1-year follow-up

1 年随访
  • 文章类型: Journal Article
    新型冠状病毒仍在变异,大流行仍在继续。同时,许多COVID-19幸存者有残留的感染后临床表现。人脐带间充质干细胞(hUC-MSCs)已被证明在COVID-19的早期阶段是有效的。
    这项研究的目的是研究接受hUC-MSCs治疗的重症COVID-19患者的长期安全性和有效性。
    对25例重度COVID-19出院患者(包括标准治疗组和标准治疗加hUC-MSCs组)进行1年随访。评估认为不良反应(包括对肝肾功能的影响,凝血,心电图,肿瘤标志物,等等),肺功能,圣乔治呼吸问卷(SGRQ),感染后后遗症和KrebsvondenLungen-6(KL-6)的血清浓度,丙二醛(MDA),H2S,肉碱,和N-6长链多不饱和脂肪酸(N-6LC-PUFA)。
    hUC-MSCs组及对照组随访1年肺通气功能均较随访3个月明显改善(P<0.01)。在1年的随访中,疲劳(60%[15/25])仍然是最常见的症状。与对照组(76.5%[13/17])相比,hUC-MSCs组(25%[2/8])的疲劳缓解率显著降低(P=0.028)。hUC-MSCs组KL-6水平(2585.5±186.5U/ml)显著低于对照组(3120.7±158.3U/ml)(P<0.001)。与对照组相比,hUC-MSCs组MDA水平较低(9.27±0.54vs.9.91±0.72nmol/ml,P=0.036)。hUC-MSCs治疗组出院后1年未见明显不良反应。
    静脉移植hUC-MSCs是治疗重症COVID-19患者的长期安全方法。此外,hUC-MSCs对COVID-19幸存者感染后后遗症有积极作用。
    中国临床试验注册;ChiCTR2000031494;注册2020年4月2日-回顾性注册,http://www。medresman.org.
    The novel coronavirus is still mutating, and the pandemic continues. Meanwhile, many COVID-19 survivors have residual postinfection clinical manifestations. Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been shown to be effective in the early stages of COVID-19.
    The aim of this study was to investigate long-term safety and efficacy of treatment in patients with severe COVID-19 patients who had received hUC-MSCs therapy.
    Twenty-five discharged patients who had severe COVID-19 (including the standard treatment group and the standard treatment plus hUC-MSCs group) were enrolled in a 1-year follow-up. The assessment considered adverse effects (including effects on liver and kidney function, coagulation, ECG, tumor marker, and so on), pulmonary function, St George\'s Respiratory Questionnaire (SGRQ), postinfection sequelae and serum concentration of Krebs von den Lungen-6 (KL-6), malondialdehyde (MDA), H2S, carnitine, and N-6 long-chain polyunsaturated fatty acids (N-6 LC-PUFAs).
    Pulmonary ventilation function had significantly improved at the 1-year follow-up in both the hUC-MSCs group and the control group compared with the 3-month follow-up (P < 0.01). Fatigue (60% [15/25]) remained the most common symptom at the 1-year follow-up. The rate of fatigue relief was significantly reduced in the hUC-MSCs group (25% [2/8]) compared to the control group (76.5% [13/17]) (P = 0.028). The level of KL-6 was significantly lower in the hUC-MSCs group (2585.5 ± 186.5 U/ml) than in the control group (3120.7 ± 158.3 U/ml) (P < 0.001). Compared with the control group, the hUC-MSCs group had a lower level of MDA (9.27 ± 0.54 vs. 9.91 ± 0.72 nmol/ml, P = 0.036). No obvious adverse effects were observed in the hUC-MSCs treatment group at 1 year after discharge.
    Intravenous transplantation of hUC-MSCs was a safe approach in the long term in the treatment of patients with severe COVID-19. In addition, hUC-MSCs had a positive effect on postinfection sequelae in COVID-19 survivors.
