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1.
Artigo em Inglês | MEDLINE | ID: mdl-35010842

RESUMO

Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76-103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Atividades Cotidianas , Idoso , Transtornos Cognitivos/epidemiologia , Disfunção Cognitiva/epidemiologia , Hospitalização , Humanos , Pacientes Internados
2.
Diabetes Metab Syndr Obes ; 14: 1473-1483, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33833538

RESUMO

PURPOSE: To examine the association between different phenotypes of obesity or metabolic syndromes and liver fibrosis score in a Taiwanese elderly population with fatty liver. PATIENTS AND METHODS: This cross-sectional study included 1817 participants aged ≥65 years with fatty liver diagnosed by sonography. We used ethnicity-specific criteria for body mass index and metabolic syndrome, and to define obesity phenotypes as metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Correlated fibrosis severity was calculated using the nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) and Fibrosis-4 (FIB-4). Fibrosis severity was divided into two categories according to NFS (no-to-mild fibrosis and advanced fibrosis, defined as NFS ≤ 0.676 and >0.676, respectively) and FIB-4 score (no-to-mild fibrosis and advanced fibrosis, defined as FIB-4 score ≤2.67 and >2.67, respectively). RESULTS: Compared with that in the MHNO group, the associated risk (odds ratio [OR], 95% confidence interval [CI]) of advanced fibrosis by NFS was 2.43 (1.50-3.93), 2.35 (1.25-4.41), and 6.11 (3.90-9.59), whereas that of advanced fibrosis by FIB-4 score was 1.34 (0.83-2.18), 2.37 (1.36-4.13), and 1.38 (0.82-2.31) in the MUNO, MHO, and MUO groups, respectively. CONCLUSION: Both metabolic syndrome and obesity were positively associated with more advanced fibrosis according to NFS. The detrimental effect of obesity appears to be more than metabolic abnormalities per se in the elderly with more advanced fibrosis severity according to the FIB-4 score.

3.
BMC Cardiovasc Disord ; 20(1): 334, 2020 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-32660417

RESUMO

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality with incidence rates of 5-10 per 1000 person-years, according to primary prevention studies. To control hyperlipidemia-a major risk factor of cardiovascular disease-initiation of lipid-lowering therapy with therapeutic lifestyle modification or lipid-lowering agent is recommended. Few systematic reviews and meta-analyses are available on lipid-lowering therapy for the primary prevention of cardiovascular diseases. In addition, the operational definitions of intensive lipid-lowering therapies are heterogeneous. The aim of our study was to investigate whether intensive lipid-lowering therapies reduce greater cardiovascular disease risks in primary prevention settings. METHODS: MEDLINE, EMBASE, and Cochrane Library databases were searched from inception to March 2019 for randomized controlled trials. We used random effects model for overall pooled risk ratio (RR) estimation with cardiovascular events of interest and all-cause mortality rate for the intensive lipid-lowering group using the standard lipid-lowering group as the reference. The Cochrane Risk of Bias Tool was used for quality assessment. RESULTS: A total of 18 randomized controlled trials were included. The risk reductions in cardiovascular outcomes and all-cause mortality associated with more intensive vs. standard lipid-lowering therapy across all trials were 24 and 10%, respectively (RR 0.76, 95% confidence interval 0.68-0.85; RR 0.90, 95% confidence interval 0.83-0.97); however, the risk reduction varied by baseline LDL-C level in the trial. A greater risk reduction was noted with higher LDL-C level. Intensive lipid-lowering for coronary heart disease protection was more pronounced in the non-diabetic populations than in the diabetic populations. CONCLUSIONS: More intensive LDL-C lowering was associated with a greater reduction in risk of total and cardiovascular mortality in trials of patients with higher baseline LDL-C levels than less intensive LDL-C lowering. Intensive lipid-lowering was associated with a significant risk reduction of coronary heart disease and must be considered even in the non-diabetic populations.


