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1.
Commun Biol ; 4(1): 1304, 2021 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-34795404

RESUMO

Modern societies are experiencing an increasing trend of reduced sleep duration, with nocturnal sleeping time below the recommended ranges for health. Epidemiological and laboratory studies have demonstrated detrimental effects of sleep deprivation on health. Sleep exerts an immune-supportive function, promoting host defense against infection and inflammatory insults. Sleep deprivation has been associated with alterations of innate and adaptive immune parameters, leading to a chronic inflammatory state and an increased risk for infectious/inflammatory pathologies, including cardiometabolic, neoplastic, autoimmune and neurodegenerative diseases. Here, we review recent advancements on the immune responses to sleep deprivation as evidenced by experimental and epidemiological studies, the pathophysiology, and the role for the sleep deprivation-induced immune changes in increasing the risk for chronic diseases. Gaps in knowledge and methodological pitfalls still remain. Further understanding of the causal relationship between sleep deprivation and immune deregulation would help to identify individuals at risk for disease and to prevent adverse health outcomes.


Assuntos
Suscetibilidade a Doenças , Imunidade , Inflamação , Privação do Sono/complicações , Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/imunologia , Humanos , Inflamação/epidemiologia , Inflamação/imunologia
2.
Thorac Cancer ; 12(20): 2637-2647, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34435733

RESUMO

Several studies have highlighted that cancer patients tend to be more susceptible to develop severe infection and to die from COVID-19. Certain medical conditions such as immunosuppression, presence of comorbidities, and underlying pulmonary damage are possible determinants of disease severity, especially in lung cancer patients. While recent studies have shown that lung cancer is one of the most prevalent tumor types among COVID-19 cancer patients, we still have an incomplete view of how data from several countries work as a whole. The aim of this review was to investigate COVID-19 prevalence in lung cancer patient cohorts and their probability to develop severe illness and death when compared to nonlung cancer patients from multiple nationalities, including countries that have been the epicenters of the pandemic. We also focus on some intrinsic lung cancer features that might influence COVID-19 outcomes. An integrative view of the susceptibility of lung cancer patients might be especially relevant to assist physicians in evaluating the risks of COVID-19 in these patients, and to foster better decisions on treatment delay.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , Neoplasias Pulmonares/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , Comorbidade , Suscetibilidade a Doenças/epidemiologia , Geografia , Humanos , Internacionalidade , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/mortalidade , Prevalência , Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Resultado do Tratamento
3.
Hepatology ; 74(5): 2353-2365, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34097776

RESUMO

BACKGROUND AND AIMS: In the USA, HBV is one of the leading causes of chronic liver disease and cirrhosis and is a major cause of liver cancer. We aimed to estimate the prevalence of past and present HBV infection, susceptibility to HBV infection, and vaccine-induced immunity to hepatitis B among the US population during 2013-2018. APPROACH AND RESULTS: Prevalence estimates and 95% CIs were analyzed using 2013-2018 data from the National Health and Nutrition Examination Survey. Serologic testing among noninstitutionalized persons aged ≥ 6 years was used for classifying persons as total hepatitis B core antibody (anti-HBc), indicative of current or previous (ever having had) HBV infection; HBsAg, indicative of current HBV infection; and antibody to ABsAg (anti-HBs), indicative of immunity attributable to hepatitis B vaccination. Persons who tested negative for anti-HBc, HBsAg, and anti-HBs were considered susceptible to HBV infection. Non-US-born residents accounted for 69.1% of the population with chronic HBV infection and were 9.1 times more likely to be living with chronic hepatitis B, compared with US-born persons. Among adults aged ≥ 25 years who resided in US households, an estimated 155.8 million persons (or 73.4%) were susceptible to HBV infection, and an estimated 45.4 million had vaccine-induced immunity to hepatitis B. Men who have sex with men (MSM) were 3.6 times more likely to have ever been infected with HBV; however, MSM were just as likely to have vaccine-induced immunity to hepatitis B as non-MSM. CONCLUSION: Despite increasing immune protection among young persons vaccinated after birth, the estimated prevalence of persons living with chronic hepatitis B in the USA has remained unchanged at 0.3% since 1999.


