共查询到20条相似文献，搜索用时 31 毫秒
1.
Taisuke Tsuji Kazunari Tsuyuguchi Kazunobu Tachibana Yohei Kimura Takehiko Kobayashi Shojiro Minomo Shinji Atagi Akihide Matsumura Seiji Hayashi Katsuhiro Suzuki 《Respiratory investigation》2017,55(1):45-50
Background
Although nontuberculous mycobacteria (NTM) lung diseases can occur in association with lung cancer, no study has evaluated the effect of lung cancer treatment on NTM lung diseases. Therefore, the present study aimed to retrospectively examine the effect of lung cancer treatment on NTM lung diseases.Methods
Patients diagnosed with NTM lung diseases in combination with cytologically or histologically proven lung cancer between January 1, 2010 and October 31, 2014 were enroled. The clinical history of eligible patients was retrospectively reviewed.Results
Seven hundred twenty-eight patients were diagnosed with NTM lung diseases. Among these patients, 29 (3.9%) also had lung cancer. Of the 29 patients with NTM and lung cancer, 62% had Mycobacterium avium complex as the pathogenic organism. The most common lung cancer histology was adenocarcinoma (62.1%). Anti-cancer cytotoxic chemotherapy was administered to seven patients, and the two patients who did not receive NTM treatment showed worsening of their NTM lung disease.Conclusion
Whether NTM lung disease should be treated during anti-cancer chemotherapy has not been not clarified by this study. Induction of anti-NTM therapy should be made after careful consideration, because the duration of anti-NTM treatment is long and anti-mycobacterial drugs have extensive effects on anti-cancer drugs. However, we think that anti-NTM therapy should be introduced after consideration of the worsening of symptoms and radiological findings associated with NTM lung disease. 相似文献2.
Hai-jian Liu Jian Guo Qin-hua Zhao Lan Wang Wen-lan Yang Jing He Su-gang Gong Jin-ming Liu 《The American journal of the medical sciences》2017,353(3):216-223
Background
To study the relationship between chronotropic incompetence (CI) and disease severity and to assess the effect of CI on exercise capacity in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods
Arterial blood gas analysis, pulmonary function test and cardiopulmonary exercise testing were conducted in 60 patients with stable COPD and 45 healthy volunteers. CI was defined using the chronotropic response index (CRI = (peak heart rate-resting heart rate) / (220-age-resting heart rate). Based on CRI, patients with COPD were divided into the normal chronotropic group (n = 23) and CI group (n = 37).Results
CI was present in 61.7% of the patients with COPD. Exercise capacity (peak oxygen uptake as percentage of predicted value, peak VO2%pred), peak heart rate and CRI were significantly lower in patients with COPD than in controls. However, resting heart rate was significantly higher than in controls. FEV1%pred and exercise capacity were significantly decreased in the CI group when compared with those in the normotropic group. There was significant association between CRI with FEV1%pred and peak VO2%pred. Multivariate regression analysis showed that CRI and FEV1%pred were independent predictors of exercise capacity in patients with COPD. A cutoff of 0.74 for the CRI showed a specificity of 94.1% in predicting patients with a peak VO2%pred < 60%.Conclusions
CRI was associated with disease severity in patients with COPD. CI may be an important parameter to reflect exercise capacity in patients with COPD. 相似文献3.
Devika Nair Laura Kidd N. Kevin Krane 《The American journal of the medical sciences》2017,353(4):320-328
Background
Membranoproliferative glomerulonephritis (MPGN) is an uncommon form of glomerulonephritis and it can be particularly difficult to predict outcomes and manage women with this disorder during pregnancy.Materials and Methods
The management of 3 successful pregnancies in women with MPGN from 1 center and previously described cases from the world literature are reviewed. This includes a number of large studies of pregnancy in women with underlying glomerular disease as well as small case series and individual reports. Courses of these pregnancies, maternal and fetal outcomes, and management, when described, were included in this review.Results
Some successful outcomes used antiplatelet therapy and plasmapheresis, but high-dose intravenous, followed by oral, corticosteroid therapy was used most frequently in patients with successful outcomes.Conclusions
The data provided is meant as a guide for clinicians who provide care for women with MPGN who are considering pregnancy or women who present with this disorder while pregnant. 相似文献4.
