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1.
Arash Babaei-Ghazani Peyman Roomizadeh Bijan Forogh Seyed-Mohammad Moeini-Taba Amin Abedini Mona Kadkhodaie Fateme Jahanjoo Bina Eftekharsadat 《Archives of physical medicine and rehabilitation》2018,99(4):766-775
Objective
To review the literature and assess the comparative effectiveness of ultrasound-guided versus landmark-guided local corticosteroid injections in patients with carpal tunnel syndrome (CTS).Data Sources
Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), Embase (Ovid), and Web of Science (from inception to February 1, 2017).Study Selection
Randomized controlled trials (RCTs) comparing ultrasound-guided injection with landmark-guided injection in patients with CTS were included.Data Extraction
Two authors independently screened abstracts and full texts. The outcomes of interest were Symptom Severity Scale (SSS) and Functional Status Scale (FSS) scores of the Boston Carpal Tunnel Questionnaire and 4 electrodiagnostic parameters, including compound muscle action potential (CMAP), sensory nerve action potential (SNAP), distal motor latency (DML), and distal sensory latency (DSL).Data Synthesis
Overall, 569 abstracts were retrieved and checked for eligibility; finally, 3 RCTs were included (181 injected hands). Pooled analysis showed that ultrasound-guided injection was more effective in SSS improvement (mean difference [MD], ?.46; 95% confidence interval [CI], ?.59 to ?.32; P<.00001), whereas no significant difference was observed between the 2 methods in terms of the FSS (MD, ?.25; 95% CI, ?.56 to .05; P=.10). There were also no statistically significant differences in improvements of CMAP (MD, 1.54; 95% CI, 0.01 to 3.07; P=.05), SNAP (MD, ?0.02; 95% CI, ?6.27 to 6.23; P>.99), DML (MD, .05; 95% CI, ?.30 to .39; P=.80), or DSL (MD, .00; 95% CI, ?.65 to .65; P>.99).Conclusions
This review suggested that ultrasound-guided injection was more effective than landmark-guided injection in symptom severity improvement in patients with CTS; however, no significant differences were observed in functional status or electrodiagnostic improvements between the 2 methods. 相似文献2.
Carlos Collet Yosuke Miyazaki Nicola Ryan Taku Asano Erhan Tenekecioglu Jeroen Sonck Daniele Andreini Manel Sabate Salvatore Brugaletta Rodney H. Stables Antonio Bartorelli Robbert J. de Winter Yuki Katagiri Ply Chichareon Giovanni Luigi De Maria Pannipa Suwannasom Rafael Cavalcante Hans Jonker Patrick W. Serruys 《Journal of the American College of Cardiology》2018,71(24):2756-2769
Background
The functional SYNTAX score (FSS) has been shown to improve the discrimination for major adverse cardiac events compared with the anatomic SYNTAX score (SS) while reducing interobserver variability. However, evidence supporting the noninvasive FSS in patients with multivessel coronary artery disease (CAD) is scarce.Objectives
The purpose of this study was to assess the feasibility of and validate the noninvasive FSS derived from coronary computed tomography angiography (CTA) with fractional flow reserve (FFRCT) in patients with 3-vessel CAD.Methods
The CTA-SS was calculated in patients with 3-vessel CAD included in the SYNTAX II (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery II) study. The noninvasive FSS was determined by including only ischemia-producing lesions (FFRCT ≤0.80). SS derived from different imaging modalities were compared using the Bland-Altman and Passing-Bablok method, and the agreement on the SS tertiles was investigated with Cohen’s Kappa. The risk reclassification was compared between the noninvasive and invasive physiological assessment, and the diagnostic accuracy of FFRCT was assessed by the area under the receiver-operating characteristic curve using instantaneous wave-free ratio as a reference.Results
