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1.
Gene ; 766: 145092, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32916247

RESUMO

Cigarette smoking is a major lifestyle factor leading to different human diseases. The DNA repair gene, thymine DNA glycosylase, is important to cell survival because it stops cells from becoming cancerous protecting/preventing DNA. Exposure to CS may induce genetic changes such as single nucleotide polymorphisms in DNA repair genes. Therefore, the purpose of this study was to investigate the genotype and allele distributions of four TDG SNPs with only smoking behavior in normal patients. Four TDG SNPs-rs4135066 (C/T), rs3751209 (A/G), rs1866074 (C/T), and rs1882018 (C/T) were analyzed by genotyping 235 and 239 blood samples collected from cigarette smokers and non-smokers, among the Saudi population. The results showed that TDG rs4135066 has a significant susceptibility effect observed in long-term smokers (>5 years; OR = 4.53; P = 0.0347) but not in short-term smokers (≤5 years) in contrast with non-smokers. Also, in smokers aged less than 29 years, the "CT," "TT," and "CT + TT" alleles of rs1882018 increased the risk of developing all diseases related to smoking by approximately 6, 4, and 5 times, respectively, in contrast with the ancestral "CC" homozygous allele. A comparison of the allele distributions of TDG SNPs in a Saudi population with those in other populations represented in the HapMap project showed that the genetic makeup of the Saudi Arabian population appears to differ from that of other ethnicities. Exceptions include the Yoruba people in Ibadan, Nigeria; those of Mexican ancestry in Los Angeles, California; the Luhya population in Webuye, Kenya; Gujarati Indians in Houston, Texas; and the Tuscan population in Italy, which showed similar allelic frequencies for rs3751209 compared to our Saudi population. In this ethnic, we have found a high variation in the distribution of the alleles and genotype frequencies on TDG gene. This variation on TDG SNP's with smoking could lead to increase the susceptibility to many diseases related to smoking habits in this population.


Assuntos
Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único/genética , Fumar/genética , Timina DNA Glicosilase/genética , Adulto , Alelos , Grupos Étnicos/genética , Feminino , Frequência do Gene/genética , Genótipo , Humanos , Masculino
2.
Rev. enferm. UERJ ; 28: e50968, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1122751

RESUMO

Objetivo: descrever as práticas culturais de cuidado no puerpério de mulheres quilombolas. Método: estudo descritivo, de abordagem qualitativa e delineado por meio da Teoria da Diversidade e Universalidade do Cuidado de Madeleine Leininger. Participaram do estudo quatorze mulheres quilombolas que já tinham vivenciado o período puerperal. A coleta das informações ocorreu de junho a setembro de 2018. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: observou-se a manutenção das crenças e valores, considerando a cultura local relacionada às práticas de cuidado de puérperas quilombolas. Considerações finais: as práticas de cuidado desenvolvidas por mulheres quilombolas no pós-parto se caracterizam por receber influência das crenças, valores e modos de vida que foram transmitidas por meio da oralidade por outras mulheres que já tinham vivenciado esse período.


Objective: to describe cultural practices of health care for quilombola women in puerperium. Method: this qualitative, descriptive study was framed by Madeleine Leininger's Theory of Culture Care Diversity and Universality. Fourteen quilombola women who had already experienced the puerperal period participated in the study. Information was collected from June to September 2018. The project was approved by the research ethics committee. Results: beliefs and values were observed to be maintained in the local culture as regards practices of care for puerperal quilombola women. Final considerations: the postpartum care practices applied by quilombola women were characteristically influenced by the beliefs, values and ways of life transmitted orally by other women who had already experienced puerperium.


Objetivo: describir las prácticas culturales de atención a la salud de las mujeres quilombolas en el puerperio. Método: este estudio cualitativo y descriptivo fue enmarcado por la Teoría de la Cultura Cuidado de la Diversidad y Universalidad de Madeleine Leininger. Participaron del estudio catorce mujeres quilombolas que ya habían pasado por el puerperio. La información se recopiló de junio a septiembre de 2018. El proyecto fue aprobado por el comité de ética en investigación. Resultados: se observó el mantenimiento de creencias y valores en la cultura local en cuanto a prácticas de cuidado de las puérperas quilombolas. Consideraciones finales: las prácticas de atención posparto aplicadas por las mujeres quilombolas estuvieron característicamente influenciadas por las creencias, valores y formas de vida transmitidas oralmente por otras mujeres que ya habían experimentado el puerperio.


