1
|
Neves PD, Watanabe A, Watanabe EH, Narcizo AM, Nunes K, Lerario AM, Ferreira FM, Cavalcante LB, Wongboonsin J, Malheiros DM, Jorge LB, Sampson MG, Noronha IL, Onuchic LF. Idiopathic collapsing glomerulopathy is associated with APOL1 high-risk genotypes or Mendelian variants in most affected individuals in a highly admixed population. Kidney Int 2024; 105:593-607. [PMID: 38143038 DOI: 10.1016/j.kint.2023.11.028] [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] [Received: 04/19/2023] [Revised: 09/04/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023]
Abstract
Collapsing glomerulopathy (CG) is most often associated with fast progression to kidney failure with an incidence apparently higher in Brazil than in other countries. However, the reason for this occurrence is unknown. To better understand this, we performed an integrated analysis of clinical, histological, therapeutic, causative genetic and genetic ancestry data in a highly genetically admixed cohort of 70 children and adult patients with idiopathic CG (ICG). The disease onset occurred at 23 (interquartile range: 17-31) years and approximately half of patients progressed to chronic kidney disease requiring kidney replacement therapy (CKD-KRT) 36 months after diagnosis. Causative genetic bases, assessed by targeted-gene panel or whole-exome sequencing, were identified in 58.6% of patients. Among these cases, 80.5% harbored APOL1 high-risk genotypes (HRG) and 19.5% causative Mendelian variants (MV). Self-reported non-White patients more frequently had HRG. MV was an independent risk factor for progression to CKD-KRT by 36 months and the end of follow-up, while remission was an independent protective factor. All patients with HRG manifested CG at 9-44 years of age, whereas in those with APOL1 low-risk genotype, the disease arose throughout life. HRGs were associated with higher proportion of African genetic ancestry. Novel causative MVs were identified in COL4A5, COQ2 and PLCE1 and previously described causative MVs were identified in MYH9, TRPC6, COQ2, COL4A3 and TTC21B. Three patients displayed HRG combined with a variant of uncertain significance (ITGB4, LAMA5 or PTPRO). MVs were associated with worse kidney prognosis. Thus, our data reveal that the genetic status plays a major role in ICG pathogenesis, accounting for more than half of cases in a highly admixed Brazilian population.
Collapse
Affiliation(s)
- Precil D Neves
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil; Nephrology and Dialysis Center, Oswaldo Cruz German Hospital, São Paulo, Brazil
| | - Andreia Watanabe
- Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil; Division of Pediatric Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Elieser H Watanabe
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Amanda M Narcizo
- Large-Scale Sequencing Laboratory, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Kelly Nunes
- Human Genome Center, Institute of Biosciences/University of São Paulo, São Paulo, Brazil
| | - Antonio M Lerario
- Division of Endocrinology, University of Michigan, Ann Arbor, Michigan, USA
| | - Frederico M Ferreira
- Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Lívia B Cavalcante
- Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Janewit Wongboonsin
- Division of Pediatric Nephrology, Boston Children's Hospital, Boston, Massachusetts, USA; Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Denise M Malheiros
- Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Lectícia B Jorge
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Matthew G Sampson
- Division of Pediatric Nephrology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Irene L Noronha
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Luiz F Onuchic
- Division of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil.
| |
Collapse
|
2
|
Møgelmose S, Neels K, Beutels P, Hens N. Exploring the impact of population ageing on the spread of emerging respiratory infections and the associated burden of mortality. BMC Infect Dis 2023; 23:767. [PMID: 37936094 PMCID: PMC10629067 DOI: 10.1186/s12879-023-08657-3] [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: 08/03/2023] [Accepted: 09/28/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Increasing life expectancy and persistently low fertility levels have led to old population age structures in most high-income countries, and population ageing is expected to continue or even accelerate in the coming decades. While older adults on average have few interactions that potentially could lead to disease transmission, their morbidity and mortality due to infectious diseases, respiratory infections in particular, remain substantial. We aim to explore how population ageing affects the future transmission dynamics and mortality burden of emerging respiratory infections. METHODS Using longitudinal individual-level data from population registers, we model the Belgian population with evolving age and household structures, and explicitly consider long-term care facilities (LTCFs). Three scenarios are presented for the future proportion of older adults living in LTCFs. For each demographic scenario, we simulate outbreaks of SARS-CoV-2 and a novel influenza A virus in 2020, 2030, 2040 and 2050 and distinguish between household and community transmission. We estimate attack rates by age and household size/type, as well as disease-related deaths and the associated quality-adjusted life-years (QALYs) lost. RESULTS As the population is ageing, small households and LTCFs become more prevalent. Additionally, families with children become smaller (i.e. low fertility, single-parent families). The overall attack rate slightly decreases as the population is ageing, but to a larger degree for influenza than for SARS-CoV-2 due to differential age-specific attack rates. Nevertheless, the number of deaths and QALY losses per 1,000 people is increasing for both infections and at a speed influenced by the share living in LTCFs. CONCLUSION Population ageing is associated with smaller outbreaks of COVID-19 and influenza, but at the same time it is causing a substantially larger burden of mortality, even if the proportion of LTCF residents were to decrease. These relationships are influenced by age patterns in epidemiological parameters. Not only the shift in the age distribution, but also the induced changes in the household structures are important to consider when assessing the potential impact of population ageing on the transmission and burden of emerging respiratory infections.
Collapse
Affiliation(s)
- Signe Møgelmose
- Data Science Institute, Interuniversity Institute of Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium.
- Center for Population, Family and Health, University of Antwerp, Antwerp, Belgium.
| | - Karel Neels
- Center for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Niel Hens
- Data Science Institute, Interuniversity Institute of Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
3
|
Heo SJ, Jee YS. Characteristics of Age Classification into Five-Year Intervals to Explain Sarcopenia and Immune Cells in Older Adults. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1700. [PMID: 37893417 PMCID: PMC10607932 DOI: 10.3390/medicina59101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: This study focused on investigating sarcopenic factors and immune cells in older adulthood. To achieve this, the variables related to sarcopenia and immune cells in people living in the same community were analyzed. Materials and Methods: A total of 433 elderly individuals aged 61 to 85 years were randomly categorized as follows in 5-year intervals: 68 in the youngest-old group (aged 61-65), 168 in the young-old group (aged 66-70), 127 in the middle-old group (aged 71-75), 46 in the old-old group (aged 76-80), and 19 in the oldest-old group (aged 81-85). Results: With the progression of age, calf circumference (-8.4 to -11.05%; p = 0.001) and grip strength (-9.32 to -21.01%; p = 0.001) exhibited a noticeable reduction with each successive 5-year age bracket. Conversely, the capability to complete the five-time chair stand demonstrated a clear incline (32.49 to 56.81%; p = 0.001), starting from the middle-aged group. As for appendicular skeletal muscle mass, there was an evident tendency for it to decrease (-7.08 to -26.62%; p = 0.001) with increasing age. A gradual decline in natural killer cells became apparent within the old-old and oldest-old groups (-9.28 to -26.27%; p = 0.001). The results of the post hoc test revealed that CD3 T cells showcased their peak levels in both the youngest-old and young-old groups. This was followed by the middle-old and old-old groups, with slightly lower levels. This pattern was similarly observed in CD4 T cells, CD8 T cells, and CD19 B cells. Conclusions: This study reaffirmed that sarcopenia and immune cell function decline with each successive 5-year increase in age. Considering these findings, the importance of implementing programs aimed at ensuring a high-quality extension of life for the elderly is strongly underscored.
Collapse
Affiliation(s)
- Seung-Jae Heo
- Department of Life Sports Education, Kongju National University, Gongju-si 32588, Republic of Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan-si 31962, Republic of Korea
| |
Collapse
|
4
|
Pasha S A R, Suresh Kumar Yadav R, Ahmed MI, Chandra P. Rapid Detection of Carbapenemase-Producing Multidrug-Resistant (MDR) Pathogens by Modified Carba NP Test in Ventilator-Associated Pneumonia (VAP) in Elderly Patients. Cureus 2023; 15:e43895. [PMID: 37746408 PMCID: PMC10511941 DOI: 10.7759/cureus.43895] [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] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background Ventilator-associated pneumonia (VAP) is defined as pneumonia that develops 48 hours or more after endotracheal intubation or tracheostomy and is brought on by infectious organisms that are not present or incubating during mechanical ventilation. Multidrug-resistant organisms originate primarily from the hospital environment and significantly contribute to ventilator-associated pneumonia. These organisms pose a severe threat, leading to a higher mortality rate due to their resistance to more potent antibiotics. Methods The study aims to assess the efficacy of the modified Carba NP test in detecting carbapenemase-producing bacteria in geriatric VAP patients. Results Forty (38 gram-negative and 2 gram-positive) pathogens were isolated from VAP patients. The isolates were identified using standard laboratory protocol; Acinetobacter spp. (n=16; 40% ), followed by Klebsiella pneumoniae (n=13; 32.5%), is the most common organism isolated. Seventeen (44.73%) were multi-drug resistant gram-negative bacteria. The carbapenemase producers were detected by the Kirby-Bauer disc diffusion method and compared with the modified Carba NP test with a turnaround time of 12-18 hrs in comparison to the disk diffusion test which requires additional 12hrs. Carbapenemase production was seen in 12 (70.59%) MDR isolates (7-Acinetobacter spp, 3-Klebsiella pneumonia, 1-Escherichia coli, and 1-Pseudomonas aeruginosa). Conclusion Modified Carba NP can be used as a rapid test to detect carbapenemase production, and it can replace the traditional disk diffusion method of detecting carbapenemase production. This test plays a crucial role in the management of critical patients by saving 12-18 hours to determine the most appropriate and effective antibiotic treatment. This timely decision is essential in preventing sepsis caused by localized infections.
Collapse
Affiliation(s)
- Rahil Pasha S A
- Department of Microbiology, Sri Devraj Urs Medical College, Kolar, IND
| | - Ruby Suresh Kumar Yadav
- Department of Microbiology, Employees' State Insurance Corporation (ESIC) Model Hospital, Gurugram, IND
| | - Md Iqbal Ahmed
- Department of Microbiology, Employees' State Insurance Corporation (ESIC) Medical College, Gulbarga, IND
| | - Pratibha Chandra
- Department of Microbiology, Employees' State Insurance Corporation (ESIC) Medical College, Patna, IND
| |
Collapse
|
5
|
Association of body mass index and weight change with pneumonia mortality in a Japanese population: Japan Public Health Center-based Prospective Study. Int J Obes (Lond) 2023; 47:479-486. [PMID: 36869152 DOI: 10.1038/s41366-023-01289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Accumulating evidence suggests that pneumonia mortality is lower for individuals with high body mass index (BMI) compared to normal BMI, but it remains unclear whether weight change during adulthood influences subsequent mortality due to pneumonia in Asian populations, who have a relatively lean body mass. This study aimed to examine the association of BMI and weight change over 5 years with the subsequent risk of pneumonia mortality in a Japanese population. METHODS The present analysis included 79,564 Japan Public Health Center (JPHC)-based Prospective Study participants who completed a questionnaire between 1995 and 1998 were followed for death through 2016. BMI was categorized into four groups: underweight (<18.5 kg/m2), normal weight (BMI: 18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (BMI: ≥30.0 kg/m2). Weight change was defined as the difference of body weight between questionnaire surveys with a 5-year interval. Cox proportional hazards regression was used to estimate hazard ratios of baseline BMI and weight change for pneumonia mortality. RESULTS During a median follow-up of 18.9 y, we identified 994 deaths from pneumonia. Compared with participants with normal weight, an elevated risk was observed among those who were underweight (hazard ratio = 2.29, 95% confidence interval [CI]: 1.83-2.87), whereas a decreased risk was found among those who were overweight (hazard ratio = 0.63, 95% CI: 0.53-0.75). Regarding weight change, the multivariable-adjusted hazard ratio (95% CI) of pneumonia mortality for a weight loss of 5 kg or more versus a weight change of less than 2.5 kg was 1.75 (1.46-2.10), whereas that for a weight gain of 5 kg or more was 1.59 (1.27-2.00). CONCLUSION Underweight and greater weight change was associated with an increase in the risk of pneumonia mortality in Japanese adults.
