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Lu J, Gong S, Zhu J, Fang Q. Relationships between obesity and functional outcome after ischemic stroke: a Mendelian randomization study. Neurol Sci 2024; 45:3869-3877. [PMID: 38466476 DOI: 10.1007/s10072-024-07415-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND OBJECTIVES Most previous studies suggested obesity deteriorates the functional outcome after ischemic stroke. But there are researches claiming that obesity is associated with lower mortality, recurrence, and readmission rates, which is known as the obesity paradox. Our current research aimed to investigate the correlation between genetically obesity and the post-stroke outcome with the Mendelian randomization (MR) method. METHODS The UK Biobank and the GIANT consortium provided instrumental variables for body mass index (BMI, 806,834 individuals) and waist-to-hip ratio (WHR, 697,734 individuals). Data of functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network (6012 individuals). Inverse-variance weighted approach was utilized as the primary analyses. Sensitivity analyses involved the utilization of different MR methods. The heterogeneity among genetic variants was assessed by I2 and Q value statistics. RESULTS In univariable analysis, there was a significant connection between genetic susceptibility to WHR and worse functional outcome (modified Rankin Scale 3) after ischemic stroke (OR [95%CI] = 1.47 [1.07, 2.02], P = 0.016). Genetic liability to BMI and was not associated with post-stroke functional outcome (all P > 0.05). The overall patterns between genetic liability to WHR and functional outcome post-ischemic outcome no longer existed in the multivariable MR analysis after adjusting for BMI (OR [95%CI] = 1.26[0.76,1.67], P = 0.56). CONCLUSION The current MR study provided evidence that WHR was correlated to unfavorable outcome post-ischemic stroke. Exploring interventions against obesity may potentially improve recovery after ischemic stroke.
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Affiliation(s)
- Jieyi Lu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Siqi Gong
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Juehua Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, 9 Chongwen Road, Suzhou, 215125, China.
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Wang L, Li X, Deng Z, Cai Q, Lei P, Xu H, Zhu S, Zhou T, Luo R, Zhang C, Yin Y, Zhang S, Wu N, Feng H, Hu R. Neuroendoscopic Parafascicular Evacuation of Spontaneous Intracerebral Hemorrhage (NESICH Technique): A Multicenter Technical Experience with Preliminary Findings. Neurol Ther 2024; 13:1259-1271. [PMID: 38914793 PMCID: PMC11263518 DOI: 10.1007/s40120-024-00642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION Intracerebral hemorrhage (ICH) is a severe manifestation of stroke, demonstrating notably elevated global mortality and morbidity. Thus far, effective therapeutic strategies for ICH have proven elusive. Currently, minimally invasive techniques are widely employed for ICH management, particularly using endoscopic hematoma evacuation in cases of deep ICH. Exploration of strategies to achieve meticulous surgery and diminish iatrogenic harm, especially to the corticospinal tract, with the objective of enhancing the neurological prognosis of patients, needs further efforts. METHODS We comprehensively collected detailed demographic, clinical, radiographic, surgical, and postoperative treatment and recovery data for patients who underwent endoscopic hematoma removal. This thorough inclusion of data intends to offer a comprehensive overview of our technical experience in this study. RESULTS One hundred fifty-four eligible patients with deep supratentorial intracerebral hemorrhage who underwent endoscopic hematoma removal were included in this study. The mean hematoma volume was 42 ml, with 74 instances of left-sided hematoma and 80 cases of right-sided hematoma. The median Glasgow Coma Scale (GCS) score at admission was 10 (range from 4 to 15), and the median time from symptom onset to surgery was 18 (range 2 to 96) h. The mean hematoma clearance rate was 89%. The rebleeding and mortality rates within 1 month after surgery were 3.2% and 7.8%, respectively. At the 6-month mark, the proportion of patients with modified Rankin Scale (mRS) scores of 0-3 was 58.4%. CONCLUSION Both the reduction of surgery-related injury and the protection of the residual corticospinal tract through endoscopic hematoma removal may potentially enhance neurological functional outcomes in patients with deep ICH, warranting validation in a forthcoming multicenter clinical study.
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Affiliation(s)
- Long Wang
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Xiaodong Li
- Department of Neurosurgery, Siping Central People's Hospital, Siping, Jilin Province, China
| | - Zhongyong Deng
- Department of Neurosurgery, Wuzhou Gongren Hospital, Wuzhou, Guangxi Province, China
| | - Qiang Cai
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Pan Lei
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Hui Xu
- Department of Neurosurgery, Hejiang County People's Hospital, Luzhou, Sichuan Province, China
| | - Sheng Zhu
- Department of Neurosurgery, Dazhu County People's Hospital, Dazhou, Sichuan Province, China
| | - Tengyuan Zhou
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Ran Luo
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Chao Zhang
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Yi Yin
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Shuixian Zhang
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Na Wu
- Department of Epidemiology, College of Preventive Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China
| | - Rong Hu
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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Ordak M. Poor statistical reporting: do we have a reason for concern? A narrative review and recommendations. Curr Opin Allergy Clin Immunol 2024; 24:237-242. [PMID: 38236908 DOI: 10.1097/aci.0000000000000965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE OF REVIEW The aim of the review conducted was to present recent articles indicating the need to implement statistical recommendations in the daily work of biomedical journals. RECENT FINDINGS The most recent literature shows an unchanged percentage of journals using specialized statistical review over 20 years. The problems of finding statistical reviewers, the impractical way in which biostatistics is taught and the nonimplementation of published statistical recommendations contribute to the fact that a small percentage of accepted manuscripts contain correctly performed analysis. The statistical recommendations published for authors and editorial board members in recent years contain important advice, but more emphasis should be placed on their practical and rigorous implementation. If this is not the case, we will additionally continue to experience low reproducibility of the research. SUMMARY There is a low level of statistical reporting these days. Recommendations related to the statistical review of submitted manuscripts should be followed more rigorously.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Warsaw, Poland
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Denoble AE, Vazquez-Benitez G, Sheth SS, Ackerman-Banks CM, DeSilva MB, Zhu J, Daley MF, Getahun D, Klein NP, Vesco KK, Irving SA, Nelson J, Williams JTB, Hambidge SJ, Donahue JG, Weintraub ES, Kharbanda EO, Lipkind HS. Coronavirus Disease 2019 (COVID-19) Vaccination and Stillbirth in the Vaccine Safety Datalink. Obstet Gynecol 2024; 144:215-222. [PMID: 38843526 PMCID: PMC11250101 DOI: 10.1097/aog.0000000000005632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/18/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) vaccination is recommended in pregnancy to reduce the risk of severe morbidity from COVID-19. However, vaccine hesitancy persists among pregnant people, with risk of stillbirth being a primary concern. Our objective was to examine the association between COVID-19 vaccination and stillbirth. METHODS We performed a matched case-control study in the Vaccine Safety Datalink (VSD). Stillbirths and live births were selected from singleton pregnancies among persons aged 16-49 years with at least one prenatal, delivery, or postpartum visit at eight participating VSD sites. Stillbirths identified through diagnostic codes were adjudicated to confirm the outcome, date, and gestational age at fetal death. Confirmed antepartum stillbirths that occurred between February 14, 2021, and February 27, 2022, then were matched 1:3 to live births by pregnancy start date, VSD site, and maternal age at delivery. Associations among antepartum stillbirth and COVID-19 vaccination in pregnancy, vaccine manufacturer, number of vaccine doses received, and vaccination within 6 weeks before stillbirth (or index date in live births) were evaluated using conditional logistic regression. RESULTS In the matched analysis of 276 confirmed antepartum stillbirths and 822 live births, we found no association between COVID-19 vaccination during pregnancy and stillbirth (38.4% stillbirths vs 39.3% live births in vaccinated individuals, adjusted odds ratio [aOR] 1.02, 95% CI, 0.76-1.37). Furthermore, no association between COVID-19 vaccination and stillbirth was detected by vaccine manufacturer (Moderna: aOR 1.00, 95% CI, 0.62-1.62; Pfizer-BioNTech: aOR 1.00, 95% CI, 0.69-1.43), number of vaccine doses received during pregnancy (1 vs 0: aOR 1.17, 95% CI, 0.75-1.83; 2 vs 0: aOR 0.98, 95% CI, 0.81-1.17), or COVID-19 vaccination within the 6 weeks before stillbirth or index date compared with no vaccination (aOR 1.16, 95% CI, 0.74-1.83). CONCLUSION No association was found between COVID-19 vaccination and stillbirth. These findings further support recommendations for COVID-19 vaccination in pregnancy.
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Affiliation(s)
- Anna E Denoble
- Yale School of Medicine, New Haven, Connecticut; HealthPartners Institute, Bloomington, Minnesota; Baylor College of Medicine, Houston, Texas; Institute for Health Research, Kaiser Permanente Colorado, and Ambulatory Care Services, Denver Health, Denver, Colorado; Kaiser Permanente Southern California, Pasadena, and Kaiser Permanente Vaccine Study Center, Oakland, California; Kaiser Permanente Center for Health Research, Portland, Oregon; Kaiser Permanente, Seattle, Washington; Marshfield Clinic Research Institute, Marshfield, Wisconsin; Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, Georgia; and Weill-Cornell School of Medicine, New York, New York
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Cracowski JL, Molimard M, Richard V, Roustit M, Khouri C. Assessing the benefit-risk balance of drugs. Some lessons from the COVID pandemic. Expert Opin Drug Saf 2024; 23:959-967. [PMID: 38898690 DOI: 10.1080/14740338.2024.2368811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Drug efficacy and effectiveness are assessed respectively through clinical trials and pharmaco-epidemiological studies. However, relative and absolute benefits of drugs are distinct measures that must be considered in relation to the baseline risk of disease incidence, complication or progression. On the other hand, adverse drug reactions are independent of the basic risk but depend on the characteristics of the population treated. Given these prerequisites, how can we balance the benefits and risks of drugs? AREAS COVERED We use the example of therapeutics evaluated during Covid to describe how assessing the benefit-risk balance of drugs is a complex process. EXPERT OPINION Clinical trials are not designed to identify rare adverse events, underscoring the necessity for a pharmacovigilance system. Evaluating the balance between the benefits and risks of drugs is an ongoing process, demanding the simultaneous analysis of data from clinical trials, potential drug-drug interactions, pharmacovigilance monitoring and pharmaco-epidemiological studies, to identify potential safety concerns. In addition, pharmacologists must play a major role in educating the general public about drugs, aiding in the accurate interpretation of the benefit-risk balance and preventing misinformation.
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Affiliation(s)
- Jean-Luc Cracowski
- Centre Régional de Pharmacovigilance de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
| | | | | | - Matthieu Roustit
- Centre d'Investigation Clinique de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
| | - Charles Khouri
- Centre Régional de Pharmacovigilance de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
- Centre d'Investigation Clinique de Grenoble, Université Grenoble Alpes, Inserm U1300, Grenoble, France
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Geslain G, Cointe A, Naudin J, Dauger S, Poey N, Pages J, Le Roux E, Bonacorsi S. Diagnostic Accuracy of Blind Bronchial Sample Testing by BioFire Pneumonia plus Panel in Pediatric Intensive Care Unit Patients and Its Impact in Early Adaptation of Antimicrobial Therapy: A Prospective Observational Study. Pediatr Infect Dis J 2024; 43:725-730. [PMID: 38621162 DOI: 10.1097/inf.0000000000004349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Community-acquired and nosocomial lower-respiratory-tract infections in critically ill pediatric patients require early appropriate antibiotic therapy to optimize outcomes. Using blind bronchial samples, we assessed the diagnostic performance of the rapid-multiplex polymerase chain reaction (PCR) assay BioFire Pneumonia plus Panel vs. reference standard culturing with antimicrobial susceptibility testing. METHODS For this prospective observational study in a single pediatric intensive care unit, we included consecutive patients younger than 18 years admitted for suspected community-, hospital- or ventilator-associated pneumonia in 2021-2022. Sensitivity, specificity, positive predictive value and negative predictive value of the multiplex PCR assay were determined. The kappa coefficient was computed to assess agreement, and univariate analyses were done to identify factors associated with discrepancies between the 2 diagnostic methods. RESULTS Of the 36 included patients (median age, 1.4 years; interquartile range, 0.2-9.2), 41.7%, 27.8%, and 30.5% had community-, hospital- and ventilator-associated pneumonia, respectively. The overall κ was 0.74, indicating good agreement. Overall, the sensitivity of the multiplex PCR assay was 92% (95% CI: 77%-98%) and specificity 95% (95% CI: 92%-97%), with variations across microorganisms. The median time from sample collection to antimicrobial susceptibility test results was 3.9 (2.5-15) hours with the multiplex PCR assay and 60.5 (47.6-72.2) hours with the reference technique. CONCLUSION The BioFire Pneumonia plus Panel used to test blind bronchial samples had satisfactory diagnostic performance in critically ill pediatric patients. The rapid results provided by this test may improve the appropriateness of antimicrobial therapy and help minimize the use of antibiotics.
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Affiliation(s)
- Guillaume Geslain
- From the Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
- Paris Cité University, IAME, INSERM UMR 1137, Paris, France
| | - Aurélie Cointe
- Paris Cité University, IAME, INSERM UMR 1137, Paris, France
- Department of Microbiology, Escherichia coli National Reference Center, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Jérôme Naudin
- From the Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Stéphane Dauger
- From the Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
- Paris Cité University, NeuroDiderot, INSERM UMR 1141, Paris, France
| | - Nora Poey
- Department of General Paediatrics, Paediatric Infectious Diseases and Internal Medicine, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Justine Pages
- Clinical Epidemiology Unit, INSERM CIC 1426, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Enora Le Roux
- Clinical Epidemiology Unit, INSERM CIC 1426, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Stéphane Bonacorsi
- Paris Cité University, IAME, INSERM UMR 1137, Paris, France
- Department of Microbiology, Escherichia coli National Reference Center, Robert-Debré University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
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Fantin R, Sierra MS, Vaccarella S, Herrero R, Barboza-Solís C. Social gradient and rural-urban disparities in cancer mortality in Costa Rica. Cancer Epidemiol 2024; 91:102604. [PMID: 38941875 PMCID: PMC11246819 DOI: 10.1016/j.canep.2024.102604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Abstract
INTRODUCTION Data on social inequalities in cancer mortality are sparse, especially in low- and middle-income countries. We aimed to analyze the socioeconomic inequalities in cancer mortality in Costa Rica between 2010 and 2018. METHODS We linked 9-years of data from the National Electoral Rolls, National Birth Index and National Death Index to classify deaths due to cancer and socioeconomic characteristics of the district of residence, as measured by levels of urbanicity and wealth. We analyzed the fifteen most frequent cancer sites in Costa Rica among the 2.7 million inhabitants aged 20 years and older. We used a parametric survival model based on a Gompertz distribution. RESULTS Compared to urban areas, mixed and rural area residents had lower mortality from pancreas, lung, breast, prostate, kidney, and bladder cancers, and higher mortality from stomach cancer. Mortality from stomach, lung and cervical cancer was higher, and mortality from colorectal cancer, non-Hodgkin lymphoma and leukemia was lower in the most disadvantaged districts, compared to the wealthiest ones. CONCLUSION We observed marked disparities in cancer mortality in Costa Rica in particular from infection- and lifestyle- related cancers. There are important opportunities to reduce disparities in cancer mortality by targeting cancer prevention, early detection and opportune treatment, mainly in urban and disadvantaged districts.
