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1.
Orthopade ; 48(11): 957-962, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31559467

RESUMO

BACKGROUND: Rheumatic and mental disorders are common and affect each other. The comorbidities are often diagnosed too late or not at all but cause considerable suffering for those affected and have a negative effect on the health-related quality of life and therapeutic success. OBJECTIVES: Is there any evidence regarding common pathophysiological mechanisms and how can they be considered in terms of therapy? METHODS: Recent findings, reviews and basic literature are analyzed and an update is presented and discussed. RESULTS: The current data suggest a mutual influence of the factors stress and inflammation both in depressive disorders, anxiety disorders and chronic pain, as well as in diseases of the rheumatic type. There is a close relationship between immunological and neuronal processes that bi-directionally regulate the individual's stress response. CONCLUSIONS: For sufficient therapy the establishment of an interdisciplinary treatment concept in clinical everyday life is to be striven for. In addition to rheumatic treatment, this should include a multimodal approach to both pharmacological and psycho-socio-therapeutic components. In particular, potential interactions must be taken into account.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Inflamação , Doenças Reumáticas/psicologia , Estresse Psicológico/epidemiologia , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/tratamento farmacológico , Comorbidade , Depressão , Humanos , Inflamação/epidemiologia , Inflamação/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Qualidade de Vida , Doenças Reumáticas/epidemiologia , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/psicologia
2.
Pan Afr Med J ; 33: 61, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448023

RESUMO

Introduction: Mortality in patients with chronic renal failure is high compared to the general population. The objective of our study is to evaluate the predictive factors related to mortality in hemodialysis. Methods: This is a retrospective study involving 126 hemodialysis patients in the Nephrology Department of Ibn Rochd Hospital, Casablanca. Data were collected between January 2012 and January 2016. For each of our patients, we analyzed demographic, clinical, biological and anthropometric data. The Kaplan-Meier method and the log-rank test were used to evaluate and compare survival curves. To evaluate the effect of predictors of mortality, we used the proportional Cox hazard model. Results: The analysis of the results showed that the surviving patients were younger than the deceased patients (43.07±13.52 years versus 53.09±13.56 years, p=0.001). Also, the latter has a significantly lower albumin and prealbumin levels (p=0.01 and p=0.04 respectively). Overall survival was 80.2%. Cox regression analysis at age (HR=1.26, p<0.0002), inflammation (HR=1.15, p<0.03), AIP> 0.24 (HR=2.1, p<0.002) and cardiovascular disease (RR=2.91, p<0.001) were associated with global and cardiovascular mortality. Conclusion: Our study showed that the mortality rate is high in our cohort. In addition, cardiovascular diseases, under nutrition and inflammation are predictive factors for mortality. Treatment and early management of these factors are essential for reducing morbidity and mortality.


Assuntos
Doenças Cardiovasculares/mortalidade , Falência Renal Crônica/terapia , Diálise Renal/métodos , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Feminino , Humanos , Inflamação/epidemiologia , Inflamação/mortalidade , Estimativa de Kaplan-Meier , Falência Renal Crônica/mortalidade , Masculino , Desnutrição/epidemiologia , Desnutrição/mortalidade , Pessoa de Meia-Idade , Marrocos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco
3.
Pan Afr Med J ; 32: 161, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31303930

RESUMO

Serum protein electrophoresis (SPE) is a routine analysis in the daily practice of a medical biology laboratory. This study aimed to analyze the different electrophoretic profiles seen in our current practice. We conducted a cross-sectional study of 410 serum samples collected during the routine analyses in the Laboratory of Biochemistry at the University Hospital Mohammed VI in Oujda. Serum protein electrophoresis was performed using automated instrument CAPILLARYS 2 FLEX-PIERCING, SEBIA. 241 sera from women and 169 sera from men were collected. Patients were aged between 1-91 years, with an average age of 49 years; 19.5% of SPEs were normal, hypoalbuminemia was found in 34% of cases, chronic inflammatory syndrome in 19.5% of cases, nephrotic syndrome in 2% of cases, 5.8% of our patients had betagamma block, hypogammaglobulinemia was found in 8.5% of cases and 29 monoclonal peaks were noted, bisalbuminemia was found in 2 patients. Out of 410 collections: 92 immunofixations were performed, of whom 23 were positive (showing monoclonal gammopathy). This study highlights the variability in prescribing serum protein electrophoresis as well as the importance of clinical data for a better interpretation.


