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1.
Background
The purpose of this study was to characterise the histopathological changes in the infrapatellar fat pad (IPFP) in the early stage of patellofemoral osteoarthritis (PFOA).Methods
Sixty-four New Zealand white rabbits were randomly divided into experimental (n?=?24), sham (n?=?16), and control groups (n?=?24). In the experimental group, denoted as the patellar ligament uneven shortening group (US group), the patellar ligament (PL) was folded eight millimetres and sutured. After eight weeks, all animals were euthanised, and magnetic resonance imaging (MRI) evaluation, wet IPFP weight measurement, and histopathological and immunohistochemistry analysis were performed to analyse the histopathological changes in the IPFPs.Results
The maximum cross-sectional area (CSA) of the IPFPs in the sagittal position of MRI in the control group, sham group, and US group were 45.50?±?7.19?mm2, 45.88?±?6.60?mm2 (vs. control group, P?=?0.907), and 53.83?±?8.24?mm2 (vs. control group, P?=?0.015; vs. sham group, P?=?0.035), respectively. The MRI intensity of the IPFPs in the control group, sham group, and US group were 115.53?±?28.85, 108.53?±?26.73 (vs. control group, P?=?0.589), and 154.52?±?18.48 (vs. control group, P?=?0.002; vs. sham group, P?=?0.002), respectively. The wet weight of the IPFPs in the control group, sham group, and US group were 0.32?±?0.05?g, 0.32?±?0.04?g (vs. control group, P?=?0.895), and 0.38?±?0.06?g (vs. control group, P?=?0.017; vs. sham group, P?=?0.033), respectively. The Osteoarthritis Research Society International (OARSI) scores of the IPFPs in the US group were 6.00?±?1.91, which was higher than the scores of 2.50?±?2.02 (P?<?0.001) in the control group and of 2.75?±?1.67 (P?=?0.001) in the sham group.Conclusions
The histopathological changes of the IPFPs as determined via MRI and microscopic structure appeared to occur much earlier than cartilage damage in PFOA. Furthermore, detecting and treating the IPFP changes may offer aid in the diagnosis and treatment of PFOA. 相似文献2.
Matthias Steinwachs Nicola Cavalcanti Santhosh Mauuva Venkatesh Reddy Clement Werner Daniel Tschopp Hema N. Choudur 《The Knee》2019,26(1):174-184
Background
CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee.Methods
A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich). Study outcomes included reoperations, infections, allergic reactions, pain, swelling, range of motion, and tissue quality and quantity. Ethics approval was obtained from the local ethics committee on 05/09/2017 (Basec. Nr: 2017-01441).Results
A total of 91 participants, with 93 treated lesions, consenting to chart review were included. No participants required reoperation due to complications on the index lesion. Fifteen participants had second-look surgery on the index knee for other reasons, allowing for visual confirmation of cartilage repair. No study participants experienced a post-surgical infection or suffered an allergic reaction. No significant changes in range of motion or T2 values were observed from pre-treatment to post-treatment follow-up. However, significant decreases were found in pain (P?<?0.001) and swelling (P?<?0.001), along with significant increases in MOCART II scores (P?<?0.001). Similar results were found in a subgroup of patients with patellar lesions.Conclusions
Patients treated with CARGEL experienced few postoperative complications and reported promising reductions in pain and swelling after treatment.Level of evidence
IV 相似文献3.
