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1.
J Virol ; 97(1): e0157722, 2023 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-36598202

RESUMEN

Duck plague virus (DPV) is a high-morbidity fowl alphaherpesvirus that causes septicemic lesions in various organs. Most DPV genes are conserved among herpesviruses, while a few are specific to fowl herpesviruses, including the LORF3 gene, for which there is currently no literature describing its biological properties and functions. This study first addressed whether the LORF3 protein is expressed by making specific polyclonal antibodies. We could demonstrate that DPV LORF3 is an early gene and encodes a protein involved in virion assembly, mainly localized in the nucleus of DPV-infected DEF cells. To investigate the role of this novel LORF3 protein in DPV pathogenesis, we generated a recombinant virus that lacks expression of the LORF3 protein. Our data revealed that the LORF3 protein is not essential for viral replication but contributes to DPV replication in vitro and in vivo and promotes duck plague disease morbidity and mortality. Interestingly, deletion of the LORF3 protein abolished thymus atrophy in DPV-vaccinated ducks. In conclusion, this study revealed the expression of avian herpesviruses-specific genes and unraveled the role of the early protein LORF3 in the pathogenesis of DPV. IMPORTANCE DPV is a highly lethal alphaherpesvirus that causes duck plague in birds of the order Anseriformes. The virus has caused huge economic losses to the poultry industry due to high morbidity and mortality and the cost of vaccination. DPV encodes 78 open reading frames (ORFs), and these genes are involved in various processes of the viral life cycle. Functional characterization of DPV genes is important for understanding the complex viral life cycle and DPV pathogenesis. Here, we identified a novel protein encoded by LORF3, and our data suggest that the LORF3 protein is involved in the occurrence and development of duck plague.


Asunto(s)
Alphaherpesvirinae , Infecciones por Herpesviridae , Animales , Alphaherpesvirinae/genética , Alphaherpesvirinae/metabolismo , Alphaherpesvirinae/patogenicidad , Patos , Infecciones por Herpesviridae/veterinaria , Infecciones por Herpesviridae/virología , Células Cultivadas
2.
Trop Med Infect Dis ; 8(7)2023 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-37505631

RESUMEN

Burkholderia cepacia is an emerging nosocomial pathogen frequently associated with outbreaks, but the exact transmission route of this pathogen can at times be elusive in spite of extensive environmental investigative cultures. Active surveillance for sputum cultures was performed for all patients from September 2008 to September 2009 in an intensive care unit (ICU) with B. cepacia outbreak. With evidence of persistent positive conversion of sputum cultures (colonization) and infections among patients, discontinuing re-usable ventilator circuits was introduced. A total of 689 patients were admitted to this unit for a mean duration of 8.7 ± 7.5 days. There were 489 patients (71.0%) with a stay for one to ten days; 161 (23.4%) patients for 11 to 20 days; and 39 (5.7%) with over 20 days. In the first group, 13.5% of patients had cultures converting from negative to positive, in contrast to 66.7% in the last group (p < 0.01). With intervention of using disposable ventilator circuits since June 2009, the incidence of isolated B. cepacia decreased gradually. The estimated 30-day isolation-free probabilities of the groups before, during, one month (August 2009) after, and two months (September 2009) after this intervention were 38.5%, 47.3%, 66.5%, and 96.0%, respectively (p < 0.01). Furthermore, the effect of discontinuing reusable ventilator circuit persisted in the following 6 years; both total isolates of B. cepacia and the infection caused by it were much lower compared to the outbreak period. In summary, this six-year outbreak in a medical ICU persisted until reusable ventilator circuits were discontinued in 2009. The effect of disposable circuits on the decreased incidence of B. cepacia infection maintained in the following years.

