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1.
Braz. j. biol ; 84: e250739, 2024. tab
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1355896

RESUMO

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.


Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.


Assuntos
Humanos , Receptores de Calcitriol/genética , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/epidemiologia , Arábia Saudita , Estudos de Casos e Controles , Polimorfismo de Nucleotídeo Único , Frequência do Gene , Genótipo
2.
Braz. j. biol ; 83: e249104, 2023. tab
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1339389

RESUMO

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.


Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Doença das Coronárias/embriologia , Hiper-Homocisteinemia/diagnóstico , Hiper-Homocisteinemia/epidemiologia , Estudos de Casos e Controles , Fatores de Risco , Jejum
3.
Eur J Neurol ; 29(1): 199-207, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570429

RESUMO

BACKGROUND AND PURPOSE: The aim of this study was to define the prevalence of pre-eclampsia, gestational hypertension (HT), chronic HT, and gestational diabetes during pregnancy in a defined population of patients with saccular intracranial aneurysms (sIAs). METHODS: We included all patients with sIA, first admitted to the Neurosurgery Department of Kuopio University Hospital from its defined catchment population between 1990 and 2015, who had given birth for the first time in 1990 or later. The patients' medical records were reviewed, and clinical data were linked with prescription drug usage, hospital diagnoses and causes of death, obtained from nationwide registries. The prevalences of pre-eclampsia, other hypertensive disorders and gestational diabetes in patients were compared with a matched control population (n = 324). In addition, the characteristics of sIA disease in patients with pre-eclampsia were compared to those of sIA patients without pre-eclampsia. RESULTS: A total of 169 patients with sIA fulfilled the inclusion criteria. Of these, 22 (13%) had pre-eclampsia and 32 (19%) had other hypertensive disorders during pregnancy. In 324 matched controls who had given birth, the prevalence of pre-eclampsia was 5% (n = 15) and other hypertensive disorders were diagnosed in 10% (n = 34). There was no significant difference in prevalence of gestational diabetes (12% vs. 11%). Patients with sIA with pre-eclampsia more frequently had irregularly shaped aneurysms (p = 0·003). CONCLUSIONS: Pre-eclampsia was significantly more frequent in patients with sIA than in their population controls. Irregularly shaped aneurysms were more frequent in sIA patients with pre-eclampsia. Further studies are required to determine whether history of pre-eclampsia may indicate an elevated risk for sIA formation or rupture.


Assuntos
Diabetes Gestacional , Hipertensão Induzida pela Gravidez , Aneurisma Intracraniano , Pré-Eclâmpsia , Estudos de Casos e Controles , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/epidemiologia , Pré-Eclâmpsia/epidemiologia , Gravidez
4.
J Neurotrauma ; 39(1-2): 86-92, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33626946

RESUMO

This case-control study using baseline data from the population cohort Adolescent Brain Cognitive Development (ABCD) Study® compared lifetime history of concussion between children with and without attention-deficit/hyperactivity disorder (ADHD). We hypothesized that children with ADHD would have a greater lifetime history of concussion than children without ADHD. Children were recruited from schools across the United States, sampled to provide strong generalizability to the US population. The current sample included 10,585 children (age: mean = 9.9; standard deviation = 0.6; range 9-10 years; 48.9% girls; 64.6% White), including 1085 with ADHD and 9500 without ADHD. The prevalence of prior concussion among children with ADHD was 7.2% (95% CI: 6.6-7.8%) compared with 3.2% (3.1-3.3%) among children without ADHD, meaning current ADHD status was associated with twice the odds of experiencing a prior concussion [χ2 = 44.54; p < 0.001; odds ratio = 2.34 (1.81-3.03)]. No significant differences were observed in proportion of boys and girls with ADHD who had a prior concussion history. The number of current ADHD symptoms were not meaningfully associated with prior concussion history. Lower socioeconomic status was associated with lower rates of reported concussion, but not differentially in association with ADHD. ADHD is associated with twice the lifetime prevalence of prior concussion before age 11 among children from the general U.S. population. Boys and girls with ADHD did not differ in proportions with prior concussion and concussion history was not related to the number of ADHD symptoms reported by parents.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Concussão Encefálica , Adolescente , Atletas/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Concussão Encefálica/psicologia , Estudos de Casos e Controles , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
5.
Artigo em Inglês | IBECS | ID: ibc-203812

