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1.
Stroke ; : 101161STROKEAHA121038196, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35713003

RESUMO

BACKGROUND: We aimed to verify the validity of the proportional recovery model for the lower extremity. METHODS: We reviewed clinical data of patients enrolled in the Korean Stroke Cohort for Functioning and Rehabilitation between August 2012 and May 2015. Recovery proportion was calculated as the amount of motor recovery over initial motor impairment, measured as the Fugl-Meyer Assessment of Lower Extremity score. We used the logistic regression method to model the probability of achieving the full Fugl-Meyer Assessment of Lower Extremity score, whereby we considered the ceiling effect of the score. To show the difference in the prevalence of achieving the full Fugl-Meyer Assessment of Lower Extremity score between 3 and 6 months poststroke, we constructed a marginal model through the generalized estimating equation method. We also performed the propensity score matching analysis to show the dependency of recovery proportion on the initial motor deficit at 3 and 6 months poststroke. RESULTS: We evaluated 1085 patients. The recovery proportions at 3 and 6 months poststroke were 0.67±0.42 and 0.75±0.39, respectively. A 1-unit decrease in the initial neurological impairment and the age at stroke onset increased the probability of achieving the full Fugl-Meyer Assessment of Lower Extremity score, which occurred at both 3 and 6 months poststroke. The prevalence of those who reach full lower limb motor recovery differs significantly between 3 and 6 months poststroke. We also found out that the recovery proportion at both 3 and 6 months poststroke is determined by the initial motor deficits of the lower limb. These results are not consistent with the proportional recovery model. CONCLUSIONS: Our results demonstrated that the proportional recovery model for the lower limb is invalid.

2.
PLoS One ; 17(6): e0269182, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35657785

RESUMO

PURPOSE: To identify the effects of prolonged type 2 diabetes (T2DM) on the retinal microvasculature of each retinal capillary plexus in patients without clinical diabetic retinopathy (DR). METHODS: Subjects were divided into three groups: the control group (98 eyes), patients with T2DM < 10 years (DM group 1, 84 eyes), and patients with T2DM ≥ 10 years (DM group 2, 55 eyes). The vessel densities (VD) of the superficial and deep capillary plexus (SCP and DCP) were compared. Linear regression analyses were performed to identify factors associated with the VD. RESULTS: The mean VDs of the SCP in the control group, DM group 1, and DM group 2 were 35.9 ± 4.2, 34.9 ± 3.9, and 34.6 ± 5.1, respectively (P = 0.042). The mean VDs of the DCP in the three groups were 36.1 ± 3.1, 35.9 ± 3.0, and 34.0 ± 3.3, respectively (P < 0.001). In multivariate analyses, the BCVA was a significant factor associated with both the superficial VD (B = -7.10, P = 0.019) and deep VD (B = -5.70, P = 0.039). Hypertension (B = -1.22, P = 0.021) and DM duration (B = -0.20, P < 0.001) were significant factors associated with deep VD. CONCLUSIONS: T2DM patients without DR showed decreased VD in the SCP and DCP. The microvascular impairment of the DCP in patients with T2DM ≥ 10 years was in particular, more severe. Additionally, ischemia caused by hypertension and accumulated impairment of microvasculature due to prolonged T2DM would affect the DCP.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Hipertensão , Diabetes Mellitus Tipo 2/complicações , Angiofluoresceinografia , Humanos , Vasos Retinianos , Tomografia de Coerência Óptica
3.
Sci Rep ; 12(1): 9463, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35676523

