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Zhu XD, Peng YJ, Chen Y, Xue M, Zhang AJ, Peng Y, Mei R, Tian MR, Zhang L. Association of maternal infection of SARS-CoV-2 and neonatal susceptibility: A retrospective cohort study. Vaccine X 2024; 20:100536. [PMID: 39176179 PMCID: PMC11338988 DOI: 10.1016/j.jvacx.2024.100536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/20/2024] [Accepted: 07/25/2024] [Indexed: 08/24/2024] Open
Abstract
Objective This study aims to assess the risk of neonatal susceptibility to COVID-19 among pregnant women. Methods We conducted a retrospective cohort study involving 1089 pregnant women ≥28 weeks of gestational age, who were categorized into infected and uninfected groups. Data for all participants were collected through a comprehensive review of electronic medical records and follow-up phone calls. The primary outcome was neonatal infection with SARS-CoV-2, while secondary outcomes included delivery patterns and gestational age at delivery. Results Maternal vaccination (OR 95%CI:0.63[0.46, 0.85]) and maternal infection with SARS-CoV-2 (OR 95%CI: 0.45[0.34, 0.60]) were found to be associated with a decreased risk of neonatal infection. The infected group exhibited a lower neonatal SARS-CoV-2 infection rate (25.93%) compared to the uninfected group (45.15%). Logistic regression analysis identified several risk factors associated with an increased risk of neonatal infection, including pregnancy BMI (OR 95%CI: 1.04[1.01, 1.08]), age at first pregnancy (OR 95%CI: 1.05[1.01, 1.10]), age at menarche (OR 95%CI: 1.13[1.02, 1.26]), and parturition (Yes vs. No) (OR 95%CI:1.4 [1.04,1.88]). Conclusion Maternal vaccination and perinatal infection with SARS-CoV-2 play a protective role in preventing neonatal SARS-CoV-2 infection.
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Affiliation(s)
- Xiao-Dan Zhu
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Yan-Jie Peng
- Clinical Medical Research Center for Women and Children Diseases, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
- Key Laboratory of Birth Defect Prevention and Genetic Medicine of Shandong Health Commission, Jinan 250001, China
| | - Ying Chen
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Mei Xue
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Ai-Juan Zhang
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Yu Peng
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Rong Mei
- Pediatric Surgery Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Mei-Rong Tian
- Obstetrics Department, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
| | - Lin Zhang
- Clinical Medical Research Center for Women and Children Diseases, Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan 250001, China
- Key Laboratory of Birth Defect Prevention and Genetic Medicine of Shandong Health Commission, Jinan 250001, China
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Garabedian C, Sibiude J, Anselem O, Attie-Bittach T, Bertholdt C, Blanc J, Dap M, de Mézerac I, Fischer C, Girault A, Guerby P, Le Gouez A, Madar H, Quibel T, Tardy V, Stirnemann J, Vialard F, Vivanti A, Sananès N, Verspyck E. [Fetal death: Expert consensus from the College of French Gynecologists and Obstetricians]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024; 52:549-611. [PMID: 39153884 DOI: 10.1016/j.gofs.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/19/2024]
Abstract
Fetal death is defined as the spontaneous cessation of cardiac activity after fourteen weeks of amenorrhea. In France, the prevalence of fetal death after 22 weeks is between 3.2 and 4.4/1000 births. Regarding the prevention of fetal death in the general population, it is not recommended to counsel for rest and not to prescribe vitamin A, vitamin D nor micronutrient supplementation for the sole purpose of reducing the risk of fetal death (Weak recommendations; Low quality of evidence). It is not recommended to prescribe aspirin (Weak recommendation; Very low quality of evidence). It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2 (Strong recommendations; Low quality of evidence). It is not recommended to systematically look for nuchal cord encirclements during prenatal screening ultrasounds (Strong Recommendation; Low Quality of Evidence) and not to perform systematic antepartum monitoring by cardiotocography (Weak Recommendation; Very Low Quality of Evidence). It is not recommended to ask women to perform an active fetal movement count to reduce the risk of fetal death (Strong Recommendation; High Quality of Evidence). Regarding evaluation in the event of fetal death, it is suggested that an external fetal examination be systematically offered (Expert opinion). It is recommended that a fetopathological and anatomopathological examination of the placenta be carried out to participate in cause identification (Strong Recommendation. Moderate quality of evidence). It is recommended that chromosomal analysis by microarray testing be performed rather than conventional karyotype, in order to be able to identify a potentially causal anomaly more frequently (Strong Recommendation, moderate quality of evidence); to this end, it is suggested that postnatal sampling of the placental fetal surface for genetic purposes be preferred (Expert Opinion). It is suggested to test for antiphospholipid antibodies and systematically perform a Kleihauer test and a test for irregular agglutinins (Expert opinion). It is suggested to offer a summary consultation, with the aim of assessing the physical and psychological status of the parents, reporting the results, discussing the cause and providing information on monitoring for a subsequent pregnancy (Expert opinion). Regarding announcement and support, it is suggested to announce fetal death without ambiguity, using simple words and adapting to each situation, and then to support couples with empathy in the various stages of their care (Expert opinion). Regarding management, it is suggested that, in the absence of a situation at risk of disseminated intravascular coagulation or maternal vitality, the patient's wishes should be taken into account when determining the time between the diagnosis of fetal death and induction of birth. Returning home is possible if it's the patient wish (Expert opinion). In all situations excluding maternal life-threatening emergencies, the preferred mode of delivery is vaginal delivery, regardless the history of cesarean section(s) history (Expert opinion). In the event of fetal death, it is recommended that mifepristone 200mg be prescribed at least 24hours before induction, to reduce the delay between induction and delivery (Low recommendation. Low quality of evidence). There are insufficient data in the literature to make a recommendation regarding the route of administration (vaginal or oral) of misoprostol, neither the type of prostaglandin to reduce induction-delivery time or maternal morbidity. It is suggested that perimedullary analgesia be introduced at the start of induction if the patient asks, regardless of gestational age. It is suggested to prescribe cabergoline immediately in the postpartum period in order to avoid lactation, whatever the gestational age, after discussing the side effects of the treatment with the patient (Expert opinion). The risk of recurrence of fetal death after unexplained fetal death does not appear to be increased in subsequent pregnancies, and data from the literature are insufficient to make a recommendation on the prescription of aspirin. In the event of a history of fetal death due to vascular issues, low-dose aspirin is recommended to reduce perinatal morbidity, and should not be combined with heparin therapy (Low recommendation, very low quality of evidence). It is suggested not to recommend an optimal delay before initiating another pregnancy just because of the history of fetal death. It is suggested that the woman and co-parent be informed of the possibility of psychological support. Fetal heart rate monitoring is not indicated solely because of a history of fetal death. It is suggested that delivery not be systematically induced. However, induction can be considered depending on the context and parental request. The gestational age will be discussed, taking into account the benefits and risks, especially before 39 weeks. If a cause of fetal death is identified, management will be adapted on a case-by-case basis (expert opinion). In the event of fetal death occurring in a twin pregnancy, it is suggested that the surviving twin be evaluated as soon as the diagnosis of fetal death is made. In the case of dichorionic pregnancy, it is suggested to offer ultrasound monitoring on a monthly basis. It is suggested not to deliver prematurely following fetal death of a twin. If fetal death occurs in a monochorionic twin pregnancy, it is suggested to contact the referral competence center, in order to urgently look for signs of acute fetal anemia on ultrasound in the surviving twin, and to carry out weekly ultrasound monitoring for the first month. It is suggested not to induce birth immediately.
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Affiliation(s)
| | - Jeanne Sibiude
- Service de gynécologie-obstétrique, hôpital Trousseau, AP-HP, Paris, France
| | - Olivia Anselem
- Maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, 75014 Paris, France
| | | | - Charline Bertholdt
- Pôle de gynécologie-obstétrique, pôle laboratoires, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | - Julie Blanc
- Service de gynécologie-obstétrique, hôpital Nord, hôpitaux universitaires de Marseille, AP-HM, Marseille, France
| | - Matthieu Dap
- Pôle de gynécologie-obstétrique, pôle laboratoires, CHRU de Nancy, université de Lorraine, 54000 Nancy, France
| | | | - Catherine Fischer
- Service d'anesthésie, maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, Paris, France
| | - Aude Girault
- Maternité Port-Royal, groupe hospitalier Paris Centre, AP-HP, 75014 Paris, France
| | - Paul Guerby
- Service de gynécologie-obstétrique, CHU de Toulouse, Toulouse, France
| | - Agnès Le Gouez
- Service d'anesthésie, hôpital Antoine-Béclère, AP-HP, université Paris Saclay, Clamart, France
| | - Hugo Madar
- Service de gynécologie-obstétrique, CHU de Bordeaux, 33000 Bordeaux, France
| | - Thibaud Quibel
- Service de gynécologie-obstétrique, CHI de Poissy Saint-Germain-en-Laye, Poissy, France
| | - Véronique Tardy
- Direction des plateaux médicotechniques, hospices civils de Lyon, Lyon, France; Département de biochimie biologie moléculaire, université Claude-Bernard Lyon, Lyon, France
| | - Julien Stirnemann
- Service de gynécologie-obstétrique, hôpital Necker, AP-HP, Paris, France
| | - François Vialard
- Département de génétique, CHI de Poissy Saint-Germain-en-Laye, Poissy, France
| | - Alexandre Vivanti
- Service de gynécologie-obstétrique, DMU santé des femmes et des nouveau-nés, hôpital Antoine-Béclère, AP-HP, université Paris Saclay, Clamart, France
| | - Nicolas Sananès
- Service de gynécologie-obstétrique, hôpital américain, Neuilly-sur-Seine, France
| | - Eric Verspyck
- Service de gynécologie-obstétrique, CHU Charles-Nicolle, Rouen, France
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153
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Jiang F, Li X, Xie Z, Liu L, Wu X, Wang Y. Bioinformatics Analysis and Identification of Ferroptosis-Related Hub Genes in Intervertebral Disc Degeneration. Biochem Genet 2024; 62:3403-3420. [PMID: 38104050 DOI: 10.1007/s10528-023-10601-8] [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: 08/13/2023] [Accepted: 11/13/2023] [Indexed: 12/19/2023]
Abstract
Approximately 80% of individuals encounter lower back pain (LBP), a prevalent clinical issue largely attributed to intervertebral disc degeneration (IDD). Ferroptosis is an iron-dependent lipid peroxidation-driven cell death, and there is growing evidence that ferroptosis plays an important role in various human diseases. However, the underlying mechanism of ferroptosis in IDD remains unclear. This study aims to reveal the potential hub genes and related pathways of ferroptosis in the pathogenesis and progression of IDD. In this study, we analyzed three microarray datasets from the GEO database. Additionally, we downloaded ferroptosis-related genes from FerrDb-V2 and extracted apoptosis-related genes from UniProt as a control to show the specificity of ferroptosis. Weighted gene co-expression network analysis (WGCNA) was performed to identify the IDD-related module genes. Then, ferroptosis-related genes and apoptosis-related genes were separately overlapped with the IDD-related module genes, resulting in the identification of 35 ferroptosis-related module genes (FRMG) and 142 apoptosis-related module genes (ARMG). Furthermore, we performed functional enrichment analysis and protein-protein interaction network, and Cytoscape along with CytoHubba was used to identify the hub genes. Finally, logistic regression models were constructed and identified two hub FRMGs (PTEN and EGFR) and one hub ARMG (CTNNB1), which could distinguish IDD patients from controls (P < 0.05). The areas under the ROC curves were 0.792 and 0.730, respectively, suggesting that ferroptosis is more specific than apoptosis in IDD. In conclusion, this study provided fresh perspectives on ferroptosis in the pathogenesis and progression of IDD that can be used to evaluate potential biomarker genes and therapeutic targets.
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Affiliation(s)
- Feng Jiang
- Southeast University Medical College, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Xinxin Li
- Southeast University Medical College, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Zhiyang Xie
- Department of Spine Surgery, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Lei Liu
- Department of Spine Surgery, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Xiaotao Wu
- Southeast University Medical College, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
- Department of Spine Surgery, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China
| | - Yuntao Wang
- Southeast University Medical College, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China.
- Department of Spine Surgery, Southeast University Zhongda Hospital, No. 87, Dingjiaqiao Road, Nanjing, 210009, Jiangsu, China.
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154
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Locatelli JC, Costa JG, Haynes A, Naylor LH, Fegan PG, Yeap BB, Green DJ. Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition? Diabetes Care 2024; 47:1718-1730. [PMID: 38687506 DOI: 10.2337/dci23-0100] [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: 12/19/2023] [Accepted: 03/22/2024] [Indexed: 05/02/2024]
Abstract
This narrative review highlights the degree to which new antiobesity medications based on gut-derived nutrient-stimulated hormones (incretins) cause loss of lean mass, and the importance of resistance exercise to preserve muscle. Glucagon-like peptide 1 receptor agonists (GLP-1RA) induce substantial weight loss in randomized trials, effects that may be enhanced in combination with glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. Liraglutide and semaglutide (GLP-1RA), tirzepatide (GLP-1 and GIP receptor dual agonist), and retatrutide (GLP-1, GIP, and glucagon receptor triple agonist) are peptides with incretin agonist activity that induce ∼15-24% weight loss in adults with overweight and obesity, alongside beneficial impacts on blood pressure, cholesterol, blood glucose, and insulin. However, these agents also cause rapid and significant loss of lean mass (∼10% or ∼6 kg), comparable to a decade or more of aging. Maintaining muscle mass and function as humans age is crucial to avoiding sarcopenia and frailty, which are strongly linked to morbidity and mortality. Studies indicate that supervised resistance exercise training interventions with a duration >10 weeks can elicit large increases in lean mass (∼3 kg) and strength (∼25%) in men and women. After a low-calorie diet, combining aerobic exercise with liraglutide improved weight loss maintenance compared with either alone. Retaining lean mass during incretin therapy could blunt body weight (and fat) regain on cessation of weight loss pharmacotherapy. We propose that tailored resistance exercise training be recommended as an adjunct to incretin therapy to optimize changes in body composition by preserving lean mass while achieving fat loss.
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Affiliation(s)
- João Carlos Locatelli
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Juliene Gonçalves Costa
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Andrew Haynes
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
| | - P Gerry Fegan
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
- Medical School, Curtin University, Perth, Australia
| | - Bu B Yeap
- Medical School, Curtin University, Perth, Australia
- Medical School, University of Western Australia, Perth, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, Australia
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155
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Chambers HF, Fowler VG. Intertwining clonality and resistance: Staphylococcus aureus in the antibiotic era. J Clin Invest 2024; 134:e185824. [PMID: 39352382 PMCID: PMC11444188 DOI: 10.1172/jci185824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2024] Open
Affiliation(s)
- Henry F Chambers
- Division of Infectious Diseases, UCSF, San Francisco, California, USA
| | - Vance G Fowler
- Division of Infectious Diseases, and
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
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156
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Fan Y, Lv Y, Fu M, Wang J, Cui Y, Zhang B, Lu Y, Chen L. Relationship between maximum carotid plaque area and prognosis of patients with acute ischaemic stroke. Ir J Med Sci 2024; 193:2501-2507. [PMID: 38890259 DOI: 10.1007/s11845-024-03739-w] [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: 04/21/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE In this study, the relationship between maximum carotid plaque area and stroke prognosis was analysed by carotid ultrasonography, and the relevant risk factors affecting the prognosis of acute ischaemic stroke (AIS) were investigated to provide novel insights into stroke prevention and management. METHODS A total of 205 AIS patients with carotid plaques were included in this study. Based on the mRS score at discharge, patients with AIS were classified into the good prognosis group (mRS ≤ 2) and poor prognosis group (mRS ≥ 3). SPSS 25.0 was used to analyse the data. Univariate and multivariate analyses were performed on the two groups with good and poor prognosis. Comparison between good and poor prognosis in patients with AIS in different circulatory systems was performed using the Kruskal-Wallis test. Differences were considered statistically significant at P < 0.05. RESULTS Comparison of baseline data revealed differences in carotid plaque diameter, carotid intima-media thickness, maximum carotid plaque area, history of previous stroke and plaque echogenicity between the good and poor prognosis groups (P < 0.05). Results of multifactorial analyses of logistic binary regression indicated that history of previous stroke and maximum carotid plaque area were predictors of poor prognosis, with odds ratio of 2.515 (95%CI [1.327-4.764]) and 1.019 (95%CI [1.006-1.032]), respectively. CONCLUSION The maximum carotid plaque area and history of previous stroke are important predictors for assessing prognosis in patients with AIS.
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Affiliation(s)
- Yani Fan
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Yue Lv
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Meng Fu
- The Third Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | - Jianhua Wang
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Ying Cui
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Binbin Zhang
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Yadan Lu
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China
| | - Lili Chen
- Tangshan Gongren Hospital, Tangshan City, Hebei Province, China.
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157
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Dickreuter JL, Schmoor C, Jähne A, Bengel J, Pschichholz B, Lorz C, Schulz C, Vozelj J, Leifert JA. Effectiveness of residential versus outpatient therapy for smoking cessation: The START randomized clinical trial. Addiction 2024; 119:1762-1773. [PMID: 38982899 DOI: 10.1111/add.16594] [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: 09/01/2023] [Accepted: 05/22/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND AND AIMS Tobacco smoking represents a major cause for preventable death and morbidity. Results from non-randomized studies suggest that smoking cessation therapy in a residential setting might be a new viable way to facilitate smoking abstinence. We aimed to test the effects of residential multicomponent group therapy for smoking cessation compared with outpatient group therapy. DESIGN Prospective parallel-group open-label randomized superiority trial, with assessments at baseline, 6 and 12 months. SETTING Recruitment throughout Germany via media advertisements. PARTICIPANTS Adult smokers (≥10 cigarettes/day) randomly assigned to residential (n = 157) or outpatient (n = 158) therapy. 51.8% female; mean age 53.2 years; mean years of smoking 34.4. INTERVENTION AND COMPARATOR Residential 9-day smoking cessation group therapy comprising six daily therapy sessions and supportive interventions for cessation and daily structure embedded in the routines of a somatic rehabilitation center, compared with weekly outpatient smoking cessation group therapy (3-7 weeks) provided in routine care courses close to the participants' places of residence, both including at least 9 h of behavioral therapy. MEASUREMENTS Co-primary outcomes were self-reported continuous 6- and 12-month abstinence (hierarchically ordered). Primary analyses were conducted in the therapy-uptake population including participants who started therapy with sensitivity analyses in the intention-to-treat population of all randomized participants. FINDINGS Intervention uptake rates were 87.3% (n = 137) in the residential and 60.1% (n = 95) in the outpatient group. In the therapy-uptake population, abstinence rates were 46.7% in the residential versus 26.3% in the outpatient group at 6 months (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.39-4.33, P = 0.0019) and 39.4% versus 24.2% at 12 months (OR = 2.04, 95% CI = 1.14-3.64, P = 0.017). Biochemically validated abstinence rates at 12 months were 33.1% in the residential versus 17.4% in the outpatient group (OR = 2.35, 95% CI = 1.22-4.51, P = 0.011). In the intention-to-treat population, self-reported and biochemically validated abstinence rates at 12 months were 34.4% in the residential versus 14.6% in the outpatient group (OR = 3.08, 95% CI = 1.77-5.34, P < 0.0001) and 28.6% versus 10.3% (OR = 3.48, 95% CI = 1.85-6.52, P = 0.0001), respectively. CONCLUSIONS Residential therapy exclusively for smoking cessation is feasible and effective and could be a beneficial new treatment for smokers.
