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1.
Alexander Real Chierika Ukogu Divya Krishnamoorthy Nicole Zubizarreta Samuel K. Cho Andrew C. Hecht James C. Iatridis 《The spine journal》2019,19(2):225-231
Background Context
Low back pain (LBP) is a common complaint in clinical practice of multifactorial origin. Although obesity has been thought to contribute to LBP primarily by altering the distribution of mechanical loads on the spine, the additional contribution of obesity-related conditions such as diabetes mellitus (DM) to LBP has not been thoroughly examined.Purpose
To determine if there is a relationship between DM and LBP that is independent of body mass index (BMI) in a large cohort of adult survey participants.Study Design
Retrospective analysis of prospectively collected National Health and Nutrition Examination Survey (NHANES) data to characterize associations between LBP, DM, and BMI in adults subdivided into 6 subpopulations: normal weight (BMI 18.5–25), overweight (BMI 25–30), and obese (BMI >30) diabetics and nondiabetics. Diabetes was defined with glycohemoglobin A1c (HbA1c) ≥6.5%.Patient Sample
11,756 participants from NHANES cohort.Outcome Measures
Percentage of LBP reported.Methods
LBP reported in the 1999-2004 miscellaneous pain NHANES questionnaire was the dependent variable examined. Covariates included HbA1c, BMI, age, and family income ratio to poverty as continuous variables as well as race, gender, and smoking as binary variables. Individuals were further subdivided by weight class and diabetes status. Regression and graphical analyses were performed on the study population as a whole and also on subpopulations.Results
Increasing HbA1c did not increase the odds of reporting LBP in the full cohort. However, multivariate logistic regression of the 6 subpopulations revealed that the odds of LBP significantly increased with increasing HbA1c levels in normal weight diabetics. No other subpopulations reported significant relationships between LBP and HbA1c. LBP was also significantly associated with BMI for normal weight diabetics and also for obese subjects regardless of their DM status.Conclusions
LBP is significantly related to DM status, but this relationship is complex and may interact with BMI. These results support the concept that LBP may be improved in normal weight diabetic subjects with improved glycemic control and weight loss, and that all obese LBP subjects may benefit from improved weight loss alone. 相似文献2.
PJ Commerford 《Cardiovascular journal of Africa》2015,26(4):151-Aug;26(4):151
3.
Amalia Moreno Concepción Montón Yolanda Belmonte Miguel Gallego Xavier Pomares Jordi Real 《Archivos de bronconeumologia》2009,45(4):181-185
ObjectiveThe objective of this study was to assess the causes of death and risk factors for mortality in a cohort of patients with severe chronic obstructive pulmonary disease (COPD).Patients and methodsWe studied 203 patients with severe COPD (forced expiratory volume in 1 second [FEV1] <50%), who were attended in our respiratory department day hospital (2001-2006). Clinical variables were recorded on inclusion, and clinical course and causes of death were retrospectively reviewed.ResultsThe mean (SD) age of patients was 69 (8) years and the mean FEV1 was 30.8% (8.2%). One-hundred and nine patients died (53.7%); death was attributed to respiratory causes in 72 (80.9%), with COPD exacerbation being the most frequent specific cause within this category (48.3%). During follow-up, 18.7% required admission to the intensive care unit (ICU). Survival at 1, 3, and 5 years was 80%, 53%, and 26%, respectively. The multivariate analysis showed that mortality was associated with age, stage IV classification according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), cor pulmonale, and hospital admission during the year prior to inclusion. Need for admission to the ICU during follow-up was a factor independently associated with higher mortality.ConclusionsMortality in patients with severe COPD was high and exacerbation of the disease was one of the most frequent causes of death. Age, GOLD stage, cor pulmonale, prior admission to hospital, and need for admission to the ICU during follow-up were independent predictors of mortality. 相似文献
4.
Sudden hearing loss and acquired immunodeficiency syndrome 总被引:1,自引:0,他引:1
We have presented a case of a male homosexual with documented acquired immune deficiency syndrome in whom sudden sensorineural hearing loss developed after a series of opportunistic infections and before a massive intracerebral hemorrhage. Two major possible causes of his hearing loss are (1) actual involvement of spiral ganglion or acoustic division of the eighth cranial nerve by HTLV III virus, or (2) cryptococcal meningitis. He ultimately died after a series of neurological complications developed. These complications, which are common in patients with AIDS, include progressive dementia, obtundation, and coma. As the number of patients with AIDS in our society increases over the next 5 years, it will become more important for the otolaryngologist to recognize the complications of this disease that involve the ear, nose, throat, head, and neck. Sudden sensorineural hearing loss is one of these complications. The acquired immune deficiency syndrome, at this point, might best be treated by an approach of preventive medicine. However, such an approach would have far-reaching social and political implications--perhaps more so than in other venereally spread diseases. In the interim, the otolaryngologist-head and neck specialist is required to recognize AIDS as it manifests itself in the head and neck. In this case, sudden-onset sensorineural hearing loss was the otolaryngologic presentation of the AIDS. 相似文献
5.
