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1.
Front Public Health ; 9: 630620, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33692982

RESUMO

The outbreak of coronavirus disease-2019 (COVID-19) ineluctably caused social distancing and unemployment, which may bring additional health risks for patients with cancer. To investigate the association of the pandemic-related impacts with the health-related quality of life (HRQoL) among patients with melanoma during the COVID-19 pandemic, we conducted a cross-sectional study among Chinese patients with melanoma. A self-administered online questionnaire was distributed to melanoma patients through social media. Demographic and clinical data, and pandemic-related impacts (unemployment and income loss) were collected. HRQoL was determined by the Functional Assessment of Cancer Therapy-General (FACT-G) and its disease-specific module (the melanoma subscale, MS). A total of 135 patients with melanoma completed the study. The mean age of the patients was 55.8 ± 14.2 years, 48.1% (65/135) were male, and 17.04% (34/135) were unemployed since the epidemic. Unemployment of the patients and their family members and income loss were significantly associated with a lower FACT-G score, while the MS score was associated with the unemployment of the patients' family members. Our findings suggested that unemployment is associated with impaired HRQoL in melanoma patients during the COVID-19 epidemic.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , /psicologia , Melanoma/economia , Melanoma/psicologia , Qualidade de Vida/psicologia , Desemprego/psicologia , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Melanoma/epidemiologia , Pessoa de Meia-Idade , Pandemias , Inquéritos e Questionários , Desemprego/estatística & dados numéricos
2.
Aging (Albany NY) ; 13(6): 7758-7766, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33735836

RESUMO

The recent outbreak of COVID-19 in the world is currently a big threat to global health and economy. Convalescent plasma has been confirmed effective against the novel corona virus in preliminary studies. In this paper, we first described the therapeutic schedule, antibody detection method, indications, contraindications of the convalescent plasmas and reported the effectiveness of convalescent plasma therapy by a retrospective cohort study.


Assuntos
/terapia , Anticorpos Antivirais/sangue , Humanos , Imunização Passiva , Estudos Retrospectivos , /isolamento & purificação
3.
Artigo em Inglês | MEDLINE | ID: mdl-33786532

RESUMO

Background: Women with a history of certain adverse outcomes in pregnancy (preterm birth, delivery of a small-for-gestational age [SGA] infant, preeclampsia, and gestational diabetes mellitus [GDM]) have an elevated lifetime prevalence of metabolic syndrome (MetS) and cardiovascular disease, compared with their peers. However, it is not known if MetS precedes the index pregnancy in young, nulliparous women who experience these antepartum outcomes. Thus, we sought to evaluate the relationship between pregravid cardiovascular risk factor profile and these pregnancy outcomes in low-risk women. Methods: In this prospective preconception cohort study, 1183 newly married women underwent systematic assessment of cardiovascular risk factors (anthropometry, blood pressure, lipids, glucose) at median 24.7 weeks before pregnancy, whereupon they were followed for the outcomes of preterm birth, SGA delivery, preeclampsia, and GDM. Results: Women who had pregravid MetS (harmonized definition) (n = 49) were more likely to have a Caesarean delivery than their peers (61.4% vs. 38.6%, p = 0.003). However, they did not have a higher incidence of preterm delivery, SGA, preeclampsia, or GDM. Similarly, women who had at least one of these adverse pregnancy outcomes (n = 141) did not have a higher prevalence of MetS or any of its component disorders before pregnancy. Indeed, before pregnancy, there were no significant differences between these women and their peers in waist circumference, body mass index, blood pressure, fasting glucose, triglycerides, low-density-lipoprotein, or high-density-lipoprotein cholesterol. Conclusions: The adverse cardiovascular risk factor profile that is seen in women with a history of preterm birth, SGA, preeclampsia, or GDM does not necessarily manifest before their pregnancy.

