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1.
Acta Psychiatr Scand ; 137(4): 296-305, 2018 04.
Article in English | MEDLINE | ID: mdl-29430641

ABSTRACT

OBJECTIVE: To investigate the association of different antipsychotic treatments with hospitalization due to self-harm among patients with schizophrenia. METHOD: This retrospective cohort study was based on Taiwan's universal health insurance database. Patients aged 15-45 years with a newly diagnosed schizophrenic disorder in 2001-2012 were included. The study outcome was the first hospitalization due to self-harm or undetermined injury after the diagnosis of schizophrenic disorders. The exposure status of antipsychotics was modeled as a time-dependent variable. The analyses were stratified by antipsychotic dosage based on defined daily dose (DDD). RESULTS: Among 70 380 patients with a follow-up of 500 355 person-years, 2272 self-harm hospitalization episodes were identified. Compared with none or former use, current use of several second-generation antipsychotics with a dose of one DDD or above, including amisulpride, aripiprazole, clozapine, risperidone, and sulpiride, was associated with decreased risk of self-harm hospitalization, with clozapine showing the strongest effect (adjusted rate ratio = 0.26, 95% confidence interval 0.15-0.47). CONCLUSION: The protective effect on self-harm may vary across different antipsychotics. Further studies are needed to replicate the findings.


Subject(s)
Antipsychotic Agents/pharmacology , Clozapine/pharmacology , Schizophrenia/drug therapy , Self-Injurious Behavior/prevention & control , Adolescent , Adult , Antipsychotic Agents/administration & dosage , Clozapine/administration & dosage , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , National Health Programs/statistics & numerical data , Risk , Schizophrenia/epidemiology , Self-Injurious Behavior/epidemiology , Taiwan/epidemiology , Young Adult
2.
Psychol Med ; 47(1): 81-92, 2017 01.
Article in English | MEDLINE | ID: mdl-27659718

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the comparative risk of self-harm associated with the use of different antidepressants. METHOD: A cohort study was conducted using data from Taiwan's National Health Insurance Research Database from 2001 to 2012. A total of 751 606 new antidepressant users with depressive disorders were included. The study outcome was hospitalization due to self-harm (International Classification of Diseases, Ninth Revision, Clinical Modification codes: E950-E958 and E980-E988). Cox proportional hazards models with stratification of the propensity score deciles were used to estimate the hazard ratios of self-harm hospitalization during the first year following the initiation of antidepressant treatment. RESULTS: There were 1038 hospitalization episodes due to self-harm that occurred during the follow-up of 149 796 person-years, with an overall incidence rate of 6.9 [95% confidence interval (CI) 6.5-7.4] per 1000. Compared with fluoxetine, the risk of self-harm hospitalization was higher for maprotiline [adjusted hazard ratio (aHR) = 3.00, 95% CI 1.40-6.45], milnacipran (aHR = 2.34, 95% CI 1.24-4.43) and mirtazapine (aHR = 1.40, 95% CI 1.06-1.86), lower for bupropion (aHR = 0.51, 95% CI 0.30-0.86), and similar level of risk was found for other selective serotonin reuptake inhibitors (citalopram, escitalopram, fluvoxamine, paroxetine and sertraline). CONCLUSIONS: The risk of self-harm may vary across different antidepressant drugs. It would be of importance to conduct further research to investigate the influence of antidepressant use on self-harm behaviors.


Subject(s)
Antidepressive Agents/pharmacology , Depressive Disorder/drug therapy , Hospitalization/statistics & numerical data , Self-Injurious Behavior/prevention & control , Adolescent , Adult , Aged , Child , Cohort Studies , Depressive Disorder/complications , Depressive Disorder/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Risk , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/etiology , Taiwan/epidemiology , Young Adult
3.
Allergy ; 71(1): 90-8, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26416225

