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1.
Gene ; 849: 146918, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36179964

RESUMO

OBJECTIVE: To explore the differences in DNA methylation associated with age-related hearing loss in a study of 57 twin pairs from China. DESIGN: Monozygotic twins were identified through the Qingdao Twin Registration system. The median age of participants was > 50 years. Their hearing thresholds were measured using a multilevel pure-tone audiometry assessment. The pure-tone audiometry was calculated at low frequencies (0.5, 1.0, and 2.0 kHz), speech frequencies (0.5, 1.0, 2.0, and 4.0 kHz), and high frequencies (4.0 and 8 kHz). The CpG sites were tested using a linear mixed-effects model, and the function of the cis-regulatory regions and ontological enrichments were predicted using the online Genomic Regions Enrichment of Annotations Tool. The differentially methylated regions were identified using a comb-p python library approach. RESULTS: In each of the PTA categories (low-, speech-, high-frequency), age-related hearing loss was detected in 25.9%, 19.3%, and 52.8% of participants. In the low-, speech- and high-frequency categories we identified 18, 42, and 12 individual CpG sites and 6, 11, and 6 differentially methylated regions. The CpG site located near DUSP4 had the strongest association with low- and speech-frequency, while the strongest association with high-frequency was near C21orf58. We identified associations of ALG10 with high-frequency hearing, C3 and LCK with low- and speech-frequency hearing, and GBX2 with low-frequency hearing. Top pathways that may be related to hearing, such as the Notch signaling pathway, were also identified. CONCLUSION: Our study is the first of its kind to identify these genes and their associated with DNA methylation may play essential roles in the hearing process. The results of our epigenome-wide association study on twins clarify the complex mechanisms underlying age-related hearing loss.


Assuntos
Presbiacusia , Gêmeos Monozigóticos , Pessoa de Meia-Idade , Idoso , Humanos , Gêmeos Monozigóticos/genética , Metilação de DNA , Epigênese Genética , Presbiacusia/genética , China , Audiometria de Tons Puros
2.
Talanta ; 251: 123759, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35952499

RESUMO

Heart failure (HF) is a chronic cardiovascular disease that represents main cause of mortality worldwide, particularly for elderly. N-terminal pro-brain natriuretic peptide (NT-proBNP) was identified as the gold standard biomarker for HF diagnosis and therapy monitoring. Presently, saliva analysis represents an emerging and powerful tool for clinical applications and electrochemical immunosensors have shown their potential in Healthcare applications as selective and reliable systems for detecting clinical biomarkers. This work presents the detection of NT-proBNP in saliva samples by an immunologically modified Field effect Transistor (IMFET). TESUD ((11-triethoxysilyl) undecanal) was used as cross-linker to immobilise anti-NT-proBNP antibody onto the device. Our IMFET that was then tested in different matrices (e.g. phosphate buffered saline (PBS), artificial saliva and human saliva) using electrochemical impedance spectroscopy (EIS), and it resulted selective to NT-proBNP with good sensitivity (detection limit of 0.02 pg/mL) and a wide linear range (0.02-1 pg/mL and 0.5-20 pg/mL). Finally, NT-proBNP concentration in ten saliva samples was determined by performing the standard addition method. An enzyme-linked immunosorbent assay was used for confirming IMFET results, highlighting both IMFET accuracy (analyte recovery of 99 ± 8%) and precision (coefficient of variation always <10%), and supporting the suitability of the device for determining salivary NT-proBNP.


Assuntos
Técnicas Biossensoriais , Insuficiência Cardíaca , Idoso , Humanos , Biomarcadores , Insuficiência Cardíaca/diagnóstico , Imunoensaio , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , Fosfatos , Saliva , Saliva Artificial , Volume Sistólico , Técnicas Eletroquímicas
3.
Behav Brain Res ; 436: 114083, 2023 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-36049659

