severity progression

  • 文章类型: Journal Article
    由于人类生理学的动态性质,理解驱动SARS-CoV-2感染进展和严重程度的因素是复杂的。因此,我们旨在通过人口统计数据探索SARS-CoV-2的严重风险指标,临床表现,和实验室参数的轮廓。该研究包括175名患者,他们要么在利雅得阿卜杜勒阿齐兹国王医疗城住院,要么在利雅得的指定酒店接受隔离,沙特阿拉伯,从2020年6月到2021年4月。住院患者在入院的第一周进行随访。人口统计数据,临床表现,并从电子病历中检索实验室结果.我们的结果显示,年龄较大(OR:1.1,CI:[1.1-1.12];p<0.0001),男性(OR:2.26,CI:[1.0-5.1];p=0.047),和血尿素氮水平(OR:2.56,CI:[1.07-6.12];p=0.034)是严重程度的潜在预测因子。总之,研究表明,除了实验室参数,年龄和性别可能在早期阶段预测SARS-CoV-2感染的严重程度。据我们所知,这项研究是沙特阿拉伯首次探索危险因素中实验室参数的纵向剖面,揭示SARS-CoV-2感染进展参数。
    Understanding the factors driving SARS-CoV-2 infection progression and severity is complex due to the dynamic nature of human physiology. Therefore, we aimed to explore the severity risk indicators of SARS-CoV-2 through demographic data, clinical manifestations, and the profile of laboratory parameters. The study included 175 patients either hospitalized at King Abdulaziz Medical City-Riyadh or placed in quarantine at designated hotels in Riyadh, Saudi Arabia, from June 2020 to April 2021. Hospitalized patients were followed up through the first week of admission. Demographic data, clinical presentations, and laboratory results were retrieved from electronic patient records. Our results revealed that older age (OR: 1.1, CI: [1.1-1.12]; p < 0.0001), male gender (OR: 2.26, CI: [1.0-5.1]; p = 0.047), and blood urea nitrogen level (OR: 2.56, CI: [1.07-6.12]; p = 0.034) were potential predictors of severity level. In conclusion, the study showed that apart from laboratory parameters, age and gender could potentially predict the severity of SARS-CoV-2 infection in the early stages. To our knowledge, this study is the first in Saudi Arabia to explore the longitudinal profile of laboratory parameters among risk factors, shedding light on SARS-CoV-2 infection progression parameters.
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  • 文章类型: Journal Article
    背景:视网膜微动脉瘤转换(MAT)的分析先前已被证明有助于识别有发生与糖尿病性视网膜病变(DR)相关的临床重大并发症的风险的眼睛。我们建议进一步表征MAT作为DR进展和视力威胁并发症发展的预测生物标志物。
    方法:每年对212名2型糖尿病患者(T2D;ETDRS等级20和35)进行5年前瞻性评估,纵向研究,通过彩色眼底照相和光学相干层析成像。终点为糖尿病性黄斑水肿(DME)或增生性视网膜病变(PDR)。MAT分析包括MA形成和消失率的测定,使用RetMarkerDR®自动评估。使用ETDRS严重程度水平的逐步增加来评估视网膜病变严重程度的进展。
    结果:在212个人中,172完成了5年的随访研究或确定了终点(n=27)。在1年计算的MAT显示终点发展组之间存在显着差异(p=0.018),特别是MA消失率(p=0.007)。MAT还显示在5年期间具有不同ETDRS严重程度进展的眼睛之间的显著差异(p=0.035)。
    结论:MAT是轻度视网膜病变的T2D个体中DME和/或PDR发展以及DR严重程度进展的指标。
    BACKGROUND: Analysis of retinal microaneurysm turnover (MAT) has been previously shown to contribute to the identification of eyes at risk of developing clinically significant complications associated with diabetic retinopathy (DR). We propose to further characterize MAT as a predictive biomarker of DR progression and development of vision-threatening complications.
    METHODS: 212 individuals with type 2 diabetes (T2D; ETDRS grades 20 and 35) were evaluated annually in a 5-year prospective, longitudinal study, by color fundus photography and optical coherence tomography. Endpoints were diabetic macular edema (DME) or proliferative retinopathy (PDR). MAT analysis included determination of MA formation and disappearance rates, automatically assessed using the RetMarkerDR®. Retinopathy severity progression was evaluated using step increases in ETDRS severity levels.
