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1.
Medicine (Baltimore) ; 100(40): e27456, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622869

RESUMO

RATIONALE: Dienogest is a type of progestin used for the treatment of endometriosis (EM). However, a significant adverse effect of dienogest is depression; therefore, assessing for a history of mood disorders is recommended before prescribing the drug. Herein, we present the case of a patient with no history of psychiatric disorders who was diagnosed with dienogest-induced major depressive disorder. This case emphasizes the importance of close monitoring for negative mood changes in patients taking dienogest. PATIENT CONCERNS: A 41-year-old woman underwent surgery for EM. Postoperatively, her gynecologist prescribed dienogest (2 mg/d) to control EM symptoms. Two months after the initiation of dienogest, she manifested insomnia almost daily, gradually became depressed, lost interest in all activities, had incessant cries, and repeatedly thought of death. She had no history of major physical or psychiatric disorders. DIAGNOSIS: Major depressive disorder, single episode, severe. INTERVENTIONS: A psychiatric consultation was recommended, an antidepressant was prescribed, and dienogest was discontinued. OUTCOMES: Two weeks later, there was significant improvement in the symptoms, and after 4 weeks, she remained in a stable mood with no suicidal thoughts. She was followed up for 13 months with a maintenance dose of escitalopram (5 -10mg/d), until the psychiatrist recommended treatment discontinuation, with a confirmed state of remission. LESSONS: This was a case of dienogest-induced depression in a patient with no history of mood disorders. Clinicians should be aware of the possibility of the occurrence of severe depression in progestin users regardless of their previous history.


Assuntos
Transtorno Depressivo Maior/etiologia , Endometriose/tratamento farmacológico , Antagonistas de Hormônios/efeitos adversos , Nandrolona/análogos & derivados , Ideação Suicida , Adulto , Endometriose/cirurgia , Feminino , Antagonistas de Hormônios/uso terapêutico , Humanos , Nandrolona/efeitos adversos , Nandrolona/uso terapêutico
2.
J Med Food ; 24(8): 883-893, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34406877

RESUMO

During constipation, indigestible foods, such as probiotics, prebiotics, and dietary fiber, may improve the bowel environment and activity. In this randomized, double-blind, and placebo-controlled study, the effects of ID-HWS1000, composed of Lactobacillus and Bifidobacterium species, xylooligosaccharide, and dietary fiber, were evaluated to determine whether it improves the perception of bowel activity or cause changes in the gut microbiome. Thirty Korean adults with "functional constipation" according to the Rome III criteria were randomly assigned to the following groups: 20 in the ID-HWS1000 group and 10 in the placebo group. ID-HWS1000 or the placebo was consumed by the participants for 4 weeks. To assess the changes in the perception of bowel activity, clinical data and gut microbiome analyses were conducted before and after the experiment. There were significant differences between the groups in the response to 9 of the 12 survey questions (the number and duration of bowel movements, amount of feces, number of irritant bowel movements, number of times bowel movements felt incomplete, shape of the feces, amount of gas in the gut, discomfort after defecation, and discomfort owing to constipation) (P < .05). There was a decrease in the proportion of Firmicutes (Ruminococcaceae and Lachnospiraceae) and an increase in Bacteroidetes (Bacteroidaceae) (P < .05). Moreover, ID-HWS1000 directly improved the discomfort associated with bowel movements, decreased the proportion of Lachnospiraceae, and increased the proportion of Bacteroidaceae. These results confirmed that ID-HWS1000 improves the perception of bowel activity and exerts positive changes in individuals with functional constipation.


Assuntos
Microbioma Gastrointestinal , Probióticos , Adulto , Constipação Intestinal , Defecação , Método Duplo-Cego , Humanos , Percepção , Resultado do Tratamento
3.
BMJ Glob Health ; 6(8)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34341020

RESUMO

BACKGROUND: Invasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant (MDR) iNTS serovars across the continent. METHODS: A total of 166 iNTS isolates collected from a multi-centre surveillance in 10 African countries (2010-2014) and a fever study in Ghana (2007-2009) were genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes-genotypes. Phylogenetic analyses were conducted in the context of the existing genomic frameworks for various iNTS serovars. Population-based incidence of MDR-iNTS disease was estimated in each study site. RESULTS: Salmonella Typhimurium sequence-type (ST) 313 and Salmonella Enteritidis ST11 were predominant, and both exhibited high frequencies of MDR; Salmonella Dublin ST10 was identified in West Africa only. Mutations in the gyrA gene (fluoroquinolone resistance) were identified in S. Enteritidis and S. Typhimurium in Ghana; an ST313 isolate carrying bla CTX-M-15 was found in Kenya. International transmission of MDR ST313 (lineage II) and MDR ST11 (West African clade) was observed between Ghana and neighbouring West African countries. The incidence of MDR-iNTS disease exceeded 100/100 000 person-years-of-observation in children aged <5 years in several West African countries. CONCLUSIONS: We identified the circulation of multiple MDR iNTS serovar STs in the sampled sub-Saharan African countries. Investment in the development and deployment of iNTS vaccines coupled with intensified antimicrobial resistance surveillance are essential to limit the impact of these pathogens in Africa.


