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1.
Purpose
Scholastic competence is a predictor of future achievement, yet there is little research about health factors that influence the development of self-perceived scholastic competence (SPSC). This study examined the relationship of insulin resistance and body fatness with SPSC in low-income, overweight and obese, African American children.Methods
Data were analyzed from a convenience sample of 9-10 years old African American children (89 boys and 113 girls) enrolled in a type 2 diabetes prevention study. Health variables analyzed for their influence on SPSC (Harter scale) included insulin resistance (Homeostatic model-derived insulin sensitivity, HOMA-IR) and body fatness (% body fat). Adjustments were made for self-esteem (Global Self Worth).Results
There was a significant gender by insulin resistance interaction effect on the child's SPSC, so separate regression models were developed for each gender. In boys, neither insulin resistance nor body fatness was related to SPSC. In girls, however, insulin resistance was negatively related to SPSC scores, and the significance of the relationship increased further after adjusting for body fatness. Body fatness alone was not significantly related to SPSC in girls, but after adjusting for insulin resistance, body fatness was positively related to SPSC. Thus, insulin resistance and body fatness mutually suppressed SPSC in girls.Conclusion
High SPSC was associated with lower insulin resistance and, with insulin resistance held constant, with higher body fatness in girls but not in boys. These relationships were not influenced by self-esteem in these children. 相似文献2.
Harrison RL Mattson LK Durbin DM Fish AF Bachman JA 《Patient education and counseling》2012,86(2):270-276
Objective
To examine physiological and health-related quality of life (HRQOL) outcomes in community living adults attending a 12-week combined lifestyle wellness program.Methods
A sample of overweight and obese adults (n = 319) and a subgroup who also had diabetes (n = 46 of 319) were studied. The program focuses on dietary, physical activity, and behavioral strategies to promote cardiovascular health. Baseline and 12-week measures were obtained.Results
In the total sample, all physiological and HRQOL outcomes improved (p < .05), except HDL. High attendance was associated with the highest weight loss. In the diabetic subgroup, weight, steps/day, low density lipoprotein, and most aspects of HRQOL improved significantly.Conclusion
Physiological and HRQOL benefits can be gained from a 12-week combined lifestyle program; greater benefits were obtained with higher attendance. Although the diabetic subgroup was not large, positive outcomes were realized.Practice implications
The 12-week combined lifestyle program shows promise for improving outcomes in community living overweight and obese adults who may also be diabetic. By attending class, participants are reminded about strategies they are to apply during the 12-week program and, by program end, they are equipped with a tool kit of strategies for use in everyday life. 相似文献3.
Objective
In a randomized, multi-centre trial, the effect of an education programme (MEDIAS 2 ICT) involving intensive insulin treatment for people with type 2 diabetes was compared with an established education programme as an active comparator condition (ACC).Methods
We investigated whether MEDIAS 2 ICT was non-inferior to ACC in overall glycaemic control. Secondary outcomes were the diabetes-related distress, diabetes knowledge, quality of life, self-care behavior, lipids, blood pressure and weight.Results
186 subjects were randomized. After a six month follow-up the mean HbA1c decrease was 0.37% (from 8.2 ± 1.1% to 7.8 ± 1.5%) in the ACC and 0.63% (from 8.5 ± 1.5% to 7.9 ± 1.2%) in MEDIAS 2 ICT. The mean difference between both groups was −0.26% (95% CI −0.63 to −0.14) in favor of MEDIAS 2 ICT. This result was within the predefined limit for non-inferiority. Diabetes-related distress was significantly more reduced in MEDIAS 2 ICT (−3.4 ± 7.1) than in ACC (0.4 ± 9.0; p = 0.31).Conclusion
MEDIAS 2 ICT is as effective in lowering HbA1c as previously established education programmes, but showed superiority in reducing diabetes-related distress.Practical implications
MEDIAS 2 ICT provides an alternative for education of people with type 2 diabetes treated by multiple injection therapy. 相似文献4.