4.
Clin Chim Acta ; 517: 66-73, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33639119

RESUMO

BACKGROUND: We investigated the dynamic changes in lipid profiles and their correlations with disease severity and clinical outcome in patients with severe COVID-19. METHODS: We retrospectively reviewed 519 severe COVID-19 patients with confirmed outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between 29 January and 8 April 2020. RESULTS: Altogether, 424 severe COVID-19 patients, including 34 non-survivors and 390 survivors, were included in the final analyses. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) showed an increasing trend in survivors, but showed a downward trend in non-survivors. The serum concentrations of HDL-C and apoA-I were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors, and disease severity scores. For in-hospital deaths, the areas under the receiver operating characteristic curves (AUCs) of the ratios of CRP/HDL-C and CRP/apoA-I at admission were 0.84 and 0.83, respectively. Moreover, patients with high ratios of CRP/HDL-C (>77.39) or CRP/apoA-I (>72.37) had higher mortality rates during hospitalization (log-rank p < 0.001). Logistic regression analysis demonstrated that hypertension, lactate dehydrogenase, SOFA score, and High CRP/HDL-C ratio were independent predictors of in-hospital mortality. CONCLUSIONS: During severe COVID-19, HDL-C and apoA-I concentrations are dramatically decreased in non-survivors. Moreover, High CRP/HDL-C ratio is significantly associated with an increase in mortality and a poor prognosis.


Assuntos
Metabolismo dos Lipídeos , Idoso , Apolipoproteína A-I/sangue , Proteína C-Reativa/análise , /mortalidade , China , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
Ecotoxicol Environ Saf ; 211: 111881, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33444878

RESUMO

BACKGROUND: Cadmium is the most prevalent form of heavy metal contaminant globally and its exposure rises serious health concern. Chronic exposure to cadmium causes immune disturbances. However, few studies have addressed how it affects circulating immune cells, one of the most essential elements for the host defense system, at both population and molecular level. Therefore, this is the first single-cell transcriptomic analysis of the response of the human circulating immune system to plasma cadmium level. METHODS: We conducted a cross-sectional study in Hunan province, which has the highest level of cadmium land contamination in China. A total of 3283 individuals were eligible for analyzing the association between plasma cadmium levels and the monocyte counts and its subgroups. Another 780 individuals were assigned for validation. Thirty propensity-matched individuals without chronic disease from the lowest- and highest-quartile groups according to serum cadmium levels were selected for single-cell RNA sequencing (scRNA-seq) and flow cytometry analyses. Moreover, the monocyte phenotypic alterations in the heavy metal-exposed population were validated with a cecal ligation and puncture sepsis mouse model. RESULTS: From August 2016 to July 2017, we conducted a cross-sectional study to identify phenotypic alterations in peripheral immune cells in cadmium polluted areas in China. Monocyte percentages were negatively associated with plasma cadmium levels in multivariable linear regression analysis. Peripheral blood mononuclear cell scRNA-seq revealed that the CD14+ monocyte subset was dramatically reduced in the highest-quartile cadmium-exposed group. Moreover, we assessed different hallmarks of immune cell dysfunction-such as host defense capability, apoptotic signaling, cellular diversity and malignant gene expression in monocytes. Importantly, cadmium induced phenotypic alterations in the immune system were validated in the cecal ligation and puncture sepsis mouse model, in which chronic exposure to cadmium not only increased the death rate but also decreased monocyte numbers and the ability to clear bacterial infections. CONCLUSION: This transcriptomic analysis provides molecular information about how the most important hallmarks of immune cell dysfunction are affected by plasma cadmium level. The significant phenotypic alterations in monocytes serving as early indicators of increased susceptibility to infectious and malignant diseases.


Assuntos
Cádmio/toxicidade , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/toxicidade , Monócitos/efeitos dos fármacos , China , Estudos Transversais , Citometria de Fluxo , Humanos , Contagem de Leucócitos , Leucócitos Mononucleares , Masculino , Monócitos/citologia , Transcriptoma
7.
J Matern Fetal Neonatal Med ; 34(2): 293-299, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30935270

