Correction to: Comparative clinical outcomes between direct oral anticoagulants and warfarin among elderly patients with non-valvular atrial fibrillation in the CMS Medicare population

Journal of Thrombosis and Thrombolysis - In the article by Amin et al., “Comparative clinical outcomes between direct oral anticoagulants and warfarin among elderly patients with non-valvular...     

Plasma endostatin predicts kidney outcomes in patients with type 2 diabetes

1. Download high-res image (294KB)
2. Download full-size image

     

Supporting addictions affected families effectively (SAFE): a mixed methods exploratory study of the 5-step method delivered in Goa,India, by lay counsellors

Aims: To explore the effect of the relatives’ drinking on their family members, and the preliminary impact of the 5-step method intervention on the adverse effect of the relatives’ drinking on their family members.

Methods: In-depth interviews were conducted with eligible Affected Family Members (AFMs) (n?=?30) to understand the effect of the relatives’ drinking on their family members. Subsequently, a different group of consecutive eligible AFMs (n?=?21) received the five-step method from lay counsellors, with outcomes measured at baseline and 3?months after delivery of the first session, to examine the impact of the intervention on AFMs.

Findings: In the in-depth interviews, the perceived impact of the relatives’ drinking on the AFM included substantial physical/emotional abuse, financial difficulties, shame, poor health, impaired interpersonal relationships and change in the AFM’s role in the family. In the case series, for AFMs who received at least one session of the intervention, there was significantly increased engaged coping, increased stress and increased professional social support; and in those who completed the intervention, there was significantly increased engaged coping, increased strain, and increased informal social support.

Conclusions: Compared to developed countries, stresses experienced by AFMs in our study are somewhat qualitatively different. The impact of an un-adapted five-step method intervention is less helpful than found elsewhere; hence an adapted version of the five-step method which is responsive to the realities of the cultural context may be better suited to Indian settings.     

嗅鞘细胞移植治疗脊髓损伤:理论研究的进展

学术背景:一般认为中枢神经系统损伤后,由于内在的再生能力差和外在环境抑制,损伤轴突不能再生。近年来研究证实脊髓损伤后采用一些改变其局部环境的方法,能促使损伤神经修复、再生及恢复脊髓部分神经功能。目的:移植的嗅鞘细胞通过加速轴突穿过受损脊髓的区域,从而恢复部分神经功能,有必要对嗅鞘细胞移植治疗脊髓损伤的基础和临床研究现状进行深入认识。检索策略:由该论文的研究人员应用计算机检索Pubmed数据库1994-01/2007-07的相关文献,检索词"spinal cord injury,Olfactory Ensheathing Cells,Neumtrophic Factors",并限定文章语言种类为English。同时计算机检索中国期刊全文数据库2000-01/2007-07的相关文献,检索词"嗅鞘细胞,脊髓损伤",并限定文章语言种类为中文。共检索到76篇文献,对资料进行初审,纳入标准:①文章所述内容应与嗅鞘细胞移植治疗脊髓损伤密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准:①重复性研究。②Meta分析。文献评价:文献的来源主要是通过对嗅鞘细胞移植治疗脊髓损伤方面内容进行汇总分析。所选用的34篇文献中,4篇为综述,其余均为临床或基础实验研究。资料综合:①大量的基础和临床研究显示:脊髓损伤后采用一些改变其局部环境的方法,能促使损伤神经修复、再生和恢复脊髓部分冲经功能。在这些方法中,嗅鞘细胞被认为是治疗脊髓损伤最有前景的方法之一。②嗅鞘细胞具有许旺细胞和星形胶质细胞相似的特征,在其膜上表达出很多与细胞黏合和轴突生长相关的分子,还能分泌大量不同种类的神经营养和支持因子;实验证实嗅鞘细胞移植入各种脊髓损伤的模型表现出促进脊髓轴突再生的能力。③临床研究证实,嗅鞘细胞移植对脊髓损伤患者的脊髓神经功能恢复具有帮助作用,且安全性有保障。结论:采用嗅鞘细胞移植治疗脊髓损伤已被公认为非常有效且前景广阔的治疗方法之一。目前采用嗅鞘细胞移植治疗的晚期脊髓损伤患者为数尚少,还需要进一步观察研究其最终恢复程度和临床安全性;此外仍需探讨如何提高脊髓神经功能恢复的程度。     

APOL1 renal risk variants are associated with obesity and body composition in African ancestry adults: An observational genotype–phenotype association study

While increased obesity prevalence among persons of African ancestry (AAs) compared to persons of European ancestry (EAs) is linked to social, environmental and behavioral factors, there are no gene variants that are common and significantly associated with obesity in AA populations. We sought to explore the association between ancestry specific renal risk variants in the apolipoprotein L1 (APOL1) gene with obesity related traits in AAs.We conducted a genotype–phenotype association study from 3 electronic medical record linked cohorts (BioMe Biobank, BioVU, nuGENE); randomized controlled trials (genetic testing to understand and address renal disease disparities) and prospective cohort study (Jackson Heart Study). We analyzed association of APOL1 renal risk variants with cross-sectional measures of obesity (average body mass index (BMI), and proportion of overweight and obesity) and with measures of body composition (in Jackson Heart Study).We had data on 11,930 self-reported AA adults. Across cohorts, mean age was from 42 to 49 years and percentage female from 58% to 75.3%. Individuals who have 2 APOL1 risk alleles (14% of AAs) have 30% higher obesity odds compared to others (recessive model adjusted odds ratio 1.30; 95% confidence interval 1.16–1.41; P = 2.75 × 10⁻⁶). An additive model better fit the association, in which each allele (47% of AAs) increases obesity odds by 1.13-fold (adjusted odds ratio 1.13; 95% confidence interval 1.07–1.19; P = 3.07 × 10⁻⁶) and increases BMI by 0.36 kg/m² (∼1 kg, for 1.7 m height; P = 2 × 10⁻⁴). APOL1 alleles are not associated with refined body composition traits overall but are significantly associated with fat free mass index in women [0.30 kg/m² increment per allele; P = .03].Thus, renal risk variants in the APOL1 gene, found in nearly half of AAs, are associated with BMI and obesity in an additive manner. These variants could, either on their own or interacting with environmental factors, explain a proportion of ethnic disparities in obesity.