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1.
Environ Health ; 22(1): 42, 2023 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-37183246

RESUMO

BACKGROUND: The objective of this study was to evaluate the behavioral determinants associated with exclusive use of arsenic-safe water in the community-led Strong Heart Water Study (SHWS) arsenic mitigation program. METHODS: The SHWS is a randomized controlled trial of a community-led arsenic mitigation program designed to reduce arsenic exposure among private well users in American Indian Great Plains communities. All households received point-of-use (POU) arsenic filters installed at baseline and were followed for 2 years. Behavioral determinants selected were those targeted during the development of the SHWS program, and were assessed at baseline and follow-up. RESULTS: Among participants, exclusive use of arsenic-safe water for drinking and cooking at follow-up was associated with higher self-efficacy for accessing local resources to learn about arsenic (OR: 5.19, 95% CI: 1.48-18.21) and higher self-efficacy to resolve challenges related to arsenic in water using local resources (OR: 3.11, 95% CI: 1.11-8.71). Higher commitment to use the POU arsenic filter faucet at baseline was also a significant predictor of exclusive arsenic-safe water use for drinking (OR: 32.57, 95% CI: 1.42-746.70) and cooking (OR: 15.90, 95% CI: 1.33-189.52) at follow-up. From baseline to follow-up, the SHWS program significantly increased perceived vulnerability to arsenic exposure, self-efficacy, descriptive norms, and injunctive norms. Changing one's arsenic filter cartridge after installation was associated with higher self-efficacy to obtain arsenic-safe water for drinking (OR: 6.22, 95% CI: 1.33-29.07) and cooking (OR: 10.65, 95% CI: 2.48-45.68) and higher perceived vulnerability of personal health effects (OR: 7.79, 95% CI: 1.17-51.98) from drinking arsenic-unsafe water. CONCLUSIONS: The community-led SHWS program conducted a theory-driven approach for intervention development and evaluation that allowed for behavioral determinants to be identified that were associated with the use of arsenic safe water and changing one's arsenic filter cartridge. These results demonstrate that theory-driven, context-specific formative research can influence behavior change interventions to reduce water arsenic exposure. The SHWS can serve as a model for the design of theory-driven intervention approaches that engage communities to reduce arsenic exposure. TRIAL REGISTRATION: The SHWS is registered with ClinicalTrials.gov (Identifier: NCT03725592).


Assuntos
Arsênio , Água Potável , Poluentes Químicos da Água , Humanos , Arsênio/análise , Poluentes Químicos da Água/análise , Abastecimento de Água
2.
Sci Rep ; 13(1): 4082, 2023 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-36906658

RESUMO

Despite the success of AlphaFold2 (AF2), it is unclear how AF2 models accommodate for ligand binding. Here, we start with a protein sequence from Acidimicrobiaceae TMED77 (T7RdhA) with potential for catalyzing the degradation of per- and polyfluoroalkyl substances (PFASs). AF2 models and experiments identified T7RdhA as a corrinoid iron-sulfur protein (CoFeSP) which uses a norpseudo-cobalamin (BVQ) cofactor and two Fe4S4 iron-sulfur clusters for catalysis. Docking and molecular dynamics simulations suggest that T7RdhA uses perfluorooctanoic acetate (PFOA) as a substrate, supporting the reported defluorination activity of its homolog, A6RdhA. We showed that AF2 provides processual (dynamic) predictions for the binding pockets of ligands (cofactors and/or substrates). Because the pLDDT scores provided by AF2 reflect the protein native states in complex with ligands as the evolutionary constraints, the Evoformer network of AF2 predicts protein structures and residue flexibility in complex with the ligands, i.e., in their native states. Therefore, an apo-protein predicted by AF2 is actually a holo-protein awaiting ligands.


