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1.
Anticancer Res ; 39(10): 5669-5674, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570465

RESUMO

BACKGROUND/AIM: We evaluated factors associated with mortality among men with breast cancer. MATERIALS AND METHODS: We used the National Cancer Database to identify men with breast cancer and evaluated factors associated with mortality, using a Cox regression model. RESULTS: Black patients experienced an increased risk of death from any cause compared to white patients [hazard ratio (HR)=1.19, 95%CI=1.05-1.37]. Patients with government insurance had a greater risk of death compared to privately insured patients (HR=1.57, 95%CI=1.41-1.75). When compared to patients with an income of >$46,000, those with an income <$30,000 presented an increased risk of death (HR=1.35, 95%CI=1.14-1.60). Finally, patients treated at a comprehensive community cancer program (HR=1.129, 95%CI=1.021-1.248), community cancer program (HR=1.164, 95%CI=1.010-1.343), or integrated network cancer program (HR=1.216; 95%CI=1.056-1.401) experienced elevated risk of death compared to those treated at academic/research-programs. CONCLUSION: Race, insurance, income, education, and facility type are associated with the risk of mortality in male patients with breast cancer.


Assuntos
Neoplasias da Mama Masculina/mortalidade , Adolescente , Adulto , Afro-Americanos , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Europeu , Disparidades em Assistência à Saúde , Humanos , Cobertura do Seguro , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores Socioeconômicos , Adulto Jovem
2.
MMWR Morb Mortal Wkly Rep ; 68(37): 801-806, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31536484

RESUMO

In 2017, preliminary data show that gay, bisexual, and other men who have sex with men (MSM) accounted for 67% of new diagnoses of human immunodeficiency virus (HIV) infection, that MSM who inject drugs accounted for an additional 3%, and that African American/black (black) and Hispanic/Latino (Hispanic) MSM were disproportionately affected (1). During 2010-2015, racial/ethnic disparities in HIV incidence increased among MSM; in 2015, rates among black and Hispanic MSM were 10.5 and 4.9 times as high, respectively, as the rate among white MSM (compared with 9.2 and 3.8 times as high, respectively, in 2010) (2). Increased use of preexposure prophylaxis (PrEP), which reduces the risk for sexual acquisition of HIV infection by approximately 99% when taken daily as prescribed,* would help to reduce these disparities and support the Ending the HIV Epidemic: A Plan for America initiative† (3). Although PrEP use has increased among all MSM since 2014 (4), racial/ethnic disparities in PrEP use could increase existing disparities in HIV incidence among MSM (5). To understand racial/ethnic disparities in PrEP awareness, discussion with a health care provider, and use (steps in the HIV PrEP continuum of care) (6), CDC analyzed 2017 National HIV Behavioral Surveillance (NHBS) data. Black and Hispanic MSM were significantly less likely than were white MSM to be aware of PrEP, to have discussed PrEP with a health care provider, or to have used PrEP within the past year. Among those who had discussed PrEP with a health care provider within the past year, 68% of white MSM, 62% of Hispanic MSM, and 55% of black MSM, reported PrEP use. Prevention efforts need to increase PrEP use among all MSM and target eliminating racial/ethnic disparities in PrEP use.§.


Assuntos
Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Disparidades em Assistência à Saúde/etnologia , Homossexualidade Masculina/etnologia , Profilaxia Pré-Exposição/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , População Urbana/estatística & dados numéricos , Adulto Jovem
3.
Pan Afr Med J ; 33: 90, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489068

RESUMO

Introduction: Syphilis rapid test results may be influenced by numerous environmental and genetic factors. Methods: The proportion of false positive syphilis non-treponemal (NT) and treponemal (T) test results using immuno-chromatographic dual syphilis rapid test on serum from Cameroonian blacks (n=103) versus French blacks (n=104) or French caucasians (n=51), all HIV-negative and free of clinical syphilis, was examined. Results: Black individuals in Cameroon had a significantly higher frequency of false positive NT or T tests than black individuals in France. black individuals in France had a higher frequency of indeterminate NT tests as compared to caucasians in France. Conclusion: Both racial and environmental factors may affect immuno-chromatographic dual syphilis rapid testing.