RESUMO

BackgroundThe incidence and mortality of gastrointestinal (GI) tumors are high in China. Some studies suggest that the gut microbiota is related to the occurrence and development of tumors. At present, there are no prospective studies based on the correlation between gastrointestinal tumors and gut microbiota in the Chinese population. The objective of this report is to characterize the fecal microbiota in healthy control participants and patients with esophageal cancer, gastric cancer, and colorectal cancer.MethodsPatients with locally advanced or metastatic esophageal, gastric, and colorectal cancer were enrolled, and healthy people were included as controls. 16S rRNA sequencing was used to analyze the characteristics of fecal microbiota. PICRUSt software was used for functional prediction.ResultsSignificant differences in the composition and abundance of fecal microbiota were identified between gastrointestinal cancer patients (n = 130) and healthy controls (n = 147). The abundance of Faecalibacterium prausnitzii, Clostridium clostridioforme and Bifidobacterium adolescent in tumor groups were all significantly lower than in the control group (P < 0.05). The levels of Blautia producta and R. faecis in the gastric (n = 46) and colorectal cancer (n = 44) groups were significantly lower than those in the control group (P < 0.05). The level of Butyricicoccus pullicaecorum in the esophageal cancer (n = 40) and gastric cancer groups was significantly lower than that in the control group (P < 0.05).


Assuntos
Humanos , DNA Bacteriano/isolamento & purificação , Fezes/microbiologia , Microbioma Gastrointestinal/fisiologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Estudos de Casos e Controles , Metabolômica , RNA Ribossômico 16S
6.
BMC Womens Health ; 22(1): 236, 2022 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-35715797

RESUMO

Cervical cancer (CC) is the fourth most common cancer in women worldwide and the leading cause of cancer deaths in developing countries. CC can be prevented through available preventive interventions. However, most patients in developing countries, such as Ethiopia, present late with advanced stage disease due to low participation in CC screening and require treatment involving multiple modalities. Women's social, economic and cultural backgrounds have been associated with the level of participation in CC screening programmes. Therefore, this study aimed to assess women's sexual autonomy as a determinant of lifetime CC screening among women in Addis Ababa, Ethiopia. An institutional-based case-control study was conducted in which controls were women who had received screening services during the last 5 years, and cases were randomly selected from women coming for other services but never screened or aware of the screening service. Accordingly, 294 women were enrolled. Data were collected by using a pre-tested standard questionnaire through interviewing. Bivariate and multivariable logistic regression analyses were performed to assess the women's sexual autonomy as a determinant of lifetime CC screening. The study revealed higher sexual autonomy led to higher odds for having been screened (adjusted odds ratio (AOR) = 3.128, 95% CI (1.730, 5.658)). Moreover, direct referral to the screening service (AOR = 3.173, 95% CI (1.57, 6.45)) and parity had positively affected the lifetime uptake of CC screening (AOR = 2.844, 95% CI (1.344, 6.014)). We found that women's own sexual autonomy was associated with the improvement of CC screening uptake. Empowering women could alleviate barriers to CC screening in the community.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Estudos de Casos e Controles , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Programas de Rastreamento , Gravidez , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
7.
BMC Womens Health ; 22(1): 244, 2022 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-35725424