Yasutaka Onishi Tetsuji Kawamura Yasuharu Nakahara Ryogo Kagami Shin Sasaki Sayaka Takahashi Ryota Kominami Katsuya Hirano Ryota Hiraoka Nobuya Hirata 《Respiratory investigation》2017,55(1):10-15
Background
Organizing pneumonia (OP) is a histopathological response pattern to lung inflammation. It is clinically classified into cryptogenic OP and secondary OP, which is associated with various clinical conditions. Rapid resolution with corticosteroids and frequent relapses are common in OP. However, few studies have investigated the factors associated with OP relapse.Methods
The medical records of 75 patients with biopsy-proven OP, diagnosed between January 2010 and August 2015, who underwent corticosteroid therapy were retrospectively reviewed. Initially, the patients were all treated successfully; however, 31 patients experienced relapse thereafter (R group), whereas the others did not (NR group; 44 patients). The clinical, radiological, and pathological characteristics and administered corticosteroid doses were compared between the two groups.Results
The neutrophil percentage in the bronchoalveolar lavage (BAL) fluid and the level of fibrin deposition in lung biopsy specimens were higher in the R group than in the NR group (P=0.01 and P=0.002, respectively). The multivariate analysis demonstrated that both factors were statistically significant predictors of OP relapse.Conclusions
A high neutrophil percentage in the BAL and the level of fibrin deposition in lung biopsy specimens are considered predictive factors of OP relapse during the tapering or after the cessation of steroid therapy. Patients without these findings may be treated with low-dose corticosteroids. 相似文献5.
Yukiyo Sakamoto Yasuhiro Yamauchi Hideo Yasunaga Hideyuki Takeshima Wakae Hasegawa Taisuke Jo Hiroki Matsui Kiyohide Fushimi Takahide Nagase 《Respiratory investigation》2017,55(1):39-44
Background
Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan.Methods
Data of CAP patients aged over 20 years who required mechanical ventilation at admission between April 2012 and March 2014 were retrospectively analyzed. Multivariable logistic regression analysis was performed to examine the association between guidelines-concordant empiric antimicrobial therapy and all-cause 7-day mortality, with adjustment for patient backgrounds and pneumonia severity.Results
There were a total of 3719 eligible patients, 836 (22.5%) of whom received guidelines-concordant combination therapy. Overall, 7-day mortality was 29.5%. Higher 7-day mortality was associated with advanced age, confusion, lower systolic blood pressure, malignant tumor or immunocompromised state, and C-reactive protein ≥20 mg/dl or infiltration occupying two-thirds of one lung on chest radiography. After adjustment for these variables, guidelines-concordant combined antimicrobial therapy was associated with significantly lower 7-day mortality (odds ratio: 0.78; 95% confidence interval: 0.65–0.95; P=0.013).Conclusions
Adherence to initial empiric treatment as recommended by the guidelines was associated with better short-term prognosis in patients with extremely severe pneumonia who required mechanical ventilation on hospital admission. 相似文献6.
Pardis Keshavarz B. Fatemeh Nobakht M. Gh Seyed Reza Mirhafez Mohsen Nematy Mohsen Azimi-Nezhad Sedigheh Ayati Afin Habibollah Esmaily Leila Pourali Atieh Mehdizadeh Hakak Mohammad Soukhtanloo Masoumeh Mirteimouri Nayereh Ghomian Gordon A. Ferns 《The American journal of the medical sciences》2017,353(6):552-558
Background
Increased oxidative stress (OS) and lipid peroxidation may be involved in the pathogenesis of preeclampsia (PE). We conducted a case-control study to evaluate the levels of plasma lipids and trace elements as well as activity of superoxide dismutase (SOD) in PE.Materials and Methods
The study consisted of 100 patients who had been diagnosed with PE and 100 normotensive pregnant women who underwent medical checkups that served as the control group. Lipid profile, zinc (Zn) and copper (Cu) levels and SOD activities were measured in the plasma of all subjects.Results
Our results showed that the plasma levels of triglycerides and SOD activity were significantly elevated and the levels of Zn and Cu were significantly reduced in patients with PE compared with healthy controls. Increased levels of SOD may indicate antioxidant protective mechanisms against OS in PE-complicated pregnancies. This finding may suggest an involvement of OS in the pathophysiology of PE.Conclusion
This study demonstrated a significant negative correlation between SOD activity and levels of trace elements. Furthermore, we suggest that higher triglyceride levels and SOD activity combined with lower Zn and Cu levels may be associated with an increased risk of PE. 相似文献7.