ABSTRACT

BACKGROUND: Although there is evidence that exposure to tobacco smoke is harmful to children's respiratory health, the effects of tobacco smoke exposure on the regulation of immunoglobulin E (IgE)-mediated immune responses to specific allergens remain unclear. This study aimed to investigate the relationship between objectively assessed tobacco smoke exposure and specific IgE profiles for a broad spectrum of allergens in a population setting. METHODS: Children aged 5-18 years (N = 1315) were assessed using serum cotinine measurement and microarray-based multiplexed detection of specific IgE against 40 allergens. RESULTS: Serum cotinine levels were positively associated with sensitization to foods (adjusted odds ratio [AOR] = 4.95; 95% CI: 1.59-15.34), cockroaches (AOR = 3.77; 95% CI: 1.49-9.51), and pollen (AOR = 2.84; 95% CI: 1.20-6.73) while the association was borderline significant for animals (AOR = 2.53; 95% CI: 0.92-6.93). No associations were found for sensitization against mites, mold, and latex. When considering the degree of allergic sensitization, serum cotinine levels were positively correlated to the number of sensitization to cockroaches (P = 0.004), pollen (P = 0.006), and foods (P < 0.001), with statistically significant positive dose-response relationships (all P < 0.01). Similar results were observed when summing up specific IgE concentrations for the aforementioned allergen categories. CONCLUSIONS: The association between tobacco smoke exposure and IgE sensitization to environmental allergens varies for different allergens among children. This study demonstrates that elevated serum cotinine levels are significantly associated with IgE sensitization to cockroaches, grass pollen, and certain foods, with potential dose-dependent relationships.


Subject(s)
Environmental Exposure/adverse effects , Hypersensitivity/epidemiology , Hypersensitivity/etiology , Immunoglobulin E/immunology , Nicotiana/adverse effects , Smoke/adverse effects , Adolescent , Allergens/immunology , Animals , Child , Child, Preschool , Cotinine/blood , Female , Humans , Immunization , Immunoglobulin E/blood , Male , Odds Ratio , Population Surveillance , Risk Factors
4.
Diabet Med ; 32(3): 382-90, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25313684

ABSTRACT

AIMS: To investigate the temporal relationship between non-steroidal anti-inflammatory drug use and the development of chronic kidney disease in people with Type 2 diabetes mellitus. METHODS: We conducted a retrospective cohort study and followed up a population with Type 2 diabetes who were chronic kidney disease-free (n = 48,715) using national health insurance claims data in Taiwan. Exposure status to non-steroidal anti-inflammatory drugs in 2007 was measured. A total of 6406 subjects with incident chronic kidney disease were identified from the period 2008 to 2011. Multivariable proportional hazards models were applied to determine the temporal relationship between non-steroidal anti-inflammatory drug use and the development of chronic kidney disease. RESULTS: We observed a significant temporal relationship between non-steroidal anti-inflammatory drug use and the development of chronic kidney disease in people with Type 2 diabetes. Compared with people not taking any non-steroidal anti-inflammatory drug in 2007, those who were taking such drugs for at least 90 days in 2007 had a higher risk of chronic kidney disease development (adjusted hazard ratio 1.37, 95% CI 1.26-1.49). In subgroup analyses, those people (irrespective of age, sex, various comorbidities and use of anti-hypertensive drugs, aspirin or acetaminophen) who were taking non-steroidal anti-inflammatory drugs for at least 90 days were more likely to develop chronic kidney disease than people who were not taking any non-steroidal anti-inflammatory drug. CONCLUSIONS: The results suggest that there is a positive temporal relationship between non-steroidal anti-inflammatory drug use and increased risk of chronic kidney disease in people with Type 2 diabetes. The use of non-steroidal anti-inflammatory drugs should be based on clinical evaluations of benefits and risks, and should be prescribed with caution for people with Type 2 diabetes.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Diabetes Mellitus, Type 2/complications , Renal Insufficiency, Chronic/epidemiology , Adult , Aged , Cohort Studies , Female , Follow-Up Studies , Humans , Incidence , Longitudinal Studies , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Risk Factors , Taiwan/epidemiology
5.
Allergy ; 69(5): 678-82, 2014 May.
Article in English | MEDLINE | ID: mdl-24576320

ABSTRACT

This study investigated the relationship between the specific immunoglobulin E (IgE) profile for 40 allergens using a novel microarray technique (BioIC) and fraction of exhaled nitric oxide (FeNO) in a population sample of 1321 children. Significant positive associations were found between FeNO and sensitization to mites (P < 0.001), animals (P = 0.001), cockroaches (P < 0.001), and foods (P = 0.042), and furthermore, between FeNO and the number of sensitizations (all P < 0.05) or the sum of specific IgE (all P ≤ 0.01) against the aforementioned allergen categories. Specifically, sensitization to the following allergens was significantly related to higher FeNO: Dermatophagoides pteronyssinus, Dermatophagoides farina, Blomia tropicalis, cat, German cockroach, Oriental cockroach, codfish, crab, shrimp, and cheese (all P ≤ 0.01). In conclusion, IgE sensitization to mites, pets, cockroaches, seafood, and cheese, respectively, is significantly associated with elevated FeNO levels in a dose-dependent fashion in children. Our results provide new evidence that sensitization to certain food allergens may contribute to prompt inflammation in the airways.


