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1.
Gene ; 807: 145951, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34500051

RESUMO

AIMS: The purpose of the present study was to analyze the role of selected polymorphisms of SIRT3 and SIRT5 in gastric carcinogenesis. METHODS: For this study, 500 blood samples of GC patients and 500 blood samples of healthy individuals were collected. Six selected polymorphisms of mitochondrial sirtuins were analyzed for analysis using Tetra-Arms PCR followed by DNA sequencing. RESULTS: Mutant allele frequencies of selected polymorphisms [rs3782116 (p < 0.0001), rs6598072 (p < 0.0001) and rs11246020 (p < 0.0001), rs938222 (p = 0.0136), rs3757261 (p = 0.0005) and rs2841511 (p = 0.0015)] were observed significant higher in GC patients vs controls. Haplotype analysis was performed, and 51 haplotypes were generated using haploview software. Among these haplotypes, eleven haplotypes were found associated with a significantly increased risk of GC. Furthermore, SNP-SNP interaction showed a significant correlation between studied SNPs and GC risk. Kaplan Meier analysis showed that mutant allele frequencies of selected polymorphisms are linked with a significant decrease in survival of GC patients CONCLUSIONS: It can be concluded that selected SNPs may be associated with enhanced risk of GC and hence can be potential prognostic markers for prognosis and predisposition of GC.


Assuntos
Sirtuína 3/genética , Sirtuínas/genética , Neoplasias Gástricas/genética , Alelos , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/epidemiologia , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Variação Genética/genética , Genótipo , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Mitocôndrias/genética , Polimorfismo de Nucleotídeo Único/genética , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Sirtuína 3/sangue , Sirtuína 3/metabolismo , Sirtuínas/sangue , Sirtuínas/metabolismo
2.
Gene ; 807: 145933, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34464678

RESUMO

BACKGROUND: Cervical-cancer is among the most commonly diagnosed cancers in women, and infection with human papillomavirus (HPV) is associated with an increased risk of cervical cancer and altered serum concentrations of inflammatory cytokines. We have explored the association between a genetic variation in the Interleukin-10 (IL-10) gene (rs1800896) and cervical cancer risk and its relationship with tissue Interferon gamma (IFN-γ), Transforming growth factor beta (TGF-ß), Tumor necrosis factor alpha (TNF-α) concentrations in women with cervical cancer. METHODS: A total of 315 women with, or without cervical cancer, were recruited into the study. DNA was extracted from cervical cells, and genotyping was undertaken using Taq-man real-time PCR. The genotype frequency and allele distribution were analyzed together with their association with pathological data. The association of the rs1800896 gene variation with tissue levels of the inflammatory cytokines was also investigated. RESULTS: Our data showed a significant association between the A allele of the rs1800896 gene variant and the presence of cervical cancer. In particular, patients with AG/AA genotypes had an increased risk of cervical cancer with an odds ratio of 1.929 (95% confidence interval [CI]: 0.879-4.23, P < 0.001) in a recessive model, compared with the GG genotype. Also, the tissue concentrations of IFN-γ, TGF-ß, and TNF-α in cervical tissues were significantly higher in women with cervical cancer (P < 0.001) and were associated with the AA genotype. CONCLUSION: We have found an association between the polymorphism rs1800896 in the IL-10 gene and an increased risk of cervical cancer as well as a higher level of tissue inflammatory cytokines. Further investigations are necessary on the value of emerging biomarkers for the risk stratification for the management of cervical cancer patients.


Assuntos
Interleucina-10/genética , Neoplasias do Colo do Útero/genética , Adulto , Alelos , Alphapapillomavirus/genética , Alphapapillomavirus/patogenicidade , Citocinas , Feminino , Frequência do Gene/genética , Genótipo , Humanos , Inflamação , Interferon gama , Interleucina-10/metabolismo , Pessoa de Meia-Idade , Razão de Chances , Papillomaviridae/genética , Papillomaviridae/patogenicidade , Polimorfismo de Nucleotídeo Único/genética , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Fator de Crescimento Transformador beta/metabolismo , Fator de Necrose Tumoral alfa/metabolismo
3.
J Environ Manage ; 301: 113801, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34600422

