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1.
Biomed Environ Sci ; 33(8): 573-582, 2020 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-32933609

RESUMO

Objective: To investigate the relationship between human cytomegalovirus (HCMV) infection and peripheral blood CD14 +CD16 + monocytes in the pathogenesis of coronary heart disease (CHD), and to elucidate the mechanism of pathogenesis in CHD by analyzing the correlation between infection, inflammation, and CHD, to provide a basis for the prevention, evaluation, and treatment of the disease. Methods: In total, 192 patients with CHD were divided into three groups: latent CHD, angina pectoris, and myocardial infarction. HCMV-IgM and -IgG antibodies were assessed using ELISA; CD14 +CD16 + monocytes were counted using a five-type automated hematology analyzer; mononuclear cells were assessed using fluorescence-activated cell sorting; and an automatic biochemical analyzer was used to measure the levels of triglyceride, cholesterol, high- and low-density lipoprotein cholesterols, lipoprotein, hs-CRp and Hcy. Results: The positive rates of HCMV-IgM and -IgG were significantly higher in the CHD groups than in the control group. HCMV infection affects lipid metabolism to promote immune and inflammatory responses. Conclusion: HCMV infection has a specific correlation with the occurrence and development of CHD. The expression of CD14 +CD16 + mononuclear cells in the CHD group was increased accordingly and correlated with acute HCMV infection. Thus, HCMV antibody as well as peripheral blood CD14 +CD16 + mononuclear cells can be used to monitor the occurrence and development of CHD.


Assuntos
Angina Pectoris/epidemiologia , Doença das Coronárias/epidemiologia , Infecções por Citomegalovirus/complicações , Citomegalovirus/fisiologia , Inflamação/epidemiologia , Infarto do Miocárdio/epidemiologia , Angina Pectoris/virologia , China/epidemiologia , Doença das Coronárias/virologia , Humanos , Incidência , Inflamação/etiologia , Contagem de Leucócitos , Monócitos/metabolismo , Infarto do Miocárdio/virologia
3.
Tohoku J Exp Med ; 252(1): 73-84, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32908083

RESUMO

The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30th until April 5th, 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/mortalidade , Pandemias , Pneumonia Viral/mortalidade , Fatores Etários , Idoso , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/sangue , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Inflamação/epidemiologia , Pacientes Internados/estatística & dados numéricos , Irã (Geográfico)/epidemiologia , Nefropatias/epidemiologia , Linfopenia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Razão de Chances , Sobrepeso/epidemiologia , Pneumonia Viral/sangue , Prognóstico , Encaminhamento e Consulta/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Avaliação de Sintomas
4.
Aging (Albany NY) ; 12(15): 15186-15195, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32788424

RESUMO

Italy was the first European nation to be affected by COVID-19. The biggest cluster of cases occurred in Lombardy, the most populous Italian region, and elderly men were the population hit in the hardest way. Besides its high infectivity, COVID-19 causes a severe cytokine storm and old people, especially those with comorbidities, appear to be the most vulnerable, presumably in connection to inflammaging. In centenarians inflammaging is much lower than predicted by their chronological age and females, presenting survival advantage in almost all centenarian populations, outnumber males, a phenomenon particularly evident in Northern Italy. Within this scenario, we wondered if: a) the COVID-19 mortality in centenarians was lower than that in people aged between 50 and 80 and b) the mortality from COVID-19 in nonagenarians and centenarians highlighted gender differences.We checked COVID-19-related vulnerability/mortality at the peak of infection (March 2020), using data on total deaths (i.e. not only confirmed COVID-19 cases). Our conclusion is that excess mortality increases steadily up to very old ages and at the same time men older than 90 years become relatively more resilient than age-matched females.