Subject(s)
Exhalation , Immunoglobulin E/immunology , Nitric Oxide/metabolism , Adolescent , Allergens/classification , Allergens/immunology , Animals , Child , Female , Humans , Hypersensitivity/epidemiology , Hypersensitivity/immunology , Hypersensitivity/metabolism , Immunoglobulin E/blood , Male , Prospective Studies
6.
Transpl Infect Dis ; 16(6): 1003-6, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25367218

ABSTRACT

Transmission of hepatitis C virus (HCV) to recipients of hematopoietic stem cell transplant (HSCT) occurs frequently from HCV viremic donors and causes complications. Here, we report the outcomes of 3 cases from our 265 allogeneic HSCTs, whose donors had HCV infections. Successful prevention of HCV transmission was noted in 1 recipient by pretreatment of the donor with peginterferon/ribavirin to undetectable levels of HCV viremia before stem cell harvest. This case stressed the important role of effective antiviral therapy and HCV RNA seronegativity before cell harvest for prevention of HCV transmission in HSCT.


Subject(s)
Hematopoietic Stem Cell Transplantation/adverse effects , Hepatitis C/transmission , Viremia , Adult , Antiviral Agents/administration & dosage , Antiviral Agents/therapeutic use , Drug Therapy, Combination , Female , Hepacivirus/isolation & purification , Hepatitis C/drug therapy , Hepatitis C/virology , Humans , Interferon-alpha/administration & dosage , Interferon-alpha/therapeutic use , Male , Polyethylene Glycols/administration & dosage , Polyethylene Glycols/therapeutic use , RNA, Viral/blood , Recombinant Proteins/administration & dosage , Recombinant Proteins/therapeutic use , Ribavirin/administration & dosage , Ribavirin/therapeutic use , Tissue Donors , Viral Load
7.
Malays J Pathol ; 35(2): 177-80, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24362481

ABSTRACT

Basaloid squamous cell carcinoma (BSCC) of the uterine cervix is a rare malignancy of the female genital tract with a poorer clinical outcome than SCC of the uterine cervix. We report a case of BSCC of the uterine cervix developing rapidly in a young adult Taiwanese. A 35-year-old woman, Para 2, visited the emergency room with severe dizziness, palpitations and sudden excessive vaginal bleeding with hemoglobin of 3.6 g/dl. She had been well and healthy but intermittent vaginal spotting developed for around 6 months previously and was treated as abnormal uterine bleeding by ob-gyn practitioners. She had a repeat cesarean operation 16 months prior to this episode and the last Pap smear showed reactive change 12 months ago at our hospital. On examination, she had an ulcerated, necrotic, and punched-out lesion of 5 cm of the cervix. A cervical biopsy revealed poorly differentiated typical BSCC. Abdominal/pelvic computerized tomography and whole body positron emission tomography confirmed FIGO staging IB2. She responded well to concurrent chemoradiotherapy. Follow-up for the patient is ongoing. This is a rapid developing BSCC of the uterine cervix, although we cannot actually ascertain when it started and how rapidly it progressed.


Subject(s)
Carcinoma, Squamous Cell/pathology , Uterine Cervical Neoplasms/pathology , Adult , Carcinoma, Squamous Cell/therapy , Chemoradiotherapy , Disease Progression , Female , Humans , Taiwan , Uterine Cervical Neoplasms/therapy
8.
Clin Exp Allergy ; 42(2): 265-74, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22093077