Kazem S van der Meijden E Kooijman S Rosenberg AS Hughey LC Browning JC Sadler G Busam K Pope E Benoit T Fleckman P de Vries E Eekhof JA Feltkamp MC 《Journal of clinical virology》2012,53(3):225-230
Background
Recently a new polyomavirus was identified in a patient with trichodysplasia spinulosa (TS), a rare follicular skin disease of immunocompromised patients characterized by facial spines and overgrowth of inner root sheath cells. Seroepidemiological studies indicate that TSPyV is ubiquitous and latently infects 70% of the healthy individuals.Objective
To corroborate the relationship between active TSPyV infection and TS disease by analyzing the presence, load, and precise localization of TSPyV infection in TS patients and in controls.Study design
TS lesional and non-lesional skin samples were retrieved from TS patients through a PubMed search. Samples were analyzed for the presence and load of TSPyV DNA with quantitative PCR, and for expression and localization of viral protein with immunofluorescence. Findings obtained in TS patients (n = 11) were compared to those obtained in healthy controls (n = 249).Results
TSPyV DNA detection was significantly associated with disease (P < 0.001), with 100% positivity of the lesional and 2% of the control samples. Quantification revealed high TSPyV DNA loads in the lesional samples (∼106 copies/cell), and low viral loads in the occasionally TSPyV-positive non-lesional and control samples (<102 copies/cell). TSPyV VP1 protein expression was detected only in lesional TS samples, restricted to the nuclei of inner root sheath cells over-expressing trichohyalin.Conclusions
The high prevalence and load of TSPyV DNA only in TS lesions, and the abundant expression of TSPyV protein in the affected hair follicle cells demonstrate a tight relation between TSPyV infection and TS disease, and indicate involvement of active TSPyV infection in TS pathogenesis. 相似文献5.
Coplan JD Abdallah CG Mathew SJ Shungu DC Mao X Smith EL Kaufman D Gorman JM Owens MJ Nemeroff CB Banerji MA Rosenblum LA Kral JG 《Physiology & behavior》2011,103(5):535-539
Objective
Obesity is associated with the insulin resistance metabolic syndrome, postulated to be mediated by stress-induced alterations within the hypothalamic-pituitary-adrenal (HPA) axis. In adult bonnet macaques we examined relationships between components of the metabolic syndrome, hippocampal neurometabolic asymmetry, an indicator of negative affect, and juvenile cerebrospinal fluid (csf) corticotropin-releasing factor (CRF) levels obtained after stress exposure associated with maternal food insecurity and in controls.Methods
Eleven adult male monkeys (seven with early life stress) who had undergone csf-CRF analyses as juveniles had magnetic resonance spectroscopic imaging (MRSI) of bilateral hippocampus, morphometry (body mass index, BMI; sagittal abdominal diameter, SAD) and determination of fasting plasma glucose and insulin as adults. Neurometabolite ratios included N-acetyl-aspartate as numerator (NAA; a marker of neuronal integrity) and choline (Cho; cell turnover) and creatine (Cr; reference analyte) as denominators.Results
Elevated juvenile csf-CRF levels positively predicted adult BMI and SAD and were associated with right > left shift of NAA ratio within the hippocampus. Adult visceral obesity and insulin level correlated with right > left shift in hippocampal NAA concentrations, controlling for age and denominator.Conclusion
Juvenile csf-CRF levels, a neuropeptide associated with early life stress, predict adult visceral obesity and hippocampal asymmetry supporting the hypothesis that metabolic syndrome in adults may be related to early life stress. Furthermore, this study demonstrates asymmetrical hippocampal alterations related to obesity. 相似文献6.
Nelson HM Daly KA Davey CS Himes JH Synder DJ Bartoshuk LM 《Physiology & behavior》2011,102(5):511-517
Introduction
Otitis media (OM) is a significant disease that affects nearly all children early in life. Recently, childhood overweight has become an epidemic. Past research has demonstrated that a history of OM is related to food preferences and overweight through proposed physiological mechanisms. The purpose of this study was to explore the relationship between recurrent OM (ROM)/tympanostomy tube treatment and overweight status.Methods
Data were analyzed from a prospective cohort of mothers and children recruited from 1991-1996 from a local health maintenance organization. ROM and tympanostomy tube status were obtained through a combination of physical exam and medical record abstraction. ROM and tympanostomy tube status were analyzed as categorical variables with weight-for-length (WFL) data from well child checks. Chi-square and logistic regression for univariate and multivariate analyses were performed.Results
11.4% of children had a WFL measure at two years of age ≥ 95th percentile. Those children with a history of tympanostomy tube treatment had a significantly increased risk of having a WFL ≥ 95th percentile after controlling for birth weight, maternal prenatal smoking, maternal education, and family income (OR 3.32, 95% CI 1.43-7.72). The alternative hypothesis that children with larger WFL at two month of age would have a greater number of OM episodes by two years of age was not significant.Conclusion
The findings of this study are consistent with the hypothesis and prior research that OM treated with tympanostomy tubes is associated with overweight status. 相似文献7.