Shun Wang Jun Jiang Chao Zhang Xuhua Zhang Chuanxin Wang 《Pathology, research and practice》2019,215(4):779-783
Background
LincRNA-p21 is involved in the initiation and progression of many human diseases. We aimed to investigate the expression of LincRNA-p21 in different types of liver diseases.Methods
Serum from patients with primary liver diseases (chronic HBV or HCV infection, hepatitis B virus-related cirrhosis, hepatitis B virus-related HCC, non-HBV/HCV-related HCC, alcoholic liver disease) and HBV negative liver metastatic cancer and control healthy individuals was collected and serum lincRNA-p21 levels were determined by RT-qPCR. Clinicopathological characteristics of the patients were also recorded.Results
Serum lincRNA-p21 levels in patients with chronic HBV infection, hepatitis B cirrhosis, hepatitis B virus-related HCC, chronic hepatitis B virus infection, non-HBV/HCV-related HCC, and alcoholic liver disease were higher than those in the control individuals (P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001, P?<?0.001 and P?=?0.002, respectively). The serum lincRNA-p21 level was not significantly different between patients with HBV negative liver metastatic cancer and the normal control (P?=?0.80). LincRNA-p21 level was negatively correlated with HBV DNA (P?=?0.02), ALT (P?=?0.01) and AST (P?=?0.01) in patients with liver disease, but not correlated with gender (P?=?0.24), age (P?=?0.11) and AFP level (P?=?0.84). Serum lincRNA-p21 in hepatocellular carcinoma patients was higher than that in liver metastatic cancer patients (P?<?0.001).Conclusion
Serum lincRNA-p21 may serve as a potential biomarker for liver cell damage in patients with hepatitis virus infection, hepatitis B cirrhosis, HBV-related HCC and alcoholic liver disease. 相似文献4.
Kasper Skriver Gravesen Thomas Kallemose Lars Blønd Anders Troelsen Kristoffer Weisskirchner Barfod 《The Knee》2019,26(1):20-25
Background
To evaluate the trends in treatment of patellar dislocation in the Danish population as a whole from 1996 to 2014 and evaluate the incidence of persistent morbidity after Medial Patellofemoral Ligament Reconstruction (MPFL-R).Methods
This epidemiological study was performed by retrospectively searching the Danish National Patients Registry from 1996 to 2014. The study investigated the trends in surgery performed on patients with patellar dislocations and the risk of persistent patellar morbidity (PPM) with an eight-year follow-up. PPM was defined as a new patella-related contact to the healthcare system more than a year after surgery.Results
From 1996 to 2014, a total of 1956 MPFL-R were performed in Denmark. In 2014, MPFL-R constituted 75% of all patella-stabilizing surgery and was performed on almost 10% of patients with patellar dislocation. The mean risk of PPM eight years after surgery was 20.9% (18.3–23.4%), and young patients aged 10–17 showed the highest risk of 28.9% (23.7–33.7%).The risk of PPM over time was significantly higher for other patella-stabilizing surgery (33.8%) and patients receiving conservative treatment (29.4%) compared to MPFL-R.Conclusions
A rapid rise in the use of MPFL-R was found from 2005 to 2014, constituting 75% of all patella-stabilizing surgery in 2014. The overall risk of persistent patellar morbidity within eight years after MPFL-R was 21%. MPFL-R was found to give a significantly lower risk of PPM over time as compared to other patella-stabilizing surgery and conservative treatment. 相似文献5.
Michael J. Dan James Crowley David Broe Mervyn Cross Chris Tan William R. Walsh 《The Knee》2019,26(1):115-123
Background
Patella tendinopathy is an overuse condition. Pathogenesis and identification of intrinsic risk factors have largely eluded the orthopaedic world. The cranial cruciate ligament (CrCL) in dogs is the equivalent to the human anterior cruciate ligament (ACL). We report the effect of two canine proximal tibial osteotomy procedures in the veterinary literature on patella tendon moment arm and describe the biomechanical rationale for a tibial tubercle osteotomy for treatment of patella tendinopathy in the human.Methods
A literature review of studies reporting clinical complications of TTA and TPLO to form an observational animal cohort study in dogs.Results
The veterinary literature reports an overall clinical complication rate of up to 61% for TTA and up to 50% for TPLO respectively. Complications associated with the extensor mechanism of the knee are < 1% for TTA compared to 1.9–19% for TPLO. Radiographic thickening of the patella tendon and tendinopathy is seen in one to 80% of TPLO cases. The TPLO decreases the moment arm of the extensor mechanism meaning increased force is required in the patella tendon to achieve the same torque when compared to the TTA which increases the efficiency of the extensor mechanism. This difference may account, in part, for the post-operative complications reported to the patella and patella tendon following TPLO.Conclusion
This observational animal cohort study demonstrates a biomechanical rationale for investigating diagnostic and potential treatment options, including a tibial tubercle osteotomy, for patella tendinopathy in humans based on this principle. 相似文献6.
