Cardiac function at diagnosis is important prognostic factor in patients with cardiac sarcoidosis -from Japanese nationwide questionnaire survey-

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Kamada ◽  
K Ishibashi ◽  
K Nakajima ◽  
N Ueda ◽  
T Kamakura ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Adverse Events ◽  
Cardiac Function ◽  
Corticosteroid Therapy ◽  
Questionnaire Survey ◽  
Cardiac Sarcoidosis ◽  
Cardiovascular Death ◽  
Cardiac Events ◽  
Relationship Of ◽  
The Relationship

Abstract Background Sarcoidosis is a systemic non-caseating granulomatous disease of unknown etiology. Cardiac involvement (cardiac sarcoidosis, CS) has been reported to be an important prognostic factor in this disease because of heart failure and/or ventricular arrhythmia, and corticosteroid therapy is usually prescribed to prevent cardiac events. However, little is known about the relationship of cardiac function and concomitant corticosteroid therapy on later cardiac events in CS. Objective We evaluated the relationship between prognosis and left ventricular ejection fraction (LVEF) at the time of diagnosis in CS patients from the Japanese nationwide questionnaire survey. Methods Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, mean age 60±13 years old, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The relationship of adverse events (all-cause death, cardiovascular death, and appropriate ICD [Implantable Cardioverter Defibrillator] discharge) and LVEF (with corticosteroid 84%) (low LVEF: LVEF≤35% n=98 [with corticosteroid in 78%], moderate LVEF: LVEF 35–50% n=104 [with corticosteroid in 93%], normal LVEF: 50≤LVEF n=218 [with corticosteroid in 83%]) were evaluated respectively. Results 89 CS patients developed all-cause death (n=50), cardiovascular death (n=30) or appropriate ICD discharge (n=48). The frequency of corticosteroid therapy was not different in the each LVEF group, but Kaplan-Meier analysis revealed that all-cause death, cardiovascular death, and all cardiovascular adverse events were more observed in lower LVEF group (log-rank p<0.0001). Furthermore, multivariate Cox hazard analysis revealed that LVEF was a most important independent prognostic factor in CS. Conclusion This Japanese nationwide questionnaire survey data showed that initial LVEF was an independent and strong prognostic predictor in CS, therefore primary prevention would be needed even after starting corticosteroid in patients with decreased cardiac function. Funding Acknowledgement Type of funding source: None

Childhood Adverse Events and Current Traumatic Distress

2007 ◽  
Vol 34 (11) ◽  
pp. 1385-1401 ◽  
Author(s):  
Nena Messina ◽  
Christine Grella ◽  
William Burdon ◽  
Michael Prendergast
Keyword(s):  
Adverse Events ◽  
Childhood Abuse ◽  
Correctional Setting ◽  
Men And Women ◽  
Household Dysfunction ◽  
Criminal Histories ◽  
Traumatic Distress ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

This study describes the prevalence of childhood adverse events (CAEs) among men and women prisoners and assesses the relationship of CAEs to adult symptoms of traumatic distress. Interview data for 427 men and 315 women were analyzed assessing childhood abuse and household dysfunction, drug and criminal histories, and symptoms of traumatic distress. Women offenders had much greater exposure to CAEs than did men and more often reported continued sexual abuse in adolescence and as an adult. Linear regression results showed that the impact of CAEs on traumatic distress was strong and cumulative for both men and women (greater exposure to CAEs increased the likelihood of 6 out of 7 mental health outcomes, although women had higher levels of traumatic distress overall). The findings indicate the need for early prevention and intervention as well as trauma-based treatment within the correctional setting.

scholarly journals Risk Stratification in Acute Myeloid Leukemia Using CXCR Gene Signatures: A Bioinformatics Analysis

2020 ◽  
Vol 10 ◽  
Author(s):  
Cong Lu ◽  
Jiang Zhu ◽  
Xiangjun Chen ◽  
Yanjie Hu ◽  
Wei Xie ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Prognostic Factor ◽  
Chemokine Receptors ◽  
Myeloid Leukemia ◽  
Independent Prognostic Factor ◽  
Cxcr2 Expression ◽  
Relationship Of ◽  
The Relationship ◽  
Acute Myeloid

The role of CXC chemokine receptors in tumors has been an increasingly researched focus in recent years. However, significant prognostic values of CXCR members in acute myeloid leukemia are yet to be explored profoundly. In this study, we firstly made an analysis of the relationship of CXCR family members and AML using samples from TCGA. Our results suggested that transcriptional expressions of CXCRs serve an important role in AML. CXCR transcript expressions, except CXCR1 expression, were significantly increased in AML. It displayed the expression pattern of CXCR members in different AML subtypes according to FAB classification. The correlations of CXCR transcript expression with different genotypes and karyotypes were also present. High CXCR2 expression was found to have a significantly worse prognosis compared with that of low CXCR2 expression, and CXCR2 was also found to be an independent prognostic factor. We also established a CXCR signature to identify high-risk subgroups of patients with AML. It was an independent prognostic factor and could become a powerful method to predict the survival rate of patients.

