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1.
Scand J Rheumatol ; 52(5): 556-563, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-36644967

RESUMEN

OBJECTIVE: Hysterectomy is the most common gynaecological surgery, performed mainly for benign uterine pathologies in women. Studies have suggested that hysterectomy is associated with osteoarthritis (OA); however, the association remains controversial. This study aimed to investigate the association between hysterectomy and the risk of OA. METHOD: We performed a population-based nested case-control study using the National Health Insurance programme database from 2000 to 2016 in Taiwan. All medical conditions for each case and control were categorized using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10. A multiple conditional logistic regression model was applied to analyse the adjusted odds ratio (aOR) and 95% confidence interval (CI) for the association between hysterectomy and OA. RESULTS: Our analyses included 16 592 patients with OA and 66 368 matched controls. After adjustment for possible confounders, hysterectomy had a significant association with OA (aOR = 1.19, 95% CI = 1.09-1.30), especially knee OA (aOR = 1.25, 95% CI = 1.13-1.38). Furthermore, women who received oestrogen therapy (ET) alone and patients who underwent hysterectomy without ET showed a greater risk of OA development compared to women who did not receive ET (aOR = 1.14, 95% CI = 1.07-1.23, and aOR = 1.19, 95% CI = 1.08-1.31, respectively). CONCLUSION: Our findings indicate that hysterectomy is associated with OA, especially knee OA. We also found that women who received ET alone and patients who underwent hysterectomy without ET had an increased risk of OA.


Asunto(s)
Histerectomía , Osteoartritis de la Rodilla , Humanos , Femenino , Estudios de Casos y Controles , Histerectomía/efectos adversos , Osteoartritis de la Rodilla/epidemiología , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/etiología , Modelos Logísticos , Taiwán/epidemiología , Factores de Riesgo , Estudios Retrospectivos
2.
Ann Oncol ; 29(12): 2356-2362, 2018 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-30481267

RESUMEN

Background: Following neoadjuvant chemotherapy for operable gastroesophageal cancer, lymph node metastasis is the only validated prognostic variable; however, within lymph node groups there is still heterogeneity with risk of relapse. We hypothesized that gene profiles from neoadjuvant chemotherapy treated resection specimens from gastroesophageal cancer patients can be used to define prognostic risk groups to identify patients at risk for relapse. Patients and methods: The Medical Research Council Adjuvant Gastric Infusional Chemotherapy (MAGIC) trial (n = 202 with high quality RNA) samples treated with perioperative chemotherapy were profiled for a custom gastric cancer gene panel using the NanoString platform. Genes associated with overall survival (OS) were identified using penalized and standard Cox regression, followed by generation of risk scores and development of a NanoString biomarker assay to stratify patients into risk groups associated with OS. An independent dataset served as a validation cohort. Results: Regression and clustering analysis of MAGIC patients defined a seven-Gene Signature and two risk groups with different OS [hazard ratio (HR) 5.1; P < 0.0001]. The median OS of high- and low-risk groups were 10.2 [95% confidence interval (CI) of 6.5 and 13.2 months] and 80.9 months (CI: 43.0 months and not assessable), respectively. Risk groups were independently prognostic of lymph node metastasis by multivariate analysis (HR 3.6 in node positive group, P = 0.02; HR 3.6 in high-risk group, P = 0.0002), and not prognostic in surgery only patients (n = 118; log rank P = 0.2). A validation cohort independently confirmed these findings. Conclusions: These results suggest that gene-based risk groups can independently predict prognosis in gastroesophageal cancer patients treated with neoadjuvant chemotherapy. This signature and associated assay may help risk stratify these patients for post-surgery chemotherapy in future perioperative chemotherapy-based clinical trials.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/genética , Neoplasias Esofágicas/terapia , Recurrencia Local de Neoplasia/prevención & control , Neoplasias Gástricas/terapia , Transcriptoma/genética , Adulto , Anciano , Quimioterapia Adyuvante/métodos , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/patología , Esofagectomía , Esófago/patología , Esófago/cirugía , Femenino , Gastrectomía , Perfilación de la Expresión Génica , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante/métodos , Recurrencia Local de Neoplasia/genética , Recurrencia Local de Neoplasia/patología , Pronóstico , Estudios Prospectivos , Medición de Riesgo/métodos , Estómago/patología , Estómago/cirugía , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología , Resultado del Tratamiento
3.
Pediatr Allergy Immunol ; 27(2): 169-76, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26647908

RESUMEN

BACKGROUND: Little is known about the effect of postnatal maternal psychologic problems on the development of childhood atopic disorders. OBJECTIVES: To assess the association between early life maternal psychologic problems and atopic dermatitis (AD) in children in a national birth cohort. METHODS: We used multistage, stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth registration. Maternal psychologic problems and potential confounders were gathered by the standard questionnaire at 6 months old. At 3 years of age, information about the development of AD was assessed by International Study of Asthma and Allergies in Childhood via home interviews. Multiple logistic regression analysis was performed to estimate the association of postnatal maternal psychologic problems (postpartum depression (PPD) and maternal mental health index) and AD. RESULTS: The prevalence of physician-diagnosed AD was 10.5%. PPD increased the risk of subsequent physician-diagnosed AD in children after adjusting for potential confounders and other maternal mental health index (aOR = 1.42, 95% CI = 1.21-1.66). We observed that the risk of AD associated with PPD was not confounded by other social demographic factors such as maternal AD, maternal education, family income, breastfeeding, day care, and number of siblings. CONCLUSIONS: Postpartum depression increased the risk of childhood AD even when other maternal mental health index and social demographic factors are considered. Early intervention of PPD might be helpful for AD prevention.