RESUMO

PURPOSE: The aim of this comprehensive systematic review and meta-analysis was to evaluate the beneficial effects of melatonin supplementation on brain-derived neurotrophic factor (BDNF) concentration and clinical depressive disorder. METHODS: A comprehensive electronic search was conducted of Medlin, Web of Science, Science Direct, and Google scholar, from database inception to January 20, 2021. Studies were eligible if they: (1) were a clinical trial; (2) enrolled adults; (3) assessed the effect of melatonin supplementation on serum concentration of BDNF or depression score. Overall effects, as weighted mean difference (WMD), were calculated for concentration of BDNF and depression score. RESULTS: Melatonin supplementation yielded no significant effect on BDNF concentration (WMD: -5.61; 95% CI: -14.10, 2.88; I-square: 85.6%), but improved depression by decreasing the score (WMD: -0.76; 95% CI: -1.12, -0.4; I-square: 88.0%). Due to high heterogeneity between studies, subgroup analysis for gender, duration and dose in BDNF studies and duration, age, dose, continent and Questionnaire type in depression studies, was utilised. The subgroup analysis showed that melatonin supplementation had a significant decreasing effect on BDNF levels in doses ≤ 10 mg/day, with more than 4 weeks of duration, and in men. CONCLUSION: The present study revealed that melatonin supplementation has a decreasing effect on depression in all duration of studies and doses subgroup and in age more than 65 years in depression studies but heterogenicity of the included studies, did not allow a definitive conclusion. There is limited evidence for effects of melatonin on serum BDNF. IMPLICATIONS FOR PRACTICE: Melatonin is a safe and effective supplement for depressive patients.


Assuntos
Melatonina , Adulto , Idoso , Fator Neurotrófico Derivado do Encéfalo , Depressão/tratamento farmacológico , Suplementos Nutricionais/análise , Humanos , Masculino , Melatonina/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
Ann Lab Med ; 43(1): 82-85, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36045060

RESUMO

Cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1) is useful for predicting and monitoring non-small cell lung cancer prognosis. We established reference intervals (RIs) of CYFRA 21-1 in Korean adults, including those older than 60 years. Data of 4,098 apparently healthy subjects (age range, 20-87 years) were analyzed after excluding those with a history of malignancy, high tumor marker concentrations (except CYFRA 21-1), and/or abnormal findings on a chest computed tomography scan through medical chart review. After removing two outliers, RIs of CYFRA 21-1 were determined using data of 4,096 subjects based on the non-parametric method (2.5th and 97.5th percentiles) according to CLSI guidelines EP28-A3c. The subjects were divided into two and four groups according to sex and age (20-40, 41-50, 51-60, and >60 years), respectively, and the median CYFRA 21-1 concentration was compared between the groups. The RI of CYFRA 21-1 was 0.66-3.84 ng/mL, applicable to both men and women. Regardless of sex, the CYFRA 21-1 concentration increased with age, suggesting that age-dependent RIs of CYFRA 21-1 should be applied. Rather than using a single RI provided by the manufacturer, the RI of CYFRA 21-1 should be continually verified and established in each clinical laboratory.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Neoplasias , Biomarcadores Tumorais , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/patologia , Feminino , Humanos , Queratina-19 , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , República da Coreia , Adulto Jovem
5.
J Biomech Eng ; 145(2)2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36082471

RESUMO

In vivo characteristics of palmar soft tissue can be used to improve the accuracy of human models to explore and simulate a range of contact scenarios. Tissue characteristics can help to assess injury prevention strategies and designing technologies that depend on quantified physical contacts such as prosthetics, wearables, and assistive devices. In this study, a simplified quasi-linear viscoelastic (QLV) model was developed to quantify large deformation, in vivo soft tissue relaxation characteristics of the palm. We conducted relaxation tests on 11 young adults (6 males, 5 females, 18 < age < 30, mean age: 25 ± 4 yr) and 9 older adults (6 males, 3 females, age > 50, mean age: 61.5 ± 11.5 yr) using a 3 mm indenter to a depth of 50% of each participant's soft tissue thickness. The relaxation parameters of the QLV model were found to differ with age and sex, emphasizing the importance of using targeted material models to represent palmar soft tissue mechanics. Older adults showed on average 2.3-fold longer relaxation time constant compared to younger adults. It took 1.2-fold longer for young males to reach equilibrium than for young females; however, young females had a higher level of relaxation (36%) than young males (33%). Differences in specific QLV model parameters, P1, P2, and α were also found between age and sex groups. QLV characteristics differentiated by age and sex, add biofidelity to computational models which can provide a better representation of the diversity of tissue properties in the population.