Assuntos
Imunidade Adaptativa , Características da Família , Vacinas contra Hepatite B/imunologia , Vírus da Hepatite B/imunologia , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/imunologia , Adolescente , Adulto , Criança , Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/imunologia , Feminino , Anticorpos Anti-Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Hepatite B Crônica/prevenção & controle , Hepatite B Crônica/virologia , Homossexualidade Masculina , Humanos , Imunogenicidade da Vacina/imunologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Testes Sorológicos , Minorias Sexuais e de Gênero , Estados Unidos/epidemiologia , Vacinação , Adulto Jovem
4.
BJOG ; 128(12): 1938-1948, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34028167

RESUMO

OBJECTIVE: To quantify familial risk of endometriosis among full siblings and examine interactions between family history and smoking, age at menarche or body mass index (BMI). DESIGN, SETTING AND POPULATION: Population-based nationwide cohort study. METHODS: Using data from the Korean National Health Insurance and Screening Programme databases on kinship, healthcare utilisation, lifestyle and anthropometrics, we identified 2 109 288 women with full siblings and their environmental risk factors from 2002 to 2018. Familial risks were estimated using Cox proportional-hazards models, represented as incidence risk ratios (IRR) with 95% CI. Interaction between family history and smoking, age at menarche or BMI were assessed on an additive scale. MAIN OUTCOME MEASURES: IRR of endometriosis among women with and without affected siblings. RESULTS: From 19 195 women with affected siblings, 1126 developed endometriosis with an incidence of 35.45/10 000 person-years. Familial risk of endometriosis with versus without affected siblings was increased to IRR 2.75 (95% CI 2.25-3.36), and the highest risk was with affected twins (IRR 6.98; 95% CI 4.19-11.62). Women with both a family history and either smoking, early menarche or low BMI had a significantly higher risk of endometriosis compared with the general population and can be regarded as a high-risk group, the IRRs were 4.28 (95% CI 2.43-7.55), 3.47 (95% CI 2.82-4.26) and 3.09 (95% CI 2.68-3.56), respectively. Substantial effect modification of the associations was noted by smoking and early menarche, as their combined risk with family history exceeded the sum of their individual risks, which was also statistically significant. CONCLUSION: Genetic factors are the primary contributor to the familial aggregation of endometriosis. Significant gene-environment interaction exists between family history and smoking or early menarche. TWEETABLE ABSTRACT: Significant gene-environment interaction exists between family history of endometriosis and smoking or early menarche.


Assuntos
Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/etiologia , Endometriose/epidemiologia , Endometriose/etiologia , Irmãos , Adolescente , Adulto , Fatores Etários , Índice de Massa Corporal , Feminino , Interação Gene-Ambiente , Humanos , Incidência , Menarca , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Adulto Jovem
5.
Infect Genet Evol ; 91: 104778, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33662586

RESUMO

The association of polymorphisms in genes responsible for immunological mediators with dengue allows the identification of certain genetic alterations that increase or decrease the development risk of the disease. A few number of studies that correlate the interleukin 6-174 G > C (IL6-174 G > C) polymorphism (rs1800795) with dengue. However, there is an inconsistency on the polymorphism influence on the disease which motivated this meta-analysis. So, this study aimed to evaluate the rs1800795 polymorphism with protection or susceptibility for development of dengue. A search of the literature was performed for studies published before 05 September 2020 in various databases. Calculations of Odds Ratio (OR) with 95% of Confidence Intervals (CI) and heterogeneity (I2) were assessed and publication bias was done by Begg' and Egger's test. The value of P < 0.05 was considered as significant. As results, five case-control studies were identified and included in the results. The analysis showed that the heterozygous genotype has a protective role against dengue without warning signs (DWOS) (OR = 0.57, p = 0.001), as well as the polymorphic C allele (OR = 0.77, p = 0.04). When unifying the data from the included studies, the GG genotype was more prevalent among individuals with dengue with warning signs (DWWS) when compared to the control group (p = 0.0221). GC genotype was more prevalent in the control group than in the DWWS group (p = 0.0119). Therefore, in our study we observed that the GC genotype and the C allele have a protective role against DWOS. Since this polymorphism is associated with low IL-6 expression, thus it is expected that there will be a decreased pro-inflammatory response. However, more studies regarding this thematic are necessary to have a consensus about this polymorphism and dengue.


