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1.
PLoS Pathog ; 18(5): e1010488, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35503780

RESUMO

Transmitted/founder (T/F) HIV-1 envelope proteins (Envs) from infected individuals that developed neutralization breadth are likely to possess inherent features desirable for vaccine immunogen design. To explore this premise, we conducted an immunization study in rhesus macaques (RM) using T/F Env sequences from two human subjects, one of whom developed potent and broad neutralizing antibodies (Z1800M) while the other developed little to no neutralizing antibody responses (R66M) during HIV-1 infection. Using a DNA/MVA/protein immunization protocol, 10 RM were immunized with each T/F Env. Within each T/F Env group, the protein boosts were administered as either monomeric gp120 or stabilized trimeric gp140 protein. All vaccination regimens elicited high titers of antigen-specific IgG, and two animals that received monomeric Z1800M Env gp120 developed autologous neutralizing activity. Using early Env escape variants isolated from subject Z1800M as guides, the serum neutralizing activity of the two immunized RM was found to be dependent on the gp120 V5 region. Interestingly, the exact same residues of V5 were also targeted by a neutralizing monoclonal antibody (nmAb) isolated from the subject Z1800M early in infection. Glycan profiling and computational modeling of the Z1800M Env gp120 immunogen provided further evidence that the V5 loop is exposed in this T/F Env and was a dominant feature that drove neutralizing antibody targeting during infection and immunization. An expanded B cell clonotype was isolated from one of the neutralization-positive RM and nmAbs corresponding to this group demonstrated V5-dependent neutralization similar to both the RM serum and the human Z1800M nmAb. The results demonstrate that neutralizing antibody responses elicited by the Z1800M T/F Env in RM converged with those in the HIV-1 infected human subject, illustrating the potential of using immunogens based on this or other T/F Envs with well-defined immunogenicity as a starting point to drive breadth.


Assuntos
Vacinas contra a AIDS , Infecções por HIV , HIV-1 , Animais , Anticorpos Neutralizantes , Anticorpos Anti-HIV , Proteína gp120 do Envelope de HIV , Infecções por HIV/prevenção & controle , Humanos , Macaca mulatta , Produtos do Gene env do Vírus da Imunodeficiência Humana
2.
Acta Pharmacol Sin ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38942954

RESUMO

C/EBP homologous protein (CHOP) triggers the death of multiple cancers via endoplasmic reticulum (ER) stress. However, the function and regulatory mechanism of CHOP in liver cancer remain elusive. We have reported that late endosomal/lysosomal adapter, mitogen-activated protein kinase and mTOR activator 5 (LAMTOR5) suppresses apoptosis in various cancers. Here, we show that the transcriptional and posttranscriptional inactivation of CHOP mediated by LAMTOR5 accelerates liver cancer growth. Clinical bioinformatic analysis revealed that the expression of CHOP was low in liver cancer tissues and that its increased expression predicted a good prognosis. Elevated CHOP contributed to destruction of LAMTOR5-induced apoptotic suppression and proliferation. Mechanistically, LAMTOR5-recruited DNA methyltransferase 1 (DNMT1) to the CpG3 region (-559/-429) of the CHOP promoter and potentiated its hypermethylation to block its interaction with general transcription factor IIi (TFII-I), resulting in its inactivation. Moreover, LAMTOR5-enhanced miR-182/miR-769 reduced CHOP expression by targeting its 3'UTR. Notably, lenvatinib, a first-line targeted therapy for liver cancer, could target the LAMTOR5/CHOP axis to prevent liver cancer progression. Accordingly, LAMTOR5-mediated silencing of CHOP via the regulation of ER stress-related apoptosis promotes liver cancer growth, providing a theoretical basis for the use of lenvatinib for the treatment of liver cancer.

