Assuntos
Hormônio Antimülleriano/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Regulação para Baixo , Reserva Ovariana , Adulto , Biomarcadores/sangue , Estudos de Coortes , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/tratamento farmacológico , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/prevenção & controle , Hipoglicemia/prevenção & controle , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/uso terapêutico , Insulina/efeitos adversos , Insulina/uso terapêutico , Estudos Longitudinais , Reserva Ovariana/efeitos dos fármacosRESUMO
CONTEXT: The role of endogenous androgens and SHBG in the development of cardiovascular disease in young adult women is unclear. OBJECTIVE: Our objective was to study the prospective association of serum androgens and SHBG with subclinical coronary and carotid disease among young to middle-aged women. DESIGN AND SETTING: This was an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based multicenter cohort study with 20 yr of follow-up. PARTICIPANTS: Participants included 1629 women with measurements of serum testosterone and SHBG from yr 2, 10, or 16 and subclinical disease assessment at yr 20 (ages 37-52 yr). MAIN OUTCOME MEASURES: Coronary artery calcified plaques (CAC) and carotid artery intima-media thickness (IMT) were assessed at yr 20. The IMT measure incorporated the common carotid arteries, bifurcations, and internal carotid arteries. RESULTS: SHBG (mean of yr 2, 10, and 16) was inversely associated with the presence of CAC (multivariable adjusted odds ratio for women with SHBG levels above the median = 0.59; 95% confidence interval = 0.40-0.87; P = 0.008). SHBG was also inversely associated with the highest quartile of carotid-IMT (odds ratio for women with SHBG levels in the highest quartile = 0.56; 95% confidence interval = 0.37-0.84; P for linear trend across quartiles = 0.005). No associations were observed for total or free testosterone with either CAC or IMT. CONCLUSION: SHBG levels were inversely associated with subclinical cardiovascular disease in young to middle-aged women. The extent to which low SHBG is a risk marker or has its own independent effects on atherosclerosis is yet to be determined.
Assuntos
Androgênios/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Globulina de Ligação a Hormônio Sexual/análise , Adolescente , Adulto , Calcinose/sangue , Calcinose/patologia , Estudos de Casos e Controles , Estudos de Coortes , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto JovemRESUMO
A dissociation between plasma human immunodeficiency virus (HIV) RNA levels and CD4(+) cell counts has been reported in patients experiencing viral relapse while receiving antiretroviral therapy. This study compared patients with stable CD4(+) lymphocytes during viral relapse while receiving treatment with patients who had sustained virus suppression. Plasma HIV RNA levels, lymphocyte immunophenotyping, and T cell receptor excision circle (TREC) levels were measured. Naive CD4(+) lymphocyte phenotype and TREC levels were not significantly different in patients with virus suppression or in those who had relapsed. However, CD8(+) lymphocyte activation, including the number and percentage of activated cells and CD38 antibody-binding capacity, was significantly elevated during viral relapse, compared with that in suppressed patients. By multivariable regression analyses, CD8(+) and CD4(+) lymphocyte activation were associated significantly with increasing plasma HIV RNA levels.
Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Feminino , Citometria de Fluxo , Rearranjo Gênico do Linfócito T , HIV/genética , HIV/isolamento & purificação , Infecções por HIV/virologia , Humanos , Imunofenotipagem , Ativação Linfocitária , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Recidiva , Indução de Remissão , Subpopulações de Linfócitos T/classificaçãoRESUMO
Clinicians and researchers use the medical literature in a variety of ways. The overwhelming volume of clinical journals necessitates tools to help healthcare professionals identify and employ relevant information. The structured abstract can facilitate browsing articles, but may not contain appropriate types of information or sufficient detail for all uses of the medical literature. We have created customized views of journal articles that provide information for specific research or clinical tasks, such as evaluating the scientific validity of a clinical trial. These summaries are called extracts because we literally extract information of a particular type from the full text of an article. We employ a context-based indexing scheme, previously designed for improving precision in literature searches, to automatically generate extracts from clinical research articles. In this paper, we present an evaluation of the content and utility of these task-specific extracts. Our results provide preliminary evidence that such extracts contain information that is relevant to clinical and research tasks and may facilitate understanding and use of the medical literature.