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81.
Kathryn M King Tracey JF Colella Peter Faris David R Thompson 《Journal of clinical nursing》2009,18(11):1617-1624
Aims. To examine the utility and validate the use of the Cardiac Depression Scale in patients who had first‐time coronary artery bypass graft surgery. Background. The Beck Depression Inventory, though frequently used, may not be sufficiently sensitive for use in cardiac patients. The Cardiac Depression Scale has been shown to identify the range of depression in medical cardiac patients. Design. Survey. Methods. The Beck Depression Inventory and Cardiac Depression Scale were administered to 120 men at hospital discharge, as well as six, 12 and 36 weeks postoperatively. Cronbach’s α scores were calculated for the measures at each point. Changes in scores over time were analysed using repeated measures analysis of variance. Associations between the measures scores were calculated using Pearson product–moment correlations. Agreement between the measures’ dichotomised scores (depression/no depression) was examined using Cohen’s Kappa statistic. Results. Internal consistency was similar for the Beck Depression Inventory (0·793–0·904) and Cardiac Depression Scale (0·859–0·910). Depression scores decreased over time with the Beck Depression Inventory [F(2·50, 175·29) = 22·27, p < 0·001] and Cardiac Depression Scale [F(2·68, 190·37) = 13·18, p < 0·001]. The measures had similar power [Cohen’s f = 0·65 (Beck Depression Inventory) and 0·43 (Cardiac Depression Scale)] to reveal changes over time. The continuous scores were highly correlated at each point [0·737 (p < 0·001)–0·819 (p < 0·001)]. However, when dichotomised scores were compared, the chance corrected level of agreement was less impressive [0·198 (p = 0·014)–0·381 (p < 0·001)]. Conclusions. The Cardiac Depression Scale may have utility for use with surgical cardiac patients. However, continued examination of this measure of depression is warranted. Relevance to clinical practice. Given the prevalence of depression and its negative impact on coronary artery disease, it is important to identify even mild depression in cardiac patients. Using a measure of depression specifically for cardiac patients, rather than a generic measure, may best accomplish this goal. 相似文献
82.
83.
Pioglitazone administration decreases cardiovascular disease risk factors in insulin-resistant smokers 总被引:1,自引:0,他引:1
Abbasi F Farin HM Lamendola C McGraw L McLaughlin T Reaven GM 《Metabolism: clinical and experimental》2008,57(8):1108-1114
Insulin sensitivity varies in cigarette smokers, and there is evidence that cardiovascular disease (CVD) risk is greatest in those smokers who are also insulin resistant. To extend these observations, we sought to (1) compare CVD risk factors in smokers who do not plan to stop smoking, divided into insulin-resistant (IR) and insulin-sensitive (IS) subgroups, and (2) evaluate the ability of drug-induced changes in insulin sensitivity to decrease CVD risk. Thirty-six cigarette smokers were divided into IR (n = 19) and IS (n = 17) subgroups by determining their steady-state plasma glucose (SSPG) concentrations during the insulin suppression test (the higher the SSPG, the more insulin resistant the individual). In addition, baseline measurements were made of fasting lipid and lipoprotein concentrations; inflammatory markers; and daylong glucose, insulin, and free fatty acid responses to test meals. All subjects were treated with pioglitazone for 12 weeks, after which all baseline measurements were repeated. Baseline triglyceride and high-density lipoprotein cholesterol concentrations were significantly different in IR as compared with IS smokers (P < .05) both before and after adjustment for differences in sex and body mass index. After pioglitazone treatment, SSPG concentration significantly fell in the IR smokers (P < .001), associated with a significant improvement in the atherogenic lipoprotein profile seen at baseline (P ≤ .03) and a decrease in soluble intercellular adhesion molecule 1 and C-reactive protein concentrations (P = .01 and .02, respectively), whereas the IS smokers only had a significant increase in high-density lipoprotein cholesterol (P = .004) and a decrease in soluble intercellular adhesion molecule 1 (P = .02) and CRP (P = .07) levels. In conclusion, cigarette smokers have profound differences in CVD risk factors related to their degree of insulin sensitivity. It is suggested that, in addition to smoking cessation efforts, attention should be given to identifying the subgroup of smokers most at risk for CVD, but unwilling or unable to stop smoking, and to initiating appropriate therapeutic interventions to decrease CVD in this high-risk group. 相似文献
84.
Tracey KAIN Jane ZOCHLING Andrew TAYLOR Nicholas MANOLIOS Malcolm D. SMITH Mark D. REED Matthew A. BROWN Lionel SCHACHNA 《International journal of rheumatic diseases》2008,11(1):45-49
Aim: To develop a set of Australian recommendations for the monitoring and treatment of ankylosing spondylitis (AS) through systematic literature review combined with the opinion of practicing rheumatologists. Methods: A set of eight questions, four in each domain of monitoring and treatment, were formulated by voting and the Delphi method. The results of a systematic literature review addressing each question were presented to the 23 participants of the Australian 3E meeting. All participants were clinical rheumatologists experienced in the daily management of AS. Results: After three rounds of breakout sessions to discuss the findings of the literature review, a set of recommendations was finalized after discussion and voting. The category of evidence and strength of recommendation were determined for each proposal. The level of agreement among participants was excellent (mean 84%, range 64–100%). Conclusions: The 12 recommendations developed from evidence and expert opinion provide guidance for the daily management of AS patients. For most recommendations, we found a paucity of supportive evidence in the literature highlighting the need for additional clinical studies. 相似文献
85.