Assuntos
Humanos , Feminino , Grupos Étnicos , Características Culturais , Período Pós-Parto , Saúde Materna , Repouso em Cama , Brasil , Higiene , Epidemiologia Descritiva , Pesquisa Qualitativa , Comportamento Alimentar , Normas Sociais
3.
Rev. enferm. UERJ ; 28: e44773, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1119608

RESUMO

Objetivo:descrever a frequência dos fatores de risco cardiovascular em idosos de uma comunidade quilombola. Método: estudo transversal desenvolvido com idosos quilombolas cadastrados na Estratégia Saúde da Família. A coleta foi realizada com uma amostra de 62 idosos, utilizando-se o teste do qui-quadrado para análise dos dados. Resultados: as frequências dos fatores de risco foram: 67,7% de hipertensão arterial, 54,8% de adiposidade abdominal, 22,6% de glicemia capilar elevada, 19,4% de excesso de peso, 3,2% de sedentarismo e 3,2% de tabagismo, com diferença estatística apenas para adiposidade abdominal em idosas de cor branca (p<0,05). Conclusão: o estudo identificou elevada frequência de fatores de risco cardiovasculares nos idosos quilombolas atendidos na atenção primária à saúde, com destaque para hipertensão arterial, adiposidade abdominal e glicemia capilar elevada. Os resultados apontam a necessidade de melhoria de acesso da comunidade quilombola aos serviços de saúde.


Objective: to describe the frequency of cardiovascular risk factors in the older adults of a quilombola community. Method: in this cross-sectional study of 62 older adults of a quilombo registered with Brazil's Family Health Strategy, the data collected were analyzed using the Chi-square test. Results: risk factor frequencies were: 67.7% for arterial hypertension; 54.8%, abdominal adiposity; 22.6%, high capillary blood glucose; 19.4%, overweight; 3.2%, sedentary lifestyle; and 3.2%, smoking. Statistical difference was observed only for abdominal adiposity in older, white women (p<0.05). Conclusion: this study identified a high frequency of cardiovascular risk factors in quilombola older adults treated in primary health care, particularly arterial hypertension, abdominal adiposity, and high capillary blood glucose. These results indicate the need to improve quilombola communities' access to health services.


Objetivo: describir la frecuencia de factores de riesgo cardiovascular en los adultos mayores de una comunidad quilombola. Método: en este estudio transversal de 62 adultos mayores de un quilombo inscrito en la Estrategia de Salud de la Familia de Brasil, los datos recolectados se analizaron mediante la prueba de Chi-cuadrado. Resultados: las frecuencias de los factores de riesgo fueron: 67,7% para la hipertensión arterial; 54,8%, adiposidad abdominal; 22,6%, glucemia capilar elevada; 19,4%, sobrepeso; 3,2%, sedentarismo; y 3,2%, tabaquismo. Se observó diferencia estadística solo para la adiposidad abdominal en mujeres blancas mayores (p<0,05). Conclusión: este estudio identificó una alta frecuencia de factores de riesgo cardiovascular en adultos mayores quilombolas tratados en atención primaria de salud, particularmente hipertensión arterial, adiposidad abdominal y glucemia capilar alta. Estos resultados indican la necesidad de mejorar el acceso de las comunidades quilombolas a los servicios de salud.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares , Grupos Étnicos , Fatores de Risco , Acesso aos Serviços de Saúde , Tabagismo , Glicemia , Brasil , Epidemiologia Descritiva , Estratégia Saúde da Família , Circunferência Abdominal , Comportamento Sedentário , Hipertensão , Obesidade
4.
PLoS One ; 15(11): e0241825, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33175863