RESUMO

To identify how diabetic retinal neurodegeneration (DRN) and microvascular impairment are affected differently by various factors in type 2 diabetes (T2DM) patients without diabetic retinopathy via the ratio of RNFL thickness/vessel density (RNFL/VD) ratio. In this retrospective cross-sectional study, subjects were divided into two groups: controls (control group) and patients with T2DM (DM group). The RNFL thickness, VD, and RNDL/VD ratio were compared between two groups, and correlation analyses were performed to identify the relationship between the RNFL/VD ratio and various factors. A total of 411 eyes were enrolled: 195 eyes in the control group and 216 eyes in the DM group. The mean RNFL thickness was 95.9 ± 8.6 and 93.7 ± 8.7 µm (P = 0.016), the VD was 18.2 ± 0.7 and 17.6 ± 1.1 mm-1 (P < 0.001), and the RNFL/VD ratio was 5.11 ± 0.47 and 5.22 ± 0.53 (P = 0.033) in the control group and DM group, respectively. In the DM group, age (coefficient = - 0.139, P = 0.041), axial length (coefficient = 0.163, P = 0.017), and T2DM duration (coefficient = - 0.180, P = 0.008) were significantly correlated with the RNFL/VD ratio. The RNFL/VD ratio of T2DM patients was higher than that of normal control, which would indicate that the impairment of microvasculature precedes DRN. Additionally, age and T2DM duration were negatively correlated with the RNFL/VD ratio, which suggests that inner retinal damage by DRN becomes more prominent over time than microvascular impairment in T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Disco Óptico , Pré-Escolar , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Humanos , Fibras Nervosas , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina , Vasos Retinianos , Estudos Retrospectivos , Tomografia de Coerência Óptica
4.
Value Health ; 2022 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-35623973

RESUMO

OBJECTIVES: Given the increasing availability of electronic health records, it has become increasingly feasible to adopt data-driven approaches to capture a deep understanding of the patient journeys. Nevertheless, simply using data-driven techniques to depict the patient journeys without an integrated modeling and analysis approach is proving to be of little benefit for improving patients' experiences. Indeed, a model of the journey patterns is necessary to support the improvement process. METHODS: We presented a 3-phase methodology that integrates a process mining-based understanding of patient journeys with a stochastic graphical modeling approach to derive and analyze the analytical expressions of some important performance indicators of an emergency department including mean and variance of patients' length of stay (LOS). RESULTS: Analytical expressions were derived and discussed for mean and variance of LOS times and discharge and admission probabilities. LOS differed significantly depending on whether a patient was admitted to the hospital or discharged. Moreover, multiparameter sensitivity equations are obtained to identify which activities contribute the most in reducing the LOS at given operating conditions so decision makers can prioritize their improvement initiatives. CONCLUSIONS: Data-driven based approaches for understanding the patient journeys coupled with appropriate modeling techniques yield a promising tool to support improving patients' experiences. The modeling techniques should be easy to implement and not only should be capable of deriving some key performance indicators of interest but also guide decision makers in their improvement initiatives.

5.
Nutr Res ; 104: 55-65, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35617713

RESUMO

Dietary patterns based on pathways of diseases such as subclinical atherosclerosis can predict diet-disease associations better than dietary quality indices or data-driven indices. We aimed to develop and validate a novel dietary atherogenic index (DAI) in adults using the common carotid artery-intima media thickness (c-IMT) in Korean adults. Participants aged ≥40 years from the Yangpyeong cohort were enrolled in the development set (n = 1373). Two DAIs were developed using 38 predefined food groups as predictors and c-IMT as response variable, using stepwise linear regression (SLR) and reduced rank regression (RRR) models. Based on the associations between DAI and c-IMT, DAIs were then validated in the total, men, and women, internally in 1000 bootstrap sets, and externally in a set combined with 2 other populations (n = 2476). The DAI-S by SLR and the DAI-R by RRR included 7 anti- and 10 pro-inflammatory food groups and 2 anti- and 6 pro-inflammatory food groups, respectively. Total rice and white root kimchi were pro-inflammatory, and mushrooms, other beverages (mostly traditional beverages), poultry, processed seafood, and pizza/hamburger were anti-inflammatory in both the DAI-S and DAI-R. They were internally valid in the multivariable-adjusted models, showing a significant linear trend in all 3 sets; they were also valid in the bootstrap at 95% confidence interval. In the external validation, only the DAI-S was significantly associated with the c-IMT (P trend = .0004, .0133, and .0212 in total, men, and women, respectively). This study indicated that DAIs, particularly DAI-S, may be useful for assessing the atherogenic potential of food-based total diets.

