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1.
BMC Med ; 22(1): 115, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481272

RESUMO

BACKGROUND: The global dementia prevalence is surging, necessitating research into contributing factors. We aimed to investigate the association between metabolic syndrome (MetS), its components, serum uric acid (SUA) levels, and dementia risk. METHODS: Our prospective study comprised 466,788 participants without pre-existing MetS from the UK Biobank. We confirmed dementia diagnoses based on the ICD-10 criteria (F00-03). To evaluate the dementia risk concerning MetS, its components, and SUA levels, we applied Cox proportional hazards models, while adjusting for demographic factors. RESULTS: Over a median follow-up of 12.7 years, we identified 6845 dementia cases. Individuals with MetS had a 25% higher risk of all-cause dementia (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.19-1.31). The risk increased with the number of MetS components including central obesity, dyslipidemia for high-density lipoprotein (HDL) cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides. Particularly for those with all five components (HR = 1.76, 95% CI = 1.51-2.04). Dyslipidemia for HDL cholesterol, hypertension, hyperglycemia, and dyslipidemia for triglycerides were independently associated with elevated dementia risk (p < 0.01). MetS was further linked to an increased risk of all-cause dementia (11%) and vascular dementia (VD, 50%) among individuals with SUA levels exceeding 400 µmol/L (all-cause dementia: HR = 1.11, 95% CI = 1.02-1.21; VD: HR = 1.50, 95% CI = 1.28-1.77). CONCLUSIONS: Our study provides robust evidence supporting the association between MetS, its components, and dementia risk. These findings emphasize the importance of considering MetS and SUA levels in assessing dementia risk, offering valuable insights for prevention and management strategies.


Assuntos
Demência , Dislipidemias , Hiperglicemia , Hipertensão , Síndrome Metabólica , Humanos , Ácido Úrico , Estudos Prospectivos , Fatores de Risco , Hipertensão/complicações , HDL-Colesterol , Triglicerídeos , Dislipidemias/complicações , Demência/etiologia , Demência/complicações
3.
Semin Ophthalmol ; 38(5): 475-481, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36318655

RESUMO

PURPOSE: To study the clinical characteristics of children with severe ocular chemical or thermal injuries in South China and evaluate prognostic factors affecting final visual acuity (VA). METHODS: A five-year retrospective study was conducted on pediatric patients who were first admitted to Zhongshan Ophthalmic Center with severe chemical or thermal ocular injuries. Data collected and analyzed comprised socioeconomic and socio-demographic data, details regarding their injury, subsequent treatment, and visual outcomes. RESULTS: Of the 105 children (121 eyes), severe ocular chemical and thermal injuries in South China were prevalent in preschool children (n = 51, 58.1%), predominantly male (n = 82, 78.1%), and primarily children in rural areas (n = 98, 93.3%). Seventy-one eyes (78.9%) had a final VA <0.05, and multivariate logistic regression analysis revealed that initial VA after injury (OR = 0.47), the maternal education level (OR = 0.23), and monthly household income (OR = 0.31) were significantly associated with final VA. CONCLUSION: Final VA was associated with the initial VA, the maternal level of education, and family income; necessitating an increased provision of public education to children from low-income families, especially in rural areas.


Assuntos
Traumatismos Oculares , Pré-Escolar , Criança , Humanos , Masculino , Feminino , Estudos Retrospectivos , Prognóstico , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/terapia , Traumatismos Oculares/complicações , Hospitalização , China/epidemiologia
4.
Ocul Surf ; 25: 1-7, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35395386

RESUMO

PURPOSE: To compare the presentation and severity of meibomian gland dysfunction (MGD) in patients with and without chronic ocular graft-versus-host disease (coGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: This prospective cross-sectional study included 79 patients (47 with coGVHD and 32 without) after allo-HSCT. All participants completed ocular surface disease index questionnaire, and received slit lamp, ocular surface interferometer, meibography and confocal microscopy examination. The prevalence and severity of MGD were compared between two groups and related factors were analyzed. Main outcome measures were lipid layer thickness (LLT) and meiboscore. RESULTS: Similarly high prevalence of MGD was detected in coGVHD and non-coGVHD groups (87.2% vs 84.4%, P = 0.977). Among those with MGD, although patients without coGVHD had longer noninvasive break-up time [5.54 (2.87, 9.37) vs 2.29 (0.00, 3.82) s, P < 0.001], patients in two groups presented similarly decreased LLT (53.5 ± 22.3 vs 47.1 ± 25.2 nm, P = 0.286), increased meiboscore (2.7 ± 1.5 vs 3.5 ± 1.8, P = 0.060) and enlarged acinar unit area (1647.7 ± 942.9 vs 1808.8 ± 1211.5 µm2, P = 0.592). Meibomian gland inflammation and fibrosis were observed in both groups, but more predominant in coGVHD group. Results were consistent when patients within a comparable post-HSCT time interval were compared. Regression analysis revealed neither LLT nor meiboscore was associated with coGVHD severity. LLT was positively correlated with systemic immunosuppressant use (ß = 12.0, P = 0.044), while meiboscore was positively correlated with lymphoma (ß = 1.78, P = 0.040) and matched unrelated donor (ß = 1.59,P = 0.008). CONCLUSIONS: MGD was common and evident in patients after allo-HSCT. MGD is not different between coGVHD and non-coGVHD patients except more inflammation and fibrosis in the former.