RESUMO

BACKGROUND: Available COVID-19 mortality indices are limited to acute inpatient data. Using nationwide medical administrative data available prior to SARS-CoV-2 infection from the US Veterans Health Administration (VA), we developed the VA COVID-19 (VACO) 30-day mortality index and validated the index in two independent, prospective samples. METHODS AND FINDINGS: We reviewed SARS-CoV-2 testing results within the VA between February 8 and August 18, 2020. The sample was split into a development cohort (test positive between March 2 and April 15, 2020), an early validation cohort (test positive between April 16 and May 18, 2020), and a late validation cohort (test positive between May 19 and July 19, 2020). Our logistic regression model in the development cohort considered demographics (age, sex, race/ethnicity), and pre-existing medical conditions and the Charlson Comorbidity Index (CCI) derived from ICD-10 diagnosis codes. Weights were fixed to create the VACO Index that was then validated by comparing area under receiver operating characteristic curves (AUC) in the early and late validation cohorts and among important validation cohort subgroups defined by sex, race/ethnicity, and geographic region. We also evaluated calibration curves and the range of predictions generated within age categories. 13,323 individuals tested positive for SARS-CoV-2 (median age: 63 years; 91% male; 42% non-Hispanic Black). We observed 480/3,681 (13%) deaths in development, 253/2,151 (12%) deaths in the early validation cohort, and 403/7,491 (5%) deaths in the late validation cohort. Age, multimorbidity described with CCI, and a history of myocardial infarction or peripheral vascular disease were independently associated with mortality-no other individual comorbid diagnosis provided additional information. The VACO Index discriminated mortality in development (AUC = 0.79, 95% CI: 0.77-0.81), and in early (AUC = 0.81 95% CI: 0.78-0.83) and late (AUC = 0.84, 95% CI: 0.78-0.86) validation. The VACO Index allows personalized estimates of 30-day mortality after COVID-19 infection. For example, among those aged 60-64 years, overall mortality was estimated at 9% (95% CI: 6-11%). The Index further discriminated risk in this age stratum from 4% (95% CI: 3-7%) to 21% (95% CI: 12-31%), depending on sex and comorbid disease. CONCLUSION: Prior to infection, demographics and comorbid conditions can discriminate COVID-19 mortality risk overall and within age strata. The VACO Index reproducibly identified individuals at substantial risk of COVID-19 mortality who might consider continuing social distancing, despite relaxed state and local guidelines.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Betacoronavirus/isolamento & purificação , Comorbidade , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Bases de Dados Factuais , Grupos Étnicos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/patologia , Pneumonia Viral/virologia , Curva ROC , Fatores de Risco , Saúde dos Veteranos , Adulto Jovem
6.
Cell Host Microbe ; 28(5): 636-637, 2020 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-33181076

RESUMO

We know little about factors that ordain the composition of the diverse community of viruses (virome) in the human gut. In this issue of Cell Host & Microbe, Zuo et al. highlight the importance of geography, urbanization, ethnicity, and diet on the shape of the adult gut DNA virome.


Assuntos
Microbioma Gastrointestinal , Adulto , DNA , Grupos Étnicos , Geografia , Humanos , Urbanização
7.
Artigo em Inglês | MEDLINE | ID: mdl-33153162

RESUMO

As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide. It is crucial to understand the effect of social determination of health on novel COVID-19 outcomes in order to establish health justice. There is an imperative need, for policy makers at all levels, to consider socioeconomic and racial and ethnic disparities in pandemic planning. Cross-sectional analysis from COVID Boston University's Center for Antiracist Research COVID Racial Data Tracker was performed to evaluate the racial and ethnic distribution of COVID-19 outcomes relative to representation in the United States. Representation quotients (RQs) were calculated to assess for disparity using state-level data from the American Community Survey (ACS). We found that on a national level, Hispanic/Latinx, American Indian/Alaskan Native, Native Hawaiian/Pacific Islanders, and Black people had RQs > 1, indicating that these groups are over-represented in COVID-19 incidence. Dramatic racial and ethnic variances in state-level incidence and mortality RQs were also observed. This study investigates pandemic disparities and examines some factors which inform the social determination of health. These findings are key for developing effective public policy and allocating resources to effectively decrease health disparities. Protective standards, stay-at-home orders, and essential worker guidelines must be tailored to address the social determination of health in order to mitigate health injustices, as identified by COVID-19 incidence and mortality RQs.


Assuntos
Infecções por Coronavirus/etnologia , Pneumonia Viral/etnologia , Determinantes Sociais da Saúde , Betacoronavirus , Grupos de Populações Continentais , Infecções por Coronavirus/mortalidade , Estudos Transversais , Grupos Étnicos , Humanos , Pandemias , Pneumonia Viral/mortalidade , Estados Unidos/epidemiologia
8.
PLoS One ; 15(11): e0241950, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33170903