3.
Environ Res ; 259: 119459, 2024 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-38942257

RESUMO

In situ immobilization is a widely used measure for passivating Cd-contaminated soils. Amendments need to be continuously applied to achieve stable remediation effects. However, few studies have evaluated the impact of consecutive application of amendments on soil health and the microecological environment. A field experiment was conducted in a Cd-contaminated paddy (available Cd concentration 0.40 mg kg-1) on the Chengdu Plain to investigate the changes in soil Cd availability and response characteristics of soil bacterial communities after consecutive application of rice straw biochar (SW), fly ash (FM) and marble powder (YH) amendments from 2018 to 2020. Compared with control treatment without amendments (CK), soil pH increased by 0.6, 0.5 and 1.5 under SW, FM and YH amendments, respectively, and the soil available Cd concentration decreased by 10.71%, 21.42% and 25.00%, respectively. The Cd concentration in rice grain was less than 0.2 mg kg-1 under YH amendment, which was within the Chinese Contaminant Limit in Food of National Food Safety Standards (GB2762-2022) in the second and third years. The three amendments had different effects on the transformation of Cd fractions in soil, which may be relevant to the specific bacterial communities shaped under different treatments. The proportion of Fe-Mn oxide-bound fraction Cd (OX-Cd) increased by 11% under YH treatment, which may be due to the promotion of Fe(III) and Cd binding by some enriched iron-oxidizing bacteria, such as Lysobacter, uncultured_Pelobacter sp. and Sulfurifusis. Candidatus_Tenderia and Sideroxydans were enriched under SW and FM amendments, respectively, and were likely beneficial for reducing Cd availability in soil through Cd immobilization. These results revealed the significance of the bacterial community in soil Cd immobilization after consecutive application of amendments and highlighted the potential of applying YH amendment to ensure the safe production of rice in Cd-contaminated soil.

4.
Eur Arch Otorhinolaryngol ; 281(3): 1357-1369, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38095707

RESUMO

PURPOSE: This study aims to aggregate and analyze existing clinical evidence to compare the efficacy and adverse effects of unilateral or bilateral botulinum toxin injections for the treatment of adductor spasmodic dysphonia (ADSD). METHODS: Reports from non-randomized controlled trials and cohort studies pertaining to the efficacy and adverse effects of unilateral and bilateral botulinum toxin injections for ADSD were identified and retrieved from four electronic databases from inception to July 2023. The meta-analysis employed fixed or random effects models to assess pooled relative risks (RR), mean differences (MDs), and standard mean differences (SMDs) with their corresponding 95% confidence intervals (CIs). RESULTS: We included two non-randomized controlled trials and seven cohort studies comprising 854 total patients. Meta-analysis of the included studies showed that bilateral botulinum toxin injections associated with a longer duration of vocal improvement (MD = - 2.89, 95% CI - 3.13 to - 2.65, I2 = 0%, P < 0.00001). However, bilateral botulinum toxin injections associated with an increase in adverse effects, including a longer duration of breathy voice quality (SMD = - 0.51, 95% CI - 0.79 to - 0.22, I2 = 35%, P = 0.0005) and a higher occurrence of swallowing difficulties (RR = 0.46, 95% CI 0.35 to 0.11, I2 = 0%, P < 0.00001). CONCLUSION: Bilateral botulinum toxin injections for ADSD showed a longer duration of vocal improvement, a longer breathy voice duration and a higher dysphagia occurrence and duration than unilateral injections.


Assuntos
Toxinas Botulínicas Tipo A , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Disfonia , Distúrbios da Voz , Humanos , Disfonia/tratamento farmacológico , Toxinas Botulínicas Tipo A/efeitos adversos , Injeções , Resultado do Tratamento , Músculos Laríngeos , Injeções Intramusculares
5.
Environ Sci Technol ; 57(9): 3722-3732, 2023 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-36826460