Assuntos
Anticolesterolemiantes/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , LDL-Colesterol/sangue , Dislipidemias/tratamento farmacológico , Prevenção Primária , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticolesterolemiantes/efeitos adversos , Biomarcadores/sangue , Doenças Cardiovasculares/mortalidade , Regulação para Baixo , Dislipidemias/sangue , Dislipidemias/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Resultado do Tratamento
4.
Artigo em Inglês | MEDLINE | ID: mdl-32722143

RESUMO

We evaluated the predictability of self-reported Health-related quality of life (HRQoL) assessed by the 3-level 5-dimensional Euro-Quality of Life tool (EQ-5D-3L) and the EQ-Visual Analog Scale (EQ-VAS) on clinical outcomes of elderly patients who were admitted to an acute geriatric ward. A total of 102 participants (56.9% men) with a median age of 81.0 years (interquartile range or IQR: 76.0-85.3 years) were studied. The age-adjusted Charlson comorbidity index was 5.0 (IQR: 4.0-6.0) with a median length of stay (LOS) of 9.0 days (IQR: 7.0-15.0 days). No death occurred during hospitalization, and within 30 days after discharge, 15 patients were readmitted. During hospitalization, the EQ-5D-3L index was 0.440 at admission and that improved to 0.648 at discharge (p < 0.001). EQ-VAS scores also improved similarly from 60 to 70 (p < 0.001). Physical, cognitive function, frailty parameters (hand grip strength and walking speed), and nutritional status at admission all improved significantly during hospitalization and were related to EQ-5D-3L index or EQ-VAS scores at discharge. After controlling for relevant factors, EQ-5D-3L index at admission was found to be associated with LOS. In addition, EQ-VAS was marginally related to readmission. HRQoL assessment during hospitalization could be useful to guide clinical practice and to improve outcome.


Assuntos
Força da Mão , Nível de Saúde , Qualidade de Vida , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Tempo de Internação , Masculino , Readmissão do Paciente , Inquéritos e Questionários
5.
Sci Rep ; 10(1): 6777, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32303691

RESUMO

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

6.
Dement Geriatr Cogn Disord ; 48(1-2): 93-104, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31600747

RESUMO

BACKGROUND: In Taiwan, the causes of death and related factors in the oldest old people with Alzheimer disease (AD) are not well characterized. We investigated the factors associated with mortality in the oldest old patients with newly diagnosed AD admitted to a long-stay residential facility. METHODS: We performed a prospective study of newly diagnosed AD patients at a veterans' home between 2012 and 2016. At admission, all eligible participants received a comprehensive geriatric assessment, including demographic variables, lifestyle habits, cognitive evaluations, medical conditions (comorbidities, Age-Adjusted Charlson Comorbidity Index score, and polypharmacy), nutritional status evaluated by the Mini Nutritional Assessment-Short Form and body mass index (BMI), and global functional status. A Cox proportional hazards model was used to evaluate the predictive values of clinical parameters for all-cause mortality. RESULTS: The cohort comprised 84 newly diagnosed AD patients (mean age 86.6 ± 3.9 years) with a mean follow-up period of 2.1 ± 1.2 years. The overall median survival was 3.5 years from the time of AD diagnosis (95% confidence interval, 3.1-3.9 years). BMI was significantly lower in the deceased group than in the alive group (20.7 ± 2.9 vs. 22.6 ± 3.4, p = 0.023). Logistic regression demonstrated that the clinical parameters significantly associated with mortality were high global comorbidity, low nutritional status (malnutrition and underweight), and impaired physical function at the time of AD diagnosis. CONCLUSION: Comorbidity burden, nutritional status, and physical functional status at the time of dementia diagnosis are important contributors to poor outcome in the oldest old. Efforts to control concurrent chronic disorders, nutritional interventions, and physical independency as a long-term care strategy for dementia may provide survival benefit.


Assuntos
Doença de Alzheimer , Comorbidade , Estado Nutricional , Desempenho Físico Funcional , Instituições Residenciais/estatística & dados numéricos , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/mortalidade , Índice de Massa Corporal , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Medição de Risco , Taiwan/epidemiologia
7.
Learn Health Syst ; 3(1): e10071, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31245594

