Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23
Filtrar
1.
Sci Rep ; 11(1): 12199, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108582

RESUMO

Stroke and cognitive impairment are common in older population. They often occur together and their combined effects significantly increase disability in both basic (BADLs) and instrumental (IADLs) activities of daily living. We investigated the individual and combined impacts of stroke and cognitive impairment on BADLs and IADLs. A total of 3331 community-dwelling older adults were enrolled from the Taiwan longitudinal study on aging in 2011. Both BADLs and IADLs were analyzed. Combination of stroke and cognitive impairment increased severity of ADL disabilities, but similar prevalence, similar numbers of summed BADL and IADL tasks with disability, and similar levels of difficulty for each BADL and IADL task were found between the stroke group and cognitive impairment group. The former had more difficult in dressing while the latter had more difficult in using the telephone, transport, and managing finances. A hierarchy of ADLs was also observed in all groups. ADL skill training supplemented with cognitive and physical interventions should focus on secondary prevention of dementia and improve motor functional capacity to reduce loss of ADLs.


Assuntos
Atividades Cotidianas , Envelhecimento , Disfunção Cognitiva/complicações , Pessoas com Deficiência/estatística & dados numéricos , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Disfunção Cognitiva/epidemiologia , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Acidente Vascular Cerebral/epidemiologia , Taiwan/epidemiologia
2.
Am J Epidemiol ; 190(10): 1977-1992, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33861317

RESUMO

Genotype-phenotype association studies often combine phenotype data from multiple studies to increase statistical power. Harmonization of the data usually requires substantial effort due to heterogeneity in phenotype definitions, study design, data collection procedures, and data-set organization. Here we describe a centralized system for phenotype harmonization that includes input from phenotype domain and study experts, quality control, documentation, reproducible results, and data-sharing mechanisms. This system was developed for the National Heart, Lung, and Blood Institute's Trans-Omics for Precision Medicine (TOPMed) program, which is generating genomic and other -omics data for more than 80 studies with extensive phenotype data. To date, 63 phenotypes have been harmonized across thousands of participants (recruited in 1948-2012) from up to 17 studies per phenotype. Here we discuss challenges in this undertaking and how they were addressed. The harmonized phenotype data and associated documentation have been submitted to National Institutes of Health data repositories for controlled access by the scientific community. We also provide materials to facilitate future harmonization efforts by the community, which include 1) the software code used to generate the 63 harmonized phenotypes, enabling others to reproduce, modify, or extend these harmonizations to additional studies, and 2) the results of labeling thousands of phenotype variables with controlled vocabulary terms.


Assuntos
Estudos de Associação Genética/métodos , Fenômica/métodos , Medicina de Precisão/métodos , Agregação de Dados , Humanos , Disseminação de Informação , National Heart, Lung, and Blood Institute (U.S.) , Fenótipo , Avaliação de Programas e Projetos de Saúde , Estados Unidos
3.
Sci Rep ; 10(1): 4508, 2020 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-32161340

RESUMO

Interferon regulatory factor 3 (IRF3) and IRF7 are closely related IRF members and the major factors for the induction of interferons, a key component in vertebrate innate immunity. However, there is limited knowledge regarding the evolution and adaptation of those IRFs to the environments. Two unique motifs in IRF3 and 7 were identified. One motif, GASSL, is highly conserved throughout the evolution of IRF3 and 7 and located in the signal response domain. Another motif, DPHK, is in the DNA-binding domain. The ancestral protein of IRF3 and 7 seemed to possess the DPHK motif. In the ray-finned fish lineage, while the DPHK is maintained in IRF7, the motif in IRF3 is changed to NPHK with a D → N amino acid substitution. The D → N substitution are also found in amphibian IRF3 but not in amphibian IRF7. Terrestrial animals such as reptiles and mammals predominantly use DPHK sequences in both IRF3 and 7. However, the D → N substitution in IRF3 DPHK is again found in cetaceans such as whales and dolphins as well as in marsupials. These observations suggest that the D → N substitutions in the IRF3 DPHK motif is likely to be associated with vertebrate's adaptations to aquatic environments and other environmental changes.