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Affiliation(s)
- Jonas Levin Dickreuter
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Claudia Schmoor
- Clinical Trials Unit, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Jürgen Bengel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Barbara Pschichholz
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina Lorz
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christina Schulz
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jana Vozelj
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Jens Albert Leifert
- Comprehensive Cancer Center (CCCF), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Breisgau-Klinik, Bad Krozingen, Germany
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158
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Quek S, Hadermann A, Wu Y, De Coninck L, Hegde S, Boucher JR, Cresswell J, Foreman E, Steven A, LaCourse EJ, Ward SA, Wanji S, Hughes GL, Patterson EI, Wagstaff SC, Turner JD, Parry RH, Kohl A, Heinz E, Otabil KB, Matthijnssens J, Colebunders R, Taylor MJ. Diverse RNA viruses of parasitic nematodes can elicit antibody responses in vertebrate hosts. Nat Microbiol 2024; 9:2488-2505. [PMID: 39232205 PMCID: PMC11445058 DOI: 10.1038/s41564-024-01796-6] [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: 08/15/2023] [Accepted: 07/25/2024] [Indexed: 09/06/2024]
Abstract
Parasitic nematodes have an intimate, chronic and lifelong exposure to vertebrate tissues. Here we mined 41 published parasitic nematode transcriptomes from vertebrate hosts and identified 91 RNA viruses across 13 virus orders from 24 families in ~70% (28 out of 41) of parasitic nematode species, which include only 5 previously reported viruses. We observe widespread distribution of virus-nematode associations across multiple continents, suggesting an ancestral acquisition event and host-virus co-evolution. Characterization of viruses of Brugia malayi (BMRV1) and Onchocerca volvulus (OVRV1) shows that these viruses are abundant in reproductive tissues of adult parasites. Importantly, the presence of BMRV1 RNA in B. malayi parasites mounts an RNA interference response against BMRV1 suggesting active viral replication. Finally, BMRV1 and OVRV1 were found to elicit antibody responses in serum samples from infected jirds and infected or exposed humans, indicating direct exposure to the immune system.
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Affiliation(s)
- Shannon Quek
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Amber Hadermann
- Global Health Institute, University of Antwerp, Antwerp, Belgium
| | - Yang Wu
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lander De Coninck
- Laboratory of Viral Metagenomics, Clinical and Epidemiological Virology, Rega Institute, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Shrilakshmi Hegde
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jordan R Boucher
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jessica Cresswell
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ella Foreman
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Andrew Steven
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - E James LaCourse
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Stephen A Ward
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Samuel Wanji
- Parasite and Vector Biology Research Unit, Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Grant L Hughes
- Centre for Neglected Tropical Diseases, Departments of Tropical Disease Biology and Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Edward I Patterson
- Department of Biological Sciences, Brock University, St Catharines, Ontario, Canada
| | - Simon C Wagstaff
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Joseph D Turner
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Rhys H Parry
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Alain Kohl
- Centre for Neglected Tropical Diseases, Departments of Tropical Disease Biology and Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Eva Heinz
- Departments of Vector Biology and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Kenneth Bentum Otabil
- Consortium for Neglected Tropical Diseases and One Health, Department of Biological Sciences, University of Energy and Natural Resources, Sunyani, Ghana
| | - Jelle Matthijnssens
- Laboratory of Viral Metagenomics, Clinical and Epidemiological Virology, Rega Institute, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | | | - Mark J Taylor
- Centre for Neglected Tropical Diseases, Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK.
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Xu K, Zhu J, Zhang T, Sui G. A phosphorylated guanidine chitosan and UiO-66-NH 2 modified magnetic nanoparticle platform for enrichment and detection of multiple bacteria. Talanta 2024; 278:126435. [PMID: 38924986 DOI: 10.1016/j.talanta.2024.126435] [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: 04/07/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Wastewater-based epidemiology (WBE) is a powerful tool for early warning of infectious disease outbreaks. Hence, a rapid and portable pathogen monitoring system is urgent needed for on-site detection. In this work, we first reported synthesis of an artificial modulated wide-spectrum bacteria capture nanoparticle (Arg-CSP@UiO@Fe3O4). Arginine-modified phosphorylated chitosan (Arg-CSP) coating could provide strongly positive charged guanidinium group for pathogen interaction by electrostatic attraction, and UiO-66-NH2 layer could help Arg-CSP graft onto Fe3O4 magnetic particles. The capture efficiency of Arg-CSP@UiO@Fe3O4 reached 92.2 % and 97.3 % for Escherichia coli (E.coli) and Staphylococcus epidermidis (S.epidermidis)within 40 min, in 10 mL sample. To prevent pathogen degradation in sewage, a portable nucleic acid extraction-free method was also developed. UiO-66-NH2 could disintegrate in buffer with high concentration of PO43- for bacterium desorption, and then nucleic acid of the bacteria was released by heating. The DNA template concentration obtained by this method was 779.28 times higher than that of the direct thermal lysis product and 8.63 times higher than that of the commercial kit. Afterwards, multiple detection of bacteria was realized by loop-mediated isothermal amplification (LAMP). Artificial regulated pathogen desorption could prevent non-specific adsorption of nucleic acid by nanoparticles. The detection limit of Arg-CSP@UiO@Fe3O4-LAMP method was 80 cfu/mL for E.coli and 300 cfu/mL for S.epidermidis. The accuracy and reliability of the method was validated by spiked sewage samples. In conclusion, this bio-monitoring system was able to detect multiple bacteria in environment conveniently and have good potential to become an alternative solution for rapid on-site pathogen detection.
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Affiliation(s)
- Kexin Xu
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, China
| | - Jinhui Zhu
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, China
| | - Tong Zhang
- Department of Clinical Laboratory, Shanghai East Hospital, School of Medicine, Tong Ji University, Shanghai, 200120, China
| | - Guodong Sui
- Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Department of Environmental Science & Engineering, Fudan University, Shanghai, 200438, China; Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai 200032, P. R. China.
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Roy PK, Paul A, Khandibharad S, Kolhe SD, Farooque QSS, Singh S, Singh S. Mechanistic and structural insights into vitamin B 2 metabolizing enzyme riboflavin kinase from Leishmania donovani. Int J Biol Macromol 2024; 278:134392. [PMID: 39098675 DOI: 10.1016/j.ijbiomac.2024.134392] [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: 03/14/2024] [Revised: 07/24/2024] [Accepted: 07/30/2024] [Indexed: 08/06/2024]
Abstract
Leishmania donovani relies on specific vitamins and cofactors crucial for its survival and pathogenesis. Tailoring therapies to disrupt these pathways offers a promising strategy for the treatment of Visceral Leishmaniasis. Current treatment regimens are limited due to drug resistance and high costs. The dependency of Leishmania parasites on Vitamin B2 and its metabolic products is not known. In this study, we have biochemically and biophysically characterized a Vitamin B2 metabolism enzyme, riboflavin kinase from L. donovani (LdRFK) which converts riboflavin (vitamin B2) into flavin mononucleotide (FMN). Sequence comparison with human counterpart reflects 31.58 % identity only, thus opening up the possibility of exploring it as drug target. The rfk gene was cloned, expressed and the recombinant protein was purified. Kinetic parameters of LdRFK were evaluated with riboflavin and ATP as substrates which showed differential binding affinity when compared with the human RFK enzyme. Thermal and denaturant stability of the enzyme was evaluated. The rfk gene was overexpressed in the parasites and its role in growth and cell cycle was evaluated. In the absence of crystal structure, homology modelling and molecular dynamic simulation studies were performed to predict LdRFK structure. The data shows differences in substrate binding between human and parasite enzyme. This raises the possibility of exploring LdRFK for specific designing of antileishmanial molecules. Gene disruption studies can further validate its candidature as antileishmanial target.
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Affiliation(s)
- Pradyot Kumar Roy
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali 160062, Punjab, India
| | - Anindita Paul
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali 160062, Punjab, India
| | - Shweta Khandibharad
- Biotechnology Research and Innovation Council- National Centre for Cell Science (BRIC-NCCS), NCCS Complex, Ganeshkhind, SP Pune University Campus, Pune 411007, India
| | - Sanket Dattatray Kolhe
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali 160062, Punjab, India
| | - Qureshi Sameer Shaikh Farooque
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali 160062, Punjab, India
| | - Shailza Singh
- Biotechnology Research and Innovation Council- National Centre for Cell Science (BRIC-NCCS), NCCS Complex, Ganeshkhind, SP Pune University Campus, Pune 411007, India
| | - Sushma Singh
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, SAS Nagar, Mohali 160062, Punjab, India.
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161
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Beckmann A, Strassner C, Kwanbunjan K. Thailand - how far are we from achieving a healthy and sustainable diet? A longitudinal ecological study. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 29:100478. [PMID: 39315384 PMCID: PMC11418144 DOI: 10.1016/j.lansea.2024.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 08/28/2024] [Accepted: 08/28/2024] [Indexed: 09/25/2024]
Abstract
Background Newly industrialized countries like Thailand have been influenced by globalization, westernization, and urbanization over the last decades, leading to changes in dietary habits as well as food production. Consequences of these changes include rising non-communicable diseases (NCDs) and environmental degradation, which are defined as the leading global challenges today. The objectives of this study are to identify Thailand's dietary changes, considering health and sustainability aspects, and to determine correlations between these changes and NCD cases as well as environmental impacts (GHG emissions, land-, nitrogen-, phosphorus-use). In this way, diet-related adjustments can be identified to promote planetary and human health. Methods In this longitudinal ecological study, relative differences between the average food consumption in Thailand and the reference values of a healthy and sustainable diet, the Planetary Health Diet (PHD), were calculated. Furthermore, a bivariate correlation analysis was conducted, using data, based on Food and Agriculture Organization's (FAO's) data, results from the Global Burden of Disease Study (GBD), and PHD's reference values. Findings The consumption quantities of meat, eggs, saturated oils, and sugar increased significantly since 1961. The food groups, that have exceeded PHD's upper reference values, include sugar (+452%), red meat (+220%), grains (+143%), saturated oils (+20%) and eggs (+19%), while vegetables (-63%), and unsaturated oils (-61%) have fallen below PHD's lower limits. Concerning the bivariate correlation analyses, all investigated variables show significant correlations. The most significant correlations were found in NCD cases (r = 0.903, 95% CI 0.804-0.953), nitrogen use (r = 0.872, 95% CI 0.794-0.922), and land use (r = 0.870, 95% CI 0.791-0.921), followed by phosphorus use (r = 0.832, 95% CI 0.733-0.897), and green-house gas (GHG) emissions (r = 0.479, 95% CI 0.15-0.712). Interpretation The results show, that the determined differences of unhealthy or unsustainable food groups have increased concurrently with NCD cases and environmental impacts over the last decades in Thailand. A shift towards a reduced intake of sugar, red meat, grains, saturated oils and eggs along with an increase in vegetables and unsaturated oils, might support environmental and human health. Funding None.
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Affiliation(s)
- Alice Beckmann
- Department of Food Nutrition Facilities, FH Münster University of Applied Sciences, Corrensstraße 25, Münster, 48149, Germany
| | - Carola Strassner
- Department of Food Nutrition Facilities, FH Münster University of Applied Sciences, Corrensstraße 25, Münster, 48149, Germany
| | - Karunee Kwanbunjan
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, 10400, Bangkok, Thailand
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162
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Zhou X, Yang M, Chen F, Wang L, Han P, Jiang Z, Shen S, Rao G, Yang F. Prediction of antimicrobial resistance in Klebsiella pneumoniae using genomic and metagenomic next-generation sequencing data. J Antimicrob Chemother 2024; 79:2509-2517. [PMID: 39028665 DOI: 10.1093/jac/dkae248] [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: 12/14/2023] [Accepted: 07/04/2024] [Indexed: 07/21/2024] Open
Abstract
OBJECTIVES Klebsiella pneumoniae is a significant pathogen with increasing resistance and high mortality rates. Conventional antibiotic susceptibility testing methods are time-consuming. Next-generation sequencing has shown promise for predicting antimicrobial resistance (AMR). This study aims to develop prediction models using whole-genome sequencing data and assess their feasibility with metagenomic next-generation sequencing data from clinical samples. METHODS On the basis of 4170 K. pneumoniae genomes, the main genetic characteristics associated with AMR were identified using a LASSO regression model. Consequently, the prediction model was established, validated and optimized using clinical isolate read simulation sequences. To evaluate the efficacy of the model, clinical specimens were collected. RESULTS Four predictive models for amikacin, ciprofloxacin, levofloxacin, and piperacillin/tazobactam, initially had positive predictive values (PPVs) of 92%, 98%, 99%, 94%, respectively, when they were originally constructed. When applied to clinical specimens, their PPVs were 96%, 96%, 95%, and 100%, respectively. Meanwhile, there were negative predictive values (NPVs) of 100% for ciprofloxacin and levofloxacin, and 'not applicable' (NA) for amikacin and piperacillin/tazobactam. Our method achieved antibacterial phenotype classification accuracy rates of 95.92% for amikacin, 96.15% for ciprofloxacin, 95.31% for levofloxacin and 100% for piperacillin/tazobactam. The sequence-based prediction antibiotic susceptibility testing (AST) reported results in an average time of 19.5 h, compared with the 67.9 h needed for culture-based AST, resulting in a significant reduction of 48.4 h. CONCLUSIONS These preliminary results demonstrated that the performance of prediction model for a clinically significant antimicrobial-species pair was comparable to that of phenotypic methods, thereby encouraging the expansion of sequence-based susceptibility prediction and its clinical validation and application.
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Affiliation(s)
- Xun Zhou
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China
| | - Ming Yang
- The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | | | - Leilei Wang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China
| | - Peng Han
- Genskey Medical Technology Co. Ltd., Beijing, China
| | - Zhi Jiang
- Genskey Medical Technology Co. Ltd., Beijing, China
| | - Siquan Shen
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China
| | - Guanhua Rao
- Genskey Medical Technology Co. Ltd., Beijing, China
| | - Fan Yang
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China
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Loggini A, Hornik J, Henson J, Wesler J, Nelson M, Hornik A. Comparison of Telemedicine-Administered Thrombolytic Therapy for Acute Ischemic Stroke by Neurology Subspecialty: A Cross-Sectional Study. Neurohospitalist 2024; 14:413-418. [PMID: 39308460 PMCID: PMC11412448 DOI: 10.1177/19418744241276244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/01/2024] [Accepted: 08/04/2024] [Indexed: 09/25/2024] Open
Abstract
Background and Purpose To determine if any difference exists in safety and outcomes of thrombolytic therapy for acute ischemic stroke administered via telemedicine, based on the subspeciality of the treating neurologist. Methods We performed a retrospective cross-sectional study using data from our local stroke registry of thrombolytic therapy administered via telemedicine at our rural stroke network over 5 years. The cohort was divided in 2 groups based on the subspecialty of the treating neurologist: vascular neurology (VN) and neurocritical care (NCC). Demographics, clinical characteristics, stroke metrics, thrombolytic complications, and final diagnosis were reviewed. In-hospital mortality and mRS and 30 days were noted. Results Among 142 patients who received thrombolytic therapy via telemedicine, 44 (31%) were treated by VN specialists; 98 (69%) by NCC specialist. There was no difference in baseline characteristics and stroke metrics between the 2 groups. Compared to NCC, VN had a trend toward higher, but non-significant, sICH (6% vs 1%, P = 0.05). In a logistic regression analysis, correcting for NIHSS, SBP, door-to-needle time, and use of antiplatelet therapy, the type of neurology subspecialty was not independently associated with development of sICH (OR: 0.141, SE: 0.188, P = 0.141). The rate of in-hospital mortality was also similar between VN and NCC (7% vs 5%, P = 0.8). In a model that accounted for stroke severity, no association was established between the type of neurology subspecialty and mRS at 30 days (OR: 1.589, SE: 0.662, P = 0.266). Conclusions Safety and outcome of thrombolytic therapy via telemedicine was not influenced by the subspecialty of treating neurologist. Our study supports the expansion of telemedicine for acute stroke patients in rural and underserved areas.
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Affiliation(s)
- Andrea Loggini
- Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, IL, USA
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
| | - Jonatan Hornik
- Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, IL, USA
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
| | - Jessie Henson
- Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, IL, USA
| | - Julie Wesler
- Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, IL, USA
| | - Madison Nelson
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
| | - Alejandro Hornik
- Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, IL, USA
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
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Li S, Amakye WK, Zhao Z, Xin X, Jia Y, Zhang H, Ren Y, Zhou Y, Zhai L, Kang W, Lu X, Guo J, Wang M, Xu Y, Yi J, Ren J. Prognostic value of anthropometric- and biochemistry-based nutrition status indices on blood chemistry panel levels during cancer treatment. Nutrition 2024; 126:112520. [PMID: 39111096 DOI: 10.1016/j.nut.2024.112520] [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: 01/22/2024] [Revised: 05/24/2024] [Accepted: 06/08/2024] [Indexed: 09/10/2024]
Abstract
Body weight, body mass index (BMI), Nutrition Risk Screening 2002 (NRS2002), and prognostic nutritional index (PNI) are among vital nutrition status indices employed during cancer treatment. These have also been associated with levels of blood chemistry panels (BCPs), which are touted as significant indicators of disease prognosis. However, it remains unclear which nutrition status index better predicts future trends in specific BCPs. Using the records of 407 cancer patients, we retrospectively examined the potential of nutritional status indices at baseline for predicting changes in specific BCPs over a 6-week period. Generally, both serum biochemical parameters and nutrition status indices fluctuated over the study period among study participants. PNI was often linearly associated with blood cell counts (white blood cells [WBCs] and hemoglobin) compared with anthropometric-based nutrition status indices. Increase in body weight was protective against having abnormal lymphocyte levels at 6 weeks (odds ratio [OR]: 0.960-0.974; CI: 0.935-0.997; P < 0.05), while increase in baseline PNI was associated with 0.865-0.941 and 0.675-0.915 odds of having future abnormal WBC and lymphocyte levels, respectively. Increases in PNI were also protective against having future abnormal albumin levels (OR: 0.734-0.886) and 8.5-12.5% decreases in the odds of having an abnormal C-reactive protein level in subsequent visits. Changes in NRS2002 tended to be associated with the odds of having future abnormal blood glucose levels. In conclusion, the serum biochemistry-derived nutrition status index, PNI, is a more consistent measure as an early indicator to track the trends of future changes in the BCPs of cancer patients. This implies that PNI could be targeted as an early-warning measure with relevant preventive interventions for patients at risk of malnutrition.