6.
Korean J Ophthalmol ; 36(3): 274-281, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35527524

RESUMO

PURPOSE: To evaluate the difference in each retinal layer thickness in central retinal vein occlusion (CRVO) with resolved macular edema after intravitreal antivascular endothelial growth factor injection and normal contralateral eyes.. METHODS: Patients with ischemic and nonischemic CRVO whose macular edema resolved after intravitreal antivascular endothelial growth factor injections and did not recur for at least 6 months, and a normal contralateral eye were enrolled. Each retinal layer thickness between CRVO and normal contralateral eyes was compared according to Early Treatment Diabetic Retinopathy Study subfields using spectral domain optical coherence tomography. RESULTS: The thicknesses of outer nuclear layer, photoreceptor layer, and retinal pigment epithelium in central ring, ganglion cell layer, inner plexiform layer, outer nuclear layer, and photoreceptor layer in the inner ring, and ganglion cell layer in the outer ring of CRVO eyes were significantly thinner than those of normal contralateral eyes (all p < 0.05). Whereas, inner nuclear layer and outer plexiform layer thicknesses in central ring of CRVO eyes were 23.86 ± 8.8 and 25.76 ± 7.6 µm, respectively, which was significantly thicker than those of normal contralateral eyes (19.52 ± 7.7 and 22.76 ± 6.5 µm; p = 0.019 and p = 0.043, respectively). Additionally, the mean best-corrected visual acuity of CRVO eyes were significantly correlated with photoreceptor layer thickness in central ring (p = 0.005). CONCLUSIONS: In CRVO eyes with resolved macular edema, the outer retinal layers were thinner as well as inner retinal layers, whereas inner plexiform layer and outer nuclear layer were thicker than normal fellow eyes. Additionally, photoreceptor layer thickness in foveal area had a significant impact on visual acuity in CRVO.


Assuntos
Edema Macular , Oclusão da Veia Retiniana , Fatores de Crescimento Endotelial/uso terapêutico , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Edema Macular/tratamento farmacológico , Edema Macular/etiologia , Retina/diagnóstico por imagem , Oclusão da Veia Retiniana/diagnóstico , Oclusão da Veia Retiniana/tratamento farmacológico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
7.
J Pers Med ; 12(3)2022 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-35330389

RESUMO

BACKGROUND: This study investigated the impact of post-stroke depression (PSD) on cognitive aging in elderly stroke patients. METHODS: This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation. Among 10,636 patients with first-ever stroke, a total of 3215 patients with normal cognitive function three months post-stroke were included in the analysis. PSD was defined using the Korean Geriatric Depression Scale Short Form (K-GDS-SF) at three months. Cognitive aging was defined as a decline in the Korean version of the Mini-Mental Status Examination (K-MMSE) score to less than the second percentile. RESULTS: The hazard ratio (HR) of PSD for cognitive decline was 2.16 (95% CI, 1.34-3.50, p < 0.01) in the older group (age ≥65 years), and 1.02 (95% CI, 0.50-2.07, n.s.) in the younger group (age <65 years). When the older group was divided by sex, the HR was 2.50 (95% CI, 1.26-4.96, p < 0.01) in male patients and 1.80 (95% CI, 0.93-3.51, n.s.) in female patients. However, women showed a higher incidence of cognitive decline in both the PSD and no PSD groups. Among K-GDS-SF factors, "Negative judgment about the past, present, and future" increased the HR of PSD in older male patients. CONCLUSIONS: Early PSD increased the HR for cognitive decline in older stroke patients, mainly in males. Specifically, older male patients with negative thinking were at increased risk of cognitive decline. The findings also suggest that older women may be at risk for cognitive decline. Therefore, preventive interventions for cognitive decline should be tailored differently for men and women.

8.
Korean Circ J ; 52(3): 220-230, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35129315

RESUMO

BACKGROUND AND OBJECTIVES: Previous observational studies presented a positive association between alcohol and atrial fibrillation (AF). However, previous studies using genetic polymorphisms on the causal relationship between alcohol consumption and AF have reported conflicting results. This study aimed to evaluate the causality between alcohol consumption and AF using the aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism, which is the genetic variant with the most potent effect on drinking behavior. METHODS: A total of 8,964 participants from the Dong-gu Study were included in the present study. The causal association between alcohol consumption and AF was evaluated through a Mendelian randomization (MR) analysis using the ALDH2 rs671 polymorphism as an instrumental variable. RESULTS: No significant relationship between alcohol consumption and AF was found in the observational analysis. However, the genetic analysis using the ALDH2 polymorphism showed a significant association in men. In the MR analysis, genetically predicted daily alcohol consumption was positively related to AF. CONCLUSIONS: MR analysis revealed a significant association between the amount of alcohol consumption and AF, which suggests that the association may be causal.