RESUMO

Indoor PM2.5, particulate matter no more than 2.5 µm in aerodynamic equivalent diameter, has very high spatiotemporal variabilities; and exploring the key factors influencing the variabilities is critical for purifying air and protecting human health. Here, we conducted a longer-term field monitoring campaign using low-cost sensors and evaluated inter- and intra-household PM2.5 variations in rural areas where energy or stove stacking is common. Household PM2.5 varied largely across different homes but also within households. Using generalized linear models and dominance analysis, we estimated that outdoor PM2.5 explained 19% of the intrahousehold variation in indoor daily PM2.5, whereas factors like the outdoor temperature and indoor-outdoor temperature difference that was associated with energy use directly or indirectly, explained 26% of the temporal variation. Inter-household variation was lower than intrahousehold variation. The inter-household variation was strongly associated with distinct internal sources, with energy-use-associated factors explaining 35% of the variation. The statistical source apportionment model estimated that solid fuel burning for heating contributed an average of 31%-55% of PM2.5 annually, whereas the contribution of sources originating from the outdoors was ≤10%. By replacing raw biomass or coal with biomass pellets in gasifier burners for heating, indoor PM2.5 could be significantly reduced and indoor temperature substantially increased, providing thermal comforts in addition to improved air quality.


Assuntos
Poluentes Atmosféricos , Poluição do Ar em Ambientes Fechados , Poluição do Ar , Humanos , Poluição do Ar em Ambientes Fechados/análise , Poluentes Atmosféricos/análise , Culinária , Poluição do Ar/análise , Material Particulado/análise , Monitoramento Ambiental
6.
Curr Pain Headache Rep ; 27(8): 239-257, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37329483

RESUMO

PURPOSE OF REVIEW: Over the past few years, there have been many systematic reviews (SRs) and meta-analyses (MAs) used to assess the safety and efficacy of acupuncture in the treatment of migraine. Our aim is to assess the methodological and reporting quality of SRs/MAs and make an evaluation about the available evidence of the safety and efficacy of acupuncture in the treatment of migraine. RECENT FINDINGS: Migraine is one of the most common primary headaches, with various symptoms, threatening human health. Acupuncture is a specific treatment of Traditional Chinese Medicine (TCM), and a validated non-pharmaceutical option as well, widely used in the treatment of migraine, and has gained remarkable therapeutic effect. An overview can evaluate research methods and evidence for SRs/MAs in evidence-based medicine, although there is much relevant research, it's still a hard work to synthesis all the evidence or to make robust conclusions, the variation in the methodological and quality evidence in such SRs/MAs play a significant role. For this overview, we searched six electronic databases from inception until 8 September 2022, and without languages restrictions, the results showed that, acupuncture as a more safety and more convenient therapeutic, and it has been shown to be effective in the treatment of migraine, that is worthy of clinical promotion. However, there are also some limitations because of the low-quality evidence of most of the studies. In conclusion, most included SRs/MAs suggested that acupuncture was more effective than the control group in the treatment of migraine. However, the quality evidence of most of the studies still needs to be improved.


Assuntos
Terapia por Acupuntura , Transtornos de Enxaqueca , Humanos , Revisões Sistemáticas como Assunto , Terapia por Acupuntura/métodos , Transtornos de Enxaqueca/terapia , Cefaleia
7.
Zhongguo Zhong Yao Za Zhi ; 48(8): 2010-2019, 2023 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-37282891

RESUMO

Chronic heart failure(CHF) has become a worldwide public health problem due to its high morbidity and mortality, which seriously endangers people's lifespan and quality of life. In recent years, the treatment strategy of CHF has shifted its emphasis on short-term improvement and transformation of hemodynamics to long-term repair as well as improvement of the biological properties of heart failure. At present, with the continuous deepening of medical research, it has been found that histone acetylation is closely related to the occurrence and development of CHF. Traditional Chinese medicine, via regulating histone acetylation, delays ventricular remodeling, improves energy metabolism, inhibits fibrosis and cardiomyocyte hypertrophy, and intervenes in the development process of heart failure, thus reducing the mortality and the readmission rate and ultimately improving long-term prognosis. Therefore, this study reviewed the mechanism of histone acetylation in the treatment of heart failure as well as its prevention and treatment with traditional Chinese medicine, to provide reference for clinical treatment of CHF.


