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1.
Sci Rep ; 10(1): 966, 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31969610

RESUMO

Bronchospasm compresses the bronchial epithelium, and this compressive stress has been implicated in asthma pathogenesis. However, the molecular mechanisms by which this compressive stress alters pathways relevant to disease are not well understood. Using air-liquid interface cultures of primary human bronchial epithelial cells derived from non-asthmatic donors and asthmatic donors, we applied a compressive stress and then used a network approach to map resulting changes in the molecular interactome. In cells from non-asthmatic donors, compression by itself was sufficient to induce inflammatory, late repair, and fibrotic pathways. Remarkably, this molecular profile of non-asthmatic cells after compression recapitulated the profile of asthmatic cells before compression. Together, these results show that even in the absence of any inflammatory stimulus, mechanical compression alone is sufficient to induce an asthma-like molecular signature.

2.
Neurorehabil Neural Repair ; 33(11): 943-950, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31660787

RESUMO

Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.

3.
Am J Physiol Lung Cell Mol Physiol ; 317(5): L690-L701, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31508974

RESUMO

Cystic fibrosis (CF) is a genetic disease that causes multiple airway abnormalities. Two major respiratory consequences of CF are airway hyperresponsiveness (AHR) and airway remodeling. Airway smooth muscle (ASM) is hypothesized to be responsible for the airway dysfunction, since their thickening is involved in remodeling, and excessive contraction by the ASM may cause AHR. It is unclear whether the ASM is intrinsically altered to favor increased contractility or proliferation or if microenvironmental influences induce pathological behavior in vivo. In this study, we examined the contractile and proliferative properties of ASM cells isolated from healthy donor and CF transplant lungs. Assays of proliferation showed that CF ASM proliferates at a higher rate than healthy cells. Through calcium analysis, no differences in contractile activation in response to histamine were found. However, CF ASM cells lagged in their reuptake of calcium in the sarcoplasmic reticulum. The combination CFTR corrector and potentiator, VX-809/770, used to restore CFTR function in CF ASM, resulted in a reduction in proliferation and in a normalization of calcium reuptake kinetics. These results show that impaired CFTR function in ASM cells causes intrinsic changes in their proliferative and contractile properties.

4.
Int J Stroke ; 14(8): 774-782, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31514685

RESUMO

Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interventions. Cognitive function following stroke was identified as an important, but relatively neglected area during the first Stroke Recovery and Rehabilitation Roundtable (SRRR I), leading to a Cognition Working Group being convened as part of SRRR II. There is currently insufficient evidence to build consensus on specific approaches to cognitive rehabilitation. However, we present recommendations on the integration of cognitive assessments into stroke recovery studies generally and define priorities for ongoing and future research for stroke recovery and rehabilitation. A number of promising interventions are ready to be taken forward to trials to tackle the gap in evidence for cognitive rehabilitation. However, to accelerate progress requires that we coordinate efforts to tackle multiple gaps along the whole translational pathway.

5.
Clin J Pain ; 35(11): 880-886, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31433319

RESUMO

OBJECTIVES: Pain catastrophizing has been shown to be correlated with measures of mental health problems such as depression and post-traumatic stress disorder (PTSD). However, the clinical implications of findings reported to date remain unclear. To date, no study has been conducted to determine meaningful cut-scores on measures of catastrophizing indicative of the heightened risk of mental health comorbidity. One objective of the present study was to identify the cut-score on the Pain Catastrophizing Scale (PCS) indicative of the heightened risk of the comorbidity of depression and PTSD. A second objective was to determine whether mental health comorbidity mediated the relationship between catastrophizing and occupational disability. MATERIALS AND METHODS: The sample consisted of 143 individuals with whiplash injuries. Pain severity, pain catastrophizing, depression, and post-traumatic stress symptoms were assessed after admission to a rehabilitation program. Mental health comorbidity was operationally defined as obtaining a score above the clinical threshold on measures of depressive and/or post-traumatic stress symptom severity. RESULTS: A receiver operating characteristic curve analysis revealed that a PCS score of 22 best distinguished between participants with and without mental health comorbidity. Results also revealed that mental health comorbidity mediated the relationship between catastrophizing and occupational disability. DISCUSSION: The findings suggest that a score of ≥22 on the PCS should alert clinicians to the possibility that patients might also be experiencing clinically significant symptoms of depression or PTSD. Greater attention to the detection and treatment of mental health conditions associated with whiplash injury might contribute to more positive recovery outcomes.