Assuntos
Envelhecimento , Betacoronavirus/fisiologia , Infecções por Coronavirus , Serviços de Saúde para Idosos/estatística & dados numéricos , Inflamação , Mortalidade , Pandemias , Pneumonia Viral , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Envelhecimento/psicologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Feminino , Necessidades e Demandas de Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Inflamação/epidemiologia , Inflamação/virologia , Itália/epidemiologia , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Saúde Pública/métodos , Fatores Sexuais , Populações Vulneráveis
5.
Biomed Environ Sci ; 33(6): 396-402, 2020 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-32641202

RESUMO

Objectives: To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein (hsCRP) in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection, inflammatory diseases, or tissue damages in the body. Methods: Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600-010 automatic biochemical analyzer (Roche Diagnostics) in 1,572 males and 1,800 females, including 78 pregnant women, who were derived from the National Health and Nutrition Survey in 2010-2012. Results: The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females. Significant differences in hsCRP were found among different age groups ( P < 0.05). Monitoring results showed no significant differences among the 6-11, 45-59, and ≥ 60-year-old groups in the comparison of hsCRP between males and females in large cities. However, hsCRP concentration was significantly higher in men aged 12-17 and 18-44 years than in women. Conclusion: The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender, and the hsCRP levels of both sexes increased gradually with age. In addition, hsCRP concentration was higher in healthy pregnant women than in non-pregnant women. Basing on our results, we recommend that this parameter be included in future national and international screening for early detection of various illnesses.


Assuntos
Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/epidemiologia , Inflamação/epidemiologia , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , População Urbana/estatística & dados numéricos , Adulto Jovem
6.
Nutr Hosp ; 34(3): 622-630, 2020 Jul 13.
Artigo em Espanhol | MEDLINE | ID: mdl-32603180

RESUMO

Introduction: The current COVID-19 pandemic mainly affects older people, those with obesity or other coexisting chronic diseases such as type-2 diabetes and high blood pressure. It has been observed that about 20 % of patients will require hospitalization, and some of them will need the support of invasive mechanical ventilation in intensive care units. Nutritional status appears to be a relevant factor influencing the clinical outcome of critically ill patients with COVID-19. Several international guidelines have provided recommendations to ensure energy and protein intake in people with COVID-19, with safety measures to reduce the risk of infection in healthcare personnel. The purpose of this review is to analyze the main recommendations related to adequate nutritional management for critically ill patients with COVID-19 in order to improve their prognosis and clinical outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/dietoterapia , Cuidados Críticos/métodos , Estado Terminal , Desnutrição/dietoterapia , Pandemias , Pneumonia Viral/dietoterapia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Proteínas na Dieta/administração & dosagem , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Gastroenteropatias/complicações , Humanos , Inflamação/epidemiologia , Inflamação/fisiopatologia , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Metanálise como Assunto , Micronutrientes/administração & dosagem , Avaliação Nutricional , Necessidades Nutricionais , Apoio Nutricional , Obesidade/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Síndrome da Realimentação/prevenção & controle , Respiração Artificial , Sarcopenia/epidemiologia
7.
Circ Arrhythm Electrophysiol ; 13(8): e008627, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32654514

RESUMO

BACKGROUND: During acute infections, the risk of malignant ventricular arrhythmias is increased, partly because of a higher propensity to develop QTc prolongation. Although it is generally believed that QTc changes almost exclusively result from concomitant treatment with QT-prolonging antimicrobials, direct effects of inflammatory cytokines on ventricular repolarization are increasingly recognized. We hypothesized that systemic inflammation per se can significantly prolong QTc during acute infections, via cytokine-mediated changes in K+ channel expression. METHODS: We evaluated (1) the frequency of QTc prolongation and its association with inflammatory markers, in patients with different types of acute infections, during active disease and remission; (2) the prevalence of acute infections in a cohort of consecutive patients with Torsades de Pointes; (3) the relationship between K+ channel mRNA levels in ventricles and peripheral blood mononuclear cells and their changes in patients with acute infection over time. RESULTS: In patients with acute infections, regardless of concomitant QT-prolonging antimicrobial treatments, QTc was significantly prolonged but rapidly normalized in parallel to CRP (C-reactive protein) and cytokine level reduction. Consistently in the Torsades de Pointes cohort, concomitant acute infections were highly prevalent (30%), despite only a minority (25%) of these cases were treated with QT-prolonging antimicrobials. KCNJ2 K+ channel expression in peripheral blood mononuclear cell, which strongly correlated to that in ventricles, inversely associated to CRP and IL (interleukin)-1 changes in acute infection patients. CONCLUSIONS: During acute infections, systemic inflammation rapidly induces cytokine-mediated ventricular electrical remodeling and significant QTc prolongation, regardless concomitant antimicrobial therapy. Although transient, these changes may significantly increase the risk of life-threatening ventricular arrhythmia in these patients. It is timely and warranted to transpose these findings to the current coronavirus disease 2019 (COVID-19) pandemic, in which both increased amounts of circulating cytokines and cardiac arrhythmias are demonstrated along with a frequent concomitant treatment with several QT-prolonging drugs. Graphic Abstract: A graphic abstract is available for this article.