Assuntos
Fluorocarbonos , Proteínas Ferro-Enxofre , Ligantes , Furilfuramida , Proteínas Ferro-Enxofre/metabolismo , Vitamina B 12/metabolismo
3.
Water Res ; 230: 119500, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36640613

RESUMO

A detailed characterization of residential water consumption is essential for ensuring urban water systems' capability to cope with changing water resources availability and water demands induced by growing population, urbanization, and climate change. Several studies have been conducted in the last decades to investigate the characteristics of residential water consumption with data at a sufficiently fine temporal resolution for grasping individual end uses of water. In this paper, we systematically review 114 studies to provide a comprehensive overview of the state-of-the-art research about water consumption at the end-use level. Specifically, we contribute with: (1) an in-depth discussion of the most relevant findings of each study, highlighting which water end-use characteristics were so far prioritized for investigation in different case studies and water demand modelling and management studies from around the world; and (2) a multi-level analysis to qualitatively and quantitatively compare the most common results available in the literature, i.e. daily per capita end-use water consumption, end-use parameter average values and statistical distributions, end-use daily profiles, end-use determinants, and considerations about efficiency and diffusion of water-saving end uses. Our findings can support water utilities, consumers, and researchers (1) in understanding which key aspects of water end uses were primarily investigated in the last decades; and (2) in exploring their main features considering different geographical, cultural, and socio-economic regions of the world.


Assuntos
Urbanização , Água , Abastecimento de Água , Recursos Hídricos
4.
Sci Total Environ ; 862: 160217, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36410482

RESUMO

Many rural populations, including American Indian communities, that use private wells from groundwater for their source of drinking and cooking water are disproportionately exposed to elevated levels of arsenic. However, programs aimed at reducing arsenic in American Indian communities are limited. The Strong Heart Water Study (SHWS) is a randomized controlled trial aimed at reducing arsenic exposure among private well users in American Indian Northern Great Plains communities. The community-led SHWS program installed point-of-use (POU) arsenic filters in the kitchen sink of households, and health promoters delivered arsenic health communication programs. In this study we evaluated the efficacy of these POU arsenic filters in removing arsenic during the two-year installation period. Participants were randomized into two arms. In the first arm households received a POU arsenic filter, and 3 calls promoting filter use (SHWS mobile health (mHealth) & filter arm). The second arm received the same filter and phone calls, and 3 in-person home visits and 3 Facebook messages (SHWS intensive arm) for program delivery. Temporal variability in water arsenic concentrations from the main kitchen faucet was also evaluated. A total of 283 water samples were collected from 50 households with private wells from groundwater (139 filter and 144 kitchen faucet samples). Ninety-three percent of households followed after baseline had filter faucet water arsenic concentrations below the arsenic maximum contaminant level of 10 µg/L at the final visit during our 2 year study period with no difference between study arms (98 % in the intensive arm vs. 94 % in the mHealth & filter arm). No significant temporal variation in kitchen arsenic concentration was observed over the study period (intraclass correlation coefficient = 0.99). This study demonstrates that POU arsenic filters installed for the community participatory SHWS program were effective in reducing water arsenic concentration in study households in both arms, even with delivery of the POU arsenic filter and mHealth program only. Furthermore, we observed limited temporal variability of water arsenic concentrations from kitchen faucet samples collected over time from private wells in our study setting.


Assuntos
Arsênio , Água Potável , Poluentes Químicos da Água , Humanos , Arsênio/análise , Monitoramento Ambiental , Água , Indígena Americano ou Nativo do Alasca , Poços de Água , Poluentes Químicos da Água/análise , Abastecimento de Água , Água Potável/análise
5.
Cancer Med ; 12(5): 6023-6039, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36224740

RESUMO

PURPOSE: To provide ways to improve the clinical practice of fertility preservation (FP) for children, adolescents, and young adults (AYA) with cancer. DESIGN: A systematic research of online databases was undertaken in March 2020 following the PRISMA criteria, including Medline and Web of Science. RESULTS: Fifty-nine articles were included. Surveys, interviews, and focus groups were used to collect data from patients, parents, and health care providers (HCPs). Four themes worth exploring emerged: (a) what do patients and professionals think of and know about FP? (b) what makes the fertility discussion happen or not? (c) what, retrospectively, led to FP being pursued or not? and (d) how do patients and HCPs feel about fertility issues? CONCLUSION: A minority of AYAs preserve their fertility (banking assay for 45% of boys and 23% of girls). Yet fertility concerns have a significant impact on the quality of life of young cancer survivors. Although recommendations and guidelines regarding FP are available internationally, there are no specific guidelines as to how to conduct fertility counseling for children and adolescents. Some barriers are not removable, such as a poor prognosis of an obvious severe disease, time constraints for starting treatment, and cultural and religious beliefs. In response to aspects hindering patients and families to be receptive to any discussion at the time of diagnosis, psychological support could reduce the level of emotional distress and help restore a degree of open-mindedness to open a window for discussion. Moreover, as the lack of knowledge of professionals about fertility is frequently pointed out as a limiting factor for fertility discussion, reinforcing professional training regarding FP could be proposed to promote fertility discussion and eventually referral for FP.