RESUMO

Indigenous communities are often on the front-lines of climate change, and for tribes such as the Pointe-au-Chien Indian Tribe (PACIT) that make their homes and livelihoods in the dynamic landscapes of Coastal Louisiana (USA), sea-level rise, subsidence, and land loss are very real reminders of why they must continue to hone their adaptive capacity that has evolved over many generations and continues to evolve as the pace of change quickens. PACIT members have an inherited wisdom about their surrounding environment and continue to build on that body of observational knowledge that is passed from generation to generation to sustain themselves in this dynamic landscape. This knowledge is woven through their culture and is sometimes referred to as traditional ecological knowledge (TEK). The PACIT and other Indigenous communities around the world are using creative strategies to adapt to the impacts of climate change that include partnering with researchers to combine their TEK with science in approaches to enhance strategies dealing with climate change impacts, mitigation, and adaptation. Tribes and other Indigenous communities often have a strong connection to place that helps to inspire innovative ideas to promote greater sustainability of vulnerable ecosystems and the communities that depend on them, but not the institutional support to implement them. Overcoming this barrier requires a better understanding of their perception of the issues and what they prioritize in sustaining their cultures and the ecosystems on which they depend. Better inclusion of their knowledge into applied research is necessary to support these communities in their efforts to make sure their knowledge is recognized, understood, and valued in environmental management applications. The primary goal for this study was to develop a decision-support tool that aids the PACIT in assessing local ecological change and associated risks to the Tribe's resilience. Using remote sensing datasets and geographic information systems (GIS) processes to represent aspects of the Tribe's TEK to achieve this goal, we developed methods for producing interactive maps that reflect local perceptions of landscape features within the Tribe's ecosystem-dependent livelihood base that contribute most to the community's physical vulnerability to coastal hazards. This case study is offered to consider how Indigenous communities like the PACIT are shaping their own coastal hazards mitigation planning efforts in line with their unique needs, cultural practices, and values. The results of this study can provide relevant insight to applied environmental scientists and others working with Indigenous communities that are facing similar circumstances around the world.


Assuntos
Mudança Climática , Ecossistema , Aclimatação , Nativos Estadunidenses , Humanos , Fatores de Risco
4.
Handb Exp Pharmacol ; 268: 359-366, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34159483

RESUMO

Air pollution is worldwide a major public health problem and affects large part of the population. Air pollution does not only harm the respiratory tract system but also the other organs of the body. The damage may result directly from the pollutants toxicity, because the pollutant enters into the organs through a direct route or indirectly through systemic inflammation. There is accumulating evidence suggesting that ambient air pollution not only affects the human lung and the cardiovascular system, but also has negative effects on allergic diseases. In this regard, it has been shown that exposure increases the risk of allergies and eczema in children and adults. However, the mechanism how ambient air pollution affects the skin is not well investigated up to now and needs further research.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Hipersensibilidade , Adulto , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Criança , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/etiologia , Pulmão , Fatores de Risco
5.
Handb Exp Pharmacol ; 268: 21-27, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34165634

RESUMO

The prevalences of allergic diseases, asthma, atopic dermatitis, allergic rhinitis and lately food allergy have been increasing over the last decades. It has been suggested that the prevalence of allergic diseases has reached a plateau in high income countries, while it is still on the rise in low and middle income countries. Generally, allergic diseases more often set on in childhood than in adulthood and affected children contribute more to the rise in allergic disease prevalence than affected adults. Epidemiological evidence suggests that not all atopic dermatitis and asthma cases are attributable to atopic sensitization. Indeed, mainly genetic association studies have prompted the unravelling of barrier dysfunction as a mainstay in the patho-mechanisms leading to atopic dermatitis and to asthma with atopic sensitization secondary to this dysfunction. Epidemiological research on risk and protective factors for allergic disease, acting against the background of genetic susceptibility, has produced an enormous body of evidence. Prominent observations are the 'sibling effect' and the 'farm effect' which gave rise to the 'hygiene hypothesis' and later the 'biodiversity hypothesis'. Future epidemiological research is required to evaluate and refine these hypotheses in light of the paradigm shift from atopic sensitization to barrier dysfunction with ever increasing options for environmental characterization, currently, e.g., 'omics'-techniques in microbiology and metabolism, and with ever increasing options for phenotyping of allergic techniques, including, e.g., high-resolution time series of symptoms using, e.g., sensing technologies.