Assuntos
Insuficiência Cardíaca , Medicina Tradicional Chinesa , Humanos , Histonas/metabolismo , Histonas/uso terapêutico , Acetilação , Qualidade de Vida , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/prevenção & controle
8.
Epilepsia ; 63(5): 1141-1151, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35188675

RESUMO

OBJECTIVES: Refractory epilepsy is a diagnosis of recurrent seizures that requires multiple resources for optimal chronic management. The disease negatively impacts the lives of affected patients and families and poses an economic burden to the health care system. This study compares hospital costs between pediatric patients treated with antiseizure medications (ASMs) only and ASMs plus vagus nerve stimulation (VNS). METHODS: Patients 0-17 years of age who were diagnosed with refractory epilepsy between January 1, 2011 and December 31, 2016, were identified from the Children's Hospital Association's Pediatric Health Information System (PHIS) database. Patients treated with ASMs only or ASMs plus VNS were included in the study and were followed 1 year prior and 2 years after meeting pre-determined criteria for refractory epilepsy. The difference-in-difference (DID) approach along with the two-part model was used to compare the changes in mean hospital costs captured in the PHIS database over time between the two cohorts. RESULTS: One thousand one hundred thirteen patients treated with ASMs plus VNS and 3471 patients treated with ASMs only were included. At a follow-up time of 2 years, for the ASMs-only cohort, the adjusted all-cause and epilepsy-related mean annual total costs increased by $14 715 (95% confidence interval [CI]: $12 375-$17 055) and $18 437 (95% CI: $15 978-$20 896), respectively. By comparison, the adjusted all-cause and epilepsy-related mean annual total costs of the ASMs plus VNS cohort increased by $12 838 (95% CI: $8171-$17 505) and $15 183 (95% CI: $10 253-$20 113), respectively. Compared to ASMs only, ASMs plus VNS generated a cost savings of $3254 for epilepsy-related annual costs per year after the index date. SIGNIFICANCE: Compared to ASMs alone, ASMs plus VNS is a treatment modality associated with lower annual hospital costs over time. Our study shows that VNS is a cost-beneficial treatment for a national cohort of pediatric patients with refractory epilepsy.


Assuntos
Epilepsia Resistente a Medicamentos , Epilepsia , Estimulação do Nervo Vago , Criança , Epilepsia Resistente a Medicamentos/etiologia , Epilepsia Resistente a Medicamentos/terapia , Epilepsia/tratamento farmacológico , Custos Hospitalares , Humanos , Resultado do Tratamento , Nervo Vago , Estimulação do Nervo Vago/efeitos adversos
9.
Environ Sci Technol ; 56(7): 3997-4004, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35262334

RESUMO

Environmentally persistent free radicals (EPFRs) can induce reactive oxygen species, causing adverse health impacts, and residential fuel (biomass and coal) combustion is believed to be an important emission source for EPFRs; however, the residential emission characteristics of EPFRs are rarely studied in the real world. Here, we conducted a field campaign evaluating the presence and characteristics of EPFRs generated from residential biomass and coal burning in rural China. The emission factors (EFs) of EPFRs (with units of 1020 spins·kg-1) in PM2.5 from the combustion of crop residues (3.97 ± 0.47) were significantly higher than those from firewood (2.06 ± 0.19) and coal (2.13 ± 0.33) (p < 0.05). The EPFRs from residential solid fuel combustion were carbon-centered free radicals adjacent to oxygen atoms. The fuel type was a primary factor controlling EPFR discharge, explaining 68% of the variation in EPFR EFs. The emissions from biomass burning had higher EPFRs per particle than those from coal combustion. EPFRs had stronger relationships with carbonaceous components than with other incomplete combustion products. The EPFRs from biomass burning were mostly generated during the pyrolysis of fuels, while the EPFRs generated from coal combustion were mainly associated with refractory organic compounds. This study provides valuable information for evaluating the fates of EPFRs, promoting a better understanding of the health impacts of air pollution.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , China , Carvão Mineral , Radicais Livres/análise , Material Particulado/análise
10.
BMC Musculoskelet Disord ; 23(1): 576, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35705950