Assuntos
Modelos Biológicos , Adulto , Idoso , Elasticidade , Humanos , Modelos Lineares , Pessoa de Meia-Idade , Estresse Mecânico , Viscosidade , Adulto Jovem
6.
Ultrasonics ; 127: 106852, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36201953

RESUMO

Chronic wounds have negative physical and psychological effects on patients and increase the health care burden. Consequently, chronic wound in the elderly population is an important issue. Ultrasound can be a great modality for treating chronic wounds because of its noninvasive and safety characteristics; it can accelerate in vitro and in vivo wound healing. In this study, we developed a novel noncontact ultrasound for wound treatment. We stimulated human epidermal keratinocyte migration using low-intensity pulsed ultrasound (LIPUS) with a noncontact transducer to avoid direct contact with the wound. We also compared the effects of 15-min contact and noncontact transducer stimulation, where a 1-MHz contact transducer (intensity = 40 or 200 mW/cm2) and a 0.45-MHz noncontact transducer (intensity = 30 mW/cm2) were used. Both contact and noncontact LIPUS considerably increased cell migration and activated the calcium (Ca2+)-dependent transcription factors cAMP-responsive element-binding protein (CREB) and nuclear factor of activated T cells (NFAT). Furthermore, noncontact transducer stimulation did not cause cell death or affect cell proliferation but significantly increased the Ca2+ influx-mediated intracellular Ca2+ levels. Ca2+-free medium and Ca2+ channel blockers effectively inhibited LIPUS-induced Ca2+-dependent transcription factor activation and cell migration.


Assuntos
Terapia por Ultrassom , Idoso , Cálcio , Movimento Celular , Humanos , Fatores de Transcrição , Ondas Ultrassônicas
7.
J Pharm Biomed Anal ; 222: 115090, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36252552

RESUMO

Endocannabinoids are endogenous lipids with the main function recognized to act as neuromodulators through their cannabinoid receptors. Dysregulation of the endocannabinoid system is implicated in various pathologies, such as inflammatory and neurodegenerative diseases. In this study we describe a sensitive UHPLC-MS/MS method for the analysis of trace levels of 7 endocannabinoids in cerebrospinal fluid samples. The analytes covered comprised 1- and 2-arachidonoylglycerol 1- and 2-AG (which were analysed as sum due to their interconversion), 2-arachidonylglycerol ether 2-AGE, anandamide AEA, N-linoleoyl ethanolamide LEA, N-palmitoyl ethanolamide PEA and N-oleoyl ethanolamide OEA. Analytes were extracted from the biofluid by a simple monophasic procedure involving protein precipitation with acetonitrile (MeCN). The analytical method is based on chromatographic separation of the analytes with solid-core (core-shell, superficially porous) particle column Cortecs C18+ . Gradient elution with changing proportion of water and acetonitrile and constant concentration of formic acid provided reasonable separation of analytes, close elution of analytes and their internal standards and minimized matrix effects in biological samples. For specific detection of the endocannabinoids a triple-quadrupole tandem mass spectrometer with electrospray ionisation (ESI) and selected reaction monitoring (SRM) mode was used, and it provided good assay selectivity. The developed method required a minute volume of the biological samples (50 µL) and achieved excellent sensitivity (the lower limit of detection was between 4.15 and 30.18 pM of the biological sample). Linear calibration was achieved in the range from 25 to 10,545 pM for AEA, 90-3802 pM for 1-AG, 90-724 pM for 2-AG, 12-5226 pM for LEA, 33-13,942 for OEA, 34-23,850 pM for 2-AGE, 72-30,190 for PEA and 10-4218 for AEA-d4 in CSF. The method was validated and revealed relative errors in the range of - 14.7 to + 12.3% at LLOQ and - 14.1 to + 14.2% for the remaining validation range. Precisions were in the acceptable range (< 20% RSD at LLOQ, and <15% for the remaining levels) as well. It was finally used to quantify endocannabinoids in human cerebrospinal fluid obtained from 118 donors. Accurate quantification of endogenous compounds in biological samples was achieved by using two different principal approaches (surrogate matrix for AEA, 2-AG, OEA, 2-AGE, LEA and PEA, and surrogate calibrant for AEA only) and they were evaluated by use of the Passing-Bablok regression. Concentrations (median) of CSF samples of patients suffering from CNS infection and controls were found to be around 160 pM for 1- and 2-AG, 86 pM for AEA, 62 for 2-AGE, 58 for LEA, 93 pM for PEA, and 83 pM for OEA.