RESUMO

BACKGROUND: Bacterial vaginosis, BV, is a common inflammatory vaginal dysbiosis. The Mediterranean diet, MD, containing foods rich in antioxidant compounds, is shown to be beneficial for inflammatory conditions. This study aimed to investigate the association between MD adherence and dietary total antioxidant capacity (DTAC) with BV. METHODS: This case-control study was conducted on 143 BV-affected and 151 healthy individuals aged between 15 and 45 years. The Amsel criteria were used to detect newly diagnosed patients with BV by a gynecologist. The 168-item food frequency questionnaire (FFQ) was used to record participants' dietary intakes in the last year. The reported data in the FFQ was used to measure adherence to the MD by calculating the Medi-Lite score and to measure the DTAC by calculating ferric-reducing antioxidant power, FRAP, based on the related databases. Logistic regression models were used to determine the association between Medi-Lite and DTAC and BV odds. RESULTS: The highest tertile of Medi-Lite score was associated with a reduced odds of BV in the crude model (Odds Ratio, OR: 0.49, 95% Confidence Interval, 95% CI 0.25, 0.96, P for trend: 0.023). This significant inverse association was not observed in the last model adjusted for age, body mass index (kg/m2), waist circumferences (cm), cigarette smoking, frequency of pregnancy, and physical activity (MET/h/d). In crude and adjusted odels, BV odds decreased in the highest tertile of vegetable (adjusted OR, aOR: 0.32, 95% CI 0.16, 0.63, P for trend: 0.001), fish (aOR: 0.46, 95% CI 0.25, 0.84, P for trend: 0.009), legumes (aOR: 0.26, 95% CI 0.14, 0.50, P for trend < 0.001), and meat (aOR: 0.29, 95% CI 0.15, 0.56, P for trend < 0.001) groups. There was no significant association between DTAC and BV odds. CONCLUSIONS: The significant inverse association between the MD adherence and BV odds did not remain after modifying for confounders; besides, DTAC was not associated with BV odds. However, some of the MD components might be associated with a reduced odds of BV.


Assuntos
Dieta Mediterrânea , Vaginose Bacteriana , Animais , Antioxidantes , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos
8.
Arq Bras Cir Dig ; 35: e1645, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35730874

RESUMO

AIM: After bariatric surgery, if there is iron-refractory iron-deficiency anemia (IRIDA) and does not respond to supplemental iron therapy, excluding other possible etiologies, genetic changes involved in iron metabolism should be considered. This study aimed to investigate the association of both mutations 1285G-C and 1246C-T, in the SLC11A2 gene, and the etiopathogenesis of anemia refractory to iron supplementation in patients undergoing bariatric surgery using Roux-en-Y gastric bypass (RYGB). METHODS: A case-control study was conducted, in which 100 patients were evaluated as Cases Group [subdivided into (i) with Anemia and (ii) without Anemia] and 100 individuals as Controls, comprising both sexes. Inherited and acquired causes of IRIDA were excluded. DNA was extracted from leukocytes of peripheral blood, and the regions that cover both mutations have been amplified by the molecular techniques such as polymerase chain reaction/restriction fragment length polymorphism. RESULTS: The 1285G-C mutation was not determined in any of the 400 alleles analyzed. Regarding the 1246C-T mutation, the wild CC genotype was found with a higher prevalence in the Control Group (34%) (OR 0.5475; 95%CI 0.2920-1.027; p=0.0827). The mutant TT genotype was found only in the Cases Group I (with Anemia) (13%). CONCLUSION: The results show the association between 1246C-T mutation, in the SLC11A2 gene, and the etiopathogenesis of IRIDA to iron supplementation in the evaluated sample. There are differences, at the molecular level, in patients with and without IRIDA after bariatric surgery using RYGB.


Assuntos
Anemia Ferropriva , Cirurgia Bariátrica , Derivação Gástrica , Anemia Ferropriva/genética , Cirurgia Bariátrica/efeitos adversos , Estudos de Casos e Controles , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Masculino , Mutação
9.
Sci Total Environ ; 838(Pt 3): 156349, 2022 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-35660436

RESUMO

INTRODUCTION: Uncertainty in the dose-response of low dose radiation raised concern of an increased cancer incidence in Sweden after the Chernobyl Nuclear Power Plant (NPP) accident. MATERIAL AND METHODS: A closed cohort was created of all males ≥18 years of age living in the Northern Sweden in 1986. In total 826,400 individuals were enrolled including 40,874 hunters. A nested case-control design was used with five controls randomly selected for each cancer case matched on year of diagnosis and year of birth. Individual absorbed colon dose was calculated 1986 to 2015. Allowing for a 5-year latency period Hazard Ratios (HR) per mGy with 95% Confidence Intervals (95% CI) were calculated in a conditional logistic regression adjusted by rural/non-rural living, length of education and pre-Chernobyl cancer incidence 1980 to 1985. A total of 127,109 cancer cases occurred from 1 January 1991 to 31 December 2015. Cancer was classified in: 1) Organ-specific (stomach, colon, liver, lung, prostate, urinary bladder, thyroid and leukaemia), 2) Other and 3) Not previously associated to ionizing radiation. RESULTS: The average colon dose in cases was 1.77 mGy compared to controls 1.73 mGy. Hunters average colon dose was 2.32 mGy. Organ-specific cancers showed the highest HR per mGy both in the full cohort, adj HR 1.019 (1.014-1.024) and the hunter subcohort, adj HR 1.014 (1.001-1.027) during follow-up 1991 to 2015. Other cancer and Not previously associated with ionizing radiation showed lower HR per mGy. Therefore, the adj HR per mGy for Total cancer, 1.013 (1.009-1.017) was explained by Organ-specific cancer. Increased adj HR per mGy was seen in stomach, colon and prostate cancer, respectively in the full cohort and lung cancer in hunters. CONCLUSIONS: Some cancer sites previously associated with ionizing radiation showed a positive adjusted HR per mGy both in the full cohort and in the hunter subcohort.