RESUMO

Introduction: Precision medicine is an important milestone toward the attainment of personalized medicine. A learning health system (LHS) may facilitate the evidence collection and knowledge generation process for disease-based research and for the diagnosis, classification, or treatment of each disease subtype to improve patient care. Methods: The LHS design and implementation used by Taichung Veterans General Hospital (TCVGH) in Taiwan for their newly funded precision medicine research, a dementia registry study, was modeled from an LHS developed at the National Institutes of Health in the United States. This Clinical Informatics and Management System (CIMS), including its subsystems, facilitates and enhances operations associated with the institutional review board, clinical research data collection and study management, the hospital biobank, and the participating health research centers to support their precision medicine research aimed at improving patient care. Results: The implementation of a shared-design, full-cycle LHS with an enhanced CIMS, combined with hospital-based real-world data marts, has made the TCVGH dementia registry study a reality. The research data, including clinical assessment and genomics analysis information collected in CIMS, combined with data marts, are the foundation of the TCVGH dementia registry for outcome analyses. These high-quality datasets are useful for clinical validation, new hypotheses, and knowledge generation, leading to new clinical recommendations or guidelines for better patient treatment and care. The cyclic data flow supports the full-cycle LHS for TCVGH's dementia research to improve the care of elderly patients. Conclusions: Knowledge generation requires high-quality research and health care datasets. While the details of LHS implementation methods in the United States and Taiwan may differ slightly, the LHS concept design and basic system architecture, with improved CIMSs, were proven feasible. As a result, learning health processes in support of translational research and the potential for improvement in patient care were significantly facilitated.

8.
Sci Rep ; 7(1): 7185, 2017 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-28775264

RESUMO

Magnesium oxide (MgO) sensing membranes in pH-sensitive electrolyte-insulator-semiconductor structures were fabricated on silicon substrate. To optimize the sensing capability of the membrane, CF4 plasma was incorporated to improve the material quality of MgO films. Multiple material analyses including FESEM, XRD, AFM, and SIMS indicate that plasma treatment might enhance the crystallization and increase the grain size. Therefore, the sensing behaviors in terms of sensitivity, linearity, hysteresis effects, and drift rates might be improved. MgO-based EIS membranes with CF4 plasma treatment show promise for future industrial biosensing applications.

9.
J Stroke Cerebrovasc Dis ; 25(5): 1229-1234, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26935120

RESUMO

BACKGROUND: This study was conducted to test the hypothesis that elevated blood pressure at the early stage is associated with unfavorable outcome in acute ischemic stroke patients with stenosis of less than 50% of the culprit artery. METHODS: Patients with acute ischemic stroke onset within 48 hours and stenosis of less than 50% of the culprit artery from a prospective stroke registry were analyzed. A modified Rankin Scale score of 1 or lower at 3 months was defined as a favorable late outcome. Univariate and multivariate logistic regression analyses were used to analyze the association between hemodynamic parameters and outcome. RESULTS: One hundred thirty-six patients fulfilled the selection criteria. Patients with favorable outcome had lower pulse pressure at emergency department (ED) triage, lower systolic blood pressure (SBP) at 24 hours, lower pulse pressure at 24 hours, and lower heart rate (HR) at 24 hours. The univariate logistic regression analysis showed that history of stroke, elevated SBP at 24 hours, elevated HR at 24 hours, elevated pulse pressure at 24 hours, and higher National Institutes of Health Stroke Scale score at ED triage were associated with a less favorable late outcome. Two separate models of multivariate logistic regression analyses showed that pulse pressure at ED triage and pulse pressure at 24 hours, respectively, were significantly associated with less favorable outcome. CONCLUSIONS: Elevated pulse pressure at the early stage is independently associated with unfavorable late outcome in acute ischemic stroke patients with culprit artery stenosis less than 50%.


Assuntos
Pressão Sanguínea , Isquemia Encefálica/etiologia , Doenças Arteriais Cerebrais/complicações , Hipertensão/complicações , Acidente Vascular Cerebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/terapia , Doenças Arteriais Cerebrais/diagnóstico , Doenças Arteriais Cerebrais/fisiopatologia , Doenças Arteriais Cerebrais/terapia , Distribuição de Qui-Quadrado , Serviço Hospitalar de Emergência , Feminino , Frequência Cardíaca , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/terapia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Admissão do Paciente , Prognóstico , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Fatores de Tempo
10.
BMC Cardiovasc Disord ; 15: 100, 2015 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-26376690

