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41.
ABSTRACT

Introduction

Biomarkers may help influence long-term outcomes of psoriatic disease by improving the objective assessment of the presence and severity of psoriatic arthritis (PsA) and by guiding treatment selection. However, there are no validated biomarkers for PsA.  相似文献   
42.

Background

We conducted a monocentric retrospective study of patients with myelodysplastic syndromes (MDS) and autoimmune or inflammatory disorders (AIMs) and a literature review. We analyzed the association with subgroups of the WHO 2016 MDS classification and patient's survival in a case control study. Risk factors associated with survival were analyzed by uni- and multivariate analysis.

Results

From all MDS patients 11% presented with AIMs. These were heterogeneous and the most frequent where polyarthritis (25%) and autoimmune cytopenias (17%). No difference for frequency and type of AIMs was observed for the WHO 2016 MDS subgroups (p?=?.3). In the case control study WHO classification, karyotype abnormalities, IPSS-R and IPSS were similar in both groups. The overall survival from MDS diagnosis was better in the group with AIMs [10.3?±?0.6 (IC95% 6.2–12.9) versus 4.8?±?1.1?years (IC95% 4.2–8.7), p?=?.04]. The better survival was restricted to MDS with low or intermediate-1 IPSS [11.1?±?1.5 (IC95% 9.9-NR) versus 8.7?±?1.3?years (IC95% 4.8–10.3), p?=?.006]. The better survival was only observed when AIMs diagnosis was timely associated or appeared after MDS diagnosis (p?=?.04). Factors associated with a better overall survival and survival without AML were steroid dependence [respectively HR?=?0.042, p?=?.003, (IC95% 0.005–0.33) and HR?=?0.07, p?=?.002, (IC95% 0.013–0.39)], a diagnosis of AIMs and MDS timely associated [respectively HR?=?0.05, p?=?.009, (IC95% 0.006–0.478) and HR?=?0.1, p?=?.008, (IC95% 0.018–0.54)] or a diagnosis of AIMs after MDS [respectively HR?=?0.024, p?=?.009, (IC95% 0.001–0.39) and HR?=?0.04, p?=?.008, (IC95% 0.003–0.43)].