Assuntos
Eletroforese das Proteínas Sanguíneas/métodos , Hipoalbuminemia/diagnóstico , Inflamação/diagnóstico , Paraproteinemias/diagnóstico , Adolescente , Adulto , Agamaglobulinemia/diagnóstico , Agamaglobulinemia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Hipoalbuminemia/epidemiologia , Lactente , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/diagnóstico , Síndrome Nefrótica/epidemiologia , Paraproteinemias/epidemiologia , Adulto Jovem
4.
Health Psychol ; 38(7): 586-595, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31120270

RESUMO

OBJECTIVE: To investigate the separate and combined associations of obesity and metabolic syndrome (MetS) with depression and the role of inflammation. METHOD: Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9) and was defined with a cutpoint of ≥10. Obesity was defined as body mass index (BMI) ≥30 kg/m2 from measured height and weight. MetS was defined based on the American Heart Association consensus definition. Participants were divided into four groups: healthy normal weight (MHN), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUN), and metabolic unhealthy obese (MUO). C-Reactive protein was assessed in a subsample. RESULTS: A total of 18,025 subjects were included in the analysis. Participants with MUO had the highest prevalence of depression compared with the MHN group (14.8% vs. 6.8, p < .001). While both obesity and MetS were independently associated with depression, there was a significant interaction between the two (p < .001), indicating that the associations of obesity and MetS with depression were synergistic. After adjusting for baseline characteristics, compared with the MHN group, the MUO group had the highest odds of depression (odds ratio [OR] = 2.30, 95% CI [2.03, 2.61]), followed by MHO group (OR = 1.51, 95% CI [1.30, 1.74]) and the MUN group (OR = 1.39, 95% CI [1.18, 1.64]). The MUO group also showed the highest level of C-reactive protein, and the latter partially mediated the effect between MUO and depressive symptoms (20.5% of the total effect). CONCLUSION: Both obesity and MetS are associated with depression independent of each other, but when present together, these conditions have a synergistic association with depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Depressão/epidemiologia , Depressão/psicologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/psicologia , Obesidade/epidemiologia , Obesidade/psicologia , Adulto , Idoso , Antropometria/métodos , Índice de Massa Corporal , Peso Corporal/fisiologia , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Inflamação/diagnóstico , Inflamação/epidemiologia , Inflamação/psicologia , Masculino , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Inquéritos Nutricionais/métodos , Obesidade/diagnóstico , Reprodutibilidade dos Testes , Circunferência da Cintura/fisiologia
5.
Vasc Health Risk Manag ; 15: 89-100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118651

RESUMO

Obesity is associated with an increased risk of developing cardiovascular disease (CVD), particularly heart failure (HF) and coronary heart disease (CHD). The mechanisms through which obesity increases CVD risk involve changes in body composition that can affect hemodynamics and alters heart structure. Pro-inflammatory cytokines produced by the adipose tissue itself which can induce cardiac dysfunction and can promote the formation of atherosclerotic plaques. When obesity and HF or CHD coexist, individuals with class I obesity present a more favorable prognosis compared to individuals who are normal or underweight. This phenomenon has been termed the "obesity paradox." Obesity is defined as an excess fat mass (FM), but individuals with obesity typically also present with an increased amount of lean mass (LM). The increase in LM may explain part of the obesity paradox as it is associated with improved cardiorespiratory fitness (CRF), a major determinant of clinical outcomes in the general population, but particularly in those with CVD, including HF. While increased LM is a stronger prognosticator in HF compared to FM, in patients with CHD excess FM can exert protective effects particularly when not associated with increased systemic inflammation. In the present review, we discuss the mechanisms through which obesity may increase the risk for CVD, and how it may exert protective effects in the setting of established CVD, with a focus on body composition. We also highlight the importance of measuring or estimating CRF, including body composition-adjusted measures of CRF (ie, lean peak oxygen consumption) for an improved risk status stratification in patients with CVD and finally, we discuss the potential non-pharmacologic therapeutics, such as exercise training and dietary interventions, aimed at improving CRF and perhaps clinical outcomes.