Assuntos
Adaptação Biológica , Evolução Biológica , Fator Regulador 3 de Interferon/genética , Fator Regulador 7 de Interferon/genética , Motivos de Aminoácidos , Sequência de Aminoácidos , Animais , Sequência Conservada , Evolução Molecular , Fator Regulador 3 de Interferon/química , Mamíferos , Modelos Moleculares , Filogenia , Conformação Proteica
4.
J Int Med Res ; 46(11): 4669-4677, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30213215

RESUMO

OBJECTIVE: The study aim was to examine the hand function (hand strength and dexterity) and intervention effects of training in adults with Prader-Willi syndrome (PWS). METHODS: Six adults with PWS (two females; mean age 26.14 years) underwent hand muscle strength and dexterity training for 3 months (2 hours per week). The following hand function tests were performed pre- and post-intervention: (1) hand grip, lateral pinch, and tip pinch hand strength tests, (2) the Box and Block test (BBT) for gross manual dexterity and (3) the Purdue Pegboard test for finger dexterity. RESULTS: Before treatment, all subjects showed lower hand grip, lateral pinch, tip pinch strength, and poorer manual/finger dexterity relative to healthy adults. After training, hand function scores improved on many test items, but only the left hand tip pinch and the right hand BBT performance showed significant improvements. CONCLUSIONS: All subjects showed lower hand strength and poorer manual/finger dexterity compared with healthy adults; this should be considered during physical training programs. Owing to limitations in the intervention intensity and possible subject behavioral deficits, further research is needed to clarify the effects of this intervention on hand function in PWS patients.


Assuntos
Lateralidade Funcional/fisiologia , Força da Mão/fisiologia , Síndrome de Prader-Willi/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Adulto Jovem
5.
G3 (Bethesda) ; 7(8): 2685-2694, 2017 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-28642364

RESUMO

In single-step analyses, missing genotypes are explicitly or implicitly imputed, and this requires centering the observed genotypes using the means of the unselected founders. If genotypes are only available for selected individuals, centering on the unselected founder mean is not straightforward. Here, computer simulation is used to study an alternative analysis that does not require centering genotypes but fits the mean [Formula: see text] of unselected individuals as a fixed effect. Starting with observed diplotypes from 721 cattle, a five-generation population was simulated with sire selection to produce 40,000 individuals with phenotypes, of which the 1000 sires had genotypes. The next generation of 8000 genotyped individuals was used for validation. Evaluations were undertaken with (J) or without (N) [Formula: see text] when marker covariates were not centered; and with (JC) or without (C) [Formula: see text] when all observed and imputed marker covariates were centered. Centering did not influence accuracy of genomic prediction, but fitting [Formula: see text] did. Accuracies were improved when the panel comprised only quantitative trait loci (QTL); models JC and J had accuracies of 99.4%, whereas models C and N had accuracies of 90.2%. When only markers were in the panel, the 4 models had accuracies of 80.4%. In panels that included QTL, fitting [Formula: see text] in the model improved accuracy, but had little impact when the panel contained only markers. In populations undergoing selection, fitting [Formula: see text] in the model is recommended to avoid bias and reduction in prediction accuracy due to selection.


Assuntos
Genética Populacional , Genômica , Modelos Genéticos , Seleção Genética , Animais , Teorema de Bayes , Cruzamento , Bovinos , Feminino , Marcadores Genéticos , Genótipo , Padrões de Herança/genética , Masculino , Locos de Características Quantitativas/genética , Análise de Regressão
6.
J Chromatogr A ; 1426: 226-32, 2015 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-26643722

RESUMO

The objective of this study was to establish a practical and reliable analytical method for monitoring trace amounts of Δ(9)-tetrahydrocannabinol (THC) and its metabolites in biological samples. A novel on-line preconcentration capillary electrophoresis method combining large volume sample injection, anion selective exhaustive injection and sweeping was developed to enhance analytical sensitivity. A background buffer composed with 30mM phosphate buffer (pH 2.5) containing 40% methanol and 100mM SDS was used to suppress the electroosmotic flow of the uncoated fused silica capillary (40cm×50µm i.d.). High conductivity buffer (200mM phosphate, pH 2.5) was injected for analyte accumulation. The samples, prepared in phosphate buffer or Tris buffer, were introduced by hydrodynamic injection and electrokinetic injection. After sweeping, the separation was performed in micellar electrokinetic chromatography (MEKC) mode at -15kV. During the method validation, the coefficient of determination of the regression curve was measured at greater than 0.993, and the relative standard deviation and relative error were lower than 11.06% and 9.24%, respectively. Under optimized conditions, an improvement of up to 2000-fold higher sensitivity was achieved. This method was applied to the analysis of urine samples, indicating that it could be satisfactorily utilized in the toxicological and clinical monitoring of cannabis.


