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1.
Sci Rep ; 12(1): 7124, 2022 May 03.
Article in English | MEDLINE | ID: mdl-35504988

ABSTRACT

Previous studies have shown that marital status can affect the overall survival (OS) of cancer patients yet its role in metastatic pancreatic ductal adenocarcinoma (mPDAC) remains unclear. This study aimed to explore the impact of marital status on the OS of mPDAC patients and to construct a prognostic nomogram to predict OS outcomes. Data from patients diagnosed with mPDAC were obtained from the Surveillance, Epidemiology, and End Results database between 1973 and 2015. The patients were randomized into primary and validation cohorts. Kaplan-Meier survival analysis was performed to compare differences in survival depending on marital status. Univariate and multivariate analyses were conducted to identify independent prognostic factors and a nomogram was established based using Cox regression analyses. Validation of the prognostic nomogram was evaluated with a calibration curve and concordance index (C-index). Our data showed significant differences in the OS of mPDAC patients with different marital status by Kaplan-Meier analysis (P < 0.05). Univariate and multivariate analyses confirmed that marital status was an independent OS-related factor in mPDAC patients. Based on the multivariate models of the primary cohort, a nomogram was developed that combined marital status, age, grade, tumor size, surgery of primary site, surgery of lymph node and metastatic. The nomogram showed that marital status had a moderate influence on predicting the OS of mPDAC patients. Moreover, the internally and externally validated C-indexes were 0.633 and 0.619, respectively. A calibration curve confirmed favorable consistency between the observed and predicted outcomes. Marital status was identified as an independent prognostic factor for OS of mPDAC patients and is a reliable and valid parameter to predict the survival of patients with mPDAC. This prognostic model has value and may be integrated as a tool to inform decision-making in the clinic.


Subject(s)
Adenocarcinoma , Nomograms , Age Factors , Humans , Marital Status , Neoplasm Staging , Pancreatic Neoplasms , Prognosis , SEER Program
2.
Article in German | MEDLINE | ID: mdl-35523164

ABSTRACT

OBJECTIVES: This study was aimed to assess the distribution and frequency of uroliths in cats as well as to evaluate gender-, age-, and breed-specific differences. MATERIAL AND METHODS: 3629 uroliths from cats in Germany were analyzed by infrared-spectroscopy during the period 2016-2020. The majority (3300) of the uroliths originated from purebred cats of 22 breeds. RESULTS: Uroliths were prevalent in the order of male neutered (45.3 %), female spayed (35.3 %), male intact (7.4 %), and female intact cats (6.3 %). Median age of the cats with uroliths was 7 years, although it varied slightly depending on types of the urolith. The most frequent uroliths were calcium oxalate (59.5 %), followed by struvite (33.7 %), ammonium urate (2 %), calcium phosphate (1.7 %), cystine (0.7 %) and xanthine (0.4 %). Males (59.4 %) and females (59.2 %) showed nearly identical prevalence of calcium oxalates, whereas it significantly diverged in castrated (60.2 %) versus intact animals (54.4 %; p = 0.01). With regard to struvites, male cats (32.6 %) were less prone than females (35.4 %; p = 0.08) while intact cats (38.2 %) significantly outnumbered the castrated cohorts (33.1 %; p = 0.02). The prevalence for calcium oxalate uroliths increased by 6.6 % during the study period, contrasting a decrease of 5.5 % for struvites. Some breeds (> 10 individuals) showed significantly higher propensities than others for urolith formation. Calcium oxalates were significantly more frequent in British shorthair cats (85.2 %), Ragdoll (75 %), Scottish fold (74.1 %) and Persians (72.4 %). Struvites were prevailing in Norwegian forest cats (48.5 %), British longhair (41.7 %), European shorthair (41.7 %) and Siberian forest cats (36.8 %). Siamese cats had the significantly highest percentage of cystine uroliths (16 %). CONCLUSIONS AND CLINICAL RELEVANCE: The occurrence of urine calculi in cats from Germany was found to be most frequent for calcium oxalate and struvite types. We also found breed-, age-, gender- specific differences in addition to variations depending on the neutering status of the animals.


