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背景及目的:Denosumab为一种人类单克隆抗体,它是核因子B配体(TANK)的受体激活剂(RANKL),RANKL,能够阻断该受体与RANK结合,从而抑制破骨细胞的生长及作用,减少骨的再吸收,增强骨密度.本研究分析了该药物对绝经后妇女骨质疏松症的预防作用. 相似文献
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Piers Dawes PhD David Reeves PhD Wai Kent Yeung PhD Fiona Holland MSc Anna Pavlina Charalambous PhD Mathieu Côté MD Renaud David MD Catherine Helmer MD Robert Laforce MD PhD Ralph N. Martins PhD Antonis Politis MD PhD Annie Pye PhD Gregor Russell MD Saima Sheikh MSc Marie-Josée Sirois PhD Hamid R. Sohrabi PhD Chyrssoula Thodi PhD Kathleen Gallant PhD Ziad Nasreddine MD Iracema Leroi MD PhD 《Journal of the American Geriatrics Society》2023,71(5):1485-1494
Background
Hearing impairment is common among older adults and affects cognitive assessments for identification of dementia which rely on good hearing function. We developed and validated a version of the Montreal Cognitive Assessment (MoCA) for people with hearing impairment.Methods
We adapted existing MoCA 8.1 items for people with hearing impairment by presenting instructions and stimuli in written rather than spoken format. One Attention domain and two Language domain items required substitution by alternative items. Three and four candidate items respectively were constructed and field-tested along with the items adapted to written form. We used a combination of individual item analysis and item substitution to select the set of alternative items to be included in the final form of the MoCA-H in place of the excluded original items. We then evaluated the performance and reliability of the final tool, including making any required adjustments for demographic factors.Results
One hundred and fifty-nine hearing-impaired participants, including 76 with normal cognition and 83 with dementia, completed the adapted version of the MoCA. A further 97 participants with normal hearing completed the standard MoCA as well as the novel items developed for the MoCA-H to assess score equivalence between the existing and alternative MoCA items and for independence from hearing impairment. Twenty-eight participants were retested between 2–4 weeks after initial testing. After the selection of optimal item set, the final MoCA-H had an area under the curve of 0.973 (95% CI 0.952–0.994). At a cut-point of 24 points or less sensitivity and specificity for dementia was 92.8% and 90.8%, respectively. The intraclass correlation for test–retest reliability was 0.92 (95%CI 0.78–0.97).Conclusion
The MoCA-H is a sensitive and reliable means of identifying dementia among adults with acquired hearing impairment. 相似文献85.
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间硝地平对左室肥厚大鼠左室舒张功能及心脑线粒体和血管组织钙含量的影响 总被引:1,自引:0,他引:1
用肾性高血压左室肥厚(LVH)大鼠模型,观察了间硝地平(m-Nif)和硝苯地平(Nif)长期给药(ig20mg·kg-1·d-1持续9周)对左室舒张功能、左心室肌和大脑线粒体及血管钙含量的影响。与假手术组相比,LVH组左室顺应性明显下降,僵硬度增高,左心室肌和大脑线粒体及尾动脉和主动脉钙含量增加。与LVH组相比,m-Nif和Nif各组左室顺应性改善,僵硬度降低(P<0.01),左心室肌线粒体及尾动脉和主动脉钙含量较LVH组显著降低(P<0.01)。两药在作用强度上无显著差异。 相似文献
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The development of a method to facilitate clinical negotiationwith diabetic patients is described. The principles of the methodincorporate patient centredness, an assessment of readinessto change and some elements of motivational interviewing. Asimple low cost technology is part of the innovative method.Details of the method and its application are published beforethe results of a randomized controlled trial to ensure thatthe techniques are in the public domain before the outcome ofthe trial is known. 相似文献
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Manna R; Todaro L; Latteri M; Gambassi G; Massi G; Grillo MR; Romito A; Caputo S; Gasbarrini GB 《Rheumatology (Oxford, England)》1997,36(1):124-125
The actiopathogenesis of leucocytoclastic vasculitis is still unknown, but
recently hepatitis C virus (HCV) has been suggested as trigger of
autoimmunity. We report a case of a 26-yr-old patient with purpura due to
leucocytoclastic vasculitis associated with hepatitis C virus infection.
Laboratory findings showed AST, ALT, gamma GT within normal limits,
positive antibodies to HCV (IIF and Riba II) and polymerase chain reaction
for HCV RNA. Anti-nuclear antibodies, IgG and IgM anti- cardiolipin
antibodies, anti-platelet antibodies and anti-neutrophil cytoplasmic
antibodies with perinuclear pattern were also present. A skin biopsy
specimen of a purpuric lesion showed leucocytoclastic vasculitis with small
vessel thrombosis and perivascular deposition of IgM and fibrinogen on
immunofluorescence study. This case shows a role of HCV in leucocytoclastic
vasculitis; it is possible that this HCV can induce autoimmunity
independently of cryoglobulins and liver involvement.
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