Keping Peng Zengnan Mo Guixiang Tian 《The American journal of the medical sciences》2017,353(3):236-241
Background
Dyslipidemia is a risk factor for nonalcoholic fatty liver disease (NAFLD). The aim of our study was to determine the associations of serum lipid indexes with NAFLD in adult males.Materials and Methods
In this cross-sectional study, 830 patients with NAFLD and 2,357 healthy individuals were assessed. Serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol and low-density lipoprotein cholesterol (LDL-C) levels were compared between patients with NAFLD and controls. The associations of dyslipidemia indexes with NAFLD occurrence were assessed by univariate analysis, and multivariate analysis was performed to identify independent dyslipidemia factors predictive of NAFLD.Results
Of the 3,187 study subjects, NAFLD occurred in 830 (26.04%), there were 504 (60.72%) patients with mild disease and 326 (39.28%) patients with moderate-to-severe disease. Although the frequency of normal TC, TG, LDL-C and high-density lipoprotein cholesterol levels in patients with NAFLD was similar to the controls, the frequencies of patients with NAFLD with marginally high and high TC, TG and LDL-C levels were significantly different when compared with controls. Interestingly, the association of the number of abnormal serum lipid indexes and NAFLD was highly significant with 2 abnormalities (odds ratio = 1.977; 95% CI: 1.436-2.722; P < 0.001) and ≥3 abnormalities (odds ratio = 3.505; 95% CI: 2.466-4.982; P < 0.001).Conclusions
A significant positive association was found between dyslipidemia characteristics and NAFLD in adult males. 相似文献8.
Kun-Qi Yang Yan-Kun Yang Xu Meng Ying Zhang Hui-Min Zhang Hai-Ying Wu Ya-Xin Liu Xiong-Jing Jiang Jun Cai Xian-Liang Zhou Ru-Tai Hui De-Yu Zheng Li-Sheng Liu 《The American journal of the medical sciences》2017,353(4):342-352
Background
Aortic dissection (AD) is a rare complication of Takayasu arteritis (TA). The clinical presentation and long-term management outcomes of AD in patients with TA have not been well described.Materials and Methods
We conducted a retrospective study of patients with TA along with AD admitted to Fuwai Hospital between January 1985 and March 2016. Clinical data and follow-up data were collected and analyzed.Results
Of the 1,154 patients with TA, we identified 10 patients (0.87%) with AD, which was likely to be associated with vasculitis. All patients were females with a median age at TA onset of 26.5 years (range: 18.3-33.3 years), had type III TA and had a history of hypertension, which was much more common than that in previously reported cases. Stanford type B or DeBakey category III was the dominant anatomic classification of AD. Four patients developed AD after the diagnosis of TA, and 6 developed AD near the time of TA diagnosis. Nine patients underwent conservative treatment, whereas 1 patient underwent endovascular repair due to extensive dissection. At a median 70.5-month follow-up (range: 31.5-138.5), we found that 7 patients had no AD progression, 1 patient had progressed without symptoms, 1 patient was lost and 1 patient died.Conclusions
Patients with TA along with long-standing and poorly controlled hypertension are liable to develop AD. Those with extensive AD in TA should be carefully treated and intensively followed up. 相似文献9.