6.
J Occup Rehabil ; 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31463870

RESUMO

Background Symptoms of fatigue have been shown to be associated with heightened levels of disability in patients suffering from a wide range of debilitating health and mental health conditions. The role of fatigue as a determinant of work disability in individuals with work-related musculoskeletal disorders (WRMD) has received little attention. The present study examined the role of fatigue as a determinant of work-disability in individuals with WRMDs. Methods Participants included 117 individuals with WRMDs who completed measures of pain severity, fatigue, depression and disability before and after participating in a behavioral activation rehabilitation intervention. Results Cross-sectional analyses on pre-treatment measures revealed that fatigue contributed significant variance to the prediction of self-reported disability, beyond the variance accounted for by pain severity and depression. Prospective analyses revealed that reductions in fatigue through the course of treatment predicted occupational re-engagement following termination of the intervention. Conclusions The results of the present study suggest fatigue contributes to occupational disability, independent of the effects of pain and depression. The findings also suggest that meaningful reductions in fatigue might be achieved through psychosocial interventions that promote gradual re-integration into discontinued activities, increase participants' exposure to success and achievement experiences, and reduce the severity of depressive symptoms. Behavioural activation interventions such as the one used in the present study might contribute to more positive occupational outcomes in work-disabled individuals who report high levels of fatigue.

7.
Artigo em Inglês | MEDLINE | ID: mdl-31231709

RESUMO

The optimal treatment for patients with locally advanced gastric adenocarcinoma is multimodal. Surgery is the cornerstone of therapeutic strategies with curative intent. The addition of chemotherapy or chemoradiation decreases rate of recurrence and prolongs survival. Guidelines differ between countries and there is no universal standard of care. Modern studies of patients with locally advanced gastric cancer showed that adjuvant chemotherapy improves survival over surgery alone in Asia. These studies could not be replicated in Europe. Peri-operative chemotherapy strategies, conversely, have been effective in Europe for improving overall and disease free survival. Adjuvant chemoradiation has also demonstrated improved survival when compared to surgery alone, but studies comparing chemotherapy with chemoradiation have not shown significant difference. Trials are ongoing to examine the role of chemoradiation in a neoadjuvant fashion. A D2 extent of lymphadenectomy improves cancer related survival for those who do not undergo distal pancreatectomy/splenectomy. Survival is also associated not only with the extent but also the number of lymph nodes examined. There are ongoing trials related to immunotherapy and targeted therapies, which may also impact or change the treatment paradigm for locally advanced gastric cancer.

8.
Clin J Pain ; 35(8): 656-667, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31145147

RESUMO

OBJECTIVES: Increasing pain during physical activity is an important, but often poorly assessed, barrier to engaging in activity-based rehabilitation among people with chronic musculoskeletal pain. Preliminary work has addressed this problem by developing new clinical measures of sensitivity to physical activity (SPA). Indices of SPA are generated by evaluating how pain changes in relation to brief physical tasks. Three strategies have been identified for structuring SPA-related physical tasks (self-paced, standardized, and tailored). This cross-sectional study aimed to comparatively estimate the extent of the 3 SPA tasks' evoked pain responses, predictive value of pain severity and pain interference, and their underlying psychological and sensory constructs, among 116 adults with chronic musculoskeletal pain. MATERIALS AND METHODS: Testing included questionnaires, quantitative sensory testing, and the 3 SPA measures (self-paced, standardized, and tailored). The primary analysis estimated the predictive value of each SPA measure for pain severity and pain interference. Correlational analyses were first conducted between all variables of interest to determine what variables will be included in the hierarchical regression analysis, which in turn was conducted for each outcome. RESULTS: Analyses revealed that the tailored SPA index was most effective at evoking activity-related pain, was uniquely associated with temporal summation of pain, and was a unique predictor of pain and pain-related interference, even when controlling for established psychological and sensory risk factors. DISCUSSION: This study further emphasizes SPA as an important and unique attribute of the pain experience and reveals the added value of using a tailored approach to assess SPA.