Assuntos
Dengue/genética , Predisposição Genética para Doença , Interleucina-6/genética , Polimorfismo de Nucleotídeo Único , Dengue/epidemiologia , Suscetibilidade a Doenças/epidemiologia , Estudos de Associação Genética , Predisposição Genética para Doença/epidemiologia , Humanos , Interleucina-6/metabolismo , Fatores de Risco
6.
J Neuroimmune Pharmacol ; 16(1): 38-47, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33405098

RESUMO

While clinical characteristics exhibit that susceptibility to COVID-19 infection is equally likely between males and females, clinical outcomes show that males experience both a higher severity and fatality for COVID-19 infection than females. This review examines the evidence for these sex and gender differences and aims to illustrate possible mechanisms behind such sensitivity. Successful entry of SARS-CoV-2 into the body is dependent on the angiotensin-converting enzyme 2 (ACE2) receptor and the transmembrane protease serine 2 (TMPRSS2). Thus, sex-based differences in the expression of the ACE2 receptor and TMPRSS2 may explain the disparities in COVID-19 severity and fatality. Furthermore, these disparities may also be attributed to sex-based difference in immunological responses. Finally, the differences in clinical outcomes of COVID-19 infections between men and women may be due to gendered differences in behaviors, such as smoking, and prevalence to comorbidities. An understanding of the sex and gender sensitivities of COVID-19 infection is a necessary component towards the creation of effective treatment options and therapies for the virus. Graphical abstract.


Assuntos
COVID-19/epidemiologia , Suscetibilidade a Doenças/epidemiologia , COVID-19/genética , COVID-19/terapia , Feminino , Identidade de Gênero , Predisposição Genética para Doença , Humanos , Masculino , Caracteres Sexuais
8.
Saudi Med J ; 41(11): 1165-1174, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33130835

RESUMO

OBJECTIVES: To determine the association between comorbidities and the severity of the disease among COVID-19 patients. METHODS: We searched the Cochrane, Medline, Trip, and EMBASE databases from 2019. The review included all available studies of COVID-19 patients published in the English language and studied the clinical characteristics, comorbidities, and disease outcomes from the beginning of the pandemic.  Two authors extracted studies characteristics and the risk of bias. Odds ratio (OR) was used to analyze the data with 95% confidence interval (CI). RESULTS: The review included 1,885 COVID-19 patients from 7 observational studies with some degree of bias risk and substantial heterogeneity. A significant association was recorded between COVID-19 severity and the following variables: male (OR= 1.60, 95%CI= 1.05 - 2.43); current smoker (OR=2.06, 95%CI= 1.08 - 3.94); and the presence of comorbidities including hypertension (OR=2.05, 95%CI= 1.56 - 2.70), diabetes (OR=2.46, 95%CI= 1.53 - 3.96), coronary heart disease (OR=4.10, 95%CI= 2.36 - 7.12), chronic kidney disease (OR=4.06, 95%CI= 1.45 - 11.35), and cancer (OR=2.28, 95%CI= 1.08 - 4.81). CONCLUSIONS: Comorbidities among COVID-19 patients may contribute to increasing their susceptibility to severe illness. The identification of these potential risk factors could help reduce mortality by identifying patients with poor prognosis at an early stage.


Assuntos
Causas de Morte , Comorbidade , Infecções por Coronavirus/epidemiologia , Suscetibilidade a Doenças/epidemiologia , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , COVID-19 , Infecções por Coronavirus/diagnóstico , Gerenciamento de Dados , Feminino , Humanos , Incidência , Masculino , Pandemias , Pneumonia Viral/diagnóstico , Arábia Saudita/epidemiologia , Síndrome Respiratória Aguda Grave/diagnóstico , Índice de Gravidade de Doença , Análise de Sobrevida
9.
Afr Health Sci ; 20(2): 860-870, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33163053

RESUMO

BACKGROUND: Kidney disease (KD) is increasingly recognized as a major public health problem worldwide with rising incidence and prevalence. Early identification of KD risk factors will slow down progression to kidney failure and death. OBJECTIVE: To determine the prevalence, risk-inducing lifestyle and perceived susceptibility among Nigerians in South-western Nigeria. METHODS: A pretested structured questionnaire was employed to draw information on socio-demographic, knowledge, risk-inducing lifestyle and perceived susceptibility to conventional risk factors of KD from 1757 residents aged ≥15 years. RESULTS: The mean age of the respondents was 47.61±13.0 years with a male-female ratio of 1.13:1. Knowledge of KD was low (mean score 2.29; 95% CI: 2.18, 2.32). The prevalence of some established KD risk factors was regular use of herbal medications, 26.8% and physical inactivity, 70.0%. Females with factors such as use of herbal drink [RRR: 1.56; CI=1.06-2.30; p=0.02] and smoking [RRR: 2.72; CI=1.37-5.37; p=0.00] predicted increased odds of perceived susceptibility to KD than their male counterparts. CONCLUSION: The prevalence of KD risk-inducing lifestyles was high. More emphasis should be placed on effective public health programmes towards behavioural change in order to adopt lifestyle modification as well as to reduce the tendency to develop KD.