Assuntos
Asma , Dermatite Atópica , Hipersensibilidade Alimentar , Adulto , Asma/epidemiologia , Asma/etiologia , Criança , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Humanos , Prevalência , Fatores de Risco
6.
J Intensive Care Med ; 37(1): 12-20, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34515571

RESUMO

Background: Since the beginning of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, pneumomediastinum has been reported in patients with COVID-19 pneumonia and acute respiratory distress syndrome. It has been suggested that pneumomediastinum may portend a worse outcome in such patients although no investigation has established this association definitively. Research Question: We hypothesized that the finding of pneumomediastinum in the setting of COVID-19 disease may be associated with a worse clinical outcome. The purpose of this study was to determine if the presence of pneumomediastinum was predictive of increased mortality in patients with COVID-19. Study Design and Methods: A retrospective case-control study utilizing clinical data and imaging for COVID-19 patients seen at our institution from 3/7/2020 to 5/20/2020 was performed. 87 COVID-19 positive patients with pneumomediastinum were compared to 87 COVID-19 positive patients without pneumomediastinum and to a historical group of patients with pneumomediastinum during the same time frame in 2019. Results: The incidence of pneumomediastinum was increased more than 6-fold during the COVID-19 pandemic compared to 2019 (P = <.001). 1.5% of all COVID-19 patients and 11% of mechanically ventilated COVID-19 patients at our institution developed pneumomediastinum. Patients who developed pneumomediastinum had a significantly higher PEEP and lower P/F ratio than those who did not (P = .002 and .033, respectively). Pneumomediastinum was not found to be associated with increased mortality (P = .16, confidence interval [CI]: 0.89-2.09, 1.37). The presence of concurrent pneumothorax at the time of pneumomediastinum diagnosis was associated with increased mortality (P = .013 CI: 1.15-3.17, 1.91). Conclusion: Pneumomediastinum is not independently associated with a worse clinical prognosis in COVID-19 positive patients. The presence of concurrent pneumothorax was associated with increased mortality.


Assuntos
COVID-19 , Enfisema Mediastínico , Estudos de Casos e Controles , Humanos , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/epidemiologia , Enfisema Mediastínico/etiologia , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
7.
J Med Virol ; 94(1): 99-109, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570905

RESUMO

A severe pandemic of Coronavirus Disease (COVID-19) has been sweeping the globe since 2019, and this time, it did not stop, with frequent mutations transforming into virulent strains, for instance, B.1.1.7, B.1.351, and B.1.427. In recent months, a fungal infection, mucormycosis has emerged with more fatal responses and significantly increased mortality rate. To measure the severity and potential alternative approaches against black fungus coinfection in COVID-19 patients, PubMed, Google Scholar, World Health Organization (WHO) newsletters, and other online resources, based on the cases reported and retrospective observational analysis were searched from the years 2015-2021. The studies reporting mucormycosis with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) coinfection and/or demonstrating potential risk factors, such as a history of diabetes mellitus or suppressed immune system were included, and reports published in non-English language were excluded. More than 20 case reports and observational studies on black fungus coinfection in COVID-19 patients were eligible for inclusion. The results indicated that diabetes mellitus, hyperglycemic, and immunocompromised COVID-19 patients with mucormycosis were at a higher risk. We found that it was prudent to assess the potential risk factors and severity of invasive mycosis via standardized diagnostic and clinical settings. Large-scale studies need to be conducted to identify early biomarkers and optimization of diagnostic methods has to be established per population and geographical variation. This will not only help clinicians around the world to detect the coinfection in time but also will prepare them for future outbreaks of other potential pandemics.