    Chinese Clinical Trial Registration; ChiCTR2000031494; Registered 02 April 2020-Retrospectively registered, http://www.medresman.org.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    液泡,E1酶,X-linked,自身炎症,体细胞(VEXAS)综合征是由UBA1基因的体细胞变异引起的自身炎症性疾病,可导致严重的全身性炎症和骨髓增生异常综合征。虽然目前还没有建立标准的治疗方法,据报道,阿扎胞苷和骨髓移植是有希望的可能性;然而,这些治疗的适应症是有问题的,不一定适用于所有患者。我们先前报道了3例VEXAS综合征患者接受托珠单抗(TCZ)和糖皮质激素短期治疗的结果。在本文中,我们报道,TCZ和糖皮质激素的联合治疗使患者能够继续治疗至少1年,而无明显疾病进展.糖皮质激素能够从TCZ开始减少。不良事件是带状疱疹,蜂窝织炎后的皮肤溃疡,血细胞计数减少。结果表明,这种疗法作为未来疗法发展的桥梁疗法具有重要意义。
    Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is an autoinflammatory disease caused by somatic variants in the UBA1 gene that lead to severe systemic inflammation and myelodysplastic syndrome. Although no standard therapy has been established yet, azacitidine and bone marrow transplantation have been reported to be promising possibilities; however, the indications for these treatments are problematic and not necessarily applicable to all patients. We previously reported the results of short-term treatment with tocilizumab (TCZ) and glucocorticoids in three patients with VEXAS syndrome. In this paper, we report that the combination of TCZ and glucocorticoids allowed the patients to continue treatment for at least one year without significant disease progression. Glucocorticoids were able to be reduced from the start of TCZ. Adverse events were herpes zoster, skin ulceration after cellulitis, and decreased blood counts. The results suggest the significance of this treatment as a bridge therapy for the development of future therapies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    未经证实:COVID-19以内皮功能障碍为特征,推测有长期心血管后遗症。在这项横断面研究中,我们旨在探讨出院后1年从COVID-19中康复的患者的血清内皮生物标志物水平.
    未经证实:在这项临床随访研究中,345名来自黄冈的COVID-19幸存者,湖北,纳入119名年龄和性别匹配的医务人员作为健康对照.进行了标准化症状问卷,而下肢的心电图和多普勒超声,血常规检查,生化和免疫学测试,血清可溶性血管细胞粘附分子-1(VCAM-1),细胞间粘附分子-1(ICAM-1),P-选择素,和fractalkine通过酶联免疫吸附测定(ELISA)进行测量。
    UNASSIGNED:出院后一年,39%的康复者患有后COVID综合征,而少数有异常的心电图表现,在所有筛选的幸存者中均未发现深静脉血栓形成.循环炎症标志物(白细胞,中性粒细胞,淋巴细胞,C反应蛋白和白细胞介素-6),丙氨酸氨基转移酶,估计肾小球滤过率,葡萄糖,甘油三酯,在先前轻度或重度感染的健康对照中观察到的总胆固醇和D-二聚体。此外,血清VCAM-1,ICAM-1,P-选择素,和fractalkine在幸存者和健康对照之间没有显着差异。
    未经评估:SARS-CoV-2感染可能不会增加发生长期心血管事件的风险,即使是那些从严重疾病中康复的人。
    UNASSIGNED: COVID-19 is characterized by endothelial dysfunction and is presumed to have long-term cardiovascular sequelae. In this cross-sectional study, we aimed to explore the serum levels of endothelial biomarkers in patients who recovered from COVID-19 one year after hospital discharge.
    UNASSIGNED: In this clinical follow-up study, 345 COVID-19 survivors from Huanggang, Hubei, and 119 age and gender-matched medical staff as healthy controls were enrolled. A standardized symptom questionnaire was performed, while electrocardiogram and Doppler ultrasound of lower extremities, routine blood tests, biochemical and immunological tests, serum soluble vascular cell adhesion molecule-1(VCAM-1), intercellular cell adhesion molecule-1(ICAM-1), P-selectin, and fractalkine were measured by enzyme-linked immunosorbent assays (ELISA).
    UNASSIGNED: At one year after discharge, 39% of recovers possessed post-COVID syndromes, while a few had abnormal electrocardiogram manifestations, and no deep vein thrombosis was detected in all screened survivors. There were no significant differences in circulatory inflammatory markers (leukocytes, neutrophils, lymphocytes, C-reactive protein and interleukin-6), alanine aminotransferase, estimated glomerular filtration rate, glucose, triglycerides, total cholesterol and D-dimer observed among healthy controls with previously mild or severe infected. Furthermore, serum levels of VCAM-1, ICAM-1, P-selectin, and fractalkine do not significantly differ between survivors and healthy controls.
