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Jon J. Ford Matt C. Richards Luke D. Surkitt Alexander Y.P. Chan Sarah L. Slater Nicholas F. Taylor Andrew J. Hahne 《Archives of physical medicine and rehabilitation》2018,99(12):2504-2512.e12
Objective
To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs).Design
Prospective inception cohort study.Setting
Primary care private physiotherapy clinics in Melbourne, Australia.Participants
Individuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration.Interventions
Not applicable.Main Outcome Measures
Numeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale.Results
Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome.Conclusions
This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use. 相似文献994.
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Serial Evaluation of Endometrial Blood Flow for Prediction of Pregnancy Outcomes in Patients Who Underwent Controlled Ovarian Hyperstimulation and In Vitro Fertilization and Embryo Transfer 下载免费PDF全文
997.
Kelvin Chan 《中国结合医学杂志》2015,21(2):83-89
In the 21 st century,the public are more informed,mainly via the Internet,about health and medical products and have become more knowledgeable about matters relating to their health conditions and well-being in curing and preventing illnesses.They often self-medicate themselves with various health products and over-the-counter(OTC) medicines apart from prescribed pharmaceutical drugs(PD).Some of those non-prescribed products may have doubtful quality control and contain harmful additives or unchecked ingredients;thus their usefulness is in doubt.The increasing popularity world-wide of using Chinese medicines(CM) and related OTC functional products has raised concerns over their concomitant use with PD and the consequential adverse effects.In most cases the alleged causes of adverse effects are linked with herbal sources,although the authorised information on the interactions between CM-PD is not plentiful in the literature.There is an urgent need for such a data base.The future professionals in health and medical care should be knowledgeable or aware of what their patients have been taking or given.In actual practice the patients may receive both treatments intentionally or unintentionally,with or without the awareness of the practitioner.In these situations a reliable database for interactions between CM-PD will be extremely useful for consultation when treatment problems appear or during emergency situations.Their combining of medications may be involved with possible outcomes of adverse reactions or beneficial effects.Such a database will be welcomed by both practitioners of herbal medicines and orthodox medicine practitioners in the emerging trend of integrative medicine.The author has been involved in various research projects of basic and clinical aspects in mainly CM among other herbal and PD.Examples will be given largely on those related to these disciplines as illustrations in this overview. 相似文献
998.
Sun Hwa Lee Seong Jong Yun Seokyong Ryu Seung Woon Choi Hye Jin Kim Tae Kyung Kang Sung Chan Oh Suk Jin Cho 《The Journal of emergency medicine》2018,54(5):607-614
Background
Neutrophil-to-lymphocyte ratio (NLR) has been used as a predictive marker for various conditions. However, there are no previous studies about NLR as a prognostic marker for acute infarction.Objective
To evaluate the potential utility of NLR as a predictor of acute infarction in acute vertigo patients without neurologic and computed tomography (CT) abnormalities.Methods
We conducted a prospective, observational study in the Emergency Department (ED) between January 2015 and December 2016. All patients underwent physical examination, laboratory tests, CT, and magnetic resonance imaging (MRI). Results of the initial and follow-up MRI with clinical progress note were considered as the reference standard. Statistically, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve were used.Results
Thirty-five (25.9%) patients were diagnosed with acute infarction and 100 (74.1%) patients were diagnosed with peripheral vertigo. Horizontal nystagmus (p = 0.03; odds ratio 0.22) and NLR (p = 0.03; odds ratio 5.4) were significant factors for the differential diagnosis of acute infarction and peripheral vertigo. NLR > 2.8 showed the greatest area under the ROC curve (AUC; 0.819), optimal sensitivity (85.7%), and specificity (78.0%). NLR > 1.4 showed the highest sensitivity (97.1%) and relatively low specificity (41%). The absence of horizontal nystagmus increased the specificity (81.0%) and AUC (0.844).Conclusions
A combination of NLR > 2.8 and the absence of horizontal nystagmus is sufficiently specific for acute infarction in an ED patient with acute vertigo; thus, further testing with MRI is indicated. NLR < 2.8 by itself or combined with the presence of horizontal nystagmus is not sufficiently sensitive to rule out the need for further testing. 相似文献999.
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