RESUMO

BACKGROUND: The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question. METHODS: A systematic review and meta-analysis were conducted to evaluate the benefit of KR surgery alone to enhance physical activity recommendations based on high validity accelerometer. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined. RESULTS: Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m2 body mass index. The results found that the number of steps was significantly improved up to 36.35 and 45.5% after 6-months and 1-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients' health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after 6-months and 1-year follow-ups. Heterogeneity among studies was low to moderate (0-63%). CONCLUSION: Knee replacement surgery is an effective treatment for improving patients' quality of life with severe knee injuries. However, various factors impact the success of surgical and achieving maximum benefit of the surgery. One factor, sedentary time, can be reduced by implementing pre-and post-surgery exercise or physical activity recommendations. Further studies are needed to understand the benefit of surgery with or without rehabilitation assessed using high validity monitors.


Assuntos
Artroplastia do Joelho , Qualidade de Vida , Artroplastia do Joelho/efeitos adversos , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Resultado do Tratamento
11.
J Environ Manage ; 301: 113896, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34731940

RESUMO

To solve the increasingly serious air pollution problem, regional air pollution collaborative governance as an effective way is introduced in this paper. Firstly, this study constructs a game model of regional air pollution collaborative governance, and three classic cost sharing methods are used to allocate the cost of air pollution governance; Then the emission reduction cost of regional cooperative governance is obtained; Finally, the study makes an empirical analysis on the cost sharing of SO2 emission reduction by four local governments of the Yangtze River Delta region in 2017. The results show that: (i) The emission reduction cost of regional cooperative governance is better than that of individual governance, and in 2017 the cost of SO2 cooperative governance in Yangtze River Delta region is reduced by about 1.8% compared with the individual governance; (ii) The Shapley value method is utilized to allocate the benefits of the cooperative SO2 governance of four provinces in the Yangtze River Delta region, which indicates that all local governments can obtain certain profits from this cooperation and the cooperative alliance is stable; (iii) Collaborative governance of regional air pollution can meet the requirements of both collective rationality and individual rationality at the same time.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/prevenção & controle , China , Custo Compartilhado de Seguro , Monitoramento Ambiental , Política Ambiental , Rios
12.
Environ Sci Technol ; 55(15): 10662-10671, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34269570

RESUMO

Black carbon (BC) emissions, derived primarily from incomplete fuel combustion, significantly affect the global and regional climate. Mass absorption efficiency (MAE) is one important parameter in evaluating the climate impacts of BC. Here, values and variabilities in the MAE of BC (MAEBC) from real-world residential emissions were investigated from a field campaign covering 163 burning events for different fuel-stove combinations. MAEBC (average: 12 ± 5 m2/g) was normally distributed and varied greatly by 2 orders of magnitude. Statistically significant differences in MAEBC were found for various fuels, while no significant differences were observed among different stoves. The fuel difference explained 72 ± 7% of the MAEBC variation. MAEBC did not correlate with the modified combustion efficiency but positively correlated with the ratio of organic carbon (OC) to elemental carbon (EC) and negatively correlated with char-EC. The OC/EC ratio was not always lower in coal emissions in comparison to biomass burning emissions. Coal- and biomass-burning emissions had different profiles of carbon fractions. Char-EC, OC, OC/EC, and char-EC/soot-EC can explain 68.7% of the MAEBC variation, providing the potential for predicting MAEBC from the carbon fractions, since they are more commonly measured and available.


Assuntos
Poluentes Atmosféricos , Fuligem , Aerossóis/análise , Poluentes Atmosféricos/análise , Biomassa , Carbono/análise , China , Monitoramento Ambiental , Tamanho da Partícula , Material Particulado/análise , Fuligem/análise
13.
BMC Cancer ; 18(1): 486, 2018 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-29703164