RESUMO

The COVID-19 pandemic has had tremendous impact on Americans' lives including their personal and social behaviors. While people of all ages are affected in some way by the pandemic, older persons have been far more likely to suffer the most severe health consequences. For this reason, how people have responded to mitigating behaviors to COVID-19 may differ by age. Using a nationally representative sample from the longitudinal data of the Understanding America Study (UAS), we examined differentials in behavioral responses to COVID-19 by age and how they changed over the first three months of the pandemic. Behavioral responses and changes in behavior over time differed by age, type of behaviors and time reference. At the beginning of the pandemic (March, 2020), older and younger people were similar in their likelihood of engaging in preventive personal behaviors when controlling for other influences. As the pandemic progressed, however, older people adopted mitigating personal behavioral changes more than younger people, such that about 1-2 months after the pandemic started, older people were more likely to comply with suggested behaviors and regulations including practicing better hygiene, quarantining, and social distancing. One month into the pandemic, older people were less likely than younger people to engage in two of four risky behaviors. The change in risky behavior over time did not differ by age; but both younger and older people were more likely to engage in risky behaviors after two months. Being female, a member of a racial/ethnic minority group, higher socioeconomic status, having more COVID-19 cases in one's state of residence, a higher perceived risk for infection and dying, and a more left-leaning political orientation were related to adopting more pandemic mitigating behaviors.


Assuntos
Infecções por Coronavirus/patologia , Comportamentos Relacionados com a Saúde , Pneumonia Viral/patologia , Comportamento Social , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
9.
MMWR Morb Mortal Wkly Rep ; 69(46): 1717-1724, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33211683

RESUMO

BACKGROUND: Life expectancy for persons with human immunodeficiency virus (HIV) infection who receive recommended treatment can approach that of the general population, yet HIV remains among the 10 leading causes of death among certain populations. Using surveillance data, CDC assessed progress toward reducing deaths among persons with diagnosed HIV (PWDH). METHODS: CDC analyzed National HIV Surveillance System data for persons aged ≥13 years to determine age-adjusted death rates per 1,000 PWDH during 2010-2018. Using the International Classification of Diseases, Tenth Revision, deaths with a nonmissing underlying cause were classified as HIV-related or non-HIV-related. Temporal changes in total deaths during 2010-2018 and deaths by cause during 2010-2017 (2018 excluded because of delays in reporting), by demographic characteristics, transmission category, and U.S. Census region of residence at time of death were calculated. RESULTS: During 2010-2018, rates of death decreased by 36.6% overall (from 19.4 to 12.3 per 1,000 PWDH). During 2010-2017, HIV-related death rates decreased 48.4% (from 9.1 to 4.7), whereas non-HIV-related death rates decreased 8.6% (from 9.3 to 8.5). Rates of HIV-related deaths during 2017 were highest by race/ethnicity among persons of multiple races (7.0) and Black/African American persons (5.6), followed by White persons (3.9) and Hispanic/Latino persons (3.9). The HIV-related death rate was highest in the South (6.0) and lowest in the Northeast (3.2). CONCLUSION: Early diagnosis, prompt treatment, and maintaining access to high-quality care and treatment have been successful in reducing HIV-related deaths and remain necessary for continuing reductions in HIV-related deaths.


Assuntos
Infecções por HIV/mortalidade , Adolescente , Adulto , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/etnologia , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
10.
Georgian Med News ; (306): 113-117, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-33130657

RESUMO

The article describes the peculiarities of suicidal behavior depending on sociodemographic characteristics, such as sex, age, level of education, housing conditions, social and family status. The article also considers the ethnic peculiarities of persons and the influence of ethnoculture on the development of suicidal behavior in the studied persons. Patients participated in the study. The purpose of this work is to assess the structure of suicidal emotional disorders in their relationship with socio-economic factors. The research material was clinical data on 131 patients of the psychoneurological dispensary in Shymkent city, including 79 men and 52 women from different age groups (from 18 to 72 years) during five years. Mathematical methods resulted in the identification of common features of suicidal behavior as well as factors influencing suicidal behavior.