Subject(s)
Cat Diseases , Urinary Calculi , Age Factors , Animals , Calcium , Calcium Oxalate/chemistry , Cat Diseases/epidemiology , Cats , Cystine , Female , Germany/epidemiology , Magnesium Compounds/chemistry , Male , Phosphates/analysis , Phosphates/chemistry , Struvite , Urinary Calculi/epidemiology , Urinary Calculi/veterinary
3.
JAMA Netw Open ; 5(5): e229706, 2022 May 02.
Article in English | MEDLINE | ID: mdl-35499828

ABSTRACT

Importance: The recommendations for the age and frequency that women at average risk for breast cancer should undergo breast cancer mammography screening have been a matter of emotional, political, and scientific debate over the past decades. Multiple national organizations provide recommendations for breast cancer screening age and frequency. US Centers for Disease Control and Prevention (CDC) funding for state comprehensive cancer control (CCC) planning requires compliance with stated objectives for attaining goals. US Preventive Services Task Force (USPSTF) recommendations on cancer prevention and control are currently used to require coverage of prevention services. Objectives: To evaluate the consistency of state CCC plan objectives compared with the most current (2016) USPSTF recommendations for the age and frequency that individuals should undergo mammography screening and to make recommendations for improvement of state CCC plans. Design, Setting, and Participants: This cross-sectional study used a descriptive, point-in-time evaluation and was conducted from November 1, 2019, to June 30, 2021. In November 2019, the most recent CCC plans from 50 US states and the District of Columbia were downloaded from the CDC website. The recommended ages at which to begin and end mammography examinations and the frequency of mammography examinations were extracted from plan objectives. Main Outcomes and Measures: The recommendations found in CCC plan objectives regarding the ages at which to begin and end mammography examinations and the frequency of mammography examinations for women with average risk for breast cancer were compared with USPSTF recommendations. Results: Of the 51 CCC plans, 16 (31%) were consistent with all USPSTF recommendations for age and frequency that women at average risk should undergo mammography. Twenty-six plans (51%) were partially consistent with recommendations, and 9 plans (18%) were not consistent with any of the 3 guideline components. Conclusions and Relevance: Compared with the USPSTF recommendation, state CCC plans are not homogenous regarding the age and frequency that women at average risk for breast cancer should undergo mammography. This variation is partially due to differences in state-specific planning considerations and discretion, variations in recommendations among national organizations, and publication of plans prior to the most current USPSTF recommendation (2016). Specifying the concept that high-risk populations need different age and frequency of screening recommendations than the general population may reduce heterogeneity among plans.


Subject(s)
Breast Neoplasms , Mammography , Age Factors , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/prevention & control , Cross-Sectional Studies , Early Detection of Cancer , Female , Humans
4.
PLoS One ; 17(4): e0264813, 2022.
Article in English | MEDLINE | ID: mdl-35482636

ABSTRACT

The relative age effect (RAE) is a statistical bias observed across sport contexts and consists of a systematic skewness in birth date distribution within an annual-age cohort. In soccer, January 1st is the common cut-off date when categorizing players in competitions according to their chronological age, which potentially disadvantages those within the cohort who were born later in the year. Thus, relatively older soccer players in their cohort can be favored in talent identification, selection, and development. The aim of the current study was to investigate the variations in RAE in male and female international youth world-cup tournaments (U17 and U20) in the period from 1997-2019 and in international senior world-cup-tournaments from 2006-2019. A total of 20,401 soccer players participating in 47 different tournaments were analyzed. The birthdate distributions were categorized into four quartiles (January-March, Q1; April-June, Q2; July-September, Q3; October-December, Q4) and compared to a uniform distribution using Chi-square analysis with Cramer's V (Vc) as a measure of effect size. Based on the existing data concerning RAE in elite junior and senior soccer, it was hypothesized that: (I) the RAE is present in youth soccer world cup tournaments but is stronger in male players than in female players; (II) the younger the soccer players, the stronger the RAE; and (III) the RAE in world cup soccer tournaments has strengthened over time. All these hypotheses were supported by the data; novel findings included that the effect has now entered women's soccer, and in men's soccer it persists into senior world cup tournaments. Thus, a strong RAE bias occurs in selection among elite soccer players competing in international world cup tournaments.


