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Results for “Modifiable factors”

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At least 289 records · Page 16Linked to original sources
PubMed2006

Factors modifying the efficacy of transcranial magnetic stimulation in the treatment of depression: a review.

OBJECTIVE: So far no convincing answer has emerged to the question of whether transcranial magnetic stimulation (TMS) can make a clinically useful contribution to the treatment of depression. Here we examine whether multiple sensitivity analyses can highlight parameters that predict a favorable treatment response. DATA SOURCES: Medline, Embase, and the Cochrane database for controlled trials were searched for relevant randomized controlled trials using the expression (transcranial magnetic stimulation or TMS) and depression. STUDY SELECTION: Thirty-three studies were identified and included in the random-effects meta-analysis, and between 17 and 31 studies were included in the secondary analyses comparing outcome of studies with different parameters. DATA EXTRACTION: Study data were extracted with a standardized data sheet. A meta-analysis based on Cohen d effect size measure was done for all studies and various subsets. Regression analysis of effect sizes with study parameters was done in 24 studies. DATA SYNTHESIS: Active TMS treatment was more effective than sham, but variability was too great to take any single study design as paradigmatic. No significant predictors of study effect size were found. Mean effect sizes were reduced, although still significant, in studies with stimulation intensity below 90% of motor threshold and new medication starting within 7 days before to 7 days after start of TMS. CONCLUSIONS: The absence of significant outcome predictors in the presence of significant variability of outcome measures can be interpreted in 2 ways: either study sizes and numbers and designs are insufficient to afford the power necessary to detect such predictors or TMS has a nonspecific effect on depression that is not influenced by study parameters. Large-scale comparative trials are necessary to decide between these interpretations.

Depressive Disorder↗
PubMed2026

Lifestyle Combination Patterns as Key Modifiable Factors for Type 2 Diabetes Mellitus Risk among Middle-Aged Korean Men.

BACKGRUOUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) worldwide highlights the need to understand risk factors and effective prevention strategies. Although individual lifestyle factors associated with diabetes risk have been identified, research on their collective interactions is limited. This study aimed to identify lifestyle combination patterns in middle-aged Korean men and evaluate their impact on T2DM risk. METHODS: A total of 2,332 middle-aged men without T2DM at baseline (2001-2002) from the Korean Genome and Epidemiology Study (KoGES) cohort were included. T2DM incidence was tracked through the 8th follow-up survey (2017-2018). Lifestyle combination patterns were identified using factor analysis based on sociodemographic, lifestyle, and dietary data. Cox regression was used to assess T2DM incidence across patterns. RESULTS: Four lifestyle combination patterns were identified: 'Healthy Lifestyle,' 'Low Carb & High Protein,' 'High SES & Irregular Lifestyle,' and 'Bad Eating Habits.' The risk of developing T2DM varied across patterns. The 'Healthy Lifestyle' and 'Low Carb & High Protein' patterns showed a slight decrease in risk in T3, but the differences were not significant. The 'High SES & Irregular Lifestyle' pattern was associated with a higher T2DM risk in T3 than in T1 (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.05 to 1.55), but the association was attenuated after adjustment for family history. The 'Bad Eating Habits' pattern showed a 1.21-fold higher risk in T3 (HR, 1.21; 95% CI, 1.01 to 1.47). CONCLUSION: This study underscores the existence of distinct lifestyle combination patterns and their differential implications for T2DM risk. These findings support the need for tailored preventive strategies based on lifestyle patterns.

Humans↗
PubMed1999

[Aromatase gene expression and its modifying factors in breast tumor tissue].