9.
Sci Rep ; 12(1): 1570, 2022 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-35091585

RESUMO

To compare changes in retinal layers and microvasculature in diabetic retinopathy (DR) patients after bevacizumab therapy and panretinal photocoagulation (PRP). This prospective study divided patients into two groups: patients treated with bevacizumab and those treated with PRP. Patients visited our retinal clinic at 1, 3, and 6 months after treatment. Retinal layer thickness and vessel density (VD) using optical coherence tomography angiography were analyzed. 37 eyes in the bevacizumab group and 36 eyes in the PRP group were enrolled. In the bevacizumab group, the parafoveal RNFL, GCL, and IPL thicknesses significantly decreased (P < 0.001, P = 0.013, and P = 0.017, respectively), whereas the thicknesses in the PRP group showed an increasing tendency over time (P = 0.087, P = 0.005, and P = 0.003, respectively). The VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the bevacizumab group did not show significant changes, whereas the VD in the PRP group significantly increased over time (both P < 0.001). Additionally, RNFL (P = 0.001) and GCL thicknesses (P = 0.035) were significant factors affecting changes in BCVA, whereas the VDs of SCP and DCP did not. Patients who received bevacizumab therapy did not show a significant change in macular VD, whereas the VD of patients after PRP significantly increased after treatment. The increased macular VD in patients after PRP would be associated with the increased inner retinal layer thickness after treatment, which was significantly related to the impairment in visual acuity.


Assuntos
Bevacizumab
10.
Am J Ophthalmol ; 238: 134-140, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35038416

RESUMO

PURPOSE: To identify how the Weiss ring affects the measurement of mean and sectoral peripapillary retinal nerve fiber layer (pRNFL) thicknesses. DESIGN: Retrospective, cross-sectional study. METHODS: Subjects were divided into two groups: controls (control group) and subjects in which a Weiss ring was visible on optical coherence tomography fundus images (WR group). Mean and sectoral pRNFL thicknesses were compared between the two groups. RESULTS: A total of 205 eyes were enrolled: 131 eyes in the control group and 74 eyes in the WR group. The mean pRNFL thicknesses of the control group and WR group were 97.2 ± 6.7 µm and 94.6 ± 10.8 µm, respectively (P = .042). In sectoral thickness, the inferior sector of the WR group was 112.1 ± 23.2 µm, which was significantly thinner than that of the control group (125.5 ± 13.3 µm; P < .001). The Weiss ring was located in 10 eyes (13.5%) in the superior sector, 7 eyes (9.5%) in the temporal sector, 40 eyes (54.1%) in the inferior sector, and 17 eyes (23.0%) in the nasal sector. In analyses of reproducibility, the coefficient of variation and intraclass coefficient of the inferior sector measurement were 10.90% and 0.409, respectively, indicating low reliability of the measurement. CONCLUSIONS: Eyes with a Weiss ring showed thinner mean and inferior pRNFL thicknesses than normal controls, which would be a measurement error caused by the Weiss ring. This could be a major confounding factor for analyses of pRNFL changes, especially in glaucoma patients.


