RESUMO
PURPOSE: To investigate the effects of positive airway pressure (PAP) device on urinary albumin to creatinine ratio (UACR) and metabolic indexes in patients with metabolic syndrome (MS) and obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: This study is a retrospective cohort study. Grouped according to whether to use PAP treatment, there were 25 cases in the PAP group and 44 cases in the no OSAHS treatment group. The PAP group received positive airway pressure device and routine treatment of MS. The no OSAHS treatment group received routine treatment of OSAHS and MS. The treatment period is 3 months. RESULTS: 1. The PAP group demonstrated significant reductions in Body Mass Index (BMI), Waist circumference (WC), Neck circumference (NC), Visceral fat area (VFA), Fasting C peptide (FCP), high-sensitivity C-reactive protein (hs-CRP), and UACR compared to the no OSAHS treatment group, with significant differences (P all <0.05). Among them, the UACR in the PAP group decreased significantly (from 86.05(52.55,131.61)mg/g to 16.76(8.70,25.12)mg/g, P<0.001). 2. Linear regression analysis using the decrease in UACR values as the dependent variable demonstrated a positive linear relationship with the decrease in BMI, VFA, fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR). Furthermore, multiple linear regression analysis indicated that the decrease in VFA (B=0.537 [95% confidence interval, 0.084 to 0.989]; P = 0.021) and HOMA-IR (B=1.000 [95% confidence interval, 0.082 to 1.917]; P = 0.033) values independently correlated with decrease in UACR values. CONCLUSIONS: PAP treatment can reduce UACR in patients with MS and OSAHS, and has the effect of improving metabolic disorders. The decrease of UACR in patients may be related to the decrease of visceral fat and the improvement of insulin resistance.
Assuntos
Síndrome Metabólica , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome Metabólica/terapia , Adulto , Creatinina/sangue , Creatinina/urina , Pressão Positiva Contínua nas Vias Aéreas , Estudos de Coortes , Índice de Massa CorporalRESUMO
PURPOSE: Impaired neurocognitive function (NCF) is extremely common in patients with higher grade primary brain tumor. We previously reported evidence of genetic variants associated with NCF in glioma patients prior to treatment. However, little is known about the effect of genetic variants on NCF decline after adjuvant therapy. METHODS: Patients (N = 102) completed longitudinal NCF assessments that included measures of verbal memory, processing speed, and executive function. Testing was conducted in the postoperative period with an average follow up interval of 1.3 years. We examined polymorphisms in 580 genes related to five pathways (inflammation, DNA repair, metabolism, cognitive, and telomerase). RESULTS: Five polymorphisms were associated with longitudinal changes in processing speed and 14 polymorphisms with executive function. Change in processing speed was strongly associated with MCPH1 rs17631450 (P = 2.2 × 10-7) and CCDC26 rs7005206 (P = 9.3 × 10-7) in the telomerase pathway; while change in executive function was more strongly associated with FANCF rs1514084 (P = 2.9 × 10-6) in the DNA repair pathway and DAOA rs12428572 (P = 2.4 × 10-5) in the cognitive pathway. Joint effect analysis found significant genetic-dosage effects for longitudinal changes in processing speed (Ptrend = 1.5 × 10-10) and executive function (Ptrend = 2.1 × 10-11). In multivariable analyses, predictors of NCF decline included progressive disease, lower baseline NCF performance, and more at-risk genetic variants, after adjusting for age, sex, education, tumor location, histology, and disease progression. CONCLUSION: Our longitudinal analyses revealed that polymorphisms in telomerase, DNA repair, and cognitive pathways are independent predictors of decline in NCF in glioma patients.