9.
Int J Stroke ; 14(5): 450-456, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31092153

RESUMO

The Stroke Recovery and Rehabilitation Roundtable (SRRR) meetings bring together an international group of preclinical and clinical researchers along with statisticians, methodologists, funders and consumers, working to accelerate the development of effective treatments for stroke recovery and to support best-evidence uptake in rehabilitation practice. The first meeting (2016) focused on four recommendation areas: translation of preclinical evidence into human discovery trials; recovery biomarkers to provide knowledge of therapeutic targets and prognosis in human stroke; intervention development, monitoring, and reporting standards; and standardized measurement in motor recovery trials. The impact of SRRR is growing, with uptake of recommendations emerging, and funders exploring ways to incorporate research targets and recommendations. At our second meeting (SRRR2, 2018), we worked on new priority areas: (1) cognitive impairment, (2) standardizing metrics for measuring quality of movement, (3) improving development of recovery trials, and (4) moving evidence-based treatments into practice. To accelerate progress towards breakthrough treatments, formation of an International Stroke Recovery and Rehabilitation Alliance is our next step, where working groups will take recommendations and build partnerships needed to achieve our goals.

10.
J Pediatr Hematol Oncol ; 41(5): 410-412, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30303869

RESUMO

BACKGROUND: Osteosarcoma in children below the age of 5 is extremely rare. OBSERVATION: We report on a previously well 14-month-old male infant, who presented with a reluctance to weight-bear on his right leg and had an associated limp. Plain imaging and a magnetic resonance imaging scan demonstrated a lytic lesion in the right distal femur. An open surgical biopsy confirmed the diagnosis of osteosarcoma. There was no significant family history of cancer and genetic screening for Li-Fraumeni syndrome was negative. CONCLUSIONS: This case highlights the importance of timely consideration of osteosarcoma in an infant, when the clinical presentation and medical imaging are consistent with that diagnosis.


Assuntos
Detecção Precoce de Câncer , Osteossarcoma/diagnóstico por imagem , Biópsia , Humanos , Lactente , Perna (Membro)/patologia , Imagem por Ressonância Magnética , Masculino , Osteossarcoma/patologia , Dor
11.
Pain Res Manag ; 2018: 7927656, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30356426

RESUMO

Background: Past decades have seen a surge of studies investigating the role of spouses in chronic illness. The present study explored an interpersonal model of health-related quality of life in chronic pain settings. Spouse personality was tested as a moderator of pain intensity-to-health associations in patients with chronic pain. Methods: This is a cross-sectional study. Participants were 185 noncancer chronic pain patients and their spouses. Patients were mostly females (58.4%). Mean age was approximately 56 years for patients and spouses. Patients completed a measure of pain intensity, health-related quality of life, and personality. Spouses also reported on their personality characteristics. Spouse personality was used as the moderator in the relationship between patients' pain intensity and health status. Patient personality was used as a covariate in the moderation analyses. Results: Spouse neuroticism moderated the relationship between pain intensity and physical health status, while spouse introversion moderated the pain-to-mental health association. Conclusions: Results support the idea that the relationship between a chronic stressor, namely, chronic pain, and health-related quality of life may be complex and contextually determined by spousal characteristics. Clinical implications are discussed in the context of couples.


Assuntos
Dor Crônica/psicologia , Nível de Saúde , Personalidade , Cônjuges/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuroticismo , Medição da Dor , Inventário de Personalidade , Qualidade de Vida/psicologia , Estudos Retrospectivos
12.
Am J Physiol Lung Cell Mol Physiol ; 315(5): L645-L652, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30070589