3.
J Microbiol Immunol Infect ; 55(2): 266-272, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33789827

RESUMEN

BACKGROUND: Cancer is an independent risk factor for tuberculosis (TB). The global burden of incident TB attributable to cancer has never been explored. We aimed to evaluate the cancer-attributable burden of TB. METHODS: We estimated the population attributable fraction (PAF) by Levin's formula. The cancer prevalence rates were derived from the Institute for Health Metrics and Evaluation. The relative risk of TB in cancer patients was estimated by using the National Health Insurance Research Database in Taiwan. The global burden of incidence TB attributable to cancer was the weighted sum of PAFs multiplied by the incidence of TB retrieved from the World Health Organization. RESULTS: Worldwide, the total of incident TB cases attributable to cancer was 115,478 cases with a 95% confidence interval (CI), 110,482-123,007, in 2019. The global PAF of TB due to cancer was 1.85% (95% CI, 1.77-1.97%). The three countries with the highest PAFs were Greenland (7.77%), Canada (7.75%), and the United States of America (6.79%), while the three countries with the highest attributable TB cases due to cancer were China (25,240), India (21,629), and Indonesia (13,917). Cancer of respiratory system contributed to 60,257 of TB cases. CONCLUSIONS: This study comprehensively explored the impact of cancer on the global burden of TB. Efforts to reduce cancer risk, delay the occurrence of cancer, or treat latent TB infection in the cancer population could potentially reduce the burden of TB and rely on formulating integrated strategies.


Asunto(s)
Neoplasias , Tuberculosis , Humanos , Incidencia , Neoplasias/complicaciones , Neoplasias/epidemiología , Factores de Riesgo , Tuberculosis/complicaciones , Tuberculosis/epidemiología , Estados Unidos , Organización Mundial de la Salud
4.
Patient Prefer Adherence ; 16: 1257-1268, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35610983

RESUMEN

Purpose: Previous studies suggested perceived social support has impact on medication adherence among hypertensive patients, but did not simultaneously elucidate the different contents or key providers of social support that patients perceived. This study was to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China, which could prove important for targeted interventions. Patients and Methods: Following a multi-stage stratified sampling framework, a total of 903 hypertensive patients from 12 primary health institutions across a middle-income city were recruited from April to June 2021. Medication adherence was measured using the Chinese version of the Morisky, Green and Levine scale; perceived social support was determined using the name generator method. A binary logistic regression model was performed to identify the association between medication adherence and perceived social support. The contents of support included informational, emotional, and instrumental support (finances and caregiving). The support providers included spouse/partner, children, parents, siblings, other relatives, and friends. Results: A total of 506 (56.04%) patients optimally adhered to their antihypertensive medication. Female, older, urban patients, patients with shorter duration of hypertension and antihypertensive medications used showed better adherence (P<0.05). Optimal medication adherence was positively associated with the overall score of caregiving support (adjusted odds ratio [AOR] = 1.128; 95% confidence interval [CI] = [1.013-1.257]), informational support from the spouse/partner (AOR = 1.574; 95% CI = [1.112-2.227]), emotional support from the spouse/partner (AOR = 1.430; 95% CI = [1.032-1.981]), financial support from the spouse/partner (AOR = 1.439; 95% CI = [1.069-1.937]) and caregiving support from the spouse/partner (AOR = 1.652; 95% CI = [1.130-2.414]), whereas optimal medication adherence was negatively associated with caregiving support from friends (AOR = 0.499; 95% CI = [0.286-0.872]). Conclusion: Informational, emotional, financial and caregiving support from spouses/partners have positive impacts on optimal medication adherence of hypertensive patients of community-level. Community-based interventions designed to improve medication adherence of hypertensive patients should target both patients and their spouses/partners; spouses/partners could be encouraged to provide various support to improve the medication adherence of hypertensive patients.