Assuntos
Neoplasias Encefálicas , Glioma , Transtornos Neurocognitivos , Adulto , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/fisiopatologia , Reparo do DNA/genética , Glioma/genética , Glioma/fisiopatologia , Humanos , Estudos Longitudinais , Transtornos Neurocognitivos/genética , Transtornos Neurocognitivos/fisiopatologia , Testes Neuropsicológicos , Polimorfismo Genético , Telomerase/genéticaRESUMO
BACKGROUND AND OBJECTIVES: The health benefits of red furu in young, healthy volunteers had not been adequately investigated. The aim of this study was to determine the effect of a single meal containing red furu on serum vitamin B-12 (B-12), homocysteine and other cardiometabolic risk factors compared with that of tofu. METHODS AND STUDY DESIGN: Twenty-three healthy volunteers from Zhejiang University, China, were randomly assigned to two groups of consumption, either red furu (n=11, 5 women and 6 men) or tofu (n=12, 6 women and 6 men). Volunteers consumed one breakfast meal composed of either 50 g of red furu (intervention group) or 50 g of tofu (non-active comparison group) with two slices of bread. Fasting blood was collected at 0 h, 24 h, and 72 h. Standard methods were used to measure the volunteers' biochemical parameters. RESULTS: The consumption of 50 g of red furu a day did not significantly affect serum B-12 and showed a non-significant trend to reduce serum homocysteine. In the red furu group, but not in tofu group, serum concentrations of B-12 and folate were negatively associated with homocysteine, and B-12 was positively associated with folate. CONCLUSIONS: A breakfast meal with 50 g of red furu containing 0.096 µg of B-12 did not increase serum B-12 in healthy volunteers. These results suggested that one meal containing B-12 could be sufficient to reduce serum Hcy.
Assuntos
Doença da Artéria Coronariana/prevenção & controle , Homocisteína/sangue , Alimentos de Soja , Vitamina B 12/sangue , Adulto , Fatores de Risco Cardiometabólico , Feminino , Voluntários Saudáveis , Humanos , Masculino , Fitoterapia , Adulto JovemRESUMO
Immune cells of myeloid origin, including microglia, macrophages, and myeloid-derived suppressor cells adopt immunosuppressive phenotypes that support gliomagenesis. Here, we tested an a priori hypothesis that single nucleotide polymorphisms (SNPs) in genes related to glioma-associated myeloid cell regulation and function are also associated with patient survival after glioma diagnosis. Subjects for this study were 992 glioma patients treated at The University of Texas MD Anderson Cancer Center in Houston, Texas between 1992 and 2008. Haplotype-tagging SNPs in 91 myeloid-associated genes were analyzed for association with survival by Cox regression. Individual SNP- and gene-based tests were performed separately in glioblastoma (WHO grade IV, n = 511) and lower-grade glioma (WHO grade II-III, n = 481) groups. After adjustment for multiple testing, no myeloid-associated gene variants were significantly associated with survival in glioblastoma. Two SNPs, rs147960238 in CD163 (p = 2.2 × 10-5) and rs17138945 in MET (p = 5.6 × 10-5) were significantly associated with survival of patients with lower-grade glioma. However, these associations were not confirmed in an independent analysis of 563 lower-grade glioma cases from the University of California at San Francisco Adult Glioma Study (p = 0.65 and p = 0.41, respectively). The results of this study do not support a role for inherited polymorphisms in myeloid-associated genes in affecting survival of patients diagnosed with glioblastoma or lower-grade glioma.
Assuntos
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/mortalidade , Glioblastoma/genética , Glioblastoma/mortalidade , Células Mieloides/metabolismo , Adolescente , Adulto , Idoso , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Adulto JovemRESUMO
Cancer studies frequently yield multiple event times that correspond to landmarks in disease progression, including non-terminal events (i.e., cancer recurrence) and an informative terminal event (i.e., cancer-related death). Hence, we often observe semi-competing risks data. Work on such data has focused on scenarios in which the cause of the terminal event is known. However, in some circumstances, the information on cause for patients who experience the terminal event is missing; consequently, we are not able to differentiate an informative terminal event from a non-informative terminal event. In this article, we propose a method to handle missing data regarding the cause of an informative terminal event when analyzing the semi-competing risks data. We first consider the nonparametric estimation of the survival function for the terminal event time given missing cause-of-failure data via the expectation-maximization algorithm. We then develop an estimation method for semi-competing risks data with missing cause of the terminal event, under a pre-specified semiparametric copula model. We conduct simulation studies to investigate the performance of the proposed method. We illustrate our methodology using data from a study of early-stage breast cancer. Copyright © 2016 John Wiley & Sons, Ltd.