Assuntos
Suscetibilidade a Doenças/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Nefropatias/epidemiologia , Estilo de Vida , Comportamento de Redução do Risco , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Estudos Transversais , Exercício Físico , Humanos , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Vigilância da População , Prevalência , Medição de Risco , Fatores de Risco , Fumar/epidemiologia , Inquéritos e Questionários , Adulto Jovem
10.
Rev Endocr Metab Disord ; 21(4): 451-463, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32743793

RESUMO

In light of the most challenging public health crisis of modern history, COVID-19 mortality continues to rise at an alarming rate. Patients with co-morbidities such as hypertension, cardiovascular disease, and diabetes mellitus (DM) seem to be more prone to severe symptoms and appear to have a higher mortality rate. In this review, we elucidate suggested mechanisms underlying the increased susceptibility of patients with diabetes to infection with SARS-CoV-2 with a more severe COVID-19 disease. The worsened prognosis of COVID-19 patients with DM can be attributed to a facilitated viral uptake assisted by the host's receptor angiotensin-converting enzyme 2 (ACE2). It can also be associated with a higher basal level of pro-inflammatory cytokines present in patients with diabetes, which enables a hyperinflammatory "cytokine storm" in response to the virus. This review also suggests a link between elevated levels of IL-6 and AMPK/mTOR signaling pathway and their role in exacerbating diabetes-induced complications and insulin resistance. If further studied, these findings could help identify novel therapeutic intervention strategies for patients with diabetes comorbid with COVID-19.


Assuntos
Comorbidade , Infecções por Coronavirus/imunologia , Diabetes Mellitus/imunologia , Suscetibilidade a Doenças/imunologia , Pandemias , Pneumonia Viral/imunologia , COVID-19 , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus/epidemiologia , Suscetibilidade a Doenças/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
11.
Med Sci (Paris) ; 36(6-7): 592-593, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32614309

RESUMO

TITLE: À quand la lumière au bout du tunnel ? ABSTRACT: Les maladies de la rétine sont des causes fréquentes de handicap visuel dans les pays industrialisés. En 2040, 25 millions d'européens seront atteints de dégénérescence maculaire liée à l'âge (DMLA) et 8,6 millions de rétinopathie diabétique. La myopie forte est une cause croissante de cécité, en Asie et dans le reste du monde. En 2050, on estime que 50 % de la population mondiale sera myope. La modification de notre environnement lumineux ne serait pas étrangère à cet allongement du globe oculaire en cause dans la myopie. Si les maladies rétiniennes les plus fréquentes sont multifactorielles, impliquant des prédispositions génétiques complexes, le vieillissement, des facteurs métaboliques et environnementaux, un petit nombre de patients sont atteints de maladies rétiniennes monogéniques qui servent de modèles pour l'étude de maladies complexes multifactorielles.


Assuntos
Degeneração Macular/complicações , Degeneração Macular/terapia , Oftalmologia/tendências , Transtornos da Visão/etiologia , Transtornos da Visão/terapia , Causalidade , Suscetibilidade a Doenças/epidemiologia , Terapia Genética/métodos , Terapia Genética/tendências , História do Século XX , História do Século XXI , Humanos , Degeneração Macular/epidemiologia , Miopia/epidemiologia , Miopia/etiologia , Oftalmologia/história , Oftalmologia/métodos , Retina/patologia , Retina/fisiologia , Fatores de Risco , Terapias em Estudo/métodos , Terapias em Estudo/tendências , Transtornos da Visão/epidemiologia , Transtornos da Visão/patologia
12.
Poult Sci ; 99(6): 2937-2943, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32475428

