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Interleukin-22-induced β‑defensin-2 expression by intranasal immunization with Streptococcus pneumoniae RrgB epitopes 肺炎链球菌RrgB表位鼻内免疫白细胞介素-22诱导β防御素-2表达
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-03-08 DOI: 10.18051/univmed.2022.v41.37-46
D. Mufida, Antonius Dwi Saputra, Bagus Hermansyah, D. Agustina, M. A. Shodikin, Yunita Armiyanti
BackgroundStreptococcus pneumoniae causes pneumococcal disease, which is responsible for millions of deaths worldwide. Various pneumococcal vaccine candidates have been developed to prevent S. pneumoniae infection, one of which is an epitope-based vaccine. This study aimed to prove that intranasal immunization with each of the five S. pneumoniae RrgB epitopes can induce a mucosal immune response by increasing the β-defensin-2 concentration through upregulation of interleukin (IL)-22 expression.MethodsAn experimental laboratory study was conducted using 28 male Wistar rats aged 3-4 months, that were randomly divided into 7 groups containing four rats each. Group 1 was given 40 mL of phosphate-buffered saline (PBS) only (control group). Group 2 was the adjuvant group that received 40 mL PBS containing 2 ìg cholera toxin B (CTB), and groups 3-7 were immunized with 40 mL PBS containing a combination of adjuvant and one of the five different S. pneumoniae RrgB epitopes. The concentrations of IL-22 and β-defensin-2 from nasal rinse examination were measured by means of ELISA. The Kruskal-Wallis test, followed by the Mann-Whitney post-hoc test were used for statistical analysis.ResultsRats immunized with the adjuvant-epitope combination had significantly higher β-defensin-2 and IL-22 levels than the control group (p=0.030; p=0.018, respectively), according to the Kruskal-Wallis test. And the Mann-Whitney statistical test, showed there was a significant increase in β-defensin-2 and IL-22 levels.ConclusionsIntranasal immunization with epitope 1 of the S. pneumoniae RrgB can increase β-defensin-2 expression significantly and has a greater potential to be developed into a pneumococcal vaccine.
肺炎链球菌引起肺炎球菌疾病,导致全球数百万人死亡。已经开发了各种候选肺炎球菌疫苗来预防肺炎链球菌感染,其中之一是基于表位的疫苗。本研究旨在证明,用五个肺炎链球菌RrgB表位中的每一个进行鼻内免疫可以通过上调白细胞介素(IL)-22的表达来增加β-防御素-2的浓度,从而诱导粘膜免疫反应。方法采用28只3-4月龄雄性Wistar大鼠,随机分为7组,每组4只。第1组仅给予40mL磷酸盐缓冲盐水(PBS)(对照组)。第2组是接受含有2μg霍乱毒素B(CTB)的40mL PBS的佐剂组,第3-7组用含有佐剂和五种不同的肺炎链球菌RrgB表位之一的组合的40ml PBS免疫。用ELISA法测定鼻腔冲洗液中IL-22和β-防御素-2的浓度。采用Kruskal-Wallis检验和Mann-Whitney事后检验进行统计分析。结果根据Kruskal-Wallis试验,用佐剂表位组合免疫的大鼠的β-防御素-2和IL-22水平显著高于对照组(分别为p=0.030和p=0.018)。Mann-Whitney统计检验显示,β-防御素-2和IL-22水平显著升高。结论肺炎链球菌RrgB表位1的鼻腔免疫可显著提高β-防御素-2的表达,具有开发肺炎球菌疫苗的更大潜力。
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引用次数: 0
Increased oxidative stress in adult women with iron deficiency anemia 缺铁性贫血的成年女性氧化应激增加
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-03-03 DOI: 10.18051/univmed.2022.v41.29-36
Alpaslan Karabulut, G. Alp Avci, E. Avci
BackgroundIron deficiency anemia (IDA), a type of anemia with an increasing global frequency, is more common in women than men in the population. In IDA, the sensitivity of erythrocytes to oxidants is increased and their lifespan is shortened. Oxidative stress is an imbalance between free radicals and antioxidant molecules which is one of the potential biochemical mechanisms involved in the pathogenesis of IDA. In our study, we aimed to determine the levels of oxidant and antioxidant markers by assessing the levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase-1 (PON-1), and myeloperoxidase (MPO) in women with IDA.MethodsThis was a cross-sectional study involving 47 women with IDA aged ³40 years and 47 women volunteers. The levels of TAS, TOS, OSI, PON-1, and MPO were determined spectrophotometrically using appropriate kits. Non-parametric Mann Whitney-U tests were used to analyze the data.ResultsThe levels of antioxidants TAS (1.42 mmol Trolox equiv./L) and MPO (54.00 U/L) in the IDA group were significantly lower than in the control group [TAS (1.67 mmol Trolox equiv./L) and MPO (89.00 U/L)] (p=0.000 and p= 0.019, respectively). However, TOS (6.25 ìmol H2O2 equiv./L) level in the IDA group was significantly higher than in the control group (4.13 ìmol H2O2 equiv./L) (p=0.000), but PON-1 was not significantly different between the two groups (p=0.375).ConclusionIn women with IDA, the oxidant-antioxidant balance is impaired, resulting in oxidative stress. Therefore, IDA in adult women must receive adequate attention in clinical practice.