Assuntos
Preparações Farmacêuticas , Salmonella typhimurium , Criança , Genômica , Humanos , Quênia , Filogenia , Salmonella typhimurium/genética
4.
ACS Appl Mater Interfaces ; 13(29): 33969-33980, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34275265

RESUMO

Precise control over the size and shape of ice crystals is a key factor to consider in designing antifreezing and cryoprotecting molecules for cryopreservation of cells. Here, we report that a poly(ethylene glycol)-poly(l-alanine) (PEG-PA) block copolymer exhibits excellent cryoprotecting properties for stem cells and antifreezing properties for water. As the molecular weight of PA increased from 500, 760, and 1750 Da (P1, P2, and P3) at the same PEG molecular weight of 5000 Da, the ß-sheet content decreased and α-helix content increased. Comparing P2 (PEG-PA; 5000-760) and P4 (PEG-PA: 1000-750), ß-sheets increased as the PEG block length decreased. The critical micelle concentration of the PEG-PA block copolymers was in a range of 0.5-3.0 mg/mL and was proportional to the hydrophobicity of the PEG-PA block copolymers. The P1, P2, and P3 self-assembled into spherical micelles, whereas P4 formed micelles with cylindrical morphology. The difference in the block copolymer structure affected ice recrystallization inhibition (IRI) activity and cryopreservation of cells. IRI activity was assayed via mean largest grain size (MLGS), and interactions between polymers and ice crystal surfaces were studied by dynamic ice-shaping studies. The MLGS decreased to 58 → 53 → 45 → 35 → 23% of that of PBS, as the polymer (PEG-PA 5000-500) concentration increased from 0.0 (PBS; control) → 1.0 → 5.0 → 10 → 30 → 50 mg/mL. The MLGS of PEG 5k solutions (negative control) decreased to 74 → 71 → 64 → 44 → 37% of that of PBS in the same concentration range. P3 and P4 with a longer hydrophobic PA block developed elongated ice crystals at above 30 mg/mL. The dynamic ice-shaping study exhibited that ice crystals became needle-shaped, as the hydrophobicity of the polymer increased as in P2-P4. The cell recovery in the P1 system after cryopreservation at -196 °C for 7 days was 87% of that of the dimethyl sulfoxide (DMSO) 10% system (positive control). The cell recovery was 48% for the P2 system and drastically decreased to less than 30% of that of the DMSO 10% system in the P3, P4, PEG 5k, PEG 1k, PVA 80H, and PVA 100H systems. Current studies suggest that IRI activity, round ice crystal shaping, and membrane stabilization activity of P1 cooperatively provide excellent cell recovery among the candidate systems. Recovered stem cells exhibited excellent proliferation and multilineage differentiation into osteocytes, chondrocytes, and adipocytes. To conclude, the PEG-PA (5000-500) block copolymer is suggested to be a promising antifreezing cryoprotectant for stem cells.

5.
PLoS One ; 15(11): e0235239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166292

RESUMO

Although rotator cuff disease is a common cause of shoulder pain, there is still no treatment method that could halt or reveres its development and progression. The purpose of this study was to investigate the efficacy of umbilical cord-derived mesenchymal stem cells (UC MSCs) on the regeneration of a full-thickness rotator cuff defect (FTD) in a rat model. We injected either UC MSCs or saline to the FTD and investigated macroscopic, histological and biomechanical results and cell trafficking. Treatment with UC MSCs improved macroscopic appearance in terms of tendon thickness at two weeks, and inflammation, defect size, swelling/redness and connection surrounding tissue and slidability at four weeks compared to the saline group. Histologically, UC MSCs induced the tendon matrix formation recovering collagen organization, nuclear aspect ratio and orientation angle of fibroblast as well as suppressing cartilage-related glycosaminoglycan compared to saline group at four weeks. The UC MSCs group also improved ultimate failure load by 25.0% and 19.0% and ultimate stress by 27.3% and 26.8% at two and four weeks compared to saline group. UC MSCs labeled with PKH26 exhibited 5.3% survival at four weeks compared to three hours after injection. This study demonstrated that UC MSCs regenerated the FTD with tendon tissue similar properties to the normal tendon in terms of macroscopic, histological and biomechanical characteristics in a rat model.


Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/citologia , Regeneração , Lesões do Manguito Rotador/terapia , Traumatismos dos Tendões/terapia , Animais , Fenômenos Biomecânicos , Masculino , Ratos , Ratos Sprague-Dawley , Lesões do Manguito Rotador/patologia , Traumatismos dos Tendões/patologia
6.
Stem Cell Res Ther ; 11(1): 387, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894193

RESUMO

BACKGROUND: It is difficult to immediately use mesenchymal stem cells (MSCs) for the patient with rotator cuff disease because isolation and culture time are required. Thus, the MSCs would be prepared in advanced in cryopreserved condition for an "off-the-shelf" usage in clinic. This study investigated the efficacy of freshly thawed MSCs on the regeneration of a full-thickness tendon defect (FTD) of rotator cuff tendon in a rat model. METHODS: We evaluated morphology, viability, and proliferation of cultured umbilical cord-derived MSCs (C-UC MSCs) and freshly thawed umbilical cord-derived MSCs (T-UC MSCs) at passage 10 in vitro. In animal experiments, we created a FTD in the supraspinatus of rats and injected the injured tendon with saline, cryopreserved agent (CPA; control), C-UC MSCs, and T-UC MSCs, respectively. Two and 4 weeks later, macroscopic, histological, biomechanical, and cell trafficking were evaluated. T test and ANOVA were used with SPSS. Differences with p < .05 were considered statistically significant. RESULTS: T-UC MSCs had fibroblast-like morphology and showed greater than 97% viability and stable proliferation comparable to the C-UC MSCs at passage 10. In animal experiments, compared with the control group, the macroscopic appearance of the T-UC MSCs was more recovered at 2 and 4 weeks such as inflammation, defect size, neighboring tendon, swelling/redness, the connecting surrounding tissue and slidability. Histologically, the nuclear aspect ratio, orientation angle of fibroblasts, collagen organization, and fiber coherence were improved by 33.33%, 42.75%, 1.86-fold, and 1.99-fold at 4 weeks, and GAG-rich area decreased by 88.13% and 94.70% at 2 and 4 weeks respectively. Further, the T-UC MSCs showed enhanced ultimate failure load by 1.55- and 1.25-fold compared with the control group at both 2 and 4 weeks. All the improved values of T-UC MSCs were comparable to those of C-UC MSCs. Moreover, T-UC MSCs remained 8.77% at 4 weeks after injury, and there was no significant difference between C-UC MSCs and T-UC MSCs. CONCLUSIONS: The morphology, viability, and proliferation of T-UC MSCs were comparable to those of C-UC MSCs. Treatment with T-UC MSCs could induce tendon regeneration of FTD at the macroscopic, histological, and biomechanical levels comparable to treatment with C-UC MSCs.


Assuntos
Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Lesões do Manguito Rotador , Animais , Humanos , Ratos , Manguito Rotador , Tendões , Cordão Umbilical
7.
Clin Infect Dis ; 69(Suppl 6): S449-S458, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31665776

RESUMO

BACKGROUND: Antimicrobial resistance (AMR) is a major global health concern, yet, there are noticeable gaps in AMR surveillance data in regions such as sub-Saharan Africa. We aimed to measure the prevalence of extended-spectrum ß-lactamase (ESBL) producing Gram-negative bacteria in bloodstream infections from 12 sentinel sites in sub-Saharan Africa. METHODS: Data were generated during the Typhoid Fever Surveillance in Africa Program (TSAP), in which standardized blood cultures were performed on febrile patients attending 12 health facilities in 9 sub-Saharan African countries between 2010 and 2014. Pathogenic bloodstream isolates were identified at the sites and then subsequently confirmed at a central reference laboratory. Antimicrobial susceptibility testing, detection of ESBL production, and conventional multiplex polymerase chain reaction (PCR) testing for genes encoding for ß-lactamase were performed on all pathogens. RESULTS: Five hundred and five pathogenic Gram-negative bloodstream isolates were isolated during the study period and available for further characterization. This included 423 Enterobacteriaceae. Phenotypically, 61 (12.1%) isolates exhibited ESBL activity, and genotypically, 47 (9.3%) yielded a PCR amplicon for at least one of the screened ESBL genes. Among specific Gram-negative isolates, 40 (45.5%) of 88 Klebsiella spp., 7 (5.7%) of 122 Escherichia coli, 6 (16.2%) of 37 Acinetobacter spp., and 2 (1.3%) of 159 of nontyphoidal Salmonella (NTS) showed phenotypic ESBL activity. CONCLUSIONS: Our findings confirm the presence of ESBL production among pathogens causing bloodstream infections in sub-Saharan Africa. With few alternatives for managing ESBL-producing pathogens in the African setting, measures to control the development and proliferation of AMR organisms are urgently needed.