Subject(s)
Soccer , Sports , Adolescent , Age Factors , Aptitude , Female , Humans , Male
5.
Eur Rev Med Pharmacol Sci ; 26(7): 2227-2237, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35442507

ABSTRACT

OBJECTIVE: Reproductive risk factors have been shown to influence breast cancer etiology for women of different origin worldwide; most studies in young/older patients have been limited to analyzing survival or tumor characteristics within their age group. This study aimed to compare the clinicopathological characteristics, treatment regimens, survival outcomes, and the impact of reproductive risk factors on young and elderly breast cancer patients. PATIENTS AND METHODS: The data were collected retrospectively between October 2015 and March 2021, where 77 young patients (≤ 40 years) and 107 elderly patients (>65 years) were included out of a total of 567 patients undergoing treatment at Kayseri City Training and Research Hospital General Surgery Clinic, Turkey. Logistic regression analysis was performed to assess the impact of risk factors according to age. RESULTS: Luminal-like tumors were in the majority in both age groups; there was no difference in diagnostic stages and survival between groups. The nulliparity ratio, total breastfeeding duration, number of biological children, first full-term pregnancy age, body mass index (BMI), and breast density distribution were significantly statistically different between groups. According to the multiple binary logistic regression analysis results for age, the most significant factors with risk effects were variables age of menarche OR= 3.36 (95% CI: 1.44-7.86) and child number OR= 2.58 (95% CI: 1.75-3.79), respectively. CONCLUSIONS: The importance of looking at the impact of different risk factors on breast cancer risk lies in the potential to develop valid risk prediction models that can allow targeted screening and preventive interventions for high-risk women. By identifying more influential risk factors in different geographical profiles, risk-based screening, and targeted prevention efforts can be encouraged, and these factors can be included in risk prediction models.


Subject(s)
Breast Neoplasms , Adult , Age Factors , Aged , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Female , Humans , Menarche , Parity , Pregnancy , Retrospective Studies , Risk Factors , Turkey/epidemiology
6.
Breast Cancer Res ; 24(1): 24, 2022 Apr 01.
Article in English | MEDLINE | ID: mdl-35365198

ABSTRACT

BACKGROUND: Multigene panel tests for breast cancer predisposition routinely include ATM as it is now a well-established breast cancer predisposition gene. METHODS: We included ATM in a multigene panel test applied to the Australian Breast Cancer Family Registry (ABCFR), a population-based case-control-family study of breast cancer, with the purpose of estimating the prevalence and penetrance of heterozygous ATM pathogenic variants from the family data, using segregation analysis. RESULTS: The estimated breast cancer hazard ratio for carriers of pathogenic ATM variants in the ABCFR was 1.32 (95% confidence interval 0.45-3.87; P = 0.6). The estimated cumulative risk of breast cancer to age 80 years for heterozygous ATM pathogenic variant carriers was estimated to be 13% (95% CI 4.6-30). CONCLUSIONS: Although ATM has been definitively identified as a breast cancer predisposition gene, further evidence, such as variant-specific penetrance estimates, are needed to inform risk management strategies for carriers of pathogenic variants to increase the clinical utility of population testing of this gene.


Subject(s)
Breast Neoplasms , Age Factors , Aged, 80 and over , Ataxia Telangiectasia Mutated Proteins/genetics , Australia/epidemiology , Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , Breast Neoplasms/pathology , Female , Genetic Predisposition to Disease , Humans , Tumor Suppressor Proteins/genetics
7.
Front Public Health ; 10: 850206, 2022.
Article in English | MEDLINE | ID: mdl-35372216

