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1.
Curr Med Res Opin ; : 1-22, 2021 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-34665066

RESUMO

OBJECTIVE: Complications affect the outcome of patients with cirrhosis. The favorable prognosis of patients with Wilson disease (WD)-related cirrhosis suggests that its complications differ from those of hepatitis B virus (HBV) infection-related cirrhosis. We aimed to delineate the differences in complications between WD-related and HBV-related cirrhosis. METHODS: The electronic-medical data from patients with WD-related and HBV-related cirrhosis were extracted and analyzed. RESULTS: In total, 211 patients with WD-related cirrhosis and 374 patients with HBV-related cirrhosis were enrolled. Most patients with WD progressed to cirrhosis <10 years after disease onset, whereas those with HBV infection often progressed after >10 years. Patients with WD-related cirrhosis had a markedly lower prevalence of ascites (8.5% vs. 38.5%), gastroesophageal varices/variceal bleeding (13.3% vs. 47.6%), renal impairment (0 vs. 7.6%) and primary liver cancer (0 vs. 39.3%; all P < 0.001) than those with HBV-related cirrhosis. After adjustment for potential confounders, patients with WD-related cirrhosis carried a lower risk of varices/variceal bleeding. CONCLUSIONS: Although patients with WD progressed to cirrhosis much faster, the prevalence of complications from WD-related cirrhosis was low. Patients with WD-related cirrhosis were less likely to develop gastroesophageal varices/variceal bleeding than those with HBV-related cirrhosis.

2.
Front Cell Infect Microbiol ; 11: 679624, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34458158

RESUMO

Background: Although transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients. Methods: The clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed. Results: WMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: -5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: -7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT via the lower gastrointestinal tract (ß = -8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (ß = -8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (ß = -8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples. Conclusion: WMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT via the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.


Assuntos
Hipertensão , Microbiota , Animais , Anti-Hipertensivos/farmacologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Humanos , Hipertensão/terapia , Estudos Retrospectivos
3.
World J Gastroenterol ; 27(26): 4248-4251, 2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34326624

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted health systems. Many guidelines on chronic liver diseases have been released to optimize the use of medical resources and patient management. However, most of these guidelines have been established through expert consensus because the existing data do not provide strong evidence for developing effective recommendations. As Wilson disease (WD) is a rare chronic liver disease, the impact of COVID-19 on the clinical status of patients with WD is unclear. The present study showed a marked shortage of medical resources for clinically managing patients with WD during the pandemic. Although patients with WD who consistently took anticopper therapy showed no significant differences in hepatic and extrahepatic markers before and after the pandemic, their complication incidences, especially the infection incidence, were significantly increased during the study period. Therefore, patients with WD should be encouraged to adhere to anticopper therapy and be closely monitored to prevent infections and other complications. The present study provides a clinical basis for further managing WD during the pandemic.


Assuntos
COVID-19 , Degeneração Hepatolenticular , Degeneração Hepatolenticular/diagnóstico , Degeneração Hepatolenticular/tratamento farmacológico , Degeneração Hepatolenticular/epidemiologia , Humanos , Pandemias , SARS-CoV-2
4.
Med Sci Monit ; 27: e928118, 2021 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-33678803

RESUMO

BACKGROUND Renal dysfunction is a leading cause of death in patients with acute pancreatitis (AP) and often occurs later than respiratory complications. Whether respiratory complications can predict renal impairment remains unclear. The aim of this study was to investigate the association between pleural effusion and renal dysfunction in AP. MATERIAL AND METHODS Medical records were reviewed from individuals who were hospitalized with AP from January 1, 2015 to December 31, 2019. The patients were divided into 2 groups, based on the presence or absence of pleural effusion on admission. Disease severity, renal function parameters, and outcomes were compared between the 2 groups. RESULTS A total of 222 patients were enrolled, 25 of whom had pleural effusion on admission and 197 who did not. Patients with AP who had pleural effusion had more serious illness (higher incidences of pancreatic inflammation, pancreatic fluid collection, and moderate-to-severe AP; worse Bedside Index for Severity in Acute Pancreatitis score; and a higher modified computed tomography severity index [all P<0.05]) plus worse outcomes (higher incidences of ventilation and vasopressor use [both P<0.05]). Moreover, patients with pleural effusion had a higher level of blood urea nitrogen and lower estimated glomerular filtration rate (both P<0.05). After adjustment for potential confounders, pleural effusion was a risk factor for renal failure in patients with AP (odds ratio 6.32, 95% confidence interval 1.08-36.78, P=0.040). CONCLUSIONS Pleural effusion is associated with severe renal dysfunction in AP. Therefore, efforts should be made to improve early recognition and timely treatment of renal failure by closely monitoring renal function in patients with AP and pleural effusion on admission.