5.
BMC Health Serv Res ; 11: 250, 2011 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-21970365

RESUMEN

BACKGROUND: To describe implementation and first-year screening results of the first Chinese telehealth system for diabetic retinopathy (DR) - the Beixinjing Community Diabetic Retinopathy Telehealth system (BCDRT). METHODS: BCDRT implementation was based on the acquisition of adequate digital retinographs, secure digital transmission, storage and retrieval of participants' data and reader-generated medical reports. Local diabetic residents meeting inclusion criteria were enrolled into the BCDRT system beginning in 2009. Participants recommended for further in-person examination with ophthalmologists were followed, and the consistencies in diagnoses between BCDRT and ophthalmologists for DR or macular edema were calculated. RESULTS: A total of 471 diabetic residents participated in BCDRT screening in 2009. The proportions of total DR, proliferative DR, and diabetic macular edema were 24.42% (115 patients), 2.12% (10 patients) and 6.47% (24 patients), respectively: 56 patients consulted ophthalmologists for further in-person retinal examination with funduscopy after pupil dilation. High rates of consistency between BCDRT screening and ophthalmologists were observed for macular edema (Kappa = 0.81), moderate or severe non-proliferative DR grade (Kappa = 0.92), and other DR grades (Kappa = 1). A total of 456 (96.82%) patients were willing to participate in the next BCDRT screening. CONCLUSIONS: BCDRT was a reliable and valid system for DR screening, and offers the potential to increase DR annual screening rates in local residents.


Asunto(s)
Retinopatía Diabética/diagnóstico , Tamizaje Masivo/métodos , Oftalmoscopía/métodos , Telemedicina/métodos , Adulto , Anciano , China , Centros Comunitarios de Salud , Retinopatía Diabética/epidemiología , Femenino , Implementación de Plan de Salud , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Medición de Riesgo
6.
Int J Infect Dis ; 108: 340-346, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34022337

RESUMEN

BACKGROUND: We aimed to investigate the time-dependent association between cancer and the risk of tuberculosis (TB) before and after cancer diagnosis. METHODS: This population-based cohort study incorporated the National Health Insurance Research Database and the National Health Interview Survey in Taiwan to estimate TB risk in cancer and noncancer populations. We estimated the period-specific incidence rate ratio (IRR) between cancer and risk of TB and used Cox proportional hazards models to estimate the average hazard ratio between cancer and TB during the peridiagnostic period. RESULTS: From 2001 to 2015, 457 673 cancer and 3 738 122 noncancer individuals were enrolled. After stratifying the IRR of TB by year relative to the date of cancer diagnosis, the peak IRRs clustered in the year before and after the index date. In the peridiagnostic period of cancer, the adjusted hazard ratio was 2.29 (95% CI, 2.22-2.35) using the Cox model and 2.20 (95% CI, 2.09-2.32) after adjustment for missing confounders. Patients with cancers in the respiratory tract, upper digestive tract, and hematologic system were at the highest risk for TB. CONCLUSIONS: Cancer is an independent risk factor for TB, with the highest risk observed around the time of cancer diagnosis.


Asunto(s)
Neoplasias , Tuberculosis , Estudios de Cohortes , Humanos , Incidencia , Neoplasias/epidemiología , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Factores de Riesgo , Taiwán/epidemiología , Tuberculosis/complicaciones , Tuberculosis/epidemiología
7.
Public Health Pract (Oxf) ; 2: 100155, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36101592

RESUMEN

Objectives: To understand the research landscape and identify the research hotspots and trends of the application of social network theory and analysis to public health. Study design: A bibliometric study of publications regarding application of social network theory and analysis to public health. Methods: Choosing 1607 articles about the application of social network theory and analysis to public health from the core collection database of Web of Science published from 1991 to 2020 as the research sample. A bibliometric and visual analysis of publication quantity and content was performed to analyze time trends, spatial distribution, cooperation networks, influential references, and keyword co-occurrence, clusters, and emergence. Results: There is an increasing trend in the use of social network theory and analysis in the public health field, with the United States taking the lead. Research focuses include on transmission of diseases or behavior through social networks and the influence of social networks on population health at different ages. Current research frontiers primarily include the role of social networks in tracking of emerging infectious diseases like COVID-19, preventing and controlling chronic diseases, and carrying out healthy behavioral interventions. Conclusions: This study provides a comprehensive quantitative overview of the historic development of and latest topics in the application of social network theory and analysis method to public health. More attention should be paid to the important role of social networks in tracing the emergence of serious infectious diseases like COVID-19, as well as preventing and controlling chronic diseases and intervening in health behaviors, considering the increasing challenges and opportunities presented by online social networking.