Sarah T. Henes Author Vitae David N. Collier Author Vitae Susan L. Morrissey Author Vitae Doyle M. Cummings Author Vitae Kathryn M. Kolasa Author Vitae 《Patient education and counseling》2010,81(1):43-46
Objective
To determine the feasibility and impact of implementing a standardized medical nutrition therapy (MNT) protocol to treat overweight children in their medical home. Primary outcomes evaluated were changes in eating behaviors, television habits, and weight status.Methods
A MNT protocol with handouts (known as KIDPOWER) was delivered by a registered dietitian (RD) to overweight children (2-20 years) in 9 primary care practices in a rural community. A medical record review yielded height, weight and selected patient/parent reported eating and TV behaviors from each MNT visit. Mean values were compared by paired samples t-tests. Changes in behaviors and BMI z score were compared using repeated measures ANOVA.Results
For patients with at least three MNT visits (n = 109) significant improvements in eating and TV viewing habits were seen by the third visit. Weight status, as determined by a significant decline in mean BMI z score, was improved.Conclusion
The KIDPOWER protocol delivered by a RD in the pediatric medical home aided overweight youth in making behavior changes that positively impacted their weight status.Practice implications
Reimbursement to RDs for treating childhood obesity is improving and KIDPOWER provides a model and tools for community practice. 相似文献8.
Mederacke I Potthoff A Meyer-Olson D Meier M Raupach R Manns MP Wedemeyer H Tillmann HL 《Journal of clinical virology》2012,53(2):110-115
Background
A quantitative HCV core antigen (HCVcoreAg) immunoassay has been developed for the confirmation of viremia in patients with hepatitis C.Objectives
We evaluated the correlation of HCV RNA and HCVcoreAg in different patient populations without HCV-specific treatment: HIV/HCV-coinfection, HBV/HCV-coinfection, and patients with end-stage renal disease.Study design
HCVcoreAg was quantified by a fully-automated immunoassay. Correlation of HCVcoreAg with HCV RNA was studied cross-sectionally in HIV/HCV- and HBV/HCV-coinfected patients, as well as before and after hemodialysis in patients with end-stage renal disease.Results
A concordant positive or negative test result for both HCV RNA and HCVcoreAg was observed in 68 of 71 (96%), 55 of 57 (96%), and in 109 of 109 (100%) samples of patients with HIV- or HBV/HCV-coinfection, and patients undergoing hemodialysis, respectively. HCVcoreAg showed high correlation with HCV RNA in samples from HIV/HCV-coinfected patients and HCV-infected patients undergoing hemodialysis (r = 0.97 and r = 0.94, p < 0.001). There was no overall correlation between HCVcoreAg and HCV RNA in HBV/HCV-coinfected individuals (r = 0.04, p = 0.822). Excluding patients with HCV RNA to HCVcoreAg ratios below 100 and above 10,000 kIU/fmol led to improved correlation (r = 0.53; p = 0.02), but remained worse than for the other cohorts. Overall, HCV RNA to HCVcoreAg ratios did not differ significantly between the different patient populations, though variation tended to be higher in HBV/HCV-coinfected patients. Patients with lower HCV RNA levels tend to have lower HCV RNA/HCVcoreAg ratios.Conclusions
HCVcoreAg represents a reliable marker of viral replication showing a good correlation with HCV RNA in various patient populations, with some limitations in HBV/HCV-coinfection. 相似文献9.
Heinrich E de Nooijer J Schaper NC Schoonus-Spit MH Janssen MA de Vries NK 《Patient education and counseling》2012,86(2):172-178
Objective
The objective in this study was to evaluate a web-based type 2 diabetes self-management education programme aimed at improving knowledge, encouraging active patient participation and providing supportive self-management tools.Methods
(1) An effect evaluation was conducted using a randomized controlled trial with a pre-test and post-test design (n = 99) and a knowledge questionnaire. (2) A user evaluation was conducted using an online questionnaire (n = 564) and one-on-one interviews (n = 11) to examine the perceived quality, use of functionalities and use of the programme as a supportive tool in education.Results
The effect evaluation showed a significant intervention effect (p < 0.01) on knowledge. The user evaluation showed high satisfaction with the programme's content, credibility and user-friendliness. However, functionalities and self-management tools were used by less than half of the participants.Conclusion
The programme can improve knowledge, but it is not fully used as intended. A more optimal use of the programme is necessary for higher efficacy.Practice implications
The use of mostly spoken text instead of written text was highly appreciated and could be used more often for educational websites. Furthermore, health care practitioners need support in implementing new educational programmes during consultations. 相似文献10.
