Coronavirus Disease 2019 (COVID-19) Vaccination Coverage, Intentions, Attitudes, and Barriers by Race/Ethnicity, Language of Interview, and Nativity-National Immunization Survey Adult COVID Module, 22 April 2021-29 January 2022.

The National Immunization Survey Adult COVID Module used a random-digit-dialed phone survey during 22 April 2021-29 January 2022 to quantify coronavirus disease 2019 (COVID-19) vaccination, intent, attitudes, and barriers by detailed race/ethnicity, interview language, and nativity. Foreign-born respondents overall and within racial/ethnic categories had higher vaccination coverage (80.9%), higher intent to be vaccinated (4.2%), and lower hesitancy toward COVID-19 vaccination (6.0%) than US-born respondents (72.6%, 2.9%, and 15.8%, respectively). Vaccination coverage was significantly lower for certain subcategories of national origin or heritage (eg, Jamaican [68.6%], Haitian [60.7%], Somali [49.0%] in weighted estimates). Respondents interviewed in Spanish had lower vaccination coverage than interviewees in English but higher intent to be vaccinated and lower reluctance. Collection and analysis of nativity, detailed race/ethnicity and language information allow identification of disparities among racial/ethnic subgroups. Vaccination programs could use such information to implement culturally and linguistically appropriate focused interventions among communities with lower vaccination coverage.

Association of Provider Recommendation and Human Papillomavirus Vaccination Initiation among Male Adolescents Aged 13-17 Years-United States.

OBJECTIVE: To assess human papillomavirus (HPV) vaccination coverage among adolescents by provider recommendation status. STUDY DESIGN: The 2011-2016 National Immunization Survey-Teen data were used to assess HPV vaccination coverage among male adolescents by provider recommendation status. Multivariable logistic analyses were conducted to evaluate associations between HPV vaccination and provider recommendation status. RESULTS: HPV vaccination coverage among male adolescents increased from 8.3% in 2011 to 57.3% in 2016. Likewise, the prevalence of provider recommendation increased from 14.2% in 2011 to 65.5% in 2016. In 2016, HPV coverage was higher in male adolescents with a provider recommendation than in those without a provider recommendation (68.8% vs 35.4%). In multivariable logistic regression, characteristics independently associated with a higher likelihood of HPV vaccination included receipt of a provider recommendation, age 16-17 years, black or Hispanic race/ethnicity, any Medicaid insurance, ≥2 physician contacts in the previous 12 months, and urban or suburban residence. Participants with a mother with some college or a college degree, those with a mother aged 35-44 years, and those who did not have a well-child visit at age 11-12 years had a lower likelihood of HPV vaccination. CONCLUSIONS: Receiving a provider recommendation for vaccination was significantly associated with receipt of HPV vaccine among male adolescents, indicating that a provider recommendation for vaccination is an important approach to increase vaccination coverage. Evidence-based strategies, such as standing orders and provider reminders, alone or in combination with health system interventions, are useful for increasing provider recommendations and HPV vaccination coverage among male adolescents.

Association of Health Insurance Status and Vaccination Coverage among Adolescents 13-17 Years of Age.

OBJECTIVE: To assess selected vaccination coverage among adolescents by health insurance status and other access-to-care characteristics. STUDY DESIGN: The 2015 National Immunization Survey-Teen data were used to assess vaccination coverage disparities among adolescents by health insurance status and other access-to-care variables. Multivariable logistic regression analysis and a predictive marginal modeling were conducted to evaluate associations between health insurance status and vaccination coverage. RESULTS: Overall, vaccination coverage was significantly lower among uninsured compared with insured adolescents for all vaccines assessed for except ≥3 doses of human papillomavirus vaccine (HPV) among male adolescents. Among adolescents 13-17 years of age, vaccination of uninsured compared with insured adolescents, respectively, for tetanus toxoid, reduced content diphtheria toxoid, and acellular pertussis vaccine was 77.4% vs 86.8%; for ≥1 dose of meningococcal conjugate vaccine was 72.9% vs 81.7%; for ≥1 dose of HPV was 38.8% vs 50.2% among male and 42.9% vs 63.8% among female adolescents; for 3 doses of HPV was 24.9% vs 42.8% among female adolescents. In addition, vaccination coverage differed by the following: type of insurance among insured adolescents, having a well-child visit at 11-12 years of age, and number of healthcare provider contacts in the past year. Uninsured were less likely than insured adolescents to be vaccinated for HPV (female: ≥1 dose and 3 doses; and male: ≥1 doses) after adjusting for confounding variables. CONCLUSIONS: Overall, vaccination coverage was lower among uninsured adolescents. HPV vaccination coverage was lower than tetanus toxoid, reduced content diphtheria toxoid, and acellular pertussis vaccine Tdap and meningococcal conjugate vaccine in both insured and uninsured adolescents. Wider implementation of effective evidence-based strategies is needed to help improve vaccination coverage among adolescents, particularly for those who are uninsured. Limitation of current federally funded vaccination programs or access to healthcare would be expected to erode vaccine coverage of adolescents.