Assuntos
Bactérias Gram-Negativas/patogenicidade , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/epidemiologia , Adolescente , Adulto , África ao Sul do Saara/epidemiologia , Antibacterianos/farmacologia , Criança , Pré-Escolar , Farmacorresistência Bacteriana Múltipla/genética , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/enzimologia , Humanos , Lactente , Recém-Nascido , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Vigilância de Evento Sentinela , Adulto Jovem , beta-Lactamases
8.
Clin Infect Dis ; 69(Suppl 6): S483-S491, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31665778

RESUMO

BACKGROUND: Clearly differentiating causes of fever is challenging where diagnostic capacities are limited, resulting in poor patient management. We investigated acute febrile illness in children aged ≤15 years enrolled at healthcare facilities in Butajira, Ethiopia, during January 2012 to January 2014 for the Typhoid Fever Surveillance in Africa Program. METHODS: Blood culture, malaria microscopy, and blood analyses followed by microbiological, biochemical, and antimicrobial susceptibility testing of isolates were performed. We applied a retrospectively developed scheme to classify children as malaria or acute respiratory, gastrointestinal or urinary tract infection, or other febrile infections and syndromes. Incidence rates per 100 000 population derived from the classification scheme and multivariate logistic regression to determine fever predictors were performed. RESULTS: We rarely observed stunting (4/513, 0.8%), underweight (1/513, 0.2%), wasting (1/513, 0.2%), and hospitalization (21/513, 4.1%) among 513 children with mild transient fever and a mean disease severity score of 12 (95% confidence interval [CI], 11-13). Blood cultures yielded 1.6% (8/513) growth of pathogenic agents; microscopy detected 13.5% (69/513) malaria with 20 611/µL blood (95% CI, 15 352-25 870) mean parasite density. Incidences were generally higher in children aged ≤5 years than >5 to ≤15 years; annual incidences in young children were 301.3 (95% CI, 269.2-337.2) for malaria and 1860.1 (95% CI, 1778.0-1946.0) for acute respiratory and 379.9 (95% CI, 343.6-420.0) for gastrointestinal tract infections. CONCLUSIONS: We could not detect the etiological agents in all febrile children. Our findings may prompt further investigations and the reconsideration of policies and frameworks for the management of acute febrile illness.


Assuntos
Monitoramento Epidemiológico , Febre/epidemiologia , Febre/etiologia , Febre Tifoide/epidemiologia , Doença Aguda , Adolescente , Hemocultura , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Instalações de Saúde , Humanos , Lactente , Malária/epidemiologia , Masculino , Estudos Prospectivos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Estudos Retrospectivos , Febre Tifoide/sangue
9.
Clin Infect Dis ; 69(Suppl 6): S474-S482, 2019 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-31665783

RESUMO

BACKGROUND: Robust household sampling, commonly applied for population-based investigations, requires sampling frames or household lists to minimize selection bias. We have applied Google Earth Pro satellite imagery to constitute structure-based sampling frames at sites in Pikine, Senegal; Pietermaritzburg, South Africa; and Wad-Medani, Sudan. Here we present our experiences in using this approach and findings from assessing its applicability by determining positional accuracy. METHODS: Printouts of satellite imagery combined with Global Positioning System receivers were used to locate and to verify the locations of sample structures (simple random selection; weighted-stratified sampling). Positional accuracy was assessed by study site and administrative subareas by calculating normalized distances (meters) between coordinates taken from the sampling frame and on the ground using receivers. A higher accuracy in conjunction with smaller distances was assumed. Kruskal-Wallis and Dunn multiple pairwise comparisons were performed to evaluate positional accuracy by setting and by individual surveyor in Pietermaritzburg. RESULTS: The median normalized distances and interquartile ranges were 0.05 and 0.03-0.08 in Pikine, 0.09 and 0.05-0.19 in Pietermaritzburg, and 0.05 and 0.00-0.10 in Wad-Medani, respectively. Root mean square errors were 0.08 in Pikine, 0.42 in Pietermaritzburg, and 0.17 in Wad-Medani. Kruskal-Wallis and Dunn comparisons indicated significant differences by low- and high-density setting and interviewers who performed the presented approach with high accuracy compared to interviewers with poor accuracy. CONCLUSIONS: The geospatial approach presented minimizes systematic errors and increases robustness and representativeness of a sample. However, the findings imply that this approach may not be applicable at all sites and settings; its success also depends on skills of surveyors working with aerial data. Methodological modifications are required, especially for resource-challenged sites that may be affected by constraints in data availability and area size.


