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Prevalence and Species Distribution of Neonatal Candidiasis: A Systematic Review and Meta-Analysis 新生儿念珠菌病的患病率和菌种分布:系统回顾与元分析
Pub Date : 2024-07-12 DOI: 10.3390/diseases12070154
Amr Molla, M. Albadrani
Background and aim: Candida infection is a significant cause of morbidity and mortality in neonatal intensive care units (NICU) globally. We aimed to conduct a systematic review to investigate the prevalence of candida among causative organisms of neonatal sepsis and identify the distribution of candida species infecting Saudi neonates. Methods: We comprehensively searched Web of Science, Scopus, PubMed, and Cochrane Library from their inception till November 2023. After screening titles, abstracts, and full texts, we ultimately included 21 eligible studies. The designs of the included studies were randomized clinical trials, cohorts, case–control, and case reports; the methodological quality was appraised using the Cochrane risk of bias assessment tool, NIH tool for observational studies, and Murad tool for assessing case reports. Results: Our systematic review and meta-analysis pooled data reported in 21 studies in the Saudi populations, which provided data on different types of candidal infections in 2346 neonates. The pooled data of ten retrospective studies enrolling 1823 neonates revealed that candida species resembled 4.2% of the causative organisms of neonatal sepsis among Saudi neonates (95%CI [2.5%; 5.9%], p = 0.000). Additionally, out of a total of 402 candida species that were identified among the included studies, C. albicans prevailed mostly among Saudi neonates, followed by C. parapsilosis, NS candida, and C. tropicalis (50.25%, 21.40%, 12.44%, and 9.45%, respectively). Conclusions: We found that candida species prevailed in 4.2% of 1823 cases of neonatal sepsis; the most common candida species was C. albicans. We could not pool data regarding risk factors or susceptibility of candida species to different treatment modalities due to insufficient data, requiring future large-scale, high-quality studies to be conducted.
背景和目的:念珠菌感染是全球新生儿重症监护病房(NICU)发病和死亡的重要原因。我们旨在开展一项系统性研究,调查新生儿败血症致病菌中念珠菌的流行情况,并确定沙特新生儿感染的念珠菌种类分布。研究方法我们全面检索了 Web of Science、Scopus、PubMed 和 Cochrane Library 从开始到 2023 年 11 月的资料。在筛选了标题、摘要和全文后,我们最终纳入了 21 项符合条件的研究。纳入研究的设计包括随机临床试验、队列、病例对照和病例报告;方法学质量采用 Cochrane 偏倚风险评估工具、NIH 观察性研究工具和 Murad 病例报告评估工具进行评估。结果我们的系统综述和荟萃分析汇集了沙特人群中 21 项研究的数据,这些研究提供了 2346 名新生儿不同类型念珠菌感染的数据。十项回顾性研究的汇总数据显示,在沙特新生儿败血症的致病菌中,念珠菌占 4.2%(95%CI [2.5%; 5.9%],P = 0.000)。此外,在纳入研究的总共 402 种念珠菌中,白念珠菌在沙特新生儿中占多数,其次是副丝状念珠菌、NS 念珠菌和热带念珠菌(分别占 50.25%、21.40%、12.44% 和 9.45%)。结论我们发现,在 1823 例新生儿败血症中,4.2% 的病例感染了念珠菌;最常见的念珠菌是白念珠菌。由于数据不足,我们无法汇集有关风险因素或念珠菌对不同治疗方式的易感性的数据,因此需要今后开展大规模、高质量的研究。
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引用次数: 0
In Silico Identification of Dysregulated miRNAs Targeting KRAS Gene in Pancreatic Cancer 针对胰腺癌 KRAS 基因的失调 miRNA 的硅学鉴定
Pub Date : 2024-07-12 DOI: 10.3390/diseases12070152
A. F. Garibaldi-Ríos, Luis E. Figuera, G. Zúñiga-González, B. Gómez-Meda, Patricia Montserrat García-Verdín, Irving Alejandro Carrillo-Dávila, I. Gutiérrez-Hurtado, B. M. Torres-Mendoza, M. Gallegos-Arreola
Pancreatic cancer (PC) is highly lethal, with KRAS mutations in up to 95% of cases. miRNAs inversely correlate with KRAS expression, indicating potential as biomarkers. This study identified miRNAs targeting KRAS and their impact on PC characteristics using in silico methods. dbDEMC identified dysregulated miRNAs in PC; TargetScan, miRDB, and PolymiRTS 3.0 identified miRNAs specific for the KRAS gene; and OncomiR evaluated the association of miRNAs with clinical characteristics and survival in PC. The correlation between miRNAs and KRAS was analysed using ENCORI/starBase. A total of 210 deregulated miRNAs were identified in PC (116 overexpressed and 94 underexpressed). In total, 16 of them were involved in the regulation of KRAS expression and 9 of these (hsa-miR-222-3p, hsa-miR-30a-5p, hsa-miR-30b-5p, hsa-miR-30e-5p, hsa-miR-377-3p, hsa-miR-495-3p, hsa-miR-654-3p, hsa-miR-877-5p and hsa-miR-885-5p) were associated with the clinical characteristics of the PC. Specifically, the overexpression of hsa-miR-30a-5p was associated with PC mortality, and hsa-miR-30b-5p, hsa-miR-377-3p, hsa-miR-495-3p, and hsa-miR-885-5p were associated with survival. Correlation analysis revealed that the expression of 10 miRNAs is correlated with KRAS expression. The dysregulated miRNAs identified in PC may regulate KRAS and some are associated with clinically relevant features, highlighting their potential as biomarkers and therapeutic targets in PC treatment. However, experimental validation is required for confirmation.