Assuntos
Antígenos de Bactérias/imunologia , Sorodiagnóstico da Sífilis/métodos , Sífilis/diagnóstico , Treponema pallidum/imunologia , Grupo com Ancestrais do Continente Africano , Camarões , Grupo com Ancestrais do Continente Europeu , Reações Falso-Positivas , França , Humanos , Estudos Prospectivos , Sífilis/imunologia
4.
Braz J Med Biol Res ; 52(8): e8443, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31365694

RESUMO

Brain-derived neurotrophic factor (BDNF) is widely expressed in the central nervous system and prolongs the survival of dopaminergic neurons in the substantia nigra. Several studies have recently investigated the association between BDNF G196A (Val66Met), a single nucleotide polymorphism influencing cognitive processes, and cognitive impairment in Parkinson's disease (PD), but with contradictory findings. Thus, this meta-analysis was performed to clarify the possible association. Relevant studies were identified by a systematic search of PubMed, Embase, and China National Knowledge Infrastructure (CNKI) databases. The strength of the association was evaluated using crude odds ratios and 95% confidence interval. Finally, six studies involving 532 cases and 802 controls were included. Our analyses suggested the G196A (Val66Met) polymorphism was significantly associated with cognitive impairment in PD, especially in Caucasian populations. In conclusion, BDNF G196A (Val66Met) is confirmed to be a risk factor for cognitive impairment in PD.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Disfunção Cognitiva/genética , Doença de Parkinson/genética , Doença de Alzheimer/complicações , Estudos de Casos e Controles , Disfunção Cognitiva/complicações , Grupo com Ancestrais do Continente Europeu , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Masculino , Razão de Chances , Doença de Parkinson/complicações , Polimorfismo de Nucleotídeo Único , Fatores de Risco
5.
Gene ; 716: 144037, 2019 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-31398377

RESUMO

COQ2 encodes para-hydroxybenzoate-polyprenyl transferase and, recently, mutations in this gene have been associated with the increase of the risk of multiple system atrophy (MSA) in Japanese cases. Subsequently, studies in Asian patients confirmed the role of COQ2 in the development of MSA, while other analysis failed to replicate these results in Caucasian population. We performed genetics screening of COQ2 in 100 MSA Italian patients. We did not find any pathogenic mutations; our results suggest that COQ2 is not a genetic risk factor for MSA in Italian population.


Assuntos
Alquil e Aril Transferases/genética , Atrofia de Múltiplos Sistemas/genética , Mutação , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade
6.
Adv Exp Med Biol ; 1152: 31-49, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31456178

RESUMO

Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. It currently affects more than one in ten women worldwide. The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975-2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survival rates, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that racial disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.


Assuntos
Neoplasias da Mama/etnologia , Neoplasias da Mama/epidemiologia , Disparidades nos Níveis de Saúde , Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Estados Unidos/epidemiologia
7.
MMWR Morb Mortal Wkly Rep ; 68(34): 745-748, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31465319

RESUMO

Surveillance of U.S. breastfeeding duration and exclusivity has historically reported estimates among all infants, regardless of whether they had initiated breastfeeding. These surveillance estimates have consistently shown that non-Hispanic black (black) infants are less likely to breastfeed, compared with other racial/ethnic groups.* Less is known about disparities in breastfeeding duration when calculated only among infants who had initiated breastfeeding, compared with surveillance estimates based on all infants. CDC analyzed National Immunization Survey-Child (NIS-Child) data for infants born in 2015 to describe breastfeeding duration and exclusivity at ages 3 and 6 months among all black and non-Hispanic white (white) infants, and among only those who had initiated breastfeeding. When calculated among all infants regardless of breastfeeding initiation, breastfeeding differences between black and white infants were 14.7 percentage points (95% confidence interval [CI] = 10.7-18.8) for any breastfeeding at age 3 months and were significantly different for both any and exclusive breastfeeding at both ages 3 and 6 months. Among only infants who had initiated breastfeeding, the magnitude of black-white differences in breastfeeding rates were smaller. This was most notable in rates of any breastfeeding at 3 months, where the percentage point difference between black and white infants was reduced to 1.2 (95% CI = -2.3-4.6) percentage points and was no longer statistically significant. Black-white disparities in breastfeeding duration result, in part, from disparities in initiation. Interventions both to improve breastfeeding initiation and to support continuation among black mothers might help reduce disparities.