Assuntos
Coleta de Dados , Monitoramento Epidemiológico , Características da Família , Sistemas de Informação Geográfica , Imagens de Satélites , Febre Tifoide/epidemiologia , Confiabilidade dos Dados , Humanos , Senegal/epidemiologia , África do Sul/epidemiologia , Sudão/epidemiologia
10.
Nucl Med Mol Imaging ; 53(1): 64-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30828403

RESUMO

Purpose: There is substantial need for optimizing radiation protection in nuclear medicine imaging studies. However, the diagnostic reference levels (DRLs) have not yet been established for nuclear medicine imaging studies in Korea. Materials and Methods: The data of administered activity in 32 nuclear medicine imaging studies were collected from the Korean Society of Nuclear Medicine (KSNM) dose survey database from 2013 and 2014. Through the expert discussions and statistical analyses, the 75th quartile value (Q3) was suggested as the preliminary DRL values. Preliminary DRLs were subjected to approval process by the KSNM Board of Directors and KSNM Council, followed by clinical applications and performance rating by domestic institutes. Results: DRLs were determined through 32 nuclear medicine imaging studies. The Q3 value was considered as appropriate selection as it was generally consistent with the most commonly administered activity. In the present study, the final version of initial DRL values for nuclear medicine imaging in Korean adults is described including various protocols of the brain and myocardial perfusion imaging. Conclusion: The first DRLs for nuclear medicine imaging in Korean adults were confirmed. The DRLs will enable optimized radiation protection in the field of nuclear medicine imaging in Korea.

11.
Neurosci Lett ; 696: 174-178, 2019 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-30593872

RESUMO

In this study, we attempted to examine the resting state functional connectivity (resting state FC) and its correlation with clinical features in depressed disorder patients with suicidal attempts (SA). A total of 32 individuals participated in this study: 12 depressive disorder patients with SA and 20 healthy controls were included. Resting state FC was investigated between the two groups by region of interest (ROI) to ROI analysis. Then seed to voxel analysis was performed using significant ROIs as a seed. The correlations of significant resting state FC with clinical data were analyzed. The connectivity of anterior division of right parahippocampus-posterior division of left parahippocampus (pPaHCl) and temporooccipital part of right inferior temporal gyrus-right frontal eye field of dorsal attention network (FEFrDAN) were significantly increased, while connectivity of medial frontal cortex (MedFC)-right supplementary motor cortex (SMAr) was significantly decreased in the patients (p-FDR [false discovery rate] <0.05). The patient group showed a stronger connectivity between the pPaHCl and a cluster of voxels in the right uncus as well as FEFrDAN and a cluster of voxels in the right fusiform gyrus (p-FDR <0.05). MedFC and SMAr connectivity showed a negative correlation to suicidal ideation (p-FDR = 0.018). These findings suggest a possible role of altered resting state FC among brain regions in neurobiology of depressive disorder and suicidal ideation.


Assuntos
Mapeamento Encefálico , Encéfalo/fisiopatologia , Transtorno Depressivo/psicologia , Descanso/psicologia , Tentativa de Suicídio/psicologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Rede Nervosa/fisiopatologia , Adulto Jovem
12.
BMJ Open ; 8(12): e021438, 2018 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-30573477

RESUMO

INTRODUCTION: The objective of the Health Population Africa (HPAfrica) study is to determine health behaviour and population-based factors, including socioeconomic, ethnographic, hygiene and sanitation factors, at sites of the Severe Typhoid Fever in Africa (SETA) programme. SETA aims to investigate healthcare facility-based fever surveillance in Burkina Faso, the Democratic Republic of the Congo, Ethiopia, Ghana, Madagascar and Nigeria. Meaningful disease burden estimates require adjustment for health behaviour patterns, which are assumed to vary among a study population. METHODS AND ANALYSIS: For the minimum sample size of household interviews required, the assumptions of an infinite population, a design effect and age-stratification and sex-stratification are considered. In the absence of a population sampling frame or household list, a spatial approach will be used to generate geographic random points with an Aeronautical Reconnaissance Coverage Geographic Information System tool. Printouts of Google Earth Pro satellite imagery visualise these points. Data of interest will be assessed in different seasons by applying population-weighted stratified sampling. An Android-based application and a web service will be developed for electronic data capturing and synchronisation with the database server in real time. Sampling weights will be computed to adjust for possible differences in selection probabilities. Descriptive data analyses will be performed in order to assess baseline information of each study population and age-stratified and sex-stratified health behaviour. This will allow adjusting disease burden estimates. In addition, multivariate analyses will be applied to look into associations between health behaviour, population-based factors and the disease burden as determined in the SETA study. ETHICS AND DISSEMINATION: Ethic approvals for this protocol were obtained by the Institutional Review Board of the International Vaccine Institute (No. 2016-0003) and by all collaborating institutions of participating countries. It is anticipated to disseminate findings from this study through publication on a peer-reviewed journal.