Assuntos
Doenças Transmissíveis/metabolismo , Citocinas/metabolismo , Parada Cardíaca/metabolismo , Frequência Cardíaca , Ventrículos do Coração/metabolismo , Inflamação/metabolismo , Leucócitos Mononucleares/metabolismo , Canais de Potássio Corretores do Fluxo de Internalização/metabolismo , Torsades de Pointes/metabolismo , Potenciais de Ação , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/efeitos adversos , Doenças Transmissíveis/tratamento farmacológico , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/fisiopatologia , Feminino , Parada Cardíaca/epidemiologia , Parada Cardíaca/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Ventrículos do Coração/efeitos dos fármacos , Ventrículos do Coração/fisiopatologia , Humanos , Inflamação/epidemiologia , Inflamação/fisiopatologia , Leucócitos Mononucleares/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Canais de Potássio Corretores do Fluxo de Internalização/genética , Prevalência , Fatores de Risco , Transdução de Sinais , Fatores de Tempo , Torsades de Pointes/epidemiologia , Torsades de Pointes/fisiopatologia , Adulto Jovem
8.
Food Chem Toxicol ; 143: 111558, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32640331

RESUMO

Prevention and treatment of non-communicable diseases (NCDs), including cardiovascular disease, diabetes, obesity, cancer, Alzheimer's and Parkinson's disease, arthritis, non-alcoholic fatty liver disease and various infectious diseases; lately most notably COVID-19 have been in the front line of research worldwide. Although targeting different organs, these pathologies have common biochemical impairments - redox disparity and, prominently, dysregulation of the inflammatory pathways. Research data have shown that diet components like polyphenols, poly-unsaturated fatty acids (PUFAs), fibres as well as lifestyle (fasting, physical exercise) are important factors influencing signalling pathways with a significant potential to improve metabolic homeostasis and immune cells' functions. In the present manuscript we have reviewed scientific data from recent publications regarding the beneficial cellular and molecular effects induced by dietary plant products, mainly polyphenolic compounds and PUFAs, and summarize the clinical outcomes expected from these types of interventions, in a search for effective long-term approaches to improve the immune system response.


Assuntos
Dieta com Restrição de Carboidratos , Ácidos Graxos Insaturados/efeitos adversos , Inflamação/etiologia , Doenças não Transmissíveis , Polifenóis/efeitos adversos , Animais , Dieta Mediterrânea , Fibras na Dieta/administração & dosagem , Exercício Físico/fisiologia , Ácidos Graxos Insaturados/administração & dosagem , Humanos , Inflamação/epidemiologia , Inflamação/prevenção & controle , Doenças não Transmissíveis/epidemiologia , Polifenóis/uso terapêutico
9.
Diabetes Metab Syndr ; 14(5): 1043-1051, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32640416