The CTA-SS was feasible in 86% of patients (66 of 77), whereas the noninvasive FSS was feasible in 80% (53 of 66). The anatomic SS was overestimated by CTA compared with conventional angiography (27.6 ± 6.4 vs. 25.3 ± 6.9; p < 0.0001) whereas the calculation of the FSS yielded similar results between the noninvasive and invasive imaging modalities (21.6 ± 7.8 vs. 21.2 ± 8.8; p = 0.589). The noninvasive FSS reclassified 30% of patients from the high- and intermediate-SS tertiles to the low-risk tertile, whereas invasive FSS reclassified 23% of patients from the high- and intermediate-SS tertiles to the low-risk tertile. The agreement on the classic SS tertiles based on Kappa statistics was slight for the anatomic SS (Kappa = 0.19) and fair for the FSS (Kappa = 0.32). The diagnostic accuracy of FFRCT to detect functional significant stenosis based on an instantaneous wave-free ratio ≤0.89 revealed an area under the receiver-operating characteristics curve of 0.85 (95% CI: 0.79 to 0.90) with a sensitivity of 95% (95% CI: 89% to 98%), specificity of 61% (95% CI: 48% to 73%), positive predictive value of 81% (95% CI: 76% to 86%), and negative predictive value of 87% (95% CI: 74% to 94%).Conclusions
Calculation of the noninvasive FSS is feasible and yielded similar results to those obtained with invasive pressure-wire assessment. The agreement on the SYNTAX score tertile classification improved with the inclusion of the functional component from slight to fair agreement. FFRCT has good accuracy in detecting functionally significant lesions in patients with 3-vessel CAD. (A Trial to Evaluate a New Strategy in the Functional Assessment of 3-Vessel Disease Using SYNTAX II Score in Patients Treated With PCI; NCT02015832) 相似文献3.
目的 探索多维疲乏目录（Multidimensional Fatigue Inventory,MFI-20）对脑卒中后疲乏（post-stroke fatigue,PSF）的诊断价值。方法 采用方便抽样法抽取328例脑卒中患者作为研究对象,以疲乏严重度量表（Fatigue Severity Scale,FSS）结果为诊断标准,评估MFI-20诊断PSF的效能。结果 328例患者中,136例使用FSS诊断PSF（41.5%）,153例应用MFI-20诊断PSF（46.6%）。以FSS为标准,MFI-20对PSF的诊断符合率为91.8%,Kappa值为0.833,灵敏度为96.3%,特异度为88.5%,阳性预测值为85.6%,阴性预测值为97.1%。MFI-20诊断PSF的ROC曲线下面积为0.924。结论 MFI-20具有良好的诊断价值,其多维的特点与PSF的复杂性相契合,可作为PSF的诊断工具。 相似文献
4.
Karin A.M. Janssens Albertine J. OldehinkelIrma J. Bonvanie Judith G.M. Rosmalen 《Journal of psychosomatic research》2014
Objective
An inactive lifestyle has been associated with functional somatic symptoms (FSS), but findings are contradictory. Moreover, mediating factors in this relationship are unclear. We examined whether low physical activity was related to FSS in adolescents, and whether this association was mediated by low physical fitness.Methods
This study was part of the Dutch longitudinal cohort study TRAILS, in which 1816 adolescents (mean age 16.3 years, SD 0.7) participated during the third (T3) and 1881 (mean age 19.1 years, SD 0.6) during the fourth (T4) assessment waves. Adolescents' exercise and sedentary behavior levels and the number of FSS were assessed by questionnaires at T3 and T4. Physical fitness (VO2Max) was determined for 687 adolescents by a shuttle run test at T3. The association between physical activity and FSS was examined with bootstrapped linear regression analyses, adjusted for smoking and gender. In addition, bootstrapped mediation analyses were performed.Results
A lack of exercise (b = 0.05, bootstrap 95%-CI: 0.01 to 0.09) and high sedentary behavior (b = 0.10, bootstrap 95%-CI: 0.06 to 0.14) at T3 were positively associated with FSS at T3. Since no longitudinal effects were found, shared associations were tested instead of mediation. The associations between a lack of exercise and FSS, and sedentary behavior and FSS were shared with physical fitness (b = 0.01, bootstrap 95%-CI: 0.010.02. and b = 0.03, bootstrap 95%-CI: 0.010.05).Conclusion
An inactive lifestyle is associated with increased FSS in adolescents. Only part of this association is shared with low physical fitness. 相似文献5.