缺铁性贫血(IDA)是一种全球发病率不断上升的贫血,在人群中女性比男性更常见。在IDA中,红细胞对氧化剂的敏感性增加,寿命缩短。氧化应激是自由基与抗氧化分子之间的失衡,是IDA发病的潜在生化机制之一。在我们的研究中,我们旨在通过评估IDA女性的总抗氧化状态(TAS)、总氧化状态(TOS)、氧化应激指数(OSI)、对氧磷酶-1 (PON-1)和髓过氧化物酶(MPO)水平来确定氧化和抗氧化标志物的水平。方法采用横断面研究方法,纳入47例40岁IDA女性患者和47名女性志愿者。采用分光光度法测定TAS、TOS、OSI、PON-1和MPO的水平。采用非参数Mann Whitney-U检验对数据进行分析。结果IDA组抗氧化剂TAS (1.42 mmol Trolox当量/L)和MPO (54.00 U/L)水平显著低于对照组[TAS (1.67 mmol Trolox当量/L)和MPO (89.00 U/L)] (p=0.000和p= 0.019)。然而,IDA组TOS (6.25 ìmol H2O2 equiv./L)水平显著高于对照组(4.13 ìmol H2O2 equiv./L) (p=0.000),而PON-1在两组间无显著差异(p=0.375)。结论IDA患者体内氧化-抗氧化平衡受损,导致氧化应激。因此,成年女性的IDA在临床实践中必须得到足够的重视。
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引用次数: 0
Processed meat consumption increases risk of type 2 diabetes mellitus in adults aged 40 years and older 食用加工肉类会增加40岁及以上成年人患2型糖尿病的风险
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-02-15 DOI: 10.18051/univmed.2022.v41.18-28
Solikhah Solikhah, Asri Lestari
Background Type 2 diabetes mellitus (T2DM) remains a public health problem in the world, including Indonesia. The high mortality of T2DM is triggered by an unhealthy eating pattern and sedentary lifestyle. We aimed to investigate the relationship of food intake pattern and its related factors with T2DM in adults 40 years and older.MethodsThis was a cross-sectional study conducted on 11,022 men and women with T2DM aged 40 years and older. Major dietary patterns were collected and multiple logistic regression analysis was used to determine the effect of covariates. Statistical significance was set at a p-value of <0.05.ResultsMales and individuals aged >40 years comprised 50.17% and 26.19%, respectively, of the 11,022 respondents. Individuals aged over 50 years had a higher risk of developing diabetes than those aged less than 50 years (AOR =5.67, 95% CI=1.37-21.94, p<0.05). Dietary processed meat was associated with a higher risk of T2DM (AOR = 4.9; 95% CI=1.08-22.20, p<0.05). Carbohydrate and fruit intakes were negatively associated with and protective factors for DM (AOR= 0.01; 95% CI=0.01-0.06, p<0.01; AOR = 0.35; 95% CI=0.15-0.83, p<0.01). However, physical activity was not a risk factor for T2DM.ConclusionsProcessed meat consumption, age over 50 years, and carbohydrate intake may increase the risk of T2DM in adults. Conversely, fruit intake may decrease the risk of T2DM in adults. There is a need to control the diet and lifestyle for the early prevention of DM. 