miRNA 与 KRAS 的表达成反比,显示了作为生物标记物的潜力。dbDEMC 鉴定了 PC 中失调的 miRNA;TargetScan、miRDB 和 PolymiRTS 3.0 鉴定了 KRAS 基因特异的 miRNA;OncomiR 评估了 miRNA 与 PC 临床特征和存活率的关系。利用 ENCORI/starBase 分析了 miRNA 与 KRAS 之间的相关性。在 PC 中总共发现了 210 个表达失调的 miRNA(116 个表达过高,94 个表达过低)。其中 16 个参与调控 KRAS 的表达,9 个(hsa-miR-222-3p、hsa-miR-30a-5p、hsa-miR-30b-5p、hsa-miR-30e-5p、hsa-miR-377-3p、hsa-miR-495-3p、hsa-miR-654-3p、hsa-miR-877-5p 和 hsa-miR-885-5p)与 PC 的临床特征相关。具体来说,hsa-miR-30a-5p的过表达与PC死亡率有关,而hsa-miR-30b-5p、hsa-miR-377-3p、hsa-miR-495-3p和hsa-miR-885-5p则与生存率有关。相关性分析表明,10 个 miRNA 的表达与 KRAS 的表达相关。在PC中发现的失调miRNA可能调控KRAS,其中一些还与临床相关特征有关,这凸显了它们作为生物标志物和PC治疗靶点的潜力。不过,这还需要实验验证来确认。
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引用次数: 0
STRILL: Phase I Trial Evaluating Stereotactic Body Radiotherapy (SBRT) Dose Escalation for Re-Irradiation of Inoperable Peripheral Lung Lesions STRILL:评估立体定向体外放射治疗 (SBRT) 剂量升级用于无法手术的周围肺部病变再照射的 I 期试验
Pub Date : 2024-07-12 DOI: 10.3390/diseases12070153
D. Franceschini, M. Loi, A. Marzo, L. Dominici, R. Spoto, A. Bertolini, L. Lo Faro, Francesco La Fauci, B. Marini, L. di Cristina, M. Scorsetti
Few data are available on the role of SBRT re-irradiation for isolated recurrences. We designed a prospective phase I study to evaluate the maximum tolerated dose (MTD) of SBRT for thoracic re-irradiation, for peripheral lung lesions. RT was delivered with a dose escalation design from 30 Gy in five fractions up to 50 Gy in five fractions. The primary end point was the definition of the maximum tolerated dose (MTD) of SBRT for thoracic re-irradiation. The dose-limiting toxicity was pneumonia ≥G3. Fifteen patients were enrolled. No cases of pneumonia ≥G3 occurred in any of our cohorts. Only one patient developed pneumonia G1 during treatment. Three patients developed acute toxicities that included dyspnea G1, cardiac failure G3, and chest wall pain. One patient developed G3 late toxicity with acute coronary syndrome. After a median follow-up of 21 months (range 3.6–29.1 months), six patients (40%) had a local relapse. Distant relapse occurred in five patients (33.3%). At the last follow-up, six patients died, all but two due to progressive disease. SBRT dose escalation for thoracic re-irradiation is an effective and well-tolerated option for patients with inoperable lung lesions after a first thoracic RT with acceptable acute and late toxicities.