Assuntos
Síndromes do Olho Seco , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Disfunção da Glândula Tarsal , Estudos Transversais , Síndromes do Olho Seco/diagnóstico , Fibrose , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/epidemiologia , Doença Enxerto-Hospedeiro/metabolismo , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Inflamação/metabolismo , Disfunção da Glândula Tarsal/diagnóstico , Disfunção da Glândula Tarsal/epidemiologia , Disfunção da Glândula Tarsal/etiologia , Glândulas Tarsais/metabolismo , Estudos Prospectivos , Lágrimas/metabolismo
5.
Taiwan J Ophthalmol ; 11(2): 132-140, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34295618

RESUMO

Immune-related ocular surface diseases, a group of diseases in which immune dysregulation damages the ocular surface, can induce uncontrolled inflammation and persistent epithelial defect, thus leading to the most severe forms of acute keratoconjunctivitis, dry eye disease, epithelial keratitis, stromal ulceration, and corneal perforation. As these diseases are often refractory to treatments, they have a threatening impact on the vision and life quality of patients. This review summarizes the current literature regarding the clinical application of sutured and self-retained cryopreserved amniotic membrane (AM) in treating Stevens-Johnson syndrome/toxic epidermal necrolysis, ocular graft-versus-host disease, Sjögren's syndrome, Mooren's ulcer, and peripheral ulcerative keratitis. Current evidence supports the safety and effectiveness of AM, especially self-retained cryopreserved AM, in decreasing ocular surface inflammation, promoting corneal epithelial and stromal healing, improving visual acuity, and preventing sight-threatening complications. Future studies are still required to validate the above findings and explore the varied application methods of AM to improve the clinical efficacy in maintaining ocular surface health.

6.
JAMA Ophthalmol ; 139(8): 830-837, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34110380

RESUMO

IMPORTANCE: Allergic conjunctivitis (AC) is one of the most common allergic diseases and is especially problematic in children and adolescents. The course of AC is generally prolonged and often recurs. Understanding the health-related quality of life (QOL) of both children with AC and their parents would be useful. OBJECTIVE: To evaluate the association between AC and health-related QOL in children and their parents. DESIGN, SETTING, AND PARTICIPANTS: A prospective case-control study was conducted at Zhongshan Ophthalmic Center, a single tertiary referral center, from November 16, 2019, through January 20, 2020. Participants comprised 92 children aged 5 to 18 years with AC and their parents and 96 healthy, age-matched children who served as controls and their parents. The 92 children in the AC group were subdivided into cohorts with vernal keratoconjunctivitis (VKC) (23 [25.0%]) or atopic keratoconjunctivitis (AKC) (7 [7.6%]) and seasonal allergic conjunctivitis (SAC) (26 [28.3%]) or perennial allergic conjunctivitis (PAC) (36 [39.1%]). EXPOSURES: Allergic conjunctivitis. MAIN OUTCOMES AND MEASURES: Pediatric Quality of Life Inventory, version 4.0 (PedsQL), scores for children and their parents. Scores range from 0 to 100, with higher scores indicating better health-related QOL and fewer negative aspects. RESULTS: In the AC group, 77 of 92 (83.7%) participants were boys, and 67 (72.8%) of the parents were women. Of the individuals in the control group, 55 of 96 (57.3%) of the children were girls and 76 (79.2%) of the parents were women. Median total PedsQL scores were reduced in both children with AC (69.6 [interquartile range [IQR], 66.3-72.8 vs 96.7; IQR, 92.7-98.9; P < .001) and their parents (68.8; IQR, 63.9-71.4 vs 96.5; IQR, 95.1-97.9; P < .001). The reduction in health-related QOL was more severe in children with VKC/AKC than in those with SAC/PAC (difference, -3.3; 95% CI, -5.4 to -1.1; P = .004) and their parents (difference, -4.3; 95% CI, -7.1 to -2.1; P < .001). In the AC group, a higher corneal fluorescein staining score was associated with lower QOL in children (ß, -1.16; 95% CI, -1.80 to -0.52; P = .001); higher corneal fluorescein staining scores (ß, -1.12; 95% CI, -1.74 to -0.50; P = .001) and multiple clinical consultations (ß, -3.96; 95% CI, -7.34 to -0.57; P = .02) were associated with lower QOL in parents. The parents' QOL scores were correlated with their children's QOL scores (correlation coefficient, r = 0.59; P < .001). CONCLUSIONS AND RELEVANCE: These findings suggest AC has a negative association with health-related QOL for children and their parents, especially in children with VKC/AKC or higher corneal fluorescein staining scores.


Assuntos
Conjuntivite Alérgica , Qualidade de Vida , Adolescente , Estudos de Casos e Controles , Criança , Feminino , Fluoresceína , Humanos , Masculino , Pais
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