8.
BMJ Open ; 11(12): e054463, 2021 12 14.
Artículo en Inglés | MEDLINE | ID: mdl-34907069

RESUMEN

INTRODUCTION: Health campaigns have the potential to improve public awareness, but their impact can be difficult to assess. Internet search data provide information concerning online health information-seeking behaviour in the population and may serve as a proxy for public awareness to evaluate health campaigns. This study aimed to measure the impact of World Stroke Day (WSD) in China using Baidu search data. METHODS: Daily search index values (SIV) for the term 'stroke' were collected from January 2011 to December 2019 using the Baidu Index platform. We examined the mean difference in SIV between the 4 weeks surrounding WSD (period of interest) and the rest of the year (control period) for each year by t-test analysis. The mean difference between the period of interest and the control period was also calculated. The joinpoint regression model was used to analyse the trends of internet search activity 30 days before and after WSD for each year (2011-2019). Finally, the top and rising queries related to stroke during the week of the campaign in 2020 were summarised. RESULTS: A significant mean increase in SIV of 418.5 (95% CI: 298.8 to 538.2) for the period of interest surrounding WSD was observed, 36.2% greater than the SIV during the control period (2011-2019). Short-term joinpoint analysis showed a significant increase in SIV 3 days before WSD, a peak on WSD and a decrease to the precampaign level 3 days after WSD. The rising related queries suggested that the public had increasing concerns about stroke warning signs, stroke prevention and stroke recovery during the campaign. CONCLUSIONS: The WSD campaign increased internet search activity. These research techniques can be applied to evaluation of other health campaigns. Advancing understanding of public demand will enable tailoring of the campaign and strengthen health management.


Asunto(s)
Promoción de la Salud , Accidente Cerebrovascular , China/epidemiología , Humanos , Conducta en la Búsqueda de Información , Internet , Accidente Cerebrovascular/prevención & control
9.
Front Microbiol ; 12: 744408, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34925260

RESUMEN

Duck plague virus (DPV) can cause high morbidity and mortality in many waterfowl species within the order Anseriformes. The DPV genome contains 78 open reading frames (ORFs), among which the LORF2, LORF3, LORF4, LORF5, and SORF3 genes are unique genes of avian herpesvirus. In this study, to investigate the role of this unique LORF5 gene in DPV proliferation, we generated a recombinant virus that lacks the LORF5 gene by a two-step red recombination system, which cloned the DPV Chinese virulent strain (DPV CHv) genome into a bacterial artificial chromosome (DPV CHv-BAC); the proliferation law of LORF5-deleted mutant virus on DEF cells and the effect of LORF5 gene on the life cycle stages of DPV compared with the parent strain were tested. Our data revealed that the LORF5 gene contributes to the cell-to-cell transmission of DPV but is not relevant to virus invasion, replication, assembly, and release formation. Taken together, this study sheds light on the role of the avian herpesvirus-specific gene LORF5 in the DPV proliferation life cycle. These findings lay the foundation for in-depth functional studies of the LORF5 gene in DPV or other avian herpesviruses.