Alireza Motealleh Amin Kordi Yoosefinejad Mahdieh Ghoddosi Negar Azhdari Soraya Pirouzi 《The Knee》2019,26(1):26-32
Background
Patellofemoral pain syndrome (PFPS) is a common orthopedic problem with a high prevalence among young women. Patients with PFPS have altered trunk muscle activity, impaired postural control and greater displacement of the center of pressure (COP) while standing. Training in unstable sitting, by putting more emphasis on trunk sensory receptors, may improve trunk proprioception by minimizing the role of the lower extremities. The aim of this study was to compare trunk postural control in healthy persons and in patients with PFPS.Methods
Twenty-one women diagnosed with PFPS and 21 healthy women volunteered to participate in this cross-sectional study. The participants were asked to maintain trunk postural balance on an unstable sitting device, and COP indices of trunk postural control were compared between groups.Results
All COP indices (e.g., mean anterior–posterior and lateral COP displacement, mean COP velocity and mean area of COP displacement) were significantly increased in participants with PFPS in comparison to healthy controls (P?<?0.001). The effect sizes of all the indices were greater than 0.80.Conclusions
Trunk postural control is impaired in patients with PFPS, and this finding has clinical implications for rehabilitation in patients with PFPS. Adding seated postural control training to conventional physical therapy management in patients with PFPS may have beneficial effects by emphasizing trunk proprioception while minimizing the role of the lower extremities. 相似文献7.
8.
Karen A. Lindsley 《Patient education and counseling》2019,102(5):944-951
Objective
To develop a patient-centered informed consent and assessment tool written at a 6th grade-level that is multimodal, affordable, transportable, and readily modifiable for protocol updates.Methods
This quality improvement initiative was performed in two phases on an actively-recruiting study at a pediatric diabetes clinic. In phase I, 38 volunteers underwent the standard-paper consent process, a comprehension assessment and provided feedback. Using feedback and the structure of the Plan-Do-Study-Act cycle a multimodal consent and assessment were developed. In phase II, volunteers were randomized to the standard (n?=?25) or the multimodal consent (n?=?25) and all completed the same comprehension assessment via touch-screen tablet. Primary outcomes were comparison of the individual and total comprehension assessment scores.Results
Total comprehension scores were higher in the multimodal versus the standard consent group (p?<? 0.001) and on the elements of benefits (p?<? 0.001), risks (p?<? 0.001), volunteerism (p?<? 0.012), results (p?<? 0.001), confidentiality (p?<? 0.004) and privacy (p < 0.001).Conclusion
A multimodal consent and assessment presented sequentially on a touch-screen tablet were patient-centered enhancements to standard consent.Practice implications
Multimodal standardization of delivery with improved readability may strengthen the informed consent process. 相似文献9.
Lifeng Yu Lin Zhao Zhen Jia Jia Bi Qian Wei Xinyue Song Longyang Jiang Shu Lin Minjie Wei 《Pathology, research and practice》2019,215(3):490-498
Background
MFG-E8(Milk fat globule-EGF factor 8), a secreted glycoprotein, plays an exceptional role in various diseases. MFG-E8 overexpression is found in a variety of cancers. However, it remains unclear whether MFG-E8 overexpression is associated with the clinicopathological characteristics and prognosis of human breast cancer.Materials and methods
In this study, we detected the expression and localization of MFG-E8 protein in breast cancer and cancer-adjacent tissues using immunohistochemical staining, Western blot analysis and immunofluorescence. We analyzed the association between MFG-E8 expression and clinical characteristics and outcomes of breast cancer patients with different HR and HER2 statuses.Results
Our results confirmed that MFG-E8 expression increased significantly in breast cancer compared with cancer-adjacent tissues by immunohistochemical staining (P?<? 0.001). Similarly, the Western blot results further confirmed the increased expression of MFG-E8 in breast cancer compared with cancer-adjacent tissues (P?=? 0.001). Immunofluorescence staining showed that MFG-E8 was mainly localized in the cytoplasm and membrane of tumor cells, consistent with the immunohistochemical staining results. The high expression levels of MFG-E8 showed a greater association with lymph node metastasis, TNM stage and histological grade (P < 0.001). Moreover, high MFG-E8 expression was related to a shortened overall survival (OS) (P?<? 0.001) and disease-free survival (DFS) (P?<? 0.001). Bioinformatics analysis with a Kaplan-Meier plotter also demonstrated a strong association of MFG-E8 mRNA overexpression with a short OS and DFS compared with low MFG-E8 expression (P?=? 0.040, P?=? 0.005).Conclusions
Our findings indicate that MFG-E8 may be a potential marker for poor prognosis and survival in breast cancer. 相似文献10.