Assuntos
COVID-19/epidemiologia , Coinfecção/epidemiologia , Mucormicose/epidemiologia , Mucormicose/mortalidade , SARS-CoV-2/isolamento & purificação , Diabetes Mellitus/patologia , Humanos , Hiperglicemia/patologia , Hospedeiro Imunocomprometido/fisiologia , Mucorales/crescimento & desenvolvimento , Mucorales/isolamento & purificação , Mucormicose/patologia , Estudos Retrospectivos , Fatores de Risco
8.
Gene ; 807: 145948, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34481002

RESUMO

BACKGROUNDS: To investigate associations of genetic and environmental factors with coronary artery disease (CAD), we collected medical reports, lifestyle details, and blood samples of 2113 individuals, and then used the polymerase chain reaction (PCR)-ligase detection reaction (LDR) to genotype the targeted 102 SNPs. METHODS: We adopted elastic net algorithm to build an association model that considered simultaneously genetic and lifestyle/clinical factors associated with CAD in Chinese Han population. RESULTS: In this study, we developed an all covariates-based model to explain the risk of CAD, which incorporated 8 lifestyle/clinical factors and a gene-score variable calculated from 3 significant SNPs (rs671, rs6751537 and rs11641677), attaining an area under the curve (AUC) value of 0.71. It was found that, in terms of genetic variants, the AA genotype of rs671 in the additive (adjusted odds ratio (OR) = 2.51, p = 0.008) and recessive (adjusted OR = 2.12, p = 0.021) models, the GG genotype of rs6751537 in the additive (adjusted OR = 3.36, p = 0.001) and recessive (adjusted OR = 3.47, p = 0.001) models were associated with increased risk of CAD, while GG genotype of rs11641677 in additive model (adjusted OR = 0.39, p = 0.044) was associated with decreased risk of CAD. In terms of lifestyle/clinical factors, the history of hypertension (unadjusted OR = 2.37, p < 0.001) and dyslipidemia (unadjusted OR = 1.82, p = 0.007), age (unadjusted OR = 1.07, p < 0.001) and waist circumference (unadjusted OR = 1.02, p = 0.05) would significantly increase the risk of CAD, while height (unadjusted OR = 0.97, p = 0.006) and regular intake of chicken (unadjusted OR = 0.78, p = 0.008) reduced the risk of CAD. A significantinteraction was foundbetween rs671 and dyslipidemia (the relative excess risk due to interaction (RERI) = 3.36, p = 0.05). CONCLUSION: In this study, we constructed an association model and identified a set of SNPs and lifestyle/clinical risk factors of CAD in Chinese Han population. By considering both genetic and non-genetic risk factors, the built model may provide implications for CAD pathogenesis and clues for screening tool development in Chinese Han population.


Assuntos
Adenilil Ciclases/genética , Aldeído-Desidrogenase Mitocondrial/genética , Doença da Artéria Coronariana/genética , beta-Caroteno 15,15'-Mono-Oxigenase/genética , Adenilil Ciclases/metabolismo , Idoso , Aldeído-Desidrogenase Mitocondrial/metabolismo , Algoritmos , Área Sob a Curva , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/epidemiologia , Doença da Artéria Coronariana/fisiopatologia , Feminino , Predisposição Genética para Doença , Humanos , Hipertensão/genética , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polimorfismo Genético/genética , Fatores de Risco , Circunferência da Cintura/genética , beta-Caroteno 15,15'-Mono-Oxigenase/metabolismo
9.
Gene ; 807: 145950, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34481003

RESUMO

This population-based longitudinal study is the first investigation that assesses the association of common MC4R SNPs with the obesity-related parameters over time and determines the effect of risk alleles during the three adulthood life periods (early, middle, and late) in a large Iranian cohort, a population with a unique genetic make-up that has been understudied and relatively unexplored. We obtained the genotype of 5370 unrelated adults who participated in the ongoing Tehran Cardiometabolic Genetic Study (TCGS) cohort project for the common MC4R SNPs. Linear regression and linear mixed model analyses were performed to examine the effect of MC4R polymorphisms on maximum BMI and other obesity-related factors over time. We recognized that several SNPs associated with the maximum BMI and the increased BMI, waist circumference, and waist-hip ratio across Iranian adults over a lifetime. Interestingly, we found that rs9954571-A has a yet unreported protective role against obesity-related factors, including BMI, waist circumference, waist-hip ratio, and triglyceride level. Additionally, a survey of the impact of the MC4R risk score throughout the adulthood life periods indicated that the MC4R risk score is influenced both the elevated BMI and waist circumference only during the early adulthood period. Our findings can expand our knowledge about the MC4R genetic variant's contributions to adulthood obesity and highlight the importance of evaluating the genetic components affecting obesity over a lifetime, which could be considered for obesity clinical screening and treatment.