ABSTRACT

BACKGROUND: Racial disparities persist in early childhood wheezing and cannot be completely explained by known risk factors. OBJECTIVE: To evaluate the associations of genetic ancestry and self-identified race with early childhood recurrent wheezing, accounting for socio-economic status (SES) and early life exposures. METHODS: We studied 1034 children in an urban, multi-racial, prospective birth cohort. Multivariate logistic regression was used to evaluate the association of genetic ancestry as opposed to self-identified race with recurrent wheezing (>3 episodes). Sequential models accounted for demographic, socio-economic factors and early life risk factors. Genetic ancestry, estimated using 150 ancestry informative markers, was expressed in deciles. RESULTS: Approximately 6.1% of subjects (mean age 3.1 years) experienced recurrent wheezing. After accounting for SES and demographic factors, African ancestry (OR: 1.16, 95% CI: 1.02-1.31) was significantly associated with recurrent wheezing. By self-reported race, hispanic subjects had a borderline decrease in risk of wheeze compared with African Americans (OR: 0.44, 95% CI: 0.19-1.00), whereas white subjects (OR: 0.46, 95% CI: 0.14-1.57) did not have. After further adjustment for known confounders and early life exposures, both African (OR: 1.19, 95% CI: 1.05-1.34) and European ancestry (OR: 0.84, 95% CI: 0.74-0.94) retained a significant association with recurrent wheezing, as compared with self-identified race (OR(whites) : 0.31, 95% CI: 0.09-1.14; OR(hispanic) : 0.47, 95% CI: 0.20-1.08). There were no significant interactions between ancestry and early life factors on recurrent wheezing. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to self-identified race, African ancestry remained a significant, independent predictor of early childhood wheezing after accounting for early life and other known risk factors associated with lung function changes and asthma. Genetic ancestry may be a powerful way to evaluate wheezing disparities and a proxy for differentially distributed genetic and early life risk factors associated with childhood recurrent wheezing.


Subject(s)
Black or African American/genetics , Environmental Exposure/adverse effects , Respiratory Sounds/genetics , Respiratory Sounds/immunology , Boston/epidemiology , Boston/ethnology , Child , Child, Preschool , Female , Genetic Markers , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Risk Factors , Social Class , White People/genetics
9.
Allergy ; 66(11): 1442-8, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21819409

ABSTRACT

BACKGROUND: It has been hypothesized that vitamin D deficiency (VDD) contributes to the development of food sensitization (FS) and then food allergy. However, the epidemiological evidence is conflicting. We aim to examine whether cord blood VDD is associated with FS and whether such association can be modified by genetic variants in a prospective birth cohort. METHODS: This study included 649 children who were enrolled at birth and followed from birth onward at the Boston Medical Center. We defined VDD as cord blood 25(OH)D < 11 ng/ml, and FS as specific IgE ≥ 0.35 kUA/l to any of eight common food allergens in early childhood. We genotyped potentially functional single-nucleotide polymorphisms (SNPs) in 11 genes known to be involved in regulating IgE and 25(OH)D concentrations. Logistic regressions were used to test the effects of VDD on FS individually and jointly with SNPs. RESULTS: Among the 649 children, 44% had VDD and 37% had FS. When examined alone, VDD was not associated with FS. When examined jointly with SNPs, a significant interaction between IL4 gene polymorphism (rs2243250) and VDD (p(interaction) = 0.003, p(FDR) = 0.10) was found: VDD increased the risk of FS among children carrying CC/CT genotypes (OR = 1.79, 95%CI: 1.15-2.77). Similar but weaker interactions were observed for SNPs in MS4A2 (rs512555), FCER1G (rs2070901), and CYP24A1 (rs2762934). When all four SNPs were simultaneously considered, a strong gene-VDD interaction was evident (p(interaction) = 9 × 10(-6) ). CONCLUSIONS: Our data demonstrate that VDD may increase the risk of FS among individuals with certain genotypes, providing evidence of gene-vitamin D interaction on FS.


Subject(s)
Food Hypersensitivity/epidemiology , Food Hypersensitivity/genetics , Interleukin-4/genetics , Polymorphism, Single Nucleotide , Vitamin D Deficiency/epidemiology , Vitamin D/blood , Adult , Child, Preschool , Cohort Studies , Female , Food Hypersensitivity/diagnosis , Food Hypersensitivity/etiology , Humans , Incidence , Infant , Infant, Newborn , Male , Prospective Studies , Risk Factors , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/genetics
11.
Br J Cancer ; 103(9): 1343-8, 2010 Oct 26.
Article in English | MEDLINE | ID: mdl-20924378