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Affiliation(s)
- Romain Fantin
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica; Centro Centroamericano de Población, Universidad de Costa Rica, Costa Rica.
| | - Mónica S Sierra
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica
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Ferreira M, Ebia MI, Reckamp KL. Early dose reduction of osimertinib in advanced EGFR -mutated non-small cell lung cancer. Anticancer Drugs 2024; 35:672-679. [PMID: 38527329 DOI: 10.1097/cad.0000000000001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Osimertinib has become the standard of care for epidermal growth factor receptor ( EGFR )-mutated non-small cell lung cancer (NSCLC). In order to prevent or treat toxicity, the osimertinib dose may be reduced. However, data regarding the impact of dose reduction during treatment are limited. We aimed to compare the efficacy of osimertinib early dose reduction during the first 3 months of treatment with late dose reduction in EGFR -mutated advanced NSCLC. This retrospective study included patients with EGFR -mutated advanced NSCLC who received osimertinib. We constituted two groups: 'early dose reduction' (early) with patients receiving a reduced dose of osimertinib from 80 to 40 mg within the 3 months of osimertinib initiation and 'late dose reduction' (late) with patients receiving a reduced dose after 3 months of full-dose treatment. Thirty-five patients were included, with 17 and 18 patients in the early and late groups, respectively, and a higher median age in the early group (76 vs. 67 years). The real-world progression-free survival (rwPFS) at 1 year was 70.5% in the early group and 88.9% in the late group ( P = 0.31). Median rwPFS was 32.7 and 24.6 months ( P = 0.98), and the median overall survival was 46.9 versus not reached in early and late groups, respectively ( P = 0.17). Central nervous system rwPFS was not different between the early and late groups: 29.8 and 35.8 months, respectively ( P = 0.39). We showed that a reduced dose of osimertinib within the first 3 months of treatment, compared to a later reduced dose, could influence treatment response or patient survival.
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Affiliation(s)
- Marion Ferreira
- Department of Pneumology and Respiratory Functional Exploration, University Hospital of Tours
- INSERM, Centre d'Etude des Pathologies Respiratoires, Tours, France
| | - Matthew I Ebia
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Karen L Reckamp
- Department of Medicine, Cedars Sinai Medical Center, Los Angeles, California, USA
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Yuan G, Nguyen TN, Liu L, Li R, Xia H, Long C, Wu J, Xu J, Huang F, He B, Wu D, Wang H, Feng C, Liang Y, Zhou X, Xiao Z, Luo L, Hu Y, Liu B, Peng W, Zhang C, Cui T, Zhao G, Xu L, Ma G, Hu W. Effect of Stroke Etiology on Endovascular Treatment for Acute Basilar-Artery Occlusion: A Post Hoc Analysis of the ATTENTION Randomized Trial. Stroke 2024; 55:1973-1981. [PMID: 39038096 DOI: 10.1161/strokeaha.124.047568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
BACKGROUND Stroke etiology could influence the outcomes in patients with basilar-artery occlusion (BAO). This study aimed to evaluate the differences in efficacy and safety of best medical treatment (BMT) plus endovascular treatment (EVT) versus BMT alone in acute BAO across different stroke etiologies. METHODS The study was a post hoc analysis of the ATTENTION trial (Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion), which was a multicenter, randomized trial at 36 centers in China from February 2021 to September 2022. Patients with acute BAO were classified into 3 groups according to stroke etiology (large-artery atherosclerosis [LAA], cardioembolism, and undetermined cause/other determined cause [UC/ODC]). The primary outcome was a favorable outcome (modified Rankin Scale score of 0-3) at 90 days. Safety outcomes included symptomatic intracranial hemorrhage and 90-day mortality. RESULTS A total of 340 patients with BAO were included, 150 (44.1%) had LAA, 72 (21.2%) had cardioembolism, and 118 (34.7%) had UC/ODC. For patients treated with BMT plus EVT and BMT alone, respectively, the rate of favorable outcome at 90 days was 49.1% and 23.8% in the LAA group (odds ratio, 3.08 [95% CI, 1.38-6.89]); 52.2% and 30.8% in the cardioembolism group (odds ratio, 2.45 [95% CI, 0.89-6.77]); and 37.5% and 17.4% in the UC/ODC group (odds ratio, 2.85 [95% CI, 1.16-7.01]), with P=0.89 for the stroke etiology×treatment interaction. The rate of symptomatic intracranial hemorrhage in EVT-treated patients with LAA, cardioembolism, and UC/ODC was 8.3%, 2.2%, and 3.2%, respectively, and none of the BMT-treated patients. Lower 90-day mortality was observed in patients with EVT compared with BMT alone across 3 etiology groups. CONCLUSIONS Among patients with acute BAO, EVT compared with BMT alone might be associated with favorable outcomes and lower 90-day mortality, regardless of cardioembolism, LAA, or UC/ODC etiologies. The influence of stroke etiology on the benefit of EVT should be explored by further trials. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT04751708.
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Affiliation(s)
- Guangxiong Yuan
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Thanh N Nguyen
- Department of Neurology and Radiology, Boston Medical Center, MA (T.N.N.)
| | - Lei Liu
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Rui Li
- Department of Neurology, First Affiliated Hospital of the University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Heifei, China (R.L., C.Z., W.H.)
| | - Hong Xia
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Chen Long
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Junxiong Wu
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Jun Xu
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Feng Huang
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Bo He
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Derong Wu
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Hailing Wang
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Can Feng
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Yong Liang
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Xianghong Zhou
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Zhenhua Xiao
- Department of Emergency, Shaoshan People's Hospital, China (Z.X.)
| | - Li Luo
- Department of Head and Neck Surgery, Xiangtan Central Hospital, China (L. Luo)
| | - Yanjuan Hu
- Department of Emergency, The First People's Hospital of Xiangtan, China (Y.H.)
| | - Bin Liu
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Weibo Peng
- Department of Emergency, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), China (G.Y., L. Liu, H.X., C.L., J.W., J.X., F.H., B.H., D.W., H.W., C.F., Y.L., X.Z., B.L., W.P.)
| | - Chao Zhang
- Department of Neurology, First Affiliated Hospital of the University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Heifei, China (R.L., C.Z., W.H.)
| | - Tao Cui
- Department of Neurology, Taihe Country People's Hospital, Linquan, China (T.C.)
| | - Gaoshan Zhao
- Department of Neurology, Linquan Country People's Hospital, China (G.Z.)
| | - Lihua Xu
- Department of Neurology, Jiamusi Central Hospital, China (L.X.)
| | - Gaoting Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China (G.M.)
| | - Wei Hu
- Department of Neurology, First Affiliated Hospital of the University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Heifei, China (R.L., C.Z., W.H.)
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Little JA, Congdon NG, Resnikoff S, Braithwaite T, Leasher J, Naidoo K, Fricke T, Tapply I, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Taylor HR, Sedighi T, Flaxman S, Parodi MB, Bikbov MM, Bron A, Cheng CY, Del Monte MA, Ehrlich JR, Ellwein LB, Friedman D, Furtado JM, Gazzard G, George R, Hartnett ME, Jonas JB, Kahloun R, Kempen JH, Khairallah M, Khanna RC, Kim JE, Lansingh VC, Nangia V, Nowak M, Pesudovs K, Peto T, Ramulu P, Topouzis F, Tsilimbaris M, Wang YX, Wang N, Bourne RRA, Little JA, Congdon NG, Resnikoff S, Braithwaite T, Leasher JL, Naidoo KS, Tahhan N, Fricke T, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Briant PS, Vos T, Flaxman S, Abate YH, Dolatabadi ZA, Abdelmasseh M, Abdollahi M, Abebe AM, Abiodun O, Aboagye RG, Abrha WA, Ali HA, Abu-Gharbieh E, Aburuz S, Adal TGG, Adamu LH, Adderley NJ, Addo IY, Adekiya TA, Adhikari K, Adnani QES, Afzal S, Aghamiri S, Agodi A, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmadzadeh H, Ahmed A, Ahmed H, Alahdab F, Albashtawy M, AlBataineh MT, Alemu T, Alfaar AS, Alhalaiqa FAN, Alhassan RK, Ali A, Ali SSS, Almidani L, Alzoubi KH, Androudi S, Anguita R, Anil A, Anyasodor AE, Arabloo J, Aravkin AY, Areda D, Asgedom AA, Ashemo MY, Ashraf T, Athari SS, Atinafu BTT, Wahbi Atout MM, Atreya A, Ayatollahi H, Azzam AY, Bagherieh S, Bai R, Baig AA, Bailey F, Baltatu OC, Barati S, Barchitta M, Bardhan M, Bärnighausen TW, Barrow A, Parodi MB, Bayileyegn NS, Berhie AY, Bhadra A, Bhagavathula ASS, Bhardwaj P, Bhaskar S, Bhat AN, Bhatti GK, Bikbov M, Birck MG, Bustanji Y, Butt ZA, dos Santos FLC, Carneiro VLA, Cenderadewi M, Chanie GS, Cherbuin N, Chu DT, Coberly K, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Dascalu AM, Dastiridou A, Dejenie TA, Demeke D, Dereje D, Dervenis N, Devanbu VGC, Diaz D, Diress M, Do TC, Do THP, Dziedzic AM, Edinur HA, Ehrlich JR, Ekholuenetale M, Elhabashy HR, Elhadi M, Emamian MH, Emamverdi M, Etemadimanesh A, Fagbamigbe AF, Farrokhpour H, Fatehizadeh A, Feizkhah A, Desideri LF, Fetensa G, Fischer F, Forouhari A, Furtado JM, Gadanya MA, Gaidhane AM, Gandhi AP, Gebi TG, Gebrehiwot M, Gebremeskel GG, Gela YY, Yazdi BG, Falavarjani KG, Ghassemi F, Ghozy S, Golchin A, Golechha M, Goleij P, Guan SY, Gupta S, Gupta VK, Haddadi R, Haile TG, Hammond BR, Harorani M, Hasaballah AI, Hasan I, Hasani H, Hassanian-Moghaddam H, Heidari G, Heyi DZ, Holla R, Hosseinzadeh M, Hu C, Huynh HH, Hwang BF, Iavicoli I, Ilic IM, Immurana M, Islam SMS, Jacob L, Jafarzadeh A, Jakovljevic M, Janodia MD, Jayapal SK, Jayaram S, Jonas JB, Joseph N, Joshua CE, Kamath S, Kandel H, Karaye IM, Kasraei H, Kaup S, Kaur H, Kaur N, Kayode GA, Kempen JH, Khader YS, Khajuria H, Khalilov R, Khan A, Khatatbeh MM, Khatib MN, Kibret BG, Kim YJ, Kisa A, Kisa S, Kosen S, Koyanagi A, Krishan K, Bicer BK, Kumar N, Kutikuppala LVS, Lahariya C, Laksono T, Lal DK, Lansingh VC, Lee M, Lee SW, Lee WC, Lim SS, Liu X, Maharaj SB, Mahmoudi A, Malhotra K, Malik AA, Malik I, Mallhi TH, Mansouri V, Marzo RR, Maugeri A, Meles GG, Mersha AM, Mestrovic T, Miller TR, Mirzaei M, Misganaw A, Misra S, Mithra P, Mohammadi S, Mohammadian-Hafshejani A, Mohammadzadeh M, Mojiri-forushani H, Mokdad AH, Momeni-Moghaddam H, Montazeri F, Moradi M, Mousavi P, Murray CJL, Naik GR, Naik G, Natto ZS, Naveed M, Nayak BP, Negash H, Nejadghaderi SA, Nguyen DH, Nguyen DH, Nguyen HQ, Nguyen PT, Nguyen VT, Niazi RK, Noman EA, Oancea B, Okonji OC, Olagunju AT, Olufadewa II, Onwujekwe OE, Opejin AO, Ordak M, Osuagwu UL, Otstavnov N, Owolabi MO, Padubidri JR, Panda-Jonas S, Pandey A, Pardhan S, Parsaei A, Patel J, Pawar S, Perianayagam A, Perumalsamy N, Pesudovs K, Petcu IR, Pham HT, Pourazizi M, Prates EJS, Qattea I, Raghav PR, Rahman MHU, Rahman M, Ramasamy SK, Ramasubramani P, Rashidi MM, Redwan EMM, Rezaei N, Rodriguez JAB, Saadatian Z, Sabour S, Saddik B, Saeed U, Safi S, Saghazadeh A, Sharif-Askari FS, Sharif-Askari NS, Sahebkar A, Sahraian MA, Sakshaug JW, Saleh MA, Samadzadeh S, Samodra YL, Samy AM, Saylan M, Selvaraj S, Sethi Y, Seylani A, Shahwan MJ, Shaikh MA, Shamim MA, Shashamo BB, Shiferaw WS, Shigematsu M, Shittu A, Shobeiri P, Shorofi SA, Sibhat MM, Siddig EE, Silva JC, Singh JA, Singh P, Sotoudeh H, Sousa RARC, Sreeramareddy CT, Tabish M, Taheri M, Tan Y, Taye BT, Temsah MH, Ticoalu JHV, Tillawi T, Tiruneh MG, Tsatsakis A, Tsegay GM, Tsilimbaris MK, Ty SS, Ubah CS, Umair M, Tahbaz SV, Valizadeh R, Viskadourou M, Wassie GT, Wickramasinghe ND, Wondimagegn GS, Yahya G, Yang L, Yao Y, Yiğit A, Yismaw Y, Yonemoto N, You Y, Zastrozhin MS, Zenebe GA, Zhang ZJ, Zhao H, Zielińska M, Zoladl M, Steinmetz JD, Bourne R. Global estimates on the number of people blind or visually impaired by Uncorrected Refractive Error: a meta-analysis from 2000 to 2020. Eye (Lond) 2024; 38:2083-2101. [PMID: 38965322 DOI: 10.1038/s41433-024-03106-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 04/08/2024] [Accepted: 04/19/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Uncorrected refractive error (URE) is a readily treatable cause of visual impairment (VI). This study provides updated estimates of global and regional vision loss due to URE, presenting temporal change for VISION 2020 METHODS: Data from population-based eye disease surveys from 1980-2018 were collected. Hierarchical models estimated prevalence (95% uncertainty intervals [UI]) of blindness (presenting visual acuity (VA) < 3/60) and moderate-to-severe vision impairment (MSVI; 3/60 ≤ presenting VA < 6/18) caused by URE, stratified by age, sex, region, and year. Near VI prevalence from uncorrected presbyopia was defined as presenting near VA < N6/N8 at 40 cm when best-corrected distance (VA ≥ 6/12). RESULTS In 2020, 3.7 million people (95%UI 3.10-4.29) were blind and 157 million (140-176) had MSVI due to URE, a 21.8% increase in blindness and 72.0% increase in MSVI since 2000. Age-standardised prevalence of URE blindness and MSVI decreased by 30.5% (30.7-30.3) and 2.4% (2.6-2.2) respectively during this time. In 2020, South Asia GBD super-region had the highest 50+ years age-standardised URE blindness (0.33% (0.26-0.40%)) and MSVI (10.3% (8.82-12.10%)) rates. The age-standardized ratio of women to men for URE blindness was 1.05:1.00 in 2020 and 1.03:1.00 in 2000. An estimated 419 million (295-562) people 50+ had near VI from uncorrected presbyopia, a +75.3% (74.6-76.0) increase from 2000 CONCLUSIONS: The number of cases of VI from URE substantively grew, even as age-standardised prevalence fell, since 2000, with a continued disproportionate burden by region and sex. Global population ageing will increase this burden, highlighting urgent need for novel approaches to refractive service delivery.
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Mountford R, Adler BL, Andersson D, Bashford-Rogers R, Berwick R, Bevan S, Caro X, Chung TH, Clark JD, Dawes JM, Dong X, Helyes Z, Kingery W, van Middendorp JJ, Neiland H, Maurer M, Scheibenbogen C, Schmack K, Schreiner T, Svensson CI, Tékus V, Goebel A. Antibody-mediated autoimmunity in symptom-based disorders: position statement and proceedings from an international workshop. Pain Rep 2024; 9:e1167. [PMID: 38873615 PMCID: PMC11175924 DOI: 10.1097/pr9.0000000000001167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 06/15/2024] Open
Abstract
A 2-day closed workshop was held in Liverpool, United Kingdom, to discuss the results of research concerning symptom-based disorders (SBDs) caused by autoantibodies, share technical knowledge, and consider future plans. Twenty-two speakers and 14 additional participants attended. This workshop set out to consolidate knowledge about the contribution of autoantibodies to SBDs. Persuasive evidence for a causative role of autoantibodies in disease often derives from experimental "passive transfer" approaches, as first established in neurological research. Here, serum immunoglobulin (IgM or IgG) is purified from donated blood and transferred to rodents, either systemically or intrathecally. Rodents are then assessed for the expression of phenotypes resembling the human condition; successful phenotype transfer is considered supportive of or proof for autoimmune pathology. Workshop participants discussed passive transfer models and wider evidence for autoantibody contribution to a range of SBDs. Clinical trials testing autoantibody reduction were presented. Cornerstones of both experimental approaches and clinical trial parameters in this field were distilled and presented in this article. Mounting evidence suggests that immunoglobulin transfer from patient donors often induces the respective SBD phenotype in rodents. Understanding antibody binding epitopes and downstream mechanisms will require substantial research efforts, but treatments to reduce antibody titres can already now be evaluated.