Assuntos
Endocanabinoides , Espectrometria de Massas em Tandem , Humanos , Idoso , Pessoa de Meia-Idade , Endocanabinoides/metabolismo , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida de Alta Pressão/métodos , Acetonitrilas
8.
Radiol Clin North Am ; 61(1): 65-70, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36336392

RESUMO

Elder abuse, defined as "harm inflicted on an older person in a relationship where there is an expectation of trust, and/or when the person is targeted based on age or disability," can be challenging for clinicians to identify. Radiologists can help raise appropriate suspicion for elder abuse based on a patient's imaging. This article reviews common distributions and radiographic patterns of injury sustained in physical elder abuse. It also discusses limitations and unique challenges to the radiologic assessment of elder abuse, including issues of communication with frontline providers, and broad overlap in the appearance of abusive and accidental injuries in the setting of old age and deconditioning.


Assuntos
Abuso de Idosos , Humanos , Idoso , Radiologistas , Diagnóstico por Imagem
9.
J Theor Biol ; 556: 111296, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36208669

RESUMO

Seroprevalence studies can estimate proportions of the population that have been infected or vaccinated, including infections that were not reported because of the lack of symptoms or testing. Based on information from studies in the United States from mid-summer 2020 through the end of 2021, we describe proportions of the population with antibodies to SARS-CoV-2 as functions of age and time. Slices through these surfaces at arbitrary times provide initial and target conditions for simulation modeling. They also provide the information needed to calculate age-specific forces of infection, attack rates, and - together with contact rates - age-specific probabilities of infection on contact between susceptible and infectious people. We modified the familiar Susceptible-Exposed-Infectious-Removed (SEIR) model to include features of the biology of COVID-19 that might affect transmission of SARS-CoV-2 and stratified by age and location. We consulted the primary literature or subject matter experts for contact rates and other parameter values. Using time-varying Oxford COVID-19 Government Response Tracker assessments of US state and DC efforts to mitigate the pandemic and compliance with non-pharmaceutical interventions (NPIs) from a YouGov survey fielded in the US during 2020, we estimate that the efficacy of social-distancing when possible and mask-wearing otherwise at reducing susceptibility or infectiousness was 31% during the fall of 2020. Initialized from seroprevalence among people having commercial laboratory tests for purposes other than SARS-CoV-2 infection assessments on 7 September 2020, our age- and location-stratified SEIR population model reproduces seroprevalence among members of the same population on 25 December 2020 quite well. Introducing vaccination mid-December 2020, first of healthcare and other essential workers, followed by older adults, people who were otherwise immunocompromised, and then progressively younger people, our metapopulation model reproduces seroprevalence among blood donors on 4 April 2021 less well, but we believe that the discrepancy is due to vaccinations being under-reported or blood donors being disproportionately vaccinated, if not both. As experimenting with reliable transmission models is the best way to assess the indirect effects of mitigation measures, we determined the impact of vaccination, conditional on NPIs. Results indicate that, during this period, vaccination substantially reduced infections, hospitalizations and deaths. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics."


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Estados Unidos/epidemiologia , Idoso , COVID-19/epidemiologia , Estudos Soroepidemiológicos , Pandemias/prevenção & controle
10.
Ann Lab Med ; 43(2): 145-152, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36281508

RESUMO

Background: Clonal hematopoiesis of indeterminate potential (CHIP), which is defined as the presence of blood cells originating from somatically mutated hematopoietic stem cells, is common among the elderly and is associated with an increased risk of hematologic malignancies. We investigated the clinical, mutational, and transcriptomic characteristics in elderly Korean individuals with CHIP mutations. Methods: We investigated CHIP in 90 elderly individuals aged ≥60 years with normal complete blood counts at a tertiary-care hospital in Korea between June 2021 and February 2022. Clinical and laboratory data were prospectively obtained. Targeted next-generation sequencing of 49 myeloid malignancy driver genes and massively parallel RNA sequencing were performed to explore the molecular spectrum and transcriptomic characteristics of CHIP mutations. Results: We detected 51 mutations in 10 genes in 37 (41%) of the study individuals. CHIP prevalence increased with age. CHIP mutations were observed with high prevalence in DNMT3A (26 individuals) and TET2 (eight individuals) and were also found in various other genes, including KDM6A, SMC3, TP53, BRAF, PPM1D, SRSF2, STAG1, and ZRSR2. Baseline characteristics, including age, confounding diseases, and blood cell parameters, showed no significant differences. Using mRNA sequencing, we characterized the altered gene expression profile, implicating neutrophil degranulation and innate immune system dysregulation. Conclusions: Somatic CHIP driver mutations are common among the elderly in Korea and are detected in various genes, including DNMT3A and TET2. Our study highlights that chronic dysregulation of innate immune signaling is associated with the pathogenesis of various diseases, including hematologic malignancies.


