scholarly journals Η επίδραση του σακχαρώδη διαβήτη τύπου ΙΙ στη βραχυχρόνια και µακροχρόνια µετεγχειρητική γνωσιακή λειτουργία ασθενών που υποβάλλονται σε µη καρδιοχειρουργικές επεµβάσεις

2020 ◽  
Author(s):  
Μαρία Νταλούκα
Keyword(s):  
Cognitive Decline ◽  
Case Control Study ◽  
Diagnostic Algorithm ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Case Control ◽  
Confusion Assessment ◽  
Control Study

Σκοπός της διδακτορικής διατριβής ήταν η διερεύνηση της επίδρασης του σακχαρώδη διαβήτη τύπου ΙΙ (ΣΔΙΙ) στη βραχυχρόνια και µακροχρόνια µετεγχειρητική (έως και 9 µήνες) έκπτωση της γνωσιακής λειτουργίας και πιο συγκεκριµένα στο µετεγχειρητικό παραλήρηµα και τη µετεγχειρητική έκπτωση της γνωσιακής λειτουργίας ασθενών που υποβάλλονται σε εκλεκτικές µη-καρδιοχειρουργικές επεµβάσεις. Πρόκειται για µία προοπτική µελέτη παρατήρησης, δείκτου-ελέγχου (case control study), στην οποία συµπεριλήφθησαν 144 ασθενείς µε ΣΔΙΙ. Στην οµάδα ελέγχουσυµµετείχαν ασθενείς αντίστοιχου φύλου, ηλικίας, εκπαιδευτικού υποβάθρου και επεµβατικής πράξης. Το µετεγχειρητικό παραλήρηµα αξιολογήθηκε µε τη µέθοδο Confusion Assessment Method Diagnostic Algorithm και η µετεγχειρητική έκπτωση της γνωσιακής λειτουργίας µε το 16-item Informant Questionnaire on Cognitive Decline αντίστοιχα. Συνολικά συµπεριλήφθηκαν 288 ασθενείς. Οι ασθενείς µε ΣΔΙΙ διαγνώσθηκαν µε υψηλότερα ποσοστά ήπιας και µέτριας έκπτωσης της νευρογνωσιακής λειτουργίας προεγχειρητικά (ν=96 έναντι ν=26, P<0,05) και µετεγχειρητικού παραληρήµατος έως και την 4η µετεγχειρητική ηµέρα (ν=204 έναντι ν=68, P<0,05). Επιπλέον, οι διαβητικοί ασθενείς εµφάνισαν αυξηµένη ήπια, µέτρια και σοβαρή έκπτωση της νευρογνωσιακήςλειτουργίας έως και 9 µήνες µετεγχειρητικά (ν=473 έναντι ν=192, P<0,05). Οι ινσουλινοεξαρτώµενοι συµµετέχοντες είχαν µεγαλύτερη συχνότητα µετεγχειρητικού παραληρήµατος την 2η (ν=38 έναντι ν=24, P<0,05) και 3η ηµέρα (ν=27 έναντι ν=16, P<0,05) και σοβαρής έκπτωσης της νευρογνωσιακής λειτουργίας στις 10 ηµέρες, σε σύγκριση µε τους µη-ινσουλινο-εξαρτωµένους. Συµπερασµατικά, οι ασθενείς µε σακχαρώδη διαβήτη τύπου ΙΙ φαίνεται ότιβρίσκονται σε αυξηµένο κίνδυνο µετεγχειρητικής έκπτωσης της γνωσιακής λειτουργίας έως και 9 µήνες µετά από εκλεκτικές µη-καρδιοχειρουργικές επεµβάσεις.

scholarly journals Genetic polymorphisms of UGT1A1 and susceptibility to anti-tuberculosis drug-induced liver: A RUCAM-based case–control study

2018 ◽  
Vol 32 ◽  
pp. 205873841881628 ◽  
Author(s):  
Bilin Tao ◽  
Shixian Chen ◽  
Guancheng Lin ◽  
Miaomiao Yang ◽  
Lihuan Lu ◽  
...  
Keyword(s):  
Liver Injury ◽  
Genetic Polymorphisms ◽  
Case Control Study ◽  
Causality Assessment ◽  
Conditional Logistic Regression ◽  
Assessment Method ◽  
Case Control ◽  
Bile Acid Metabolism ◽  
Drug Induced ◽  
Control Study