Conclusion

Autoimmune and inflammatory diseases associated to MDS are heterogeneous. AIMs diagnosed after or concomitantly to MDS seems associated with a better survival. Prospective studies are necessary to demonstrate that autoimmunity is associated to a better control of the MDS clone.  相似文献   
43.
Two hundred forty-six children (96 Whites, of whom 51 were mates; 150 African- Americans, of whom 69 were males) with a familial history of essential hypertension (EH) were re-evaluated 5 years after an initial evaluation. During the initial visit, anthropometric, demographic, and resting cardiovascular (CV) parameters (designated initial baseline levels) were assessed. These CV parameters (systolic and diastolic blood pressure [BP], heart rate, cardiac output index [CI], and total peripheral resistance index [TPRI]) were also measured during postural challenge, a video game challenge, and a cold pressor task. At follow-up, resting CV parameters were again evaluated, and designated as follow-up resting levels. Moderate temporal stability (r range = .43-.56) was observed for all resting CV parameters. Mean stress responses for each CV parameter for all 3 stressors during the initial visit were positively related to the respective CV follow-up resting level. BP stress responses to postural change and video game challenge were found to be significant independent predictors of future resting BP after controlling for standard EH risk factors. Follow-up resting CI was not predicted by any stress responses, whereas follow-up resting TPRI was predicted by TPRI responses to the video game after controlling for standard EH risk Factors. These results contrast with those from an earlier 1-year follow-up. where stress responses for neither CI nor TPRI predicted follow-up resting levels. It appears that, as children get older. TPRI stress responses play a stronger role in vasoconstrictive function. This research was supported by National Institutes of Health Grant HL41781.  相似文献   
44.
We investigated the ability to generate anticipatory smooth pursuit to sequences of constant velocity (ramp) stimuli of increasing complexity. Previously, it was shown that repeated presentation of sequences composed of four ramps with two speeds in two directions, evoked anticipatory smooth pursuit after only one or two presentations. Here, sequences of four or six ramps, each having a choice of four speeds and either one or two directions (uni- or bi-directional) were examined. The components of each sequence were presented as discrete ramps (duration: 400 ms; randomised velocity: 10–40°/s), each starting from the centre with 1,200 ms periods of central fixation between ramps, allowing anticipatory activity to be segregated from prior eye movement. Auditory warning cues occurred 600 ms prior to each target presentation. Anticipatory smooth eye velocity was assessed by calculating eye velocity 50 ms after target onset (V 50), prior to the availability of visual feedback. Despite being required to re-fixate centre during inter-ramp gaps, subjects could still generate anticipatory smooth pursuit with V 50 comparable to single speed control sequences, but with less accuracy. In the steady state V 50 was appropriately scaled in proportion to upcoming target velocity for each ramp component and thus truly predictive. Only one to two repetitions were required to attain a steady-state for unidirectional sequences (four or six ramps), but three or four repeats were required for bi-directional sequences. Results suggest working memory can be used to acquire multiple levels of velocity information for prediction, but its use in rapid prediction is compromised when direction as well as speed must be retained.  相似文献   
45.
Early life markers of atopy and asthma   总被引:1,自引:0,他引:1  
Since early intervention could modulate the natural course of atopic disease, the availability of predictive markers is of considerable interest. As long as specific genetic markers are not available, early IgE-responses (hen's egg) together with a positive family history of atopy can be proposed as highly specific and predictive markers, which could define subgroups as potential candidates for secondary prevention.  相似文献   
46.
目的探讨三种手术方式对腰椎间盘突出症(LDH)临床疗效的影响。方法 2007年1月~2012年10月于我科行手术治疗LDH的患者中选择110例患者,男63例,女47例;年龄18~73岁,平均45岁;均为单节段椎间盘突出(L3/46例,L4/560例,L5/S144例)。分别采用腰椎间盘髓核摘除术(A组,40例)、椎间融合联合单侧椎弓根螺钉内固定(B组,51例)、腰椎间盘髓核摘除联合棘突间稳定装置X-STOP系统植入(C组,19例),3组患者一般资料比较差异均无统计学意义(0.05)。每位患者术前及术后末次随访时通过完成欧洲五维健康量表及进行Oswestry功能障碍指数评分,比较评分改善情况。结果 110例患者均获得随访,平均随访时间18个月(6~38个月),末次随访时EQ-VAS评分、EQ-5D健康指数和ODI评分组内比较均明显改善(0.05),组间比较均无统计学差异(0.05)。结论对于单纯LDH可行腰椎间盘髓核摘除术,LDH合并腰椎不稳者可行椎间融合+单侧椎弓根螺钉内固定,对于椎间盘突出合并椎管狭窄,尤其是临床症状在屈曲位缓解的患者尤其适宜椎间盘髓核摘除联合棘突间动态内固定。  相似文献   
47.
The Scandinavian Simvastatin Survival Study (4S) was a double-blind. randomized placebo-controlled multi-centre clinical trial of long-term Simvastatin therapy in patients with coronary heart disease who had total cholesterol levels between 5.5 and 8.0 mmol/1, comprising 4444 patients, equally distributed to a Simvastatin and a placebo group. Patients achieved a significant 30% relative reduction in overall mortality with Simvastatin therapy through a 42% relative reduction in coronary heart disease mortality. Lp(a) lipoprotein levels in Scandinavian coronary heart disease patients were strikingly higher than in healthy controls. Numbers of deaths in the Simvastatin group differed significantly between quartiles of Lp(a) lipoprotein levels, the reduction in deaths being most pronounced in the second (next to lowest) quartile. Subjects with major coronary events had significantly higher Lp(a) lipoprotein levels than subjects without such events, in all groups. The relationship between Lp(a) lipoprotein level and total mortality as well as between Lp(a) lipoprotein level and major coronary events was significantly different from zero, in logistic regression analyses. The findings show that Lp(a) lipoprotein predicts major coronary events as well as death in secondary prevention with Simvastatin. This prospective study provides independent confirmation that a high Lp(a) lipoprotein level is a significant coronary heart disease risk factor.  相似文献   
48.
Total ovarian volumes were measured before the administrationof HCG in 42 women undergoing treatment for infertility by in-vitrofertilization (IVF) and embryo transfer and considered to havean exaggerated response to stimulation (>20 follicles). Sevenwomen who subsequently developed moderate or severe ovarianhyperstimulation syndrome (OHSS) (n = 7; group 1) were comparedwith 35 matched controls (five matched controls per case; n= 35; group 2) of similar age, number of follicles and durationof infertility who underwent follicular stimulation, oocyterecovery, in-vitro fertilization and embryo transfer duringthe same period but did not develop moderate or severe OHSS.The mean age, duration of infertility and total number of follicleswere similar but the mean total ovarian volume was significantlyhigher in the group of women who developed moderate or severeOHSS compared with controls (271.00 ± 87.00 versus 157.30± 54.20 ml; P < 0.01). We conclude that total ovarianvolume measured before HCG administration is higher in womenwho develop moderate or severe OHSS compared with controls andmay therefore be used as an additional parameter in the preventativestrategy for the ovarian hyperstimulation syndrome.  相似文献   
49.
The predictability of individual differences in activation processes was investigated in a multi-method laboratory-field study. Male students of physical education (N=58) were examined under various emotionally activating and physically demanding conditions (mental arithmetic, reaction time, free speech, cold pressor test, bicycle ergometer). The assessment included multi-channel recordings of pre-start phases in an athletic stadium and performance on a 1000 m run. Basal heart rate was also recorded during sleep. This multi-situational assessment was repeated after three weeks, three months, and, for most (N=42) subjects, after one year. Significant relationships exist between scores from corresponding conditions of relaxation, anticipation, and performance of physical exercise. However, with the exception of heart rate, correlation coefficients are rather small and seem to be of questionable predictive validity. A generalizability study further supports the general conclusion: To increase the practical relevance in psychophysiological investigations of stress/strain phenomena, such studies should directly assess individual differences in the criterion situations themselves.  相似文献   
50.
In a previous study the concept "patient involvement" was found to be strongly predictive of therapy outcome. On the basis of a questionnaire concerning patients' background and motivation, 82 patients were interviewed before treatment. To cover the concept "patient involvement" 16 variables were considered as relevant measures. In a factor analysis four factors accounted for 90% of the common variance. The factors were interpreted in terms of: initial attitudes, attendance, self-confidence and teeth-mindedness.  相似文献   
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