RESUMO

BACKGROUND: Intravenous chemotherapy (IVC) and intra-arterial chemotherapy (IAC) have become the primary treatments for retinoblastoma; however, some controversy remains over which method is more effective. We conducted a meta-analysis to compare the clinical efficacy of IVC and IAC. METHODS: We systematically searched literature published on PubMed, Embase, and Cochrane Library up to May 2017. Studies containing either IAC or IVC that reported on efficacy were included. The effects estimate was expressed as a pooled rate with 95% confidence interval (CI), using a fixed-effects or random-effects model. RESULTS: Twenty-six studies were identified which included 1541 eyes (IAC: 11 trials, 445 eyes; IVC: 16 trials, 1096 eyes). The mean follow-up times were 49.4 months (range, 13.0-105.3 months) for IVC and 21.7 months (range, 8.8-38.7 months) for IAC. For the International Classification of Intraocular Retinoblastoma (ICRB) grading, the overall success rate was higher with IAC than with IVC (75.7% [95%CI: 65.7%-83.6%] vs. 69.5% [95%CI: 51.9%-82.8%], P < 0.001). The globe salvage with IAC was higher than with IVC in group D eyes (79.5% [95%CI: 71.8%-85.4%] vs. 55.1% [95%CI: 45.6%-64.2%], P < 0.001), but not in groups B (95.8% [95%CI: 57.5%-99.7%] vs. 82.5% [95%CI: 58.9%-94.0%], P = 0.163), C (91.3% [95%CI: 65.9%-98.3%] vs. 89.0% [95%CI: 69.0%-96.7%], P = 0.212), and E eyes (51.2% [95%CI: 37.0%-65.2%] vs. 43.2% [95%CI: 18.3%-72.1%], P = 0.578). IAC and IVC were not significantly different regarding the recurrence and metastasis rates (15.0% vs. 15.4%, P = 0.148 and 2.7% vs. 0.6%, P = 0.194, respectively). For Reese-Ellsworth (RE) grading, IAC had a higher globe salvage in groups IV (90.9% [95%CI: 56.0%-98.7%] vs. 66.3% [95%CI: 32.4%-89.0%], P = 0.047) and V eyes (83.2% [95%CI: 72.0%-90.5%] vs. 59.9% [95%CI: 43.1%-74.6%], P = 0.003), but not in group I-III eyes (88.6% [95%CI: 58.3%-97.7%] vs. 88.1% [95%CI: 76.6%-94.4%], P = 0.244). The overall success rate was higher in IAC than in IVC (87.1% [95%CI: 78.1%-92.7%] vs. 77.3% [95%CI: 68.1%-84.4%], P = 0.033). CONCLUSIONS: IAC may be superior to IVC for the treatment of retinoblastoma, with a higher overall success rate and higher globe salvage in group D or groups IV and V eyes.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Retina/tratamento farmacológico , Retinoblastoma/tratamento farmacológico , Administração Intravenosa , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Terapia Combinada , Feminino , Angiofluoresceinografia , Humanos , Infusões Intra-Arteriais , Masculino , Gradação de Tumores , Neoplasias da Retina/diagnóstico , Retinoblastoma/diagnóstico , Resultado do Tratamento
14.
BMC Pregnancy Childbirth ; 17(1): 118, 2017 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-28403832

RESUMO

BACKGROUND: In the United States, preterm birth (PTB) before 37 weeks gestational age occurs at an unacceptably high rate, and large racial disparities persist. To date, medical and public health interventions have achieved limited success in reducing rates of PTB. Innovative changes in healthcare delivery are needed to improve pregnancy outcomes. One such model is CenteringPregnancy group prenatal care (GPNC), in which individual physical assessments are combined with facilitated group education and social support. Most existing studies in the literature on GPNC are observational. Although the results are promising, they are not powered to detect differences in PTB, do not address the racial disparity in PTB, and do not include measures of hypothesized mediators that are theoretically based and validated. The aims of this randomized controlled trial (RCT) are to compare birth outcomes as well as maternal behavioral and psychosocial outcomes by race among pregnant women who participate in GPNC to their counterparts in individual prenatal care (IPNC) and to investigate whether improving women's behavioral and psychosocial outcomes will explain the potential benefits of GPNC on birth outcomes and racial disparities. METHODS/DESIGN: This is a single site RCT study at Greenville Health System in South Carolina. Women are eligible if they are between 14-45 years old and enter prenatal care before 20 6/7 weeks of gestational age. Eligible, consenting women will be randomized 1:1 into GPNC group or IPNC group, stratified by race. Women allocated to GPNC will attend 2-h group prenatal care sessions according to the standard curriculum provided by the Centering Healthcare Institute, with other women due to deliver in the same month. Women allocated to IPNC will attend standard, traditional individual prenatal care according to standard clinical guidelines. Patients in both groups will be followed up until 12 weeks postpartum. DISCUSSION: Findings from this project will provide rigorous scientific evidence on the role of GPNC in reducing the rate of PTB, and specifically in reducing racial disparities in PTB. Establishing the improved effect of GPNC on pregnancy and birth outcomes can change the way healthcare is delivered, particularly with populations with higher rates of PTB. TRIAL REGISTRATION: NCT02640638 Date Registered: 12/20/2015.