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Interpretação Estatística de Dados , Medição de Risco/métodos , Algoritmos , Causalidade , Progressão da Doença , Humanos , Neoplasias/epidemiologia , Neoplasias/patologia , Fatores de Risco , Estatísticas não Paramétricas , Análise de SobrevidaRESUMO
Decades of research have established only a few etiological factors for glioma, which is a rare and highly fatal brain cancer. Common methodological challenges among glioma studies include small sample sizes, heterogeneity of tumor subtypes, and retrospective exposure assessment. Here, we briefly describe the Glioma International Case-Control (GICC) Study (recruitment, 2010-2013), a study being conducted by the Genetic Epidemiology of Glioma International Consortium that integrates data from multiple data collection sites, uses a common protocol and questionnaire, and includes biospecimen collection. To our knowledge, the GICC Study is the largest glioma study to date that includes collection of blood samples, which will allow for genetic analysis and interrogation of gene-environment interactions.
Assuntos
Glioma/genética , Cooperação Internacional , Epidemiologia Molecular/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Interação Gene-Ambiente , Predisposição Genética para Doença , Glioma/sangue , Glioma/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
Accumulative epidemiological evidence suggests that single nucleotide polymorphisms (SNPs) in genes involved in homologous recombination (HR) DNA repair pathway play an important role in glioma susceptibility. However, the effects of such SNPs on glioma risk remain unclear. We used a used a candidate pathway-based approach to elucidate the relationship between glioma risk and 12 putative functional SNPs in genes involved in the HR pathway. Genotyping was conducted on 771 histologically-confirmed glioma patients and 752 cancer-free controls from the Chinese Han population. Odds ratios (OR) were calculated both for each SNP individually and for grouped analyses, examining the effects of the numbers of adverse alleles on glioma risk, and evaluated their potential gene-gene interactions using the multifactor dimensionality reduction (MDR). In the single-locus analysis, two variants, the NBS1 rs1805794 (OR 1.42, 95% CI 1.15-1.76, P = 0.001), and RAD54L rs1048771 (OR 1.61, 95% CI 1.17-2.22, P = 0.002) were significantly associated with glioma risk. When we examined the joint effects of the risk-conferring alleles of these three SNPs, we found a significant trend indicating that the risk increases as the number of adverse alleles increase (P = 0.005). Moreover, the MDR analysis suggested a significant three-locus interaction model involving NBS1 rs1805794, MRE11 rs10831234, and ATM rs227062. These results suggested that these variants of the genes involved in the HR pathway may contribute to glioma susceptibility.
Assuntos
Neoplasias Encefálicas/genética , Predisposição Genética para Doença/genética , Glioma/genética , Polimorfismo de Nucleotídeo Único/genética , Reparo de DNA por Recombinação/genética , Transdução de Sinais/genética , Transdução de Sinais/imunologia , Adolescente , Adulto , Povo Asiático/etnologia , Povo Asiático/genética , Proteínas Mutadas de Ataxia Telangiectasia/genética , Estudos de Casos e Controles , Feminino , Frequência do Gene , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
For many forms of cancer, patients will receive the initial regimen of treatments, then experience cancer progression and eventually die of the disease. Understanding the disease process in patients with cancer is essential in clinical, epidemiological and translational research. One challenge in analyzing such data is that death dependently censors cancer progression (e.g., recurrence), whereas progression does not censor death. We deal with the informative censoring by first selecting a suitable copula model through an exploratory diagnostic approach and then developing an inference procedure to simultaneously estimate the marginal survival function of cancer relapse and an association parameter in the copula model. We show that the proposed estimators possess consistency and weak convergence. We use simulation studies to evaluate the finite sample performance of the proposed method, and illustrate it through an application to data from a study of early stage breast cancer.