Tiejun Yang Yanlong Jia Yongkang Ma Liang Cao Xiaobing Chen Baoping Qiao 《The American journal of the medical sciences》2017,353(1):49-58
Background
Pulmonary fibrosis (PF) is a destructive pulmonary disease and the molecular mechanisms underlying PF are unclear. This study investigated differentially expressed proteins associated with the occurrence and development of PF in rat lung tissue with bleomycin-induced PF.Methods
Sixteen Sprague-Dawley rats were randomly divided into 2 groups: the PF model group (n = 8) and the control group (n = 8). After successfully establishing the rat PF model induced by bleomycin, the differentially expressed proteins in the 2 groups were identified through isobaric tag for relative and absolute quantitation coupled with liquid chromatography-mass spectrometry and bioinformatics analysis.Results
A total of 146 differentially expressed proteins were identified; 88 of which displayed increased abundance and 58 were downregulated in the PF rat model group. Most functional proteins were associated with extracellular matrix, inflammation, damage response, vitamin A synthesis and metabolism. Critical proteins related to PF development and progression was identified, such as type V collagen-3, arachidonic acid 12-lipoxygenase, arachidonic acid 15-lipoxygenase and cytochrome P4501A1. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that these differentially expressed proteins were enriched in extracellular matrix receptor interaction pathway, renin-angiotensin system and metabolic pathway of retinol.Conclusions
The proteins expressed in bleomycin-induced PF rat model provide important data for further functional analysis of proteins involved in PF. 相似文献10.
Li Na Zhou Qiong Wang Chen Juan Gu Ning Li Jian Ping Zhou Xian Wen Sun Jun Zhou Qing Yun Li 《The American journal of the medical sciences》2017,353(3):224-229
Background
Obesity is linked to variation of lung volume; however, it is still unclear whether a sex difference exists. The study aimed to find out the effect of obesity on lung volume and sex difference among the Chinese population.Method
Pulmonary function test results were collected from 300 patients (aged 18 to ~80 years) with normal airway function and a wide range of body mass indexes (BMI). Measures of total lung capacity, vital capacity (VC), inspiratory capacity (IC), reserve volume, expiratory reserve volume (ERV) and functional reserve capacity (FRC) were analyzed by sex and different BMI groups.Results
BMI was correlated with VC inversely and IC positively in liner relationships (VC: r = ?0.115, P < 0.05; IC: r = 0.168, P < 0.05, respectively), whereas ERV and FRC decreased exponentially with increasing BMI (FRC: r = ?0.298, P < 0.01; ERV: r=?0.348, P < 0.01, respectively). Significant correlations were identified for the effect of BMI on ERV and IC and FRC in females (r = ?0.354, P < 0.01; r = 0.206, P < 0.05; r = ?0.335, P < 0.01), whereas only on ERV in males (r = ?0.230, P < 0.05).Conclusions
BMI affected the lung volume, and females were more susceptible to the effects than males. 相似文献11.
Kathleen A. Clark J. Jay Flynn Wilfried J.J. Karmaus Lawrence C. Mohr 《The American journal of the medical sciences》2017,353(6):533-542
Background
This study was conducted to assess associations of pleural plaques (PP) and longitudinal lung function in vermiculite miners of Libby, Montana who are occupationally exposed to asbestos. High-resolution computed tomography (HRCT) was used to identify asbestos-related findings in former Libby vermiculite miners. We investigated annual lung function decline in miners with PP only and compared them to miners with normal HRCT findings.Materials and Methods
HRCTs from 128 miners were categorized into the following 4 diagnostic groups: (1) normal computed tomography scan (n = 9); (2) PP only (n = 72); (3) PP and interstitial fibrosis (n = 26) and (4) additional HRCT abnormalities (n = 21) such as rounded atelectasis, diffuse pleural thickening, pleural effusions or pulmonary nodules or tumor >1 cm in diameter. Random intercept and slope linear mixed-effect regression models identified differences in lung function decline between miners with asbestos-associated outcomes and those with normal HRCT. Models were adjusted for follow-up time, body mass index, smoking status, latent exposure period and employment years. Interactions for smoking status with age and smoking status with pleural plaque severity were examined.Results
Miners with PP only did not have an accelerated decline in lung function between 40 and 80 years. Miners with PP and additional HRCT abnormalities displayed significantly accelerated declines in forced expiratory volume in 1 second and diffusing capacity of the lungs for carbon monoxide (P = 0.05 and P < 0.01, respectively). Plaque severity did not affect lung function decline. However, smokers with extensive plaques displayed accelerated loss in diffusing capacity of the lungs for carbon monoxide and forced expiratory volume in 1 second when compared to nonsmoking miners with mild plaque formation.Conclusions
PP alone did not significantly affect lung function decline in vermiculite miners of Libby, Montana. 相似文献12.
