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991.
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G.?JóhannessonEmail author P.?Hallberg K.?Ambarki A.?Eklund C.?Lindén 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2015,253(11):1979-1983
Purpose
To investigate the effect of aging on ocular parameters, including intraocular pressure (IOP), measured with different tonometry methods in healthy young (HY) and healthy elderly (HE) subjects and to study the effect of corneal parameters on tonometry methods.Methods
In this prospective, cross-sectional study, fifty eyes of 50 HY subjects (28 females, 22–31 years of age) and 43 eyes of 43 HE subjects (22 females, 64–79) were included. IOP was measured with four tonometry methods in a standardized order: ocular response analyser (ORA), dynamic contour tonometry (DCT), applanation resonance tonometry (ART) and Goldmann applanation tonometry (GAT). Other measurements included axial length (AL), central corneal thickness (CCT), corneal curvature (CC), anterior chamber volume (ACV), corneal hysteresis (CH) and corneal resistance factor (CRF).Results
The mean IOP (HY/HE; mmHg?±?standard deviation (SD)) was 12.2?±?2.2/14.1?±?3.5 with GAT. IOP was significantly higher (difference?±?standard error) in HE compared to HY measured with an ORA (+3.1 mmHg?±?0.6), GAT (+1.9?±?0.6) and DCT (+1.6?±?0.6). No significant difference was found in IOP measured with ART. CH and ACV were significantly lower in HE compared to HY. There was no difference between the groups in CCT, CC, AL or CRF. No tonometry method was dependant on CCT or CC.Conclusions
IOP measured with an ORA and via DCT and GAT was higher in HE compared to HY Swedish subjects, while IOP measured with ART did not differ between the groups. In these homogeneous groups, tonometry methods were independent of CCT and CC.994.
Long‐term safety of proton pump inhibitor therapy assessed under controlled,randomised clinical trial conditions: data from the SOPRAN and LOTUS studies
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OBJECTIVES: To investigate candidate predictors for insulin sensitivity in healthy elderly males, with special reference to the influence of insulin-mediated skeletal muscle blood flow and serum nonesterified fatty acids (NEFA). SUBJECTS: From the participants in a health survey of 70-year-old males, focusing on cardiovascular risk factors, a subgroup of 46 men was sampled. Only men who declared themselves healthy and without medication were included. INTERVENTIONS: Insulin sensitivity was measured with the euglycaemic hyperinsulinaemic clamp. Leg blood flow was measured before and during the clamp, using the Doppler ultrasound technique. RESULTS: Hyperinsulinaemia [steady-state plasma insulin 105(15) mU L-1] increased leg blood flow by 10% (P < 0.004). When tested in bivariate analysis incremental leg blood flow was only significantly related to the serum NEFA concentration (r = - 0.38, P < 0.01) amongst a number of measured variables. Insulin-mediated glucose disposal was related to body mass index (BMI) (r = -0.49, P = 0. 0006), waist/hip ratio (r = - 0.31, P = 0.036), NEFA (r = - 0.50, P = 0.0004) and heart rate (r = - 0.34, P = 0.02). In multivariate analysis only BMI and NEFA remained significantly related to whole-body glucose uptake. CONCLUSIONS: The study demonstrates that in elderly men BMI and fasting serum NEFA but not insulin-induced vasodilation are related to insulin sensitivity. High fasting levels of NEFA relate to both impaired insulin-mediated vasodilation and impaired glucose disposal, respectively. These two insulin actions were not interrelated, however, a finding which may indicate dissociated mechanisms. 相似文献
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998.
Gary McLean Bruce Guthrie Stewart W Mercer Graham CM Watt 《The British journal of general practice》2015,65(641):e799-e805
Background
Universal access to health care, as provided in the NHS, does not ensure that patients’ needs are met.Aim
To explore the relationships between multimorbidity, general practice funding, and workload by deprivation in a national healthcare system.Design and setting
Cross-sectional study using routine data from 956 general practices in Scotland.Method
Estimated numbers of patients with multimorbidity, estimated numbers of consultations per 1000 patients, and payments to practices per patient are presented and analysed by deprivation decile at practice level.Results
Levels of multimorbidity rose with practice deprivation. Practices in the most deprived decile had 38% more patients with multimorbidity compared with the least deprived (222.8 per 1000 patients versus 161.1; P<0.001) and over 120% more patients with combined mental–physical multimorbidity (113.0 per 1000 patients versus 51.5; P<0.001). Practices in the most deprived decile had 20% more consultations per annum compared with the least deprived (4616 versus 3846, P<0.001). There was no association between total practice funding and deprivation (Spearman ρ −0.09; P = 0.03). Although consultation rates increased with deprivation, the social gradients in multimorbidity were much steeper. There was no association between consultation rates and levels of funding.Conclusion
No evidence was found that general practice funding matches clinical need, as estimated by different definitions of multimorbidity. Consultation rates provide only a partial estimate of the work involved in addressing clinical needs and are poorly related to the prevalence of multimorbidity. In these circumstances, general practice is unlikely to mitigate health inequalities and may increase them. 相似文献999.
Bookwala J Zdaniuk B Burton L Lind B Jackson S Schulz R 《Journal of aging and health》2004,16(1):88-115
Objective: This study examined concurrent and long-term associations between caregiver-related characteristics and the use of community long-term care services in a sample of 186 older adults caring for a disabled spouse. Method: We used two waves of data from the Caregiver Health Effects Study, an ancillary study of the Cardiovascular Health Study. Caregiver-related need variables as predictors of service use were of primary interest and included caregiving demands, caregiver mental and physical health, and mastery. Their contribution to service use was examined after controlling for known predictors of service use. Results: At Time 1, more caregiver depressive symptoms predicted greater service use; at Time 2, more caregiver activity restriction and depressive symptoms predicted greater formal service use; increases in caregiver activity restriction and depressive symptomatology over time predicted increases in service use. Discussion: Caregiver-related need variables play a significant role in defining utilization patterns of community-based long-term care services among older adults. 相似文献
1000.
Jolie N Haun Nitin R Patel Jason D Lind Nicole Antinori 《Journal of medical Internet research》2015,17(12)