    UNASSIGNED: SARS-CoV-2 infection may not impose a higher risk of developing long-term cardiovascular events, even for those recovering from severe illness.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    封锁措施有明显的心理影响,这可能,反过来,增加心血管风险。我们评估了封锁相关因素与心血管风险恶化之间的关系,12个月随访期间发生焦虑和抑郁。在封锁期间(2020年4月至5月),534个科目,50-89岁,纳入PSYCOV-CV研究(NCT04397835),并在封锁后随访12个月。我们发现,在封锁期间有抑郁症状的参与者更有可能报告心血管药物治疗增加(赔率比(OR)=5.08(1.78-14.5),p=0.002),体力活动减少(OR=1.76(1.10-2.82),p=0.019)和体重增加(OR=1.85(1.08-3.17),锁定后p=0.024)。此外,睡眠模式的变化(OR=2.35(1.13-4.88),p=0.022)或在封锁期间居住在农村地区(OR=1.70(0.96-3.03,p=0.069)与较高的抑郁发生率有关,而一个更好的关系与一个人的合作伙伴在锁定与较少的事件抑郁症相关(OR=0.56(0.29-1.08),p=0.084)。最后,我们发现,在封锁期间继续工作,需要与公众面对面接触(比如收银员,护士或医生)与锁定后更多的焦虑相关(OR=3.38(1.12-10.2),p=0.031)。有趣的是,禁闭期间饮酒减少与焦虑事件减少相关(OR=0.30(0.10-0.90),p=0.032)。我们的研究,在心血管疾病和严重COVID-19风险均增加的年龄组的代表性样本中进行,增加了对与封锁措施对健康影响相关的可改变因素的理解。
    Lockdown measures have obvious psychological impacts, which could, in turn, increase cardiovascular risk. We assessed the association between lockdown-related factors and the worsening of cardiovascular risk, incident anxiety and depression during 12 months\' follow-up. During lockdown (April-May 2020), 534 subjects, aged 50-89 years, were included in the PSYCOV-CV study (NCT04397835) and followed for up to 12 months post-lockdown. We found that participants with symptoms of depression during lockdown were more likely to report increased cardiovascular drug treatment (Odds-Ratio (OR) = 5.08 (1.78-14.5), p = 0.002), decreased physical activity (OR = 1.76 (1.10-2.82), p = 0.019) and weight gain (OR = 1.85 (1.08-3.17), p = 0.024) after lockdown. Moreover, changes in sleep patterns (OR = 2.35 (1.13-4.88), p = 0.022) or living in a rural area during lockdown (OR = 1.70 (0.96-3.03, p = 0.069) were associated with higher incident depression, whereas a better relationship with one\'s partner during lockdown was associated with less incident depression (OR = 0.56 (0.29-1.08), p = 0.084). Finally, we found that continuing to work during lockdown in a role requiring in-person contact with the public (such as cashiers, nurses or physicians) was associated with more incident anxiety after lockdown (OR = 3.38 (1.12-10.2), p = 0.031). Interestingly, decreased consumption of alcohol during lockdown was associated with less incident anxiety (OR = 0.30 (0.10-0.90), p = 0.032). Our study, conducted in a representative sample of an age group at increased risk of both cardiovascular disease and severe COVID-19, increases the understanding of modifiable factors associated with the health impacts of lockdown measures.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    本文报告了一项随机对照试验(RCT)的1年随访结果,与等待条件相比,该研究检查了元认知治疗(MCT)对单相抑郁症的疗效。为39例重度抑郁症患者提供了MCT,并分为两种情况;立即进行MCT,每周10次,或等待10周的MCT延迟开始。两名参与者在等待期间退出。34例患者参加了随访评估。根据意向治疗样本和所有患者,67%被归类为回收,提高了13%,在1年的随访中,20%没有变化。对于已回收73%的完成者样本,改进12%,15%没有变化。治疗后缓解的31例患者中有5例(13%)在1年随访时复发。在1年时,由于抑郁症(d=2.09)和焦虑(d=1.16)症状的减轻,组内效应大小较大。治疗反应与沉思减少有关,担心,和元认知模型预测的元认知信念,但从治疗前到1年随访,元认知的降低独立预测了抑郁评分的降低.结果表明,在1年的随访中,治疗进展是稳定的。这项研究为未来的研究奠定了基础,它应该在更长期内评估MCT,并将其与使用适当动力RCT的积极治疗进行比较。
    This paper reports the 1-year follow-up results from a randomized controlled trial (RCT), which examined the efficacy of metacognitive therapy (MCT) for unipolar depression compared to a waiting condition. Thirty-nine patients with major depression were offered MCT and were divided into two conditions; immediate MCT with 10 weekly sessions or a waiting period that had a 10-week delayed MCT start. Two participants dropped out during the waiting condition. Thirty-four patients participated in the follow-up assessment. Based on the intent-to-treat sample and all patients, 67% were classified as recovered, 13% improved, and 