The relationship between patient safety culture and adverse events: A questionnaire survey

2014 ◽  
Vol 51 (8) ◽  
pp. 1114-1122 ◽  
Author(s):  
Xue Wang ◽  
Ke Liu ◽  
Li-ming You ◽  
Jia-gen Xiang ◽  
Hua-gang Hu ◽  
...  
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Safety Culture ◽  
Questionnaire Survey ◽  
Patient Safety Culture ◽  
The Relationship

A Study on Environmental Attitude, Environmental Behavior and Environment Issues of Living Place: The Questionnaire Survey for some Dwellers in Shenzhen

2013 ◽  
Vol 368-370 ◽  
pp. 290-296
Author(s):  
Xiang Yang Wu ◽  
Wei Jia Lu
Keyword(s):  
Statistical Analysis ◽  
Questionnaire Survey ◽  
Environmental Behavior ◽  
Environmental Issues ◽  
Actual Situation ◽  
Environmental Attitude ◽  
Relationship Of ◽  
The Relationship ◽  
The City

Firstly, the study took the environmental attitude, environmental behavior of the city dwellers and the environment issues in living place for the target, and designed the questionnaire with the actual situation in Shenzhen. Secondly, the questionnaires returned back were analyzed in details. According to the conclusion from the statistical analysis for the questionnaires' data, the relationship of the environmental attitude and environmental behavior of the city dwellers was explored and the environmental issues were found out in the end.

Long-term follow up ventricular tachycardia patients with preserved cardiac function -from Japanese cardiac sarcoidosis nationwide questionnaire survey-

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Kamada ◽  
K Ishibashi ◽  
K Nakajima ◽  
N Ueda ◽  
T Kamakura ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Function ◽  
Questionnaire Survey ◽  
Cardiac Sarcoidosis ◽  
Left Ventricular Ejection ◽  
Icd Implantation ◽  
Icd Therapy ◽  
New Guidelines

Abstract Background Prior ventricular tachycardia (VT) and low left ventricular ejection fraction (LVEF) are the most important prognostic factors in cardiac sarcoidosis (CS). Recently diagnosis of CS was renewed according to Japanese new guidelines. Patients with preserved cardiac function often have VT events, thus new guidelines recommends to assess the implantable cardioverter defibrillator (ICD) implantation for CS patients with preserved LVEF (35%≤LVEF<50%). However, the long-term prognosis of CS patients with preserved LVEF is unclear. Objective In CS patients with preserved LVEF, we evaluated the prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis from Japanese nationwide questionnaire survey. Methods Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, who had LVEF≤35%, LVEF>50%, or who underwent cardiac transplantations were excluded. 104 patients with LVEF 35–50% (67 females, mean age 60±15 years old, median follow-up periods 2134 days [interquartile range: 758–2935 days]) were analyzed. The prognosis between VT manifestation and non-VT manifestation groups at CS diagnosis were evaluated. Results 30 patients had VT manifestation at CS diagnosis and 24 patients (80%) received ICDs. 74 patients had no VT manifestation at CS diagnosis and 19 patients (44%) received ICDs during follow up period. All-cause mortality was not different between two groups (Figure). Appropriate ICD therapy of non-VT manifestation group was significantly lower compared with that of VT manifestation group (log-rank p=0.001), however considerable number (n=7, 15%) of non-VT manifestation group had appropriate ICD therapy event during follow-up period. Cox hazard analysis revealed that concomitant non-sustained VT (NSVT) with atrioventricular block (AVB) was a predictor of appropriate ICD therapy in non-VT manifestation group. Conclusion This nationwide survey showed that considerable number of CS patients with preserved LVEF had VT events, independent of VT manifestation. Concomitant NSVT with AVB was a predictor of VT events, and ICD implantation should be assessed. Funding Acknowledgement Type of funding source: None

scholarly journals Long time clinical course of cardiac sarcoidosis with corticosteroid therapy -from Japanese nationwide questionnaire survey-

