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41.
Rebecca L. Sudore MD Andrew J. Karter PhD Elbert S. Huang MD MPH Howard H. Moffet MPH Neda Laiteerapong MD Yael Schenker MD Alyce Adams PhD Rachel A. Whitmer PhD Jennifer Y. Liu MPH Yinghui Miao MPH Priya M. John MPH Dean Schillinger MD 《Journal of general internal medicine》2012,27(12):1674-1681
BACKGROUND
Reducing symptom burden is paramount at the end-of-life, but typically considered secondary to risk factor control in chronic disease, such as diabetes. Little is known about the symptom burden experienced by adults with type 2 diabetes and the need for symptom palliation.OBJECTIVE
To examine pain and non-pain symptoms of adults with type 2 diabetes over the disease course ?C at varying time points before death and by age.DESIGN
Survey follow-up study.PARTICIPANTS
13,171 adults with type 2 diabetes, aged 30?C75?years, from Kaiser Permanente, Northern California, who answered a baseline symptom survey in 2005?C2006.MAIN MEASURES
Pain and non-pain symptoms were identified by self-report and medical record data. Survival status from baseline was categorized into ??6, >6?C24, or alive >24?months.KEY RESULTS
Mean age was 60?years; 48?% were women, and 43?% were non-white. Acute pain was prevalent (41.8?%) and 39.7?% reported chronic pain, 24.6?% fatigue, 23.7?% neuropathy, 23.5?% depression, 24.2?% insomnia, and 15.6?% physical/emotional disability. Symptom burden was prevalent in all survival status categories, but was more prevalent among those with shorter survival, p?<?.001. Adults ??60?years who were alive >24?months reported more physical symptoms such as acute pain and dyspnea, whereas participants <60?years reported more psychosocial symptoms, such as depressed mood and insomnia. Adjustment for duration of diabetes and comorbidity reduced the association between age and pain, but did not otherwise change our results.CONCLUSIONS
In a diverse cohort of adults with type 2 diabetes, pain and non-pain symptoms were common among all patients, not only among those near the end of life. However, symptoms were more prevalent among patients with shorter survival. Older adults reported more physical symptoms, whereas younger adults reported more psychosocial symptoms. Diabetes care management should include not only good cardiometabolic control, but also symptom palliation across the disease course. 相似文献42.
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Abdolaziz Rastegar Lari Leila Azimi Mohammad Rahbar Fatemeh Fallah Reza Alaghehbandan 《Burns : journal of the International Society for Burn Injuries》2013
Background
Resistance to antimicrobial agents such as carbapenems among enterobacteriacea has been increasing, especially in Klebsiella pneumonia that produces variety of enzymes including Klebsiella pneumoniae carbapenemase (KPC). This study is the first report of its kind investigating the resistance to carbapenems among burns patients in Iran.Method
During a 6-month period, 28 hospitalized burn patients who required to be placed on broad spectrum antibiotics were studied. Isolated species identified by routine biochemical test. Susceptibility testing for these species was performed by recommended the CLSI guidelines method. The tested antibiotics included cefotaxime, cefepime, aztreonam, imipenem, amoxicillin + clavulonic acid, gentamicin, amikacin, tobramycin, tetracycline, and trimethoprim-sulfamethoxazole, and chloramphenicol. For determination of KPC in phenotypical forms, Modified Hodge Test was utilized as per CLSI recommendation.Results
Thirty-five Klebsiella spp. were isolated from 28 hospitalized patients. Nineteen out of 35 Klebsiella isolates were resistant to imipenem and that all of them had positive KPC. Nine of imipenem resistant isolates were also resistant to all tested antibiotics. Mortality rate among patients with positive KPC was 33%.Conclusion
High rate of multi-drug resistant (MDR) strains in isolates with positive KPC is a major challenge in Iran and that it could cause an increase in both mortality and morbidity among burn patients. Thus, appropriate infection control measures and guidelines are needed to prevent such infections among burn patients. 相似文献45.
