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1.
BMC Public Health ; 24(1): 116, 2024 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-38191335

RESUMEN

BACKGROUND: Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene's Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care. METHODS: During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services. RESULTS: The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants' own care. CONCLUSIONS: This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.


Asunto(s)
Hepatitis B , Parto , Femenino , Embarazo , Humanos , Periodo Posparto , Hepatitis B/diagnóstico , Hepatitis B/prevención & control , Familia , Instituciones de Salud
2.
J Community Health ; 49(4): 755-762, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38407756

RESUMEN

Food insecurity, a critical social determinant of health, has been measured nationwide in the United States for years. This analysis focuses on food insufficiency, a more severe form of food insecurity, in New York City (NYC) and its association with self-reported physical and mental health conditions. Data from the 2017-2018 NYC Community Health Survey were used to estimate the prevalence of food insufficiency citywide, by neighborhood, and across selected socioeconomic characteristics. Multivariable logistic regression was used to explore the associations between food insufficiency and hypertension, diabetes obesity, and depression, adjusting for selected sociodemographic characteristics. Approximately 9.4% (95% CI:8.8-10.0%]) of adult New Yorkers aged 18 + reported food insufficiency, with neighborhood variation from 1.7% (95% CI:0.5-6.2%) to 19.4% (95% CI:14.2-25.8%). Food insufficiency was more prevalent among Latinos/as (16.9%, 95% CI:15.5-18.3%, p < 0.001), Black (10.1%, 95% CI:8.8-11.5%, p < 0.001) and Asian/Pacific Islanders (6.6%, 95% CI:5.4-8.1%, p = 0.002) compared to White New Yorkers (4.2%, 95% CI:3.5-5.1%). Prevalence of food insufficiency was higher among NYC adults with less than a high school education, (19.6%, 95% CI:17.7-21.6%), compared to college graduates (3.8%, 95% CI:3.2-4.4%, p < 0.001). In the adjusted logistic regression model, food insufficiency was associated with diabetes (OR = 1.36; 95% CI:1.12-1.65), hypertension (OR = 1.58; 95% CI:1.32-1.89]) and depression (OR = 2.98; 95% CI:2.45-3.59), but not with obesity (OR = 0.99; 95% CI:0.84-1.21). Our findings highlight food insufficiency at an important intersection of inequity and disease burden which is critical to informing public health interventions in the context of a large, densely populated metropolis like NYC.


Asunto(s)
Inseguridad Alimentaria , Humanos , Ciudad de Nueva York/epidemiología , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adulto Joven , Adolescente , Depresión/epidemiología , Hipertensión/epidemiología , Anciano , Obesidad/epidemiología , Factores Socioeconómicos , Estado de Salud , Prevalencia , Características de la Residencia/estadística & datos numéricos , Encuestas Epidemiológicas , Diabetes Mellitus/epidemiología
3.
J Public Health Manag Pract ; 29(1): 11-20, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36112356

RESUMEN

OBJECTIVE: To develop recommendations to embed equity into data work at a local health department and a framework for antiracist data praxis. DESIGN: A working group comprised staff from across the agency whose positions involved data collection, analysis, interpretation, or communication met during April-July 2018 to identify and discuss successes and challenges experienced by staff and to generate recommendations for achieving equitable data practices. SETTING: Local health department in New York City. RESULTS: The recommendations encompassed 6 themes: strengthening analytic skills, communication and interpretation, data collection and aggregation, community engagement, infrastructure and capacity building, and leadership and innovation. Specific projects are underway or have been completed. CONCLUSIONS: Improving equity in data requires changes to data processes and commitment to racial and intersectional justice and process change at all levels of the organization and across job functions. We developed a collaborative model for how a local health department can reform data work to embed an equity lens. This framework serves as a model for jurisdictions to build upon in their own efforts to promote equitable health outcomes and become antiracist organizations.