Assuntos
Composição Corporal , Doenças Cardiovasculares/epidemiologia , Hemodinâmica , Obesidade/epidemiologia , Aptidão Cardiorrespiratória , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Comorbidade , Exercício , Dieta Saudável , Humanos , Inflamação/sangue , Inflamação/epidemiologia , Mediadores da Inflamação/sangue , Estado Nutricional , Obesidade/sangue , Obesidade/fisiopatologia , Obesidade/terapia , Prognóstico , Fatores de Proteção , Fatores de Risco , Comportamento de Redução do Risco
6.
Maturitas ; 124: 68-71, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097182

RESUMO

There is an ongoing misperception that women under 60 years of age are at low risk of cardiovascular disease (CVD). As there is an important variation in risk among women in this age group, we need to tailor risk assessment by using additional risk parameters during their life-course. For this, valuable tools are family risk, female-specific risk factors and inflammatory co-morbidities, which can be enriched by measuring the coronary artery calcium (CAC) score using computerized tomography. Depending on the results, we can readily adapt lifestyle advice and preventive treatment to every individual woman. Progress has been made in the recognition of stable and unstable manifestations of ischemic heart disease in middle-aged women. Whereas the traditional cardiovascular risk factors are involved in classic obstructive coronary disease, female-specific risk variables, inflammatory co-morbidities and psychosocial stress are also involved in other types of ischemic disease. We therefore need a more sex- and gender-sensitive way to look at women's cardiovascular health.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Inflamação/epidemiologia , Doenças Cardiovasculares/genética , Comorbidade , Feminino , Humanos , Estilo de Vida , Medição de Risco , Fatores de Risco , Fatores Sexuais , Estresse Psicológico/epidemiologia , Saúde da Mulher
7.
Cancer Causes Control ; 30(7): 677-686, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31111277

RESUMO

Neighborhoods encompass complex environments comprised of unique economic, physical, and social characteristics that have a profound impact on the residing individual's health and, collectively, on the community's wellbeing. Neighborhood disadvantage (ND) is one of several factors that prominently contributes to racial breast cancer (BC) health disparities in American women. African American (AA) women develop more aggressive breast cancer features, such as triple-negative receptor status and more advanced histologic grade and tumor stage, and suffer worse clinical outcomes than European American (EA) women. While the adverse effects of neighborhood disadvantage on health, including increased risk of cancer and decreased longevity, have recently come into focus, the specific molecular mechanisms by which neighborhood disadvantage increases BC risk and worsens BC outcomes (survivorship, recurrence, mortality) are not fully elucidated. This review illuminates the probable biological links between neighborhood disadvantage and predominantly BC risk, with an emphasis on stress reactivity and inflammation, epigenetics and telomere length in response to adverse neighborhood conditions.


Assuntos
Neoplasias da Mama/epidemiologia , Disparidades nos Níveis de Saúde , Características de Residência , Neoplasias da Mama/etnologia , Grupos de Populações Continentais , Feminino , Humanos , Inflamação/epidemiologia , Inflamação/etnologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etnologia
8.
Acta Haematol ; 141(4): 245-253, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30965330

RESUMO

BACKGROUND: The incidence of venous thromboembolism (VTE) in haematological malignancies varies according to the type and grade of the disease and clinical variables, and there is a need to develop a tool to predict the occurrence of VTE in cancer patients at diagnosis to tailor prophylactic anticoagulation use during treatment. OBJECTIVE: To study the incidence of VTE in haematological malignancies and clarify whether vascular and inflammatory biomarkers could be used as predictors of VTE in those patients. METHODS: This was a prospective observational cohort study. Hypercoagulability and inflammatory biomarkers were assayed in a group of 171 patients with haematological malignancies at diagnosis. These markers included (1) coagulation and fibrinolysis activation markers (D-dimer, fibrinogen, antithrombin, plasminogen activator inhibitor 1), (2) endothelial and platelet activation markers (von Willebrand factor and soluble P-selectin), and (3) inflammatory markers (tumour necrosis factor αand interleukin 6). The end point was mortality or symptomatic VTE. RESULTS/CONCLUSION: The incidence of symptomatic VTE was 7%. None of the tested biomarkers showed statistical significance as predictors for the occurrence of VTE in haematological malignancies. However, there were statistically significant associations between the occurrence of VTE and central venous access device insertion, the prothrombin time, and the erythrocyte sedimentation rate. An ESR above 106.5 mm/h is associated with increased VTE occurrence.


