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Magnesium and Health 镁与健康
Pub Date : 2019-04-05 DOI: 10.35248/2165-8048.19.9.e105
M. Barbagallo, L. Dominguez
Magnesium (Mg) is the second most abundant cation after potassium in the intracellular compartment and has a critical role in modulating a large variety of cellular activities and metabolic pathways. Mg is cofactor in over 300 enzymatic reactions including all reactions that involve ATP utilization and transfer [1,2]. Over the past decades, the clinical relevance of Mg and its impact on health has been documented. In the human body, around 24 grams (1 mole) of Mg are present. Less than 1% of total Mg is in the serum; normal serum Mg concentrations range between 0.75-0.95 mmol/L (1.7-2.5 mg/dL or 1.5-1.9 meq/L). In healthy adults, daily Mg requirement is around 300-400 mg (5 to 6 mg/kg/day) but it is higher in several physiological conditions (i.e. pregnancy, aging, exercise, etc.) and diseases (type-2 diabetes, infections, etc.). Severe Mg deficit may be associated with neuromuscular symptoms, such as weakness, tremor, muscle fasciculation, dysphagia, positive Chvostek’s sign (facial twitching as a reaction to the tapping of the facial nerve), and positive Trousseau’s sign (spasm of muscles of the hand and forearm following the application of a pressure cuff). Neurologic disturbances may involve the sympathetic and parasympathetic nervous systems, causing orthostatic hypotension or borderline hypertension. Mild to moderate Mg deficits are generally asymptomatic and clinical signs are usually absent and/or nonspecific. Subjective symptomatology may include anxiety, hyperemotionality, and fatigue, depressive symptoms to major depression, headache, insomnia, light-headedness, and dizziness. Peripheral signs such as myalgias, paresthesias, and cramps may be present. Non-specific functional complains may include chest pain, sine materia dyspnea, precordialgia, palpitations, extrasystoles, etc. Hyperemotionality, tremor, asthenia, sleep disorders, amnesic and cognitive disturbances are particularly important in older adults, and may be often overlooked or confused with age-related symptoms [3].
镁(Mg)是细胞内仅次于钾的第二丰富的阳离子,在调节多种细胞活动和代谢途径中起着关键作用。Mg是300多种酶促反应的辅助因子,包括所有涉及ATP利用和转移的反应[1,2]。在过去的几十年里,镁的临床相关性及其对健康的影响已被记录在案。在人体内,大约有24g (1mol) Mg存在。血清中Mg含量低于总Mg含量的1%;正常血清Mg浓度范围为0.75-0.95 mmol/L (1.7-2.5 Mg /dL或1.5-1.9 meq/L)。健康成人每日所需镁约为300-400毫克(5 - 6毫克/公斤/天),但在一些生理状况(如怀孕、衰老、运动等)和疾病(2型糖尿病、感染等)下,镁的需要量会更高。严重的镁缺乏可能与神经肌肉症状相关,如虚弱、震颤、肌肉束动、吞咽困难、Chvostek征阳性(面神经轻敲引起的面部抽搐)和Trousseau征阳性(使用压力袖带后手部和前臂肌肉痉挛)。神经系统障碍可累及交感和副交感神经系统,引起直立性低血压或边缘性高血压。轻至中度镁缺乏通常无症状,临床症状通常不存在和/或非特异性。主观症状包括焦虑、情绪亢进、疲劳、抑郁症状至重度抑郁、头痛、失眠、头晕。周围体征如肌痛、感觉异常和痉挛可能存在。非特异性功能性主诉可包括胸痛、原发性呼吸困难、心前痛、心悸、心动过速等。情绪亢进、震颤、虚弱、睡眠障碍、健忘症和认知障碍在老年人中尤为重要,它们可能经常被忽视或与年龄相关症状相混淆[3]。
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引用次数: 3
Autologous Peripheral Blood Mononuclear Cells can Lead to Pancreatic Beta Cell Regeneration 自体外周血单个核细胞可诱导胰腺β细胞再生
Pub Date : 2019-03-09 DOI: 10.35248/2165-8048.19.9.305
M. Younis
