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1.
Med Care ; 58(11): 974-980, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32947512

RESUMO

OBJECTIVE: To assess differences in health access and utilization among Middle Eastern American adults by White racial identity and citizenship. METHODS: Data from the 2011 to 2018 National Health Interview Surveys (N=1013) and survey-weighted logistic regression analyses compare Middle Eastern immigrants by race and citizenship on access and utilization of health care in the United States. RESULTS: White respondents had 71% lower odds of delaying care [adjusted odds ratio (AOR)=0.34; 95% confidence interval (CI)=0.13, 0.71] and 84% lower odds of being rejected by a doctor as a new patient (AOR=0.16; 95% CI=0.03, 0.88) compared to non-White respondents. US citizens had higher odds of visiting the doctor in the past 12 months compared with noncitizens (AOR=1.76; 95% CI=1.25, 2.76). CONCLUSION: Middle Eastern immigrants who do not identify as White and who are not US citizens are significantly less likely to access and utilize health care compared with those who identify as White and are US citizens. POLICY IMPLICATIONS: This study shows that racial and citizenship disparities persist among Middle Eastern Americans at a national-level, playing a critical role in access to and use of health care.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/etnologia , Fatores Socioeconômicos , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
2.
Stroke ; 51(8): 2428-2434, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32673520

RESUMO

BACKGROUND AND PURPOSE: Stroke incidence and mortality are declining rapidly in developed countries. Little data on ethnic-specific stroke recurrence trends exist. Fourteen-year stroke recurrence trend estimates were evaluated in Mexican Americans and non-Hispanic whites in a population-based study. METHODS: Recurrent stroke was ascertained prospectively in the population-based BASIC (Brain Attack Surveillance in Corpus Christi) project in Texas, between 2000 and 2013. Incident cases were followed forward to determine 1- and 2-year recurrence. Fine & Gray subdistribution hazard models were used to estimate adjusted trends in the absolute recurrence risk and ethnic differences in the secular trends. The ethnic difference in the secular trend was examined using an interaction term between index year and ethnicity in the models adjusted for age, sex, hypertension, diabetes mellitus, smoking, atrial fibrillation, insurance, and cholesterol and relevant interaction terms. RESULTS: From January 1, 2000 to December 31, 2013 (N=3571), the cumulative incidence of 1-year recurrence in Mexican Americans decreased from 9.26% (95% CI, 6.9%-12.43%) in 2000 to 3.42% (95% CI, 2.25%-5.21%) in 2013. Among non-Hispanic whites, the cumulative incidence of 1-year recurrence in non-Hispanic whites decreased from 5.67% (95% CI, 3.74%-8.62%) in 2000 to 3.59% (95% CI, 2.27%-5.68%) in 2013. The significant ethnic disparity in stroke recurrence existed in 2000 (risk difference, 3.59% [95% CI, 0.94%-6.22%]) but was no longer seen by 2013 (risk difference, -0.17% [95% CI, -1.96% to 1.5%]). The competing 1-year mortality risk was stable over time among Mexican Americans, while for non-Hispanic whites it was decreasing over time (difference between 2000 and 2013: -4.67% [95% CI, -8.72% to -0.75%]). CONCLUSIONS: Mexican Americans had significant reductions in stroke recurrence despite a stable death rate, a promising indicator. The ethnic disparity in stroke recurrence present early in the study was gone by 2013.


Assuntos
Isquemia Encefálica/etnologia , Isquemia Encefálica/mortalidade , Grupo com Ancestrais do Continente Europeu/etnologia , Americanos Mexicanos , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/mortalidade , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos Prospectivos , Recidiva , Acidente Vascular Cerebral/diagnóstico , Texas/etnologia
3.
Stroke ; 51(8): 2445-2453, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32673521