Assuntos
Obesidade/genética , Receptor Tipo 4 de Melanocortina/genética , Adulto , Alelos , Índice de Massa Corporal , Estudos de Coortes , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Genótipo , Humanos , Irã (Geográfico)/epidemiologia , Estudos Longitudinais , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Obesidade/metabolismo , Fenótipo , Polimorfismo de Nucleotídeo Único/genética , Receptor Tipo 4 de Melanocortina/metabolismo , Fatores de Risco , Circunferência da Cintura/genética , Relação Cintura-Quadril/métodos
10.
Urol Clin North Am ; 49(1): 129-152, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776047

RESUMO

Organ sparing approaches for the management of localized prostate cancer were developed in part to overcome the morbidity associated with standard, whole gland treatment options. The first description of focal therapy was now over two decades ago and since that time much has changed. The evolution of patient selection, the approach to ablation, and surveillance after focal therapy have mirrored the technologic advancements in the field as well as the improved understanding of the biology of low-grade, low-risk prostate cancer. This review presents the evidence for the basis of focal therapy from the past to the present and future endeavors.


Assuntos
Técnicas de Ablação/métodos , Seleção de Pacientes , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Técnicas de Ablação/tendências , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Imagem Multimodal , Imageamento por Ressonância Magnética Multiparamétrica , Gradação de Tumores , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Fatores de Risco , Ultrassonografia
11.
Oncol Rep ; 47(1)2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34779496

RESUMO

The devastating complications of coronavirus disease 2019 (COVID­19) result from the dysfunctional immune response of an individual following the initial severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS­CoV­2 exploits the dysfunctional immune system to trigger a chain of events, ultimately leading to COVID­19. The authors have previously identified a number of contributing factors (CFs) common to myriad chronic diseases. Based on these observations, it was hypothesized that there may be a significant overlap between CFs associated with COVID­19 and gastrointestinal cancer (GIC). Thus, in the present study, a streamlined dot­product approach was used initially to identify potential CFs that affect COVID­19 and GIC directly (i.e., the simultaneous occurrence of CFs and disease in the same article). The nascent character of the COVID­19 core literature (~1­year­old) did not allow sufficient time for the direct effects of numerous CFs on COVID­19 to emerge from laboratory experiments and epidemiological studies. Therefore, a literature­related discovery approach was used to augment the COVID­19 core literature­based 'direct impact' CFs with discovery­based 'indirect impact' CFs [CFs were identified in the non­COVID­19 biomedical literature that had the same biomarker impact pattern (e.g., hyperinflammation, hypercoagulation, hypoxia, etc.) as was shown in the COVID­19 literature]. Approximately 2,250 candidate direct impact CFs in common between GIC and COVID­19 were identified, albeit some being variants of the same concept. As commonality proof of concept, 75 potential CFs that appeared promising were selected, and 63 overlapping COVID­19/GIC potential/candidate CFs were validated with biological plausibility. In total, 42 of the 63 were overlapping direct impact COVID­19/GIC CFs, and the remaining 21 were candidate GIC CFs that overlapped with indirect impact COVID­19 CFs. On the whole, the present study demonstrates that COVID­19 and GIC share a number of common risk/CFs, including behaviors and toxic exposures, that impair immune function. A key component of immune system health is the removal of those factors that contribute to immune system dysfunction in the first place. This requires a paradigm shift from traditional Western medicine, which often focuses on treatment, rather than prevention.


Assuntos
COVID-19/epidemiologia , Neoplasias Gastrointestinais/epidemiologia , COVID-19/etiologia , COVID-19/imunologia , Neoplasias Gastrointestinais/etiologia , Neoplasias Gastrointestinais/imunologia , Humanos , Fatores de Risco , SARS-CoV-2/fisiologia , Fatores Socioeconômicos
12.
Emerg Med Clin North Am ; 40(1): 1-17, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34782082

RESUMO

Allergic reactions and anaphylaxis occur on a severity continuum from mild and self-limited to potentially life-threatening or fatal reactions. Anaphylaxis is typically a multiorgan phenomenon involving a broad range of effector cells and mediators. Emergency department visits for anaphylaxis are increasing, especially among children. There is a broad differential diagnosis for anaphylaxis, and the diagnosis of anaphylaxis can be aided by the use of the National Institutes of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network clinical diagnostic criteria. Risk factors for severe anaphylaxis include older age, delayed epinephrine administration, and cardiopulmonary comorbidities.