Asunto(s)
Depresión Posparto/epidemiología , Dermatitis Atópica/epidemiología , Trastornos Mentales/epidemiología , Preescolar , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Exposición Materna/efectos adversos , Prevalencia , Riesgo , Encuestas y Cuestionarios , Taiwán
4.
Br J Dermatol ; 173(4): 981-8, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26202732

RESUMEN

BACKGROUND: Hereditary and environmental factors have been related to the occurrence of atopic dermatitis (AD) in early childhood. However, the role of prenatal and early postnatal exposure to air pollutants has not been totally elucidated. OBJECTIVES: To evaluate the association between prenatal air pollutant exposure and occurrence of AD. METHODS: In total 24 200 infant-mother pairs were recruited to participate in the Taiwan Birth Cohort Study in 2005 using multistage stratified sampling. Medical history, including physician-diagnosed AD, was inquired by questionnaire at the infant's age of 6 months. Monthly averages of five criteria air pollutants - NO2 , CO, O3 , SO2 and PM10 - were retrieved from 66 air-quality-monitoring stations, and interpolated to all administrative districts using the kriging method. Exposure data during each of the three gestational trimesters and three months after birth were calculated for each study subject, and odds ratios (ORs) of AD occurrence were calculated by logistic regression. RESULTS: Among the participants, 16 686 mother-infant pairs were qualified for and included in the analysis. Among them, 1206 infants (7·2%) had been diagnosed as having AD before the age of 6 months, and the prevalence was higher in boys (8·3%) than in girls (6·1%). The occurrence of AD was significantly associated with CO exposure during the whole gestational period [adjusted OR (aOR) 1·37, 95% confidence interval (CI) 1·06-1·78] and the first trimester (aOR 1·51, 95% CI 1·16-1·97). We did not observe any significant association among the other air pollutants during either the whole gestational period or any period of the three trimesters and 3 months after birth. CONCLUSIONS: Our study found a relationship between AD occurrence and gestational exposure to CO, where exposure during the first trimester seemed to be the most important.


Asunto(s)
Contaminación del Aire/efectos adversos , Dermatitis Atópica/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Prevalencia , Características de la Residencia/estadística & datos numéricos , Distribución por Sexo , Taiwán/epidemiología
5.
Br J Dermatol ; 173(1): 146-54, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25511692

RESUMEN

BACKGROUND: Few studies have examined the association between psoriasis and glomerulonephritis (GN) as well as chronic kidney disease (CKD). OBJECTIVES: To determine the risk of CKD in patients with psoriasis and evaluate the impact of the severity of psoriasis, comorbidities and concomitant drugs on the risk of GN and CKD in patients with psoriasis. METHODS: We identified 4344 patients with psoriasis for the study cohort and randomly selected 13,032 subjects as a control cohort. Each subject was individually followed for up for 5 years to identify those who subsequently developed GN and CKD. RESULTS: After adjustment for traditional CKD risk factors, psoriasis was found to be independently associated with an increased risk of CKD during the follow-up period [hazard ratio (HR) 1.28; 95% confidence interval (CI) 1.14-1.44]. The increased incidence of GN in patients with psoriasis (HR 1.50, 95% CI 1.24-1.81) may contribute to the positive association between psoriasis and CKD. Patients with mild and severe psoriasis had an increased risk of CKD and GN compared with the control cohort; the risk increased with severity. Patients with psoriasis and arthritis exhibited a higher risk of CKD than patients without arthritis (HR 1.62 vs. 1.26). Among drugs, nonsteroidal anti-inflammatory drugs (NSAIDs) have the strongest association with CKD in patients with psoriasis (adjusted odds ratio 1.69, 95% CI 1.14-2.49). CONCLUSIONS: Psoriasis was associated with a higher risk of developing CKD and GN. High severity, psoriatic arthritis involvement and concomitant NSAIDs use further increased the risk of CKD in patients with psoriasis.