RESUMO

BACKGROUND AND PURPOSE: Social determinants of health (SDOH) have been previously associated with incident stroke. Although SDOH often cluster within individuals, few studies have examined associations between incident stroke and multiple SDOH within the same individual. The objective was to determine the individual and cumulative effects of SDOH on incident stroke. METHODS: This study included 27 813 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, a national, representative, prospective cohort of black and white adults aged ≥45 years. SDOH was the primary exposure. The main outcome was expert adjudicated incident stroke. Cox proportional hazards models examined associations between incident stroke and SDOH, individually and as a count of SDOH, adjusting for potential confounders. RESULTS: The mean age was 64.7 years (SD 9.4) at baseline; 55.4% were women and 40.4% were blacks. Over a median follow-up of 9.5 years (IQR, 6.0-11.5), we observed 1470 incident stroke events. Of 10 candidate SDOH, 7 were associated with stroke (P<0.10): race, education, income, zip code poverty, health insurance, social isolation, and residence in one of the 10 lowest ranked states for public health infrastructure. A significant age interaction resulted in stratification at 75 years. In fully adjusted models, among individuals <75 years, risk of stroke rose as the number of SDOH increased (hazard ratio for one SDOH, 1.26 [95% CI, 1.02-1.55]; 2 SDOH hazard ratio, 1.38 [95% CI, 1.12-1.71]; and ≥3 SDOH hazard ratio, 1.51 [95% CI, 1.21-1.89]) compared with those without any SDOH. Among those ≥75 years, none of the observed effects reached statistical significance. CONCLUSIONS: Incremental increases in the number of SDOH were independently associated with higher incident stroke risk in adults aged <75 years, with no statistically significant effects observed in individuals ≥75 years. Targeting individuals with multiple SDOH may help reduce risk of stroke among vulnerable populations.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Disparidades nos Níveis de Saúde , Determinantes Sociais da Saúde/etnologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etnologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pobreza/economia , Pobreza/etnologia , Estudos Prospectivos , Fatores de Risco , Autorrelato/normas , Determinantes Sociais da Saúde/economia , Determinantes Sociais da Saúde/tendências , Fatores Socioeconômicos , Acidente Vascular Cerebral/economia
4.
Am J Ophthalmol ; 219: 332-340, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32681910

RESUMO

PURPOSE: To determine whether clinical features and visual outcomes of myelin oligodendrocyte glycoprotein antibody-associated optic neuritis (MOG-ON) differ between White and Asian subjects. DESIGN: Multicenter retrospective cohort. METHODS: This was a multicenter study of 153 subjects who were White or Asian with a history of adult-onset (age 18 years or older) optic neuritis (ON) and positive MOG-IgG serology by cell-based assay. Subjects were enrolled from 2 unpublished cohorts (January 2017-November 2019) and 9 published cohorts with case-level data available (2012-2018). Subjects with alternative etiologies of demyelinating disease and positive or lack of aquaporin-4-IgG serology result were excluded. The main outcome measurements were clinical features and final visual outcomes. RESULTS: Of the 153 subjects who were White (n = 80) or Asian (n = 73) included in the study, 93 (61%) were women, mean age of onset was 40.8 ± 14.9 years, and median follow-up was 35.2 months (range: 1-432 months); all of these characteristics were similar between White and Asian subjects. White subjects were more likely to have recurrent ON (57 [71%] vs 20 [27%]; P = .001) and extra-optic nerve manifestations (35 [44%] vs 8 [11%]; P = .001). Optic disc swelling, neuroimaging findings, presenting visual acuity (VA), treatment, and final VA did not differ according to subjects' race. Despite the high prevalence of severe visual loss (<20/200) during nadir, most subjects had good recovery of VA (>20/40) at final examination (51/77 [66%] White subjects vs 52/70 [74%] Asian subjects). CONCLUSION: White subjects with MOG-ON were more likely to have recurrent disease and extra-optic nerve manifestations. Visual outcomes were similar between White and Asian subjects.


Assuntos
Grupo com Ancestrais do Continente Asiático/etnologia , Autoanticorpos/sangue , Grupo com Ancestrais do Continente Europeu/etnologia , Glicoproteína Mielina-Oligodendrócito/imunologia , Neurite Óptica/diagnóstico , Adulto , Aquaporina 4/imunologia , Dor Ocular/diagnóstico , Dor Ocular/etnologia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Neurite Óptica/etnologia , Neurite Óptica/imunologia , Recidiva , Estudos Retrospectivos , Microscopia com Lâmpada de Fenda , Tailândia/epidemiologia , Estados Unidos/epidemiologia , Acuidade Visual
5.
PLoS One ; 15(7): e0233808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32673320