Assuntos
Afro-Americanos/psicologia , Aleitamento Materno/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Mães/psicologia , Adulto , Afro-Americanos/estatística & dados numéricos , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Humanos , Lactente , Mães/estatística & dados numéricos , Fatores de Tempo , Estados Unidos , Adulto Jovem
8.
Stud Health Technol Inform ; 264: 974-978, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438069

RESUMO

To develop personalized treatments for diseases, it is essential that they reflect the population of individuals that may be affected by a given disease. Amidst claims that there may be racial disparities in research populations, there have been no direct studies to explore this disparity in disease incidence and research projects that involve genomic sequencing. The precise relationship between underrepresentation of certain races in genomic sequencing studies and health outcomes relative to these races is unknown. Here, we examine the disparities in racial representation of national datasets pertaining to clinical data, mortality rates, and a major initiative involving genomic sequence analysis (The Cancer Genome Atlas [TCGA]). The results suggest that black Americans are underrepresented for most cancers in TCGA compared to clinical and mortality datasets, whereas Asian Americans are overrepresented. These findings accentuate the importance of targeted efforts to recruit representative patient populations into studies involving genomic sequencing.


Assuntos
Grupo com Ancestrais do Continente Europeu , Genômica , Afro-Americanos , Americanos Asiáticos , Humanos , Neoplasias
9.
JAMA ; 322(8): 756-763, 2019 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-31454044

RESUMO

Importance: There are substantial and increasing educational differences in US adult life expectancy. To reduce social inequalities in mortality, it is important to understand how specific causes of death have contributed to increasing educational differences in adult life expectancy in recent years. Objective: To estimate the relationship of specific causes of death with increasing educational differences in adult life expectancy from 2010 to 2017. Design, Setting, and Participants: Serial cross-sectional study of 4 690 729 deaths recorded in the US National Vital Statistics System in 2010 and 2017. Exposures: Sex, race/ethnicity, and educational attainment. Main Outcomes and Measures: Life expectancy at age 25 years and years of life lost between ages 25 and 84 years by cause of death. Results: The analysis included a total of 2 211 633 deaths in 2010 and 2 479 096 deaths in 2017. Between 2010 and 2017, life expectancy at age 25 significantly declined among white and black non-Hispanic US residents from an expected age at death of 79.34 to 79.15 years (difference, -0.18 [95% CI, -0.23 to -0.14]). Greater decreases were observed among persons with a high school degree or less (white men: -1.05 years [95% CI, -1.15 to -0.94], white women: -1.14 years [95% CI, -1.24 to -1.04], and black men: -0.30 years [95% CI, -0.56 to -0.04]). White adults with some college education but no 4-year college degree experienced similar declines in life expectancy (men: -0.89 years [95% CI, -1.07 to -0.73], women: -0.59 years [95% CI, -0.77 to -0.42]). In contrast, life expectancy at age 25 significantly increased among the college-educated (white men: 0.58 years [95% CI, 0.42 to 0.73], white women: 0.78 years [95% CI, 0.57 to 1.00], and black women: 1.70 years [95% CI, 0.91 to 2.53]). The difference between high- and low-education groups increased from 2010 to 2017, largely because life-years lost to drug use increased among those with a high school degree or less (white men: 0.93 years [95% CI, 0.90 to 0.96], white women: 0.50 years [95% CI, 0.47 to 0.52], black men: 0.75 years [95% CI, 0.71 to 0.79], and black women: 0.28 years [95% CI, 0.25 to 0.31]). Conclusions and Relevance: In this serial cross-sectional study, estimated life expectancy at age 25 years declined overall between 2010 and 2017; however, it declined among persons without a 4-year college degree and increased among college-educated persons. Much of the increasing educational differences in years of life lost may be related to deaths attributed to drug use.


Assuntos
Afro-Americanos/estatística & dados numéricos , Causas de Morte , Escolaridade , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Expectativa de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Expectativa de Vida/etnologia , Expectativa de Vida/tendências , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Estados Unidos/epidemiologia
10.
J Stroke Cerebrovasc Dis ; 28(9): 2459-2467, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31281111