ABSTRACT

Background: The comprehensive impacts of diverse breathing air volumes and preexisting immunity on the host susceptibility to and transmission of COVID-19 at various pandemic stages have not been investigated. Methods: We classified the US weekly COVID-19 data into 0-4, 5-11, 12-17, 18-64, and 65+ age groups and applied the odds ratio (OR) of incidence between one age group and the 18-64 age group to delineate the transmissibility change. Results: The changes of incidence ORs between May, 2020 and November, 2021 were 0.22-0.66 (0-4 years), 0.20-1.34 (5-11 years), 0.39-1.04 (12-17 years), and 0.82-0.73 (65+ years). The changes could be explained by age-specific preexisting immunity including previous infection and vaccination, as well as volumes of breathing air. At the early pandemic, the ratio that 0-4-year children exhaled one-fifth of air and discharge a similar ratio of viruses was closely associated with incidence OR between two age groups. While, after a rollout of pandemic and vaccination, the much less increased preexisting immunity in children resulted in rapidly increased OR of incidence. The ARIMA model predicted the largest increase of relative transmissibility in 6 coming months in 5-11-year children. Conclusions: The volume of breathing air may be a notable factor contributing to the infectivity of COVID-19 among different age groups of patients. This factor and the varied preexisting greatly shape the transmission of COVID-19 at different periods of pandemic among different age groups of people.


Subject(s)
COVID-19 , Age Factors , COVID-19/epidemiology , Child , Government , Humans , Pandemics , Vaccination
8.
J Cardiothorac Surg ; 17(1): 85, 2022 Apr 27.
Article in English | MEDLINE | ID: mdl-35477470

ABSTRACT

BACKGROUND: To inquiry the predictive value of the age, creatinine, and ejection fraction (ACEF) score for cardiac mortality in patients diagnosed with heavily calcified coronary lesions at 1 year after percutaneous coronary intervention (PCI) with rotational atherectomy (RA). METHODS: 275 patients with heavily calcified coronary lesions undergoing PCI with RA in the Department of Cardiology of Anhui Provincial Hospital from January 2017 to December 2019 were consecutively recruited. The primary endpoint event was cardiac death at postoperative 1 year. The ROC curve was used to assess ACEF scoring system and predict cardiac mortality. RESULTS: In term of ACEF score upon admission, 275 patients were divided into low-to-intermediate risk group (n = 130) with ACEF score < 1.23 and high-risk group (n = 145) with ACEF score ≥ 1.23. The age, gender proportion and left ventricular ejection fraction (LVEF) have a significant difference between the low-to-intermediate risk group and the high-risk group (all P < 0.05). The area under ROC curve for ACEF scoring system to predict cardiac mortality at 1 year after PCI with RA was 0.756 and 0.715, respectively. CONCLUSIONS: ACEF value upon admission can predict the cardiac mortality at 1 year following PCI with RA in heavily calcified coronary lesions patients.


Subject(s)
Atherectomy, Coronary , Percutaneous Coronary Intervention , Age Factors , Humans , Prognosis , Risk Assessment , Stroke Volume , Ventricular Function, Left
9.
Accid Anal Prev ; 171: 106667, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35413615

ABSTRACT

Road Traffic Injuries (RTIs) have imposed a great global burden on public health. Motorcyclists and pedestrians comprise the most significant proportion of this burden. Several studies have demonstrated a link between helmet wearing and a decline in the impact of RTIs in motorcyclists. In this study, we aimed to review the barriers to helmet utilization by motorcyclists. This scoping review has been conducted in accordance with the guidelines for the systematic review of observational studies and the PRISMA Checklist. The search was conducted by using related keywords in EMBASE, PubMed, Scopus, and Cochrane Library. Four independent reviewers carried out the screening. The main outcomes of interest were barriers to helmet usage among motorcyclists, drawn from the finally included studies. Fifty-three records were selected for data extraction. According to these reports, the barriers and factors associated with helmet usage among motorcyclists were categorized into five entities as: legislations/enforcement strategies, helmet disadvantages (discomfort, visual/auditory blockage, and thermal dysregulation), risky behaviors (riding while drunk or high on drugs), sex and/or age factors, and the location and time of the injury event (rural vs. urban locations, day vs. night riding). From the perspective of policymakers, the findings of this review are of utmost importance and could be used in addressing the challenge of inadequate compliance with helmet use.


