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1.
Joseph Wheatley Zhengyang Liu Joel Loth Mark P. Plummer Jahan C. Penny-Dimri Reny Segal Julian Smith Luke A. Perry 《Acta anaesthesiologica Scandinavica》2023,67(2):131-141
Background
Patients undergoing cardiac surgery are at significant risk of developing postoperative acute kidney injury (AKI). Neutrophil–lymphocyte ratio (NLR) is a widely available inflammatory biomarker which may be of prognostic value in this setting.Methods
We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity.Results
Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18–1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50–3.72). Postoperative NLR measurements were not of prognostic significance.Conclusions
Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery. 相似文献2.
Luke D. Kim Elizabeth R. Pfoh Bo Hu Lei Kou Lisa M. Knowlton Kristan Staudenmayer Michael B. Rothberg 《Journal of the American Medical Directors Association》2019,20(9):1086-1090.e2
ObjectivesTo identify factors associated with 30-day all-cause readmission rates in surgical patients discharged to skilled nursing facilities (SNFs), and derive and validate a risk score.DesignRetrospective cohort.Setting and participantsPatients admitted to 1 tertiary hospital's surgical services between January 1, 2011, and December 31, 2014 and subsequently discharged to 110 SNFs within a 25-mile radius of the hospital. The first 2 years were used for the derivation set and the last 2 for validation.MethodsData were collected on 30-day all cause readmissions, patient demographics, procedure and surgical service, comorbidities, laboratory tests, and prior health care utilization. Multivariate regression was used to identify risk factors for readmission.ResultsDuring the study period, 2405 surgical patients were discharged to 110 SNFs, and 519 (21.6%) of these patients experienced readmission within 30 days. In a multivariable regression model, hospital length of stay [odds ratio (OR) per day: 1.03, 95% confidence interval (CI) 1.02-1.04], number of hospitalizations in past year (OR 1.24 per hospitalization, 95% CI 1.18-1.31), nonelective surgery (OR 1.33, 95% CI 1.18-1.65), low-risk service (orthopedic/spine service) (OR 0.32, 95% CI 0.25-0.42), and intermediate-risk service (cardiothoracic surgery/urology/gynecology/ear, nose, throat) (OR 0.69, 95% CI 0.53-0.88) were associated with all-cause readmissions. The model had a C index of 0.71 in the validation set. Using the following risk score [0.8 × (hospital length of stay) + 7 × (number of hospitalizations in past year) +10 for nonelective surgery, +36 for high-risk surgery, and +20 for intermediate-risk surgery], a score of >40 identified patients at high risk of 30-day readmission (35.8% vs 12.6%, P < .001).Conclusions/ImplicationsAmong surgical patients discharged to an SNF, a simple risk score with 4 parameters can accurately predict the risk of 30-day readmission. 相似文献
3.
Daniel Rohan Phadke Daniel P. Sheeran Luke R. Wilkins John A. Kern Margaret C. Tracci John F. Angle 《Journal of vascular and interventional radiology : JVIR》2019,30(4):572-577
Purpose
To characterize the degree of venous collateralization before and after endovascular therapy and determine the effect of collateralization on success of thrombolysis and rate of repeat intervention in patients with Paget–Schroetter syndrome.Materials and Methods
A single-center retrospective study of 37 extremities in 36 patients (mean age, 32.64 y; range, 15–72 y; 24 men) with PSS treated with endovascular therapy from 2007 through 2017 was conducted. Venograms at presentation, after lysis, postoperatively, and at each repeat intervention were graded for venous stenosis, thrombus burden, and collateralization on a 5-point scale. Collateralization was classified as high-grade (9 extremities) or low-grade (28 extremities) based on grading of the venograms at presentation.Results
Primary technical success rate for endovascular treatment was 100%. Eighty-six percent of patients (32 of 37) underwent thrombolysis, 91% (34 of 37) underwent mechanical thrombectomy, and 83% (30 of 37) underwent balloon angioplasty. Overall primary patency rate was 50% at 12 months. The repeat intervention rate within 12 months was significantly higher for extremities with high- vs low-grade collateralization (89% vs 43%; P = .016). There was a significant decrease in the median grade of collateral severity after initial intervention (2 vs 1; P = .044) and 1 day postoperatively (2 vs 1; P = .040) vs the venogram at presentation.Conclusions
Severity of venous collateralization on the venogram at presentation of patients with PSS does not appear to affect success of endovascular therapy but may predict long-term patency of affected extremities. Patients in this cohort with severe collateralization on presentation were more likely to need repeat intervention. 相似文献4.
