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1.
Adv Exp Med Biol ; 1191: 187-196, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32002930

RESUMEN

Under the partial influences of paradigm shift form category to dimension, the Diagnostic and Statistical Manual of Mental Disorder (DSM) was revised to the fifth edition (DSM-5); however, due to the lack of consistent biological makers and processes and the restricted availability of dimensional meta-structure, the revisions for the DSM-5 were based on a combination of categorical and dimensional approaches. Anxiety disorders were more clearly and consistently defined in the DSM-5 with the removal of obsessive compulsive, acute stress, and post-traumatic stress disorders. Differences between the childhood and adulthood categories of anxiety disorders were decreased, and overall, the symmetrical classification of anxiety subtypes was increased, since separation anxiety disorder and selective mutism were considered anxiety disorders, not neurodevelopmental disorders. Additionally, based on growing evidence, agoraphobia is distinct from panic disorder. Next, considering cultural syndromes including taijin kyofusho, khyal cap, trung gio attacks, and ataque de nervios, cultural influences are considered a significant factor for definitions and presentations of anxiety disorders. Controversies in the DSM-5 criteria for anxiety disorders are lowering the diagnostic thresholds of anxiety disorders and limiting the dichotomous view of anxiety and depression when defining generalized anxiety disorder. Further studies of alternative approaches to the restrictions of the DSM-5 criteria of anxiety disorders, including transdiagnostic specifiers and dimensional assessment tools, may be required.


Asunto(s)
Trastornos de Ansiedad/clasificación , Trastornos de Ansiedad/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Factores de Edad , Ansiedad/complicaciones , Ansiedad/psicología , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/psicología , Depresión/complicaciones , Depresión/psicología , Humanos , Trastornos por Estrés Postraumático/clasificación , Trastornos por Estrés Postraumático/diagnóstico
2.
Medicine (Baltimore) ; 99(6): e19105, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028437

RESUMEN

This study is to explore the quality of life (QoL) of the rural poor elderly in central China (Anhui province) and the influencing factors.A multi-stage random sampling method was used to extract 3352 effective samples of the rural elderly in Anhui, including 1206 poor and 2146 non-poor elderly subjects. Euro QoL 5-dimension questionnaire (EQ-5D) was used for the measurement of QoL. Descriptive statistics and χ test were used to compare and analyze the sociodemographic characteristics and QoL scores between poor and non-poor elderly. Multiple linear regression was used to assess the influencing factors of QoL.There were significant differences in gender, age, education levels, professions, chronic diseases, physical discomfort within 2 weeks, hospitalization within 1 year, economic sources, and migrant workers between the rural poor and non-poor elderly groups. The QoL of rural poor elderly scored significantly higher than the non-poor elderly, in all these five dimensions. The average EuroQol Visual Analogue Scale (EQ-VAS) of poor elderly was 65.689, lower than the non-poor elderly (71.039). After controlling the confounding factors, there was a significant statistical difference in the total utility score of EQ-5D between the poor and non-poor elderly groups.The QoL of poor elderly in central China is lower than non-poor elderly, with the worst dimension of pain/discomfort. The QoL of rural poor elderly in this area could be affected by many factors, to which more attention should be paid.


Asunto(s)
Pobreza , Calidad de Vida , Población Rural , Factores de Edad , Anciano , Anciano de 80 o más Años , China , Femenino , Estado de Salud , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Pobreza/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios
3.
Isr Med Assoc J ; 22(2): 75-78, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32043322