Assuntos
Dronabinol/análise , Tampões (Química) , Cromatografia Capilar Eletrocinética Micelar/métodos , Dronabinol/metabolismo , Dronabinol/urina , Eletroforese Capilar , Humanos , Sensibilidade e Especificidade , Detecção do Abuso de Substâncias
7.
Anal Bioanal Chem ; 407(23): 7093-100, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26159571

RESUMO

Phenolic acids are natural antioxidants. Many studies have confirmed that these compounds can reduce the risk of developing chronic diseases such as diabetes, cardiovascular diseases, and certain cancers. In this work, we developed a rapid and efficient capillary electrophoresis method with an on-line preconcentration technique that could be used to simultaneously analyze 10 commonly found phenolic acids in plants. Briefly, phosphate buffer solution (pH 2) was filled into an uncoated fused silica capillary as the leading electrolyte, and then samples which were prepared in borate buffer (as the terminating ion) were loaded by electrokinetic injection (-10 kV, 900 s). After sample injection, both ends of the capillary were switched to the vial containing phosphate buffer with sodium dodecyl sulfate. The separation was then performed in micellar electrokinetic chromatography (MEKC) mode at -20 kV. During the method validation, the correlation coefficient of the regression curve was measured as greater than 0.997 and the relative standard deviation and relative error were lower than 9.63 % and 4.7 %, respectively. The limits of detection (LODs, S/N = 3) of these 10 analytes ranged from 0.01 to 2.5 ng/mL. Compared with the conventional capillary zone electrophoresis (CZE) method, the sensitivity for the analytes could be increased up to 25,000-fold. The method that we developed here was applied successfully to the detection of phenolic acids in fruit juices.


Assuntos
Eletro-Osmose/métodos , Eletroforese Capilar/métodos , Sucos de Frutas e Vegetais/análise , Hidroxibenzoatos/análise , Hidroxibenzoatos/química , Manejo de Espécimes/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
8.
AIDS Res Hum Retroviruses ; 31(5): 479-87, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25560398

RESUMO

The Liangshan prefecture in Sichuan province is an area in China severely affected by the HIV epidemic, with intravenous drug use (IDU) as the main risk factor. No reports on HIV subtypes prevalent in IDUs in Liangshan prefecture could be found. In this study, we have characterized the genotypes of HIV-1 in the IDU population in Liangshan prefecture and further determined the phylogenetic relationship of the CRF07_BC strains to HIV-1 sequences from the other regions of China, including Xinjiang and Yunnan provinces, to explore the pattern and possible diffusion pathway of HIV-1 in these regions. HIV-1-seropositive drug-naive IDUs identified in Liangshan prefecture, Sichuan province were enrolled in 2009. Full-length gag and pol genes were amplified by reverse transcription and nested PCR and then sequenced. All of the sequences were subtyped. Phylogenetic trees were constructed using the neighbor-joining and maximum likelihood methods. Divergence times were estimated using a Bayesian molecular clock approach. CRF07_BC was found to be the predominant strain in IDUs in Liangshan prefecture (95.5%). The CRF07_BC strains from Liangshan prefecture were found to be intermixed with those from Yunnan province in phylogenetic trees. The CRF07_BC sequences from Xinjiang province can be grouped into several clusters, suggesting that the expansion of the CRF07_BC epidemic in Xinjiang province was the result of a local epidemic driven by multiple independent introductions in the late 1990s. Only low-level drug-resistant viruses were found in the IDU population. CRF07_BC strains from Liangshan prefecture were more similar to those from Yunnan province than those from Xinjiang province. This finding will contribute to our understanding of the distribution, the evolution, and the potential source of CRF07_BC founder strains, and will also provide useful information for the development of strategies to prevent transmission.