Assuntos
Nefropatias/etiologia , Pancreatite/fisiopatologia , Derrame Pleural/fisiopatologia , Adulto , China/epidemiologia , Feminino , Humanos , Incidência , Nefropatias/complicações , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pancreatite/complicações , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos
5.
Int J Med Sci ; 17(10): 1345-1350, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32624691

RESUMO

Background: Patients with Wilson disease (WD) progress to cirrhosis at an early age but have good prognoses. This study aimed to delineate hepatic features in WD patients with or without cirrhosis. Methods: Medical data were retrospectively collected from 27 July 2015 to 27 June 2018. WD patients were divided into two groups based on whether or not they progressed to cirrhosis. Liver function, portal hypertension features and hematocytopenia rates were compared between groups. Results: The study enrolled 119 WD patients with cirrhosis and 53 WD patients without cirrhosis. There were no differences between groups for liver enzyme levels or incidence rates of Kayser-Fleischer ring (all P > 0.05). Ascites and hepatic encephalopathy were nearly absent in both groups, and almost all patients were Child-Pugh group A. However, WD-associated cirrhotic patients had a higher prothrombin time (beta = 0.908, P = 0.004) and international normalized ratio (beta = 0.089, P = 0.040), wider portal vein diameter (beta = 1.330, P < 0.001), and an increased risk of splenomegaly/splenectomy (odds ratio [OR] = 4.36, 95% confidence interval [CI]: 2.15-8.84, P < 0.001). Moreover, WD-associated cirrhotic patients have significantly increased risks of leukopenia (OR = 2.30, 95% CI: 1.00-5.25, P = 0.049) and thrombocytopenia (OR = 6.89, 95% CI: 2.01-23.59, P = 0.002). Conclusions: Despite presenting good outcomes, mild hepatocyte injury, and good hepatic metabolic function, WD-associated cirrhotic patients show more serious impairment of hepatic synthetic function, wider portal vein diameter, and higher risk of splenomegaly due to portal hypertension.


Assuntos
Degeneração Hepatolenticular/patologia , Degeneração Hepatolenticular/fisiopatologia , Adulto , Feminino , Humanos , Hipertensão Portal/patologia , Hipertensão Portal/fisiopatologia , Leucopenia/patologia , Leucopenia/fisiopatologia , Cirrose Hepática/patologia , Cirrose Hepática/fisiopatologia , Masculino , Prognóstico , Estudos Retrospectivos , Trombocitopenia/patologia , Trombocitopenia/fisiopatologia , Adulto Jovem
6.
Lupus ; 29(10): 1189-1197, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32635879

RESUMO

OBJECTIVE: The objective of this study was to explore the association between periodontitis and systemic lupus erythematosus (SLE). METHODS: To identify eligible studies, the PubMed, EMBASE and Web of Science databases were searched from inception to 19 September 2019. Associations of periodontitis, and other periodontal parameters, with SLE were assessed. RESULTS: Ten studies involving 80,633 subjects were included in this meta-analysis. Pooled data showed a significant association between periodontitis and SLE (odds ratio=5.32, 95% confidence interval (CI) 1.69-16.78, p = 0.004). In addition, SLE patients had a higher prevalence of bleeding on probing (mean difference = 0.03, 95% CI 0.00-0.06, p = 0.02) and higher mean clinical attachment loss (mean difference = 0.69, 95% CI 0.39-1.00, p < 0.001). However, there were no significant differences between SLE and reference subjects in mean plaque index, gingival index, pocket depth or decayed, missing or filled teeth. CONCLUSIONS: This study demonstrates a significant association between periodontitis and SLE, which indicates that avoidance of periodontitis by maintaining oral health may be a simple and economical way to prevent SLE.