RESUMO

Objectives: Previous studies examined the association of maternal race with pregnancy outcomes. The study aimed to examine the effects of maternal, paternal, and parental race on intertwin birth weight discordance.Methods: We used the 2011-2015 multiple birth files of the USA for this study. The exposure variable of this study was parental race and intertwin birthweight discordance >25% was the outcome. In addition to separately analyzing maternal and paternal races, we assessed the effect of the combined race after grouping the participants into nine groups based on the race of both parents.Results: A total of 203,872 pairs of twins were included in the final analysis. The overall incidence of intertwin birthweight discordance in this population was 7.8%. Birthweight discordance was significantly associated with maternal, paternal, and parental races. Twins born to Black parents had significant risks of developing birthweight discordance than twins born to White parents (adjusted OR = 1.11, 95% CI: 1.06-1.17 for Black mothers and Black fathers). Combined parental race showed that compared to twins born to both parents Whites, twins born to both parents Blacks had a significantly elevated risk of developing birthweight discordance (adjusted OR = 1.13, 95% CI: 1.07-1.18). No significant difference in the risk of developing birthweight discordance was found for other parental race groups, same race or different race parents.Conclusions: Twins born to Black mothers, fathers, or both parents had significant risks of developing intertwin birthweight discordance than twins born to White mothers, fathers, or both parents.

8.
Mol Cell Endocrinol ; : 111097, 2020 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-33278491

RESUMO

BACKGROUND: Coronavirus disease (COVID-19) has resulted in considerable morbidity and mortality worldwide. Thyroid hormones play a key role in modulating metabolism and the immune system. However, the prevalence of thyroid dysfunction (TD) and its association with the prognosis of COVID-19 have not yet been elucidated. In this study, we seek to address this gap and understand the link between TD and COVID-19. METHODS: Herein, we enrolled patients who were hospitalised with COVID-19 and had normal or abnormal thyroid function test results at the West Court of Union Hospital in Wuhan, China, between 29 January and 26 February 2020. We carried out follow up examinations until 26 April 2020. Data on clinical features, treatment strategies, and prognosis were collected and analysed. TD was defined as an abnormal thyroid function test result, including overt thyrotoxicosis, overt hypothyroidism, subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroid sick syndrome. RESULTS: A total of 25 and 46 COVID-19 patients with and without TD, respectively, were included in the study. COVID-19 patients with TD had significantly higher neutrophil counts and higher levels of C-reactive protein, procalcitonin, lactate dehydrogenase, serum creatine kinase, aspartate transaminase, and high-sensitive troponin I and a longer activated partial thromboplastin time but lower lymphocyte, platelet, and eosinophil counts. A longitudinal analysis of serum biomarkers showed that patients with TD presented persistently high levels of biomarkers for inflammatory response and cardiac injury. COVID-19 patients with TD were more likely to develop a critical subtype of the disease. Patients with TD had a significantly higher fatality rate than did those without TD during hospitalisation (20% vs 0%, P<0.0001). Patients with TD were more likely to stay in the hospital for more than 28 days than were those without TD (80% vs 56.52%, P=0.048). CONCLUSIONS: Our preliminary findings suggest that TD is associated with poor outcomes in patients with COVID-19.

9.
Neurotoxicology ; 82: 100-107, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33249123

RESUMO

BACKGROUND: The influence of chronic arsenic exposure on cognitive impairment has been explored broadly by previous studies. However, most of them focused mainly on children rather than adults. In addition, in China, studies in this field are not sufficient. To illustrate how long-term arsenic exposure affects cognitive function, we designed a cross-sectional study involving 1556 adults. METHODS: All of them came from three locations around the Realgar Plant. The cognitive function of the participants was evaluated using a Chinese version of the Mini-mental state Examination (MMSE). The participants' internal arsenic exposure status (hair arsenic concentrations) and the external arsenic exposure status (the distance between the participants' location of residence and the Realgar Plant) were measured. RESULTS: Our research revealed that both of hair arsenic concentrations and the prevalence of arsenicosis, two important indexes, were significantly higher in the cognitive-impaired (CI) group than in the cognitive-normal (CN) group (P < 0.05). In addition, distance from the Realgar Plant was positively correlated with the MMSE scores and was negatively correlated with the prevalence of cognitive impairment. Moreover, our results demonstrated that there was a negative correlation between hair arsenic concentrations and MMSE scores. We conducted a two-level Logistic regression analysis and further confirmed that even after adjusting for potential confounding variables, arsenicosis retained a risk factor for cognitive impairment (odds ratio (OR) = 1.84, P < 0.05). CONCLUSIONS: Our results indicated that chronic arsenic exposure could impair adults' cognitive function in a dose-dependent manner. Additionally, arsenicosis could be an independent risk factor for cognitive impairment.

