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1.
J Headache Pain ; 22(1): 89, 2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380431

RESUMO

BACKGROUND: Considering the involvement of genetics in migraine pathogenesis in diverse ethnic populations, genome-wide association studies (GWAS) are being conducted to identify migraine-susceptibility genes. However, limited surveys have focused on the onset age of migraine (AoM) in Asians. Therefore, in this study, we aimed to identify the susceptibility loci of migraine considering the AoM in an Asian population. METHODS: We conducted a GWAS in 715 patients with migraine of Han Chinese ethnicity, residing in Taiwan, to identify the susceptibility genes associated with AoM. Based on our standard demographic questionnaire, the population was grouped into different subsets. Single-nucleotide polymorphism (SNP) associations were examined using PLINK in different AoM onset groups. RESULTS: We discovered eight novel susceptibility loci correlated with AoM that reached the GWAS significance level in the Han Chinese population. First, rs146094041 in ESRRG was associated with AoM [Formula: see text] 12 years. The other SNPs including rs77630941 in CUX1, rs146778855 in CDH18, rs117608715 in NOL3, rs150592309 in PRAP1, and rs181024055 in NRAP were associated with the later AoM. CONCLUSIONS: To our knowledge, this is the first GWAS to investigate the AoM in an Asian Han Chinese population. Our newly discovered susceptibility genes may have prospective associations with migraine pathogenesis.


Assuntos
Estudo de Associação Genômica Ampla , Transtornos de Enxaqueca , Idade de Início , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China , Predisposição Genética para Doença , Genótipo , Humanos , Transtornos de Enxaqueca/genética , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Taiwan
2.
Sci Rep ; 11(1): 14843, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34290337

RESUMO

Aromatase inhibitors (AIs) are standard adjuvant therapy for postmenopausal women with oestrogen receptor-positive, early-stage, and metastatic breast cancer. Although effective, the risk of falls due to AI-associated knee joint pain significantly increased. The aim of this study was to evaluate the therapeutic effects of yoga and massage on AI-associated knee joint pain. Breast cancer survivors were randomly assigned to a 6-week yoga intervention-2-week rest-6-week massage exposure (Yoga first, n = 30) or a 6-week massage intervention-2-week rest-6-week yoga exposure (Massage first, n = 30). Evaluations of the treatment efficacy were made at baseline, post-intervention, and post-exposure using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale, plasma cytokine levels, and changes in meridian energy. The results showed that yoga, superior to massage intervention, significantly reduced AI-associated knee joint pain, as demonstrated by the WOMAC pain score. The yoga intervention improvements were also associated with changes in plasma cytokine levels and meridian energy changes. In conclusion, this study provides scientific evidence that yoga was more effective than massage for reducing AI-associated knee joint pain. Meridian energy changes may provide another scientific, objective, non-invasive way to monitor the therapeutic effects of yoga and investigate another alternative, complementary medicine.

3.
Headache ; 61(5): 715-726, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33818765

RESUMO

BACKGROUND AND OBJECTIVES: Migraine has been associated with many comorbidities. However, lifestyle factors and the presence of comorbid diseases have not previously been extensively studied in the same sample. This study aimed to compare the prevalence of unhealthy lifestyle factors and comorbid diseases between patients with migraine and migraine-free controls with subgroup analyses to determine the pathophysiology and possible consequences. METHODS: This cross-sectional study recruited 1257 patients with migraine between the ages of 20 and 65 years from a headache outpatient clinic in Taiwan and 496 non-migraine controls. All participants completed questionnaires regarding demographics, migraine diagnosis, sleep, headache burden, and medical, pain, and psychiatric conditions. Participants also underwent a structured interview. The associations between comorbidities and migraine were investigated and further stratified by sex and aura. RESULTS: Patients with migraine with aura had an unhealthier lifestyle compared with controls in the form of current smoking status (15.5% [67/431] vs. 11.5% [57/496], p = 0.013). Furthermore, medical- (e.g., thyroid disease; 7.2% [91/1257 vs. 2.8% [14/496]; p = 0.006), psychiatric- (e.g., depression; 6% [76/1257 vs. 2.6% [13/496]; p = 0.031), and pain-related (e.g., fibromyalgia; 8% [101/1257 vs. 3.2% [16/496]; p = 0.006) comorbidities were more prevalent in patients compared with controls. Subgroup analyses revealed that chronic migraine, migraine with aura, and female sex were associated with a greater number of significant comorbidities than episodic migraine, migraine without aura, and male patients with migraine, respectively. CONCLUSION: Individuals seeking treatment for migraine reported greater levels of smoking and medical, psychiatric, and pain conditions than non-treatment-seeking healthy controls who were recruited from the community. Understanding the relationship between migraine and comorbid diseases may improve medical care as well as the quality of life.