Assuntos
Hematopoiese Clonal , Neoplasias Hematológicas , Idoso , Humanos , Hematopoese/genética , Transcriptoma , Proteínas Proto-Oncogênicas B-raf/genética , Mutação , Histona Desmetilases/genética , RNA Mensageiro
11.
Parasitol Int ; 92: 102689, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36240994

RESUMO

This study aimed to estimate dynamic changes in seroprevalence of Toxoplasma gondii within the general population living in the northern part of the Republic of Serbia (Province of Vojvodina) during a 14-year period. The differences in prevalence of anti-toxoplasma antibodies were analyzed in correlation with age, gender, residential area (rural/urban) and meteorological factors. In this cohort retrospective study, 24,440 subjects between 1 and 88 years old were enrolled. To determine the presence of T. gondii-specific IgM and IgG antibodies in serum samples, commercially available ELISA kits were used (Euroimmun, Luebeck, Germany). During the study period, the overall T. gondii seroprevalence was 23.5%. The seroprevalence continuously decreased over time from 31.7% in 2008 to 20.4% in 2021 (0.81% per year, p < 0.001). Approximately 2% of patients had a serologic profile positive for both anti-Toxoplasma IgG and IgM antibodies. The seroprevalence was higher (28.87%) among men compared to women (24.28%), while urban residents (24.94%) had lower seroprevalence than the rural population (28.17%). A statistically significant negative correlation (r = -0.559) was found between serologic profile of patients positive for both T. gondii IgG and IgM antibodies and the annual mean air temperature. No significant association was observed between seropositivity to T. gondii infection and examined meteorological factors. These data could be useful to national and regional health authorities to create an optimal health policy to reduce rate of T. gondii infections.


Assuntos
Toxoplasma , Toxoplasmose , Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Soroepidemiológicos , Sérvia/epidemiologia , Iugoslávia , Estudos Retrospectivos , Anticorpos Antiprotozoários , Imunoglobulina G , Imunoglobulina M , Fatores de Risco
12.
J Theor Biol ; 557: 111336, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36323394

RESUMO

The COVID-19 epidemic has lasted for more than two years since the outbreak in late 2019. An urgent and challenging question is how to systematically evaluate epidemic developments in different countries, during different periods, and to determine which measures that could be implemented are key for successful epidemic prevention. In this study, SBD distance-based K-shape clustering and hierarchical clustering methods were used to analyse epidemics in Asian countries. For the hierarchical clustering, epidemic time series were divided into three periods (epidemics induced by the Original/Alpha, Delta and Omicron variants separately). Standard deviations, the Hurst index, mortality rates, peak value of confirmed cases per capita, average growth rates, and the control efficiency of each period were used to characterize the epidemics. In addition, the total numbers of cases in the different countries were analysed by correlation and regression in relation to 15 variables that could have impacts on COVID-19. Finally, some suggestions on prevention and control measures for each category of country are given. We found that the total numbers of cases per million of a population, total deaths per million and mortality rates were highly correlated with the proportion of people aged over 65 years, the prevalence of multiple diseases, and the national GDP. We also found significant associations between case numbers and vaccination rates, health expenditures, and stringency of control measures. Vaccinations have played a positive role in COVID-19, with a gradual decline in mortality rates in later periods, and are still playing protective roles against the Delta and Omicron strains. The stringency of control measures taken by a government is not an indicator of the appropriateness of a country's response to the outbreak, and a higher index does not necessarily mean more effective measures; a combination of factors such as national vaccination rates, the country's economic foundation and the availability of medical equipment is also needed. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".