Collapse
|
6
|
Abdel-azim N, Alkilany LF, Hassan ZK, Gaber N. Investigating causes and risk factors of pre-chemotherapy viremia in acute lymphoblastic leukemia pediatric patients. Infection 2023; 51:203-211. [PMID: 35876981 PMCID: PMC9309998 DOI: 10.1007/s15010-022-01878-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/21/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Leukemia patients are immune-compromised even before starting chemotherapy because the malignant cells invade the bone marrow and destroy WBC precursors. Leukemic patients are more susceptible to infection by a wide range of microorganisms. Viral infections and reactivations are common and may result in severe complications. The aim of this study is to investigate different causes of viremia in ALL pediatric patients as well as the clinical and the laboratory characteristics associated with viral infections. METHODS Qualitative real-time PCR was used to detect (polyoma BK, parvo B19 and herpes simplex virus) DNA in the blood of ALL patients and routine hospital records were used to provide the data of hepatitis B & C virus infection. RESULTS Polyoma BK was the most common detected virus (51.2%) followed by herpes simplex (30.2%). Viremia by single virus was found in 16 (37.2%) cases, while viremia by multiple viruses was found in 15 (34.8%) cases. The most frequent co-detected viruses were herpes simplex and polyoma BK (11.6%) followed by herpes simplex, parvo B19 and polyoma BK (9.3%). CONCLUSION There is a high frequency of viremia by single virus and viremia by multiple viruses at the time of diagnosis of acute lymphoblastic leukemia in pediatric patients admitted to South Egypt Cancer Institute (SECI) compared to studies in other regions. Polyoma BK is the most common detected virus and is mainly associated with lymphopenia. It was also significantly associated with herpes simplex viremia. HCV infection was associated with increased incidence of CNS leukemia.
Collapse
Affiliation(s)
- Nivin Abdel-azim
- Cancer Biology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71516 Egypt
| | - Lamiaa Fadel Alkilany
- Cancer Biology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71516 Egypt
| | - Zeinab Korany Hassan
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Noha Gaber
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| |
Collapse
|
7
|
Chintapula U, Chikate T, Sahoo D, Kieu A, Guerrero Rodriguez ID, Nguyen KT, Trott D. Immunomodulation in age-related disorders and nanotechnology interventions. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023; 15:e1840. [PMID: 35950266 PMCID: PMC9840662 DOI: 10.1002/wnan.1840] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/19/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
Recently, the aging population has increased exponentially around the globe bringing more challenges to improve quality of life in those populations while reducing the economic burden on healthcare systems. Aging is associated with changes in the immune system culminating in detrimental effects such as immune dysfunction, immunosenescence, and chronic inflammation. Age-related decline of immune functions is associated with various pathologies including cardiovascular, autoimmune, neurodegenerative, and infectious diseases to name a few. Conventional treatment addresses the onset of age-related diseases by early detection of risk factors, administration of vaccines as preventive care, immunomodulatory treatment, and other dietary supplements. However, these approaches often come with systemic side-effects, low bioavailability of therapeutic agents, and poor outcomes seen in the elderly. Recent innovations in nanotechnology have led to the development of novel biomaterials/nanomaterials, which explore targeted drug delivery and immunomodulatory interactions in vivo. Current nanotechnology-based immunomodulatory approaches that have the potential to be used as therapeutic interventions for some prominent age-related diseases are discussed here. Finally, we explore challenges and future aspects of nanotechnology in the treatments of age-related disorders to improve quality of life in the elderly. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Cardiovascular Disease Therapeutic Approaches and Drug Discovery > Nanomedicine for Neurological Disease Therapeutic Approaches and Drug Discovery > Emerging Technologies.
Collapse
Affiliation(s)
- Uday Chintapula
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
- Joint Bioengineering Program, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tanmayee Chikate
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
| | - Deepsundar Sahoo
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
| | - Amie Kieu
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
| | | | - Kytai T. Nguyen
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
- Joint Bioengineering Program, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Daniel Trott
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| |
Collapse
|
8
|
Akpalu W, Amegashie JA, Karuaihe ST. COVID -19 Morbidity and mortality in tropical countries: The effects of economic, institutional, and climatic variables. SCIENTIFIC AFRICAN 2022; 16:e01257. [PMID: 35765587 PMCID: PMC9221631 DOI: 10.1016/j.sciaf.2022.e01257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/21/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the significant and rising human and economic costs of the novel coronavirus disease (COVID-19), our knowledge on its epidemiology remains limited necessitating expedited research to aid public policy. This study contributes to the knowledge gap by focusing on exploring the effects of potential covariates (economic, institutional, and climatic conditions) on COVID-19 in tropical countries. Using an Ordinary Least Square (OLS) regression, our results showed a non-linear relationship between temperature and infection-to-test ratio. Specifically, temperatures warmer than 18 °C can favor the spread of the disease. In addition, strikingly, countries with better democratic principles registered more positive cases than their counterparts at high levels of corruption.
Collapse
|
9
|
Sanders EC, Sen SR, Gelston AA, Santos AM, Luo X, Bhuvan K, Tang DY, Raston CL, Weiss GA. Under-5-Minute Immunoblot Assays by Vortex Fluidic Device Acceleration. Angew Chem Int Ed Engl 2022; 61:e202202021. [PMID: 35333430 PMCID: PMC9156566 DOI: 10.1002/anie.202202021] [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: 02/06/2022] [Indexed: 11/09/2022]
Abstract
Unlocking the potential of personalized medicine in point-of-care settings requires a new generation of biomarker and proteomic assays. Ideally, assays could inexpensively perform hundreds of quantitative protein measurements in parallel at the bedsides of patients. This goal greatly exceeds current capabilities. Furthermore, biomarker assays are often challenging to translate from benchtop to clinic due to difficulties achieving and assessing the necessary selectivity, sensitivity, and reproducibility. To address these challenges, we developed an efficient (<5 min), robust (comparatively lower CVs), and inexpensive (decreasing reagent use and cost by >70 %) immunoassay method. Specifically, the immunoblot membrane is dotted with the sample and then developed in a vortex fluidic device (VFD) reactor. All assay steps-blocking, binding, and washing-leverage the unique thin-film microfluidics of the VFD. The approach can accelerate direct, indirect, and sandwich immunoblot assays. The applications demonstrated include assays relevant to both the laboratory and the clinic.
Collapse
Affiliation(s)
- Emily C. Sanders
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Sanjana R. Sen
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Aidan A. Gelston
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Alicia M. Santos
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Xuan Luo
- Flinders Institute for Nanoscale Sciences and Technology, Flinders University, Adelaide, SA 5042 (AU)
| | - Keertna Bhuvan
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Derek Y. Tang
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| | - Colin L. Raston
- Flinders Institute for Nanoscale Sciences and Technology, Flinders University, Adelaide, SA 5042 (AU)
| | - Gregory A. Weiss
- Departments of Chemistry, Molecular Biology and Biochemistry, and Pharmaceutical Sciences, University of California, Irvine, Irvine, CA 92697-2025 (USA)
| |
Collapse
|
10
|
Chinpong K, Thavornwattana K, Armatrmontree P, Chienwichai P, Lawpoolsri S, Silachamroon U, Maude RJ, Rotejanaprasert C. Spatiotemporal Epidemiology of Tuberculosis in Thailand from 2011 to 2020. BIOLOGY 2022; 11:755. [PMID: 35625483 PMCID: PMC9138531 DOI: 10.3390/biology11050755] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022]
Abstract
Tuberculosis is a leading cause of infectious disease globally, especially in developing countries. Better knowledge of spatial and temporal patterns of tuberculosis burden is important for effective control programs as well as informing resource and budget allocation. Studies have demonstrated that TB exhibits highly complex dynamics in both spatial and temporal dimensions at different levels. In Thailand, TB research has been primarily focused on surveys and clinical aspects of the disease burden with little attention on spatiotemporal heterogeneity. This study aimed to describe temporal trends and spatial patterns of TB incidence and mortality in Thailand from 2011 to 2020. Monthly TB case and death notification data were aggregated at the provincial level. Age-standardized incidence and mortality were calculated; time series and global and local clustering analyses were performed for the whole country. There was an overall decreasing trend with seasonal peaks in the winter. There was spatial heterogeneity with disease clusters in many regions, especially along international borders, suggesting that population movement and socioeconomic variables might affect the spatiotemporal distribution in Thailand. Understanding the space-time distribution of TB is useful for planning targeted disease control program activities. This is particularly important in low- and middle-income countries including Thailand to help prioritize allocation of limited resources.
Collapse
Affiliation(s)
- Kawin Chinpong
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Kaewklao Thavornwattana
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Peerawich Armatrmontree
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
- Department of Computer Engineering, Faculty of Engineering, King Mongkut’s University of technology Thonburi, Bangkok 10140, Thailand
| | - Peerut Chienwichai
- Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok 10210, Thailand; (K.C.); (K.T.); (P.A.); (P.C.)
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Udomsak Silachamroon
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Richard J. Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA 02115, USA
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Road, Oxford OX1 1NF, UK
- The Open University, Milton Keynes MK7 6AA, UK
| | - Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| |
Collapse
|
11
|
Adhikari S, Halden RU. Opportunities and limits of wastewater-based epidemiology for tracking global health and attainment of UN sustainable development goals. ENVIRONMENT INTERNATIONAL 2022; 163:107217. [PMID: 35395576 PMCID: PMC9815123 DOI: 10.1016/j.envint.2022.107217] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 05/11/2023]
Abstract
Wastewater-based epidemiology (WBE) emerged as a powerful, actionable health management tool during the COVID-19 pandemic. Hypothesizing future uses, we explored its potential for real-time, tracking of progress in attaining United Nations Sustainable Development Goals (SDGs) globally as a non-expensive method using existing infrastructure. We inventoried (i) literature-documented sewerage infrastructure, (ii) demographics of populations served, and (iii) WBE markers informative of 9 SDGs. Among the 17 different sustainable development goals listed by the UN 2030 agenda, more than half of these may be monitored by using WBE monitoring at centralized treatment infrastructure as tabulated in this study. Driven mainly by COVID-19, WBE currently is practiced in at least 55 countries, reaching about 300 million people. Expansion of WBE to 109,000 + treatment plants inventoried in 129 countries would increase global coverage 9-fold to 34.7% or 2.7 billion, leaving out 5 billion people not served by centralized sewerage systems. Associations between population demographics and present-day infrastructure are explored, and geospatial regions particularly vulnerable to infectious disease outbreaks are identified. The results suggest that difference in the differential outcomes in well-being is an outcome of the sanitation infrastructure inequalities and lack of sanitation infrastructure creates doubly disadvantaged populations at risk of poor hygiene and cut off from the early-warning benefits of conventional WBE. This is the first study to explore the feasibility and potential barriers to the use of WBE for tracking the attainment of SDGs globally with at least 9 out of 17 SDGs.