Sasayama D Hori H Teraishi T Hattori K Ota M Matsuo J Kawamoto Y Kinoshita Y Hashikura M Koga N Okamoto N Sakamoto K Higuchi T Amano N Kunugi H 《Journal of affective disorders》2011,132(3):319-324
Background
Although some core personality variables are known to be characteristic of unipolar or bipolar depression, few studies have compared the personality profile between these two disorders.Methods
Temperament and Character Inventory (TCI) was employed to assess the personality of 36 depressed patients with bipolar II disorder (BPII), 90 patients with unipolar major depressive disorder (UP), and 306 healthy controls. The TCI was administered during the depressive episode in BPII and UP patients so that the results can be applied in a clinical setting.Results
Significantly higher scores in harm avoidance (p < 0.0001) and lower scores in self-directedness (p < 0.0001) and cooperativeness (p < 0.05) were observed in both BPII and UP patients compared to controls. Lower novelty seeking in UP patients compared to BPII patients and controls was observed in females (p < 0.0001, p < 0.01, respectively). A significant difference in self-transcendence score was observed between BPII and UP patients in females (p < 0.0005), with higher scores in BPII (p = 0.009) and lower scores in UP (p = 0.046) patients compared to controls. A logistic regression model predicted BPII in depressed females based on novelty seeking and self-transcendence scores with a sensitivity of 89% and a specificity of 73%, but did not accurately predict BPII in males.Limitations
Patients in our study were limited to those receiving outpatient treatments, and bipolar patients were limited to those with BPII.Conclusions
Novelty seeking and self-transcendence scores of TCI might be useful in the differentiation of UP and BPII in female patients. 相似文献11.
Bobo WV Chen H Trivedi MH Stewart JW Nierenberg AA Fava M Kurian BT Warden D Morris DW Luther JF Husain MM Cook IA Lesser IM Kornstein SG Wisniewski SR Rush AJ Shelton RC 《Journal of affective disorders》2011,133(3):467-476
Background
The clinical effects of antidepressant combinations vs. monotherapy as initial treatment for major depression with melancholic features (MDD-MF) are unknown.Methods
Outpatients with chronic or recurrent major depression (MDD) were randomized to initial treatment with escitalopram + placebo (the MONO condition), bupropion-sustained release + escitalopram, or venlafaxine-extended release + mirtazapine (the COMB conditions) in the Combining Medications to Enhance Depression Outcomes (CO-MED) trial. Secondary data analyses were conducted to compare demographic and clinical characteristics, and contrast clinical responses according to drug treatment, in patients with MDD-MF (n = 124) and non-melancholic MDD (n = 481).Results
While numerically lower, remission rates in MDD-MF did not differ significantly from those with non-melancholic MDD either at 12 (33.1% vs. 41.0%, aOR 1.16, p = 0.58) or 28 (39.5% vs. 46.8%, aOR = 1.02, p = 0.93) weeks of treatment. Remission rates did not differ significantly between combination and monotherapy groups in either MDD-MF or non-melancholic MDD patients at either time point. Similar conclusions were reached for response rates, premature study discontinuation, and self-rated depression symptom severity.Limitations
This is a secondary analysis of data from the CO-MED trial, which was not designed to address differential treatment response in melancholic and non-melancholic MDD.Conclusions
We found no evidence of differential remission or response rates to antidepressant combination or monotherapy between melancholic/non-melancholic MDD patients, or according to antidepressant treatment group, after 12 and 28 weeks. Melancholic features may not be a valid predictor of more favorable response to antidepressant combination therapy as initial treatment. 相似文献12.