Tyler C Hein Leigh G Goetschius Vonnie C McLoyd Jeanne Brooks-Gunn Sara S McLanahan Colter Mitchell Nestor L Lopez-Duran Luke W Hyde Christopher S Monk 《Social cognitive and affective neuroscience》2020,15(11):1252
BackgroundChildhood adversity is, unfortunately, highly prevalent and strongly associated with later psychopathology. Recent theories posit that two dimensions of early adversity, threat and deprivation, have distinct effects on brain development. The current study evaluated whether violence exposure (threat) and social deprivation (deprivation) were associated with adolescent amygdala and ventral striatum activation, respectively, in a prospective, well-sampled, longitudinal cohort using a pre-registered, open science approach.MethodsOne hundred and sixty-seven adolescents from the Fragile Families and Child Wellbeing Study completed functional magnetic resonance imaging (fMRI) scanning. Prospective longitudinal data from ages 3, 5 and 9 years were used to create indices of childhood violence exposure and social deprivation. We evaluated whether these dimensions were associated with adolescent brain function in response to threatening and rewarding faces.ResultsChildhood violence exposure was associated with decreased amygdala habituation (i.e. more sustained activation) and activation to angry faces in adolescence, whereas childhood social deprivation was associated with decreased ventral striatum activation to happy faces in adolescence. These associations held when adjusting for the other dimension of adversity (e.g., adjusting for social deprivation when examining associations with violence exposure), the interaction of the two dimensions of adversity, gender, internalizing psychopathology, and current life stress.ConclusionsConsistent with recent theories, different forms of early adversity were associated with region-specific differences in brain activation. 相似文献
5.
Luke Mugge Tarek R. Mansour Megan Crippen Yasaman Alam Jason Schroeder 《Neurosurgical review》2020,43(2):497-511
Glioblastoma multiforme (GBM) is the most common primary brain cancer. Depression is a common co-morbidity of this condition. Despite this common interaction, relatively little research has been performed on the development of GBM-associated depression. We performed a literary search of the PubMed database for articles published relating to GBM and depression. A total of 85 articles were identified with 46 meeting inclusion criteria. Depression significantly impacts care, decreasing medication compliance, and patient survival. Diagnostically, because depression and GBM share intricate neuro-connectivity in a way that effect functionality, these diseases can be mistaken for alternative psychological or pathological disorders, complicating care. Therapeutically, anti-depressants have anti-tumor properties; yet, some have been shown to interfere with GBM treatment. One reason for this is that the pathophysiological development of depression and GBM share several pathways including altered regulation of the 5-HT receptor, norepinephrine, and 3′:5′-cyclic monophosphate. Over time, depression can persist after GBM treatment, affecting patient quality of life. Together, depression and GBM are complicated concomitant diseases. Clinicians must be aware of their co-existence. Because of overlapping molecular pathways involved in both diseases, careful medication selection is imperative to avoid potential adverse interactions. Since GBMs are the most common primary brain cancer, physicians dealing with this disease should be prepared for the development of depression as a potential sequela of this condition, given the related pathophysiology and the known poor outcomes. 相似文献
6.
<正>Photobiomodulation (PBM)-the irradiation of cells or tissues with low-intensity red to near-infrared light-is emerging as an effective means of enhancing cell and tissue resilience and repair. As reviewed elsewhere (Gordon et al., 2019), the intracellular effects of 相似文献
7.
Murat Yücel Erin Oldenhof Serge H. Ahmed David Belin Joel Billieux Henrietta Bowden‐Jones Adrian Carter Samuel R. Chamberlain Luke Clark Jason Connor Mark Daglish Geert Dom Pinhas Dannon Theodora Duka Maria Jose Fernandez‐Serrano Matt Field Ingmar Franken Rita Z. Goldstein Raul Gonzalez Anna E. Goudriaan Jon E. Grant Matthew J. Gullo Robert Hester David C. Hodgins Bernard Le Foll Rico S. C. Lee Anne Lingford‐Hughes Valentina Lorenzetti Scott J. Moeller Marcus R. Munaf Brian Odlaug Marc N. Potenza Rebecca Segrave Zsuzsika Sjoerds Nadia Solowij Wim van den Brink Ruth J. van Holst Valerie Voon Reinout Wiers Leonardo F. Fontenelle Antonio Verdejo‐Garcia 《Addiction (Abingdon, England)》2019,114(6):1095-1109
8.
9.
Oliver Sartor MD Daniel Heinrich MD Neil Mariados MD Maria José Méndez Vidal MD Daniel Keizman MD Camilla Thellenberg Karlsson MD Avivit Peer MD Giuseppe Procopio MD Stephen J. Frank MD Kalevi Pulkkanen MD Eli Rosenbaum MD Stefano Severi MD José Trigo MD Lucia Trandafir MD Volker Wagner MD Rui Li MS Luke T. Nordquist MD 《The Prostate》2019,79(14):1683-1691
10.
Luke Witherspoon Sean O'Reilly Jeremiah Hadwen Nafisa Tasnim Alex MacKenzie Faraz Farooq 《CTS Clinical and Translational Science》2015,8(4):298-304
Myotonic dystrophy type 1 (DM1) is caused by an expanded trinucleotide (CTG)n tract in the 3′ untranslated region (UTR) of the dystrophia myotonica protein kinase (DMPK) gene. This results in the aggregation of an expanded mRNA forming toxic intranuclear foci which sequester splicing factors. We believe down‐regulation of DMPK mRNA represents a potential, and as yet unexplored, DM1 therapeutic avenue. Consequently, a computational screen for agents which down‐regulate DMPK mRNA was undertaken, unexpectedly identifying the sodium channel blockers mexiletine, prilocaine, procainamide, and sparteine as effective suppressors of DMPK mRNA. Analysis of DMPK mRNA in C2C12 myoblasts following treatment with these agents revealed a reduction in the mRNA levels. In vivo analysis of CD1 mice also showed DMPK mRNA and protein down‐regulation. The role of DMPK mRNA suppression in the documented efficacy of this class of compounds in DM1 is worthy of further investigation. 相似文献