O. Real del Sartre F. Stiefel S. Leyvraz J. Bauer T. M. Gehring P. Guex 《Supportive care in cancer》1998,6(4):416-420
The impact of a cancer diagnosis upon a family has become a focus of clinical interest, but few scientific studies have been completed in this area. The objectives of this pilot study were twofold: first, to test the applicability of the Family System Test (FAST) in families (n=5) with a young adult member with cancer and secondly to evaluate patterns of interactions within these families. Results show that the FAST is applicable and useful to evaluate the different perceptions of hierarchy and cohesion - two essential variables - within these families. The great majority of family members represented their relationships as balanced (i.e., cohesive and moderately hierarchical). However, contrary to nonclinical families, fathers had a less positive view than mothers and patients: fathers more often perceived family and parenteral relations as unbalanced, and also more often perceived a reversal of hierarchy and a cross-generational coalition within the family. Implications for future research and clinical care are discussed. 相似文献
6.
F. M. González Valverde F. Mauri Barberá M. Molto Aguado N. Torregrosa A. Hernández Quiles F. Menárguez Pina M. J. Gómez Ramos M. García Real J. A. Barreras Mateos J. L. Vázquez Rojas 《European Surgery》2004,36(4):253-256
Summary BACKGROUND: Endometriosis is a relatively common pathology in women of childbearing age and of low parity but rarely shows
extraperitoneal involvement. The main aim of this paper is to raise the attention of specialists to the necessity of carrying
out penetrating diagnosis of nonspecific extraperitoneal masses occurring in women of reproductive age. METHODS: We performed
a retrospective review of six patients diagnosed with extraperitoneal endometriosis who were treated at the Vega Baja University
Hospital (Spain) during the last 5 years. RESULTS: Surgical treatment had positive results in five patients. The preoperative
diagnosis was correctly made in only two patients. The accurate aetiology of endometriosis remains unknown and diagnosis is
based on clinical and cytopathological findings. CONCLUSIONS: Surgical treatment of extraperitoneal endometriosis is recommended.
However, postoperative follow-up is obligatory and hormonal suppressive therapy may be necessary. Medical treatment with gestagens,
Danazol, or agonists of the gonadotropin-releasing hormone are ineffective in endometriomas which are bigger than 2 cm.
相似文献
7.
A Real G Güenechea J A Bueren G Maganto 《International journal of radiation biology》1992,62(1):65-72
The haemopoietic and radioprotective effects of a protein-associated polysaccharide named AM5, have been studied following i.v. injection in mice. A dose-related accumulation of the splenic granulocyte-macrophage colony-forming units (CFU-GM) and colony-forming units in the spleen (CFU-S) was observed in mice treated with doses ranging from 0.1 to 0.4 mg/kg of AM5. The accumulation of splenic CFU-S, CFU-GM and BFU-e (erythroid burst-forming units) was always maximal 5 days after treatment with 0.4 mg/kg of AM5, with increases over control values between 300% and 500%. When the number of haemopoietic progenitors was quantified in the bone marrow, only slight increases of CFU-S were obtained, corresponding to the administration of low doses of AM5 (0.1 mg/kg). However, significant increases of circulating CFU-S were observed following administration of higher doses of AM5, suggesting a mobilization of haemopoietic progenitors from this organ. A faster recovery of spleen CFU-GM was observed in mice treated with 0.4 mg/kg of AM5 3 days or 1 day prior to a sublethal irradiation, and at this later time AM5 produced a significant survival enhancement from 10% to 90% in mice irradiated with 7.6 Gy X-rays. This effect was correlated with an increase in the nadir of leucocytes, characteristic of the radiation syndrome. 相似文献
8.
9.
Previous reports in the literature have described correlation of increasing repeat length with severity of the phenotype, in Kennedy syndrome. We describe male siblings with different repeat lengths, with lack of expression of the phenotype in the sibling with the longer repeat length. The phenotype was identical to motor neurone disease. There is variability of expression in Kennedy syndrome and repeat length even in siblings cannot be taken as a conclusive indicator of severity. CAG repeat length cannot be used to predict the natural history of Kennedy disease. The diagnosis of Kennedy syndrome should be considered in male patients presenting with atypical motor neurone disease. 相似文献
10.