Introduction: Type-1 diabetes (T1D) is a disease that leads to pancreatic beta cells death, resulting in complete insulin loss. T1D occurs as a result of autoimmunity which takes insulin producing β cells as a target and is considered as a metabolic disorder causing hyperglycemia resulting from a serious loss of endogenous insulin roduction. Using cadaveric islets as a replacement therapy was done to reverse diabetes. Many various progenitor cell types have been found in the peripheral blood mononuclear cell (PBMC) fraction denoting hose PBMCs may have the ability to differentiate into many mature functional cell types in certain microenvironments. It is settled that circulating peripheral blood mononuclear cells (PBMC) contain germinal cell population which can share in the regeneration of tissues in different organs. Materials and Methods: 2 groups of type I diabetes patients had been monitored in a private clinic, number 40 each group, with 35 females and 45 males. It lied between 8-25 years old with 4-7 years of diabetes onset. The first group was on insulin therapy and they received peripheral blood mononuclear cells concentrate directly in the dorsal pancreatic artery. The second group was only on insulin injection. Results: The results show a significant increase in c peptide levels after direct injection of peripheral blood mononuclear cells in the dorsal pancreatic artery with p-value less than 0.0001. Conclusion: The peripheral blood mononuclear cells can induce beta cell regeneration and increase beta cell mass which is detected by an increase in c peptide levels.
1型糖尿病(T1D)是一种导致胰腺β细胞死亡,导致胰岛素完全丧失的疾病。T1D是一种以产生胰岛素的β细胞为靶点的自身免疫的结果,被认为是一种由内源性胰岛素产生严重丧失引起高血糖的代谢紊乱。用尸体胰岛作为替代疗法来逆转糖尿病。在外周血单核细胞(PBMC)中发现了许多不同的祖细胞类型,这表明PBMC可能在特定的微环境中有能力分化为许多成熟的功能细胞类型。认为循环外周血单核细胞(PBMC)中含有生发细胞群,这些生发细胞群可参与不同器官组织的再生。材料与方法:在某私人诊所对2组I型糖尿病患者进行监测,每组40例,其中女性35例,男性45例。年龄在8-25岁之间,发病4-7年。第一组接受胰岛素治疗,他们接受了直接集中于胰腺背动脉的外周血单个核细胞。第二组只注射胰岛素。结果:直接注射外周血单个核细胞后,胰腺背动脉c肽水平明显升高,p值小于0.0001。结论:外周血单个核细胞可诱导β细胞再生,增加β细胞质量,其表现为c肽水平升高。
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引用次数: 0
Recurrent Spontaneous Jejunal Hematomas Resulting in Bowel Obstruction 复发性自发性空肠血肿导致肠梗阻
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.306
G. Pollock, A. Chakraborty, C. Parr
Spontaneous intramural small bowel hematomas are rare complications of anticoagulation therapy. We present a case of a 71-year-old male presenting to hospital twice with supratherapeutic international normalized ratio (INR) and bowel obstruction, resulting in the diagnosis of recurrent intramural small bowel hematoma. This case illustrates the importance of stringent INR monitoring in those anticoagulated with warfarin and also demonstrates the importance of remaining clinically suspicious for this complication in patients who present with abdominal pain or intestinal obstruction symptoms in the setting of a supratherapeutic INR.
自发性小肠壁内血肿是抗凝治疗的罕见并发症。我们报告一例71岁男性患者,因治疗超国际标准化比率(INR)和肠梗阻两次就诊,最终诊断为复发性肠壁内小肠血肿。本病例说明了在使用华法林抗凝的患者中严格监测INR的重要性,也说明了在采用超治疗INR的情况下,对出现腹痛或肠梗阻症状的患者保持临床怀疑的重要性。
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引用次数: 0
Does Rheumatoid Arthritis Affects the Nitrergic Density and Somatic Area of the nNOS-Immunoreactive (IR) Myenteric Neurons, as well as the Morphometric Areas of CGRP and VIP-IR Varicosities of the Ileum of Arthritic Rats? 类风湿关节炎是否影响关节炎大鼠回肠nnos -免疫反应性(IR)肌神经元的氮能密度和体区,以及CGRP和VIP-IR静脉曲张的形态测量区?