Assuntos
Sobreviventes de Câncer , Preservação da Fertilidade , Neoplasias , Masculino , Adolescente , Adulto Jovem , Feminino , Humanos , Criança , Qualidade de Vida , Estudos Retrospectivos , Neoplasias/terapia , Neoplasias/psicologia , Aconselhamento
6.
Ann Endocrinol (Paris) ; 84(1): 57-68, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36183805

RESUMO

Male sex is a major cardiovascular risk factor in the general population, with men showing higher age-adjusted prevalence of cardiovascular disease than women. Diabetes, another major cardiovascular risk factor, affects cardiovascular risk differentially between men and women. Data from prospective observational studies showed that women with diabetes had greater relative risk of cardiovascular events than men with diabetes, leading to a smaller difference between diabetic men and women than between non-diabetic men and women in terms of cardiovascular disease. This excess relative risk concerns cardiovascular death, coronary heart disease, stroke and heart failure. It is greatest in the youngest age group and decreases gradually with age. Although many mechanisms have been proposed to explain the greater cardiovascular burden in women with diabetes, little is known about the impact of diverse anti-hyperglycemic drugs on cardiovascular events according to sex. Hence, cardiovascular outcomes trials provide a unique opportunity to study the impact of novel anti-hyperglycemic drugs on cardiovascular outcomes in men and women with type-2 diabetes. Here, we present an overview of the epidemiological data concerning sex-related differences in cardiovascular disease in people with diabetes, with a focus on the effects of novel anti-hyperglycemic drugs on cardiovascular outcomes in men and women. In addition, we summarize proposed mechanisms to explain these differences, with relevant references for the interested reader.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Humanos , Masculino , Feminino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fatores de Risco , Fatores Sexuais , Fatores de Risco de Doenças Cardíacas , Hipoglicemiantes/uso terapêutico , Estudos Observacionais como Assunto
7.
J Integr Complement Med ; 28(3): 268-277, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35244456

RESUMO

Background: In integrative medicine, complementary healing methods, such as external applications (massages, rhythmic rubs, and compresses), are part of the practice and clinical application and have proven their therapeutic effect in various fields. Objective: Aim of this exploratory, controlled, single-blinded study was to investigate the effects of three different warming chest compresses on cardiovascular regulation by analyzing heart rate variability (HRV) in healthy subjects. Methods: Over a period of 4 weeks, three different warming chest compresses (a hot water compress, a ginger powder compress, and a mustard flour compress) in 30 healthy subjects were analyzed. For all subjects, 48-h long-term electrocardiograms were recorded, and afterward, epochs of 5 min length extracted and analyzed by different linear and nonlinear HRV indices. Results: A moist chest compress did not result in any significant short- and long-term stimulation of the autonomic regulation, except for a short-term significant decrease in heart rate (meanNN, p < 0.05). Warm and moist chest compresses with ginger flour led to significantly increased HRV (sdNN, p < 0.05; symbolic dynamics2, p < 0.05) and its complexity (renyi4 entropy, p < 0.05) and a significant decrease in heart rate (meanNN, p < 0.00036), and thus to a short-term relaxation effect. In contrast, warm and moist chest compresses with mustard flour led to significantly decreased HRV and their complexity (time-, frequency-, and nonlinear dynamics domain, p < 0.00036), which can be interpreted as a stress reaction of the autonomous nervous system. Conclusions: The application of chest compresses led to short-term relaxation effects (ginger) as well as short-term stress effects (mustard) but not to any significant longer-term effect on HRV in healthy subjects.