Assuntos
Genótipo , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , Abuso de Substâncias por Via Intravenosa/complicações , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Análise por Conglomerados , Transmissão de Doença Infecciosa , Usuários de Drogas , Feminino , Infecções por HIV/transmissão , HIV-1/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Homologia de Sequência , Adulto Jovem , Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/genética
9.
Obes Surg ; 23(12): 2068-74, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23832520

RESUMO

BACKGROUND: The Bioenterics Intragastric Balloon (BIB) is effective for weight loss. However, comparisons of its effectiveness between groups with different body mass index (BMI) are rare. This study compared the effectiveness of BIB treatment in patients with BMI <32 kg/m(2) and those with BMI ≥ 32 kg/m(2) at the time of BIB removal and at 1 year later. METHODS: Between April 2009 and June 2011, 28 obese patients who completed a full course of BIB treatment were enrolled. There are 16 patients with BMI <32 and 12 with BMI ≥ 32. Patients who lost more than 20 % of excess weight (% EWL) were categorized as responders. RESULTS: The BMI significantly fell from 32.4 ± 3.7 to 28.5 ± 3.7 kg/m(2) (P < 0.01) at the time of BIB removal. All biochemical measurements except for cholesterol level were significantly improved. The median value of %EWL of all patients at BIB removal was 40.1, and 20 patients (71.4 %) were responders. Adherence to dietitian counseling was significantly better in responders than in non-responders (85 vs. 25 %, respectively; P < 0.01). The percentage of responders at 1 year after BIB removal was significantly higher among patients with BMI <32 than those with ≥ 32 (62.5 vs. 16.7 %, respectively; P = 0.02). CONCLUSIONS: BIB placement can achieve significant weight loss and improvement of co-morbidities in obese patients. Better adherence to dietitian counseling is associated with better response. Patients with BMI <32 maintain better weight loss at 1 year after BIB removal.


Assuntos
Grupo com Ancestrais do Continente Asiático , Índice de Massa Corporal , Remoção de Dispositivo , Balão Gástrico , Obesidade Mórbida/cirurgia , Perda de Peso , Adulto , Terapia Combinada , Comorbidade , Feminino , Seguimentos , Balão Gástrico/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevenção Secundária , Taiwan/epidemiologia , Fatores de Tempo , Resultado do Tratamento
10.
J Radiol Prot ; 33(2): 281-93, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23482396

RESUMO

There is no convincing evidence regarding radiation-induced heritable risks of adult-onset multifactorial diseases in humans, although it is important from the standpoint of protection and management of populations exposed to radiation. The objective of the present study was to examine whether parental exposure to atomic-bomb (A-bomb) radiation led to an increased risk of common polygenic, multifactorial diseases-hypertension, hypercholesterolaemia, diabetes mellitus, angina pectoris, myocardial infarction or stroke-in the first-generation (F1) offspring of A-bomb survivors. A total of 11,951 F1 offspring of survivors in Hiroshima or Nagasaki, conceived after the bombing, underwent health examinations to assess disease prevalence. We found no evidence that paternal or maternal A-bomb radiation dose, or the sum of their doses, was associated with an increased risk of any multifactorial diseases in either male or female offspring. None of the 18 radiation dose-response slopes, adjusted for other risk factors for the diseases, was statistically significantly elevated. However, the study population is still in mid-life (mean age 48.6 years), and will express much of its multifactorial disease incidence in the future, so ongoing longitudinal follow-up will provide increasingly informative risk estimates regarding hereditary genetic effects for incidence of adult-onset multifactorial disease.


Assuntos
Anormalidades Induzidas por Radiação/epidemiologia , Anormalidades Induzidas por Radiação/genética , Doenças Genéticas Inatas/epidemiologia , Exposição Materna/estatística & dados numéricos , Guerra Nuclear/estatística & dados numéricos , Exposição Paterna/estatística & dados numéricos , Sobreviventes/estatística & dados numéricos , Carga Corporal (Radioterapia) , Causalidade , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Monitoramento de Radiação/estatística & dados numéricos , Medição de Risco
11.
Radiat Res ; 179(3): 361-82, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23398354