Collapse
Affiliation(s)
- Sangeet Adhikari
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ 85287, USA; Biodesign Center for Environmental Engineering, Arizona State University, Tempe, AZ 85287, USA
| | - Rolf U Halden
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, AZ 85287, USA; Biodesign Center for Environmental Engineering, Arizona State University, Tempe, AZ 85287, USA; OneWaterOneHealth, Nonprofit Project of the Arizona State University Foundation, Tempe, AZ 85287, USA; Global Futures Laboratory, Arizona State University, 800 S. Cady Mall, Tempe, AZ 85281, USA.
| |
Collapse
|
12
|
Weiss GA, Sanders EC, Sen SR, Gelston AA, Santos AM, Luo X, Bhuvan K, Tang DY, Raston CL. Under‐5‐Minute Immunoblot Assays by Vortex Fluidic Device Acceleration. Angew Chem Int Ed Engl 2022. [DOI: 10.1002/ange.202202021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Gregory Alan Weiss
- University of California, Irvine Department of Chemistry 1102 Natural Sciences 2 92697-2025 Irvine UNITED STATES
| | | | - Sanjana R. Sen
- University of California Irvine Molecular Biology and Biochemistry UNITED STATES
| | | | | | - Xuan Luo
- Flinders University aFlinders Institute for Nanoscale Science and Technology AUSTRALIA
| | | | - Derek Y. Tang
- University of California Irvine Chemistry UNITED STATES
| | - Colin L. Raston
- Flinders University aFlinders Institute for Nanoscale Science and Technology UNITED STATES
| |
Collapse
|
13
|
Baclet N, Calafiore M, Fregnac C, Gavazzi G, Forestier E, Roubaud-Baudron C, Fraisse T, Alfandari S, Senneville E, Beuscart JB. Explicit definitions of potentially inappropriate prescriptions of antibiotics in hospitalized older patients. Infect Dis Now 2022; 52:214-222. [PMID: 35158094 DOI: 10.1016/j.idnow.2022.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/25/2021] [Accepted: 02/08/2022] [Indexed: 11/27/2022]
Abstract
CONTEXT The use of explicit definitions of potentially inappropriate prescriptions of antibiotics (antibiotic PIPs) might constitute an innovative means to fight against antimicrobial resistance. Explicit definitions of PIPs can reduce the rate of inappropriate prescriptions, but explicit definitions of antibiotic PIPs in geriatric medicine are currently lacking. The objective of the study was to develop explicit definitions of antibiotic PIPs for hospitalized older patients. METHOD We performed a qualitative study of focus groups involving geriatricians and infectious disease specialists. The study complied with the Consolidated Criteria for Reporting Qualitative Research. Transcripts of audio recordings were analyzed in a two-step independent reviewing process. The exact wording of the definitions was validated by a steering committee, an independent expert group, and the focus group participants. RESULTS The four focus groups comprised 28 stakeholders. Our analysis identified 65 explicit definitions of antibiotic PIPs: 47 (73%) concerned misuse, 15 (23%) concerned overuse and three (5%) concerned underuse. Most definitions were related to critically important antibiotics: 11 (17%) for fluoroquinolones, eight (12%) for amoxicillin-clavulanic acid, eight (12%) for cephalosporins, seven (11%) for aminoglycosides, and five (8%) for carbapenems. CONCLUSION To address the public health challenge of antimicrobial resistance, our study generated explicit definitions for antibiotic PIPs in older patients. We intend to refine and to validate these definitions through a national Delphi survey; the resulting consensus might provide key messages for prescribers and open up perspectives for reducing the incidence of antibiotic PIPs.
Collapse
Affiliation(s)
- N Baclet
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; Lille Catholic Hospitals, Department of Infectious Diseases, F-59160 Lille, France
| | - M Calafiore
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - C Fregnac
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France
| | - G Gavazzi
- Clinique Universitaire de Médecine Gériatrique, Centre Hospitalier Universitaire de Grenoble-Alpes, GREPI EA7408 Université Grenoble-Alpes, F-38000 Grenoble, France
| | - E Forestier
- Service de Maladies Infectieuses, Centre Hospitalier Métropole Savoie, F-73000 Chambéry, France
| | - C Roubaud-Baudron
- CHU Bordeaux, Pôle de Gérontologie Clinique, Univ. Bordeaux, INSERM 1053 BaRITOn, F-33000 Bordeaux, France
| | - T Fraisse
- Court Séjour Gériatrique Aigu, Centre Hospitalier Alès-Cévennes, F-30100 Alès, France
| | - S Alfandari
- Gustave Dron Hospital, University Department of Infectious Diseases, F-59200 Tourcoing, France
| | - E Senneville
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France; Gustave Dron Hospital, University Department of Infectious Diseases, F-59200 Tourcoing, France
| | - J-B Beuscart
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France.
| | | |
Collapse
|
14
|
Huang G, Guo F. Loss of life expectancy due to respiratory infectious diseases: findings from the global burden of disease study in 195 countries and territories 1990-2017. JOURNAL OF POPULATION RESEARCH 2022; 39:1-43. [PMID: 35153621 PMCID: PMC8821806 DOI: 10.1007/s12546-021-09271-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 12/12/2022]
Abstract
Understanding of the patterns of and changes in mortality from respiratory infectious diseases (RID) and its contribution to loss of life expectancy (LE) is inadequate in the existing literature. With rapid sociodemographic changes globally, and the current COVID-19 pandemic, it is timely to revisit the disease burden of RID. Using the approaches of life table and cause-eliminated life table based on data from the Global Burden of Disease Study (GBD), the study analyses loss of LE due to RID in 195 countries/territories and its changes during the period 1990-2017. Results indicate that loss of LE due to RID stood at 1.29 years globally in 2017 globally and varied widely by age, gender, and geographic location, with men, elderly people, and populations in middle/low income countries/territories suffering a disproportionately high loss of LE due to RID. Additionally, loss of LE due to RID decreased remarkably by 0.97 years globally during the period 1990-2017 but increased slightly among populations older than 70 years and in many high income countries/territories. Results suggest that RID still pose a severe threat for population and public health, and that amid dramatic sociodemographic changes globally, the disease burden of RID may resurge. The study presents the first examination of the life-shortening effect of RID at the global and country/territory levels, providing new understanding of the changing disease burden of RID and shedding light on the potential consequences of the current COVID-19 pandemic.
Collapse
Affiliation(s)
- Guogui Huang
- Centre for Workforce Futures, Macquarie Business School, Macquarie University, North Ryde, NSW 2109 Australia
- Centre for Health Systems and Safety Research, Australia Institute of Health and Innovation, Macquarie University, North Ryde, NSW 2109 Australia
| | - Fei Guo
- Department of Management, Macquarie Business School, Macquarie University, North Ryde, NSW 2109 Australia
| |
Collapse
|
15
|
Social distanciation through COVID-19: A narrative analysis of Indian Peri-Urban Elderly. SOCIAL SCIENCES & HUMANITIES OPEN 2021; 4:100139. [PMID: 34927054 PMCID: PMC8665153 DOI: 10.1016/j.ssaho.2021.100139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
The world encountered an emergent issue of great concern, regarding the new pandemic virus termed as ‘Novel Coronavirus (COVID-19)’. This pandemic situation has disconcerted the socio-economic and psychological situations of people and their livelihoods, thus, disturbing societal equilibrium. Social distancing is considered to be an influential weapon to restrict this virus transmission. Like many others, especifically, the elderly people, face pressing difficulties in their daily life-world. Thus, a qualitative study is being considered among the Indian peri-urban elderly (N = 15, >60 years) to identify the experiences of social distancing on their lives and their situation in an everyday living context. The dominant themes are being identified in this study reveal that social relationships are in ‘paradox’ as it binds the proximate familial relations and distantiate the relations with their significant others that is the bonding between their friends and neighbours along with the coping strategies that have been recorded to overcome their immense psychological stress. Moreover, their preparedness to get back to the normal routines of their daily lives in post-COVID-19 is certainly a matter of concern to them. Thus, the study proposes to develop plans and policies towards awareness, counseling, and volunteering services based on local or remote area approach to make coping strategies for them more viable to combat this unforeseen crisis.
Collapse
|
16
|
Suwannatrai AT, Thinkhamrop K, Suwannatrai K, Pratumchart K, Wangdi K, Kelly M, Restrepo AMC, Gray DJ, Clements ACA, Tangkawattana S, Sripa B. Opisthorchis viverrini and Strongyloides stercoralis mono- and co-infections: Bayesian geostatistical analysis in an endemic area, Thailand. Acta Trop 2021; 223:106079. [PMID: 34363777 DOI: 10.1016/j.actatropica.2021.106079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 12/19/2022]
Abstract
Parasitic infections caused by Opisthorchis viverrini and Strongyloides stercoralis remain a major public health threat in the Greater Mekong Sub-region. An understanding of climate and other environmental influences on the geographical distribution and emergence of parasitic diseases is a crucial step to guide targeted control and prevention programs. A parasitological survey was conducted from 2008 to 2013 and included 12,554 individuals (age between 20 and 60 years) from 142 villages in five districts in Khon Kaen Province, Thailand. Geographical information systems, remote sensing technologies and a Bayesian geostatistical framework were used to develop models for O. viverrini and S. stercoralis mono- and co-infections in areas where both parasites are known to co-occur. The results indicate that male sex, increased age, altitude, precipitation, and land surface temperature have influenced the infection rate and geographical distribution of mono- and co-infections of O. viverrini and S. stercoralis in this area. Males were 6.69 times (95% CrI: 5.26-8.58) more likely to have O. viverrini - S. stercoralis co-infection. We observed that O. viverrini and S. stercoralis mono-infections display distinct spatial pattern, while co-infection is predicted in the center and southeast of the study area. The observed spatial clustering of O. viverrini and S. stercoralis provides valuable information for the spatial targeting of prevention interventions in this area.
Collapse
Affiliation(s)
- Apiporn T Suwannatrai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Health and Epidemiology Geoinformatics Research (HEGER), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
| | - Kavin Thinkhamrop
- Health and Epidemiology Geoinformatics Research (HEGER), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand; Cholangiocarcinoma Screening and Care Program (CASCAP), Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Data Management and Statistical Analysis Center (DAMASAC), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Kulwadee Suwannatrai
- Department of Biology, Faculty of Science and Technology, Sakon Nakhon Rajabhat University, Sakon Nakhon, Thailand
| | - Khanittha Pratumchart
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Health and Epidemiology Geoinformatics Research (HEGER), Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Kinley Wangdi
- Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Matthew Kelly
- Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Angela M Cadavid Restrepo
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia; Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Banchob Sripa
- WHO Collaborating Centre for Research and Control of opisthorchiasis, Tropical Disease Research Center, Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
17
|
Miller M, Oldewage-Theron W, Napier C. Eat clean and safe food: a food-based dietary guideline for the elderly in South Africa. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1947040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Makenzie Miller
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, United States
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, United States
- Department of Sustainable Food Systems and Development, University of the Free State, Bloemfontein, South Africa
| | - Carin Napier
- Department of Food and Nutrition Consumer Sciences, Durban University of Technology, Durban, South Africa
- Centre for Longitudinal Research, University of Auckland, Auckland, New Zealand
| |
Collapse
|
18
|
Oduro JK, Kissah-Korsah K. Aged Persons Living with HIV and Nutritional Wellness: Analysis of 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2. J Aging Res 2021; 2021:6635814. [PMID: 34258065 PMCID: PMC8249153 DOI: 10.1155/2021/6635814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/11/2021] [Accepted: 06/09/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION This study sought to examine the nutritional wellness among aged persons living with HIV in Somkhele, South Africa. METHODS Data were extracted from the 2013 South Africa-SAGE Well-Being of Older People Study (WOPS) Wave 2. The study sampled 440 aged persons (50 years and above). The proportion of the aged persons with high nutritional wellness by key covariates was reported with chi-square and p-values (p < 0.05). Two-level binary logistic regression models were fitted. RESULTS Results show that there were more aged women (79.8%) than men (20.2%) and the younger old (50-64) dominated (65.7%) in the ages, among the respondents. A higher percent of the aged persons were widows (39.5%) and had no formal education (46.1%). Six in 10 aged persons were HIV infected (59.5%). Percentage distribution of men with high nutrition was higher (78.7%). Regression results show that having nutritional wellness was low for aged persons who were infected by HIV (OR = 0.74, 95% CI = 0.69, 1.26) when compared to those who were not infected. Regarding ages of respondents, having high nutritional wellness was higher for young old (65-74 years) (OR = 1.21, 95% CI = 0.65, 2.25) compared to younger old (50-64 years). CONCLUSION This study suggests that age, education, source of drinking water, household source of income, and financial situation are important for nutritional wellness of aged persons who are HIV infected in South Africa. Moreover, having HIV infection is associated with low nutritional wellness. Being a young old (65-74 years) and receiving government grants and with better financial situation is associated with high nutritional wellness. Stakeholders and agencies who have interest in aged persons affected by HIV must understand the socioeconomic status in relation to their nutritional wellness. The results are of great importance to ageing policies, specifically in health and nutrition.