关于SBRT再照射治疗孤立复发的作用,目前鲜有数据。我们设计了一项前瞻性 I 期研究,以评估 SBRT 用于胸腔再放射治疗外周肺部病变的最大耐受剂量 (MTD)。放射治疗采用剂量递增设计,从 30 Gy(5 次分次)到 50 Gy(5 次分次)。主要终点是确定SBRT用于胸部再照射的最大耐受剂量(MTD)。剂量限制性毒性为肺炎≥G3。共有 15 名患者入组。我们的队列中没有出现肺炎≥G3的病例。只有一名患者在治疗期间出现了肺炎 G1。三名患者出现了急性毒性反应,包括呼吸困难 G1、心力衰竭 G3 和胸壁疼痛。一名患者出现了 G3 级晚期毒性,并伴有急性冠状动脉综合征。中位随访 21 个月(3.6-29.1 个月)后,6 名患者(40%)出现局部复发。5名患者(33.3%)出现远处复发。在最后一次随访中,六名患者死亡,除两人外,其余均死于疾病进展。SBRT剂量升级胸腔再照射对于首次胸腔RT后无法手术的肺部病变患者来说是一种有效且耐受性良好的选择,其急性和晚期毒性反应均可接受。
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引用次数: 0
Novel Methodology for the Design of Personalized Cancer Vaccine Targeting Neoantigens: Application to Pancreatic Ductal Adenocarcinoma 设计靶向新抗原的个性化癌症疫苗的新方法:应用于胰腺导管腺癌
Pub Date : 2024-07-11 DOI: 10.3390/diseases12070149
Kush Savsani, S. Dakshanamurthy
Personalized cancer vaccines have emerged as a promising avenue for cancer treatment or prevention strategies. This approach targets the specific genetic alterations in individual patient’s tumors, offering a more personalized and effective treatment option. Previous studies have shown that generalized peptide vaccines targeting a limited scope of gene mutations were ineffective, emphasizing the need for personalized approaches. While studies have explored personalized mRNA vaccines, personalized peptide vaccines have not yet been studied in this context. Pancreatic ductal adenocarcinoma (PDAC) remains challenging in oncology, necessitating innovative therapeutic strategies. In this study, we developed a personalized peptide vaccine design methodology, employing RNA sequencing (RNAseq) to identify prevalent gene mutations underlying PDAC development in a patient solid tumor tissue. We performed RNAseq analysis for trimming adapters, read alignment, and somatic variant calling. We also developed a Python program called SCGeneID, which validates the alignment of the RNAseq analysis. The Python program is freely available to download. Using chromosome number and locus data, SCGeneID identifies the target gene along the UCSC hg38 reference set. Based on the gene mutation data, we developed a personalized PDAC cancer vaccine that targeted 100 highly prevalent gene mutations in two patients. We predicted peptide-MHC binding affinity, immunogenicity, antigenicity, allergenicity, and toxicity for each epitope. Then, we selected the top 50 and 100 epitopes based on our previously published vaccine design methodology. Finally, we generated pMHC-TCR 3D molecular model complex structures, which are freely available to download. The designed personalized cancer vaccine contains epitopes commonly found in PDAC solid tumor tissue. Our personalized vaccine was composed of neoantigens, allowing for a more precise and targeted immune response against cancer cells. Additionally, we identified mutated genes, which were also found in the reference study, where we obtained the sequencing data, thus validating our vaccine design methodology. This is the first study designing a personalized peptide cancer vaccine targeting neoantigens using human patient data to identify gene mutations associated with the specific tumor of interest.