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.311
Ahmed S. Ashour, K. Virginia
Few studies regarding arthritic diseases have been performed to verify the presence of the neurodegeneration. Given the increased oxidative stress and extra-articular effects of the rheumatoid arthritis, the gastrointestinal studies should be further investigated aiming a better understanding of the systemic effects the disease on enteric nervous system. To determine whether the rheumatoid arthritis affects the nitrergic density and somatic area of the nNOSimmunoreactive (IR) myenteric neurons, as well as the morphometric areas of CGRP and VIP-IR varicosities of the ileum of arthritic rats. Twenty 58-day-old male Holtzmann rats were distributed in two groups: control and arthritic. The arthritic group received a single injection of the Freund’s Complete Adjuvant in order to induce arthritis model. The whole-mount preparations of ileum were processed for immunohistochemistry to VIP, CGRP and nNOS. Quantification was used for the nitrergic neurons and morphometric analyses were performed for the three markers. The arthritic disease induced a reduction 6% in ileal area compared to control group. No significant differences were observed in nitrergic density comparing both groups. However, arthritic group yielded a reduction of the nitrergic neuronal somatic area and VIP-IR varicosity areas. However, an increase of varicosity CGRP-IR areas was also observed. Despite arthritis resulted in no alterations in the number of nitrergic neurons, the retraction of ileal area and reduction of nitrergic somatic and VIP-IR varicosity areas may suggest a negative impact the disease on the ENS.
很少有关于关节炎疾病的研究证实了神经变性的存在。鉴于类风湿关节炎增加的氧化应激和关节外影响,应进一步研究胃肠道研究,以更好地了解疾病对肠道神经系统的全身影响。探讨类风湿关节炎是否影响关节炎大鼠回肠nnoimmunoreactive (IR)肌神经元的氮能密度和体区,以及回肠CGRP和VIP-IR静脉曲张的形态计量区。58日龄雄性Holtzmann大鼠20只,分为对照组和关节炎组。关节炎组给予单次注射弗氏完全佐剂以诱导关节炎模型。对回肠全载体进行VIP、CGRP和nNOS免疫组化处理。对氮能神经元进行定量分析,并对三种标记物进行形态计量学分析。与对照组相比,关节炎导致回肠面积减少6%。两组间氮密度无显著差异。然而,关节炎组氮神经元体区和VIP-IR静脉曲张区减少。然而,也观察到CGRP-IR区域的静脉曲张增加。尽管关节炎没有导致氮能神经元数量的改变,但回肠区缩回和氮能躯体和VIP-IR静脉曲张区减少可能提示疾病对ENS的负面影响。
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引用次数: 0
Carnitine Deficiency in a Patient with Shapiro Syndrome 夏皮罗综合征患者肉碱缺乏症
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.312
P. Yager, Maria Alkhasova, D. Rudy
Spontaneous hyperhidrosis with hypothermia and agenesis of the corpus callosum is known as Classical Shapiro Syndrome (CSS) and was first reported by Shapiro and Plum in 1967. We report a well-documented case of a 39-yearold woman with SS diagnosed at the age of 5-years-old who was diagnosed with Carnitine deficiency at 30-years-old. This is the first reported case of SS with Carnitine deficiency, which was treated with levocarnitine. Our patient also carries with her several comorbid diagnoses which have been reported in other cases of SS. These include primary amenorrhea (untreated), primary hypothyroidism (treated with levothyroxine and liothyronine), seizure disorder (treated with lamotrigine, levetiracetam, and eslicarbazepine acetates), and hypothermia-induced cytopenia (resolved with the addition of liothyronine). Additionally, this case offers unique insights gained from longitudinal care.