RESUMO

During acute bronchoconstriction, the airway epithelium becomes mechanically compressed, as airway smooth muscle contracts and the airway narrows. This mechanical compression activates airway epithelium to promote asthmatic airway remodeling. However, whether compressed airway epithelium can feed back on the cause of bronchoconstriction has remained an open question. Here we examine the potential for epithelial compression to augment proliferation and contraction of airway smooth muscle, and thus potentiate further bronchoconstriction and epithelial compression. Well-differentiated primary human bronchial epithelial (HBE) cells maintained in air-liquid interface culture were mechanically compressed to mimic the effect of bronchoconstriction. Primary human airway smooth muscle (HASM) cells were incubated with conditioned media collected from mechanically compressed HBE cells to examine the effect of epithelial-derived mediators on HASM cell proliferation using an EdU assay and HASM cell contraction using traction microscopy. An endothelin receptor antagonist, PD-145065, was employed to probe the role of HBE cell-derived endothelin-1 on the proliferation and contraction of HASM cells. Conditioned media from compressed HBE cells increased HASM cell proliferation, independent of the endothelin-1 signaling pathway. However, conditioned media from compressed HBE cells significantly increased HASM cell basal contraction and histamine-induced contraction, both of which depended on the endothelin-1 signaling pathway. Our data demonstrate that mechanical compression of bronchial epithelial cells contributes to proliferation and basal contraction of airway smooth muscle cells and that augmented contraction depends on epithelial cell-derived endothelin-1. By means of both airway smooth muscle remodeling and contractility, our findings suggest a causal role of epithelial compression on asthma pathogenesis.


Assuntos
Remodelação das Vias Aéreas/fisiologia , Asma/patologia , Broncoconstrição/fisiologia , Proliferação de Células , Contração Muscular , Músculo Liso/fisiologia , Sistema Respiratório/patologia , Asma/metabolismo , Células Cultivadas , Endotelina-1/metabolismo , Humanos , Músculo Liso/citologia , Sistema Respiratório/metabolismo , Transdução de Sinais
13.
Pain Rep ; 3(4): e661, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30123856

RESUMO

Introduction: Sensitivity to Movement-Evoked Pain is a pain summation phenomenon identified in various chronic pain populations. Objectives: This study investigated the validity of a procedure used to assess pain summation in response to a repeated lifting task in individuals with whiplash injuries. Methods: Sixty-five participants completed measures of pain severity and duration, Temporal Summation (TS) of pinprick pain, pain catastrophizing and fear of movement, and work-related disability before lifting a series of 18 weighted canisters. An index of Sensitivity to Movement-Evoked Pain was computed as the increase in pain reported by participants over successive lifts of the weighted canisters. An index of TS was computed by dividing the pain reported in response to the final pinprick by the pain reported in response to the 1st pinprick in a train of 10 pinpricks. Results: Analyses replicated previous findings showing a repetitive lifting task-induced pain summation in approximately 20% to 25% of a sample of individuals with whiplash injuries. Analyses also revealed significant correlations between SMEP, TS, and pain-related psychological variables. Hierarchical regression analyses showed that TS and pain catastrophizing made significant unique contributions to the prediction of SMEP. These findings join a growing body of research on movement-evoked pain in persistent spinal pain conditions. Conclusion: The repeated lifting task used in this study successfully induced pain summation in a group of patients with whiplash injuries.

14.
Protist ; 169(4): 539-568, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30036779

RESUMO

Until now only one group of diatoms, the Bacillariaceae, was known to contain heterotrophic representatives. We show that a second group, represented by species in the genus Tursiocola, has undergone evolutionary loss of photosynthesis within the Bacillariophyta. Heterotrophy was evidenced by the presence of only apochlorotic cells in live and motile specimens. Three species of Tursiocola (T. bondei sp. nov., T. alata sp. nov., and T. gracilis sp. nov.), of which at least two are apochlorotic, are described as new to science from the skin of Florida manatees. T. ziemanii and T. varicopulifera were also observed to be apochlorotic. A new morphological feature termed a "fastigium" was observed on some Tursiocola spp. and is described as an extension of the mantle margin at the valve apex that overhangs the apex and extends towards the valve face. The presence of greatly elevated marginal ridges on the valve face of T. alata sp. nov. is a newly observed morphological character within the genus. Phylogenetic analyses using ribosomal RNA sequences indicate that Tursiocola is monophyletic, though morphological character analysis suggests paraphyly as species of the closely related Epiphalaina genus are embedded within a larger Tursiocola clade.