Assuntos
Anafilaxia/fisiopatologia , Hipersensibilidade/fisiopatologia , Anafilaxia/diagnóstico , Epinefrina/uso terapêutico , Humanos , Hipersensibilidade/diagnóstico , Fatores de Risco
13.
Emerg Med Clin North Am ; 40(1): 19-32, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34782088

RESUMO

Anaphylaxis is a potentially life-threatening, multisystem allergic reaction that can cause airway, breathing, or circulatory compromise. Intramuscular epinephrine is the immediate treatment of all patients. Intravenous epinephrine should be used in patients in shock, either as a bolus or infusion, along with fluid resuscitation. Airway obstruction must be recognized, and early intubation may be necessary. For shock that is refractory to epinephrine, additional vasopressors may be needed. Disposition depends on patient presentation and response to treatment. Mandatory observation periods are not necessary, because biphasic reactions are difficult to predict and may occur outside of typical observation periods.


Assuntos
Anafilaxia/terapia , Manuseio das Vias Aéreas/métodos , Anafilaxia/classificação , Anafilaxia/fisiopatologia , Medicina de Emergência/métodos , Epinefrina/administração & dosagem , Epinefrina/uso terapêutico , Hidratação , Humanos , Fatores de Risco , Vasoconstritores/administração & dosagem , Vasoconstritores/uso terapêutico
14.
Emerg Med Clin North Am ; 40(1): 33-37, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34782089

RESUMO

After treating the acute anaphylactic reaction, the clinician's next task is to prevent a recurrence. The patient should be observed in the ED. How long this observation period should last depends on their clinical course, risk factors, and social support. All patients should be discharged with a prescription for 2 epinephrine autoinjectors and counseled on appropriate use. The patient should also receive education on the signs and symptoms of anaphylaxis and avoiding triggers. The patient should follow-up with an allergy specialist who can confirm triggers and provide immunotherapy as indicated.


Assuntos
Anafilaxia/terapia , Alta do Paciente , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/tendências , Epinefrina/administração & dosagem , Epinefrina/uso terapêutico , Humanos , Fatores de Risco
15.
Appl Ergon ; 98: 103574, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34547578

RESUMO

To determine the applications of machine learning (ML) techniques used for the primary prevention of work-related musculoskeletal disorders (WMSDs), a scoping review was conducted using seven literature databases. Of the 4,639 initial results, 130 primary research studies were deemed relevant for inclusion. Studies were reviewed and classified as a contribution to one of six steps within the primary WMSD prevention research framework by van der Beek et al. (2017). ML techniques provided the greatest contributions to the development of interventions (48 studies), followed by risk factor identification (33 studies), underlying mechanisms (29 studies), incidence of WMSDs (14 studies), evaluation of interventions (6 studies), and implementation of effective interventions (0 studies). Nearly a quarter (23.8%) of all included studies were published in 2020. These findings provide insight into the breadth of ML techniques used for primary WMSD prevention and can help identify areas for future research and development.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Humanos , Incidência , Aprendizado de Máquina , Doenças Musculoesqueléticas/prevenção & controle , Doenças Profissionais/prevenção & controle , Prevenção Primária , Fatores de Risco
16.
Sci Total Environ ; 802: 149839, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34455276