RESUMEN

BACKGROUND: The treatment of elderly patients with advanced stage ovarian carcinoma is challenging due to a high morbidity. OBJECTIVES: To evaluate the clinical course and outcome of elderly patients with advanced stage ovarian carcinoma receiving neoadjuvant chemotherapy (NACT). METHODS: A retrospective study of all patients with stage IIIC and IV ovarian carcinoma receiving NACT in one medical center (between 2005 and 2017). The study group criteria age was above 70 years. The control group criteria was younger than 70 years old at diagnosis. Demographics and treatment outcomes were compared between groups. Primary outcomes were progression-free survival (PFS) and overall survival (OS). RESULTS: Overall, 105 patients met the inclusion criteria, 71 patients (67.6%) were younger than 70 years and 34 patients (32.4%) older. Rates of interval cytoreduction were significantly higher in younger patients (76.1% vs. 50.0%, P = 0.01). Of those who underwent interval cytoreduction, no difference was found in rates of optimal debulking between groups (83.35% vs. 100%, P = 0.10). Using a Kaplan-Meier survival analysis, no significant differences were observed between groups in PFS or OS, P > 0.05. Among the elderly group alone, patients who underwent interval cytoreduction had significantly longer PFS than those without surgical intervention (0.4 ± 1.7 vs. 19.3 ± 19.4 months, P = 0.001). CONCLUSIONS: Elderly patients with ovarian carcinoma who received NACT undergo less interval cytoreduction than younger patients, with no difference in PFS and OS. However, among the elderly, interval cytoreduction is associated with significantly higher PFS.


Asunto(s)
Carcinoma Epitelial de Ovario , Quimioterapia Adyuvante/métodos , Procedimientos Quirúrgicos de Citorreducción/estadística & datos numéricos , Neoplasias Ováricas , Factores de Edad , Anciano , Carcinoma Epitelial de Ovario/mortalidad , Carcinoma Epitelial de Ovario/patología , Carcinoma Epitelial de Ovario/terapia , Supervivencia sin Enfermedad , Femenino , Humanos , Israel/epidemiología , Terapia Neoadyuvante/métodos , Estadificación de Neoplasias , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/patología , Neoplasias Ováricas/terapia , Supervivencia sin Progresión , Estudios Retrospectivos , Resultado del Tratamiento
4.
Medicine (Baltimore) ; 99(3): e18793, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011479

RESUMEN

Pulse wave velocity (PWV) is a reliable measurement of arterial stiffness. Our study assesses the association between body mass index (BMI) and brachial-ankle PWV (baPWV) in a healthy cohort and seeks to explain possible mechanisms associated with the obesity paradox.A cross-sectional study was conducted in 578 normal individuals. The mean age was 48.3 ±â€Š14.6 years, and 468 (81.0%) were men. 288 subjects (49.8%) were overweight and obese. baPWV and ankle-brachial index (ABI) were performed to evaluate arterial stiffness and atherosclerosis respectively. Normal weight was defined as 18.5 < BMI <25 kg/m, overweight as 25 ≤ BMI < 28 kg/m and obesity as BMI ≥28 kg/m.The overweight/obese subjects had significantly higher baPWV than the normal-weight group (1490.0 ±â€Š308.0/1445.2 ±â€Š245.2 cm/s vs 1371.2 ±â€Š306.4 cm/s, P < .001). For the whole cohort, baPWV showed a significant positive correlation with BMI (r = 0.205, P < .001). However, baPWV was significantly lower as BMI increased: 1490.0 ±â€Š308.0 cm/s (overweight); 1445.2 ±â€Š245.2 cm/s (obese); P < .001) when adjusted for age, gender, heart rate, mean blood pressure, and cardiovascular risk factors (glucose, cholesterol, triglyceride, and low-density lipoprotein). For the whole cohort BMI was negatively associated with baPWV (ß = -0.06, P = .042). ABI showed no relationship with BMI. In a middle-age healthy Chinese population, arterial stiffness measured as baPWV increased with BMI.Evidence of reduced arterial stiffness with increasing BMI when accounting for all other cardiovascular risk factors may contribute to underlying factors involved in the obesity paradox that becomes more prominent with increasing age.