10.
Vet Microbiol ; 257: 109078, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33906107

RESUMEN

Studies have shown that proteins in the tegument (located between the viral capsid and envelope layer) play critical roles in the assembly and budding of herpesviruses. The UL11 protein of herpesviruses is important in the process of virus particle cell entry, release, assembly and secondary envelopment. Herpesvirus glycoprotein E (gE) is involved in syncytia formation, transmission between cells and nerve invasion. In herpes simplex virus, UL11 has been shown to interact with gE. However, little is known about the relationship of duck plague virus (DPV) pUL11 and gE. In this study, we constructed DPV cytoplasmic domain (CT)-gE, and extracellular domain (ET)-gE deletion mutants, pCMV-gE, CT-gE, and ET-gE and UL11 recombinant plasmids. We found that pUL11 can interact and colocalize with gE, CT-gE and ET-gE. Together, these results highlight an important role for UL11 in the function of gE, and may also have important implications for the role of pUL11 and gE.


Asunto(s)
Mardivirus/genética , Glicoproteínas de Membrana/genética , Proteínas del Envoltorio Viral/genética , Proteínas Estructurales Virales/metabolismo , Animales , Línea Celular , Patos , Células HEK293 , Humanos , Mardivirus/química , Mardivirus/metabolismo , Glicoproteínas de Membrana/química , Glicoproteínas de Membrana/metabolismo , Proteínas del Envoltorio Viral/química , Proteínas del Envoltorio Viral/metabolismo , Proteínas Estructurales Virales/genética , Virión/genética , Virión/metabolismo , Ensamble de Virus
11.
Medicine (Baltimore) ; 95(10): e2953, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26962795

RESUMEN

A number of cardiac fluoroscopic interventions have increased rapidly worldwide over the past decade. Percutaneous transluminal coronary angioplasty (PTCA) and stent implantation have become increasingly popular, and these advancements have allowed patients to receive repetitive treatments for restenosis. However, these advancements also significantly increase radiation exposure that may lead to higher cumulative doses of radiation. In the present study, a nationwide population-based case-controlled study was used to explore the risk of leukemia after cardiac angiographic fluoroscopic intervention.A total of 5026 patients with leukemia and 100,520 control patients matched for age and sex (1:20) by a propensity score method without any cancer history were enrolled using the Registry Data for Catastrophic Illness and the National Health Insurance Research Database (NHIRD) of Taiwan between 2008 and 2010. All subjects were retrospectively surveyed (from year 2000) to determine receipt of cardiac fluoroscopic interventions. Data were analyzed using conditional logistic regression models, and estimated crude and adjusted odds ratios (95% confidence interval).After adjusting for age, gender, and comorbidities, PTCA was found to be associated with an increased risk of leukemia with an adjusted OR of 1.566 (95% CI, 1.282-1.912), whereas coronary angiography alone without PTCA and cardiac electrophysiologic study were not. Our results also showed that an increased frequency of PTCA and coronary angiography was associated with a higher risk of leukemia (adjusted OR: 1.326 to 1.530 [all P < 0.05]). Gender subgroup analyses demonstrated that men were associated with a higher risk of leukemia compared with women.These results provide additional data in the quantification of the long-term health effects of radiation exposure derived from the cardiac fluoroscopic diagnostic and therapeutic intervention. PTCA alone or PTCA with coronary angiography was associated with an elevated risk of leukemia. Continued follow-up of existing cohorts will be valuable to help assess lifetime risks of cancer.


Asunto(s)
Angiografía Coronaria/efectos adversos , Leucemia/etiología , Angioplastia Coronaria con Balón , Estudios de Casos y Controles , Femenino , Fluoroscopía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Riesgo , Factores Sexuales , Factores de Tiempo
12.
Medicine (Baltimore) ; 95(34): e4717, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27559982