Juan Antonio Riesco Miranda Bernardino Alcázar Inmaculada Alfageme Ciro Casanova Bartolomé Celli Juan P. de-Torres Carlos A. Jiménez Ruiz 《Archivos de bronconeumología》2017,53(10):574-582
Objective
To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD).Methods
Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥ 7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels.Results
A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed.Conclusions
These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD. 相似文献13.
Ashwani K. Singal Krishna V.R. Venkata Sarat Jampana Fakhar-Ul Islam Karl E. Anderson 《The American journal of the medical sciences》2017,353(6):523-528
Background
Hepatitis C virus (HCV) infection is a common susceptibility factor for porphyria cutanea tarda (PCT). Experience on HCV treatment in patients with PCT is limited. Recently, HCV treatment has improved with direct-acting antivirals (DAA). We review our experience on HCV treatment in patients with PCT with older and newer regimens.Materials and Methods
A retrospective chart review was conducted. HCV treatment was attempted 22 times in 13 patients with PCT (5 attempts in 1, 2 in 5 and 1 in the other 7 patients).Results
Before starting HCV treatment, PCT was in complete remission in 16, partial remission in 2, unknown status in 2 and active in 2 instances. PCT relapsed during therapy 6 times (all interferon-based regimens and 2 including telaprevir), 4 requiring treatment interruption. Treatment was interrupted for reasons other than PCT relapse in 2 patients treated with interferon-based regimens. To prevent PCT recurrence, hydroxychloroquine was continued during HCV therapy 6 times (3 interferon regimens, 2 ribavirin regimens without interferon and 1 DAA alone). Twelve patients achieved sustained viral response, 3 with interferon regimens and 9 with DAA. Two patients with active PCT were treated with DAA, with reduction of plasma porphyrins in 1 and normalization in the other at the end of HCV therapy.Conclusions
HCV treatment regimens including interferon or ribavirin may precipitate PCT relapse. Hydroxychloroquine may be useful to prevent such relapses. In this limited experience, DAA were not associated with PCT relapse. Studies are needed to examine DAA as a primary PCT treatment in HCV-infected patients. 相似文献14.
Guixia Wang Zhengyun Zhang Yakun Feng Lin Sun Xianchao Xiao Gang Wang Yuan Gao Huan Wang Hong Zhang Yufeng Deng Chenglin Sun 《The American journal of the medical sciences》2017,353(1):1-5
Objective
To explore a model of Internet-based integrated management of diabetes, we established a remote diabetes medical service platform (U-Healthcare) and evaluated its effectiveness and practicality.Materials and Methods
In total, 212 patients with type 2 diabetes mellitus were randomly assigned to 2 groups. Data from the intervention group were automatically transmitted through a glucometer; furthermore, this group received information regarding medicines, diet, exercise and other management through U-Healthcare. The control group received conventional medical treatment without any additional intervention. All patients were regularly followed up every 3 months for half a year.Results
At the 3-month follow-up, fasting plasma glucose levels of the intervention group were significantly lower than those at the baseline as well as those of the control group. Triglyceride levels of the intervention group were much lower than those at the baseline. At the 6-month follow-up, 2-hour postprandial plasma glucose levels of the intervention group significantly improved compared with those of the control group. HbA1c levels gradually decreased every 3 months in the intervention group, and the mean change in the levels was significantly greater in this group than in the control group (from 1.27-0.68%). At the end of the study, more than 80% of the patients in the intervention group adhered to blood glucose monitoring 2-3 days per week, and their compliance degree was 72%.Conclusions
The Internet-based U-Healthcare system of integrated management in diabetes not only achieved better glycemic control, effectively improved HbA1c levels and decreased triglyceride levels but also enhanced patients’ adherence to the medical team’s instructions. 相似文献15.