RESUMO

INTRODUCTION: There have been recent mounting concerns regarding multiple reports stating a significantly elevated relative-risk of COVID-19 mortality amongst the Black and Minority Ethnic (BAME) population. An urgent national enquiry investigating the possible reasons for this phenomenon has been issued in the UK. Inflammation is at the forefront of COVID-19 research as disease severity appears to correlate with pro-inflammatory cytokine dysregulation. This narrative review aims to shed light on the novel, pathophysiological role of inflammation in contributing towards the increased COVID-19 mortality risk amongst the BAME population. METHODS: Searches in PubMed, Medline, Scopus, medRxiv and Google Scholar were performed to identify articles published in English from inception to 18th June 2020. These databases were searched using keywords including: 'COVID-19' or 'Black and Minority Ethnic' or 'Inflammation'. A narrative review was synthesized using these included articles. RESULTS: We suggest a novel pathophysiological mechanism by which acute inflammation from COVID-19 may augment existing chronic inflammation, in order to potentiate a 'cytokine storm' and thus the more severe disease phenotype observed in the BAME population. Obesity, insulin resistance, cardiovascular disease, psychological stress, chronic infections and genetic predispositions are all relevant factors which may be contributing to elevated chronic systemic inflammation amongst the BAME population. CONCLUSION: Overall, this review provides early insights and directions for ongoing research regarding the pathophysiological mechanisms that may explain the severe COVID-19 disease phenotype observed amongst the BAME population. We suggest 'personalization' of chronic disease management, which can be used with other interventions, in order to tackle this.


Assuntos
Betacoronavirus/isolamento & purificação , Doenças Cardiovasculares/fisiopatologia , Infecções por Coronavirus/mortalidade , Grupos Étnicos/estatística & dados numéricos , Infecções/fisiopatologia , Inflamação/epidemiologia , Obesidade/fisiopatologia , Pneumonia Viral/mortalidade , Estresse Psicológico/fisiopatologia , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Humanos , Incidência , Inflamação/virologia , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Taxa de Sobrevida , Reino Unido/epidemiologia
10.
Arterioscler Thromb Vasc Biol ; 40(9): 2045-2053, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32687400

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented challenge and opportunity for translational investigators to rapidly develop safe and effective therapeutic interventions. Greater risk of severe disease in COVID-19 patients with comorbid diabetes mellitus, obesity, and heart disease may be attributable to synergistic activation of vascular inflammation pathways associated with both COVID-19 and cardiometabolic disease. This mechanistic link provides a scientific framework for translational studies of drugs developed for treatment of cardiometabolic disease as novel therapeutic interventions to mitigate inflammation and improve outcomes in patients with COVID-19.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/epidemiologia , Infecções por Coronavirus/epidemiologia , Inflamação/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Sistema Cardiovascular , Comorbidade , Humanos , Fatores de Risco
11.
Medicine (Baltimore) ; 99(28): e20887, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664082

RESUMO

BACKGROUND: Dry eye symptom threatens human health and causes a larger burden of disease, the study aims to systematically compare the therapeutic effect of Lycium-rehmannia pills combined with topical eye drops and pure western medicine (western medicine eye drops) on dry eye symptom, to provide a reflection and enlightenment for clinical treatment. METHOD: PubMed, The Cochrane Library, EMbase, MEDLINE, CBM, WanFang, VIP, and CNKI databases were searched manually and automatically by the computer until March 2019 and relevant randomized controlled trials (RCTs) were selected. Article selection and data extraction were conducted by 2 researchers independently, then RevMan 5.3 was applied for meta-analysis. RESULT: Fifteen randomized controlled trials were included, including 1222 patients (eyes = 2382). The meta-analysis results showed that Lycium-rehmannia pills combined with western medicine were superior to the control group in terms of therapeutic efficiency [OR = 4.38, 95% confidence interval (CI) (3.26, 5.89), P < .00001]. There were controversial results that the study group was better than the control group in Basic Schirmer test [MD, 2.46, 95% CI (1.49, 3.44), P < .00001], tear break up time [MD, 3.79, 95% CI (3.57, 4.01), P < .00001], and Fluorescein test [MD, -1.29, 95% CI (-1.42, -1.15), P < .00001], but Lycium-rehmannia pills combined with western medicine could not reduce the incidence of adverse reactions, including eyelid inflammation [OR = 1.00, 95% CI (0.37, 2.72), P = 1.00] and congestion symptom [OR = 0.55, 95% CI (0.18, 1.65), P = .28]. CONCLUSION: Lycium-rehmannia pills combined with western medicine is better than the control group of therapeutic efficiency in the treatment of dry eye symptom. Due to the quantity and quality limitations of the literature, there were controversial results that the study group was better than the control group in Basic Schirmer test, Tear break up time, Fluorescein test, and reduced adverse reactions, including inflammation of the eyelids and congestion. The above conclusion needs more clinical trials to test and verify.