RESUMO

Infectious bronchitis virus (IBV) infection is highly infectious respiratory disease in poultry industry with significant economic importance. The prevalence of IBV in quail industry in Malaysia was not well documented; therefore, its actual role in the epidemiology of the disease is relatively unknown. This study was to determine the susceptibility of Japanese quail, as one of the species in commercial poultry industry, toward IBV. In addition, it will also give a potential impact on the overall health management in the quail industry even though it had been established that quail are resistant to diseases affecting poultry. Moreover, to the best of our knowledge, it is the first experimental study on IBV inoculation in quail. In this experimental study, 20 quails were divided into 4 groups (n = 5 for group A, B, and C, n = 5 for control group). The quails in group A, B, and C were infected via intraocular and intranasal routes with 0.2 mL of 10 × 5 EID50 of the virus. Clinical signs, gross lesions, positive detection of virus, and trachea histopathological scoring were used to assess the susceptibility of these Japanese quails. The results have indicated mild ruffled feathers and watery feces in these inoculated birds. Trachea, lung, and kidney were subjected to one-step reverse transcription polymerase chain reaction for virus detection. The virus was found from trachea and lung samples, whereas it was absent from all kidney samples. Only 3 quails were found with gross lesions. There was a significant difference of tracheal lesion by 0.009 ± 0.845 (P < 0.05) within the treatment groups. In summary, Japanese quails might be susceptible to IBV.


Assuntos
Infecções por Coronavirus/veterinária , Coturnix , Suscetibilidade a Doenças/veterinária , Vírus da Bronquite Infecciosa/fisiologia , Vírus da Bronquite Infecciosa/patogenicidade , Doenças das Aves Domésticas/epidemiologia , Animais , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Suscetibilidade a Doenças/epidemiologia , Suscetibilidade a Doenças/virologia , Malásia/epidemiologia , Doenças das Aves Domésticas/virologia , Prevalência , Virulência
13.
Tohoku J Exp Med ; 251(1): 51-59, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32461503

RESUMO

It is already known that adult height is a factor associated with an increased risk of colon cancer and postmenopausal breast cancer, pancreatic cancer, premenopausal breast cancer, and ovarian cancer. However, the association between adult height and lung cancer incidence remains unclear. The purpose of the present study was to examine the association between adult height and the risk of lung cancer incidence in the Japanese population. We analyzed data for 43,743 men and women who were 40-64 years old at the baseline in 1990. We divided the participants into quintiles based on height at the baseline. Cox proportional hazards analysis was used to estimate the multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of lung cancer according to adult height, after adjustment for potential confounders. We identified 1,101 incident case of lung cancer during 24.5 years of follow-up. The multivariate HRs and 95% CIs for the highest category relative to the lowest were 1.48 (1.15-1.91) in men and 1.35 (0.91-1.99) in women. Furthermore, the association between adult height and the incidence of lung cancer was found the significant increased risk among ever smokers in men, but not never smokers. We also observed that adult height tend to be associated with an increased risk of small cell lung cancer and squamous cell carcinoma. This prospective cohort study has demonstrated a positive association between adult height and the risk of lung cancer incidence among men, especially those who have ever smoked.


Assuntos
Estatura , Neoplasias Pulmonares/epidemiologia , Adulto , Idoso , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Estudos de Coortes , Suscetibilidade a Doenças/epidemiologia , Feminino , Humanos , Incidência , Japão , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia
14.
J Hepatol ; 73(2): 303-314, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32145259

RESUMO

BACKGROUND & AIMS: Severe forms of alcohol-related liver disease are associated with increased susceptibility to infections which are associated with poor prognosis. The cellular and molecular mechanisms responsible for this altered host defense are incompletely understood. METHODS: We performed whole blood phenotypic analysis and ex vivo stimulation with various pathogen-associated molecular patterns (PAMPs). We included 34 patients with alcohol-related cirrhosis (18 of whom had biopsy-proven severe alcoholic hepatitis [sAH]), 12 healthy controls and 11 patients with chronic alcohol consumption without significant liver disease. We also evaluated the transcriptomic (RNA-seq) and chromatin accessibility (ATAC-seq) profiles of CD14+ monocytes from a subset of patients. RESULTS: Circulating monocytes and conventional dendritic cells (DCs) from patients with sAH displayed complex alterations characterized by increased expression of both activating and inhibitory surface markers and an impaired pro-inflammatory response upon stimulation with PAMPs representative of gram-negative bacteria (lipopolysaccharide, Pam3CSK4) or fungal pathogens (Zymosan). Their decreased ability to produce more than 1 cytokine (polyfunctionality) upon PAMP stimulation correlated with the risk of developing infection at 28 days or mortality at 90 days. The presence of acute-on-chronic liver failure in patients with sAH did not significantly modify the immune profile of monocytes and DCs. Moreover, CD14+ monocytes of patients with sAH displayed altered transcriptional and epigenomic profiles characterized by downregulation of key innate immune and metabolic pathways and upregulation of important immunomodulatory factors. CONCLUSIONS: In patients with sAH, the altered transcriptional program and functional properties of monocytes that contribute to patients' susceptibility to infection have strong epigenetic determinants. LAY SUMMARY: Patients with severe alcoholic hepatitis are at increased risk of infections, which contribute to the poor prognosis associated with the disease. Herein, we show that epigenetic determinants underly the immune cell dysfunction and inappropriate responses to pathogens that are associated with severe alcoholic hepatitis.