20% were unchanged at 1-year follow-up. For the completers sample 73% recovered, 12% improved, and 15% were unchanged. Five of the 31 patients (13%) that were in remission at post-treatment experienced relapse at 1-year follow-up. Within-group effect sizes were large for reductions in symptoms of depression (d = 2.09) and anxiety (d = 1.16) at 1-year. Treatment response was associated with reductions in rumination, worry, and metacognitive beliefs as predicted by the metacognitive model, but reductions in metacognitions independently predicted reductions in depression scores from pre-treatment to 1-year follow-up. The results suggest that treatment gains are stable at 1-year follow-up. The study sets the stage for future research, which should evaluate MCT over a longer term and compare it with active treatments using suitably powered RCTs.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

  • 文章类型: Journal Article
    To assess peri-implant soft tissue dimensions at implant sites, previously augmented with a collagen matrix (VCMX) or an autogenous subepithelial connective tissue graft (SCTG), between crown insertion and 1 year.
    Twenty patients with single-tooth implants received soft tissue augmentation prior to abutment connection randomly using VCMX or SCTG. Following abutment connection 3 months later, final reconstructions were fabricated and inserted (baseline). Patients were recalled at 6 months (6M) and at 1 year (FU-1). Measurements included clinical data, soft tissue thickness, volumetric outcomes and patient-reported outcome measures (PROMs).
    The buccal soft tissue thickness showed a median decrease of -0.5 mm (-1.0;0.3) (VCMX) and 0.0 mm (-0.5;1.0) (SCTG) (p = .243) up to FU-1. The soft tissue volume demonstrated a median decrease between BL and FU-1 of -0.1 mm (-0.2;0.0) (p = .301) for VCMX and a significant decrease of -0.2 mm (-0.4; -0.1) (p = .002) for SCTG, respectively. Intergroup comparisons did not reveal any significant differences between the groups for peri-implant soft tissue dimensions and changes up to FU-1 (p > .05). PROMs did not show any significant changes over time nor differences between the groups.
    Between crown insertion and 1 year, the buccal peri-implant soft tissue dimensions remained stable without relevant differences between sites that had previously been grafted with VCMX or SCTG.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Clinical Trial
    Few studies have reported the return-to-sport rate at 1-year follow-up after primary and revision anterior cruciate ligament (ACL) reconstruction.
    To compare the return-to-sport rate 1 year after primary and revision ACL reconstruction in the same cohort according to 2 modalities: any kind of sport and the patient\'s usual sport at the same level as before the injury.
    Cohort study; Level of evidence, 3.
    A single-center, prospective cohort study of patients undergoing ACL reconstruction (French prospective Acl STudy [FAST]) was begun in 2012. A comparative study was performed based on a retrospective analysis of data collected prospectively. Included were all athletes aged 18 to 50 years who underwent primary or revision isolated ACL reconstruction between 2012 and 2014. Two groups were formed: primary reconstruction and revision reconstruction. The main criterion was return to sport at 1-year follow-up (yes/no); secondary criteria were return to the usual sport at 1-year follow-up, knee function (International Knee Documentation Committee [IKDC] and Knee injury and Osteoarthritis Outcome Score [KOOS] scores), and psychological readiness (ACL-Return to Sports after Injury [ACL-RSI] score) at 6 months and 1 year.