Asunto(s)
Índice de Masa Corporal , Análisis de la Onda del Pulso , Rigidez Vascular , Factores de Edad , China , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/fisiopatología
5.
Medicine (Baltimore) ; 99(5): e18438, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000356

RESUMEN

Burkitt lymphoma (BL), an aggressive malignancy, brings a prognosis varying among children, adolescents, and adults. Most of previous retrospective studies of BL focused on a part of population. This study aimed to find the leading prognostic factors in BL among patients of different age groups. World Health Organization classification of lymphoid neoplasms in 2008 and revision in 2016 were used as diagnostic criteria for BL. We compared the laboratory results and clinical manifestations in 2 age groups by Kaplan-Meier survival analysis. Our study strongly indicated that age >14 years and lactate dehydrogenase >570 U/L were 2 powerful prognostic factors for BL. The results indicated that poor prognosis may be for the poor tolerance and low dose of drugs in adolescents and adults.


Asunto(s)
Linfoma de Burkitt/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
6.
Medicine (Baltimore) ; 99(3): e18686, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011444

RESUMEN

The coexistence of low back pain (LBP) and temporomandibular disorder (TMD) has often been noted clinically. However, studies of the association between these two conditions involving a large population with longitudinal evidences are lacking. Therefore, the study aimed to investigate the association between LBP and TMD in a nationwide-matched cohort population with a 15-year follow-up.Data of 65,121 patients newly diagnosed with LBP were analyzed, along with those of 195,363 (1:3) sex- and age-matched controls. Multivariate Cox regression analysis was used to determine TMD risk between the LBP and non-LBP groups. Kaplan-Meier method was used for determining the cumulative risk of first-onset TMD between groups, with a 15-year follow-up.The LBP group was more likely to develop first-onset TMD (adjusted hazards ratio (HR) = 1.561, P < .001), after adjusting for demographic variables and comorbidities. The risk factors for TMD were LBP, young age, higher insured premium, and osteoporosis. In the subgroup analysis, the LBP group had a higher risk of TMD than the non-LBP group in all stratifications.LBP is the risk factor contributing to the development of first-onset TMD. Therefore, clinicians should be reminded to manage LBP disorders concurrently when treating TMD.


Asunto(s)
Dolor de la Región Lumbar/epidemiología , Trastornos de la Articulación Temporomandibular/epidemiología , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores Socioeconómicos
7.
Medicine (Baltimore) ; 99(3): e18750, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011458

RESUMEN

BACKGROUND: The use of cemented and cementless fixations in primary total knee arthroplasty (TKA) in young patients is controversial. Previous reviews predominantly relied on data from retrospective studies. This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the optimal fixation mode in TKA for young patients. METHODS: The PubMed, Embase, Medline, Web of Science, and full Cochrane Library electronic databases were searched from inception to July 2018. The outcome measurements consisted of functional outcomes (Knee Society Score [KSS], range of motion [ROM]), radiolucent lines, aseptic loosening, total complications, and reoperation rate. Study data were pooled using a random-effects model. RESULTS: Six RCTs were included in the systematic review and meta-analysis. The mean follow-up period was 12 years (range, 2-16.6 years). Cementless TKA was associated with higher KSS-function (P < .0001), higher KSS-pain (P = .005), better ROM recovery (P = .01), and fewer radiolucent lines (<1 mm) (P = .04) compared with cemented TKA. No significant intergroup differences were observed for KSS-knee, total complications, aseptic loosening, or reoperation rate. These results based on a random-effects model were unchanged by sensitivity analysis assumptions. CONCLUSION: Cementless TKA was substantially superior to cemented TKA in young patients. Although the complication and survival rates were similar between groups, better clinical outcomes were obtained with cementless fixation. Further well-designed studies with long follow-up durations are necessary to confirm our findings.


Asunto(s)
Artroplastia de Reemplazo de Rodilla/métodos , Cementos para Huesos , Adulto , Factores de Edad , Anciano , Humanos , Persona de Mediana Edad , Dimensión del Dolor , Complicaciones Posoperatorias , Falla de Prótesis , Ensayos Clínicos Controlados Aleatorios como Asunto , Rango del Movimiento Articular , Reoperación
8.
Medicine (Baltimore) ; 99(3): e18754, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011459