RESUMO

A marked increase in leukemia risks was the first and most striking late effect of radiation exposure seen among the Hiroshima and Nagasaki atomic bomb survivors. This article presents analyses of radiation effects on leukemia, lymphoma and multiple myeloma incidence in the Life Span Study cohort of atomic bomb survivors updated 14 years since the last comprehensive report on these malignancies. These analyses make use of tumor- and leukemia-registry based incidence data on 113,011 cohort members with 3.6 million person-years of follow-up from late 1950 through the end of 2001. In addition to a detailed analysis of the excess risk for all leukemias other than chronic lymphocytic leukemia or adult T-cell leukemia (neither of which appear to be radiation-related), we present results for the major hematopoietic malignancy types: acute lymphoblastic leukemia, chronic lymphocytic leukemia, acute myeloid leukemia, chronic myeloid leukemia, adult T-cell leukemia, Hodgkin and non-Hodgkin lymphoma and multiple myeloma. Poisson regression methods were used to characterize the shape of the radiation dose-response relationship and, to the extent the data allowed, to investigate variation in the excess risks with gender, attained age, exposure age and time since exposure. In contrast to the previous report that focused on describing excess absolute rates, we considered both excess absolute rate (EAR) and excess relative risk (ERR) models and found that ERR models can often provide equivalent and sometimes more parsimonious descriptions of the excess risk than EAR models. The leukemia results indicated that there was a nonlinear dose response for leukemias other than chronic lymphocytic leukemia or adult T-cell leukemia, which varied markedly with time and age at exposure, with much of the evidence for this nonlinearity arising from the acute myeloid leukemia risks. Although the leukemia excess risks generally declined with attained age or time since exposure, there was evidence that the radiation-associated excess leukemia risks, especially for acute myeloid leukemia, had persisted throughout the follow-up period out to 55 years after the bombings. As in earlier analyses, there was a weak suggestion of a radiation dose response for non-Hodgkin lymphoma among men, with no indication of such an effect among women. There was no evidence of radiation-associated excess risks for either Hodgkin lymphoma or multiple myeloma.


Assuntos
Leucemia/epidemiologia , Linfoma/epidemiologia , Mieloma Múltiplo/epidemiologia , Guerra Nuclear , Sobreviventes , Estudos de Coortes , História do Século XX , História do Século XXI , Humanos , Incidência , Japão/epidemiologia , Sistema de Registros
12.
Epidemiology ; 23(4): 565-73, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22517300

RESUMO

In epidemiologic cohort studies of chronic diseases, such as heart disease or cancer, confounding by age can bias the estimated effects of risk factors under study. With Cox proportional-hazards regression modeling in such studies, it would generally be recommended that chronological age be handled nonparametrically as the primary time scale. However, studies involving baseline measurements of biomarkers or other factors frequently use follow-up time since measurement as the primary time scale, with no explicit justification. The effects of age are adjusted for by modeling age at entry as a parametric covariate. Parametric adjustment raises the question of model adequacy, in that it assumes a known functional relationship between age and disease, whereas using age as the primary time scale does not. We illustrate this graphically and show intuitively why the parametric approach to age adjustment using follow-up time as the primary time scale provides a poor approximation to age-specific incidence. Adequate parametric adjustment for age could require extensive modeling, which is wasteful, given the simplicity of using age as the primary time scale. Furthermore, the underlying hazard with follow-up time based on arbitrary timing of study initiation may have no inherent meaning in terms of risk. Given the potential for biased risk estimates, age should be considered as the preferred time scale for proportional-hazards regression with epidemiologic follow-up data when confounding by age is a concern.


Assuntos
Fatores Etários , Seguimentos , Modelos de Riscos Proporcionais , Fatores de Tempo , Adulto , Idoso , Idoso de 80 Anos ou mais , Viés , Fatores de Confusão Epidemiológicos , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias Induzidas por Radiação , Armas Nucleares
13.
Nutrition ; 28(5): 559-65, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22261578