Christi A. Patten Kathryn R. Koller Christie A. Flanagan Vanessa Y. Hiratsuka Christine A. Hughes Abbie W. Wolfe Paul A. Decker Kristin Fruth Tabetha A. Brockman Molly Korpela Diana Gamez Carrie Bronars Neil J. Murphy Dorothy Hatsukami Neal L. Benowitz Timothy K. Thomas 《Patient education and counseling》2019,102(3):528-535
Objective
There is some evidence for biomarker feedback when combined with cessation counseling for reducing smoking in pregnancy. This randomized controlled pilot study evaluated feasibility and potential efficacy of a social-cognitive theory (SCT)-based biomarker feedback intervention among pregnant Alaska Native (AN) smokers.Methods
Participants were randomly assigned to receive three study calls (10–20?min each): (1) biomarker feedback intervention (n?=?30) including personalized cotinine results and feedback on their baby’s likely exposure to carcinogen metabolite NNAL, or (2) contact control usual care condition based on the 5As (n?=?30). Assessments were conducted at baseline, post-treatment, and delivery.Results
High rates of treatment compliance, study retention, and treatment acceptability were observed in both groups. 7-day point prevalence smoking abstinence rates at delivery verified with urinary cotinine were the same in both study groups (20% intent-to-treat analysis, 26% per-protocol). SCT-based measures did not change differentially from baseline by study group.Conclusion
This trial supports the feasibility and acceptability of providing biomarker feedback within the clinical care delivery system, but the intervention did not promote increased smoking cessation during pregnancy compared to usual care.Practice Implications
Efforts are needed to promote the usual care and to develop alternative biomarker feedback messaging for pregnant AN women. 相似文献11.
Salman Nazary-Moghadam Mahyar Salavati Ali Esteki Behnam Akhbari Sohrab Keyhani Afsaneh Zeinalzadeh 《The Knee》2019,26(1):88-96
Background
Several investigations have studied gait variability of individuals with anterior cruciate ligament (ACL) deficiency; however, the effect of dual-tasking on the gait variability of these individuals remained unclear. The aim of the present study was to determine the effect of gait speed and dual-tasking on knee flexion–extension variability in subjects with and without ACL deficiency.Methods
The knee flexion–extension Lyapunov exponent (LyE) was measured in 22 ACL-deficient (Mean±SD) (25.95?±?4.69?years) and 22 healthy subjects (24.18?±?3.32?years). They walked at three levels of gait speed in isolation or concurrently with a cognitive task.Results
Repeated-measure analyses of variance (ANOVAs) demonstrated that the interaction of group by gait speed was statistically significant. As the gait speed increased from low to high, the knee flexion–extension LyE significantly decreased for the subjects with ACL deficiency (effect size: 0.57, P?=?0.01). The interaction of group by cognitive load was not statistically significant (P?=?0.07). In addition, the ACL-deficient subjects had statistically slower reaction times than healthy subjects during the dual-task compared with the single-task condition.Conclusions
The ACL-deficient and healthy individuals had a tendency to maintain safe gait. It seems that the ACL-deficient subjects sacrificed the cognitive task more than the healthy individuals to pay more attention toward gait. Additionally, it seems that the gait speed was more challenging than cognitive load on the stride-to-stride variability in the individuals with ACL deficiency. 相似文献12.