背景2型糖尿病(T2DM)在包括印度尼西亚在内的世界范围内仍然是一个公共卫生问题。T2DM的高死亡率是由不健康的饮食模式和久坐的生活方式引发的。我们旨在研究40岁及以上成年人的食物摄入模式及其相关因素与T2DM的关系。方法对11022名40岁及以上的T2DM男性和女性进行横断面研究。收集主要的饮食模式,并使用多元逻辑回归分析来确定协变量的影响。统计显著性设定为40年的p值,在11022名受访者中分别占50.17%和26.19%。50岁以上的人比50岁以下的人患糖尿病的风险更高(AOR=5.67,95%CI=1.37-219.94,p<0.05)。饮食加工肉类与T2DM的风险更大相关(AOR=4.9;95%CI=1.08-222.20,p<0.05),碳水化合物和水果的摄入与DM的保护因素呈负相关(AOR=0.01;95%CI=0.01-0.06,p<0.01;AOR=0.35;95%CI=0.15-0.83,p<0.01)。然而,体育活动不是T2DM的危险因素。结论加工肉类消费、50岁以上年龄和碳水化合物摄入可能会增加成人患T2DM的风险。相反,水果摄入可以降低成年人患T2DM的风险。有必要控制饮食和生活方式,以早期预防糖尿病。
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引用次数: 1
Pre-operative intraocular pressure as a predictor of post-operative intraocular pressure after phacoemulsification in non-glaucomatous patients 非青光眼患者白内障超声乳化术后术前眼压与术后眼压的预测
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-02-08 DOI: 10.18051/univmed.2022.v41.11-17
Titiek Ernawati, K. Hendrawan, Wilson Christianto Khudrati, K. Samsudin
BackgroundCataract has been known to cause high intraocular pressure which may lead to secondary glaucoma. Some anatomical changes in cataract patients are assumed to be factors contributing to increased intraocular pressure (IOP). The changes in IOP after cataract surgery tend to help surgeons to predict clinical outcomes. Therefore, IOP control is very important in these patients. This study aimed to determine the ocular biometric parameters and pressure-to-depth (PD) ratio associated with IOP in non-glaucomatous patients who undergo cataract surgery.MethodsA prospective study using secondary clinical data collected from 81 non-glaucomatous patients. Data were collected by examining each subject pre- and post-operatively. The changes in ocular biometry parameters and IOP were measured one week before surgery and 8 weeks after the surgery. Univariate and multivariate linear regression were performed to analyze the data.ResultsThe mean anterior chamber depth (ACD) change was 0.73 ± 0.16 mm, mean PD ratio was 5.04 ± 1.16, and the mean pre-operative IOP was 16.07 ± 2.92 mmHg, decreasing by 2.35 mm Hg (14.6 %) to 13.72 ± 3.42 mm Hg at 8 weeks postoperatively. Univariate linear regression results showed a significant correlation between PD ratio and post-operative IOP (p=0.000), but no significant association was observed between PD ratio and post-operative IOP in multiple linear regression (p=0.126). However, pre-operative IOP was significantly associated with post-operative IOP (Beta=1.244; p=0.004)ConclusionsOur data demonstrated that pre-operative IOP was the most influential risk factor of IOP reduction after phacoemulsification in non-glaucomatous patients.
背景众所周知,白内障会导致高眼压,进而导致继发性青光眼。白内障患者的一些解剖变化被认为是导致眼压升高的因素。白内障手术后眼压的变化往往有助于外科医生预测临床结果。因此,对这些患者的眼压控制非常重要。本研究旨在确定接受白内障手术的非青光眼患者的眼部生物特征参数和与眼压相关的压深比。方法对81例非青光眼患者的二次临床资料进行前瞻性研究。通过对每个受试者进行术前和术后检查来收集数据。术前1周和术后8周分别测量眼生物测量参数和眼压的变化。对数据进行单变量和多变量线性回归分析。结果平均前房深度(ACD)变化为0.73±0.16mm,平均PD率为5.04±1.16,术前平均眼压为16.07±2.92mmHg,术后8周下降2.35mmHg(14.6%)至13.72±3.42mmHg。单变量线性回归结果显示PD比率与术后眼压之间存在显著相关性(p=0.000),但在多元线性回归中PD比率与手术后眼压之间没有显著相关性(p=0.126),术前眼压与术后眼压显著相关(Beta=1.244;p=0.004)结论我们的数据表明,术前眼压是非青光眼患者超声乳化术后眼压降低的最有影响的风险因素。
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引用次数: 0
Bone metastases tend to increase in non-small cell lung cancer with epidermal growth factor receptor mutation 表皮生长因子受体突变的非小细胞肺癌癌症骨转移倾向增加
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-27 DOI: 10.18051/univmed.2022.v41.4-10
Reginald Maleachi, D. Erawati, S. Pratiwi, S. Andarini
BackgroundIncreased understanding in molecular pathology of advanced non-small cell lung cancer (NSCLC) over the past decades has led to personalized treatment approaches being advocated. Epidermal growth factor receptor (EGFR) mutation that often occurs in NSCLC can be identified using immunohistochemical examinations. Moreover, clarifying the relationship between computed tomography (CT) and EGFR mutation of NSCLC might inform therapeutic decision-making. The purpose of this study was to determine the relationship between metastatic sites on primary chest CT-scan and EGFR mutation in NSCLC lung cancer patients.MethodsAn cross-sectional design using secondary data was conducted, involving 76 NSCLC patients. EGFR mutations were determined by immunohistochemical examination and metastatic sites by chest CT-scan with contrast. The collected metastatic sites comprised hilar and mediastinal lymphadenopathy, pulmonary nodules, and bone, liver, spleen and suprarenal metastases. A