Assuntos
Síndromes do Olho Seco/tratamento farmacológico , Lycium/efeitos adversos , Plantas Medicinais/efeitos adversos , Rehmannia/efeitos adversos , Lágrimas/efeitos dos fármacos , Administração Tópica , Adulto , Quimioterapia Combinada/métodos , Doenças Palpebrais/epidemiologia , Doenças Palpebrais/patologia , Feminino , Humanos , Incidência , Inflamação/epidemiologia , Inflamação/patologia , Masculino , Medicina Tradicional Chinesa/métodos , Pessoa de Meia-Idade , Soluções Oftálmicas/administração & dosagem , Soluções Oftálmicas/uso terapêutico , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Lágrimas/fisiologia
12.
J Allergy Clin Immunol Pract ; 8(8): 2585-2591.e1, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32574840

RESUMO

BACKGROUND: The clinical management of coronavirus disease 2019 (COVID-19) is dependent on understanding the underlying factors that contribute to the disease severity. In the absence of effective antiviral therapies, other host immunomodulatory therapies such as targeting inflammatory response are currently being used without clear evidence of their effectiveness. Because inflammation is an essential component of host antiviral mechanisms, therapies targeting inflammation may adversely affect viral clearance and disease outcome. OBJECTIVE: To understand whether the persistent presence of the virus is a key determinant in the disease severity during COVID-19 and to determine whether the viral reactivation in some patients is associated with infectious viral particles. METHODS: The data for patients were available including the onset of the disease, duration of viral persistence, measurements of inflammatory markers such as IL-6 and C-reactive protein, chest imaging, disease symptoms, and their durations among others. Follow-up tests were performed to determine whether the viral negative status persists after their recovery. RESULTS: Our data show that patients with persistent viral presence (>16 days) have more severe disease outcomes including extensive lung involvement and requirement of respiratory support. Two patients who died of COVID-19 were virus-positive at the time of their death. Four patients demonstrated virus-positive status on the follow-up tests, and these patient samples were sent to viral culture facility where virus culture could not be established. CONCLUSIONS: These data suggest that viral persistence is the key determining factor of the disease severity. Therapies that may impair the viral clearance may impair the host recovery from COVID-19.


Assuntos
Infecções por Coronavirus/fisiopatologia , Inflamação/fisiopatologia , Pneumonia Viral/fisiopatologia , Adolescente , Adulto , Idoso , Betacoronavirus , Proteína C-Reativa/imunologia , Criança , Pré-Escolar , Comorbidade , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Lactente , Inflamação/epidemiologia , Inflamação/imunologia , Mediadores da Inflamação/imunologia , Interleucina-6/imunologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Reação em Cadeia da Polimerase em Tempo Real , Respiração Artificial , Índice de Gravidade de Doença , Adulto Jovem
13.
Proc Natl Acad Sci U S A ; 117(28): 16258-16263, 2020 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-32581123

RESUMO

Chronic stress has been widely proposed to increase systemic inflammation, a pathway that may link stress with a heightened risk for many diseases. The chronic stress-inflammation relationship has been challenging to study in humans, however, and family caregiving has been identified as one type of stressful situation that might lead to increased inflammation. Previous studies of caregiving and inflammation have generally used small convenience samples, compared caregivers with poorly characterized control participants, and assessed inflammation only after caregivers provided care for extended periods of time. In the current project, changes over a 9-y period were examined on six circulating biomarkers of inflammation for 480 participants from a large population-based study. All participants reported no involvement in caregiving prior to the first biomarker assessment, and 239 participants then took on extensive and prolonged family caregiving responsibilities at some point prior to the second biomarker assessment. Incident caregivers were individually matched on multiple demographic and health history variables with participants who reported no caregiving responsibilities. Of the six biomarkers examined, only tumor necrosis factor alpha receptor 1 showed a significantly greater increase in caregivers compared with controls. This effect was small (d = 0.14), and no effects were found for a subset of 45 caregivers who were living with a spouse with dementia. These results are consistent with recent meta-analytic findings and challenge the widespread belief that caregiving is a substantial risk factor for increased inflammation. Future research is warranted on factors that may account for stress resilience in family caregivers.