个性化癌症疫苗已成为癌症治疗或预防策略的一个前景广阔的途径。这种方法针对患者肿瘤中的特定基因改变,提供了更个性化、更有效的治疗方案。以往的研究表明,针对有限范围基因突变的通用肽疫苗效果不佳,这就强调了个性化方法的必要性。虽然已有研究对个性化 mRNA 疫苗进行了探索,但在这种情况下,个性化多肽疫苗尚未得到研究。胰腺导管腺癌(PDAC)仍然是肿瘤学中的难题,需要创新的治疗策略。在本研究中,我们开发了一种个性化多肽疫苗设计方法,利用 RNA 测序(RNAseq)来确定患者实体瘤组织中 PDAC 发生的流行基因突变。我们进行了 RNAseq 分析,包括修剪适配体、读取比对和体细胞变异调用。我们还开发了一个名为 SCGeneID 的 Python 程序,用于验证 RNAseq 分析的比对结果。Python 程序可免费下载。SCGeneID 利用染色体号和基因座数据,沿着 UCSC hg38 参考集识别目标基因。根据基因突变数据,我们开发了针对两名患者 100 个高发基因突变的个性化 PDAC 癌症疫苗。我们预测了每个表位的肽-MHC 结合亲和力、免疫原性、抗原性、过敏性和毒性。然后,我们根据之前公布的疫苗设计方法,选出了前 50 个和前 100 个表位。最后,我们生成了 pMHC-TCR 三维分子模型复合物结构,可免费下载。所设计的个性化癌症疫苗包含 PDAC 实体瘤组织中常见的表位。我们的个性化疫苗由新抗原组成,可对癌细胞产生更精确、更有针对性的免疫反应。此外,我们还发现了突变基因,这些基因在我们获得测序数据的参考研究中也有发现,从而验证了我们的疫苗设计方法。这是第一项利用人类患者数据设计针对新抗原的个性化多肽癌症疫苗的研究,目的是识别与特定肿瘤相关的基因突变。
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引用次数: 0
An Alternative Non-Invasive Screening Model for Liver Fibrosis among US Adults at Risk of MASLD 在有 MASLD 风险的美国成年人中开展肝纤维化非侵入性筛查的替代模式
Pub Date : 2024-07-11 DOI: 10.3390/diseases12070150
Hongbing Sun
Background and Aims: Screening for liver fibrosis presents a clinical challenge. This study aimed to explore a useful alternative method for assessing fibrosis risk among US adults at risk of metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: A liver stiffness score (LSS) model was proposed and tested using data from 3976 participants at possible risk of MASLD, obtained from the US National Health and Nutrition Examination Survey (NHANES). Results: The LSS model was developed using liver stiffness measurements, blood biochemistry, and body measurement data from 2414 NHANES participants at risk of MASLD, sampled between 2017 and 2020: LSS = exp(0.007035 × bodyweightkg − 0.1061 × raceblack1,0 + 0.183221 × diabetes1,0 + 0.008539 × ASTIU/L − 0.0018 × plateletcount1000cell/UL − 0.21011 × albuming/dL + 2.259087). The probability (P) of having fibrosis F3 + F4 is calculated as follows: P = 0.0091 × LSS2 − 0.0791 × LSS + 0.1933. The developed LSS model was tested on 1562 at-risk participants from the 2017–2018 cycle. The results showed that the LSS model achieved AUROC values of 0.79 and 0.78 for diagnosing cirrhosis (F4) and advanced fibrosis (F3 + F4) in the US population, respectively. It outperformed existing models such as NFS, FIB-4, SAFE, and FIB-3. For screening F3 + F4 fibrosis, the LSS model’s top decile outperformed the NFS and FIB-4 models by 37.7% and 42.6%, respectively. Additionally, it showed superior performance compared to the waist circumference classification method by 29.5%. Conclusions: derived from an ethnically diverse population dataset, the LSS screening model, along with its probability equation, may offer clinicians a valuable alternative method for assessing the risk of liver fibrosis in the at-risk adult population.
背景和目的:肝纤维化筛查是一项临床挑战。本研究旨在探索一种有用的替代方法,用于评估有代谢功能障碍相关脂肪性肝病(MASLD)风险的美国成年人的肝纤维化风险。方法:从美国国家健康与营养调查(NHANES)中获得了 3976 名可能有 MASLD 风险的参与者的数据,提出并测试了肝僵化评分(LSS)模型。结果:LSS 模型是利用 2017 年至 2020 年间采样的 2414 名有 MASLD 风险的 NHANES 参与者的肝脏硬度测量、血液生化和身体测量数据建立的:LSS = exp(0.007035 × bodyweightkg - 0.1061 × raceblack1,0 + 0.183221 × diabetes1,0 + 0.008539 × ASTIU/L - 0.0018 × plateletcount1000cell/UL - 0.21011 × albuming/dL + 2.259087)。纤维化 F3 + F4 的概率(P)计算如下:P = 0.0091 × LSS2 - 0.0791 × LSS + 0.1933。开发的 LSS 模型在 2017-2018 年周期的 1562 名高危参与者身上进行了测试。结果显示,LSS 模型在美国人群中诊断肝硬化(F4)和晚期纤维化(F3 + F4)的 AUROC 值分别达到 0.79 和 0.78。它的表现优于现有的模型,如 NFS、FIB-4、SAFE 和 FIB-3。在筛查 F3 + F4 纤维化方面,LSS 模型的最高十分位数分别比 NFS 和 FIB-4 模型高出 37.7% 和 42.6%。此外,与腰围分类法相比,LSS 模型的性能优越 29.5%。结论:LSS筛查模型及其概率方程来源于不同种族的人群数据集,可为临床医生评估高危成年人群的肝纤维化风险提供一种有价值的替代方法。
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引用次数: 0
Acute Effect of Simultaneous Exercise and Cognitive Tasks on Cognitive Functions in Elderly Individuals with Mild Cognitive Impairment 运动和认知任务同时进行对轻度认知障碍老年人认知功能的急性影响
Pub Date : 2024-07-10 DOI: 10.3390/diseases12070148
Ines Ben Ayed, A. Ammar, M. Boujelbane, Atef Salem, Salma Naija, Sana Ben Amor, Khaled Trabelsi, Haitham A. Jahrami, Hamdi Chtourou, Yassine Trabelsi, Farid El Massioui