Assuntos
Diatomáceas/isolamento & purificação , Trichechus manatus/microbiologia , Animais , Diatomáceas/classificação , Diatomáceas/ultraestrutura , Pele/microbiologia
15.
N Engl J Med ; 378(25): 2376-2385, 2018 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-29924955

RESUMO

BACKGROUND: Cisplatin chemotherapy and surgery are effective treatments for children with standard-risk hepatoblastoma but may cause considerable and irreversible hearing loss. This trial compared cisplatin with cisplatin plus delayed administration of sodium thiosulfate, aiming to reduce the incidence and severity of cisplatin-related ototoxic effects without jeopardizing overall and event-free survival. METHODS: We randomly assigned children older than 1 month and younger than 18 years of age who had standard-risk hepatoblastoma (≤3 involved liver sectors, no metastatic disease, and an alpha-fetoprotein level of >100 ng per milliliter) to receive cisplatin alone (at a dose of 80 mg per square meter of body-surface area, administered over a period of 6 hours) or cisplatin plus sodium thiosulfate (at a dose of 20 g per square meter, administered intravenously over a 15-minute period, 6 hours after the discontinuation of cisplatin) for four preoperative and two postoperative courses. The primary end point was the absolute hearing threshold, as measured by pure-tone audiometry, at a minimum age of 3.5 years. Hearing loss was assessed according to the Brock grade (on a scale from 0 to 4, with higher grades indicating greater hearing loss). The main secondary end points were overall survival and event-free survival at 3 years. RESULTS: A total of 109 children were randomly assigned to receive cisplatin plus sodium thiosulfate (57 children) or cisplatin alone (52) and could be evaluated. Sodium thiosulfate was associated with few high-grade toxic effects. The absolute hearing threshold was assessed in 101 children. Hearing loss of grade 1 or higher occurred in 18 of 55 children (33%) in the cisplatin-sodium thiosulfate group, as compared with 29 of 46 (63%) in the cisplatin-alone group, indicating a 48% lower incidence of hearing loss in the cisplatin-sodium thiosulfate group (relative risk, 0.52; 95% confidence interval [CI], 0.33 to 0.81; P=0.002). At a median of 52 months of follow-up, the 3-year rates of event-free survival were 82% (95% CI, 69 to 90) in the cisplatin-sodium thiosulfate group and 79% (95% CI, 65 to 88) in the cisplatin-alone group, and the 3-year rates of overall survival were 98% (95% CI, 88 to 100) and 92% (95% CI, 81 to 97), respectively. CONCLUSIONS: The addition of sodium thiosulfate, administered 6 hours after cisplatin chemotherapy, resulted in a lower incidence of cisplatin-induced hearing loss among children with standard-risk hepatoblastoma, without jeopardizing overall or event-free survival. (Funded by Cancer Research UK and others; SIOPEL 6 ClinicalTrials.gov number, NCT00652132 ; EudraCT number, 2007-002402-21 .).


Assuntos
Cisplatino/efeitos adversos , Perda Auditiva/prevenção & controle , Hepatoblastoma/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Tiossulfatos/uso terapêutico , Adolescente , Criança , Pré-Escolar , Cisplatino/administração & dosagem , Doxorrubicina/administração & dosagem , Quimioterapia Combinada , Feminino , Seguimentos , Taxa de Filtração Glomerular , Perda Auditiva/induzido quimicamente , Hepatoblastoma/mortalidade , Humanos , Incidência , Lactente , Neoplasias Hepáticas/mortalidade , Masculino , Método Simples-Cego , Análise de Sobrevida , Tiossulfatos/administração & dosagem , Tiossulfatos/efeitos adversos
16.
Health Qual Life Outcomes ; 16(1): 126, 2018 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-29914521