4.
J Nurs Adm ; 51(5): 242-248, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33882551

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the Casey-Fink Graduate Nurse Experience Survey (CFGNES). BACKGROUND: Transitioning from the student role to professional nurse is challenging and stressful. Accurate measurement of role transition is important because of concerns regarding retention. METHODS: A secondary analysis of 71 919 graduate nurse responses to the CFGNES, collected 6 months into the Vizient/AACN residency program, was conducted. Psychometric testing included exploratory and confirmatory factor analysis. Internal consistency reliability was measured using Cronbach's α. RESULTS: Analysis revealed a consistent 5-factor solution. Factors were labeled job satisfaction, support, organize/prioritize care, role confidence, and professional socialization. Results demonstrated the CFGNES is a reliable and valid instrument for measuring perceptions of role transition. CONCLUSIONS: This study was needed to inform survey item revisions. The CFGNES continues to be valuable in providing voice to the needs of graduate nurses and evidence for improving nurse residency program outcomes.


Assuntos
Competência Clínica/normas , Educação Continuada em Enfermagem/organização & administração , Recursos Humanos de Enfermagem no Hospital/educação , Humanos , Satisfação no Emprego , Pesquisa Metodológica em Enfermagem , Avaliação de Programas e Projetos de Saúde , Psicometria , Reprodutibilidade dos Testes , Estudantes de Enfermagem/psicologia , Inquéritos e Questionários
5.
Handb Exp Pharmacol ; 2021 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-33454856

RESUMO

For a chemotherapeutic agent to be effective, it must conquer the presence of blood-brain barrier (BBB), which limits the penetration of drugs into the brain. Tumours in the brain compromise the integrity of BBB and result in a highly heterogeneous vasculature, known as blood-brain tumour barrier (BBTB). In this chapter, we firstly highlight the cellular and molecular characteristics of the BBB and BBTB as well as the challenges aroused by BBB/BBTB for drug delivery. Secondly, we discuss the current strategies overcoming the challenges in invasive and non-invasive manners. Finally, we highlight the emerging strategy using focused ultrasound (FUS) with systemic microbubbles to transiently and reversibly enhance the permeability of these barriers for drug delivery.

6.
Sleep ; 44(3)2021 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-32979047

RESUMO

STUDY OBJECTIVES: While insomnia and migraine are often comorbid, the shared and distinct neuroanatomical substrates underlying these disorders and the brain structures associated with the comorbidity are unknown. We aimed to identify patterns of neuroanatomical substrate alterations associated with migraine and insomnia comorbidity. METHODS: High-resolution T1-weighted images were acquired from subjects with insomnia, migraine, and comorbid migraine and insomnia, respectively, and healthy controls (HC). Direct group comparisons with HC followed by conjunction analyses identified shared regional gray matter volume (GMV) alterations between the disorders. To further examine large-scale anatomical network changes, a seed-based structural covariance network (SCN) analysis was applied. Conjunction analyses also identified common SCN alterations in two disease groups, and we further evaluated these shared regional and global neuroanatomical signatures in the comorbid group. RESULTS: Compared with controls, patients with migraine and insomnia showed GMV changes in the cerebellum and the lingual, precentral, and postcentral gyri (PCG). The bilateral PCG were common GMV alteration sites in both groups, with decreased structural covariance integrity observed in the cerebellum. In patients with comorbid migraine and insomnia, shared regional GMV and global SCN changes were consistently observed. The GMV of the right PCG also correlated with sleep quality in these patients. CONCLUSION: These findings highlight the specific role of the PCG in the shared pathophysiology of insomnia and migraine from a regional and global brain network perspective. These multilevel neuroanatomical changes could be used as potential image markers to decipher the comorbidity of the two disorders.