The increasing prevalence of age-related cognitive decline, alongside the aging global population, underscores the urgent need for innovative and effective preventative strategies. While the advantages of combining physical and cognitive exercises have been recognized as a promising approach to address these socioeconomic challenges, the acute effects of such interventions on cognitive functions remain understudied. This study aimed to investigate whether simultaneous physical and cognitive exercise has a greater beneficial impact on the cognitive functions of older adults with mild cognitive impairment (MCI) than physical exercise alone or reading activities. A total of 44 MCI patients (75% females aged between 65 and 75 years) were randomly assigned to one of three groups: aerobic exercise alone (EG group, n = 15), aerobic combined with cognitive exercises (CEG group, n = 15), or a reading task for controls (CG group, n = 14). Attention, memory, and problem solving were assessed before and after the acute intervention using the Tower of Hanoi, Digit Span, and Stroop tasks, respectively. Statistical analysis revealed that both of the experimental interventions appeared to enhance cognitive function scores (p < 0.05), except for the number of moves in the Tower of Hanoi task, where no improvement was noted. In contrast, no significant differences in any cognitive performance measures were observed following the reading session. Notably, the CEG group exhibited a more pronounced positive impact, especially on working memory. This advantage was specifically evident in the digit span tasks, where significantly greater percentage gains were found in the CEG than in the CG (p = 0.02), while no significant difference existed between the EG and CG. Simultaneous combined exercise has proven to be a more effective method than aerobic physical exercise alone for improving cognitive function. The results of this study are recommended for inclusion in clinical practice guidelines to maintain the mental health of older adults, as simultaneous exercise seems to offer a time-efficient strategy to enhance cognitive performance in adults with MCI.
随着全球人口老龄化的加剧,与年龄相关的认知能力衰退现象日益普遍,这凸显了对创新和有效预防策略的迫切需求。虽然将体育锻炼和认知锻炼相结合的优势已被认为是应对这些社会经济挑战的一种有前途的方法,但这种干预措施对认知功能的急性影响仍未得到充分研究。本研究旨在探讨,与单纯的体育锻炼或阅读活动相比,同时进行体育锻炼和认知锻炼对患有轻度认知障碍(MCI)的老年人的认知功能是否有更大的益处。研究人员将 44 名 MCI 患者(75% 为女性,年龄在 65 岁至 75 岁之间)随机分配到三组中的一组:单独有氧运动组(EG 组,n = 15)、有氧运动与认知运动相结合组(CEG 组,n = 15)或对照组阅读任务组(CG 组,n = 14)。在急性干预前后,分别使用河内塔、数字跨度和 Stroop 任务对注意力、记忆力和问题解决能力进行了评估。统计分析显示,除了河内塔任务中的移动次数没有改善外,其他两项实验干预似乎都提高了认知功能得分(P < 0.05)。与此相反,在阅读课后的认知表现测量中没有观察到明显的差异。值得注意的是,CEG 组表现出了更明显的积极影响,尤其是在工作记忆方面。这种优势在数字跨度任务中尤为明显,CEG 组的百分比收益明显高于 CG 组(p = 0.02),而 EG 组和 CG 组之间则没有明显差异。事实证明,在改善认知功能方面,同步综合锻炼比单独的有氧体育锻炼更有效。这项研究的结果建议纳入临床实践指南,以维护老年人的心理健康,因为同步运动似乎是提高患有 MCI 的成年人认知能力的一种省时高效的策略。
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引用次数: 0
Association of Number of Comorbid Conditions and Pain among United States Adults 美国成年人中合并症数量与疼痛的关系
Pub Date : 2024-07-10 DOI: 10.3390/diseases12070147
David R. Axon, B. Eckert
Studies have explored the association of particular conditions, or combinations of conditions, and pain among specific populations. However, there is limited information regarding the association of the number of comorbid conditions, as well as other demographic, economic, health, and limitation variables, with pain among adults in the United States. This cross-sectional database study aimed to examine the relationships between number of comorbid conditions (including cancer, arthritis, joint pain, stroke, heart attack, angina, coronary heart disease, high cholesterol, high blood pressure, other heart diseases, diabetes, asthma, chronic bronchitis, and emphysema), demographic, economic, health, and limitation variables with pain among United States adults using 2021 Medical Expenditure Panel Survey data. A multivariable logistic model assessed the association between the number of comorbid conditions (≥6, 5, 4, 3, 2, 1, versus 0 conditions) and quite a bit/extreme (versus little/moderate) pain, adjusting for demographic, economic, health, and limitation variables. The study found that greater numbers of comorbid conditions were associated with higher odds of quite a bit or extreme pain. In addition, age, education, employment, income, overall health, regular physical activity, and three limitation variables were each associated with pain in the multivariable model. These findings offer insight into the association between number of comorbid conditions and other variables with pain and suggest areas where interventions may be helpful to help improve pain outcomes for United States adults.