Assuntos
Sistema Nervoso Autônomo , Coração , Sistema Nervoso Autônomo/fisiologia , Voluntários Saudáveis , Frequência Cardíaca/fisiologia , Humanos , Tórax
9.
Microbiol Resour Announc ; 10(44): e0063521, 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34734765

RESUMO

Delftia acidovorans strain D4B is an aerobic bacterium within the Betaproteobacteria lineage that was isolated from soil. The genome size is 6.26 Mbp, with a G+C content of 67%. The genome encodes enzymes potentially involved in the degradation of fluorinated compounds.

10.
Am J Physiol Renal Physiol ; 321(5): F600-F616, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34541901

RESUMO

Following our previous reports on mesangial sclerosis and vascular proliferation in diabetic nephropathy (DN) (Kriz W, Löwen J, Federico G, van den Born J, Gröne E, Gröne HJ. Am J Physiol Renal Physiol 312: F1101-F1111, 2017; Löwen J, Gröne E, Gröne HJ, Kriz W. Am J Physiol Renal Physiol 317: F399-F410, 2019), we now describe the advanced stages of DN terminating in glomerular obsolescence and tubulointerstitial fibrosis based on a total of 918 biopsies. The structural aberrations emerged from two defects: 1) increased synthesis of glomerular basement membrane (GBM) components by podocytes and endothelial cells leading to an accumulation of GBM material in the mesangium and 2) a defect of glomerular vessels consisting of increased leakiness and an increased propensity to proliferate. Both defects may lead to glomerular degeneration. The progressing compaction of accumulated worn-out GBM material together with the retraction of podocytes out of the tuft and the collapse and hyalinosis of capillaries results in a shrunken tuft that fuses with Bowman's capsule (BC) to glomerular sclerosis. The most frequent pathway to glomerular decay starts with local tuft expansions that result in contacts of structurally intact podocytes to the parietal epithelium initiating the formation of tuft adhesions, which include the penetration of glomerular capillaries into BC. Exudation of plasma from such capillaries into the space between the parietal epithelium and its basement membrane causes the formation of insudative fluid accumulations within BC spreading around the glomerular circumference and, via the glomerulotubular junction, onto the tubule. Degeneration of the corresponding tubule develops secondarily to the glomerular damage, either due to cessation of filtration in cases of global sclerosis or due to encroachment of the insudative spaces. The degenerating tubules induce the proliferation of myofibroblasts resulting in interstitial fibrosis.NEW & NOTEWORTHY Based on analysis of 918 human biopsies, essential derangement in diabetic nephropathy consists of accumulation of worn-out glomerular basement membrane in the mesangium that may advance to global sclerosis. The most frequent pathway to nephron dropout starts with the penetration of glomerular capillaries into Bowman's capsule (BC), delivering an exudate into BC that spreads around the entire glomerular circumference and via the glomerulotubular junction onto the tubule, resulting in glomerular sclerosis and chronic tubulointerstitial damage.


Assuntos
Nefropatias Diabéticas/patologia , Glomerulonefrite/patologia , Néfrons/patologia , Biópsia , Cápsula Glomerular/patologia , Capilares/patologia , Permeabilidade Capilar , Nefropatias Diabéticas/metabolismo , Progressão da Doença , Células Endoteliais/patologia , Fibrose , Membrana Basal Glomerular/patologia , Glomerulonefrite/metabolismo , Humanos , Microscopia Eletrônica de Transmissão , Neovascularização Patológica , Néfrons/metabolismo , Néfrons/ultraestrutura , Podócitos/patologia
11.
Biologicals ; 71: 9-19, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34006447

RESUMO

The European Directorate for the Quality of Medicines & HealthCare (EDQM) has run proficiency testing schemes on the detection of viral contaminants in human plasma pools by nucleic-acid amplification techniques since 1999 for hepatitis C virus and since 2004 for parvovirus B19. A retrospective analysis was performed to assess their impact and identify trends and progress in the results obtained by participating laboratories over a 15-year span, from 2004 to 2018. The results demonstrate that overall performance improved over that time, especially among the regular participants. Participation in these proficiency testing schemes is therefore recommended for all interested control laboratories. This analysis also shows that hepatitis C virus detection now seems well established compared to that of parvovirus B19, which still appears more challenging.