Collapse
Affiliation(s)
- Joseph Kojo Oduro
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Kwaku Kissah-Korsah
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
19
|
Ebrahimzadeh-Attari V, Panahi G, Hebert JR, Ostadrahimi A, Saghafi-Asl M, Lotfi-Yaghin N, Baradaran B. Nutritional approach for increasing public health during pandemic of COVID-19: A comprehensive review of antiviral nutrients and nutraceuticals. Health Promot Perspect 2021; 11:119-136. [PMID: 34195036 PMCID: PMC8233676 DOI: 10.34172/hpp.2021.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background: The novel coronavirus (COVID-19) is considered as the most life-threatening pandemic disease during the last decade. The individual nutritional status, though usually ignored in the management of COVID-19, plays a critical role in the immune function and pathogenesis of infection. Accordingly, the present review article aimed to report the effects of nutrients and nutraceuticals on respiratory viral infections including COVID-19, with a focus on their mechanisms of action. Methods: Studies were identified via systematic searches of the databases including PubMed/ MEDLINE, ScienceDirect, Scopus, and Google Scholar from 2000 until April 2020, using keywords. All relevant clinical and experimental studies published in English were included. Results: Protein-energy malnutrition (PEM) is common in severe respiratory infections and should be considered in the management of COVID-19 patients. On the other hand, obesity can be accompanied by decreasing the host immunity. Therefore, increasing physical activity at home and a slight caloric restriction with adequate intake of micronutrients and nutraceuticals are simple aids to boost host immunity and decrease the clinical manifestations of COVID-19. Conclusion: The most important nutrients which can be considered for COVID-19 management are vitamin D, vitamin C, vitamin A, folate, zinc, and probiotics. Their adequacy should be provided through dietary intake or appropriate supplementation. Moreover, adequate intake of some other dietary agents including vitamin E, magnesium, selenium, alpha linolenic acid and phytochemicals are required to maintain the host immunity.
Collapse
Affiliation(s)
| | - Ghodratollah Panahi
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - James R. Hebert
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Lotfi-Yaghin
- Student Research Committee, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
20
|
Alaazi DA, Stafinski T, Evans J, Hodgins S, Oteng-Ababio M, Menon D. "Our Home Is a Muddy Structure": Perceptions of Housing and Health Risks Among Older Adults in Contrasting Neighborhoods in Ghana. Front Public Health 2021; 9:650861. [PMID: 33987164 PMCID: PMC8112157 DOI: 10.3389/fpubh.2021.650861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/19/2021] [Indexed: 11/26/2022] Open
Abstract
Aging occurs in a variety of social and physical environmental settings that affect health. However, despite their rapidly growing populations, public health research in sub-Saharan Africa has yet to address the role of residential environments in the health and well-being of older adults. In this study, we utilized an ethnographic research methodology to explore barriers and facilitators to health among older adults residing in two contrasting neighborhoods in Accra, Ghana. Our specific objective was to identify patterns of health risks among older adults in the two neighborhoods. Data were collected through qualitative interviews with a purposive sample of health workers (n = 5), community leaders (n = 2), and older adults residing in a slum and non-slum neighborhood (n = 30). Our thematic data analysis revealed that, despite different underlying drivers, health barriers across the slum and non-slum were largely similar. The harmful effects of these health barriers - poor built environments, housing precariousness, unsanitary living conditions, defective public services, and social incivilities - were mitigated by several facilitators to health, including affordable housing and social supports in the slum and better housing and appealing doors in the non-slum. Our study contributes to a more nuanced understanding of the ways in which aging and urban environments intersect to influence population health in resource poor settings. In particular, rather than the commonly referenced dichotomy of poor and non-poor settlements in discourses of neighborhood health, our findings point to convergence of health vulnerabilities that are broadly linked to urban poverty and governmental neglect of the elderly.
Collapse
Affiliation(s)
- Dominic A. Alaazi
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Tania Stafinski
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Joshua Evans
- Earth and Atmospheric Sciences, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Stephen Hodgins
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Martin Oteng-Ababio
- Department of Geography and Resource Development, University of Ghana, Accra, Ghana
| | - Devidas Menon
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
21
|
Shree Ganesh HR, Subramanya P, Rao M R, Udupa V. Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial. J Bodyw Mov Ther 2021; 27:692-697. [PMID: 34391308 DOI: 10.1016/j.jbmt.2021.04.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Constipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly. MATERIALS AND METHODS Ninety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0-2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants. RESULTS Eighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls. DISCUSSION The results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.
Collapse
Affiliation(s)
| | - Pailoor Subramanya
- Department of Yoga Studies, Central University of Kerala, Kasaragod, Kerala, India.
| | - Raghavendra Rao M
- Central Council for Research in Yoga and Naturopathy, New Delhi, India
| | - Vivek Udupa
- SarvaKshema Hospital and Research Foundation, Saligrama, Udupi, Karnataka, India
| |
Collapse
|
22
|
Infectious diseases in India: assessing the role of household amenities and socio-demographic determinants. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01549-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
23
|
Ding X, Lian H, Wang X. Management of Very Old Patients in Intensive Care Units. Aging Dis 2021; 12:614-624. [PMID: 33815886 PMCID: PMC7990356 DOI: 10.14336/ad.2020.0914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023] Open
Abstract
The global population is aging and the demand for critical care wards increasing. Aging is associated not only with physiological and cognitive vulnerability, but also with a decline in organ function. A new topic in geriatric care is how to appropriately use critical care resources and provide the best treatment plan for very old patients (VOPs). Our special geriatric intensive care unit has admitted nearly 500 VOPs. In this review, we share our VOP treatment strategy and summarize the key points as “ABCCDEFGHI bundles.” The aim is to help intensivists to provide more comprehensive therapy for VOPs in intensive care units.
Collapse
Affiliation(s)
- Xin Ding
- 1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hui Lian
- 2Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoting Wang
- 1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,2Department of Health Care, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | |
Collapse
|
24
|
Dias LD, Blanco KC, Mfouo-Tynga IS, Inada NM, Bagnato VS. Curcumin as a photosensitizer: From molecular structure to recent advances in antimicrobial photodynamic therapy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY C: PHOTOCHEMISTRY REVIEWS 2020. [DOI: 10.1016/j.jphotochemrev.2020.100384] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
25
|
Batista MA, Calvo-Fortes F, Silveira-Nunes G, Camatta GC, Speziali E, Turroni S, Teixeira-Carvalho A, Martins-Filho OA, Neretti N, Maioli TU, Santos RR, Brigidi P, Franceschi C, Faria AMC. Inflammaging in Endemic Areas for Infectious Diseases. Front Immunol 2020; 11:579972. [PMID: 33262758 PMCID: PMC7688519 DOI: 10.3389/fimmu.2020.579972] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/13/2020] [Indexed: 12/20/2022] Open
Abstract
Immunosenescence is marked by a systemic process named inflammaging along with a series of defects in the immunological activity that results in poor responses to infectious agents and to vaccination. Inflammaging, a state of low-grade chronic inflammation, usually leads to chronic inflammatory diseases and frailty in the elderly. However, some elderly escape from frailty and reach advanced age free of the consequences of inflammaging. This process has been called immunological remodeling, and it is the hallmark of healthy aging as described in the studies of centenarians in Italy. The biological markers of healthy aging are still a matter of debate, and the studies on the topic have focused on inflammatory versus remodeling processes and molecules. The sub-clinical inflammatory status associated with aging might be a deleterious event for populations living in countries where chronic infectious diseases are not prevalent. Nevertheless, in other parts of the world where they are, two possibilities may occur. Inflammatory responses may have a protective effect against these infectious agents. At the same time, the long-term consequences of protective immune responses during chronic infections may result in accelerated immunosenescence in these individuals. Therefore, the biological markers of healthy aging can vary according to environmental, cultural, and geographical settings that reflect worldwide, and in a non-biased, non-westernized perspective, the changes that we experience regarding our contacts with microorganisms and the outcomes of such contacts.
Collapse
Affiliation(s)
- Marina Andrade Batista
- Programa de Pós Graduação em Nutrição e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda Calvo-Fortes
- Programa de Pós Graduação em Nutrição e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gabriela Silveira-Nunes
- Departamento de Medicina, Universidade Federal de Juiz de Fora, Governador Valadares, Brazil
| | - Giovanna Caliman Camatta
- Programa de Pós Graduação em Nutrição e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Elaine Speziali
- Instituto Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Silvia Turroni
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | | | | | - Nicola Neretti
- Departament of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, RI, United States
| | - Tatiani Uceli Maioli
- Programa de Pós Graduação em Nutrição e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rodrigo Ribeiro Santos
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patrizia Brigidi
- Unit of Microbial Ecology of Health, Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Claudio Franceschi
- Center for Biophysics, Bioinformatics, Biocomplexity, University of Bologna, Bologna, Italy.,Laboratory of Systems Biology of Healthy Aging, Department of Applied Mathematics, Lobachevsky University, Nizhny Novgorod, Russia
| | - Ana Maria Caetano Faria
- Programa de Pós Graduação em Nutrição e Saúde, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
26
|
Understanding how geographic, demographic and treatment history impact health outcomes of patients with multi-drug-resistant tuberculosis in Pakistan, 2014-2017. Epidemiol Infect 2020; 148:e253. [PMID: 32993828 PMCID: PMC7689600 DOI: 10.1017/s0950268820002307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) is one of the top 10 leading causes of morbidity and mortality worldwide [1]. In 2017, approximately 10 million people were infected with TB and 1.3 million patients faced mortality [1]. Patients with active TB can infect up to 10–15 people over a year. There is a greater risk of transmission in overcrowded areas with limited air ventilation including large family units, prisons and slums [1, 2]. Without proper diagnosis and treatment, roughly 45% of non-HIV positive TB patients face mortality [1]. With the help of global organizations and national TB treatment and control programmes, the global incidence of TB is declining by approximately 2% each year [1]. The World Health Organization (WHO) TB-strategy aims to end the TB epidemic and encourages partners to fund national TB programmes to improve diagnosis and treatment of TB. The goal is to ultimately decrease death rates by 90% and decrease incidence rates by 80% [1]. To achieve these goals, the decline in TB incidence needs to reach approximately 4–5% per year [1]. The WHO 2018 TB report identified multidrug resistant TB (MDR-TB) as the leading factor hindering that goal [1]. The incidence and spread of MDR-TB has drastically increased, where approximately 558 000 new cases of MDR-TB were diagnosed in 2017 causing more than 230 000 deaths globally [1]. MDR-TB is identified by resistance to the two most powerful anti-TB treatment drugs including isoniazid and rifampicin [3]. Patients with MDR-TB are required to start second-line anti-TB drugs (SLDs), which are limited, expensive, less effective and more toxic [1,2]. Therapy duration is one of the major limitations of second-line treatments, which may require up to two years of consistent use. Since TB affects mostly developing countries, long treatment durations and associated costs become a major challenge. In 2015, 15% of new TB cases were reported as MDR-TB, which drastically increased to 24% by 2017 [1]. Even with significant improvements in molecular tests and diagnostic methods, MDR-TB is still on the rise where the success rate of treatments is between 50 and 60% [1]. Additional characteristics including socioeconomic and sociocultural factors need to be considered when targeting and treating patients with MDR-TB.