Inma Castilla-Cortazar Julieta Rodriguez de Ita Gabriel Amador Aguirre Fabiola Castorena-Torres Jesús Ortiz-Urbina Mariano García-Magariño Rocío García de la Garza Carlos Diaz Olachea Martha Irma Elizondo Leal 《The American journal of the medical sciences》2017,353(5):425-432
Background
Fanconi anemia (FA) is a condition characterized by genetic instability and short stature, which is due to growth hormone (GH) deficiency in most cases. However, no apparent relationships have been identified between FA complementation group genes and GH. In this study, we thereby considered an association between FA and Laron syndrome (LS) (insulin-like growth factor 1 [IGF-1] deficiency).Methods
A 21-year-old female Mexican patient with a genetic diagnosis of FA was referred to our research department for an evaluation of her short stature. Upon admission to our facility, her phenotype led to a suspicion of LS; accordingly, serum levels of IGF-1 and IGF binding protein 3 were analyzed and a GH stimulation test was performed. In addition, we used a next-generation sequencing approach for a molecular evaluation of FA disease-causing mutations and genes involved in the GH-IGF signaling pathway.Results
Tests revealed low levels of IGF-1 and IGF binding protein 3 that remained within normal ranges, as well as a lack of response to GH stimulation. Sequencing confirmed a defect in the GH receptor signaling pathway.Conclusions
To the best of our knowledge, this study is the first to suggest an association between FA and LS. We propose that IGF-1 administration might improve some FA complications and functions based upon IGF-1 beneficial actions observed in animal, cell and indirect clinical models: erythropoiesis modulation, immune function improvement and metabolic regulation. 相似文献16.
Naomi Yoshida Masaki Okamoto Shinjiro Kaieda Kiminori Fujimoto Tomohiro Ebata Morihiro Tajiri Masayuki Nakamura Masaki Tominaga Daisuke Wakasugi Tomotaka Kawayama Masataka Kuwana Tsuneyo Mimori Hiroaki Ida Tomoaki Hoshino 《Respiratory investigation》2017,55(1):24-32
Background
We attempted to clarify whether the presence of anti-aminoacyl-transfer RNA synthetase antibody (anti-ARS Ab) or anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) is associated with the therapeutic response of polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD).Methods
We retrospectively investigated 22 patients with PM/DM-ILD (10 positive for anti-ARS Ab and nine positive for anti-MDA5 Ab) for whom antibody analysis of conserved serum was possible. We assessed mortality in the first three months as the therapeutic response in the acute phase and compared changes in clinical data for up to one year considered as the chronic phase. We classified the clinical changes over the year into three groups: Improvement (increased % vital capacity [%VC] or diffusing capacity of the lung for carbon monoxide [%DLCO]≥10 or 15%), deterioration (decreased %VC or %DLCO≥10 or 15%), and no change (remainder of the changes). The extent of abnormality demonstrated by high-resolution computed tomography (HRCT) was scored.Results
Positivity for anti-MDA5 Ab, but not for anti-ARS Ab, was associated with mortality in the first 3 months. Evaluation of the therapeutic response in the first year showed that positivity for the anti-ARS Ab, but not for the anti-MDA5 Ab, was associated with an improvement in %DLCO and a decline in the serum KL-6 levels. Positivity for the anti-ARS Ab or negativity for anti-MDA5 Ab was associated with a greater decrease in bronchial dilatation as seen by HRCT.Conclusions
Anti-ARS and anti-MDA5 Abs are associated with the therapeutic response of PM/DM-ILD. 相似文献17.
Nian-Sheng Tzeng Chi-Hsiang Chung Fu-Huang Lin Chin-Bin Yeh San-Yuan Huang Ru-Band Lu Hsin-An Chang Yu-Chen Kao Wei-Shan Chiang Yu-Ching Chou Chang-Huei Tsao Yung-Fu Wu Wu-Chien Chien 《The American journal of the medical sciences》2017,353(3):197-206
Background
Primary headaches include migraines, tension-type headaches and other primary headache syndromes. Migraines and tension-type headaches are associated with patient discomfort and other diseases. This study aimed to investigate the association between primary headaches and the risk of developing dementia, and to clarify the association between different types of headaches and dementia.Materials and Methods
We conducted a nationwide matched cohort population-based study. A total of 3,620 patients with newly diagnosed primary headaches, including migraines and tension-type headaches, between January 1 and December 31, 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 10,860 controls matched for sex and age. After adjusting for confounding factors, Fine and Gray?s competing risk analysis was used to compare the risk of developing dementia during 10 years of follow-up.Results
Of the study subjects, 170 (4.70 %) developed dementia compared with 433 (3.99%) of the controls. Fine and Gray?s competing risk analysis revealed that the study subjects were more likely to develop dementia (hazard ratio = 2.057; 95% CI: 1.718-2.462; P < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region of residence and comorbidities, the hazard ratio for dementia was 2.048 (95% CI: 1.705-2.461, P < 0.001). Migraines and tension-type headaches were associated with nonvascular dementia but not vascular dementia.Conclusions
The patients with headaches had a 105% increased risk of dementia. Further studies are needed to elucidate the underlying mechanisms. 相似文献18.