Assuntos
Acidente Nuclear de Chernobyl , Neoplasias Induzidas por Radiação , Neoplasias , Adulto , Estudos de Casos e Controles , Colo , Humanos , Incidência , Masculino , Neoplasias Induzidas por Radiação/epidemiologia , Centrais Nucleares , Doses de Radiação , Suécia/epidemiologia
10.
PLoS Negl Trop Dis ; 16(6): e0010508, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35666717

RESUMO

BACKGROUND: Cryptosporidiosis is a major cause of diarrhoea in young children in low-and-middle-income countries. New interventions should be informed by evidence pertaining to risk factors and their relative importance. Inconsistencies in the literature may to some extent be explained by choice of methodology, furthermore, most previous risk factor studies compared cryptosporidiosis cases to diarrhoea cases of other aetiologies rather than with controls without diarrhoea. METHODOLOGY/PRINCIPAL FINDINGS: We investigated a broad set of factors in under-2-year-olds presenting with diarrhoea to a hospital and a health center in southwestern Ethiopia. We applied quantitative cut-offs to distinguish between cryptosporidiosis and incidental Cryptosporidium infection or carriage, a hierarchical causal framework to minimize confounding and overadjustment, and a case-case-control design, to describe risk factors for both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Moderate and severe acute malnutrition were strongly associated with both cryptosporidiosis and non-cryptosporidiosis diarrhoea. Previous healthcare attendance and low maternal education were only associated with cryptosporidiosis, whereas unsafe child stool disposal, prematurity and early cessation of exclusive breastfeeding were significantly associated with non-cryptosporidiosis diarrhoea only. By estimation of population attributable fractions, socioeconomic factors-specifically low maternal education-and public tap water use, were apparently more important risk factors for cryptosporidiosis than for non-cryptosporidiosis diarrhoea. CONCLUSIONS/SIGNIFICANCE: Nutritional management of moderate acute malnutrition may be an effective intervention against cryptosporidiosis, particularly if combined with targeted therapy for cryptosporidiosis which, again, may mitigate nutritional insult. Focused caregiver education in healthcare settings and follow-up of children with acute malnutrition may prevent or improve outcomes of future episodes of cryptosporidiosis.


Assuntos
Criptosporidiose , Cryptosporidium , Desnutrição , Estudos de Casos e Controles , Criança , Pré-Escolar , Criptosporidiose/complicações , Criptosporidiose/epidemiologia , Diarreia/complicações , Diarreia/epidemiologia , Etiópia/epidemiologia , Feminino , Humanos , Lactente , Desnutrição/complicações , Fatores de Risco
11.
Urol Oncol ; 40(7): 347.e17-347.e27, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35643842