RESUMEN

The purpose of this study was to evaluate related risk factors for gallstone disease in Shanghai.We analyzed successive physical examinations of 2288 adults who were recruited at the Jinshan Branch of the Sixth People's Hospital of Shanghai and Jinshan Hospital Affiliated to Fudan University Hospital from July 2010 to December 2012. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to measure the influence factors on the risks of gallstone development.The incidence of gallstone disease was 4.11% (94/2,288). Older age (OR: 1.02; 95% CI: 1.00-1.03; P = .039), higher body weight (OR: 1.02; 95% CI: 1.00-1.04; P = .021), alanine transaminase activity (ALT) (OR: 1.02; 95% CI: 1.01-1.03; P = .001), total standard bicarbonate (SB) (OR: 1.04; 95% CI: 1.02-1.06; P < .001), free SB (OR: 1.17; 95% CI: 1.12-1.21; P < .001), and low density lipoprotein (LDL) levels (OR: 1.59; 95% CI: 1.32-1.91; P < .001) were associated with an increased risk of gallstone disease. Based on univariate logistic analysis, increased triglyceride (TG) levels were associated with a reduced risk of gallstone disease (OR: 0.76; 95% CI: 0.60-0.97; P = .024). The results of multivariable logistic regression analysis showed higher LDL levels correlated with an increased risk of gallstone disease (OR: 1.92; 95% CI: 1.31-2.81; P < .001), while age, weight, ALT, total SB, free SB, and TG levels did not affect the risk of gallstone disease.The although unadjusted results showed age, weight, ALT, total SB, free SB, TG, and LDL levels to be associated with the risk of gallstone disease, adjusting for potential factors revealed only increased LDL levels to be associated with an increased risk of gallstone disease.


Asunto(s)
Cálculos Biliares/epidemiología , Factores de Edad , Alanina Transaminasa/sangre , Biomarcadores/sangre , Peso Corporal , China/epidemiología , Femenino , Humanos , Incidencia , Lípidos/sangre , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
9.
Anticancer Res ; 40(2): 1087-1093, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32014958

RESUMEN

BACKGROUND: The short- and long-term outcomes of esophagectomy for esophageal cancer were fully evaluated in patients older than 75 years of age. PATIENTS AND METHODS: The present study selected patients who received esophagectomy for esophageal cancer. Patients were divided into non-elderly patients [age <75 years (non-elderly group)] and elderly patients [age ≥75 years (elderly group)]. The postoperative surgical morbidity, postoperative 30-days mortality, recurrence-free survival (RFS), and overall survival (OS) rates were evaluated between the non-elderly group and elderly group. RESULTS: One hundred twenty-two patients were evaluated in this study. Ninety-eight patients and 24 patients were classified into the non-elderly group and elderly group, respectively. The postoperative surgical complication rates in the non-elderly and elderly groups were 71.4% and 75.0%. There was not a statistically significant difference between the two groups (p=0.710). Mortality was observed in 1 patient in the elderly group (4.2%) due to cardiovascular disease. Significant differences were observed in the five-year OS and RFS rates of the elderly and non-elderly groups (55.4% vs. 29.7%, p=0.0017 and 42.2% vs. 21.2%, p=0.0334, respectively). CONCLUSION: Although the rate of postoperative surgical complications after esophagectomy for esophageal cancer was almost equal in the elderly and the non-elderly patients, significant differences were observed in the mortality and long-term outcomes of the two groups. Thus, the surgical strategy and perioperative care must be carefully planned for esophageal cancer patients older than 75 years of age.


Asunto(s)
Neoplasias Esofágicas/cirugía , Esofagectomía , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etiología , Neoplasias Esofágicas/mortalidad , Esofagectomía/efectos adversos , Esofagectomía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Atención Perioperativa , Complicaciones Posoperatorias/etiología , Pronóstico , Resultado del Tratamiento
12.
Life Sci ; 242: 117242, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31891723