Assuntos
COVID-19 , Humanos , Idoso , COVID-19/epidemiologia , SARS-CoV-2 , Pandemias , Ásia/epidemiologia
13.
Phys Med Rehabil Clin N Am ; 34(1): 199-237, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36410883

RESUMO

This section is devoted to a review of the literature regarding the usage of orthobiologics in the special populations of elite athletes, the elderly, and pediatrics. The prospect of these regenerative options is encouraging to help provide alternative options that may enhance recovery and healing of acute and degenerative pathologic conditions. The goal is to provide the readers an overview of the existing literature highlighting areas with growing research and others that are still lacking.


Assuntos
Esportes , Humanos , Criança , Idoso , Atletas
14.
Dermatol Clin ; 41(1): 101-115, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36410971

RESUMO

Merkel cell carcinoma (MCC) is a neuroendocrine carcinoma that typically presents as a rapidly enlarging violaceous papulonodule on sun-damaged skin in elderly patients. MCC has high rates of local recurrence, metastasis, and poor survival. Treatment of the primary tumor involves surgical excision with possible adjuvant radiation therapy, whereas regional nodal disease is treated with some combination of lymph node dissection and radiation therapy. Immune checkpoint inhibitors, such as avelumab and pembrolizumab, are first-line agents for metastatic MCC. Monitoring for recurrence can be aided by Merkel cell polyomavirus oncoprotein antibody titers.


Assuntos
Carcinoma de Célula de Merkel , Poliomavírus das Células de Merkel , Neoplasias Cutâneas , Humanos , Idoso , Carcinoma de Célula de Merkel/patologia , Neoplasias Cutâneas/patologia , Excisão de Linfonodo
15.
Arch Gerontol Geriatr ; 104: 104820, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36108360

RESUMO

INTRODUCTION: The aim of this paper is to demonstrate how graphical chain models can be used to model how cardiovascular disease affected quality of life in later life over the course of 17 years of data. METHODS: Waves 1-9 of the English Longitudinal Study of Ageing was used to investigate how quality of life changed over each wave using the CASP-19 questionnaire, and whether having experienced a cardiovascular event had an effect on quality of life. RESULTS: A total of 12,099 participants were included in the study. Participants had a mean age of 64.2 years, the majority of which were over 50 years old. Older people are more likely to have cardiac events. A one-unit rise in CES-D 8-item score was related with a 14% increased risk of CVD at Wave 1. Those with an O-level, A-level, or degree (or equivalent) had lower CVD risks than those with no education. Women had half the CVD risk of men. Living alone reduced the risk of a CVD-event by 15%. Moderate and vigorous exercise lowered cardiac event risk compared to no exercise. Current or ex-smokers have a 30% higher risk of CVD than non-smokers. Cardiovascular event was significantly associated with quality of life at waves 1 and 2 only. DISCUSSION: Events related to cardiovascular disease only affected quality of life in later life up to 4 years. Factors such as age, depression, perceived position on social ladder, and high levels of physical activity affected quality of life throughout the majority of waves.


Assuntos
Doenças Cardiovasculares , Qualidade de Vida , Idoso , Feminino , Humanos , Masculino , Envelhecimento , Doenças Cardiovasculares/epidemiologia , Exercício Físico , Estudos Longitudinais , Fatores de Risco , Pessoa de Meia-Idade , Escolaridade , Fumar/efeitos adversos
16.
Sci Total Environ ; 855: 158652, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36108864

RESUMO

Due to the public health concern of arsenic, environmental management measures in mining areas had been implemented. To assess the effect of environmental management measures in the mining area comprehensively, arsenic accumulation in the urine, hair, nails, and urinary metabolites of residents in a realgar mining area in Hunan province, China were investigated in 2019, and the changes in arsenic levels in the biomarkers during 2012-2019 were tracked. The importance of confounding factors (age, sex, occupation, residence, clinical history, vegetable source, cooking fuel, smoking, alcohol consumption, BMI) was analyzed using the Boruta algorithm. After the implementation of environmental management measures (including ceasing mining and smelting activities, building landfills, adjusting the planting structure, and soil restoration), urine, hair, and nail arsenic concentration decreased drastically but were still excessive. Arsenic accumulation was highest in older male miners who were long settled in the mining area and consumed homegrown vegetables. The only factor for changes in urinary arsenic levels was the cooking fuel type; residents using wood as cooking fuel experienced sustained arsenic exposure. Occupation and sex were important for determining arsenic changes in the hair and nails. Short-term arsenic accumulation in urine was affected by arsenic exposure, while long-term accumulation in hair and nails by arsenic metabolic capacity. The percentage of urinary arsenic metabolism and arsenic methylation indices of the participants in the mining area were within the normal range (%iAs: 10-30 %, %MMA: 10-20 %, % DMA: 60-80 %); samples indicated worse metabolic capacity than the reference population. The arsenic metabolic capacity of male miners was relatively weak, probably aggravated by alcohol drinking and smoking. Without soil remediation, arsenic exposure will continue. Homegrown vegetables and biomass fuels should be abandoned; reduced cigarette and alcohol consumption is recommended. Urinary arsenic would be more proper for assessing environmental remediation in mining areas.