RESUMO

BACKGROUND: The 10-meter Walking Test (10MWT) is often used to assess people with, e.g., stroke, but often using different procedures. The aims of this study were to translate the 10MWT into Danish, to determine the number of trials needed to achieve performance stability, and to examine the interrater reliability and agreement of the 10MWT in people with neurological disorders. METHODS: Translation followed international recommendations, and evaluated in a consecutive sample of 50 people with a neurological disorder. All participants performed 5 timed 10MWT trials (usual speed) with 20-seconds rest intervals between trials, supervised by a physical therapist. A second session was conducted with another physical therapist, separated with a mean (SD) of 2.7 (0.9) hours. The order of raters was randomized and they were blinded to each other's ratings. Repeated measures ANOVA determined performance stability, while ICC1.1, standard error of measurement (SEM), and minimal detectable change (MDC95) determined reproducibility. RESULTS: Participant's improved their 10MWT scores significantly between the first and second trial only. The faster of the 2 trials took a mean of 11.95 (5.40) seconds, and significantly (P < 0.001) faster than the slowest; mean of 12.80 (6.13) seconds. The intraclass correlation coefficient (ICC; 95% confidence interval), SEM, and MDC, based on the fastest of 2 trials, were 0.97 (0.95-0.98), 0.06 m/s, and 0.17 m/s, respectively, and with no systematic between rater's bias. CONCLUSIONS: We suggest that the faster of 2 timed trials be recorded for the 10MWT in people with neurological disorders, as we found excellent interrater reliability and low measurement error using this score.


Assuntos
Características Culturais , Tolerância ao Exercício , Doenças do Sistema Nervoso/diagnóstico , Tradução , Teste de Caminhada , Caminhada , Idoso , Idoso de 80 Anos ou mais , Dinamarca/epidemiologia , Grupo com Ancestrais do Continente Europeu , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etnologia , Doenças do Sistema Nervoso/fisiopatologia , Variações Dependentes do Observador , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fatores de Tempo , Velocidade de Caminhada
11.
Medicine (Baltimore) ; 98(27): e16314, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277174

RESUMO

The Ladybird Homeobox 1 (LBX1) gene has been implicated in the etiology of adolescent idiopathic scoliosis (AIS). The association between LBX1 gene polymorphisms and AIS has been investigated in several studies. However, these findings have yield contradictory results rather than conclusive evidence.This study is to provide a meta-analysis of the published case-control studies on the association between LBX1 gene polymorphisms and AIS in Asian and Caucasian populations.This meta-analysis conformed to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We conducted a literature research on PubMed, Embase, Web of Science, and Cochrane Library until February 10, 2018. We included all case-control or cohort studies about association between LBX1 gene polymorphisms and AIS. The Risk Of Bias In Non-randomised Studies-of Interventions and Critical Appraisal Skills Programme were used to evaluate the risk of bias and study quality. We assessed the strength of association by pooled odds ratios (ORs) and 95% confidence intervals (CIs) in all genetic models under a fixed-effect model or random-effect model. We further performed subgroup analysis by ethnicity and sex. Sensitivity analysis and publication bias were also undertaken.A total of 10 studies (11,411 cases and 26,609 controls) were included in this meta-analysis. The pooled results showed a statistically significant association between LBX1 gene polymorphisms and AIS (for rs11190870, T vs C, OR = 1.54, 95% CI = 1.48-1.61, P < .00001; for rs625039, G vs A, OR = 1.50, 95% CI: 1.38-1.62; P < .00001; for rs678741, G vs A, OR = 0.74, 95% CI: 0.63-0.86; P < .0001; for rs11598564, G vs A, OR = 1.41, 95% CI: 1.31-1.51; P < .0001). For stratified analyses by ethnicity and sex, robust significant associations were detected in Asian and Caucasian populations, and in women and men under all genetic models.T allele of rs11190870 and G alleles of rs625039 and rs11598564 represent risk factors for AIS, but G allele of rs678741 may play a protective role in the occurrence of AIS. Further research is needed to confirm this finding and to understand its implications.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Grupo com Ancestrais do Continente Europeu/genética , Proteínas de Homeodomínio/genética , Polimorfismo Genético/genética , Escoliose/genética , Fatores de Transcrição/genética , Adolescente , Feminino , Humanos , Masculino , Estudos Observacionais como Assunto , Razão de Chances , Escoliose/etnologia
12.
Am Surg ; 85(6): 572-578, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31267896

RESUMO

Despite low mortality rates, self-inflicted stab wounds (SISWs) can result in significant morbidity and often reflect underlying substance abuse and mental health disorders. This study aimed to characterize demographics, comorbidities, and outcomes seen in self-inflicted stabbings and compare these metrics to those seen in assault stabbings. A Level I trauma center registry was queried for patients with stab injuries between January 2010 and December 2015. Classification was based on whether injuries were SISWs or the result of assault stab wounds (ASWs). Demographic, injury, and outcome measures were recorded. Differences between genders, ethnicities, individuals with and without psychiatric comorbidities, and SISW and ASW patients were assessed. Within the SIWS cohort, no differences were found when comparing age, gender, or race, including need for operative intervention. However, patients with psychiatric histories were less likely to have a positive toxicology test on arrival than those without psychiatric histories (22% vs. 0%, P = 0.04). When compared with 460 ASW patients, SISW were older (41 vs. 35, P < 0.001), more likely to be white (92% vs. 64%, P < 0.001), more likely to have a psychiatric history (15% vs. 4%, P < 0.001), require operative intervention (65% vs. 50%, P = 0.008), and be discharged to a psychiatric facility (47% vs. 0.2%, P < 0.001). SISW patients have higher rates of psychiatric illness and an increased likelihood to require operative intervention as compared with ASW patients. This population demonstrates an acute need for both inpatient and outpatient psychiatric care with early involvement of multidisciplinary teams for treatment and discharge planning.