Delles C Zimmerli LU McGrane DJ Koh-Tan CH Pathi VL McKay AJ Steedman T Dargie HJ Hamilton CA Dominiczak AF 《Journal of hypertension》2008,26(5):946-955
OBJECTIVES: Oxidative stress causes endothelial dysfunction and plays a major role in the pathogenesis of cardiovascular disease. Increased vascular stiffness is an intermediate phenotype in the development of cardiovascular disease. We hypothesized that vascular stiffness is partially determined by oxidative stress. METHODS: We examined 163 participants out of whom 80 had coronary artery disease. Vascular stiffness was assessed by pulse wave analysis, pulse wave velocity and measurement of aortic compliance by cardiac MRI. Circulating markers of oxidative stress and vascular superoxide generation in saphenous vein were measured. RESULTS: After adjustment for age, sex, BMI, heart rate, blood pressure and lipids only carotid-femoral pulse wave velocity and aortic compliance were different between patients and control group. Aortic compliance was reduced (11.4 +/- 6.3 vs. 13.9 +/- 7.3 ml x 10(-3) per mmHg; P = 0.035) and vascular superoxide generation increased (1.01 +/- 0.45 vs. 0.76 +/- 0.44 nmol/mg per min; P = 0.035) in patients with coronary artery disease compared with those without. In a multiple stepwise regression analysis, aortic compliance was determined by age (P < 0.001) and vascular superoxide production (P = 0.033). CYBA C242T and NOS3 G894T polymorphisms had additive effects on vascular superoxide generation (P = 0.026) and xanthine oxidase activity was increased in patients with CAD (P = 0.043). Genetic factors (P = 0.033) and xanthine oxidase activity (P < 0.001) were also related to aortic compliance. CONCLUSION: By measuring vascular superoxide generation and aortic compliance using cardiac MRI, we demonstrated a functional relationship between oxidative stress and vascular stiffness. Patients identified with high levels of vascular stiffness are most likely to benefit from strategies to reduce vascular oxidative stress. 相似文献
86.
W. Dean Klinkenberg Robert J. Calsyn Gary A. Morse Suzanne McCudden Tracey L. Richmond Gary K. Burger 《AIDS and behavior》2002,6(4):295-307
In this paper we present data from a study of the consistency of recall of several sexual and drug-using behaviors gathered from face-to-face interviews with homeless persons who have dual diagnosis (severe mental illness plus a substance use disorder). Factors associated with inconsistent reporting are also examined. One hundred and thirty-three individuals participating in a longitudinal study of HIV risk behaviors were recruited for a retrospective recall study. Participants were completing monthly interviews that included assessments of sexual behaviors and drug use. Participants completed an additional interview using the same instruments and were randomly assigned to a 3- or 6-month recall condition; the data from the additional interview were correlated with the regular, monthly interviews. Results indicated that reports of sexual and substance-using behaviors were generally reported consistently for both 3- and 6-month recall periods; however, coefficients for the 3-month interval were generally better than those for the 6-month interval. One exception was that protected intercourse was generally not reported consistently. Inconsistent reporting of sexual and drug-using behaviors was associated with the severity of substance abuse; inconsistent reporting of sexual behaviors was also associated with African-American race. Our data suggest that a 3-month recall interval is generally superior to a 6-month interval for persons with severe mental illness. 相似文献
87.
Vergara C Tsai YJ Grant AV Rafaels N Gao L Hand T Stockton M Campbell M Mercado D Faruque M Dunston G Beaty TH Oliveira RR Ponte EV Cruz AA Carvalho E Araujo MI Watson H Schleimer RP Caraballo L Nickel RG Mathias RA Barnes KC 《American journal of respiratory and critical care medicine》2008,178(10):1017-1022
88.
Stone AF Mendall MA Kaski JC Edger TM Risley P Poloniecki J Camm AJ Northfield TC 《Circulation》2002,106(10):1219-1223
89.
Tracey A. Milligan 《The American journal of medicine》2021,134(7):840-847
The diagnosis and treatment of seizures and epilepsy is a common task of the physician. Approximately 1 in 10 people will have a seizure during their lifetime. Epilepsy is the tendency to have unprovoked seizures. Epilepsy is the fourth most common neurological disorder and affects 1 in 26 people in the United States and 65 million people worldwide. Evaluation of a patient presenting with a seizure involves excluding an underlying neurologic or medical condition, classifying the seizure type and determining if the patient has epilepsy. Proper treatment requires accurate diagnosis of the epilepsy type and syndrome and use of a medication that is effective and without adverse effects. Most patients can achieve complete seizure control with medication, but if medication is unsuccessful, surgical treatment can be an option. Special situations in the care of people with epilepsy include status epilepticus, women with epilepsy, the older adult, and safety issues. 相似文献
90.
Tymms Kathleen Butcher Belinda E. Sletten Tracey L. Smith Tegan O’Sullivan Catherine Littlejohn Geoffrey Sadler Ricky Tronnberg Rebecca Griffiths Hedley 《Clinical rheumatology》2022,41(4):1105-1114
Clinical Rheumatology - Sleep disturbance and fatigue are commonly reported in ankylosing spondylitis (AS) but specific prevalence and the relationship to disease control are unknown. This... 相似文献