自发性多汗症伴低体温和胼胝体发育不全被称为经典夏皮罗综合征(CSS),由夏皮罗和梅在1967年首次报道。我们报告了一个有充分文献记载的病例,一名39岁的女性在5岁时被诊断为SS,她在30岁时被诊断为肉碱缺乏症。这是第一例报道的左旋肉碱缺乏症的SS,用左卡尼汀治疗。本例患者还伴有其他SS病例报告的合并症诊断,包括原发性闭经(未经治疗)、原发性甲状腺功能减退(用左甲状腺素和碘甲状腺原氨酸治疗)、癫痫发作(用拉莫三嗪、左乙拉西坦和醋酸埃斯卡巴西平治疗)和低温诱导的细胞减少(用碘甲状腺原氨酸治疗)。此外,本病例提供了从纵向护理中获得的独特见解。
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引用次数: 1
Explosive Granulomatosis with Polyangiitis Mimicking Infective Endocarditis 爆炸性肉芽肿病伴感染性心内膜炎样多血管炎
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.302
L. Shue, Maggie L Chow, Br., O. Cohen, David Peng
Background: Granulomatosis with polyangiitis (GPA) is a rare systemic disease that causes necrotizing granulomatous inflammation of small- and medium-sized blood vessels. Infective endocarditis (IE), which is a disease due to infection of the innermost surface of the heart, is pathophysiologically distinct from GPA and yet these two entities can manifest in strikingly similar ways. Case presentation: We report a case of a 46-year-old male whose presentation and history were strikingly suggestive of IE but was ultimately diagnosed with GPA. Originally, he presented with fever, oral ulcers, and purpuric lesions on the extremities. The patient had a history of illicit drug use and had recently undergone a dental procedure one week prior to presentation, which were classic risk factors for IE. His fever and respiratory difficulty were unresponsive to antibiotic therapy. His respiratory and renal status declined explosively during his hospitalization, requiring intubation and intensive level care. His clinical progression, negative blood cultures, and a positive c-ANCA screen prompted a workup that was more consistent with GPA. Administration of anti-inflammatory medications and plasmapheresis eventually lead to the resolution of his symptoms. Because of his precipitous pulmonary decline, his outcome would have been poor if the correct diagnosis of GPA were to have been overlooked. Conclusions: ANCA-associated vasculitis and infective endocarditis can demonstrate similar clinical findings, including in the skin. Overlap in serologic markers and other organ involvement can lead to difficulty in distinguishing these two diseases, which require contrasting treatment methods. We highlight and compare the similarities and differences between GPA and IE in discussion of this interesting case to emphasize the importance of being clinically vigilant in differentiating these two separate disease processes.
背景:肉芽肿病合并多血管炎(GPA)是一种罕见的全身性疾病,引起中小血管坏死性肉芽肿性炎症。感染性心内膜炎(IE)是一种由心脏最内层表面感染引起的疾病,在病理生理学上与GPA不同,但这两种疾病的表现方式却惊人地相似。病例介绍:我们报告一个46岁男性的病例,其表现和病史明显提示IE,但最终被诊断为GPA。最初,他表现为发烧、口腔溃疡和四肢紫癜性病变。患者有非法药物使用史,最近在就诊前一周进行了牙科手术,这些都是IE的典型危险因素。他的发烧和呼吸困难对抗生素治疗无反应。他的呼吸和肾脏状况在住院期间急剧下降,需要插管和重症监护。他的临床进展,阴性血培养,阳性c-ANCA筛查促使检查更符合GPA。抗炎药物和血浆置换治疗最终使他的症状得到缓解。由于他的肺功能急剧下降,如果忽视了对GPA的正确诊断,他的预后就会很差。结论:anca相关血管炎和感染性心内膜炎可表现出相似的临床表现,包括皮肤。血清学标记物和其他器官受累的重叠可能导致难以区分这两种疾病,这需要对比治疗方法。在讨论这个有趣的病例时,我们强调并比较GPA和IE之间的异同,以强调临床警惕区分这两种不同疾病过程的重要性。
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引用次数: 1
MRI Assessment of Associations between Brown Adipose Tissue and Cachexia in Murine Pancreatic Ductal Adenocarcinoma. 小鼠胰腺导管腺癌棕色脂肪组织与恶病质相关性的MRI评估。
Pub Date : 2019-01-01 Epub Date: 2019-02-08 DOI: 10.4172/2165-8048.1000301
Yaqi Zhang, Su Hu, Junjie Shangguan, Liang Pan, Xin Zhou, Vahid Yaghmai, Yuri Velichko, Chunhong Hu, Jia Yang, Zhuoli Zhang

Objective: As the major thermogenic tissue in body, the brown adipose tissue (BAT) was recently identified as an important factor to induce the rapid weight loss and malnutrition in malignancy. Current methods for detecting and quantifying brown adipose tissue (BAT) are in limited use. The aim of this study was to evaluate the changes of BAT tissue and its function in the development of pancreatic ductal adenocarcinoma (PDAC) by using magnetic resonance imaging (MRI).

