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Happe M, Samuvel DJ, Ohtola JA, Korte JE, Westerink MAJ. Race-related differences in functional antibody response to pneumococcal vaccination in HIV-infected individuals. Vaccine 2019; 37:1622-1629. [PMID: 30797636 PMCID: PMC6428581 DOI: 10.1016/j.vaccine.2019.01.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Both HIV positivity and African American (AA) ethnicity are associated with increased incidence of invasive pneumococcal disease (IPD). Poor immune response to pneumococcal polysaccharide-based vaccines may contribute to the race related increased frequency of IPD in African American HIV positive individuals. METHODS Caucasian and AA HIV-infected (HIV+) individuals 40-65 years old with CD4+ T cells/µl (CD4) >200 on antiretroviral therapy (ART) received either the 13-valent pneumococcal conjugate vaccine (PCV) followed by the 23-valent pneumococcal polysaccharide vaccine (PPV) or PPV only. Serum IgG, IgM and opsonophagocytic antibody responses to serotypes 14 and 23F as well as serum IgG and opsonophagocytic antibody responses to serotype 19A were measured pre- and post-vaccination. We measured serum markers of inflammation in all participants and performed single cell gene expression profiling at the baseline by HD Biomark in Caucasians and African Americans. RESULTS There were no significant differences in pre-immunization inflammatory markers or post-vaccination IgG and IgM concentrations between Caucasian and African American participants. However, we found significantly lower opsonophagocytic activity in response to serotypes 14 and 19A in the AA group compared to the Caucasian group. There was no association between inflammatory markers and immune response to vaccination, however we found extensive biomodal variation in gene expression levels in single IgM+ memory B cells. Differentially expressed genes may be related to differences in the immune response between ethnic groups. CONCLUSIONS Distinct racial differences were found in the functional immune response following either PPV and/or PCV/PPV immunization in HIV-positive adults, although these differences were serotype dependent. Decreased ability to respond to vaccination may in part explain racial disparities in pneumococcal disease epidemiology. ClinicalTrials.gov ID: NCT03039491.
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Affiliation(s)
- Myroslawa Happe
- Department of Immunology and Microbiology, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States.
| | - Devadoss J Samuvel
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States.
| | - Jennifer A Ohtola
- Department of Medicine, University of Toledo College of Medicine & Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, United States.
| | - Jeff E Korte
- Department of Public Health Sciences, 135 Cannon St, Charleston, SC 29425, United States.
| | - M A Julie Westerink
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 927, Charleston, SC 29425, United States; Department of Medicine, Ralhp H. Johnson Veterans Administration Medical Center, 109 Bee Street, Charleston, SC 29401, United States.
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Merghati-Khoei E, Emami-Razavi SH, Bakhtiyari M, Lamyian M, Hajmirzaei S, Ton-Tab Haghighi S, Korte JE, Maasoumi R. Spinal cord injury and women's sexual life: case-control study. Spinal Cord 2016; 55:269-273. [PMID: 27401126 DOI: 10.1038/sc.2016.106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 06/11/2016] [Accepted: 06/13/2016] [Indexed: 01/01/2023]
Abstract
Study design :This is a case-control study. OBJECTIVE The objective of this study was to estimate the magnitude of association between spinal cord injury (SCI) and women's quality of sexual life and sexual function. SETTING This study was conducted in the Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS From the referral university-based clinics, we used simple random sampling to recruit 62 women: 31 women with SCI and 31 women without SCI. Socio-demographic and reproductive traits questionnaire, Sexual Quality of life-Female (SQOL-F), Female Sexual Function Index (FSFI) and Spinal Cord Independence Measure (SCIM) were completed using telephone and face-to-face interviews in the cases and controls. After univariate analyses, multivariate linear and proportional odds regression models were conducted to investigate the relation between SCI and women's quality of sexual life, as well as sexual function. RESULTS The mean age of cases and controls was 35.42±6.51 and 33.77±4.02 years. Most women were high school-educated and housewives. Adjusting for probable confounders, the proportional odds regression model showed a significant relationship between the spinal cord injury (AOR=4.2, 95% CI: 1.8-9.2), non-college-educated (AOR=3.1, 95% CI: 1.2-5.9) and employed (AOR=1.8, 95% CI: 1.1-1.8) variables and being in one of the moderate or poor quality of life classes. Scores of SQOL-F and FSFI domains, except satisfaction, were significantly worse in cases versus controls (P<0.001). CONCLUSION Although our participants showed low sexual dysfunction, they tended to report moderate to poor quality of sexual life. Our findings support the implication that sexual rehabilitation must be provided for women with SCI soon after injury.
