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recovery rates of persistent post-COVID-19 olfactory dysfunction using psychophysical assessment:A longitudinal cohort study

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World journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 79-87页

作者： jeremy P.Tervo Patricia T.jacobson Brandon j.Vilarello Tiana M.Saak Francesco F.Caruana Liam W.Gallagher.j.seph B.Gary David A.Gudis Paule V.joseph D.P.Devanand Terry E.goldberg jonathan B.Overdevest Columbia University Vagelos College of Physicians and Surgeons New YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery New York-Presbyterian/Columbia University Irving Medical CenterNew YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery University of PittsburghPittsburghPennsylvaniaUSA Department of Otolaryngology-Head and Neck Surgery University of MinnesotaMinneapolisMinnesotaUSA National Institute of Alcohol Abuse and Alcoholism Section of Sensory Science and Metabolism&National Institute of Nursing ResearchBethesdaMarylandUSA New York-Presbyterian/Columbia University Irving Medical Center New YorkNew YorkUSA

Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SArS-CoV-2 infection is a major feature of long *** on the prevalence of persistent OD predominantly rely on self-reported olfactory *** studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute *** anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of *** study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical ***:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time *** had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not ***:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up *** participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year *** had reliable trends in self-rated versus psychophysically tested olfactory function at both time *** total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at *** in threshold,but not discrimination or identification,most significantly mediate improvement

关键词： long COVID olfaction post-COVID condition smell dysfunction

Environmental variation shifts the relationship between trees and scatterhoarders along the continuum from mutualism to antagonism

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Integrative Zoology 2018年第3期13卷 319-330页

作者： Gina M.SAWAYA Adam S.goldberg Michael A.STEELE Harmony j.DALGLEISH Department of Biology College of William and MaryWilliamsburgVirginiaUSA Department of Biology Wilkes UniversityWilkes-BarrePennsylvaniaUSA

The conditional mutualism between scatterhoarders and trees varies on a continuum from mutualism to antagonism and can change across time and space,and among *** examined 4 tree species(red oak[Quercus rubra],white oak[Quercus alba],American chestnut[Castanea dentata]and hybrid chestnut[***×Castanea] mollissima)across 5 sites and 3 years to quantify the variability in this conditional *** used a published model to compare the rates of seed emergence with and without burial to the probability that seeds will be cached and left uneaten by scatterhoarders to quantify variation in the conditional mutualism that can be explained by environmental variation among sites,years,species,and seed provenance within *** species tested had increased emergence when ***,comparing benefits of burial to the probability of caching by scatterhoarders indicated a mutualism in red oak,while white oak was nearly always *** was variable around the boundary between mutualism and antagonism,indicating a high degree of context dependence in the relationship with *** found that different seed provenances did not vary in their potential for *** did not explain microsite differences in seed emergence in any of the species *** hybrid chestnut only,emergence on the surface declined with soil moisture in the *** quantifying the variation in the conditional mutualism that was not caused by changes in scatterhoarder behavior,we show that environmental conditions and seed traits are an important and underappreciated component of the variation in the relationship between trees and scatterhoarders.

关键词： Castanea dentata conditional mutualism Quercus alba Quercus rubra temperate forest

Ineffective esophageal motility is associated with acute r.j.ction after lung transplantation independent of gastroesophageal reflux

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World journal of Gastroenterology 2023年第21期29卷 3292-3301页

作者： Wai-Kit Lo Brent Hiramoto Hilary j goldberg Nirmal Sharma Walter W Chan Division of Gastroenterology Hepatology and EndoscopyBrigham and Women's HospitalBostonMA 02115United States Division of Pulmonary and Critical Care Medicine Brigham and Women's HospitalBostonMA 02115United States

BACKGrOUND Gastroesophageal reflux is associated with poorer outcomes after lung transplant,likely through recurrent aspiration and allograft *** prior studies have demonstrated a relationship between impedance-pH results and transplant outcomes,the role of esophageal manometry in the assessment of lung transplant patients remains debated,and the impact of esophageal dysmotility on transplant outcomes is *** particular interest is ineffective esophageal motility(IEM)and its associated impact on esophageal *** To assess the relationship between pre-transplant IEM diagnosis and acute r.j.ction after lung *** This was a retrospective cohort study of lung transplant recipients at a tertiary care center between 2007 and *** with pre-transplant anti-reflux surgery were *** and reflux diagnoses were recorded from pre-transplant esophageal function ***-to-event analysis using Cox proportional hazards model was applied to evaluate outcome of first episode of acute cellular r.j.ction,defined histologically per International Society of Heart and Lung Transplantation *** not meeting this endpoint were censored at time of post-transplant anti-reflux surgery,last clinic visit,or ***’s exact test for binary variables and student’s t-test for continuous variables were performed to assess for differences between *** Of 184 subjects(54%men,mean age:58,follow-up:443 person-years)met criteria for *** pulmonary fibrosis represented the predominant pulmonary diagnosis(41%).During the follow-up period,60 subjects(33.5%)developed acute *** all-cause mortality was 16.3%.Time-to-event univariate analyses demonstrated significant association between IEM and acute r.j.ction[hazard ratio(Hr):1.984,95%CI:1.03-3.30,P=0.04],confirmed on Kaplan-Meier *** multivariable analysis,IEM remained independently associated with acute r.j.ction,even after c

