control group. The potential mediators pain-related fears decreased significantly in both groups, but there were no significant differences between groups, which indicated that there was no mediation.Conclusion
The reduction of pain-related fears was comparable in both groups. We found no indication that pain-related fears mediate the larger reduction of disability and pain in patients with Complex Regional Pain Syndrome type 1 treated with Pain Exposure Physical Therapy compared to conventional treatment.Trial registration
International Clinical Trials Registry NCT00817128 相似文献17.
Sung Han Kim Sohee Kim Byung-Ho Nam Sang Eun Lee Choung Soo Kim Ill Young Seo Tae Nam Kim Sung-Hoo Hong Tae Gyun Kwon Seong Il Seo Kwan Joong Joo Kanghyon Song Cheol Kwak Jinsoo Chung 《PloS one》2015,10(8)
Objective
To evaluate the efficacy and safety of sorafenib for Korean patients with metastatic renal cell carcinoma (mRCC).Methods
A total of 177 mRCC patients using sorafenib as first- (N = 116), second- (N = 43), and third-line (N = 18) therapies were enrolled from 11 Korean centers between 2006 and 2012. The patient characteristics, therapy duration, tumor response, disease control rate, and tolerability were assessed at baseline and at routine follow-ups, and the progression-free survival (PFS) and overall survival (OS) times and rates were analyzed.Results
Among all patients, 18 (10.2%) stopped sorafenib treatment for a median of 1.7 weeks, including 15 (8.5%) who discontinued the drug, while 40 (22.6%) and 12 (6.8%) patients required dose reductions and drug interruptions, respectively. Severe adverse events (AEs) or poor compliance was observed in 64 (36.2%) patients, with 118 (7.4%) ≥grade 3 AEs. During the treatment, one myocardial infarction was observed. The number of ≥grade 3 AEs in the first-line sorafenib group was 71 (6.8% of the total 1048 AEs). During a median follow-up of 17.2 months, the radiologically confirmed best objective response rate, disease control rate, median PFS, and median OS were 22.0%, 53.0%, 6.4 months (95% confidence interval [CI], 5.2–8.9), and 32.6 months (95% CI, 27.3–63.8) for the total 177 sorafenib-treated patients, respectively, and 23.2%, 56.0%, 7.4 months (95% CI, 5.5–10.5), and not reached yet (95% CI, 1.0–31.1) for the first-line sorafenib group, respectively.Conclusions
Sorafenib produced tolerable safety, with a ≥grade 3 AE rate of 7.4% and an acceptable disease control rate (53.0%) in Korean mRCC patients. 相似文献18.
Objective
Tiredness, low energy, and listlessness are common symptoms to be associated with depression. The question remains to what extent these symptoms influence the effects of fatigue on sustained performance tasks, such as impaired task engagement and performance. Based on earlier findings, it was hypothesized that dysphoric (i.e., mildly depressed) individuals, compared to healthy controls, would display earlier fatigue onset and more severe fatigue effects on task engagement and performance during a cognitive task.Methods
Sixty-one dysphoric and twenty-one non-dysphoric control participants were compared during one hour of continuous performance on a 2-back task. During the task subjective fatigue, subjective engagement, objective task performance, baseline pupil diameter and stimulus-evoked pupil dilation were measured.Results
While we found that the dysphoric group reported relatively higher subjective fatigue than the healthy control group at the start of the experiment, we did not find any other divergent fatigue effects during the experimental task.Conclusion
One explanation for the absence of divergent effect is that dysphoria may not have such a profound impact on available cognitive resources, like attention, as initially thought. Based on the results of the present study, we conclude that dysphoria is not necessarily an increased risk factor for impaired sustained performance on cognitive tasks that may induce mental fatigue. 相似文献19.
Background
This study aimed to evaluate initial hyperleukocytosis and neutrophilia as prognostic indicators in patients with nasopharyngeal carcinoma.Methods
A retrospective analysis of 5,854 patients identified from a cohort of 6,035 patients diagnosed with nasopharyngeal carcinoma was performed with initial hyperleukocytosis and neutrophilia analyzed as prognostic factors. Multivariate Cox proportional hazards analyses were applied.Results
Hyperleukocytosis was observed in 508 patients (8.7%). Multivariate analysis showed that initial hyperleukocytosis was an independent predictor of death (HR 1.40, 95%CI 1.15–1.70, p = 0.001), progression (HR 1.25, 95%CI 1.06–1.47, p = 0.007) and, marginally, distant metastasis (HR 1.21, 95%CI 0.97–1.52, p = 0.088). Neutrophilia was also an independent predictor of death (HR 1.46, 95%CI 1.18–1.81, p = 0.001), progression (HR 1.31, 95%CI 1.10–1.56, p = 0.003), and distant metastasis (HR 1.29, 95%CI 1.02–1.65, p = 0.036), after adjusting for prognostic factors and excluding hyperleukocytosis.Conclusion
Initial hyperleukocytosis and neutrophilia were independent, poor prognostic factors and may be convenient and useful biological markers for survival of patients with nasopharyngeal carcinoma. 相似文献20.
Anna-Lotta Irewall Joachim ?gren Lisa Bergstr?m Katarina Laurell Lars S?derstr?m Thomas Mooe 《PloS one》2015,10(10)