Assuntos
Lúpus Eritematoso Sistêmico/complicações , Periodontite/complicações , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto Jovem
7.
Front Med (Lausanne) ; 7: 543698, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33585498

RESUMO

Background: Previous studies have indicated an association between hypertension and intestinal barrier dysfunction in mice models. The present study aims to investigate the association between hypertension and intestinal barrier impairment in humans and identify the novel potential risk factors for hypertension. Methods: Medical data from consecutive inpatients were retrospectively pooled from patient records. We compared intestinal barrier serum markers [diamine oxidase (DAO), lipopolysaccharide (LPS), and D-lactate] between those patients with and without hypertension. Moreover, the associations between intestinal barrier markers and cardiovascular risk, hypertension history, blood pressure control, hypertensive complications, and antihypertensive medication history were also analyzed. Results: Overall, 106 hypertensive and 251 normotensive subjects were included. Patients with hypertension had a higher level of DAO (28.30 vs. 18.73%, P = 0.044) and LPS (22.64 vs. 11.16%, P = 0.005). In hypertensive patients, multivariate logistic regression analyses showed that long hypertension history (≥20 years), poor control of diastolic blood pressure, cardiac and renal complications, and use of multiple antihypertensive medications were risk factors for elevated DAO, while the use of multiple antihypertensive medications was a risk factor for elevated D-lactate (P < 0.05). Conclusions: Hypertension is associated with impairment of intestinal barrier, especially in patients with long duration, poor blood pressure control, cardiac and renal complications, and use of multiple antihypertensive medications. The current study indicates that intestinal barrier dysfunction might be a potential predictor of hypertension.

8.
World J Gastroenterol ; 25(3): 378-387, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30686905

RESUMO

BACKGROUND: Cirrhosis is a chronic late stage liver disease associated with hepatitis viruses, alcoholism, and metabolic disorders, such as Wilson disease (WD). There are no clear markers or clinical features that define cirrhosis originating from these disparate origins. We hypothesized that cirrhosis is not one disease and cirrhosis of different etiology may have differential clinical hepatic features. AIM: To delineate the liver features between WD-associated cirrhosis and hepatitis B-associated cirrhosis in the Chinese population. METHODS: In this observational study, we reviewed the medical data of consecutive inpatients who had WD-associated cirrhosis or hepatitis B-associated cirrhosis from January 2010 to August 2018, and excluded patients who had carcinoma, severe heart or pulmonary diseases, or other liver diseases. According to the etiology of cirrhosis, patients were divided into two groups: WD-associated cirrhosis group (60 patients) and hepatitis B-associated cirrhosis group (56 patients). The liver fibrosis degree, liver function indices, and portal hypertension features of these patients were compared between the two groups. RESULTS: No inter-group differences were observed in the diagnostic liver fibrosis markers, however, clinical features clearly defined the origin of cirrhosis. WD-associated cirrhosis patients (16-29 years) had lower levels of alanine transaminase, aspartate transaminase, and bilirubin, lower prothrombin time, lower incidence of hepatic encephalopathy, and lower portal vein diameter (P < 0.05), compared to cirrhosis resulting from hepatitis B in older patients (45-62 years). Importantly, they had decreased risks of progression from Child-Pugh grade A to B (odds ratio = 0.046, 95% confidence interval: 0.006-0.387, P = 0.005) and of ascites (odds ratio = 0.08, 95% confidence interval: 0.01-0.48, P = 0.005). Conversely, WD-associated cirrhosis patients had a higher risk of splenomegaly (odds ratio = 4.15, 95% confidence interval: 1.38-12.45, P = 0.011). CONCLUSION: WD-associated cirrhosis presents a higher risk of splenomegaly associated with leukopenia and thrombocytopenia, although revealing milder liver dysfunction and portal hypertension symptoms, which recommends WD patients to be monitored for associated complications.


Assuntos
Hepatite B Crônica/complicações , Degeneração Hepatolenticular/complicações , Hipertensão Portal/etiologia , Cirrose Hepática/etiologia , Fígado/patologia , Adolescente , Adulto , Biomarcadores/análise , China/epidemiologia , Feminino , Hepatite B Crônica/sangue , Hepatite B Crônica/virologia , Degeneração Hepatolenticular/sangue , Humanos , Hipertensão Portal/sangue , Hipertensão Portal/diagnóstico por imagem , Leucopenia/epidemiologia , Leucopenia/etiologia , Fígado/irrigação sanguínea , Fígado/diagnóstico por imagem , Fígado/virologia , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/virologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Veia Porta/diagnóstico por imagem , Veia Porta/patologia , Estudos Retrospectivos , Esplenomegalia/diagnóstico por imagem , Esplenomegalia/epidemiologia , Esplenomegalia/etiologia , Trombocitopenia/epidemiologia , Trombocitopenia/etiologia , Adulto Jovem
9.
J Clin Pharm Ther ; 44(2): 209-215, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30332507