Assuntos
Mortalidade Hospitalar , Sistema de Registros , Comportamento Autodestrutivo/psicologia , Centros de Traumatologia , Ferimentos Perfurantes/epidemiologia , Ferimentos Perfurantes/cirurgia , Adolescente , Adulto , Distribuição por Idade , Idoso , Distribuição de Qui-Quadrado , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Incidência , Escala de Gravidade do Ferimento , Kentucky , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Taxa de Sobrevida , Resultado do Tratamento , Ferimentos Perfurantes/prevenção & controle , Adulto Jovem
13.
BMC Public Health ; 19(1): 892, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286920

RESUMO

BACKGROUND: Few population-based studies of Arab American health behaviors and outcomes exist outside of Michigan. We aimed to provide prevalence estimates of health behaviors and outcomes for Arab Americans and compare them to non-Hispanic Whites in California. METHODS: We used data from the 2003-2016 California Health Interview Surveys. We determined Arab American ethnicity using an algorithm that considered place of birth of the respondent or parent and use of Arabic language at home. Survey-weighted frequencies, chi-squared statistics, and logistic regression analyses were used to compare Arab Americans and non-Hispanic Whites on socioeconomic indicators, health behaviors and health outcomes. Multivariable models were adjusted for age, education level, and insurance status. RESULTS: Arab Americans had higher prevalence of no insurance, living below the federal poverty level, and home ownership than non-Hispanic Whites despite high levels of education and low unemployment prevalence. Arab Americans had reduced odds of alcohol consumption (OR: 0.33, 95% CI: 0.24, 0.45), binge drinking (OR: 0.28, 95% CI: 0.19, 0.40), and suicidal ideation (OR: 0.41, 0.25, 0.66) when compared to non-Hispanic Whites in multivariable models. Arab Americans had decreased odds of hypertension (OR: 0.64, 95% CI: 0.50, 0.83) and increased odds of diabetes (OR: 2.03, 95% CI: 1.23, 3.34) when compared to non-Hispanic Whites in multivariable models. CONCLUSIONS: Arab Americans in California participate in less risky health behaviors and have better health outcomes than non-Hispanic Whites, except with regards to diabetes. Future work aiming to understand the health of Arab Americans should allow for self-identification and less reliance on country of origin and language use at home for sample selection.


Assuntos
Árabes/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/etnologia , California/epidemiologia , Distribuição de Qui-Quadrado , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etnologia , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Hipertensão/epidemiologia , Hipertensão/etnologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores Socioeconômicos
14.
BMC Infect Dis ; 19(1): 626, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307403

RESUMO

BACKGROUND: In the United States Hepatitis C virus (HCV) viral clearance is estimated to range between 20 and 30%. The objective of this study was to estimate the frequency of HCV clearance and identify correlates of viral clearance among patients newly identified as HCV antibody positive in a large urban health system in Los Angeles, California. METHODS: We identified patients between November 2015 and September 2017 as part of a newly implemented HCV screening and linkage-to-care program at University of California Los Angeles (UCLA) Health System. All patients were eligible for screening, though there were additional efforts to screen patients born between 1945 and 1965. We reviewed Medical records to categorize anti-HCV antibody positive patients as having spontaneously cleared HCV infection (HCV RNA not detected) or not (HCV RNA detected). We excluded those with a prior history of anti-HCV positivity or history of HCV treatment. We compared differences between those with and without detectable HCV RNA using chi-square test, Fisher's exact test, and t-test as appropriate. We assessed factors associated with HCV clearance using logistic regression analysis. RESULTS: Among the 320 patients included in this study, 56% were male. Baby boomers (52-72 years of age) comprised the single largest age group (62%). We found spontaneous HCV clearance in 58% (n = 185). HCV viral clearance was slightly higher among women as compared to men (63% vs. 53%; p value = 0.07) and varied by race/ethnicity: clearance among Blacks/African Americans was 37% vs. 58% among whites (p value = 0.02). After adjusting for age, race/ethnicity, and sex we found that those diagnosed with chronic kidney disease had a tendency of decreased HCV viral clearance (adjusted OR = 0.34; 95% CI 0.14-1.03). CONCLUSION: Of those patients newly identified as anti-HCV positive, 58% had cleared HCV virus, while the rest showed evidence of active infection. In addition, we found that clearance varied by race/ethnicity and clinical characteristics.