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Kamada ◽  
K Ishibashi ◽  
K Nakajima ◽  
N Ueda ◽  
T Kamakura ◽  
...  
Keyword(s):  
Ventricular Arrhythmia ◽  
Corticosteroid Therapy ◽  
Questionnaire Survey ◽  
Clinical Characteristics ◽  
Cardiac Involvement ◽  
Cardiac Sarcoidosis ◽  
Japanese Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Abstract Background Sarcoidosis is a systemic inflammatory syndrome of unknown etiology and cardiac involvement has been reported to be an important prognostic factor in this disease. An autopsy study has reported that the frequency of this cardiac involvement (cardiac sarcoidosis: CS) varies in the different countries and races and very frequent in Japanese patients. We therefore performed the nationwide questionnaire survey and try to clarify the clinical characteristics and corticosteroid effect in CS, especially focused on arrhythmic events in this disease. Methods Total of 757 Japanese patients from 57 hospitals who diagnosed CS were examined. Patients who unsatisfied the criteria of the Japanese new guidelines, or who underwent cardiac transplantations were excluded, and 420 patients (287 females, median follow-up periods 1864 days [interquartile range: 845–3159 days]) were analyzed. The clinical outcome and corticosteroid effect were evaluated. Results Clinical characteristics at diagnosis was as follows: female dominant (68%), mean age of 60±13 years old, mean left ventricular ejection fraction was 49±16%. Arrhythmic events were very frequently observed as an initial cardiac manifestation in 263 patients (62%) of CS, of which atrioventricular block (AVB) in 174 (41%), ventricular tachycardia (VT) in 73 (17%) and AVB with VT in 17 (4%) (Figure 1A). Pacemaker was implanted in 166 patients (40%) and defibrillators was 137 patients (33%). Corticosteroid was prescribed in 144 (83%) of 174 patients with AVB and in 62 (85%) of 73 patients with VT. Initial dose was mean 47.9 mg and maintenance dose of mean 7.3 mg. Corticosteroid improved VT as good as AVB (27% vs. 29%). However, corticosteroid sometimes worsened VT events compared with AVB (10% vs. 2%) (Figure 1B). During the course of follow-up, 32 patients were needed to increase corticosteroid in 23 of AVB and 10 of VT cases. However, there were no difference in mortality between the groups, whether or not to increase corticosteroid. All survival rate was 92% (5-year mortality), 83% (10-year mortality) and free from all cause death and defibrillator charge was 81% (5 year), 71% (10 year). Conclusion Fatal arrhythmia is commonly observed in CS as a primary symptom. Corticosteroid sometimes worsen ventricular arrhythmia and appropriate defibrillator discharge was common. Thus, careful attention for activating ventricular arrhythmia would be needed during the follow-up period even after corticosteroid therapy. Funding Acknowledgement Type of funding source: None

scholarly journals Factors Associated with Lumbar Puncture Participation in Alzheimer’s Disease Research

2020 ◽  
Vol 77 (4) ◽  
pp. 1559-1567
Author(s):  
Madeleine M. Blazel ◽  
Karen K. Lazar ◽  
Carol A. Van Hulle ◽  
Yue Ma ◽  
Aleshia Cole ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Adverse Events ◽  
Important Predictor ◽  
Parental History ◽  
Factors Associated ◽  
Disease Research ◽  
Relationship Of ◽  
The Relationship

Background: Cerebrospinal fluid (CSF) provides insight into the spectrum of Alzheimer’s disease (AD) pathology. While lumbar punctures (LPs) for CSF collection are generally considered safe procedures, many participants remain hesitant to participate in research involving LPs. Objective: To explore factors associated with participant willingness to undergo a research LP at baseline and follow-up research study visit. Methods: We analyzed data from 700 participants with varying cognition (unimpaired, mild cognitive impairment, and dementia) in the Wisconsin Alzheimer’s Disease Research Center. We evaluated the relationship of demographic variables (age, sex, race, ethnicity, and years of education) and clinical variables (waist-to-hip ratio, body mass index, AD parental history, cognitive diagnosis) on decision to undergo baseline LP1. We evaluated the relationship of prior LP1 experience (procedure success and adverse events) with the decision to undergo follow-up LP2. The strongest predictors were incorporated into regression models. Results: Over half of eligible participants opted into both baseline and follow-up LP. Participants who underwent LP1 had higher mean education than those who declined (p = 0.020). White participants were more likely to choose to undergo LP1 (p < 0.001); 33% of African American participants opted in compared to 65% of white participants. Controlling for age, education, and AD parental history, race was the only significant predictor for LP1 participation. Controlling for LP1 mild adverse events, successful LP1 predicted LP2 participation. Conclusion: Race was the most important predictor of baseline LP participation, and successful prior LP was the most important predictor of follow-up LP participation.

The management of myasthenia gravis

1977 ◽  
Vol 15 (8) ◽  
pp. 29-32
Keyword(s):  
Myasthenia Gravis ◽  
Corticosteroid Therapy ◽  
The Past ◽  
Relationship Of ◽  
The Relationship ◽  
Established Treatment

Our understanding of myasthenia and its management has increased in the past few years, and the relationship of corticosteroid therapy and thymectomy to established treatment has become much clearer.

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