Assuntos
Fibras Nervosas , Disco Óptico , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Células Ganglionares da Retina , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
11.
J Bone Miner Metab ; 40(1): 167-173, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34626249

RESUMO

INTRODUCTION: Many previous studies have reported a positive relationship between alcohol and bone mineral density (BMD). However, the causality between alcohol and BMD has not been fully evaluated. MATERIALS AND METHODS: This study enrolled 8892 participants from the Dong-gu study. Mendelian randomization (MR) using two-stage least-squared regression was used to evaluate the association between the genetically predicted amount of alcohol consumption per day and BMD. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as instrumental variables for alcohol consumption. Age, smoking history, and BMI were adjusted in the multivariate model. RESULTS: Self-reported alcohol consumption was positively related to total hip and lumbar spine BMD in both sexes. In multivariate Mendelian randomization analysis, the genetically predicted amount of alcohol consumption was positively associated with both total hip and lumbar spine BMD in men. Total hip BMD and lumbar spine BMD increased by 0.004 g/cm2 (95% confidence interval [CI] 0.002-0.007) and 0.007 g/cm2 (95% CI 0.004-0.011) with doubling of alcohol consumption. However, in women, genetically predicted alcohol consumption was not significantly associated with BMD. CONCLUSION: In our MR study, genetically predicted alcohol consumption was positively associated with BMD in men. This result suggests that the association between alcohol consumption and BMD is causal.


Assuntos
Densidade Óssea , Análise da Randomização Mendeliana , Aldeído-Desidrogenase Mitocondrial/genética , Densidade Óssea/genética , Causalidade , Feminino , Humanos , Vértebras Lombares , Masculino , Polimorfismo de Nucleotídeo Único/genética
12.
Sci Rep ; 11(1): 23697, 2021 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-34880392

RESUMO

Although the resting heart rate (RHR) predicts the clinical outcomes of cardiovascular disease, chronic obstructive lung disease, diabetes mellitus, and the risk of cancer, its role in patients with musculoskeletal diseases, such as osteoarthritis (OA), remains unclear. We explored the association of the RHR with the extents of radiographic changes in the knees and hands of 2369 subjects from the Dong-gu Study. The radiographic hand and knee joint findings were graded semi-quantitatively; we calculated total hand and knee joint scores. Multiple linear regression was performed to examine the associations between the RHR and the radiographic characteristics of these joints. For the knee joints, the RHR was associated positively with the total (p < 0.01), osteophyte (p < 0.01), joint space narrowing (JSN; p < 0.01), and tibial attrition (p = 0.02) scores after adjustment for age, sex, body mass index, smoking status, alcohol consumption, educational and physical activity levels, and comorbidities. For the hand joints, the RHR was associated positively with the JSN (p = 0.01) and subchondral cyst (p < 0.01) scores after such adjustment. The RHR was not associated with the total, osteophyte, sclerosis, erosion, or malalignment score for the hand joints. This study is the first to reveal an association between the RHR and the radiographic severity of knee, but not hand, OA.


Assuntos
Biomarcadores , Articulação da Mão/diagnóstico por imagem , Frequência Cardíaca , Articulação do Joelho/diagnóstico por imagem , Osteoartrite , Radiografia , Descanso , Diagnóstico Diferencial , Suscetibilidade a Doenças , Articulação da Mão/patologia , Humanos , Articulação do Joelho/patologia , Masculino , Razão de Chances , Osteoartrite/diagnóstico , Osteoartrite/epidemiologia , Osteoartrite/etiologia , Vigilância da População
13.
ACS Appl Mater Interfaces ; 13(38): 45778-45788, 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34519475

RESUMO

The design of robust boron acceptors plays a key role in the development of boron-based thermally activated delayed fluorescence (TADF) emitters for the realization of efficient and stable blue organic light-emitting diodes (OLEDs). Herein, we report a set of donor (D)-acceptor (A)-type blue TADF compounds (1-3) comprising triply bridged triarylboryl acceptors, the so-called B-heterotriangulenes, which differ depending on the identity of one of the bridging groups: methylene (1), dimethylmethylene (2), or oxo (3). The X-ray crystal structures of 2 and 3 reveal a highly twisted D-A connectivity and a completely planar geometry for the B-heterotriangulene rings. All compounds exhibit blue emissions with the unitary photoluminescence quantum yields and small singlet-triplet energy splitting (<0.1 eV) in their doped host films. The compounds exhibit a fast reverse intersystem crossing rate (kRISC ≈ 106 s-1) with short-lived delayed fluorescence (τd ≈ 2 µs), which is found to be promoted by the strong spin-orbit coupling between the local triplet excited state (3LE, T2) and singlet (S1) states. Using compounds 1-3 as the emitters, highly efficient blue TADF-OLEDs are realized. The devices based on the emitters with B-heterotriangulenes exhibit better performances than the device incorporating a singly bridged reference emitter over the whole luminance range. Notably, the device based on the fully dimethylmethylene-bridged emitter (2) achieves the highest maximum external quantum efficiency (EQE) of 28.2% and the lowest efficiency roll-off, maintaining a high EQE value of 21.2% at 1000 cd/m2.