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Affiliation(s)
- Suyun Li
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Beijing, 100021, China
| | - William Kwame Amakye
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China
| | - Zikuan Zhao
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China
| | - Xiaowei Xin
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Beijing, 100021, China
| | - Ying Jia
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Beijing, 100021, China
| | - Hui Zhang
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Beijing, 100021, China
| | - Yuwei Ren
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Langfang, 065001, China
| | - Yuxin Zhou
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Langfang, 065001, China
| | - Lina Zhai
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Langfang, 065001, China
| | - Weicong Kang
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Langfang, 065001, China
| | - Xuemin Lu
- Department of Clinical Nutrition, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Langfang, 065001, China
| | - Ji Guo
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China
| | - Min Wang
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China
| | - Yongzhao Xu
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China
| | - Junlin Yi
- Department of Radiotherapy, National Cancer Hospital/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Science, Beijing, 100021, China
| | - Jiaoyan Ren
- School of Food Science and Engineering, South China University of Technology, Guangzhou, 510641, Guangdong, China.
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165
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Klammer MG, Reimann L, Richter O, Lieschke S, Stengl H, Hellwig S, Ganeshan R, Schöls M, Nelde A, Meisel C, Villringer K, Nolte CH, Endres M, Scheitz JF. Association Between Stroke Lesion Size and Atrial Fibrillation Detected After Stroke: An Observational Cohort Study. J Am Heart Assoc 2024; 13:e035285. [PMID: 39344635 DOI: 10.1161/jaha.124.035285] [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] [Accepted: 07/31/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Atrial fibrillation detected after stroke (AFDAS) is considered to be a distinct entity influenced by cardiogenic and neurogenic factors. We hypothesized that patients with AFDAS have larger stroke lesions than patients without atrial fibrillation (AF) and with known AF (KAF). METHODS AND RESULTS Consecutive patients with magnetic resonance imaging-confirmed acute ischemic stroke admitted to a university hospital between October 2020 and January 2023 were prospectively registered. We categorized patients as AFDAS, no AF or KAF upon hospital discharge. We manually segmented diffusion-weighted imaging lesions to determine lesion volume. We analyzed 1420 patients (median age, 78; 47.2% women, median National Institutes of Health Stroke Scale score, 3; median hospital stay, 5 days). Of these, 81 had AFDAS (5.7%), 329 had KAF (23.2%) and 1010 had no AF (71.1%). Lesion volume was larger in patients with AFDAS (median, 5.4 mL [interquartile range, 1.0-21.6]) compared with patients with no AF and KAF (median, 0.7 [interquartile range,0.2-4.4] and 2.0 [interquartile range,0.3-11.1] mL, respectively; both P<0.001). Lesion volume was independently associated with AFDAS compared with no AF (adjusted odds ratio, 1.37 [95% CI, 1.20-1.58] per log mL) and KAF (adjusted odds ratio, 1.22 [95% CI, 1.07-1.41] per log mL). Patients in the highest lesion volume quartile (>6.5 mL) were more likely to be diagnosed with AFDAS compared with the lowest quartile (<0.22 mL, 13.6% versus 2.1%; adjusted odds ratio, 5.88 [95% CI, 2.30-17.40]). These associations were more pronounced when excluding 151 patients with nonembolic lesion pattern and similar when excluding 199 patients with KAF on oral anticoagulation. CONCLUSIONS Larger stroke lesions were independently associated with AFDAS diagnosis during index stroke hospitalization highlighting a potential neurogenic contribution to AFDAS pathogenesis.
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Affiliation(s)
- Markus G Klammer
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Exzellenzcluster NeuroCure Berlin Germany
| | - Laura Reimann
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
| | - Oskar Richter
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
| | - Simone Lieschke
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
| | - Helena Stengl
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
| | - Simon Hellwig
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
| | | | - Maximilian Schöls
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
| | - Alexander Nelde
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
| | - Christian Meisel
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Exzellenzcluster NeuroCure Berlin Germany
- Berlin Institute of Health Berlin Germany
| | - Kersten Villringer
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
| | - Christian H Nolte
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), partner site Berlin Berlin Germany
| | - Matthias Endres
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK) Berlin Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen e. V. (DZNE), partner site Berlin Berlin Germany
- Deutsches Zentrum für psychische Gesundheit (DZPG) Berlin Germany
| | - Jan Friedrich Scheitz
- Center for Stroke Research Berlin (CSB) Berlin Germany
- Department of Neurology with Experimental Neurology Charité Universitätsmedizin Berlin Berlin Germany
- Berlin Institute of Health Berlin Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK) Berlin Germany
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Zhao M, Ma J, Wu Y, Zhang Y, Wang L, Song H, Sun X. Depressive and anxiety symptoms among schizophrenia patients. J Affect Disord 2024; 362:749-754. [PMID: 39029687 DOI: 10.1016/j.jad.2024.07.130] [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: 03/21/2024] [Revised: 07/03/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Depressive and anxiety symptoms commonly manifested throughout the progression of schizophrenia. However, the prevalence of these symptoms, alongside their co-occurrence, remains uncertain, and clinical correlates remain elusive. OBJECTIVES This study seeks to investigate the prevalence of such symptoms and their demographic and clinical associations among patients diagnosed with schizophrenia. METHODS The study included 19,623 patients diagnosed with schizophrenia based on the ICD-10 criteria. Participants were recruited from community-dwelling patients registered in the local health system in Hangzhou of China between August 1 and October 30, 2022. RESULTS The prevalence rates of depressive and anxiety symptoms, as well as their co-occurrence, were determined to be 19 % (95%CI = 18.5-19.6 %), 37.4 % (95%CI = 36.8-38.0 %), and 17.7 % (95%CI = 17.2-18.2 %), respectively. Patients prescribed quetiapine, olanzapine, and risperidone exhibited significantly lower prevalence rates of these symptoms (P < 0.01). Spearman's correlation analysis revealed a significant correlation between depressive symptoms and anxiety symptoms (r = 0.60, P = 0.006). Additionally, age, social relationships, and sleep status were significantly associated with depressive and anxiety symptoms, and their co-occurrence, in both univariate and multivariate analyses. CONCLUSION Given the pervasive nature and detrimental consequences of these symptoms among individuals diagnosed with schizophrenia, comprehensive evaluation and implementation of efficacious interventions are highly recommended.
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Affiliation(s)
- Mingzhe Zhao
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingsong Ma
- School of Early Childhood Education, Hangzhou Polytechnic, Hangzhou, China
| | - Yue Wu
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuyin Zhang
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Wang
- Department of Applied Psychology, Education Science Research Institute, Heilongjiang University, Harbin, China
| | - Haidong Song
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Xiaohua Sun
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Kinnard MJ, Cohen JS, Quan T, Foran JR, Sheth NP. Liver Disease Increases the Risk of Postoperative Complications in Patients Undergoing Aseptic Revision Total Hip and Knee Arthroplasty. Arthroplast Today 2024; 29:101516. [PMID: 39363937 PMCID: PMC11447298 DOI: 10.1016/j.artd.2024.101516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 07/07/2024] [Accepted: 08/09/2024] [Indexed: 10/05/2024] Open
Abstract
Background Due to the multiorgan effects of liver disease, surgical patients with liver disease have an increased risk of perioperative complications. With revision total hip and knee arthroplasty surgeries increasing, it is important to determine the effects of liver disease in this patient population. The purpose of this study was to evaluate the impact of underlying liver disease on postoperative outcomes following revision total joint arthroplasty (TJA). Methods The National Surgical Quality Improvement Program database was used to identify patients undergoing aseptic revision TJA from 2006-2019 and group them based on liver disease. The presence of liver disease was assessed by calculating the Model for End-Stage Liver Disease-Sodium score. Patients with a Model for End-Stage Liver Disease-Sodium score of > 10 were classified as having underlying liver disease. In this analysis, differences in demographics, comorbidities, and postoperative complications were assessed. Results Of 7102 patients undergoing revision total hip arthroplasty, 11.6% of the patients had liver disease. Of 8378 patients undergoing revision total knee arthroplasty, 8.4% of the patients had liver disease. Following adjustment on multivariable regression analysis, patients with liver disease undergoing revision total hip arthroplasty or revision total knee arthroplasty had an increased risk of major complications, wound complications, septic complications, bleeding requiring transfusion, extended length of stay, and readmission compared to those without liver disease. Conclusions Patients with liver disease have an increased risk of complications following revision TJA. A multidisciplinary team approach should be employed for preoperative optimization and postoperative management of these vulnerable patients to improve outcomes and decrease the incidence and severity of complications. Level of evidence This is retrospective cohort study and is level 3 evidence.
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Affiliation(s)
- Matthew J. Kinnard
- Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jordan S. Cohen
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Theodore Quan
- Department of Orthopaedic Surgery, George Washington University Hospital, Washington, DC, USA
| | | | - Neil P. Sheth
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
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Raffetti E, Bolton T, Nolan J, Zuccolo L, Denholm R, Smith G, Akbari A, Harron K, Curry G, Allara E, Lawlor DA, Caputo M, Abbasizanjani H, Chico T, Wood AM. COVID-19 diagnosis, vaccination during pregnancy, and adverse pregnancy outcomes of 865,654 women in England and Wales: a population-based cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 45:101037. [PMID: 39262452 PMCID: PMC11388188 DOI: 10.1016/j.lanepe.2024.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/04/2024] [Accepted: 08/06/2024] [Indexed: 09/13/2024]
Abstract
Background The extent to which COVID-19 diagnosis and vaccination during pregnancy are associated with risks of common and rare adverse pregnancy outcomes remains uncertain. We compared the incidence of adverse pregnancy outcomes in women with and without COVID-19 diagnosis and vaccination during pregnancy. Methods We studied population-scale linked electronic health records for women with singleton pregnancies in England and Wales from 1 August 2019 to 31 December 2021. This time period was divided at 8th December 2020 into pre-vaccination and vaccination roll-out eras. We calculated adjusted hazard ratios (HRs) for common and rare pregnancy outcomes according to the time since COVID-19 diagnosis and vaccination and by pregnancy trimester and COVID-19 variant. Findings Amongst 865,654 pregnant women, we recorded 60,134 (7%) COVID-19 diagnoses and 182,120 (21%) adverse pregnancy outcomes. COVID-19 diagnosis was associated with a higher risk of gestational diabetes (adjusted HR 1.22, 95% CI 1.18-1.26), gestational hypertension (1.16, 1.10-1.22), pre-eclampsia (1.20, 1.12-1.28), preterm birth (1.63, 1.57-1.69, and 1.68, 1.61-1.75 for spontaneous preterm), very preterm birth (2.04, 1.86-2.23), small for gestational age (1.12, 1.07-1.18), thrombotic venous events (1.85, 1.56-2.20) and stillbirth (only within 14-days since COVID-19 diagnosis, 3.39, 2.23-5.15). HRs were more pronounced in the pre-vaccination era, within 14-days since COVID-19 diagnosis, when COVID-19 diagnosis occurred in the 3rd trimester, and in the original variant era. There was no evidence to suggest COVID-19 vaccination during pregnancy was associated with a higher risk of adverse pregnancy outcomes. Instead, dose 1 of COVID-19 vaccine was associated with lower risks of preterm birth (0.90, 0.86-0.95), very preterm birth (0.84, 0.76-0.94), small for gestational age (0.93, 0.88-0.99), and stillbirth (0.67, 0.49-0.92). Interpretation Pregnant women with a COVID-19 diagnosis have higher risks of adverse pregnancy outcomes. These findings support recommendations towards high-priority vaccination against COVID-19 in pregnant women. Funding BHF, ESRC, Forte, HDR-UK, MRC, NIHR and VR.
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Affiliation(s)
- Elena Raffetti
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Deparment of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden
| | - Thomas Bolton
- British Heart Foundation Data Science Centre, Health Data Research UK, London, UK
| | - John Nolan
- British Heart Foundation Data Science Centre, Health Data Research UK, London, UK
| | - Luisa Zuccolo
- Health Data Science Centre, Human Technopole, Milan, Italy
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel Denholm
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Health Data Research UK South-West, Bristol, UK
| | - Gordon Smith
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
| | - Katie Harron
- Population, Policy & Practice Dept UCL GOS Institute of Child Health, London, UK
| | - Gwenetta Curry
- Edinburgh Migration and Ethnicity Health Research Group, College of Medicine and Veterinary Medicine, Usher Institute, University of Edinburgh, UK
| | - Elias Allara
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Massimo Caputo
- Translational Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hoda Abbasizanjani
- Population Data Science, Swansea University Medical School, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, UK
| | - Tim Chico
- Division of Clinical Medicine, School of Medicine and Population Health, The Medical School, University of Sheffield, Beech Hill Road, Sheffield, UK
| | - Angela M Wood
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- British Heart Foundation Data Science Centre, Health Data Research UK, London, UK
- National Institute for Health and Care Research Blood and Transplant Research Unit in Donor Health and Behaviour, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- Cambridge Centre of Artificial Intelligence in Medicine, UK
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169
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Zhang L, Xiao M, Chu H, Kotsakis GA, Guan W. Estimating Periodontitis Susceptibility Cases for Epidemiological Studies with Multiple Imputation. JDR Clin Trans Res 2024; 9:378-386. [PMID: 38482579 PMCID: PMC11403924 DOI: 10.1177/23800844241228277] [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] [Indexed: 09/17/2024] Open
Abstract
KNOWLEDGE TRANSFER STATEMENT Our proposed estimate of periodontitis susceptibility cases addresses the issue of missing teeth, offering an innovative solution through a generative missing data imputation model. The implications of our findings extend to fostering more robust investigations into the relationships between periodontal health and systemic diseases, thereby offering valuable insights to clinicians for informed decision-making. Moreover, the study's capacity to shape clinical practices and interventions in public health will further fortify health policy strategies.
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Affiliation(s)
- L Zhang
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - M Xiao
- Department of Biostatistics and Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - H Chu
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Statistical Research and Data Science Center, Pfizer Inc., New York, NY, USA
| | - G A Kotsakis
- Department of Oral Biology & Clinical Research Center, Rutgers School of Dental Medicine, Newark, NJ, USA
| | - W Guan
- Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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170
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Yang WG, Peng YF, Yang YB, Li B, Wei YG, Liu F. Timing of hepatectomy following the Omicron variant infection for vaccinated-patients: A retrospective cohort study. Hepatobiliary Pancreat Dis Int 2024; 23:515-520. [PMID: 38281903 DOI: 10.1016/j.hbpd.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024]
Affiliation(s)
- Wu-Gui Yang
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yu-Fu Peng
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yu-Bo Yang
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bo Li
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yong-Gang Wei
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Fei Liu
- Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
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Yuan J, Cheng Y, Han X, Zhu N, Ma W, Li J, Jiang S, Zhao J, Liu F. Association between C-reactive protein/albumin ratio and all-cause mortality in patients with stroke: Evidence from NHANES cohort study. Nutr Metab Cardiovasc Dis 2024; 34:2305-2314. [PMID: 39004593 DOI: 10.1016/j.numecd.2024.05.024] [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: 03/18/2024] [Revised: 05/16/2024] [Accepted: 05/27/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND AND AIMS The inflammatory nutritional status is widely associated with the long-term prognosis of non-fatal stroke. The objective of this study is to examine the correlation between the C-reactive protein to albumin ratio (CAR), a new marker indicating both inflammatory and nutritional status, and the overall mortality rate among stroke patients. METHODS AND RESULTS Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database and corresponding public-use mortality data from the linked National Death Index (NDI). The study utilized maximally selected rank statistics to determine the optimal cutoff points for the CAR. Subsequently, participants were stratified into higher- and lower-CAR groups based on these cutoff points. The Kaplan-Meier survival method was used to study overall survival probability. Multivariable Cox proportional regression models were employed to calculate the Hazard Ratio (HR) and corresponding confidence interval (CI). Restricted cubic spline (RCS) model was applied to detect potential non-linear relationship between CAR and mortality risk. Furthermore, stratified and sensitive analyses were performed to examine the robustness and reliability of the results. The study, encompassing 1043 participants with an average age of 64.61 years, identified a cutoff value of 0.32 for CAR, with notable variances observed across gender and age cohorts. Over an average follow-up period of 116 months, 679 instances of all-cause mortality were documented. Kaplan-Meier survival analysis unveiled noteworthy disparities in survival probabilities between groups categorized by high and low CAR levels (p = 0.00081). Continuous CAR analysis consistently demonstrated a positive correlation between elevated CAR values and heightened risk (HR = 1.78 (1.36, 2.33)) of all-cause mortality among stroke patients. Similarly, individuals in the high CAR group exhibited adjusted HR of 1.34 (0.96, 1.89) for all-cause mortality compared to their low CAR counterparts. Subgroup and sensitive analysis consistently reinforced these findings. Smoothing curve fitting further validated CAR's significance as a prognostic indicator of all-cause mortality, indicating a linear relationship. CONCLUSION Elevated CAR is associated with increased long-term risk of mortality for individuals who have experienced a stroke, suggesting that CAR could serve as a survival indicator.