Assuntos
Citocinas/metabolismo , Epigênese Genética , Hepatite Alcoólica , Infecções , Receptores de Lipopolissacarídeos/análise , Monócitos/imunologia , Biópsia/métodos , Células Dendríticas/imunologia , Progressão da Doença , Suscetibilidade a Doenças/epidemiologia , Regulação para Baixo , Feminino , Bactérias Gram-Negativas/isolamento & purificação , Hepatite Alcoólica/sangue , Hepatite Alcoólica/imunologia , Hepatite Alcoólica/mortalidade , Hepatite Alcoólica/patologia , Humanos , Infecções/epidemiologia , Infecções/microbiologia , Fígado/patologia , Masculino , Prognóstico , Medição de Risco/métodos
15.
Int J Radiat Oncol Biol Phys ; 108(3): 602-611, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31987971

RESUMO

PURPOSE: This study aimed to identify vulnerable patients with head and neck cancer undergoing concurrent chemoradiation therapy (CCRT) who are susceptible to higher treatment-related adverse effects and have poorer treatment tolerance. This study also aimed to determine whether comprehensive geriatric assessment, developed in the geriatric population, can predict vulnerability to treatment-related adverse events and survival even in nongeriatric patients with head and neck cancer, as well as the prevalence of vulnerability and its effect on toxicities and survival among these patients. METHODS AND MATERIALS: This prospective cohort study examined 461 patients with primary head and neck cancer who underwent definitive CCRT during 2016 to 2017 at 3 medical centers across Taiwan. Vulnerability is defined as susceptibility to cancer- and treatment-related adverse events that result in poor treatment tolerance and unexpected emergent medical needs, such as hospitalization and emergency room visits. Vulnerability was assessed as impairment with ≥2 dimensions on comprehensive geriatric assessment, 7 days before CCRT. The association of vulnerability with treatment-related adverse events and survival was analyzed. RESULTS: The prevalence of vulnerability was 22.2%, 27.3%, 30.2%, and 27.9% among patients aged 20 to 34, 35 to 49, 50 to 64, and >65 years, respectively. Survival was poorer in vulnerable patients than in nonvulnerable patients (hazard ratio, 1.97; 95% confidence interval, 1.26-3.07; P = .003). Vulnerable patients showed a higher tendency toward CCRT incompletion (19.5% vs 6.1%, P < .001), hospitalization (34.6% vs 23.5%, P = .020), need for tubal feeding (29.3% vs 11.8%, P < .001), and longer length of hospital stay (8.1 days vs 4.0 days, P = .004) than nonvulnerable patients. Hematologic and nonhematologic toxicities were more severe in vulnerable patients than in nonvulnerable patients. CONCLUSIONS: Vulnerability, which is an urgent concern when it presents among patients with head and neck cancer, was independently associated with poorer survival and severe treatment-related complications. Vulnerability assessment should be routinely evaluated in all patients with primary head and neck cancer who are undergoing definitive CCRT, not only in such patients who are geriatric.


Assuntos
Quimiorradioterapia/efeitos adversos , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Neoplasias de Cabeça e Pescoço/terapia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/métodos , Quimiorradioterapia/mortalidade , Intervalos de Confiança , Suscetibilidade a Doenças/epidemiologia , Nutrição Enteral/estatística & dados numéricos , Feminino , Fragilidade/diagnóstico , Fragilidade/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Inquéritos Epidemiológicos , Hospitalização/estatística & dados numéricos , Humanos , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Cooperação do Paciente/estatística & dados numéricos , Polimedicação , Prevalência , Estudos Prospectivos , Dosagem Radioterapêutica , Taiwan/epidemiologia , Adulto Jovem
16.
Support Care Cancer ; 28(6): 2941-2947, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31768730