Methods: Ten-week-old female C57BL/6 mice were inoculated orthotopically with Pan02 tumor cells. R2* maps and two-point Dixon MRI were performed weekly for evaluation of BAT function and volume, respectively. The T2-weighted MRI was applied weekly for monitoring tumor growth. Meanwhile, the body weight was measured daily as another indication of malnutrition. The UCP1 levels in BAT and white adipose tissue (WAT) were assessed. The serum IL-6 was also measured as the biomarker of cancer-associated cachexia.

Results: T2-weighted MRI indicated the rapid tumor growth from week 3 to week 5 after tumor cell inoculation. The water-fat separated MRI could clearly identify and quantify the BAT. The function and volume of BAT could be monitored by weekly MRI measurement in tumor-bearing mice. The total body weights of PDAC tumor-bearing mice were relatively stable, however, was significantly lower than that of control C57BL/6 mice.

Conclusion: The results of this study demonstrated the feasibility of detection and quantification of BAT in vivo by MRI during the development of pancreatic cancer.

目的:褐色脂肪组织(brown aditissue, BAT)是机体主要的产热组织,近年来被认为是恶性肿瘤患者体重快速下降和营养不良的重要诱发因素。目前检测和定量棕色脂肪组织(BAT)的方法使用有限。本研究的目的是利用磁共振成像(MRI)评价BAT组织的变化及其在胰腺导管腺癌(PDAC)发展中的作用。方法:将10周龄雌性C57BL/6小鼠原位接种Pan02肿瘤细胞。每周分别进行R2*图和两点Dixon MRI评估BAT功能和体积。每周应用t2加权MRI监测肿瘤生长情况。同时,每天测量体重,作为营养不良的另一个指标。评估BAT和白色脂肪组织(WAT)中UCP1的水平。同时测定血清IL-6作为癌症相关恶病质的生物标志物。结果:肿瘤细胞接种后第3 ~ 5周,t2加权MRI显示肿瘤生长迅速。水脂分离MRI可以清晰地识别和量化BAT。通过每周一次的MRI检测,可监测荷瘤小鼠BAT的功能和体积。PDAC荷瘤小鼠的总体重相对稳定,但明显低于对照C57BL/6小鼠。结论:本研究结果证明了MRI在胰腺癌发展过程中检测和定量体内BAT的可行性。
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引用次数: 8
Tobacco Education: Reduced Risk for Peripheral Artery Disease 烟草教育:降低外周动脉疾病的风险
Pub Date : 2019-01-01 DOI: 10.4172/2165-8048.1000303
Blessings Wiyeh Fanka, S. Chaney
Peripheral arterial (vascular) disease (PAD/PVD) in its association with significant mortality and morbidity rates has become a significant public health concern. One of the most influential risk factors for PAD is tobacco use, which carries a 3-4-fold increase d risk for PAD often presenting as severe disease. The diagnosis of PAD is usually made a decade earlier in smokers than nonsmokers. The amputation rates in patients with PAD who smoke is twice higher than those that have never smoked. Smoking elevates the risk for PAD several folds and approximately 90% of persons with PAD have a history of smoking. Although the precise mechanism by which chronic smoking induces vascular disease is not entirely understood, growing evidence shows that impairment of endothelial morphology and function plays a crucial role in the pathogenesis of vascular disease. Oxidants, delivered by cigarette and deposited in pulmonary vessels through the systemic vasculature, activate superoxide producing enzymes within the vascular wall via oxidative stress and might be the cause of endothelial dysfunction and dysregulation of endothelial barrier. The World Health Organization (WHO) estimates that there are currently 1.1 billion tobacco smokers’ worldwide ages 15 years and older. Recently, smoking-related death have been said to account for 4.9 million persons per year worldwide. Tobacco use is considered the most important preventable vascular risk factor for PAD in men and women. The association between smoking and PAD is even stronger than that between smoking and coronary disease. The connection between smoking and PAD was identified in 1911 when Erb reported that intermittent claudication was three times more common in smokers and six times more common in heavy smokers in comparison with nonsmokers.