Assuntos
Fibrinólise , Neoplasias Hematológicas/sangue , Ativação Plaquetária , Tromboembolia/sangue , Biomarcadores/sangue , Feminino , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/epidemiologia , Humanos , Incidência , Inflamação/sangue , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tromboembolia/epidemiologia , Tromboembolia/etiologia
9.
Medicine (Baltimore) ; 98(17): e15340, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027108

RESUMO

The cardiovascular disease (CVD) has been identified as a leading cause of premature mortality among middle-aged and elderly individuals globally. Inflammation plays an important role in aging and age-related diseases, such as atherosclerosis and CVD. White blood cell (WBC) count is an inexpensive, simple biomarker of systemic inflammations and includes several cell subtype counts, such as neutrophils, monocytes, lymphocytes, basophils, and eosinophils. However, which component of a WBC count has the ability to predict CVD remains controversial. The objective of this study was to assess the association between monocyte counts and 10 year-CVD risk among community-dwelling Korean individuals using the Framingham risk score (FRS). We studied a total of 627 participants aged over 30 years who underwent routine health examinations. The mean age of the study population was 48.1 ±â€Š11.7 years, and 56.9% were male. In the multiple regression analysis, the independent contribution of monocyte count to Framingham 10-year CVD risk was 0.217 ±â€Š0.092 (P = .018) after adjusting for confounding variables. We found that of the various WBCs, monocyte count is an independent predictor of CVD risk. Further larger-scale prospective cohort studies are warranted to determine these associations in the future.


Assuntos
Doenças Cardiovasculares/epidemiologia , Mediadores da Inflamação/metabolismo , Contagem de Leucócitos/estatística & dados numéricos , Monócitos/metabolismo , Adulto , Fatores Etários , Idoso , Grupo com Ancestrais do Continente Asiático , Biomarcadores , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Feminino , Humanos , Inflamação/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , República da Coreia/epidemiologia , Fatores de Risco
10.
BMC Med ; 17(1): 75, 2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30961604

RESUMO

BACKGROUND: Comorbidity patterns of childhood infections, atopic diseases, and adverse childhood experiences (ACE) are related to immune system programming conditions. The aim of this study was to make a step beyond the hygiene hypothesis and to comprehensively classify these patterns with latent class analysis (LCA). A second aim was to characterize the classes by associations with immunological, clinical, and sociodemographic variables. METHODS: LCA was applied to data from the CoLaus|PsyCoLaus study (N = 4874, age range 35-82 years) separately for men and women. It was based on survey information on chickenpox, measles, mumps, rubella, herpes simplex, pertussis, scarlet fever, hay fever, asthma, eczema, urticaria, drug allergy, interparental violence, parental maltreatment, and trauma in early childhood. Subsequently, we examined how immune-mediated classes were reflected in leukocyte counts, inflammatory markers (IL-1ß, IL-6, TNF-α, hsCRP), chronic inflammatory diseases, and mental disorders, and how they differed across social classes and birth cohorts. RESULTS: LCA results with five classes were selected for further analysis. Latent classes were similar in both sexes and were labeled according to their associations as neutral, resilient, atopic, mixed (comprising infectious and atopic diseases), and ACE class. They came across with specific differences in biomarker levels. Mental disorders typically displayed increased lifetime prevalence rates in the atopic, the mixed, and the ACE classes, and decreased rates in the resilient class. The same patterns were apparent in chronic inflammatory diseases, except that the ACE class was relevant specifically in women but not in men. CONCLUSIONS: This is the first study to systematically determine immune-mediated classes that evolve early in life. They display characteristic associations with biomarker levels and somatic and psychiatric diseases occurring later in life. Moreover, they show different distributions across social classes and allow to better understand the mechanisms beyond the changes in the prevalence of chronic somatic and psychiatric diseases.


Assuntos
Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/imunologia , Hipótese da Higiene , Fenômenos do Sistema Imunológico/fisiologia , Análise de Classes Latentes , Adulto , Idoso , Idoso de 80 Anos ou mais , Asma/epidemiologia , Asma/imunologia , Criança , Comorbidade , Feminino , Humanos , Inflamação/complicações , Inflamação/epidemiologia , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Múltiplas Afecções Crônicas/epidemiologia , Prevalência , Inquéritos e Questionários
11.
J Fr Ophtalmol ; 42(4): e133-e146, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30850197

RESUMO

Behçet's disease is a chronic multisystem disorder characterized by relapsing inflammation for which the underlying histopathology is an occlusive vasculitis. The disease has a high prevalence in the Mediterranean region, Far and Middle Eastern countries. It is clinically characterized by oral and genital ulcerations, ocular inflammatory involvement, skin lesions, vascular involvement and numerous other systemic manifestations. Uveitis is by far the most common ocular manifestation of Behçet's disease. It typically presents in the form of relapsing-remitting panuveitis with retinal vasculitis that may result in severe visual loss. Management of Behçet's uveitis relies on corticosteroid therapy, conventional immunosuppressive drugs and biological agents and requires a close collaboration between ophthalmologist and internist. A better understanding of auto-inflammatory process and of the role of cytokines implicated in the pathogenesis of Behçet's disease will enable researchers to develop more specific and effective therapy.