RESUMO

OBJECTIVES: To determine 1-year and 5-year total healthcare costs and healthcare resource (HRU) associated with renal cell carcinoma (RCC) in older Americans, from a healthcare sector perspective. MATERIALS AND METHODS: This was a longitudinal, retrospective cohort study using the Surveillance, Epidemiology and End Results-Medicare linked data (2006-2014), which included older (≥66 years) patients with primary RCC and 1:5 matched noncancer controls. Patients/controls were followed from diagnosis (pseudo-diagnosis for controls) until death or up to loss-to-follow-up (censored). Per-patient average 1-year and 5-year cumulative total and incremental total healthcare costs and HRU were reported. RESULTS: A total of 11,228 RCC patients were matched to 56,140 controls. Per-patient cumulative average 1-year (incremental = $38,291 [$36,417-$40,165]; $57,588 vs. $19,297) and 5-year (incremental = $68,004 [$55,123-$80,885]; $183,550 vs. $115,547) total costs (excluding prescription drug costs) were 3 and 1.6 times higher for RCC vs. controls. These estimates were 3.6 and 1.7 times higher for RCC vs. controls when prescription costs were included in total costs. Prescription drug costs accounted for 8.4% (incremental = $3,715) and 18.1% (incremental = $15,375) of the 1-year and 5-year incremental total costs, respectively. RCC patients had greater cumulative number of hospitalizations, emergency department visits and prescriptions in 1- and 5-years, compared to controls. CONCLUSIONS: Average first year total cost for a patient with incident diagnosis of RCC is substantially higher than that for controls and it varies depending on the stage at diagnosis. Study findings could help in planning future resource allocation and in determining research and unmet needs in this patient population.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Medicamentos sob Prescrição , Idoso , Estudos de Casos e Controles , Custos de Cuidados de Saúde , Humanos , Neoplasias Renais/terapia , Medicare , Estudos Retrospectivos , Estados Unidos/epidemiologia
12.
Transpl Immunol ; 73: 101633, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35644312

RESUMO

OBJECTIVE: To investigate the effects of hypoxia-inducible factor-1α (HIF-1α), hepcidin, and parathyroid hormone (PTH) on the serum nuclear factor κB and receptor activating factor ligand (RankL) in patients with chronic kidney disease (CKD) stages 3-5. METHODS: A total of 90 patients admitted to our hospital's Department of Nephrology from March 2018 to December 2019 were randomly selected as the subjects (30 patients with CKD3, CKD4, and CKD5 each). A total of 30 healthy volunteers receiving a physical examination in our hospital during the same period were selected for the control group. Then, the participants' HIF-1α, hepcidin, and RankL levels were detected by double-antibody sandwiched enzyme-linked immunosorbent assay. The serum creatinine, serum iron, hemoglobin, and phosphorus (P3+) levels were determined by BeckMAN-c800 automatic biochemical analysis. The glomerular filtration rate (eGFR) was calculated by the CKD-EPI formula. RESULTS: (1) The levels of HIF-1α, RankL, hepcidin, and PTH were all elevated, and the serum ferritin and P3+ were elevated in each stage; (2) Linear correlation analysis: The HIF-1α and hepcidin showed a higher correlation with RankL in CKD3 and CKD4(CKD3: The correlation coefficient r = 0.558 between HIF-1α and RankL, and r = 0.604 between HEpcidin and RankL; CKD4: Correlation coefficient r = 0.840 between HIF-1α and RankL, and r = 0.753 between HEpcidin and RankL), while the PTH showed a higher correlation with RankL in CKD5 (correlation index r = 0.631). Multiple linear stepwise regression analysis: RankL was independently correlated with HIF-1α, hepcidin, and PTH. Regression coefficient B of HIF-1α was the highest in both CKD3 and CKD4. The coefficient B value of PTH in CKD5 was 3.971; HIF-1α and hepcidin were not included in the regression equation. CONCLUSION: The levels of RankL in both CKD3 and CKD4 were increased and mainly affected by HIF-1α, followed by hepcidin. Moreover, HIF-1α and PTH had a combined effect on the RankL level in CKD5, and PTH was the main influencing factor.


Assuntos
Hepcidinas , Insuficiência Renal Crônica , Estudos de Casos e Controles , Taxa de Filtração Glomerular , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia , Hormônio Paratireóideo
13.
Lancet Public Health ; 7(6): e529-e536, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35660214