外周动脉(血管)疾病(PAD/PVD)与显著的死亡率和发病率相关,已成为一个重要的公共卫生问题。吸烟是PAD最具影响的危险因素之一,它会使PAD的患病风险增加3-4倍,通常表现为严重疾病。吸烟者通常比非吸烟者早10年确诊外周动脉疾病。吸烟的PAD患者截肢率比从不吸烟的患者高两倍。吸烟使患PAD的风险增加数倍,大约90%的PAD患者有吸烟史。尽管慢性吸烟诱发血管疾病的确切机制尚不完全清楚,但越来越多的证据表明,内皮细胞形态和功能的损害在血管疾病的发病机制中起着至关重要的作用。香烟输送的氧化剂通过全身血管沉积在肺血管中,通过氧化应激激活血管壁内产生超氧化物的酶,可能是内皮功能障碍和内皮屏障失调的原因。世界卫生组织(世卫组织)估计,目前全世界有11亿15岁及以上的吸烟者。最近,据说全世界每年有490万人死于吸烟。吸烟被认为是男性和女性PAD最重要的可预防血管危险因素。吸烟与外周动脉疾病之间的联系甚至比吸烟与冠心病之间的联系更强。1911年,Erb报道间歇性跛行在吸烟者中的发病率是不吸烟者的3倍,在重度吸烟者中的发病率是不吸烟者的6倍。
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引用次数: 0
The Role of Pain Catastrophizing and Anxiety Levels on Quality of Life in Fibromyalgia Compared with Healthy Women 纤维肌痛患者与健康女性相比疼痛灾难化和焦虑水平对生活质量的影响
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.313
K. Grinberg, Dyana Meshalhov, Daniel Adadi, Tomer Biton
Patients with fibromyalgia (FM) present with chronic and diffuse musculoskeletal pain, a low pain threshold at specific anatomical points, weakness and fatigue, which eventually lead to reduced physical activity and decreased quality of life. Some studies have indicated a link between FM and personality and mental characteristics, but few have examined differences between women with FM and healthy women. The goals of this research were to investigate these differences, as well as the link between the degree of catastrophizing and coping with the disease among sick women. This comparative and correlative study examined 165 women 75 (46%) with FM and 90 (54%) healthy women. All the subjects filled out a socio-demographic questionnaire, the State and Trait Anxiety Questionnaire, and the Short Form Health Survey (SF-12). In addition, the women diagnosed with FM answered the Pain Catastrophizing Scale and the Fibromyalgia Impact Questionnaire (FIQ). We found that women with FM report high levels of anxiety and low levels of quality of life regarding their disease. It seems that their mental health is linked to their physical status. Interventions to improve mental health in this patient population may also bring enhancement in quality of life.