RESUMO

OBJECTIVE: Conjugated linoleic acid (CLA) has several benefits, including body fat reduction, as proved in animals. However, the results of CLA-induced body composition alterations in humans are inconsistent, and no related data are available for Chinese populations. This study aimed to determine whether CLA affects body weight (BW) loss and body composition of overweight and obese Chinese subjects. METHODS: In this randomized, double-blind, placebo-controlled trial, subjects with a body mass index (BMI) of 24 to 35 kg/m(2) randomly received 1.7 g of cis-9,trans-11 and trans-10,cis-12 CLA (n = 30) or placebo (salad oil; n = 33) in 200 mL of sterilized milk twice daily for 12 wk. Changes in body composition were determined by bioimpedance measurements. RESULTS: Sixty-three subjects completed the study (CLA, n = 30). After 12 wk, compared with the baseline, the BW, BMI, total fat mass, fat percentage, subcutaneous fat mass, and waist-to-hip ratio decreased in the CLA group (P < 0.05). The CLA group was stratified by BMI and gender. The BW, BMI, subcutaneous fat mass, and waist-to-hip ratio decreased in 27 subjects with a BMI ≥ 27, and these indices, except subcutaneous fat mass, were lower in female subjects. The levels of total cholesterol, triacylglycerol, low-density lipoprotein, and plasma fasting glucose increased, whereas those of high-density lipoprotein decreased after 3 mo of CLA treatment. The changes were not significantly different from the baseline values. CONCLUSION: The supplementation of CLA for 12 wk in overweight and grade I obese Chinese subjects yielded lower obesity indices, with no obvious adverse effects.


Assuntos
Grupo com Ancestrais do Continente Asiático , Composição Corporal/efeitos dos fármacos , Suplementos Nutricionais , Ácidos Linoleicos Conjugados/farmacologia , Perda de Peso/efeitos dos fármacos , Tecido Adiposo/efeitos dos fármacos , Adulto , Glicemia/análise , Índice de Massa Corporal , Peso Corporal , Colesterol/sangue , Método Duplo-Cego , Feminino , Humanos , Masculino , Obesidade/tratamento farmacológico , Obesidade/epidemiologia , Sobrepeso/tratamento farmacológico , Sobrepeso/epidemiologia , Triglicerídeos/sangue , Relação Cintura-Quadril
14.
Radiat Res ; 176(6): 787-95, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21988524

RESUMO

Exposure to ionizing radiation has been thought to induce ovarian failure and premature menopause. Proximally exposed female atomic bomb survivors were reported to experience menopause immediately after the exposure more often than those who were distally exposed. However, it remains unclear whether such effects were caused by physical injury and psychological trauma or by direct effects of radiation on the ovaries. The objective of this study was to see if there are any late health effects associated with the exposure to atomic bomb radiation in terms of age at menopause in a cohort of 21,259 Life Span Study female A-bomb survivors. Excess absolute rates (EAR) of natural and artificial menopause were estimated using Poisson regression. A linear threshold model with a knot at 0.40 Gy [95% confidence interval (CI): 0.13, 0.62] was the best fit for a dose response of natural menopause (EAR at 1 Gy at age of 50 years = 19.4/1,000 person-years, 95% CI: 10.4, 30.8) and a linear threshold model with a knot at 0.22 Gy (95% CI: 0.14, 0.34) was the best fit for artificial menopause (EAR at 1 Gy at age of 50 years for females who were exposed at age of 20 years = 14.5/1,000 person-years, 95% CI: 10.2, 20.1). Effect modification by attained age indicated that EARs peaked around 50 years of age for both natural and artificial menopause. Although effect modification by age at exposure was not significant for natural menopause, the EAR for artificial menopause tended to be larger in females exposed at young ages. On the cumulative incidence curve of natural menopause, the median age at menopause was 0.3 years younger in females exposed to radiation of 1 Gy compared with unexposed females. The median age was 1 year younger for combined natural and artificial menopause in the same comparison. In conclusion, age at menopause was thought to decrease with increasing radiation dose for both natural and artificial menopause occurring at least 5 years after the exposure.


Assuntos
Exposição Ambiental/efeitos adversos , Menopausa Precoce/efeitos da radiação , Armas Nucleares , Sobreviventes/estatística & dados numéricos , Adulto , Idade de Início , Estudos de Coortes , Relação Dose-Resposta à Radiação , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Ovário/fisiopatologia , Ovário/efeitos da radiação
15.
J Clin Oncol ; 29(4): 428-34, 2011 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-21149671