Assuntos
Síndrome de Behçet/complicações , Síndrome de Behçet/fisiopatologia , Olho/fisiopatologia , Fenômenos Fisiológicos Oculares , Síndrome de Behçet/tratamento farmacológico , Síndrome de Behçet/epidemiologia , Produtos Biológicos/uso terapêutico , Olho/efeitos dos fármacos , Olho/patologia , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Inflamação/complicações , Inflamação/tratamento farmacológico , Inflamação/epidemiologia , Vasculite Retiniana/tratamento farmacológico , Vasculite Retiniana/epidemiologia , Vasculite Retiniana/etiologia , Uveíte/tratamento farmacológico , Uveíte/epidemiologia , Uveíte/etiologia , Uveíte/fisiopatologia , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/epidemiologia , Transtornos da Visão/etiologia
12.
Proc Natl Acad Sci U S A ; 116(13): 6013-6018, 2019 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-30858317

RESUMO

As the United States becomes more diverse, the ways in which mainstream institutions recognize and address race and ethnicity will be increasingly important. Here, we show that one novel and salient characteristic of an institutional environment, that is, whether a school emphasizes the value of racial and ethnic diversity, predicts better cardiometabolic health among adolescents of color. Using a diverse sample of adolescents who attend more than 100 different schools in predominantly urban locations, we find that when schools emphasize the value of diversity (operationalized as mentioning diversity in their mission statements), students of color, but not white students, have lower values on a composite of five biomarkers of inflammation, have less insulin resistance and compensatory ß-cell activity, and have fewer metabolic syndrome signs and score lower on a continuous metabolic syndrome composite. These results suggest that institutions that emphasize diversity may play an unacknowledged role in protecting the health of people of color and, thus, may be a site for future interventions to reduce health disparities.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Diversidade Cultural , Instituições Acadêmicas/organização & administração , Estudantes/estatística & dados numéricos , Adolescente , Biomarcadores , Feminino , Disparidades nos Níveis de Saúde , Humanos , Inflamação/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Racismo/estatística & dados numéricos , Fatores de Risco , Instituições Acadêmicas/normas , Instituições Acadêmicas/estatística & dados numéricos , Estados Unidos/epidemiologia
13.
Spine (Phila Pa 1976) ; 44(12): E742-E748, 2019 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-30817739

RESUMO

STUDY DESIGN: Retrospective observational histological study. OBJECTIVE: To evaluate the reliability of gadolinium enhancement as a marker for inflammation by associating gadolinium enhancement findings with the degree of inflammation as measured by macrophage infiltration in disc material retrieved during disc surgery in patients with sciatica. SUMMARY OF BACKGROUND DATA: Disc inflammation often occurs in sciatica patients, a noninvasive tool that is used to assess disc inflammation is Gadolinium enhanced MR imaging. METHODS: Disc tissue was retrieved from patients in the Sciatica trial (N = 119), a multicenter randomized controlled trial in patients with sciatica. Disc tissue was embedded in paraffin and stained with hematoxylin and CD68. Tissue samples were categorized as mild (0-10 macrophages/cm), moderate (10-100 macrophages/cm), and considerable (>100 macrophages/cm) inflammation. Of the 119 MRIs, 96 were additionally performed with contrast-enhanced gadolinium. RESULTS: Seventy-four patients showed gadolinium enhancement of the disc herniation and 26 of the nerve root. Degree of inflammation by macrophages was not associated with gadolinium enhancement of nerve roots or herniated discs. These results did not change if the patient groups with and without Modic type 2 changes were evaluated separately. Furthermore, no associations were observed between gadolinium enhancement and presence of Modic type 2 changes. CONCLUSION: This study found gadolinium enhanced MRI findings to be unreliable as an indicator for inflammation of disc herniation or nerve root in patients with sciatica. LEVEL OF EVIDENCE: 2.