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Neoplasias da Mama , Risco , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Feminino , Humanos , Modelos Estatísticos , Recidiva Local de Neoplasia , PrognósticoRESUMO
Rhabdomyosarcoma (RMS) is a highly malignant tumor of developing muscle that can occur anywhere in the body. Due to its rarity, relatively little is known about the epidemiology of RMS. Atopic disease is hypothesized to be protective against several malignancies; however, to our knowledge, there have been no assessments of atopy and childhood RMS. Therefore, we explored this association in a case-control study of 322 childhood RMS cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Controls were matched to cases on race, sex and age. The following atopic conditions were assessed: allergies, asthma, eczema and hives; in addition, we examined other immune-related factors: birth order, day-care attendance and breastfeeding. Conditional logistic-regression models were used to calculate an odds ratio (OR) and 95% confidence interval (CI) for each exposure, adjusted for age, race, sex, household income and parental education. As the two most common histologic types of RMS are embryonal (n=215) and alveolar (n=66), we evaluated effect heterogeneity of these exposures. Allergies (OR=0.60, 95% CI: 0.41-0.87), hives (OR = 0.61, 95% CI: 0.38-0.97), day-care attendance (OR=0.48, 95% CI: 0.32-0.71) and breastfeeding for ≥ 12 months (OR=0.36, 95% CI: 0.18-0.70) were inversely associated with childhood RMS. These exposures did not display significant effect heterogeneity between histologic types (p>0.52 for all exposures). This is the first study indicating that atopic exposures may be protective against childhood RMS, suggesting additional studies are needed to evaluate the immune system's role in the development of this tumor.
Assuntos
Asma/complicações , Eczema/complicações , Hipersensibilidade/complicações , Rabdomiossarcoma/etiologia , Rabdomiossarcoma/prevenção & controle , Urticária/complicações , Adolescente , Adulto , Asma/imunologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Eczema/imunologia , Feminino , Seguimentos , Humanos , Hipersensibilidade/imunologia , Lactente , Recém-Nascido , Masculino , Prognóstico , Fatores de Risco , Urticária/imunologia , Adulto JovemRESUMO
BACKGROUND: Although birthplace data are routinely collected in the participating Surveillance, Epidemiology, and End Results (SEER) registries, such data are missing in a nonrandom manner for a large percentage of cases. This hinders analysis of nativity-related cancer disparities. In the current study, the authors evaluated multiple imputation of nativity status among Hispanic patients diagnosed with cervical, prostate, and colorectal cancer and demonstrated the effect of multiple imputation on apparent nativity disparities in survival. METHODS: Multiple imputation by logistic regression was used to generate nativity values (US-born vs foreign-born) using a priori-defined variables. The accuracy of the method was evaluated among a subset of cases. Kaplan-Meier curves were used to illustrate the effect of imputation by comparing survival among US-born and foreign-born Hispanics, with and without imputation of nativity. RESULTS: Birthplace was missing for 31%, 49%, and 39%, respectively, of cases of cervical, prostate, and colorectal cancer. The sensitivity of the imputation strategy for detecting foreign-born status was ≥90% and the specificity was ≥86%. The agreement between the true and imputed values was ≥0.80 and the misclassification error was ≤10%. Kaplan-Meier survival curves indicated different associations between nativity and survival when nativity was imputed versus when cases with missing birthplace were omitted from the analysis. CONCLUSIONS: Multiple imputation using variables available in the SEER data file can be used to accurately detect foreign-born status. This simple strategy may help researchers to disaggregate analyses by nativity and uncover important nativity disparities in regard to cancer diagnosis, treatment, and survival.
Assuntos
Hispânico ou Latino , Neoplasias/etnologia , Características de Residência , Adulto , Idoso , Neoplasias Colorretais/etnologia , Emigração e Imigração , Feminino , Disparidades nos Níveis de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias da Próstata/etnologia , Programa de SEER , Neoplasias do Colo do Útero/etnologiaRESUMO
The aim of this study is to identify and validate copy number aberrations in early-stage primary breast tumors associated with bone or non-bone metastasis. Whole-genome molecular inversion probe arrays were used to evaluate copy number imbalances (CNIs) in breast tumors from 960 early-stage patients with information about site of metastasis. The CoxBoost algorithm was used to select metastasis site-related CNIs and to fit a Cox proportional hazards model. Gains at 1q41 and 1q42.12 and losses at 1p13.3, 8p22, and Xp11.3 were significantly associated with bone metastasis. Gains at 2p11.2, 3q21.3-22.2, 3q27.1, 10q23.1, and 14q13.2-3 and loss at 7q21.11 were associated with non-bone metastasis. To examine the joint effect of CNIs and clinical predictors, patients were stratified into three risk groups (low, intermediate, and high) based on the sum of predicted linear hazard ratios. For bone metastasis, the hazard (95 % confidence interval) for the low-risk group was 0.32 (0.11-0.92) compared to the intermediate-risk group and 2.99 (1.74-5.11) for the high-risk group. For non-bone metastasis, the hazard for the low-risk group was 0.34 (0.17-0.66) and 2.33 (1.59-3.43) for the high-risk group. The prognostic value of loss at 8p22 for bone metastasis and gains at 10q23.1 for non-bone metastasis, and gain at 11q13.5 for both bone and non-bone metastases were externally validated in 335 breast tumors pooled from four independent cohorts. Distinct CNIs are independently associated with bone and non-bone metastasis for early-stage breast cancer patients across cohorts. These data warrant consideration for tailoring surveillance and management of metastasis risk.