Collapse
|
27
|
Domingues R, Lippi A, Setz C, Outeiro TF, Krisko A. SARS-CoV-2, immunosenescence and inflammaging: partners in the COVID-19 crime. Aging (Albany NY) 2020; 12:18778-18789. [PMID: 32991323 PMCID: PMC7585069 DOI: 10.18632/aging.103989] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
Pneumonia outbreak in the city of Wuhan, China, prompted the finding of a novel strain of severe acute respiratory syndrome virus (SARS-CoV-2). Here, we discuss potential long-term consequences of SARS-CoV-2 infection, and its possibility to cause permanent damage to the immune system and the central nervous system. Advanced chronological age is one of the main risk factors for the adverse outcomes of COVID-19, presumably due to immunosenescence and chronic low-grade inflammation, both characteristic of the elderly. The combination of viral infection and chronic inflammation in advanced chronological age might cause multiple detrimental unforeseen consequences for the predisposition and severity of neurodegenerative diseases and needs to be considered so that we can be prepared to deal with future outcomes of the ongoing pandemic.
Collapse
Affiliation(s)
- Renato Domingues
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany
| | - Alice Lippi
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany,Center of Excellence for Science and Technology-Integration of Mediterranean Region (STIM), Faculty of Science, University of Split, Split, Croatia
| | - Cristian Setz
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany,Department of Otolaryngology-Head and Neck Surgery, University Medical Center Goettingen, Goettingen, Germany
| | - Tiago F. Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany,Max Planck Institute for Experimental Medicine, Goettingen, Germany,Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, UK
| | - Anita Krisko
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany
| |
Collapse
|
28
|
Morales ML, Lopez M, Ly P, Anjum S, Fernandez-Baca MV, Valdivia-Rodriguez AM, Mamani-Licona FM, Baca-Turpo B, Farfan-Gonzales N, Chaman-Illanes Y, Cabada MM. Strongyloides stercoralis Infection at Different Altitudes of the Cusco Region in Peru. Am J Trop Med Hyg 2020; 101:422-427. [PMID: 31264557 DOI: 10.4269/ajtmh.18-0568] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Strongyloides stercoralis affects 30-100 million people worldwide. The burden is underestimated because of the paucity of studies, limited geographical areas surveyed, and poor quality of diagnostic tests. This study aimed at determining the epidemiology of strongyloidiasis using sensitive microscopy testing in rural populations living at different altitudes in Cusco, Peru. Data were collected from subjects aged > 3 years living in Quellouno (elevation 2,600 ft) and Limatambo (elevation 8,379 ft) districts. Subjects provided one fresh stool sample and answer a standardized questionnaire. Fresh stool was tested on site using the Baermann's test and agar plate culture. Formalin-preserved stool was tested by rapid sedimentation. Eighty percent (585/715) of eligible subjects consented to participate; after excluding subjects with missing data, 65% (462/715) were included. Fifty-five percentage were female; the median age was 33 years (interquartile range 13-52), and 72% had government health insurance. Half had intestinal parasites, and Strongyloides was the most common (24.5%) followed by Giardia (15.5%), Blastocystis (14.9%), and hookworm (11.5%). The agar plate culture detected more cases of Strongyloides than Baermann's or sedimentation tests. Strongyloides infection was more common at low altitude (26.4%) than at high altitude (18.6%), but the difference was not statistically significant (P = 0.08). Older age, walking barefoot, bathing in rivers/streams, and using municipal sewage were associated with strongyloidiasis. Strongyloides was the most prevalent parasite in the areas studied and was associated with demographic, socioeconomic, and sanitary factors.
Collapse
Affiliation(s)
- Maria Luisa Morales
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Martha Lopez
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Priscilla Ly
- School of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Seher Anjum
- Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas
| | - Martha Vanessa Fernandez-Baca
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Angela Maria Valdivia-Rodriguez
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Frecia Maribel Mamani-Licona
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Benicia Baca-Turpo
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru
| | - Nedhy Farfan-Gonzales
- Sede Administrativa de la Red de Servicios de Salud Cusco Norte, Ministerio de Salud, Cusco, Peru
| | - Yeshica Chaman-Illanes
- Centro de Salud de Putucusi, Red de Servicios de Salud Cusco Norte, Ministerio de Salud, Cusco, Peru
| | - Miguel Mauricio Cabada
- Universidad Peruana Cayetano Heredia-University of Texas Medical Branch, Collaborative Research Center-Cusco, Universidad Peruana Cayetano Heredia, Cusco, Peru.,Division of Infectious Diseases, Department of Medicine, University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
29
|
Hong H, Wang Q, Li J, Liu H, Meng X, Zhang H. Aging, Cancer and Immunity. J Cancer 2019; 10:3021-3027. [PMID: 31281479 PMCID: PMC6590045 DOI: 10.7150/jca.30723] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/23/2019] [Indexed: 12/31/2022] Open
Abstract
Cancers are being frequently diagnosed in the elderly. Immunosenescence which refers to the gradual deterioration of the immune system brought on by natural age advancement, has been the key cross center in the increasing frequency and severity of cancer, aging and immunity. Monoclonal antibodies targeting immune checkpoint molecules CTLA-4, PD-1 or PD-L1 are the promising anticancer therapeutics in multiple cancer subtypes generating remarkable and long-lasting clinical responses. These immune checkpoint blockers (ICBs)have already obtained approval for the treatment of patients with metastatic melanoma, advanced/refractory non-small cell lung cancer and renal cell cancer. ICBs can not only enhance immune responses against cancer cells but can also lead to inflammatory side effects called immune-related adverse events (irAEs). As none or only a small number of older patients were enrolled in most ICBs studies, it remains difficult to confirm the impacts of ICBs on the elderly. We could expect that clinical specificity of older patients (co-medications, comorbidities and reduced functional reserve) and immunosenescence may affect the efficacy of ICBs and tolerance in this population. However, the results from meta-analysis on the efficacy of ICBs are very encouraging and suggesting that the older patients will benefit from the ICBs revolution in oncology without increased toxicity.
Collapse
Affiliation(s)
- Hong Hong
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Qi Wang
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Jing Li
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, 110001, China.,Division of Geriatrics, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, 21224, USA.,Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences of China Medical University Shenyang, 110022, P.R. China
| | - Hans Liu
- Division of Geriatrics, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, 21224, USA
| | - Xin Meng
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences of China Medical University Shenyang, 110022, P.R. China
| | - Haiyan Zhang
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, 110001, China
| |
Collapse
|
30
|
Khan A, Rebhan A, Seminara D, Szerszen A. Enduring Challenge of Latent Tuberculosis in Older Nursing Home Residents: A Brief Review. J Clin Med Res 2019; 11:385-390. [PMID: 31143304 PMCID: PMC6522238 DOI: 10.14740/jocmr3763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/04/2019] [Indexed: 12/17/2022] Open
Abstract
Tuberculosis (TB) kills almost 4,000 people a day and is competing with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) as the most deadly infectious disease in the world. The gold standards of detection and management of latent tuberculosis infection (LTBI) have not been successful in complete eradication of the disease. Current screening modalities of TB include tuberculin skin testing (TST) and/or interferon-γ release assay (IGRA). However, these screening tests have been heavily studied in healthy populations but not in the elderly who are more likely to have multiple risk factors for progression to active TB from LTBI. The largest population that is harboring LTBI is the elderly, specifically those residing in nursing homes. Yet, unfortunately, guidelines for standards of detection and treatment for this specific group are lacking. In this review, we look at TST versus IGRA screening for LTBI in the elderly living in nursing homes. We review a cross-sectional study done at Staten Island University Hospital, and several other assessments of the sensitivity and accuracy of both screening tools. Furthermore, this review looks at the appropriateness of current LTBI treatment and prophylaxis in elderly patients residing in close quarters. The reviews point to the superiority of IGRA testing in the elderly for screening LTBI. The IGRA has been shown to be more sensitive to the detection of LTBI than TST. Additionally, medical complexities that the elderly population possesses may present challenges and resistance to standard treatments of LTBI. It is recommended via the literature that the addition of vitamin D, or alternative therapies (e.g. rifampin) could produce better outcomes for elderly patients with LTBI than the current 9 months of isoniazid (INH). As the older adults represent the fastest growing segment of our population and the largest LTBI reservoir in the USA, revisiting screening and treatment of LTBI in the elderly living in nursing homes may prove to lead to a path of TB eradication once and for all.
Collapse
Affiliation(s)
- Asif Khan
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Anh Rebhan
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Donna Seminara
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| | - Anita Szerszen
- Department of Internal Medicine, Staten Island University Hospital, Staten Island, NY, USA
| |
Collapse
|
31
|
Genetic polymorphism in association with susceptibility to tuberculosis: a study in a Pakistani population. Braz J Microbiol 2019; 50:429-434. [PMID: 30805894 DOI: 10.1007/s42770-019-00048-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022] Open
Abstract
Tuberculosis is becoming a global issue with raising occurrences; particularly in developing countries, the situation is alarming. Besides environmental factors, host genetic factors are vital in disease development. A demographical and genotypic analysis in relation to tuberculosis commencement is conducted in a Pakistani population, and genotypic frequency of EBI3 (rs4740) was analyzed. Allelic frequencies of EBI3 (rs4740) were significantly associated with disease susceptibility in the reviewed population. Analysis for EBI3 (rs4740) genotyping showed a significant association of "GG" with reduced risk for disease. Moreover, females and older age found to be more perilous to develop TB while smoking and a family history of TB are additional risk factors for disease development. Further work with a larger population is necessary to identify the true causative variants of tuberculosis.
Collapse
|
32
|
Falcone M, Paul M, Yahav D, Orlando G, Tiseo G, Prendki V, Güerri-Fernández R, Gavazzi G, Mutters NT, Cookson B, Tinelli Marco M. Antimicrobial consumption and impact of antimicrobial stewardship programmes in long-term care facilities. Clin Microbiol Infect 2018; 25:562-569. [PMID: 30076978 DOI: 10.1016/j.cmi.2018.07.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/13/2018] [Accepted: 07/19/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Antimicrobials are among the most frequently prescribed drugs in long-term care facilities (LTCFs). Implementation of antimicrobial stewardship programmes (ASPs) is often challenging because of scarce data in this setting. OBJECTIVES This narrative review aimed to provide data about antibiotic consumption in LTCFs and the need, implementation, and organization of ASPs in this setting. SOURCE PubMed was searched for studies assessing antimicrobial consumption and implementation of ASPs in LTCFs. The search was restricted to articles published in English in the last 10 years. Experts belonging to the ESCMID Study Group for Infections in the Elderly (ESGIE) reviewed the selected studies and evaluated the studies on ASPs according to the GRADE approach. Moreover, the quality of reporting has been assessed according to TREND and CONSORT checklists for quasi-experimental and cluster randomized clinical trials (cRCT), respectively. CONTENT Data on antibiotic consumption in LTCFs show great variability in LTCFs across and within countries. Reasons for this variability are difficult to analyse because of the differences in the types of LTCFs, their organization, and the population cared-for in the different LTCFs. However, studies show that the use of antibiotics among elderly patients in LTCFs, especially in cases of asymptomatic bacteriuria and influenza-like syndromes, is often inappropriate. High-quality cRCTs and low to moderate quality quasi-experimental studies show that educational interventions direct at nurse and physicians are effective in reducing unnecessary antibiotic prescriptions. IMPLICATIONS There is an urgent need for ASPs tailored for LTCFs. Multifaceted organized educational interventions, involving both clinicians and nursing staff, should be advocated and require institutional intervention by health authorities. Future studies assessing the impact of well-defined ASPs in LTCFs should produce compelling evidence in this setting.