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Affiliation(s)
- Jinguo Yuan
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yawen Cheng
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiangning Han
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ning Zhu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenlong Ma
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiahao Li
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shiliang Jiang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Zhao
- Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Fude Liu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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172
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Marrero N, Jha K, Hughes TM, Razavi AC, Grant JK, Boakye E, Anchouche K, Dzaye O, Budoff MJ, Rotter JI, Guo X, Yao J, Wood AC, Blumenthal RS, Michos ED, Thanassoulis G, Post WS, Blaha MJ, Ibeh C, Whelton SP. Association of aortic valve calcium with dementia and stroke: The Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2024; 397:117596. [PMID: 38890039 DOI: 10.1016/j.atherosclerosis.2024.117596] [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: 12/21/2023] [Revised: 05/01/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND AND AIMS Calcific aortic valve disease is associated with increased thrombin formation, platelet activation, decreased fibrinolysis, and subclinical brain infarcts. We examined the long-term association of aortic valve calcification (AVC) with newly diagnosed dementia and incident stroke in the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS AVC was measured using non-contrast cardiac CT at Visit 1. We examined AVC as a continuous (log-transformed) and categorical variable (0, 1-99, 100-299, ≥300). Newly diagnosed dementia was adjudicated using International Classification of Disease codes. Stroke was adjudicated from medical records. We calculated absolute event rates (per 1000 person-years) and multivariable adjusted Cox proportional hazards ratios (HR). RESULTS Overall, 6812 participants had AVC quantified with a mean age of 62.1 years old, 52.9 % were women, and the median 10-year estimated atherosclerotic cardiovascular disease (ASCVD) risk was 13.5 %. Participants with AVC >0 were older and less likely to be women compared to those with AVC=0. Over a median 16-year follow-up, there were 535 cases of dementia and 376 cases of stroke. The absolute risk of newly diagnosed dementia increased in a stepwise pattern with higher AVC scores, and stroke increased in a logarithmic pattern. In multivariable analyses, AVC was significantly associated with newly diagnosed dementia as a log-transformed continuous variable (HR 1.09; 95 % CI 1.04-1.14) and persons with AVC ≥300 had nearly a two-fold higher risk (HR 1.77; 95 % CI 1.14-2.76) compared to those with AVC=0. AVC was associated with an increased risk of stroke after adjustment for age, sex, and race/ethnicity, but not after adjustment for ASCVD risk factors. CONCLUSIONS After multivariable adjustment, AVC >0 was significantly associated with an increased risk of newly diagnosed dementia, but not incident stroke. This suggests that AVC may be an important risk factor for the long-term risk of dementia beyond traditional ASCVD risk factors.
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Affiliation(s)
- Natalie Marrero
- University of Miami/Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kunal Jha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; University of Louisville, Division of Cardiology, Louisville, KY, USA
| | - Timothy M Hughes
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Alexander C Razavi
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center for Heart Disease Prevention, Emory School of Medicine, Atlanta, GA, USA
| | - Jelani K Grant
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ellen Boakye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Khalil Anchouche
- Preventive and Genomic Cardiology, Department of Medicine, McGill University, and the McGill University Health Center Research Institute, Montréal, Québec, Canada
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Matthew J Budoff
- Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | | | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - George Thanassoulis
- Preventive and Genomic Cardiology, Department of Medicine, McGill University, and the McGill University Health Center Research Institute, Montréal, Québec, Canada
| | - Wendy S Post
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Chinwe Ibeh
- Columbia University, Department of Neurology, New York, NY, USA
| | - Seamus P Whelton
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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173
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Gonzalez-Aquines A, Rosales J, De Souza AC, Corredor-Quintero A, Barboza MA, Navia-Gonzalez V, Brunet-Perez F, Lagos-Servellon J, Novarro-Escudero N, Ortega-Moreno DA, Villarroel-Saavedra V, Abanto C, Barrientos-Guerra JD, Saltos-Mata F, Papavasileiou V, Todd O, Gongora-Rivera F. Availability and barriers to access post-stroke rehabilitation in Latin America. J Stroke Cerebrovasc Dis 2024; 33:107917. [PMID: 39111374 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107917] [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: 01/10/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES To describe the availability and barriers to access post-stroke rehabilitation services in Latin America. MATERIALS AND METHODS We conducted a multi-national survey in Latin American countries. The survey consisted of three sections: (1) the national state of post-stroke rehabilitation; (2) the local state of post-stroke rehabilitation; and (3) the coverage and financing of post-stroke services. Stroke leaders from the surveyed countries were involved in developing and disseminating the survey. RESULTS 261 responses were collected from 17 countries. The mean age of respondents was 42.4 ± 10.1 years, and 139 (54.5 %) of the respondents were male. National clinical guidelines for post-stroke rehabilitation were reported by 67 (25.7 %) of the respondents. However, there were discrepancies between respondents within the same country. Stroke units, physiotherapy, occupational therapy, speech therapy, and neuropsychological therapy services were less common in public than private settings. The main barriers for inpatient and outpatient services included limited rehabilitation facilities, coverage, and rehabilitation personnel. The main source of financing for the inpatient and outpatient services was the national health insurance, followed by out-of-pocket payments. Private and out-of-pocket costs were more frequently reported in outpatient services. CONCLUSIONS Post-stroke rehabilitation services in Latin American countries are restricted due to a lack of coverage by the public health system and private insurers, human resources, and financial aid. Public settings offer fewer post-stroke rehabilitation services compared to private settings. Developing consensus guidelines, increasing coverage, and using innovative approaches to deliver post-stroke rehabilitation is paramount to increase access without posing a financial burden.
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Affiliation(s)
| | - Julieta Rosales
- Vascular Neurology Division, Department of Neurology, Fleni, Argentina. Montañeses, 2325, Buenos Aires, Argentina
| | - Ana Claudia De Souza
- Neurology and Neurosurgery Department, Hospital Moinhos de Vento, Brazil. Rua Ramiro Barcelos, 910, Bairro Moinhos de Ven, Porto Alegre, RS, 90.035-001
| | - Angel Corredor-Quintero
- Centro de ACV, Departamento de Neurología, Clínica Central del Quindío, Armenia, Colombia. Carrera 13 # 1N - 35, Armenia, Quindío, Colombia
| | - Miguel A Barboza
- Departamento de Neurociencias, Hospital Dr. Rafael A. Calderón Guardia, CCSS. San José, Costa Rica. Avenidas 7 y 9, calles 15 y 17, C. 17, San José, Aranjuez, Costa Rica
| | - Victor Navia-Gonzalez
- Facultad de Medicina, Clínica Alemana, Departamento de Neurologia, Universidad del Desarrollo, Chile. Avenida Manquehue Norte, 1410, Chile
| | | | - Javier Lagos-Servellon
- Hospital Nacional Mario Catarino Rivas, GXG5+665, 1 Calle, 21102, San Pedro Sula, Cortés, Honduras; Hospital CEMESA, 21 Calle A, 21104, San Pedro Sula, Honduras
| | - Nelson Novarro-Escudero
- Primary Stroke Center, Pacifica Salud, Panama. Pacific Boulevard and, Blvd, Pacífica, Panamá, Panama; Centro de Neurociencias, Ciudad de la Salud, Caja de Seguro Social, Panamá
| | - Diego A Ortega-Moreno
- Department of Neurology, University Hospital, Universidad Autonoma de Nuevo Leon, Gonzalitos y Madero S/N, Monterrey, Nuevo Leon, Mexico
| | - Victor Villarroel-Saavedra
- Hospital Obrero N 2-seguro de la Caja Nacional de Salud, Cochabamba, Bolivia. Av. Avenida Blanco Galindo km 5 ½, Bolivia
| | - Carlos Abanto
- Departamento de Enfermedades Neurovasculares, Instituto Nacional de Ciencias Neurológicas, Jr. Ancash 1271, Barrios Altos, Lima, Perú
| | | | - Filadelfo Saltos-Mata
- Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador. Q482+VGH, Av. 25 de Julio, Guayaquil, 090203, Ecuador
| | - Vasileios Papavasileiou
- Department of Neurosciences, Leeds Teaching Hospitals NHS Trust, England, St. James's University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF; School of Medicine, Faculty of Medicine and Health, University of Leeds, England, University of Leeds Woodhouse Lane Leeds, LS2 9JT
| | - Oliver Todd
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds, England, LS2 9LH, UK; Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, England, BD9 6RJ, UK
| | - Fernando Gongora-Rivera
- Department of Neurology, University Hospital, Universidad Autonoma de Nuevo Leon, Gonzalitos y Madero S/N, Monterrey, Nuevo Leon, Mexico
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Zhang Z, Yang Z, Wang S, Wang X, Mao J. Overview of pyroptosis mechanism and in-depth analysis of cardiomyocyte pyroptosis mediated by NF-κB pathway in heart failure. Biomed Pharmacother 2024; 179:117367. [PMID: 39214011 DOI: 10.1016/j.biopha.2024.117367] [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: 07/17/2024] [Revised: 08/14/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
The pyroptosis of cardiomyocytes has become an essential topic in heart failure research. The abnormal accumulation of these biological factors, including angiotensin II, advanced glycation end products, and various growth factors (such as connective tissue growth factor, vascular endothelial growth factor, transforming growth factor beta, among others), activates the nuclear factor-κB (NF-κB) signaling pathway in cardiovascular diseases, ultimately leading to pyroptosis of cardiomyocytes. Therefore, exploring the underlying molecular biological mechanisms is essential for developing novel drugs and therapeutic strategies. However, our current understanding of the precise regulatory mechanism of this complex signaling pathway in cardiomyocyte pyroptosis is still limited. Given this, this study reviews the milestone discoveries in the field of pyroptosis research since 1986, analyzes in detail the similarities, differences, and interactions between pyroptosis and other cell death modes (such as apoptosis, necroptosis, autophagy, and ferroptosis), and explores the deep connection between pyroptosis and heart failure. At the same time, it depicts in detail the complete pathway of the activation, transmission, and eventual cardiomyocyte pyroptosis of the NF-κB signaling pathway in the process of heart failure. In addition, the study also systematically summarizes various therapeutic approaches that can inhibit NF-κB to reduce cardiomyocyte pyroptosis, including drugs, natural compounds, small molecule inhibitors, gene editing, and other cutting-edge technologies, aiming to provide solid scientific support and new research perspectives for the prevention and treatment of heart failure.
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Affiliation(s)
- Zeyu Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Zhihua Yang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shuai Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
| | - Xianliang Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
| | - Jingyuan Mao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China.
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Hu W, Luo L, Li M, Xiong X, Huang W, Huang Y, Sun J, Ding H, Yu H. Anti-inflammatory diet reduces risk of metabolic dysfunction-associated fatty liver disease among US adults: a nationwide survey. Scand J Gastroenterol 2024; 59:1192-1201. [PMID: 39215699 DOI: 10.1080/00365521.2024.2395851] [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: 04/08/2024] [Revised: 08/12/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND While dietary intervention was an important public health strategy for the prevention and intervention of metabolic dysfunction-associated fatty liver disease (MAFLD), the effect of diet-induced inflammation on MAFLD has not been studied in detail. Therefore, we aimed to analyze the relationship between dietary inflammatory index (DII) and MAFLD. METHODS This study included data from the National Health and Nutrition Examination Survey 2017-2018. MAFLD was diagnosed based on the presence of hepatic steatosis, as determined by transient elastography, along with evidence of either overweight/obesity, type 2 diabetes mellitus, or metabolic dysfunction. DII was calculated using 27 dietary components collected through 24-hour dietary recall questionnaire. Weighted logistic regression was used to analyze the relationship between DII and MAFLD and its main components in three different models. Subgroup analyses were performed by age, sex, and alcohol use. RESULTS A total of 1991 participants were included, and the MAFLD group had higher DII scores. After adjusting for age, sex, race, physical activity, smoking status, and alcohol use, the highest quartile of DII was associated with increased risk of MAFLD (OR:2.90, 95% CIs: 1.46, 5.75). Overweight/obesity, central obesity, low high density lipoprotein cholesterol (HDL-C) and high C-reactive protein (CRP) also shared the same characteristics in the main components of MAFLD. Results were consistent across subgroups (age, sex, and alcohol use). CONCLUSIONS A higher DII diet was positively associated with the risk of MAFLD in American adults, particularly as related to overweight/obesity, central obesity, high CRP level, and low HDL-C level.
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Affiliation(s)
- Wei Hu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Dongguan, China
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ling Luo
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingzi Li
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xi Xiong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Wenlong Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yanfang Huang
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jianbo Sun
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
| | - Haifeng Ding
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
| | - Haibing Yu
- The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, China
- The First Dongguan Affiliated Hospital, Guangdong Medical University; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Dongguan, China
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
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Tummoszeit IZ, Olofsson IA, Chalmer MA, Henriksen AP, Aagaard B, Brunak S, Bruun MT, Didriksen M, Erikstrup C, Hjalgrim H, Mikkelsen C, Mikkelsen S, Ostrowski SR, Pedersen OBV, Quinn L, Sørensen E, Ullum H, Olesen J, Banasik K, Hansen TF, Kogelman LJA. No association between migraine and HLA alleles in a cohort of 13,210 individuals with migraine from the Danish Blood Donor Study. Headache 2024. [PMID: 39352055 DOI: 10.1111/head.14784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 10/03/2024]
Abstract
OBJECTIVE To determine the association between human leukocyte antigen (HLA) alleles and migraine, migraine subtypes, and sex-specific factors. BACKGROUND It has long been hypothesized that inflammation contributes to migraine pathophysiology. This study examined the association between migraine and alleles in the HLA system, a key player in immune response and genetic diversity. METHODS We performed a case-control study and included 13,210 individuals with migraine and 86,738 controls. All participants were part of the Danish Blood Donor Study Genomic Cohort. Participants were genotyped and 111 HLA alleles on 15 HLA genes were imputed. We examined the association between HLA alleles and migraine subtypes, considering sex-specific differences. RESULTS We found no association between HLA alleles and migraine, neither overall, nor in the sex-specific analysis. In the migraine subtype analysis, three HLA alleles were associated with migraine without aura; however, these associations could not be replicated in an independent Icelandic cohort (2191 individuals with migraine without aura and 278,858 controls). Furthermore, we found no association between HLA alleles and migraine with aura or chronic migraine. CONCLUSION We found no evidence of an association between the HLA system and migraine, suggesting that genetic factors related to the HLA system do not play a significant role in migraine susceptibility.
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Affiliation(s)
- Inga Zalia Tummoszeit
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
| | - Isa Amalie Olofsson
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
- Department of Cellular and Molecular Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mona Ameri Chalmer
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
| | - Alexander Pil Henriksen
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bitten Aagaard
- Department of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mie Topholm Bruun
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
| | - Maria Didriksen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Hjalgrim
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Institute, Copenhagen, Denmark
- Department of Haematology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christina Mikkelsen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ole Birger Vesterager Pedersen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Liam Quinn
- Department of Clinical Immunology, Zealand University Hospital, Køge, Denmark
| | - Erik Sørensen
- Department of Clinical Immunology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Jes Olesen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
| | - Karina Banasik
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynecology and Obstetrics, Hvidovre University Hospital, Copenhagen, Denmark
| | - Thomas Folkmann Hansen
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisette J A Kogelman
- Danish Headache Center, Department of Neurology, Copenhagen University Hospital, Glostrup, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Polemiti E, Hese S, Schepanski K, Yuan J, Schumann G. How does the macroenvironment influence brain and behaviour-a review of current status and future perspectives. Mol Psychiatry 2024; 29:3268-3286. [PMID: 38658771 DOI: 10.1038/s41380-024-02557-x] [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] [Received: 07/07/2023] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024]
Abstract
The environment influences brain and mental health, both detrimentally and beneficially. Existing research has emphasised the individual psychosocial 'microenvironment'. Less attention has been paid to 'macroenvironmental' challenges, including climate change, pollution, urbanicity, and socioeconomic disparity. Notably, the implications of climate and pollution on brain and mental health have only recently gained prominence. With the advent of large-scale big-data cohorts and an increasingly dense mapping of macroenvironmental parameters, we are now in a position to characterise the relation between macroenvironment, brain, and behaviour across different geographic and cultural locations globally. This review synthesises findings from recent epidemiological and neuroimaging studies, aiming to provide a comprehensive overview of the existing evidence between the macroenvironment and the structure and functions of the brain, with a particular emphasis on its implications for mental illness. We discuss putative underlying mechanisms and address the most common exposures of the macroenvironment. Finally, we identify critical areas for future research to enhance our understanding of the aetiology of mental illness and to inform effective interventions for healthier environments and mental health promotion.
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Affiliation(s)
- Elli Polemiti
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience CCM, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Sören Hese
- Institute of Geography, Friedrich Schiller University Jena, Jena, Germany
| | | | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences & CMA-FDU Joint Laboratory of Marine Meteorology & IRDR-ICOE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Gunter Schumann
- Centre of Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Clinical Neuroscience CCM, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China.
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Paterson KL, Metcalf BR, Campbell PK, Bennell KL, Li P, De Silva AP, Hinman RS. Associations between static foot posture, dynamic in-shoe plantar foot forces and knee pain in people with medial knee osteoarthritis: A cross-sectional exploratory study. Osteoarthritis Cartilage 2024; 32:1339-1345. [PMID: 38986834 DOI: 10.1016/j.joca.2024.04.023] [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: 10/24/2023] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 07/12/2024]
Abstract
OBJECTIVE To investigate relationships between static foot posture, dynamic plantar foot forces and knee pain in people with medial knee osteoarthritis (OA). DESIGN Data from 164 participants with symptomatic, moderate to severe radiographic medial knee OA were analysed. Knee pain was self-reported using a numerical rating scale (NRS; scores 0-10; higher scores worse) and the Knee Injury and Osteoarthritis Outcome Score pain subscale (KOOS; scores 0-100; lower scores worse). Static foot posture was assessed using clinical tests (foot posture index, foot mobility magnitude, navicular drop). Dynamic plantar foot forces (lateral, medial, whole foot, medial-lateral ratio, arch index) were measured using an in-shoe plantar pressure system while walking. Relationships between foot posture and plantar forces (independent variables) and pain (dependent variables) were evaluated using linear regression models, unadjusted and adjusted for sex, walking speed, Kellgren & Lawrence grade, shoe category, and body mass (for dynamic plantar foot forces). RESULTS No measure of static foot posture was associated with any knee pain measure. Higher medial-lateral foot force ratio at midstance, and a higher arch index during overall stance, were weakly associated with higher knee pain on the NRS (regression coefficient = 0.69, 95% confidence interval (CI) 0.09 to 1.28) and KOOS (coefficient=3.03, 95% CI 0.71 to 5.35) pain scales, respectively. CONCLUSION Dynamic plantar foot forces, but not static foot posture, were associated with knee pain in people with medial knee OA. However, the amount of pain explained by increases in plantar foot force was small; thus, these associations are unlikely to be clinically meaningful.