Aromatase (CYP 19) gene expression was studied in 70 breast tumors. When RNA-dot-blot or rt-polymerase chain reaction were used expression frequency was 60.4 and 91.7%, respectively. An analysis of individual variants of non-coding exon of aromatase gene confirmed that, unlike normal mammary tissue, tumor switched from activation of exon I.4 ("sensitive" to glucocorticoids) to exons II ("sensitive" to cAMP) or I.3. This difference was relatively somewhat more pronounced in the Russian material. Direct correlation between aromatase enzymatic activity and expression of exons II and I.3 in tumor tissue appeared more significant than that of aromatase gene coding site. An evaluation of the expression of adenylate cyclase G-protein alpha-subunit genes established an inverse correlation between expression of Gi2a and exon I.3. Breast tumors with elevated basal aromatase activity were more sensitive to aromatase inhibitors (letrozole, 4-OHA) in vitro although no relationship between use of CYP19 (aromatase) 5' exon variant and in vitro inhibition of aromatase was detected. A correlation was observed between expression of aromatase gene and variants of its 5' exon, on the one hand, and age, tumor grade, steroid receptor presence and tumor lymphocytic infiltration, on the other. To summarize, local estrogen production in breast tumor tissue is regulated by a wide range of factors expression both aromatase gene influencing and its enzymatic activity, thus providing leverage on both.

Adult↗
PubMedDate not supplied

[Patients' sleep in intensive care units and sleep-modifying factors].

Patients admitted to intensive care units sleep poorly, generally because of the environmental conditions of these units. Sleep deprivation in critical patients has severe consequences and can contribute to deterioration of their condition. The quality of sleep of the patients in our unit was evaluated to identify factors that they considered disruptive of sleep. The study included 33 patients who were admitted between April 1998 and January 1999 and had remained conscious and oriented for at least 5 days before being included in the study. We asked them to evaluate how well they had slept during their stay in the unit and to score specific factors that could disrupt sleep (environment, admission to the unit, techniques and procedures) on a scale of 0 to 10. Most patients (63.6%) claimed that they "always" or "usually" slept well. The most disruptive environmental factor was the sound of alarms, pain bothered patients more than fear or anxiety, and endotracheal intubation and mechanical ventilation were the techniques that most interfered with sleep. The quality of sleep of patients in the unit was apparently uninfluenced by pre-admission sleep problems, the severity of the process, or the type of analgesia-sedation administered. The largest percentage of patients who slept poorly had been admitted to one of the wings of the unit, which should be studied specifically.

Attitude to Health↗
PubMedDate not supplied

Age and sex as factors modifying the function of the blood-cerebrospinal fluid barrier.

INTRODUCTION: The aim of the study was to find out, if there was a difference in function of the blood/cerebrospinal fluid barrier (BCSFB) in females and males, and if those differences intensify with age. MATERIAL AND METHODS: 120 patients of both sexes who underwent subarachnoideal anesthesia were divided into 6 groups, 20 patients each, considering sex and age criteria. Samples of venous blood (5 ml) and cerebrospinal fluid (1 ml) were collected from every patient simultaneously; then albumin permeability indexes (Qalb) were counted. The achieved results were compared using the t-Student test at the significance level of P < or = 0.05. RESULTS: The mean value of Qalb in patients aged 20-50 was significantly lower than in the group of patients aged 51-70, as well as in the group of patients over 71. The difference between mean Qalb values in patients aged 51-70 and those aged over 71 was also statistically significant. No statistically significant difference between mean Qalb values in females and in males in the corresponding age groups was found. In every age group the value of albumin permeability index was lower in females. CONCLUSIONS: 1) The permeability of BCSFB increases with age. 2) There was no statistically significant difference between the values of albumin permeability index in females and males in the corresponding age groups. The function of BCSFB in the corresponding age groups of males and females was the same.

Adult↗
PubMed2002

SHOX haploinsufficiency and its modifying factors.

SHOX (short stature homeobox-containing gene) is the first gene that has been shown to be relevant to the development of specific features in Turner's syndrome. This article reviews clinical findings in patients with SHOX haploinsufficiency caused by intragenic mutations, pseudoautosomal submicroscopic deletions, and cytogenetically recognizable Xp deletions. SHOX haploinsufficiency can result in not only short stature but also Turner skeletal features, such as cubitus valgus, short metacarpals, Madelung deformity, Léri-Weill dyschondrosteosis, high arched palate, and short neck. Rare Turner skeletal features such as Madelung deformity and Léri-Weill dyschondrosteosis are primarily facilitated by the bone-maturing effect of gonadal estrogens. Common Turner skeletal features such as short metacarpals, cubitus valgus, and various craniofacial and cervical skeletal stigmata are largely caused by a compressive effect of distended lymphatics and lymphedema on the developing skeletal tissues.

Bone Development↗