Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who un...Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator （CRT-Dvs. CRT-P）, at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients 〈 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls （P 〈 0.001）. Across both groups, 70% were male, mean left ventricular ejection fraction （LVEF） was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy （74%vs. 37%,P 〈 0.001） and more likely to undergo upgrade to CRT instead of an initial implant （42%vs. 19%,P 〈 0.001）. The rate of appropriate defibrillator shocks was lower among octogenarians （14%vs. 27%,P = 0.02） whereas the rate of inappropriate shocks was similar （3%vs. 6%,P = 0.55）. At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians （11%） and controls （8%,P = 0.381）.ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.展开更多
Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 m...Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 mo following initiation of treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. High titers of glutamic acid decarboxylase, antinuclear and thyroid (thyroid peroxidase and thyroglobulin) antibodies were detected. Antiviral treatment was withdrawn and the patient was treated with insulin for insulin-dependent diabetes mellitus and propranolol for hyperthyroidism. Twelve months after cessation of pegylated interferon-α therapy the patient was euthyroid without any medication but remained insulin-dependent.展开更多
Objective To construct a model of Seasonal Autoregressive Integrated Moving Average （SARIMA） for forecasting the epidemic of Japanese encephalitis （JE） in Xianyang, Shaanxi, China, and provide valuable reference ...Objective To construct a model of Seasonal Autoregressive Integrated Moving Average （SARIMA） for forecasting the epidemic of Japanese encephalitis （JE） in Xianyang, Shaanxi, China, and provide valuable reference information for JE control and prevention. Methods Theoretically epidemiologic study was employed in the research process. Monthly incidence data on JE for the period from Jan 2005 to Sep 2014 were obtained from a passive surveillance system at the Center for Diseases Prevention and Control in Xianyang, Shaanxi province. An optimal SARIMA model was developed for JE incidence from 2005 to 2013 with the Box and Jenkins approach. This SARIMA model could predict JE incidence for the year 2014 and 2015. Results SARIMA （1, 1, 1） （2, 1, 1）12 was considered to be the best model with the lowest Bayesian information criterion, Akaike information criterion, Mean Absolute Error values, the highest R2, and a lower Mean Absolute Percent Error. SARIMA （1, 1, 1） （2, 1, 1）12 was stationary and accurate for predicting JE incidence in Xianyang. The predicted incidence, around 0.3/100 000 from June to August in 2014 with low errors, was higher compared with the actual incidence. Therefore, SARIMA （1, 1, 1） （2, 1, 1）12 appeared to be reliable and accurate and could be applied to incidence prediction. Conclusions The proposed prediction model could provide clues to early identification of the JE incidence that is increased abnormally （≥0.4/100 000）. According to the predicted results in 2014, the JE incidence in Xianyang will decline slightly and reach its peak from June to August.The authors wish to thank the staff from the CDCs from 13 counties of Xianyang, Shaanxi province, China, for their contribution to Japanese encephalitis cases reporting.展开更多
文摘Background Clinical outcomes of cardiac resynchronization therapy （CRT） in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator （CRT-Dvs. CRT-P）, at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients 〈 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls （P 〈 0.001）. Across both groups, 70% were male, mean left ventricular ejection fraction （LVEF） was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy （74%vs. 37%,P 〈 0.001） and more likely to undergo upgrade to CRT instead of an initial implant （42%vs. 19%,P 〈 0.001）. The rate of appropriate defibrillator shocks was lower among octogenarians （14%vs. 27%,P = 0.02） whereas the rate of inappropriate shocks was similar （3%vs. 6%,P = 0.55）. At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians （11%） and controls （8%,P = 0.381）.ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.
文摘Classical interferon-alpha has been shown to be correlated with the development of a variety of autoimmune disorders. A 38 year-old female patient developed simultaneously diabetic ketoacidosis and hyperthyroidism 5 mo following initiation of treatment with pegylated interferon-α and ribavirin for chronic hepatitis C. High titers of glutamic acid decarboxylase, antinuclear and thyroid (thyroid peroxidase and thyroglobulin) antibodies were detected. Antiviral treatment was withdrawn and the patient was treated with insulin for insulin-dependent diabetes mellitus and propranolol for hyperthyroidism. Twelve months after cessation of pegylated interferon-α therapy the patient was euthyroid without any medication but remained insulin-dependent.
基金Supported by the Youth Project of Shaanxi University of Chinese Medicine(2015QN05)
文摘Objective To construct a model of Seasonal Autoregressive Integrated Moving Average （SARIMA） for forecasting the epidemic of Japanese encephalitis （JE） in Xianyang, Shaanxi, China, and provide valuable reference information for JE control and prevention. Methods Theoretically epidemiologic study was employed in the research process. Monthly incidence data on JE for the period from Jan 2005 to Sep 2014 were obtained from a passive surveillance system at the Center for Diseases Prevention and Control in Xianyang, Shaanxi province. An optimal SARIMA model was developed for JE incidence from 2005 to 2013 with the Box and Jenkins approach. This SARIMA model could predict JE incidence for the year 2014 and 2015. Results SARIMA （1, 1, 1） （2, 1, 1）12 was considered to be the best model with the lowest Bayesian information criterion, Akaike information criterion, Mean Absolute Error values, the highest R2, and a lower Mean Absolute Percent Error. SARIMA （1, 1, 1） （2, 1, 1）12 was stationary and accurate for predicting JE incidence in Xianyang. The predicted incidence, around 0.3/100 000 from June to August in 2014 with low errors, was higher compared with the actual incidence. Therefore, SARIMA （1, 1, 1） （2, 1, 1）12 appeared to be reliable and accurate and could be applied to incidence prediction. Conclusions The proposed prediction model could provide clues to early identification of the JE incidence that is increased abnormally （≥0.4/100 000）. According to the predicted results in 2014, the JE incidence in Xianyang will decline slightly and reach its peak from June to August.The authors wish to thank the staff from the CDCs from 13 counties of Xianyang, Shaanxi province, China, for their contribution to Japanese encephalitis cases reporting.