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Affiliation(s)
- Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia.
| | - Ben R Metcalf
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Penny K Campbell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
| | - Peixuan Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Anurika P De Silva
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Methods and Implementation Support for Clinical and Health Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Melbourne, Australia
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179
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Zhang Y, Jia X, Yang Y, Sun N, Shi S, Wang W. Change in the global burden of depression from 1990-2019 and its prediction for 2030. J Psychiatr Res 2024; 178:16-22. [PMID: 39106579 DOI: 10.1016/j.jpsychires.2024.07.054] [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: 04/18/2024] [Revised: 07/25/2024] [Accepted: 07/31/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVE Depression is a global health challenge, but only a few studies have fully assessed and predicted the disease burden. This study described the trend of global depression burden from 1990 to 2019 through age-standardized incidence rate (ASIR), age-standardized disability-adjusted life rate (ASDR), and predicted the number of cases of depression during 2020-2030. METHODS Linear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. The trends of global depression burden from 1990 to 2019 were analyzed by age, sex, and socio-demographic index (SDI) across various regions. Finally, we used the Bayesian age-period-cohort (BAPC) model to predict the disease burden in the coming 10 years. RESULTS Globally, the ASIR of depression decreased from 3681.24 per 100,000 population in 1990 to 3588.25 per 100,000 population in 2019 and the EAPC was -0.29%. ASDR also decreased, following a similar trend as the ASIR. The highest ASDR was observed in adults aged 60-64 years. The burden of depressive illness was higher in women, with the greatest increase in incidence in low SDI areas. BAPC predicted that the worldwide ASIR and ASDR of depression would stabilize from 2020 to 2030, with an increasing number of cases. By 2030, the ASIR was estimated to be 2519.88 per 100,000 men and 3835.11 per 100,000 women. CONCLUSION From 1990 to 2019, the global burden of depression remained significant, especially among women. It is important to address depression in older people, and it is therefore necessary to develop measures for prevention.
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Affiliation(s)
- Ying Zhang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Xiaocan Jia
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Yongli Yang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Na Sun
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Shuyan Shi
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Wei Wang
- Department of Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China; Henan Medical Association, Zhengzhou, 450003, China.
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180
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Lu M, Feng R, Li M, Liu L, Xiao Y, Liu Y, Yin C. Causal relationship between gut microbiota and childhood obesity: A Mendelian randomization study and case-control study. Clin Nutr ESPEN 2024; 63:197-206. [PMID: 38963766 DOI: 10.1016/j.clnesp.2024.05.012] [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: 12/03/2023] [Revised: 03/28/2024] [Accepted: 05/17/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Gut microbiota and obesity are deeply interconnected. However, the causality in the relationship between these factors remains unclear. Therefore, this study aimed to elucidate the genetic relationship between gut microbiota and childhood obesity. METHODS Genetic summary statistics for the gut microbiota were obtained from the MiBioGen consortium. Genome-wide association studies (GWAS) summary data for childhood obesity were obtained from North American, Australian, and European collaborative genome-wide meta-analyses. Mendelian randomization (MR) analyses were performed using the inverse variance weighting method. 16 children with obesity and 16 without obesity were included for clinical observation, and their weight, body mass index, blood lipid levels, and gut microbiology were assessed. Paired t-test was the primary method of data analysis, and statistical significance was set at P < 0.05. RESULTS MR identified 16 causal relationships between the gut microbiome and childhood obesity. In the case-control study, we found that five gut microorganisms differed between children with and without obesity, whereas three gut microorganisms changed after weight loss in children with obesity. CONCLUSION Our study provides new insights into the genetic mechanisms underlying gut microbiota and childhood obesity. TRIAL REGISTRATION NUMBER ChiCTR2300072179. NAME OF REGISTRY Change of intestinal flora and plasma metabolome in obese children and their weight loss intervention: a randomized controlled tria URL OF REGISTRY: https://www.chictr.org.cn/showproj.html. DATE OF REGISTRATION 2023-06-06. DATE OF ENROLMENT OF THE FIRST PARTICIPANT TO THE TRIAL 2023-06-07.
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Affiliation(s)
- Mengnan Lu
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China
| | - Ruoyang Feng
- Department of Joint Surgery, Xi'an Jiaotong University HongHui Hospital, Xi'an, Shanxi, 710054, China
| | - Meng Li
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China
| | - Lujie Liu
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China
| | - Yanfeng Xiao
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China.
| | - Yuesheng Liu
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China.
| | - Chunyan Yin
- Department of Pediatrics, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, Shanxi, 710054, China.
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181
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Sun Z, Huang S, Li W, Yang Y, Wu Y, Ma X, Nie X, Jin W, Liu C, Li X, Xu Y, Dong J, Liao Y, Sun B, Han W, Zhao Q, Chi H, Wang Y, Liu L, Zhang M. Preoperative and intraoperative tirofiban during endovascular thrombectomy in large vessel occlusion stroke due to large artery atherosclerosis. Eur J Neurol 2024; 31:e16419. [PMID: 39072930 DOI: 10.1111/ene.16419] [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: 05/27/2024] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND AND PURPOSE The aim of this study is to investigate the efficacy and safety of preoperative versus intraoperative tirofiban in patients with large vessel occlusion (LVO) due to large artery atherosclerosis (LAA). METHODS This is a retrospective multicenter cohort study based on the RESCUE-RE (Registration Study for Critical Care of Acute Ischemic Stroke After Recanalization) trial enrolling patients with anterior circulation LVO classified as LAA within 24 h of onset. Patients were divided into three groups: preoperative tirofiban (PT), intraoperative tirofiban (IT), and no tirofiban (NT). Propensity score matching (PSM) was used to balance baseline characteristics. The efficacy outcomes included 90-day functional independence (modified Rankin Scale score = 0-2) and early partial recanalization (EPR; defined as a modified Thrombolysis in Cerebral Infarction score = 1-2a). The safety outcomes included symptomatic intracranial hemorrhage (sICH). RESULTS A total of 104 matched triplets were obtained through PSM. Compared with NT, PT increased 90-day functional independence (60.8% vs. 42.3%, p = 0.008) and EPR (42.7% vs. 18.3%, p < 0.001) rate, with a tendency to increase the asymptomatic intracranial hemorrhage (aICH) proportion (28.8% vs. 18.3%, p = 0.072). Compared with IT, PT had a higher 90-day functional independence (60.8% vs. 45.2%, p = 0.025) and EPR (42.7% vs. 20.2%, p = 0.001) rate, with no significant difference in sICH (14.4% vs. 7.7%, p = 0.122) and aICH (28.8% vs. 21.2%, p = 0.200). Compared with NT, IT had a lower 90-day mortality rate (9.6% vs. 24.0%, p = 0.005). CONCLUSIONS Tirofiban shows good adjuvant therapy potential in acute ischemic stroke-LVO due to LAA patients. PT is associated with higher rates of EPR and better therapeutic efficacy. In addition, EPR may be a potential way to improve prognosis.
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Affiliation(s)
- Zhiqiang Sun
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Shuhan Huang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
- Department of Neurology, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Li
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yi Yang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ya Wu
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xue Ma
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ximing Nie
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Wangsheng Jin
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Chengchun Liu
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xiaoshu Li
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yaning Xu
- Department of Neurology, 985 Hospital of Joint Logistics Support Force, Taiyuan, China
| | - Jun Dong
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yisi Liao
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Binlu Sun
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Wenjun Han
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Qing Zhao
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Huaqiao Chi
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yanjiang Wang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Meng Zhang
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
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Li Z, Liu X, Wen J, Wang Z, Xie Y, Zhu L, Wu X, Fang C, Tian Y, Li Q. Genetically proxied appendicular lean mass and stroke risk: A two-step mendelian randomization study. J Stroke Cerebrovasc Dis 2024; 33:107915. [PMID: 39098364 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107915] [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: 11/18/2023] [Revised: 07/30/2024] [Accepted: 08/01/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND AND PURPOSE Prior observational studies have suggested a strong correlation between sarcopenia and stroke, but the causal link between them remains uncertain. This study aims to investigate the associations between genetically predicted sarcopenia-related traits and stroke using a two-step Mendelian randomization (MR) approach. METHODS Genome-wide association study (GWAS) summary data for sarcopenia-related traits were acquired from the UK Biobank. Genetic associations for ischemic stroke (IS) and its subtypes were selected from the MEGASTROKE consortium comprising European ancestry participants. GWAS summary data for cerebral hemorrhage were obtained from the FinnGen consortium, including intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). MR estimates were calculated using the inverse-variance weighted (IVW) method. The robustness of results was assessed for heterogeneity and pleiotropy of individual single nucleotide polymorphisms (SNPs). RESULTS Higher appendicular lean mass (ALM) exhibited a potential causal association with a reduced incidence of large artery atherosclerosis (LAA) (odds ratio [OR] = 0.81, 95% confidence interval [CI]:0.71-0.93; P = 0.003) and small vessel disease (SVD) (OR = 0.83, 95% CI:0.74-0.94; P = 0.002). The associations of ALM with IS and ICH were compromised after adjusting for body fat and physical activity with multivariable MR. Two-step MR mediation analysis explored 33 candidate mediators, among which hypertension and SBP accounted for more than 10% of the mediation proportion in the relationship between ALM and stroke and its subtypes. CONCLUSION Our research findings indicate that lower ALM is associated with a increased risk of stroke . It is necessary to explore the specific protective mechanisms of higher ALM for preventing stroke occurrence.
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Affiliation(s)
- Zhiming Li
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Xueyun Liu
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Jianshang Wen
- Department of Neurology, Shucheng People's Hospital, Lu'an 231300, Anhui, China.
| | - Zijie Wang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Yanfang Xie
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Lei Zhu
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Xiaosan Wu
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Chuanqin Fang
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Yanghua Tian
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China.
| | - Qi Li
- Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601, Anhui, China; Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Wang A, Zhai Y, Zhang J, Che B, Zheng X, Peng Y, Xu T, He J, Zhang Y, Zhong C. Serum Soluble Corin and Long-Term Clinical Outcomes After Acute Ischemic Stroke. J Am Heart Assoc 2024; 13:e035075. [PMID: 39291499 DOI: 10.1161/jaha.123.035075] [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: 03/22/2024] [Accepted: 08/15/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Corin plays important roles in the regulation of blood volume and pressure and cardiac function by activating natriuretic peptide pathway, exerting multiple cardioprotective effects. But the impacts of soluble corin on clinical outcomes after ischemic stroke are unclear. We aimed to investigate the associations between serum soluble corin and long-term clinical outcomes after acute ischemic stroke. METHODS AND RESULTS We measured the concentrations of serum soluble corin in 3162 participants (2010 men and 1152 women) from the China Antihypertensive Trial in Acute Ischemic Stroke. The clinical outcomes were recurrent stroke, cardiovascular events, all-cause mortality, and unfavorable functional outcome within 24 months after stroke. Risk reclassification for study clinical outcomes of models with soluble corin were evaluated. Serum soluble corin was inversely associated with recurrent stroke, cardiovascular events, and unfavorable functional outcome after ischemic stroke. After adjusting for multiple covariates, each additional SD of log-corin was associated with a 21% (95% CI, 11-30), 16% (95% CI, 6-26), and 12% (95% CI, 3-21) decreased risk for recurrent stroke, cardiovascular events, and unfavorable functional outcome, respectively. Furthermore, the addition of soluble corin to the basic model with conventional risk factors significantly improved risk discrimination for recurrent stroke, cardiovascular events, and the composite outcome of all-cause mortality and cardiovascular events, as shown by C-statistics (all P<0.05). CONCLUSIONS Serum soluble corin was associated with decreased risks of long-term clinical outcomes, and may be a promising prognostic biomarker for risk stratification in patients with acute ischemic stroke.
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Affiliation(s)
- Aili Wang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
| | - Yujia Zhai
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
| | - Jin Zhang
- Suzhou Industrial Park Centers for Disease Control and Prevention Suzhou China
| | - Bizhong Che
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
| | - Xiaowei Zheng
- Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University Wuxi Jiangsu China
| | - Yanbo Peng
- Department of Neurology Affiliated Hospital of North China University of Science and Technology Tangshan China
| | - Tan Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
| | - Jiang He
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
- Department of Medicine Tulane University School of Medicine New Orleans LA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology Suzhou Medical College of Soochow University Suzhou China
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Harryvan TJ, Schaftenaar E, Franssens BT, Melles DC, Rentenaar RJ. EUCAST ciprofloxacin area of technical uncertainty in Escherichia coli and Klebsiella pneumoniae using BD Phoenix™ and VITEK® 2 automated susceptibility systems. J Antimicrob Chemother 2024; 79:2718-2719. [PMID: 39011864 PMCID: PMC11441992 DOI: 10.1093/jac/dkae245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Affiliation(s)
- T J Harryvan
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - E Schaftenaar
- Department of Medical Microbiology and Immunology, St Antonius Hospital, Utrecht/Nieuwegein, The Netherlands
| | - B T Franssens
- Department of Medical Microbiology, St Jansdal Hospital, Harderwijk, The Netherlands
| | - D C Melles
- Department of Medical Microbiology and Medical Immunology, Meander Medical Centre, Amersfoort, The Netherlands
| | - R J Rentenaar
- Department of Medical Microbiology, University Medical Centre Utrecht, Utrecht, The Netherlands
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185
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Jiang N, Gelfond J, Liu Q, Strong R, Nelson JF. The Gehan test identifies life-extending compounds overlooked by the log-rank test in the NIA Interventions Testing Program: Metformin, Enalapril, caffeic acid phenethyl ester, green tea extract, and 17-dimethylaminoethylamino-17-demethoxygeldanamycin hydrochloride. GeroScience 2024; 46:4533-4541. [PMID: 38630424 PMCID: PMC11335987 DOI: 10.1007/s11357-024-01161-9] [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: 02/17/2024] [Accepted: 04/10/2024] [Indexed: 05/08/2024] Open
Abstract
The National Institute on Aging Interventions Testing Program (ITP) has so far identified 12 compounds that extend the lifespan of genetically heterogeneous mice using the log-rank test. However, the log-rank test is relatively insensitive to any compound that does not uniformly reduce mortality across the lifespan. This test may thus miss compounds that only reduce mortality before midlife, for example, a plausible outcome if a compound only mitigates risk factors before midlife or if its efficacy is reduced at later ages. We therefore reanalyzed all data collected by the ITP from 2004-2022 using the Gehan test, which is more sensitive to mortality differences earlier in the life course and does not assume a uniformly reduced mortality hazard across the lifespan. The Gehan test identified 5 additional compounds, metformin, enalapril, 17-dimethylaminoethylamino-17-demethoxygeldanamycin hydrochloride (17-DMAG), caffeic acid phenethyl ester (CAPE), and green tea extract (GTE), which significantly increased survival but were previously missed by the log-rank test. Three (metformin, enalapril, and 17-DMAG) were only effective in males and two (CAPE and GTE) were only effective in females. In addition, 1,3-butanediol, which by log-rank analysis increased survival in females but not males, increased survival in males by the Gehan test. These results suggest that statistical tests sensitive to non-uniformity of drug efficacy across the lifespan should be included in the standard statistical testing protocol to minimize overlooking geroprotective interventions.
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Affiliation(s)
- Nisi Jiang
- The Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
- Department of Cellular and Integrative Physiology, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
| | - Jonathan Gelfond
- The Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
- Department of Population Health Sciences, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
| | - Qianqian Liu
- Department of Population Health Sciences, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
| | - Randy Strong
- The Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
- Department of Pharmacology, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A
- Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, TX, U.S.A
| | - James F Nelson
- The Sam and Ann Barshop Institute for Longevity and Aging Studies, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A..
- Department of Cellular and Integrative Physiology, UT Health San Antonio; San Antonio, San Antonio, TX, U.S.A..
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186
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Lu B, Luo J, Yan Y, Zhang Y, Luo C, Li N, Zhou Y, Wu D, Dai M, Chen H. Evaluation of long-term benefits and cost-effectiveness of nation-wide colorectal cancer screening strategies in China in 2020-2060: a modelling analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 51:101172. [PMID: 39247209 PMCID: PMC11380381 DOI: 10.1016/j.lanwpc.2024.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/22/2024] [Accepted: 08/01/2024] [Indexed: 09/10/2024]
Abstract
Background Evidence on the long-term benefits and cost-effectiveness of colorectal cancer (CRC) screening strategies in China remains limited. This modelling study aims to address this issue for various CRC screening strategies in China between 2020 and 2060. Methods Using a previously developed microsimulation model (MIMIC-CRC) with Chinese epidemiological data, we evaluated four CRC screening strategies targeting population aged 45-74 years: no screening, colonoscopy every 10 years, biennial faecal immunochemical testing (FIT), and a roll-out FIT screening strategy. Screening coverage (invitation) rates from 5% to 100% were analysed. Single-cohort analysis of 100,000 individuals was conducted to estimate the relative cost-effectiveness of each strategy. A multiple-cohort analysis of 100,000 people aged 40+ over 2020-2060 was conducted to project nation-wide long-term benefits and cost-effectiveness. Findings In single-cohort analysis, all strategies yielded reductions in CRC incidence and mortality compared to no screening, with colonoscopy outperforming FIT-based strategies at the same invitation rates. In multiple-cohort analysis, among people over 40 years of age in China over 2020-2060, compared to no screening, at invitation rate of 5%, screening by colonoscopy, biennial FIT and roll-out FIT-based approach were estimated to avert 1.2, 0.4, and 0.3 million incident CRCs and 0.2, 0.1, and 0.1 million CRC-related deaths, respectively, compared to no screening (25.4 million incident CRCs and 4.4 million CRC-related deaths), and this preventive effect enlarged as the screening coverage rate increased. At full coverage, colonoscopy achieved the largest reductions (38.2% lower incidence and 43.2% lower mortality) but required the most resources. Biennial FIT and roll-out FIT-based approach screening was slightly less effective but had significant reduced colonoscopy needs (reduction of 83.8% and 85.2%, respectively) and overall cost (reduction of 23.4% and 37.8%, respectively) compared to colonoscopy screening. Interpretation Nation-wide implementation of screening would be effective in reducing the burden of CRC in China. Biennial FIT and roll-out FIT-based screening strategies could prevent incident CRC cases and CRC-related deaths with considerably fewer resources than colonoscopy screening. Efforts should be made to increase the screening coverage in China. Funding Chinese Academy of Medical Science Innovation Fund for Medical Science (2022-I2M-1-0031); National Natural Science Foundation of China (82173606; 82273726); Beijing Nova Program of Science and Technology (20230484397).