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Affiliation(s)
- E Merghati-Khoei
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S H Emami-Razavi
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Bakhtiyari
- Safety Promotion and Injury Prevention Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Lamyian
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - S Hajmirzaei
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - S Ton-Tab Haghighi
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - J E Korte
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - R Maasoumi
- Department of Reproductive Health, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Merghati-Khoei E, Maasoumi R, Rahdari F, Bayat A, Hajmirzaei S, Lotfi S, Hajiaghababaei M, Emami-Razavi SH, Korte JE, Atoof F. Psychometric properties of the Sexual Adjustment Questionnaire (SAQ) in the Iranian population with spinal cord injury. Spinal Cord 2015; 53:807-10. [PMID: 25917953 DOI: 10.1038/sc.2015.69] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 11/10/2022]
Abstract
STUDY DESIGN This is a cross-sectional study. OBJECTIVES The objective of this study was to examine the psychometric properties of the Sexual Adjustment Questionnaire (SAQ) for Iranian people with spinal cord injury. SETTING This study was conducted in the brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS We assessed the psychometric properties of the SAQ, with 200 participants (men=146, women=54) completing the scale. An evaluation of its test-retest reliability was performed over a 2-weeks period, on a subsample of 30 patients recruited from the overall group. Cronbach's α-coefficient was computed for assessment of internal consistency reliability. In addition, content and face validity were examined by an expert committee. Construct validity was assessed by examining convergent and discriminant validity. Finally, exploratory factor analysis was used to extract the factor structure of the questionnaire. RESULTS The Cronbach's α and intraclass correlation coefficient were 0.77 and 0.72 retrospectively. With regard to construct validity, there was a significant (P=0.009) negative correlation (r=-0.28) between the SAQ score and age. Those with lower levels of educations scored significantly lower on the SAQ (P=0.04). The exploratory factor analysis indicated a four-factor structure for the questionnaire, accounting for 68.9% of the observed variance. The expert committee approved the face and content validity of the developed measure. CONCLUSION The SAQ is a valid measure for assessing sexual adjustment in people with spinal cord injury. The evaluation of sexual well-being may be useful in clinical trials and practical settings.