Assuntos
Transtornos de Enxaqueca , Distúrbios do Início e da Manutenção do Sono , Encéfalo/diagnóstico por imagem , Comorbidade , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Transtornos de Enxaqueca/diagnóstico por imagem , Transtornos de Enxaqueca/epidemiologia , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Distúrbios do Início e da Manutenção do Sono/epidemiologia
7.
Curr Pain Headache Rep ; 24(11): 68, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32990832

RESUMO

PURPOSE OF REVIEW: This review provides an update on chronic cluster headache (CH) focusing on clinical features, pathophysiology, and management as well as comparisons between Eastern and Western populations. RECENT FINDINGS: Chronic CH in Eastern populations was relatively rare, compared to that in Western populations. Lacrimation and/or conjunctival injection is the most frequently reported cranial autonomic symptom, and visual aura is predominant in chronic CH patients. Neuroimaging evidence in both ethnic groups suggests that CH pathophysiology involves the hypothalamus and pain-modulatory areas, with dynamic alternations between CH episodes. Recent evidence indicates that midbrain dopaminergic systems may participate in CH chronicity. Noteworthy advances have emerged in neuromodulatory therapies for chronic CH, but treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies has been unsuccessful. Recent evidence shows divergence of chronic CH between Eastern and Western populations. Neuromodulatory therapies but not CGRP inhibition is effective in this intractable patient group.

8.
Ann Clin Transl Neurol ; 7(10): 1942-1950, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32918390

RESUMO

OBJECTIVE: Several single-nucleotide polymorphisms (SNPs) are associated with restless legs syndrome (RLS). This study investigated whether or not additional SNP variants increase the risk of RLS in migraineurs and in migraine with aura (MA) and migraine without aura (MoA) subgroups. METHODS: Migraineurs with and without RLS were genotyped using an Affymetrix array. We performed association analyses for the entire cohort and the MA and MoA subgroups, which were divided further into episodic migraine (EM) and chronic migraine (CM). Potential correlations between SNPs and clinical indices in migraineurs with RLS were examined by multivariate regression analysis. RESULTS: The rs77234324 and rs79004933 SNPs were found in migraineurs with (P = 2.57E-07) and without (P = 3.03E-07) RLS. The A allele frequency for rs77234324 (on LGR6) was 0.1321 in migraineurs with RLS and 0.0166 in those without RLS (odds ratio, 8.978). The T allele frequency for rs79004933 (in the intergenic region) was 0.1981 in migraineurs with RLS and 0.0446 in those without (odds ratio, 5.281). rs2858654, rs76770509, rs4243475 in UTRN, rs150762626, and rs2668375 were identified in migraine with and without RLS in the MoA subgroup (P = 7.56E-09, P = 2.30E-08, P = 1.19E-07, P = 6.86E-07, and P = 8.05E-07, respectively). There was a suggestion of an association between rs10510331 (P = 1.50E-06) and CM and EM in patients with MoA and RLS. Multivariate regression showed a significant relationship between rs79004933 and the Beck Depression Inventory score. INTERPRETATION: rs77234324 in LGR6 and rs79004933 in the intergenic region were associated with RLS in migraineurs. Five SNPs increased the risk of RLS in patients with MoA.

9.
J Am Vet Med Assoc ; 257(5): 537-545, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32808895

RESUMO

OBJECTIVE: To investigate job satisfaction and engagement among credentialed veterinary technicians (CVTs) employed in the United States. SAMPLE: 873 CVTs who responded to an internet-based survey in 2017. PROCEDURES: A survey was conducted to collect information on demographics, individual engagement, and job satisfaction among a convenience sample of CVTs in the United States. Only responses from those employed in small animal practice were included. Demographic and job-related factors were evaluated for associations with individual engagement and job satisfaction. RESULTS: The mean (SD) score for overall individual engagement (7-point Likert scale, with 7 representing strong engagement) was 4.9 (1.0) and for job satisfaction (7 representing extreme satisfaction) was 5.4 (1.5). Factors associated with lower individual engagement and lower job satisfaction included most frequently working overnight shifts and having more veterinarians in the respondent's practice, whereas holding a supervisory role, receiving a higher hourly wage, and having more veterinary technicians in the practice were significantly associated with higher individual engagement and higher job satisfaction, with other variables held constant. Having a veterinary technician specialist designation was not associated with individual engagement or job satisfaction. CONCLUSIONS AND CLINICAL RELEVANCE: To the authors' knowledge, this was the first study to investigate factors associated with individual engagement and job satisfaction among CVTs in the United States. Employers should review these factors and support and enhance those associated with enhanced engagement and increased job satisfaction. Employers should regularly review factors identified as negatively associated with job satisfaction and engagement and do their best to mitigate them.