ABSTRACT

BACKGROUND: Docetaxel plus cisplatin and 5-fluorouracil has become a new standard for treating advanced gastric cancer. However, high rates of severe neutropenia limit its application. Modification of the regimen could be the solution to get similar activity but less myelosuppression. METHODS: Patients with histologically confirmed, locally advanced, or recurrent/metastatic gastric adenocarcinoma without previous chemotherapy were enrolled. This regimen consisted of docetaxel (Tyxan, TTY, Taipei, Taiwan) 30-min infusion at a dose of 36 mg m(-2), followed by cisplatin 30 mg m(-2) infusion over 1 h on days 1 and 8, and oral tegafur/uracil 300 mg m(-2) per day plus leucovorin 90 mg per day on days 1-14, every 3 weeks. Tumour response was evaluated after every 2 cycles of treatment. RESULTS: From August 2007 to March 2009, 45 patients were enrolled. The median age was 56 years (range: 22-75). Among the 40 patients evaluable for tumour response, one achieved a complete response, 22 had partial responses and 11 had stable disease. The overall response rates of the evaluable and intent-to-treat (ITT) populations were 58% (95% CI: 41-74%) and 53% (95% CI: 38-68%), respectively. The disease control rates in these populations were 85% (95% CI: 70-94%) and 82% (95% CI: 68-92%), respectively. In the ITT analysis, the median time to progression and overall survival were 6.8 and 13.9 months, respectively. Major grade 3-4 toxicities were neutropenia (51%), anaemia (22%), diarrhoea (16%), and infections (20%). No patient died of treatment-related toxicities. CONCLUSION: Concurrent weekly docetaxel and cisplatin plus oral tegafur/uracil and leucovorin are effective and well tolerated in the treatment of advanced gastric cancer.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Stomach Neoplasms/drug therapy , Taxoids/administration & dosage , Administration, Oral , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Cisplatin/administration & dosage , Docetaxel , Drug Administration Schedule , Female , Humans , Leucovorin/administration & dosage , Middle Aged , Neoplasm Metastasis , Stomach Neoplasms/pathology , Tegafur/administration & dosage , Uracil/therapeutic use
12.
Am J Physiol Heart Circ Physiol ; 298(3): H795-806, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20035028

ABSTRACT

The soluble epoxide hydrolase enzyme (SEH) and vascular remodeling are associated with cardiovascular disease. Although inhibition of SEH prevents smooth muscle cell proliferation in vitro, the effects of SEH inhibition on vascular remodeling in vivo and mechanisms of these effects remain unclear. Herein we determined the effects of SEH antagonism in an endothelium intact model of vascular remodeling induced by flow reduction and an endothelium denuded model of vascular injury. We demonstrated that chronic treatment of spontaneously hypertensive stroke-prone rats with 12-(3-adamantan-1-yl-ureido) dodecanoic acid, an inhibitor of SEH, improved the increment of inward remodeling induced by common carotid ligation to a level that was comparable with normotensive Wistar Kyoto rats. Similarly, mice with deletion of the gene responsible for the production of the SEH enzyme (Ephx2(-/-)) demonstrated enhanced inward vascular remodeling induced by carotid ligation. However, the hyperplastic response induced by vascular injury that denudes the endothelium was unabated by SEH inhibition or Ephx2 gene deletion. These results suggest that SEH inhibition or Ephx2 gene deletion antagonizes neointimal formation in vivo by mechanisms that are endothelium dependent. Thus SEH inhibition may have therapeutic potential for flow-induced remodeling and neointimal formation.


Subject(s)
Carotid Arteries/physiopathology , Carotid Artery Injuries/physiopathology , Epoxide Hydrolases/antagonists & inhibitors , Epoxide Hydrolases/physiology , Animals , Blood Pressure/physiology , Carotid Arteries/pathology , Carotid Artery Injuries/etiology , Cell Proliferation , Endothelium, Vascular/pathology , Endothelium, Vascular/physiopathology , Epoxide Hydrolases/genetics , Hyperplasia/pathology , Hyperplasia/physiopathology , Lauric Acids/pharmacology , Ligation , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Models, Animal , Rats , Rats, Inbred SHR , Rats, Inbred WKY , Tunica Intima/pathology , Tunica Intima/physiopathology
13.
Eur Respir J ; 33(1): 42-8, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18829683

ABSTRACT

Although it has been recognised that genetics plays an important role in the development of asthma, important causal loci remain to be identified. The aim of the present study was to examine the association of known and novel candidate genes with asthma. Two independent samples, including 170 asthmatic cases and 347 controls in the initial sample, and 202 asthmatic cases and 332 controls in the confirmation sample, were recruited from the same region of China. Functional single nucleotide polymorphisms (SNPs; n = 129) from 105 genes were genotyped using MassARRAY technology, and 119 SNPs were used for the subsequent analysis. In the initial sample, three SNPs, rs320995 in the cysteinyl leukotriene receptor 1 gene, rs1047266 in the tumour necrosis factor receptor superfamily, member 10b, gene and rs40401 in the interleukin-3 gene, were associated with risk of asthma. Notably, under the recessive genetic model, subjects without the thymidine allele in SNP rs320995 had a 3.1 times higher risk of asthma, which remained significant after accounting for multiple testing. This association was replicated in the confirmation sample and validated by meta-analysis. Further, sex-specific analysis was performed, but no sex difference was found. The present study provided coherent evidence that cysteinyl leukotriene receptor 1 gene variation is associated with risk of asthma.


