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141.
Pasqualina L. Santaguida Andrew C. Don-Wauchope Usman Ali Mark Oremus Judy A. Brown Amy Bustamam Stephen A. Hill Ronald A. Booth Nazmul Sohel Robert McKelvie Cynthia Balion Parminder Raina 《Heart failure reviews》2014,19(4):507-519
The aim of this systematic review was to determine whether B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) independently add incremental value for predicting mortality and morbidity in patients with acute decompensated heart failure (ADHF). Medline®, Embase?, AMED, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL were searched from 1989 to June 2012. We also searched reference lists of included articles, systematic reviews, and the gray literature. Studies were screened for eligibility criteria and assessed for risk of bias. Data were extracted on study design, population demographics, assay cutpoints, prognostic risk prediction model covariates, statistical methods, outcomes, and results. From 183 citations, only seven studies (5 BNP and 2 NT-proBNP) considered incremental value in ADHF subjects admitted to acute care centers. Admission assay levels and length of follow-up varied for BNP studies (31 days to 12 months) and for NT-proBNP studies (25–82 months). All studies presented at least one estimate of incremental value of BNP/NT-proBNP relative to the base prognostic model. Using discrimination or likelihood statistics, these studies consistently showed that BNP or NT-proBNP increased model performance. Three studies used reclassification and model validation computations to establish incremental value; these studies showed less consistency with respect to added value. In conclusion, the literature assessing incremental value of BNP/NT-proBNP in ADHF populations is limited to seven studies evaluating only mortality outcomes and at moderate risk of bias. Although there were differences in the base risk prediction models, assay cutpoints, and lengths of follow-up, there was consistency in BNP/NT-proBNP adding incremental value in prediction models in ADHF patients. 相似文献
142.
Victoria Vaughan Dickson Gail D’Eramo Melkus Stuart Katz Alissa Levine-Wong Judy Dillworth Charles M. Cleland Barbara Riegel 《Patient education and counseling》2014
Objective
Most of the day-to-day care for heart failure (HF) is done by the patient at home and requires skill in self-care. In this randomized controlled trial (RCT) we tested the efficacy of a community-based skill-building intervention on HF self-care, knowledge and health-related quality of life (HRQL) at 1- and 3-months.Methods
An ethnically diverse sample (n = 75) of patients with HF (53% female; 32% Hispanic, 27% Black; mean age 69.9 ± 10 years) was randomized to the intervention group (IG) or a wait-list control group (CG). The protocol intervention focused on tactical and situational HF self-care skill development delivered by lay health educators in community senior centers. Data were analyzed using mixed (between–within subjects) ANOVA.Results
There was a significant improvement in self-care maintenance [F(2, 47) = 3.42, p = .04, (Cohen's f = .38)], self-care management [F(2, 41) = 4.10, p = .02, (Cohen's f = .45) and HF knowledge [F(2, 53) = 8.00, p = .001 (Cohen's f = .54)] in the IG compared to the CG.Conclusions
The skill-building intervention improved self-care and knowledge but not HRQL in this community-dwelling sample.Practice implications
Delivering an intervention in a community setting using lay health educators provides an alternative to clinic- or home-based teaching that may be useful across diverse populations and geographically varied settings. 相似文献143.
Stefanie E. Kuchinsky Jayne B. Ahlstrom Stephanie L. Cute Larry E. Humes Judy R. Dubno Mark A. Eckert 《Psychophysiology》2014,51(10):1046-1057
The current pupillometry study examined the impact of speech‐perception training on word recognition and cognitive effort in older adults with hearing loss. Trainees identified more words at the follow‐up than at the baseline session. Training also resulted in an overall larger and faster peaking pupillary response, even when controlling for performance and reaction time. Perceptual and cognitive capacities affected the peak amplitude of the pupil response across participants but did not diminish the impact of training on the other pupil metrics. Thus, we demonstrated that pupillometry can be used to characterize training‐related and individual differences in effort during a challenging listening task. Importantly, the results indicate that speech‐perception training not only affects overall word recognition, but also a physiological metric of cognitive effort, which has the potential to be a biomarker of hearing loss intervention outcome. 相似文献
144.