    RESULTS: Of the 212 individuals, 172 completed the 5-year follow-up study or developed an endpoint (n = 27). MAT calculated at 1 year showed a significant difference between groups of endpoint developments (p = 0.018), particularly MA disappearance rate (p = 0.007). MAT also showed a significant difference between eyes with different ETDRS severity progression in the 5-year period (p = 0.035).
    CONCLUSIONS: MAT is an indicator of the development of DME and/or PDR as well as of DR severity progression in T2D individuals with mild retinopathy.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是一种与衰老密切相关的慢性进行性神经退行性疾病。AD是否通过靶向局部大脑区域而起源,并在疾病严重程度进展中传播到大脑的其余部分,这是一个未知答案的问题。这里,我们的目标是通过观察扩散张量脑网络的差异,在群体层面提供这个问题的答案。特别是,利用阿尔茨海默病神经影像学倡议(ADNI)的数据,定义了四个不同的组(所有组都按年龄匹配,性别和教育水平):G1(N1=36,健康对照受试者,Control),G2(N2=36,早期轻度认知障碍,EMCI),G3(N3=36,晚期轻度认知障碍,LMCI)和G4(N4=36,AD)。在三个疾病阶段比较了扩散张量脑网络:I期(对照与EMCI),第二阶段(控制与LMCI)和第三阶段(对照与AD).分组比较采用多变量距离矩阵回归分析,一种在基因组学中诞生的技术,最近被提出来处理大脑功能网络,但这里适用于扩散张量数据。结果有三个方面:第一,在I阶段没有发现显著差异。在与记忆功能密切相关的子网络的连接模式的II期发现了显着差异(包括海马的一部分,杏仁核,内嗅皮层,梭状回,下颞中回,海马旁回和颞极)。第三,在第三阶段发现了整个AD大脑的广泛断开,对第二阶段出现的相同记忆子网络的影响更大,加上其他新的子网,包括默认模式网络,媒体视觉网络,额顶叶区和纹状体。我们的结果与随着疾病严重程度的增加而出现连接性进行性改变的情况一致,并提供可能参与这种退行性过程的大脑区域。需要对纵向数据应用相同策略的进一步研究才能充分证实这种情况。
    Alzheimer\'s disease (AD) is a chronically progressive neurodegenerative disease highly correlated to aging. Whether AD originates by targeting a localized brain area and propagates to the rest of the brain across disease-severity progression is a question with an unknown answer. Here, we aim to provide an answer to this question at the group-level by looking at differences in diffusion-tensor brain networks. In particular, making use of data from Alzheimer\'s Disease Neuroimaging Initiative (ADNI), four different groups were defined (all of them matched by age, sex and education level): G1 (N1 = 36, healthy control subjects, Control), G2 (N2 = 36, early mild cognitive impairment, EMCI), G3 (N3 = 36, late mild cognitive impairment, LMCI) and G4 (N4 = 36, AD). Diffusion-tensor brain networks were compared across three disease stages: stage I (Control vs. EMCI), stage II (Control vs. LMCI) and stage III (Control vs. AD). The group comparison was performed using the multivariate distance matrix regression analysis, a technique that was born in genomics and was recently proposed to handle brain functional networks, but here applied to diffusion-tensor data. The results were threefold: First, no significant differences were found in stage I. Second, significant differences were found in stage II in the connectivity pattern of a subnetwork strongly associated to memory function (including part of the hippocampus, amygdala, entorhinal cortex, fusiform gyrus, inferior and middle temporal gyrus, parahippocampal gyrus and temporal pole). Third, a widespread disconnection across the entire AD brain was found in stage III, affecting more strongly the same memory subnetwork appearing in stage II, plus the other new subnetworks, including the default mode network, medial visual network, frontoparietal regions and striatum. Our results are consistent with a scenario where progressive alterations of connectivity arise as the disease severity increases and provide the brain areas possibly involved in such a degenerative process. Further studies applying the same strategy to longitudinal data are needed to fully confirm this scenario.
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