RESUMO

PURPOSE: The risk of myelodysplastic syndromes (MDS) has not been fully investigated among people exposed to ionizing radiation. We investigate MDS risk and radiation dose-response in Japanese atomic bomb survivors. PATIENTS AND METHODS: We conducted a retrospective cohort study by using two databases of Nagasaki atomic bomb survivors: 64,026 people with known exposure distance in the database of Nagasaki University Atomic-Bomb Disease Institute (ABDI) and 22,245 people with estimated radiation dose in the Radiation Effects Research Foundation Life Span Study (LSS). Patients with MDS diagnosed from 1985 to 2004 were identified by record linkage between the cohorts and the Nagasaki Prefecture Cancer Registry. Cox and Poisson regression models were used to estimate relationships between exposure distance or dose and MDS risk. RESULTS: There were 151 patients with MDS in the ABDI cohort and 47 patients with MDS in the LSS cohort. MDS rate increased inversely with exposure distance, with an excess relative risk (ERR) decay per km of 1.2 (95% CI, 0.4 to 3.0; P < .001) for ABDI. MDS risk also showed a significant linear response to exposure dose level (P < .001) with an ERR per Gy of 4.3 (95% CI, 1.6 to 9.5; P < .001). After adjustment for sex, attained age, and birth year, the MDS risk was significantly greater in those exposed when young. CONCLUSION: A significant linear radiation dose-response for MDS exists in atomic bomb survivors 40 to 60 years after radiation exposure. Clinicians should perform careful long-term follow-up of irradiated people to detect MDS as early as possible.


Assuntos
Síndromes Mielodisplásicas/etiologia , Armas Nucleares , Lesões por Radiação/etiologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Bases de Dados como Assunto , Relação Dose-Resposta à Radiação , Feminino , Humanos , Lactente , Japão , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Sistema de Registros , Características de Residência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Adulto Jovem
16.
Surg Laparosc Endosc Percutan Tech ; 20(3): e99-102, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20551805

RESUMO

Single-incision laparoscopic surgery is a new approach considered as an alternative to natural orifice transluminal endoscopic surgery. Here, we describe a novel technique for laparoscopic adjustable gastric banding (LAGB) using a single-incision transumbilical (SITU) approach and an intraoperative method for liver retraction. Three patients (18 to 23 y) with a mean body mass index of 38.1 kg/m2 underwent LAGB with the "pars flaccida" technique through an SITU approach. Retraction of the left liver lobe was achieved with a specially designed "liver suspension tape" attached with sutures to the left upper quadrant abdominal wall and midline. The mean operative time was 62 minutes, with no intraoperative complications. These patients responded well postoperatively and were discharged after 2 days. SITU-LAGB is a safe, technically feasible, and reproducible procedure resulting in a more beneficial cosmetic appearance as the incision wound is hidden in the umbilicus, thus avoiding visible abdominal scars.


Assuntos
Gastroplastia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Adolescente , Feminino , Humanos , Fígado/cirurgia , Masculino , Técnicas de Sutura , Tração/métodos , Umbigo , Adulto Jovem
17.
J Radiat Res ; 51(4): 431-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20543527

RESUMO

In studying the late health effects of atomic-bomb (A-bomb) survivors, earlier findings were that white blood cell (WBC) count increased with radiation dose in cross-sectional studies. However, a persistent effect of radiation on WBC count and other risk factors has yet to be confirmed. The objectives of the present study were 1) to examine the longitudinal relationship between A-bomb radiation dose and WBC and differential WBC counts among A-bomb survivors and 2) to investigate the potential confounding risk factors (such as age at exposure and smoking status) as well as modification of the radiation dose-response. A total of 7,562 A-bomb survivors in Hiroshima and Nagasaki were included in this study from 1964-2004. A linear mixed model was applied using the repeated WBC measurements. During the study period, a secular downward trend of WBC count was observed. Radiation exposure was a significant risk factor for elevated WBC and differential WBC counts over time. A significant increase of WBC counts among survivors with high radiation dose (> 2 Gy) was detected in men exposed below the age of 20 and in women regardless of age at exposure. Effects on WBC of low dose radiation remain unclear, however. Cigarette smoking produced the most pronounced effect on WBC counts and its impact was much larger than that of radiation exposure.