Subject(s)
Asian People/genetics , Asthma/genetics , Interleukin-3/genetics , Polymorphism, Single Nucleotide/genetics , Receptors, Leukotriene/genetics , Receptors, TNF-Related Apoptosis-Inducing Ligand/genetics , Adolescent , Adult , Asthma/epidemiology , Case-Control Studies , Child , China , Cohort Studies , Female , Genotype , Humans , Male , Middle Aged , Young Adult
14.
Clin Exp Allergy ; 39(7): 991-8, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19302247

ABSTRACT

BACKGROUND: Allergic disease is on the rise worldwide. Effective prevention of allergic disease requires comprehensive understanding of the factors that contribute to its intermediate phenotypes, such as sensitization to common allergens. OBJECTIVE: To estimate the degree of genetic and environmental contributions to sensitization to food and aeroallergens. METHODS: Sensitization was defined as a positive skin prick test to an allergen. We calculated the zygosity-specific concordance rates and odds ratios (ORs) for sensitization to food and aeroallergens in 826 Chinese twin pairs [472 monozygotic (MZ) and 354 dizygotic (DZ)] aged 12-28 years. We also applied structural equation modelling procedures to estimate genetic and environmental influences on sensitization. RESULTS: The concordance rates and risk of sensitization in one twin given the presence vs. the absence of sensitization in the other twin were higher in MZ twins than those in DZ twins. However, a large number of MZ twins were discordant in sensitization to common allergens. These observations suggest both genetic and environmental factors influence sensitization. Consistently, the estimated heritability and individual environmental components of the liability to sensitization ranged from 0.51 to 0.68 and 0.32 to 0.49, respectively, based on the best-fitted structural equation model. We also observed high phenotypic correlations between sensitization to two aeroallergens (cockroach and dust mite: 0.83) and two food allergens (peanut and shellfish: 0.58), but only moderate correlations for the pairs between sensitization to a food and an aeroallergen (0.31-0.46). The shared genetic and environmental factors between paired sensitizations contribute to the observed correlations. CONCLUSION: We demonstrated that sensitization to common food and aeroallergens were influenced by both genetic and environmental factors. Moreover, we found that paired allergen sensitizations might share some common sets of genes and environmental factors. This study underscores the need to further delineate unique and/or pleiotropic genetic and environmental factors for allergen sensitization.


Subject(s)
Allergens/genetics , Asian People/genetics , Environment , Hypersensitivity/etiology , Hypersensitivity/genetics , Twins, Dizygotic/genetics , Twins, Monozygotic/genetics , Adolescent , Adult , Allergens/immunology , Animals , Child , China/epidemiology , Cohort Studies , Female , Follow-Up Studies , Food Hypersensitivity/epidemiology , Food Hypersensitivity/etiology , Food Hypersensitivity/genetics , Food Hypersensitivity/immunology , Humans , Hypersensitivity/epidemiology , Hypersensitivity/immunology , Male , Odds Ratio , Phenotype , Prospective Studies , Risk Factors , Sensitivity and Specificity , Sex Characteristics , Skin Tests , Twins, Dizygotic/immunology , Twins, Monozygotic/immunology , Young Adult
15.
Clin Exp Allergy ; 39(1): 101-9, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19016802