Collapse
Affiliation(s)
- M Falcone
- Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
| | - M Paul
- Infectious Diseases Institute, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - D Yahav
- Infectious Diseases Unit, Rabin Medical Centre, Beilinson Hospital, Petah-Tikva, Israel
| | - G Orlando
- Clinic of Infectious Diseases, University Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | - G Tiseo
- Department of Internal Medicine and Medical Specialties, "Sapienza" University of Rome, Rome, Italy
| | - V Prendki
- Internal Medicine and Rehabilitation Unit, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - R Güerri-Fernández
- Infectious Diseases, Hospital Del Mar Medical Research Institute, Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - G Gavazzi
- University of Grenoble-Alpes and Clinic of Geriatrics, University Hospital of Grenoble-Alpes, Grenoble, France
| | - N T Mutters
- Institute for Infection Prevention and Hospital Epidemiology, Medical Centre - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - B Cookson
- Division of Infection and Immunity, University College London, Gower Street, London, WCl E 68T, UK
| | - M Tinelli Marco
- Long Term Care Facility "Pio Albergo Trivulzio", Milan, Italy
| | | |
Collapse
|
33
|
Araújo AC, Villela MM, Sena-Lopes Â, Farias NADR, Faria LMJD, Avila LFDC, Berne MEA, Borsuk S. Seroprevalence of Toxoplasma gondii and Toxocara canis in a human rural population of Southern Rio Grande do Sul. Rev Inst Med Trop Sao Paulo 2018; 60:e28. [PMID: 29972461 PMCID: PMC6029849 DOI: 10.1590/s1678-9946201860028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/02/2018] [Indexed: 01/14/2023] Open
Abstract
Due to the growing population of pets, especially homeless dogs and cats, zoonoses still represent a significant public health problem. Toxoplasma gondii and Toxocara spp. are epidemiologically important zoonotic agents as they are etiological factors of human toxoplasmosis and toxocariasis, respectively. These parasites remain neglected even though they are substantially prevalent in rural areas. The aim of this study was to investigate T. gondii and T. canis seroprevalence and risk factors of seropositivity in a rural population in Pelotas municipality, Brazil. The study participants (n=344) were patients of a Basic Healthcare Unit (BHU) located in Cerrito Alegre. Blood samples were collected and tested for T. gondii antibodies by indirect immunofluorescence and T. canis antibodies by an indirect ELISA that targets an excreted-secreted antigen (TES). T. gondii seropositivity was 53.2%, with higher titers (1:256 - 1:1,024) in individuals who habitually eat pork, beef, or chicken, while T. canis seropositivity was 71.8% and concomitant T. gondii and T. canis seropositivity was 38.3%. Among the seropositivity risk factors assessed, only habitual undercooked meat consumption was significant (p = 0.046; OR = 3.7) for T. gondii and none of them were associated with T. canis seropositivity. Both parasites have a high prevalence in rural areas, which reinforces the need to invest in rural community education and health.
Collapse
Affiliation(s)
- Adelita Campos Araújo
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Marcos Marreiro Villela
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ângela Sena-Lopes
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Nara Amélia da Rosa Farias
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Laura Maria Jorge de Faria
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Luciana Farias da Costa Avila
- Laboratório de Parasitologia, Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Maria Elisabeth Aires Berne
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Sibele Borsuk
- Departamento de Microbiologia e Parasitologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| |
Collapse
|
34
|
Felizardo AA, Marques DVB, Caldas IS, Gonçalves RV, Novaes RD. Could age and aging change the host response to systemic parasitic infections? A systematic review of preclinical evidence. Exp Gerontol 2018; 104:17-27. [PMID: 29366738 DOI: 10.1016/j.exger.2018.01.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/17/2018] [Accepted: 01/19/2018] [Indexed: 01/03/2023]
Abstract
The impact of age and aging in the evolution of systemic parasitic infections remains poorly understood. We conducted a systematic review from preclinical models of Chagas disease, leishmaniasis, malaria, sleeping sickness and toxoplasmosis. From a structured and comprehensive search in electronic databases, 29 studies were recovered and included in the review. Beyond the characteristics of the experimental models, parasitological and immunological outcomes, we also discussed the quality of current evidence. Our findings indicated that throughout aging, parasitemia and mortality were consistently reduced in Chagas disease and malaria, but were similar or increased in leishmaniasis and highly variable in toxoplasmosis. While a marked humoral response in older animals was related to the anti-T. cruzi protective phenotype, cellular responses mediated by a polarized Th1 phenotype were associated with a more effective defense against Plasmodium infection. Conversely, in leishmaniasis, severe infections and high mortality rates were potentially related to attenuation of humoral response and an imbalance between Th1 and Th2 phenotypes. Due to the heterogeneous parasitological outcomes and limited immunological data, the role of aging on toxoplasmosis evolution remains unclear. From a detailed description of the methodological bias, more controlled researches could avoid the systematic reproduction of inconsistent and poorly reproducible experimental designs.
Collapse
Affiliation(s)
- Amanda Aparecida Felizardo
- Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil; Department of Structural Biology, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - Débora Vasconcelos Bastos Marques
- Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil; Department of Pathology and Parasitology, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | - Ivo Santana Caldas
- Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil; Department of Pathology and Parasitology, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil
| | | | - Rômulo Dias Novaes
- Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil; Department of Structural Biology, Federal University of Alfenas, Alfenas, 37130-001, Minas Gerais, Brazil.
| |
Collapse
|
35
|
Abstract
The thermoregulatory functions may vary with age. Thermosensitivity is active in neonates and children; both heat production and heat loss effector mechanisms are functional but easily exhaustable. Proportional and lasting defense against thermal challenges is difficult, and both hypothermia and hyperthermia may easily develop. Febrile or hypothermic responses to infections or endotoxin can also develop, together with confusion. In small children febrile convulsions may be dangerous. In old age the resting body temperature may be lower than in young adults. Further, thermosensitivity decreases, the thresholds for activating skin vasomotor and evaporative responses or metabolism are shifted, and responses to thermal challenges are delayed or insufficient: both hypothermia and hyperthermia may develop easily. Infection-induced fevers are often limited or absent, or replaced by hypothermia. Various types of brain damage may induce special forms of hypothermia, hyperthermia, or severe fever. Impaired mental state often accompanies hypothermia and hyperthermia, and may occasionally be a dominant feature of infection (instead of the most commonly observed fever). Aging brings about a turning point in women's life: the menopause. The well-known influence of regular hormonal cycles on the thermoregulation of a woman of fertile age gives way to menopausal hot flushes caused by estrogen withdrawal. Not all details of this thermoregulatory anomaly are fully understood yet.
Collapse
|
36
|
Transcriptome profiling analysis of senescent gingival fibroblasts in response to Fusobacterium nucleatum infection. PLoS One 2017; 12:e0188755. [PMID: 29190775 PMCID: PMC5708803 DOI: 10.1371/journal.pone.0188755] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 10/18/2017] [Indexed: 11/19/2022] Open
Abstract
Periodontal disease is caused by dental plaque biofilms. Fusobacterium nucleatum is an important periodontal pathogen involved in the development of bacterial complexity in dental plaque biofilms. Human gingival fibroblasts (GFs) act as the first line of defense against oral microorganisms and locally orchestrate immune responses by triggering the production of reactive oxygen species and pro-inflammatory cytokines (IL-6 and IL-8). The frequency and severity of periodontal diseases is known to increase in elderly subjects. However, despite several studies exploring the effects of aging in periodontal disease, the underlying mechanisms through which aging affects the interaction between F. nucleatum and human GFs remain unclear. To identify genes affected by infection, aging, or both, we performed an RNA-Seq analysis using GFs isolated from a single healthy donor that were passaged for a short period of time (P4) 'young GFs' or for longer period of time (P22) 'old GFs', and infected or not with F. nucleatum. Comparing F. nucleatum-infected and uninfected GF(P4) cells the differentially expressed genes (DEGs) were involved in host defense mechanisms (i.e., immune responses and defense responses), whereas comparing F. nucleatum-infected and uninfected GF(P22) cells the DEGs were involved in cell maintenance (i.e., TGF-β signaling, skeletal development). Most DEGs in F. nucleatum-infected GF(P22) cells were downregulated (85%) and were significantly associated with host defense responses such as inflammatory responses, when compared to the DEGs in F. nucleatum-infected GF(P4) cells. Five genes (GADD45b, KLF10, CSRNP1, ID1, and TM4SF1) were upregulated in response to F. nucleatum infection; however, this effect was only seen in GF(P22) cells. The genes identified here appear to interact with each other in a network associated with free radical scavenging, cell cycle, and cancer; therefore, they could be potential candidates involved in the aged GF's response to F. nucleatum infection. Further studies are needed to confirm these observations.
Collapse
|
37
|
Ncube RT, Takarinda KC, Zishiri C, van den Boogaard W, Mlilo N, Chiteve C, Siziba N, Trinchán F, Sandy C. Age-stratified tuberculosis treatment outcomes in Zimbabwe: are we paying attention to the most vulnerable? Public Health Action 2017; 7:212-217. [PMID: 29201656 DOI: 10.5588/pha.17.0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/24/2017] [Indexed: 11/10/2022] Open
Abstract
Setting: A high tuberculosis (TB) incidence, resource-limited urban setting in Zimbabwe. Objectives: To compare treatment outcomes among people initiated on first-line anti-tuberculosis treatment in relation to age and other explanatory factors. Design: This was a retrospective record review of routine programme data. Results: Of 2209 patients included in the study, 133 (6%) were children (aged <10 years), 132 (6%) adolescents (10-19 years), 1782 (81%) adults (20-59 years) and 162 (7%) were aged ⩾60 years, defined as elderly. The highest proportion of smear-negative pulmonary TB cases was among the elderly (40%). Unfavourable outcomes, mainly deaths, increased proportionately with age, and were highest among the elderly (adjusted relative risk 3.8, 95%CI 1.3-10.7). Having previous TB, being human immunodeficiency virus positive and not on antiretroviral treatment or cotrimoxazole preventive therapy were associated with an increased risk of unfavourable outcomes. Conclusion: The elderly had the worst outcomes among all the age groups. This may be related to immunosuppressant comorbidities or other age-related diseases mis-classified as TB, as a significant proportion were smear-negative. Older persons need better adapted TB management and more sensitive diagnostic tools, such as Xpert® MTB/RIF.
