检索结果-南通市图书馆

Mental and physical symptoms associated with lower social support for patients with hepatitis C

World Journal of Gastroenterology 2006年第29期12卷 4665-4672页

作者： Julie A Blasiole Laura Shinkunas Douglas R LaBrecque Robert M Arnold Susan L Zickmund va pittsburgh healthcare system center for health equity research and promotion PittsburghPAUnited States Department of Epidemiology University of Iowa School of Public health Iowa CityIAUnited States Department of Internal Medicine University of Iowa Hospitals and Clinics Iowa CityIAUnited States Department of Medicine University of pittsburgh School of Medicine PittsburghPAUnited States Department of Medicine University of pittsburgh School of Medicine VA Pittsburgh Healthcare SystemCenter for Health Equity Research and PromotionPittsburghPAUnited States

AIM: To systematically examine the impact of the hepatitis C virus (HCV) diagnosis on patients' level of social support in a large-scale study. METHODS: Patients evaluated and treated for HCV in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status as measured by the Hospital Anxiety and Depression Scale (HAD) and the Sickness Impact Profile (SIP), severity of liver disease, mode of acquisition, and physical and psychiatric comorbidities were collected from patients or abstracted from the medical record. All participants completed a semi-structured interview, addressing questions of social support. RESULTS: A total of 342 patients (mean age 45.2 years; 37% women) were enrolled. Ninety-two (27%) patients described lower levels of support by family and friends. Nearly half of the participants (45%) noted the loss of at least one relationship due to the disease. Fears related to transmitting the disease (25%) were common and often associated with ignorance or even discrimination by others (19%). Nearly one fifth of the patients did not share information about their disease with others to avoid being stigmatized. Lower levels of social support were significantly associated with living alone, being unemployed, being excluded from antiviral therapy, having psychiatric comorbidities, contracting HCV through intravenous drug use, having high levels of anxiety and depression as measured by the HAD and negative mood state as measured by the SIP. Patients reporting lower levels of social support also noted more physical symptoms as measured by the SIP. CONCLUSION: Patients with hepatitis C often face significant social problems, ranging from social isolation to familial stress. The most common concerns reflect a limited insight of patients and their relatives and friends about the disease, the risk factors for its spread, and about potential consequences. Our data suggest that educational interventions targeting

关键词： Hepatitis C Social support Depression Anxiety Quality of life Stigmatization

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Clinical pharmacology relevant to older adults with cardiovascular disease

引用

Journal of Geriatric Cardiology 2015年第3期12卷 192-195页

作者： Jorge A Brenes-Salazar Laith Alshawabkeh Kenneth E Schmader Joseph T Hanlon Daniel E Forman Department of Medicine Division of Cardiovascular Diseases Mayo Clinic Rochester MN USA Department of Medicine Division of Cardiovascular Medicine University of lowa Iowa City IA USA Department of Medicine Division of Geriatrics Duke University School of Medicine Durham NC USA Departments of Medicine (Division of Geriatric Medicine) Pharmacy and Epidemiology University of Pittsburgh Geriatric Research Education and Clini- cal Center and Center for Health Equity Research and Promotion VA Pittsburgh Health System Pittsburgh PA USA Department of Medicine (Divisions of Geriatric Medicine and Cardiology) University of Pittsburgh Medical Center Geriatric Research Education and Clinical Center VA Pittsburgh Health System Pittsburgh PA USA

1 Introduction Although older adults are generally among the highest users of cardiovascular medications, they are typically underrepresented or excluded from most efficacy and safety trials. Drug developers are usually reluctant to include many senior adults in randomized controlled clinical trials in part due to their high prevalence of multiple comorbidities, frailty, and polypharmacy; and to age-related pharmacokinetic and pharmacodynamic complexities. Consequently, there is often insufficient high quality evidence-based data to inform pharmacologic management of common cardiovascular conditions on older adults. In the absence of data, clinicians often rely on conceptual principles regarding metabolism and drug-drug interactions to minimize adverse drug events, but this is often not well-substantiated or standardized. A related challenge is poor cardiovascular medication adherence among older adults, and its detrimental impact on their health outcomes. In this brief review we highlight some aspects of these topics.