RESUMEN

Age is closely related with the occurrence and development of tumors, and with treatment outcomes. To improve the accuracy and rigor of preclinical studies, and to enhance consistency between the preclinical research and the clinical reality, the age of experimental animals used in preclinical studies is important. The mouse genome is 99% identical to the human genome, and mice have similar patterns with respect to organs and systemic physiology. Thus, mice have been the most widely used animals in anti-tumor research. However, most mice used in such studies are 6 to 8 weeks old, ignoring the fact that different tumors may often occur in various periods, with a particular tendency to occur in later stages of life. The great difference in age limits the success rate of clinical transformation. Therefore, it is very important to choose mice of suitable age for preclinical studies and to correlate ages of human and mice. Only a few related studies have been reported and there is a lack of consistency in the findings. This review points out that age is one of the important factors in anti-tumor research, and establishes a new method for calculating the age correlation between humans and mice. The equations obtained from the method can help researchers conveniently determine suitable aged mouse for their research, which will improve the rigor of their experimental results. Furthermore, this method can be used beyond anti-tumor research, in studies on other diseases that use mouse as an animal model.


Asunto(s)
Envejecimiento , Antineoplásicos/uso terapéutico , Neoplasias/tratamiento farmacológico , Factores de Edad , Animales , Investigación Biomédica , Modelos Animales de Enfermedad , Humanos , Ratones
13.
J Insect Sci ; 20(1)2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31899494

RESUMEN

Mamestra brassicae L. is an important, regionally migratory pest of vegetable crops in Europe and Asia. Its migratory activity contributes significantly to population outbreaks, causing severe crop yield losses. Because an in-depth understanding of flight performance is key to revealing migratory patterns, here we used a computer-linked flight mill and stroboscope to study the flight ability and wingbeat frequency (WBF) of M. brassicae in relation to sex, age, temperature, and relative humidity (RH). The results showed that age significantly affected the flight ability and WBF of M. brassicae, and 3-d-old individuals performed the strongest performance (total flight distance: 45.6 ± 2.5 km; total flight duration: 9.3 ± 0.3 h; WBF: 44.0 ± 0.5 Hz at 24°C and 75% RH). The age for optimal flight was considered to be 2-3 d old. Temperature and RH also significantly affected flight ability and WBF; flight was optimal from 23°C to 25°C and 64-75% RH. Because M. brassicae thus has great potential to undertake long-distance migration, better knowledge of its flight behavior and migration will help establish a pest forecasting and early-warning system.


Asunto(s)
Vuelo Animal , Mariposas Nocturnas/fisiología , Alas de Animales/fisiología , Factores de Edad , Animales , Femenino , Humedad , Masculino , Factores Sexuales , Temperatura Ambiental
14.
Medicine (Baltimore) ; 99(2): e18440, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914017

RESUMEN

To investigate the relationship amongst human growth hormone (HGH), sex, and age groups.A cross-sectional study was conducted on a health check-up population from Wannan area of China from 2014 to 2016. The study involved 6843 individuals aged 23 to 85 years. Logistic regression analysis and smooth curve were applied to determine the relationship amongst age, sex, and HGH.The average level of HGH in the population was 0.37 ±â€Š0.59 ng/mL. There were significant differences in sex, age, body mass index (BMI), triglycerides (TG), total cholesterol (TC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glucose (GLU) amongst different quartiles of HGH (P < .001). A U-shape relationship was established between HGH and age. After sex stratification, the results showed that the thresholds of age were 60 years in women, and 50 years in men, after adjusting for body mass index, triglycerides, total cholesterol, blood pressure, and blood glucose. Logistic regression showed that HGH level decreased in women aged <60 years (OR = 1.472, P < .001) and increased in men aged >50 years (OR = 0.711, P < .001). So the distributive characteristics of HGH concentration vary with sex and age group.


