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At day 7, increased (P ≤ 0.01) clustering, node strength, network segregation, and activation of prefrontal-limbic pathways are observed only in the group that develops persistent pain. Later, increased clustering and node strength are more pronounced with persistent pain, particularly within the limbic system, and decrease when pain resolves. Pretreatment with intra-articular etanercept to attenuate pain confirms that these adaptations are associated with pain onset. Results suggest that early and sustained brain changes can differentiate persistent and transient pain, implying they could be useful as prognostic biomarkers for persistent pain and in identifying therapeutic targets.
Cognitive behavioral therapy (CBT) is a psychological intervention that involves development of coping strategies to reduce the experience of pain. Although CBT is a promising intervention to reduce headache days in patients with migraine, it may not be effective for all patients. Thus, there is a need to identify markers that could predict which patients will respond to CBT. We aimed to determine whether baseline brain function and amygdalar connectivity, assessed by functional magnetic resonance imaging, or pain modulation capacities, assessed by the conditioned pain modulation (CPM) response, can predict a reduction in headache days after CBT in adolescents with migraine. Patients with migraine (n = 20; age range 10-17 years) completed 8 weekly CBT sessions. The CPM response was examined in the trapezius and the leg. Headache days significantly decreased after CBT (P < 0.001). Greater functional connectivity before CBT between the right amygdala and frontal gyrus, anterior cingulate cortex, and precen. These findings suggest that individual differences in brain function and pain modulation can be associated with clinical improvements and help with determination of CBT responsiveness.
Frailty syndrome in older population generates formidable social cost. The early detection of "prefrail" stage is essential so that interventions could be performed to prevent deterioration. The purpose of this study was to organize appropriate physical performance tests into a computerized early frailty screening platform, called frailty assessment tools (FAT) system, to detect individuals who are in the prefrail stage.
Four switches, one distance meter, and one power measure were adopted to build the FAT system that could perform six physical performance tests including single leg standing (SLS), repeated chair rise, timed up and go, self-selected walking speed, functional reach, and grip power. Participants over 65 years old were recruited and classified into three groups according to Fried criteria. The differences in variables between prefrail and robust groups were compared by the χ test, independent samples t test, and Mann-Whitney U test, for nominal variables, normal, and non-normal distributive arly intervention to prevent individuals from progressing into frailty. The FAT system provides a more convenient and comprehensive frailty screening. Using this computerized automatic screening platform, it may be possible to expand the scope of frailty prevention.
Acute heart failure (AHF) is a major and rapidly growing health problem responsible for millions of hospitalizations annually. Due to a high proportion of in-hospital mortality and postdischarge rehospitalization and mortality, a prompt strategy for risk stratification and subsequently tailored therapy is desirable to help improve clinical outcomes. The AHEAD (A atrial fibrillation; H hemoglobin; E elderly; A abnormal renal parameters; D diabetes mellitus) and AHEAD-U (A atrial fibrillation; H hemoglobin; E elderly; A abnormal renal parameters; D diabetes mellitus, U uric acid) are popular prognostic scoring systems. Sodium palmitate chemical structure However, only a specific follow-up period is considered in these systems, and whether their predictive capability is still accurate in a significantly shorter or longer follow-up period is not known.
In this research, we adapted extensive statistical approaches based on the Cox model to explore consistent risk factors in various follow-up durations. Results showed that six factors, namely, hetly validated.
The use of the HANBAH scoring system, which is a clinically friendly tool, was proposed, and its efficacy in predicting the mortality rates of patients with AHF regardless of the follow-up duration was independently validated.
To explore the potential role of the platelet/lymphocyte ratio (PLR) as a prognostic marker in septic patients with acute kidney injury (AKI) and to provide theoretical evidence for the epidemiological study of the prognosis of patients with septic AKI in its early stage.
A pilot study was conducted. A logistic regression analysis was conducted to screen the risk factors, and the selected factors were performed using multiple logistic regression analysis; a Receiver Operating Characteristic curve was used to determine the optimal cutoff value of the PLR and then to calculate the sensitivity and specificity of the PLR ratio.
Mechanical ventilation, platelet count, PLR, and arterial blood lactate concentration have a correlation with sepsis (p < 0.05). An elevated PLR is significantly associated with a worse prognosis of sepsis-induced AKI (higher mortality).
The PLR might be an effective factor in predicting a worse prognosis of septic AKI patients.
The PLR might be an effective factor in predicting a worse prognosis of septic AKI patients.
Abnormal serum sodium levels in various diseases increase mortality; however, hyperglycemia depresses serum sodium concentration significantly. This study aimed to evaluate the clinical impact of measured serum sodium levels and corrected sodium levels among patients with severe hyperglycemia.
Patients with blood glucose levels ≥500 mg/dL visiting the emergency department between July 2008 and September 2010 were enrolled retrospectively. The participants were divided into five groups for measured sodium levels and five groups for corrected sodium levels according to blood glucose levels. Multivariate Cox regression was used. The primary outcome was all-cause 90-day mortality. Secondary outcomes included rate of intensive care unit hospitalization, respiratory failure, and renal failure.
A total of 755 patients with severe hyperglycemia were enrolled, and the 90-day mortality was 17.2%. Compared with the reference group, the 90-day mortality was higher in the patients with measured hypernatremia (adjusted hazard ratio [HR], 2.
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