Assuntos
Técnicos em Manejo de Animais , Médicos Veterinários , Animais , Credenciamento , Humanos , Satisfação no Emprego , Inquéritos e Questionários , Estados Unidos
10.
Alzheimers Res Ther ; 12(1): 86, 2020 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-32678011

RESUMO

BACKGROUND: The neuroprotective role of interleukin (IL)-33 is supported by numerous preclinical studies, but it remains uninvestigated in clinical studies of Alzheimer's disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD. METHODS: A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) completed two Mini-Mental State Examinations (MMSEs) over a 1-year interval. In all 100 participants at the second MMSE, we examined the plasma levels of IL-33, IL-ß, IL-1 receptor agonist (IL-1RA), beta amyloid (Aß), and tau and apolipoprotein E (ApoE) genotyping; we also performed Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating. RESULTS: IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P < 0.001). Patients expressing IL-33 preserved their cognitive function compared with IL-33 non-expressing patients (1-year ΔMMSE, 0.16 ± 1.6 vs - 1.5 ± 2.6; P = 0.006). The cognitive preservation was not associated with the lower levels of Aß, tau, and ApoE ε4, while higher levels of ApoE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(-) than non-AD converters (90.9% vs 53.3%, P = 0.04). CONCLUSIONS: IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Doença de Alzheimer/genética , Peptídeos beta-Amiloides , Apolipoproteína E4 , Biomarcadores , Disfunção Cognitiva/genética , Humanos , Interleucina-33
13.
J Psychiatr Res ; 129: 66-72, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32592947

RESUMO

Plasma levels of biomarkers change with the progression of Alzheimer's disease (AD), which involves the accumulation of pathological amyloid ß (Aß) and Tau protein tangles. However, few studies have investigated the association between plasma biomarkers and rapid cognitive decline in patients with amnestic mild cognitive impairment (aMCI) and AD. A total of 10 healthy controls, 24 patients with aMCI, and 19 patients with AD were enrolled. All participants underwent twice Mini-Mental State Examination (MMSE), with a mean 1.2 year interval. Immunomagnetic reduction was utilized to evaluate levels of plasma biomarkers, including amyloid ß 1-40 (Aß1-40), Aß1-42, total Tau protein, phosphorylated Tau protein (Threonine 181), and α-synuclein (α-Syn). The correlations between plasma levels of biomarkers and MMSE change were examined. Our analysis reveals that current higher plasma levels of Aß1-42 and α-Syn with the cut-off value of plasma Aß1-42 >17.26 pg/mL and α-Syn >105 fg/mL had a moderate-to-high discriminatory capacity (area under the curve >0.70) for identifying cognitive deterioration in patients with aMCI. Our results thus suggest that plasma levels of Aß1-42 and α-Syn may be considered as useful markers to assess the severity of global cognitive decline in patients with aMCI.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Peptídeos beta-Amiloides , Biomarcadores , Humanos , Imunoensaio , Fragmentos de Peptídeos
14.
PLoS One ; 15(2): e0228284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32023286

RESUMO

INTRODUCTION: The relationships between family history, sex, age at onset, and migraine occurrence have been documented. However, the associations between these factors across different sexes and subgroups of patients have yet to be elucidated. This study evaluated the association between family history and migraine in male and female patients experiencing episodic and chronic migraine with and without aura. METHODS: This cross-sectional, case-control study included 299 headache-free controls and 885 patients receiving outpatient treatment for migraine. Participants were classified into episodic (1-14 days/month) and chronic (≥15 days/month) migraine groups. RESULTS: Positive family history was significantly more frequently observed in the episodic group than in the chronic group (49.5% vs. 26%; P < 0.001) in male patients, particularly in male patients without aura (50.3% vs. 21.9%; P = 0.003); it was less frequently observed (58.7% vs. 73.7%; P = 0.048) in female patients with aura. Family history was correlated with an earlier age at onset (20.7 years vs. 22.8 years; P = 0.002), particularly in patients without aura (21 years vs. 23.7 years; P = 0.002), who were women (20.9 years vs. 23.9 years; P = 0.002). CONCLUSIONS: Different patterns of association between family history and migraine can be observed between men and women. A positive family history of migraine is correlated with an earlier age at onset, particularly among female patients without aura.