RESUMO

Similarly to other populations across the Americas, Argentinean populations trace back their genetic ancestry into African, European and Native American ancestors, reflecting a complex demographic history with multiple migration and admixture events in pre- and post-colonial times. However, little is known about the sub-continental origins of these three main ancestries. We present new high-throughput genotyping data for 87 admixed individuals across Argentina. This data was combined to previously published data for admixed individuals in the region and then compared to different reference panels specifically built to perform population structure analyses at a sub-continental level. Concerning the Native American ancestry, we could identify four Native American components segregating in modern Argentinean populations. Three of them are also found in modern South American populations and are specifically represented in Central Andes, Central Chile/Patagonia, and Subtropical and Tropical Forests geographic areas. The fourth component might be specific to the Central Western region of Argentina, and it is not well represented in any genomic data from the literature. As for the European and African ancestries, we confirmed previous results about origins from Southern Europe, Western and Central Western Africa, and we provide evidences for the presence of Northern European and Eastern African ancestries.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Grupo com Ancestrais do Continente Europeu/genética , Genoma Humano , Índios Sul-Americanos/genética , Casamento , Linhagem , Grupo com Ancestrais do Continente Africano/etnologia , Argentina , Colonialismo , DNA/genética , Escravização , Grupo com Ancestrais do Continente Europeu/etnologia , Marcadores Genéticos , Variação Genética , Genética Populacional , Genótipo , Migração Humana , Humanos , Índios Sul-Americanos/etnologia , Modelos Genéticos
6.
J Stud Alcohol Drugs ; 81(2): 180-189, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32359047

RESUMO

OBJECTIVE: Low parental involvement and monitoring are risk factors for adolescent cigarette use. Assessments of parental involvement and monitoring by youth and parents may capture an additional source of risk: differences in perceptions of these parenting behaviors. This study tested for unique contributions of youth-reported parental involvement and monitoring and youth-parent discrepancies in reporting to first cigarette use in girls. METHOD: Data were drawn from interviews at ages 8-17 with 1,869 girls (57.3% Black, 42.7% White) and their primary caregivers (94% mothers) in the Pittsburgh Girls Study. Cox proportional hazards regression analyses were conducted to predict first cigarette use as a function of girls' reports of parental involvement and monitoring, magnitude and direction of youth-parent reporting discrepancies, and the interaction between them, adjusting for neighborhood, socioeconomic, and individual level factors. RESULTS: High magnitude of discrepancy in parental involvement reports (hazard ratio [HR] = 1.14, 95% confidence interval [CI] [1.03, 1.26]) and lower perceived parental involvement by girls (HR = 1.14, CI [1.03, 1.27]) were associated with an elevated risk for first cigarette use. Girls' reports of low parental monitoring also predicted first cigarette use (HR = 1.14, CI [1.06, 1.21]). CONCLUSIONS: Girls whose parents have limited awareness of their whereabouts and friends (i.e., low monitoring) are at an elevated risk for trying cigarettes, but parent-daughter differences in perceived awareness do not affect risk. By contrast, girls who perceive a lower degree of parental involvement than their parents do are at increased risk. Monitoring is one component of parenting that may reduce smoking risk; shared perspectives on the parent's level of involvement are similarly important.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Fumar Cigarros/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Relações Pais-Filho , Pais/psicologia , População Urbana , Adolescente , Grupo com Ancestrais do Continente Africano/etnologia , Criança , Fumar Cigarros/etnologia , Fumar Cigarros/tendências , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Estudos Longitudinais , Relações Pais-Filho/etnologia , Poder Familiar/etnologia , Poder Familiar/psicologia , Características de Residência , Fatores de Risco , População Urbana/tendências
7.
GMS J Med Educ ; 37(2): Doc16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328518

RESUMO

Objective: This position paper draws on findings from the Straight White College Men Project, a qualitative study with heterosexual white college male participants across college campuses in the United States. The purpose of the larger project was to explore and understand how participants perceived institutional and community diversity issues; how they conceptualized their own privileges; and how they articulated their own responsibility to engage in social change. Thus, this paper delivers "lessons learned" from engaging white men in conversations on racism and to provide recommendations for medical educators in the U.S. and in Europe. Methods: Following purposeful sampling methods using expert nominators, data were collected in phenomenological focus groups at 10 U.S. 4-year universities. Focus groups included 3 to 8 participants and were 60 to 90 minutes in length. Analysis included open and axial coding and two themes emerged from a single question focusing on students' potential dissent of racist family or peer comments. Results: Participants struggled articulating how and in what contexts they would challenge family members or friends on inappropriate language or behavior. Reasons for their reticence included struggling to confront parents, not wanting to ruin male friendships, or jeopardizing being ousted by the male peer group. Conclusion: Educators must find ways to help male university students explore their privileges and proclivity to engage in oppressive behaviors. Men also need to understand how their inactions perpetuate systemic oppression and create environments in which minoritized individuals cannot thrive. Recommendations for medical school educators are provided.