RESUMO

BACKGROUND: Pre-exposure prophylaxis (PrEP) has shown high efficacy in clinical trials, but few observational studies have confirmed its effectiveness when prescribed in real life to users with diverse profiles. This study aimed to assess real-world PrEP effectiveness. METHODS: We did a matched, nested case-control study among adult men at high risk of HIV infection between Jan 1, 2016, and June 30, 2020, using data from the French national health data system. Men who were newly diagnosed with HIV infection up to Dec 31, 2020, were individually matched with up to five controls for age, socioeconomic status, place of residence, calendar year, and follow-up duration. PrEP use was characterised on the basis of tenofovir disoproxil fumarate plus emtricitabine dispensing over time. Conditional logistic regression was used to calculate the adjusted odds ratios (ORs) of PrEP use associated with HIV infection. PrEP effectiveness (computed as 1-adjusted OR), was estimated overall, by mode of PrEP use, and by individuals' sociodemographic characteristics. FINDINGS: Among a total of 46 706 individuals, 256 patients with HIV infection were identified and matched with 1213 controls. PrEP users accounted for 29% of cases and 49% of controls. PrEP effectiveness was 60% (95% CI 46 to 71) overall, reaching 93% (84 to 97) for a high amount of PrEP consumption, and 86% (78 to 92) if excluding periods after PrEP discontinuation. PrEP effectiveness was significantly reduced in people younger than 30 years (26% [-21 to 54]) and in those who were socioeconomically deprived (-64% [-392 to 45]), both of which groups showed low amounts of PrEP consumption and high rates of PrEP discontinuation. INTERPRETATION: PrEP effectiveness appears to be lower in real-world conditions than is reported in clinical trials. Strengthening efforts to improve the monitoring of PrEP compliance will be essential to ensure PrEP effectiveness, especially among young and socioeconomically deprived recipients. FUNDING: None.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Adulto , Fármacos Anti-HIV/uso terapêutico , Estudos de Casos e Controles , França/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Masculino
14.
J Craniomaxillofac Surg ; 50(6): 493-498, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35672203

RESUMO

The aim of this study was to evaluate the impact of drainless parotidectomy using fibrin sealant on length of stay, post-operative seroma and related complications. For this purpose, a retrospective matched case-control series was held in a single academic center. All patients who underwent drainless parotidectomies, including deep lobe tumors and revision surgeries, were compared to matched controls in which a suction drain was inserted. Main outcomes were length of hospital stay and post-operative seroma. A total of 123 patients (41 cases and 82 controls) were included in the study. Fibrin sealant group had higher rates of total parotidectomy compared with the control group (25.0% vs. 10.5%, p = 0.054). Length of stay was significantly shorter in the fibrin sealant group (1.0 ± 0.3 days vs. 1.5 ± 0.6 days, p < 0.001, respectively). No statistically significant difference was found between the fibrin sealant group and the control regarding post-operative seromas (9.8% vs. 14.6%, p = 0.574, respectively), aspirations rate (7.3% vs. 14.6%, p = 0.381), and infection rates (0% vs.3.7%, p = 0.550). In conclusion, drainless parotidectomy does not increase post operative seroma rates and related complications, and can also be implemented for revision surgery.


Assuntos
Adesivo Tecidual de Fibrina , Adesivos Teciduais , Estudos de Casos e Controles , Drenagem , Adesivo Tecidual de Fibrina/uso terapêutico , Humanos , Tempo de Internação , Complicações Pós-Operatórias , Estudos Retrospectivos , Seroma/etiologia , Adesivos Teciduais/uso terapêutico
15.
Environ Pollut ; 307: 119563, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-35654255

RESUMO

Essential trace element zinc is associated with decreased lung cancer risk, but underlying mechanisms remain unclear. This study aimed to investigate role of DNA methylation in zinc-lung cancer association. We conducted a case-cohort study within prospective Dongfeng-Tongji cohort, including 359 incident lung cancer cases and a randomly selected sub-cohort of 1399 participants. Epigenome-wide association study (EWAS) was used to examine association of plasma zinc with DNA methylation in peripheral blood. For the zinc-related CpGs, their mediation effects on zinc-lung cancer association were assessed; their diagnostic performance for lung cancer was testified in the case-cohort study and further validated in another 126 pairs of lung cancer case-control study. We identified 28 CpGs associated with plasma zinc at P < 1.0 × 10-5 and seven of them (cg07077080, cg01077808, cg17749033, cg15554270, cg26125625, cg10669424, and cg15409013 annotated to GSR, CALR3, SLC16A3, PHLPP2, SLC12A8, VGLL4, and ADAMTS16, respectively) were associated with incident risk of lung cancer. Moreover, the above seven CpGs were differently methylated between 126 pairs of lung cancer and adjacent normal lung tissues and had the same directions with EWAS of zinc. They could mediate a separate 7.05%∼22.65% and a joint 29.42% of zinc-lung cancer association. Compared to using traditional factors, addition of methylation risk score exerted improved discriminations for lung cancer both in case-cohort study [area under the curve (AUC) = 0.818 vs. 0.738] and in case-control study (AUC = 0.816 vs. 0.646). Our results provide new insights for the biological role of DNA methylation in the inverse association of zinc with incident lung cancer.