Assuntos
Hepacivirus/isolamento & purificação , Parvovirus B19 Humano/isolamento & purificação , Plasma/virologia , Doadores de Sangue , DNA Viral/isolamento & purificação , Hepacivirus/genética , Humanos , Parvovirus B19 Humano/genética , Estudos Retrospectivos
12.
Genet Med ; 23(1): 111-122, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32855533

RESUMO

PURPOSE: Thoracic aortic aneurysm and dissection (TAAD) is a life-threatening disease with often unrecognized inherited forms. We sought to identify novel pathogenic variants associated with autosomal dominant inheritance of TAAD. METHODS: We analyzed exome sequencing data from 35 French TAAD families and performed next-generation sequencing capture panel of genes in 1114 unrelated TAAD patients. Functional effects of pathogenic variants identified were validated in cell, tissue, and mouse models. RESULTS: We identified five functional variants in THSD4 of which two heterozygous variants lead to a premature termination codon. THSD4 encodes ADAMTSL6 (member of the ADAMTS/L superfamily), a microfibril-associated protein that promotes fibrillin-1 matrix assembly. The THSD4 variants studied lead to haploinsufficiency or impaired assembly of fibrillin-1 microfibrils. Thsd4+/- mice showed progressive dilation of the thoracic aorta. Histologic examination of aortic samples from a patient carrying a THSD4 variant and from Thsd4+/- mice, revealed typical medial degeneration and diffuse disruption of extracellular matrix. CONCLUSION: These findings highlight the role of ADAMTSL6 in aortic physiology and TAAD pathogenesis. They will improve TAAD management and help develop new targeted therapies.


Assuntos
Aneurisma da Aorta Torácica , Dissecção Aórtica , Proteínas ADAM , Dissecção Aórtica/genética , Animais , Aneurisma da Aorta Torácica/genética , Exoma/genética , Fibrilina-1/genética , Humanos , Camundongos
13.
Complement Ther Med ; 54: 102537, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33183659

RESUMO

OBJECTIVES: To differentiate the effect of ginger and mustard as warming ingredients from the effect of calmness & attentiveness and thermal warmth in chest compress application. DESIGN & SETTING: In an exploratory, controlled, single-blinded study, we compared the effect of ginger and mustard in healthy adults. INTERVENTIONS: Participants received four different chest compress types over four weeks: simple dry, hot water, with ginger powder and with mustard flour. OUTCOME MEASURES: The somatic and psychological experience of the participants was collected through psychometric measurements (list of somatic complaints (B-L), questionnaire on mental state (MDBF), 5-point-rating scale (RS) containing eight questions on the experience of relaxation and warmth) and was further complemented through qualitative interview data. RESULTS: Participants (15 female and 15 male) ranged between 21-36 years (M = 27). No significant changes in the B-L could be found. The MDBF found significant change towards calmness after every application (P < 0.05). Significant improvement in mood was found after the ginger compress (P = 0.00). The RS found significant changes towards relaxation (P = 0.00), emotional balance (P = 0.03), deep (P = 0.03) and slow (P = 0.00) breathing as well as warm hands (P = 0.03) and feet (P = 0.00) with the ginger compress. No significant changes on the RS could be found after the mustard compress. Qualitative-phenomenological data underlined the difference between ginger and mustard in quality of warmth. No adverse effects were reported. CONCLUSIONS: Ginger and mustard induced a strong and lasting response on perceived distribution of warmth and relaxation. Compound effect quality could be differentiated: mustard triggered a strong relaxing effect after the intervention and ginger a warmth quality that spread throughout the body.


Assuntos
Bandagens , Temperatura Alta , Mostardeira , Relaxamento , Zingiber officinale , Administração Cutânea , Adulto , Feminino , Humanos , Masculino , Método Simples-Cego , Inquéritos e Questionários , Tórax , Adulto Jovem
15.
Genes (Basel) ; 11(5)2020 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-32443863