Asunto(s)
Presión Sanguínea/fisiología , Hormona de Crecimiento Humana/sangre , Triglicéridos/sangre , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , China/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales
15.
Medicine (Baltimore) ; 99(2): e18625, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914043

RESUMEN

BACKGROUND: Inequality in health and health care remains a rather challenging issue in China, existing both in rural and urban area, and between rural and urban. This study used nationally representative data to assess inequality in both rural and urban China separately and to identify socioeconomic factors that may contribute to this inequality. METHODS: This study used 2008 National Health Services Survey data. Demographic characteristics, income, health status, medical service utilization, and medical expenses were collected. Horizontal inequality analysis was performed using nonlinear regression method. RESULTS: Positive inequity in outpatient services and inpatient service was evident in both rural and urban area of China. Greater inequity of outpatient service use in urban than that in rural areas was evident (horizontal inequity index [HI] = 0.085 vs 0.029). In contrast, rural areas had greater inequity of inpatient service use compared to urban areas (HI = 0.21 vs 0.16). The decomposition analysis found that the household income made the greatest pro-rich contribution in both rural and urban China. However, chronic diseases and aging were also important contributors to the inequality in rural area. CONCLUSION: The inequality in health service in both rural and urban China was mainly attributed to the household income. In addition, chronic disease and aging were associated with inequality in rural population. Those findings provide evidences for policymaker to develop a sustainable social welfare system in China.


Asunto(s)
Utilización de Instalaciones y Servicios/estadística & datos numéricos , Disparidades en Atención de Salud/economía , Aceptación de la Atención de Salud/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , China , Femenino , Gastos en Salud/estadística & datos numéricos , Estado de Salud , Humanos , Renta/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Adulto Joven
16.
Medicine (Baltimore) ; 99(2): e18630, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914045

RESUMEN

Work stress and burnout have become important issues. Changes in work patterns frequently, long working hours, and too much pressure among workers in high-tech companies may result in the chronic fatigue symptoms and increase the risk of cardiovascular diseases, even leading to sudden death. Changes of heart rate variability (HRV) can be treated as a warning from the autonomic nervous systems and as a long-term monitoring method for chronic disease, for example, cardiovascular diseases and sudden death. The purpose of this study was to explore the association between occupational burnout and HRV.Proportional stratified convenient sampling was performed and in total, 120 individuals participated in this study. Questionnaires and the "occupational burnout inventory" were used to collect biographical and burnout information. A novel wrist physiological monitor was used to measure autonomic nervous system-related data, including HRV, low-frequency (LF) %, high-frequency (HF) %, and LF/HF ratio. Descriptive statistics and logistic regressions were computed using SPSS 17.0 (Chinese version, IBM Corp., New York, NY).The results show that participants who were 20 to 25 years old, work overtime because of onerous personal tasks, had a medical history, and recently felt unwell have higher "personal burnout." "Participants with a graduate degree, with onerous tasks, who were indirect staff, and with a regular-hour job tended to overcommit to their work." Significant associations were found among medical history, recently feeling unwell, and "work-related burnout." There was a positive association between HRV and job seniority. LF%, HF%, and LF/HF ratio were significantly correlated with job category. "Work overcommitment" was related to LF/HF ratio among men. Some items in "personal burnout" and "work overcommitment" were also associated with HRV among women.The findings suggest that the measurement of HRV can be applied in occupational settings to assess burnout. It not only allows administrators to quickly select the colleagues who need health care, but also provides timely and appropriate care, thereby promoting the health of the worker.


Asunto(s)
Sistema Nervioso Autónomo/fisiopatología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/fisiopatología , Frecuencia Cardíaca/fisiología , Adulto , Factores de Edad , Índice de Masa Corporal , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estrés Laboral/epidemiología , Estrés Laboral/fisiopatología , Ocupaciones , Proyectos Piloto , Factores Socioeconómicos , Taiwán/epidemiología , Factores de Tiempo , Carga de Trabajo , Adulto Joven
17.
Medicine (Baltimore) ; 99(2): e18660, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914052