Assuntos
Gadolínio , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Ciática/diagnóstico por imagem , Adulto , Feminino , Humanos , Inflamação/diagnóstico por imagem , Inflamação/epidemiologia , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/epidemiologia , Deslocamento do Disco Intervertebral/epidemiologia , Vértebras Lombares/diagnóstico por imagem , Macrófagos/patologia , Imagem por Ressonância Magnética/normas , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Ciática/epidemiologia
14.
Health Qual Life Outcomes ; 17(1): 26, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30728031

RESUMO

BACKGROUND: Few studies have specifically investigated the inverse relationship between reduced quality of life in different domains and elevated C-reactive protein (CRP) serum levels in older adults. Therefore, this study investigates the cross-sectional association between quality of life and inflammation in older Brazilian adults. METHODS: Data were collected from 1255 participants from the third wave (2010) of the Brazilian Health, Well-being and Aging study (SABE), a community-based cohort study of aging. Inflammation was assessed using CRP serum levels and quality of life (QoL) was measured using the 12-item Short-Form Health Survey (SF-12) questionnaire. The covariates included age, sex, education level, financial sufficiency, number of non-communicable diseases, self-reported doctor diagnosed diseases, Activity of Daily Living (ADL) difficulties, Body Mass Index (BMI), and waist circumference. RESULTS: The fully adjusted models showed that older adults with low scores in the physical domain of the SF12 (OR 1.34, 95%CI 1.02;1.77) and high BMI values (> 30) (OR 2.05, 95%CI 1.50;2.81) were more likely to present high CRP serum levels. CONCLUSION: Our findings suggest a significant association of lower scores in the physical domain of quality of life and the presence of obesity with high CRP serum levels.


Assuntos
Atividades Cotidianas , Inflamação/diagnóstico , Qualidade de Vida , Idoso , Índice de Massa Corporal , Brasil , Proteína C-Reativa/análise , Estudos de Coortes , Comorbidade , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Inquéritos e Questionários , Circunferência da Cintura
15.
Restor Neurol Neurosci ; 37(1): 41-59, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30714983

RESUMO

BACKGROUND: Recovery of patients with rheumatoid arthritis (RA) depends on several physical and psychological factors, besides pharmacological treatment. Co-morbid depression adversely affects the outcome in RA. Usual medical therapies have a limited scope and fail to cure the psychological component of the disease. With advanced therapeutic options, achieving a state of remission has become the treatment goal, yoga based mind body intervention (MBI) may provide a holistic approach in its treatment dimension. Hence, MBIs are the need of hour as majority of diseases have a psychosomatic component. OBJECTIVE: To explore the effect of Yoga based MBI on disease specific inflammatory markers and depression severity in active RA patients on routine disease modifying anti-rheumatic drugs (DMARDs) therapy. METHODS: A total of 72 RA patients were randomized into 2 groups: yoga group (yoga with DMARDs) and control group (DMARDs only). Blood samples were collected pre and post intervention for primary outcome measurements of systemic biomarkers. Disease activity score 28, erythrocyte sedimentation rate (DAS28ESR) and health assessment questionnaire disability index (HAQ-DI) were used to assess disease activity and functional status respectively at pre and post intervention time-points. Secondary outcome, depression severity, was assessed by Beck Depression Inventory II scale (BDI-II) at 2 weekly intervals during 8 weeks of the study interventional plan. RESULTS: After 8 weeks of yoga based MBI, there was significant decrease in the severity of RA as seen by reduction in levels of various systemic inflammatory markers as well as in DAS28ESR (p-value <0.0001; effect size = 0.210) and HAQ-DI (p-value 0.001; effect size = 0.159). Also, yoga group experienced a statistically significant time dependent step-wise decline in depression symptoms over the period of 8 weeks as compared to control group (p-value <0.0001; effect size = 0.5). Regression analysis showed greater reduction in the scores of BDI-II with DAS28ESR (R2 = 0.426; p <  0.0001) and HAQ-DI (R2 = 0.236; p = 0.003) in yoga group. CONCLUSIONS: Yoga, a mind body intervention re-established immunological tolerance by aiding remission at molecular and cellular level along with significant reduction in depression. Thus in this severe autoimmune inflammatory arthritis with a major psychosomatic component, yoga can be used as a complementary/adjunct therapy.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/terapia , Depressão/terapia , Ioga , Adulto , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/imunologia , Artrite Reumatoide/psicologia , Biomarcadores/sangue , Terapia Combinada , Comorbidade , Depressão/epidemiologia , Depressão/imunologia , Feminino , Humanos , Inflamação/epidemiologia , Inflamação/imunologia , Inflamação/psicologia , Inflamação/terapia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Método Simples-Cego , Resultado do Tratamento
16.
J Steroid Biochem Mol Biol ; 188: 166-171, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30738820