Assuntos
Neoplasias Ósseas/secundário , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Variações do Número de Cópias de DNA , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Reprodutibilidade dos TestesRESUMO
PURPOSE: Previous assessments of childhood rhabdomyosarcoma have indicated maternal and birth characteristics may be associated with tumor development; however, much work remains to identify novel and confirm suspected risk factors. Our objective was to evaluate the associations between maternal and birth characteristics and childhood rhabdomyosarcoma. METHODS: This case-control study included 322 cases and 322 pair-matched controls. Cases were enrolled in a trial run by the Intergroup Rhabdomyosarcoma Study Group. Population-based controls were identified using random digit dialing and were individually matched to cases on race, sex, and age. Families of the case and control subjects participated in a telephone interview, which captured information on maternal characteristics (birth control use, number of prenatal visits, anemia, and abnormal bleeding during pregnancy) and birth characteristics [birth weight, preterm birth, and type of delivery (vaginal vs. cesarean)]. Conditional logistic regression models were used to calculate an odds ratio (OR) and 95% confidence interval (CI) for each exposure, adjusted for age, race, sex, household income, and parental education. As the two most common histologic types of rhabdomyosarcoma are embryonal (n = 215) and alveolar (n = 66), we evaluated effect heterogeneity of these exposures. RESULTS: The only characteristic that was associated with childhood rhabdomyosarcoma, and statistically significant, was abnormal vaginal bleeding during pregnancy (OR 1.75, 95% CI 1.12-2.74). Birth control use (OR 1.45, 95% CI 0.96-2.18), anemia during pregnancy (OR 1.27, 95% CI 0.81-1.99), and preterm birth (OR 2.51, 95% CI 0.74-8.49) were positively associated with childhood rhabdomyosarcoma, but were not statistically significant. Low birth weight [adjusted odds ratios (aOR) 4.46, 95% CI 1.41-14.1] and high birth weight (aOR 2.41, 95% CI 1.09-5.35) were strongly associated with alveolar rhabdomyosarcoma. However, these factors did not display significant effect heterogeneity between histologic types (p > 0.15 for all characteristics). CONCLUSIONS: Overall, we found little evidence that these maternal and birth characteristics are strongly associated with childhood rhabdomyosarcoma.
Assuntos
Rabdomiossarcoma/epidemiologia , Ordem de Nascimento , Peso ao Nascer , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Idade Materna , Razão de Chances , Gravidez , Complicações na Gravidez/epidemiologia , Fatores de RiscoRESUMO
To examine the role of germline genetic variations in inflammatory pathways as modifiers of time to recurrence (TTR) in patients with early stage breast cancer (BC), DNA from 997 early stage BC patients was genotyped for 53 tagging single nucleotide polymorphisms (SNPs) in 12 genes involved in inflammation. SNPs were analyzed separately for Caucasians versus African-Americans and Hispanics. Cox proportional hazards models were used to evaluate the association between SNPs in the inflammatory genes and TTR, adjusted for clinical and pathologic covariates. In univariable analyses of Caucasian women, the homozygous genotype of 12 SNPs, including 6 NFKB1 SNPs, 4 IL4 SNPs, and 2 IL13 SNPs, were significantly associated with a decrease in TTR compared with the heterozygous and/or corresponding homozygous genotype (P < 0.05). The significant NFKB1 and IL4 SNPs were in an area of high linkage disequilibrium (D' > 0.8). After adjusting for stage, age, and treatment, carriage of the homozygous genotypes for NFKB1 rs230532 and IL13rs1800925 were independently associated with a shorter TTR (P = 0.001 and P = 0.034, respectively). In African-American and Hispanic patients, expression of NFKB1 rs3774932, TNFrs1799964, and IL4rs3024543 SNPs were associated with a shorter TTR in univariable model. Only NFKB1 rs3774932 (P = 0.02) and IL4Rrs3024543 (P = 0.03) had independent prognostic value in the multivariable model These data support the existence of host genetic susceptibility as a component in recurrence risk mediated by pro-inflammatory and immune factors, and suggest the potential for drugs which modify immune responses and inflammatory genes to improve prognosis in early stage BC.