RESUMO

WHAT IS KNOWN AND OBJECTIVE: Mounting evidence suggests that long-term use of gastric-acid suppressants (GASs) may be associated with adverse effects. Whether GAS use increases the risk of enteric peritonitis in patients undergoing peritoneal dialysis (PD) is not known. The aim of this meta-analysis was to evaluate the association between GAS use and enteric peritonitis in PD patients. METHODS: We searched PubMed, Embase and Cochrane Library databases from inception to 23 January 2018 to identify eligible studies. The primary outcome was an association between GAS use and enteric peritonitis in PD patients. RESULTS AND DISCUSSION: Six studies involving 829 people were included in this meta-analysis. Pooled data showed that GAS use in PD patients was associated with an increased risk of enteric peritonitis (odds ratio [OR] = 1.27; 95% confidence interval [CI]: 1.02-1.57, I2  = 48%). Subgroup analyses based on GAS type revealed that histamine-2 receptor antagonists (H2 RAs) might increase the risk of enteric peritonitis in PD patients (OR = 1.40; 95% CI: 1.01-1.93; I2  = 8%), but proton pump inhibitors (PPIs) might not (1.13; 0.72-1.77; 6; 34%). WHAT IS NEW AND CONCLUSION: Gastric-acid suppressants use might be a risk factor for enteric peritonitis in PD patients. In particular, H2 RAs increased the risk of enteric peritonitis, but PPIs did not. Therefore, to prevent enteric peritonitis, H2 RAs should probably be prescribed with caution for PD patients.


Assuntos
Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Diálise Peritoneal/métodos , Peritonite/etiologia , Fármacos Gastrointestinais/administração & dosagem , Fármacos Gastrointestinais/efeitos adversos , Antagonistas dos Receptores H2 da Histamina/efeitos adversos , Humanos , Peritonite/epidemiologia , Inibidores da Bomba de Prótons/administração & dosagem , Inibidores da Bomba de Prótons/efeitos adversos , Fatores de Risco
10.
Front Biosci (Landmark Ed) ; 22: 1365-1378, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28199208

RESUMO

The purpose of this study was to assess the anti-tumor effects of macrophage migration inhibitory factor (MIF) siRNA on colorectal cancer in a mouse xenograft model. MIF specific siRNA (MIF siRNA) or a nonspecific control siRNA was introduced to murine colorectal cancer CT-26 cells. Mouse xenograft models of colorectal cancer were established. MIF siRNA, control siRNA or water was injected twice a week intravenously for 4 weeks. MIF siRNA inhibited the proliferation and migration, while induced apoptosis of CT-26 cells in vitro. Injection of MIF siRNA resulted in a significant decrease of serum MIF and VEGF levels, and the weight and volume of cecum-grafted tumors in vivo. In contrast, the number of apoptotic cells and caspase-3 expression were increased by MIF siRNA in cecum graft tumor tissues. Moreover, the water and fodder consumption were significantly improved by MIF siRNA treatment. Importantly, MIF siRNA reduced the hepatic metastases from colorectal cancer. Our results suggest that siRNA targeting MIF is a promising agent for the treatment of hepatic metastasis of colorectal cancer cells.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Oxirredutases Intramoleculares/antagonistas & inibidores , Neoplasias Hepáticas Experimentais/prevenção & controle , Neoplasias Hepáticas Experimentais/secundário , Fatores Inibidores da Migração de Macrófagos/antagonistas & inibidores , Animais , Antígenos de Diferenciação de Linfócitos B/genética , Antígenos de Diferenciação de Linfócitos B/metabolismo , Apoptose , Caspase 3/genética , Caspase 3/metabolismo , Caspase 8/genética , Caspase 8/metabolismo , Linhagem Celular Tumoral , Neoplasias Colorretais/genética , Regulação para Baixo , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe II/metabolismo , Oxirredutases Intramoleculares/genética , Oxirredutases Intramoleculares/metabolismo , Neoplasias Hepáticas Experimentais/genética , Fatores Inibidores da Migração de Macrófagos/genética , Fatores Inibidores da Migração de Macrófagos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Invasividade Neoplásica , RNA Interferente Pequeno/genética , Proteína 1 Indutora de Invasão e Metástase de Linfoma de Células T/genética , Proteína 1 Indutora de Invasão e Metástase de Linfoma de Células T/metabolismo
11.
PLoS One ; 11(9): e0162354, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27598308