Lawrence B. Afrin Sally Self Jeremiah Menk John Lazarchick 《The American journal of the medical sciences》2017,353(3):207-215
Background
Mast cell activation syndrome (MCAS), a recently recognized nonneoplastic mast cell disease driving chronic multisystem inflammation and allergy, appears prevalent and thus important. We report the first systematic characterization of a large MCAS population.Method
Demographics, comorbidities, symptoms, family histories, physical examination and laboratory findings were reviewed in 298 retrospective and 115 prospective patients with MCAS. Blood samples from prospective subjects were examined by flow cytometry for clonal mast cell disease and tested for cytokines potentially driving the monocytosis frequent in MCAS.Results
Demographically, white females dominated. Median ages at symptom onset and diagnosis were 9 and 49 years, respectively (range: 0-88 and 16-92, respectively) and median time from symptom onset to diagnosis was 30 years (range: 1-85). Median numbers of comorbidities, symptoms, and family medical issues were 11, 20, and 4, respectively (range: 1-66, 2-84, and 0-33, respectively). Gastroesophageal reflux, fatigue and dermatographism were the most common comorbidity, symptom and examination finding. Abnormalities in routine laboratories were common and diverse but typically modest. The most useful diagnostic markers were heparin, prostaglandin D2, histamine and chromogranin A. Flow cytometric and cytokine assessments were unhelpful.Conclusions
Our study highlights MCAS?s morbidity burden and challenging heterogeneity. Recognition is important given good survival and treatment prospects. 相似文献19.
Hyeyoung Park Seung-Ick Cha Jae-Kwang Lim Kyung Nyeo Jeon Seung-Soo Yoo Jaehee Lee Shin-Yup Lee Chang-Ho Kim Jae-Yong Park 《The American journal of the medical sciences》2017,353(2):166-171
Objectives
Data regarding coexisting pulmonary thromboembolism (PTE) in patients with tuberculosis are limited. The aim of this study was to investigate the clinical features of coexisting PTE in patients with respiratory tuberculosis.Methods
Clinical parameters were retrospectively compared between the tuberculosis group (PTE and coexisting respiratory tuberculosis) and unprovoked or provoked group selected from a single institution in South Korea, a country that has an intermediate tuberculosis burden.Results
Twenty-four patients with PTE and concomitant respiratory tuberculosis were identified. These patients accounted for 1.0% of 2,386 patients with respiratory tuberculosis and 2.8% of 867 PTE patients who were enrolled over the same period. Compared with the unprovoked group, the tuberculosis group had significantly lower body mass index, higher levels of blood inflammatory markers and higher pulmonary embolism severity index (PESI) with a higher incidence of high PESI class (≥3). The tuberculosis group had a significantly lower incidence of central PTE than the unprovoked group, but the rate of right ventricular dilation on computed tomography scan was not significantly different between the 2 groups. Adverse outcomes, PTE-related in-hospital mortality and the recurrence of venous thromboembolism were not significantly different between the tuberculosis and unprovoked or provoked group.Conclusions
The coexistence of PTE and respiratory tuberculosis rarely occurred in clinical practice. Compared with unprovoked PTE, PTE with respiratory tuberculosis is characterized by lower body mass index, higher levels of blood inflammatory markers, higher PESI and less frequent central PTE, but it is not associated with any differences in outcomes caused by PTE. 相似文献20.
Yuri Gorelik Mical Paul Yuval Geffen Mogher Khamaisi 《The American journal of the medical sciences》2017,353(6):529-532