Assuntos
Neoplasias da Mama/genética , Predisposição Genética para Doença , Inflamação/genética , Polimorfismo de Nucleotídeo Único , Negro ou Afro-Americano/genética , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Estudos de Coortes , Feminino , Hispânico ou Latino/genética , Homozigoto , Humanos , Inflamação/etiologia , Neoplasias Inflamatórias Mamárias/genética , Interleucina-13/genética , Interleucina-4/genética , Subunidade alfa de Receptor de Interleucina-4/genética , Desequilíbrio de Ligação , Pessoa de Meia-Idade , Análise Multivariada , Subunidade p50 de NF-kappa B/genética , Recidiva Local de Neoplasia/genética , Prognóstico , Modelos de Riscos Proporcionais , População Branca/genéticaRESUMO
PURPOSE: While cervical cancer screening and risk behaviors have been found to vary among US- and foreign-born Hispanic women, many cancer epidemiology studies have conceptualized Hispanics as a homogenous group. Here, we examine differences in cervical cancer stage at diagnosis and survival among Hispanic women by nativity. METHODS: We use data from the Surveillance, Epidemiology, and End Results program, 1998-2008. Nativity was based on place of birth and was categorized as US versus foreign born. Distant and regional tumors were classified as late stage, while local tumors were classified as early stage. RESULTS: Forty-seven percent of cases of invasive cervical cancer among Hispanics were diagnosed at a late stage, and over half of invasive cervical cancer cases were among foreign-born women. Foreign-born Hispanic women were significantly more likely than US-born Hispanics to have late-stage diagnosis, after adjusting for age at diagnosis and tumor histology (adjusted odds ration = 1.09, p value = 0.003). There was heterogeneity in the association between nativity and survival by stage at diagnosis. Among cases with early-stage diagnosis, survival was poorer among foreign-born versus US-born Hispanics after adjusting for age at diagnosis, histology, and cancer-directed therapy [adjusted hazard ratios (HR) = 1.31, p value = 0.030]. However, among cases with late-stage diagnosis, survival was better among foreign-born Hispanics (adjusted HR = 0.81, p value < 0.001). CONCLUSIONS: We hypothesize that nativity differences in survival may be indicative of diverse risk, screening, and treatment profiles. Given such differences, it may be inappropriate to aggregate Hispanics as a single group for cervical cancer research.
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Emigrantes e Imigrantes/estatística & dados numéricos , Hispânico ou Latino/estatística & dados numéricos , Programa de SEER/estatística & dados numéricos , Neoplasias do Colo do Útero/etnologia , Adulto , Feminino , Disparidades nos Níveis de Saúde , Hispânico ou Latino/etnologia , Humanos , Incidência , Estimativa de Kaplan-Meier , Modelos Logísticos , Pessoa de Meia-Idade , Invasividade Neoplásica , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/patologiaRESUMO
Background: We sought to identify clinical and genetic predictors of temozolomide-related myelotoxicity among patients receiving therapy for glioblastoma. Methods: Patients (n = 591) receiving therapy on NRG Oncology/RTOG 0825 were included in the analysis. Cases were patients with severe myelotoxicity (grade 3 and higher leukopenia, neutropenia, and/or thrombocytopenia); controls were patients without such toxicity. A risk-prediction model was built and cross-validated by logistic regression using only clinical variables and extended using polymorphisms associated with myelotoxicity. Results: 23% of patients developed myelotoxicity (n = 134). This toxicity was first reported during the concurrent phase of therapy for 56 patients; 30 stopped treatment due to toxicity. Among those who continued therapy (n = 26), 11 experienced myelotoxicity again. The final multivariable clinical factor model included treatment arm, gender, and anticonvulsant status and had low prediction accuracy (area under the curve [AUC] = 0.672). The final extended risk prediction model including four polymorphisms in MGMT had better prediction (AUC = 0.827). Receiving combination chemotherapy (OR, 1.82; 95% CI, 1.02-3.27) and being female (OR, 4.45; 95% CI, 2.45-8.08) significantly increased myelotoxicity risk. For each additional minor allele in the polymorphisms, the risk increased by 64% (OR, 1.64; 95% CI, 1.43-1.89). Conclusions: Myelotoxicity during concurrent chemoradiation with temozolomide is an uncommon but serious event, often leading to treatment cessation. Successful prediction of toxicity may lead to more cost-effective individualized monitoring of at-risk subjects. The addition of genetic factors greatly enhanced our ability to predict toxicity among a group of similarly treated glioblastoma patients.