Assuntos
Grupo com Ancestrais do Continente Europeu/psicologia , Racismo/psicologia , Estudantes/psicologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Grupos Focais/métodos , Humanos , Masculino , Cultura Organizacional , Grupo Associado , Pesquisa Qualitativa , Racismo/etnologia , Racismo/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Estados Unidos/etnologia , Universidades/organização & administração , Universidades/estatística & dados numéricos , Adulto Jovem
8.
Cancer Res ; 80(9): 1893-1901, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32245796

RESUMO

Women of Latin American origin in the United States are more likely to be diagnosed with advanced breast cancer and have a higher risk of mortality than non-Hispanic White women. Studies in U.S. Latinas and Latin American women have reported a high incidence of HER2 positive (+) tumors; however, the factors contributing to this observation are unknown. Genome-wide genotype data for 1,312 patients from the Peruvian Genetics and Genomics of Breast Cancer Study (PEGEN-BC) were used to estimate genetic ancestry. We tested the association between HER2 status and genetic ancestry using logistic and multinomial logistic regression models. Findings were replicated in 616 samples from Mexico and Colombia. Average Indigenous American (IA) ancestry differed by subtype. In multivariate models, the odds of having an HER2+ tumor increased by a factor of 1.20 with every 10% increase in IA ancestry proportion (95% CI, 1.07-1.35; P = 0.001). The association between HER2 status and IA ancestry was independently replicated in samples from Mexico and Colombia. Results suggest that the high prevalence of HER2+ tumors in Latinas could be due in part to the presence of population-specific genetic variant(s) affecting HER2 expression in breast cancer. SIGNIFICANCE: The positive association between Indigenous American genetic ancestry and HER2+ breast cancer suggests that the high incidence of HER2+ subtypes in Latinas might be due to population and subtype-specific genetic risk variants.


Assuntos
Neoplasias da Mama/química , Neoplasias da Mama/etnologia , Hispano-Americanos/genética , Receptor ErbB-2/análise , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Neoplasias da Mama/genética , Colômbia/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Índios Norte-Americanos , Índios Sul-Americanos , América Latina/etnologia , Modelos Lineares , Modelos Logísticos , México/etnologia , Pessoa de Meia-Idade , Peru/etnologia , Receptor ErbB-2/genética , Receptores Estrogênicos/sangue , Receptores de Progesterona/sangue , Estados Unidos , Adulto Jovem
9.
Sci Rep ; 10(1): 5543, 2020 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-32218479

RESUMO

The FUT3 (Lewis) gene is responsible for the expression of Lewis fucosyltransferase, which is required for the synthesis of the structural determinants of both Lewisa and Lewisb specificity. These factors play an important role not only in clinical but also in medico-legal investigations. The gene sequence is highly polymorphic and ethnically specific. In the current study, we performed systematic sequence analysis of the coding region of FUT3 by DNA sequencing to investigate the genetic variations of FUT3 and the molecular basis of the Lewis phenotype in the Sindhi and Punjabi populations of Pakistan. Twenty-three point mutations were observed, including 7 unreported mutations, among which two missense mutations (490 G > A and 959 T > C) were predicted to be deleterious to enzyme activity by software assessment. In total, we observed 24 Lewis alleles, including 11 novel ones. However, all unreported missense mutations were present in Lewis-negative alleles confirmed previously. According to genotypic data, the Lewis-negative phenotypic frequencies were 11.5% and 22.93% in the Sindhi and Punjabi ethnic groups, respectively. Moreover, we found that le202,314 and le59,1067 were predominant among Lewis-negative alleles, while the frequency of le59,1067 in the Punjabi population was significantly higher than that in the Sindhi population. In summary, our study revealed that there is a relatively high degree of sequence variation of the Lewis gene in Pakistani populations and provided the first genetic data on FUT3 in these two ethnic groups from Pakistan. The allele types and their frequencies showed that these ethnic groups exhibit more Caucasian components.


Assuntos
Grupo com Ancestrais do Continente Europeu/genética , Fucosiltransferases/genética , Mutação Puntual , Análise de Sequência de DNA/métodos , Grupo com Ancestrais do Continente Europeu/etnologia , Frequência do Gene , Humanos , Paquistão/etnologia
10.
Ophthalmology ; 127(4S): S72-S81, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32200829

RESUMO

OBJECTIVE: Central corneal thickness influences intraocular pressure (IOP) measurement. We examined the central corneal thickness of subjects in the Ocular Hypertension Treatment Study (OHTS) and determined if central corneal thickness is related to race. DESIGN: Cross-sectional study. PARTICIPANTS: One thousand three hundred one OHTS subjects with central corneal thickness measurements. INTERVENTION: Central corneal thickness was determined with ultrasonic pachymeters of the same make and model at all clinical sites of the OHTS. MAIN OUTCOME MEASURES: Correlation of mean central corneal thickness with race, baseline IOP, refraction, age, gender, systemic hypertension, and diabetes. RESULTS: Mean central corneal thickness was 573.0 ± 39.0 µm. Twenty-four percent of the OHTS subjects had central corneal thickness > 600 µm. Mean central corneal thickness for African American subjects (555.7 ± 40.0 µm; n = 318) was 23 µm thinner than for white subjects (579.0 ± 37.0 µm; P < 0.0001). Other factors associated with greater mean central corneal thickness were younger age, female gender, and diabetes. CONCLUSIONS: OHTS subjects have thicker corneas than the general population. African American subjects have thinner corneas than white subjects in the study. The effect of central corneal thickness may influence the accuracy of applanation tonometry in the diagnosis, screening, and management of patients with glaucoma and ocular hypertension.