有研究探讨了特定人群中某些疾病或疾病组合与疼痛的关系。然而,关于美国成年人中合并症数量以及其他人口、经济、健康和限制变量与疼痛之间关系的信息却很有限。这项横断面数据库研究旨在利用 2021 年医疗支出小组调查数据,研究美国成年人中合并症(包括癌症、关节炎、关节痛、中风、心脏病、心绞痛、冠心病、高胆固醇、高血压、其他心脏病、糖尿病、哮喘、慢性支气管炎和肺气肿)的数量、人口、经济、健康和限制变量与疼痛之间的关系。多变量逻辑模型评估了合并症数量(≥6、5、4、3、2、1 与 0 症状)与相当多/极度(与很少/适度)疼痛之间的关系,并对人口统计学、经济、健康和限制变量进行了调整。研究发现,合并症越多,出现相当程度或极度疼痛的几率越高。此外,在多变量模型中,年龄、教育程度、就业、收入、总体健康状况、定期体育锻炼和三个限制变量均与疼痛有关。这些研究结果让我们深入了解了合并症数量和其他变量与疼痛之间的关系,并提出了干预措施可能有助于改善美国成年人疼痛结果的领域。
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引用次数: 0
The Association between Marital Status and Obesity: A Systematic Review and Meta-Analysis 婚姻状况与肥胖之间的关系:系统回顾与元分析
Pub Date : 2024-07-05 DOI: 10.3390/diseases12070146
T. Turnic, V. Jakovljević, Zulfiya A. Strizhkova, N. Polukhin, Dmitry Ryaboy, Mariia Kartashova, Margarita Korenkova, Valeriia Kolchina, Vladimir A. Reshetnikov
Background: Obesity was included in the International Classification of Diseases in 1990 as a chronic disease characterized by the excessive accumulation of body fat and a body mass index (BMI) greater than 30 kg/m2. Aim: This systematic review was aimed to examine the role of marital status in determining body mass index and the risk of obesity. Methods: We performed a systematic literature search using three databases (PubMed (Medline), Embase, and Google Scholar) with the search query. Results: Of the 105 studies included in the systematic review, 76 studies (72%) reported a greater risk of obesity in married individuals compared to unmarried individuals. A meta-analysis of 24 studies included a total population of 369,499 participants: 257,257 married individuals (40,896 of whom had obesity) and 112,242 comparison subjects (single, divorced, or widowed individuals, 15,084 of whom had obesity). Odds ratios for obesity found a significant pooled odds ratio for obesity in married individuals compared with controls (OR 1.70; 95% CI 1.38–2.10). The socioeconomic environment was not the same throughout the period of studies analyzed. The odds of obesity in married individuals during economic crises was greater than during the period between crises: OR 2.56 (95% CI 2.09–3.13) during crises vs. OR 1.55 (95% CI 1.24–1.95) between crises. Conclusion: The results of this review confirm the importance of considering marital status in determining the risk of obesity.