RESUMO

Marfan syndrome (MFS) is an autosomal dominant connective tissue disorder with considerable inter- and intra-familial clinical variability. The contribution of inherited modifiers to variability has not been quantified. We analyzed the distribution of 23 clinical features in 1306 well-phenotyped MFS patients carrying FBN1 mutations. We found strong correlations between features within the same system (i.e., ophthalmology vs. skeletal vs. cardiovascular) suggesting common underlying determinants, while features belonging to different systems were largely uncorrelated. We adapted a classical quantitative genetics model to estimate the heritability of each clinical feature from phenotypic correlations between relatives. Most clinical features showed strong familial aggregation and high heritability. We found a significant contribution by the major locus on the phenotypic variance only for ectopia lentis using a new strategy. Finally, we found evidence for the "Carter effect" in the MFS cardiovascular phenotype, which supports a polygenic model for MFS cardiovascular variability and indicates additional risk for children of MFS mothers with an aortic event. Our results demonstrate that an important part of the phenotypic variability in MFS is under the control of inherited modifiers, widely shared between features within the same system, but not among different systems. Further research must be performed to identify genetic modifiers of MFS severity.


Assuntos
Ectopia do Cristalino/genética , Fibrilina-1/genética , Fibrilinas/genética , Síndrome de Marfan/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aorta/metabolismo , Aorta/patologia , Ectopia do Cristalino/fisiopatologia , Feminino , Genótipo , Humanos , Masculino , Síndrome de Marfan/fisiopatologia , Proteínas dos Microfilamentos/genética , Pessoa de Meia-Idade , Mutação/genética , Fenótipo , Adulto Jovem
16.
Neurology ; 94(22): e2337-e2345, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32371447

RESUMO

OBJECTIVE: Because little is known about associations between biomarkers of vascular injury and stroke risk, we evaluated associations between plasma concentrations of 6 novel biomarkers of vascular injury and stroke risk in a population-based study. METHODS: A case-cohort subset of EPIC-Heidelberg (European Prospective Investigation for Cancer and Nutrition-Heidelberg) including incident stroke cases (n = 335) and a random subcohort (n = 2,418) was selected. Concentrations of intercellular adhesion molecule 3 (ICAM3), soluble E-selectin and P-selectin, soluble thrombomodulin (sTM), thrombopoietin, and glycoprotein IIb/IIIa were measured in baseline plasma samples. Weighted Cox regression analyses were used to assess associations between biomarker levels and stroke risk. RESULTS: Median follow-up in the subcohort and among cases was 9.8 (range, 0.1-12.5) years and 6.2 (range, 0.01-12.1) years, respectively. ICAM3 levels were associated with increased risk of incident stroke after multivariable adjustment (hazard ratio, highest vs lowest quartile: 1.64 [95% confidence interval, 1.15-2.32]; p linear trend < 0.001). This association was more apparent for ischemic (1.65 [1.12-2.45]; p linear trend < 0.01) than for hemorrhagic stroke (1.29 [0.60-2.78]; p linear trend = 0.3). We further observed a borderline significant trend for a positive association between sTM and overall stroke risk (1.47 [0.99-2.19]; p linear trend = 0.05). CONCLUSIONS: In this population-based study, circulating levels of ICAM3, an adhesion molecule shed by leukocytes, were associated with increased risk of incident stroke. Further mechanistic studies are needed to elucidate the pathophysiology underlying this association. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that plasma levels of ICAM3 are associated with increased stroke risk.


Assuntos
Antígenos CD/sangue , Moléculas de Adesão Celular/sangue , Vigilância da População , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/epidemiologia , Lesões do Sistema Vascular/sangue , Lesões do Sistema Vascular/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Estudos de Coortes , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Lesões do Sistema Vascular/diagnóstico
17.
Circulation ; 141(25): e948-e959, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32460555

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death among American Indians and Alaska Natives. Over the past 50 years, the prevalence of CVD has been rising among American Indians and Alaska Natives. The objective of this statement is to summarize population-level risk factors and management techniques tailored for the American Indian and Alaska Native populations. METHODS: PubMed/MEDLINE, the Centers for Disease Control and Prevention, and the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify risk factors and interventions specific to American Indians and Alaska Natives. RESULTS: Diabetes mellitus is a major contributor to disproportionately higher rates of coronary heart disease among American Indians and Alaska Natives compared with other racial and ethnic groups. Additional risk factors for CVD include low-density lipoprotein cholesterol levels, hypertension, renal disease, age, and sex. Smoking and exposure to toxic metals are risk factors for some subpopulations. A quarter of American Indians live below the federal poverty line, and thus, low socioeconomic status is an important social determinant of cardiovascular health. Community-based interventions have reduced CVD risk in American Indians and Alaska Natives. Underreporting of American Indian and Alaska Native race could underestimate the extent of CVD in this population. CONCLUSIONS: Prevention and treatment of CVD in American Indians and Alaska Natives should focus on control of risk factors and community-based interventions that address social determinants of health, particularly among individuals with diabetes mellitus. Accurate reporting of race/ethnicity is encouraged to address race-specific risk factors.