Subject(s)
Craniocerebral Trauma , Head Protective Devices , Accidents, Traffic/prevention & control , Age Factors , Craniocerebral Trauma/prevention & control , Humans , Motorcycles , Risk-Taking
13.
Pediatr Allergy Immunol ; 33(4): e13771, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35470939

ABSTRACT

BACKGROUND: The effects of infection and developmental adaptations in infancy on the prevalence of subsequent atopy-related diseases at different ages during childhood are not fully determined. This study aims to examine the similarities and differences in the age-specific association of asthma, allergic rhinitis/conjunctivitis, and atopic dermatitis with early-life infection-related factors (i.e., daycare, older siblings, and severe airway infection) and developmental adaptations (i.e., preterm birth and rapid weight gain) in children. METHODS: In this longitudinal cohort study (n = 47,015), children were followed from 0.5 to 11 years. The potential risks and protective factors, including daycare attendance at 0.5 years, existence of older siblings, history of hospitalization due to cold/bronchitis/bronchiolitis/pneumonia during 0.5-1.5 years, preterm birth, and rapid weight gain in the first 2.5 years, were assessed using multivariable logistic regression with adjustments for potential confounders. RESULTS: A protective association was observed between early-life daycare attendance and asthma at 5.5-9 years, which disappeared after 10 years. A protective association was also noted throughout childhood between early daycare attendance and older siblings with allergic rhinitis/conjunctivitis. However, the association between early daycare and atopic dermatitis was found to be risky during childhood. In contrast, the early-life history of hospitalization owing to cold/bronchitis/bronchiolitis/pneumonia was identified to be a risk factor for developing both asthma and allergic rhinitis/conjunctivitis. Preterm birth was a significant risk factor for childhood asthma. CONCLUSION: Different age-specific patterns were demonstrated in the relationship between early daycare, severe airway infection, preterm birth, and atopy-related diseases in childhood.


Subject(s)
Asthma , Bronchiolitis , Bronchitis , Conjunctivitis, Allergic , Dermatitis, Atopic , Premature Birth , Rhinitis, Allergic , Age Factors , Bronchiolitis/complications , Bronchitis/complications , Child , Dermatitis, Atopic/etiology , Female , Humans , Infant, Newborn , Longitudinal Studies , Pregnancy , Premature Birth/epidemiology , Rhinitis, Allergic/epidemiology , Risk Factors , Siblings , Weight Gain
14.
Front Immunol ; 13: 786586, 2022.
Article in English | MEDLINE | ID: mdl-35418996

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine-induced adaptive responses have been well investigated. However, the effects of sex, age, and ethnic background on the immune responses elicited by the mRNA vaccine remain unclear. Here, we performed comprehensive analyses of adaptive immune responses elicited by the SARS-CoV-2 mRNA vaccine. Vaccine-induced antibody and T cell responses declined over time but persisted after 3 months, and switched memory B cells were even increased. Spike-specific CD4+ T and CD8+ T cell responses were decreased against the B.1.351 variant, but not against B.1.1.7. Interestingly, T cell reactivity against B.1.617.1 and B.1.617.2 variants was decreased in individuals carrying HLA-A24, suggesting adaptive immune responses against variants are influenced by different HLA haplotypes. T follicular helper cell responses declined with increasing age in both sexes, but age-related decreases in antibody levels were observed only in males, and this was associated with the decline of T peripheral helper cell responses. In contrast, vaccine-induced CD8+ T cell responses were enhanced in older males. Taken together, these findings highlight that significant differences in the reactogenicity of the adaptive immune system elicited by mRNA vaccine were related to factors including sex, age, and ethnic background.


Subject(s)
Adaptive Immunity , Age Factors , COVID-19 Vaccines , COVID-19 , Sex Factors , Antibodies, Viral , COVID-19/ethnology , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Female , Humans , Immunity, Humoral , Male , SARS-CoV-2 , Vaccines, Synthetic
15.
JAMA Netw Open ; 5(4): e227512, 2022 Apr 01.
Article in English | MEDLINE | ID: mdl-35426922