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SCOPE: The role of palmitoleic acid (POA) in hypertension or blood pressure remains uncertain. This study aims to investigate the epidemiological association between circulating POA and primary hypertension in humans, and subsequently evaluate the effects of exogenous POA on blood pressure and aortic remodeling in spontaneously hypertensive rats (SHRs). METHODS AND RESULTS: A case-control study of 349 hypertensive and 1396 normotensive children and adolescents is conducted, and found hypertensive cases show significant lower erythrocyte phospholipid POA than normotensive controls (p < 0.001). In conditional logistic regression model, participants in the top quartile of POA have a lower prevalence of primary hypertension than those in the bottom (multivariate-adjusted OR: 0.47, 95% CI: 0.25-0.89). In animal study, 24 SHRs are randomly assigned to n-3 PUFAs (500 mg kg-1 ), POA (500 mg kg-1 ), or vehicle (olive oil) for 8 weeks. At the end of intervention, as compared to SHRs treated with vehicle, SHRs treated with POA shows significantly decreased systolic blood pressure (SBP), improved aortic remodeling, and also decreased aortic expressions of NF-κB and its downstream proinflammatory cytokines. CONCLUSIONS: Circulating POA is inversely associated with risk of primary hypertension, and exogenous POA supplementation can decrease SBP and improve aortic remodeling by inhibiting NF-κB-mediated inflammation.
Assuntos
Ácidos Graxos Monoinsaturados/sangue , Ácidos Graxos Monoinsaturados/farmacologia , Hipertensão/sangue , Inflamação/tratamento farmacológico , NF-kappa B/metabolismo , Adolescente , Animais , Anti-Hipertensivos/farmacologia , Aorta/efeitos dos fármacos , Aorta/metabolismo , Aorta/fisiopatologia , Pequim/epidemiologia , Pressão Sanguínea/efeitos dos fármacos , Estudos de Casos e Controles , Criança , Eritrócitos/metabolismo , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Inflamação/metabolismo , Masculino , Ratos Endogâmicos SHR , Remodelação Ventricular/efeitos dos fármacosRESUMO
Bacteria in human milk could directly seed the infant intestinal microbiota, while information about how milk microbiota develops during lactation and how geographic location, gestational hypertensive status, and maternal age influence this process is limited. Here, we collected human milk samples from mothers of term infants at the first day, 2 weeks, and 6 weeks postpartum from 117 longitudinally followed-up mothers (age: 28.7 ± 3.6 y) recruited from three cities in China. We found that milk microbial diversity and richness were the highest in colostrum but gradually decreased over lactation. Microbial composition changed across lactation and exhibited more discrete compositional patterns in 2-week and 6-week milk samples compared with colostrum samples. At phylum level, the abundance of Proteobacteria increased during lactation, while Firmicutes showed the opposite trend. At genus level, Staphylococcus, Streptococcus, Acinetobacter, Pseudomonas, and Lactobacillus were predominant in colostrum samples and showed distinct variations across lactation. Maternal geographic location was significantly associated with the milk microbiota development and the abundance of predominant genus. In addition, milk from mothers with gestational prehypertension had a different and less diverse microbial community at genus level in early lactation times, and contained less Lactobacillus in the 2-week milk samples than those from normotensive mothers. Findings of our study outlined the human milk microbial diversity and community development over lactation, and underscored the importance of maternal geographic locations and gestational hypertensive status on milk microbiota, which might have important implications in the establishment of the infant intestinal microbiota via breastfeeding.