Assuntos
Contagem de Leucócitos , Armas Nucleares/história , Lesões por Radiação/história , Adulto , Idoso , Relação Dose-Resposta à Radiação , Feminino , História do Século XX , História do Século XXI , Humanos , Japão , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Lesões por Radiação/sangue , Fatores de Risco , Adulto Jovem
18.
Radiat Res ; 172(3): 368-82, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19708786

RESUMO

This paper provides the first comprehensive report on mortality by type of leukemia among the Japanese atomic bomb survivors in the Life Span Study (LSS). Analyses include 310 deaths due to leukemia during the period 1950-2000 among 86,611 people in the LSS. Poisson regression methods were used to evaluate associations between estimated bone marrow dose and leukemia mortality. Attention was given to variation in the radiation dose-leukemia mortality association by time since exposure, age at exposure, city and sex. The excess relative rate per gray of acute myeloid leukemia was best described by a quadratic dose-response function that peaked approximately 10 years after exposure. Acute lymphatic leukemia and chronic myeloid leukemia mortality were best described by a linear dose-response function that did not vary with time since exposure. Adult T-cell leukemia was not associated with estimated bone marrow dose. Overall, 103 of the 310 observed leukemia deaths were estimated to be excess deaths due to radiation exposure. In the most recent decade of observation (1991-2000), the estimated attributable fraction of leukemia deaths among those survivors exposed to >0.005 Gy was 0.34, suggesting that the effect of the atomic bombings on leukemia mortality has persisted in this cohort for more than five decades.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Leucemia Induzida por Radiação/mortalidade , Guerra Nuclear/estatística & dados numéricos , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Análise de Sobrevida , Taxa de Sobrevida , Adulto Jovem
19.
Hypertens Res ; 31(7): 1391-7, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18957810

RESUMO

Although several studies have shown that high WBC count is a risk factor for hypertension, the relationship between WBC count and the incidence of hypertension in Japanese is poorly understood, as are the effects of WBC components on that relationship. Our objective was to verify in a Japanese population whether WBC or differential WBC count predicts hypertension incidence. A total of 9,383 initially hypertension-free subjects (3,356 men and 6,027 women), whose WBC counts were within the normal range (3,000 to < 10,000 cells/mm3), were followed from 1965 to 2004. During this 40-year follow-up, 4,606 subjects developed hypertension. After adjusting for conventional risk factors, including smoking status, we found that elevated WBC count was associated with hypertension incidence in a Cox regression model with both fixed and time-varying covariates for women. For men, elevated WBC count was a significant risk factor for hypertension only in the time-varying Cox-regression covariate. We also observed a significant association between increased neutrophil count and hypertension incidence among women. In a fully adjusted model, the relative risks of hypertension incidence, from the lowest to the highest quartiles of neutrophil count, were 1.00, 1.18, 1.28, and 1.22 in women (p for trend < 0.001). In conclusion, elevated WBC count predicted an increased incidence of hypertension in Japanese, especially among females. Moreover, neutrophils were the major WBC component contributing to the increased risk.


Assuntos
Hipertensão/etiologia , Contagem de Leucócitos , Neutrófilos/fisiologia , Adulto , Idoso , Feminino , Humanos , Hipertensão/sangue , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco
20.
Ann Epidemiol ; 18(7): 584-91, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18486486

RESUMO

PURPOSE: We aimed to examine the relationships between education and mortality and incidence for major sites of cancer in a Japanese population. METHODS: Subjects were 32,883 respondents of questionnaire survey in 1978 with ages younger than 75 years. Cancer cases were ascertained through 2001, and causes of deaths were identified through 2003. Hazard ratios of deaths from cancer or developing cancers were compared among those with 9 or less, 10-12, and 13 years or more of education using Cox proportional hazard models. RESULTS: As for cancer mortality of all sites combined, a statistically significantly decreasing trend was observed in age-adjusted models in both men and women, but no significant differences were observed in multivariate-adjusted (age, body mass index, smoking, radiation dose, and city) models. Among major cancer sites (stomach, colon/rectum, liver, lung, and female breast) examined, a significantly decreasing trend was observed for male liver cancer in a multivariate-adjusted model. As for incidence, a significantly decreasing trend was observed for cancer of all sites combined in men, and for male liver and prostate cancer and female lung cancer in a multivariate-adjusted model. CONCLUSIONS: Educational differences in cancer incidence and mortality were generally rather small, but were significant for incidence for male all-site, male liver, prostate, and female lung cancers.


Assuntos
Escolaridade , Neoplasias/epidemiologia , Adulto , Idoso , Distribuição de Qui-Quadrado , Estudos de Coortes , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/mortalidade , Armas Nucleares , Sistema de Registros , Fatores Socioeconômicos , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...