RESUMO

Elevated human exposure to metals and metalloids (metal(loid)s) may lead to acute sickness and pose a severe threat to human health. The human body is exposed to metal(loid)s principally through food, water, supplements, and (occasionally) air. There are inherent background levels of many metal(loid)s in regional soils as a consequence of geological sources. Baseline levels coupled with anthropogenic sources such as regional application of biosolids may lead to increased levels of certain metal(loid)s in soil, leading to potential transfer to water sources and potential uptake by plants. The latter could potentially transfer into the feed-to-food chain, viz. grazing animals, and bio-transfer to food products resulting in human exposure. This study addresses health concerns due to excessive intake of metal(loid)s by conducting a traditional review of peer-reviewed journals between 2015 and 2019, secondary references and relevant websites. The review identified the most researched metal(loid)s as Cu, Zn, Pb, Cd, Ni, Cr, As, Hg, Mn, Fe in the environment. The potential uptake of metal(loid)s by plants (phytoavailability) is a function of the mobility/retainability of metal(loid)s in the soil, influenced by soil geochemistry. The most critical parameters (including soil pH, soil organic matter, clay content, cation exchange capacity, the capability of decomposition of organic matter by microbes, redox potential, ionic strength) influencing metal(loid)s in soil are reviewed and used as a foundation to build a framework model for ranking metal(loid)s of concern. A robust quantitative risk assessment model is recommended for evaluating risk from individual metal(loid)s based on health-based indices (Daily Dietary Index (DDI), No Observed Adverse Effect Level (NOAEL), and Lowest Observed Adverse Effect Level (LOAEL)). This research proposes a risk assessment framework for potentially harmful metal(loid)s in the environment and highlights where regulation and intervention may be required.


Assuntos
Metais Pesados , Poluentes do Solo , Monitoramento Ambiental , Humanos , Irlanda , Metais Pesados/análise , Fatores de Risco , Poluentes do Solo/análise
17.
J Affect Disord ; 296: 577-586, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34606803

RESUMO

BACKGROUND: The COVID-19 pandemic gave rise to concerns about its potential impact on the mental health of pregnant and postpartum women as the general postpartum depression rates increased. METHODS: Three postpartum questionnaires (Edinburgh Postnatal Depression Scale - EPDS; Anxiety and Depression Scale - HAD; and a demographic questionnaire about isolation and information acquisition) were used to evaluate the mental health of women with and without COVID-19 and determine the factors associated with depressive symptoms (EPDS ≥ 12). RESULTS: Data from 184 participants with a mean of 56 postpartum days were analyzed. The rate of symptoms compatible with postpartum depression (PPD) was 38.8%, with a 14.3% positive response to item 10 on the EPDS (suicidal ideation - SI). Listening to the news about COVID-19 averaged 4.45 hours a day. Factors related to PPD were concerns about lack of hospital beds (OR = 2.45), absence of a partner (OR = 2.70), and anxiety symptoms (OR = 10). Factors related to SI were anxiety symptoms (OR = 1.56) and friends as a source of information (OR = 5.60). LIMITATIONS: Considering the rapidly changing epidemiological conditions of this pandemic, this study may only be the photograph of an instant. CONCLUSIONS: Higher rates of PPD in the Brazilian population are related not only to anxiety but also to an inadequate family environment, kind of information acquisition and concerns about the lack of hospital beds.


Assuntos
COVID-19 , Depressão Pós-Parto , Depressão , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Pandemias , Período Pós-Parto , Gravidez , Escalas de Graduação Psiquiátrica , Fatores de Risco , SARS-CoV-2
18.
J Infect Chemother ; 28(1): 54-60, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34649759

RESUMO

INTRODUCTION: Invasive Aspergillus infection (IA) in lung transplantation can result in poor outcomes. Itraconazole has been shown to be effective for fungal prophylaxis in lung transplant recipients. However, IA remains a major cause of death after lung transplantation. Therefore, we aimed to clarify the risk factors for IA on itraconazole prophylaxis. METHODS: We examined 120 recipients to uncover their IA epidemiology, clinical characteristics, and outcomes. In addition, a case-control study was performed to identify risk factors of IA. RESULTS: Of the 120 patients, 12 developed IA under itraconazole prophylaxis. The patient demographics and clinical characteristics were compared among the following two groups: IA group, 12 patients, and control group, 108 patients. Significant differences were observed in age (p = 0.004), history of interstitial pneumonia (p = 0.032), and CMV infection (p < 0.001) between the groups. Before the onset of IA, 92% (11/12) of the patients received itraconazole with trough concentrations above the therapeutic range. IA developed at 272.9 ± 114.1 days after lung transplantation. Of the 12 patients who developed IA, 66.7% (8/12) had early cessation of cytomegalovirus (CMV) prophylaxis due to toxicity of valganciclovir, as follows: leukocytopenia in 4 patients, and renal dysfunction in 4 patients. Of the 8 patients who stopped valganciclovir, 75% (6/8) developed CMV infection subsequently. CONCLUSION: This study suggests that older age, history of interstitial pneumonia, and CMV infection may be important risk factors for IA on itraconazole prophylaxis. These results may help clinicians optimize prophylactic strategies for IA.