Assuntos
Cuidadores/psicologia , Inflamação/epidemiologia , Estresse Psicológico/epidemiologia , Idoso , Biomarcadores/sangue , Feminino , Humanos , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estresse Psicológico/sangue , Estados Unidos/epidemiologia
14.
PLoS One ; 15(5): e0232933, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407417

RESUMO

INTRODUCTION: Deficiencies in innate immune responses may contribute to the increased susceptibility to infection in preterm infants. In vivo cytokine profiles in response to sepsis in very preterm infants are not fully understood. AIMS: To characterise plasma pro- and anti-inflammatory cytokine concentrations and pre-defined ratios in very preterm infants with late-onset sepsis (LOS). METHODS: In this observational study, peripheral blood samples were collected at the time of evaluation for suspected LOS from 31 preterm infants (<30 weeks gestational age). Plasma cytokine concentrations were determined by 12-plex immunoassay. RESULTS: IL-10, IFN-γ, IL-12p70, IP-10, IL-6 and CCL2 were elevated in the majority infants with LOS (n = 12) compared to those without LOS (n = 19). There was no difference in TNF-α, IL-1ß, IL-17AF, IL-8 and IL-15 concentrations between groups. IL-10/TNF-α ratios were increased, while CCL2/IL-10 and IL-12p70/IL-10 ratios were decreased in infants with LOS compared to those without. CONCLUSION: Very preterm infants have a marked innate inflammatory response at the time of LOS. The increase in IL-10/TNF-α ratio may indicate early immune hypo-responsiveness. Longitudinal studies with a larger number of participants are required to understand immune responses and clinical outcomes following LOS in preterm infants.


Assuntos
Biomarcadores/sangue , Citocinas/sangue , Doenças do Prematuro/diagnóstico , Recém-Nascido Prematuro/imunologia , Recém-Nascido de muito Baixo Peso/imunologia , Inflamação/diagnóstico , Sepse/diagnóstico , Austrália/epidemiologia , Estudos de Casos e Controles , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro/sangue , Doenças do Prematuro/sangue , Doenças do Prematuro/epidemiologia , Doenças do Prematuro/imunologia , Recém-Nascido de muito Baixo Peso/sangue , Inflamação/sangue , Inflamação/epidemiologia , Inflamação/imunologia , Masculino , Estudos Prospectivos , Sepse/sangue , Sepse/epidemiologia , Sepse/imunologia
15.
Nutr Metab Cardiovasc Dis ; 30(6): 872-888, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32409275

RESUMO

AIMS: This study aimed to summarize earlier studies on the effects of dairy consumption on inflammatory biomarkers in adults and to quantify these effects through meta-analysis. DATA SYNTHESIS: A comprehensive search of all relevant articles, published up to December 2019 indexed in PubMed, ISI (Institute for Scientific Information), EmBase, Scopus, and Google Scholar was done using relevant keywords. Randomized controlled trials (RCTs) that examined the effect of dairy products consumption, compared with low or no dairy intake, on inflammatory biomarkers in adults were included. Overall, 11 RCTs with 663 participants were included in this meta-analysis. We found that high consumption of dairy products, compared with low or no dairy intake, might significantly reduce CRP [weighed mean difference (WMD): -0.24 mg/L; 95% CI, -0.35, -0.14], TNF-α (WMD:- 0.66 pg/mL; 95% CI, -1.23, -0.09), IL-6 (WMD: -0.74 pg/mL; 95% CI, -1.36, -0.12), and MCP concentrations (WMD: -25.58 pg/mL; 95% CI, -50.31, -0.86). However, when the analyses were confined to cross-over trials, no such beneficial effects of dairy intake on inflammation were observed. In addition, high dairy intake might result in increased adiponectin levels (WMD: 2.42 µg/mL; 95% CI, 0.17, 4.66). No significant effect of dairy consumption on serum leptin (WMD: -0.32 ng/mL; 95% CI, -3.30, 2.65), ICAM-1 (WMD: -3.38 ng/ml; 95% CI, -15.57, 8.96) and VCAM-1 (WMD: 3.1 ng/mL; 95% CI, -21.38, 27.58) levels was observed. CONCLUSIONS: In summary, the current meta-analysis indicated that dairy intake might improve several inflammatory biomarkers in adults. In most subgroups without heterogeneity, effects tended to be null. Study design and participants' age were the main sources of heterogeneity. More research, with a particular focus on fat content of dairy foods, is recommended.