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Affiliation(s)
- Rebecca Mountford
- Pain Research Institute, University of Liverpool, Liverpool, United Kingdom
| | - Brittany L. Adler
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - David Andersson
- Wolfson SPaRC, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Richard Berwick
- Pain Research Institute, University of Liverpool, Liverpool, United Kingdom
- Wolfson SPaRC, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Stuart Bevan
- Wolfson SPaRC, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Xavier Caro
- Southern California Fibromyalgia Research & Treatment Centre, Northridge Hospital Medical Center Professional Building, Los Angeles, CA, USA
| | - Tae Hwan Chung
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Department of Neurology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - J. David Clark
- Department of Anesthesia, Stanford University School of Medicine, Redwood City, CA, USA
| | - John M. Dawes
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Xinzhong Dong
- Solomon H. Snyder Department of Neuroscience, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Medial School, University of Pécs, Pécs, Hungary
- HUNREN-PTE Chronic Pain Research Group, University of Pécs, Pécs, Hungary
- PharmInVivo Ltd., Pécs, Hungary
| | - Wade Kingery
- Palo Alto Veterans Institute for Research, Palo Alto, CA, USA
| | | | - Harvey Neiland
- Pain Research Institute, University of Liverpool, Liverpool, United Kingdom
| | - Margot Maurer
- Wolfson SPaRC, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité—Universitätsmedizin Berlin, Berlin Institute of Health, Berlin, Germany
| | - Katharina Schmack
- Francis Crick Institute, London, United Kingdom
- Division of Psychiatry, University College London, London, United Kingdom
| | | | - Camilla I. Svensson
- Department of Physiology and Pharmacology, Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Valéria Tékus
- Department of Pharmacology and Pharmacotherapy, Medial School, University of Pécs, Pécs, Hungary
- Department of Laboratory Diagnostics, University of Pécs, Pécs, Hungary
| | - Andreas Goebel
- Pain Research Institute, University of Liverpool, Liverpool, United Kingdom
- Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
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Chen YY, Gong ZC, Zhang MM, Huang ZH. Brain-Targeting Emodin Mitigates Ischemic Stroke via Inhibiting AQP4-Mediated Swelling and Neuroinflammation. Transl Stroke Res 2024; 15:818-830. [PMID: 37380800 DOI: 10.1007/s12975-023-01170-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/26/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
Failure to achieve target-specific delivery to ischemic brain sites has hampered the clinical efficacy of newly developed therapies for ischemic stroke. Emodin, an active ingredient isolated from traditional Chinese medicine, has been indicated to alleviate ischemic stroke; however, the underlying mechanism remains unclear. In this study, we aimed to achieve brain-targeted delivery of emodin to maximize its therapeutic efficacy and elucidate the mechanisms by which emodin alleviates ischemic stroke. A polyethylene glycol (PEG)/cyclic Arg-Gly-Asp (cRGD)-modified liposome was used to encapsulate emodin. TTC, HE, Nissl staining, and immunofluorescence staining were employed to evaluate the therapeutic efficacy of brain-targeting emodin in MCAO and OGD/R models. Inflammatory cytokine levels were determined using ELISA. Immunoprecipitation, immunoblotting, and RT-qPCR were utilized for clarifying the changes in key downstream signaling. Lentivirus-mediated gene restoration was employed to verify the core effector of emodin for relieving ischemic stroke. Encapsulating emodin in a PEG/cRGD-modified liposome enhanced its accumulation in the infarct region and substantially raised its therapeutic efficacy. Furthermore, we demonstrated that AQP4, the most abundant water transporter subunit expressed in astrocytes, plays a crucial role in mediating the mechanisms by which emodin inhibits astrocyte swelling, neuroinflammatory blood-brain barrier (BBB) breakdown in vivo and in vitro, and brain edema in general. Our study unveiled the critical target of emodin responsible for alleviating ischemic stroke and a localizable drug delivery vehicle in the therapeutic strategy for ischemic stroke and other brain injuries.
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Affiliation(s)
- Yan-Yan Chen
- Wuxi Cancer Institute, and Wuxi Institute of Integrated Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, 214062, Jiangsu, China.
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, Shaanxi University of Chinese Medicine, Xi'an, 712046, Shaanxi, China.
| | - Zhi-Cheng Gong
- Wuxi Cancer Institute, and Wuxi Institute of Integrated Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, 214062, Jiangsu, China
| | - Mei-Mei Zhang
- Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for TCM Compatibility, Shaanxi University of Chinese Medicine, Xi'an, 712046, Shaanxi, China
| | - Zhao-Hui Huang
- Wuxi Cancer Institute, and Wuxi Institute of Integrated Chinese and Western Medicine, Affiliated Hospital of Jiangnan University, Wuxi, 214062, Jiangsu, China.
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Hastrup S, Hedegaard JN, Andersen G, Rungby J, Johnsen SP. Type 2 diabetes mellitus in patients with ischemic stroke - A nationwide study. Diabet Med 2024; 41:e15337. [PMID: 38662635 DOI: 10.1111/dme.15337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/29/2024] [Accepted: 04/12/2024] [Indexed: 07/23/2024]
Abstract
AIMS Type 2 diabetes (T2D) is a risk factor for ischemic stroke (IS) and associated with an adverse prognosis. Both stroke and diabetes care has evolved substantially during the last decade. This study aimed to determine the prevalence of T2D among IS patients along with time trends in the risk profile, use of glucose-lowering medications, quality-of-care and clinical outcomes, including stroke severity; length-of-stay; mortality, readmission and recurrent stroke in a large national cohort. METHODS Registry-based cohort study including all IS events in Denmark from 2004 to 2020. IS with co-morbid T2D were compared to IS without diabetes while adjusting for age, sex, stroke severity, co-morbidity and socio-economic factors. RESULTS The study included 169,262 IS events; 24,479 with co-morbid T2D. The prevalence of T2D in IS increased from 12.0% (2004-2006) to 17.0% (2019-2020). The adjusted absolute 30-day mortality risk in IS with T2D decreased from 9.9% (2004-2006) to 7.8% (2019-2020). The corresponding adjusted risk ratios (aRR) were 1.22 95% confidence interval (1.09-1.37) and 1.29 (1.11-1.50), respectively. The aRR of 365-day mortality was in 2004-2006: 1.20 (1.12-1.29) and in 2019-2020: 1.34 (1.22-1.47). The 30- and 365-day readmissions rates were also consistently higher in IS with T2D. CONCLUSIONS The prevalence of T2D in IS increased over time. The 30- and 365-day mortality rates decreased over the time-period but were consistently higher in IS with co-morbid T2D. Readmissions were also higher in IS with T2D. This highlights an urgent need for strategies to further improve the prognosis in IS patients with co-morbid T2D.
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Affiliation(s)
- Sidsel Hastrup
- Danish Stroke Centre, Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Jakob Nebeling Hedegaard
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Grethe Andersen
- Danish Stroke Centre, Neurology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Jorgen Rungby
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Soren Paaske Johnsen
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Matsunaga K, Yoshida Y, Makita N, Nishida K, Rhodes K, Nordon C. Increased Risk of Severe Cardiovascular Events Following Exacerbations of Chronic Obstructive Pulmonary Disease: Results of the EXACOS-CV Study in Japan. Adv Ther 2024; 41:3362-3377. [PMID: 38976123 PMCID: PMC11263248 DOI: 10.1007/s12325-024-02920-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/05/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Severe exacerbations of chronic obstructive pulmonary disease (COPD) are known to increase the risk of cardiovascular events. However, this association has not been investigated specifically in patients with COPD in Japan, whose characteristics may differ from those of Western patients (i.e., western Europe, the US, and Canada). METHODS This longitudinal retrospective cohort study analyzed secondary claims data and included patients aged ≥ 40 years with COPD (International Classification of Diseases-10 codes J41-J44). All exacerbations occurring during follow-up were measured. Time-dependent Cox models were used to estimate hazard ratios (HRs) for the association between time periods following an exacerbation of COPD (vs. time prior to a first exacerbation) and occurrence of a first hospitalization for a severe fatal or non-fatal cardiovascular event. RESULTS The analysis included 152,712 patients with COPD with a mean age of 73.8 years and 37.6% of whom were female. During a median follow-up of 37 months, 63,182 (41.4%) patients experienced ≥ 1 exacerbation and 13,314 (8.7%) patients experienced ≥ 1 severe cardiovascular event. Following an exacerbation of COPD, the risk of a severe cardiovascular event was increased in the first 30 days [adjusted HR (aHR) 1.44, 95% confidence interval (CI) 1.33-1.55] and remained elevated for 365 days post-exacerbation (aHR 1.13, 95% CI 1.04-1.23). Specifically, the risks of acute coronary syndrome or arrhythmias remained significantly increased for up to 180 days, and the risk of decompensated heart failure for 1 year. CONCLUSION Among Japanese patients with COPD, the risk of experiencing a severe cardiovascular event increased following a COPD exacerbation and remained elevated for 365 days, emphasizing the need to prevent exacerbations.
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Affiliation(s)
- Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
| | - Yuri Yoshida
- Medical Department, AstraZeneca K.K., 3-1 Ofukacho, Kita-ku, Osaka, 530-0011, Japan
| | - Naoyuki Makita
- Medical Department, AstraZeneca K.K., 3-1 Ofukacho, Kita-ku, Osaka, 530-0011, Japan
| | - Kenichiro Nishida
- Medical Department, AstraZeneca K.K., 3-1 Ofukacho, Kita-ku, Osaka, 530-0011, Japan
| | - Kirsty Rhodes
- Real-World Science and Analytics, BioPharmaceuticals Medical Evidence, AstraZeneca UK, Academy House, 136 Hills Road, Cambridge, CB2 8PA, UK
| | - Clementine Nordon
- Medical and Payer Evidence Strategy, AstraZeneca UK, Academy House, 136 Hills Road, Cambridge, CB2 8PA, UK
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Zhang PF, You WY, Gao YJ, Wu XB. Activation of pyramidal neurons in the infralimbic cortex alleviates LPS-induced depressive-like behavior in mice. Brain Res Bull 2024; 214:111008. [PMID: 38866373 DOI: 10.1016/j.brainresbull.2024.111008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/23/2024] [Accepted: 06/07/2024] [Indexed: 06/14/2024]
Abstract
The infralimbic (IL) cortex dysfunction has been implicated in major depressive disorder (MDD), yet the precise cellular and molecular mechanisms remain poorly understood. In this study, we investigated the role of layer V pyramidal neurons in a mouse model of MDD induced by repeated lipopolysaccharide (LPS) administration. Our results demonstrate that three days of systemic LPS administration induced depressive-like behavior and upregulated mRNA levels of interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and transforming growth factor-β (TGF-β) in the IL cortex. Electrophysiological recordings revealed a significant decrease in the intrinsic excitability of layer V pyramidal neurons in the IL following systemic LPS exposure. Importantly, chemogenetic activation of IL pyramidal neurons ameliorated LPS-induced depressive-like behavior. Additionally, LPS administration significantly increased microglial activity in the IL, as evidenced by a greater number of Ionized calcium binding adaptor molecule-1 (IBA-1)-positive cells. Morphometric analysis further unveiled enlarged soma, decreased branch numbers, and shorter branch lengths of microglial cells in the IL cortex following LPS exposure. Moreover, the activation of pyramidal neurons by clozapine-N-oxide increased the microglia branch length but did not change branch number or cytosolic area. These results collectively suggest that targeted activation of pyramidal neurons in the IL cortex mitigates microglial response and ameliorates depressive-like behaviors induced by systemic LPS administration. Therefore, our findings offer potential therapeutic targets for the development of interventions aimed at alleviating depressive symptoms by modulating IL cortical circuitry and microglial activity.
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Affiliation(s)
- Peng-Fei Zhang
- Institute of Pain Medicine and Special Environmental Medicine, Co-innovation Center of Neuroregeneration, Nantong University, Jiangsu 226019, China
| | - Wen-Yong You
- Institute of Pain Medicine and Special Environmental Medicine, Co-innovation Center of Neuroregeneration, Nantong University, Jiangsu 226019, China
| | - Yong-Jing Gao
- Institute of Pain Medicine and Special Environmental Medicine, Co-innovation Center of Neuroregeneration, Nantong University, Jiangsu 226019, China.
| | - Xiao-Bo Wu
- Institute of Pain Medicine and Special Environmental Medicine, Co-innovation Center of Neuroregeneration, Nantong University, Jiangsu 226019, China.
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Merrell KW, Konney TO, Acheamfour O, Lucido J, Aduse-Poku AY, Kumar A, Ansah MB, Amankwa AT, Shumway D, Awittor FK, Badu-Peprah A, Fonkoua LAAK, Hendrickson AEW, Boakye E, Adjei EK, Kyei I, Kemper K, Rank M, Peethambaram PP, Spangenberg K, Sorenson K, Hearrold M, Garda A, Graham R, Lang K, Adom J, Achiaa R, Jakub J, Amo BD, Osei-Bonsu E, Camacho R, Addison ECDK. Participant Evaluation of a Multi-disciplinary Oncology Preceptorship Training Program for Oncology Health Professionals from Kumasi, Ghana. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:360-367. [PMID: 38506985 PMCID: PMC11219391 DOI: 10.1007/s13187-024-02417-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
A critical shortage of skilled healthcare workers is a primary cause of disparate global cancer outcomes. We report participant evaluation of a multidisciplinary preceptorship program. In collaboration with the city of Kumasi, Ghana, Mayo Clinic and the City Cancer Challenge hosted a preceptorship program for comprehensive multidisciplinary breast and cervix cancer training. A total of 14 healthcare workers from Kumasi received two weeks of training at Mayo Clinic in November and December 2021. Each participant and preceptor were requested to complete an anonymous post-participation survey. Of the 14 trainee participants, 10 (71%) completed the survey. All respondents found the program "valuable and applicable to their clinical practice." Ninety percent reported they were able to "review effective and critical elements in the development and expansion of the multidisciplinary team" and able to "solve practical clinical cases as a team". General themes of satisfaction included: (1) organization and administration, (2) clinical observations and demonstrations, (3) guidelines development, and (4) recognizing the central importance of cultivating a team-based approach. Of the 40 preceptors, 16 (40%) completed the survey. All respondents reported they felt the training would meaningfully "influence patient care in Ghana", that participation "added value or joy to their clinical practice," and all wished to "participate in future preceptorship programs". After a focused two-week program, trainees reported high satisfaction, usefulness from observing specialized cancer care, and value in closely observing a multidisciplinary oncology team. Preceptors reported the experience added joy and perspective to their clinical practice and wished to participate in future programs.