The diagnostic value of circulating microRNAs for middle-aged (40-60-year-old) coronary artery disease patients.

OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40-60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49-57 years old), 30 unstable coronary artery disease patients (49-58 years old), and 32 non-coronary artery disease patients (49--57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, miR-424 and miR-765 might be novel, non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged patients. However, future prospective trials in large patient cohorts are necessary before reaching a solid conclusion.

The diagnostic value of circulating microRNAs for middle-aged (40–60-year-old) coronary artery disease patients

OBJECTIVE: Circulating microRNAs have been recognized as promising biomarkers for various diseases. The present study aimed to explore the potential roles of circulating miR-149, miR-424 and miR-765 as non-invasive biomarkers for the diagnosis of coronary artery disease in middle-aged (40–60-year-old) patients. METHODS: Sixty-five stable coronary artery disease patients (49–57 years old), 30 unstable coronary artery disease patients (49–58 years old), and 32 non-coronary artery disease patients (49–-57 years old) who were matched for age, sex, smoking habits, hypertension and diabetes were enrolled in this study. Total RNA was isolated from plasma with TRIzol reagent. Circulating miRNA levels were measured by quantitative real-time polymerase chain reaction. RESULTS: Circulating miR-149 levels were decreased 4.49-fold in stable coronary artery disease patients (1.18 ± 0.84) and 5.09-fold in unstable coronary artery disease patients (1.04 ± 0.65) compared with non-coronary artery disease patients (5.30 ± 2.57) (p<0.001). Circulating miR-424 levels were reduced 3.6-fold in stable coronary artery disease patients (1.18 ± 0.60) and 5-fold in unstable coronary artery disease patients (0.86 ± 0.54) compared with non-coronary artery disease patients (4.35 ± 2.20) (p<0.001). In contrast, circulating miR-765 levels were elevated 3.98-fold in stable coronary artery disease patients (6.09 ± 2.27) and 5.33-fold in unstable coronary artery disease patients (8.17 ± 2.77) compared with non-coronary artery disease patients (1.53 ± 0.99) (p<0.001). Receiver operating characteristic curve analysis revealed that the respective areas under the curve for circulating miR-149, miR-424 and miR-765 were 0.938, 0.919 and 0.968 in stable CAD patients and 0.951, 0.960 and 0.977 in unstable coronary artery disease patients compared with non-coronary artery disease patients. CONCLUSION: Our results suggest that circulating miR-149, ...

Serum metabolic profiling of human gastric cancer based on gas chromatography/mass spectrometry

Research on molecular mechanisms of carcinogenesis plays an important role in diagnosing and treating gastric cancer. Metabolic profiling may offer the opportunity to understand the molecular mechanism of carcinogenesis and help to non-invasively identify the potential biomarkers for the early diagnosis of human gastric cancer. The aims of this study were to explore the underlying metabolic mechanisms of gastric cancer and to identify biomarkers associated with morbidity. Gas chromatography/mass spectrometry (GC/MS) was used to analyze the serum metabolites of 30 Chinese gastric cancer patients and 30 healthy controls. Diagnostic models for gastric cancer were constructed using orthogonal partial least squares discriminant analysis (OPLS-DA). Acquired metabolomic data were analyzed by the nonparametric Wilcoxon test to find serum metabolic biomarkers for gastric cancer. The OPLS-DA model showed adequate discrimination between cancer and non-cancer cohorts while the model failed to discriminate different pathological stages (I-IV) of gastric cancer patients. A total of 44 endogenous metabolites such as amino acids, organic acids, carbohydrates, fatty acids, and steroids were detected, of which 18 differential metabolites were identified with significant differences. A total of 13 variables were obtained for their greatest contribution in the discriminating OPLS-DA model [variable importance in the projection (VIP) value >1.0], among which 11 metabolites were identified using both VIP values (VIP >1) and the Wilcoxon test. These metabolites potentially revealed perturbations of glycolysis and of amino acid, fatty acid, cholesterol, and nucleotide metabolism of gastric cancer patients. These results suggest that gastric cancer serum metabolic profiling has great potential in detecting this disease and helping to understand its metabolic mechanisms.

Serum metabolic profiling of human gastric cancer based on gas chromatography/mass spectrometry.