Feingold KR Grunfeld C Heuer JG Gupta A Cramer M Zhang T Shigenaga JK Patzek SM Chan ZW Moser A Bina H Kharitonenkov A 《Endocrinology》2012,153(6):2689-2700
The acute phase response (APR) produces marked alterations in lipid and carbohydrate metabolism including decreasing plasma ketone levels. Fibroblast growth factor 21 (FGF21) is a recently discovered hormone that regulates lipid and glucose metabolism and stimulates ketogenesis. Here we demonstrate that lipopolysaccharide (LPS), zymosan, and turpentine, which induce the APR, increase serum FGF21 levels 2-fold. Although LPS, zymosan, and turpentine decrease the hepatic expression of FGF21, they increase FGF21 expression in adipose tissue and muscle, suggesting that extrahepatic tissues account for the increase in serum FGF21. After LPS administration, the characteristic decrease in plasma ketone levels is accentuated in FGF21-/- mice, but this is not due to differences in expression of carnitine palmitoyltransferase 1α or hydroxymethyglutaryl-CoA synthase 2 in liver, because LPS induces similar decreases in the expression of these genes in FGF21-/- and control mice. However, in FGF21-/- mice, the ability of LPS to increase plasma free fatty acid levels is blunted. This failure to increase plasma free fatty acid could contribute to the accentuated decrease in plasma ketone levels because the transport of fatty acids from adipose tissue to liver provides the substrate for ketogenesis. Treatment with exogenous FGF21 reduced the number of animals that die and the rapidity of death after LPS administration in leptin-deficient ob/ob mice and to a lesser extent in control mice. FGF21 also protected from the toxic effects of cecal ligation and puncture-induced sepsis. Thus, FGF21 is a positive APR protein that protects animals from the toxic effects of LPS and sepsis. 相似文献
145.
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148.
Marchaim D Chopra T Bogan C Bheemreddy S Sengstock D Jagarlamudi R Malani A Lemanek L Moshos J Lephart PR Ku K Hasan A Lee J Khandker N Blunden C Geffert SF Moody M Hiro R Wang Y Ahmad F Mohammadi T Faruque O Patel D Pogue JM Hayakawa K Dhar S Kaye KS 《American journal of infection control》2012,40(8):760-765
149.
Lucy Duncombe Nicola J. Commander Sevil Erdenlig John A. McGiven Judy Stack 《Clinical and Vaccine Immunology : CVI》2013,20(11):1669-1674
Brucella abortus, a smooth strain of the genus Brucella, is the causative agent of bovine brucellosis. To support the ongoing development of diagnostic tests for bovine brucellosis, the use of Protein Saver cards (Whatman) for bovine blood serum and plasma sample collection has been evaluated. These cards offer significant logistical and safety alternatives to transporting and storing liquid samples and may aid in diagnostic programs and validation studies. To evaluate the utility of these cards, 204 bovine blood serum samples from Brucella-infected and noninfected animals were stored on and eluted from the Protein Saver cards. Anti-Brucella smooth lipopolysaccharide (sLPS) antibody titers for the serum eluates were compared to those of the unprocessed original serum samples by indirect enzyme-linked immunosorbent assay (ELISA). The results showed a highly significant correlation between titers from the serum eluates and the unprocessed sera. Therefore, under these circumstances, serum eluates and unprocessed serum samples may be used interchangeably. Blood plasma from 113 mitogen-stimulated whole-blood samples was added to and eluted from the Protein Saver cards. The gamma interferon (IFN-γ) titers in the plasma eluates were compared to those of the unprocessed plasma samples obtained by IFN-γ ELISA. The results showed a significant correlation between the plasma eluates and the unprocessed plasma samples. To derive a signal in the plasma eluate, it was necessary to develop a novel and highly sensitive ELISA for the detection of IFN-γ. The serum samples stored on cards at room temperature over a 10-day period showed little variation in antibody titers. However, the plasma eluates showed a progressive loss of IFN-γ recovery over 10 days when stored at room temperature. 相似文献
150.