Assuntos
Indígena Americano ou Nativo do Alasca , Doenças Cardiovasculares/epidemiologia , Fenômenos Fisiológicos Cardiovasculares , Nível de Saúde , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Gerenciamento Clínico , Suscetibilidade a Doenças , Etnicidade , Humanos , Guias de Prática Clínica como Assunto , Vigilância em Saúde Pública , Medição de Risco , Fatores de Risco
18.
J Clin Med ; 8(12)2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31783601

RESUMO

Data on biomarkers of vascular injury and type 2 diabetes (T2D) risk from prospective studies are lacking. We evaluated seven biomarkers of vascular injury in relation to T2D. Additionally, a meta-analysis was performed. From the EPIC-Heidelberg cohort, 2224 participants were followed-up from baseline for 16 (median) years. E-Selectin, P-Selectin, intercellular adhesion molecule 3 (ICAM3), thrombomodulin, thrombopoietin, glycoprotein IIb/IIIa and fibrinogen levels were measured in baseline blood samples. The systematic review and meta-analysis included prospective studies identified through MEDLINE and Web of Science that investigated the association between mentioned biomarkers and T2D. The study population included 55% women, median age was 50 years, and 163 developed T2D. ICAM3 was associated with lower T2D risk (fully adjusted HRhighest vs. lowest tertile 0.62 (95% CI: 0.43, 0.91)), but no other studies on ICAM3 were identified. Overall, fifteen studies were included in the systematic review and meta-analysis (6,171 cases). E-Selectin was associated with higher T2D risk HRper SD: 1.34 (95% CI: 1.16, 1.54; I2 = 63%, n = 9 studies), while thrombomodulin was associated with lower risk HRper SD: 0.82 (95% CI: 0.71, 0.95; I2 = 0%, n = 2 studies). In the EPIC-Heidelberg, ICAM3 was associated with lower T2D risk. The meta-analysis showed a consistent positive association between E-Selectin and T2D. It was also suggestive of an inverse association between thrombomodulin and T2D, although further studies are needed to corroborate this finding.

19.
Mol Ther Nucleic Acids ; 17: 210-222, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31265949

RESUMO

Heart failure occurs in over 30% of the worldwide population and most commonly originates from cardiovascular diseases such as myocardial infarction. microRNAs (miRNAs) target and silence specific mRNAs, thereby regulating gene expression. Because the endogenous miR-155-5p has been ascribed to vasculoprotection, loading it onto positively charged, core-shell poly(isobutylcyanoacrylate) (PIBCA)-polysaccharide nanoparticles (NPs) was attempted. NPs showed a decrease (p < 0.0001) in surface electrical charge (ζ potential), with negligible changes in size or shape when loaded with the anionic miR-155-5p. Presence of miR-155-5p in loaded NPs was further quantified. Cytocompatibility up to 100 µg/mL of NPs for 2 days with human coronary artery endothelial cells (hCAECs) was documented. NPs were able to enter hCAECs and were localized in the endoplasmic reticulum (ER). Expression of miR-155-5p was increased within the cells by 75-fold after 4 hours of incubation (p < 0.05) and was still noticeable at day 2. Differences between loaded NP-cultured cells and free miRNA, at days 1 (p < 0.05) and 2 (p < 0.001) suggest the ability of prolonged load release in physiological conditions. Expression of miR-155-5p downstream target BACH1 was decreased in the cells by 4-fold after 1 day of incubation (p < 0.05). This study is a first proof of concept that miR-155-5p can be loaded onto NPs and remain intact and biologically active in endothelial cells (ECs). These nanosystems could potentially increase an endogenous cytoprotective response and decrease damage within infarcted hearts.

20.
Sci Rep ; 9(1): 8037, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31142825

RESUMO

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

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