RESUMO

BACKGROUND: Arterial stiffness predicts the future risk of macro- and micro-vascular diseases. Only a few studies have reported longitudinal changes. The present study aimed to investigate the progression rate of arterial stiffness and the factors influencing stiffness progression in a Han Chinese population residing in Taiwan. METHODS: The pulse wave velocity (PWV), elasticity modulus (Ep) and arterial stiffness index (ß) of the common carotid artery were measured in 577 stroke- and myocardial infarction-free subjects at baseline and after an average interval of 4.2 ± 0.8 years. Stepwise multivariate linear regression was conducted to elucidate the predictors of stiffness progression. RESULTS: For both baseline and follow-up data, men had significantly higher values of PWV, Ep and ß in comparison to women. The progression rates of PWV, Ep and ß were faster in men, but the difference was not statistically significant (ΔPWV = 0.20 ± 0.20 and 0.18 ± 0.20 m/s/yr; ΔEp = 8.17 ± 8.65 and 6.98 ± 8.26 kPa/yr; Δß = 0.70 ± 0.64 and 0.67 ± 0.56 for men and women, respectively). In the multivariate regression analyses, age, baseline stiffness parameters, baseline mean arterial pressure (MAP), baseline body mass index (BMI) and changes in MAP (ΔMAP) were independent predictors of PWV and Ep progression. There was an inverse correlation between the stiffness parameters at baseline and their progression rate (correlation coefficient (r) = -0.12 to -0.33, p = 0.032-1.6 × 10(-16)). Changes in MAP (ΔMAP) rather than baseline MAP were more strongly associated with PWV progression (p = 8.5 × 10(-24) and 1.9 × 10(-5) for ΔMAP and baseline MAP, respectively). Sex-specific analyses disclosed that baseline BMI and changes in BMI (ΔBMI) were significantly associated with stiffness progression in men (p = 0.010-0.026), but not in women. CONCLUSIONS: Aging and elevated blood pressure at baseline and during follow-up were the major determinants of stiffness progression in the Han Chinese population. For men, increased baseline BMI and changes in BMI were additional risk factors.


Assuntos
Arteriosclerose/fisiopatologia , Artéria Carótida Primitiva/fisiopatologia , Rigidez Vascular , Fatores Etários , Idoso , Arteriosclerose/diagnóstico por imagem , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Artéria Carótida Primitiva/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Fatores Sexuais , Taiwan , Ultrassonografia
11.
Ultrasound Med Biol ; 40(7): 1427-33, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24768488

RESUMO

This study evaluated the relationship between spontaneous echo contrast (SEC) in the internal jugular vein (JV), atherosclerotic markers and ischemic stroke. One hundred twenty patients with acute ischemic stroke and 120 controls were recruited. SEC score correlated with plasma level of fibrinogen (coefficient: 0.105, p = 0.022), hemoglobin (coefficient: 0.122, p = 0.008) and presence of JV reflux (coefficient: 0.314, p < 0.001) and peak flow velocity (coefficient: -0.244, p < 0.001) in the corresponding JV, but did not correlate with carotid plaque score (coefficient: 0.042, p = 0.358) or intima-media thickness (coefficient: 0.067, p = 0.303). Multivariate regression analysis revealed that fibrinogen level, SEC score, intima-media thickness, plaque score and history of coronary artery disease were associated with acute ischemic stroke. In conclusion, the severity of SEC in the JV might represent the tendency toward thrombogenesis in diseased cerebral circulation possibly through mechanisms other than arterial atherosclerosis.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/etiologia , Doenças das Artérias Carótidas/complicações , Doenças das Artérias Carótidas/diagnóstico por imagem , Veias Jugulares/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Idoso , Espessura Intima-Media Carotídea , Feminino , Humanos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Ultrassonografia/métodos
12.
J Stroke Cerebrovasc Dis ; 23(4): e249-54, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24295603