Assuntos
Epilepsia/patologia , Transtornos de Enxaqueca/patologia , Adulto , Idade de Início , Estudos de Casos e Controles , Estudos Transversais , Epilepsia/complicações , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/complicações , Razão de Chances , Q-Sort , Fatores de Risco , Fatores Sexuais , Adulto Jovem
15.
Acta Neurol Scand ; 141(4): 319-327, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31856293

RESUMO

OBJECTIVES: Subjective cognitive complaints by patients with migraine have been associated with memory impairment. However, whether the severity of memory impairment relates to migraine characteristics, such as attack frequency and aura, remains undetermined. We investigated the relationship between subjective cognitive complaints and migraine characteristics. MATERIALS AND METHODS: This cross-sectional study recruited 669 clinic outpatients from Taiwan. We stratified them by migraine frequency and the presence or absence of aura, and we controlled the data for confounding variables. We performed multivariable linear and logistic regressions to investigate whether different migraine frequencies are associated with subjective cognitive complaints, which were evaluated by the subjective memory complaints scale and the Ascertain Dementia 8 (AD8) questionnaire. RESULTS: Total subjective memory complaints scores tended to increase with the migraine attack frequency (P = .022) in patients with migraine with aura; similar results were obtained for AD8 scores in women with migraine with aura. Poor sleep quality was associated with a higher total subjective memory complaint (B = 0.08, 95% confidence interval [CI] = 0.03-0.14) and AD8 (B = 0.07, 95% CI = 0.02-0.11) scores. In addition, more severe depression was associated with higher total subjective memory complaints and AD8 scores (B = 0.05, 95% CI = 0.02-0.09; B = 0.08, 95% CI = 0.05-0.11, respectively). CONCLUSIONS: Subjective cognitive complaints tend to increase with the frequency of migraines with aura, and this interrelation is substantially influenced by depression severity and sleep disturbances.


Assuntos
Autoavaliação Diagnóstica , Transtornos de Enxaqueca/psicologia , Idoso , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/patologia , Inquéritos e Questionários
16.
J Clin Med ; 8(11)2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31698867

RESUMO

Brain degeneration in patients with Alzheimer's disease (AD) results from the accumulation of pathological amyloid- (Aß) plaques and tau protein tangles, leading to altered plasma levels of biomarkers. However, few studies have investigated the association between plasma biomarkers and cognitive impairment in patients with AD. In this cross-sectional study, we investigated correlations between mini-mental state examination (MMSE) scores and levels of plasma biomarkers in patients with amnestic mild cognitive impairment (aMCI) and AD. Thirteen individuals with normal cognition, 40 patients with aMCI, and 37 patients with AD were enrolled. Immunomagnetic reduction was used to assess the levels of plasma biomarkers, including amyloid A1-40, A1-42, total tau protein (t-Tau), and phosphorylated tau protein (threonine 181, p-Tau181). Our analysis revealed a significant negative correlation between MMSE and both measures of tau, and a trend toward negative correlation between MMSE and A1-42. In a longitudinal study involving three patients with aMCI and two patients with AD, we observed strong negative correlations (r < -0.8) between changes in MMSE scores and plasma levels of t-Tau. Our results suggest that plasma levels of t-Tau and p-Tau181 can be used to assess the severity of cognitive impairment in patients with AD. Furthermore, the results of our preliminary longitudinal study suggest that levels of t-Tau can be used to monitor the progression of cognitive decline in patients with aMCI/AD.

17.
Front Neurol ; 10: 598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31231306

RESUMO

Background: Perceived stress has been related to migraine. The relationship between sex, migraine frequency, and severity of perceived stress remains unclear. We investigated perceived stress among migraineurs. Methods: This cross-sectional case-control study involved 577 clinical outpatients at a tertiary hospital in Taiwan. Demographic and clinical data, including migraine characteristics, were collected. Migraineurs were stratified by episode frequency, aura and sex, and analyses were controlled for confounding variables. Multivariable linear regressions were used to inspect whether migraine frequency (1-4, 5-8, 9-14, or ≥15 headache days per month) was associated with perceived stress as assessed by the Perceived Stress Scale (PSS). Results: Perceived stress was significantly higher in high frequency migraineurs (mean ± standard deviation (SD), 23.3 ± 8.7) than in low frequency migraineurs (mean ± SD, 21.9 ± 9.2; P < 0.05). After stratifying the analysis by sex, this result was observed in male subjects, but was insignificant in female subjects. In addition, the relationship between migraine frequency and perceived stress was not prominent in aura-present or -absent subgroups. Conclusions: Higher perceived stress was associated with higher migraine frequency, but not in chronic migraine and female subgroups. Adaptation to migraine and various psychiatric comorbidities may contribute to these associations.