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Affiliation(s)
- Bin Lu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jiahui Luo
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yike Yan
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yuhan Zhang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Chenyu Luo
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Na Li
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yueyang Zhou
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dong Wu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Min Dai
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongda Chen
- Center for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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187
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Qiu W, Cai A, Nie Z, Wang J, Ou Y, Feng Y. Age and sex differences in the impact of common comorbidities on stroke and myocardial infarction: results from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project. Public Health 2024; 235:119-127. [PMID: 39096776 DOI: 10.1016/j.puhe.2024.06.005] [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: 12/14/2023] [Revised: 05/15/2024] [Accepted: 06/05/2024] [Indexed: 08/05/2024]
Abstract
OBJECTIVES This study aims to evaluate the age- and sex-specific associations of comorbidities with stroke and MI and further calculate the population-attributable fractions (PAFs) of five comorbid diseases for stroke and myocardial infarction (MI) by age and sex. STUDY DESIGN This is a prospective cohort study. METHODS This study leveraged data from a sub-cohort of the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project. Participants aged 35-75 years without a prevalent stroke and MI were enrolled from January 2016 to December 2020, with follow-up through December 2021. Five common comorbidities were collected at baseline, and the study outcome was hospitalization for stroke and MI identified from the Inpatients Registry. RESULTS Of 100,873 participants, the mean age was 54.2 (±10.2) years, 34.2% were ≥60 years old, and 60.8% were women. After a median follow-up of 3.52 years, 4156 participants had stroke/MI. The strengths of the associations between hypertension, diabetes, and obesity with stroke/MI were higher in younger individuals than in seniors, and obesity had a more hazardous impact on stroke/MI in men than in women. The five comorbidities collectively explained a higher population attributable fraction (PAF) for stroke/MI in the young group (51.5[46.9, 55.7] %) than in the senior group (41.3[37.0, 45.4] %), in men (45.6[40.9, 49.9] %) than in women (41.1[36.1, 45.7] %). CONCLUSIONS Most of the common comorbidities were significantly associated with stroke and MI. Several age and sex differences in the impacts of comorbidities on stroke/MI were observed, highlighting the importance of age- and sex-specific preventive strategies to reduce premature stroke and MI.
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Affiliation(s)
- W Qiu
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - A Cai
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Z Nie
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China; Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - J Wang
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Y Ou
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Y Feng
- Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
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188
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Beşler MS, Karadenizli MB, Ökten RS. A novel imaging biomarker for prediction of cerebrovascular ischemic events: Pericarotid fat density. Am J Emerg Med 2024; 84:130-134. [PMID: 39116673 DOI: 10.1016/j.ajem.2024.08.004] [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: 04/25/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND To investigate the relationship between pericarotid fat density measured in carotid CTA and vulnerable carotid plaque. METHODS This retrospective study included 374 participants who underwent carotid CTA between June 1, 2021, and December 1, 2021 (234 males, median age 68 years [interquartile range: 61-75]). Two groups, symptomatic and asymptomatic, were defined based on either diffusion-weighted MRI or a clinical history of acute ischemia or TIA within 6 months before or after CTA. The relationship between pericarotid fat density and cerebrovascular ischemic events was assessed using receiver operating characteristic analysis and binary logistic regression analysis. RESULTS In the symptomatic group (n = 135), mean pericarotid fat density (-63.3 ± 21.7 vs. -81.7 ± 16.9 HU, respectively; p < 0.001) and median maximum plaque thickness (4 [interquartile range: 3-6] vs. 3.7 [interquartile range: 2.6-4.7] mm, respectively; p = 0.002) were higher, while plaque density (42.1 ± 19.6 vs. 50.6 ± 20.4 HU, respectively; p = 0.001) was lower compared to the asymptomatic group. Pericarotid fat density (OR: 1.038, 95% CI: 1.023-1.053, p < 0.001) was identified as an independent predictor for symptomatic patients. The optimal cut-off value for pericarotid fat density predicting symptomatic patients was estimated as -74 HU (area under the curve: 0.753, 95% CI:0.699-0.808, p < 0.001). Inter-reader agreement for pericarotid fat density was found to be almost perfect (intraclass correlation coefficient: 0.818, 95% CI: 0.770-0.856, p < 0.001). CONCLUSION Pericarotid fat density may serve as an imaging biomarker in predicting acute cerebrovascular ischemic events.
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Affiliation(s)
- Muhammed Said Beşler
- Department of Radiology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Türkiye.
| | | | - Rıza Sarper Ökten
- Department of Radiology, Ankara Bilkent City Hospital, Ankara, Türkiye
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189
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Cocker D, Birgand G, Zhu N, Rodriguez-Manzano J, Ahmad R, Jambo K, Levin AS, Holmes A. Healthcare as a driver, reservoir and amplifier of antimicrobial resistance: opportunities for interventions. Nat Rev Microbiol 2024; 22:636-649. [PMID: 39048837 DOI: 10.1038/s41579-024-01076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/27/2024]
Abstract
Antimicrobial resistance (AMR) is a global health challenge that threatens humans, animals and the environment. Evidence is emerging for a role of healthcare infrastructure, environments and patient pathways in promoting and maintaining AMR via direct and indirect mechanisms. Advances in vaccination and monoclonal antibody therapies together with integrated surveillance, rapid diagnostics, targeted antimicrobial therapy and infection control measures offer opportunities to address healthcare-associated AMR risks more effectively. Additionally, innovations in artificial intelligence, data linkage and intelligent systems can be used to better predict and reduce AMR and improve healthcare resilience. In this Review, we examine the mechanisms by which healthcare functions as a driver, reservoir and amplifier of AMR, contextualized within a One Health framework. We also explore the opportunities and innovative solutions that can be used to combat AMR throughout the patient journey. We provide a perspective on the current evidence for the effectiveness of interventions designed to mitigate healthcare-associated AMR and promote healthcare resilience within high-income and resource-limited settings, as well as the challenges associated with their implementation.
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Affiliation(s)
- Derek Cocker
- David Price Evans Infectious Diseases & Global Health Group, University of Liverpool, Liverpool, UK
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
| | - Gabriel Birgand
- Centre d'appui pour la Prévention des Infections Associées aux Soins, Nantes, France
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
- Cibles et medicaments des infections et de l'immunitée, IICiMed, Nantes Universite, Nantes, France
| | - Nina Zhu
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
- Department of Infectious Disease, Imperial College London, London, UK
| | - Jesus Rodriguez-Manzano
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
- Department of Infectious Disease, Imperial College London, London, UK
| | - Raheelah Ahmad
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK
- Department of Health Services Research & Management, City University of London, London, UK
- Dow University of Health Sciences, Karachi, Pakistan
| | - Kondwani Jambo
- Malawi-Liverpool-Wellcome Research Programme, Blantyre, Malawi
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Anna S Levin
- Department of Infectious Disease, School of Medicine & Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
| | - Alison Holmes
- David Price Evans Infectious Diseases & Global Health Group, University of Liverpool, Liverpool, UK.
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, London, UK.
- Department of Infectious Disease, Imperial College London, London, UK.
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Thompson SL, Lindgren A, McDermott J, Barnes SG, Tennyson CD, Granger B. Impact and Sustainability of a Palliative Care Education Module in Patients With Heart Failure. Am J Hosp Palliat Care 2024; 41:1132-1137. [PMID: 38048776 DOI: 10.1177/10499091231220255] [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: 12/06/2023] Open
Abstract
BACKGROUND Approximately 6.7 million American adults are living with heart failure (HF). Current therapies are geared toward preventing progression and managing symptoms, as there is no cure. Multiple studies have shown the benefit of including palliative care (PC) in patients with HF to improve symptoms and quality of life. Heart failure guidelines recommend the inclusion of PC in therapy, but referrals are often delayed. A previous pilot project demonstrated increased involvement of PC when targeted education was given to patients with HF. OBJECTIVE Educate patients with HF on PC and examine the impact on PC consults, readmission, mortality, intensive care unit (ICU) transfers and evaluate sustainability of the intervention. METHODS Patients (n = 124) admitted to an academic hospital with a diagnosis of HF were asked to view an educational module on PC. Patients who completed the module were placed in the intervention group (n = 39). Patients who declined were placed in the usual care group (n = 38). The number of PC consults, re-admissions, mortality, and transfers to the ICU were compared among participants and those who declined. Results were compared to previous pilot project. RESULTS Eleven patients in the intervention group (IG) requested a PC consult vs one in the usual care group (UCG) (P = .006). There was no statistically significant difference in readmissions, mortality, or ICU transfers between groups. CONCLUSIONS This sustainable project again demonstrated education on PC increases utilization of PC but does not statistically impact mortality, re-admissions, or transfers to higher levels of care.
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191
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Costa V, Gianlorenço AC, Andrade MF, Camargo L, Menacho M, Arias Avila M, Pacheco-Barrios K, Choi H, Song JJ, Fregni F. Transcutaneous vagus nerve stimulation effects on chronic pain: systematic review and meta-analysis. Pain Rep 2024; 9:e1171. [PMID: 39131814 PMCID: PMC11309651 DOI: 10.1097/pr9.0000000000001171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 08/13/2024] Open
Abstract
Chronic pain is one of the major causes of disability with a tremendous impact on an individual's quality of life and on public health. Transcutaneous vagus nerve stimulation (tVNS) is a safe therapeutic for this condition. We aimed to evaluate its effects in adults with chronic pain. A comprehensive search was performed, including randomized controlled trials published until October 2023, which assessed the effects of noninvasive tVNS. Cohen's d effect size and 95% confidence intervals (CIs) were calculated, and random-effects meta-analyses were performed. Fifteen studies were included. The results revealed a mean effect size of 0.41 (95% CI 0.17-0.66) in favor of tVNS as compared with control, although a significant heterogeneity was observed (χ2 = 21.7, df = 10, P = 0.02, I 2 = 53.9%). However, when compared with nonactive controls, tVNS shows a larger effect size (0.79, 95% CI 0.25-1.33), although the number of studies was small (n = 3). When analyzed separately, auricular tVNS and cervical tVNS against control, it shows a significant small to moderate effect size, similar to that of the main analysis, respectively, 0.42 (95% CI 0.08-0.76, 8 studies) and 0.36 (95% CI 0.01-0.70, 3 studies). No differences were observed in the number of migraine days for the trials on migraine. This meta-analysis indicates that tVNS shows promise as an effective intervention for managing pain intensity in chronic pain conditions. We discuss the design of future trials to confirm these preliminary results, including sample size and parameters of stimulation.
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Affiliation(s)
- Valton Costa
- Neurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna Carolyna Gianlorenço
- Neurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Maria Fernanda Andrade
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lucas Camargo
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Maryela Menacho
- Neurosciences Laboratory, Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mariana Arias Avila
- Study Group on Chronic Pain (NEDoC), Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Federal University of Sao Carlos, Sao Carlos, SP, Brazil
| | - Kevin Pacheco-Barrios
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Hyuk Choi
- Department of Medical Sciences, Graduate School of Medicine, Korea University, Seoul, South Korea
- Neurive Co, Ltd, Gimhae, South Korea
| | - Jae-Jun Song
- Neurive Co, Ltd, Gimhae, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Seoul, South Korea
| | - Felipe Fregni
- Spaulding Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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192
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Chachlaki K, Duc KL, Storme L, Prévot V. Novel insights into minipuberty and GnRH: Implications on neurodevelopment, cognition, and COVID-19 therapeutics. J Neuroendocrinol 2024; 36:e13387. [PMID: 38565500 PMCID: PMC7616535 DOI: 10.1111/jne.13387] [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: 01/03/2024] [Revised: 03/18/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
In humans, the first 1000 days of life are pivotal for brain and organism development. Shortly after birth, gonadotropin-releasing hormone (GnRH) neurons in the hypothalamus are activated, a phenomenon known as minipuberty. This phenomenon, observed in all mammals studied, influences the postnatal development of the hypothalamic-pituitary-gonadal (HPG) axis and reproductive function. This review will put into perspective the results of recent studies showing that the impact of minipuberty extends beyond reproductive function, influencing sensory and cognitive maturation. Studies in mice have revealed the role of nitric oxide (NO) in regulating minipuberty amplitude, with NO deficiency linked to cognitive and olfactory deficits. Additionally, findings indicate that cognitive and sensory defects in adulthood in a mouse model of Down syndrome are associated with an age-dependent decline of GnRH production, whose origin can be traced back to minipuberty, and point to the potential therapeutic role of pulsatile GnRH administration in cognitive disorders. Furthermore, this review delves into the repercussions of COVID-19 on GnRH production, emphasizing potential consequences for neurodevelopment and cognitive function in infected individuals. Notably, GnRH neurons appear susceptible to SARS-CoV-2 infection, raising concerns about potential long-term effects on brain development and function. In conclusion, the intricate interplay between GnRH neurons, GnRH release, and the activity of various extrahypothalamic brain circuits reveals an unexpected role for these neuroendocrine neurons in the development and maintenance of sensory and cognitive functions, supplementing their established function in reproduction. Therapeutic interventions targeting the HPG axis, such as inhaled NO therapy in infancy and pulsatile GnRH administration in adults, emerge as promising approaches for addressing neurodevelopmental cognitive disorders and pathological aging.
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Affiliation(s)
- Konstantina Chachlaki
- Univ. Lille, Inserm, CHU Lille, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille Neuroscience & Cognition, UMR_S1172, Lille, France
- Univ. Lille, Inserm, CHU Lille, Hospital-University Federation (FHU) 1000 first days of Life, Lille, France
| | - Kevin Le Duc
- Univ. Lille, Inserm, CHU Lille, Hospital-University Federation (FHU) 1000 first days of Life, Lille, France
- CHU Lille, Neonatology Department, Jeanne de Flandres Hospital, Lille, France
| | - Laurent Storme
- Univ. Lille, Inserm, CHU Lille, Hospital-University Federation (FHU) 1000 first days of Life, Lille, France
- CHU Lille, Neonatology Department, Jeanne de Flandres Hospital, Lille, France
| | - Vincent Prévot
- Univ. Lille, Inserm, CHU Lille, Laboratory of Development and Plasticity of the Neuroendocrine Brain, Lille Neuroscience & Cognition, UMR_S1172, Lille, France
- Univ. Lille, Inserm, CHU Lille, Hospital-University Federation (FHU) 1000 first days of Life, Lille, France
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193
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Du T, Zhang Y, Zha X, Huang Q. Association of SARS-CoV-2 infection during late pregnancy with maternal and neonatal outcomes. BMC Pregnancy Childbirth 2024; 24:632. [PMID: 39354438 PMCID: PMC11446016 DOI: 10.1186/s12884-024-06816-1] [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: 04/23/2024] [Accepted: 09/10/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Limited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy. METHOD This was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed. RESULTS Among 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P < 0.01) and longer duration of hospital stay (6.39 ± 2.2 vs. 4.92 ± 1.6, P < 0.01). However, comparing neonatal complications, including Apgar score, preterm birth, low birth weight, cesarean section rate, newborn hearing, neonatal congenital heart defects, and height and weight compliance rate of 6-month-old children, between non-infected and infected participants did not reach statistical significance. CONCLUSION SARS-CoV-2 infection in late pregnancy has no significant impact on neonatal outcomes. After six months of follow-up of the neonates, we observed that SARS-CoV-2 infection in the third trimester of pregnancy did not affect their growth and development. Hopefully, these findings will guide management strategies and clinical practice.
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Affiliation(s)
- Ting Du
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Yawen Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Xueli Zha
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China
| | - Qin Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China.
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Wen J, Antoniades M, Yang Z, Hwang G, Skampardoni I, Wang R, Davatzikos C. Dimensional Neuroimaging Endophenotypes: Neurobiological Representations of Disease Heterogeneity Through Machine Learning. Biol Psychiatry 2024; 96:564-584. [PMID: 38718880 PMCID: PMC11374488 DOI: 10.1016/j.biopsych.2024.04.017] [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: 01/17/2024] [Revised: 03/29/2024] [Accepted: 04/22/2024] [Indexed: 05/21/2024]
Abstract
Machine learning has been increasingly used to obtain individualized neuroimaging signatures for disease diagnosis, prognosis, and response to treatment in neuropsychiatric and neurodegenerative disorders. Therefore, it has contributed to a better understanding of disease heterogeneity by identifying disease subtypes with different brain phenotypic measures. In this review, we first present a systematic literature overview of studies using machine learning and multimodal magnetic resonance imaging to unravel disease heterogeneity in various neuropsychiatric and neurodegenerative disorders, including Alzheimer's disease, schizophrenia, major depressive disorder, autism spectrum disorder, and multiple sclerosis, as well as their potential in a transdiagnostic framework, where neuroanatomical and neurobiological commonalities were assessed across diagnostic boundaries. Subsequently, we summarize relevant machine learning methodologies and their clinical interpretability. We discuss the potential clinical implications of the current findings and envision future research avenues. Finally, we discuss an emerging paradigm called dimensional neuroimaging endophenotypes. Dimensional neuroimaging endophenotypes dissects the neurobiological heterogeneity of neuropsychiatric and neurodegenerative disorders into low-dimensional yet informative, quantitative brain phenotypic representations, serving as robust intermediate phenotypes (i.e., endophenotypes), presumably reflecting the interplay of underlying genetic, lifestyle, and environmental processes associated with disease etiology.
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Affiliation(s)
- Junhao Wen
- Laboratory of AI and Biomedical Science, University of Southern California, Los Angeles, California.
| | - Mathilde Antoniades
- Artificial Intelligence in Biomedical Imaging Laboratory, Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zhijian Yang
- Artificial Intelligence in Biomedical Imaging Laboratory, Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gyujoon Hwang
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Ioanna Skampardoni
- Artificial Intelligence in Biomedical Imaging Laboratory, Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rongguang Wang
- Artificial Intelligence in Biomedical Imaging Laboratory, Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory, Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
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195
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Bahaa MM, Hegazy SK, Maher MM, Bahgat MM, El-Haggar SM. Pentoxifylline in patients with ulcerative colitis treated with mesalamine by modulation of IL-6/STAT3, ZO-1, and S1P pathways: a randomized controlled double-blinded study. Inflammopharmacology 2024; 32:3247-3258. [PMID: 39192162 DOI: 10.1007/s10787-024-01560-6] [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] [Received: 03/26/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that lasts a long time and has a variety of causes. AIM The primary aim of this study was to evaluate pentoxifylline's (PTX) essential function in patients with UC. METHODS Fifty-two mild to moderate UC patients who matched the eligibility requirements participated in this clinical study. One gram of mesalamine (t.i.d.) and a placebo were administered to the mesalamine group (n = 26) for a duration of 24 weeks. Mesalamine 1 g t.i.d. and PTX 400 mg two times daily were administered to the PTX group (n = 26) for 24 weeks. A gastroenterologist investigated patients at the start and 6 months after the medication was given to assess disease activity index (DAI) and numeric pain rating scale (NRS). Also, interleukin-6 (IL-6), sphingosine 1 phosphate (S1P), tumor necrosis factor-alpha (TNF-α), and fecal myeloperoxidase (MPO) were measured before and after therapy. Zonula occuldin-1 (ZO-1) and signal transducer and activator of transcription factor-3 (STAT-3) expression was assessed before and after therapy as well as histological assessment. Short Form 36 Health Survey (SF-36), was assessed for each patient before and after 6 months of treatment. RESULTS The PTX group showed statistically lower levels of serum SIP, TNF-α, IL-6, faecal MPO, gene expression of STAT-3, and a significant increase of ZO-1 in comparison with the mesalamine group. DAI and NRS significantly decreased whereas SF-36 significantly increased in the PTX group. CONCLUSION PTX could alleviate inflammation in patients with UC, so it might be promising adjunctive for patients with UC. TRIAL REGISTRATION IDENTIFIER NCT05558761.