Assuntos
Comportamentos Relacionados com a Saúde , Higiene , Vigilância da População , Fatores Socioeconômicos , África ao Sul do Saara/epidemiologia , Estudos de Coortes , Estudos Transversais , Sistemas de Informação Geográfica , Humanos , Projetos de Pesquisa , Saneamento , Análise Espaço-Temporal , Febre Tifoide/epidemiologia
13.
Compr Psychiatry ; 87: 123-127, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30343247

RESUMO

OBJECTIVES: This study aimed to assess the immediate stress and psychological impact experienced by quarantined patients undergoing hemodialysis and university hospital workers who treated patients Middle East respiratory syndrome (MERS) during its outbreak. DESIGN: The group of subjects consisted of 1800 hospital practitioners and 73 quarantined patients undergoing hemodialysis. The Impact of Events Scale-Revised (IES-R) was administered to the practitioners twice, once during the hospital shutdown and again one month after the shutdown. The Mini International Neuropsychiatric Interview and Hospital Anxiety and Depression Scale were administered to patients undergoing hemodialysis. RESULTS: During the initial stages of the MERS outbreak, healthcare workers who performed MERS-related tasks scored significantly higher on the total IES-R and its subscales. In the second assessment of the high-risk group, the sleep and numbness subscale scores from the IES-R differed depending on the implementation of home quarantine, and the intrusion subscale scores differed depending on the performance of MERS-related tasks. CONCLUSION: Medical staff that performed MERS-related tasks showed the highest risk for post-traumatic stress disorder symptoms even after time had elapsed. The risk increased even after home quarantine. Prompt and continuous psychiatric intervention is needed in high mortality infectious disease outbreaks.


Assuntos
Infecções por Coronavirus/psicologia , Doenças Profissionais/psicologia , Recursos Humanos em Hospital/psicologia , Quarentena/psicologia , Diálise Renal/psicologia , Estresse Psicológico/virologia , Adulto , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Coronavírus da Síndrome Respiratória do Oriente Médio , Doenças Profissionais/virologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/virologia
14.
Korean J Fam Med ; 39(5): 279-283, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29972899

RESUMO

BACKGROUND: Epidemiological studies suggest that serum calcium levels correlate with cardiovascular events. An ankle-brachial index (ABI) between 0.9 and 1.00 is a surrogate estimation of preclinical peripheral arterial disease (PAD). Prior studies have shown that an ABI of 0.9-1.0 is also associated with endothelial dysfunction. Therefore, we sought to investigate the relationship between serum calcium levels and preclinical PAD in apparently healthy Korean individuals. METHODS: We evaluated the association between serum calcium levels and preclinical PAD in 596 participants (334 males, 262 females) in a health examination program. Preclinical PAD was defined by an ABI of 0.9-1.0. Multiple logistic regression analysis was used to determine whether the serum calcium level was an independent determinant of preclinical PAD. RESULTS: The overall prevalence of preclinical PAD was 14.3%. The mean age was 44.0±12.5 years in the non-PAD group and 48.3±11.4 years in the preclinical PAD group (P=0.001). After adjusting for age, gender, systolic blood pressure, fasting plasma glucose, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, g-glutamyltransferase, uric acid, hypertension medication, diabetes medication, and hyperlipidemia medication, the odds ratio (95% confidence intervals) for preclinical PAD was 2.28 (1.02-5.11) with a 1-mg/dL increase in the serum calcium. CONCLUSION: These findings suggest that increased serum calcium is independently and positively associated with preclinical PAD regardless of the presence of classic cardiovascular risk factors.