RESUMEN

BACKGROUND: Clinically, elderly patients with unresectable bulky hepatocellular carcinoma (HCC) are difficult to manage, especially in those with co-infections of hepatitis B and C virus. Herein, we reported such a case treated with radiotherapy (RT) by using combined simultaneously integrated inner-escalated boost and volumetric-modulated arc radiotherapy (SIEB-VMAT). After RT, significant symptoms alleviation and durable tumor control were observed. CASE SUMMARY: At presentation, an 85-year-old male patient complained abdominal distention/pain, poor appetite, and swelling over bilateral lower limbs for 1 month. On physical examination, a jaundice pattern was noted. Laboratory studies showed impaired liver and renal function. Abdominal computed tomography (CT) revealed a 12.5-cm bulky tumor over the caudate lobe of the liver. Biopsy was done, and hepatocellular carcinoma (HCC) was reported histopathologically. As a result, AJCC stage IIIA (cT3aN0M0) and BCLC stage C were classified. Surgery, radiofrequency ablation (RFA), trans-catheter arterial chemoembolization (TACE), and sorafenib were not recommended because of his old age, central bulky tumor, and a bleeding tendency. Thus, RT with SIEB-VMAT technique was given alternatively. RT was delivered in 26 fractions, with dose gradience as follows: 39 Gy on the outer Plan Target Volume (PTV), 52 Gy in the middle PTV, and 57.2 Gy in the inner PTV. Unexpectedly, cyproheptadine (a newly recognized potential anti-HCC agent) was retrospectively found to be prescribed for alleviating skin itching and allergic rhinitis since the last 2 weeks of the RT course (2 mg by mouth Q12h for 24 months).After RT, significant symptoms alleviation and tumor volume reduction were observed for 32 months till multiple bone metastases. Before and after RT, a large tumor volume reduction rate of 88.7% was observed (from 608.4 c.c. to 68.7 c.c.). No severe treatment toxicity was noted during and after RT. The patient died due to aspiration pneumonia with septic shock at 4 months after bone metastases identified. CONCLUSIONS: SIEB-VMAT physically demonstrated double benefits of intratumor dose escalation and extra-tumor dose attenuation. Significant tumor regression and symptoms alleviation were observed in this elderly patient with unresectable bulky HCC. Further prospective randomized trials are encouraged to demarcate effective size of SIEB-VMAT with or without cyproheptadine.


Asunto(s)
Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Dolor Abdominal/etiología , Anciano de 80 o más Años , Neoplasias Óseas/secundario , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/secundario , Terapia Combinada , Resultado Fatal , Humanos , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Masculino , Tomografía Computarizada por Rayos X
13.
Huan Jing Ke Xue ; 36(10): 3839-44, 2015 Oct.
Artículo en Zh | MEDLINE | ID: mdl-26841620

RESUMEN

Soil microbe plays an important role in carbon cycling, however, the effect of land use on soil microbe remain unclear. In present study, soil samples were collected from a long-term field experiment (Pantang Agroecosystem) in subtropical China (established in 1989), including paddy-rice (PR), upland-crop (UC), and paddy rice-upland crop rotation (PU) on soil bacterial (bacteria and Archaea) community structures. The effects of long-term different land uses were determined using terminal restriction fragment length polymorphism (T-RFLP) and quantitative PCR (RT-PCR) of the 16S rRNA gene. The abundance of soil microbial 16S rRNA genes ranged from 2.5 x 10(9)-1.5 x 10(10) copies x g(-1) dry soil. Compared with the PR, UP and UC led to a significant reduction in 16S rRNA genes abundance (P < 0.05). The soil microbial communities were dominated by bacteria such as Proteobacteria (76 and 90 and 327 bp; relative abundance of 47% - 53%) and Chloroflexi (65 bp; relative abundance of 10% - 12%). RDA statistical analyses demonstrated that there were significant differences in the microbial community composition in PR, UC, and PU treated soils. Soil organic carbon and total nitrogen content were the most highly statistically significant factors which positively influenced the soil microbial population. Taken together, our findings prove the long-term different land uses significantly influence the microbial diversity and community structure. The rice planting is an effective way of sustainable utilization of subtropical red soil, and it is more advantageous to the accumulation of soil organic matter, soil fertility and microbial diversity.