RESUMO

BACKGROUND: Total knee arthroplasty (TKA) is a highly effective procedure that yields reductions in pain and disability associated with end stage osteoarthritis (OA) of the knee. Quality of life instruments are frequently used to gauge the outcomes of total knee arthroplasty (TKA). However, research suggests that post-TKA reductions in symptom severity may not be the sole predictors of quality of life post-TKA. The primary objective of the present study was to examine the prognostic value of catastrophic thinking in health-related quality of life (HRQoL) judgments in patients with severe OA after TKA. METHODS: In this study we used a prospective cohort design to examine the value of pain catastrophizing in predicting HRQoL 1 year after TKA. Participants with advanced OA of the knee who were scheduled for TKA were recruited at one of three hospitals in Canada. The study sample consisted of 116 individuals (71 women, 45 men) who completed study questionnaires at their pre-surgical evaluation and 1 year after surgery. Hierarchical regression analysis was used to assess the unique contribution of pre-surgical pain catastrophizing to the prediction of post-surgical HRQoL judgments. RESULTS: The results of the hierarchical regression equation revealed that the overall model was significant, F (9,106) = 8.3, p < 001, and accounted for 36.4% of the variance in the prediction of post-surgical physical component score of HRQoL. Pain catastrophizing was entered in the last step of the equation and contributed significant unique variance (ß = -.35, p < .001) to the prediction of post-surgical physical component score of HRQoL above and beyond the variance accounted for by demographic variables, co-morbid health conditions, baseline HRQoL, and post-surgical reductions in pain, joint stiffness and physical disability. CONCLUSIONS: The current findings highlight the importance of pre-surgical catastrophic cognitions in influencing HRQoL judgments after TKA. The findings suggest that psychosocial interventions designed to reduce pain catastrophizing before TKA might contribute to better quality of life outcomes following surgery.


Assuntos
Artroplastia do Joelho/psicologia , Catastrofização/psicologia , Osteoartrite do Joelho/psicologia , Dor Pós-Operatória/psicologia , Qualidade de Vida/psicologia , Idoso , Artroplastia do Joelho/efeitos adversos , Canadá , Medo/psicologia , Feminino , Humanos , Julgamento , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Prognóstico , Estudos Prospectivos , Inquéritos e Questionários
17.
Neuroimage ; 178: 129-135, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29778641

RESUMO

BACKGROUND: Total hippocampal volume has been consistently linked to cognitive function and dementia. Yet, given its complex and parcellated internal structure, the role of subregions of the hippocampus in cognition and risk of dementia remains relatively underexplored. We studied subregions of the hippocampus in a large population-based cohort to further understand their role in cognitive impairment and dementia risk. METHODS: We studied 5035 dementia- and stroke-free persons from the Rotterdam Study, aged over 45 years. All participants underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Automatic segmentation of the hippocampus and 12 of its subregions was performed using the FreeSurfer software (version 6.0). A cognitive test battery was performed, and participants were followed up for the development of dementia until 2015. Associations of hippocampal subregion volumes with cognition and incident dementia were examined using linear and Cox regression models, respectively. All analyses were adjusted for age, sex, education, and total hippocampal volume. RESULTS: Mean age was 64.3 years (SD 10.6) with 56% women. Smaller volumes of the hippocampal fimbria, presubiculum and subiculum showed the strongest associations with poor performance on several cognitive domains, including executive function but not memory. During a mean follow-up of 5.5 years, 76 persons developed dementia. Smaller subiculum volume was associated with risk of dementia adjusted for total volume (hazard ratio per SD decrease in volume: 1.75, 95% confidence interval 1.35; 2.26). CONCLUSIONS: In a community-dwelling non-demented population, we describe patterns of association between hippocampal subregions with cognition and risk of dementia. Specifically, the subiculum was associated with both poorer cognition and higher risk of dementia.


Assuntos
Disfunção Cognitiva , Demência , Função Executiva/fisiologia , Hipocampo , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Neuroimagem/métodos , Idoso , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Demência/diagnóstico por imagem , Demência/patologia , Demência/fisiopatologia , Feminino , Seguimentos , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Hipocampo/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Sintomas Prodrômicos
18.
Appl Ergon ; 69: 17-24, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29477325

RESUMO

Workers with low back pain (LBP) may benefit from wearing a lumbar belt (LB), but the biomechanical and psychological mechanisms involved are not fully understood. Two types of flexible LB (extensible and non-extensible) were compared to a control condition (no LB) regarding pain-related (pain, fear of pain and catastrophizing) and biomechanical (range of motion - ROM) outcomes related to two tasks: maximal trunk flexion-extension and manual material handling. Healthy controls and participants with LBP were tested. During both tasks, the two LBs reduced the lumbar ROM in participants with LBP in the same way as healthy controls. This was observed even at the beginning of the trunk flexion movement, allowing generalization to many work tasks, that is to say tasks performed with small or deep trunk flexion. The two LBs reduced pain, fear of pain and catastrophizing in subjects with LBP. That may help a gradual re-exposure to physical work activities (disability prevention perspective), or maintaining these activities (secondary prevention perspective), following a LBP episode.