Asunto(s)
Glomerulonefritis/etiología , Psoriasis/complicaciones , Insuficiencia Renal Crónica/etiología , Adolescente , Adulto , Distribución por Edad , Anciano , Antiinflamatorios no Esteroideos/efectos adversos , Métodos Epidemiológicos , Femenino , Glomerulonefritis/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/epidemiología , Insuficiencia Renal Crónica/epidemiología , Factores Socioeconómicos , Taiwán/epidemiología , Adulto Joven
6.
Osteoporos Int ; 25(5): 1503-11, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24515577

RESUMEN

UNLABELLED: Evidence of the incidence and risk of osteonecrosis of the jaw (ONJ) in Asian osteoporosis populations receiving different osteoporosis medications is lacking. We found that there is no excess incidence of or risk for ONJ in osteoporosis patients >50 years old using alendronate as compared with patients using raloxifene or calcitonin under real-world conditions in Taiwan. INTRODUCTION: To provide information on ONJ in Asian populations, this study compares the incidence and risk of ONJ between patients receiving alendronate and those receiving non-bisphosphonate osteoporosis medications in Taiwan. METHODS: Enrollees in the National Health Insurance Research Database (NHIRD) from 2003 to 2007, aged above 50 years, with vertebral/hip fracture, and new to osteoporosis therapy were recruited. Patients with Paget's disease or cancer during the baseline period were excluded. Patients were classified into either the alendronate or the calcitonin/raloxifene (control) group according to their exposure during follow-up. Previously proposed possible ONJ diagnosis codes were adopted as potential ONJ cases, but qualifying cases also had a repeated ONJ diagnosis within 8 weeks of the first diagnosis and received one or more broad-spectrum oral antibiotics. Cox modeling compared the risk of ONJ between the alendronate and the control groups, which were matched using propensity scores. Results were examined in series sensitivity analyses, including different cumulative dose groups. RESULTS: We found 25 potential ONJ cases in the alendronate (N = 18,030) and 21 in the control groups (N = 25,615). Over the 6-year follow-up period, no increased risk of ONJ in the alendronate group in the original (hazard ratio (HR), 0.87; 95% confidence interval (CI), 0.47-1.58) or propensity score-matched cohorts (HR, 0.86; 95% CI, 0.44-1.69) was found. All comparison groups exhibited a similar incidence of ONJ, ranging from 6.9 to 8.2/10,000 person-years. CONCLUSION: Under real-world conditions, there is no excess risk for ONJ in osteoporosis patients >50 years old using alendronate as compared with patients using raloxifene or calcitonin.


Asunto(s)
Alendronato/efectos adversos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/epidemiología , Conservadores de la Densidad Ósea/efectos adversos , Anciano , Anciano de 80 o más Años , Alendronato/uso terapéutico , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Conservadores de la Densidad Ósea/uso terapéutico , Calcitonina/efectos adversos , Calcitonina/uso terapéutico , Femenino , Humanos , Incidencia , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Osteoporosis/tratamiento farmacológico , Osteoporosis/epidemiología , Fracturas Osteoporóticas/epidemiología , Fracturas Osteoporóticas/prevención & control , Clorhidrato de Raloxifeno/efectos adversos , Clorhidrato de Raloxifeno/uso terapéutico , Estudios Retrospectivos , Medición de Riesgo/métodos , Taiwán/epidemiología
7.
Br J Dermatol ; 171(5): 1181-8, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24734995

RESUMEN

BACKGROUND: Ustekinumab, an interleukin-12/23 inhibitor, is effective in the treatment of psoriasis. A recent Italian study showed more favourable response to ustekinumab in patients with positive human leucocyte antigen (HLA)-Cw6. Nonetheless, there are differences in genetic susceptibility to psoriasis between races, and no studies have specifically assessed the candidate genetic markers in predicting therapy outcome in Chinese patients with psoriasis treated with ustekinumab. OBJECTIVES: To determine whether HLA gene polymorphisms can predict the response to ustekinumab in Chinese patients with psoriasis. METHODS: Sixty-six patients with psoriasis treated with ustekinumab were included in the study, and the effectiveness of ustekinumab therapy was evaluated at weeks 0, 16 and 28 by Psoriasis Area and Severity Index (PASI). RESULTS: More HLA-Cw6-positive patients achieved a PASI 75 response at week 4 compared with HLA-Cw6-negative patients (38% vs. 9%, P = 0·019). Similarly, at week 16, patients carrying the HLA-Cw6 allele showed a higher likelihood of achieving PASI 50, 75 and 90 than Cw6-negative patients, although this was not statistically significant. At week 28, a significantly higher percentage of HLA-Cw6-positive patients maintained PASI 90 response compared with Cw6-negative patients (63% vs. 26%, P = 0·035). Further analysis of other HLA allele polymorphisms did not show significant associations with therapeutic response to ustekinumab. CONCLUSIONS: This pharmacogenetic study provides preliminary data indicating that positive HLA-Cw6 is associated with a good response to ustekinumab treatment in Chinese patients with psoriasis.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Antígenos HLA-C/metabolismo , Psoriasis/tratamiento farmacológico , Biomarcadores/metabolismo , China/etnología , Femenino , Antígenos HLA-C/genética , Humanos , Interleucina-12/antagonistas & inhibidores , Interleucina-23/antagonistas & inhibidores , Masculino , Persona de Mediana Edad , Polimorfismo Genético/genética , Psoriasis/etnología , Psoriasis/genética , Estudios Retrospectivos , Resultado del Tratamiento , Ustekinumab
8.
J Investig Allergol Clin Immunol ; 24(5): 338-45, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25345304