18.
Postgrad Med J ; 95(1124): 307-313, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209183

RESUMO

BACKGROUND: Growing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population. METHODS: The study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment. RESULTS: Individuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45-64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS. CONCLUSIONS: Our results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.


Assuntos
Doenças Autoimunes Desmielinizantes do Sistema Nervoso Central/epidemiologia , Sepse/epidemiologia , Adolescente , Adulto , Idoso , Estudos de Coortes , Doenças Autoimunes Desmielinizantes do Sistema Nervoso Central/imunologia , Doenças Desmielinizantes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glicoproteína Mielina-Oligodendrócito/imunologia , Neuromielite Óptica/epidemiologia , Neuromielite Óptica/imunologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
19.
Postgrad Med J ; 95(1120): 72-77, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30936249

RESUMO

BACKGROUND: Primary headache disorders (PHDs) are associated with sleep problems. It is suggested that headache and sleep disorder share anatomical and physiological characteristics. We hypothesised that patients with PHDs were exposed to a great risk for developing sleep apnoea (SA). METHODS: In this retrospective longitudinal study, the data obtained from the Longitudinal Health Insurance Database in Taiwan were analysed. The study included 1346 patients with PHDs who were initially diagnosed and 5348 patients who were randomly selected and age/sex matched with the study group as controls. PHDs, SA, comorbidities and other confounding factors were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification. Cox proportional hazards regressions were employed to examine adjusted HRs after adjusting with confounding factors. RESULTS: Our data revealed that patients with PHDs had a higher risk (HR 2.17, 95% CI 1.259 to 3.739, p<0.05) to develop SA compared with matched cohorts, whereas patients with migraine exhibited a high risk (HR 2.553, 95% CI 1.460 to 4.395, p<0.01). The results showed that patients with PHDs aged 18-44 exhibited highest risk of developing SA. In addition, males with PHDs exhibited an HR 3.159 (95% CI 1.479 to 6.749, p<0.01) for developing SA, respectively. The impact of PHDs on SA risk was progressively increased by various follow-up time intervals. CONCLUSION: Our results suggest that PHDs are linked to an increased risk for SA with sex-dependent and time-dependent characteristics.


Assuntos
Transtornos da Cefaleia Primários/complicações , Síndromes da Apneia do Sono/etiologia , Adulto , Idoso , Feminino , Transtornos da Cefaleia Primários/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Síndromes da Apneia do Sono/epidemiologia , Taiwan/epidemiologia
20.
Front Neurol ; 10: 228, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30941087

RESUMO

Background: Migraines with aura have been associated with suicide in adolescents and young adults, but the association between suicide and migraine frequency has not been determined. This study investigated suicidal ideation and suicide attempts among patients with varying frequencies of migraines, with and without auras. Methods: This cross-sectional study analyzed 528 patients aged between 20 and 60 years from a headache outpatient clinic in Taiwan. All patients completed a set of questionnaires, including a demographic questionnaire, the Migraine Disability Assessment questionnaire, the Hospital Anxiety and Depression Scale, the Beck Depression Inventory, and the Pittsburgh Sleep Quality Index. Suicide risk was evaluated by self-reported lifetime suicidal ideation and attempts. Patients were divided into low-frequency (1-4 days/month), moderate-frequency (5-8 days/month), high-frequency (9-14 days/month), and chronic (≥15 days/month) migraine groups. The association between migraine frequency and suicidality was investigated using multivariable linear regression and logistic regression. Results: The rates of suicidal ideation and suicide attempts were the highest for chronic migraine with aura (ideation: 47.2%; attempts: 13.9%) and lowest in migraine-free controls (2.8%). Migraine frequency was an independent risk factor for suicidal ideation and attempts in patients with aura (both P trend < 0.001), but not in patients without auras. Migraine aura and depression were associated with higher risks of suicidal ideation and suicide attempts in patients with migraine. Conclusion: High migraine frequency has a correlation with high suicide risk in patients who experience an aura, but not in other patients with migraine.

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