Objective
To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS).Design
Single-blinded, randomized placebo-controlled trial.Setting
Several medical clinics.Participants
Volunteer sample of patients (N=250) diagnosed with CTS (n=150).Interventions
Neurodynamic techniques were used in the neurodynamic techniques group, and sham therapy was used in the sham therapy group. In the neurodynamic techniques group, neurodynamic sequences were used, and sliding and tension techniques were also used. In the sham therapy group, no neurodynamic sequences were used, and therapeutic procedures were performed in an intermediate position. Therapy was conducted twice weekly for a total of 20 therapy sessions.Main Outcome Measures
Symptom severity (symptom severity scale) and functional status (functional status scale) of the Boston Carpal Tunnel Questionnaire.Results
A baseline assessment revealed no intergroup differences in all examined parameters (P>.05). After therapy, there was statistically significant intragroup improvement in nerve conduction study (sensory and motor conduction velocity and motor latency) only for the neurodynamic techniques group (P<.01). After therapy, intragroup statistically significant changes also occurred for the neurodynamic techniques group in pain assessment, 2-point discrimination sense, symptom severity scale, and functional status scale (in all cases P<.01). There were no group differences in assessment of grip and pinch strength (P>.05).Conclusions
The use of neurodynamic techniques has a better therapeutic effect than sham therapy in the treatment of mild and moderate forms of CTS. 相似文献6.
血管内皮细胞糖萼是位于内皮细胞表面的一层多糖蛋白复合结构,在内皮细胞表面形成选择性通透屏障。在对糖萼进行概述后,主要针对在流动剪切力作用下,糖萼与物质传输,尤其是与大分子物质如低密度脂蛋白(low density lipoprotein,LDL)的关系展开论述。其关系体现为:一方面,糖萼的厚度和完整性影响LDL的浓度极化及跨内膜输运;糖萼中的硫酸肝素蛋白聚糖参与残余脂蛋白代谢的全过程。另一方面,LDL的氧化产物ox-LDL会破坏内皮细胞糖萼层的主要成分硫酸肝素。研究糖萼与脂蛋白的关系,将为阐明动脉粥样硬化的发病机理提供新的线索,并为将糖萼作为新的防治靶点提供更多依据。 相似文献
7.
Gustaf Magaard Per Wester Richard Levi Peter Lindvall Emma Gustafsson Arzhang Nazemroaya Sedeh Malin Lönnqvist Stina Berggren Kristin Nyman Xiaolei Hu 《Journal of stroke and cerebrovascular diseases》2018,27(11):3224-3235
Background
Unmet rehabilitation needs are common among stroke survivors. We aimed to evaluate whether a comprehensive graphic “Rehab-Compass,” a novel combination of structured patient-reported outcome measures, was feasible and useful in facilitating a capture of patients' rehabilitation needs in clinical practice.Methods
A new graphic overview of broad unmet rehabilitation needs covers deficits in functioning, daily activity, participation, and quality of life. It was constructed by using 5 patient-oriented, well-validated, and reliable existing instruments with converted data into a 0 (worst outcome) to 100 (best outcome) scale but unchanged in terms of variable properties. Satisfaction of the Rehab-CompassTM was studied by a qualitative interview of 9 patients with stroke and 3 clinicians. Practical feasibility and capacity of the instrument were evaluated in a cross-sectionalstudy with 48 patients at 5-month follow-ups after subarachnoid hemorrhage.Results
The Rehab-CompassTM identified and graphically visualized a panoramic view of the multidimensional needs over time which was completed before clinical consultation. The Rehab-CompassTM appeared to be feasible and time-efficientin clinical use. The interviews of both patients and clinicians showed high satisfaction when using the Rehab-CompassTM graph. In the studied stroke patients, the Rehab-CompassTM identified memory and processing information, fatigue, mood, and pain after subarachnoid hemorrhage as the most common problems.Conclusions
The graphic Rehab-CompassTM seems to be a feasible, useful, and time-saving tool for identification of unmet rehabilitation needs among stroke survivors in clinical practice. Further research is needed to make the Rehab-CompassTM more concise and evaluate the instrument among different stroke subgroups. 相似文献8.