Background
The purpose of this retrospective cohort study was to investigate the influence of parameters of malalignment on knee function 5?years post TKA and, additionally, to explore alterations in patellar height after TKA.Methods
All 661 patients undergoing TKA between 2010 and 2011 were considered for inclusion. Preoperative and 1-year postoperative short-leg radiographs were assessed for malalignment parameters: coronal tibial angle (cTA), sagittal tibial angle (sTA), femoral flexion angle (FFA) and mediolateral tibial mismatch. Patellar height was measured using the modified Insall-Salvati ratio. We determined improvements in knee function utilizing the Knee Society Score (Function score, KSS-F), Oxford Knee Score (OKS) and Algofunctional index (AI). Influences of malalignment parameters were analyzed univariate and selected (p?<?0.10) for multivariate linear regression analysis. Inter-observer reproducibility was assessed by test–retest analysis of 30 randomly selected radiographs and calculation of an intra-class correlation coefficient (ICC) for all radiographic parameters.Results
Three-hundred and four patients were included. Multivariate regression showed degrees of cTA malalignment to be significantly associated with only the KSS-F (β?=?? 3.52). Correction of coronal deformity was stronger associated with knee function (KSS-F β?=?2.81; AI β?=?? 0.36). Patellar height was significantly reduced after TKA (1.51 vs 1.44). Decrease of patellar height was weakly associated with the OKS (β?=?10.69). ICC scores were: cTA 0.81, sTA 0.57, IS 0.72, FFA 0.75.Conclusion
Postoperative coronal tibial plate alignment and correction of preoperative coronal deformity are associated with improved knee function 5?years post TKA. Decrease in patellar height was weakly associated with knee function. Short-leg radiography can be a sufficient screening tool for prosthesis alignment. 相似文献13.
Objective
Information overload can negatively impact positive health behaviors such as cancer screening. The 8-item Cancer Information Overload (CIO) scale appears to be the only validated measure of health-related information overload. The present study assesses the validity of the CIO scale when modified for use in patients with atrial fibrillation (AF) residing in Australia.Methods
We conducted a secondary analysis of data from a study of adult Australian patients with AF (N?=?386) in which a modified version of the CIO scale was used. In the present study, we examined the construct (convergent and divergent) validity and performed an exploratory factor analysis for the modified scale.Results
All items on the modified-CIO scale appear to load onto a single factor. As predicted, higher education levels (rs=-.24, p?<?.001) and higher oral anticoagulant knowledge (rs=-.17, p?=?.001) were significantly associated with lower modified-CIO scores; no other demographic characteristics were significantly associated with CIO scores.Conclusion
When adapted to the AF context, the modified-CIO scale appears to be a valid measure of information overload.Practice Implications
A valid scale is required to measure information overload accurately. Knowledge of the interplay between information overload and various health behaviors help focus future efforts to support patient empowerment. 相似文献14.
M.J. Maze K.J. Sharples K.J. Allan M.P. Rubach J.A. Crump 《Clinical microbiology and infection》2019,21(4):437-444
Background
Leptospirosis is under-diagnosed by clinicians in many high-incidence countries, because reference diagnostic tests are largely unavailable. Lateral flow assays (LFA) that use antigen derived from heat-treated whole cell Leptospira biflexa serovar Patoc have the potential to improve leptospirosis diagnosis in resource-limited settings.Objectives
We sought to summarize estimates of sensitivity and specificity of LFA by conducting a systematic review and meta-analysis of evaluations of the accuracy of LFA to diagnose human leptospirosis.Data sources
On 4 July 2017 we searched three medical databases.Study eligibility criteriaArticles were included if they were a study of LFA sensitivity and specificity.Participants
Patients with suspected leptospirosis.Interventions
Nil.Methods
For included articles, we assessed study quality, characteristics of participants and diagnostic testing methods. We estimated sensitivity and specificity for each study against the study-defined case definition as the reference standard, and performed a meta-analysis using a random-effects bivariate model.Results
Our search identified 225 unique reports, of which we included nine (4%) published reports containing 11 studies. We classified one (9%) study as high quality. Nine (82%) studies used reference tests with considerable risk of misclassification. Our pooled estimates of sensitivity and specificity were 79% (95% CI 70%–86%) and 92% (95% CI 85%–96%), respectively.Conclusions
As the evidence base for determining the accuracy of LFA is small and at risk of bias, pooled estimates of sensitivity and specificity should be interpreted with caution. Further studies should use either reference tests with high sensitivity and specificity or statistical techniques that account for an imperfect reference standard. 相似文献15.