15.
J Med Food ; 21(6): 544-550, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29708804

RESUMO

Korean red ginseng (KRG), a heat-processed Korean ginseng (Panax ginseng C.A. Meyer), has been used as a traditional medicine for its beneficial effects on hyperglycemia. This study aimed to investigate whether the antidiabetic action of KRG in an animal model of type 2 diabetes mellitus (DM) is partly mediated by prevention of mitochondrial dysfunction and intracellular inflammation. Four-week-old C57BL/KsJ db/db mice (a genetic animal model of obese type 2 DM) and C57BL/KsJ db/+ mice were divided into three groups: db/+ mice (normoglycemic control group, n = 8), db/db mice (untreated DM group, n = 8), and db/db mice with KRG administration (KRG-treated DM group, n = 8). After 12 weeks, metabolic parameters of fasting blood glucose concentrations, hemoglobin A1c (HbA1c) level, insulin level, lipid profile, and leukocyte count were determined using high-performance liquid chromatography. Mitochondrial DNA (mtDNA) copy number and inflammatory marker (interleukin-6, cyclooxygenase-2, and C-reactive protein) expression levels were measured in skeletal muscle tissue using quantitative real-time PCR analysis. After 12 weeks of KRG treatment at 100 mg/kg, the fasting glucose, HbA1c, insulin, and low-density lipoprotein cholesterol concentrations were lower, whereas mtDNA copy numbers were higher in the KRG-treated DM group than in the untreated DM group. Compared with the untreated DM group, the messenger RNA expression levels of mitochondrial biogenesis-related transcription factors and inflammatory markers were lower in the KRG-treated DM group. In conclusion, KRG had a beneficial effect on the metabolic profile by preserving mitochondrial function and protecting against intracellular inflammation.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Panax/química , Extratos Vegetais/administração & dosagem , Animais , Proteína C-Reativa/imunologia , Ciclo-Oxigenase 2/genética , Ciclo-Oxigenase 2/imunologia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/imunologia , Modelos Animais de Doenças , Glucose/metabolismo , Hemoglobina A Glicada/metabolismo , Humanos , Interleucina-6/genética , Interleucina-6/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/imunologia
16.
BMC Infect Dis ; 18(1): 84, 2018 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-29463233

RESUMO

BACKGROUND: Oral cholera vaccine (OCV) is a feasible tool to prevent or mitigate cholera outbreaks. A better understanding of the vaccine's efficacy among different age groups and how rapidly its protection wanes could help guide vaccination policy. METHODS: To estimate the level and duration of OCV efficacy, we re-analyzed data from a previously published cluster-randomized, double-blind, placebo controlled trial with five years of follow-up. We used a Cox proportional hazards model and modeled the potentially time-dependent effect of age categories on both vaccine efficacy and risk of infection in the placebo group. In addition, we investigated the impact of an outbreak period on model estimation. RESULTS: Vaccine efficacy was 38% (95% CI: -2%,62%) for those vaccinated from ages 1 to under 5 years old, 85% (95% CI: 67%,93%) for those 5 to under 15 years, and 69% (95% CI: 49%,81%) for those vaccinated at ages 15 years and older. Among adult vaccinees, efficacy did not appear to wane during the trial, but there was insufficient data to assess the waning of efficacy among child vaccinees. CONCLUSIONS: Through this re-analysis we were able to detect a statistically significant difference in OCV efficacy when the vaccine was administered to children under 5 years old vs. children 5 years and older. The estimated efficacies are more similar to the previously published analysis based on the first two years of follow-up than the analysis based on all five years. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT00289224.


Assuntos
Vacinas contra Cólera/imunologia , Cólera/prevenção & controle , Administração Oral , Adolescente , Adulto , Criança , Pré-Escolar , Cólera/epidemiologia , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Lactente , Masculino , Efeito Placebo , Modelos de Riscos Proporcionais , Fatores de Risco , Resultado do Tratamento
17.
Psychiatry Res ; 259: 197-202, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29065368

RESUMO

Prenatal exposure to infectious or inflammatory insults can increase the risk of developing neuropsychiatric disorders such as bipolar disorder, autism, and schizophrenia in later life. Gamma-butyrobetaine hydroxylase (BBOX 1) is an enzyme responsible for the biosynthesis of l-carnitine, a key molecule in fatty acid metabolism. This cytosolic dimeric protein belongs to the dioxygenase family. In this study, we investigated whether BBOX 1 expression was related to psychiatric disorder in an animal model. We also conducted a case-control study using 284 schizophrenia patients and 409 controls with single-nucleotide polymorphisms (SNPs) in the 5'-near region of BBOX 1. BBOX 1 expression was increased in the medial frontal cortex of a mouse model of schizophrenia induced by maternal immune activation. Furthermore, the genotype and allele frequencies of two SNPs (rs7939644 and rs10767592) were significantly associated with schizophrenia susceptibility. Our results suggest that BBOX 1 might be associated with maternal immune activation and schizophrenia susceptibility. Therefore, it might be involved in the pathophysiology of schizophrenia.