Asunto(s)
Agricultura/métodos , Archaea/aislamiento & purificación , Bacterias/aislamiento & purificación , Microbiología del Suelo , Archaea/clasificación , Bacterias/clasificación , Biodiversidad , Carbono/análisis , Ciclo del Carbono , China , Nitrógeno/análisis , Oryza , Polimorfismo de Longitud del Fragmento de Restricción , ARN Ribosómico 16S , Suelo/química
14.
Medicine (Baltimore) ; 94(26): e1022, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26131806

RESUMEN

To evaluate effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) inoculated during defined "vaccination period," first 6 months post cancer diagnosis (ie, an anti-cancer treatment period), in elderly lung cancer patients on community-acquired pneumonia (CAP) hospitalization incidence.This was a nationwide population-based cohort study of 157 newly diagnosed elderly lung cancer patients receiving PPSV23 during "vaccination period", and 628 age and sex one-to-one matched controls enrolled in the National Health Insurance Research Database (NHIRD) of Taiwan between 2007 and 2010. All patients were ≥75 years old and still survival post "vaccination period." Incidence density (ID) of all-cause inpatient CAP and cumulative survival risk were analyzed by multivariate Poisson regression and Kaplan-Meier method, respectively.After a 4-year follow-up, IDs of all-cause inpatient CAP for vaccination and control cohorts were 297 and 444 per 1000 PYs, respectively. Less vaccinated patients had CAP incidence density >1 time per PY (12.7% vs 21.2%) than non-vaccinated patients. After adjusting for potential confounding variables, like influenza vaccination, comorbidities, cancer treatment modalities, and socioeconomic status, adjusted inpatient CAP incidence rate in PPSV23 vaccination cohort was 0.74 times lower than control cohort (incidence rate ratio [IRR] = 0.740, P = 0.0339). Two-year cumulative CAP hospitalization rates and overall survival rates were 37.1% vs. 55.4%, and 46.6% vs. 26.2%, respectively, for lung cancer patients with and without PPSV23 (both P < 0.001). Subgroup analysis showed that for elderly lung cancer patients not ever receiving influenza vaccine, PPSV23 still had trend to reduce all-cause inpatient CAP.For elderly lung cancer patients aged ≥75 years, PPSV23 inoculated during anti-cancer treatment period could reduce CAP hospitalizations and improve survival.


Asunto(s)
Hospitalización/estadística & datos numéricos , Neoplasias Pulmonares/complicaciones , Vacunas Neumococicas , Neumonía Neumocócica/prevención & control , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Estudios de Cohortes , Infecciones Comunitarias Adquiridas/prevención & control , Femenino , Humanos , Masculino
15.
Onco Targets Ther ; 6: 25-8, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23359785

RESUMEN

Development of nonantibiotic-associated pseudomembranous colitis has been reported in patients receiving chemotherapy. Herein, we report a case of a 70-year-old man with diabetes mellitus and hypertension who received concurrent chemoradiation therapy after surgery for stage III pT3N1M0 rectal cancer. After completion of the therapy, the patient presented with a 2-week history of intermittent watery diarrhea (seven to nine times per day). However, the patient was afebrile and laboratory examination revealed no evidence of leukocytosis. Computed tomography disclosed inflammation of the sigmoid colon, infiltrative changes around the anastomotic site, and edematous changes straddling the serosal surface. Colonoscopic examination revealed multiple whitish patches within the radiation field, a finding suggestive of pseudomembranous colitis. No concomitant antibiotics were used during the period of concurrent chemoradiation therapy. Empirical oral metronidazole (500 mg every 8 hours) was administrated for 2 weeks. At the end of this treatment, stool culture was negative for Clostridium difficile. Physicians should be aware of the potential for the development of pseudomembranous colitis following concurrent chemoradiation therapy.