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Affiliation(s)
- Mostafa M Bahaa
- Pharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, Egypt.
| | - Sahar K Hegazy
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, El-Guiesh Street, El-Gharbia Government, Tanta, 31527, Egypt
| | - Maha M Maher
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Internal Medicine Department, Faculty of Medicine, Horus University, New Damietta, Egypt
| | - Monir M Bahgat
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Internal Medicine Department, Faculty of Medicine, Horus University, New Damietta, Egypt
| | - Sahar M El-Haggar
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, El-Guiesh Street, El-Gharbia Government, Tanta, 31527, Egypt
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196
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Zhao J, Liu S, Li K, Yang Y, Zhao Y, Zhu X. RBM3 Promotes Anti-inflammatory Responses in Microglia and Serves as a Neuroprotective Target of Ischemic Stroke. Mol Neurobiol 2024; 61:7384-7402. [PMID: 38386136 DOI: 10.1007/s12035-024-04052-4] [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: 06/27/2023] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
Ischemic stroke is a major cause of death and disability in adults. Hypothermic treatment is successful in treating neonatal cerebral ischemia, but its application is restricted in adult patients due to complex management strategies and severe adverse effects. Two homologous RNA-binding proteins, RBM3 and CIRP, are the only known cold-inducible proteins in vertebrates, and their expression levels are robustly elevated by mild to moderate hypothermia. In previous studies, we and others have demonstrated that both RBM3 and CIRP mediate the neuroprotective and neurogenic effects of hypothermia in cell and animal models. However, CIRP can also be detrimental to neurons by triggering neuroinflammatory responses, complicating its post-stroke functions. In this study, we compared the properties of the two cold-inducible RNA-binding proteins after ischemic stroke. Our results indicated that RBM3 expression was stimulated in the ischemic brain of stroke patients, while CIRP expression was not. In an experimental model, RBM3 can ameliorate ischemic-like insult by promoting neuronal survival and eliciting anti-inflammatory responses in activated microglia, while the impact of CIRP was intriguing. Collectively, our data supported the notion that RBM3 may be a more promising therapeutic target than CIRP for treating ischemic stroke. We further demonstrated that zr17-2, a small molecule initially identified to target CIRP, can specifically target RBM3 but not CIRP in microglia. zr17-2 demonstrated anti-inflammatory and neuroprotective effects after ischemic stroke both in vitro and in vivo, suggesting its potential therapeutic value.
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Affiliation(s)
- Junyi Zhao
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, Shenzhen, China
| | - Siyu Liu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, Shenzhen, China
| | - Kunyu Li
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
| | - Yulu Yang
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
- School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Yue Zhao
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, Shenzhen, China
| | - Xinzhou Zhu
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China.
- Shenzhen Key Laboratory of Neuroimmunomodulation for Neurological Diseases, Shenzhen, China.
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.
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197
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Hussain M, Khan I, Chaudhary MN, Ali K, Mushtaq A, Jiang B, Zheng L, Pan Y, Hu J, Zou X. Phosphatidylserine: A comprehensive overview of synthesis, metabolism, and nutrition. Chem Phys Lipids 2024; 264:105422. [PMID: 39097133 DOI: 10.1016/j.chemphyslip.2024.105422] [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: 06/07/2024] [Revised: 07/21/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Abstract
Phosphatidylserine (PtdS) is classified as a glycerophospholipid and a primary anionic phospholipid and is particularly abundant in the inner leaflet of the plasma membrane in neural tissues. It is synthesized from phosphatidylcholine or phosphatidylethanolamine by exchanging the base head group with serine, and this reaction is catalyzed by PtdS synthase-1 and PtdS synthase-2 located in the endoplasmic reticulum. PtdS exposure on the outside surface of the cell is essential for eliminating apoptotic cells and initiating the blood clotting cascade. It is also a precursor of phosphatidylethanolamine, produced by PtdS decarboxylase in bacteria, yeast, and mammalian cells. Furthermore, PtdS acts as a cofactor for several necessary enzymes that participate in signaling pathways. Beyond these functions, several studies indicate that PtdS plays a role in various cerebral functions, including activating membrane signaling pathways, neuroinflammation, neurotransmission, and synaptic refinement associated with the central nervous system (CNS). This review discusses the occurrence of PtdS in nature and biosynthesis via enzymes and genes in plants, yeast, prokaryotes, mammalian cells, and the brain, and enzymatic synthesis through phospholipase D (PLD). Furthermore, we discuss metabolism, its role in the CNS, the fortification of foods, and supplementation for improving some memory functions, the results of which remain unclear. PtdS can be a potentially beneficial addition to foods for kids, seniors, athletes, and others, especially with the rising consumer trend favoring functional foods over conventional pills and capsules. Clinical studies have shown that PtdS is safe and well tolerated by patients.
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Affiliation(s)
- Mudassar Hussain
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Imad Khan
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Muneeba Naseer Chaudhary
- Integrative Science Center of Germplasm Creation in Western China (CHONGQING) Science City/College of Food Science, Southwest University, Chongqing, 400715, China
| | - Khubaib Ali
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Anam Mushtaq
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Bangzhi Jiang
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Lei Zheng
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Yuechao Pan
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Jijie Hu
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China
| | - Xiaoqiang Zou
- State Key Laboratory of Food Science and Resources, National Engineering Research Center for Functional Food, National Engineering Research Center of Cereal Fermentation and Food Biomanufacturing, Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, 1800 Lihu Road, Wuxi, Jiangsu 214122, China.
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198
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d'Avanzo N, Paolino D, Barone A, Ciriolo L, Mancuso A, Christiano MC, Tolomeo AM, Celia C, Deng X, Fresta M. OX26-cojugated gangliosilated liposomes to improve the post-ischemic therapeutic effect of CDP-choline. Drug Deliv Transl Res 2024; 14:2771-2787. [PMID: 38478324 PMCID: PMC11384645 DOI: 10.1007/s13346-024-01556-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 09/10/2024]
Abstract
Cerebrovascular impairment represents one of the main causes of death worldwide with a mortality rate of 5.5 million per year. The disability of 50% of surviving patients has high social impacts and costs in long period treatment for national healthcare systems. For these reasons, the efficacious clinical treatment of patients, with brain ischemic stroke, remains a medical need. To this aim, a liposome nanomedicine, with monosialic ganglioside type 1 (GM1), OX26 (an anti-transferrin receptor antibody), and CDP-choline (a neurotrophic drug) (CDP-choline/OX26Lip) was prepared. CDP-choline/OX26Lip were prepared by a freeze and thaw method and then extruded through polycarbonate filters, to have narrow size distributed liposomes of ~80 nm. CDP-choline/OX26Lip were stable in human serum, they had suitable pharmacokinetic properties, and 30.0 ± 4.2% of the injected drug was still present in the blood stream 12 h after its systemic injection. The post-ischemic therapeutic effect of CDP-choline/OX26Lip is higher than CDP-choline/Lip, thus showing a significantly high survival rate of the re-perfused post-ischemic rats, i.e. 96% and 78% after 8 days. The treatment with CDP-choline/OX26Lip significantly decreased the peroxidation rate of ~5-times compared to CDP-choline/Lip; and the resulting conjugated dienes, that was 13.9 ± 1.1 mmol/mg proteins for CDP-choline/Lip and 3.1 ± 0.8 for CDP-choline/OX26Lip. OX26 increased the accumulation of GM1-liposomes in the brain tissues and thus the efficacious of CDP-choline. Therefore, this nanomedicine may represent a strategy for the reassessment of CDP-choline to treat post-ischemic events caused by brain stroke, and respond to a significant clinical need.
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Affiliation(s)
- Nicola d'Avanzo
- Department of Clinical and Experimental Medicine, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Donatella Paolino
- Department of Clinical and Experimental Medicine, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Antonella Barone
- Department of Clinical and Experimental Medicine, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Luigi Ciriolo
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Antonia Mancuso
- Department of Clinical and Experimental Medicine, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Maria Chiara Christiano
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy
| | - Anna Maria Tolomeo
- Department of Cardiac, Thoracic and Vascular Science and Public Health, University of Padova, 35128, Padua, Italy
- Perdiatric Research Institute "Città della Speranza", Corso Stati Uniti, 4, 35127, Padua, Italy
| | - Christian Celia
- Department of Pharmacy, University of Chieti - Pescara "G. d'Annunzio", Via dei Vestini 31, 66100, Chieti, Italy.
- Lithuanian University of Health Sciences, Laboratory of Drug Targets Histopathology, Institute of Cardiology, A. Mickeviciaus g. 9, LT-44307, Kaunas, Lithuania.
- Institute of Nanochemistry and Nanobiology, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, 200444, China.
| | - Xiaoyong Deng
- Institute of Nanochemistry and Nanobiology, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, 200444, China.
| | - Massimo Fresta
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale "S. Venuta", 88100, Catanzaro, Italy.
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199
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Deng H, Zhao Y, Zou Q, Chen Z, Liao X. Global burden, trends, and cross-country inequalities of urinary tract infections in adolescents and young adults, 1990 to 2019. Am J Infect Control 2024; 52:1176-1183. [PMID: 38885792 DOI: 10.1016/j.ajic.2024.06.007] [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: 05/08/2024] [Revised: 06/11/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Limited studies have evaluated the global burden, trends, and cross-country inequalities for urinary tract infections (UTIs) in adolescents and young adults (AYAs). METHODS Age-standardized incidence rate, age-standardized mortality rate, and age-standardized Disability-Adjusted Life Years (DALYs) rate were used to describe the UTI burden. The estimated annual percentage changes were calculated to evaluate the temporal trends from 1990 to 2019. The slope index of inequality and concentration index were utilized to quantify the distributive inequalities. RESULTS From 1990 to 2019, a significant increase in age-standardized incidence rate (estimated annual percentage change =0.22%, 95% confidence interval 0.19%-0.26%) was found for UTIs in AYAs, and the increasing trend was more pronounced in males than females. Significant decreases in age-standardized mortality rate and age-standardized DALY rate were found in females but not in males. The slope index of inequality changed from 21.80 DALYs per 100,000 in 1990 to 20.91 DALYs per 100,000 in 2019 for UTIs in AYAs. Moreover, the concentration index showed -0.23 in 1990 and -0.14 in 2019. DISCUSSION Countries with lower sociodemographic development levels shouldered a disproportionately higher UTI burden. CONCLUSIONS UTIs remain an ongoing health burden for AYAs globally, with substantial heterogeneities found across countries, sex, and age groups.
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Affiliation(s)
- Hua Deng
- Department of Nephrology, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Yan Zhao
- Reproductive Medicine Center, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Qin Zou
- Department of Nephrology, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Zhe Chen
- Department of Nephrology, The First People's Hospital of Chenzhou, Chenzhou, China
| | - Xiangping Liao
- Department of Nephrology, The First People's Hospital of Chenzhou, Chenzhou, China.
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200