Chi square test was used to analyze the data.ResultsThis study revealed that the highest NSCLC stage was IVb, found in 39 samples (51.3%), while 34 (44.7%) subjects had EGFR mutation. There was no statistically significant difference between metastatic site and positive EGFR mutation, although positive bone metastases (54.8%) tend to have more numerous positive EGFR mutations compared to negative bone metastases (37.7%) (p=0.142).ConclusionsPatients with positive bone metastases tend to have higher positive EGFR mutation compared to negative bone metastases in NSCLC lung cancer patients. Prospective studies evaluating patients with EGFR mutation for bone metastases should be considered. This can provide information on therapeutic decision-making to obtain good clinical outcomes.
在过去的几十年里,对晚期非小细胞肺癌(NSCLC)分子病理学的了解不断增加,导致个性化治疗方法被提倡。表皮生长因子受体(EGFR)突变经常发生在NSCLC中,可以通过免疫组织化学检查来识别。此外,阐明计算机断层扫描(CT)与非小细胞肺癌EGFR突变之间的关系可能为治疗决策提供信息。本研究的目的是确定NSCLC肺癌患者原发性胸部ct扫描转移部位与EGFR突变之间的关系。方法采用二次资料进行横断面设计,纳入76例非小细胞肺癌患者。通过免疫组织化学检查确定EGFR突变,通过胸部ct扫描和对比检查确定转移部位。收集到的转移部位包括肺门和纵隔淋巴结病变、肺结节、骨、肝、脾和肾上转移。采用卡方检验对数据进行分析。结果39例(51.3%)NSCLC分期最高,34例(44.7%)发生EGFR突变。转移部位与EGFR阳性突变之间无统计学差异,但骨转移阳性(54.8%)比骨转移阴性(37.7%)有更多EGFR阳性突变(p=0.142)。结论非小细胞肺癌骨转移阳性患者EGFR阳性突变高于骨转移阴性患者。应考虑对骨转移的EGFR突变患者进行前瞻性研究。这可以为治疗决策提供信息,以获得良好的临床结果。
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引用次数: 0
Tale of the double pandemics, COVID-19 and obesity: a never ending story COVID-19和肥胖这两大流行病的故事:一个永远不会结束的故事
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-26 DOI: 10.18051/univmed.2022.v41.1-3
R. A. Hamid
It has been almost two years since we have been shocked by the COVID-19 pandemic, which initially started in Wuhan, China, on December 31, 2019. It was not long before the World Health Organization (WHO) finally declared it as a global pandemic on March 11, 2020, after announcing it as a public health emergency of international concern (PHEIC) on January 30, 2020. Since then, we can see the pandemic accelerated in most countries all over the world. Globally, as of 4 December 2021, there have been 270,031,622 confirmed cases of COVID-19, including 5,310,502 deaths. Due to the COVID-19 pandemic, a number of non-pharmaceutical interventions colloquially known as lockdowns have been implemented in numerous countries and territories around the world. The results of the pandemic lockdown have instigated another major concern, i.e. obesity. Overweight and obesity are defined as excessive or abnormal fat accumulation that may impair health. Based on the WHO classification for adults of both genders and all ages, overweight is defined as a body mass index (BMI) over 25 kg/ m2 and obese as a BMI over 30 kg/m2. COVID-19 has ubiquitously proven to be a major challenge for people struggling with obesity as the unfavorable effects of excess body weight in the course of SARS-CoV-2 infections have been mainly attributed to the metabolic perturbations and chronic inflammation of the adipose tissue leading to impaired immunity (blunted macrophage activation, impaired B and T lymphocyte responses) and more severe clinical outcomes. To make the matters worse, the COVID-19 pandemic has taken place at a time when there are around 2 billion overweight adults, of whom 650 million are considered to be affected by obesity (BMI ?30 kg/m2). That equates to respectively 39% and 40% of adult men and women aged 18 or over who are overweight, with 13% obese. To top it up, the lockdowns do force us to stay at home to avoid crowds by practising social distancing and locking ourselves at home with limited outdoor activities, which ultimately leads to another undeniable pandemic, obesity. The COVID-19 pandemic with its lockdowns has caused many to put on pounds. At the same time, obesity has emerged as a major risk for severe disease and death from the virus. In many countries, the interventions required to combat COVID-19 have resulted in severe socioeconomic crises. Given the well-described relationship between socio-economic status and risk of obesity, a widening societal inequality propelled by the political interventions against COVID-19 might translate into an increase in obesity and metabolic diseases in groups with a lower socio-economic status. People of lower socio-economic status with limited income and resources prefer cheap and readily available and palatable foods, which are highly processed and promote high caloric intake beyond energy needs.