Assuntos
Córnea/patologia , Pressão Intraocular/fisiologia , Hipertensão Ocular/fisiopatologia , Adulto , Afro-Americanos/etnologia , Fatores Etários , Idoso , Paquimetria Corneana , Estudos Transversais , Diabetes Mellitus/fisiopatologia , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/etnologia , Tamanho do Órgão , Fatores Sexuais , Tonometria Ocular
11.
Stroke ; 51(4): 1135-1141, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32126942

RESUMO

Background and Purpose- Selective serotonin reuptake inhibitors (SSRIs) have a well-established association with bleeding complications and conflicting reports on outcome after stroke. We sought to evaluate whether pre-intracerebral hemorrhage (ICH) SSRI use increased ICH risk and post-ICH SSRI use improved ICH outcome. Methods- Through post hoc analysis of the ERICH study (Ethnic/Racial Variations of Intracerebral Hemorrhage), SSRI use was categorized into no use, pre-ICH only, pre- and post-ICH use (termed "continuous"), and post-ICH only (termed "new"). Using multivariable modeling, associations were sought between pre-ICH SSRI use and ICH risk in the case-control set, and associations between post-ICH SSRI use and 3-month outcome were analyzed in the ICH case set. Exploratory analyses sought to assess influence of race/ethnicity in models. Results- The final study cohort consisted of 2287 ICH cases and 2895 controls. Pre-ICH SSRI use was not associated with ICH risk (odds ratio, 0.824 [95% CI, 0.632-1.074]) nor potentiation of ICH risk with anticoagulant or antiplatelet use. New post-ICH SSRI use was associated with unfavorable modified Rankin Scale score at 3 months after ICH (odds ratio, 1.673 [95% CI, 1.162-2.408]; P=0.006) in multivariable analyses. Additional propensity score analysis indicated a similar trend but did not reach statistical significance (P=0.107). When stratified by race/ethnicity, multivariable modeling demonstrated reduced ICH risk with pre-ICH SSRI use in Hispanics (odds ratio, 0.513 [95% CI, 0.301-0.875]; P=0.014), but not non-Hispanic whites or blacks, and no associations between post-ICH SSRI use and 3-month outcome in any racial/ethnic group. Conclusions- In a large multiethnic cohort, pre-ICH SSRI use was not associated with increased ICH risk, but post-ICH SSRI use was associated with unfavorable 3-month neurological outcome after ICH. Registration- URL: https://www.clinicaltrials.gov; Unique identifier: NCT01202864.


Assuntos
Afro-Americanos/etnologia , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Hispano-Americanos , Inibidores de Captação de Serotonina/uso terapêutico , Adulto , Idoso , Estudos de Casos e Controles , Hemorragia Cerebral/induzido quimicamente , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Inibidores de Captação de Serotonina/efeitos adversos , Resultado do Tratamento
12.
J Hum Genet ; 65(5): 461-468, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32081902

RESUMO

Predicting the biogeographical ancestries of populations and unknown individuals based on ancestry-informative markers (AIMs) has been widely applied in providing DNA clues to criminal investigations, correcting the factor of population stratification in genome-wide association studies (GWAS), and working as the basis of predicting the externally visible characteristics (EVCs) of individuals. The present study chose Chinese Xinjiang Kazak (XJK) group as research object using a 165 AIM-SNPs panel via next generation sequencing (NGS) technology to reveal its ancestral information and genetic background by referencing the populations' data from 1000 Genomes Phase 3. After the Bonferroni correction, there were no significant deviations at the 165 AIM-SNP loci except two loci with homozygote in the studied XJK group. Ancestry information inference and populations genetic analyses were conducted basing on multiplex statistical methods such as forensic statistical parameter analyses, estimation of the success ratios with cross-validation, population tree, principal component analysis (PCA), and genetic structure analysis. The present results revealed that XJK group had the admixed ancestral components of East Asian and European populations with the ratio of about 62:37.