Assuntos
Arsênio , Humanos , Masculino , Idoso , Arsênio/análise , Conservação dos Recursos Naturais , Exposição Ambiental/análise , Mineração , Solo
17.
Vasc Endovascular Surg ; 57(1): 35-40, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36113165

RESUMO

INTRODUCTION: Transcarotid artery revascularization (TCAR) is a hybrid open and endovascular technique to treat carotid stenosis. The purpose of this study is to present a large cohort of patients who underwent TCAR at 2 high-volume TCAR health systems. METHODS: This study was a retrospective chart review of all instances of TCAR within the Memorial Hermann Health System and Indiana University Health, from December 2015-January 2022, using the ENROUTE Neuroprotection Device (Silk Road Medical, Sunnyvale, CA). We report patient demographics, intraoperative metrics, 30-day results and long-term results. RESULTS: In all, 750 patients underwent TCAR in the designated time period. Average patient age was 73 years, with 68% being male. Overall, 53.9% of patients had coronary artery disease, 45.4% had diabetes, and 36.9% were symptomatic. Technical success was achieved in 98.8% of patients with conversion to open endarterectomy in 1.1%. Average reverse flow time was 9.1 minutes with length of stay greater than 1 day 38%. Ipsilateral stroke rate within 30 days was 2.3% and long-term cumulative stroke rate was 3.0%. Death within 30 days occurred in 1.2% of patients and in 5.9% over long-term follow up. In all, 1% of patients required reintervention. CONCLUSIONS: TCAR is a safe and effective treatment modality for carotid artery stenotic disease. Its outcomes are similar to historical results associated with carotid endarterectomy, long considered the gold standard.


Assuntos
Doenças das Artérias Carótidas , Estenose das Carótidas , Procedimentos Endovasculares , Acidente Vascular Cerebral , Humanos , Masculino , Idoso , Feminino , Estudos Retrospectivos , Resultado do Tratamento , Fatores de Risco , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Doenças das Artérias Carótidas/cirurgia , Acidente Vascular Cerebral/etiologia , Artérias , Stents
18.
J Infect Chemother ; 29(1): 95-97, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36113848

RESUMO

Healthcare-associated COVID-19 among vulnerable patients leads to disproportionate morbidity and mortality. Early pharmacologic intervention may reduce negative sequelae and improve survival in such settings. This study aimed to describe outcome of patients with healthcare-associated COVID-19 who received early short-course remdesivir therapy. We reviewed the characteristics and outcome of hospitalized patients who developed COVID-19 during an outbreak that involved two wards at a non-acute care hospital in Japan and received short-course remdesivir. Forty-nine patients were diagnosed with COVID-19, 34 on a comprehensive inpatient rehabilitation ward and 15 on a combined palliative care and internal medicine ward. Forty-seven were symptomatic and 46 of them received remdesivir. The median age was 75, and the median Charlson comorbidity index was 6 among those who received it. Forty-one patients had received one or two doses of mRNA vaccines, while none had received a third dose. Most patients received 3 days of remdesivir. Of the patients followed up to 14 and 28 days from onset, 41/44 (95.3%) and 35/41(85.4%) were alive, respectively. Six deaths occurred by 28 days in the palliative care/internal medicine ward and two of them were possibly related to COVID-19. Among those who survived, the performance status was unchanged between the time of onset and at 28 days.