RESUMEN

BACKGROUND AND OBJECTIVE: Allergic airway diseases are not only a T,2-mediated chronic airway inflammation, but also a condition of epithelial barrier defects and dysfunction. Allergens with protease activities are known factors that initiate respiratory epithelial damage. Cockroach allergy is the second leading cause of allergic respiratory airway diseases in Taiwan, and cockroach allergens have strong serine protease activity. This study aimed to determine the protective effect of the direct local administration of gabexate mesilate (GM) on American cockroach allergen (CraA)-induced human bronchial epithelial cell inflammation. METHODS: BEAS-2B cells, from the human bronchial epithelial cell line, were stimulated with CraA or co-cultured with different doses of GM. Cellular morphologic changes were observed by microscopy and changes in chemokine mRNA expression and protein levels were determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and ELISA. Effects of specific inhibitors of ERK1/2 (U0126), INK (SP600125), and p38 MAPK (SB203580) on CraA-induced chemokine mRNA expression were also tested by RT-PCR. RESULTS: GM prevented CraA-induced bronchial epithelial cell detachment and morphological changes. It had superior and more extensive suppression effects than specific target MAPK inhibitors in CraA-induced mRNA expression of IL-8, monocyte chemotactic protein (MCP) 1, chemokine (C-C motif) ligand 20, and granulocyte-macrophage colony-stimulating factor from the cells in a dose-dependent manner. CraA-induced IL-8 and MCP-1 protein production from BEAS-2B cells was also attenuated by GM. CONCLUSIONS: The serine protease inhibitor GM has local protective effects against CraA-induced bronchial epithelial inflammation. The development of an inhaled or intranasal protease inhibitor may be a potential strategy for the treatment of allergic airway diseases induced by allergens with protease activities.


Asunto(s)
Bronquios/patología , Cucarachas/inmunología , Citocinas/biosíntesis , Gabexato/farmacología , Inhibidores de Serina Proteinasa/farmacología , Animales , Células Cultivadas , Quimiocina CCL2/biosíntesis , Quimiocinas/genética , Células Epiteliales/patología , Humanos , Interleucina-8/biosíntesis , Proteínas Quinasas Activadas por Mitógenos/antagonistas & inhibidores , Fosforilación
9.
Genet Mol Res ; 13(2): 2709-17, 2014 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-24782085

RESUMEN

The Orchidaceae is one of the largest and most diverse families of flowering plants. The Dendrobium genus has high economic potential as ornamental plants and for medicinal purposes. In addition, the species of this genus are able to produce large crops. However, many Dendrobium varieties are very similar in outward appearance, making it difficult to distinguish one species from another. This study demonstrated that the 12 Dendrobium species used in this study may be divided into 2 groups by internal transcribed spacer (ITS) sequence analysis. Red and yellow flowers may also be used to separate these species into 2 main groups. In particular, the deciduous characteristic is associated with the ITS genetic diversity of the A group. Of 53 designed simple sequence repeat (SSR) primer pairs, 7 pairs were polymorphic for polymerase chain reaction products that were amplified from a specific band. The results of this study demonstrate that these 7 SSR primer pairs may potentially be used to identify Dendrobium species and their progeny in future studies.


Asunto(s)
Dendrobium/genética , Variación Genética , Repeticiones de Microsatélite/genética , Filogenia , ADN de Plantas/genética , Reacción en Cadena de la Polimerasa , Especificidad de la Especie
10.
Ann Oncol ; 24(4): 1055-61, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23172635

RESUMEN

BACKGROUND: We aimed to investigate the efficacy and tolerability of sorafenib combined with cisplatin and 5-fluorouracil (5-FU) in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: It was a Simon two-stage designed trial. Chemotherapy-naive patients with recurrent or metastatic disease were enrolled. The regimen was sorafenib 400 mg orally b.i.d., cisplatin 80 mg/m(2) i.v. day 1, and 5-FU 1000 mg/m(2)/day CIV for 4 days, repeated every 21 days. After a maximum of six cycles of chemotherapy, patients received maintenance of sorafenib. RESULTS: In total, 54 patients were enrolled. The objective response rate reached 77.8%, including 1 complete response and 41 partial responses. The median progression-free survival was 7.2 months (95% CI 6.8-8.4 months), and the median overall survival was 11.8 months (95% CI 10.6-18.7 months). Major toxic effects included hand-foot skin reaction, myelosuppression, and gastrointestinal (GI) reaction. The incidence of hemorrhage was 22.2%, and one patient with liver metastases died of GI bleeding. Contrast-enhanced ultrasonography was carried out in a subset of patients with liver metastases. CONCLUSION: Combination of sorafenib, cisplatin (80 mg/m(2)) and 5-FU (3000 mg/m(2)) was tolerable and feasible in recurrent or metastatic NPC. Further randomized trials to compare sorafenib plus cisplatin and 5-FU with standard dose of cisplatin plus 5-FU in NPC are warranted.