Collapse
Affiliation(s)
- R T Ncube
- International Union Against Tuberculosis and Lung Disease (The Union), Zimbabwe Country Office, Harare, Zimbabwe
| | - K C Takarinda
- Centre for Operations Research, The Union, Paris, France.,AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - C Zishiri
- International Union Against Tuberculosis and Lung Disease (The Union), Zimbabwe Country Office, Harare, Zimbabwe
| | - W van den Boogaard
- Operational Research Unit, Médecins Sans Frontières, Luxembourg City, Luxembourg
| | - N Mlilo
- International Union Against Tuberculosis and Lung Disease (The Union), Zimbabwe Country Office, Harare, Zimbabwe
| | - C Chiteve
- International Union Against Tuberculosis and Lung Disease (The Union), Zimbabwe Country Office, Harare, Zimbabwe
| | - N Siziba
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| | - F Trinchán
- Bulawayo City Health Department, Bulawayo, Zimbabwe
| | - C Sandy
- AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe
| |
Collapse
|
38
|
Baclet N, Ficheur G, Alfandari S, Ferret L, Senneville E, Chazard E, Beuscart JB. Explicit definitions of potentially inappropriate prescriptions of antibiotics in older patients: a compilation derived from a systematic review. Int J Antimicrob Agents 2017; 50:640-648. [PMID: 28803931 DOI: 10.1016/j.ijantimicag.2017.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/12/2017] [Accepted: 08/01/2017] [Indexed: 12/23/2022]
Abstract
Potentially inappropriate prescriptions (PIPs) of antibiotics (antibiotic-PIPs) are generally detected by applying implicit definitions based on expert opinion. Explicit definitions are less frequently used, even though this approach would enable the automated detection of antibiotic-PIPs in electronic health records. Here, explicit definitions of antibiotic-PIPs used in studies of older adults were systematically reviewed. The MEDLINE®, Scopus® and Web of ScienceTM core collection databases were searched with a combination of three terms and their synonyms: 'potentially inappropriate prescription' AND 'antibiotic treatment' AND 'older patients'. Following standardised selection of publications, explicit definitions of antibiotic-PIPs were extracted and were classified into infectious diseases domains and subdomains. A total of 600 search queries identified 4270 records, 93 of which were selected for review. A total of 160 mentions of antibiotic-PIPs were found, corresponding to 62 distinct definitions in 19 infectious diseases domains. Nearly one-half of the definitions were related to upper respiratory tract infections (n = 11 definitions; 17.7%), lower respiratory tract infections (n = 8; 12.9%) and drug-drug interactions (n = 11; 17.7%). Almost 75% of definitions (n = 46) were mentioned in a single study only. Only three definitions concerned critically important antibiotics such as third-generation cephalosporins and fluoroquinolones. This systematic review identified 62 explicit definitions of antibiotic-PIPs. Most of the definitions were not found in more than one study and they varied in the degree of precision. We advocate the implementation of an expert consensus on explicit definitions of antibiotic-PIPs that correspond to today's challenges in public health.
Collapse
Affiliation(s)
- Nicolas Baclet
- Univ. Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000 Lille, France; Lille Catholic Hospitals, Department of Infectious Diseases, F-59160 Lille, France.
| | - Grégoire Ficheur
- Univ. Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000 Lille, France
| | - Serge Alfandari
- Gustave Dron Hospital, University Department of Infectious Diseases, F-59200 Tourcoing, France
| | - Laurie Ferret
- Univ. Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000 Lille, France; Valenciennes General Hospital, Pharmacy Department, F-59300 Valenciennes, France
| | - Eric Senneville
- Gustave Dron Hospital, University Department of Infectious Diseases, F-59200 Tourcoing, France
| | - Emmanuel Chazard
- Univ. Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000 Lille, France
| | - Jean-Baptiste Beuscart
- Univ. Lille, EA 2694 - Santé publique : épidémiologie et qualité des soins, F-59000 Lille, France; CHU Lille, Department of Geriatric Medicine, F-59000 Lille, France
| |
Collapse
|
39
|
Bhan N, Madhira P, Muralidharan A, Kulkarni B, Murthy G, Basu S, Kinra S. Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study. BMC Geriatr 2017; 17:156. [PMID: 28724399 PMCID: PMC5517927 DOI: 10.1186/s12877-017-0544-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND India's elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers. We examined perceptions of health needs of the elderly across local stakeholders in an urbanizing rural area. METHODS The qualitative study was conducted among participants in the Andhra Pradesh Children and Parents Study (APCAPS) site in Rangareddy district, Telangana. We collected data using focus group discussions and interviews among communities (n = 6), health providers (n = 9) and administrators (n = 6). We assessed stakeholders' views on the influence of urbanization on health issues faced and interventions for alleviating these challenges. We used a conceptual-analytical model to derive themes and used an inductive approach to organizing emerging codes as per a priori themes. These were organized as per thematic groups and ranked by different authors in order of importance. Bronfebrenner's theory was used to understand stakeholder perspectives and suggest interventions within four identified spheres of influence - individual, household, community and services. RESULTS Stakeholders reported frailty, lack of transport and dependence on others as factors impacting health access of the elderly. Existing public health systems were perceived as overburdened and insensitive towards the elderly. Urbanization was viewed positively, but road accidents, crime and loneliness were significant concerns. Interventions suggested by stakeholders included health service outreach, lifestyle counseling, community monitoring of healthcare and engagement activities. CONCLUSIONS We recommend integrating outreach services and lifestyle counseling within programs for care of the elderly. Community institutions can play an important role in the delivery and monitoring of health and social services for the elderly.
Collapse
Affiliation(s)
- Nandita Bhan
- Public Health Foundation of India, Plot 47, Sector 44, Gurgaon, India.
| | - Pavitra Madhira
- Indian Institute of Public Health Hyderabad, Hyderabad, India
| | | | | | - Gvs Murthy
- Indian Institute of Public Health Hyderabad, Hyderabad, India.,Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Sanjay Basu
- Stanford Prevention Research Center, Palo Alto, USA
| | - Sanjay Kinra
- Clinical Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
40
|
Breaking the population barrier by single cell analysis: one host against one pathogen. Curr Opin Microbiol 2017; 36:69-75. [DOI: 10.1016/j.mib.2017.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/03/2017] [Accepted: 01/20/2017] [Indexed: 12/30/2022]
|
41
|
González-González C, Palloni A, Wong R. Mortality and its association with chronic and infectious diseases in Mexico: A panel data analysis of the elderly. SALUD PUBLICA DE MEXICO 2017; 57 Suppl 1:S39-45. [PMID: 26172233 DOI: 10.21149/spm.v57s1.7588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 04/29/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study examines the relationship between chronic and infectious diseases on mortality risks under conditions of accelerated aging.The main hypothesis is that individuals who report both types of diseases experience higher mortality risks than those reporting only chronic diseases. MATERIALS AND METHODS We used a nationally representative sample of 12 128 individuals aged 50 years and over included in the three waves of the Mexican Health and Aging Study. We estimated Cox regression models to assess the combined effect of self-reported chronic and infectious diseases on subsequent mortality. RESULTS In the period under study there were 2 723 deaths, 22.5% of the baseline sample. Having reported chronic and infectious diseases significantly increases mortality risks compared to having reported only chronic diseases. CONCLUSION In a context of socioeconomic inequality and a mixed epidemiological regime it is crucial to understand how diseases combine to generate excess mortality risks among the elderly.
Collapse
Affiliation(s)
| | - Alberto Palloni
- University of Wisconsin, Madison, Wisconsin, Estados Unidos de América
| | - Rebeca Wong
- University of Texas Medical Branch, Galveston, Texas, Estados Unidos de América
| |
Collapse
|
42
|
Pomorska-Wesołowska M, Różańska A, Natkaniec J, Gryglewska B, Szczypta A, Dzikowska M, Chmielarczyk A, Wójkowska-Mach J. Longevity and gender as the risk factors of methicillin-resistant Staphylococcus aureus infections in southern Poland. BMC Geriatr 2017; 17:51. [PMID: 28187785 PMCID: PMC5303243 DOI: 10.1186/s12877-017-0442-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 02/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The proportion of older people among the general population has risen. Staphylococcus aureus (SA) constitutes a significant problem. Underlying disease and functional debility, predispose the older adult to staphylococcal carriage and infection, specially bloodstream infection and pneumonia. METHODS This is a retrospective cohort study of older patients with SA infections. We analyzed a database containing the results of laboratory cultures from patients treated in 2013 for SA infections and selected 613 hospitalized and non-hospitalized people aged ≥60 years. RESULTS The prevalence of Methicillin-resistant SA (MRSA) were significantly different in categories of patients: from 14.1% in young old, 19.5% in old old and 26.7 in longevity. MRSA was significantly more frequently reported in cases of pneumonia, 40.4% of SA strains (p < 0.0001, OR 0.3, 95%CI 0.14-0.49). The nosocomial MRSA infections were more common in ICU departments: prevalence 36.8%, than in non-ICU departments: prevalence 17.3% (OR 2.8, 95%CI 1.06-7.34, p = 0.014). Bloodstream infections, which accounted for 6% of all infections, were more frequent in males (p = 0.0231, OR 2.25, 95%CI 1.098-4.604). The greatest increase in antibiotic resistance was related to trimethoprim/sulfamethoxazole (TMP/SXT), which increased to over 80% in the older study groups. All age groups demonstrated increased MIC90 values for glycopeptide and tigecycline. Although strains isolated from patients in all age groups remained sensitive to vancomycin, strains isolated from patients in the old-old and longevity groups demonstrated resistance to teicoplanin. The MIC90 for tigecycline was the highest in the group aged >90 years. CONCLUSIONS MRSA constitutes a significant epidemiological problem in cases of hospital-treated pneumonia. The findings were similar for long-term-care facilities, where MRSA appears to affect male residents in particular, although there were fewer male residents than female residents. The low sensitivity to TMP/SXT of SA strains isolated from the oldest patients indicates potentially serious challenges pertaining to efficacious treatment of SA infections.
Collapse
Affiliation(s)
- Monika Pomorska-Wesołowska
- Department of Microbiology, Analytical and Microbiological Laboratory of Ruda Slaska, KORLAB NZOZ, Ruda Slaska, Poland
| | - Anna Różańska
- Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121, Krakow, Poland.
| | - Joanna Natkaniec
- Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121, Krakow, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Szczypta
- Faculty of Health and Medical Sciences, Andrzej Frycz-Modrzewski Krakow University, Krakow, Poland
| | - Mirosława Dzikowska
- Department of Clinical Nursing Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Chmielarczyk
- Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121, Krakow, Poland
| | - Jadwiga Wójkowska-Mach
- Chair of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, 18 Czysta Street, 31-121, Krakow, Poland
| |
Collapse
|
43
|
Si A, Misra AK. Concise synthesis of the pyruvic acid acetal containing pentasaccharide repeating unit of the cell wall O-antigen of Escherichia coli O156. RSC Adv 2017. [DOI: 10.1039/c7ra07567g] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The pentasaccharide repeating unit of the cell wall O-antigen ofEscherichia coliO156 containing 4,6-O-(R)-pyruvate acetal was synthesized using stereoselective [2 + 3] block glycosylation in satisfactory yield.