纤维肌痛(FM)患者表现为慢性和弥漫性肌肉骨骼疼痛,特定解剖点疼痛阈值低,虚弱和疲劳,最终导致体力活动减少和生活质量下降。一些研究表明FM与人格和心理特征之间存在联系,但很少有人研究FM女性与健康女性之间的差异。这项研究的目的是调查这些差异,以及患病妇女的灾难程度与应对疾病之间的联系。这项比较和相关研究调查了165名患有FM的妇女75名(46%)和90名(54%)健康妇女。所有被试均填写了社会人口调查问卷、状态与特质焦虑问卷和简短健康调查问卷(SF-12)。此外,诊断为纤维肌痛的女性还填写了疼痛灾难量表和纤维肌痛影响问卷(FIQ)。我们发现患有FM的女性报告了与疾病相关的高度焦虑和低水平的生活质量。他们的心理健康似乎与他们的身体状况有关。改善这类患者心理健康的干预措施也可能带来生活质量的提高。
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引用次数: 2
Predictors of Impaired Quality of Life and Work Disability in Patients with Systemic Diseases 全身性疾病患者生活质量受损和工作残疾的预测因素
Pub Date : 2019-01-01 DOI: 10.35248/2165-8048.19.9.309
Ben Hadj Ali Emna, Bouker Ahmed, Guiga Ahmed, B. Y. Wissal, Atig Amira, Bahri Fethi, G. Neirouz
Background: Systemic diseases are heterogeneous diseases that represent one of the leading causes of disability with high rates of premature mortality and significant social costs. Methods: We conducted a cross-sectional study at an Internal Medicine Department between July 2017 and September 2017. We investigated patients with systemic rheumatic diseases and we evaluated the Quality of Life (QoL). The outcomes were baseline Short Form Health Survey Physical (PCS) and Mental (MCS) Component Scores. Work disability was evaluated by the Work Productivity Assessment Impairment (WPAI) questionnaire. Correlations were calculated by the test t student or ANOVA factor test and comparison with Chi2 test and multivariate regressions were then performed. Results: Two hundred thirty five patients were included, 183 females and 52 males. The average age was 48.3 years. 47% of the population had work during the study. The most frequent diseases were: Systemic lupus erythematosus in 66 patients, Behcet syndrome in 33 patients and Sjogren primary syndrome in 27 patients. Mean PCS were 52.55 ± 17.3 and MCS scores were 47.74 ± 14.8. For the predictors related to patients: the age ((PCS:r=-0.250,p=0.000), (MCS:r=-0.160,p=0.014)), the presence of comorbidities (PCS p=0.003) and the low level of education (p=0.001) were significantly correlated with impaired QoL, the presence of profession was not significantly correlated with QoL. For the predictors related to the disease; inflammatory myositis influences most the QoL. Pulmonary manifestations (PCS:p=0.021,MCS: p=0.006) were the most correlated with impaired QoL. Multivariate analysis showed effect of age, corticosteroids therapy and work disability on MCS and the effect of age and gender on PCS. Work disability was evaluated in working patients: absenteeism was at 31.16 ± 24, productivity impairment at 48.77and systemic sclerosis was the most disease predictive of absenteeism and work disability (p=0.011). Conclusion: QoL may be severely impaired in patients suffering from systemic diseases. We studied for the first time, in Tunisia, the predictors of impaired QoL for all patients followed in our department. This measure aims to further humanize medical practice, to maintain the quality of life of patients and to take into account the individuality of each patient.
背景:全身性疾病是异质性疾病,是致残的主要原因之一,具有高过早死亡率和巨大的社会成本。方法:我们于2017年7月至2017年9月在某内科进行了一项横断面研究。我们调查了患有系统性风湿病的患者,并评估了他们的生活质量(QoL)。结果是基线简短健康调查身体(PCS)和心理(MCS)成分得分。通过工作效率评估障碍(WPAI)问卷对工作障碍进行评估。通过检验t学生或方差分析因子检验计算相关性,并与Chi2检验和多变量回归进行比较。结果:共纳入235例患者,其中女性183例,男性52例。平均年龄为48.3岁。47%的人在研究期间有工作。最常见的疾病为:系统性红斑狼疮66例,Behcet综合征33例,干燥综合征27例。平均PCS为52.55±17.3分,MCS为47.74±14.8分。与患者相关的预测因子:年龄(PCS:r=-0.250,p=0.000)、MCS:r=-0.160,p=0.014)、是否存在合共病(PCS: p=0.003)、文化程度低(p=0.001)与生活质量受损有显著相关性,职业与生活质量受损无显著相关性。对于与疾病相关的预测因子;炎性肌炎对生活质量影响最大。肺部表现(PCS:p=0.021,MCS: p=0.006)与生活质量受损最相关。多因素分析显示年龄、皮质激素治疗和工作失能对MCS有影响,年龄和性别对PCS有影响。对工作患者的工作能力进行评估:缺勤率为31.16±24,生产力损害为48.77,系统性硬化症是缺勤和工作能力丧失的最预测性疾病(p=0.011)。结论:全身性疾病患者生活质量严重受损。在突尼斯,我们第一次研究了我们科室所有患者生活质量受损的预测因素。这项措施的目的是进一步使医疗实践人性化,保持病人的生活质量,并考虑到每个病人的个性。
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引用次数: 1
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Internal medicine: open access
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