Sander R. Hilberink Johanna E. JacobsMarinus H.M. Breteler Hein de VriesRichard P.T.M. Grol 《Patient education and counseling》2011,83(1):120-124
Objective
To evaluate two counseling programs in general practice to help smokers with chronic obstructive pulmonary disease (COPD) to quit smoking.Methods
Cluster randomized controlled trial including 68 general practices (667 patients) using a randomly assigned intervention program with counseling and advice about nicotine replacement therapy (and additional bupropion-SR in one of the programs) or usual care. Usual care consisted of periodic regular check-ups and COPD information. The main outcome measure was biochemically verified point prevalence at 12 months.Results
The two intervention groups were treated as one in the analysis because they were equally effective. The intervention resulted in a significantly self-reported higher success rate (14.5%) compared to usual care (7.4%); odds ratio = 2.1, 95% confidence interval = 1.1-4.1. Biochemically verified quit rates were 7.5% (intervention) and 3.4% (usual care); odds ratio = 2.3, 95% confidence interval = 0.9-6.0.Conclusion
The program doubled the cessation rates (statistically nonsignificant). Too few participants used the additional bupropion-SR to prove its effectiveness.Practice implications
The protocols can be used for COPD patients in general practice, but expectations should be modest. If quitting is unsuccessful, a stepped care approach should be considered. 相似文献13.
14.
Lawrence Wissow Anne GadomskiDebra Roter Susan LarsonBarry Lewis Jonathan Brown 《Patient education and counseling》2011,82(2):226-232
Objective
Training in communication can change clinician behaviors, but brief training may function by altering attitudes rather than teaching new skills. We used data from a trial of mental health training for office-based primary care to determine indicators of uptake that predicted parent and child outcomes.Methods
Clinicians (n = 50) were randomized to be controls or receive training. Uptake was determined comparing pre- and post-training visits with standardized patients (SPs) coded for skills and patient centeredness. Clinical outcomes were assessed by recruiting and following 403 children/youth ages 5-16 making visits to participants. At 6 months, change in mental health was assessed by parent and youth reports using the Strengths and Difficulties Questionnaire.Results
Trained clinicians used more agenda setting, time, and anger management skills than controls and showed increased patient centeredness toward SP parents, but not adolescents. Increased patient-centeredness toward parents predicted improvement in child/youth symptoms and functioning (rated by parents), and improvement in youth-rated symptoms. Increased skills alone were not associated with improvement, but patients of clinicians above the mean for both skill and patient-centeredness change improved most. 相似文献15.
Objective
To examine the situation preceding “late” smoking relapse, particularly the availability of tobacco, mood and intentions at first lapse.Methods
A questionnaire was sent to 1439 adults identified as abstinent after treatment with a National Health Service stop-smoking clinic over the previous 3 years. Relapsers were asked where they had obtained their first cigarette, their mood and intentions immediately before first lapse.Results
40% (n = 556) responded, of whom 35.8% (n = 199) had relapsed. At the time of first lapse, only 27.1% had made a decision to return to smoking while 48.9% intended to smoke only one or two cigarettes before stopping again. In 45.7% of cases, respondents bought cigarettes to smoke again. Prior to lapse the majority (53.8%) reported “really needing a cigarette”. Similarly 53.8% reported being miserable at the time, while only 16% were happy.Conclusion
The most common pattern of late lapse appears to be intending to suspend the quit attempt temporarily in circumstances of needing to smoke and of negative emotional state, and in many cases cigarettes are actually sought out.Practice implications
Promoting strong ‘not a puff’ rules, a non-smoker identity and identifying negative mood as a potential vulnerability are important components of relapse prevention intervention. 相似文献16.
Objective
The objectives of the study are to develop a patient-oriented and theory-based questionnaire on the communication preferences of chronically ill patients (KOPRA questionnaire) and to carry out psychometric testing of the instrument.Methods
Following two preliminary studies (focus groups, cognitive interviews), a total of 472 patients with chronic back pain or chronic ischemic heart disease were surveyed. In the main sample (N = 333), communication preferences regarding the physician were assessed; for N = 89 (or N = 50) patients, preferences regarding nursing staff (or therapists) were analyzed. Psychometric testing was done with respect to unidimensionality, fit to an item response theory (IRT) model, and for reliability. The questionnaire was developed and validated in German.Results
In the physician version with a total of 32 items, there are four scales (“Patient participation and patient orientation”, “Effective and open communication”, “Emotionally supportive communication”, and “Communication about personal circumstances”) that are unidimensional, fulfill the demands for a 1-parameter IRT model, and are reliable (Cronbach's alpha between .80 and .92). The psychometric properties with respect to nursing staff and therapists are slightly worse.Conclusion
The KOPRA questionnaire has good psychometric properties.Practice implications
Clinical use of the questionnaire appears useful to determine patients’ communication preferences. 相似文献17.