RESUMO

BACKGROUND: Clinical and experimental research has revealed that diabetes mellitus (DM) is characterized by intestinal hypomotility, gut microbial dysbiosis, increased gut permeability, microcirculation disorders, circulatory changes, and dysfunction of intestinal stem cells, which may be linked to inflammation of intestinal mucosa. However, the relationship between type 2 DM (T2DM) and macroscopic small intestinal mucosal injuries is still unclear. Therefore, we retrospectively studied capsule endoscopy data to determine the relationship between T2DM and small intestinal mucosal injuries. MATERIALS AND METHODS: We compared the records of 38 T2DM patients with those of 152 non-DM patients for small intestinal mucosal injuries. Different types of mucosal injuries and Lewis scores were compared between T2DM and non-DM patients. The relationships between patients with or without different types of diabetic complications and the Lewis score was assessed. Moreover, the relationships between insulin resistance and Lewis score, between HbA1c and Lewis score, were also both assessed. RESULTS: The prevalence of a villous edema in subjects with T2DM was significantly higher than in those without DM (P < 0.001), but incidence of ulcers was not different (P = 1.000). With T2DM, the Lewis score was also significantly higher (P = 0.002). In addition, subjects with diabetic nephropathy showed significantly higher Lewis scores than patients without diabetic nephropathy (P = 0.033). In Pearson's correlation tests, the homeostasis model assessment of insulin resistance (HOMA-IR) value was correlated positively with the Lewis score (γ = 0.175, P = 0.015), but no statistical correlation was found between HbA1c level and Lewis score (γ = 0.039, P = 0.697). CONCLUSIONS: Subjects with T2DM, especially those with diabetic nephropathy, have higher Lewis scores and more serious small intestinal mucosal lesions.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Nefropatias Diabéticas/diagnóstico , Edema/diagnóstico , Mucosa Intestinal/patologia , Intestino Delgado/patologia , Idoso , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Tipo 2/cirurgia , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/patologia , Nefropatias Diabéticas/cirurgia , Edema/patologia , Edema/cirurgia , Ressecção Endoscópica de Mucosa , Feminino , Hemoglobina A Glicada/metabolismo , Humanos , Resistência à Insulina , Mucosa Intestinal/cirurgia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
PLoS One ; 11(2): e0149468, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26894876

RESUMO

BACKGROUND: The disease burden associated with influenza in developing tropical and subtropical countries is poorly understood owing to the lack of a comprehensive disease surveillance system and information-exchange mechanisms. The impact of influenza on outpatient visits, hospital admissions, and deaths has not been fully demonstrated to date in south China. METHODS: A time series Poisson generalized additive model was used to quantitatively assess influenza-like illness (ILI) and influenza disease burden by using influenza surveillance data in Zhuhai City from 2007 to 2009, combined with the outpatient, inpatient, and respiratory disease mortality data of the same period. RESULTS: The influenza activity in Zhuhai City demonstrated a typical subtropical seasonal pattern; however, each influenza virus subtype showed a specific transmission variation. The weekly ILI case number and virus isolation rate had a very close positive correlation (r = 0.774, P < 0.0001). The impact of ILI and influenza on weekly outpatient visits was statistically significant (P < 0.05). We determined that 10.7% of outpatient visits were associated with ILI and 1.88% were associated with influenza. ILI also had a significant influence on the hospitalization rates (P < 0.05), but mainly in populations <25 years of age. No statistically significant effect of influenza on hospital admissions was found (P > 0.05). The impact of ILI on chronic obstructive pulmonary disease (COPD) was most significant (P < 0.05), with 33.1% of COPD-related deaths being attributable to ILI. The impact of influenza on the mortality rate requires further evaluation. CONCLUSIONS: ILI is a feasible indicator of influenza activity. Both ILI and influenza have a large impact on outpatient visits. Although ILI affects the number of hospital admissions and deaths, we found no consistent influence of influenza, which requires further assessment.