ABSTRACT

Importance: Subjective memory complaints (SMCs) are associated with a faster cognitive decline; whether this association is also associated with structural brain alterations, such as white matter hyperintensity (WMH) volumes, requires investigation. Objective: To evaluate the association of SMCs with WMH volumes and cognitive decline and investigate the role of WMH volumes in the association between SMCs and cognitive decline. Design, Setting, and Participants: The Chicago Health and Aging Project, a population-based cohort study, enrolled adults aged 65 years or older. Data collection occurred in 3-year cycles from 1993 until 2012. Our study comprised 975 participants with magnetic resonance imaging assessments, of which 900 participants had data on SMCs and covariates, and 713 participants provided 2 or more cognitive assessments during the follow-up. Statistical analyses were conducted from May to October 2021. Exposures: SMCs were obtained from self-reported questionnaire data during clinical evaluations, and the cycle, when reported, constituted the baseline of our study. Based on the frequency and severity of concerns, we categorized participants into 3 groups, (1) no concerns, (2) moderate concerns, and (3) very worried. Main Outcomes and Measures: Volumetric magnetic resonance imaging measures of WMH volume and neuropsychological testing assessments of global cognition. Linear regression analysis was used to investigate the association between SMCs and WMH volumes in a multivariable model adjusted for age, sex, race and ethnicity, education, APOE4 status, and total intracranial volume. The association of SMCs with cognitive decline was investigated using linear mixed-effects models for age, sex, race and ethnicity, education, APOE4 status, follow-up time, and each variable in interaction with time to estimate the annual longitudinal change in cognitive function. Results: Of the 900 participants with data on SMCs, covariates, and WMH volumes, 553 (61.4%) were women, 539 (59.9%) were African American, and the mean (SD) age was 79.5 (6.2) years. SMCs were associated with a larger WMH volume and faster cognitive decline. Compared with participants with no concerns, participants who were very worried had higher WMH volumes (ß = 0.833; 95% CI, 0.203-1.463) and 174% faster cognitive decline (ß = -0.049; 95% CI, -0.076 to -0.022). The association between SMCs and cognitive decline remained statistically significant among individuals with large WMH volumes (ie, within the fourth quartile). Within the fourth quartile of WMH volumes, participants who were very worried had 428% faster cognitive decline (ß = -0.077; 95% CI, -0.144 to -0.011) compared with participants with no concerns. Conclusions and Relevance: This cohort study suggests that SMCs, frequently reported by older individuals, are an important sign of cognitive impairment, especially among people with abnormalities in brain structure, such as larger WMH volumes.


Subject(s)
Cognitive Dysfunction , White Matter , Age Factors , Aged , Apolipoprotein E4 , Chicago/epidemiology , Cognitive Dysfunction/diagnostic imaging , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/pathology , Cohort Studies , Female , Humans , Male , White Matter/pathology
16.
PLoS Comput Biol ; 18(4): e1010002, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35452459

ABSTRACT

We investigated the effects of updating age-specific social contact matrices to match evolving demography on vaccine impact estimates. We used a dynamic transmission model of tuberculosis in India as a case study. We modelled four incremental methods to update contact matrices over time, where each method incorporated its predecessor: fixed contact matrix (M0), preserved contact reciprocity (M1), preserved contact assortativity (M2), and preserved average contacts per individual (M3). We updated the contact matrices of a deterministic compartmental model of tuberculosis transmission, calibrated to epidemiologic data between 2000 and 2019 derived from India. We additionally calibrated the M0, M2, and M3 models to the 2050 TB incidence rate projected by the calibrated M1 model. We stratified age into three groups, children (<15y), adults (≥15y, <65y), and the elderly (≥65y), using World Population Prospects demographic data, between which we applied POLYMOD-derived social contact matrices. We simulated an M72-AS01E-like tuberculosis vaccine delivered from 2027 and estimated the per cent TB incidence rate reduction (IRR) in 2050 under each update method. We found that vaccine impact estimates in all age groups remained relatively stable between the M0-M3 models, irrespective of vaccine-targeting by age group. The maximum difference in impact, observed following adult-targeted vaccination, was 7% in the elderly, in whom we observed IRRs of 19% (uncertainty range 13-32), 20% (UR 13-31), 22% (UR 14-37), and 26% (UR 18-38) following M0, M1, M2 and M3 updates, respectively. We found that model-based TB vaccine impact estimates were relatively insensitive to demography-matched contact matrix updates in an India-like demographic and epidemiologic scenario. Current model-based TB vaccine impact estimates may be reasonably robust to the lack of contact matrix updates, but further research is needed to confirm and generalise this finding.