RESUMEN

Verrucous carcinoma is a rare variant of squamous cell carcinoma. The oral cavity, genitals, larynx, esophagus, and skin are usually affected, and the head and neck regions are the most affected areas. Few studies reported about head and neck verrucous carcinoma (VC) in the literature. Therefore, we conducted an extensive population-based study about the VCs to use population-based data to further investigate the incidence, treatment, and survival of head and neck verrucous carcinoma.Patients from Surveillance, Epidemiology, and End Results database (SEER) between 1973 and 2015 were brought into our study. The data of VCs and other head and neck malignancies (OHNMs) patients were extracted for analysis. We compared characteristics of patients with VC with those of patients with OHNMs.Results were obtained for 2039 cases of VC and 394,739 cases of OHNM. Compared to patients with OHNM, patients with VC were more often female (36.6% vs 31.1%; P < .001), younger (median age 62 vs 67 years; P < .001), and had a smaller tumor size (P < .001). VC cases were of lower histological grade and SEER stage (P < .001). The incidence of VC was 0.075 per 100,000 and decreased over time (annual change -1.855%, P < .001), whereas the incidence of OHNM showed no change. The primary treatment method for VC was surgery, with other treatments showing no significant therapeutic effect.VC is rare, with a decreasing incident trend. The outcome is better compared with OHNM patients. Surgery could significantly improve VC patients' prognosis.


Asunto(s)
Carcinoma Verrugoso/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma Verrugoso/cirugía , Grupos de Población Continentales , Femenino , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Pronóstico , Programa de VERF , Factores Sexuales , Carga Tumoral , Estados Unidos/epidemiología
18.
Medicine (Baltimore) ; 99(2): e18670, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914056

RESUMEN

This retrospective study is to explore the clinicopathologic, immunophenotypic, and molecular genetic features of Waldeyer ring B-cell lymphoma (WR-BCL).Tissue arrays from 65 WR-BCL cases were subjected to pathologic and immunophenotypic detections. Expression of Epstein-Barr virus-encoded small RNA (EBER) was detected by in situ hybridization. Interferon regulatory factor 4 (IRF4), BCL-2, BCL-6, and C-myelocytomatosis viral oncogeneav (MYC) gene abnormalities were investigated using interphase fluorescence in situ hybridization.Among the 65 patients, there were 12 nasopharynx cases, 49 tonsil cases, and 4 tongue root cases. Moreover, there were 49 cases of diffuse large BCL (DLBCL) and 16 cases of follicular lymphoma (FL). More than 60% of the patients had Ann Arbor stage III/IV disease, with infiltrated neighboring organs, invaded spleens, and increased lactate dehydrogenase (LDH) levels. Tumor cells were positive for multiple myeloma antigen 1 (MUM1), BCL-2, BCL-6, and C-MYC. EBER expression was detected in lymphoma cells of 2 cases. Alteration frequencies of IRF4, BCL-2, BCL-6, and C-MYC were 24.6%, 32.3%, 27.7%, and 30.7%, respectively. Approximately 67.69% cases had stages 0 to II disease, while 32.31% cases had stage III disease. Five-year overall survival rate was 65.12%. Eastern Cooperative Oncology Group performance status (ECOG) score ≥2 was the only adverse factor for overall survival. IRF4/MUM1, C-MYC, and CD10 expressions were related to poor disease prognosis. WR-BCLs were largely dependent on ECOG, LDH, and bone marrow involvement. WR-DLBCL was associated with poor survival outcomes compared with WR-FL.The WR-DLBCLs have distinct clinicopathologic features, with correlations between the IRF4/MUM1, C-MYC and CD10 expressions, ECOG, LDH, bone marrow involvement, and the disease prognosis.


Asunto(s)
Linfoma de Células B/epidemiología , Linfoma de Células B/fisiopatología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor , Femenino , Humanos , Hibridación Fluorescente in Situ , Factores Reguladores del Interferón/biosíntesis , Linfoma de Células B/clasificación , Linfoma de Células B/mortalidad , Masculino , Persona de Mediana Edad , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Proteínas Proto-Oncogénicas c-bcl-6/biosíntesis , Proteínas Proto-Oncogénicas c-myc/biosíntesis , Proteínas de Unión al ARN/biosíntesis , Estudios Retrospectivos , Proteínas Ribosómicas/biosíntesis , Factores Sexuales
19.
Medicine (Baltimore) ; 99(2): e18675, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914059