Assuntos
Hepacivirus/isolamento & purificação , Hepatite C/diagnóstico , Adolescente , Adulto , Afro-Americanos , Idoso , California/epidemiologia , Grupo com Ancestrais do Continente Europeu , Feminino , Hepacivirus/genética , Hepatite C/epidemiologia , Hepatite C/etnologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/sangue , Remissão Espontânea , Insuficiência Renal Crônica/diagnóstico , Estudos Retrospectivos , Adulto Jovem
15.
BMC Public Health ; 19(1): 891, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277617

RESUMO

BACKGROUND: Although the black-white gap in life expectancy has narrowed in the U.S., there is considerable variability across states. In Wisconsin, the black-white gap exceeds 6 years, well above the national average. Reducing this disparity is an urgent public health priority, but there is limited understanding of what contributes to Wisconsin's racial gap in longevity. Our investigation identifies causes of death that contribute most to Wisconsin's black-white gap in life expectancy among males and females, and highlights specific ages where each cause of death contributes most to the gap. METHODS: Our study employs 1999-2016 restricted-use mortality data provided by the National Center for Health Statistics. After generating race- and sex-specific life tables for each 3-year period of observation (e.g., 1999-2001), we trace recent trends in the black-white life expectancy gap in Wisconsin. We subsequently conduct a series of analyses to decompose the black-white gap in three time periods into 13 separate causes and 19 different age groups. RESULTS: In 2014-16, Wisconsin's black-white gap in life expectancy was 7.34 years for males (67% larger than the national gap), and 5.61 years for females (115% larger than the national gap). Among males, homicide was the single largest contributor, accounting for 1.56 years of the total gap. Heart disease and cancer followed, contributing 1.43 and 1.42 years, respectively. Among females, heart disease and cancer were the two leading contributors to the gap, accounting for 1.12 and 1.00 years, respectively. Whereas homicide contributed most to the racial gap in male longevity during late adolescence and early adulthood, heart disease and cancer exerted most of their influence between ages 50-70 for both males and females. Other notable contributors were unintentional injuries (males), diabetes and cerebrovascular disease (females), and perinatal conditions (males and females). CONCLUSIONS: Our study identifies targets for future policy interventions that could substantially reduce Wisconsin's racial gap in life expectancy. Concerted efforts to eliminate racial disparities in perinatal mortality and homicide early in the life course, and chronic conditions such as cancer and heart disease in later life, promise to help Wisconsin achieve the public health objective of racial parity in longevity.


Assuntos
Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Expectativa de Vida/etnologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte/tendências , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Expectativa de Vida/tendências , Tábuas de Vida , Masculino , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Wisconsin/epidemiologia , Adulto Jovem
16.
Hum Genet ; 138(10): 1155-1169, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31342140

RESUMO

Vitamin D inadequacy, assessed by 25-hydroxyvitamin D [25(OH)D], affects around 50% of adults in the United States and is associated with numerous adverse health outcomes. Blood 25(OH)D concentrations are influenced by genetic factors that may determine how much vitamin D intake is required to reach optimal 25(OH)D. Despite large genome-wide association studies (GWASs), only a small portion of the genetic factors contributing to differences in 25(OH)D has been discovered. Therefore, knowledge of a fuller set of genetic factors could be useful for risk prediction of 25(OH)D inadequacy, personalized vitamin D supplementation, and prevention of downstream morbidity and mortality. Using PRSice and weights from published African- and European-ancestry GWAS summary statistics, ancestry-specific polygenic scores (PGSs) were created to capture a more complete set of genetic factors in those of European (n = 9569) or African ancestry (n = 2761) from three cohort studies. The PGS for African ancestry was derived using all input SNPs (a p value cutoff of 1.0) and had an R2 of 0.3%; for European ancestry, the optimal PGS used a p value cutoff of 3.5 × 10-4 in the target/tuning dataset and had an R2 of 1.0% in the validation cohort. Those with highest genetic risk had 25(OH)D that was 2.8-3.0 ng/mL lower than those with lowest genetic risk (p = 0.0463-3.2 × 10-13), requiring an additional 467-500 IU of vitamin D intake to maintain equivalent 25(OH)D. PGSs are a powerful predictive tool that could be leveraged for personalized vitamin D supplementation to prevent the negative downstream effects of 25(OH)D inadequacy.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Grupo com Ancestrais do Continente Europeu/genética , Genética Populacional , Padrões de Herança , Herança Multifatorial , Polimorfismo de Nucleotídeo Único , Vitamina D/análogos & derivados , Estudos de Coortes , Bases de Dados Genéticas , Suplementos Nutricionais , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Raios Ultravioleta , Vitamina D/sangue
17.
Gene ; 719: 144009, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31357020