Subject(s)
Tuberculosis , Adult , Age Factors , Aged , Child , Humans , Incidence , Models, Theoretical , Tuberculosis/epidemiology , Tuberculosis/prevention & control , Vaccination
17.
Geriatr Gerontol Int ; 22(5): 373-383, 2022 May.
Article in English | MEDLINE | ID: mdl-35362258

ABSTRACT

Thus far, the prevalence and correlates of obesity among the oldest have been identified in several studies. Nevertheless, there is a lack of a systematic review, meta-analysis and meta-regression synthesizing the existing observational studies. Consequently, our aim was to fill this knowledge gap. Three electronic databases were searched (Medline, PsycINFO, CINAHL) and an additional hand search was performed. Observational studies (both, cross-sectional and longitudinal) determining the prevalence and (preferably) the correlates of obesity in the oldest old (≥80 years) were included. Data extraction covered study design, measurement of obesity, analytical approach, sample characteristics and main results. In total, 19 studies were included. Reported prevalence of obesity in the community varied greatly (range 0.7%-71.5%). The pooled prevalence of obesity was 17.8% (95% CI: 13.3%-22.2%), with significant heterogeneity between studies (I2  = 99.7%, P < 0.001). There is evidence of a publication bias. Meta-regressions showed that some of the heterogeneity was explained by the types of measures of obesity and country of the respective sample. In conclusion, obesity remains a key challenge among the oldest old. Future research in this age bracket is urgently required in regions mostly neglected thus far (e.g., South America, Africa or Asia). Moreover, studies based on longitudinal data are required to clarify the determinants of obesity among the oldest old. Furthermore, studies based on objectively recorded obesity (e.g., waist circumference) are also required. Geriatr Gerontol Int 2022; 22: 373-383.


Subject(s)
Aged, 80 and over , Obesity , Age Factors , Asia , Cross-Sectional Studies , Humans , Obesity/epidemiology , Prevalence , Waist Circumference
18.
Cancer Treat Rev ; 106: 102394, 2022 May.
Article in English | MEDLINE | ID: mdl-35472632

ABSTRACT

Immune checkpoint blockers (ICBs) have a pivotal role in the management of non-small cell lung cancer (NSCLC), both as single agent and in combination strategies, providing a meaningful clinical and survival benefit. Older patients are underrepresented in clinical trials, including those involving immunotherapy, even though almost half of the patients with newly diagnosed NSCLC are aged 70 years or older. Moreover, due to selection biases, usually "fit" patients are preferably enrolled. This results in a lack of evidence regarding the use of ICBs in the older population, particularly when referring to chemo-immunotherapy regimens. Since ICBs are indeed of paramount importance in the treatment of patients with NSCLC, efforts are needed to optimize their use also in the older population. This entails furthermore taking into account additional features including the degree of fitness of the patient and the different health domains that can be affected by aging. This review aims to delve into the current evidences about the efficacy and toxicity of ICBs in monotherapy and in combination in older patients with advanced NSCLC, the role of the comprehensive geriatric assessment in supporting the selection of patients receiving immunotherapy, as well as the value of immunosenescence in modulating the activity of these drugs.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Age Factors , Aged , Carcinoma, Non-Small-Cell Lung/drug therapy , Geriatric Assessment , Humans , Immunotherapy/methods , Lung Neoplasms/drug therapy
19.
Medicine (Baltimore) ; 101(9): e29020, 2022 Mar 04.
Article in English | MEDLINE | ID: mdl-35244084