10.
Aging (Albany NY) ; 12(21): 20982-20996, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33170150

RESUMO

Elderly patients with coronavirus disease 2019 (COVID-19) are more likely to develop severe or critical pneumonia, with a high fatality rate. To date, there is no model to predict the severity of COVID-19 in elderly patients. In this study, patients who maintained a non-severe condition and patients who progressed to severe or critical COVID-19 during hospitalization were assigned to the non-severe and severe groups, respectively. Based on the admission data of these two groups in the training cohort, albumin (odds ratio [OR] = 0.871, 95% confidence interval [CI]: 0.809 - 0.937, P < 0.001), d-dimer (OR = 1.289, 95% CI: 1.042 - 1.594, P = 0.019) and onset to hospitalization time (OR = 0.935, 95% CI: 0.895 - 0.977, P = 0.003) were identified as significant predictors for the severity of COVID-19 in elderly patients. By combining these predictors, an effective risk nomogram was established for accurate individualized assessment of the severity of COVID-19 in elderly patients. The concordance index of the nomogram was 0.800 in the training cohort and 0.774 in the validation cohort. The calibration curve demonstrated excellent consistency between the prediction of our nomogram and the observed curve. Decision curve analysis further showed that our nomogram conferred significantly high clinical net benefit. Collectively, our nomogram will facilitate early appropriate supportive care and better use of medical resources and finally reduce the poor outcomes of elderly COVID-19 patients.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33038239

RESUMO

OBJECTIVES: We sought to systematically investigate the effectiveness of secukinumab in psoriatic arthritis (PsA) patients who previously received TNFs inhibitor (TNFi) treatment and those who were TNFi naïve. METHODS: Databases (PubMed, EMBase and Cochrane library) and ClinicalTrials.gov were searched from inception to 22 May 2020 for randomized control trails and observational studies of secukinumab, with or without a history of previous anti-TNFi treatment, in PsA. Effectiveness data were extracted and combined using a random-effects meta-analysis. The ACR20 and ACR50 (20% and 50% improvement in American College of Rheumatology response criteria) responses were the endpoints. RESULTS: Six randomized controlled trials that reported the effectiveness of secukinumab by previous anti-TNFi treatment were included. Among patients exposed to a prior anti-TNFi treatment (n = 738), 33.7% (249/738) of patients achieved an ACR20 response. In contrast, in the anti-TNFi-naïve group (n = 1754), 49.8% (873/1754) of patients achieved an ACR20 response. Prior treatment with anti-TNFi was significantly associated with a poorer response to secukinumab compared with the anti-TNFi-naïve group with an effect size of 2.09 (95% CI: 1.69, 2.58). CONCLUSION: Some patients benefit from switching from TNFi to secukinumab, but previous anti-TNFi treatment is associated with poorer effectiveness of secukinumab.

12.
Sci Rep ; 10(1): 17400, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-33060809

RESUMO

Smoking has been identified as a risk factor for atopic dermatitis and hand eczema, but less is known about the association of exposure to second-hand smoke (SHS) with hand eczema. The study aimed to investigate the association of SHS exposure with hand eczema and atopic dermatitis in a group of adolescents. We conducted a cross-sectional study among first-year college students. SHS exposure was measured by a self-administered questionnaire. Skin diseases were diagnosed by dermatologists in the field survey. Mixed models were used to estimate the associations. A total of 20,129 participants that underwent skin examination and a questionnaire survey were included in the analyses. The prevalence rates of atopic dermatitis and hand eczema were 3.86% and 3.35%, respectively. Crude and adjusted estimates consistently showed that exposure to SHS was significantly associated with atopic dermatitis and hand eczema in a dose-response manner. Attention deficit/hyperactivity disorder mediated minimal or no effect of SHS on hand eczema and atopic dermatitis. Subgroup analysis by type of hand eczema, and sensitivity analysis by excluding data with center effect showed consistent results. Exposure to SHS is an independent but modifiable risk factor for hand eczema and atopic dermatitis in adolescents.