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Feigin VL, Abate MD, Abate YH, Abd ElHafeez S, Abd-Allah F, Abdelalim A, Abdelkader A, Abdelmasseh M, Abd-Elsalam S, Abdi P, Abdollahi A, Abdoun M, Abd-Rabu R, Abdulah DM, Abdullahi A, Abebe M, Abeldaño Zuñiga RA, Abhilash ES, Abiodun OO, Abiodun O, Abo Kasem R, Aboagye RG, Abouzid M, Abreu LG, Abrha WA, Abtahi D, Abu Rumeileh S, Abualhasan A, Abualruz H, Abu-Gharbieh E, Abukhadijah HJ, Abu-Rmeileh NME, Aburuz S, Abu-Zaid A, Acuna JM, Adane DE, Adane MM, Addo IY, Adedoyin RA, Adegboye OA, Adekanmbi V, Adhikari K, Adnani QES, Adra S, Adzigbli LA, Afify AY, Afolabi AA, Afrashteh F, Afzal MS, Afzal S, Aghamiri S, Agyemang-Duah W, Ahinkorah BO, Ahmad A, Ahmad MM, Ahmad S, Ahmad S, Ahmad T, Ahmadzade AM, Ahmed A, Ahmed A, Ahmed H, Ahmed SA, Ajami M, Aji B, Akara EM, Akinyemi RO, Akkaif MA, Akrami AE, Al Awaidy S, Al Hamad H, Al Hasan SM, Al Qadire M, Al Ta'ani O, Al-Ajlouni Y, Alalalmeh SO, Alalwan TA, Al-Aly Z, Al-amer RM, Aldhaleei WA, Aldossary MS, Alemohammad SY, Al-Fatly B, Al-Gheethi AAS, Alhalaiqa FN, Alharrasi M, Ali A, Ali MU, Ali R, Ali SS, Ali W, Al-Ibraheem A, Alif SM, Aljunid SM, Almahmeed W, Al-Marwani S, Alomari MA, Alonso J, Alqahtani JS, Al-Raddadi RMM, Alrawashdeh A, Alsabri MA, Alshahrani NZ, Altaany Z, Altaf A, Al-Tammemi AB, Altwalbeh D, Alvis-Guzman N, Alwafi H, Al-Wardat M, Al-Worafi YM, Aly H, Aly S, Alyahya MSI, Alzoubi KH, Al-Zyoud WA, Amani R, Amegbor PM, Amera TG, Amin TT, Amindarolzarbi A, Amiri S, Amu H, Amugsi DA, Amusa GA, Ancuceanu R, Anderlini D, Angappan D, Anil A, Ansari MTT, Ansari-Moghaddam A, Ansong R, Anvari S, Anwar S, Anwar SL, Anyabolo EE, Anyasodor AE, Apostol GLC, Appiah F, Aqeel M, Arabloo J, Arabzadeh Bahri R, Arafat M, Aravkin AY, Ardekani A, Areda D, Aregawi BB, Aregu GM, Aremu O, Arifin H, Ärnlöv J, Artamonov AA, Arulappan J, Aryal UR, Aryan Z, Asbeutah AM, Asemahagn MA, Asemu MT, Asghari-Jafarabadi M, Ashemo MY, Ashraf T, Aslani A, Asmerom HA, Astell-Burt T, Athari SS, Atorkey P, Atout MMW, Atreya A, Aujayeb A, Ausloos M, Avan A, Awad H, Awotidebe AW, Ayana LAA, Aychiluhm SB, Aynalem AA, Aynalem ZB, Azadnajafabad S, Azami H, Aziz S, Azzam AY, Babu AS, Babu GR, Badar M, Badiye AD, Bahrami Taghanaki P, Bahramian S, Bai R, Baig AA, Bakkannavar SM, Bako AT, Baltatu OC, Bam K, Banach M, Banakar M, Bandyopadhyay S, Banik PC, Bansal K, Bao Y, Barboza MA, Bardhan M, Barengo NC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Barrow A, Barua L, Bashiri A, Bashiru HA, Basiru A, Bastan MM, Basu S, Basu S, Batra K, Begde A, Behnam B, Behnoush AH, Belayneh MBY, Belingheri M, Bello UM, Bennett DA, Bensenor IM, Berhe FT, Bermudez ANC, Beyene HBB, Beyene KA, Bhagat DS, Bhagavathula AS, Bhala N, Bhalla A, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhat AN, Bhat V, Bhatti GK, Bhatti JSS, Bhuiyan MA, Bhusal S, Bikbov B, Bilgin C, Biondi A, Bishaw KA, Biswas A, Biswas B, Bodhare T, Bogale EK, Boloor A, Bonakdar Hashemi M, Bonny A, Bora Basara B, Borhany H, Bosoka SA, Bouaoud S, Bouyahya A, Boyko EJ, Bozic MM, Braithwaite D, Breitner S, Brenner H, Britton G, Brunoni AR, Bryazka D, Bugiardini R, Bulto LN, Burkart K, Bustanji Y, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos LA, Campos-Nonato IR, Cao F, Capodici A, Cárdenas R, Carr S, Carreras G, Carvalho AF, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catapano AL, Cattaruzza MS, Cegolon L, Cembranel F, Cenko E, Cerin E, Chadwick J, Chakraborty C, Chakraborty S, Chan JSK, Chandika RM, Chandrasekar EK, Chanie GS, Chattu VK, Chaudhary AA, Chaurasia A, Chen H, Chen M, Chen S, Chi G, Chichagi F, Chimoriya R, Ching PR, Chitheer A, Cho SMJ, Choi DW, Chong B, Chong CL, Chopra H, Choudhari SG, Choudhary R, Chu DT, Chukwu IS, Chung SC, Cindi Z, Cioffi I, Cogen RM, Columbus A, Costanzo S, Couto RAS, Criqui MH, Cruz-Martins N, Cuadra-Hernández SM, da Silva AG, Dadana S, Dadras O, Dai X, Dalal K, Dalli LL, Damiani G, D'Amico E, Dandona L, Dandona R, Darwish AH, Das S, Dashti M, Dashtkoohi M, Dashtkoohi M, Dastmardi M, Davletov K, De la Cruz-Góngora V, DeAngelo S, Debele AT, Debopadhaya S, Delgado-Enciso I, Demessa BH, Demetriades AK, Denova-Gutiérrez E, Dervišević E, Desai HD, Desale AT, Desta F, Devanbu VGC, Devegowda D, Dewan SMR, Dhane AS, Dhimal M, Dhulipala VR, Diaz MJ, Diress M, Dodangeh M, Doegah PT, Dohare S, Doheim MF, Dokova KG, Dongarwar D, D'Oria M, Doshi OP, Doshi RP, Douiri A, Dowou RK, Dsouza AC, Dsouza HL, Dsouza VS, Duncan BB, Duraes AR, Dziedzic AM, Ekholuenetale M, El Bayoumy IF, El Sayed Zaki M, Elbarazi I, El-Dahiyat F, Elgendy IY, Elhadi M, El-Huneidi W, Elmonem MA, Elmoselhi AB, Eltaha C, Emeto TI, Esezobor CI, Esfandiari N, Esmaeili Z, Esposito F, Etoom M, Fabin N, Fadhil I, Fagbamigbe AF, Fagbule OF, Faghani S, Fahim A, Fakhradiyev IR, Falzone L, Fareed M, Fares J, Farinha CSES, Faris MEM, Faris PS, Farjoud Kouhanjani M, Faro A, Farrokhpour H, Fasanmi AO, Fauk NK, Fazeli P, Fazylov T, Feizkhah A, Fekadu G, Feng X, Fereshtehnejad SM, Ferrara P, Ferreira N, Fetensa G, Feyisa BR, Fischer F, Flor LS, Foley KM, Fonseca AC, Foroumadi R, Foroutan B, Fortuna D, Foschi M, Franklin RC, Fridayani NKY, G S, Gaal PA, Gaidhane AM, Gaipov A, Galali Y, Gallus S, Gandhi AP, Ganesan B, Gasevic D, Gautam P, Gautam RK, Gebregergis MW, Gebrehiwot M, Gebrekidan KG, Getacher L, Getahun GK, Getie M, Ghadimi DJ, Ghadirian F, Ghaffari Jolfayi A, Ghafourifard M, Ghasemi MR, Ghasemzadeh A, Ghazy RM, Gholami E, Gholami Z, Ghozy S, Giannoni Luza S, Gilani JA, Gill TK, Gillum RF, Gindaba EZ, Gnedovskaya EV, Goel A, Goldust M, Golechha M, Goleij P, Golinelli D, Gona PN, Gorini G, Goulart AC, Goulart BNG, Gouravani M, Grivna M, Grosso G, Grover A, Guan SY, Guarducci G, Guha A, Guicciardi S, Gulati S, Gunawardane DA, Guo C, Guo Z, Gupta AK, Gupta B, Gupta M, Gupta R, Gupta RD, Gupta R, Gupta S, Habibzadeh F, Hadi NR, Haghani Dogahe M, Haghi-Aminjan H, Haghmorad D, Haj-Mirzaian A, Halimi A, Hamdy NM, Hamidi S, Hamilton EB, Hanif A, Hanifi N, Hankey GJ, Hannan MA, Haq ZA, Hargono A, Harlianto NI, Haro JM, Has EMM, Hasaballah AI, Hasan I, Hasnain MS, Hassan I, Hassan Zadeh Tabatabaei MS, Haubold J, Havmoeller RJ, Hay SI, Hbid Y, Hebert JJ, Hegazi OE, Heidari M, Hemmati M, Heyi DZ, Hezam K, Hiraike Y, Hoan NQ, Holla R, Horita N, Hossain MM, Hosseinzadeh H, Hosseinzadeh M, Hosseinzadeh Adli A, Hostiuc M, Hostiuc S, Hu B, Hu C, Huang J, Humayun A, Hussain S, Huy LD, Huynh HH, Hwang BF, Ibitoye SE, Ikeda N, Ikiroma A, Ilesanmi OS, Ilic IM, Ilic MD, Imam MT, Immurana M, Inbaraj LR, Iqhrammullah M, Iradukunda A, Irham LM, Islam MR, Ismail F, Ismail NE, Iso H, Isola G, Itumalla R, Iwagami M, Iwu CDCD, J V, Jaafari J, Jacob L, Jafarzadeh A, Jahrami H, Jain A, Jain N, Jairoun AA, Jaiswal A, Jakovljevic M, Jalilzadeh Yengejeh R, Janakiraman B, Jatau AI, Jayapal SK, Jayaram S, Jee SH, Jeganathan J, Jegnie M, Jema AT, Jeswani BM, Jeyakumar A, Jha AK, Jha RP, Ji Z, Jiang H, Jin S, Jin Y, Jokar M, Jonas JB, Joo T, Jose J, Joseph N, Joshua CE, Joukar F, Jozwiak JJ, Jürisson M, Kabir A, Kabir MA, Kabir Z, Kadashetti V, Kalani R, Kalra S, Kamal VK, Kamireddy A, Kan H, Kanaan M, Kandel H, Kanmodi KK, Kantar RS, Kapoor N, Karakasis P, Karaye IM, Karch A, Karimi H, Karimi SE, Karimi Y, Karimi Behnagh A, Karki P, Kasraei H, Kauppila JH, Kaur H, Kaydi N, Kayode GA, Kazemi F, Kazemian S, Kesse-Guyot E, Khader YS, Khafaie MA, Khaing IK, Khajuria H, Khalaji A, Khalid N, Khalil AA, Khan A, Khan F, Khan MN, Khan M, Khan MJ, Khan MAB, Khan YH, Khanmohammadi S, Khatab K, Khatatbeh H, Khatatbeh MM, Khateri S, Khatib MN, Khayamzadeh M, Khayat Kashani HR, Khidri FF, Khokhar M, Khosla AA, Khosravi M, Khubchandani J, Kian S, Kim K, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kolahi AA, Koly KN, Kompani F, Kondlahalli SKMM, Korja M, Korshunov VA, Korzh O, Kosen S, Kostev K, Kothari N, Kotnis AL, Koulmane Laxminarayana SL, Krishan K, Krishna V, Krishnamoorthy V, Krishnan B, Kruja J, Kuate Defo B, Kucuk Bicer B, Kuddus MA, Kuddus M, Kugbey N, Kulimbet M, Kulkarni V, Kumar A, Kumar A, Kumar D, Kumar GA, Kumar N, Kumar R, Kumaran D S, Kundu A, Kundu S, Kunutsor SK, Kurmi OP, Kusuma D, Kutikuppala LVS, Kuttikkattu A, Kytö V, La Vecchia C, Lacey B, Lahariya C, Lal DK, Lallukka T, Lám J, Landires I, Larsson AO, Lasrado S, Latifinaibin K, Lauriola P, Lavados PM, Lawal BK, Le LKD, Le NHH, Le TTT, Le TDT, Lee PH, Lee SW, Lee WC, Lee YH, Li MC, Li W, Li X, Li Y, Lim LL, Lim SS, Lin JC, Lindholm D, Linn S, Liu G, Liu R, Liu S, Liu X, Liu X, Llanaj E, Lo CH, Lo WD, Lohner V, López-Gil JF, Lorenzovici L, Lorkowski S, Lotufo PA, Lucchetti G, Luo L, Lusk JB, Ma ZF, Machoy M, Madadizadeh F, Maddison R, Mahmoudi E, Mahmoudvand G, Makram OM, Malakan Rad E, Malhotra K, Malik AA, Malik I, Mallhi TH, Malta DC, Mamun AA, Manla Y, Mansouri MH, Mansouri P, Mansouri V, Mansournia MA, Mantovani LG, Manu E, Marateb HR, Marjani A, Martini D, Martini S, Martorell M, Maryam S, Marzo RR, Masrie A, Mathangasinghe Y, Maulik PK, Mayeli M, Mazidi M, McKee M, McPhail SM, Mechili EA, Mehmood A, Mehrabani-Zeinabad K, Mekene Meto T, Meles HN, Mendoza W, Menezes RG, Mensah GA, Meo SA, Meretoja A, Meretoja TJ, Mestrovic T, Mettananda CDK, Miazgowski T, Michalek IM, Micheletti Gomide Nogueira de Sá AC, Minervini G, Minh LHN, Mini GK, Mirghafourvand M, Mirica A, Mirrakhimov EM, Mirza-Aghazadeh-Attari M, Mishra M, Misra S, Mithra P, Mohamed AI, Mohamed J, Mohamed NS, Mohammad AM, Mohammadi E, Mohammadi S, Mohammadi S, Mohammadian-Hafshejani A, Mohammadzadeh I, Mohammed H, Mohammed M, Mohammed S, Mohammed S, Mokdad AH, Molavi Vardanjani H, Molokhia M, Momani S, Monasta L, Moni MA, Montazeri F, Moodi Ghalibaf A, Moosazadeh M, Moradi M, Moradi Y, Moraga P, Morawska L, Moreira RS, Morrison SD, Mosaddeghi Heris R, Mossialos E, Mousavi P, Msherghi A, Mubarik S, Muccioli L, Mulita A, Muniyandi M, Munjal K, Murillo-Zamora E, Muthu S, Myung W, Nabavi A, Nabhan AF, Nafei A, Nagarajan AJ, Naghavi P, Naik GR, Naik G, Naimzada MD, Nair S, Nair TS, Najdaghi S, Najmuldeen HHR, Nakhostin Ansari N, Nangia V, Narasimha Swamy S, Nargus S, Narimani Davani D, Nascimento BR, Nascimento GG, Nasrollahizadeh A, Nasrollahizadeh A, Natto ZS, Nauman J, Navaratna SNK, Nayak BP, Nayak VC, Nazri-Panjaki A, Ndejjo R, Negoi I, Negoi RI, Nejadghaderi SA, Nejjari C, Nematollahi MH, Nepal S, Newton CRJ, Nguyen DH, Nguyen DH, Nguyen HTH, Nguyen HQ, Nguyen NNY, Nguyen PT, Nguyen VT, Niazi RK, Nigatu YT, Nikravangolsefid N, Ningrum DNA, Nnaji CA, Nnyanzi LA, Nomura S, Noor STA, Norrving B, Nawsherwan N, Noubiap JJ, Nri-Ezedi CA, Ntaios G, Ntsekhe M, Nugen F, Nurchis MC, Nurrika D, Nzoputam CI, Nzoputam OJ, Oancea B, Obamiro KO, Odetokun IA, O'Donnell MJ, Oguta JO, Oh IH, Ojo-Akosile TR, Okati-Aliabad H, Okeke SR, Okekunle AP, Okidi L, Okonji OC, Oladnabi M, Olagunju AT, Olaiya MT, Olalusi OV, Olasehinde TA, Olasupo OO, Olatubi MI, Oliveira AB, Oliveira GMM, Olorukooba AA, Olufadewa II, Oluwafemi YDD, Oluwatunase GO, Omar HA, Omar Bali A, O'Neil AE, Ong SK, Onwujekwe OE, Opejin AO, Ordak M, Ornello R, Ortega-Altamirano DV, Ortiz A, Ortiz-Prado E, Osman WMS, Osuagwu UL, Otstavnov SS, Owolabi MO, Oyeyemi IT, Ozair A, P A MP, Pacheco-Barrios K, Padron-Monedero A, Padubidri JR, Palicz T, Palma-Alvarez RF, Pan F, Panda-Jonas S, Pande Katare D, Pandey A, Pandey A, Pandi-Perumal SR, Panos LD, Pantazopoulos I, Papadopoulou P, Pardhan S, Parija PP, Parikh RR, Parsons N, Passera R, Patoulias D, Paudel U, Pawar S, Peden AE, Pedersini P, Peprah P, Pereira MO, Peres MFP, Perianayagam A, Perico N, Perna S, Pestell RG, Petcu IR, Petermann-Rocha FE, Pham HN, Pham HT, Phillips MR, Pilgrim T, Piradov MA, Pirouzpanah S, Plotnikov E, Poddighe D, Poluru R, Popovic DS, Postma MJ, Pourshams A, Pourtaheri N, Pradhan J, Pradhan PMS, Prakash V, Prasad M, Prates EJS, Pribadi DRA, Puvvula J, Qattea I, Qian G, Qiao Y, Raggi A, Raghav PR, Raghuveer P, Rahim F, Rahim MJ, Rahimifard M, Rahimi-Movaghar V, Rahman MM, Rahman MHU, Rahman M, Rahman MA, Rahmani AM, Rahmanian M, Rahmanian N, Rahmanian V, Rahmati R, Rahmawaty S, Raj GM, Rajaa S, Rajendran V, Rajpoot PL, Rajput P, Ram P, Ramadan MM, Ramadan M, Ramanarayanan V, Ramasamy SK, Ramazanu S, Rana J, Rana K, Rana RK, Ranabhat CL, Rancic N, Rane A, Ranta A, Rao M, Rao SJ, Rashedi S, Rashidi MM, Rasouli-Saravani A, Rathish D, Rauniyar SK, Rawaf S, Razo C, Reddy MMRK, Redwan EMM, Rehman IU, Remuzzi G, Rezaei N, Rezaeian M, Rezazadeh H, Rhee TG, Riaz MA, Ribeiro ALP, Rodrigues M, Rodrigues da Silva TPR, Rodriguez JAB, Roever L, Romadlon DS, Ross AG, Rout HS, Roy B, Roy P, Roy S, Ruela GDA, Russo M, Rwegerera GM, S N C, Saad AMA, Saber K, Saber-Ayad MM, Sabet CJ, Sabour S, Sacco S, Saddik BA, Sadeghi E, Saeb MR, Saeed U, Safi SZZ, Sagar R, Saghafi A, Sagoe D, Saheb Sharif-Askari F, Sahebkar A, Sahoo PM, Sahoo SS, Sajid MR, Salami AA, Salaroli LB, Saleh MA, Salem MZY, Salum GA, Samadzadeh S, Samargandy S, Samodra YL, Samuel VP, Samy AM, Sanabria J, Santos IS, Santric-Milicevic MM, Sarasmita MA, Saravanan A, Sarikhani Y, Sarode GS, Sarode SC, Satpathy M, Sattouf Z, Saya GK, Sayeed MA, Sayyah M, Scarmeas N, Schaarschmidt BM, Schlaich MP, Schmidt MI, Schneider IJC, Schuermans A, Schumacher AE, Schutte AE, Schwebel DC, Selvaraj S, Sen P, Senapati S, Senthilkumaran S, Sergindo MT, Sethi Y, Seylani A, Shafie M, Shah PA, Shahabi S, Shahbandi A, Shahid S, Shahsavari HR, Shahwan MJ, Shaikh MA, Shalash AS, Shamim MA, Shams-Beyranvand M, Shamsi A, Shamsutdinova A, Shanawaz M, Shannawaz M, Sharath M, Sharifan A, Sharifi A, Sharifi-Rad J, Sharma A, Sharma M, Sharma S, Sharma U, Sharma V, Sheikhi RA, Shetty A, Shetty M, Shetty PK, Shiferaw D, Shigematsu M, Shimels T, Shin MJ, Shiri R, Shittu A, Shitu AKO, Shiue I, Shorofi SA, Shrestha S, Shuval K, Si Y, Siddig EE, Sikdar M, Silva JP, Silva LMLR, Singh A, Singh B, Singh G, Singh H, Singh JA, Singh K, Singh NP, Singh P, Singh P, Sipilä JOT, Sivakumar S, Skryabin VY, Skryabina AA, Sleet DA, Sobia F, Socea B, Sohag AAM, Solanki R, Solanki S, Solomon Y, Song Y, Soraneh S, Sorensen RJD, Sotoudeh H, Soyiri IN, Spartalis M, Sreeramareddy CT, Srinivasamurthy SK, Stachteas P, Stafford LK, Stark BA, Starodubova AV, Subedi N, Subramaniyan V, Suleman M, Sultana A, Sun Z, Sundström J, Suresh V, Susanty S, Swain CK, Szarpak L, T Y SS, Tabaee Damavandi P, Tabarés-Seisdedos R, Tabatabaei SM, Tabatabai S, Tabche C, Tabish M, Tadakamadla J, Tadakamadla SK, Taheri A, Taiba J, Talaat IM, Talukder A, Tampa M, Tamuzi JL, Tan KK, Tang H, Tanwar M, Tarigan IU, Tarkang EE, Tat NY, Tavangar SM, Tehrani-Banihashemi A, Teimoori M, Temsah MH, Temsah RMH, Teramoto M, Tesfamariam WB, Tesfaye Gta EG, Thakur R, Thangaraju P, Thapa R, Thapar R, Thayakaran R, Thirunavukkarasu S, Thomas J, Thomas NKK, Thrift AG, Tian J, Tichopad A, Ticoalu JHV, Tiruneh C, Tiwari K, Tiyuri A, Tonelli M, Topor-Madry R, Tovani-Palone MR, Trabelsi K, Tran NH, Tran TH, Tran Minh Duc N, Trico D, Tromans SJ, Truyen TTTT, Tsai DHT, Tsatsakis A, Tsermpini EE, Turuse EAA, Tyrovolas S, Udoakang AJ, Udoh A, Ullah A, Ullah S, Umair M, Umar M, Unim B, Unnikrishnan B, Urso D, Usman JS, Vacante M, Vahabi SM, Vahdati S, Vaithinathan AG, Vakili O, Valizadeh R, Van den Eynde J, Varga O, Varthya SB, Vasankari TJ, Vellingiri B, Venketasubramanian N, Verma M, Veroux M, Verras GI, Vervoort D, Villafañe JH, Villani S, Vinayak M, Viskadourou M, Volovat SR, Volovici V, Wafa HA, Waheed Y, Wahood W, Wang C, Wang F, Wang S, Wang S, Wang Y, Wang YP, Wanjau MN, Waqas M, Wassie EG, Wassie GT, Wei Z, Weintraub RG, Weldetinsaa HL, Wickramasinghe DP, Wickramasinghe ND, Wijeratne T, Willeit P, Wolfe CDA, Wong YJ, Wongsin U, Wu C, Wu F, Wu Y, Wu Z, Xiao H, Xu S, Xu X, Yamagishi K, Yang D, Yano Y, Yarahmadi A, Yaribeygi H, Yasufuku Y, Yatsuya H, Yazdanpanah F, Yazdanpanah MH, Ye P, Yesodharan R, Yezli S, Yi S, Yi X, Yin D, Yon DK, Yonemoto N, Yu C, Yu EA, Yun K, Yusuf H, Zadey S, Zafari N, Zaman BA, Zaman SB, Zanghì A, Zare I, Zarimeidani F, Zarrintan A, Zastrozhin M, Zemedikun D, Zeng Y, Zhang B, Zhang H, Zhang L, Zhang Y, Zhang Z, Zhao H, Zhong CC, Zhou SC, Zhu B, Zhu L, Zhumagaliuly A, Ziafati M, Zielińska M, Zikarg YT, Zoghi G, Zyoud SH, Zyoud SH, Johnson CO, Roth GA, Nair BS, Rautalin I, Bhati A, Bisignano C, Vos T, Murray CJL. Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 2024; 23:973-1003. [PMID: 39304265 DOI: 10.1016/s1474-4422(24)00369-7] [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] [Received: 04/27/2024] [Revised: 06/10/2024] [Accepted: 08/28/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990-2021. METHODS We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. FINDINGS In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6-7·8] deaths; 10·7% [9·8-11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8-171·6] DALYs; 5·6% [5·0-6·1] of all DALYs). In 2021, there were 93·8 million (89·0-99·3) prevalent and 11·9 million (10·7-13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4-67·7), intracerebral haemorrhage constituted 28·8% (28·3-28·8), and subarachnoid haemorrhage constituted 5·8% (5·7-6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4-117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7-38·1]), diet high in sugar-sweetened beverages (23·4% [12·7-35·7]), low physical activity (11·3% [1·8-34·9]), high systolic blood pressure (6·7% [2·5-11·6]), lead exposure (6·5% [4·5-11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5-10·5]). INTERPRETATION Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. FUNDING Bill & Melinda Gates Foundation.
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