背景:肥胖症于 1990 年被列入《国际疾病分类》,是一种慢性疾病,其特征是体内脂肪过度堆积,体重指数(BMI)大于 30 kg/m2。目的:本系统综述旨在研究婚姻状况在决定体重指数和肥胖风险方面的作用。研究方法我们使用三个数据库(PubMed (Medline)、Embase 和 Google Scholar)进行了系统性文献检索。结果在纳入系统综述的 105 项研究中,有 76 项研究(72%)报告已婚人士的肥胖风险高于未婚人士。对 24 项研究进行的荟萃分析共纳入 369,499 名参与者:257,257 名已婚人士(其中 40,896 人有肥胖症)和 112,242 名对比对象(单身、离婚或丧偶人士,其中 15,084 人有肥胖症)。研究发现,与对照组相比,已婚者的肥胖几率明显高于对照组(OR 1.70;95% CI 1.38-2.10)。在所分析的研究期间,社会经济环境并不相同。在经济危机期间,已婚者肥胖的几率大于危机间歇期:危机期间的 OR 为 2.56(95% CI 为 2.09-3.13),危机间歇期的 OR 为 1.55(95% CI 为 1.24-1.95)。结论本研究结果证实了考虑婚姻状况对确定肥胖风险的重要性。
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引用次数: 0
Effects of Combustible Cigarettes and Heated Tobacco Products on Systemic Inflammatory Response in Patients with Chronic Inflammatory Diseases 可燃卷烟和加热烟草制品对慢性炎症患者全身炎症反应的影响
Pub Date : 2024-07-05 DOI: 10.3390/diseases12070144
N. Kastratović, Natasa Zdravkovic, Ivan Cekerevac, Vanesa Sekerus, C. Harrell, Violeta Mladenovic, Aleksandar Djukic, A. Volarević, Marija Branković, Tijana Gmizić, Marija Zdravković, J. Bjekić-Macut, N. Zdravković, Valentin Djonov, V. Volarevic
Smoke derived from combustible cigarettes (CCs) contains numerous harmful chemicals that can impair the viability, proliferation, and activation of immune cells, affecting the progression of chronic inflammatory diseases. In order to avoid the detrimental effects of cigarette smoking, many CC users have replaced CCs with heated tobacco products (HTPs). Due to different methods of tobacco processing, CC-sourced smoke and HTP-derived aerosols contain different chemical constituents. With the exception of nicotine, HTP-sourced aerosols contain significantly lower amounts of harmful constituents than CC-derived smoke. Since HTP-dependent effects on immune-cell-driven inflammation are still unknown, herein we used flow cytometry analysis, intracellular staining, and an enzyme-linked immunosorbent assay to determine the impact of CCs and HTPs on systemic inflammatory response in patients suffering from ulcerative colitis (UC), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD). Both CCs and HTPs significantly modulated cytokine production in circulating immune cells, affecting the systemic inflammatory response in COPD, DM, and UC patients. Compared to CCs, HTPs had weaker capacity to induce the synthesis of inflammatory cytokines (IFN-γ, IL-1β, IL-5, IL-6, IL-12, IL-23, IL-17, TNF-α), but more efficiently induced the production of immunosuppressive IL-10 and IL-35. Additionally, HTPs significantly enhanced the synthesis of pro-fibrotic TGF-β. The continuous use of CCs and HTPs aggravated immune-cell-driven systemic inflammation in COPD and DM patients, but not in UC patients, suggesting that the immunomodulatory effects of CC-derived smoke and HTP-sourced aerosols are disease-specific, and need to be determined for specific immune-cell-driven inflammatory diseases.
可燃卷烟(CC)产生的烟雾含有多种有害化学物质,会损害免疫细胞的活力、增殖和活化,从而影响慢性炎症性疾病的发展。为了避免吸烟的有害影响,许多可燃卷烟使用者用加热烟草制品(HTP)代替可燃卷烟。由于烟草加工方法不同,CC烟和加热烟草制品产生的气溶胶含有不同的化学成分。除尼古丁外,HTP气溶胶中的有害成分含量明显低于CC烟。由于 HTP 对免疫细胞驱动的炎症反应的影响尚不清楚,我们在此使用流式细胞仪分析、细胞内染色和酶联免疫吸附试验来确定 CC 和 HTP 对溃疡性结肠炎(UC)、糖尿病(DM)和慢性阻塞性肺病(COPD)患者全身炎症反应的影响。CCs和HTPs都能明显调节循环免疫细胞中细胞因子的产生,影响COPD、DM和UC患者的全身炎症反应。与CCs相比,HTPs诱导炎性细胞因子(IFN-γ、IL-1β、IL-5、IL-6、IL-12、IL-23、IL-17、TNF-α)合成的能力较弱,但能更有效地诱导免疫抑制性IL-10和IL-35的产生。此外,HTPs 还能显著增强促纤维化 TGF-β 的合成。持续使用CC和HTP会加重慢性阻塞性肺病和糖尿病患者由免疫细胞驱动的全身炎症,但不会加重慢性阻塞性肺病患者的炎症。
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引用次数: 0
Post-Operative Radiation in Early Breast Cancer with N1 Disease: 10-Year Follow-Up N1 病变早期乳腺癌术后放疗:10 年随访
Pub Date : 2024-07-05 DOI: 10.3390/diseases12070145
Ee Ling Serene Tang, E-Jan Sim, W. Ang, Jun Su, J. Chen, M. Chan, B. A. Choo, Ern Yu Tan
Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed. We aimed to evaluate the OS, disease-free survival (DFS), and factors affecting OS and DFS. A retrospective review of 191 post-menopausal women with early breast cancer and N1 disease from 2004 to 2011 was performed. Demographics, post-operative histology, adjuvant treatment, OS, and DFS were evaluated. Post-operative radiation was given to 95 of 191 women (49.7%). Younger age at diagnosis (p < 0.001), a greater number of involved nodes (p = 0.004), lymphovascular invasion (LVI), and a higher tumor grade (p = 0.001) were more likely in women who received post-operative radiation. Nodal radiation did not improve 10-year DFS (p = 0.084) or OS (p = 0.203). Post-operative nodal radiation was associated with significant improvement in 10-year OS in women who received only hormonal therapy (p = 0.047) and no other systemic therapy. Women with unfavorable risk factors were more likely to receive post-operative radiation, likely due to a perceived higher risk of recurrence. Nodal radiation did not significantly improve 10-year DFS or OS in early breast cancer patients with N1 disease, and the benefit was not clearly demonstrated. However, in those who were on hormonal therapy, radiotherapy was beneficial in improving overall survival.