RESUMO

Phosphates are associated with numerous disorders, ranging from vascular calcification to premature aging, possibly because of an increased inflammatory response. We therefore investigated the association of dietary phosphorus with gingivitis. We analyzed consumption of both phosphorus and sugar and related it to the concentrations of inflammatory biomarkers in saliva samples collected from 8314 children (mean age, 9.99 ± 0.68 years). About 64% of the children consumed more than 1250 mg phosphorus daily, and 34% consumed more than 82 g of sugar daily. Gingivitis was prevalent, with an average of 74% of possible gingival sites considered red. Quantile regression analysis revealed a statistically significant correlation between the occurrence of gingivitis and calorie-adjusted phosphorus intake and between gingivitis and calorie-adjusted sugar intake (both significant either as a linear trend or a categorical variable). In a subset (n = 744) investigation of nutrient consumption related to salivary biomarkers, we found that elevated calorie-adjusted phosphorus intake was directly associated with salivary IL-1ß concentration (OR1.40, 95% CI 1.04-1.89), and inversely associated with salivary IL-4 concentration (OR0.62, 95% CI 0.46-0.84). Sugar intake was not significantly associated with either biomarker. Thus, elevated dietary phosphorus consumption may influence inflammatory disease by altering cytokine levels.


Assuntos
Açúcares da Dieta/imunologia , Gengivite/epidemiologia , Inflamação/epidemiologia , Fósforo na Dieta/imunologia , Biomarcadores/análise , Criança , Ingestão de Energia , Feminino , Gengivite/diagnóstico , Gengivite/imunologia , Humanos , Inflamação/diagnóstico , Inflamação/imunologia , Masculino , Saliva/imunologia
17.
Turk J Med Sci ; 49(1): 327-335, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30761853

RESUMO

Background/aim: Fetuin-A, a circulating inhibitor of calcification, is a marker of inflammatory-nutritional state. We evaluated the association between serum fetuin-A levels and vascular calcification, intima-media thickness, and nutritional and inflammatory markers in different stages of chronic kidney disease (CKD). Materials and methods: CKD patients were sampled for calcium-phosphate parameters and nutritional and inflammatory markers [highly sensitive C-reactive protein (hs-CRP)], and serum fetuin-A levels. Intima-media thicknesses of the common carotid arteries (CIMT) were measured. Peripheral artery calcification scores were obtained. Results: A total of 238 patients were included in the study. Fetuin-A levels in patients with end-stage renal disease were significantly lower than those in patients with stage-3 and stage-4 CKD (stage-5 vs. stage-4, P < 0.001; stage-5 vs. stage-3, P < 0.001). Fetuin-A was negatively correlated with creatinine (P < 0.001), Ca × P product (P < 0.001), hs-CRP (P = 0.01), vascular calcification score (P < 0.001), and CIMT (P < 0.001), and positively correlated with BMI (P < 0.001, r = 0.30) and serum albumin (P < 0.001). Conclusion: Lower levels of fetuin-A were associated with higher vascular calcification scores, CIMT, hs-CRP levels, and lower BMI and albumin. Fetuin-A deficiency may be a key element for MIAC syndrome.


Assuntos
Inflamação , Insuficiência Renal Crônica , alfa-2-Glicoproteína-HS/análise , Adulto , Idoso , Aterosclerose/sangue , Aterosclerose/complicações , Aterosclerose/epidemiologia , Calcinose/sangue , Calcinose/complicações , Calcinose/epidemiologia , Feminino , Humanos , Inflamação/sangue , Inflamação/complicações , Inflamação/epidemiologia , Masculino , Desnutrição/sangue , Desnutrição/complicações , Desnutrição/epidemiologia , Pessoa de Meia-Idade , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Síndrome
18.
J Am Acad Dermatol ; 80(6): 1682-1690, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30797850