Asunto(s)
Cisplatino/administración & dosificación , Fluorouracilo/administración & dosificación , Neoplasias Nasofaríngeas/tratamiento farmacológico , Niacinamida/análogos & derivados , Compuestos de Fenilurea/administración & dosificación , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma , Cisplatino/efectos adversos , Supervivencia sin Enfermedad , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/inducido químicamente , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/patología , Femenino , Fluorouracilo/efectos adversos , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Carcinoma Nasofaríngeo , Metástasis de la Neoplasia/tratamiento farmacológico , Metástasis de la Neoplasia/patología , Recurrencia Local de Neoplasia/patología , Niacinamida/administración & dosificación , Niacinamida/efectos adversos , Compuestos de Fenilurea/efectos adversos , Sorafenib , Ultrasonografía
11.
Br J Dermatol ; 168(4): 794-801, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23528059

RESUMEN

BACKGROUND: Considering the early onset of atopic dermatitis (AD), which most often arises in the first year of life, risk factors occurring very early in life must be considered. Little is known about the effects of maternal occupational exposure on the development of atopic disorders in children. OBJECTIVES: The aim of this study was to evaluate associations between maternal employment and childhood AD. METHODS: We used multistage stratified systematic sampling to recruit 24,200 mother-newborn pairs from the Taiwan national birth register. Information on maternal occupation categories, work stress, working time, shift work and potential confounders during pregnancy was gathered by questionnaires after birth. At 3 years of age, information on the development of AD was assessed by home interviews. Multiple logistic regression analysis was performed to estimate the association of maternal employment and AD. RESULTS: Overall, 11,962 out of 19,381 mothers (61·7%) worked during pregnancy. The children of mothers who worked during pregnancy had an increased risk of AD compared with those whose mothers did not work [odds ratio (OR) 1·38, 95% confidence interval (CI) 1·25-1·53]. The children of mothers with a professional or technical occupation had a higher risk of AD (OR 1·64, 95% CI 1·44-1·87). The risk of AD was found to increase with maternal work stress during pregnancy in a dose-response manner (P(trend)<0·01). The mothers of children with AD had a longer working time than those without AD (P<0·0001). However, no significant association between AD and maternal shift work was found. CONCLUSIONS: Working in professional or technical occupations increased the risk of childhood AD in addition to work stress during pregnancy.


Asunto(s)
Dermatitis Atópica/epidemiología , Exposición Materna/efectos adversos , Exposición Profesional/efectos adversos , Empleo/estadística & datos numéricos , Femenino , Humanos , Masculino , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones del Embarazo/prevención & control , Efectos Tardíos de la Exposición Prenatal/epidemiología , Estudios Prospectivos , Factores de Riesgo , Estrés Psicológico/epidemiología , Taiwán/epidemiología
12.
Lymphology ; 56(2): 41-60, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38621383

RESUMEN

The generalizability of findings from Clinical Trials (CTs) investigating lymphedema treatment modalities requires an accurate representation of the target population. This study aims to evaluate racial and ethnic reporting and representation in lymphedema CTs. A comprehensive systematic literature search was conducted during May 2023 using multiple databases, following the PRISMA guidelines. All CTs published from 2018 to 2023 were included. A total of 84 articles were included in this review, from which 6,546 participants were included in the analysis. Seventy-four (88.1%) articles addressed secondary lymphedema, of which 60 (81.1%) were related to breast cancer. Only 12 (13%) of CTs reported at some extend race or ethnicity. Of these, five (41.6%) reported race and two (16.6%) reported ethnicity according to FDA guidelines. White race had the highest pooled prevalence (80%; 95% CI 72-86%; I2=90%), followed by Black (7%; 95% CI 2- 15%; I2= 94.3%) and Asian (4%; 95% CI 1-8%; I2= 89.9%). In studies reporting ethnicity, participants were predominantly non-Hispanic (92.1%; 95% CI 90 - 94%). There is an underreporting and underrepresentation of racial and ethnic minorities among lymphedema CTs, limiting their generalizability. It is imperative to future development of strategies to enhance diversity in the study sample.


Asunto(s)
Etnicidad , Linfedema , Humanos , Estados Unidos , Minorías Étnicas y Raciales , Grupos Minoritarios , Linfedema/terapia , Blanco
13.
ESMO Open ; 8(5): 101629, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37660406