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Affiliation(s)
- E Merghati-Khoei
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Iranian National Center of Addiction Studies (INCAS); Institution of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran
| | - R Maasoumi
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Rahdari
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Bayat
- Iranian National Center of Addiction Studies (INCAS); Institution of Risk Behavior Reduction, Tehran University of Medical Sciences, Tehran, Iran
| | - S Hajmirzaei
- Department of Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - S Lotfi
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Hajiaghababaei
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - S H Emami-Razavi
- Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - J E Korte
- Public Health Sciences, College of Medicine, Medical University of South Carolina, SC, USA
| | - F Atoof
- Department of Biostatistics and Epidemiology, Tehran University of Medical Sciences, Tehran, Iran
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Hunt KJ, Marlow NM, Gebregziabher M, Ellerbe CN, Mauldin J, Mayorga ME, Korte JE. Impact of maternal diabetes on birthweight is greater in non-Hispanic blacks than in non-Hispanic whites. Diabetologia 2012; 55:971-80. [PMID: 22237686 PMCID: PMC3677815 DOI: 10.1007/s00125-011-2430-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 12/02/2011] [Indexed: 12/18/2022]
Abstract
AIMS/HYPOTHESIS To determine the impact of maternal diabetes during pregnancy on racial disparities in fetal growth. METHODS Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births of mothers resident in South Carolina who self-reported their race as non-Hispanic white (NHW; n = 140,128) or non-Hispanic black (NHB; n = 82,492) and delivered at 28-42 weeks' gestation between 2004 and 2008. RESULTS Prepregnancy diabetes prevalence was higher in NHB (3.0%) than in NHW (1.7%), while the prevalence of gestational diabetes mellitus (GDM) was similar in NHB (6.1%) and NHW (6.3%). At a delivery BMI of 35 kg/m(2), GDM exposure was associated with an average birthweight only 17 g (95% CI 4, 30) higher in NHW, but 78 g (95% CI 61, 95) higher in NHB (controlling for gestational age, maternal age, infant sex and availability of information on prenatal care). Figures for prepregnancy diabetes were 58 g (95% CI 34, 81) in NHW and 60 g (95% CI 37, 84) in NHB. GDM had a greater impact on birthweight in NHB than in NHW (60 g racial difference [95% CI 39, 82]), while prepregnancy diabetes had a large but similar impact. Similarly, the RR for GDM of having a large- relative to a normal-weight-for-gestational-age infant was lower in NHW (RR 1.41 [95% CI 1.34, 1.49]) than in NHB (RR 2.24 [95% CI 2.05, 2.46]). CONCLUSIONS/INTERPRETATION These data suggest that the negative effects of GDM combined with obesity during pregnancy may be greater in NHB than in NHW individuals.
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Affiliation(s)
- K J Hunt
- Department of Medicine/Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA.
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Haynes LF, Korte JE, Holmes BE, Gooden L, Matheson T, Feaster DJ, Leff JA, Wilson L, Metsch LR, Schackman BR. HIV rapid testing in substance abuse treatment: implementation following a clinical trial. Eval Program Plann 2011; 34:399-406. [PMID: 21367457 PMCID: PMC3124222 DOI: 10.1016/j.evalprogplan.2011.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial, the agency implemented an HIV testing and counseling program. During the trial, a post-trial pilot, and early implementation the agency identified challenges and developed strategies to overcome barriers to adoption of the intervention. Their experience may be instructive for other treatment providers seeking to implement an HIV testing program. Lessons learned encompassed the observed acceptability of testing and counseling to clients, the importance of a "champion" and staff buy-in, the necessity of multiple levels of community and agency support and collaboration, the ability to streamline staff training, the need for a clear chain of command, the need to develop program specific strategies, and the requirement for sufficient funding. An examination of costs indicated that some staff time may not be adequately reimbursed by funding sources for activities such as adapting the intervention, start-up training, ongoing supervision and quality assurance, and overhead costs.
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Affiliation(s)
- LF Haynes
- Medical University of South Carolina, Division of Clinical Neuroscience, 67 President St, Charleston SC 29425
| | - JE Korte
- Medical University of South Carolina, Division of Biostatistics and Epidemiology, 135 Cannon Street, Charleston SC 29425
| | - BE Holmes
- Lexington Richland Alcohol and Drug Abuse Council, 2711 Colonial Dr., Columbia SC 29203
| | - L Gooden
- University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, 1120 Northwest 14 St., Miami Fl 33136
| | - T Matheson