RESUMO

PURPOSE: Breast cancer (BC) is the most common cancer in women worldwide. The main treatment for BC is surgery, which involves an axillary procedure that associates with the development of axillary web syndrome (AWS). The incidence of AWS among Chilean women with BC and its possible predisposing factors are currently unknown. Thus, we aimed to (1) determine the incidence of AWS among Chilean women with BC after surgery and (2) identify possible predisposing factors. METHODS: Within 90 days post-surgery, patients were assessed for AWS, i.e., palpable or visible axillary cords in the axillary region extending down from the mid-axilla to the ipsilateral arm. We then computed the odds ratio with 95% confidence interval (OR [95% CI]) for having AWS considering the following predisposing factors: age, body mass index (BMI), number of lymph nodes removed, axillary procedure, days from surgery to the physical therapy assessment, hospital for the surgery, type of breast surgery, and neoadyuvant chemotherapy. RESULTS: AWS was present in 49 out of 107 patients (45.8%). Younger age and lower BMI appeared as the sole predisposing factors for AWS (age, 0.95 [0.91-0.99]; BMI, normal weight 1.00, overweight 0.35 [0.11-1.12], obesity 0.28 [0.08-0.97]). CONCLUSION: The incidence of AWS among Chilean women with BC was 45.8%. Our study also confirms data from previous reports showing that younger age and low BMI are associated with the development of AWS.


Assuntos
Axila/patologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Síndromes Paraneoplásicas/epidemiologia , Síndromes Paraneoplásicas/etiologia , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Chile/epidemiologia , Suscetibilidade a Doenças/epidemiologia , Feminino , Humanos , Incidência , Excisão de Linfonodo/efeitos adversos , Linfonodos/cirurgia , Mastectomia/efeitos adversos , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/patologia , Fatores de Risco
17.
Presse Med ; 48(12): 1439-1444, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31471092

RESUMO

Malignant hypertension has not disappeared, it has been forgotten. Its incidence is increasing again. It considerably worsens the prognosis of young patients (35 to 55 years old on average). There might be susceptibility factors, several hypotheses are under study. New diagnostic criteria and therapeutic options have been proposed and will have to be validated. Faced with these important challenges for patients, the first prospective multicentric register on this pathology will be set up in France in September 2019.


Assuntos
Hipertensão Maligna , Técnicas de Diagnóstico Cardiovascular/tendências , Suscetibilidade a Doenças/epidemiologia , França/epidemiologia , Humanos , Hipertensão Maligna/diagnóstico , Hipertensão Maligna/epidemiologia , Hipertensão Maligna/terapia , Incidência , Prognóstico , Sistema de Registros
18.
Epidemics ; 29: 100349, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31257014

RESUMO

Parasite genetic diversity can provide information on disease transmission dynamics but most mathematical and statistical frameworks ignore the exact combinations of genotypes in infections. We introduce and validate a new method that combines explicit epidemiological modelling of coinfections and regression-Approximate Bayesian Computing (ABC) to detect within-host interactions. Using a susceptible-infected-susceptible (SIS) model, we show that, if sufficiently strong, within-host parasite interactions can be detected from epidemiological data. We also show that, in this simple setting, this detection is robust even in the face of some level of host heterogeneity in behaviour. These simulations results offer promising applications to analyse large datasets of multiple infection prevalence data, such as those collected for genital infections by Human Papillomaviruses (HPVs).


Assuntos
Suscetibilidade a Doenças/epidemiologia , Genótipo , Interações Hospedeiro-Parasita/genética , Teorema de Bayes , Humanos , Modelos Teóricos , Prevalência
19.
Ann Surg ; 270(3): 484-492, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31356281