RESUMEN

BACKGROUND: We aimed to investigate the efficacy of locoregional radiotherapy (LRRT) in patients with de novo metastatic nasopharyngeal carcinoma (dmNPC) receiving chemotherapy combined with anti-programmed cell death receptor-1 monoclonal antibodies (anti-PD-1 mAbs) as first-line treatment and identify optimal candidates for LRRT. MATERIALS AND METHODS: We enrolled patients with dmNPC receiving platinum-based palliative chemotherapy and anti-PD-1 mAbs followed or not followed by LRRT from four centers. The endpoints were progression-free survival (PFS), objective response rate (ORR), and overall survival (OS). We used the inverse probability of treatment weighting (IPTW) to balance the baseline characteristics of the LRRT and non-LRRT groups to minimize selection bias before comparative analyses. Multivariate analyses were carried out using the Cox proportional hazards model. RESULTS: We included 163 patients with dmNPC (median follow-up: 22 months). The median PFS was 20 months, and the ORR was 92.0%; the median OS was not achieved. After IPTW adjustments, patients who received LRRT had a significant survival benefit over those not receiving LRRT (median PFS: 28 versus 15 months, P < 0.001). The Epstein-Barr virus DNA (EBV DNA) level after four to six cycles of anti-PD-1 mAbs [weighted hazard ratio (HR): 2.19, 95% confidence interval (CI) 1.22-3.92, P = 0.008] and LRRT (weighted HR: 0.58, 95% CI 0.34-0.99, P = 0.04) were independent prognostic factors. Patients with undetectable EBV DNA levels after four to six cycles of anti-PD-1 mAbs (early EBV DNA clearance) benefitted from LRRT (HR: 0.41, 95% CI 0.22-0.79, P = 0.008), whereas those with detectable levels did not (HR: 1.30, 95% CI 0.59-2.87, P = 0.51). CONCLUSIONS: Palliative chemotherapy combined with anti-PD-1 mAbs followed by LRRT was associated with improved PFS in patients with dmNPC, especially for patients with early EBV DNA clearance.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Neoplasias Nasofaríngeas , Humanos , Carcinoma Nasofaríngeo/terapia , Carcinoma Nasofaríngeo/patología , Infecciones por Virus de Epstein-Barr/terapia , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/radioterapia , Pronóstico , Herpesvirus Humano 4/genética , Quimioradioterapia , ADN
14.
Gene Ther ; 19(1): 86-93, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21593794

RESUMEN

The present study investigates the efficacy of polyethylenimine (PEI)-DNA complex that expressed human telomerase reverse transcriptase (hTERT) to transfect hair follicle stem cells and produce sufficient hTERT to stimulate hair growth. Transfection with pLC-hTERT-DNA-PEI complex (D+P group) in vitro induced expression of proliferating cell nuclear antigen in 35.8% of the purified stem cell population, suggesting enhanced cell proliferation. In vivo transfection efficiency of rat dorsal skin was determined by staining for ß-gal activity. Cells positive for ß-gal were located in the bulge region and dermal sheath of hair follicles. The follicles in the hTERT-transfected region entered anagenon day 15 after transfection, whereas non-transfected (Neg) controls remained in telogen. The similar effect was observed in 50-day-old rat dorsal skin. D+P group displayed a specific expression of hTERT and sufficient to initiate a transition to the anagen phase and promote new hair synthesis 18 days after the transfection. hTERT promoted follicle neogenesis following wounding. In all, 60 days after wounding, tissues of the D+P group showed more newly regenerating hair follicles (83±52 regenerated follicles per rat) in contrast to control group tissues (15±15 regenerated follicles per rat). These studies provide a potential approach for gene therapy of skin disease.


Asunto(s)
ADN/administración & dosificación , Técnicas de Transferencia de Gen , Folículo Piloso/crecimiento & desarrollo , Polietileneimina/uso terapéutico , Regeneración , Telomerasa/administración & dosificación , Animales , Proliferación Celular , Supervivencia Celular , ADN/metabolismo , ADN/uso terapéutico , Citometría de Flujo , Terapia Genética , Folículo Piloso/lesiones , Folículo Piloso/metabolismo , Folículo Piloso/fisiología , Humanos , Queratinocitos/citología , Queratinocitos/metabolismo , Ratones , Plásmidos/genética , Plásmidos/metabolismo , Polietileneimina/metabolismo , Antígeno Nuclear de Célula en Proliferación/metabolismo , Ratas , Ratas Wistar , Células Madre/metabolismo , Células 3T3 Swiss , Telomerasa/genética , Telomerasa/metabolismo , Factores de Tiempo , Transfección , Heridas y Lesiones/terapia , beta-Galactosidasa/metabolismo
15.
Breast Cancer Res Treat ; 135(1): 177-87, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22729891

RESUMEN

Mammographic density (MD) is the area of breast tissue that appears radiologically white on mammography. Although high MD is a strong risk factor for breast cancer, independent of BRCA1/2 mutation status, the molecular basis of high MD and its associated breast cancer risk is poorly understood. MD studies will benefit from an animal model, where hormonal, gene and drug perturbations on MD can be measured in a preclinical context. High and low MD tissues were selectively sampled by stereotactic biopsy from operative specimens of high-risk women undergoing prophylactic mastectomy. The high and low MD tissues were transferred into separate vascularised biochambers in the groins of SCID mice. Chamber material was harvested after 6 weeks for histological analyses and immunohistochemistry for cytokeratins, vimentin and a human-specific mitochondrial antigen. Within-individual analysis was performed in replicate mice, eliminating confounding by age, body mass index and process-related factors, and comparisons were made to the parental human tissue. Maintenance of differential MD post-propagation was assessed radiographically. Immunohistochemical staining confirmed the preservation of human glandular and stromal components in the murine biochambers, with maintenance of radiographic MD differential. Propagated high MD regions had higher stromal (p = 0.0002) and lower adipose (p = 0.0006) composition, reflecting the findings in the original human breast tissue, although glands appeared small and non-complex in both high and low MD groups. No significant differences were observed in glandular area (p = 0.4) or count (p = 0.4) between high and low MD biochamber tissues. Human mammary glandular and stromal tissues were viably maintained in murine biochambers, with preservation of differential radiographic density and histological features. Our study provides a murine model for future studies into the biomolecular basis of MD as a risk factor for breast cancer.