Assuntos
Bactérias/classificação , Hipertensão Induzida pela Gravidez/microbiologia , Lactação , Microbiota , Leite Humano/microbiologia , Adulto , Bactérias/crescimento & desenvolvimento , Colostro/microbiologia , Dieta , Feminino , Firmicutes/crescimento & desenvolvimento , Geografia , Humanos , Lactente , Recém-Nascido , Gravidez , Proteobactérias/crescimento & desenvolvimentoRESUMO
Short-term intervention studies support a link between animal-based diet and the outgrowth of microorganisms capable of triggering inflammatory bowel disease. However, whether habitual animal fat intake is associated with gut-related health remains unclear. Thus, we collected dietary information, clinical data and fecal samples from 297 healthy young subjects and characterized gut microbiota by 16S rRNA gene sequencing and microbial metabolites, including short-chain fatty acids (SCFAs) and bile acids (BAs) using a gas chromatography coupled to time-of-flight mass spectrometry (GC-TOF/MS) system and ultra performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) platform, respectively. We found that the microbial diversity of butyric acid (rho = -0.17, p = 0.004 for the Shannon index) and the concentrations of butyric acid (rho = -0.33, p < 0.001) and valeric acid (rho = -0.28, p = 0.002) were negatively associated with animal fat consumption. In line with this, the abundance of SCFAs-producing bacteria such as Blautia, Eubacterium hallii, and Megamonas were significantly lower in the high animal fat group compared with the low animal fat group (all p < 0.05). Additionally, the high animal fat group had higher concentrations of total (p = 0.06) and unconjugated (p = 0.09) BAs relative to the lower animal fat groups. The findings of our study indicate that a diet with higher animal-based fat consumption is likely to be associated with moderately unfavorable impacts on gut microbial diversity, community, and regulation of fecal SCFAs, which may influence the host cardiometabolic health in the long term among healthy Chinese adults whose diet is in a nutrition transition.
Assuntos
Bactérias/metabolismo , Ácidos Graxos Voláteis/metabolismo , Microbioma Gastrointestinal , Adulto , Animais , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Gorduras na Dieta/metabolismo , Ácidos Graxos Voláteis/química , Fezes/microbiologia , Feminino , Humanos , Masculino , Espectrometria de Massas em Tandem , Adulto JovemRESUMO
BACKGROUND: Fatigue is a consistently reported, severe symptom among patients with gliomas throughout the disease trajectory. Genomic pathways associated with fatigue in glioma patients have yet to be identified. METHODS: Clinical factors (performance status, tumor details, age, gender) were collected by chart review on glioma patients with fatigue ("I have lack of energy" on Functional Assessment of Cancer Therapy-Brain), as well as available genotyping data. Candidate genes in clock and inflammatory pathways were identified from a literature review, of which 50 single nucleotide polymorphisms (SNPs) in 7 genes were available. Clinical factors and SNPs identified by univariate analyses were included in a multivariate model for moderate-severe fatigue. RESULTS: The study included 176 patients (median age = 47 years, 67% males). Moderate-severe fatigue was reported by 43%. Results from multivariate analysis revealed poor performance status and 2 SNPs were associated with fatigue severity. Moderate-severe fatigue was more common in patients with poor performance status (OR = 3.52, P < .01). For each additional copy of the minor allele in rs934945 (PER2) the odds of fatigue decreased (OR = 0.51, P < .05). For each additional copy of the minor allele in rs922270 (ARTNL2) the odds of fatigue increased (OR = 2.38, P < .01). Both of these genes are important in the circadian clock pathway, which has been implicated in diurnal preference, and duration and quality of sleep. No genes in the inflammatory pathway were associated with fatigue in the current study. CONCLUSIONS: Identifying patients at highest risk for fatigue during treatment allows for improved clinical monitoring and enrichment of patient selection for clinical trials.