14.
Diabetes ; 70(11): 2663-2667, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34475099

RESUMO

Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are both relatively common systemic diseases and cause damage to the retina, such as inner retina reduction and microvascular impairment. The purpose of this study was to identify peripapillary retinal nerve fiber layer (pRNFL) damage by diabetic neurodegeneration and the effects of HTN on the pRNFL thickness in patients with T2DM without clinical diabetic retinopathy. Subjects were divided into three groups: healthy control subjects (group 1), patients with T2DM (group 2), and patients with both diabetes and HTN (group 3). The pRNFL thickness was measured using optical coherence tomography and compared among each group. Linear regression analyses were performed to identify factors associated with pRNFL thickness. A total of 325 eyes were included: 143 eyes in the group 1, 126 eyes in group 2, and 56 eyes in group 3. The mean pRNFL thicknesses of each group were 96.1 ± 7.7, 94.4 ± 8.6, and 91.6 ± 9.6 µm, respectively (P = 0.003). In multivariate linear analyses, diabetes duration (ß = -0.236; P = 0.018) and HTN (ß = -3.766; P = 0.008) were significant factors affecting the pRNFL thickness in groups 2 and 3. Additionally, the HTN duration was significantly correlated with pRNFL thickness in group 3 (R 2 = 0.121; P = 0.008). In conclusion, patients with T2DM with HTN showed thinner pRNFL thickness than those with T2DM only. Additionally, the duration of HTN was significantly correlated with pRNFL thickness in patients with both diabetes and HTN.


Assuntos
Diabetes Mellitus Tipo 2/patologia , Retinopatia Diabética/patologia , Hipertensão/patologia , Neurônios Retinianos/patologia , Idoso , Estudos Transversais , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
15.
Invest Ophthalmol Vis Sci ; 62(12): 21, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34546323

RESUMO

Purpose: To identify the impact of hypertension (HTN) on macular microvasculature in type 2 diabetes (T2DM) patients without clinical diabetic retinopathy. Methods: In this retrospective cross-sectional study, subjects were divided into three groups: controls (control group), patients with T2DM (DM group), and patients with both T2DM and HTN (DM + HTN group). The vessel length density (VD) was compared among the groups. Linear regression analyses were performed to identify factors associated with VD. Results: The VD in the control, DM, and DM + HTN groups was 20.43 ± 1.16, 19.50 ± 1.45, and 18.19 ± 2.06 mm-1, respectively (P < 0.001). The best-corrected visual acuity (B = -9.30; P = 0.002), duration of T2DM (B = -0.04; P = 0.020), HTN (B = -0.51; P = 0.016), signal strength (B = 1.12; P < 0.001), and ganglion cell-inner plexiform layer thickness (B = 0.06; P < 0.001) were significant factors affecting VD in patients with T2DM. Additionally, the hemoglobin A1c (HbA1c) (B = -0.49; P = 0.016) was significantly associated with VD in patients with both T2DM and HTN. Conclusions: Patients with T2DM had impaired macular microvasculature, and patients with T2DM with HTN exhibited greater impairment of the microvasculature than did patients with T2DM only. Additionally, physicians should be aware that the macular microvasculature would be more vulnerable to hyperglycemic damage under ischemic conditions by HTN.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Hipertensão/fisiopatologia , Disco Óptico/irrigação sanguínea , Vasos Retinianos/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Angiofluoresceinografia , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Microvasos/fisiopatologia , Pessoa de Meia-Idade , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia
16.
Yonsei Med J ; 62(9): 792-798, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34427064