RESUMO

OBJECTIVE: To investigate subtype-specific risk of germline alleles associated with triple negative breast cancer (TNBC) in African ancestry populations. BACKGROUND: Breast cancer (BC) mortality is higher in African American (AA) compared to White American (WA) women; this disparity is partly explained by 2-fold higher TNBC incidence. METHODS: We used a surgically maintained biospecimen cohort of 2884 BC cases. Subsets of the total (760 AA; 962 WA; 910 West African/Ghanaian; 252 East African/Ethiopian) were analyzed for genotypes of candidate alleles. A subset of 417 healthy controls were also genotyped, to measure associations with overall BC risk and TNBC. RESULTS: TNBC frequency was highest in Ghanaian and AA cases (49% and 44% respectively; P < 0.0001) and lowest in Ethiopian and WA cases (17% and 24% respectively; P < 0.0001). TNBC cases had higher West African ancestry than non-TNBC (P < 0.0001). Frequency of the Duffy-null allele (rs2814778; an African ancestral variant adopted under selective pressure as protection against malaria) was associated with TNBC-specific risk (P < 0.0001), quantified West African Ancestry (P < 0.0001) and was more common in AA, Ghanaians, and TNBC cases. Additionally, rs4849887 was significantly associated with overall BC risk, and both rs2363956 and rs13000023 were associated with TNBC-specific risk, although none as strongly as the Duffy-null variant. CONCLUSIONS: West African ancestry is strongly correlated with TNBC status, as well as germline variants related to BC risk. The Duffy-null allele was associated with TNBC risk in our cohort.


Assuntos
Negro ou Afro-Americano/genética , Suscetibilidade a Doenças/epidemiologia , Mutação em Linhagem Germinativa/genética , Receptor ErbB-2/genética , Neoplasias de Mama Triplo Negativas/genética , Adulto , África Subsaariana/etnologia , Idoso , Estudos de Casos e Controles , Bases de Dados Factuais , Feminino , Gana/etnologia , Humanos , Incidência , Internacionalidade , Pessoa de Meia-Idade , Receptores de Estrogênio/genética , Receptores de Progesterona/genética , Medição de Risco , Neoplasias de Mama Triplo Negativas/etnologia , Neoplasias de Mama Triplo Negativas/patologia , Estados Unidos
20.
JAMA Oncol ; 5(4): 537-545, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30844031

RESUMO

IMPORTANCE: Long-term health effects of cancer in adult survivors are a major concern; however, it is difficult to differentiate between the consequences of cancer and cancer treatment and those of normal aging or comorbidity. OBJECTIVES: To provide an overview and investigate the temporal pattern of hospitalizations for medically verified incident somatic disease in adult survivors compared with cancer-free comparison people, taking into consideration pretreatment comorbidity and the socioeconomic position of the participants. DESIGN, SETTING, AND PARTICIPANTS: In this nationwide, population-based cohort-cohort study, 458 646 survivors of the 12 most frequent first primary cancers listed in the Danish Cancer Registry between January 1, 1997, and December 31, 2014, and 2 121 567 matched cancer-free comparison people were identified from the Danish Central Population Registry. Hospitalizations for somatic diseases after cancer diagnosis or study entry were identified from the National Patient Register and stratified according to the 11 main diagnostic groups in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. A cohort of cancer survivors was formed for each combination of cancer type and diagnostic group, with a corresponding group of cancer-free people, resulting in 132 unique cohorts. Data analysis was performed from September 1, 2017, to January 15, 2018. MAIN OUTCOMES AND MEASURES: Risk of hospitalization and the temporal pattern of incidence were analyzed in Cox proportional hazards regression models. Cumulative incidence proportions were calculated by the pseudo-observation method. RESULTS: A total of 2 580 213 people were investigated, of whom 458 646 were cancer survivors (mean [SD] age, 69 [11.6] years; 230 793 [50.3%] male and 227 853 [49.7%] female) and 2 121 567 were comparison people (mean [SD] age, 69 [11.5] years; 1 054 465 [49.7%] male and 1 067 102 [50.3%] female). More cancer survivors vs comparison people had comorbid conditions at the time of cancer diagnosis or study entry (Charlson Comorbidity Index ≥1: 19% vs 13%). Overall, the risk of hospitalizations for somatic diseases was significantly higher for cancer survivors in almost all diagnostic groups (eg, diseases in the nervous system among breast cancer survivors: hazard ratio, 1.20; 95% CI, 1.17-1.22; diseases in the respiratory system in lung cancer survivors: hazard ratio, 5.85; 95% CI, 5.63-6.07; and diseases in blood and blood-forming organs in prostate cancer survivors: hazard ratio, 2.60; 95% CI, 2.50-2.71). CONCLUSIONS AND RELEVANCE: The findings suggest that adult survivors of the 12 most common cancers are at significantly higher risk for a broad range of somatic diseases that require hospitalization compared with matched cancer-free comparison people. The results of this study suggest the importance of close, targeted monitoring for new somatic disease during follow-up care of cancer survivors.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Suscetibilidade a Doenças/epidemiologia , Hospitalização/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade
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