Asunto(s)
Equidad en Salud , Liderazgo , Humanos , Creación de Capacidad , Ciudad de Nueva York
4.
Soc Psychiatry Psychiatr Epidemiol ; 57(6): 1157-1165, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34783860

RESUMEN

PURPOSE: Residential instability is associated with poor mental health, but its causal inference is challenging due to time-varying exposure and confounding, and the role of changing social environments. We tested the association between frequent residential moving and depression risk among adults exposed to the 9/11 disaster. METHODS: We used four waves of survey data from the World Trade Center Health Registry. We measured residential movement and depression using geocoded annual address records and the Personal Health Questionnaire Depression Scale, respectively, for a prospective cohort of 38,495 adults. We used the longitudinal Targeted Maximum Likelihood Method to estimate depression risk by frequent residential moving and conducted causal mediation analysis to evaluate a mediating role of social environments. RESULTS: Most enrollees (68%) did not move in 2007-2014, and 6% moved at least once every 4 years. The remaining 26% moved less frequently (e.g., only moving in 2007-2010). Frequent moving versus no moving was associated with risk of depression in 2015-16 (RR = 1.20, 95% CI = 1.06, 1.37). Frequent residential moving-depression pathway was mediated by high social integration (OR = 0.93, 95% CI = 0.90, 0.97). CONCLUSION: These findings demonstrate the importance of social networks in understanding increased risk of depression associated with housing instability.


Asunto(s)
Depresión , Salud Mental , Adulto , Estudios de Cohortes , Depresión/epidemiología , Humanos , Estudios Prospectivos , Sistema de Registros
5.
J Urban Health ; 98(6): 727-741, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34811698

RESUMEN

Communities marginalized because of racism, heterosexism, and other systems of oppression have a history of being aggressively policed, and in those contexts, researchers have observed associations between a range of negative experiences with police and poor physical, mental, and behavioral health outcomes. However, past studies have been limited in that experiences of police contacts were aggregated at the neighborhood level and, if police contacts were self-reported, the sample was not representative. To address these limitations, we employed NYC Department of Health and Mental Hygiene 2017 Social Determinants of Health Survey (n = 2335) data to examine the associations of self-reported police contacts and discrimination by police and the courts with measures of physical (poor physical health), mental (poor mental health, serious psychological distress), and behavioral health (binge drinking). Residents marginalized because of racial, ethnic, and sexual minority status were more likely to be stopped, searched, or questioned by the police; threatened or abused by the police; and discriminated against by the police or in the courts; those experiences were associated with poor physical, mental, and behavioral health outcomes. The associations between experiences with police and poor health outcomes were strongest among Black residents and residents aged 25-44. Our findings suggest that the health of NYC residents who have had exposure to police and experienced discrimination by the police and courts is poorer than those who have not, and build on a growing body of evidence that aggressive policing practices have implications for public health.


Asunto(s)
Racismo , Minorías Sexuales y de Género , Adulto , Humanos , Ciudad de Nueva York/epidemiología , Evaluación de Resultado en la Atención de Salud , Policia
6.
Int J Mol Sci ; 22(7)2021 Mar 26.
Artículo en Inglés | MEDLINE | ID: mdl-33810359

RESUMEN

Despite the strong evidence for the immunomodulatory activity of mesenchymal stromal cells (MSCs), clinical trials have so far failed to clearly show benefit, likely reflecting methodological shortcomings and lack of standardization. MSC-mediated tissue repair is commonly believed to occur in a paracrine manner, and it has been stated that extracellular vesicles (EVs) secreted by MSCs (EVMSC) are able to recapitulate the immunosuppressive properties of parental cells. As a next step, clinical trials to corroborate preclinical studies should be performed. However, effective dose in large mammals, including humans, is quite high and EVs industrial production is hindered by the proliferative senescence that affects MSCs during massive cell expansion. We generated a genetically modified MSC cell line overexpressing hypoxia-inducible factor 1-alpha and telomerase to increase the therapeutic potency of EVMSC and facilitate their large-scale production. We also developed a cytokine-based preconditioning culture medium to prime the immunomodulatory response of secreted EVs (EVMSC-T-HIFc). We tested the efficacy of this system in vitro and in a delayed-type hypersensitivity mouse model. MSC-T with an HIF-1α-GFP lentiviral vector (MSC-T-HIF) can be effectively expanded to obtain large amounts of EVs without major changes in cell phenotype and EVs composition. EVMSC-T-HIFc suppressed the proliferation of activated T-cells more effectively than did EVs from unmodified MSC in vitro, and significantly blunted the ear-swelling response in vivo by inhibiting cell infiltration and improving tissue integrity. We have developed a long-lived EV source that secretes high quantities of immunosuppressive EVs, facilitating a more standard and cost-effective therapeutic product.


