Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury

Objective

To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).

The impact of critical illness on perceived health-related quality of life during ICU treatment, hospital stay, and after hospital discharge: a long-term follow-up study

BACKGROUND: The time course of changes in health-related quality of life (HRQOL) following discharge from the ICU and during a general ward stay has not been studied. We therefore studied the immediate impact of critical illness on HRQOL and its recovery over time. METHODS: In a prospective study, all patients admitted to the ICU for > 48 h who ultimately survived to follow-up at 6 months were included. The Medical Outcomes Study 36-item short form was used to measure HRQOL before ICU admission, at discharge from the ICU and hospital, and at 3 and 6 months following discharge from the ICU and hospital. An age-matched healthy Dutch population was used as a reference. RESULTS: Of the 451 included patients, 252 could be evaluated at 6 months (40 were lost to follow-up, and 159 died). Pre-ICU admission HRQOL in survivors was significantly worse compared to the healthy population. Patients who died between ICU admission and long-term follow-up had significantly worse HRQOL in all dimensions already at ICU admission when compared to the long-term survivors. HRQOL decreased in all dimensions (p < 0.001) during ICU stay followed by a rapid improvement during hospital stay, gradually improving to near pre-ICU admission HRQOL at 6 months following ICU discharge. Physical functioning (PF), general health (GH), and social functioning (SF) remained significantly lower than pre-ICU admission values. Compared to the healthy Dutch population, ICU survivors had significantly lower HRQOL 6 months following ICU discharge (except for the bodily pain score). CONCLUSIONS: A sharp multidimensional decline in HRQOL occurs during ICU admission where recovery already starts following ICU discharge to the general ward. Recovery is incomplete for PF, GH, and SF when compared to baseline values and the healthy population.     

Albuminuric and non-albuminuric chronic kidney disease in type 1 diabetes: Association with major vascular outcomes risk and all-cause mortality

Aims

Albuminuric and non-albuminuric phenotypes of chronic kidney disease (CKD) may have different cardiovascular risk and survival in type 1 diabetes (T1DM). Herein we estimated risk of major vascular outcomes by the EURODIAB PCS score and determined all-cause mortality rate in 774 T1DM according to CKD phenotypes.

后路单开门颈椎管扩大椎板成形术治疗OPLL效果分析

目的探讨后路单开门颈椎管扩大椎板成形术治疗颈椎后纵韧带骨化症患者的临床效果.方法将200例颈椎后纵韧带骨化症患者,根据手术方法不同分为研究组与对照组,每组100例,分别予以后路单开门椎管扩大成形术及前路椎体次全切减压融合术,术后观察12个月.于术前及术后1个月、12个月采用日本矫形外科协会评分系统评定神经功能,采用视觉模拟疼痛评分法评定疼痛状况;比较两组颈椎矢状位参数、颈椎脊髓整体后移距离、脊髓前缘后移距离、脊髓膨胀度.结果(1)术后1个月、12个月两组日本矫形外科协会评分系统评分均显著高于术前(P<0.01),视觉模拟疼痛评分法评分均显著低于术前(P<0.01);术前及术后1个月、12个月两组日本矫形外科协会评分系统、视觉模拟疼痛评分法评分比较差异均无统计学意义(P>0.05).(2)术后12个月两组颈椎矢状面轴向距离均较术前显著增大(P<0.01);术前及术后12个月两组颈椎Cobb角、颈椎矢状面轴向距离比较差异均无统计学意义(P>0.05).(3)术后12个月研究组颈椎脊髓整体后移距离为(2.21±0.54)mm、脊髓前缘后移距离为(1.85±0.37)mm,脊髓膨胀度测定值显著大于对照组(P<0.01).结论后路单开门颈椎管扩大椎板成形术治疗颈椎后纵韧带骨化症患者临床效果显著,对患者的颈椎脊髓整体后移距离、脊髓前缘后移距离、脊髓膨胀度的改善作用显著优于前路椎体次全切减压融合术.     

胆囊切除术后综合征临床相关因素分析与预防

目的探讨胆囊切除术后综合征(PCS)预防与临床因素的关系。方法对我院2000年1月～2009年1月收治的68例高度怀疑胆囊切除术后综合征患者的资料进行回顾性分析。结果经过CT、B超、胃镜、肝功能等查因分析,证实30例为PCS,主要与急性炎症期手术、术式选择不当、术前病程过长等因素相关;其余38例患者虽然出现PCS相同的症状,但与胆囊切除无关,不能诊断为PCS。结论 PCS的发生与临床因素密切相关,术者严格规范操作可以减少PCS发生;查因可有助于正确判断PCS。     

Nanoemulsions as vehicles for topical administration of glycyrrhetic acid: Characterization and in vitro and in vivo evaluation

Nano-emulsions are innovative colloidal systems characterized by high kinetic stability, low viscosity, and optical transparency, which make them very attractive in many dermatological applications. Furthermore their small size seems to favor the topical administration of actives which scarcely cross the skin. In the light of these interesting features, the present study was aimed to the evaluation, in vitro and in vivo, of glycyrrhetic acid (GA) release through the skin from the nanoemulsion system. GA-loaded nanoemulsion (GA_N) was prepared by phase inversion temperature (PIT) method, and was characterized in order to determine mean droplet size and its stability during a well-defined storage period. Further Cryo-TEM studies were performed to obtain information regarding nanoemulsion structure. The GA release pattern from nanoemulsion was evaluated in vitro, to determine its percutaneous absorption through excised human skin (stratum corneum and epidermis, SCE), and in vivo evaluating GA topical anti-inflammatory activity on healthy human volunteers by the UVB-induced erythema model. Nanoemulsions prepared by PIT method showed a mean droplet diameter of 210?nm that drastically changed during a storage of 5 weeks at room temperature. In vitro and in vivo evidence showed that the nanoemulsion system significantly increased the transdermal permeability of GA in comparison to a control O/W emulsion (GA_O/W) containing the same amount of active compound.