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Affiliation(s)
- Kenneth W Merrell
- Department of Radiation Oncology, Global Bridges, Mayo Clinic, Rochester, MN, USA.
| | | | | | - Joseph Lucido
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Amanika Kumar
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Dean Shumway
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Ernest Boakye
- Ernphil Laboratory and Diagnostic Services, Kumasi, Ghana
| | | | | | | | | | | | | | - Kasie Sorenson
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Miranda Hearrold
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Allison Garda
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Rondell Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Karen Lang
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Joseph Adom
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - James Jakub
- General Surgery, Mayo Clinic, Jacksonville, FL, USA
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Zhang S, Yang L, Xu W, Han L, Zhao G, Cai T. Global, regional, and national burden of trachea, bronchus, and lung cancer among women of reproductive age, 1990-2019. Cancer Epidemiol 2024; 91:102585. [PMID: 38815483 DOI: 10.1016/j.canep.2024.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/03/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Trachea, bronchus, and lung (TBL) cancer has demonstrated a discernible feminization and a tendency towards younger onset in recent decades. Therefore, our objective is to examine the most recent patterns in the worldwide prevalence of TBL among women of reproductive age on a global, regional, and national scale. METHODS To assess the prevalence trends of TBL in women of reproductive age, we calculated the estimated annual percentage change (EAPC), age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and disability-adjusted life years (DALYs) for 204 countries and territories from 1990 to 2019. These calculations were based on the Global Burden of Disease (GBD) 2019 database. RESULTS From 1990 to 2019, there was a global increase in the absolute number of incidence cases, deaths, and DALYs of TBL in women of reproductive age. However, the ASIR, ASDR, and age-standardized DALY rates were decreasing over this period, with EAPC of -0.77 (95 % confidence interval [CI]: -1.03 to -0.51), -1.08 (95 % CI: -1.34 to -0.82), and -1.10 (95 % CI: -1.36 to -0.84), respectively. This trend was observed even in regions with higher Socio-Demographic Index (SDI). East Asia consistently had the highest ASIR, ASDR, and age-standardized DALY rate, but there was a decreasing trend. Conversely, Eastern Sub-Saharan Africa displayed an increasing burden pattern. When examining countries individually, Monaco, Greenland, and Palau had the highest ASIR. Moreover, in most countries, the ASIR for TBL increased with age, particularly among women aged 35-49 years. CONCLUSIONS Despite a global decline in ASIR, ASDR, and age-standardized DALY rates for TBL in women of reproductive age over the past three decades, there is still a troubling increase observed in low- and low-middle SDI regions. It is crucial to implement effective preventive and curative measures in these regions in order to address this concerning trend.
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Affiliation(s)
- Siqi Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310000, China
| | - Liangwei Yang
- Department of Cardiothoracic Surgery, Ningbo No.2 Hospital, Ningbo 315010, China
| | - Weiwen Xu
- Department of Cardiothoracic Surgery, Ningbo No.2 Hospital, Ningbo 315010, China
| | - Liyuan Han
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China
| | - Guofang Zhao
- Department of Cardiothoracic Surgery, Ningbo No.2 Hospital, Ningbo 315010, China.
| | - Ting Cai
- Center for Cardiovascular and Cerebrovascular Epidemiology and Translational Medicine, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo 315000, China.
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Bourne RRA, Jonas JB, Friedman D, Nangia V, Bron A, Tapply I, Fernandes AG, Cicinelli MV, Arrigo A, Leveziel N, Resnikoff S, Taylor HR, Sedighi T, Bikbov MM, Braithwaite T, Cheng CY, Congdon N, Del Monte MA, Ehrlich JR, Fricke T, Furtado JM, Gazzard G, George R, Hartnett ME, Kahloun R, Kempen JH, Khairallah M, Khanna RC, Kim JE, Lansingh VC, Leasher J, Naidoo KS, Nowak M, Pesudovs K, Peto T, Ramulu P, Topouzis F, Tsilimbaris M, Wang YX, Wang N, Flaxman S, Bourne RRA, Jonas JB, Casson RJ, Friedman DS, Nangia V, Bron AM, Tapply I, Fernandes AG, Cicinelli MV, Leveziel N, Briant PS, Vos T, Resnikoff S, Abate YH, Abate MD, Dolatabadi ZA, Abdollahi M, Aboagye RG, Abu-Gharbieh E, Aburuz S, Adnani QES, Aghamiri S, Ahinkorah BO, Ahmad D, Ahmadieh H, Ahmadzadeh H, Ahmed A, Alfaar AS, Alinia C, Almidani L, Amu H, Androudi S, Anil A, Arabloo J, Areda D, Ashraf T, Bagherieh S, Baltatu OC, Baran MF, Barrow A, Bashiri A, Bayileyegn NS, Bazvand F, Berhie AY, Bhatti JS, Bikbov M, Birck MG, Bitra VR, Bozic MM, Braithwaite T, Burkart K, Bustanji Y, Butt ZA, Cenderadewi M, Chattu VK, Coberly K, Dadras O, Dai X, Dascalu AM, Dastiridou A, Devanbu VGC, Dhimal M, Diaz D, Do THP, Do TC, Dziedzic AM, Ehrlich JR, Ekholuenetale M, Elhadi M, Emamian MH, Emamverdi M, Farrokhpour H, Fetensa G, Fischer F, Forouhari A, Fowobaje KR, Furtado JM, Gandhi AP, Gebregergis MWW, Goulart BNG, Gudeta MD, Gupta S, Gupta VK, Gupta VB, Heidari G, Hong SH, Huynh HH, Ibitoye SE, Ilic IM, Immurana M, Jayapal SK, Joseph N, Joshua CE, Kahloun R, Kandel H, Karaye IM, Kasraei H, Kebebew GM, Kempen JH, KhalafAlla MT, Khanal S, Khatib MN, Krishan K, Lahariya C, Leasher JL, Lim SS, Marzo RR, Maugeri A, Meng Y, Mestrovic T, Mishra M, Mohamed NS, Mojiri-forushani H, Mokdad AH, Momeni-Moghaddam H, Montazeri F, Mulita A, Murray CJL, Foodani MN, Naik GR, Natto ZS, Nayak BP, Negaresh M, Negash H, Nguyen DH, Oancea B, Olagunju AT, Olatubi MI, Osman WMS, Osuagwu UL, Padubidri JR, Panda-Jonas S, Pardhan S, Park S, Patel J, Perianayagam A, Pesudovs K, Pham HT, Prates EJS, Qattea I, Rahim F, Rahman M, Rapaka D, Rawaf S, Rezaei N, Roy P, Saddik B, Saeed U, Safi SZ, Safi S, Sakshaug JW, Saleh MA, Samuel VP, Samy AM, Saravanan A, Seylani A, Shaikh MA, Shamim MA, Shannawaz M, Shashamo BB, Shayan M, Shittu A, Siddig EE, Singh JA, Solomon Y, Sousa RARC, Tabatabaei SM, Tabish M, Ticoalu JHV, Toma TM, Tsatsakis A, Tsegay GM, Valizadeh R, Viskadourou M, Wassie GT, Wickramasinghe ND, Yon DK, You Y, Flaxman S, Steinmetz JD. Global estimates on the number of people blind or visually impaired by glaucoma: A meta-analysis from 2000 to 2020. Eye (Lond) 2024; 38:2036-2046. [PMID: 38565601 DOI: 10.1038/s41433-024-02995-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 11/20/2023] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES To estimate global and regional trends from 2000 to 2020 of the number of persons visually impaired by glaucoma and their proportion of the total number of vision-impaired individuals. METHODS A systematic review and meta-analysis of published population studies and grey literature from 2000 to 2020 was carried out to estimate global and regional trends in number of people with vision loss due to glaucoma. Moderate or severe vision loss (MSVI) was defined as visual acuity of 6/60 or better but <6/18 (moderate) and visual acuity of 3/60 or better but <6/60 (severe vision loss). Blindness was defined as presenting visual acuity <3/60. RESULTS Globally, in 2020, 3.61 million people were blind and nearly 4.14 million were visually impaired by glaucoma. Glaucoma accounted for 8.39% (95% uncertainty intervals [UIs]: 6.54, 10.29) of all blindness and 1.41% (95% UI: 1.10, 1.75) of all MSVI. Regionally, the highest proportion of blindness relating to glaucoma was found in high-income countries (26.12% [95% UI: 20.72, 32.09]), while the region with the highest age-standardized prevalence of glaucoma-related blindness and MSVI was Sub-Saharan Africa. Between 2000 and 2020, global age-standardized prevalence of glaucoma-related blindness among adults ≥50 years decreased by 26.06% among males (95% UI: 25.87, 26.24), and by 21.75% among females (95% UI: 21.54, 21.96), while MSVI due to glaucoma increased by 3.7% among males (95% UI: 3.42, 3.98), and by 7.3% in females (95% UI: 7.01, 7.59). CONCLUSIONS Within the last two decades, glaucoma has remained a major cause of blindness globally and regionally.
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Li XY, Lv JJ, Zhao Y, Zhang YJ, Yang XT, Zhang RH, Guo ZL, Wang ZW, Cheng ZH. Global Burden of Stroke Attributable to Low Physical Activity/High Body Mass Index Among People Aged 55 Years and Older. Stroke 2024; 55:2075-2085. [PMID: 38920043 DOI: 10.1161/strokeaha.123.046180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/06/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND This study aimed to quantify the global stroke burden attributable to low physical activity and high body mass index in adults aged ≥55 years using data from the Global Burden of Disease 2019 study. METHODS We extracted data on stroke mortality, disability-adjusted life years, and risk factor exposure from the Global Burden of Disease 2019 study for people aged ≥55 years. We calculated the population-attributable fraction and absolute number of stroke cases and disability-adjusted life years attributable to low physical activity and high body mass index by location, age group, sex, and year. RESULTS Globally, body mass index and physical inactivity-attributable stroke burden have declined modestly since 1990, but with diverging escalatory regional trajectories. Population growth and aging drive this rising burden. CONCLUSIONS Multidimensional, context-specific strategies focused on modifiable lifestyle risks are imperative to address the modest declines and escalatory regional trajectories in body mass index and physical inactivity-attributable stroke burden.
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Affiliation(s)
- Xin-Yu Li
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
- Department of Plastic and Reconstructive Surgery (X.-Y.L., R.-H.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Jia-Jie Lv
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Yan Zhao
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
- Department of Nursing (Y.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Yuan-Jie Zhang
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Xi-Tao Yang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies (X.-T.Y.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Ru-Hong Zhang
- Department of Plastic and Reconstructive Surgery (X.-Y.L., R.-H.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Zhi-Lin Guo
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Zhao-Wei Wang
- Department of Neurology, Qianjiang Central Hospital of Hubei Province, PR China (Z.-W.W.)
| | - Zhi-Hua Cheng
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
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Soeiro RE, Souza RT, Bento SF, Cecatti JG, Surita FG, Freitas-Jesus JV, Pacagnella RC, Ribeiro-Do-Valle CC, Luz AG, Lajos GJ, Nobrega GM, Griggio TB, Charles CM, Silveira C, Miele MJ, Tedesco RP, Fernandes KG, Martins-Costa SH, Peret FJ, Feitosa FE, Traina E, Cunha Filho EV, Vettorazzi J, Haddad SM, Andreucci CB, Guida JP, Correa Junior MD, Dias MA, Oliveira LG, Melo Junior EF, Luz MGDA, Costa ML. The experience of pregnant women and their families who were infected with covid-19 before vaccination: A qualitative approach within a multicenter study in Brazil. Midwifery 2024; 135:104018. [PMID: 38729000 DOI: 10.1016/j.midw.2024.104018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 06/21/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Pregnant and postpartum women infected by COVID-19 are at increased risk of adverse outcomes, including negative effects on their mental health. Brazilian maternal mortality rate due to COVID-19 is 2.5 times higher than overall mortality rates. This study aimed to understand how pregnant/postpartum women experienced the COVID-19 suspicion/investigation or confirmed infection in different Brazilian cities, the pandemic's consequences to women and their families, and their needs to improve maternal health services during public health emergencies. METHODS We conducted a qualitative study with 27 women with COVID-19 and 6 of their family members, as part of a multicenter study among 15 maternity hospitals in Brazil. We applied in-depth interviews through telephone calls when women received the diagnostic or had a suspect infection and after 60 days. Another semi-structured interview was applied to their close family members. The interviews were considered through thematic analysis. RESULTS From the thematic content analysis three major themes emerged from the first and second interviews: (Cucinotta and Vanelli, 2020) assistance received by the woman and newborn in the medical services; (World Health Organization (WHO) 2021) stigma/fear of contamination from health workers and from family and friends reported by the women; (Allotey et al., 2020) the COVID-19 pandemic impact. CONCLUSION Before the availability of the COVID-19 vaccine, pregnant women experienced fear of death, hospitalization, quarantine, loss of family members, and financial repercussions, resulting in physical, psychological, and socioeconomic impacts on these women's lives.
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Affiliation(s)
- Rachel E Soeiro
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil.
| | - Silvana F Bento
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Jose G Cecatti
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Fernanda G Surita
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | | | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | | | - Adriana G Luz
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Giuliane J Lajos
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Guilherme M Nobrega
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Thayna B Griggio
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Charles M Charles
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Carla Silveira
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | - Maria J Miele
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
| | | | | | | | | | | | - Evelyn Traina
- Federal University of São Paulo - UNIFESP/EPM, São Paulo, SP, Brazil
| | | | - Janete Vettorazzi
- Clinics Hospital of Porto Alegre, Porto Alegre, RS, Brazil; Moinhos de Vento Hospital - HMV, Porto Alegre, RS, Brazil
| | - Samira M Haddad
- Jorge Rossmann Regional Hospital - Sócrates Guanaes Institute, Itanhaém, SP, Brazil
| | | | | | | | - Marcos Ab Dias
- Fernandes Figueira Institute - IFF/Fiocruz, Rio de Janeiro, RJ, Brazil
| | | | | | | | - Maria Laura Costa
- Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil
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Saade Y, Deraz O, Chatzopoulou E, Rangé H, Boutouyrie P, Perier MC, Guibout C, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Recalled body silhouette trajectories over the lifespan and oral conditions in adulthood: A cross-sectional analysis of the Paris Prospective Study 3. Community Dent Oral Epidemiol 2024; 52:518-526. [PMID: 38273719 DOI: 10.1111/cdoe.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To examine the association between life-course body silhouette changes and oral conditions in adulthood. METHODS At study recruitment (2008-2012), 5430 adults underwent a full-mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life-course trajectories of body silhouettes were computed using group-based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression. RESULTS The final analysis included 4472 participants. Five body silhouette trajectories were established: lean-stable (30.0%), lean-increased (19.3%), moderate stable (18.1%), lean-marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean-increased trajectory were 58% more likely than those with a lean-stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides. CONCLUSIONS A life-course lean-increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood.
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Affiliation(s)
- Yara Saade
- Department of Periodontology, Université Paris Cité, Paris, France
- Rothschild Hospital, APHP, Paris, France
| | - Omar Deraz
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Eirini Chatzopoulou
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Hélène Rangé
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
- Department of Periodontology, Service of Odontology, University hospital of Rennes, University of Rennes 1, U.F.R. of Odontology, Paris, France
- INSERM, INRAE, University of Rennes 1 NUMECAN Institute (Nutrition Metabolisms and Cancer), Rennes, France
- FHU PaCeMM Paris Center for Microbiome Medicine, Paris, France
| | - Pierre Boutouyrie
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Catherine Guibout
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | | | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
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Ruíz-Patiño A, Rojas L, Zuluaga J, Arrieta O, Corrales L, Martín C, Franco S, Raez L, Rolfo C, Sánchez N, Cardona AF. Genomic ancestry and cancer among Latin Americans. Clin Transl Oncol 2024; 26:1856-1871. [PMID: 38581481 PMCID: PMC11249489 DOI: 10.1007/s12094-024-03415-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/20/2024] [Indexed: 04/08/2024]
Abstract
Latin American populations, characterized by intricate admixture patterns resulting from the intermingling of ancestries from European, Native American (NA) Asian, and African ancestries which result in a vast and complex genetic landscape, harboring unique combinations of novel variants. This genetic diversity not only poses challenges in traditional population genetics methods but also opens avenues for a deeper understanding of its implications in health. In cancer, the interplay between genetic ancestry, lifestyle factors, and healthcare disparities adds a layer of complexity to the varying incidence and mortality rates observed across different Latin American subpopulations. This complex interdependence has been unveiled through numerous studies, whether conducted on Latin American patients residing on the continent or abroad, revealing discernible differences in germline composition that influence divergent disease phenotypes such as higher incidence of Luminal B and Her2 breast tumors, EGFR and KRAS mutated lung adenocarcinomas in addition to an enrichment in BRCA1/2 pathogenic variants and a higher than expected prevalence of variants in colorectal cancer associated genes such as APC and MLH1. In prostate cancer novel risk variants have also been solely identified in Latin American populations. Due to the complexity of genetic divergence, inputs from each individual ancestry seem to carry independent contributions that interplay in the development of these complex disease phenotypes. By understanding these unique population characteristics, genomic ancestries hold a promising avenue for tailoring prognostic assessments and optimizing responses to oncological interventions.