Asunto(s)
Vesículas Extracelulares/trasplante , Hipersensibilidad Tardía/terapia , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Inmunomodulación , Trasplante de Células Madre Mesenquimatosas/métodos , Células Madre Mesenquimatosas/metabolismo , Linfocitos T/inmunología , Animales , Línea Celular , Proliferación Celular , Células Cultivadas , Citocinas/farmacología , Pulpa Dental/citología , Vesículas Extracelulares/inmunología , Vectores Genéticos/genética , Proteínas Fluorescentes Verdes/genética , Proteínas Fluorescentes Verdes/metabolismo , Humanos , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Lentivirus/genética , Masculino , Células Madre Mesenquimatosas/efectos de los fármacos , Ratones , Ratones Endogámicos BALB C , Ingeniería de Proteínas/métodos , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Linfocitos T/fisiología , Telomerasa/genética , Telomerasa/metabolismo , Adulto Joven
7.
Int J Mol Sci ; 22(20)2021 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-34681929

RESUMEN

Extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) have therapeutic potential in the treatment of several immune disorders, including ulcerative colitis, owing to their regenerative and immunosuppressive properties. We recently showed that MSCs engineered to overexpress hypoxia-inducible factor 1-alpha and telomerase (MSC-T-HIF) and conditioned with pro-inflammatory stimuli release EVs (EVMSC-T-HIFC) with potent immunomodulatory activity. We tested the efficacy of EVMSC-T-HIFC to repolarize M1 macrophages (Mφ1) to M2-like macrophages (Mφ2-like) by analyzing surface markers and cytokines and performing functional assays in co-culture, including efferocytosis and T-cell proliferation. We also studied the capacity of EVMSC-T-HIFC to dampen the inflammatory response of activated endothelium and modulate fibrosis. Finally, we tested the therapeutic capacity of EVMSC-T-HIFC in an acute colitis model. EVMSC-T-HIFc induced the repolarization of monocytes from Mφ1 to an Mφ2-like phenotype, which was accompanied by reduced inflammatory cytokine release. EVMSC-T-HIFc-treated Mφ1 had similar effects of immunosuppression on activated peripheral blood mononuclear cells (PBMC) as Mφ2, and reduced the adhesion of PBMCs to activated endothelium. EVMSC-T-HIFc also prevented myofibroblast differentiation of TGF-ß-treated fibroblasts. Finally, administration of EVMSC-T-HIFc promoted healing in a TNBS-induced mouse colitis model in terms of preserving colon length and intestinal mucosa architecture and altering the ratio of Mφ1/ Mφ2 infiltration. In conclusion, EVMSC-T-HIFC have effective anti-inflammatory properties, making them potential therapeutic agents in cell free-based therapies for the treatment of Crohn's disease and likely other immune-mediated inflammatory diseases.


Asunto(s)
Enfermedad de Crohn/terapia , Vesículas Extracelulares/trasplante , Subunidad alfa del Factor 1 Inducible por Hipoxia/genética , Subunidad alfa del Factor 1 Inducible por Hipoxia/metabolismo , Células Madre Mesenquimatosas/metabolismo , Animales , Adhesión Celular , Polaridad Celular , Enfermedad de Crohn/inducido químicamente , Enfermedad de Crohn/inmunología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Vesículas Extracelulares/genética , Vesículas Extracelulares/inmunología , Células Endoteliales de la Vena Umbilical Humana , Humanos , Masculino , Ratones , Telomerasa/metabolismo , Ácido Trinitrobencenosulfónico/efectos adversos , Adulto Joven
8.
Am J Public Health ; 110(3): 378-384, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31944850

RESUMEN

Objectives. To quantify the association between personal and family history of criminal justice system (CJS) involvement (PHJI and FHJI, respectively), health outcomes, and health-related behaviors.Methods. We examined 2017 New York City Community Health Survey data (n = 10 005) with multivariable logistic regression. We defined PHJI as ever incarcerated or under probation or parole. FHJI was CJS involvement of spouse or partner, child, sibling, or parent.Results. We found that 8.9% reported only FHJI, 5.4% only PHJI, and 2.9% both FHJI and PHJI (mean age = 45.4 years). Compared with no CJS involvement, individuals with only FHJI were more likely to report fair or poor health, hypertension, diabetes, obesity, depression, heavy drinking, and binge drinking. Respondents with only PHJI reported more fair or poor health, asthma, depression, heavy drinking, and binge drinking. Those with both FHJI and PHJI were more likely to report asthma, depression, heavy drinking, and binge drinking.Conclusions. New York City adults with personal or family CJS involvement, or both, were more likely to report adverse health outcomes and behaviors.Public Health Implications. Measuring CJS involvement in public health monitoring systems can help to identify important health needs, guiding the provision of health care and resource allocation.