Objectives
To investigate the effects of various diets on structure and function of the bladder in both normal and obstructed bladders of male Wistar rats.Methods
Sham-operated rats and rats with experimentally-induced bladder outlet obstruction (BOO) were fed with standard rats’ feed (control), High-carbohydrate (HCD), High-fat (HFD) and High-protein (HPD) diets. Feeding was continued for 4 weeks after BOO surgery. Bladder weight, detrusor contractility, Rho-Kinase (ROK) and Myosin Light Chain Kinase (MLCK) expressions were determined using standard methods.Results
In comparison with control, bladder weight was increased in HFD (164?±?9?mg), BOO (437?±?21?mg), HFD-BOO (523?±?19?mg) and HPD-BOO (268?±?18?mg). Detrusor contractility was reduced in BOO and HFD-BOO. The ROK- I and II expressions were high in HCD-BOO and low in HPD-BOO but ROK-I was also elevated in BOO. However, MLCK increased only in HCD-BOO.Conclusion
The results of the study reveal that diets with varying macronutrient compositions have variable effects on the bladder with and without obstruction. High-fat diets especially, affect detrusor morphology and function in both obstructed and unobstructed bladders. 相似文献16.
Annemie Smeets Bart Malfait Bart Dingenen Mark A. Robinson Jos Vanrenterghem Koen Peers Stefaan Nijs Styn Vereecken Filip Staes Sabine Verschueren 《The Knee》2019,26(1):40-51
Background
There is limited evidence on neuromuscular risk factors for anterior cruciate ligament (ACL) injuries, with most work mainly focusing on hamstrings and quadriceps muscle strength. This prospective pilot study explored if neuromuscular activation patterns of the quadriceps and hamstrings during a drop vertical jump influence ACL injury risk.Methods
Forty-six female athletes performed a drop vertical jump at baseline. Injuries were monitored throughout a one-year follow-up. Neuromuscular activation patterns of the vastus medialis, vastus lateralis, hamstrings medialis and hamstrings lateralis, and selected landing kinematic and kinetic profiles (knee flexion, knee abduction and hip flexion angles, and knee abduction moments), were compared between athletes who sustained a non-contact ACL injury and those who remained injury free. Electromyogram vector fields were created to represent neuromuscular activation patterns of muscle pairs around the knee joint rather than only considering individual muscle activations, and compared using Statistical Parametric Mapping.Results
Four athletes sustained an ACL injury. Significantly greater {hamstrings medials, hamstrings lateralis}, {vastus lateralis, hamstrings lateralis} and {hamstrings lateralis, vastus medialis} activations, mainly due to greater hamstrings lateralis activation, were found in the injured group around peak loading and just before take-off (P?<?0.001). No group differences were found in knee flexion, knee abduction and hip flexion angles, or knee abduction moments.Conclusions
This pilot study revealed initial evidence that athletes already showed altered neuromuscular activation patterns prior to sustaining an ACL injury, namely increased lateral and posterior muscle activations. 相似文献17.
Nae Yu Kim Jung-Soo Pyo Dong-Wook Kang Seung-Min Yoo 《Pathology, research and practice》2019,215(3):580-585
Objective
The aim of this study was to elucidate the clinicopathological significance and prognostic role of loss of claudin-1 in colorectal cancer (CRC).Methods
The correlations between claudin-1 expression and clinicopathological characteristics, including survival rates, were assessed using immunohistochemistry on 260 archival, paraffin-embedded CRC tissues. In addition, the correlations between cludin-1 and nuclear factor-kappa B (NF-κB), epithelial-mesenchymal transition markers and tumor-infiltrating lymphocytes were investigated.Results
Claudin-1 expression was markedly lost in 42.7% of the 260 CRCs analyzed. Loss of claudin-1 expression significantly correlated with larger tumor size, vascular invasion, higher pT stage, and high metastatic lymph node ratio. In addition, loss of claudin-1 expression significantly correlated with NF-κB activation (P?<?0.001), high SNAI (P?<?0.001), and low E-cadherin (P?<?0.001) expressions. Patients with high immunoscores showed significantly lower rates of claudin-1 expression loss (P?=?0.020). In detail, loss of claudin-1 expression were frequently found in CRCs low CD3- and CD8-positive lymphocytes. There were significant correlations between claudin-1 expression loss and poor overall and recurrence-free survivals (P?<?0.001 and P?<?0.001, respectively).Conclusion
Taken together, our results suggest that the loss of claudin-1 expression significantly correlates with aggressive tumor behaviors, high SNAI expression, lower immunoscore, and poor prognoses. 相似文献18.