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Affiliation(s)
- Alejandro Ruíz-Patiño
- Clinical Genetics, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
- Foundation for Clinical and Applied Cancer Research - FICMAC, Bogotá, Colombia
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia
| | - Leonardo Rojas
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Jairo Zuluaga
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Oscar Arrieta
- Instituto Nacional de Cancerología -INCaN, Mexico City, Mexico
| | - Luis Corrales
- Thoracic Oncology Unit, Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica
| | - Claudio Martín
- Thoracic Oncology Unit, Instituto Alexander Fleming, Buenos Aires, Argentina
| | - Sandra Franco
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia
- Breast Cancer Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Luis Raez
- Oncology Department, Memorial Cancer Institute (MCI), Memorial Healthcare System, Miami, FL, USA
| | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Natalia Sánchez
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia
- Institute of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
| | - Andrés Felipe Cardona
- GIGA/TERA Research Group, CTIC/Universidad El Bosque, Bogotá, Colombia.
- Thoracic Oncology Unit, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
- Institute of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia.
- Direction of Research and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Cra. 14 #169-49, Bogotá, Colombia.
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Wang J, Han L, Liu Z, Zhang W, Zhang L, Jing J, Gao A. Targeting IGF2BP1 alleviated benzene hematotoxicity by reprogramming BCAA metabolism and fatty acid oxidation. Chem Biol Interact 2024; 398:111107. [PMID: 38866309 DOI: 10.1016/j.cbi.2024.111107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/30/2024] [Accepted: 06/09/2024] [Indexed: 06/14/2024]
Abstract
Benzene is the main environmental pollutant and risk factor of childhood leukemia and chronic benzene poisoning. Benzene exposure leads to hematopoietic stem and progenitor cell (HSPC) dysfunction and abnormal blood cell counts. However, the key regulatory targets and mechanisms of benzene hematotoxicity are unclear. In this study, we constructed a benzene-induced hematopoietic damage mouse model to explore the underlying mechanisms. We identified that Insulin like growth factor 2 mRNA binding protein 1 (IGF2BP1) was significantly reduced in benzene-exposed mice. Moreover, targeting IGF2BP1 effectively mitigated damages to hematopoietic function and hematopoietic molecule expression caused by benzene in mice. On the mechanics, by metabolomics and transcriptomics, we discovered that branched-chain amino acid (BCAA) metabolism and fatty acid oxidation were key metabolic pathways, and Branched-chain amino acid transaminase 1 (BCAT1) and Carnitine palmitoyltransferase 1a (CPT1A) were critical metabolic enzymes involved in IGF2BP1-mediated hematopoietic injury process. The expression of the above molecules in the benzene exposure population was also examined and consistent with animal experiments. In conclusion, targeting IGF2BP1 alleviated hematopoietic injury caused by benzene exposure, possibly due to the reprogramming of BCAA metabolism and fatty acid oxidation via BCAT1 and CPT1A metabolic enzymes. IGF2BP1 is a potential regulatory and therapeutic target for benzene hematotoxicity.
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Affiliation(s)
- Jingyu Wang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Lin Han
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Ziyan Liu
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Wei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Lei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Jiaru Jing
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China
| | - Ai Gao
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, PR China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, PR China.
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Long CM, Li Z, Song W, Zeng X, Yang R, Lu L. The Roles of Non-coding RNA Targeting Astrocytes in Cerebral Ischemia. Mol Neurobiol 2024; 61:5814-5825. [PMID: 38236344 DOI: 10.1007/s12035-023-03898-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024]
Abstract
Astrocytes are key targets for treating cerebral ischemia in the central nervous system. Non-coding RNAs (ncRNAs) participate in the pathological processes of astrocytes in cerebral ischemia. Recent reports suggest that ncRNAs ameliorate the outcome of cerebral ischemia by mediating astrocytes' inflammatory reaction, oxidative stress, excitotoxicity, autophagy, and apoptosis. Reconstructing cellular systems might offer a promising strategy for treating cerebral ischemia. This review briefly discusses the potential of ncRNAs as drug targets and explores the molecular regulatory mechanisms through which ncRNAs target astrocytes in cerebral ischemia. It provides an overview of the current research, discusses ncRNAs' implications as clinical markers for cerebral ischemia, and anticipates that ongoing research on ncRNAs may contribute to novel therapeutic approaches for treating this condition.
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Affiliation(s)
- Chun-Mei Long
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, 73000, Gansu, China
| | - Zhen Li
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, 73000, Gansu, China
| | - Wang Song
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, 73000, Gansu, China
| | - Xin Zeng
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, 73000, Gansu, China
| | - Rui Yang
- The Endocrinology Department, Lanzhou Hospital of Traditional Chinese Medicine, Lanzhou, 73000, Gansu, China
| | - Li Lu
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, 73000, Gansu, China.
- Medical College of Lanzhou University, 199 Dong gang West Road, Cheng guan District, Lanzhou, China.
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75
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Gerhards C, Teufel A, Gerigk M, French M, Antoni C, Ebert M, Neumaier M, Evliyaoglu O. Potential role of Vitamin D in immune response in patients with viral hepatitis. Nutrition 2024; 124:112447. [PMID: 38669827 DOI: 10.1016/j.nut.2024.112447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND To study the relationship of Vitamin D with innate and adaptive immune response parameters in chronic hepatitis B and C patients. METHODS The laboratory data between January 1, 2013 and February 1, 2023, for patients with chronic hepatitis B (CHB), and chronic hepatitis C (CHC) were extracted. Serum 25-hydroxyl vitamin D, hepatitis B virus serological markers, complements, and subsets of T lymphocytes were determined. Study cohorts were divided into groups based on serum 25-hydroxyl vitamin D levels with further evaluation of laboratory data. RESULTS In CHB and CHC patients the percentage of CD4+ T lymphocytes and the CD4+/CD8+ ratio significantly decreased (P < 0.05), but the percentage of CD8+ increased (P < 0.05) compared to the control group. In CHB patients Vitamin D decrease was significant (P < 0.001) but not in CHC patients. Vitamin D showed a moderate negative influence on the CD8 cell count in CHB patients. The positive ratio of HBV DNA and HBsAg decreased with increasing serum vitamin D levels. The vitamin D deficient group showed significantly lower antibody production compared to the normal group, and exhibited significantly decreased CD4 numbers and increased CD8 numbers (P < 0.05 and P < 0.001, respectively), while the CD4/CD8 ratio was also significantly decreased in the insufficiency group (P < 0.001). Complement C3 levels were not associated with CD4 and CD8, but had an inverse relation with Vitamin D. Vitamin D levels were significantly associated with complement C3, CD8+, CD4+, CD19+ cells, and HBV DNA levels. CONCLUSIONS Vitamin D may be a modulator of immune function not only via CD8+ and CD4+ cells but also via CD19+ cells in the course of chronic HBV infection. The negative relationship between vitamin D and complement C3 needs elucidation. Moreover, the increased proportion of B cells and decreased CD4+ cells in Vitamin D deficiency disrupt the immune response against HBV since the expected antibody response was not obtained despite the increase in B cell ratio. This indicates an influence of CD4+ cells for B cell functionality. In summary, sufficient levels of Vitamin D may lead to a sustained virological response that is debatable by artificially correcting the deficiency.
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Affiliation(s)
- Catharina Gerhards
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Andreas Teufel
- Division of Hepatology, Division of Clinical Bioinformatics, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marlis Gerigk
- Institute of Medical Microbiology and Hygiene, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael French
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Christoph Antoni
- Clinical Cooperation Unit Healthy Metabolism, Center for Disease Prevention and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthias Ebert
- Clinical Cooperation Unit Healthy Metabolism, Center for Disease Prevention and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Medicine II, University, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Michael Neumaier
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Osman Evliyaoglu
- Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany.
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Xu JJ, Kan WJ, Wang TY, Li L, Zhang Y, Ge ZY, Xu JY, Yin ZJ, Feng Y, Wang G, Du J. Ganoderic acid A ameliorates depressive-like behaviors in CSDS mice: Insights from proteomic profiling and molecular mechanisms. J Affect Disord 2024; 358:270-282. [PMID: 38723681 DOI: 10.1016/j.jad.2024.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Ganoderic Acid A (GAA), a primary bioactive component in Ganoderma, has demonstrated ameliorative effects on depressive-like behaviors in a Chronic Social Defeat Stress (CSDS) mouse model. This study aims to elucidate the underlying molecular mechanisms through proteomic analysis. METHODS C57BL/6 J mice were allocated into control (CON), chronic social defeat stress (CSDS), GAA, and imipramine (IMI) groups. Post-depression induction via CSDS, the GAA and IMI groups received respective treatments of GAA (2.5 mg/kg) and imipramine (10 mg/kg) for five days. Behavioral assessments utilized standardized tests. Proteins from the prefrontal cortex were analyzed using LC-MS, with further examination via bioinformatics and PRM for differential expression. Western blot analysis confirmed protein expression levels. RESULTS Chronic social defeat stress (CSDS) induced depressive-like behaviors in mice, which were significantly alleviated by GAA treatment, comparably to imipramine (IMI). Proteomic analysis identified distinct proteins in control (305), GAA-treated (949), and IMI-treated (289) groups. Enrichment in mitochondrial and synaptic proteins was evident from GO and PPI analyses. PRM analysis revealed significant expression changes in proteins crucial for mitochondrial and synaptic functions (namely, Naa30, Bnip1, Tubgcp4, Atxn3, Carmil1, Nup37, Apoh, Mrpl42, Tprkb, Acbd5, Dcx, Erbb4, Ppp1r2, Fam3c, Rnf112, and Cep41). Western blot validation in the prefrontal cortex showed increased levels of Mrpl42, Dcx, Fam3c, Ppp1r2, Rnf112, and Naa30 following GAA treatment. CONCLUSION GAA exhibits potential antidepressant properties, with its action potentially tied to the modulation of synaptic functions and mitochondrial activities.
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Affiliation(s)
- Jin-Jie Xu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Wei-Jing Kan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Tian-Yi Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Lei Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Yi Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zi-Yu Ge
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Ji-Yi Xu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Zi-Jia Yin
- Harbin Medical University Daqing Campus, Heilongjiang 163319, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
| | - Jing Du
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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Chemaitelly H, Akhtar N, Jerdi SA, Kamran S, Joseph S, Morgan D, Uy R, Abid FB, Al-Khal A, Bertollini R, Abou-Samra AB, Butt AA, Abu-Raddad LJ. Association between COVID-19 vaccination and stroke: a nationwide case-control study in Qatar. Int J Infect Dis 2024; 145:107095. [PMID: 38777080 DOI: 10.1016/j.ijid.2024.107095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This study investigated the association between Coronavirus Disease 2019 mRNA vaccination and stroke in Qatar. METHODS Between December 1, 2020, and April 11, 2023, a matched case-control study was conducted to investigate the association between 3036 acute stroke cases and 3036 controls drawn from the entire population of Qatar. RESULTS The adjusted odds ratio (aOR) for vaccination among cases compared to controls was 0.87 (95% CI: 0.75-1.00). The aOR was 0.74 (95% CI: 0.45-1.23) for a single vaccine dose, 0.87 (95% CI: 0.73-1.04) for primary-series vaccination (two doses), and 0.91 (95% CI: 0.66-1.25) for booster vaccination (three or more doses). The aOR was 0.87 (95% CI: 0.72-1.04) for BNT162b2 and 0.86 (95% CI: 0.67-1.11) for mRNA-1273. Subgroup analyses, considering different durations since vaccination, also demonstrated no association. Subgroup analyses based on nationality, age, number of coexisting conditions, or prior infection status yielded similar results. Subgroup analysis, stratified by stroke type, suggested an association between vaccination and cerebral venous sinus thrombosis (aOR of 2.50 [95% CI: 0.97-6.44]), but it did not reach statistical significance. CONCLUSION There was no evidence of an increased risk of stroke following vaccination, both in the short term and in the long term, extending beyond a year after receiving the vaccine.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Naveed Akhtar
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Salman Al Jerdi
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar; Department of Medical Education, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - Saadat Kamran
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Sujatha Joseph
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Deborah Morgan
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Ryan Uy
- Neurosciences Institute, Hamad Medical Corporation, Doha, Qatar
| | - Fatma B Abid
- Department of Medical Education, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; Infectious Disease Division, Hamad Medical Corporation, Doha, Qatar; College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | | | - Abdul-Badi Abou-Samra
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
| | - Adeel A Butt
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA; Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar; Department of Medicine, Weill Cornell Medicine, Cornell University, New York, New York, USA
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar; World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar.
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Wandscher K, Hoffmann F, Heesen C, Thomalla G, Rahn AC, Helbach J. Effectiveness of motivational interviewing on medication adherence for the prevention of recurrent stroke or transient ischemic attack: Systematic review of randomized controlled trials. Eur J Neurol 2024; 31:e16313. [PMID: 38676444 DOI: 10.1111/ene.16313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/28/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND PURPOSE This systematic review examines the effectiveness of motivational interviewing (MI) on medication adherence for preventing recurrent stroke and transient ischemic attack (TIA). METHODS MEDLINE (via PubMed), CINAHL, PsycINFO, CENTRAL, and ClinicalTrials.gov were searched from inception to 12 June 2023. Randomized controlled trials comparing MI with usual care or interventions without MI in participants with any stroke type were identified and summarized descriptively. Primary outcome was medication adherence. Secondary outcomes were quality of life (QoL) and different clinical outcomes. We assessed risk of bias with RoB 2 (revised Cochrane risk-of-bias tool) and intervention complexity with the iCAT_SR (intervention Complexity Assessment Tool for Systematic Reviews). RESULTS We screened 691 records for eligibility and included four studies published in five articles. The studies included a total of 2751 participants, and three were multicentric. Three studies had a high risk of bias, and interventions varied in complexity. Two studies found significantly improved medication adherence, one at 9 (96.9% vs. 88.2%, risk ratio = 1.098, 95% confidence interval = 1.03-1.17) and one at 12 months (97.0% vs. 95.0%, p = 0.026), but not at other time points, whereas two other studies reported no significant changes. No significant differences were found in QoL or clinical outcomes. CONCLUSIONS Evidence on MI appears inconclusive for improving medication adherence for recurrent stroke and TIA prevention, with no benefits on QoL and clinical outcomes. There is a need for robustly designed studies and process evaluations of MI as a complex intervention for people with stroke. REGISTRATION PROSPERO (CRD42023433284).
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Affiliation(s)
- Kathrin Wandscher
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Falk Hoffmann
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Christoph Heesen
- Institute of Neuroimmunology and Multiple Sclerosis, Center for Molecular Neurobiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
- Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Christin Rahn
- Nursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Jasmin Helbach
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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Mei J, Yao Y, Wang X, Liu T, Sun L, Zhang G. Construction of a Model for Predicting the Risk of pT3 Based on Perioperative Characteristics in cT1 Renal Cell Carcinoma: A Retrospective Study at a Single Institution. Clin Genitourin Cancer 2024; 22:102122. [PMID: 38861916 DOI: 10.1016/j.clgc.2024.102122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION This study explored the predictors of upstaging and multiple sites of extension, and constructed a predictive model based on perioperative characteristics to calculate the risk of upstaging of cT1 renal cell carcinoma to pT3. METHODS We retrospectively reviewed 1012 patients diagnosed with cT1 renal cell carcinoma who underwent surgical treatment at the Affiliated Hospital of Qingdao University between June 2016 and August 2021. The continuous and categorical variables were analyzed using the Mann-Whitney U test and Chi-square test, respectively. After randomly dividing patients into a training set and an internal validation set with a ratio of 7:3, univariate and multivariate logistic regression analyses were used to explore the predictors of upstaging and multiple sites of extension. A nomogram model was established based on the predictors of upstaging and was validated. RESULTS Ninety-one cases (8.99%) of renal cell carcinoma were upstaged to pT3. In the training set, multivariate logistic regression identified the following predictors of upstaging: maximum tumor diameter, hilus involvement, tumor necrosis, tumor edge irregularity, symptoms, smoking, and platelet-lymphocyte ratio. A nomogram model was established based on the predictors. The area under the receiver operating characteristic curve was 0.810 in the training set, and 0.804 in the validation set. A 10-fold internal cross-validation conducted 200 times showed that the mean area under the curve was 0.797. The calibration curve and decision curve analysis suggested that the nomogram had robust clinical predictive power. Analyses showed higher neutrophil-lymphocyte ratio and tumor necrosis were associated with multiple sites of extrarenal extension in patients with pT3a renal cell carcinoma. CONCLUSIONS We identified 7 predictors of upstaging to pT3 and 2 predictors of multiple sites of extension. A nomogram model was constructed with satisfactory accuracy for predicting upstaging to pT3.