Asunto(s)
Criminales/estadística & datos numéricos , Salud de la Familia , Conductas Relacionadas con la Salud , Estado de Salud , Alcoholismo/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Ciudad de Nueva York/epidemiología , Encuestas y Cuestionarios
9.
Am J Public Health ; 106(8): 1491-7, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27310345

RESUMEN

OBJECTIVES: To examine the association of maternal race/ethnicity only and parental race/ethnicity jointly with adverse birth outcomes (low birth weight, small for gestational age, preterm birth, and infant mortality) among New York City women. METHODS: We used Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene birth- and death-linked data from 2000 to 2010 (n = 984 807) to quantify the association of maternal race/ethnicity and parental race/ethnicity concordance or discordance with each outcome. RESULTS: By maternal race/ethnicity, infants of non-Hispanic Black, Hispanic, and Asian women had risks of adverse birth outcomes between 10% and 210% greater than infants of non-Hispanic White women. Infants of non-Hispanic Black, Asian, and Hispanic couples exhibited higher risk of adverse birth outcomes than infants of non-Hispanic White couples. Moreover, parental racial/ethnic discordance was associated with an increased risk of adverse birth outcomes, with highest risks for pairings of Asian men with non-Hispanic White, non-Hispanic Black, and Hispanic women, and of Asian women with non-Hispanic Black and Hispanic men. CONCLUSIONS: Parental race/ethnicity discordance may add stress to women during pregnancy, affecting birth outcomes. Thus, parental race/ethnicity should be considered when examining such outcomes.


Asunto(s)
Mortalidad Infantil/etnología , Recién Nacido de Bajo Peso , Padres , Resultado del Embarazo/etnología , Nacimiento Prematuro/etnología , Adulto , Negro o Afroamericano/estadística & datos numéricos , Asiático/estadística & datos numéricos , Padre/estadística & datos numéricos , Femenino , Edad Gestacional , Conductas Relacionadas con la Salud , Hispánicos o Latinos/estadística & datos numéricos , Humanos , Lactante , Masculino , Madres/estadística & datos numéricos , Ciudad de Nueva York/epidemiología , Embarazo , Factores Socioeconómicos , Población Blanca/estadística & datos numéricos
10.
Int J Antimicrob Agents ; 63(3): 107095, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38244814

RESUMEN

INTRODUCTION: Antivirals and monoclonal antibodies lower the risk of progression in immunocompromised patients. However, combination therapy with both types of agents has not been studied. PATIENTS AND METHODS: This was a single-centre, prospective, cohort study. All immunocompromised patients who received treatment for mild-to-moderate COVID-19 from 1 January 2022 to 30 October 2022 were enrolled. The primary endpoint was COVID-19 progression at 90 days, defined as hospital admission or death due to COVID-19 and/or seronegative persistent COVID-19. RESULTS: A total of 304 patients were included: 43 patients (14.1%) received sotrovimab plus a direct-acting antiviral, and 261 (85.9%) received monotherapy. Primary outcome occurred more frequently after monotherapy (4.6% vs. 0%, P=0.154). Among patients with anti-spike immunoglobulin G (anti-S IgG) titre <750 BAU/mL, COVID-19 progression was more common after monotherapy (23.9% vs. 0%, P=0.001), including more frequent COVID-related admission (15.2% vs. 0%, P=0.014) and seronegative persistent COVID-19 (10.9% vs. 0%, P=0.044). Combination therapy was associated with lower risk of progression (odds ratio [OR] 0.08, 95% confidence interval [95% CI] 0.01-0.64). Anti-S IgG titre <750 BAU/mL and previous anti-CD20 were associated with higher risk of progression (OR 13.70, 95% CI 2.77-67.68; and OR 3.05, 95% CI 1.20-10.94, respectively). CONCLUSIONS: In immunocompromised patients, combination therapy with sotrovimab plus an antiviral may be more effective than monotherapy for SARS-CoV2.