Assuntos
Laticínios , Mediadores da Inflamação/sangue , Inflamação/epidemiologia , Adipocinas/sangue , Adulto , Idoso , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Citocinas/sangue , Laticínios/efeitos adversos , Regulação para Baixo , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Inflamação/prevenção & controle , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Fatores de Tempo , Adulto Jovem
16.
Medicine (Baltimore) ; 99(20): e20202, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443343

RESUMO

AIM: Maintenance hemodialysis (MHD) frequency is associated with survival and complication rates. Achieving the optimal balance between healthcare, quality of life (QOL), and medical costs is challenging. We compared complications, inflammatory status, nutritional status, and QOL between patients with different MHD frequencies. MATERIAL AND METHODS: This was a multicenter randomized trial of patients treated between May 2011 and August 2017 at 3 tertiary hospitals in Wenzhou. Patients were grouped according to their treatment schedule over 1 year: twice-weekly or 3-times-weekly. Complications, biochemistry parameters, and QOL (KDQOL-SFTM 1.3 scale) were assessed. RESULTS: One hundred forty patients were included aged 29 to 68 years (mean age, 50.9 ±â€Š4.3 years). There were no significant differences in infection, heart failure, or cerebral hemorrhage complications between the 2 groups (P = .664). Pre-dialysis hemoglobin, high-sensitivity C-reactive protein, serum albumin, total cholesterol, triglyceride, calcium, phosphate, parathyroid hormone, and ejection fraction were similar in both groups (P > .05). After 1 year of MHD, both groups exhibited significant improvements in these parameters (all P < .05) with no significant differences between groups. Serum creatinine, blood urea nitrogen (BUN), and weekly standard hemodialysis treatment adequacy did not improve after treatment (all P > .05), although a difference in BUN was observed between the 2 groups (P < .001). QOL was superior in the twice-weekly group than in the 3-times-weekly group (all P < .05), except for social support, which was slightly better in the 3-times-weekly group than in the twice-weekly group. CONCLUSIONS: Twice- and 3-times-weekly MHD resulted in comparable inflammatory and nutritional clinical outcomes and adverse events. QOL was better for the twice-weekly schedule. Even for patients with economic constraints, twice- or 3-times-weekly MHD should be selected with caution after consideration of BUN levels at baseline.


Assuntos
Falência Renal Crônica/terapia , Diálise Renal/efeitos adversos , Diálise Renal/tendências , Nitrogênio da Ureia Sanguínea , Proteína C-Reativa/análise , Cálcio/sangue , Hemorragia Cerebral/epidemiologia , China/epidemiologia , Colesterol/sangue , Creatinina/sangue , Feminino , Insuficiência Cardíaca/epidemiologia , Hemoglobinas/análise , Humanos , Infecções/epidemiologia , Inflamação/epidemiologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Qualidade de Vida/psicologia , Diálise Renal/economia , Diálise Renal/psicologia , Albumina Sérica , Volume Sistólico/fisiologia , Triglicerídeos/sangue
17.
Medicine (Baltimore) ; 99(20): e20288, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443374