Assuntos
Efeitos Psicossociais da Doença , Hospitalização/estatística & dados numéricos , Influenza Humana/economia , Idoso , Assistência Ambulatorial/estatística & dados numéricos , China/epidemiologia , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Distribuição de Poisson , Infecções Respiratórias/economia
14.
PLoS One ; 9(1): e85596, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24465613

RESUMO

OBJECTIVES: Frequent outbreaks of dengue are considered to be associated with an increased risk for endemicity of the disease. The occurrence of a large number of indigenous dengue cases in consecutive years indicates the possibility of a changing dengue epidemic pattern in Guangdong, China. METHODS: To have a clear understanding of the current dengue epidemic, a retrospective study of epidemiological profile, serological response, and virological features of dengue infections from 2005-2011 was conducted. Case data were collected from the National Notifiable Infectious Diseases Reporting Network. Serum samples were collected and prepared for serological verification and etiological confirmation. Incidence, temporal and spatial distribution, and the clinical manifestation of dengue infections were analyzed. Pearson's Chi-Square test was used to compare incidences between different age groups. A seroprevalence survey was implemented in local healthy inhabitants to obtain the overall positive rate for the specific immunoglobulin (Ig) G antibody against dengue virus (DENV). RESULTS: The overall annual incidence rate was 1.87/100000. A significant difference was found in age-specific incidence (Pearson's Chi-Square value 498.008, P<0.001). Children under 5 years of age had the lowest incidence of 0.28/100000. The vast majority of cases presented with a mild manifestation typical to dengue fever. The overall seroprevalence of dengue IgG antibody in local populations was 2.43% (range 0.28%-5.42%). DENV-1 was the predominant serotype in circulation through the years, while all 4 serotypes were identified in indigenous patients from different outbreak localities since 2009. CONCLUSIONS: A gradual change in the epidemic pattern of dengue infection has been observed in recent years in Guangdong. With the endemic nature of dengue infections, the transition from a monotypic to a multitypic circulation of dengue virus in the last several years will have an important bearing on the prevention and control of dengue in the province and in the neighboring districts.


Assuntos
Dengue/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Doenças Endêmicas , Humanos , Incidência , Lactente , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Estações do Ano , Estudos Soroepidemiológicos , Adulto Jovem
16.
Curr Microbiol ; 62(3): 950-5, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21079963

RESUMO

To enhance the understanding of epidemiological impact of environmental Vibrio cholerae O139 strains, we characterized 10 clinical and 20 environmental isolates collected from human clinical samples and Pear River estuary during 2006 to 2008. Isolates were tested by PCR for eight virulence genes: cholera toxin (ctxA), zonula occludens toxin (zot), accessory cholera enterotoxin (ace), hemolysin (hlyA), NAG-specific heat-stable toxin (st), toxin-coregulated pilus (tcpA), outer membrane protein (ompU), and regulatory protein genes (tcpI). Genetic relatedness was assessed by pulsed-field gel electrophoresis (PFGE), and antibiotic susceptibility was determined using disk diffusion. Seven of eight virulence markers were detected in six clinical isolates and one environmental isolate. One clinical and one environmental isolate were positive for six virulence markers. 60% clinical isolates showed multi-drug resistance to tetracycline (TET), Nalidixic acid (NAL), chloramphenicol (CHL), and ampicillin (AMP), 70% were resistant to Trimethoprim + Sulfamethoxazole (SXT), while only 35% environmental strains were resistant to SXT. PFGE analysis revealed that the isolates in this study were formed three clusters. Cluster III was more related to strains from diarrheal patients than the strains in other clusters. Different from the clinical strains, most environmental strains lacked CTX and TCP gene clusters. Most environmental strains possess a single resistance profile, while most clinical isolates show multidrug resistant. PFGE analysis indicated the cluster III has more possibility to become a potential pathogenic clonal cluster.


Assuntos
Cólera/microbiologia , Vibrio cholerae O139/classificação , Vibrio cholerae O139/isolamento & purificação , Microbiologia da Água , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , China , Análise por Conglomerados , DNA Bacteriano/genética , Farmacorresistência Bacteriana Múltipla , Eletroforese em Gel de Campo Pulsado , Genótipo , Humanos , Testes de Sensibilidade Microbiana , Tipagem Molecular , Fenótipo , Reação em Cadeia da Polimerase , Rios , Vibrio cholerae O139/genética , Vibrio cholerae O139/fisiologia , Fatores de Virulência/genética
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 31(3): 304-7, 2010 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-20510059