- San Francisco Department of Public Health, 25 Van Ness Ave., San Francisco CA 94102
| | - DJ Feaster
- University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, 1120 Northwest 14 St., Miami Fl 33136
| | - JA Leff
- Weill Cornell Medical College, Department of Public Health, 402 East 67 St., New York, NY 10065
| | - L Wilson
- Lexington Richland Alcohol and Drug Abuse Council, 2711 Colonial Dr., Columbia SC 29203
| | - LR Metsch
- University of Miami Miller School of Medicine, Department of Epidemiology and Public Health, 1120 Northwest 14 St., Miami Fl 33136
| | - BR Schackman
- Weill Cornell Medical College, Department of Public Health, 402 East 67 St., New York, NY 10065
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Hunt KJ, Hansis-Diarte A, Shipman K, Korte JE, Fowler SP, Stern MP. Impact of parental smoking on diabetes, hypertension and the metabolic syndrome in adult men and women in the San Antonio Heart Study. Diabetologia 2006; 49:2291-8. [PMID: 16896933 DOI: 10.1007/s00125-006-0382-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 06/07/2006] [Indexed: 10/24/2022]
Abstract
AIMS/HYPOTHESIS In the San Antonio Heart Study (SAHS) we investigated the effects of exposure to parental smoking on diabetes, hypertension and the metabolic syndrome in adult offspring aged 25-64 years. SUBJECTS, MATERIALS AND METHODS In a retrospective cohort study the parental smoking status during childhood, obtained through a postal questionnaire, determined a person's exposure status. Logistic regression models were used to calculate odds ratios for diabetes, hypertension and the metabolic syndrome at the baseline SAHS examination in relation to parental smoking status. All models were adjusted for age, sex, ethnicity, education years, personal smoking status (current, former or never-smoker), BMI and, in the case of diabetes, a family history of diabetes. RESULTS Of the 2,371 participants who returned the mailing, 44.5, 5.4, 20.0 and 30.1% reported that their father, mother, both or neither parent smoked, respectively. Participants reporting that both parents smoked were 1.60 (95% CI: 0.95-2.69) times more likely to have diabetes, 1.55 (95% CI: 1.05-2.28) times more likely to have hypertension, and 1.46 (95% CI: 1.01-2.10) times more likely to have the metabolic syndrome than participants reporting that neither parent smoked during their childhood. Odds ratios, after limiting the population to younger participants (i.e. <or=50 years) to reduce survivor bias, were 2.53 (95% CI: 1.21-5.31), 1.29 (95% CI: 0.78-2.16), and 1.41 (95% CI: 0.89-2.22) for diabetes, hypertension and the metabolic syndrome, respectively. CONCLUSIONS/INTERPRETATION These results provide evidence that early exposure to parental smoking may be associated with an increased risk of diabetes and perhaps hypertension and the metabolic syndrome.
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Affiliation(s)
- K J Hunt
- Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, 135 Cannon Street, Suite 303, P.O. Box 250835, Charleston, SC 29425, USA.
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Abstract
Cigarette smoking is associated with an increased risk of leukemia; benzene, an established leukemogen, is present in cigarette smoke. By combining epidemiologic data on the health effects of smoking with risk assessment techniques for low-dose extrapolation, we assessed the proportion of smoking-induced total leukemia and acute myeloid leukemia (AML) attributable to the benzene in cigarette smoke. We fit both linear and quadratic models to data from two benzene-exposed occupational cohorts to estimate the leukemogenic potency of benzene. Using multiple-decrement life tables, we calculated lifetime risks of total leukemia and AML deaths for never, light, and heavy smokers. We repeated these calculations, removing the effect of benzene in cigarettes based on the estimated potencies. From these life tables we determined smoking-attributable risks and benzene-attributable risks. The ratio of the latter to the former constitutes the proportion of smoking-induced cases attributable to benzene. Based on linear potency models, the benzene in cigarette smoke contributed from 8 to 48% of smoking-induced total leukemia deaths [95% upper confidence limit (UCL), 20-66%], and from 12 to 58% of smoking-induced AML deaths (95% UCL, 19-121%). The inclusion of a quadratic term yielded results that were comparable; however, potency models with only quadratic terms resulted in much lower attributable fractions--all < 1%. Thus, benzene is estimated to be responsible for approximately one-tenth to one-half of smoking-induced total leukemia mortality and up to three-fifths of smoking-related AML mortality. In contrast to theoretical arguments that linear models substantially overestimate low-dose risk, linear extrapolations from empirical data over a dose range of 10- to 100-fold resulted in plausible predictions.
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Affiliation(s)
- J E Korte
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400, USA
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