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Affiliation(s)
- Jingchang Mei
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Yao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xin Wang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tian Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lijiang Sun
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
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Are C, Schissel M, Smith LM, Rao TS. Series on the Lancet Oncology Commission on Global Cancer Surgery: Introduction-Intent and Content. Ann Surg Oncol 2024; 31:4868-4872. [PMID: 38831196 DOI: 10.1245/s10434-024-15554-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Surgery plays a key role in the multi-disciplinary cancer care pathway. Nearly 80% of patients with solid tumors will require surgical intervention during the course of their disease. Unfortunately, the vast majority of these patients do not have access to safe, timely, high-quality, and affordable cancer surgical care. The first Lancet Oncology Commission on Global Cancer Surgery shone a light on this grave situation and outlined some strategies to address them. The second Lancet Oncology Commission on Global Cancer Surgery (TLO- II) was conceived to continue the work of its predecessor by developing a roadmap of practical solutions to propel improvements in cancer surgical care globally. METHODS The Commission was developed by involving approximately 50 cancer care leaders and experts from different parts of the world to ensure diversity of input and global applicability. RESULTS The Commission identified nine solutional domains that are considered essential to deliver safe, timely, high-quality, and affordable cancer surgical care. These nine domains were further refined to develop solutions specific to each of the six World Health Organization regions. Based on the above solutions, we developed eight action items that are intended to propel improvements in cancer surgical care on the global stage. CONCLUSIONS The second Lancet Oncology Commission on Global Cancer Surgery builds on the first Commission by developing a pragmatic roadmap of practical solutions that we hope will ensure access to safe, timely, high-quality, and affordable cancer surgical care for everyone regardless of their socioeconomic status or geographic location.
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Affiliation(s)
- Chandrakanth Are
- Division of Surgical Oncology, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Makayla Schissel
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lynette M Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - T S Rao
- Department of Surgical Oncology, Basavtarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
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Loeser JD, Ballantyne JC. Pains Revisited. Clin J Pain 2024; 40:459-462. [PMID: 38751345 DOI: 10.1097/ajp.0000000000001224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/07/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES The management of pain patients has not evolved as rapidly as envisioned when IASP was founded almost 50 years ago. We sought to identify factors that could contribute to this situation, with a focus on concepts of pain and the education of pain physicians. METHODS Relevant literature describing new strategies for diagnosing and managing patients with high-impact chronic pain was reviewed. RESULTS It appears that the acute-chronic dichotomy has outlived its usefulness and pains should be identified as of peripheral origin or due to central processing errors. Pains of peripheral origin and those of central processing errors require different diagnostic and therapeutic strategies. DISCUSSION Peripheral treatments and opioids are not effective for central pains. When the cause of the pain lies in the central nervous system, a more centrally focused approach is needed to minimize wasteful pursuit of peripheral causes. The education and training of pain physicians should reflect the skills needed to address these 2 very different clinical problems.
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Affiliation(s)
- John D Loeser
- Departments of Neurological Surgery and Anesthesiology and Pain Medicine
| | - Jane C Ballantyne
- Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA
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Window P, McGrath M, Harvie DS, Smits E, Johnston V, Murdoch M, Russell T. Pain Education and Virtual Reality Improves Pain, Pain-related Fear of Movement, and Trunk Kinematics in Individuals With Persistent Low Back Pain. Clin J Pain 2024; 40:478-489. [PMID: 38708788 DOI: 10.1097/ajp.0000000000001221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/16/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVES To evaluate the effect of combining pain education and virtual reality (VR) exposure therapy using a cognitive-behavioral therapy-informed approach (virtual reality-based cognitive behavioral therapy [VR-CBT]) on pain intensity, fear of movement, and trunk movement in individuals with persistent low back pain. MATERIALS AND METHODS Thirty-seven participants were recruited in a single cohort repeated measures study, attending 3 sessions 1 week apart. The VR-CBT intervention included standardized pain education (session 1) and virtual reality-based exposure therapy (VRET; session 2) incorporating gameplay with mixed reality video capture and reflective feedback of performance. Outcome measures (pain intensity, pain-related fear of movement (Tampa Scale of Kinesiophobia), and trunk kinematics during functional movements (maximum amplitude and peak velocity) were collected at baseline (session 1) and 1 week after education (session 2) and VRET (session 3). One-way repeated measures analysis of variances evaluated change in outcomes from baseline to completion. Post hoc contrasts evaluated effect sizes for the education and VR components of VR-CBT. RESULTS Thirty-four participants completed all sessions. Significant ( P < 0.001) reductions were observed in mean (SD) pain (baseline 5.9 [1.5]; completion 4.3 [2.1]) and fear of movement (baseline 42.6 [6.4]; completion 34.3 [7.4]). Large effect sizes (Cohen d ) were observed for education (pain intensity: 0.85; fear of movement: 1.28), whereas the addition of VRET demonstrated very small insignificant effect sizes (pain intensity: 0.10; fear of movement: 0.18). Peak trunk velocity, but not amplitude, increased significantly ( P < 0.05) across trunk movement tasks. CONCLUSION A VR-CBT intervention improved pain, pain-related fear of movement, and trunk kinematics. Further research should explore increased VR-CBT dosage and mechanisms underlying improvement.
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Affiliation(s)
- Peter Window
- Department of Physiotherapy, Royal Brisbane and Women's Hospital
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane
| | - Michelle McGrath
- Department of Physiotherapy, Royal Brisbane and Women's Hospital
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane
| | - Daniel S Harvie
- School of Allied Health and Human Performance, University of South Australia, Adelaide
| | - Esther Smits
- RECOVER Injury Research Centre, University of Queensland
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich
- Centre for Health Research, University of Sothern Queensland, Australia
| | - Megan Murdoch
- Department of Physiotherapy, Royal Brisbane and Women's Hospital
- Tess Cramond Pain and Research Centre, Surgical Treatment and Rehabilitation Service, Herston
| | - Trevor Russell
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Brisbane
- RECOVER Injury Research Centre, University of Queensland
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83
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Liu L, Yi X, Li J, Luo H, Yu M, Wang Z, Zhou J. The incidence of stroke and contribution of risk factors for stroke in high-risk stroke population in southwestern China. Clin Neurol Neurosurg 2024; 243:108391. [PMID: 38879899 DOI: 10.1016/j.clineuro.2024.108391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/18/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To estimate the incidence of stroke and determine the role that risk factors play in the high-risk stroke populace in southwest China. METHODS This research employed a prospective cohort design that focused on the community. Eight communities in southwest China were selected randomly for this study. The residents aged 40 years and older who volunteered to participate were surveyed through face-to-face interviews. Those with a history of stroke or at least three of the eight stroke-related risk factors were categorized as the high-risk stroke population. A total of 2698 high-risk individuals were included in the study after a 4.7-year follow-up period. The incidence of stroke and the association between risk variables and stroke occurrence were estimated. RESULTS During 4.7-year follow-up, the incidence of total stroke, ischemic stroke, and hemorrhagic stroke in high-risk stroke population were 5.0 %, 4.4 % and 0.9 % respectively. It should be noted that some participants experienced both cerebral infarction and cerebral hemorrhage during the follow-up period. The multivariate analytic model revealed that a personal history of stroke (OR=3.397, 95 % CI 2.365-4.878, p<.001) was substantially linked with an elevated risk of overall stroke. This correlation remained consistent for both ischemic and hemorrhagic stroke. CONCLUSIONS This study revealed a high prevalence and incidence of stroke among a high-risk group in southwestern China. Furthermore, it demonstrated that individuals with a personal history of stroke are at an elevated risk of future stroke, suggesting the need for additional precautions in this population.
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Affiliation(s)
- Lin Liu
- Department of Neurology, Deyang People's Hospital, Deyang, China.
| | - Xingyang Yi
- Department of Neurology, Deyang People's Hospital, Deyang, China
| | - Jie Li
- Department of Neurology, Deyang People's Hospital, Deyang, China
| | - Hua Luo
- Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ming Yu
- Department of Neurology, the Suining Central Hospital, Suining, China
| | - Zhihao Wang
- Department of Neurology, Deyang People's Hospital, Deyang, China
| | - Ju Zhou
- Department of Neurology, Deyang People's Hospital, Deyang, China
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84
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Mohammedi K, Hess S, McQueen M, Pigeyre M, Lee SF, Pare G, Gerstein HC. Determinants of serious health outcome-free status in middle-aged and older people with dysglycaemia: Exploratory analysis of the ORIGIN trial. Diabetes Obes Metab 2024; 26:3272-3280. [PMID: 38747213 DOI: 10.1111/dom.15654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 07/10/2024]
Abstract
AIM To assess clinical and biochemical measurements that can identify people with dysglycaemia (i.e. diabetes or pre-diabetes) who remain free of serious outcomes during follow-up. MATERIALS AND METHODS We conducted exploratory analyses using data from the Outcomes Reduction with an Initial Glargine Intervention (ORIGIN) study to identify independent determinants of outcome-free status in 12 537 middle-aged and older adults with prediabetes and early type 2 diabetes from 40 countries. Serious outcome-free status was defined as the absence of major cardiovascular outcomes, kidney or retinal outcomes, peripheral artery disease, dementia, cancer, any hospitalization, or death during follow-up. RESULTS In total, 3328 (26.6%) participants remained free of serious outcomes during a median follow-up of 6.2 years (IQR 5.8, 6.7). Independent clinical determinants of outcome-free status included younger age, female sex, non-White ethnicity, shorter diabetes duration, absence of previous cardiovascular disease, current or former smokers, higher grip strength, Mini-Mental State Examination score, and ankle-brachial index, lower body mass index and kidney disease index, and non-use of renin-angiotensin system drugs and beta-blockers. In a subset of 8401 people with baseline measurements of 238 biomarkers, growth differentiation factor 15, kidney injury molecule-1, N-terminal pro-brain natriuretic peptide, uromodulin, C-reactive protein, factor VII and ferritin were independent determinants. The combination of clinical determinants and biomarkers best identified participants who remained outcome-free (C-statistics 0.71, 95% confidence interval 0.70-0.73; net reclassification improvement 0.55, 95% confidence interval 0.48-0.58). CONCLUSIONS A set of routinely measured clinical characteristics and seven protein biomarkers identify middle-aged and older people with prediabetes or early type 2 diabetes as least likely to experience serious outcomes during follow-up.
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Affiliation(s)
- Kamel Mohammedi
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
- Université de Bordeaux, INSERM, BMC, U1034, Avenue de Magellan, Pessac, France
| | - Sibylle Hess
- Sanofi, Global Medical Diabetes, Frankfurt, Germany
| | - Matthew McQueen
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Marie Pigeyre
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Shun Fu Lee
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Guillaume Pare
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
| | - Hertzel C Gerstein
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Canada
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85
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Li ZH, Pu XQ, Li SS, Dong XK, Zhang GQ, Wang Y, Liu JM. Neuroprotective Effect and Mechanism of Tanreqing Injection on Ischemic Stroke: Insights from Network Pharmacology and in vivo Experiments. Chin J Integr Med 2024; 30:713-720. [PMID: 38910191 DOI: 10.1007/s11655-024-3910-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To explore the neuroprotective effects and mechanism of Tanreqing Injection (TRQ) on treating ischemic stroke based on network pharmacology and in vivo experimental validation. METHODS The chemical compounds of TRQ were retrieved based on published data, with targets retrieved from PubChem, Therapeutic Target Database and DrugBank. Network visualization and analysis were performed using Cytoscape, with protein-protein interaction networks derived from the STRING database. Enrichment analysis was performed using Kyoto Encyclopedia of Genes Genomes pathway and Gene Ontology analysis. In in vivo experiments, the middle cerebral artery occlusion (MCAO) model was used. Infarct volume was determined by 2,3,5-triphenyltetrazolium hydrochloride staining and protein expressions were analyzed by Western blot. Molecular docking was performed to predict ligand-receptor interactions. RESULTS We screened 81 chemical compounds in TRQ and retrieved their therapeutic targets. Of the targets, 116 were therapeutic targets for stroke. The enrichment analysis showed that the apelin signaling pathway was a key pathway for ischemic stroke. Furthermore, in in vivo experiment we found that administering with intraperitoneal injection of 2.5 mL/kg TRQ every 6 h could significantly reduce the infarct volume of MCAO rats (P<0.05). In addition, protein levels of the apelin receptor (APJ)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway were increased by TRQ (P<0.05). In addition, 41 chemical compounds in TRQ could bind to APJ. CONCLUSIONS The neuroprotective effect of TRQ may be related to the APJ/PI3K/AKT signaling pathway. However, further studies are needed to confirm the findings.
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Affiliation(s)
- Zhong-Hao Li
- Department of Emergency, China-Japan Friendship Hospital, Beijing, 100029, China
- Department of Neurology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, 100078, China
| | - Xiao-Qi Pu
- Department of Radiology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Sha-Sha Li
- Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiao-Ke Dong
- Department of Neurology, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine, Beijing, 100163, China
| | - Guo-Qiang Zhang
- Department of Emergency, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Yu Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Jin-Min Liu
- Department of Neurology, Beijing University of Chinese Medicine Dongfang Hospital, Beijing, 100078, China
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86
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Liu YH, Hu C, Yang XM, Zhang Y, Cao YL, Xiao F, Zhang JJ, Ma LQ, Zhou ZW, Hou SY, Wang E, Loepke AW, Deng M. Association of preoperative coronavirus disease 2019 with mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery: An observational cohort study. J Clin Anesth 2024; 95:111467. [PMID: 38593491 DOI: 10.1016/j.jclinane.2024.111467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/09/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Abstract
STUDY OBJECTIVE To assess the impact of preoperative infection with the contemporary strain of severe acute respiratory coronavirus 2 (SARS-CoV-2) on postoperative mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery. DESIGN An ambidirectional observational cohort study. SETTING A tertiary and teaching hospital in Shanghai, China. PATIENTS All adult patients (≥ 18 years of age) who underwent elective, noncardiac surgery under general anesthesia at Huashan Hospital of Fudan University from January until March 2023 were screened for eligibility. A total of 2907 patients were included. EXPOSURE Preoperative coronavirus disease 2019 (COVID-19) positivity. MEASUREMENTS The primary outcome was 30-day postoperative mortality. The secondary outcomes included postoperative pulmonary complications (PPCs), myocardial injury after noncardiac surgery (MINS), acute kidney injury (AKI), postoperative delirium (POD) and postoperative sleep quality. Multivariable logistic regression was used to assess the risk of postoperative mortality and morbidity imposed by preoperative COVID-19. MAIN RESULTS The risk of 30-day postoperative mortality was not associated with preoperative COVID-19 [adjusted odds ratio (aOR), 95% confidence interval (CI): 0.40, 0.13-1.28, P = 0.123] or operation timing relative to diagnosis. Preoperative COVID-19 did not increase the risk of PPCs (aOR, 95% CI: 0.99, 0.71-1.38, P = 0.944), MINS (aOR, 95% CI: 0.54, 0.22-1.30; P = 0.168), or AKI (aOR, 95% CI: 0.34, 0.10-1.09; P = 0.070) or affect postoperative sleep quality. Patients who underwent surgery within 7 weeks after COVID-19 had increased odds of developing delirium (aOR, 95% CI: 2.26, 1.05-4.86, P = 0.036). CONCLUSIONS Preoperative COVID-19 or timing of surgery relative to diagnosis did not confer any added risk of 30-day postoperative mortality, PPCs, MINS or AKI. However, recent COVID-19 increased the risk of POD. Perioperative brain health should be considered during preoperative risk assessment for COVID-19 survivors.