Uridine 5’-diphospho-glucuronosyl-transferase 1A1 (UGT1A1) plays an important role in the biliary excretion of bilirubin, suggesting genetic polymorphisms of UGT1A1 may have an impact on bile acid metabolism, which may be related to the development of anti-tuberculosis drug-induced liver injury (ATLI). This study explores the associations between genetic polymorphisms of UGT1A1 and ATLI in a Chinese anti-tuberculosis population. A 1:2 matched case–control study was conducted among 290 ATLI cases and 580 controls, of which causality assessment of ATLI cases was based on the updated Roussel Uclaf Causality Assessment Method (RUCAM). Conditional logistic regression was applied to calculate odds ratio (OR) and 95% confidence intervals (CIs), with weight and use of hepatoprotectant as covariates. The Bonferroni correction was used to adjust P values for multiple testing. Compared with those carrying rs6719561 TT genotype, patients with TC genotype had lower risk of ATLI (adjusted OR = 0.723, 95% CI: 0.531–0.985, P = 0.040). The haplotype TAG (rs3755319-rs2003569-rs4148323) could marginally significantly increase the risk of ATLI (adjusted OR = 5.071, 95% CI: 1.007–25.531, P = 0.049), while haplotype TC (rs4148329-rs6719561) could reduce the risk of ATLI (adjusted OR = 0.719, 95% CI: 0.527–0.982, P = 0.038). Patients with polymorphisms at rs4148328 or rs3755319 were at a reduced risk of moderate and severe liver injury under different genetic models. Based on this case–control study, genetic polymorphisms of UGT1A1 may be associated with susceptibility to ATLI in the Chinese anti-tuberculosis population.

scholarly journals Hippocampal Calcification on Computed Tomography in Relation to Cognitive Decline in Memory Clinic Patients: A Case-Control Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0167444 ◽  
Author(s):  
Remko Kockelkoren ◽  
Jill B. De Vis ◽  
Willem P. Th. M. Mali ◽  
Jeroen Hendrikse ◽  
Pim A. de Jong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cognitive Decline ◽  
Case Control Study ◽  
Case Control ◽  
Memory Clinic ◽  
Control Study

scholarly journals Serum albumin to globulin ratio is related to cognitive decline via reflection of homeostasis: a nested case-control study

BMC Neurology ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Teruhide Koyama ◽  
Nagato Kuriyama ◽  
Etsuko Ozaki ◽  
Daisuke Matsui ◽  
Isao Watanabe ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Cognitive Decline ◽  
Case Control Study ◽  
Case Control ◽  
Nested Case Control ◽  
Control Study ◽  
Albumin To Globulin Ratio

Prevalence of COPD in a lung cancer case-control study: Variability by assessment method and by race.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 1609-1609
Author(s):  
Ann G. Schwartz ◽  
Shirish M. Gadgeel ◽  
Chrissy Lusk ◽  
Angie Wenzlaff ◽  
Stephanie Pandolfi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Control Study ◽  
Assessment Method ◽  
Case Control ◽  
Cancer Case ◽  
Lung Cancer Case ◽  
Control Study

scholarly journals Performance of a diagnostic algorithm for fibrotic hypersensitivity pneumonitis. A case–control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sabina A. Guler ◽  
Eva Wohlfarth ◽  
Sabina Berezowska ◽  
Thomas K. Geiser ◽  
Lukas Ebner ◽  
...  
Keyword(s):  
Confidence Level ◽  
Test Performance ◽  
Hypersensitivity Pneumonitis ◽  
Case Control Study ◽  
Diagnostic Algorithm ◽  
Case Control ◽  
Cox Proportional Hazards ◽  
Diagnostic Process ◽  
Risk Of Death ◽  
Control Study

Abstract Background The differential diagnosis fibrotic hypersensitivity pneumonitis (HP) versus idiopathic pulmonary fibrosis (IPF) is important but challenging. Recent diagnostic guidelines for HP emphasize including multidisciplinary discussion (MDD) in the diagnostic process, however MDD is not comprehensively available. We aimed to establish the diagnostic accuracy and prognostic validity of a previously proposed HP diagnostic algorithm that foregoes MDD. Methods We tested the algorithm in patients with an MDD diagnosis of fibrotic HP or IPF (case control study) and determined diagnostic test performances for diagnostic confidences of ≥ 90% and ≥ 70%. Prognostic validity was established using Cox proportional hazards models. Results Thirty-one patients with fibrotic HP and 50 IPF patients were included. The algorithm-derived ≥ 90% confidence level for HP had high specificity (0.94, 95% confidence interval [CI] 0.83–0.99), but low sensitivity (0.35 [95%CI 0.19–0.55], J-index 0.29). Test performance was improved for the ≥ 70% confidence level (J-index 0.64) with a specificity of 0.90 (95%CI 0.78–0.97), and a sensitivity of 0.74 (95%CI 0.55–0.88). MDD fibrotic HP diagnosis was strongly associated with lower risk of death (adjusted hazard ratio [HR] 0.10 [0.01–0.92], p = 0.04), whereas the algorithm-derived ≥ 70% and ≥ 90% confidence diagnoses were not significantly associated with survival (adjusted HR 0.37 [0.07–1.80], p = 0.22, and adjusted HR 0.41 [0.05–3.25], p = 0.39, respectively). Conclusion The algorithm-derived ≥ 70% diagnostic confidence had satisfactory test performance for MDD-HP diagnosis, with insufficient sensitivity for ≥ 90% confidence. The lowest risk of death in the MDD-derived HP diagnosis validates the reference standard and suggests that a diagnostic algorithm not including MDD, might not replace the latter.

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