Claudia Martinez-Tapia Florence Canoui-Poitrine Philippe Caillet Sylvie Bastuji-Garin Christophe Tournigand Elias Assaf Gwénaëlle Varnier Frederic Pamoukdjian Etienne Brain Florence Rollot-Trad Marie Laurent Elena Paillaud 《Patient education and counseling》2019,102(3):429-435
Objective
To compare the preferences of older (≥70 years old) versus younger (<70 years old) cancer patients regarding surrogate designation and decision making.Methods
A cross-sectional survey. Patient characteristics and information about surrogacy and involvement in decision making were collected. Associations between patient characteristics and preferences were examined.Results
The study included 130 patients aged ≥70 years (mean age 80 years) and 102 patients aged <70 years (mean age 55) and. Factors independently associated with surrogate knowledge (66%): younger age, more children living nearby, high income; factors associated with having already designated a surrogate (62%): younger age, decreased number of daily medications; factors associated with designating a surrogate after questionnaire administration (40%): low education, metastasis. Patients requiring an informed consent for any intervention was associated with older age (adjusted OR [aOR]per year?=?1.04[95% confidence interval 1.00–1.08]), not living alone (aOR?=?2.52[1.00–6.36]), and having children (aOR?=?4.49[1.13–17.81]).Conclusion
All cancer patients, wanted to be fully informed and 72% wanted to be involved in medical decisions. Preferences for decision control vary between age groups, depending on family members’ presence and living alone.Practice implications
Sharing complete and clear information should be an important key in the process of cancer patients’ care, regardless of patient age. 相似文献19.
David Latz Erik Schiffner Johannes Schneppendahl Konstantin Klein Lisa Oezel Lars Fabian Seiler Pascal Jungbluth Robert Alexander Kaufmann Joachim Windolf Sebastian Viktor Gehrmann 《The Knee》2019,26(1):33-39
Background
One of the most important activities of daily living is operating a motor vehicle. With increasing age the prevalence of musculoskeletal disorders such as knee osteoarthritis may interfere with an individual's ability to do so safely. Physicians are tasked with determining a patient's ability to drive and yet the necessary joint range of motion required for driving a car has not been characterized.Methods
The range of motion of the right and left knees was recorded using electrogoniometers in 20 healthy subjects while driving a car on three route types (a) city streets, b) country roads and c) highways). Special emphasis was placed on the left knee associated with changing a gear.Results
The range of motion while driving is 40–80° for the right and 20–85° flexion for the left knee. A significant difference was noted for each side (p?<?0.01) with a higher flexion occurring in the left knee (p?<?0.01). The average position of the knee while changing a gear (beginning, maximum, ending) was: right: 55°±10°, 62°±10°, 53°±10°; left: 67°±7°, 39°±8°, 66°±8° (mean flexion±standard deviation).Conclusion
This study characterized the knee range of motion that occurs while driving a car. Our data suggests that common driving activities such as accelerating a vehicle or braking can be achieved with the right knee through a limited range of motion. The greater range of motion and the higher flexion of the left knee are mainly attributed to the gear changing. The present data may benefit physicians in their evaluation of driving capability. 相似文献20.
Binnari Kim Yun-jeong Jang Sujin Park Jung-Il Lee Hong Kwan Kim Joungho Han 《Pathology, research and practice》2019,215(4):807-815