ABSTRACT

BACKGROUND: The increasing prevalence of food allergy (FA) is a growing clinical and public health problem. The contribution of genetic factors to FA remains largely unknown. OBJECTIVE: This study examined the pattern of familial aggregation and the degree to which genetic factors contribute to FA and sensitization to food allergens. METHODS: This study included 581 nuclear families (2,004 subjects) as part of an ongoing FA study in Chicago, IL, USA. FA was defined by a set of criteria including timing, clinical symptoms obtained via standardized questionnaire interview and corroborative specific IgE cut-offs for > or =95% positive predictive value (PPV) for food allergens measured by Phadia ImmunoCAP. Familial aggregation of FA as well as sensitization to food allergens was examined using generalized estimating equation (GEE) models, with adjustment for important covariates including age, gender, ethnicity and birth order. Heritability was estimated for food-specific IgE measurements. RESULTS: FA in the index child was a significant and independent predictor of FA in other siblings (OR=2.6, 95% CI: 1.2-5.6, P=0.01). There were significant and positive associations among family members (father-offspring, mother-offspring, index-other siblings) for total IgE and specific IgE to all the nine major food allergens tested in this sample (sesame, peanut, wheat, milk, egg white, soy, walnut, shrimp and cod fish). The estimated heritability of food-specific IgE ranged from 0.15 to 0.35 and was statistically significant for all the nine tested food allergens. CONCLUSION: This family-based study demonstrates strong familial aggregation of FA and sensitization to food allergens, especially, among siblings. The heritability estimates indicate that food-specific IgE is likely influenced by both genetic and environmental factors. Together, this study provides strong evidence that both host genetic susceptibility and environmental factors determine the complex trait of IgE-mediated FA.


Subject(s)
Allergens/adverse effects , Family , Food Hypersensitivity , Genetic Predisposition to Disease , Immunoglobulin E/blood , Adolescent , Adult , Allergens/administration & dosage , Allergens/immunology , Animals , Cats , Child , Child, Preschool , Dogs , Female , Food Hypersensitivity/diagnosis , Food Hypersensitivity/epidemiology , Food Hypersensitivity/genetics , Food Hypersensitivity/immunology , Humans , Infant , Infant, Newborn , Interviews as Topic , Male , Prevalence , Surveys and Questionnaires , Young Adult
16.
Rev Sci Tech ; 27(2): 581-97, 2008 Aug.
Article in English | MEDLINE | ID: mdl-18819679

ABSTRACT

The threat of climate change and global warming is now recognised worldwide and some alarming manifestations of change have occurred. The Asian continent, because of its size and diversity, may be affected significantly by the consequences of climate change, and its new status as a 'hub' of livestock production gives it an important role in mitigating possible impacts of climate variability on animal health. Animal health may be affected by climate change in four ways: heat-related diseases and stress, extreme weather events, adaptation of animal production systems to new environments, and emergence or re-emergence of infectious diseases, especially vector-borne diseases critically dependent on environmental and climatic conditions. To face these new menaces, the need for strong and efficient Veterinary Services is irrefutable, combined with good coordination of public health services, as many emerging human diseases are zoonoses. Asian developing countries have acute weaknesses in their Veterinary Services, which jeopardises the global surveillance network essential for early detection of hazards. Indeed, international cooperation within and outside Asia is vital to mitigating the risks of climate change to animal health in Asia.


Subject(s)
Animal Diseases/epidemiology , Animal Welfare , Climate , Communicable Disease Control/methods , Communicable Diseases, Emerging/veterinary , Greenhouse Effect , Animal Diseases/prevention & control , Animals , Asia/epidemiology , Communicable Diseases, Emerging/epidemiology , Disease Reservoirs/veterinary , Disease Vectors , Environment , Humans , International Cooperation , Public Health , Risk Assessment , Sentinel Surveillance/veterinary , Stress, Physiological/veterinary , Zoonoses
18.
Aliment Pharmacol Ther ; 47(12): 1673-1681, 2018 06.
Article in English | MEDLINE | ID: mdl-29696665

ABSTRACT

BACKGROUND: Renal dysfunction remains an issue in tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB) patients. AIM: To evaluate renal safety of TDF according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. METHODS: We retrospectively recruited CHB patients who received either TDF or entecavir (ETV) monotherapy from January 2008 to August 2015. After excluding confounding conditions, 253 patients who received TDF were randomly matched 1:2 with 506 patients who received ETV through the propensity scores, which consisted of age, gender, cirrhosis, chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR). Renal function deterioration was defined as a drop in GFR category accompanied with a ≥25% eGFR decline. Cumulative incidences of and hazard ratios (HRs) for renal dysfunction were analysed. RESULTS: The mean eGFR decline was significantly greater in the TDF group over 48 months (TDF vs ETV: 15.73 mL/min/1.73 m2 , 95% confidence interval [CI]: 13.76-17.70 vs 5.96 mL/min/1.73 m2 , 95% CI: 4.72-7.19; P < 0.001). The cumulative incidence of renal function deterioration was significantly higher in the TDF group (TDF vs ETV: 11.1%, 95% CI: 7.4-14.8 vs 1.7%, 95% CI: 1.0-2.4; P < 0.001). After adjusting for age, pre-existing CKD and diabetes, TDF was independently associated with an increased risk of renal function deterioration (HR 5.36, 95% CI: 2.16-13.35; P < 0.001). Pre-existing CKD (HR 6.71, 95% CI: 2.25-17.65), proteinuria (HR 3.39, 95% CI: 1.23-9.39), and haematuria (HR 4.25, 95% CI: 1.32-13.68) were also independent factors of renal dysfunction. CONCLUSION: By following the KDIGO guidelines, we confirmed that TDF was associated with a higher risk of renal dysfunction as compared to ETV.