Assuntos
Predisposição Genética para Doença/genética , Esquizofrenia/enzimologia , Esquizofrenia/genética , gama-Butirobetaína Dioxigenase/metabolismo , Animais , Estudos de Casos e Controles , Regulação para Baixo , Feminino , Lobo Frontal/metabolismo , Frequência do Gene , Genótipo , Humanos , Imunidade Ativa/genética , Masculino , Camundongos , Polimorfismo de Nucleotídeo Único , Esquizofrenia/imunologia
18.
Psychiatry Investig ; 15(12): 1174-1180, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30602107

RESUMO

OBJECTIVE: Structural changes of brain areas have been reported in depressive disorder and suicidal behavior (SB), in which TPH1 also has been known as a promising candidate gene. We investigated gray matter volume (GMV) differences, TPH1 rs1800532 and rs1799913 polymorphisms previously found to be associated with depressive disorder and SB, and the relationship between the two markers. METHODS: Thirteen depressive disorder patients with suicidal attempts (SA) and twenty healthy controls were included. We examined GMV differences using a voxel-based morphometry and regions of interest analysis. Direct sequencing was used for genotyping. RESULTS: The patients showed significant GMV reduction in left cerebral region including middle frontal gyrus, inferior frontal gyrus, and anterior cingulate cortex; in right middle temporal gyrus; in left cerebellar tonsil; and in right cerebral region including precentral gyrus and postcentral gyrus (corrected p<0.005). The right precentral and postcentral gyri GMV values of AA and CA genotypes patients were significantly decreased compared to those of CC genotype subjects (corrected p=0.040). CONCLUSION: These findings show the possibility that both GMV reductions and TPH1 rs1800532/rs1799913 A allele may be involved in the pathogenesis of depressive disorder patients with SA.

19.
Maturitas ; 103: 3-7, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28778329

RESUMO

OBJECTIVE: Serum ferritin, a marker of iron metabolism, has recently emerged as a biomarker of chronic low-grade inflammation. After menopause, there is a remarkable increase in insulin resistance (IR) and metabolic syndrome (MetS), which is increasingly being viewed as an inflammatory disease. Thus, we examined the associations of serum ferritin with insulin resistance and MetS in postmenopausal women. METHODS: A nationwide cross-sectional study was conducted to examine the relationship between serum ferritin and IR and MetS in 2734 postmenopausal women using data from the 2010-2012 Korean National Health and Nutrition Examination Survey. The odds ratios (ORs) and 95% confidence intervals (CIs) for insulin resistance (HOMA-IR≥75th percentile, 3.04) and MetS were calculated using multiple logistic regression analyses across serum ferritin quartiles (Q1,≤36.25; Q2, 36.56-56.56; Q3, 56.57-85.98; and Q4≥85.99ng/ml). RESULTS: The mean values of most cardiometabolic variables tended to increase proportionally with serum ferritin quartiles. The proportion of women with IR and MetS significantly increased in accordance with serum ferritin quartiles. Compared to individuals in the lowest quartile, the ORs (95% CIs) in the highest quartile were 2.06 (1.23-3.45) for IR and 1.92 (1.44-2.55) for MetS after adjusting for age, cigarette smoking, alcohol intake, and regular exercise. CONCLUSION: Serum ferritin levels were positively and independently associated with IR and MetS in postmenopausal women. These findings suggest that serum ferritin level in postmenopausal women may help to identify the presence of IR and MetS.


Assuntos
Ferritinas/sangue , Resistência à Insulina , Síndrome Metabólica/sangue , Pós-Menopausa/sangue , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Razão de Chances , República da Coreia
20.
J Exerc Nutrition Biochem ; 21(1): 7-12, 2017 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-28712260

RESUMO

PURPOSE: This study examined the effects of an integrated health care program in elementary school students. METHODS: The integrated program comprised exercises (3-4 times/week) and six sessions on nutritional and psychological education. Anthropometric measurements were recorded before the intervention. Additionally, physical fitness, dietary habits, nutrition knowledge, and psychological changes were assessed before and after the program. RESULTS: In total, 29% of the subjects were overweight and obese before the intervention (32% boys and 26% girls). There was a significant increase in flexibility, endurance, and cardiovascular endurance after the implementation of the program. Additionally, as a result of the program, participants showed improvement in nutrition knowledge and dietary habits. After the training, children tended to exhibit increased self-efficacy and lower stress, but the findings were not statistically significant. CONCLUSION: Implementation of an integrated health care program for the prevention and treatment of obesity could have a positive impact on children's health. It is hoped that continued research on the long-term effects of such programs is conducted along with the development of various programs.

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