Assuntos
Cuidado Pós-Natal/organização & administração , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/organização & administração , Qualidade da Assistência à Saúde , Feminino , Humanos , Período Pós-Parto , Gravidez , Nascimento Prematuro/epidemiologia , South Carolina , Resultado do Tratamento , Estados Unidos
16.
J Int Med Res ; 52(5): 3000605241252238, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38759222

RESUMO

An accessory cavitated uterine mass (ACUM) is a very rare obstructive genital malformation characterized by pelvic pain and severe dysmenorrhea. It is easily mistaken for other obstructive genital malformations in women, such as cystic uterine adenomyosis or cystic degeneration of uterine fibroids. This case report describes a 30-year-old patient with a huge uterine cornual mass. Successful resection was performed by surgical excision, and the lesion was diagnosed as an ACUM. Given the rarity of a giant ACUM, this report also includes a brief review of the relevant literature.


Assuntos
Útero , Humanos , Feminino , Adulto , Útero/anormalidades , Útero/cirurgia , Útero/patologia , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/patologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Resultado do Tratamento , Dismenorreia/etiologia , Dismenorreia/cirurgia , Dismenorreia/diagnóstico
17.
Chest ; 164(2): 418-428, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36963752

RESUMO

BACKGROUND: Previous studies about multicentric Castleman disease-associated pulmonary manifestations have been limited by small cohorts and not following the Castleman Disease Collaborative Network classification criteria of multicentric Castleman disease. The pulmonary manifestations in idiopathic multicentric Castleman disease-not otherwise specified (iMCD-NOS), a distinct clinical phenotype in the classification criteria, have not been reported. RESEARCH QUESTION: Which pulmonary abnormalities in iMCD-NOS are advanced manifestations and which are reversible after effective treatment? STUDY DESIGN AND METHODS: Patients diagnosed with iMCD-NOS with pulmonary involvement were enrolled. The baseline CT scan was evaluated for the presence and anatomic locations of pulmonary abnormalities. Patients were further divided into different subgroups according to baseline CT scan manifestations. Follow-up CT scan was reviewed to assess the changes in pulmonary lesions among patients without and with treatment. RESULTS: Of 162 patients with iMCD-NOS, 58 individuals (35.8%) with pulmonary involvement were identified. Pulmonary manifestations included nodules (96.6%), cysts (65.5%), consolidation (22.4%), interstitial thickening (50.0%-87.9%), and ground-glass opacities (55.2%). Patients (n = 58) were further classified into nodule (n = 15), cyst (n = 33), and consolidation (n = 10) subgroups. Patients in the consolidation (median, 67 months) and cyst (median, 23 months) subgroups had a longer duration of symptoms before the baseline CT examination than those in the nodule subgroup (median, 12 months) (P = .016). During follow-up, the evolution of pulmonary lesions from nodules to cysts was observed in two patients without treatment. After treatment, pulmonary lesions, except for cysts, improved in most patients. Moreover, nodules or cysts progressed into consolidation in two patients. INTERPRETATION: Pulmonary involvement is not rare in iMCD-NOS. Chest CT scan examination is very essential in finding potential pulmonary abnormalities. Pulmonary manifestations follow a unique pattern with evolution from nodules to cysts or consolidation, the latter of which can also form in cystic areas. Timely diagnosis of pulmonary involvement is crucial because of possible reversibility after treatment.


