Medicine
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Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis. ⋯ The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.
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Observational Study
Clinical significance of serum magnesium levels in patients with heart failure with preserved ejection fraction.
Although serum magnesium (Mg) levels are closely associated with the prognosis of heart failure (HF) patients, the clinical significance of sMg levels on the cardiovascular outcomes of HF with preserved ejection fraction (HFpEF) patients is not fully understood. This study was a retrospective, single-center, observational study. We enrolled 452 consecutive HFpEF patients admitted to Kumamoto University Hospital. ⋯ Kaplan-Meier curve revealed a significantly higher probability of HF-related events in the lower sMg group compared with the higher sMg group (log-rank test, P = .012). Multivariate Cox-proportional-hazard analysis revealed that the lower sMg group had significantly and independently higher probabilities of HF-related events compared with the higher sMg group (hazard ratio = 2.37, 95% confidence intervals = 1.27-4.41, P = .007). We reclassified the risk of HF-related events after adding the lower sMg to the other prognostic factors (age, previous hospitalization for HF, DM, Ln-BNP); the continuous net reclassification improvement was 29.0% (P = .041). sMg levels might provide important prognostic information in regard to HFpEF.
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Meta Analysis
Non-pharmacological interventions for patients with dementia: A protocol for a systematic review and meta-analysis.
This protocol for a systematic review describes the methods that will be used to evaluate the efficacy and safety of non-pharmacological interventions for patients with dementia. ⋯ CRD42019136435.
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Randomized Controlled Trial
Sphingosine-1-phosphate as an indicator for deciding the use of adjuvant corticosteroids therapy in community-acquired pneumonia (sphingosine-1-phosphate and pneumonia trial): Study protocol for a randomized, placebo-controlled trial.
Pneumonia is one of the leading causes of death worldwide, represents a potentially life-threatening condition. In recent studies, adjuvant corticosteroids therapy has been shown to improve outcome in severe community-acquired pneumonia (CAP); however, the treatment response to corticosteroids vary. It is important to select patients likely to benefit from the treatment. Currently, the optimal patient selection of corticosteroids treatment is not yet clearly defined. ⋯ SOPN trial is the first randomized placebo-controlled trial to investigate whether S1P can be a predictive biomarker for adjuvant corticosteroids therapy in patients with severe CAP. The trial will add additional data for the appropriate use of adjuvant corticosteroids therapy in patients with severe CAP. Results from this clinical trial will provide foundational information supporting that if the S1P is appropriate for guiding the patient selection for corticosteroids adjuvant therapy.
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Red and (particularly) processed meats are high in cholesterol and saturated and solid fatty acids. Their consumption is considered one of the risk factors for metabolic disorders. Numerous studies demonstrated a possible association between red meat consumption and cardiovascular disease (CVD). In this protocol, we propose a systematic review of the literature to examine the associations of red meat consumption with CVD incidence and mortality, and explore the potential dose-response relationship. ⋯ PROSPERO CRD42019100914.