Research on molecular mechanisms of carcinogenesis plays an important role in diagnosing and treating gastric cancer. Metabolic profiling may offer the opportunity to understand the molecular mechanism of carcinogenesis and help to non-invasively identify the potential biomarkers for the early diagnosis of human gastric cancer. The aims of this study were to explore the underlying metabolic mechanisms of gastric cancer and to identify biomarkers associated with morbidity. Gas chromatography/mass spectrometry (GC/MS) was used to analyze the serum metabolites of 30 Chinese gastric cancer patients and 30 healthy controls. Diagnostic models for gastric cancer were constructed using orthogonal partial least squares discriminant analysis (OPLS-DA). Acquired metabolomic data were analyzed by the nonparametric Wilcoxon test to find serum metabolic biomarkers for gastric cancer. The OPLS-DA model showed adequate discrimination between cancer and non-cancer cohorts while the model failed to discriminate different pathological stages (I-IV) of gastric cancer patients. A total of 44 endogenous metabolites such as amino acids, organic acids, carbohydrates, fatty acids, and steroids were detected, of which 18 differential metabolites were identified with significant differences. A total of 13 variables were obtained for their greatest contribution in the discriminating OPLS-DA model [variable importance in the projection (VIP) value >1.0], among which 11 metabolites were identified using both VIP values (VIP >1) and the Wilcoxon test. These metabolites potentially revealed perturbations of glycolysis and of amino acid, fatty acid, cholesterol, and nucleotide metabolism of gastric cancer patients. These results suggest that gastric cancer serum metabolic profiling has great potential in detecting this disease and helping to understand its metabolic mechanisms.

Exeresis de paraganglioma retroperitoneal extra-adrenal por videolaparoscopia / Exeresis of extra-adrenal retroperitoneal paraganglioma by videolaparoscopy

Los paragangliomas extraadrenales son tumores neuroendocrinos raros que derivan de las células cromafines con capacidad de secretar cantidades excesivas de catecolaminas. Objetivos. Evaluar el tratamiento de este raro tumor retroperitoneal con una técnica laparoscópica de avanzada, mínimamente invasiva, y sus resultados. Material y métodos. Paciente femenino, 26 años, presenta episodios de HTA frecuentes durante el día, no relacionados a situaciones de estrés. Se estudia con ecografía abdominal, evidenciándose masa infrarenal izquierda. Se completan TAC y RNM, evidenciándose lesión infrarenal izquierda de 40 mm de diámetro lateroaórtica, en íntimo contacto con la misma. PET-TC no evidencia metástasis. Se planifica resolución del caso por vía laparoscópica. Previamente la paciente se trata con Doxazosina. Resultados. Abordaje laparoscópico con 4 trocares. Exéresis en forma completa. Durante la cirugía requiere presencia activa del anestesiólogo por oscilación hemodinámica. El procedimiento no tuvo complicaciones intra ni postoperatorias. La paciente evolucionó favorablemente sin requerimiento de bloqueantes desde extraída la pieza hasta los controles ambulatorios. El resultado de anatomía patológica mostró paraganglioma extraadrenal. Conclusiones. El tratamiento mínimamente invasivo laparoscópico de este tipo de tumores encuentra su fundamento en la selección del caso y el entrenamiento del equipo quirúrgico, así como la necesidad de un centro de alta complejidad con un manejo minucioso del intraoperatorio. La resección es equiparable a la resección a cielo abierto con los beneficios que otorga la mini invasividad.

Extra-adrenal paragangliomas are rare neuroendocrine tumors derived from chromaffin cells capable of secreting excessive amounts of catecholamines. Objective. Evaluate surgical treatment of this rare tumor with a minimally invasive technique as laparoscopy and its results. Methods. Female, 26 Y-O, with frequent and daily arterial hypertension episodes, stress not related. US showed lateroaortic mass, under left kidney. CT and MRI were completed, making evidence of intimal with Aorta. PET-TC revealed no distant metastasis. Laparoscopic approach was performed. Doxazosine treatment previous to surgery was established. 4 trocar laparoscopic approach. Complete tumor removal. Hemodynamic oscillation during surgery required active presence of anesthesiologist. No complications where reported. No further requirement of blocking drugs since surgery. Pathological findings showed extra-adrenal paraganglioma. Conclusion. Minimally invasive laparoscopic technique is feasible for these tumors. Patient selection and advance laparoscopic training is required for management of this pathology. Laparoscopic results are comparable to open surgery, but add the benefits of minimally invasive technique.

Prevalence and characteristics of children at increased risk for complications from influenza, United States, 2000.

OBJECTIVES: Annual influenza vaccination is recommended for children at high risk of complications from influenza due to underlying medical conditions, but few children are vaccinated. Vaccination also is encouraged for all children aged 6 to 23 months when feasible. This study describes the prevalence and characteristics of at-risk children nationwide. STUDY DESIGN: A descriptive analysis of the 2000 National Health Interview Survey (NHIS) was conducted among children in the United States aged 6 months through 17 years with identified high-risk conditions, and among all children aged 6 to 23 months. RESULTS: Approximately 5.2 to 10.0 million children aged 6 months through 17 years (7.4%-14.2%) had high-risk conditions indicated for influenza vaccination. Asthma accounted for the majority of conditions. An estimated 7.7 million children would be aged 6 to 23 months during influenza season. Most young children and older children at high-risk have access to and frequently utilize healthcare services. CONCLUSIONS: Existing doctor visits are important opportunities for vaccinating children with high-risk conditions, or for those aged 6 to 23 months. Additional efforts are needed to implement and evaluate efficient strategies for annual influenza vaccination of children aged 6 to 23 months and for older children with medical indications.