Assuntos
Grupos Étnicos , Ideação Suicida , Feminino , Humanos , Masculino , Fatores de Risco
12.
Medicine (Baltimore) ; 99(43): e22778, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120788

RESUMO

BACKGROUND: To analyze the sagittal positions of the mandibular prominence and maxillary central incisors in adult Chinese Han men to establish their aesthetic profile characteristics. METHODS: Seventy-four Chinese Han men aged 18 to 40 years underwent cone beam computed tomography for detecting the distances between Glabella and Subnasale, Subnasale and Menthon of soft tissue, Condyle and Gonion, Pogonion and Pogonion's Anterior Limit Line, Facial Axis point of maxillary central incisor and the Goal Anterior Limit Line as well as the angle of the Occlusal Plane. Dolphin Imaging and Photoshop software packages were used to generate silhouette profiles. Thirteen orthodontists assessed the silhouette profiles and assigned visual analog scale scores. Scores >70 were assigned to the aesthetic (group 1), scores of 60to 70 to the general (group 2), scores of 50 to 60 to the acceptable (group 3), and scores of <50 to the unaesthetic profile (group 4). RESULTS: A total of 15 men were assigned to group 1, 35 to group 2, 14 to group 3, and 10 to group 4. There were no significant differences in the variables examined between groups 1, 2, and 3, but comparing group 1 with group 4, Pogonion and Pogonion's Anterior Limit Line (1.16 ±â€Š2.61 mm vs -1.44 ±â€Š2.92 mm, P = .046) and Facial Axis-Goal Anterior Limit Line (-0.61 ±â€Š2.54 mm vs 1.70 ±â€Š2.62 mm, P = .038) there were significant differences. CONCLUSION: Compared with the unaesthetic profile group, the sagittal positions of the maxillary central incisors were slightly posterior, and the chin was slightly anterior in adult Chinese Han men with an aesthetic profile.


Assuntos
Grupos Étnicos , Incisivo/anatomia & histologia , Incisivo/diagnóstico por imagem , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Adolescente , Adulto , Cefalometria/métodos , Queixo/anatomia & histologia , Queixo/diagnóstico por imagem , China , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Masculino , Mandíbula/anatomia & histologia , Mandíbula/diagnóstico por imagem , Estudos Prospectivos , Valores de Referência , Adulto Jovem
13.
PLoS Med ; 17(10): e1003406, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33125416

RESUMO

BACKGROUND: Initial reports indicate a high incidence of acute kidney injury (AKI) in Coronavirus Disease 2019 (COVID-19), but more data are required to clarify if COVID-19 is an independent risk factor for AKI and how COVID-19-associated AKI may differ from AKI due to other causes. We therefore sought to study the relationship between COVID-19, AKI, and outcomes in a retrospective cohort of patients admitted to 2 acute hospitals in Derby, United Kingdom. METHODS AND FINDINGS: We extracted electronic data from 4,759 hospitalised patients who were tested for COVID-19 between 5 March 2020 and 12 May 2020. The data were linked to electronic patient records and laboratory information management systems. The primary outcome was AKI, and secondary outcomes included in-hospital mortality, need for ventilatory support, intensive care unit (ICU) admission, and length of stay. As compared to the COVID-19-negative group (n = 3,374), COVID-19 patients (n = 1,161) were older (72.1 ± 16.1 versus 65.3 ± 20.4 years, p < 0.001), had a greater proportion of men (56.6% versus 44.9%, p < 0.001), greater proportion of Asian ethnicity (8.3% versus 4.0%, p < 0.001), and lower proportion of white ethnicity (75.5% versus 82.5%, p < 0.001). AKI developed in 304 (26.2%) COVID-19-positive patients (COVID-19 AKI) and 420 (12.4%) COVID-19-negative patients (AKI controls). COVID-19 patients aged 65 to 84 years (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.11 to 2.50), needing mechanical ventilation (OR 8.74, 95% CI 5.27 to 14.77), having congestive cardiac failure (OR 1.72, 95% CI 1.18 to 2.50), chronic liver disease (OR 3.43, 95% CI 1.17 to 10.00), and chronic kidney disease (CKD) (OR 2.81, 95% CI 1.97 to 4.01) had higher odds for developing AKI. Mortality was higher in COVID-19 AKI versus COVID-19 patients without AKI (60.5% versus 27.4%, p < 0.001), and AKI was an independent predictor of mortality (OR 3.27, 95% CI 2.39 to 4.48). Compared with AKI controls, COVID-19 AKI was observed in a higher proportion of men (58.9% versus 51%, p = 0.04) and lower proportion with white ethnicity (74.7% versus 86.9%, p = 0.003); was more frequently associated with cerebrovascular disease (11.8% versus 6.0%, p = 0.006), chronic lung disease (28.0% versus 19.3%, p = 0.007), diabetes (24.7% versus 17.9%, p = 0.03), and CKD (34.2% versus 20.0%, p < 0.001); and was more likely to be hospital acquired (61.2% versus 46.4%, p < 0.001). Mortality was higher in the COVID-19 AKI as compared to the control AKI group (60.5% versus 27.6%, p < 0.001). In multivariable analysis, AKI patients aged 65 to 84 years, (OR 3.08, 95% CI 1.77 to 5.35) and ≥85 years of age (OR 3.54, 95% CI 1.87 to 6.70), peak AKI stage 2 (OR 1.74, 95% CI 1.05 to 2.90), AKI stage 3 (OR 2.01, 95% CI 1.13 to 3.57), and COVID-19 (OR 3.80, 95% CI 2.62 to 5.51) had higher odds of death. Limitations of the study include retrospective design, lack of urinalysis data, and low ethnic diversity of the region. CONCLUSIONS: We observed a high incidence of AKI in patients with COVID-19 that was associated with a 3-fold higher odds of death than COVID-19 without AKI and a 4-fold higher odds of death than AKI due to other causes. These data indicate that patients with COVID-19 should be monitored for the development of AKI and measures taken to prevent this. TRIAL REGISTRATION: ClinicalTrials.gov NCT04407156.