13.
Chemosphere ; 264(Pt 2): 128505, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33068969

RESUMO

We sought to evaluate whether essential and toxic metals are cross-sectionally related to blood lipid levels using data among adults from Shimen (n = 564) and Huayuan (n = 637), two counties with different exposure profiles in Hunan province of China. Traditional and grouped weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were performed to assess association between exposure to a mixture of 22 metals measured in urine or plasma, and lipid markers. Most of the exposure levels of metals were significantly higher in Shimen area than those in Huayuan area (all P-values < 0.001). Traditional WQS regression analyses revealed that the WQS index were both significantly associated with lipid markers in two areas, except for the HDL-C. Grouped WQS revealed that essential metals group showed significantly positive associations with lipid markers except for HDL-C in Huayuan area, while toxic metals group showed significantly negative associations except for HDL-C and LDL-C in Huayuan area. There were no significant joint effects, but potential non-linear relationships between metals mixture and TC or LDL-C levels were observed in BKMR analyses. Although consistent significantly associations of zinc and titanium with TG levels were found in both areas, the metals closely related to other lipid markers were varied by sites. Additionally, the BKMR analyses revealed an inverse U shaped association of iron with LDL-C levels and interaction effects of zinc and cadmium on LDL-C in Huayuan area. The relationship between metal exposure and blood lipid were not identical against different exposure profiles.

14.
Biomed Res Int ; 2020: 6195975, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33015173

RESUMO

Purpose: Previous studies confirmed that chronic arsenic exposure could lead to pigmentary changes and hyperkeratosis. However, skin health-related quality of life (HRQoL) among people under lifetime arsenic exposure remains underappreciated. Our study is aimed at investigating several patient-reported outcomes in a population under chronic arsenic exposure. Patients and Methods. A cross-sectional study was conducted in communities in Shimen, China. Dermatologists performed skin examinations for participants. Patient-reported outcomes (PROs) included HRQoL, itch, sleep quality, and symptoms of anxiety and depression. The Dermatology Life Quality Index (DLQI) was used to measure skin HRQoL. The numerical rating scale (NRS) was used to measure the intensity of itching. Sleep disturbance was measured by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression were measured by two-item Generalized Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2), respectively. Results: A total of 464 participants suffering from arsenic-related skin lesions finished the assessment of DLQI. Pigmentary changes and arsenical keratosis were not associated with the patient-reported outcomes except PHQ-2. Hair arsenic exceeding 1 µg/g was associated with higher itch NRS and DLQI (P < 0.05). Itch NRS (adjusted ß = 0.80, 95% CI: 0.70-0.90, P < 0.01) and hair arsenic concentration (adjusted ß = 0.12, 95% CI: 0.01-0.24, P < 0.05) were independently associated with the DLQI. Conclusion: HRQoL, sleep quality, and mental wellbeing are impaired in residents under chronic arsenic exposure. Itching and hair arsenic are independent risk factors for impaired HRQoL.

15.
Patient Prefer Adherence ; 14: 1403-1409, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32884243

RESUMO

Purpose: The COVID-19 epidemic has caused difficulties in continuous treatment for patients with chronic diseases and resulted in nonadherence to treatment and adverse health outcomes. This study aimed to investigate the associations of nonadherence to treatment with patient-reported outcomes of psoriasis during the COVID-2019 epidemic. Methods: A cross-sectional study among Chinese patients with psoriasis was conducted through a web-based questionnaire survey during 25 Feb 2020 and 6 Mar 2020. Demographic and clinical data, nonadherence to treatment, and patient-reported outcomes were collected. The outcomes included deterioration of the disease condition, perceived stress, and symptoms of anxiety and depression. Logistic regression was used to investigate the associations. Results: A total of 926 questionnaires were collected. A total of 634 (68.5%) reported nonadherence to treatment, and worse adherence was found among patients receiving systemic treatment (adjusted odds ratio [AOR]: 2.67; 95% CI: 1.40-5.10) and topical treatment (AOR: 4.51; 95% CI: 2.66-7.65) compared to biological treatment. Nonadherence to treatment (less than two weeks and more than two weeks) was significantly associated with deterioration of psoriasis (aOR: 2.83 to 5.25), perceived stress (AOR: 1.86 to 1.57), and symptoms of anxiety (AOR: 1.42 to 1.57) and depression (AORs: 1.78). Subgroup analysis by treatment showed consistent results in general. Conclusion: Nonadherence to treatment was associated with the aggravation of psoriasis conditions, perceived stress, and symptoms of anxiety and depression.

