Enfermedades neurológicas

  • 文章类型: Journal Article
    背景:虽然血清中神经丝轻链(NfL)浓度的增加与几种神经系统疾病的进展有关,它们在一般成年人口中的分布和影响在很大程度上仍未被探索。当前的研究旨在阐明广泛且具有代表性的人群样本中血清NfL水平与神经系统疾病之间的关系。
    方法:我们利用了2013-2014年国家健康与营养调查(NHANES)周期中1,751名成年人的信息。我们的分析方法包括逻辑回归,平滑曲线拟合,和亚组分析,以确定血清NfL水平和神经系统疾病之间的潜在相关性,包括抑郁症,严重的听力和视力障碍,中风,主观记忆缺陷,和睡眠问题。
    结果:调整混杂因素后,我们发现,较高的血清NfL浓度与抑郁症风险增加显著相关,中风,主观记忆缺陷,和更长的睡眠时间(p<0.05)。亚组分析支持这些发现。此外,BMI显著影响血清NfL水平与主观记忆缺陷之间的关系。
    结论:我们的研究表明,较高的血清NfL水平与几种神经系统疾病的风险升高密切相关。这些发现强调了血清NfL作为早期检测和监测神经系统疾病的关键标志物的作用。强调其在临床和公共卫生环境中的重要性。
    BACKGROUND: While increased neurofilament light chain (NfL) in serum concentrations are linked to the progression of several neurological conditions, their distribution and implications within the general adult population remain largely unexplored. The current research aims to clarify the relationship between serum NfL levels and neurological disorders in a broad and representative population sample.
    METHODS: We utilized information gathered from 1751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey . Our analytical approach encompassed logistic regression, smoothed curve fitting, and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions, such as depression, severe hearing and visual impairments, stroke, subjective memory deficits, and sleep problems.
    RESULTS: After adjusting for all confounders, we found that higher serum NfL levels were significantly associated with increased risks of depression, stroke, subjective memory deficits, and longer sleep duration (p < 0.05). Subgroup analyses supported these findings. Additionally, BMI significantly influenced the relationship between serum NfL levels and long-term subjective memory decline.
    CONCLUSIONS: Our research shows that higher serum NfL levels are strongly related to an elevated risk for several neurological disorders. These findings highlight the role of serum NfL serving as a critical marker for early detection and monitoring of neurological conditions, emphasizing its importance in both clinical and public health settings.
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  • 文章类型: Journal Article
    背景:经皮内镜胃造瘘术(PEG)对于吞咽受损和胃肠道系统功能正常的患者是一种有用的干预措施。引起神经运动性吞咽困难的神经系统疾病,脑肿瘤,脑血管疾病是最常见的适应症;并发症很少见,发病率和死亡率都很低。
    目的:描述PEG在神经系统疾病患者中的应用,以及它对护理的影响,生存,成本和收益。
    方法:我们进行了一项回顾性观察研究,回顾了在美国国家神经病学和神经外科研究所住院的患者(2015-2017年)接受PEG安置的临床档案.
    结果:样本包括51例患者:62.7%为女性,平均(SD)年龄为54.4(18.6)岁(范围,18-86).肿瘤占37.3%,脑血管病占33.3%。16例患者(33.3%)死亡,11例出现轻微并发症。PEG管保持在原位平均9.14个月;在52.9%的患者中,由于缺乏改善和/或耐受口服摄入,移除发生在平均5.1(4.4)个月后。在患者家属中,78.4%的人报告说有很大的好处,43.1%的人报告难以照顾PEG,45.1%报告一般护理复杂。维持PEG的每月成本平均为175.78欧元(范围,38.38-293.45)。
    结论:这项初步研究表明,PEG在神经系统疾病患者中的适应症很好,生存率与其他长期随访研究中报道的相似。在脑血管病患者中,PEG管平均保持在9.14个月,在吞咽功能恢复期间;然而,对我们的人口来说成本很高。
    BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a useful intervention for patients with impaired swallowing and a functional gastrointestinal system. Neurological diseases that cause neuromotor dysphagia, brain tumors, and cerebrovascular disease are the most frequent indications; complications are rare, and morbidity and mortality rates are low.
    OBJECTIVE: To describe the usefulness of PEG in patients with neurological diseases, and its impact on care, survival, and costs and benefits.