RESUMO

BACKGROUND: The F+1 (rs511898 G>A) polymorphism in a disintegrin and metalloprotease 33 (ADAM33) gene has been implicated in susceptibility of chronic obstruction pulmonary disease (COPD). However, a series of studies have reported inconclusive. The aim of this study is to explore the association between the F+1 (rs511898) of ADAM33 gene and COPD susceptibility by using the method of meta-analysis. METHOD: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI), Chongqing VIP database, Wanfang and China Biology Medicine (CBM) were searched comprehensively to obtain the related cohort studies and case-control studies. The included studies were selected according to inclusion criteria. The pooled odds ratios were performed respectively for allele comparison, additive model, dominant genetic model and recessive genetic model. The association between the F+1 polymorphism of ADAM33 gene and COPD susceptibility was measured by OR and 95%CI by STATA 12.0. The subgroup analysis was distinguished according to the ethnicity. The publication bias was tested by funnel plots and Egger's linear regression method. RESULTS: Twelve case-control studies were included in the meta-analysis, which study is comprised of 6935 participants (2454 patients with COPD and 4481 controls). The meta results showed significant association between ADAM33 F+1 polymorphism and COPD susceptibility in allele model OR total = 1.16(95% CI 1.04-1.30, P = 0.007), OR Asian = 1.14(95% CI 1.02-1.27, P = 0.022), additive model OR total = 1.27 (95% CI 1.13-1.43, P = 0.000), OR Asian = 1.25 (95% CI 1.08-1.45, P = 0.003), recessive model OR total = 1.49 (95% CI 1.16-1.91, P = 0.002), OR Asian = 1.56(95% CI 1.09-2.22, P = 0.014), but not significant in Caucasians. CONCLUSION: The ADAM33 F+1 mutant gene A may increase the risk of COPD among the Asian population, while it may not associate with the European population.


Assuntos
Proteínas ADAM/genética , Medicina Baseada em Evidências , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Doença Pulmonar Obstrutiva Crônica/genética , Proteínas ADAM/química , Grupo com Ancestrais do Continente Asiático/genética , Grupo com Ancestrais do Continente Europeu/genética , Humanos
18.
Nat Commun ; 10(1): 2491, 2019 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-31171785

RESUMO

Genetic factors underlying leukocyte telomere length (LTL) may provide insights into telomere homeostasis, with direct links to disease susceptibility. Genetic evaluation of 23,096 Singaporean Chinese samples identifies 10 genome-wide loci (P < 5 × 10-8). Several of these contain candidate genes (TINF2, PARP1, TERF1, ATM and POT1) with potential roles in telomere biology and DNA repair mechanisms. Meta-analyses with additional 37,505 European individuals reveals six more genome-wide loci, including associations at MPHOSPH6, NKX2-3 and TYMS. We demonstrate that longer LTL associates with protection against respiratory disease mortality [HR = 0.854(0.804-0.906), P = 1.88 × 10-7] in the Singaporean Chinese samples. We further show that the LTL reducing SNP rs7253490 associates with respiratory infections (P = 7.44 × 10-4) although this effect may not be strongly mediated through LTL. Our data expands on the genetic basis of LTL and may indicate on a potential role of LTL in immune competence.