新冠肺炎疫情最初于2019年12月31日在中国武汉开始,我们对这场疫情感到震惊已经快两年了。不久,世界卫生组织(世界卫生组织)在2020年1月30日宣布其为国际关注的突发公共卫生事件(PHEIC)后,终于于2020年3月11日宣布其成为全球大流行。从那时起,我们可以看到疫情在世界上大多数国家加速蔓延。截至2021年12月4日,全球共有270031222例新冠肺炎确诊病例,其中5310502例死亡。由于新冠肺炎大流行,世界各地的许多国家和地区实施了一些非药物干预措施,俗称封锁。疫情封锁的结果引发了另一个主要担忧,即肥胖。超重和肥胖被定义为可能损害健康的过度或异常脂肪堆积。根据世界卫生组织对所有性别和年龄的成年人的分类,超重被定义为体重指数(BMI)超过25 kg/m2,肥胖被定义为BMI超过30 kg/m2。新冠肺炎已被普遍证明是肥胖患者面临的主要挑战,因为在严重急性呼吸系统综合征冠状病毒2型感染过程中,超重的不利影响主要归因于代谢紊乱和脂肪组织的慢性炎症,导致免疫受损(巨噬细胞活化减弱、B和T淋巴细胞反应受损)等严重的临床结果。更糟糕的是,新冠肺炎大流行发生时,约有20亿超重成年人,其中6.5亿人被认为受到肥胖(BMI?30 kg/m2)的影响。这分别相当于39%和40%的18岁或以上成年男性和女性超重,13%的人肥胖。更重要的是,封锁确实迫使我们呆在家里,通过保持社交距离和限制户外活动来避免人群聚集,这最终导致了另一种不可否认的流行病——肥胖。新冠肺炎疫情及其封锁导致许多人体重增加。与此同时,肥胖已成为该病毒导致严重疾病和死亡的主要风险。在许多国家,抗击新冠肺炎所需的干预措施导致了严重的社会经济危机。鉴于社会经济地位与肥胖风险之间的关系已得到充分描述,针对新冠肺炎的政治干预措施推动的社会不平等加剧可能会导致社会经济地位较低群体的肥胖和代谢性疾病增加。社会经济地位较低、收入和资源有限的人更喜欢廉价、易得、可口的食物,这些食物经过高度加工,可以促进高热量摄入,超过能量需求。
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引用次数: 0
Barriers to breast cancer screening in Iranian females: a review article 伊朗女性乳腺癌癌症筛查的障碍:一篇综述文章
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-26 DOI: 10.18051/univmed.2022.v41.79-89
Nazanin Masoudi, S. Dastgiri, Z. Sanaat, Z. Abbasi, R. Dolatkhah
Breast cancer is one of the most common malignancies among females in Iran. Screening and detection in the early stages can increase the likelihood of breast cancer treatment and prognosis, thereby decreasing the mortality rate and promoting patient survival. However, mass screening programs for breast cancer are still confronted by predominant barriers in Iran. We tried to review and recognize the barriers to breast cancer screening and early detection in Iranian females as the main research question. We searched all available databases, and screened manuscripts for eligibility according to our inclusion/exclusion criteria. The search strategy was based on the following keywords: Breast, Malignancy, Cancer, Screening, Early Detection, Mammography, Iran, and Barrier. Responsible authors performed a literature review and compiled the results into a report. Various perceived barriers at different levels (individual, intrapersonal, health systems, and community) play influential and pivotal roles in women’s decisions to participate in breast cancer screening programs to facilitate early detection. Lack of awareness, neglect, procrastination, embarrassment, religious beliefs, and lack of primary health workers awareness and recommendation were cited as perceived barriers in screening procedures in Iran. There are still barriers in performing mammography at population levels in five major dimensions including availability, accessibility, cost, fears, and acceptability. However, the rate of regular mammography utilization in Iran is low compared with other countries and needs increasing through informing women. Many perceived barriers can affect women’s willingness and self-efficacy in screening procedures and one of the most effective ways of overcoming these barriers is to increase women’s awareness.