Asunto(s)
Neoplasias de la Mama/patología , Mama/patología , Mamografía , Ingeniería de Tejidos , Animales , Mama/fisiología , Mama/trasplante , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Humanos , Ratones , Ratones SCID , Células del Estroma , Trasplante de Tejidos , Trasplante Heterólogo
16.
Epidemiol Infect ; 140(7): 1277-85, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21920066

RESUMEN

Pneumonia is an important cause of mortality and morbidity in infants. However, information of risk factors for pneumonia in children aged <6 months is limited. This study aimed to evaluate the risk factors and their contribution to infantile pneumonia in a large population-based survey. Of 24,200 randomly sampled main caregivers invited, 21,248 (87.8%) participated in this study. A structured questionnaire was used to interview the main caregivers. Information regarding whether hospitalization was required, family environment, and medical history were obtained. The prevalence of pneumonia was 0.62% in our study cohort. Multivariate logistic regression analysis showed that preterm birth, congenital cardiopulmonary disease, antibiotic use during pregnancy, maternal overweight, daily prenatal exposure to environmental tobacco smoke, maternal smoking during pregnancy, and visible mould on walls at home are risk factors associated with infantile pneumonia. Further study is warranted to investigate the causality and mechanisms of these novel factors.


Asunto(s)
Neumonía/epidemiología , Estudios de Cohortes , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Embarazo , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios
17.
J Periodontal Res ; 47(6): 701-10, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22533969

RESUMEN

UNLABELLED: Lin S-J, Lu H-K, Lee H-W, Chen Y-C, Li C-L, Wang L-F. Nitric oxide inhibits androgen receptor-mediated collagen production in human gingival fibroblasts. J Periodont Res 2012; 47: 701-710. © 2012 John Wiley & Sons A/S Background and Objective: In our previous study, we found that flutamide [an androgen receptor (AR) antagonist] inhibited the up-regulation of collagen induced by interleukin (IL)-1ß and/or nifedipine in gingival fibroblasts. The present study attempted to verify the role of nitric oxide (NO) in the IL-1ß/nifedipine-AR pathway in gingival overgrowth. MATERIAL AND METHODS: Confluent gingival fibroblasts derived from healthy individuals (n = 4) and those with dihydropyridine-induced gingival overgrowth (DIGO) (n = 6) were stimulated for 48 h with IL-1ß (10 ng/mL), nifedipine (0.34 µm) or IL-1ß + nifedipine. Gene and protein expression were analyzed with real-time RT-PCR and western blot analyses, respectively. Meanwhile, Sircol dye-binding and the Griess reagent were, respectively, used to detect the concentrations of total soluble collagen and nitrite in the medium. RESULTS: IL-1ß and nifedipine simultaneously up-regulated the expression of the AR and type-I collagen α1 [Colα1(I)] genes and the total collagen concentration in DIGO cells (p < 0.05). IL-1ß strongly increased the expression of inducible nitric oxide synthase (iNOS) mRNA and the nitrite concentration in both healthy and DIGO cells (p < 0.05). However, co-administration of IL-1ß and nifedipine largely abrogated the expression of iNOS mRNA and the nitrite concentration with the same treatment. Spearman's correlation coefficients revealed a positive correlation between the AR and total collagen (p < 0.001), but they both showed a negative correlation with iNOS expression and the NO concentration (p < 0.001). The iNOS inhibitor, 1400W, enhanced IL-1ß-induced AR expression; furthermore, the NO donor, NONOate, diminished the expression of the AR to a similar extent in gingival fibroblasts derived from both healthy patients and DIGO patients (p < 0.05). CONCLUSION: IL-1ß-induced NO attenuated AR-mediated collagen production in human gingival fibroblasts. The iNOS/NO system down-regulated the axis of AR/Colα1(I) mRNA expression and the production of AR/total collagen proteins by DIGO cells.