Assuntos
Grupo com Ancestrais do Continente Asiático/genética , Reparo do DNA/genética , Leucócitos/metabolismo , Homeostase do Telômero/genética , Telômero/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções Respiratórias/genética , Singapura , Adulto Jovem
19.
J Pediatr Orthop ; 39(Issue 6, Supplement 1 Suppl 1): S20-S22, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31169642

RESUMO

BACKGROUND: A common claim in the orthopaedic literature is that acetabular dysplasia (AD) exists when the center-edge angle of Wiberg (CE angle) is <20 degrees and that AD leads to osteoarthritis (OA). Our purpose is to evaluate the validity of the linkage between AD and OA. METHODS: We assess and discuss the theories and the empirical evidence relating AD to OA. Moreover, we test the rule that hips with a CE angle <20 degrees will develop OA by 65 years of age, by looking for exceptions to this rule. RESULTS: Wiberg and Cooperman and colleagues present 30 ideal patients for assessing the relationship between AD and OA. Each was arthritis free, with stable AD, CE angle <20 degrees, without signs of subluxation. They were all followed and all developed OA. In the studies by Stulberg and colleagues, and Jacobsen and colleagues, every patient presented with OA, making it difficult to be certain about the appearance of the hip before the onset of OA. In the study by Murphy and colleagues, we have the same problem, as an unknown number of patients already had OA at first assessment. All of these studies used different schemes for diagnosing OA, making the studies difficult to compare. Most of the patients in the studies were of Northern European ancestry, making the results difficult to generalize to other populations. Four patients had CE angles <20 degrees and did not develop severe arthritis by 65 years of age. CONCLUSIONS: Our conclusions apply directly to patients of Northern European ancestry. A few patients with stable, mild AD (CE angle 15 to 19 degrees) will be arthritis free at 65 years of age. Almost all patients with stable AD develop OA by 65 years of age. Unstable AD (CE angle <20 degrees, with subluxation) always leads to OA by 65 years of age. It is probably reasonable to extend these conclusions to other populations, but the reader must be prepared to re-evaluate them, as more data accumulates.


Assuntos
Luxação Congênita de Quadril/complicações , Luxação do Quadril/complicações , Osteoartrite do Quadril/etiologia , Acetábulo , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca , Grupo com Ancestrais do Continente Europeu , Feminino , Luxação do Quadril/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/diagnóstico por imagem , Radiografia , Suécia
20.
Clin Interv Aging ; 14: 959-968, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31213783

RESUMO

Objective: To bridge the efficacy and compare the safety of the 24-week teriparatide treatment in a Chinese osteoporosis study (NCT00414973) to a large international trial (FPT, NCT00670501) to determine whether long-term results from the international study were applicable to Chinese patients. Methods: In this post-hoc analysis, a propensity score matching method was used to select patients with similar baseline characteristics. Patients were female with osteoporosis at high risk of fracture, aged ≥55 years, and had no history of rheumatoid arthritis or corticosteroid use. Outcomes included percentage changes in lumbar-spine bone mineral density (LS-BMD) from baseline to 24 weeks, safety in matched-pair patients, and long-term percentage changes in LS-BMD and fragility fracture incidence in the matched fracture prevention trial (FPT) population. The determination of the acceptability of bridging results was based on the International Conference on Harmonization E5 guidelines. Results: A total number of 228 patients from each study were matched and paired. Patients were similar at baseline (P-values >0.33) except for ethnicity (98% Caucasian for FPT). For changes in LS-BMD from baseline to week 24, treatment with teriparatide showed significantly greater increases (P-values <0.001; least-squares mean difference: 5.0% in the Chinese study and 5.4% in FPT) than comparator (calcitonin/placebo). The safety profiles over 24 weeks were similar between two studies. For matched-pair FPT patients, long-term changes in LS-BMD were significantly greater (least-squares mean difference: 11.5%, P<0.001) and the fragility fracture rate was marginally lower in the teriparatide group compared with the placebo group (13.1% vs 22.3%, P=0.070). Conclusion: Assuming similar pharmacokinetic profiles for teriparatide between populations, comparable increases in LS-BMD and consistent safety profiles within 24 weeks of the treatment suggest long-term LS-BMD results from the FPT may be applicable to Chinese population.


Assuntos
Densidade Óssea/efeitos dos fármacos , Hormônios e Agentes Reguladores de Cálcio , Vértebras Lombares/diagnóstico por imagem , Fraturas por Osteoporose/prevenção & controle , Teriparatida , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Calcitonina/uso terapêutico , Hormônios e Agentes Reguladores de Cálcio/administração & dosagem , Hormônios e Agentes Reguladores de Cálcio/efeitos adversos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Análise por Pareamento , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Teriparatida/administração & dosagem , Teriparatida/efeitos adversos , Resultado do Tratamento
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