Assuntos
Grupo com Ancestrais do Continente Asiático , Estudo de Associação Genômica Ampla , Sequenciamento de Nucleotídeos em Larga Escala , Polimorfismo de Nucleotídeo Único , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/genética , China/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/genética , Humanos
13.
Stroke ; 51(4): 1064-1069, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32078475

RESUMO

Background and Purpose- An excess incidence of strokes among blacks versus whites has been shown, but data on disparities related to Hispanic ethnicity remain limited. This study examines race/ethnic differences in stroke incidence in the multiethnic, largely Caribbean Hispanic, NOMAS (Northern Manhattan Study), and whether disparities vary by age. Methods- The study population included participants in the prospective population-based NOMAS, followed for a mean of 14±7 years. Multivariable-adjusted Cox proportional hazards models were constructed to estimate the association between race/ethnicity and incident stroke of any subtype and ischemic stroke, stratified by age. Results- Among 3298 participants (mean baseline age 69±10 years, 37% men, 24% black, 21% white, 52% Hispanic), 460 incident strokes accrued (400 ischemic, 43 intracerebral hemorrhage, 9 subarachnoid hemorrhage). The most common ischemic subtype was cardioembolic, followed by lacunar infarcts, then cryptogenic. The greatest incidence rate was observed in blacks (13/1000 person-years), followed by Hispanics (10/1000 person-years), and lowest in whites (9/1000 person-years), and this order was observed for crude incidence rates until age 75. By age 85, the greatest incidence rate was in Hispanics. Blacks had an increased risk of stroke versus whites overall in multivariable models that included sociodemographics (hazard ratio, 1.51 [95% CI, 1.13-2.02]), and stratified analyses showed that this disparity was driven by women of age ≥70. The increased rate of stroke among Hispanics (age/sex-adjusted hazard ratio, 1.48 [95% CI, 1.13-1.93]) was largely explained by education and insurance status (a proxy for socieoeconomic status; hazard ratio after further adjusting for these variables, 1.17 [95% CI, 0.85-1.62]) but remained significant for women age ≥70. Conclusions- This study provides novel data regarding the increased stroke risk among Caribbean Hispanics in this elderly population. Results highlight the need to create culturally tailored campaigns to reach black and Hispanic populations to reduce race/ethnic stroke disparities and support the important role of low socioeconomic status in driving an elevated risk among Caribbean Hispanics.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Isquemia Encefálica/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos , Acidente Vascular Cerebral/etnologia , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/economia , Estudos de Coortes , Grupos de Populações Continentais/etnologia , Grupos Étnicos , Feminino , Seguimentos , Disparidades em Assistência à Saúde/economia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/etnologia , Estudos Prospectivos , Fatores de Risco , Classe Social , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/economia
15.
Dev Psychobiol ; 62(1): 62-76, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31172517

RESUMO

Maternal psychosocial stress during pregnancy can adversely influence child development, but few studies have investigated psychosocial stress during the postpartum period and its association with risk of toddler developmental delays. Moreover, given the expanding diversity of the U.S. population, and well-documented health and stress disparities for racial and ethnic minorities, research examining the effect of postpartum stress on risk of developmental delays in diverse populations is of critical importance. In this study, data from the Community Child Health Network provided the opportunity to test maternal postpartum stress as a predictor of toddler risk of developmental delay in a sample of African American, Latina and non-Hispanic White women and their toddlers (N = 1537) recruited in urban, suburban, and rural communities. Postpartum maternal stress over 1 year was operationalized as perceived stress, life events, and negative impact of life events. Regression results revealed higher risk of developmental delays in toddlers whose mothers experienced more negative life events, greater negative impact of events, and higher perceived stress over the year. Prenatal stress, pregnancy/birth complications, and postpartum depression did not explain these associations. Maternal postpartum stress may contribute to increased risk for developmental delays and is an important target for psychosocial intervention.


Assuntos
Afro-Americanos/etnologia , Deficiências do Desenvolvimento/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Hispano-Americanos/estatística & dados numéricos , Transtornos Puerperais/etnologia , Estresse Psicológico/etnologia , Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Estados Unidos/etnologia , Adulto Jovem
16.
J Neurol ; 267(1): 125-131, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31583427