16.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(4): 449-455, 2020 Apr 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879071

RESUMO

By searching the database of CNKI, Wanfang and PubMed, the prevalence and risk factors of atopic dermatitis, psoriasis, acne, and urticaria were relatively more investigated, which were the skin diseases of more concern in the current epidemiological study of skin diseases. Three national epidemiologic surveys reported that the prevalence of atopic dermatitis increased from 0.69% in 1998, to 3.07% in 2002, and 12.94% in 2014, respectively. The prevalence of psoriasis increased from 0.123% in 1984 to 0.47% in 2009 according to 2 national surveys. The prevalence of acne was 8.1% in a national investigation in 2008. Representative national prevalence data of urticaria is not available. Risk factors for these skin diseases are distinct. Atopic dermatitis, psoriasis, and urticaria are more related to environment and mental stress, while acne is more related to skin type and dietary factors. Owing to the heterogeneities in diagnostic methods used in the dermatoepidemiologic surveys (some of the diagnoses were self-reported) and a lack of follow ups, the reliability of data remained questionable, and the comparability across the surveys was difficult. As a result, it is necessary to conduct population-based cohort studies on skin diseases in China.


Assuntos
Acne Vulgar/epidemiologia , Dermatite Atópica , Psoríase/epidemiologia , Urticária , China/epidemiologia , Humanos , Prevalência , Reprodutibilidade dos Testes , Fatores de Risco
17.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(6): 665-672, 2020 Jun 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879123

RESUMO

OBJECTIVES: To evaluate residents' knowledge, attitude and behavior towards coronavirus disease 2019 (COVID-19) in Hunan Province, and to explore the factors influencing behaviors. METHODS: A self-designed questionnaire was used to conduct an online survey for 4 139 Hunan residents. The contents included general population information, residents' knowledge, attitude and practice to COVID-19. RESULTS: Mean scores of knowledge, attitude, and behavior were 29.82±3.16, 6.71±1.12, and 14.93±1.45, respectively. Residents had the highest score of major symptoms of COVID-19 (3.96±0.39), but the lowest was the main transmission routes (3.47±0.89). A total of 22.68% of the residents were very or relatively afraid of the outbreak, but 95.22% of the residents had confidence in defeating COVID-19. In behavior dimension, "handling of suspicious symptoms" had the lowest score (3.58±0.75). The behavior implementation rate of "keep the surfaces of household items clean" (80.50%), "doing more exercise, reasonable diet, working and resting regularly" (84.59%), and "avoid hand contacting with eyes, mouth or nose" (89.51%) were relatively low. Pearson correlation coefficient showed that the knowledge, attitude, and practices score were correlated with each other (knowledge vs behavior: r=0.366; knowledge vs attitude: r=0.041; attitude vs behavior: r=0.100; all P<0.05). Multiple linear regression analysis showed that the knowledge, attitude and behavior on COVID-19 were mostly influenced by education background (all P<0.05), and the independent factors affecting behavior included knowledge and attitude, gender, permanent residence, education background (all P<0.05). CONCLUSIONS: Residents in Hunan Province have a good knowledge, attitude, and behavior to COVID-19. Nevertheless there are still weak links to be improved in all dimensions. It is necessary to strengthen knowledge and behavior of family protection, and care for residents' psychological health, especially persons with low education degree, male and rural residents.


Assuntos
Infecções por Coronavirus/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pneumonia Viral/psicologia , Betacoronavirus , China , Humanos , Pandemias , Inquéritos e Questionários
18.
J Med Internet Res ; 22(9): e22288, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32845850