Asunto(s)
COVID-19 , Hepatitis C Crónica , Humanos , Estudios Prospectivos , ARN Viral , Antivirales/uso terapéutico , Estudios de Cohortes , SARS-CoV-2 , Anticuerpos Monoclonales/efectos adversos , Huésped Inmunocomprometido , Inmunoglobulina G
11.
Data Brief ; 48: 109222, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37383762

RESUMEN

Previous work has suggested that the price of food sold at supermarkets may vary according to the socioeconomic characteristics of a neighborhood. Given the importance of food prices in securing access to food, understanding how food prices vary across neighborhoods is crucial to assessing affordability. To study food pricing in New York City (NYC) a defined standard food basket (SFB) was collected in supermarkets across NYC neighborhoods. A dataset was created that includes pricing data collected in-person for ten pre-determined food items from 163 supermarkets across 71 of the 181 NYC neighborhoods during March through August of 2019. Included in these data are raw and processed pricing data files that illustrate the complexity of standardizing pricing across items. An additional dataset includes neighborhood-level variables of selected socioeconomic and demographic characteristics from the 2014-2018 American Community Survey that is publicly available via the Census API. The pricing data and the data on neighborhood-level characteristics were merged. Basic statistical measures suggest some distributional differences in the price of a SFB by socioeconomic differences between neighborhoods. This database can be used to describe spatial patterns in food pricing in a dense urban setting, while exploring pricing inequities across neighborhoods. In addition, by working with these data, researchers, policy analysts and educators will gain an understanding of the methodologies used to generate pricing data for an SFB.

12.
Cancer ; 118(19): 4660-9, 2012 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-22359235

RESUMEN

BACKGROUND: Microtubule-associated proteins (MAPs) endogenously regulate microtubule stability. Here, the prognostic value of stathmin, a destabilizing protein, was assessed in combination with MAP-tau, a stabilizing protein, in order to evaluate microtubule stabilization as a potential biomarker. METHODS: Stathmin and MAP-tau expression levels were measured in a breast cancer cohort (n = 651) using the tissue microarray format and quantitative immunofluorescence (AQUA) technology, then correlated with clinical and pathological characteristics and disease-free survival. RESULTS: Univariate Cox proportional hazard models indicated that high stathmin expression predicts worse overall survival (hazard ratio [HR] = 1.48; 95% confidence interval [CI] = 1.119-1.966; P = .0061). Survival analysis showed 10-year survival of 53.1% for patients with high stathmin expression versus 67% for low expressers (log-rank, P < .003). Cox multivariate analysis showed high stathmin expression was independent of age, menopausal status, nodal status, nuclear grade, tumor size, and estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression (HR = 1.19; 95% CI = 1.03-1.37; P = .01). The ratio of MAP-tau to stathmin expression showed a positive correlation to disease-free survival (HR = 0.679; 95% CI = 0.517-0.891; P = .0053) with a 10-year survival of 65.4% for patients who had a high ratio of MAP-tau to stathmin versus 52.5% 10-year survival rate for those with a low ratio (log-rank, P = .0009). Cox multivariate analysis showed the ratio of MAP-tau to stathmin was an independent predictor of overall survival (HR = 0.609; 95% CI = 0.422-0.879; P = .008). CONCLUSIONS: Low stathmin and high MAP-tau are associated with increased microtubule stability and better prognosis in breast cancer.


Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama/química , Estatmina/análisis , Proteínas tau/análisis , Adulto , Anciano , Análisis de Varianza , Western Blotting , Mama/química , Neoplasias de la Mama/mortalidad , Neoplasias de la Mama/patología , Línea Celular Tumoral , Estudios de Cohortes , Femenino , Técnica del Anticuerpo Fluorescente , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Metástasis Linfática , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Oportunidad Relativa , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , ARN Interferente Pequeño/metabolismo , Medición de Riesgo , Factores de Riesgo , Análisis de Matrices Tisulares , Resultado del Tratamiento
13.
Ethn Dis ; 32(2): 123-130, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35497392

RESUMEN

Objectives: To examine racial and ethnic disparities in COVID-19-like illness (CLI) during March - August 2020 in New York City, and to test effect modification by age, nativity, and working from home vs outside the home, and mediation via social distancing behavior. Design: Analysis of the monthly Community Health Survey datasets. Setting: New York City. Participants: 5,305 adults living in New York City. Main Outcome Measures: A binary indicator of having new onset of CLI in the past 30 days. Methods: Prevalence of having CLI was compared among racial and ethnic groups using multivariable log-linear regression. Stratified and causal mediation analyses were conducted to test effect modification and mediation, respectively. Results: Overall percentage of CLI decreased from 25% during March-May to 14% during June-August. In both periods, there was no increased prevalence of CLI among Black or Latino New Yorkers compared with White New Yorkers. However, in stratified analyses, Latino vs White New Yorkers had 2.05 times (95%CI=1.09, 3.83) higher prevalence of CLI among adults working outside the home. Mediation via social distancing was not statistically significant. Conclusions: Excess burden of CLI among Latino adults working outside the home underscores inequitable impacts of COVID-19 in New York City.