    A total of 552 patients (primary reconstruction group: n = 497, revision reconstruction group: n = 55) were included in the study. There were 373 men and 179 women (mean [±SD] age, 30.2 ± 8.4 years). No significant difference in the return-to-sport rate was found between the 2 groups at 1-year follow-up (primary reconstruction group: 90.9%, revision reconstruction group: 87.3%; P = .38), but patients in the primary reconstruction group resumed their usual sport significantly more often (primary reconstruction group: 63.6%, revision reconstruction group: 49.1%; P = .04). Eight (1.4%) retears occurred during a new sport-related injury within a mean 8.9 ± 2.9 months: 7 (1.4%) in the primary reconstruction group and 1 (1.8%) in the revision reconstruction group ( P = .8). At 1-year follow-up, functional scores were significantly better in the primary reconstruction group for subjective IKDC (82.6 ± 13.3 vs 78.4 ± 16.6; P = .04); KOOS Symptoms/Stiffness (73.3 ± 15.2 vs 67.7 ± 19.6; P = .02), Activities of Daily Living (96.3 ± 6.4 vs 94.3 ± 9.1; P = .04), Sport (79.7 ± 19.1 vs 69.1 ± 24.8; P = .0004), and Quality of Life (69.6 ± 22.7 vs 54.7 ± 24.8; P < .00001) subscales; and ACL-RSI (65 ± 23 vs 49.5 ± 24.8; P < .00001). On multivariate analysis, patients who were more likely to resume their usual sport at 1 year were high-level players (odds ratio [OR], 2.2) who underwent primary reconstruction (OR, 2.0) and had better KOOS Quality of Life (OR, 1.7) and subjective IKDC (OR, 2.1) scores at 6-month follow-up without complications or retears during the first postoperative year (OR, 2.6).
    At 1-year follow-up, there was no significant difference in the return-to-sport rate between primary and revision ACL reconstruction. Patients who underwent primary reconstruction returned to their usual sport significantly more often.
    NCT02511158 ( ClinicalTrials.gov identifier).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Comparative Study
    BACKGROUND: Although direct repair (DR) with screw fixation at the pars defect is a common surgical treatment for lumbar spondylolysis, it is unknown whether DR leads to better outcomes for young patients with spondylolysis than traditional nonsurgical treatment.
    OBJECTIVE: The purpose of the study was to investigate whether DR was associated with better outcomes for lumbar spondylolysis in young patients than traditional conservative treatment.
    METHODS: This is a prospective cohort study.
    METHODS: Of 1,784 patients with low back pain in the reference period, 149 young patients with spondylolysis who followed up for at least 1 year were enrolled in the study.
    METHODS: The primary outcome was pain intensity at the lower back measured with a Visual Analog Scale. Secondary outcomes included the functional outcome as measured with the Oswestry disability index (ODI) and the 12-item short-form health survey (SF-12) consisting of the physical component summary (PCS) and mental component summary (MCS) scores, the radiologic outcome as measured with lumbar spine radiographs and computed tomography scans, and complications of treatment.
    METHODS: This was a prospective comparative study between two groups of patients who were treated with either conservative treatment or surgery for lumbar spondylolysis. Enrolled patients self-selected their own treatment and were allocated to either the traditional care group with conservative treatment (87 patients) or the surgery group (62 patients). All patients were followed up for at least 1 year.
    RESULTS: Pain intensity at the lower back did not differ significantly between groups at the final follow-up. Likewise, the ODI and SF-12 (PCS and MCS) scores did not differ significantly between groups (p=.13, .71, and .68, respectively). The change in the gap distance of the pars defect at the final follow-up was significantly different between groups (traditional care group: +0.8±0.4 mm; surgery group: -0.7±0.5; p=.01). The union rate at 1 year after surgical treatment was 52% (32/61). The rate of complications was significantly higher in the surgery group (31%) than the traditional care group (20%) (p=.02).
    CONCLUSIONS: Conservative treatment for young patients with spondylolysis may produce similar clinical outcomes and fewer complications over 12-month follow-up than surgical treatment with DR.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    This study examined whether patients\' drinking goals at admission to and discharge from 12 residential alcohol use disorder treatment programs were associated with alcohol-related outcomes at 1-year follow-up. Detoxified patients (N = 289) completed assessments at admission, after treatment, and at 1-year follow-up. Drinking goals of abstinence, conditional abstinence (in principle abstinence but potential occurrence of lapses or drinking, when urges are strong), and controlled drinking changed during treatment and predicted the 1-year follow-up outcomes (abstinence, number of standard drinks, and number of days to the first alcohol use). Goals at discharge had a better predictive value. The goal of abstinence at discharge had better outcomes than conditional abstinence; the poorest had controlled drinking.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号