Assuntos
Metilação de DNA , Neoplasias Pulmonares , Estudos de Casos e Controles , Estudos de Coortes , Epigênese Genética , Epigenoma , Estudo de Associação Genômica Ampla/métodos , Humanos , Pulmão , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/genética , Fosfoproteínas Fosfatases/genética , Estudos Prospectivos , Fatores de Transcrição/genética , Zinco
16.
Environ Pollut ; 307: 119581, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-35680067

RESUMO

Observational studies reported inconsistent results on the association between bisphenol A (BPA) and type 2 diabetes (T2D) risk. Whether genetic factors modified the association remains unclear. The present nested case-control study prospectively investigated the association of BPA with T2D risk, and the interaction and combined effects of diabetes genetic risk score (GRS) and serum BPA on T2D risk. Based on the Dongfeng-Tongji cohort study, 995 incident diabetes cases and 1:1 age- and gender-matched controls were included. T2D was diagnosed based on the American Diabetes Association criteria. Serum BPA concentration was measured at baseline. Diabetes GRS was constructed by 88 diabetes-related SNPs selected from large-scale GWASs. A U-shaped association was observed between serum BPA levels and T2D risk, with the lowest odds of T2D at the serum BPA levels of 1.00 ng/mL (P = 0.001 for nonlinearity). Compared with the middle group, the multivariate-adjusted ORs of T2D in the lowest group and the highest group of serum BPA were 1.52 (95% CI: 1.04, 2.22) and 1.40 (95% CI: 1.08, 1.81), respectively. Both serum BPA levels (ß = 0.107, P = 0.001) and weighted-GRS (w-GRS) (ß = 0.072, P = 0.02) were significantly associated with baseline FPG levels. Participants with both highest w-GRS and serum BPA levels had highest risk of T2D (OR = 2.53, 95%CI: 1.49, 4.31, P = 0.001) and higher baseline FPG levels (ß = 0.218, P = 0.01), compared with those with both lowest w-GRS and serum BPA levels. Non modified effects of serum BPA levels and w-GRS on T2D, baseline FPG levels, and 5-y changes of FPG levels were detected (All Pinteraction > 0.05). Our results suggested a U-shaped association between serum BPA levels and T2D risk. Participants with higher serum BPA levels and diabetes genetic risk had higher FPG levels and higher risk of T2D.


Assuntos
Diabetes Mellitus Tipo 2 , Compostos Benzidrílicos , Estudos de Casos e Controles , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Humanos , Fenóis , Fatores de Risco
17.
BMC Pediatr ; 22(1): 320, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641965

RESUMO

AIM: To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children. MATERIALS AND METHODS: A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity. RESULTS: Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls. CONCLUSION: TMI and NC seem to predict general and central obesity in Iranian preschool children.


Assuntos
Obesidade Abdominal , Obesidade , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade Abdominal/diagnóstico , Razão Cintura-Estatura
18.
Clin Appl Thromb Hemost ; 28: 10760296221103868, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35642285

RESUMO

We developed a computerized clinical decision support system (CCDSS) for venous thromboembolism (VTE) risk assessment. We aimed to demonstrate its relevance and evaluate associations between risk level and VTE incidence in patients undergoing total hip/knee arthroplasty. In this case-control study, VTE was confirmed using ultrasonography/computed tomography angiography in 1098 adults at a tertiary care hospital over five years (2013-2018). Postoperative VTE incidence was classified into three risk levels (moderate, high, and highest). The overall VTE incidence was 11.7%, which increased with a risk level of 0%, 5.8%, and 12.8% in moderate-risk, high-risk, and highest-risk patients, respectively. Highest-risk patients were significantly more likely to develop VTE than high-risk patients (odds ratio [OR] 2.4; 95% confidence interval [CI] 1.2-5.5; p = 0.01). VTE development was more likely in patients with risk scores ≥4 relative to those with risk scores of 2-3 (OR 1.8; 95% CI 1.2-2.7; p = 0.003) and -1 to 1 (OR 3.3; 95% CI 1.6-7.7; p < 0.001). This study indicates that risk level and VTE incidence are associated; our scoring system appears useful for patients undergoing total hip/knee arthroplasty.


