Background and Purpose:Functional outcome scales are typically used to measur e quality of life (QOL) and outcomes in patients with cerebral aneurysms; howeve r, these instruments only examine a limited number of doma...Background and Purpose:Functional outcome scales are typically used to measur e quality of life (QOL) and outcomes in patients with cerebral aneurysms; howeve r, these instruments only examine a limited number of domains that contribute to QOL. An alternative are preference-based QOL methods,which integrate all facto rs contributing to QOL and provide a comprehensive individualized measure of how patients value their current health state. An additional advantage of preferenc e-based QOL values is that they can be incorporated into decision analyses and cost-effectiveness analyses. Methods:We used 4 preference-based QOL methods t o measure QOL in176 outpatients with cerebral aneurysms: (1) standard gamble;(2) time trade-off; (3) visual analogue scale; and (4) willingness to pay. We meas ured functional status with the Glasgow Outcome Scale (GOS), Rankin Scale, and B arthel Index. We then built multivariate linear regression models to examine the relationships between preference-based QOL, functional status,and patient char acteristics. Results:Preference-based QOL was moderately diminished in the ane urysm patients. Mean values were; standard gamble, 0.78; time trade-off, 0.79; visual analogue scale, 0.67; and willingness to pay, ＄121 000. Preference-base d QOL was not well-explained by functional status or patient characteristics, a s shown by regression models that accounted for < 15%of the variation in prefer ence-based QOL (R2 < 0.15). Conclusions:Preference-based QOL instrument scapt ure components of QOL in patients with cerebral aneurysms not assessed by functi onal status measures or patient characteristics.Studies of patients with cerebra l aneurysms should consider incorporating preference-based QOL measures for a f uller evaluation of the impact of aneurysmal disease and its treatment on QOL.展开更多
AA （Alopecia areata） is the most frequent cause of inflammation-induced hair loss, affecting 0.1 to 0.2% of population worldwide. The development of organ-specific autoimmune reactions directed against anagen hair f...AA （Alopecia areata） is the most frequent cause of inflammation-induced hair loss, affecting 0.1 to 0.2% of population worldwide. The development of organ-specific autoimmune reactions directed against anagen hair follicles seems to play a key role in the pathogenesis of alopecia areata. However, the triggering antigen（s） responsible for inducing autoimmune phenomena in these individuals remain unknown. Viral, bacterial or fungal pathogens have been implied as possible triggering factors of autoimmune reactions. The present study aims to identify the role of dematiaceous fungi in the pathogenesis of alopecia areata. 30 patients diagnosed clinically as alopecia areata and 30 normal age matched persons have undergone mycological examination. Mycology examination of the epidermal scrapings was done by DME （direct microscopic examination）, culture on SDA （sabouraud＇s dextrose agar） and imaging. There is significantly higher percentage of positive results for Alternaria species by culture on sabouraud＇s agar in patients group （20%） compared to controls （13.3%） P-value 〈 0.05. The possible role of Alternaria antigens （e.g. antigens involved in melanin synthesis） in triggering autoimmunity in alopecia areata still needs further research on a wider scale of cases.展开更多
文摘Background and Purpose:Functional outcome scales are typically used to measur e quality of life (QOL) and outcomes in patients with cerebral aneurysms; howeve r, these instruments only examine a limited number of domains that contribute to QOL. An alternative are preference-based QOL methods,which integrate all facto rs contributing to QOL and provide a comprehensive individualized measure of how patients value their current health state. An additional advantage of preferenc e-based QOL values is that they can be incorporated into decision analyses and cost-effectiveness analyses. Methods:We used 4 preference-based QOL methods t o measure QOL in176 outpatients with cerebral aneurysms: (1) standard gamble;(2) time trade-off; (3) visual analogue scale; and (4) willingness to pay. We meas ured functional status with the Glasgow Outcome Scale (GOS), Rankin Scale, and B arthel Index. We then built multivariate linear regression models to examine the relationships between preference-based QOL, functional status,and patient char acteristics. Results:Preference-based QOL was moderately diminished in the ane urysm patients. Mean values were; standard gamble, 0.78; time trade-off, 0.79; visual analogue scale, 0.67; and willingness to pay, ＄121 000. Preference-base d QOL was not well-explained by functional status or patient characteristics, a s shown by regression models that accounted for < 15%of the variation in prefer ence-based QOL (R2 < 0.15). Conclusions:Preference-based QOL instrument scapt ure components of QOL in patients with cerebral aneurysms not assessed by functi onal status measures or patient characteristics.Studies of patients with cerebra l aneurysms should consider incorporating preference-based QOL measures for a f uller evaluation of the impact of aneurysmal disease and its treatment on QOL.
文摘AA （Alopecia areata） is the most frequent cause of inflammation-induced hair loss, affecting 0.1 to 0.2% of population worldwide. The development of organ-specific autoimmune reactions directed against anagen hair follicles seems to play a key role in the pathogenesis of alopecia areata. However, the triggering antigen（s） responsible for inducing autoimmune phenomena in these individuals remain unknown. Viral, bacterial or fungal pathogens have been implied as possible triggering factors of autoimmune reactions. The present study aims to identify the role of dematiaceous fungi in the pathogenesis of alopecia areata. 30 patients diagnosed clinically as alopecia areata and 30 normal age matched persons have undergone mycological examination. Mycology examination of the epidermal scrapings was done by DME （direct microscopic examination）, culture on SDA （sabouraud＇s dextrose agar） and imaging. There is significantly higher percentage of positive results for Alternaria species by culture on sabouraud＇s agar in patients group （20%） compared to controls （13.3%） P-value 〈 0.05. The possible role of Alternaria antigens （e.g. antigens involved in melanin synthesis） in triggering autoimmunity in alopecia areata still needs further research on a wider scale of cases.