关键词： Metabolism Pharmacokinetics Pharmacodynamics Polypharmacy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Associations between Pneumococcal vaccinationand Adverse Outcomes in Patients with Suspected Acute Coronary Syndrome

引用

Advances in Infectious Diseases 2012年第4期2卷 122-134页

作者： Maliha Zahid Ish Singla Chester B. Good Roslyn A. Stone Sunghee Kim Michael J. Fine Ali F. Sonel center for healthy equity and research promotion VA Pittsburgh Healthcare System Pittsburgh USA Department of Developmental Biology University of Pittsburgh Pittsburgh USA Division of General Medicine Department of Medicine University of Pittsburgh Pittsburgh USA

Background: Although pneumococcal vaccination prevents the most common pneumonia of bacterial etiology, its associations without comes of Acute Coronary Syndrome (ACS) are unknown. Methods: This is a prospective cohort study of 1436 patients hospitalized with suspected ACS/non-ST elevation MI that were eligible for pneumococcal vaccination. Primary outcomes were death and subsequent Myocardial Infarction (MI) within 6-months of the index hospitalization. We used Cox regression to assess associations between pneumococcal vaccination and outcomes, adjusting for influenza vaccination and relevant clinical covariates. We also utilized propensity scores to adjust for potential confounding. Results: Overall, 937 (65.3%) patients received pneumococcal vaccination either prior to or during the index hospitalization. Unvaccinated patients had higher mortality (26.9% vs. 7.9%;p vaccination, the unadjusted Hazard Ratio (HR) of death was significantly lower for those who received only pneumococcal vaccination (HR = 0.13;95% CI 0.07 - 0.23) or both vaccinations (HR = 0.66, 95% CI 0.47 - 0.92), and significantly higher for patients who received only influenza vaccination (HR = 1.88, 95% CI 1.33 - 2.64). The corresponding HRs and 95% CIs for subsequent MI were 0.58 (95% CI 0.32 - 1.03) for pneumococcal vaccination only, 0.41 (95% CI 0.21 - 0.80) for both vaccinations and 0.97 (95% CI 0.48 - 1.95) for influenza vaccination alone. These remained unchanged after covariate or propensity score adjustment. Conclusions: Among patients hospitalized with suspected ACS, pneumococcal vaccination, with or without influenza vaccination, was associated with significantly lower risk of mortality within 6 months.

关键词： Pneumococcal vaccination Acute Coronary Syndromes Outcomes

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Medical decision making for older adults： an international perspective comparing the United States and India

引用

Journal of Geriatric Cardiology 2015年第4期12卷 329-334页

作者： Ankur Kalra Daniel E Forman Sarah J Goodlin Division of lnterventional Cardiology Beth lsrael Deaconess Medical Center and Harvard Medical School Boston Massachusetts USA Division of Cardiology Department of Medicine Kalra Hospital SRCNC Pvt. Ltd. New Delhi India Section of Geriatric Cardiology University of Pittsburgh Medical Center Pittsburgh PA USA Geriatrics research Education and Clinicai Center VA Pittsburgh Healthcare System Pittsburgh PA USA Department of Medicine-Geriatrics Oregon Health & Sciences University and Veterans Affairs Portland Health Care System Portland Oregon USA

There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutane- ous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advan- tages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac dis- ease with comparisons of West to East, focusing particularly on the United States versus India.

关键词： Advance care planning Advance directive End-of-life India Surrogate decision-making

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Stable ischemic heart disease in the older adults

引用

Journal of Geriatric Cardiology 2016年第2期13卷 109-114页

作者： Xuming DAI Jan Busby-Whitehead Daniel E Forman Karen P Alexander Division of Cardiology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA Division of Geriatric Medicine Center for Aging and Health University of North Carolina at Chapel Hill North Carolina USA Section of Geriatric Cardiology University of Pittsburgh Medical Center Geriatrics Research Education and Clinical Center VA Pittsburgh Healthcare System Pittsburgh PA USA Division of Cardiology Duke University Medical Center Durham North Carolina USA

1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.

关键词： Aging Coronary artery disease Older adults Risk assessment Stable ischemic heart disease

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Conditions for autonomous choice： a qualitative study of older adults＇ experience of decision-making in TAVR

引用

Journal of Geriatric Cardiology 2017年第1期14卷 42-48页

作者： Elisabeth Skaar Anette Hylen Ranhoff Jan Erik Nordrehaug Daniel E Forman Margrethe Aase Schaufel Department of Heart Disease Haukeland University Hospital Bergen Norway Department of Clinical Science University of Bergen Bergen Norway Kavli research Centre for Geriatrics and Dementia Haraldsplass Deaconess Hospital Bergen Norway University of pittsburgh Medical center VA Pittsburgh Healthcare System Pittsburgh USA research Unit for General Practice Uni research health Bergen Norway Department of Thoracic Medicine Haukeland University Hospital Bergen Norway