Asunto(s)
Colágeno Tipo I/biosíntesis , Encía/metabolismo , Sobrecrecimiento Gingival/metabolismo , Óxido Nítrico/metabolismo , Receptores Androgénicos/metabolismo , Anciano , Estudios de Casos y Controles , Células Cultivadas , Colágeno Tipo I/antagonistas & inhibidores , Dihidropiridinas/farmacología , Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Encía/citología , Encía/efectos de los fármacos , Sobrecrecimiento Gingival/inducido químicamente , Humanos , Interleucina-1beta/metabolismo , Persona de Mediana Edad , Nifedipino/metabolismo , Óxido Nítrico Sintasa de Tipo II/metabolismo , Estadísticas no Paramétricas
18.
Child Care Health Dev ; 37(2): 211-23, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21083687

RESUMEN

BACKGROUND: This study investigated a possible pathway of the childrearing context and maternal mental health at 6 months, and how these factors influence children's development at 6, 18 and 36 months. METHODS: Using random sampling, 2048 children and mothers were selected. The mother's health status was evaluated using the Taiwanese version of the 36-Item Short Form Health Survey (SF-36), and infant development was assessed using the high reliable Taiwan birth cohort study instrument. All data were collected using parental self-report, and were analysed using multiple linear regression analysis and further pathway using structural equation modelling. RESULTS: This study showed that 12 factors effected children's development at 6 months, and some dissipated with growth. Of these, maternal education had an enduring effect on different domains of child development, and this effect intensified as the child grew older. Children who grew up in a family with more siblings would show a delay in language development at 6 months; they have a delay in motor and social development at 18 and 36 months. Additionally, maternal mental health effected the children's fine motor development at 6 months. However, this effect disappeared at 18 months, and influenced children's social development at 36 months. CONCLUSIONS: This study demonstrated that the development of children at as young as 6 months is affected by various factors. These factors may dissipate, continue to influence child development up to 3 years of age, turn from being disadvantageous to beneficial, or affect different domains of child development. Also, parental self-report instrument might be has its limitation and could be contributed by several confounding factors. Thus, continuous longitudinal follow-up on changes in maternal conditions, family factors, and environmental factors is vital to understand how these early infantile factors affect each other and influence the developmental trajectories of children into early childhood.


Asunto(s)
Desarrollo Infantil , Crianza del Niño/psicología , Salud Mental , Madres/psicología , Hijo de Padres Discapacitados/psicología , Discapacidades del Desarrollo/etiología , Escolaridad , Métodos Epidemiológicos , Composición Familiar , Femenino , Humanos , Lactante , Trastornos del Desarrollo del Lenguaje/etiología , Masculino , Modelos Psicológicos , Desempeño Psicomotor , Factores Socioeconómicos
19.
Pharmacogenomics J ; 10(6): 537-44, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20066004

RESUMEN

Because angiotensin-converting enzyme (ACE) activity is implicated widely in biological systems, we aimed to identify its novel quantitative trait loci for the purposes of understanding ACE activity regulation and pharmacogenetics relating to ACE inhibitor (ACEI). We performed a two-stage genome-wide association study: (1) from 400 young-onset hypertension (YOH) subjects and (2) a confirmation study with an additional 623 YOH subjects. In the first stage, eight single nucleotide polymorphisms (SNPs) of the ACE structural gene and one SNP of ABO genes were significantly associated with ACE activity. SNP rs4343 in exon17 near the well-known insertion/deletion polymorphism had the strongest association. We confirmed in the second stage that three SNPs: rs4343 in ACE gene (P=3.0 x 10⁻²5), rs495828 (P=3.5 x 10⁻8) and rs8176746 (P=9.3 x 10⁻5) in ABO gene were significantly associated with ACE activity. We further replicated the association between ABO genotype/blood types and ACE activity in an independent YOH family study (428 hypertension pedigrees), and showed a potential differential blood pressure response to ACEI in subjects with varied numbers of ACE-activity-raising alleles. These findings may broaden our understanding of the mechanisms controlling ACE activity and advance our pharmacogenetic knowledge on ACEI.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Peptidil-Dipeptidasa A/genética , Sitios de Carácter Cuantitativo , Sistema del Grupo Sanguíneo ABO/genética , Adulto , Inhibidores de la Enzima Convertidora de Angiotensina/farmacología , Presión Sanguínea/genética , Femenino , Estudio de Asociación del Genoma Completo , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/genética , Masculino , Peptidil-Dipeptidasa A/sangre , Polimorfismo de Nucleótido Simple
20.
J Nanosci Nanotechnol ; 10(3): 2208-12, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20355657

RESUMEN

Quadrilateral CdO nanoparticles were grown from cadmium cupferronate complex by injecting the precursor dissolved in octylamine into trioctylamine at 220 and 250 degrees C. CdO/ZnO core/shell structures were synthesized with a method similar to that of growing CdO cores by injecting the shell precursor following the growth of cores. The shell growth temperature was adjusted from 160 to 130 degrees C, and the shell precursor supply speed was adjusted from 4 to 8 ml/h. The obtained nanostructures were characterized by X-ray diffraction, high resolution transmission electron microscope, and ultraviolet-visible spectrophotometer. No core/shell structures formed if the shell precursor injection speed was as high as 8 ml/h. A very thin layer of ZnO shells would form on CdO cores if the shell precursor was injected at a speed of 4 ml/h at temperature of 160 degrees C, and the shells had good crystal quality. CdO/ZnO core/shell nanostructures were inclined to be spherical, and no homogeneous formation of ZnO nanoparticles was observed if the shell precursor injection temperature was lowered to 130 degrees C.

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