Assuntos
Hiperplasia do Linfonodo Gigante , Cistos , Humanos , Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/diagnóstico , Pulmão/diagnóstico por imagem , Pulmão/patologia , Resultado do Tratamento
18.
Front Pharmacol ; 14: 1024807, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36744244

RESUMO

Background: No consensus exists on the antibiotic treatment course for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Former studies indicate that shorter courses might have the same efficacy with fewer adverse events, which is inconsistent with guidelines and general practice. Existing evidence allows us to conduct a systematic review and Bayesian analysis on this topic. Methods: Four databases were searched from their inception to January 5, 2023. All statistical estimations were performed using R. "Gemtc" was the core package of analysis. CINeMA was used to assess the grade of confidence of the results. Results: Fourteen studies were included in the Bayesian meta-analysis. No difference in the clinical success rate of antibiotic treatment was observed from a super short course (1-3 days) to a long course (≥10 days). Considering the adverse events, the short course (4-6 days) might be the safest. The majority of results were of high or moderate confidence grade. Conclusion: Short course might cause the fewest adverse events. The clinical efficacy of antibiotics might not depend on the course length. Undeniably, more systematic explorations are warranted to investigate the clinical application of a shorter course of antibiotic treatment.

19.
Food Chem X ; 19: 100752, 2023 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-37384144

RESUMO

The n6/n3 ratios improved meat quality of terrestrial animals, but alpha-linolenic acid/linoleic acid (ALA/LNA) ratios were rarely studied in aquatic animals. In this study, sub-adult grass carp (Ctenopharyngodon idella) were fed diets fed diets containing six varying ALA/LNA ratios (0.03, 0.47, 0.92, 1.33, 1.69, and 2.15) for 9 weeks and the total value of n3 + n6 (1.98) was kept constant for all six treatments. The results indicated optimal ALA/LNA ratio improved growth performance, changed fatty acid composition in grass carp muscle, and promoted glucose metabolism. Additionally, optimal ALA/LNA ratio improved chemical attributes by increasing crude protein and lipid contents, and technological attributes by increasing pH24h value and shear force in grass carp muscle. The signaling pathways related to fatty acid metabolism and glucose metabolism (LXRα/SREBP-1, PPARα, PPARγ, AMPK) might be responsible for these changes. Dietary optimal ALA/LNA ratio based on PWG, UFA and glucose contents was 1.03, 0.88 and 0.92, respectively.

20.
Am J Chin Med ; 51(2): 391-405, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36655685

RESUMO

To compare the long-term efficacy and safety of glycyrrhizic acid preparation and hormone treatment in patients with autoimmune hepatitis, we enrolled 377 patients in a study that lasted from January 2009 to January 2020. After performing propensity score matching, we included 58 patients in the hormone group and 58 in the glycyrrhizic acid preparation group in statistical analysis. We then compared the ratio of sustained biochemical responses at 48 weeks after treatment. Adverse events, including some incidence of decompensated liver cirrhosis and liver cancer, were evaluated. The results showed that a total of 61.8% of treated patients achieved complete biochemical remission. The cumulative biochemical remission rate in the hormone group and glycyrrhizic acid preparation group showed no significant difference (62.3% vs. 60.7%, [Formula: see text], [Formula: see text]). At the end of follow-up, the total bile acid in the hormone group was significantly higher than that in the glycyrrhizic acid preparation group (8.9[Formula: see text][Formula: see text]mol/L vs. 5.6[Formula: see text][Formula: see text]mol/L, [Formula: see text], [Formula: see text]). The incidence of adverse reactions in the hormone group was significantly higher than that in the glycyrrhizic acid preparation group (31.03% vs. 15.52%, [Formula: see text], [Formula: see text]). In conclusion, compared with the hormone treatment, glycyrrhizic acid preparation might be a safe and effective treatment for autoimmune hepatitis.


Assuntos
Ácido Glicirrízico , Hepatite Autoimune , Humanos , Ácido Glicirrízico/efeitos adversos , Hepatite Autoimune/tratamento farmacológico , Resultado do Tratamento
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