ABSTRACT

ABSTRACT: Medical care should be equally provided to the public regardless of their financial capability. In the real world, expenditures directly out from the patient sector decide the medical journey, even in a country with national health insurance. The aim of this study was to investigate whether there are differences in the diagnostic and treatment processes in hematologic malignancies based on patient characteristics, such as health insurance status.Through the review of 5614 "CBCs with differential count" results with abnormal cells from 358 patients from January 2010 to June 2017, 238 patients without past medical histories of hematologic malignancies were enrolled. Excluding reactive cases, 206 patients with hematologic malignancy were classified into 8 disease categories: acute leukemia, myelodysplastic syndrome, myeloproliferative neoplasm (MPN), myelodysplastic syndrome/MPN, lymphoid neoplasm, plasma cell neoplasm, r/o hematologic malignancy, and cancer.The patients' age, sex, disease categories and follow-up durations showed associations with the clinical course. The "refusal of treatment" group was the oldest and had a relatively higher percentage of females, whereas those who decided to transfer to a tertiary hospital were younger. The age, clinical course, and follow-up durations were different across health insurance statuses. The medical aid group was the oldest, and the group whose status changed from a medical insurance subscriber to a medical aid beneficiary during treatment was the youngest. The majority of patients who refused treatment or wished to be transferred to a tertiary hospital were medical insurance subscribers. The percentage of patients who were treated in this secondary municipal hospital was higher in the medical-aid beneficiaries group than in the medical insurance group. Follow-up durations were longest in the status change group and shortest in the medical insurance group.Almost all medical aid beneficiaries with hematologic malignancies opted to continue treatment at this secondary/municipal hospitals, indicating that this category of medical institutions provides adequate levels and qualified healthcare services to those patients. The secondary municipal hospital provides qualified healthcare services for medical aid beneficiaries with hematologic malignancies.


Subject(s)
Health Services Accessibility , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/therapy , Insurance Coverage/statistics & numerical data , Insurance, Health/economics , Insurance, Health/statistics & numerical data , National Health Programs , Age Factors , Female , Health Expenditures , Health Services Accessibility/economics , Health Services Accessibility/statistics & numerical data , Hematologic Neoplasms/economics , Humans , Sex Factors
20.
Life Sci ; 296: 120446, 2022 May 01.
Article in English | MEDLINE | ID: mdl-35245521

ABSTRACT

Changes in sphingolipid metabolism regulate and/or alter many cellular functions in the brain. Ceramide, a central molecule of sphingolipid metabolism, is phosphorylated to ceramide-1-phosphate (C1P) by ceramide kinase (CerK). CerK and C1P were reported to regulate many cellular responses, but their roles in immune-related diseases in vivo have not been well elucidated. Thus, we investigated the effects of CerK knockout on the onset/progression of multiple sclerosis (MS), which is a chronic neurodegenerative disease accompanied by the loss of myelin sheaths in the brain. MS-model mice were prepared using a diet containing the copper chelator cuprizone (CPZ). Treatment of 8-week-old mice with 0.2% CPZ for 8 weeks resulted in motor dysfunction based on the Rota-rod test, and caused the loss of myelin-related proteins (MRPs) in the brain and demyelination in the corpus callosum without affecting synaptophysin levels. CerK knockout, which did not affect developmental changes in MRPs, ameliorated the motor dysfunction, loss of MRPs, and demyelination in the brain in CPZ-treated mice. Loss of tail tonus, another marker of motor dysfunction, was detected at 1 week without demyelination after CPZ treatment in a CerK knockout-independent manner. CPZ-induced loss of tail tonus progressed, specifically in female mice, to 6-8 weeks, and the loss was ameliorated by CerK knockout. Activities of ceramide metabolic enzymes including CerK in the lysates of the brain were not affected by CPZ treatment. Inhibition of CerK as a candidate for MS treatment was discussed.


Subject(s)
Corpus Callosum/physiopathology , Multiple Sclerosis/genetics , Phosphotransferases (Alcohol Group Acceptor)/genetics , Age Factors , Animals , Behavior, Animal/physiology , Brain/drug effects , Brain/physiology , Corpus Callosum/drug effects , Cuprizone/toxicity , Demyelinating Diseases/chemically induced , Demyelinating Diseases/etiology , Demyelinating Diseases/genetics , Disease Models, Animal , Female , Male , Mice, Inbred C57BL , Mice, Knockout , Multiple Sclerosis/chemically induced , Multiple Sclerosis/etiology , Oligodendroglia/drug effects , Oligodendroglia/metabolism , Phosphotransferases (Alcohol Group Acceptor)/metabolism , Proteins/genetics , Proteins/metabolism , Tail/drug effects , Tail/physiopathology
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