RESUMEN

BACKGROUND: The efficacy of patent foramen ovale (PFO) closure remains controversial, and it is unclear which patient groups are best benefited. We performed this meta-analysis to clarify the efficacy of PFO closure of younger patients for prevention of recurrent ischemic neurological events. METHODS: We systematically searched for studies of PFO closure for younger patients under the age of 55, and pooled available data on PFO closure of younger vs older patients and on PFO closure of younger patients vs medical therapy. The primary endpoints were the composite outcome of recurrent ischemic neurological events [stroke and/or transient ischemic attack (TIA)]. The secondary endpoints included recurrent stroke, TIA, atrial fibrillation (AF) and bleeding events. We calculated the odds ratios (OR) and 95% confidence interval (CI) using fixed-effect and random-effect models. RESULTS: Three randomized controlled trials (RCT) and 13 observational studies were eligible. Compared with older patients undergoing PFO closure, younger patients undergoing closure had a lower risk of composite outcome (OR: 0.40, 95% CI: 0.28 to .56; P < .001) and AF (OR: 0.25, 95% CI: 0.10-0.61; P = .003). Compared with medical therapy, PFO closure of younger patients reduced the risk of composite outcome (OR: 0.50, 95% CI: 0.33-0.75; P<.001); there was no statistical difference in total complications of AF and bleeding events (OR: 2.15, 95% CI: 0.15-30.37; P = .57). Separate analysis of stroke and TIA showed that PFO closure in younger patients was more effective in preventing stroke (OR: 0.45, 95% CI: 0.28-0.72; P < .001) and TIA (OR: 0.35, 95% CI: 0.21-0.58); P < .001) compared with older patients. Compared with medical therapy, PFO closure of younger patients reduced the risk of stroke (OR: 0.26, 95% CI: 0.13-0.51; P < .001); but there was no difference in the risk of TIA (OR: 1.07, 95% CI: 0.16-7.01; P = .94). CONCLUSIONS: Compared with PFO closure of older patients and medical therapy, PFO closure of younger patients can benefit more for the prevention of recurrent ischemic neurological events. Our results indicate that PFO closure is the best treatment strategy for younger patients under the age of 55.


Asunto(s)
Foramen Oval Permeable/cirugía , Ataque Isquémico Transitorio/prevención & control , Accidente Cerebrovascular/prevención & control , Adulto , Factores de Edad , Fibrilación Atrial/etiología , Fibrilación Atrial/prevención & control , Femenino , Foramen Oval Permeable/complicaciones , Humanos , Ataque Isquémico Transitorio/etiología , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/etiología , Factores de Tiempo
20.
Medicine (Baltimore) ; 99(2): e18680, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914063

RESUMEN

The prognosis of acute ischemic stroke patients treated with intravenous (IV) recombinant tissue plasminogen activator (rtPA) is poorer in patients with atrial fibrillation (AF) than patients without AF, which might be related to the greater stroke severity in AF patients. Higher pre-stroke CHA2DS2-VASc scores are associated with greater stroke severity and poorer outcomes. AF Patients tend to have higher CHA2DS2-VASc scores than the non-AF patients. We thus hypothesized that pre-stroke CHA2DS2-VASc scores can be used to improve outcome stratification of IV thrombolysis therapy in acute stroke patients with and without AF. We retrospectively enrolled ischemic stroke patients who received IV-rtPA and categorized them into 2 groups: low-risk (CHA2DS2-VASc scores ≤ 2) and high-risk (CHA2DS2-VASc scores ≥ 3) groups. We compared the outcomes between AF and non-AF patients and the interactive effects of the levels of CHA2DS2-VASc scores on this outcome difference. In the low-risk group, there was no difference in outcomes between the AF and non-AF patients. In the high-risk group, the AF patients had worse outcomes at 3 and 6 months. Our results suggest that pre-stroke CHA2DS2-VASc scores are a useful outcome predictor of IV thrombolytic therapy in acute stroke patients with AF.


Asunto(s)
Fibrilación Atrial/complicaciones , Fibrinolíticos/uso terapéutico , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/tratamiento farmacológico , Activador de Tejido Plasminógeno/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Activador de Tejido Plasminógeno/administración & dosificación
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