Collapse
Affiliation(s)
- Anshupriya Si
- Bose Institute
- Division of Molecular Medicine
- Kolkata 700054
- India
| | | |
Collapse
|
44
|
Ortiz-Martínez Y, Rios-González C, Carrascal A. Infectious diseases in patients over 65 years attended in Leticia, The Amazonas, Colombia. MEDICINA UNIVERSITARIA 2017. [DOI: 10.1016/j.rmu.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
45
|
Fréquence élevée de la prescription d’amoxicilline/acide clavulanique chez les personnes âgées de plus de 75 ans par rapport à une population jeune au service d’accueil des urgences : une étude cas-témoin. ANNALES FRANCAISES DE MEDECINE D URGENCE 2016. [DOI: 10.1007/s13341-016-0677-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
46
|
Live Attenuated Leishmania donovani Centrin Knock Out Parasites Generate Non-inferior Protective Immune Response in Aged Mice against Visceral Leishmaniasis. PLoS Negl Trop Dis 2016; 10:e0004963. [PMID: 27580076 PMCID: PMC5007048 DOI: 10.1371/journal.pntd.0004963] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 08/09/2016] [Indexed: 11/19/2022] Open
Abstract
Background Visceral leishmaniasis (VL) caused by the protozoan parasite Leishmania donovani causes severe disease. Age appears to be critical in determining the clinical outcome of VL and at present there is no effective vaccine available against VL for any age group. Previously, we showed that genetically modified live attenuated L. donovani parasites (LdCen-/-) induced a strong protective innate and adaptive immune response in young mice. In this study we analyzed LdCen-/- parasite mediated modulation of innate and adaptive immune response in aged mice (18 months) and compared to young (2 months) mice. Methodology Analysis of innate immune response in bone marrow derived dendritic cells (BMDCs) from both young and aged mice upon infection with LdCen-/- parasites, showed significant enhancement of innate effector responses, which consequently augmented CD4+ Th1 cell effector function compared to LdWT infected BMDCs in vitro. Similarly, parasitized splenic dendritic cells from LdCen-/- infected young and aged mice also revealed induction of proinflammatory cytokines (IL-12, IL-6, IFN-γ and TNF) and subsequent down regulation of anti-inflammatory cytokine (IL-10) genes compared to LdWT infected mice. We also evaluated in vivo protection of the LdCen-/- immunized young and aged mice against virulent L. donovani challenge. Immunization with LdCen-/- induced higher IgG2a antibodies, lymphoproliferative response, pro- and anti-inflammatory cytokine responses and stimulated splenocytes for heightened leishmanicidal activity associated with nitric oxide production in young and aged mice. Furthermore, upon virulent L. donovani challenge, LdCen-/- immunized mice from both age groups displayed multifunctional Th1-type CD4 and cytotoxic CD8 T cells correlating to a significantly reduced parasite burden in the spleen and liver compared to naïve mice. It is interesting to note that even though there was no difference in the LdCen-/- induced innate response in dendritic cells between aged and young mice; the adaptive response specifically in terms of T cell and B cell activation in aged animals was reduced compared to young mice which correlated with less protection in old mice compared to young mice. Conclusions Taken together, LdCen-/- immunization induced a significant but diminished host protective response in aged mice after challenge with virulent L. donovani parasites compared to young mice. Visceral leishmaniasis (VL) is caused by the protozoan parasite Leishmania donovani. There is no effective vaccine available against VL for any age group and importantly, there are no previous studies regarding immune responses against experimental Leishmania vaccines tested in aged animals. We have reported earlier that immunization with a live attenuated L. donovani parasites (LdCen-/-) induced protective immune response in young animals viz, mice, hamsters and dogs. In this study we analyzed LdCen-/- mediated modulation of innate and adaptive responses in aged mice and compared to young mice. We observed that LdCen-/- infected dendritic cells from young and aged mice resulted in enhanced innate effector functions compared to LdWT parasites both in vitro and in vivo. Further, upon virulent challenge, LdCen-/- immunized young and aged mice displayed protective Th1 immune response which correlated with a significantly reduced parasite burden in the visceral organs compared with naïve challenged mice. Although there was no difference in the LdCen-/- induced dendritic cell response between aged and young mice; adaptive response in aged was reduced, compared to young which correlated with less protection in aged compared to young mice. This study supports the potential use of LdCen-/- as vaccine candidate across all age groups against VL.
Collapse
|
47
|
Wrotek S, Jędrzejewski T, Nowakowska A, Kozak W. LPS alters pattern of sickness behavior but does not affect glutathione level in aged male rats. Biogerontology 2016; 17:715-23. [PMID: 26829940 PMCID: PMC4933742 DOI: 10.1007/s10522-016-9636-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 01/25/2016] [Indexed: 01/09/2023]
Abstract
Behavioral symptoms of sickness, such as fever and motor activity are a coordinated set of changes that develop during infection. The aim of study was to compare the sickness behaviour (SB) in healthy old and young rats treated with pyrogenic dose of endotoxin and to check their glutathione level. Before experimentation male Wistar rats were selected according to standard body mass, motor activity, and white blood cells count. Intraperitoneal injection of lipopolysaccharide (LPS) from E. coli was used to provoke SB. The level of liver glutathione, interleukin (IL) -6, deep body temperature (Tb) and motor activity were measured. Glutathione level in old and young rats did not differ significantly. In both young and old rats LPS administration provoked fever (the mean value of Tb was 38.06 ± 0.01 °C in old rats, and 38.19 ± 0.06 °C in young rats). LPS injection affected night-time activity in both groups (12 h averages were 1.56 ± 0.40 counts in old LPS-treated rats vs 2.74 ± 0.53 counts in not-treated old rats and 3.44 ± 0.60 counts for young LPS-treated vs 4.28 ± 0.57 counts for young not-treated rats). The injection of LPS provoked an elevation of plasma IL-6 concentration (from values below the lowest detectable standard in not-treated groups of animals to 6322.82 ± 537.00 pg/mL in old LPS-treated rats and 7415.62 ± 451.88 pg/mL in young LPS-treated rats). Based on these data, we conclude that good health of aged rats prevents decrease in the glutathione level. Old rats are still able to develop SB in response to pyrogenic dose of LPS, although its components have changed pattern compared to young animals.
Collapse
Affiliation(s)
- Sylwia Wrotek
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Tomasz Jędrzejewski
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Anna Nowakowska
- />Department of Animal Physiology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| | - Wiesław Kozak
- />Department of Immunology, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland
| |
Collapse
|
48
|
Ahn SH, Cho SH, Song JE, Kim S, Oh SS, Jung S, Cho KA, Lee TH. Caveolin-1 serves as a negative effector in senescent human gingival fibroblasts during Fusobacterium nucleatum infection. Mol Oral Microbiol 2016; 32:236-249. [PMID: 27315395 DOI: 10.1111/omi.12167] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 12/11/2022]
Abstract
It is well established that aging is associated with increased susceptibility to infectious diseases. Fusobacterium nucleatum is a well-known bacterial species that plays a central bridging role between early and late colonizers in the human oral cavity. Further, the ability of F. nucleatum to invade gingival fibroblasts (GFs) is critical to the development of periodontal diseases. However, the mechanisms underlying the age-related infection of GFs by F. nucleatum remain unknown. We used young (fourth passage) and senescent (22nd passage) GFs to investigate the mechanisms of F. nucleatum infection in aged GFs and first observed increased invasion of F. nucleatum in senescent GFs. We also found that the co-localization of caveolin-1 (Cav-1), a protein marker of aging, with F. nucleatum and the knockdown of Cav-1 in GFs reduced F. nucleatum invasion. Additionally, F. nucleatum infection triggered the production of reactive oxygen species (ROS) through activation of NADPH oxidase in GFs, but senescent GFs exhibited significantly lower levels of NADPH oxidase activity and ROS production compared with young GFs in both the uninfected and infected conditions. Also, senescent GFs exhibited a decline in proinflammatory cytokine production and extracellular signal regulated kinase (ERK) phosphorylation following F. nucleatum infection. Interestingly, the knockdown of Cav-1 in senescent GFs increased NADPH oxidase activity and caused the upregulation of interleukin-6 and interleukin-8 and the phosphorylation of ERK. Collectively, the increased expression of Cav-1 might play a critical role in F. nucleatum invasion and could hinder the host response in senescent GFs.
Collapse
Affiliation(s)
- S H Ahn
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S-H Cho
- Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - J-E Song
- Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - S Kim
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea.,Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| | - S S Oh
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - S Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea
| | - K A Cho
- Department of Biochemistry, Chonnam National University Medical School, Gwangju, Korea
| | - T-H Lee
- Department of Oral Biochemistry, Dental Science Research Institute, Medical Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, Korea.,Department of Molecular Medicine (BK21plus), Chonnam National University Graduate School, Gwangju, Korea
| |
Collapse
|
49
|
Hammers M, Komdeur J, Kingma SA, Hutchings K, Fairfield EA, Gilroy DL, Richardson DS. Age-specific haemosporidian infection dynamics and survival in Seychelles warblers. Sci Rep 2016; 6:29720. [PMID: 27431430 PMCID: PMC4949462 DOI: 10.1038/srep29720] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 06/22/2016] [Indexed: 11/09/2022] Open
Abstract
Parasites may severely impact the fitness and life-history of their hosts. After infection, surviving individuals may suppress the growth of the parasite, or completely clear the infection and develop immunity. Consequently, parasite prevalence is predicted to decline with age. Among elderly individuals, immunosenescence may lead to a late-life increase in infection prevalence. We used a 21-year longitudinal dataset from one population of individually-marked Seychelles warblers (Acrocephalus sechellensis) to investigate age-dependent prevalence of the GRW1 strain of the intracellular protozoan blood parasite Haemoproteus nucleocondensus and whether infections with this parasite affect age-dependent survival. We analyzed 2454 samples from 1431 individuals and found that H. nucleocondensus infections could rarely be detected in nestlings. Prevalence increased strongly among fledglings and peaked among older first year birds. Prevalence was high among younger adults and declined steeply until ca 4 years of age, after which it was stable. Contrary to expectations, H. nucleocondensus prevalence did not increase among elderly individuals and we found no evidence that annual survival was lower in individuals suffering from an infection. Our results suggest that individuals clear or suppress infections and acquire immunity against future infections, and provide no evidence for immunosenescence nor an impact of chronic infections on survival.
Collapse
Affiliation(s)
- Martijn Hammers
- Behavioural and Physiological Ecology, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands.,Theoretical Research in Evolutionary Life Sciences, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands
| | - Jan Komdeur
- Behavioural and Physiological Ecology, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands
| | - Sjouke A Kingma
- Behavioural and Physiological Ecology, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands.,Theoretical Research in Evolutionary Life Sciences, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands
| | - Kimberly Hutchings
- Behavioural and Physiological Ecology, GELIFES, University of Groningen, P.O. Box 11103, 9700 CC, Groningen, The Netherlands.,School of Biological Sciences, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, UK
| | - Eleanor A Fairfield
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, UK
| | - Danielle L Gilroy
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, UK
| | - David S Richardson
- School of Biological Sciences, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, UK.,Nature Seychelles, Roche Caiman, Mahé, Republic of Seychelles
| |
Collapse
|
50
|
Lin HS, Cheng CW, Lin MS, Chou YL, Chang PJ, Lin JC, Ye JJ. The clinical outcomes of oldest old patients with tuberculosis treated by regimens containing rifampicin, isoniazid, and pyrazinamide. Clin Interv Aging 2016; 11:299-306. [PMID: 27042029 PMCID: PMC4795580 DOI: 10.2147/cia.s95411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives To investigate the clinical characteristics, adverse drug reactions, and outcomes of the oldest old patients (aged ≥80 years) with tuberculosis (TB) treated with rifampicin, isoniazid, and pyrazinamide (RIP)-containing regimens. Design A retrospective chart review study. Setting A 1,200-bed tertiary teaching hospital in southwest Taiwan. Participants We conducted a retrospective observational study between January 1, 2005 and December 31, 2011. Seven hundred adult patients (aged ≥18 years) with TB treated with RIP-containing anti-TB regimens were reviewed, including 161 oldest old patients. Outcome measures Clinical outcomes included clinical responsiveness and microbiological eradication. Adverse outcomes included drug-induced hepatitis, and other symptoms included gastrointestinal upset (eg, abdominal pain, vomiting, diarrhea, or dyspepsia), skin rash, joint pain, and hyperuricemia. Results Compared with the non-oldest old adult patients, the oldest old patients more frequently had hepatitis (P=0.014), gastrointestinal upset (P=0.029), and unfavorable outcomes (P<0.001). In a multivariate analysis, hepatitis during treatment (adjusted odds ratio: 3.482, 95% confidence interval: 1.537–7.885; P<0.003) and oldest old age (adjusted odds ratio: 5.161, 95% confidence interval: 2.294–11.613; P<0.010) were independent risk factors for unfavorable outcomes. In the oldest old patients with hepatitis, rifampicin use was more common in the favorable outcome group than in the unfavorable outcome group (100% vs 37.5%; P=0.001). Conclusion The oldest old age and hepatitis during RIP treatment were associated with unfavorable outcomes. For the oldest old patients with TB having hepatitis during treatment, rifampicin rechallenge and use might benefit the treatment outcome.
Collapse
Affiliation(s)
- Huang-Shen Lin
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Wen Cheng
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Shyan Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
| | - Yen-Li Chou
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Pey-Jium Chang
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jing-Chi Lin
- Division of Allergy and Immunology and Rheumatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
| | - Jung-Jr Ye
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| |
Collapse
|