Background
Ciclesonide, an inhaled corticosteroid with almost no affinity for the glucocorticoid receptor, is highly effective in downregulating in vitro pro-inflammatory activities of airway parenchymal cells when converted into the active metabolite desisobutyryl-ciclesonide.Objective
We evaluate whether ciclesonide could effectively downregulate also antigen- or allergen-induced activation of peripheral blood mononuclear cell and of allergen-specific T-cell blasts.Methods
Peripheral blood mononuclear cells were isolated from non atopic and atopic asthmatic children sensitized to Phleum pratense (PhlP5). Proliferation toward Candida albicans or PhlP5 in the presence of ciclesonide or desisobutyryl-ciclesonide (0.003-3.0 μM) was evaluated as [3H]thymidine incorporation. Modulation of PhlP5-specific T-cell blasts proliferation and PhlP5-induced interleukin 4 expression by ciclesonide and desisobutyryl-ciclesonide were measured.Results
Peripheral blood mononuclear cell proliferation to C. albicans was dose-dependently inhibited by 0.3-3.0 μM ciclesonide and desisobutyryl-ciclesonide but inhibition by desisobutyryl-ciclesonide was higher. A significant proliferation to PhlP5 was observed only in cultures from atopic subjects: an effective downregulation was already detected at 0.03 μM ciclesonide and 0.003 μM desisobutyryl-ciclesonide (complete inhibition at 3 μM ciclesonide and 0.03 μM desisobutyryl-ciclesonide). 3 μM ciclesonide and desisobutyryl-ciclesonide reduced the PhlP5-specific T-cell blast proliferation and interleukin 4-producing cell proportion.Conclusions and clinical relevance
These in vitro data, obtained at concentrations similar to those reached in vivo at bronchial level, are in favor of an efficient inhibition of ciclesonide on the T-cell mediated response toward allergens. Additional studies are required to confirm these preliminary data on the reduced activity of the drug on allergen-specific T-cell blast activation that may have clinical relevance. 相似文献18.
Wang RY Covault KK Halcrow EM Gardner AJ Cao X Newcomb RL Dauben RD Chang AC 《Molecular genetics and metabolism》2011,104(4):592-596
Background
The feasibility of carotid artery intima-media thickness (C-IMT), an established cardiovascular disease marker, as a cardiac risk marker in mucopolysaccharidosis (MPS) patients was explored.Objectives
To determine if C-IMT is abnormal in MPS versus unaffected controls, and if C-IMT correlates with coronary artery diameter in MPS.Material and methods
Measurements of C-IMT via neck ultrasound and echocardiographic parameters, including coronary artery diameters, were obtained from MPS and control patients, and compared.Results
Sixteen MPS subjects (6 MPS I, 6 MPS II, 2 MPS III, 1 MPS VI, 1 MPS VII) and sixteen age, ethnicity, and gender-matched controls were enrolled. Median MPS and control subject ages were 8.3 ± 4.5 and 8.6 ± 4.3 years, respectively (p = 0.73). Mean MPS and control C-IMTs were 0.54 ± 0.070 and 0.48 ± 0.034 mm (p = 0.0029). No differences in left main, left anterior descending, or right coronary artery diameters were seen between MPS and controls. A significant proportion of MPS subjects had mitral insufficiency (14/16; p = 0.0002), aortic insufficiency (10/16; p = 0.0021), and left ventricular dilatation (7/16, p = 0.037) versus controls. C-IMT did not correlate significantly with age, height, weight, coronary measurements, or duration of treatment.Conclusion
C-IMT in MPS patients is increased compared to matched controls, likely reflective of arterial intima-medial glycosaminoglycan accumulation. MPS subjects demonstrated a high percentage of left-sided valvular insufficiency and ventricular dilatation. Additional studies should be performed in MPS patients to determine if C-IMT correlates with arterial elasticity, biomarkers of vascular dysfunction, and higher risk of cardiovascular events. 相似文献19.
20.
Allan Smith Ilona JuraskovaPhyllis Butow Caroline MiguelAnna-Lena Lopez Sarah ChangRichard Brown Jurg Bernhard 《Patient education and counseling》2011,82(2):233-239