Assuntos
Lesão Renal Aguda/etiologia , Infecções por Coronavirus/complicações , Mortalidade Hospitalar , Pneumonia Viral/complicações , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Grupos Étnicos , Feminino , Hospitalização , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia , Insuficiência Renal Crônica/complicações , Respiração Artificial , Estudos Retrospectivos , Fatores de Risco , Reino Unido/epidemiologia , Adulto Jovem
14.
Medicine (Baltimore) ; 99(44): e23006, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126384

RESUMO

Interleukin-10(IL-10) is an immunosuppressive cytokine and plays an important role in inflammation and cancers. Numerous studies have explored the association between single nucleotide polymorphisms of IL-10 and leukemia, but their results were conflicting, so we performed this meta-analysis to elucidate the association between 3 common single nucleotide polymorphisms of IL-10 (rs1800896, rs1800871 and rs1800872) and risk of leukemia.We conducted a comprehensive research in Pubmed, Chinese Biomedical Literature Database disc and Embase using related terms. After strict selection, 18 studies with 2264 cases and 3846 controls were included into this meta-analysis. Odds ratio and 95% confidence interval were used to evaluate the strength of the association.We found that polymorphism of IL-10 -1082A/G was associated with decreased risk of leukemia both in overall analysis and in stratified analysis according to ethnicity and cancer type. A strong relationship was also uncovered between polymorphism of IL-10 -592C/A and increased risk of leukemia in non-Chinese.GG genotype of IL-10 -1082A/G is associated with decreased risk of leukemia, especially chronic lymphocytic leukemia. CC genotype of -592C/A is associated with decreased risk of leukemia in non-Chinese.


Assuntos
Predisposição Genética para Doença , Interleucina-10/genética , Leucemia/genética , Estudos de Casos e Controles , Grupos Étnicos , Humanos , Polimorfismo de Nucleotídeo Único , Risco
15.
MMWR Morb Mortal Wkly Rep ; 69(39): 1391-1397, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33001873

RESUMO

Vaccination of pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can decrease the risk for influenza and pertussis among pregnant women and their infants. The Advisory Committee on Immunization Practices (ACIP) recommends that all women who are or might be pregnant during the influenza season receive influenza vaccine, which can be administered at any time during pregnancy (1). ACIP also recommends that women receive Tdap during each pregnancy, preferably during the early part of gestational weeks 27-36 (2,3). Despite these recommendations, vaccination coverage among pregnant women has been found to be suboptimal with racial/ethnic disparities persisting (4-6). To assess influenza and Tdap vaccination coverage among women pregnant during the 2019-20 influenza season, CDC analyzed data from an Internet panel survey conducted during April 2020. Among 1,841 survey respondents who were pregnant anytime during October 2019-January 2020, 61.2% reported receiving influenza vaccine before or during their pregnancy, an increase of 7.5 percentage points compared with the rate during the 2018-19 season. Among 463 respondents who had a live birth by their survey date, 56.6% reported receiving Tdap during pregnancy, similar to the 2018-19 season (4). Vaccination coverage was highest among women who reported receiving a provider offer or referral for vaccination (influenza = 75.2%; Tdap = 72.7%). Compared with the 2018-19 season, increases in influenza vaccination coverage were observed during the 2019-20 season for non-Hispanic Black (Black) women (14.7 percentage points, to 52.7%), Hispanic women (9.9 percentage points, to 67.2%), and women of other non-Hispanic (other) races (7.9 percentage points, to 69.6%), and did not change for non-Hispanic White (White) women (60.6%). As in the 2018-19 season, Hispanic and Black women had the lowest Tdap vaccination coverage (35.8% and 38.8%, respectively), compared with White women (65.5%) and women of other races (54.0%); in addition, a decrease in Tdap vaccination coverage was observed among Hispanic women in 2019-20 compared with the previous season. Racial/ethnic disparities in influenza vaccination coverage decreased but persisted, even among women who received a provider offer or referral for vaccination. Consistent provider offers or referrals, in combination with conversations culturally and linguistically tailored for patients of all races/ethnicities, could increase vaccination coverage among pregnant women in all racial/ethnic groups and reduce disparities in coverage.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Disparidades em Assistência à Saúde/etnologia , Vacinas contra Influenza/administração & dosagem , Gestantes/etnologia , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Estados Unidos , Adulto Jovem
16.
BMJ Open ; 10(10): e040441, 2020 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-33109676