Assuntos
Braquetes , Remoção , Dor Lombar/terapia , Doenças Profissionais/terapia , Suporte de Carga/fisiologia , Adolescente , Adulto , Idoso , Fenômenos Biomecânicos , Segurança de Equipamentos , Feminino , Humanos , Dor Lombar/fisiopatologia , Dor Lombar/psicologia , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Movimento , Doenças Profissionais/fisiopatologia , Doenças Profissionais/psicologia , Amplitude de Movimento Articular/fisiologia , Resultado do Tratamento , Adulto Jovem
19.
N Z Med J ; 131(1468): 15-24, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29346353

RESUMO

AIMS: New Zealand currently defines the adolescent and young adult (AYA) group for cancer services as young people 12-24 years of age, while other countries favour a designation of 15-29 years. This study was undertaken to compare cancer incidence and survival among 25-29 year olds to New Zealand's younger AYA population and to assess survival for our 15-29 year population against international benchmarks. METHODS: Diagnostic and demographic information for cancer registrations between 2000 and 2009 for 25-29 year olds was obtained from the New Zealand Cancer Registry. Incidence rates (IR) and five-year relative survival estimates were calculated according to AYA diagnostic group/sub-group, sex and prioritised ethnicity. RESULTS: 1,541 new primary malignant cancers were diagnosed (IR: 588 per million). Five-year relative survival was 85%, but was significantly lower for Maori and Pacific peoples (both 77%) compared to non-Maori/non-Pacific peoples (88%). In the overall 15-29 year AYA cohort, disease-specific outcomes for bone tumours (46%) and breast cancer (64%) were inferior to international standards. CONCLUSION: New Zealand 25 to 29 year olds are at twice the risk of developing cancer as those 15-24 years. Given that the survival disparities identified were remarkably consistent with those for younger AYA, consideration should be given widening New Zealand's AYA age range.


Assuntos
Efeitos Psicossociais da Doença , Neoplasias/mortalidade , Adolescente , Adulto , Feminino , Humanos , Incidência , Masculino , Neoplasias/epidemiologia , Nova Zelândia/epidemiologia , Sistema de Registros , Taxa de Sobrevida , Adulto Jovem
20.
Disabil Rehabil ; 40(3): 317-322, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27866430

RESUMO

PURPOSE: The present study examined the psychometric properties of the Symptom Catastrophizing Scale (SCS). The SCS items were drawn from the Pain Catastrophizing Scale but were modified to make them better suited to the context of debilitating mental health conditions that are not necessarily associated with pain. The number of items was reduced from 13 to 7, and the response scale was simplified. METHODS: The SCS was administered to individuals diagnosed with Major Depressive Disorder (MDD) (N = 79) or with a chronic musculoskeletal (MSK) condition (N = 88). RESULTS: Exploratory factor analyzes revealed single factor solutions of the SCS for both the MSK and MDD samples. The internal consistency of the SCS was good. The SCS was significantly correlated with measures of pain severity, depressive symptom severity and disability in both samples. Individuals with MDD scored higher on the SCS than individuals with MSK. The SCS was shown to be sensitive to treatment-related reductions in catastrophic thinking. CONCLUSIONS: Preliminary analyzes suggest that the SCS is a reliable and valid measure of symptom-related catastrophic thinking associated with debilitating mental health conditions. Implications for Rehabilitation Although catastrophic thinking has been identified as a risk factor for disability, current assessment tools are not well suited for individuals with debilitating mental health conditions. This paper describes a brief assessment instrument that can be used to assess catastrophic thinking in individuals with debilitating mental health conditions. The results of this study suggest that targeting catastrophic thinking might yield reductions in symptom severity and disability in work-disabled individuals with major depressive disorder.


Assuntos
Catastrofização/psicologia , Transtorno Depressivo Maior/psicologia , Doenças Musculoesqueléticas/psicologia , Escalas de Graduação Psiquiátrica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Psicometria
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