RESUMO

PURPOSE: In this prospective study, we evaluated the association between the serum levels of antioxidants uric acid (UA), albumin, and total bilirubin and the risk of cancer in a Korean population. MATERIALS AND METHODS: A total of 15882 subjects were followed up for cancer development and cancer-related death. During the follow-up period, 1619 cancer diagnoses and 617 cancer-related deaths were recorded. Cox proportional regression was performed to calculate the hazard ratio (HR) per standard deviation (SD) increment and 95% confidence interval (CI). The model was adjusted for covariates such as the age, sex, smoking, alcohol consumption, physical activity, education level, body mass index, and family history. Sensitivity analyses using the study subjects with physiological serum levels of each indicator were also performed. RESULTS: UA levels were positively correlated with cancer risk (HR per SD increment 1.04; 95% CI, 1.01-1.09), and albumin levels were inversely associated with the overall cancer risk (HR, 0.92; 95% CI, 0.88-0.96) and cancer-related death (HR, 0.86; 95% CI, 0.80-0.93). Total bilirubin levels were negatively correlated with the risk of cancer-related death (HR, 0.91; 95% CI, 0.83-0.99). By cancer type, UA was positively associated with prostate cancer, total bilirubin was positively associated with liver cancer, and albumin was inversely associated with lung cancer. CONCLUSION: The findings of this study support the role of antioxidants in carcinogenesis. Future large-cohort studies are needed to confirm the predictive value of albumin, UA, and total bilirubin levels in each type of cancer.


Assuntos
Neoplasias , Ácido Úrico , Bilirrubina , Humanos , Masculino , Neoplasias/epidemiologia , Estudos Prospectivos , República da Coreia/epidemiologia , Albumina Sérica
17.
J Korean Med Sci ; 36(30): e195, 2021 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-34342185

RESUMO

BACKGROUND: Several studies have reported conflicting results regarding the relationship between alcohol consumption and cortisol levels. However, the causality between alcohol consumption and cortisol levels has not been evaluated. METHODS: This study examined 8,922 participants from the Dong-gu Study. The aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism was used as an instrumental variable for alcohol consumption. The association between the genetically predicted alcohol consumption and cortisol level was evaluated with Mendelian randomization (MR) using two-stage least squares regression. RESULTS: Alcohol consumption was positively associated with the serum cortisol level in both sexes in the observational analysis. In the MR analysis, the genetically predicted alcohol consumption was positively related to the cortisol level in men, with cortisol levels increasing by 0.18 µg/dL per drink per day. However, there was no relationship in women in the MR analysis. CONCLUSION: The predicted alcohol consumption according to the ALDH2 rs671 polymorphism was positively related to the cortisol levels, suggesting a causal relationship between alcohol consumption and cortisol levels.


Assuntos
Consumo de Bebidas Alcoólicas/genética , Aldeído-Desidrogenase Mitocondrial/genética , Hidrocortisona/sangue , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Causalidade , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade
18.
Arch Phys Med Rehabil ; 102(12): 2343-2352.e3, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34348122

RESUMO

OBJECTIVE: To identify the incidence of dysphagia after ischemic stroke and determine factors affecting the presence of dysphagia. DESIGN: Retrospective case-control study. This was an interim analysis of a prospective multicenter Korean stroke cohort. SETTING: Acute care university hospitals. PARTICIPANTS: Patients (N=6000) with first-ever acute ischemic stroke. Patients were divided into 2 groups according to the presence or absence of dysphagia confirmed at 7 days after onset using the American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, which was determined after conducting screening or standardized tests. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Age at stroke onset, body mass index (BMI), premorbid modified Rankin Scale (mRS), brainstem lesions, National Institutes of Health Stroke Scale (NIHSS), poststroke mRS, and ASHA-NOMS swallowing level at poststroke day 7 were evaluated. RESULTS: Among patients with ischemic stroke, 32.3% (n=1940) had dysphagia at 7 days after stroke onset. At discharge, 80.5% (n=1561) still had dysphagia. The prediction model for the presence of dysphagia identified age at onset, underweight (BMI <18.5 kg/m2), premorbid mRS, brainstem lesions, and NIHSS as independent predictors. The odds ratio (OR) for the presence of dysphagia significantly increased with underweight (OR, 1.6684; 95% confidence interval [CI], 1.27-2.20), increased age at onset (OR, 1.0318; 95% CI, 1.03-1.04), premorbid mRS (OR, 1.1832; 95% CI, 1.13-1.24), brainstem lesions (OR, 1.6494; 95% CI, 1.39-1.96), and NIHSS (OR, 1.2073; 95% CI, 1.19-1.23). CONCLUSIONS: The incidence of dysphagia after ischemic stroke was 32.3%. The prediction model for the presence of dysphagia identified age, low BMI, premorbid disabilities, brainstem lesions, and NIHSS as predictive factors.