Assuntos
Artroplastia do Joelho , Tromboembolia Venosa , Adulto , Anticoagulantes , Artroplastia do Joelho/efeitos adversos , Estudos de Casos e Controles , Humanos , Fatores de Risco , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia
19.
Open Heart ; 9(1)2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35649573

RESUMO

AIM: Inflammatory cytokines in patients with rheumatoid arthritis (RA) directly affect cardiac electrophysiology by inhibiting cardiac potassium currents, leading to delay of cardiac repolarisation and QT-prolongation. This may result in lethal arrhythmias. We studied whether RA increases the rate of out-of-hospital cardiac arrest (OHCA) in the general population. METHODS: We conducted a nested case-control in a cohort of individuals between 1 June 2001 and 31 December 2015. Cases were OHCA patients from presumed cardiac causes, and were matched with non-OHCA-controls based on age, sex and OHCA date. Cox-regression with time-dependent covariates was conducted to assess the association between RA and OHCA by calculating the HR and 95% CI. Stratified analyses were performed according to sex and presence of cardiovascular diseases. Also, the association between OHCA and use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with RA was studied. RESULTS: We included 35 195 OHCA cases of whom 512 (1.45%) had RA, and 351 950 non-OHCA controls of whom 3867 (1.10%) had RA. We found that RA was associated with increased rate of OHCA after adjustment for cardiovascular comorbidities and use of QT-prolonging drugs (HR: 1.22, 95% CI: 1.11 to 1.34). Stratification by sex revealed that increased OHCA rate occurred in women (HR: 1.32, 95% CI: 1.16 to 1.50) but not in men (HR: 1.12, 95% CI: 0.97 to 1.28; P value interaction=0.046). OHCA rate of RA was not further increased in patients with cardiovascular disease. Finally, in patients with RA, use of NSAIDs was not associated with OHCA. CONCLUSION: In the general population, RA is associated with increased rate of OHCA in women but not in men.


Assuntos
Artrite Reumatoide , Parada Cardíaca Extra-Hospitalar , Arritmias Cardíacas , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/tratamento farmacológico , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Masculino , Parada Cardíaca Extra-Hospitalar/diagnóstico , Parada Cardíaca Extra-Hospitalar/epidemiologia
20.
BMC Geriatr ; 22(1): 480, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35658833

RESUMO

BACKGROUND: Although individuals with dementia have a high risk of developing seizures, whether seizures are associated with cholinesterase inhibitors, which are commonly prescribed to treat individuals with dementia, remains unknown. This study investigated the risk of incident seizure following cholinesterase inhibitor use in patients with dementia. METHODS: A nationwide, nested case-control study was conducted using data from the Korean Health Insurance Review and Assessment Service (HIRA) from 2014 through 2018. A total of 13,767 participants aged 65-95 years who experienced incident seizure were propensity score-matched for medical comorbidities and drug exposure at a 1:3 ratio with a control group of 39,084 participants. The study examined the incidence of seizures in patients diagnosed with dementia within one year after receiving cognitive enhancers. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for seizure incidence according to cholinesterase inhibitor use were analyzed using a multivariable conditional logistic regression model. RESULTS: There was no statistically significant association between duration of cholinesterase inhibitors use and seizure risk. Although there was slight increased seizure risk in patient after receiving donepezil for 1 year compared to memantine, subgroup analyses stratified age and sex did not reveal any significant association between cholinesterase inhibitors use and late-onset seizure. CONCLUSIONS: Our findings suggest no immediate increase in seizure risk is associated with cholinesterase inhibitor use, although the risk of seizure in patients with dementia did increase after one year of continued medication intake. Further study is required to obtain confirmatory results on the seizure-related safety of cognitive enhancers in patients with dementia.


Assuntos
Demência , Nootrópicos , Estudos de Casos e Controles , Inibidores da Colinesterase/efeitos adversos , Demência/diagnóstico , Demência/tratamento farmacológico , Demência/epidemiologia , Humanos , Nootrópicos/uso terapêutico , Convulsões/induzido quimicamente , Convulsões/tratamento farmacológico , Convulsões/epidemiologia
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