对于绝经后患有早期乳腺癌 N1 病变的妇女进行术后放疗还存在争议。虽然局部控制得到了改善,但总生存率(OS)的益处尚不明确。我们回顾了这组患者术后放疗 10 年来的临床获益情况。我们的目的是评估 OS、无病生存期(DFS)以及影响 OS 和 DFS 的因素。我们对2004年至2011年期间191名绝经后患有早期乳腺癌且病情为N1的女性患者进行了回顾性研究。对人口统计学、术后组织学、辅助治疗、OS和DFS进行了评估。191 名女性中有 95 人(49.7%)接受了术后放射治疗。接受术后放射治疗的女性更容易出现诊断时年龄较小(p < 0.001)、受累结节数量较多(p = 0.004)、淋巴管侵犯(LVI)和肿瘤分级较高(p = 0.001)的情况。结节放射并不能改善 10 年 DFS(p = 0.084)或 OS(p = 0.203)。在只接受激素治疗(p = 0.047)而未接受其他系统治疗的女性中,术后结节放射与 10 年 OS 的显著改善相关。具有不利风险因素的女性更有可能接受术后放射治疗,这可能是由于她们认为复发风险更高。结节放射治疗并不能明显改善 N1 早期乳腺癌患者的 10 年 DFS 或 OS,其益处也没有得到明确证实。不过,对于那些正在接受激素治疗的患者来说,放疗有利于提高总生存率。
{"title":"Post-Operative Radiation in Early Breast Cancer with N1 Disease: 10-Year Follow-Up","authors":"Ee Ling Serene Tang, E-Jan Sim, W. Ang, Jun Su, J. Chen, M. Chan, B. A. Choo, Ern Yu Tan","doi":"10.3390/diseases12070145","DOIUrl":"https://doi.org/10.3390/diseases12070145","url":null,"abstract":"Post-operative radiotherapy for post-menopausal women with early breast cancer and N1 disease is controversial. Although locoregional control is improved, overall survival (OS) benefit is unclear. The clinical benefit of post-operative irradiation in this group of patients over 10 years was reviewed. We aimed to evaluate the OS, disease-free survival (DFS), and factors affecting OS and DFS. A retrospective review of 191 post-menopausal women with early breast cancer and N1 disease from 2004 to 2011 was performed. Demographics, post-operative histology, adjuvant treatment, OS, and DFS were evaluated. Post-operative radiation was given to 95 of 191 women (49.7%). Younger age at diagnosis (p < 0.001), a greater number of involved nodes (p = 0.004), lymphovascular invasion (LVI), and a higher tumor grade (p = 0.001) were more likely in women who received post-operative radiation. Nodal radiation did not improve 10-year DFS (p = 0.084) or OS (p = 0.203). Post-operative nodal radiation was associated with significant improvement in 10-year OS in women who received only hormonal therapy (p = 0.047) and no other systemic therapy. Women with unfavorable risk factors were more likely to receive post-operative radiation, likely due to a perceived higher risk of recurrence. Nodal radiation did not significantly improve 10-year DFS or OS in early breast cancer patients with N1 disease, and the benefit was not clearly demonstrated. However, in those who were on hormonal therapy, radiotherapy was beneficial in improving overall survival.","PeriodicalId":11200,"journal":{"name":"Diseases","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Diseases
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