    METHODS: We performed a retrospective observational study, reviewing clinical files of patients hospitalised at the National Institute of Neurology and Neurosurgery (years 2015-2017) who underwent PEG placement.
    RESULTS: The sample included 51 patients: 62.7% were women and the mean (SD) age was 54.4 (18.6) years (range, 18-86). Diagnosis was tumor in 37.3% of cases and cerebrovascular disease in 33.3%. Sixteen patients (33.3%) died and 11 presented minor complications. The PEG tube remained in place for a mean of 9.14 months; in 52.9% of patients it was removed due to lack of improvement and/or tolerated oral intake, with removal occurring after a mean of 5.1 (4.4) months. Among patients\' family members, 78.4% reported a great benefit, 43.1% reported difficulty caring for the PEG, and 45.1% reported complicated care in general. The monthly cost of maintaining the PEG was €175.78 on average (range, 38.38-293.45).
    CONCLUSIONS: This preliminary study reveals that PEG was well indicated in patients with neurological diseases, with survival rates similar to those reported in other studies with long follow-up periods. In patients with cerebrovascular disease, the PEG tube remained in place a mean of 9.14 months, during recovery of swallowing function; however, the cost is high for our population.
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  • 文章类型: Observational Study
    背景:经皮内镜胃造瘘术(PEG)对于吞咽受损和胃肠道系统功能正常的患者是一种有用的干预措施。引起神经运动性吞咽困难的神经系统疾病,脑肿瘤,脑血管疾病是最常见的适应症;并发症很少见,发病率和死亡率都很低。
    目的:描述PEG在神经系统疾病患者中的应用,以及它对护理的影响,生存,成本和收益。
    方法:我们进行了一项回顾性观察研究,回顾了在美国国家神经病学和神经外科研究所住院的患者(2015-2017年)接受PEG安置的临床档案.
    结果:样本包括51例患者:62.7%为女性,平均(SD)年龄为54.4(18.6)岁(范围,18-86).肿瘤占37.3%,脑血管病占33.3%。16例患者(33.3%)死亡,11例出现轻微并发症。PEG管保持在原位平均9.14个月;在52.9%的患者中,由于缺乏改善和/或耐受口服摄入,移除发生在平均5.1(4.4)个月后。在患者家属中,78.4%的人报告说有很大的好处,43.1%的人报告难以照顾PEG,45.1%报告一般护理复杂。维持PEG的每月成本平均为175.78欧元(范围,38.38-293.45)。
    结论:这项初步研究表明,PEG在神经系统疾病患者中的适应症很好,生存率与其他长期随访研究中报道的相似。在脑血管病患者中,PEG管平均保持在9.14个月,在吞咽功能恢复期间;然而,对我们的人口来说成本很高。
    BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a useful intervention for patients with impaired swallowing and a functional gastrointestinal system. Neurological diseases that cause neuromotor dysphagia, brain tumors, and cerebrovascular disease are the most frequent indications; complications are rare, and morbidity and mortality rates are low.
    OBJECTIVE: To describe the usefulness of PEG in patients with neurological diseases, and its impact on care, survival, and costs and benefits.
    METHODS: We performed a retrospective observational study, reviewing clinical files of patients hospitalised at the National Institute of Neurology and Neurosurgery (years 2015-2017) who underwent PEG placement.
    RESULTS: The sample included 51 patients: 62.7% were women and the mean (SD) age was 54.4 (18.6) years (range, 18-86). Diagnosis was tumor in 37.3% of cases and cerebrovascular disease in 33.3%. Sixteen patients (33.3%) died and 11 presented minor complications. The PEG tube remained in place for a mean of 9.14 months; in 52.9% of patients it was removed due to lack of improvement and/or tolerated oral intake, with removal occurring after a mean of 5.1 (4.4) months. Among patients\' family members, 78.4% reported a great benefit, 43.1% reported difficulty caring for the PEG, and 45.1% reported complicated care in general. The monthly cost of maintaining the PEG was €175.78 on average (range, 38.38-293.45).
    CONCLUSIONS: This preliminary study reveals that PEG was well indicated in patients with neurological diseases, with survival rates similar to those reported in other studies with long follow-up periods. In patients with cerebrovascular disease, the PEG tube remained in place a mean of 9.14 months, during recovery of swallowing function; however, the cost is high for our population.
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