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Affiliation(s)
- Yi-Heng Liu
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Chenghong Hu
- Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Xia-Min Yang
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Yu Zhang
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Yan-Ling Cao
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Fan Xiao
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Jun-Jie Zhang
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Li-Qing Ma
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Zi-Wen Zhou
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - Si-Yu Hou
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China
| | - E Wang
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Andreas W Loepke
- Department of Anesthesiology and Critical Care Medicine and Division of Cardiac Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Meng Deng
- Department of Anesthesiology, Huashan Hospital of Fudan University, Shanghai, China.
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87
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Rossing P, Groop PH, Singh R, Lawatscheck R, Tuttle KR. Prevalence of Chronic Kidney Disease in Type 1 Diabetes Among Adults in the U.S. Diabetes Care 2024; 47:1395-1399. [PMID: 38857124 DOI: 10.2337/dc24-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/02/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE The prevalence of chronic kidney disease (CKD) in adults ≥18 years of age with type 1 diabetes in the U.S. was determined using National Health and Nutrition Examination Survey (NHANES) data. RESEARCH DESIGN AND METHODS A modified treatment-based algorithm applying a subset of NHANES diabetes questionnaires was used. The number of respondents with CKD and type 1 diabetes was weighted (extrapolated) to the U.S. population. RESULTS Based on data between 2015 and 2018, type 1 diabetes was identified in 47 out of 19,225 adults with evaluable kidney function data. CKD was present in 20 out of 47 people identified with type 1 diabetes. The weighted estimate of CKD in type 1 diabetes was 21.5%, corresponding to 258,196 (95% CI 71,189-445,203) people in the U.S. CONCLUSIONS Applying a conservative approach in our study indicates that CKD is common in adults with type 1 diabetes in the U.S.
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Affiliation(s)
- Peter Rossing
- Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per-Henrik Groop
- Department of Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | | | | | - Katherine R Tuttle
- Providence Inland Northwest Health, University of Washington School of Medicine, Spokane, WA
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88
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Morris RK, Johnstone E, Lees C, Morton V, Smith G. Investigation and Care of a Small-for-Gestational-Age Fetus and a Growth Restricted Fetus (Green-top Guideline No. 31). BJOG 2024; 131:e31-e80. [PMID: 38740546 DOI: 10.1111/1471-0528.17814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Key recommendations
All women should be assessed at booking (by 14 weeks) for risk factors for fetal growth restriction (FGR) to identify those who require increased surveillance using an agreed pathway [Grade GPP]. Findings at the midtrimester anomaly scan should be incorporated into the fetal growth risk assessment and the risk assessment updated throughout pregnancy. [Grade GPP]
Reduce smoking in pregnancy by identifying women who smoke with the assistance of carbon monoxide (CO) testing and ensuring in‐house treatment from a trained tobacco dependence advisor is offered to all pregnant women who smoke, using an opt‐out referral process. [Grade GPP]
Women at risk of pre‐eclampsia and/or placental dysfunction should take aspirin 150 mg once daily at night from 12+0–36+0 weeks of pregnancy to reduce their chance of small‐for‐gestational‐age (SGA) and FGR. [Grade A]
Uterine artery Dopplers should be carried out between 18+0 and 23+6 weeks for women at high risk of fetal growth disorders [Grade B]. In a woman with normal uterine artery Doppler and normal fetal biometry at the midtrimester scan, serial ultrasound scans for fetal biometry can commence at 32 weeks. Women with an abnormal uterine artery Doppler (mean pulsatility index > 95th centile) should commence ultrasound scans at 24+0–28+6 weeks based on individual history. [Grade B]
Women who are at low risk of FGR should have serial measurement of symphysis fundal height (SFH) at each antenatal appointment after 24+0 weeks of pregnancy (no more frequently than every 2 weeks). The first measurement should be carried out by 28+6 weeks. [Grade C]
Women in the moderate risk category are at risk of late onset FGR so require serial ultrasound scan assessment of fetal growth commencing at 32+0 weeks. For the majority of women, a scan interval of four weeks until birth is appropriate. [Grade B]
Maternity providers should ensure that they clearly identify the reference charts to plot SFH, individual biometry and estimated fetal weight (EFW) measurements to calculate centiles. For individual biometry measurements the method used for measurement should be the same as those used in the development of the individual biometry and fetal growth chart [Grade GPP]. For EFW the Hadlock three parameter model should be used. [Grade C]
Maternity providers should ensure that they have guidance that promotes the use of standard planes of acquisition and calliper placement when performing ultrasound scanning for fetal growth assessment. Quality control of images and measurements should be undertaken. [Grade C]
Ultrasound biometry should be carried out every 2 weeks in fetuses identified to be SGA [Grade C]. Umbilical artery Doppler is the primary surveillance tool and should be carried out at the point of diagnosis of SGA and during follow‐up as a minimum every 2 weeks. [Grade B]
In fetuses with an EFW between the 3rd and 10th centile, other features must be present for birth to be recommended prior to 39+0 weeks, either maternal (maternal medical conditions or concerns regarding fetal movements) or fetal compromise (a diagnosis of FGR based on Doppler assessment, fetal growth velocity or a concern on cardiotocography [CTG]) [Grade C]. For fetuses with an EFW or abdominal circumference less than the 10th centile where FGR has been excluded, birth or the initiation of induction of labour should be considered at 39+0 weeks after discussion with the woman and her partner/family/support network. Birth should occur by 39+6 weeks. [Grade B]
Pregnancies with early FGR (prior to 32+0 weeks) should be monitored and managed with input from tertiary level units with the highest level neonatal care. Care should be multidisciplinary by neonatology and obstetricians with fetal medicine expertise, particularly when extremely preterm (before 28 weeks) [Grade GPP]. Fetal biometry in FGR should be repeated every 2 weeks [Grade B]. Assessment of fetal wellbeing can include multiple modalities but must include computerised CTG and/or ductus venous. [Grade B]
In pregnancies with late FGR, birth should be initiated from 37+0 weeks to be completed by 37+6 weeks [Grade A]. Decisions for birth should be based on fetal wellbeing assessments or maternal indication. [Grade GPP]
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89
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DeLoughery EP. Global prevalence of anemia among women of reproductive age, 2000-2019. Eur J Haematol 2024; 113:253-256. [PMID: 38775787 DOI: 10.1111/ejh.14227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 07/04/2024]
Abstract
A common disease with significant impacts on health and quality of life, anemia is particularly prevalent in women of reproductive age due to blood losses during menstruation and pregnancy. Data from the World Health Organization (WHO) was analyzed to compare trends in prevalence of anemia in women aged 15-49 among countries and over time with the goal of identifying regions both successful and in need of assistance in combatting anemia. Worldwide from 2000 to 2013 the prevalence of anemia among women aged 15-49 decreased, and then increased from 2013 to 2019; severe anemia decreased throughout the world from 2000 to 2019. Throughout all years, African countries had the highest prevalence of anemia and severe anemia while American and European countries had the lowest. With each decrease in human development index (HDI) category (very high to high, etc.) there was a significant increase in prevalence of total anemia (P < 0.001 for all). This data suggests that although the prevalence of anemia among reproductive age women has decreased over time there is still much work remaining, particularly in low HDI countries. More effort is needed in preventing, recognizing and treating anemia.
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Affiliation(s)
- Emma P DeLoughery
- Division of Hematology/Medical Oncology, Oregon Health & Science University, Portland, Oregon, USA
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90
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Patel MJ, Jones A, Jiang Y, Gowda P, VanWagner LB, Cotter TG, Seif El Dahan K, Louissaint J, Patel M, Rich NE, Singal AG, Lieber SR. Psychiatric disorders in patients with hepatocellular carcinoma: A large US cohort of commercially insured individuals. Aliment Pharmacol Ther 2024; 60:469-478. [PMID: 38863242 DOI: 10.1111/apt.18115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/20/2024] [Accepted: 06/02/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND/AIMS Patients with hepatocellular cancer (HCC) are vulnerable to psychological distress given a new cancer diagnosis superimposed on pre-existing chronic liver disease. We aimed to characterise the psychiatric burden in HCC, risk factors for incident diagnosis and treatment patterns over time. METHODS Using IQVIA PharMetrics® Plus for Academics-a nationally representative claims database of the commercially insured US population-we identified psychiatric diagnoses and treatment among patients with newly diagnosed HCC. Multivariable logistic regression modelling identified factors associated with psychiatric diagnosis and treatment. RESULTS Of 11,609 patients with HCC, 2166 (18.6%) had a psychiatric diagnosis after cancer diagnosis with depression (58.3%) and anxiety (53.0%) being most common. Women (aOR 1.33, 95% CI [1.19-1.49]), pre-existing psychiatric diagnoses (aOR 9.12 [8.08-10.3]) and HCC treatment type (transplant: aOR 2.15 [1.66-2.77]; locoregional therapies: aOR 1.74 [1.52-1.99]; hospice: aOR 2.43 [1.79-3.29]) were significantly associated with psychiatric diagnosis. Female sex, ascites, higher comorbidity and treatment type were associated with incident psychiatric diagnosis. Pharmacotherapy was used in 1392 (64.3%) patients with a psychiatric diagnosis, with antidepressants (46.2%) and anxiolytics (32.8%) being most common. Psychiatric diagnoses increased from 14.8% in 2006-2009 to 21.1% in 2018-2021 (p < 0.001). In almost 20% of patients with pre-existing psychiatric conditions, therapy was discontinued after HCC diagnosis. CONCLUSIONS Nearly 2 of 10 patients with HCC were diagnosed with a psychiatric condition after cancer diagnosis with unique sociodemographic and clinical risk factors identified. This highlights a risk for increased psychological burden in need of early evaluation and treatment among patients with newly diagnosed HCC.
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Affiliation(s)
- Mausam J Patel
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Alex Jones
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Yue Jiang
- Department of Statistical Science, Duke University, Durham, North Carolina, USA
| | - Prajwal Gowda
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Lisa B VanWagner
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Thomas G Cotter
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Karim Seif El Dahan
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jeremy Louissaint
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Madhukar Patel
- Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Nicole E Rich
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Amit G Singal
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Sarah R Lieber
- Department of Internal Medicine, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
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91
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Schellack S, Breidenbach C, Rick O, Kowalski C. Predictive factors for return to work among cancer survivors in Europe: A systematic review. Crit Rev Oncol Hematol 2024; 200:104422. [PMID: 38897312 DOI: 10.1016/j.critrevonc.2024.104422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
Of the 4.4 million people diagnosed with cancer in Europe each year, around 36 % are of working age. Return-to-work rates vary across Europe. Work is important for the individual, as well as for society, and this review aims to provide an overview of the predictors for the return to work (RTW) process in European cancer survivors of working age. A systematic literature search was conducted. The present review included quantitative and qualitative study designs published since 2013. In total, the review included 85 papers examining cancer survivors with various cancer diagnoses in 18 European countries. Identified predictive factors for RTW related to the social system, treatment, disease, health behavior, the individuals' psychosocial, work, and sociodemographic situations. There is a need for a standardized definition and operationalization of RTW. Providers can use these results to identify survivors at risk and support cancer survivors in their RTW process.
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Affiliation(s)
- Sophie Schellack
- German Cancer Society, Kuno-Fischer-Straße 8, Berlin 14057, Germany.
| | | | - Oliver Rick
- Center for Oncology Rehabilitation, Clinic Reinhardshoehe, Quellenstraße 8-12, Bad Wildungen 34537, Germany
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Wu Q, Que W, Zhang J, Chen X, Wang M, Kou J, Chen G. Enhanced effect of limb remote ischemic postconditioning combined with paeoniflorin on alleviating cerebral ischemic injury via neutrophil NADPH pathway. Brain Res Bull 2024; 214:111006. [PMID: 38852654 DOI: 10.1016/j.brainresbull.2024.111006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/24/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Limb remote ischemic postconditioning (LRIP) and paeoniflorin (PF) both can ameliorate cerebral ischemia reperfusion (I/R) injury. At present, whether LRIP combined with PF can achieve better therapeutic effect is unknown. PURPOSE This study explored the alleviating effect and mechanism of LRIP in combination with PF on cerebral I/R injury in rats. METHODS Middle cerebral artery occlusion (MCAO) surgery was performed on rats except Sham group. Then PF (2.5 mg/kg, 5 mg/kg, 10 mg/kg) was administrated by intraperitoneal injection 10 min before the start of reperfusion. LRIP was operated on the left femoral artery at 0 h of reperfusion. Behavioral testing was used to assess neurological impairment, while TTC staining was used to examine infarct volume. Protein expression of MyD88, TRAF6, p38-MAPK and phosphorylation of p47phox in neutrophils from rat peripheral blood were tested by Western blot. Rat bone marrow neutrophils were extracted and incubated for 24 h with serum from rats after LRIP combined with PF. p38 MAPK inhibitor group was administrated SB203580 while the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase inhibitor group was administrated Apocynin. Neutrophils were stimulated by fMLP (10 μM). Reactive oxygen species (ROS) production and protein expression of MyD88, TRAF6, p38 MAPK, and p47phox (ser 304 and ser 345) were detected. RESULTS LRIP combined with PF (5 mg/kg) reduced cerebral infarct volume, ameliorated neurological deficit score (NDS), decreased fMLP-stimulated ROS release and downregulated the protein expression of MyD88, TRAF6, p38-MAPK and phosphorylation of p47phox (ser 304 and ser 345) in neutrophils. CONCLUSION The protective effect of LRIP combined with PF on cerebral I/R injury was better than either alone. Taken together, we provided solid evidence to demonstrate that the combination of LRIP and PF had potential to alleviate cerebral I/R injury, which was regulated by MyD88-TRAF6-p38 MAPK pathway and neutrophil NADPH oxidase pathway.
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Affiliation(s)
- Qi Wu
- State Key Laboratory of Natural Medicines, Research Department of Pharmacognosy, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China
| | - Wenxuan Que
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Pharmacology of Chinese Material Medica, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China
| | - Jiangwei Zhang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Pharmacology of Chinese Material Medica, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China
| | - Xun Chen
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Pharmacology of Chinese Material Medica, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China
| | - Min Wang
- Medical Outpatient Department, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China
| | - Junping Kou
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Pharmacology of Chinese Material Medica, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China.
| | - Gangling Chen
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Department of Pharmacology of Chinese Material Medica, School of Traditional Chinese Pharmacy, China Pharmaceutical University, 639 Longmian Road, Nanjing, Jiangsu 211198, China.
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Orwa SA, Gudnadottir U, Boven A, Pauwels I, Versporten A, Vlieghe E, Brusselaers N. Global prevalence of antibiotic consumption during pregnancy: A systematic review and meta-analysis. J Infect 2024; 89:106189. [PMID: 38844084 DOI: 10.1016/j.jinf.2024.106189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Antibiotic use during pregnancy is widespread with notable variations across regions. METHODS This systematic review and meta-analysis (Prospero protocol CRD42023418979) examines the prevalence and variability of antibiotic use in pregnancy globally and regionally, considering different methodologies and maternal characteristics. We searched Embase, PubMed, and Web of Science for observational studies published in English from the year 2000 and onwards. Random-effect meta-analyses were used to pool the prevalence of antibiotic consumption during pregnancy, presented as percentages with 95% confidence intervals (CI). Joanna Briggs Institute Critical appraisal checklist for prevalence studies was used for bias assessment. FINDINGS Overall, 116 studies (14 from Africa, 24 from the Americas, six from Eastern Mediterranean, 57 from Europe, four from South-East Asia and 11 from Western Pacific) were included (33,821,194 pregnancies). The majority of studies (84.5%) were appraised with a low risk of bias. The prevalence of antibiotic consumption during pregnancy ranged between 0.04 to 90%, with a pooled estimate of 23.6% (95% CI: 20.1-27.5, I2 =100%). Low-income countries had the highest pooled prevalence (45.3%, 95% CI: 15.4-79.1, I2 =99.6%). Regionally, the Western Pacific had the highest pooled prevalence (34.4%, 95% CI: 13.4-64.1, I2 =100%). The prevalence of antibiotic consumption during pregnancy increased over time in the Americas and Western Pacific. The studies exhibited considerable heterogeneity (I2 >95%), and the trim-and-fill method estimated a potential 10% underestimation of the overall pooled prevalence, suggesting publication bias. INTERPRETATION This meta-analysis suggests that about 1/4 of women worldwide use antibiotics during pregnancy. This study suggests a high prevalence of antibiotic consumption during pregnancy with disparities according to region and level of country income, ethnicity and whether antibiotics were prescribed or self-medicated. There was a variability in reported findings across age categories, potential bias from small sample sizes, and language bias from including only studies published in English.