RESUMO

BACKGROUND: As one of the complications after abdominal operation, early postoperative inflammatory small bowel obstruction (EPISBO) is a great trouble for many patients. The use of somatostatin in treating this disease had been widely reported, but its efficacy and safety were controversial. Therefore, the present research carried out a systematic review of the clinical efficacy and safety of somatostatin in treating EPISBO. METHODS: Computer retrieval was conducted in foreign databases (including PubMed, The Cochrane Library, and Embase) and Chinese database (including Sino Med, CNKI, VIP, and WangFang Data), supplementary search for the literatures included was performed, and manual retrieval was performed in abstracts, books, and non-electronic magazines related to the present research to ensure the recall rate. Among all republished relevant experimental studies in Chinese and English from January 1, 1996 to February 1, 2020, randomized controlled trials on the curative efficacy of somatostatin for EPISBO were collected. The evaluation measures included patients' total effective rate, peristaltic sound recovery time, time of disappearance of abdominal pain, time of first defecation after operation, drainage of gastrointestinal decompression and length of stay after treatment. The literatures were selected by two investigators independently to extract data according to the inclusion and exclusion criteria, Bias Risk Assessment Tool recommended by Cochrane Review Hand book 5.2 was used to assess literature quality, and meta-analysis was carried out by using soft Stata 12.0. RESULTS: This study will scientifically and effectively analyze the clinical efficacy and safety of somatostatin in the treatment of EPISBO through systematic review and meta-analysis. ETHICS AND DISSEMINATION: The results of this study will be published in a peer-reviewed SCI journal to provide evidence-based medical evidence for the clinical treatment of early postoperative inflammatory bowel obstruction. PROTOCOL AND REGISTRATION: Open Science Framework (https://osf.io, OSF), registration number: ryd2g.


Assuntos
Inflamação/tratamento farmacológico , Obstrução Intestinal/tratamento farmacológico , Intestino Delgado/patologia , Complicações Pós-Operatórias/tratamento farmacológico , Somatostatina/uso terapêutico , Dor Abdominal/epidemiologia , Defecação , Humanos , Inflamação/epidemiologia , Obstrução Intestinal/epidemiologia , Tempo de Internação , Peristaltismo/fisiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Fatores de Tempo
18.
Aliment Pharmacol Ther ; 52(1): 54-72, 2020 07.
Artigo em Inglês | MEDLINE | ID: covidwho-612318

RESUMO

BACKGROUND: The current COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune-based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID-19. AIM: To summarise the scale of the COVID-19 pandemic, review unique concerns regarding IBD management and infection risk during the pandemic and assess COVID-19 management options and drug interactions in the IBD population. METHODS: A literature review on IBD, SARS-CoV-2 and COVID-19 was undertaken and relevant literature was summarised and critically examined. RESULTS: IBD patients do not appear to be more susceptible to SARS-CoV-2 infection and there is no evidence of an association between IBD therapies and increased risk of COVID-19. IBD medication adherence should be encouraged to prevent disease flare but where possible high-dose systemic corticosteroids should be avoided. Patients should exercise social distancing, optimise co-morbidities and be up to date with influenza and pneumococcal vaccines. If a patient develops COVID-19, immune suppressing medications should be withheld until infection resolution and if trial medications for COVID-19 are being considered, potential drug interactions should be checked. CONCLUSIONS: IBD patient management presents a challenge in the current COVID-19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.


Assuntos
Infecções por Coronavirus/epidemiologia , Doenças Inflamatórias Intestinais/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus/isolamento & purificação , Comorbidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Humanos , Inflamação/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
19.
Aliment Pharmacol Ther ; 52(1): 54-72, 2020 07.
Artigo em Inglês | MEDLINE | ID: covidwho-141484

RESUMO

BACKGROUND: The current COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune-based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID-19. AIM: To summarise the scale of the COVID-19 pandemic, review unique concerns regarding IBD management and infection risk during the pandemic and assess COVID-19 management options and drug interactions in the IBD population. METHODS: A literature review on IBD, SARS-CoV-2 and COVID-19 was undertaken and relevant literature was summarised and critically examined. RESULTS: IBD patients do not appear to be more susceptible to SARS-CoV-2 infection and there is no evidence of an association between IBD therapies and increased risk of COVID-19. IBD medication adherence should be encouraged to prevent disease flare but where possible high-dose systemic corticosteroids should be avoided. Patients should exercise social distancing, optimise co-morbidities and be up to date with influenza and pneumococcal vaccines. If a patient develops COVID-19, immune suppressing medications should be withheld until infection resolution and if trial medications for COVID-19 are being considered, potential drug interactions should be checked. CONCLUSIONS: IBD patient management presents a challenge in the current COVID-19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.


Assuntos
Infecções por Coronavirus/epidemiologia , Doenças Inflamatórias Intestinais/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus/isolamento & purificação , Comorbidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Humanos , Inflamação/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia
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