Subject(s)
Antiviral Agents/adverse effects , Guanine/analogs & derivatives , Hepatitis B, Chronic/drug therapy , Tenofovir/adverse effects , Adult , Antiviral Agents/therapeutic use , Female , Glomerular Filtration Rate , Guanine/administration & dosage , Guanine/adverse effects , Humans , Incidence , Kidney/pathology , Liver Cirrhosis/epidemiology , Male , Middle Aged , Renal Insufficiency, Chronic/epidemiology , Retrospective Studies , Tenofovir/therapeutic use
19.
Rev Sci Instrum ; 78(5): 055109, 2007 May.
Article in English | MEDLINE | ID: mdl-17552862

ABSTRACT

A quadruple-bend achromatic (QBA) cell, defined as a supercell made of two double-bend cells with different outer and inner dipole bend angles, is found to provide a factor of 2 in lowering the beam emittance relative to the more conventional double-bend achromat. The ratio of bending angles of the inner dipoles to that of the outer dipoles is numerically found to be about 1.5-1.6 for an optimal low beam emittance in the isomagnetic condition. The QBA lattice provides an advantage over the double-bend achromat or the double-bend nonachromat in performance by providing a small natural beam emittance and some zero-dispersion straight sections. A lattice with 12 QBA cells and a preliminary dynamic aperture study serves as an example.


Subject(s)
Computer-Aided Design , Synchrotrons/instrumentation , Transducers , Energy Transfer , Equipment Design , Equipment Failure Analysis , Radiation Dosage , Reproducibility of Results , Scattering, Radiation , Sensitivity and Specificity
20.
Vet Res Commun ; 31(8): 931-9, 2007 Nov.
Article in English | MEDLINE | ID: mdl-17285243

ABSTRACT

Rectal swabs were collected from 437 household and 491 stray dogs in northern Taiwan from May 2003 to June 2005 to investigate the prevalence and antimicrobial susceptibilities of salmonellae and campylobacters. The results revealed that 2.1% of household dogs and 6.3% of stray dogs were positive for salmonellae, with Salmonella Duesseldorf being the most dominant serotype in both. Additionally, 2.7% of the household dogs and 23.8% of the stray dogs were positive for campylobacters. Campylobacter jejuni was the most prevalent species (86.8%), followed by C. upsaliensis (9.3%) and C. coli (3.9%). Both salmonella and campylobacter isolation rates from the stray dogs were significantly higher than those from the household dogs (p < 0.01). The susceptibility of 33 C. jejuni isolates to eight antimicrobials was studied by the E-test. A high rate of resistance was observed to azithromycin (93.9%), clindamycin (87.9%), erythromycin (81.8%), tetracycline (78.8%), chloramphenicol (69.7%), nalidixic acid (51.5%), gentamicin (33.3%), and ciprofloxacin (18.2%). The susceptibility of 40 Salmonella isolates to 15 antimicrobials was also studied by the disc-diffusion method. All the Salmonella isolates were susceptible to ciprofloxacin and ceftriaxone. Resistance was observed most frequently to tetracycline (77.5%), chloramphenicol (52.5%), and ampicillin (50%).


Subject(s)
Campylobacter Infections/veterinary , Campylobacter jejuni/isolation & purification , Dog Diseases/microbiology , Gastrointestinal Diseases/veterinary , Salmonella Infections, Animal/epidemiology , Salmonella/isolation & purification , Animals , Campylobacter Infections/epidemiology , Campylobacter Infections/microbiology , Campylobacter jejuni/genetics , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , Dog Diseases/epidemiology , Dogs , Drug Resistance, Bacterial , Feces/microbiology , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/microbiology , Microbial Sensitivity Tests/veterinary , Polymerase Chain Reaction/veterinary , Prevalence , Salmonella Infections, Animal/microbiology , Taiwan/epidemiology , Zoonoses/microbiology
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