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Affiliation(s)
- Sheila A Orwa
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Unnur Gudnadottir
- Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Annelies Boven
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ines Pauwels
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Ann Versporten
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Erika Vlieghe
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium; General Internal Medicine, Infectious Diseases and Tropical Medicine, Antwerp University Hospital, Antwerp, Belgium
| | - Nele Brusselaers
- Global Health Institute, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
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Li YJ, Wang X, Wu YJ, Zhou XY, Li J, Qin J, Xu W, Lew JB, Chen W, Shi JF. Access to colorectal cancer screening in populations in China, 2020: A coverage-focused synthesis analysis. Int J Cancer 2024; 155:558-568. [PMID: 38554129 DOI: 10.1002/ijc.34938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 04/01/2024]
Abstract
In populations in China, colorectal cancer (CRC) screening can be mainly accessed through organized screening, opportunistic screening, and physical examination. This screening intervention is found to be effective but the exact coverage rate is difficult to measure. Based on data from published articles, official websites, and available program reports, the screening coverage rate and related indicators were quantified. A rapid review was then conducted to estimate the overall and the breakdown coverage rates of the sub-type screening services, by leveraging the numbers of articles and the by-type median sample sizes. Up to 2020, two central government-funded and four provincial/municipal-level organized CRC screening programs have been initiated and included in this analysis. For populations aged 40-74, the estimated coverage rate of organized programs in China was 2.7% in 2020, and the 2-year cumulative coverage rate in 2019-2020 was 5.3% and the 3-year cumulative coverage rate in 2018-2020 was 7.7%. The corresponding coverage rates of 50-74-year-olds were estimated to be 3.4%, 7.1%, and 10.3%, respectively. Based on the rapid review approach, the overall screening coverage rate for 40-74 years, considering organized screening programs, opportunistic screening, and physical examinations, was then estimated to be 3.0% in China in 2020. However, comparing the findings of this study with the number of health check-ups reported in the local national health statistics yearbooks suggests that the number of CRC physical examinations may be underestimated in this study. The findings suggest that further efforts are needed to improve population access to CRC screening in China. Furthermore, evidence for access to opportunistic CRC screening and physical examination is limited, and more quantitative investigation is needed.
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Affiliation(s)
- Yan-Jie Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu-Jie Wu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Yi Zhou
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jibin Li
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiangmei Qin
- Department of Health Development Strategy and Health Care System Research, China National Health Development Research Centre, Beijing, China
| | - Wanghong Xu
- Global Health Institute, School of Public Health, Fudan University, Shanghai, China
| | - Jie-Bin Lew
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council New South Wales, Sydney, Australia
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhai D, Liu R, Liu Y, Yin H, Tang W, Yang J, Liu K, Fan G, Ju S, Cai W. Deep learning-based fully automatic screening of carotid artery plaques in computed tomography angiography: a multicenter study. Clin Radiol 2024; 79:e994-e1002. [PMID: 38789330 DOI: 10.1016/j.crad.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 04/18/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024]
Abstract
AIM To develop and validate a deep learning (DL) algorithm for the automated detection and classification of carotid artery plaques (CAPs) on computed tomography angiography (CTA) images. MATERIALS AND METHODS This retrospective study enrolled 400 patients (300 in the Center Ⅰ and 100 in Ⅱ). Three radiologists co-labeled CAPs, and their revised calcification status (noncalcified, mixed, and calcified) was regarded as ground truth. Center Ⅰ patients were randomly divided into training and internal validation datasets, while Center Ⅱ patients served as the external validation dataset. Carotid artery regions were segmented using a modified 3D-UNet network, followed by CAPs detection and classification using a ResUNet-based architecture in a two-step DL system. The DL model's detection and classification performance were evaluated on the validation dataset using precision-recall curve, free-response receiver operating characteristic (fROC) curve, Cohen's kappa, and ROC curve analysis. RESULTS The DL model had achieved 83.4% sensitivity at 3.0 false positives (FPs)/CTA scan in internal validation and 78.9% in external validation. F1-scores were 0.764 and 0.769 at the optimal threshold, and area under fROC curves were 0.756 and 0.738, respectively, indicating good overall accuracy for CAP detection. The DL model also showed good performance for the ternary classification of CAPs, with Cohen's kappa achieved 0.728 and 0.703 in both validation datasets. CONCLUSION This study demonstrated the feasibility of using a fully automated DL-based algorithm for the detection and ternary classification of CAPs, which could be helpful for the workloads of radiologists.
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Affiliation(s)
- D Zhai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China
| | - R Liu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China
| | - Y Liu
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China
| | - H Yin
- Institute of Advanced Research, Infervision Medical Technology Co., Beijing, 18 / f, Seat E, Ocean International Center, Chaoyang District, Beijing, CN, 100025, China
| | - W Tang
- Institute of Advanced Research, Infervision Medical Technology Co., Beijing, 18 / f, Seat E, Ocean International Center, Chaoyang District, Beijing, CN, 100025, China
| | - J Yang
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China
| | - K Liu
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical Univercity, No 242, Guangji Road, Suzhou, Jiangsu, 215008, China
| | - G Fan
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China
| | - S Ju
- Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Ding Jia Qiao Road No. 87, Nanjing, Jiangsu, 210009, China
| | - W Cai
- Department of Radiology, The Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, Jiangsu, 215004, China.
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Guo H, Li Y, Wang S, Yang Y, Xu T, Zhao J, Wang J, Zuo W, Wang P, Zhao G, Wang H, Hou W, Dong H, Cai Y. Dysfunction of astrocytic glycophagy exacerbates reperfusion injury in ischemic stroke. Redox Biol 2024; 74:103234. [PMID: 38861834 PMCID: PMC11215420 DOI: 10.1016/j.redox.2024.103234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 05/27/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
Glycophagy has evolved from an alternative glycogen degradation pathway into a multifaceted pivot to regulate cellular metabolic hemostasis in peripheral tissues. However, the pattern of glycophagy in the brain and its potential therapeutic impact on ischemic stroke remain unknown. Here, we observed that the dysfunction of astrocytic glycophagy was caused by the downregulation of the GABA type A receptor-associated protein like 1 (GABARAPL1) during reperfusion in ischemic stroke patients and mice. PI3K-Akt pathway activation is involved in driving GABARAPL1 downregulation during cerebral reperfusion. Moreover, glycophagy dysfunction-induced glucosamine deficiency suppresses the nuclear translocation of specificity protein 1 and TATA binding protein, the transcription factors for GABARAPL1, by decreasing their O-GlcNAcylation levels, and accordingly feedback inhibits GABARAPL1 in astrocytes during reperfusion. Restoring astrocytic glycophagy by overexpressing GABARAPL1 decreases DNA damage and oxidative injury in astrocytes and improves the survival of surrounding neurons during reperfusion. In addition, a hypocaloric diet in the acute phase after cerebral reperfusion can enhance astrocytic glycophagic flux and accelerate neurological recovery. In summary, glycophagy in the brain links autophagy, metabolism, and epigenetics together, and glycophagy dysfunction exacerbates reperfusion injury after ischemic stroke.
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Affiliation(s)
- Haiyun Guo
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yumeng Li
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shiquan Wang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yongheng Yang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Tiantian Xu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jianshuai Zhao
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jin Wang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wenqiang Zuo
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Pengju Wang
- The State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Guangchao Zhao
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wugang Hou
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Hailong Dong
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
| | - Yanhui Cai
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China; Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.
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Moraga-Llop F, Andradas E, Blesa-Baviera LC, Cantón R, González Del Castillo J, Martinón-Torres F, Moya E, Trilla A, Vazquez J, Villena RJ, Ruiz-Galiana J, De Lucas Ramos P, García-Botella A, García-Lledó A, Hernández-Sampelayo T, Gómez-Pavón J, Martín-Delgado MC, Martín Sánchez FJ, Martínez-Sellés M, Molero García JM, Moreno Guillén S, Rodríguez-Artalejo FJ, Bouza E. Meningococcal meningitis in Spain in the Horizon 2030: A position paper. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2024; 37:285-298. [PMID: 38515374 PMCID: PMC11231484 DOI: 10.37201/req/023.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas del Hospital General Universitario Gregorio Marañón, Universidad Complutense. CIBERES. Ciber de Enfermedades Respiratorias. Madrid, Spain.
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Leeds IL, Park LS, Akgun K, Weintrob A, Justice AC, King JT. Postoperative Outcomes Associated with the Timing of Surgery After SARS-CoV-2 Infection. Ann Surg 2024; 280:241-247. [PMID: 38323413 PMCID: PMC11236522 DOI: 10.1097/sla.0000000000006227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Examine the association between prior SARS-CoV-2 infection, interval from infection to surgery, and adverse surgical outcomes. SUMMARY BACKGROUND DATA Earlier series have reported worse outcomes for surgery after COVID-19 illness, and these findings have led to routinely deferring surgery seven weeks after infection. METHODS We created a retrospective cohort of patients from the US Veterans Health Administration facilities nationwide, April 2020 to September 2022, undergoing surgical procedures. Primary outcomes were 90-day all-cause mortality and 30-day complications. Within surgical procedure groupings, SARS-CoV-2 infected and uninfected patients were matched in a 1:4 ratio. We categorized patients by 2-week intervals from SARS-CoV-2 positive test to surgery. Hierarchical multilevel multivariable logistic regression models were used to estimate the association between infection to surgery interval versus no infection and primary end points. RESULTS We identified 82,815 veterans undergoing eligible operations (33% general, 27% orthopedic, 13% urologic, 9% vascular), of whom 16,563 (20%) had laboratory-confirmed SARS-CoV-2 infection before surgery. The multivariable models demonstrated an association between prior SARS-CoV-2 infection and increased 90-day mortality (odds ratio (OR) 1.42, 95% CI: 1.08, 1.86) and complications (OR 1.32, 95% CI: 1.11, 1.57) only for patients having surgery within 14 days of infection. ASA-stratified multivariable models showed that the associations between increased 90-day mortality (OR 1.40, 95% CI: 1.12, 1.75) and complications (OR 1.73, 95% CI: 1.34, 2.24) for patients having surgery within 14 days of infection were confined to those with ASA 4-5. CONCLUSIONS In a contemporary surgical cohort, patients with prior SARS-CoV-2 infection only had increased postoperative mortality or complications when they had surgery within 14 days after the positive test. These findings support revising timing recommendations between surgery and prior SARS-CoV-2 infection.
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Affiliation(s)
- Ira L Leeds
- Department of Surgery, Yale University School of Medicine, New Haven, CT
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Lesley S Park
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA
| | - Kathleen Akgun
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - Amy Weintrob
- Veterans Affairs Washington DC Healthcare System, Washington, DC
| | - Amy C Justice
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Department of Medicine, Yale University School of Medicine, New Haven, CT
- Department of Public Policy, School of Public Health, Yale University School of Medicine, New Haven, CT
| | - Joseph T King
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT
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Zhou R, Xiao Q, Zhao L, Tang J, Han Y, Huang N, Wang Y, Cheng J, Lyu J, Xiong L, Li L. The association between weight-adjusted-waist index and psoriasis: A cross-sectional study. Prev Med 2024; 185:108026. [PMID: 38844051 DOI: 10.1016/j.ypmed.2024.108026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION This study explored the association between psoriasis and the weight-adjusted waist index (WWI), a newly developed measure of adiposity. The research was conducted among adults in the United States. METHODS Utilizing survey data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2009 to 2014, the present study aimed to investigate the potential correlation between psoriasis and WWI within a sample of 15,920 adult participants. Employing multivariable logistic regression and nonlinear curve fitting techniques, we analyzed this plausible association. Additionally, a subgroup analysis was conducted to ascertain the consistency across diverse populations. RESULTS A significant positive association was discovered between psoriasis and WWI in the investigated sample of 15,920 adults. After conducting a comprehensive adjustment of the model, it was observed that each incremental unit of WWI was significantly associated with an 14% elevated likelihood of developing psoriasis (OR = 1.16, 95% CI 1.01-1.36). Moreover, individuals belonging to the highest quartile of WWI exhibited a 47% higher risk of psoriasis compared to those in the lowest quartile (OR = 1.44, 95% CI 1.01-2.06). This positive correlation remained consistent across various subgroups. The study also compared WWI with BMI and waist circumference, finding that WWI is a more stable metric of obesity. CONCLUSIONS Our study suggested that in US adults, there is a positive association between WWI and psoriasis. It also indicated that WWI showed potential as a valuable index of psoriasis among the general population.
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Affiliation(s)
- Runke Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xiao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Lingyun Zhao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Tang
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China
| | - Yuanyuan Han
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Nan Huang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Yixin Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Ji Cheng
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaqi Lyu
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lidan Xiong
- Cosmetics Safety and Efficacy Evaluation Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China.
| | - Li Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China; Cosmetics Safety and Efficacy Evaluation Center, West China Hospital, Sichuan University, Chengdu, China; NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China.
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Numanovic P, Darlow B, Larsson ME. The Swedish version of the back pain attitudes questionnaire - Translation, cross-cultural adaptation and validation. Musculoskelet Sci Pract 2024; 72:102984. [PMID: 38851177 DOI: 10.1016/j.msksp.2024.102984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 05/24/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Psychosocial factors influence low back pain (LBP) and guidelines recommend assessing unhelpful beliefs. The Back Pain Attitudes Questionnaire (Back-PAQ) is an instrument developed to assess LBP attitudes and beliefs. There is currently no Swedish translation of Back-PAQ. OBJECTIVES To translate and culturally adapt the Back-PAQ into Swedish (Back-PAQ-S) and to test its measurement properties. DESIGN Study of diagnostic accuracy/assessment scale. METHODS The cultural adaptation followed established guidelines and 120 individuals with and without nonspecific LBP (NSLBP) were recruited for the assessment of Back-PAQ-S's internal consistency, test-retest reliability, standard error of measurement (SEM) and smallest detectable change (SDC). Construct validity was assessed by testing hypotheses regarding Back-PAQ-S's relationship to the Back Beliefs Questionnaire (BBQ) and Tampa Scale of Kinesiophobia (TSK). RESULTS The Back-PAQ was translated and culturally adapted to Swedish. Expert panelists and informants thought items were relevant, comprehensive, and understandable. Back-PAQ-S of all lengths (34, 20 and 10-items) showed good internal consistency (Cronbach's α 0.95, 0.91 and 0.82) and excellent test-retest reliability (Intraclass correlation coefficient (ICC) 0.97, 0.96 and 0.95). The SEM was found to be 4.28, 3.13 and 1.66, and the SDC to be 11.85, 8.68 and 4.59 respectively. The Back-PAQ-S showed high positive correlations (Spearman's rho (rs) 0.78, 0.76 and 0.72) to the BBQ and moderate negative correlations (rs -0.67, -0.50 and -0.69) to the TSK. CONCLUSION The Back-PAQ-S has good validity and excellent reliability. It is viable for clinical and research use to assess LBP attitudes and beliefs in Swedish populations with and without NSLBP.
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Affiliation(s)
- Patrik Numanovic
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Närhälsan Sannegården Rehabilitation Centre, Gothenburg, Sweden.
| | - Ben Darlow
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Maria Eh Larsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden; Centre of Clinical Research and Education, Karlstad, Region Värmland, Sweden
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