RESUMO

BACKGROUND: The outbreak of COVID-19 has profoundly influenced people's lifestyles; these impacts have varied across subgroups of people. The pandemic-related impacts on the health outcomes of people with dermatological conditions are unknown. OBJECTIVE: The aim of this paper was to study the association of COVID-19 pandemic-related impacts with health-related quality of life in patients with skin diseases. METHODS: This was a cross-sectional study among Chinese patients with skin diseases. A self-administered web-based questionnaire was distributed through social media. Demographic and clinical data and pandemic-related impacts (isolation status, income changes, and employment status) were collected. The main outcomes included perceived stress (Visual Analog Scale), symptoms of anxiety (Generalized Anxiety Disorder-7) and depression (9-Item Patient Health Questionnaire), quality of life (Dermatology Life Quality Index), and health utility mapping based on the EQ-5D-3L descriptive system. Multivariable logistic regression was used to investigate the associations. RESULTS: A total of 506 patients with skin diseases completed the survey. The mean age of the patients was 33.5 years (SD 14.0), and 217/506 patients (42.9%) were male. Among the 506 respondents, 128 (25.3%) were quarantined, 102 (20.2%) reported unemployment, and 317 (62.6%) reported decrease or loss of income since the pandemic. The pandemic-related impacts were significantly associated with impaired mental well-being and quality of life with different effects. Unemployment and complete loss of income were associated with the highest risks of adverse outcomes, with increases of 110% to 162% in the prevalence of anxiety, depression, and impaired quality of life. CONCLUSIONS: Isolation, income loss, and unemployment are associated with impaired health-related quality of life in patients with skin diseases during the COVID-19 pandemic.


Assuntos
Ansiedade/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Qualidade de Vida , Dermatopatias/complicações , Desemprego/psicologia , Adulto , China/epidemiologia , Infecções por Coronavirus/complicações , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Saúde Mental , Pandemias , Pneumonia Viral/complicações , Prevalência , Fatores Socioeconômicos
19.
Front Med (Lausanne) ; 7: 236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32626717

RESUMO

Background: Psoriasis is a chronic recurrent inflammatory disease involving many common mechanisms associated with obesity, such as systemic inflammation and vitamin D deficiency. This study aimed to examine the association of the serum concentration of 25-hydroxyvitamin D with psoriasis and the effect modification by obesity among the affected patients. Methods: A mixed cross-section study was conducted. We consecutively included untreated psoriasis patients from the outpatients who visited the Department of Dermatology of Xiangya Hospital and recruited 205 gender-matched healthy controls from the Hunan Civil Servant Cohort. In both groups, we measured the serum 25-hydroxyvitamin D level, body mass index (BMI), waist-hip-ratio (WHR) and other psoriasis-related clinical indicators. Results: A total of 203 psoriasis outpatients and 205 gender-matched cohort participants with complete data of serum vitamin D concentration were included in the analysis. The serum vitamin D levels of the two groups were close to each other, while the mean WHR of the psoriasis outpatients was significantly higher. Compared with the controls, the risk of psoriasis increased significantly when the vitamin D level decreased from 20 to 10 nmol/L. A significant interaction between the serum vitamin D level and the obesity category (BMI × WHR) was identified. After stratification by WHR, vitamin D was not associated with psoriasis in subjects with normal WHR. In contrast, the association between vitamin D deficiency and psoriasis retained and the effect size augmented in patients with central obesity. Conclusions: WHR may modify the association between serum vitamin D and psoriasis. Treatment advocating Vitamin D supplements may tailor to psoriasis patients with metabolic disorders.

20.
J Dermatolog Treat ; : 1-5, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32419530

RESUMO

Background: Targeted UVB and topical calcipotriene have frequently been used in the treatment of psoriasis, but the joint effect of calcipotriene and targeted UVB has been controversial.Objectives: The purpose of this study was to systematically evaluate whether the efficacy of the combined use of targeted UVB and calcipotriene is superior to the targeted UVB alone.Methods: We performed systematic review and meta-analysis of randomized controlled trials (RCTs) in patients with plaque-type psoriasis through searching the defined key words in the PubMed, EMBase, and Cochrane Central Register databases. Pooled mean difference of the Psoriasis Area and Severity Index (PASI) relative change (%) was estimated using a random effect model. The quality of included studies and publication bias were assessed using the Jadad scale and the Egger's test, respectively.Results: A total of five RCTs including 182 patients were included in the systematic review. The mean difference of the PASI relative change (%) between the combined therapy versus the targeted UVB alone was -22.68 (95%CI: -37.12 to -8.24; p = .002). Publication bias was not supported by the Egger's test (p = .424).Conclusion: Addition of calcipotriene ointment may improve the efficacy of the targeted UVB phototherapy in the treatment of plaque-type psoriasis.

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