目的 :N -乙酰氨基葡糖苷酶 (N -acetylglucosaminidase)是链球菌gordonii六种胞外糖苷酶之一。为研究该酶 ,克隆和表达该基因片段。方法 :将链球菌gordoniiFSS2染色体DNA分离提纯 ,用限制性内切酶Sau 3AI不完全酶切 ,产生长度不等的随机片段 ,琼脂糖凝胶电泳分离和回收 2 - 8kpb的随机片段 ,然后与BamHI线性化及 5’端脱磷处理的载体pUC 18连接 ,转化大肠杆菌XL1-Blue;β—半乳糖苷酶筛选系统及酶切 ,检测插入片段。根据N -乙酰氨基葡糖苷酶与特异人工底物X -GlucNac反应 ,有色物质X被释放原理 ,筛选表达克隆。结果 :共有 6×10 6个转化子 ,约 5 0 %转化子含有插入片段 ;检测到 8个N—乙酰氨基葡糖苷酶表达克隆。结论 :所构建的基因组文库具有完整性 ,该基因在大肠杆菌XL1-Blue中成功表达。 相似文献
9.
Background
Prior studies have shown that children with congenital hearing loss have increased rates of behavior disorders. Child hearing loss has also been reported to be associated with increased maternal stress. Little is known about the behavior or the predictors of behavioral outcomes of children with hearing loss identified early and receiving Early Intervention services.Aim
The objective of this study was to identify the behavioral outcomes in early identified children with hearing loss and control hearing children at 18-24 months of age and to examine the impact of stress on early behavior development. It was hypothesized that children with hearing loss will have more behavior problems, and maternal stress will be associated with child behavior problems.Study design
Prospective observational.Subjects
Children with and without congenital hearing loss and their mothers.Outcome measures
The Parenting Stress Index and the Child Behavior Checklist.Results
Children with hearing loss had increased scores for withdrawn and internalizing behavior. In multivariate analyses after adjusting for hearing loss, Neonatal Intensive Care Unit stay, and socioeconomic status, maternal stress independently contributed to higher scores for internalizing behavior, externalizing behavior, and total behavior problems.Conclusion
Maternal stress is an important correlate of behavior problems for children with hearing loss and should be considered by Early Intervention providers. 相似文献10.
目的 探讨流体剪切力(fluid shear stress, FSS)对成骨细胞p21表达的影响,并明确p21在FSS诱导的成骨细胞增殖过程中的作用。方法 对成骨细胞加载不同时间(0、15、30、45、60 min)、1.2 Pa FSS。用CCK-8实验、EdU实验检测成骨细胞增殖活性。用siRNA p21或pcDNA p21转染成骨细胞,并用Western blotting检测转染效果。Western blotting检测不同干预条件下p21、cyclin D1、CDK4的表达变化。结果 加载1.2 Pa FSS后,p21表达显著下调,且加载45 min后表达水平最低。加载FSS和下调p21表达都显著增强成骨细胞增殖,并增加cyclin D1、CDK4表达。而上调p21表达后,加载FSS不再具有增强成骨细胞增殖和增加cyclin D1、CDK4表达的作用。结论 1.2 Pa FSS能够下调成骨细胞p21表达,在加载45 min时下调最为明显。p21下调对成骨细胞增殖具有促进作用,且FSS通过下调p21促进成骨细胞增殖。 相似文献