关键词： Ineffective esophageal motility Esophageal hypomotility Esophageal manometry Gastroesophageal reflux disease Lung transplantation Acute r.j.ction

急性心肌梗死后男女患者的体重过重、临床状况、治疗实施及院内预后

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 16-17页

作者： goldberg r.j. Olendzki B. 罗亮 Division of Cardiovascular Medicine Department of Medicine University of Massachusetts Medical School Worcester MAUnited States Dr.

Background: Excess body weight is increasingly being recognized as a major health problem in American men and women. It is unclear, however, whether body weight is associated with the demographic and clinical profile, treatment of, and hospital prognosis after acute myocardial infarction(AMI). Methods: Nonconcurrent prospective epidemiologic investigation of Worcester(Massachusetts) metropolitan residents hospitalized at all 11 greater Worcester medical centers with validated AMI in 1997, 1999, 2001, and 2003. results: A total of 2008 men and 1505 women were hospitalized with confirmed AMI during the 4 study periods. Approximately 41%of men and 29%of women were classified as being overweight(body mass index[BMI] of 25-29.9), whereas 27%of men and 26%of women hospitalized with AMI were considered to be obese(BMI ≥30). Obese men and women were significantly younger than individuals of normal weight. Effective cardiac treatment regimens were less often used in men and women of normal body weight, compared with patients who were overweight or obese. After controlling for several potentially confounding prognostic factors, there were no significant differences in the risk of dying during hospitalization for either overweight or obese men and women, compared with patients of normal body weight. Obese men and women were, however, at greater risk for developing heart failure during the acute hospitalization than men and women of normal weight. Conclusions: The results of this community study suggest an association between BMI and use of different treatment approaches in patients with AMI. Further examination of the impact of excess body weight on hospital outcomes associated with AMI remains warranted.

关键词：急性心肌梗死临床状况体重过重正常体重流行病学调查确诊患者马萨诸塞州女性人群人口统计学

Incident frailty and cognitive impairment by heart failure status in older patients with atrial fibrillation: the SAGE-AF study

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journal of Geriatric Cardiology 2020年第11期17卷 653-658页

作者： Wei-jia WANG Darleen Lessard jane Saczynski robert j goldberg Alan S.Go Tenes Paul Ely Gracia David D McManus Department of Medicine University of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Division of research Kaiser Permanente Northern CaliforniaOaklandCAUSA

Background Atrial fibrillation(AF) and heart failure(HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF. Methods The SAGE-AF(Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF(mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICD-9/10 codes. At baseline and 1-year, frailty was assessed by Cardiovascular Health Survey score and cognition was assessed by the Montreal Cognitive Assessment. results Patients with prevalent HF(n = 463, 37.2%) were older, less likely to be non-Hispanic white, had less education, and had greater cardiovascular comorbidity burden and higher CHA2 DS2 VASC and HAS-BLED scores than patients without HF(all P's riable adjusted regression models, HF(present vs. absent) was associated with both prevalent frailty(adjusted odds ratio [a Or]: 2.38, 95% confidence interval [CI]: 1.64-3.46) and incident frailty at 1 year(a Or: 2.48, 95% CI: 1.37-4.51). HF was also independently associated with baseline cognitive impairment(a Or: 1.60, 95% CI: 1.22-2.11), but not with developing cognitive impairment at 1 year(a Or 1.04, 95%CI: 0.64-1.70). Conclusions Among ambulatory older patients with AF, the co-existence of HF identifies individuals with physical and cognitive impairments who are at higher short-term risk for becoming frail. Preventive strategies to this vulnerable subgroup merit consideration.