Assuntos
Aspergilose , Itraconazol , Idoso , Antivirais/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/etiologia , Estudos de Casos e Controles , Ganciclovir/uso terapêutico , Humanos , Itraconazol/efeitos adversos , Pulmão , Estudos Retrospectivos , Fatores de Risco , Transplantados
19.
J Med Virol ; 94(1): 272-278, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34468994

RESUMO

Data pertaining to risk factor analysis in coronavirus disease 2019 (COVID-19) is confounded by the lack of data from an ethnically diverse population. In addition, there is a lack of data for young adults. This study was conducted to assess risk factors predicting COVID-19 severity and mortality in hospitalized young adults. A retrospective observational study was conducted at two centers from China and India on COVID-19 patients aged 20-50 years. Regression analysis to predict adverse outcomes was performed using parameters including age, sex, country of origin, hospitalization duration, comorbidities, lymphocyte count, and National Early Warning Score 2 (NEWS2) score at admission. A total of 420 patients (172 East Asians and 248 South Asians) were included. The predictive model for intensive care unit (ICU) admission with variables NEWS2 Category II and higher, diabetes mellitus, liver dysfunction, and low lymphocyte counts had an area under the curve (AUC) value of 0.930 with a sensitivity of 0.931 and a specificity of 0.784. The predictive model for mortality with NEWS2 Category III, cancer, and decreasing lymphocyte count had an AUC value of 0.883 with a sensitivity of 0.903 and a specificity of 0.701. A combined predictive model with bronchial asthma and low lymphocyte count, in contrast, had an AUC value of 0.768 with a sensitivity of 0.828 and a specificity of 0.719 for NEWS2 score (5 or above) at presentation. NEWS2 supplemented with comorbidity profile and lymphocyte count could help identify hospitalized young adults at risk of adverse COVID-19 outcomes.


Assuntos
COVID-19/diagnóstico , COVID-19/etnologia , Adulto , Grupo com Ancestrais do Continente Asiático , COVID-19/mortalidade , COVID-19/fisiopatologia , China , Comorbidade , Progressão da Doença , Escore de Alerta Precoce , Feminino , Hospitalização , Humanos , Índia , Unidades de Terapia Intensiva , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
20.
Handb Exp Pharmacol ; 268: 213-225, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34031758

RESUMO

Occupational allergies are among the most common recorded occupational diseases. The skin and the upper and lower respiratory tract are the classical manifestation organs. More than 400 occupational agents are currently documented as being potential "respiratory sensitizers" and new reported causative agents are reported each year. These agents may induce occupational rhinitis (OR) or occupational asthma (OA) and can be divided into high-molecular weight (HMW) and low-molecular weight (LMW) agents. The most common occupational HMW agents are (glycol)proteins found in flour and grains, enzymes, laboratory animals, fish and seafood, molds, and Hevea brasiliensis latex. Typical LMW substances are isocyanates, metals, quaternary ammonium persulfate, acid anhydrides, and cleaning products/disinfectants. Diagnosis of occupational respiratory allergy is made by a combination of medical history, physical examination, positive methacholine challenge result or bronchodilator responsiveness, determination of IgE-mediated sensitization, and specific inhalation challenge tests as the gold standard. Accurate diagnosis of asthma is the first step to managing OA as shown above. Removal from the causative agent is of central importance for the management of OA. The best strategy to avoid OA is primary prevention, ideally by avoiding the use of and exposure to the sensitizer or substituting safer substances for these agents.


Assuntos
Asma Ocupacional , Hipersensibilidade , Doenças Profissionais , Alérgenos , Animais , Asma Ocupacional/diagnóstico , Asma Ocupacional/epidemiologia , Asma Ocupacional/etiologia , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Fatores de Risco
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