Ingmar Blümcke Maria Thom Eleonora Aronica Dawna D. Armstrong Fabrice Bartolomei Andrea Bernasconi Neda Bernasconi Christian G. Bien Fernando Cendes Roland Coras J. Helen Cross Thomas S. Jacques Philippe Kahane Gary W. Mathern Haijme Miyata Solomon L. Moshé Buge Oz Çiğdem Özkara Emilio Perucca Sanjay Sisodiya Samuel Wiebe Roberto Spreafico 《Epilepsia》2013,54(7):1315-1329
Hippocampal sclerosis (HS) is the most frequent histopathology encountered in patients with drug‐resistant temporal lobe epilepsy (TLE). Over the past decades, various attempts have been made to classify specific patterns of hippocampal neuronal cell loss and correlate subtypes with postsurgical outcome. However, no international consensus about definitions and terminology has been achieved. A task force reviewed previous classification schemes and proposes a system based on semiquantitative hippocampal cell loss patterns that can be applied in any histopathology laboratory. Interobserver and intraobserver agreement studies reached consensus to classify three types in anatomically well‐preserved hippocampal specimens: HS International League Against Epilepsy (ILAE) type 1 refers always to severe neuronal cell loss and gliosis predominantly in CA1 and CA4 regions, compared to CA1 predominant neuronal cell loss and gliosis (HS ILAE type 2), or CA4 predominant neuronal cell loss and gliosis (HS ILAE type 3). Surgical hippocampus specimens obtained from patients with TLE may also show normal content of neurons with reactive gliosis only (no‐HS). HS ILAE type 1 is more often associated with a history of initial precipitating injuries before age 5 years, with early seizure onset, and favorable postsurgical seizure control. CA1 predominant HS ILAE type 2 and CA4 predominant HS ILAE type 3 have been studied less systematically so far, but some reports point to less favorable outcome, and to differences regarding epilepsy history, including age of seizure onset. The proposed international consensus classification will aid in the characterization of specific clinicopathologic syndromes, and explore variability in imaging and electrophysiology findings, and in postsurgical seizure control. 相似文献
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47.
Fatemeh Gholami Sajjad Moradi Niloufar Rasaei Neda Soveid Leila Setayesh Khadijeh Mirzaei 《Journal of neurology》2022,269(1):205-216
Journal of Neurology - The Present study was conducted to systematically review the effect of the melatonin on sleep quality. We summarized evidence from randomized clinical trials (RCTs) that... 相似文献
48.
Philipp G. Smann Juan Eugenio Iglesias Boris Gutman Dominik Grotegerd Ramona Leenings Claas Flint Udo Dannlowski Emily K. Clarke-Rubright Rajendra A. Morey Theo G.M. van Erp Christopher D. Whelan Laura K. M. Han Laura S. van Velzen Bo Cao Jean C. Augustinack Paul M. Thompson Neda Jahanshad Lianne Schmaal 《Human brain mapping》2022,43(1):207-233
Structural hippocampal abnormalities are common in many neurological and psychiatric disorders, and variation in hippocampal measures is related to cognitive performance and other complex phenotypes such as stress sensitivity. Hippocampal subregions are increasingly studied, as automated algorithms have become available for mapping and volume quantification. In the context of the Enhancing Neuro Imaging Genetics through Meta Analysis Consortium, several Disease Working Groups are using the FreeSurfer software to analyze hippocampal subregion (subfield) volumes in patients with neurological and psychiatric conditions along with data from matched controls. In this overview, we explain the algorithm's principles, summarize measurement reliability studies, and demonstrate two additional aspects (subfield autocorrelation and volume/reliability correlation) with illustrative data. We then explain the rationale for a standardized hippocampal subfield segmentation quality control (QC) procedure for improved pipeline harmonization. To guide researchers to make optimal use of the algorithm, we discuss how global size and age effects can be modeled, how QC steps can be incorporated and how subfields may be aggregated into composite volumes. This discussion is based on a synopsis of 162 published neuroimaging studies (01/2013–12/2019) that applied the FreeSurfer hippocampal subfield segmentation in a broad range of domains including cognition and healthy aging, brain development and neurodegeneration, affective disorders, psychosis, stress regulation, neurotoxicity, epilepsy, inflammatory disease, childhood adversity and posttraumatic stress disorder, and candidate and whole genome (epi-)genetics. Finally, we highlight points where FreeSurfer-based hippocampal subfield studies may be optimized. 相似文献
49.
Sarah E. Medland Katrina L. Grasby Neda Jahanshad Jodie N. Painter Lucía Colodro-Conde Janita Bralten Derrek P. Hibar Penelope A. Lind Fabrizio Pizzagalli Sophia I. Thomopoulos Jason L. Stein Barbara Franke Nicholas G. Martin Paul M. Thompson 《Human brain mapping》2022,43(1):292-299
Here we review the motivation for creating the enhancing neuroimaging genetics through meta-analysis (ENIGMA) Consortium and the genetic analyses undertaken by the consortium so far. We discuss the methodological challenges, findings, and future directions of the genetics working group. A major goal of the working group is tackling the reproducibility crisis affecting “candidate gene” and genome-wide association analyses in neuroimaging. To address this, we developed harmonized analytic methods, and support their use in coordinated analyses across sites worldwide, which also makes it possible to understand heterogeneity in results across sites. These efforts have resulted in the identification of hundreds of common genomic loci robustly associated with brain structure. We have found both pleiotropic and specific genetic effects associated with brain structures, as well as genetic correlations with psychiatric and neurological diseases. 相似文献
50.