Assuntos
Transtornos de Deglutição/etiologia , AVC Isquêmico/complicações , Idoso , Estudos de Coortes , Avaliação da Deficiência , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recuperação de Função Fisiológica , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Inquéritos e Questionários
19.
PLoS One ; 16(8): e0256131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388218

RESUMO

PURPOSE: To identify the impacts of hypertension (HTN), high myopia, and the combination thereof on peripapillary retinal nerve fiber layer (pRNFL) thickness. METHODS: All subjects were divided into four groups: control (group 1); patients with HTN without high myopia (group 2); patients with high myopia without HTN (group 3); and patients with both HTN and high myopia (group 4). The pRNFL thicknesses were compared using a one-way analysis of variance. Univariate and multivariate linear regression analyses were used to identify factors affecting pRNFL thickness in subjects with and without HTN. RESULTS: The mean pRNFL thicknesses were 93.9±8.8, 88.7±6.8, 86.4±8.1, and 82.5±9.6 µm in group 1, 2, 3, and 4, respectively, and differed significantly (P<0.001). On multivariate linear regression analyses, age (ß = -0.181, P = 0.044), axial length (ß = -1.491, P<0.001), and HTN (ß = -4.876, P = 0.044) significantly affected pRNFL thickness. Additionally, age and axial length affected the pRNFL thickness in subjects with HTN (age, ß = -0.254, P = 0.020; axial length, ß = -1.608, P<0.001) much more than in subjects without HTN (age, ß = -0.028, P = 0.712; axial length, ß = -1.324, P<0.001). CONCLUSIONS: High myopia and HTN affected pRNFL reduction and a combination of the 2 diseases exacerbated pRNFL damage. This could be a confounding factor in interpreting pRNFL thickness in patients with ophthalmic diseases affecting the pRNFL thickness when combined with the 2 diseases.


Assuntos
Hipertensão/fisiopatologia , Pressão Intraocular/fisiologia , Miopia/epidemiologia , Fibras Nervosas/patologia , Retina/patologia , Acuidade Visual/fisiologia , Estudos de Casos e Controles , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miopia/patologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
20.
Korean Circ J ; 51(9): 752-763, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34227268

RESUMO

BACKGROUND AND OBJECTIVES: The aim of this study was to assess sex difference in the association between coronary artery disease (CAD) status and depression in a representative nationwide Korean population. METHODS: In total, 4,620 male and 6,151 female aged ≥40 years, who participated in the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, and 2018, were included in the analysis. Depression was defined as ≥10 points on the 9-item Patient Health Questionnaire. RESULTS: Among male participants, no significant association between CAD status and depression was observed. However, female with CAD had higher odds ratio (OR) for depression (OR, 2.68; 95% confidence interval [CI], 1.78-4.03) compared with those without CAD in a multiple logistic regression analysis after adjustment for covariates. Younger age at diagnosis of CAD was a significant relating factor for depression in female; OR (95% CI) was 1.73 (0.88-3.40), 3.01 (1.52-5.97), and 4.11 (2.04-8.28) for age ≥65 years, 55-64 years, and ≤54 years, respectively, compared with that in non-CAD controls. In addition, shorter duration of CAD was a significant relating factor for depression in female; OR (95% CI) was 2.42 (1.26-4.67), 2.61 (1.32-5.16), and 3.13 (1.54-6.34) for duration ≥10 years, 5-9 years, and ≤4 years, respectively, compared with that in non-CAD controls. CONCLUSIONS: Consistent screening and psychosocial supports for depression after discharge are required to improve the mental health care of CAD survivors in the community, especially for female diagnosed at a younger age and recently diagnosed.

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