16.
Radiat Oncol ; 6: 95, 2011 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-21838917

RESUMEN

BACKGROUND: To evaluate the experience of induction chemotherapy followed by concurrent chemoradiationwith helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC). METHODS: Between August 2006 and December 2009, 28 patients with pathological proven nonmetastatic NPC were enrolled. All patients were staged as IIB-IVB. Patients were first treated with 2 to 3 cycles of induction chemotherapy with EP-HDFL (Epirubicin, Cisplatin, 5-FU, and Leucovorin). After induction chemotherapy, weekly based PFL was administered concurrent with HT. Radiation consisted of 70 Gy to the planning target volumes of the primary tumor plus any positive nodal disease using 2 Gy per fraction. RESULTS: After completion of induction chemotherapy, the response rates for primary and nodal disease were 96.4% and 80.8%, respectively. With a median follow-up after 33 months (Range, 13-53 months), there have been 2 primary and 1 nodal relapse after completion of radiotherapy. The estimated 3-year progression-free rates for local, regional, locoregional and distant metastasis survival rate were 92.4%, 95.7%, 88.4%, and 78.0%, respectively. The estimated 3-year overall survival was 83.5%. Acute grade 3, 4 toxicities for xerostomia and dermatitis were only 3.6% and 10.7%, respectively. CONCLUSION: HT for locoregionally advanced NPC is feasible and effective in regard to locoregional control with high compliance, even after neoadjuvant chemotherapy. None of out-field or marginal failure noted in the current study confirms the potential benefits of treating NPC patients by image-guided radiation modality. A long-term follow-up study is needed to confirm these preliminary findings.


Asunto(s)
Carcinoma/tratamiento farmacológico , Carcinoma/radioterapia , Neoplasias Nasofaríngeas/tratamiento farmacológico , Neoplasias Nasofaríngeas/radioterapia , Terapia Neoadyuvante/métodos , Radioterapia Guiada por Imagen/métodos , Radioterapia de Intensidad Modulada/métodos , Adulto , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Radiometría/métodos , Recurrencia , Análisis de Regresión , Resultado del Tratamiento
17.
PLoS Curr ; 2: RRN1141, 2010 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-20130781

RESUMEN

Early data from the 2009 H1N1 pandemic (H1N1pdm) suggest that previous studies over-estimated the within-country rate of spatial spread of pandemic influenza. As large spatially-resolved data sets are constructed, the need for efficient simulation code with which to investigate the spatial patterns of the pandemic becomes clear. Here, we describe a significant improvement in the efficiency of an individual-based stochastic disease simulation framework that has been used for multiple previous studies. We quantify the efficiency of the revised algorithm and present an alternative parameterization of the model in terms of the basic reproductive number. We apply the model to the population of Taiwan and demonstrate how the location of the initial seed can influence spatial incidence profiles and the overall spread of the epidemic. Differences in incidence are driven by the relative connectivity of alternate seed locations.

18.
PLoS One ; 5(11): e13292, 2010 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-21079810

RESUMEN

Early data from the 2009 H1N1 pandemic (H1N1pdm) suggest that previous studies over-estimated the within-country rate of spatial spread of pandemic influenza. As large spatially resolved data sets are constructed, the need for efficient simulation code with which to investigate the spatial patterns of the pandemic becomes clear. Here, we present a significant improvement to the efficiency of an individual-based stochastic disease simulation framework commonly used in multiple previous studies. We quantify the efficiency of the revised algorithm and present an alternative parameterization of the model in terms of the basic reproductive number. We apply the model to the population of Taiwan and demonstrate how the location of the initial seed can influence spatial incidence profiles and the overall spread of the epidemic. Differences in incidence are driven by the relative connectivity of alternate seed locations. The ability to perform efficient simulation allows us to run a batch of simulations and take account of their average in real time. The averaged data are stable and can be used to differentiate spreading patterns that are not readily seen by only conducting a few runs.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , Gripe Humana/transmisión , Pandemias , Adolescente , Adulto , Anciano , Algoritmos , Niño , Preescolar , Simulación por Computador , Geografía , Humanos , Incidencia , Lactante , Recién Nacido , Persona de Mediana Edad , Taiwán/epidemiología , Factores de Tiempo , Adulto Joven
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