Asunto(s)
COVID-19 , Distanciamiento Físico , Adulto , Etnicidad , Humanos , Ciudad de Nueva York/epidemiología , Grupos Raciales
14.
PLoS One ; 17(9): e0274362, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36129918

RESUMEN

BACKGROUND: Leptospirosis causes significant economic losses and is an occupational risk in the swine industry, especially in developing tropical regions where social and geoclimatic conditions are favorable for the transmission of this disease. Although vaccination can reduce infection risk, efficacy is diminished if local genetic and antigenic variants of the pathogen are not accounted for in the vaccine. Identifying and characterizing strains hosts, and potential mechanisms of transmission is therefore critical for public health mitigation practices. METHODOLOGY/PRINCIPAL FINDINGS: Our study was conducted on a rural breeding farm in Ecuador, where we used a PCR assay that targets lipL32 to detect Leptospira spp. and targeted gene sequencing to identify Leptospira santarosai in the kidneys, testicles, and ejaculate of a vaccinated boar. MAT results showed low titers against serovars found in the vaccine, but the MAT panel did not include serovars of L. santarosai. The boar showed no symptoms of leptospirosis but did show blood in the semen. However, no postmortem histopathological lesions were observed tissue samples. Vaccinated sows that were artificially inseminated with the semen from this boar had reproductive problems, suggesting that transmission had occurred. This is the first documented case of Leptospira santarosai in the reproductive tract of a boar. CONCLUSIONS/SIGNIFICANCE: As L. santarosai is pathogenic in other livestock species and humans, our finding highlights the need to evaluate the prevalence and epidemiological significance of this pathogen in livestock and consider the possibility of venereal transmission. In addition, further studies are needed to identify and characterize local serovars that may impact diagnosis and vaccination programs to better control leptospirosis in livestock and spillover into the human population.


Asunto(s)
Leptospira , Leptospirosis , Animales , Femenino , Leptospira/genética , Leptospirosis/epidemiología , Leptospirosis/prevención & control , Leptospirosis/veterinaria , Ganado , Masculino , Salud Pública , Serogrupo , Porcinos
15.
Breast Cancer Res ; 13(3): R51, 2011 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-21592345

RESUMEN

INTRODUCTION: Biomarkers, such as Estrogen Receptor, are used to determine therapy and prognosis in breast carcinoma. Immunostaining assays of biomarker expression have a high rate of inaccuracy; for example, estimates are as high as 20% for Estrogen Receptor. Biomarkers have been shown to be heterogeneously expressed in breast tumors and this heterogeneity may contribute to the inaccuracy of immunostaining assays. Currently, no evidence-based standards exist for the amount of tumor that must be sampled in order to correct for biomarker heterogeneity. The aim of this study was to determine the optimal number of 20X fields that are necessary to estimate a representative measurement of expression in a whole tissue section for selected biomarkers: ER, HER-2, AKT, ERK, S6K1, GAPDH, Cytokeratin, and MAP-Tau. METHODS: Two collections of whole tissue sections of breast carcinoma were immunostained for biomarkers. Expression was quantified using the Automated Quantitative Analysis (AQUA) method of quantitative immunofluorescence. Simulated sampling of various numbers of fields (ranging from one to thirty five) was performed for each marker. The optimal number was selected for each marker via resampling techniques and minimization of prediction error over an independent test set. RESULTS: The optimal number of 20X fields varied by biomarker, ranging between three to fourteen fields. More heterogeneous markers, such as MAP-Tau protein, required a larger sample of 20X fields to produce representative measurement. CONCLUSIONS: The optimal number of 20X fields that must be sampled to produce a representative measurement of biomarker expression varies by marker with more heterogeneous markers requiring a larger number. The clinical implication of these findings is that breast biopsies consisting of a small number of fields may be inadequate to represent whole tumor biomarker expression for many markers. Additionally, for biomarkers newly introduced into clinical use, especially if therapeutic response is dictated by level of expression, the optimal size of tissue sample must be determined on a marker-by-marker basis.


Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Interpretación Estadística de Datos , Femenino , Humanos , Tamaño de la Muestra , Coloración y Etiquetado/métodos
16.
Breast Cancer Res ; 13(5): R85, 2011 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-21888627

RESUMEN

INTRODUCTION: Microtubule associated proteins (MAPs) endogenously regulate microtubule stabilization and have been reported as prognostic and predictive markers for taxane response. The microtubule stabilizer, MAP-tau, has shown conflicting results. We quantitatively assessed MAP-tau expression in two independent breast cancer cohorts to determine prognostic and predictive value of this biomarker. METHODS: MAP-tau expression was evaluated in the retrospective Yale University breast cancer cohort (n = 651) using tissue microarrays and also in the TAX 307 cohort, a clinical trial randomized for TAC versus FAC chemotherapy (n = 140), using conventional whole tissue sections. Expression was measured using the AQUA method for quantitative immunofluorescence. Scores were correlated with clinicopathologic variables, survival, and response to therapy. RESULTS: Assessment of the Yale cohort using Cox univariate analysis indicated an improved overall survival (OS) in tumors with a positive correlation between high MAP-tau expression and overall survival (OS) (HR = 0.691, 95% CI = 0.489-0.974; P = 0.004). Kaplan Meier analysis showed 10-year survival for 65% of patients with high MAP-tau expression compared to 52% with low expression (P = .006). In TAX 307, high expression was associated with significantly longer median time to tumor progression (TTP) regardless of treatment arm (33.0 versus 23.4 months, P = 0.010) with mean TTP of 31.2 months. Response rates did not differ by MAP-tau expression (P = 0.518) or by treatment arm (P = 0.584). CONCLUSIONS: Quantitative measurement of MAP-tau expression has prognostic value in both cohorts, with high expression associated with longer TTP and OS. Differences by treatment arm or response rate in low versus high MAP-tau groups were not observed, indicating that MAP-tau is not associated with response to taxanes and is not a useful predictive marker for taxane-based chemotherapy.


Asunto(s)
Biomarcadores de Tumor/análisis , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/metabolismo , Proteínas tau/análisis , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/mortalidad , Estudios de Cohortes , Ciclofosfamida/uso terapéutico , Citoplasma/metabolismo , Docetaxel , Doxorrubicina/uso terapéutico , Células Epiteliales/metabolismo , Femenino , Fluorouracilo/uso terapéutico , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Tasa de Supervivencia , Taxoides/uso terapéutico , Proteínas tau/metabolismo
17.
J Dairy Res ; 78(2): 250-6, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-24725675

RESUMEN

Dry matter, protein, fat, pH, mineral (Na, K, Ca and Mg) and trace elements (Fe, Cu, Zn and Se) concentrations were determined in samples of goats' milk and in fresh, semi-hard and hard cheeses to study the effect of the goats' diet and the type of rennet used for the cheese processing of the Palmero Protected Designation of Origin cheeses. Two groups of 20 Palmero goats were fed 2 different diets: a Palmero diet (PD supplied by native forages adapted to subhumid areas, which had a high ratio of long fibre to concentrates (65:35), and an actual diet (AD), the most commonly used by goat farmers, with a low ratio of long fibre to concentrates (35:65). In general, the cheese samples from goats fed with PD had higher mean Ca, Zn, Cu and Se concentrations than the samples obtained from AD fed goats. The diet exhibited a greater influence on the chemical composition of the cheeses than the rennet used in their production. Applying a stepwise linear discriminant analysis a complete percentage of correct classifications of the three types of cheeses according to the diet of the goats was observed.


Asunto(s)
Alimentación Animal/análisis , Queso/análisis , Quimosina/química , Dieta/veterinaria , Cabras , Leche/química , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Queso/clasificación , Femenino , Análisis de los Alimentos
18.
Diagnostics (Basel) ; 11(5)2021 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-34066599

RESUMEN

In recent years, the etiology of caries has evolved from a simplistic infectious perspective based on Streptococcus mutans and/or Lactobacillus activity, to a multifactorial disease involving a complex oral microbiota, the human genetic background and the environment. The aim of this work was to identify bacterial markers associated with early caries using massive 16S rDNA. To minimize the other factors, the composition of the oral microbiota of twins in which only one of them had caries was compared with their healthy sibling. Twenty-one monozygotic twin pairs without a previous diagnosis of caries were recruited in the context of their orthodontic treatment and divided into two categories: (1) caries group in which only one of the twins had caries; and (2) control group in which neither of the twins had caries. Each participant contributed a single oral lavage sample in which the bacterial composition was determined by 16S rDNA amplification and further high-throughput sequencing. Data analysis included statistical comparison of alpha and beta diversity, as well as differential taxa abundance between groups. Our results show that twins of the control group have a closer bacterial composition than those from the caries group. However, statistical differences were not detected and we were unable to find any particular bacterial marker by 16S rDNA high-throughput sequencing that could be useful for prevention strategies. Although these results should be validated in a larger population, including children from other places or ethnicities, we conclude that the occurrence of caries is not related to the increase of any particular bacterial population.