Background Patient autonomy is a leading principle in bioethics and a basis for shared decision making. This study explores conditions for an autonomous choice experienced by older adults who recently underwent trans-catheter aortic valve replacement （TAVR）. Methods Qualitative study entailing semi-structured interviews of a purposive sample often older （range 73-89, median 83.5 years） adults after TAVR （median 23 days）. The study setting was a cardiac department at a university hospital performing TAVR since 2010. Analysis was by systematic text condensation. Results Even when choice seemed hard or absent, TAVR-patients deliberately took the chance offered them by processing risk assessment, ambivalence and fate. They regarded declining the treatment to be worse than accepting the risk related to the procedure. The experience of being thoroughly advised by their physician formed the basis of an autonomous trust. The trust they felt for the physicians＇ recommendations mitigated ambivalence about the procedure and risks. TAVR patients expressed feelings consistent with self-empowerment and claimed that it had to be their decision. Even so, choosing the intervention as an obligation to their family or passively accepting it was also reported. Conclusions Older TAVR patients＇ experience of an autonomous decision may encompass frank tradeoff; deliberate physician dependency as well as a resilient self-view. Physicians should be especially aware of how older adults＇ subtle cognitive declines and inclinations to preserve their identities which can influence their medical decision making when obtaining in- formed consent. Cardiologists and other providers may also use these insights to develop new strategies that better respond to such inherent complexities.

关键词： Aortic stenosis Older adults Patient-centered care Shared decision-making Trans-catheter aortic valve replacement

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Lung epithelial cell-derived IL-25 negatively regulates LPS-induced exosome release from macrophages

引用

Military Medical research 2018年第4期5卷 324-334页

作者： Zhi-Gang Li Melanie J. Scott Tomasz Brzóska Prithu Sundd Yue-Hua Li Timothy R. Billiar Mark A. Wilson Ping Wang Jie Fan Department of Surgery University of Pittsburgh School of MedicinePittsburgh PA 15213 USA research and Development Veterans Affairs Pittsburgh Healthcare System Pittsburgh PA 15240 USA Heart Lung Blood and Vascular Medicine Institute University of Pittsburgh Pittsburgh PA 15213 USA McGowan Institute for Regenerative Medicine University of Pittsburgh Pittsburgh PA 15219USA The Feinstein Institute for Medical research Manhasset NY11030 USA.

Background: Acute lung injury(ALI) is a major component of multiple organ dysfunction syndrome(MODS) following pulmonary and systemic infection. Alveolar macrophages(AMφ) are at the center of ALI pathogenesis. Emerging evidence has shown that cell-cell interactions in the lungs play an important regulatory role in the development of acute lung inflammation. However, the underneath mechanisms remain poorly addressed. In this study, we explore a novel function of lung epithelial cells(LEPCs) in regulating the release of exosomes from AMφ following LPS ***: For the in vivo experiments, C57 BL/6 wildtype(WT) mice were treated with lipopolysaccharide(LPS)(2 mg/kg) in 0.2 ml of saline via intratracheal aerosol administration. Bronchoalveolar lavage fluid was collected at 0–24 h after LPS treatment, and exosomes derived from AMφ were measured. For the in vitro studies, LEPCs and bone marrowderived Mφ(BMDM) were isolated from WT or TLR4-/-mice and were then cocultured in the Transwell? system. After coculture for 0–24 h, the BMDM and supernatant were harvested for the measurement of exosomes and ***: We demonstrate that LPS induces macrophages(Mφ) to release exosomes, which are then internalized by neighboring Mφ to promote TNF-α expression. The secreted interleukin(IL)-25 from LEPCs downregulates Rab27 a and Rab27 b expression in Mφ, resulting in suppressed exosome release and thereby attenuating exosome-induced TNF-α expression and ***: These findings reveal a previously unidentified crosstalk pathway between LEPCs and Mφ that negatively regulates the inflammatory responses of Mφ to LPS. Modulating IL-25 signaling and targeting exosome release may present a new therapeutic strategy for the treatment of ALI.

关键词： Acute lung injury Sepsis Multiple organ failure Rab27

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Programmed cell death and its role in inflammation

引用

Journal of Medical Colleges of PLA(China) 2015年第2期30卷 96-109页

作者： Yong Yang Ge-Ning Jiang Peng Zhang Jie Fan Department of Surgery University of Pittsburgh School of Medicine Depar tment of Thoracic Surgery Shanghai Pulmonary HospitalTongji University School of Medicine research and Development Veterans Af airs Pittsburgh Healthcare System

Cell death plays an important role in the regulation of inflammation and may be the result of inflammation. The maintenance of tissue homeostasis necessitates both the recognition and removal of invading microbial pathogens as well as the clearance of dying cells. In the past few decades, emerging knowledge on cell death and inflammation has enriched our molecular understanding of the signaling pathways that mediate various programs of cell death and multiple types of inflammatory responses. This review provides an overview of the major types of cell death related to inflammation. Modification of cell death pathways is likely to be a logical therapeutic target for inflammatory diseases.