关键词： Atrial fibrillation Cognitive impairment Heart failure Frailty

Pre-Lung transplant reflux testing demonstrates high prevalence of gastroesophageal reflux in cystic fibrosis and reduces chronic r.j.ction risk

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World journal of Transplantation 2023年第4期13卷 138-146页

作者： Wai-Kit Lo ryan Flanagan Nirmal Sharma Hilary j goldberg Walter W Chan Division of Gastroenterology Hepatology and EndoscopyBrigham and Women's HospitalHarvard Medical SchoolBostonMA Division of Pulmonary and Critical Care Medicine Brigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

BACKGrOUND Gastroesophageal reflux(GEr)has been associated with poor outcomes after lung transplantation for chronic lung disease,including increased risk of chronic *** is common in cystic fibrosis(CF),but factors influencing the likelihood of pre-transplant pH testing,and the impact of testing on clinical management and transplant outcomes in patients with CF are *** To evaluate the role of pre-transplant reflux testing in the evaluation of lung transplant candidates with *** This was a retrospective study from 2007-2019 at a tertiary medical center that included all patients with CF undergoing lung *** with pretransplant anti-reflux surgery were *** characteristics(age at transplantation,gender,race,body mass index),self-reported GEr symptoms prior to transplantation,and pre-transplant cardiopulmonary testing results,were *** testing consisted of either 24-h pH-or combined multichannel intraluminal impedance and pH ***-transplant care included a standard immunosuppressive regimen,and regular surveillance bronchoscopy and pulmonary spirometry in accordance with institutional practice as well as in symptomatic *** primary outcome of chronic lung allograft dysfunction(CLAD)was defined clinically and histologically per International Society of Heart and Lung Transplantation *** analysis was performed with Fisher’s exact test to assess differences between cohorts,and time-to-event Cox proportional hazards *** After applying inclusion and exclusion criteria,a total of 60 patients were included in the *** all CF patients,41(68.3%)completed reflux monitoring as part of pre-lung transplant *** evidence of pathologic reflux,defined as acid exposure time>4%,was found in 24 subjects,representing 58%of the tested *** patients with pre-transplant reflux testing were older(35.8 vs 30.1 years,P=0.01)and more commonly reported typical

关键词： Cystic fibrosis Gastroesophageal reflux Lung transplantation pH monitoring

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Hearing loss and cognitive decline among older adults with atrial fibrillation:the SAGE-AF study

作者： [美]j.r.Hermanr.A.goldberg

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journal of Geriatric Cardiology 2020年第4期17卷 177-183页

作者： Wei-jia WANG Darleen Lessard Hawa Abu David D.McManus Tanya Mailhot jerry H.Gurwitz robert j.goldberg jane Saczynski Division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Meyers Primary Care Institute University of Massachusetts Medical SchoolWorcesterMAUSA

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation(AF).Methods Patients with AF≥65-year-old(n=1244)in the SAGE(Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and *** was assessed by a structured questionnaire at *** function was assessed by Montreal Cognitive Assessment(MoCA)at baseline and one *** impairment was defined as score≤23 on the *** associations between hearing loss and cognitive function were examined by multivariable adjusted logistic *** Participants with hearing loss(n=451,36%)were older,more likely to be male,and have depressive symptoms than patients without hearing *** baseline,528(42%)participants were cognitively *** with hearing loss were significantly more likely to have cognitive impairment at baseline[adjusted odds ratio(Or)=1.37,95%confidence interval(CI):1.05–1.81].Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit,106(16%)developed incident cognitive *** with,versus those without,hearing loss were significantly more likely to develop incident cognitive impairment at one year(adjusted Or=1.68,95%CI:1.07–2.64).Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with *** for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.

关键词： Atrial fibrillation Cognitive function Hearing

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社区冠心病死亡率的变化趋势

世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 24-25页

作者： goldberg r.j. Glatfelter K. Burbank- Schmidt E. 赵君 Division of Cardiovascular Medicine Department of Medicine University of Massachusetts Medical School 55 Lake Avenue North Worcester MA 01655 United States Dr.

Background: relatively little data are available, particularly from the more generalizable perspective of a population- based investigation, describing recent trends in death rates due to coronary heart disease(CHD). The objectives of this observational study were to describe changes over a twelve year period(1990- 2001) in death rates due to CHD and acute myocardial infarction(AMI) in residents of the Worcester, Massachusetts, metropolitan area(2000 census=478,000). A secondary study goal was to describe changes in death rates attributed to CHD over time separately in men and in women, in persons of different ages, and according to location of death. Methods: Death datatapes were obtained from the Massachusetts Department of Public Health for greater Worcester residents who died over the period 1990 to 2001. results: Marked declines were observed in the population death rates(per 100,000) due to CHD(1990 death rate=322; 2001 death rate=224) and AMI(1990 death rate=137; 2001 death rate=87) in the greater Worcester population. Declines in the annual death rates attributed to CHD were observed in both the hospital(4.4% decline) and out- of- hospital setting(1.6% decline) as well as for patients dying from AMI(annual declines of 4.8% and 1.9% respectively). reductions in CHD death rates over time were observed in men and in women and in persons of all ages. Conclusions: The present results demonstrate encouraging declines in community death rates due to CHD and AMI over time and the impact of evolving primary and secondary prevention efforts.

关键词：冠心病(CHD) 年死亡率急性心肌梗死(AMI) 不同年龄人群社区观察性研究研究资料人口普查死亡地点死亡资料