RESUMO

BACKGROUND: Cerebrovascular disease is the second leading cause of central nervous system pathology in cancer patients. Cancer-associated hypercoagulation plays an important role in cancer-related stroke. The present study aims to test whether plasma d-dimer levels could predict comorbid malignancy in patients with ischemic stroke. METHODS: Five hundred sixteen stroke patients with measured d-dimer levels and who were consecutively admitted to our stroke center from 2009 to 2012 were included. Cancer status was determined by medical chart, and 59 patients were identified to have active cancer. An additional 48 cancer patients with stroke were identified from the hospital database. Several d-dimer cutoff levels were used to predict cancer-related stroke. RESULTS: Stroke patients with active cancer had significantly higher d-dimer levels than those without cancer (P < .001). The average d-dimer level in stroke patients without cancer was .66 ± 1.83 mg/L, whereas the levels for active cancer patients from the stroke center and hospital database were 5.70 ± 9.63 mg/L and 10.47 ± 12.31 mg/L, respectively. When using d-dimer of .55 mg/L or more and multiple territory infarctions as criteria, the specificity and positive predictive value (PPV) for cancer-related stroke were 99.7% and 92.9%, respectively. When using d-dimer of 5.5 mg/L or more as the cutoff value, the test had a high specificity and PPV regardless the brain magnetic resonance imaging (MRI) findings. Six stroke patients fitting our criteria were confirmed to have occult malignancy after comprehensive cancer survey. CONCLUSIONS: Extraordinary high d-dimer levels or combining d-dimer and MRI findings may be used as a screening tool to detect malignancy in stroke patients.


Assuntos
Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Neoplasias/complicações , Neoplasias/metabolismo , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/metabolismo , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico
13.
Dalton Trans ; 42(43): 15332-42, 2013 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-24002544

RESUMO

Six new alkaline-earth metal carboxyphosphonates [Mg(H2O)(H2PMIDA)] (1), [Sr(H2O)(H2PMIDA)] (2), [Sr2(H2O)(PMIDA)] (3), [Sr2(HPO4)(H2PMIDA)] (4), [Ba2(HPO4)(H2PMIDA)] (5), and [Ba2(H2O)(H2PMIDA)2] (6) (H4PMIDA = N-(phosphonomethyl)iminodiacetic acid) have been synthesized solvothermally in order to study the coordination behavior of H4PMIDA towards alkaline-earth metal ions (Mg(2+), Sr(2+), and Ba(2+)) and the structural features of the resulting polymeric compounds. The newly synthesized compounds have been characterized by elemental analysis, UV-Vis spectrometry, IR spectroscopy, thermogravimetry analysis, solid state (31)P MAS NMR, powder X-ray diffraction analysis and single crystal X-ray diffraction techniques. The single crystal structure analysis revealed structural variability of the prepared compounds. Compounds 1, 2, 4 and 5 are three-dimensional with the H2PMIDA skeletons connecting the inorganic parts to each other, whereas compound has a layered structure. Compounds 2, 4 and 5 contain helical structural motifs. In addition, the extrinsic luminescent properties of Eu(III)- and Tb(III)-doped compounds 1, 4 and 5 have also been studied.

14.
Arch Gerontol Geriatr ; 49 Suppl 2: S26-31, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20005422

RESUMO

The incidence of ischemic stroke increases with age, and it has a great impact on patients' functional independence. The aim of this study was to analyze the clinical features, laboratory findings, and stroke subtypes in different age subgroups and identify the predictive factors for functional independence 6 months after stroke. A total of 533 patients with first-ever ischemic stroke were enrolled in this study. They were divided into two subgroups: more than 80 years old (n = 108) and less than 80 years old (n = 425). Patients aged 80 years or over had higher frequencies of heart disease and atrial fibrillation, and lower frequencies of dyslipidemia, alcohol drinking, and a family history of ischemic stroke. Significantly lower body mass index, serum albumin levels, and lipid profiles, including total cholesterol, low-density lipoprotein, and triglyceride levels, but higher severity of initial neurologic deficit, and higher rates of mortality and complications during hospitalization were noted in patients aged over 80 years. The multivariate logistic regression analysis showed that higher serum total cholesterol level, less severity of neurologic deficit at admission, and absence of a history of diabetes mellitus were predictive of functional independence 6 months after stroke.