关键词： Inflammation Necroptosis Apoptosis Pyroptosis Pyronecrosis NETosis Autophagy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics:The Study of Muscle,Mobility and Aging(SOMMA)

引用

Journal of Sport and health Science 2024年第5期13卷 621-630页

作者： Yujia(Susanna)Qiao Terri L.Blackwell Peggy M.Cawthon Paul M.Coen Steven R.Cummings Giovanna Distefano Samaneh Farsijani Daniel E.Forman Bret H.Goodpaster Stephen B.Kritchevsky Theresa Mau Frederico G.S.Toledo Anne B.Newman Nancy W.Glynn Department of Epidemiology School of Public HealthUniversity of PittsburghPittsburghPA 15261USA San Francisco Coordinating center California Pacific Medical Center Research InstituteSan FranciscoCA 94143USA Department of Epidemiology and Biostatistics University of CaliforniaSan FranciscoCA 94143USA Translational research Institute AdventHealthOrlandoFL 32804USA Department of Medicine(Geriatrics and Cardiology) University of Pittsburghand GeriatricsResearchEducationand Clinical Center(GRECC)VA Pittsburgh Healthcare SystemPittsburghPA 15261USA Department of Internal Medicine Section on Gerontology and Geriatric MedicineWake Forest School of MedicineWinston-SalemNC 27109USA Division of Endocrinology and Metabolism Department of MedicineUniversity of PittsburghPittsburghPA 15261USA

Background:Skeletal muscle energetics decline with age,and physical activity(PA)has been shown to offset these declines in older ***,many studies reporting these effects were based on self-reported PA or structured exercise ***,we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior(SB)with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle ***:As part of the Study of Muscle,Mobility and Aging,enrolled older adults(n=879),810(age=76.4±5.0 years old,mean±SD;58%women)had maximal muscle oxidative capacity measured ex vivo via high-resolution re spirometry of permeabilized myofibers(maximal oxidative phosphorylation(maxOXPHOS))and in vivo by ^(31)phosphorus magnetic resonance spectroscopy(maximal adenosine triphosphate(ATP_(max))).Accelerometry-measured sedentary behavior,light activity,and moderate-to-vigorous PA(MVPA)were assessed using a wrist-worn ActiGraph GT9X over 7 ***-reported sedentary behavior,MVPA,and all PA were assessed with the Community healthy Activities Model Program for Seniors(CHAMPS)*** regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics,as well as the attenuation of the age/muscle energetics association by MVP A and sedentary *** a sensitivity analysis,we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle ***:Every 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s×mg)higher maxOXPHOS and 0.012 mM/s higher ATP_(max)after adjusting for age,site/technician,and sex(p<0.05).Light activity was not associated with maxOXPHOS or ATP_(max).Meanwhile,every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s×mg lower maxOXPHOS and0.

关键词： Aging Exercise Mitochondria

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Recurrent deletions in the SARS-CoV-2 spike glycoprotein drive antibody escape

引用

四川生理科学杂志 2021年第1期43卷 86-86页

作者： Kevin R McCarthy center for vaccine research University of Pittsburgh School of Medicine Pittsburgh PA USA. Department of Microbiology and Molecular Genetics University of Pittsburgh School of Medicine Pittsburgh PA USA. Laboratory of Molecular Medicine Boston Children’s Hospital Harvard Medical School Boston MA USA. Department of Genetics Harvard Medical School Boston MA USA. Division of Pulmonary Allergy and Critical Care Medicine Department of Internal Medicine UPMC Pittsburgh PA USA. Division of Pulmonary Allergy and Critical Care Medicine Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA USA. va pittsburgh healthcare system Pittsburgh PA USA. Division of Infectious Disease Department of Medicine University of Pittsburgh School of Medicine Pittsburgh PA USA. Division of Infectious Disease Department of Internal Medicine UPMC Pittsburgh PA USA.

Zoonotic pandemics,like that caused by SARS-CoV-2,can follow the spillover of animal viruses into highly susceptible human *** descendants have adapted to the human host and evolved to evade immune *** acquire substitutions more slowly than other RNA viruses,due to a proofreading *** the spike glycoprotein,we find recurrent deletions overcome this slow substitution rate.

关键词： glycoprotein overcome slowly

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：