RESUMO

OBJECTIVE: To assess association of clinical features on COVID-19 patient outcomes. DESIGN: Retrospective observational study using electronic medical record data. SETTING: Five member hospitals from the Mount Sinai Health System in New York City (NYC). PARTICIPANTS: 28 336 patients tested for SARS-CoV-2 from 24 February 2020 to 15 April 2020, including 6158 laboratory-confirmed COVID-19 cases. MAIN OUTCOMES AND MEASURES: Positive test rates and in-hospital mortality were assessed for different racial groups. Among positive cases admitted to the hospital (N=3273), we estimated HR for both discharge and death across various explanatory variables, including patient demographics, hospital site and unit, smoking status, vital signs, lab results and comorbidities. RESULTS: Hispanics (29%) and African Americans (25%) had disproportionately high positive case rates relative to their representation in the overall NYC population (p<0.05); however, no differences in mortality rates were observed in hospitalised patients based on race. Outcomes differed significantly between hospitals (Gray's T=248.9; p<0.05), reflecting differences in average baseline age and underlying comorbidities. Significant risk factors for mortality included age (HR 1.05, 95% CI 1.04 to 1.06; p=1.15e-32), oxygen saturation (HR 0.985, 95% CI 0.982 to 0.988; p=1.57e-17), care in intensive care unit areas (HR 1.58, 95% CI 1.29 to 1.92; p=7.81e-6) and elevated creatinine (HR 1.75, 95% CI 1.47 to 2.10; p=7.48e-10), white cell count (HR 1.02, 95% CI 1.01 to 1.04; p=8.4e-3) and body mass index (BMI) (HR 1.02, 95% CI 1.00 to 1.03; p=1.09e-2). Deceased patients were more likely to have elevated markers of inflammation. CONCLUSIONS: While race was associated with higher risk of infection, we did not find racial disparities in inpatient mortality suggesting that outcomes in a single tertiary care health system are comparable across races. In addition, we identified key clinical features associated with reduced mortality and discharge. These findings could help to identify which COVID-19 patients are at greatest risk of a severe infection response and predict survival.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hospitalização/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Pandemias , Pneumonia Viral , Fatores Etários , Técnicas de Laboratório Clínico/estatística & dados numéricos , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Grupos Étnicos , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Cidade de Nova Iorque/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Retrospectivos , Fatores de Risco
18.
J Perinat Med ; 48(9): 900-911, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33001856

RESUMO

The objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1-7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Grupos Étnicos , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Gravidez , Nascimento Prematuro/epidemiologia , PubMed
19.
Am J Nephrol ; 51(10): 786-796, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33011717