RESUMO

OBJECTIVES: To identify risk factors for DMF-induced lymphopenia and characterize its impact on T lymphocyte subsets in MS patients. METHODS: We performed a retrospective analysis of 194 RRMS patients treated with DMF at the Beth Israel Deaconess Medical Center (BIDMC) over a median of 17 months. We reviewed demographics, ethnic background, prior medication history, complete blood counts and T lymphocyte subsets. Possible lymphopenia risk factors examined included age, prior natalizumab exposure, vitamin D levels, and concomitant exposure to carbamazepine, opiates, tobacco, or steroids. Lymphopenia was defined as grade 1: absolute lymphocytes count (ALC) 800-999/µl; grade 2: ALC 500-799/µl; grade 3: ALC 200-499/µl; and grade 4: ALC < 200/µl. RESULTS: Of 194 DMF-treated patients, 73 (38%) developed lymphopenia and reached an ALC nadir after a median of 504 days (range 82-932). Risk of developing DMF-induced lymphopenia increased with BMI 25-30, older age, white ethnicity, non-smoking status, and lowest quartile baseline ALC. Prior exposure to natalizumab or concomitant steroid, opiates or carbamazepine/oxcarbamazepine use was not associated with lymphopenia. Compared to baseline levels, CD8 T cells were significantly more reduced than CD4 cells. CD8 counts were more commonly reduced with age or white ethnicity. Subjects with BMI 25-30 was associated with a higher risk of abnormal CD4 cell count reductions. In contrast, non-smokers were more likely to experience reductions in both CD4 and CD8 counts while on DMF. CONCLUSIONS: Patients with low baseline lymphocyte counts, with intermediate BMI, with white ethnicity, with advanced age, or with no tobacco use, had a significantly higher incidence of lymphopenia on DMF. Intermediate BMI or lowest quartile baseline ALC predicted low CD4 levels, while advanced age or white ethnicity predicted low CD8 levels from DMF exposure.


Assuntos
Fumarato de Dimetilo/efeitos adversos , Imunossupressores/efeitos adversos , Linfopenia/induzido quimicamente , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla Recidivante-Remitente/etnologia , Estudos Retrospectivos , Fatores de Risco
17.
Psychol Addict Behav ; 34(2): 382-391, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31750700

RESUMO

The focus of the current investigation is to examine the temporal relationship of gambling onset and alcohol, tobacco, and cannabis initiation in adolescents and young adults (M age = 20.3 years) by examining the prevalence and pattern of onset for each substance and gambling pairing and the associated risk between gambling and each substance use. Data were drawn from the multiwave Missouri Family Study (n = 1,349) of African American (AA; n = 450) and White families (n = 317) enriched for risk for alcohol use disorder and includes those who were assessed for gambling behaviors and problems: AA (360 males, 390 females) and White (287 males, 312 females). Findings indicated racial differences in the overall prevalence of gambling behaviors and substance use as well as patterns of initiation-particularly within gambling/alcohol and gambling/tobacco for males. Survival models revealed some similarities as well as differences across race and gender groups in associations of gambling with initiation of substances, as well as substances with initiation of gambling. Alcohol use (AA males only) and cannabis use (AA males and White females) elevated the hazards of initiating gambling. In contrast, gambling significantly elevated the hazards of initiation alcohol across 3 of 4 groups and of cannabis use in AA males only. The results highlight some overlapping as well as distinct risk factors for both gambling and substance use initiation in this cohort enriched for vulnerability to alcohol use disorder (AUD). These findings have implications for integrating gambling prevention into existing substance use prevention and intervention efforts-particularly but not exclusively for young AA males. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Comportamento do Adolescente , Afro-Americanos/etnologia , Alcoolismo/epidemiologia , Grupo com Ancestrais do Continente Europeu/etnologia , Jogo de Azar/epidemiologia , Uso da Maconha/epidemiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Missouri/epidemiologia , Adulto Jovem
18.
Pain Pract ; 20(2): 129-137, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31505082

RESUMO

The objective of the present analysis was to determine whether changes in Brief Pain Inventory (BPI) average pain scores by patient global impression of improvement (PGI-I) category and the cut-off for clinically important difference (CID) were different between Asian and Caucasian patients with chronic pain due to osteoarthritis. This analysis used data from 3 (Caucasian) and 2 (Asian) randomized, placebo-controlled, 10- to 14-week duloxetine studies for the treatment of patients ≥40 years of age with osteoarthritis pain. The receiver operating characteristic (ROC) analysis was used to characterize the association between changes in BPI average pain scores and PGI-I levels at study endpoint. The CID was characterized by PGI-I, and the cut-off point for CID in BPI average pain scores was determined by the intersection of a 45-degree tangent line with each ROC curve. Data from 668 Asian and 868 Caucasian patients were available for analysis. Baseline BPI average pain ratings including worst and least pain were comparable between Asians and Caucasians. Ratings for percentage change from baseline to endpoint for BPI average pain scores in Asian patients and Caucasian patients were similar across the 7 PGI-I categories, regardless of age, gender, study, and treatment. The ROC analysis results of cut-off points in BPI average pain scores demonstrated the raw change cut-off was -3.0, and percentage change cut-off was -40% for both Asian and Caucasian patients. Overall, the present analysis concludes changes in BPI average pain scores by PGI-I category and the cut-off for CID were similar for Asian and Caucasian patients with chronic pain due to osteoarthritis.