Assuntos
Isquemia Encefálica/complicações , Vida Independente , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Fibrilação Atrial/epidemiologia , Índice de Massa Corporal , Colesterol/sangue , Dislipidemias/epidemiologia , Feminino , Cardiopatias/epidemiologia , Humanos , Lipídeos/sangue , Lipoproteínas LDL/sangue , Masculino , Prognóstico , Estudos Prospectivos , Albumina Sérica/análise , Acidente Vascular Cerebral/etiologia , Taiwan/epidemiologia
15.
Acta Neurol Taiwan ; 18(2): 130-1, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19673367

RESUMO

Foot drop is commonly caused by lumbar radiculopathy, peroneal nerve injury, spinal stenosis and other systemic diseases. It is usually thought as peripheral etiology, but it could be attributed to a central lesion, too. However, central lesions are rarely reported. We report a case diagnosed as a left parasagittal parietal tumor, in which drop foot was the only abnormal neurologic finding.


Assuntos
Neoplasias Encefálicas/complicações , Pé/inervação , Transtornos Neurológicos da Marcha/etiologia , Adulto , Neoplasias Encefálicas/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino
16.
J Chem Phys ; 126(3): 034311, 2007 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-17249875

RESUMO

Elimination of molecular bromine is probed in the B (3)Pi(ou) (+)<--X (1)Sigma(g) (+) transition following photodissociation of CHBr(2)Cl at 248 nm by using cavity ring-down absorption spectroscopy. The quantum yield for the Br(2) elimination reaction is determined to be 0.05+/-0.03. The nascent vibrational population ratio of Br(2)(v=1)Br(2)(v=0) is obtained to be 0.5+/-0.2. A supersonic beam of CHBr(2)Cl is similarly photofragmented and the resulting Br atoms are monitored with a velocity map ion-imaging detection, yielding spatial anisotropy parameters of 1.5 and 1.1 with photolyzing wavelengths of 234 and 267 nm, respectively. The results justify that the excited state promoted by 248 nm should have an A(") symmetry. Nevertheless, when CHBr(2)Cl is prepared in a supersonic molecular beam under a cold temperature, photofragmentation gives no Br(2) detectable in a time-of-flight mass spectrometer. A plausible pathway via internal conversion is proposed with the aid of ab initio potential energy calculations. Temperature dependence measurements lend support to the proposed pathway. The production rates of Br(2) between CHBr(2)Cl and CH(2)Br(2) are also compared to examine the chlorine-substituted effect.

17.
Neurotoxicology ; 27(6): 1052-63, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16815549

RESUMO

Germanium (Ge) is commonly used in the semiconductor industry as well as health-promoting and medical field. Biologically, germanium possesses erythropoietic, anti-microbial, anti-tumor, anti-amyloidosis, and immunomodulative effects. However, toxic effects of Ge-containing compounds on kidney, muscle, neuronal cells, and nerves have been reported. Mitochondrial dysfunction was found to be involved in the pathogenesis of GeO(2)-induced nephropathy and myopathy. Since it is well known that mitochondria play a major role in apoptosis triggered by many stimuli, an effort was made to examine whether the Ge-induced neurotoxicity occurs through mitochondria-mediated apoptosis. A mouse neuroblastoma cell line, Neuro-2A, was used in the present study. After incubating with 0.1-800microM of GeO(2) for 0-72h, the cell viability of Neuro-2A cells was inhibited in a dose- and time-dependent manner. Further analysis showed that aside from the changes in the nuclear morphology responsible for apoptosis, the release of cytochrome c, the loss of mitochondrial membrane potential, the translocation of Bax, and the reduction of Bcl-2 expression were also observed in Neuro-2A cells after GeO(2) treatment. These results indicate that the mitochondria-mediated apoptosis is involved in this in vitro model of GeO(2)-induced neurotoxicity.


Assuntos
Antimutagênicos/farmacologia , Apoptose/efeitos dos fármacos , Germânio/farmacologia , Mitocôndrias/efeitos dos fármacos , Laranja de Acridina , Análise de Variância , Animais , Apoptose/fisiologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Citocromos c/metabolismo , Relação Dose-Resposta a Droga , Etídio , Citometria de Fluxo/métodos , Imuno-Histoquímica/métodos , Marcação In Situ das Extremidades Cortadas/métodos , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Camundongos , Neuroblastoma , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Fatores de Tempo , Proteína X Associada a bcl-2/metabolismo
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