RESUMO

BACKGROUND: Although diffuse alveolar damage and respiratory failure are the key features of coronavirus disease 2019 (COVID-19), the involvement of other organs such as the kidney has also been reported. The reports of the incidence of acute kidney injury (AKI) in COVID-19 patients vary widely. In this study, we report our unique experience with AKI in COVID-19 patients in a low socioeconomic and predominantly ethnic minority group and provide its incidence, risk factors, and prognosis to expand the current understanding of this complication. METHODS: In this single-center, retrospective cohort study, we analyzed the data of 469 COVID-19 patients admitted to the Brookdale University Hospital in Brooklyn, NY, from March 18 through April 23, 2020. Information regarding demographics, comorbidities, medications, clinical and laboratory data, and outcomes was collected from the electronic medical records. Both univariate and multivariate analyses were performed to determine the association of AKI with in-hospital mortality. RESULTS: The median age was 66 years (interquartile range [IQR] 25-75; range 19-101 years), and 268 (57.14%) patients were male. Estimated glomerular filtration rate (eGFR) as determined by the Modification of Diet in Renal Disease Study Equation was low (<60 mL/min/1.73 m2) in 207 (44.1%) patients. During hospitalization, 128 (27.3%) patients developed AKI, and the incidence was significantly higher in those patients presenting with a low eGFR (N = 81, 39.1%; p < 0.001). Male sex, hypertension, the use of angiotensin-converting enzyme inhibitors and non-steroidal anti-inflammatories, hemodynamic instability, mechanical ventilation, acute respiratory distress syndrome, and admission elevated ferritin, creatinine kinase, brain natriuretic peptide, and troponin 1 were identified as the risk factors for in-hospital AKI. Ninety-seven (28.45%) patients died in the non-AKI group versus 91 (71.1%) in the AKI group (p < 0.001). The Cox proportional hazard model after adjusting for age, gender, comorbidities, hemodynamic status, and PF ratio (arterial oxygen partial pressure [PaO2]/fractional inspired oxygen [FiO2]) determined that on admission, an elevated blood urea nitrogen (hazard ratio [HR]: 1.75; 95% confidence interval [CI] 1.23-2.48), a low eGFR (HR 1.43; CI 1.1-2.03), AKI stage 1 (HR 1.14; CI 0.64-2.03), AKI stage 2 (HR 1.86; CI 1.03-3.56), and AKI stage 3 (HR 2.1; CI 1.3-2.81) were independent risk factors for in-hospital mortality. Renal replacement therapy (RRT) did not improve survival in stage III AKI. CONCLUSION: AKI in our hospitalized COVID-19 patients was common and carried a high mortality, especially in patients with AKI stage 3. RRT did not improve survival. Policy changes and planning for this high incidence of AKI in COVID-19 patients and its associated high mortality are necessary at the local and national levels.


Assuntos
Lesão Renal Aguda/mortalidade , Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Hospitais Urbanos/organização & administração , Pneumonia Viral/complicações , Políticas , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/terapia , Lesão Renal Aguda/virologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Hospitais Urbanos/estatística & dados numéricos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Cidade de Nova Iorque/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Prognóstico , Terapia de Substituição Renal/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Análise de Sobrevida , Resultado do Tratamento , Adulto Jovem
20.
Fa Yi Xue Za Zhi ; 36(4): 497-501, 2020 Aug.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33047533

RESUMO

Abstract: Objective To explore the association of cardiac disease associated genetic variants and the high incidence of Yunnan sudden unexplained death (YNSUD) in Yi nationality. Methods The genomic DNA was extracted from peripheral blood samples collected from 205 Yi villagers from YNSUD aggregative villages (inpatient group) and 197 healthy Yi villagers from neighboring villages (control group). Fifty-two single nucleotide variants (SNVs) of 25 cardiac disease associated genes were genotyped using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). The SPSS 17.0 was used to analyze data. The pathogenicities of variants with differences between the two groups that have statistical significance were predicted by protein function prediction software PolyPhen-2 and SIFT. All villagers from inpatient group were given electrocardiogram (ECG) examination using a 12-lead electrocardiograph. Results The allele frequency and the genotype frequency of missense mutation DSG2 (rs2278792, c.2318G>A, p.R773K) of pathogenic genes of arrhythmogenic right ventricular cardiomyopathy (ARVC) in inpatient group was higher than that in control group (P<0.05). Abnormal ECG changes were detected in 71 individuals (34.6%) in the inpatient group, among which 54 individuals carried R773K mutation, including clockwise (counterclockwise) rotation, left (right) axis deviation, ST segment and T wave alteration and heart-blocking. Conclusion Definite pathogenic mutations have not been found in the 52 cardiac disease genes associated SNVs detected in Yi nationality in regions with high incidence of YNSUD. The cause of high incidence of YNSUD in Yi nationality needs further study.


Assuntos
Displasia Arritmogênica Ventricular Direita , Grupos Étnicos , China/epidemiologia , Morte Súbita/epidemiologia , Morte Súbita/etiologia , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Grupos Étnicos/genética , Humanos , Incidência , Mutação
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