Assuntos
Grupo com Ancestrais do Continente Asiático/etnologia , Dor Crônica/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Osteoartrite/etnologia , Medição da Dor/métodos , Índice de Gravidade de Doença , Adulto , Idoso , Analgésicos/uso terapêutico , Dor Crônica/diagnóstico , Dor Crônica/tratamento farmacológico , Método Duplo-Cego , Cloridrato de Duloxetina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/tratamento farmacológico , Resultado do Tratamento
19.
Arthritis Care Res (Hoboken) ; 72(2): 225-232, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31507071

RESUMO

OBJECTIVE: Lupus low disease activity state (LLDAS) is a potential treat-to-target goal in systemic lupus erythematosus (SLE). This study determined predictors of time to reach LLDAS in a longitudinal cohort. METHODS: Patients were grouped according to LLDAS status at cohort entry. Those who did not satisfy LLDAS at cohort entry were analyzed prospectively. The Kaplan-Meier approach was used to estimate the time to LLDAS. Cox regression was used to identify patient characteristics that were associated with time to LLDAS. RESULTS: The probability of LLDAS attainment within 1 year was 52% for Caucasians, 36% for African Americans, and 33% for SLE patients with renal involvement. The median time to LLDAS was 1.1 years. In multivariable models, African American ethnicity, baseline prednisone >10 mg daily, hypocomplementemia, baseline damage, and baseline renal activity remained significant predictors of longer time to attain LLDAS, while disease duration <1 year and cutaneous activity were associated with earlier attainment. CONCLUSION: LLDAS is potentially attainable in the majority of SLE patients. The time to LLDAS was found to be longer in African American patients with SLE. Characteristics of African American patients with SLE, such as renal activity and hypocomplementemia, were also independent predictors of slower attainment of LLDAS. These findings point to the need to include African American patients with SLE in both clinical and pharmaceutical research.


Assuntos
Afro-Americanos/etnologia , Progressão da Doença , Grupo com Ancestrais do Continente Europeu/etnologia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/etnologia , Índice de Gravidade de Doença , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo
20.
Acta Diabetol ; 57(3): 263-269, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31494746

RESUMO

AIMS: To compare gestational diabetes mellitus (GDM) risk among two ethnic minority groups, with high type-2 diabetes (T2DM) prevalence, as compared to the Jewish population majority group. METHODS: A historical cohort study was conducted using clinical data collected between January 1, 2007, and December 31, 2011. The study sample included 20-45-year-old women; 2938 Ethiopian, 5849 Arab and 5156 non-Ethiopian Jewish women. GDM was defined according to the two-step strategy: step 1: glucose ≥ 140 mg/dl and step 2: using Coustan and Carpenter's diagnostic criteria. GDM risk was tested in a multivariable model, adjusted for age, parity and pre-gestational values of the metabolic syndrome components. RESULTS: Mean body mass index (BMI) values and morbid obesity rates were lowest among Ethiopian women and highest among Arab women. The prevalence of pre-gestational diabetes was significantly higher among Ethiopian (2.7%) and Arab (4.1%) women than among non-Ethiopian Jewish women (1.6%), and GDM screening rates were relatively high (85.5%, 87.2% and 83%, respectively). The proportion of pregnancies complicated with GDM was higher among Ethiopian women (4.3%) but not significantly different between Arab (2.9%) and non-Ethiopian Jewish (2.2%) women. In multivariable analysis, GDM was associated with Ethiopian ancestry (OR, 2.55; 95% CI, 1.60-4.08), adjusted for age, BMI, plasma triglyceride level and parity. Arab ethnicity was not significantly associated with GDM risk in multivariable analysis. CONCLUSIONS: Both Ethiopian and Arab minority ethnicities have a higher risk of T2DM in comparison with other Israeli women, but only Ethiopian origin is an independent risk factor for GDM while Arab ethnicity is not.


Assuntos
Diabetes Gestacional/etnologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Glicemia/metabolismo , Índice de Massa Corporal , Estudos de Coortes , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/metabolismo , Diabetes Gestacional/fisiopatologia , Grupos Étnicos , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etnologia , Síndrome Metabólica/metabolismo , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Grupos Minoritários , Paridade , Gravidez , Prevalência , Fatores de Risco , Adulto Jovem
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