19.
Appl Environ Microbiol ; 76(6): 1746-58, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-20097818

RESUMEN

Mutation frequencies were studied in 174 Stenotrophomonas maltophilia isolates from clinical and nonclinical environments by detecting spontaneous rifampin-resistant mutants in otherwise-susceptible populations. The distribution of mutation frequencies followed a pattern similar to that found for other bacterial species, with a modal value of 1 x 10(-8). Nevertheless, the proportion of isolates showing mutation frequencies below the modal value (hypomutators) was significantly higher for S. maltophilia than those so far reported in other organisms. Low mutation frequencies were particularly frequent among environmental S. maltophilia strains (58.3%), whereas strong mutators were found only among isolates with a clinical origin. These results indicate that clinical environments might select bacterial populations with high mutation frequencies, likely by second-order selection processes. In several of the strong-mutator isolates, functional-complementation assays with a wild-type allele of the mutS gene demonstrated that the mutator phenotype was due to the impairment of MutS activity. In silico analysis of the amino acid changes present in the MutS proteins of these hypermutator strains in comparison with the normomutator isolates suggests that the cause of the defect in MutS might be a H683P amino acid change.


Asunto(s)
Microbiología Ambiental , Infecciones por Bacterias Gramnegativas/microbiología , Polimorfismo Genético , Stenotrophomonas maltophilia/genética , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana , Prueba de Complementación Genética , Proteína MutS de Unión a los Apareamientos Incorrectos del ADN/genética , Mutación , Rifampin/farmacología , Stenotrophomonas maltophilia/aislamiento & purificación
20.
Comp Immunol Microbiol Infect Dis ; 72: 101501, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32535110

RESUMEN

Antibiotic resistance is one of the biggest threats to human and animal health. Methicillin-resistant Staphylococcus spp. (MRS) and vancomycin-resistant Enterococcus spp. (VRE) are of increasing importance in hospital and/or nosocomial infections and represent a potential risk of transmission to humans from infected or colonized companion animals. Studies on the risk factors associated with colonization by multiresistant bacteria in animals are scarce. The present study aimed to estimate the prevalence and incidence of MRS and VRE in canine patients hospitalized in a veterinary hospital and to identify the risk factors for its acquisition and persistence. Nasal and perianal swabs were obtained from 72 dogs. Antimicrobial susceptibility assays and molecular detection of mecA and van genes were performed. A prevalence of 13.9% and incidence of 26.5% was observed in dogs colonized by MRS at hospital admission and release, respectively, higher values than those described in most veterinary studies. Thirty-five Staphylococcus isolates had mecA gene and showed higher resistance levels to most of the antimicrobials evaluated. Previous and concomitant use of antibiotics and corticosteroids has been associated with an increase in MRS colonization. The use of antibiotics in other animals living with the canine patients has also been identified as an associated factor, suggesting cross transmission. The presence of van-resistant genes from Enterococcus spp. was not detected. Pets should be considered possible vehicles of transmission and reservoirs for MRS bacteria and veterinary hospitals should be considered high-risk environments for the occurrence and spread of nosocomial infections and resistant bacteria.


Asunto(s)
Enfermedades de los Perros , Infecciones por Bacterias Grampositivas , Resistencia a la Meticilina , Infecciones Estafilocócicas , Staphylococcus , Enterococos Resistentes a la Vancomicina , Animales , Antibacterianos/farmacología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/microbiología , Perros , Infecciones por Bacterias Grampositivas/epidemiología , Infecciones por Bacterias Grampositivas/veterinaria , Hospitales Veterinarios , España/epidemiología , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/veterinaria , Staphylococcus/efectos de los fármacos , Staphylococcus/genética , Enterococos Resistentes a la Vancomicina/efectos de los fármacos , Enterococos Resistentes a la Vancomicina/genética
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