RESUMO

OBJECTIVE: To improve the national surveillance plan on bacillary dysentery and to increase the sensitivity of the surveillance system on the disease. METHODS: Data was collected through China Disease Reporting Information System (CDRIS) and National Sentinel Surveillance Sites on bacillary dysentery. Data from the CDRIS was compared with the data from the National Sentinel Surveillance to identify the exiting problems. RESULTS: Data from the monitoring sites showed that the detection rate of infant cases of bacillary dysentery infection was 1%, less than that of other age groups. The highest rates were seen in children aged 3 through 9 years. Rate on misdiagnosis in all age group was 23.38%, when using the surveillance case definition of clinical cases and suspect case. The rate of misdiagnosis on infant cases of bacillary dysentery infection by clinical diagnosis was 50%. It showed that Shigella flexneri and Shigella sonnei were dominant with the positive rates as 57.21% and 42.41%, respectively. From the national sentinel surveillance sites, the confirmed cases taking up 43.39% which did not match the figure from the CDRIS. CONCLUSION: The diagnostic criterion for bacillary dysentery fit well on other age groups in surveillance system except on infants. Active surveillance on bacillary dysentery that combining both clinical and laboratory diagnosis seems quite necessary on CDRIS, especially for infants.


Assuntos
Disenteria Bacilar/epidemiologia , Vigilância da População , Criança , Pré-Escolar , China/epidemiologia , Disenteria Bacilar/prevenção & controle , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Shigella dysenteriae
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 31(1): 43-6, 2010 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-20302697

RESUMO

OBJECTIVE: To study the status of norovirus in environment of the patient's residence and water samples after a norovirus gastroenteritis outbreak, to provide evidences for the development of strategies for prevention and control of the disease. METHODS: After a norovirus gastroenteritis outbreak, anus swabs from the patient, swabs from the household environment and the water samples were collected to detect the norovirus by RT-PCR methods. Sequencing analysis was conducted on those positive specimens. RESULTS: Three specimens of the anus swabs from 9 patients and 2 samples of the 46 house environment swabs were positive to the virus. The latter were from the surface of water-closets of two families that the illness were asymptomatic. Among 5 water samples, only one was positive, which was the rivulet water that the feces of the villagers evacuated directly. RESULTS: showed that the sequences of the virus detected from the anus swabs of the patients, the swabs from the household environment and the samples of the rivulet water belonged to the same species. CONCLUSION: It is necessary to strengthen activities as supervision and disinfection to the feces of the patients, especially on monitoring the feces that might have contaminated the water during the norovirus gastroenteritis outbreak.


Assuntos
Microbiologia Ambiental , Monitoramento Ambiental , Gastroenterite/epidemiologia , Norovirus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Caliciviridae/epidemiologia , Infecções por Caliciviridae/virologia , Criança , Pré-Escolar , Surtos de Doenças , Fezes/virologia , Feminino , Gastroenterite/virologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 31(12): 1329-31, 2010 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-21223657

RESUMO

OBJECTIVE: To understand the infection status of pandemic 2009 H1N1 influenza after the first epidemic wave and to estimate the infected population. METHODS: Multi-stage stratified random sampling was introduced with 4500 subjects chosen in Guangdong province. 1500 people were selected from 5 districts (3 streets were selected in every district) in Guangzhou city which was representing the large cities. 1500 people were respectively selected from medium-sized city and rural areas, including 20 cities (1 county or district was selected in every city, at least 1 street or town was selected in every county or district respectively and then 1 - 2 residential area or county was selected in every street or township, respectively). Every sample was selected in accordance with the principle of random sampling, excluding those who had injected with novel H1N1 vaccine. We used hemagglutination inhibition test to understand the serum antibody level of novel H1N1, with title of 1:40 as positive. RESULTS: A number of 4319 specimens, distributed in 21 cities, 25 counties, 85 streets or townships, 144 residential areas, were tested, with an overall positive rate as 22.82% (985/4319). The positive rate of those who had no symptoms of cold since June was 23.47% (471/2007). The positive rate of those who had fever, cough or sore throat was 26.25% (714/2720). The positive rate of those who had influenza-like illness (ILI) was 29.69% (337/1135). CONCLUSION: The infection rate in the first epidemic wave of the novel influenza A (H1N1) pandemic in Guangdong province was 22.82% (985/4317). Based on the number of residents in Guangdong province, the number of natural was estimated to have reached 21.78 million.


Assuntos
Influenza Humana/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Soroepidemiológicos , Adulto Jovem
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