Assuntos
COVID-19 , Humanos , Idoso , COVID-19/tratamento farmacológico , SARS-CoV-2 , Antivirais , Alanina/uso terapêutico , Alanina/efeitos adversos , Atenção à Saúde , Hospitais
19.
Sci Total Environ ; 855: 158784, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36116662

RESUMO

INTRODUCTION: Serval longitudinal investigations have reported relationships between long-term nitrogen dioxide (NO2) exposure and mortality. In developing countries such as China, however, the cohort evidence was extremely rare. In this study, we aimed to establish the concentration-response relationship between long-term exposure to NO2 and mortality in Chinese adults. METHODS: We conducted a prospective cohort study followed up from 2011 to 2018, by enrolling 15,440 participants aged ≥45 years from 28 provincial regions of China. NO2 concentration estimates were derived from high-quality spatiotemporal datasets developed by machine learning methods and were assigned for each participant according to their residential cities. We applied Cox proportional hazard models with time-varying exposures to assess the association of all-cause death with long-term NO2 exposure. Subgroup analyses were performed to identify effect modifications. RESULTS: A total of 1646 death events occurred during 105,478.5 person-years' follow-up (median 7.1 years). No evident violation for linear NO2-mortality relationship (P nonlinear = 0.332) was observed at a range of 7.4-45.0 µg/m3. Per 10-µg/m3 rise in NO2 was associated with an hazard ratio of 1.220 (95% confidence interval: 1.103-1.350) for all-cause mortality. The association between NO2 and mortality was generally robust after adjusting for co-pollutants including fine particulate matter or/and ozone. Only participants aged 65 and over (1.351 [1.193-1.531]) suffered from increased risks of death associated with NO2 exposure, and an evident effect modification by age (P = 0.008) was identified. The elevated risk of death induced by NO2 was also observed in participants living in rural areas and those with elementary school education or below, though effect modifications were non-significant in these subgroups. CONCLUSIONS: This study provided novel evidence that long-term NO2 exposure could be an independent risk for mortality among Chinese middle-aged and older adults. Our findings highlighted the importance of controlling air pollution induced by vehicle emissions.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Humanos , Pessoa de Meia-Idade , Idoso , Dióxido de Nitrogênio/análise , Poluentes Atmosféricos/análise , Estudos Prospectivos , Poluição do Ar/análise , Material Particulado/análise , China/epidemiologia , Exposição Ambiental/análise
20.
Sci Total Environ ; 855: 158843, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36122716

RESUMO

Pentachlorophenol (PCP) is ubiquitous and moderately persistent in the environment, and it is an identified human carcinogen. Previous animal experiments indicate that toxic mechanisms of PCP include oxidative stress. However, no epidemiological study has reported the association between PCP exposure and oxidative stress; such association in pregnant women, a vulnerable population, is of particular interest. This study aimed to characterize PCP concentrations in 2304 urine samples from 768 pregnant women, explore its determinants, and evaluate the associations between PCP exposure and three oxidative stress biomarkers across three trimesters. The median concentrations of PCP (100% detected) in the first, second, and third trimester were 0.61, 0.59, and 0.48 ng/mL, respectively, with a significant decrease trend. The intraclass correlation coefficient of specific gravity (SG)-adjusted PCP was 0.26, indicating high variability for PCP across the three trimesters. PCP concentrations were significantly higher in older, pre-pregnancy overweight, multiparous, high-income, and employed women during pregnancy. Urinary PCP was markedly lower in samples collected during spring compared to other seasons. Linear mixed effect models for repeated measures revealed that ln-transformed SG-adjusted PCP was significantly associated with increased 8-hydroxy-2'-deoxyguanosine (8-OHdG; percent change [%Δ] caused by each interquartile range increase of PCP: 46.2, 95% confidence interval [CI]: 40.2, 52.5) and 8-hydroxyguanosine (8-OHG;%Δ [95% CI]: 44.8 [40.1, 49.8]), but the positive association with 4-hydroxy2-nonenal-mercapturic acid (HNE-MA) was not significant. PCP was also positively associated with increased 8-OHdG and 8-OHG in each trimester using general linear models, and its associations with HNE-MA were only significant at T1 (%Δ [95% CI]: 19.1 [1.05, 40.3]) and T2 (%Δ [95% CI]: 12.6 [0.32, 26.3]). Our findings provide valuable information about PCP exposure characteristics during pregnancy and the potential effects of PCP exposure on oxidative stress in pregnant women.


Assuntos
Pentaclorofenol , Humanos , Animais , Feminino , Gravidez , Idoso , Pentaclorofenol/toxicidade , Estudos Longitudinais , Gestantes , Biomarcadores/urina , Estresse Oxidativo , 8-Hidroxi-2'-Desoxiguanosina , China
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