RESUMO

BACKGROUND: Diet is a modulator of inflammation that might impact inflammatory skin diseases. OBJECTIVE: To assess the relationship between pro-inflammatory dietary patterns and incident psoriasis, psoriatic arthritis (PsA), and atopic dermatitis (AD). METHODS: We conducted cohort studies among women in the Nurses' Health Study II. The Empirical Dietary Inflammatory Pattern (EDIP) score was calculated at baseline and every 4 years. Incident psoriasis, PsA, and AD were assessed by validated self-report. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDIP quintiles and risk for psoriasis, PsA, and AD. RESULTS: We had 85,185 participants in the psoriasis analysis and 63,443 in the AD analysis. There were 1432 cases of psoriasis, 262 cases of PsA, and 403 cases of AD. Pro-inflammatory dietary patterns were not associated with the risk for outcomes in multivariable models (all P values for trend >.05). HRs comparing the highest to the lowest EDIP quintile were 0.99 (95% CI 0.83-1.18) for psoriasis, 1.22 (95% CI 0.81-1.83) for PsA, and 0.96 (95% CI 0.69-1.34) for AD. LIMITATIONS: Recall and self-report. CONCLUSION: Our findings do not support dietary inflammatory potential as a risk factor for psoriasis, PsA, or AD.


Assuntos
Dermatite Atópica/epidemiologia , Dieta , Comportamento Alimentar , Inflamação/epidemiologia , Psoríase/epidemiologia , Adulto , Artrite Psoriásica/epidemiologia , Índice de Massa Corporal , Comorbidade , Dieta/efeitos adversos , Feminino , Seguimentos , Humanos , Enfermeiras e Enfermeiros , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
19.
PLoS One ; 14(1): e0210316, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30625218

RESUMO

BACKGROUND: The impact of obesity on cardiovascular health of young children is still to be fully illustrated. This study measured biomarkers for glycemic control, lipid metabolism, systemic inflammation, endothelial dysfunction, and hepatic cholestasis in schoolchildren. Its main purpose was to determine whether metabolic derangements could be detected in young children with excess fat. METHOD: This cross-sectional study involved 967 children in the second, sixth, and tenth grades (median age, 7.3, 11.3, and 15.4 years, respectively). Using the International Obesity Task Force interpretation (IOTF) of body-mass-index (BMI), children were stratified as thin (<5th centiles), normal (5th to <85th centiles), overweight (85th to <95th centiles), obese (95th to <98th centiles), or extremely-obese (≥98th centiles). Waist circumference was also measured. Several metabolic determinations were then used as surrogate biomarkers for cardiovascular risks. RESULTS: Prevalence of BMI≥85th centile among the second graders was 13.1%, sixth graders 42.2%, and tenth graders 33.8%. BMI≥85th centile was associated with a tendency for higher hemoglobin A1c (p≥0.160) and higher blood glucose (p≥0.197). For the second graders, BMI≥85th centile was associated with higher high-sensitivity C-reactive protein (hs-CRP, p<0.001), higher tumor necrosis factor-α (TNF-alpha, p<0.001), higher interleukin-6 (IL-6, p<0.001), higher soluble intercellular cytoadhesive molecule-1 (sICAM-1), higher triglycerides (p≤0.024), and lower high-density lipoprotein (HDL, p<0.001). Additionally, for the sixth and tenth graders, BMI≥85th centile was associated with higher gamma-glutamyl transferase (GGT, p<0.001). In the sixth graders, BMI≥85th centile was insignificantly changed with sICAM-1 or the soluble vascular cytoadhesive molecule-1 (sVCAM-1). CONCLUSIONS: The studied children with excess fat had increased risks for developing systemic inflammation, dyslipidemia, endothelial dysfunction, cholestasis, and diabetes. These results suggest that metabolic biomarkers should be included in the routine assessment of children with an overweight problem.


Assuntos
Colestase/epidemiologia , Dislipidemias/epidemiologia , Obesidade/epidemiologia , Adolescente , Biomarcadores/sangue , Doenças Cardiovasculares/etiologia , Criança , Comorbidade , Estudos Transversais , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Inflamação/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Sobrepeso/epidemiologia , Fatores de Risco , Emirados Árabes Unidos/epidemiologia
20.
Mult Scler Relat Disord ; 28: 309-312, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30665072

RESUMO

BACKGROUND: Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE). OBJECTIVES: The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system. METHODS: We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society). RESULTS: Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25). CONCLUSIONS: This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.


Assuntos
Doenças do Sistema Nervoso Central/epidemiologia , Doenças Desmielinizantes/epidemiologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Doenças do Sistema Nervoso Central/diagnóstico , Doenças do Sistema Nervoso Central/terapia , Doenças Desmielinizantes/diagnóstico , Doenças Desmielinizantes/terapia , Feminino , Seguimentos , Humanos , Inflamação/diagnóstico , Inflamação/epidemiologia , Inflamação/terapia , Masculino , Estudos Retrospectivos , Medula Espinal/diagnóstico por imagem
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