癌症是伊朗女性最常见的恶性肿瘤之一。早期筛查和检测可以增加癌症治疗的可能性和预后,从而降低死亡率并促进患者生存。然而,癌症的大规模筛查项目在伊朗仍然面临主要障碍。我们试图回顾并认识到伊朗女性乳腺癌症筛查和早期检测的障碍是主要的研究问题。我们搜索了所有可用的数据库,并根据我们的入选/排除标准筛选了手稿的资格。搜索策略基于以下关键词:乳腺、恶性肿瘤、癌症、筛查、早期检测、乳腺造影、伊朗和屏障。负责的作者进行了文献综述,并将结果汇编成一份报告。不同层次(个人、个人、卫生系统和社区)的各种感知障碍在妇女决定参与癌症筛查计划以促进早期发现方面发挥着影响和关键作用。缺乏意识、忽视、拖延、尴尬、宗教信仰以及缺乏初级卫生工作者的意识和建议被认为是伊朗筛查程序中的障碍。在人群水平上进行乳房X光检查仍然存在五个主要方面的障碍,包括可用性、可及性、成本、恐惧和可接受性。然而,与其他国家相比,伊朗的常规乳房X光检查使用率较低,需要通过向妇女提供信息来提高。许多感知障碍会影响女性在筛查过程中的意愿和自我效能,克服这些障碍的最有效方法之一是提高女性的意识。
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引用次数: 2
Obesity is the most influential risk factor of cardiopulmonary endurance in older women 肥胖是影响老年女性心肺耐力的最重要危险因素
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-12-06 DOI: 10.18051/univmed.2021.v40.254-262
Rita Khairani, Donna Adriani, Patwa Amani
BackgroundPulmonary function decreases with age. Similarly, physical exercise capacity measured by maximal oxygen uptake, which is one indicator to measure the level of cardiac and pulmonary vascular resistance, decreases by >1% per year. This results in many respiratory diseases that occur in older persons, especially in obese older persons. Pulmonary function is a basic component of cardiopulmonary endurance, besides other factors such as age, hemodynamics, metabolism, and lifestyle. The objective of this study was to determine whether body mass index (BMI) and pulmonary function have a significant association with cardiopulmonary endurance in older women.MethodsThe study used a cross-sectional design involving 66 subjects aged 60 years and older in South Jakarta. Data was collected by measuring body mass index (BMI), pulmonary function (FEV1, FVC, FEV1/FVC) and maximal oxygen uptake (VO2 max) for cardiopulmonary endurance. Data analysis used simple and multiple linear regression tests in SPSS v.25, with p<0.05.ResultsOf the 66 older persons, 57.6% was obese. Pulmonary function of subjects showed restriction (33.3%), obstruction (6.1%) and a combination of restriction and obstruction (1.5%). Furthermore, mean VO2 max was 12.2 mL/kg/min. Multiple linear regression analysis showed a significant association of BMI and FEV1/FVC with VO2 max (â =-0.56; 95% CI=-0.81 - (-) 0.31; p=0.000; â =0.09; 95% CI=0.01-0.18; p=0.028). BMI was the most influential risk factor of VO2 max (Beta = -0.46).ConclusionsThere was a significant association of BMI and FEV1/FVC with VO2 max, BMI being the most influential risk factor of cardiopulmonary endurance in older women.
背景肺功能随着年龄的增长而下降。同样,通过最大摄氧量(衡量心肺血管阻力水平的指标之一)衡量的体育锻炼能力每年下降>1%。这导致了许多发生在老年人身上的呼吸道疾病,尤其是肥胖的老年人。除了年龄、血流动力学、代谢和生活方式等其他因素外,肺功能是心肺耐力的基本组成部分。本研究的目的是确定老年女性的体重指数(BMI)和肺功能是否与心肺耐力有显著相关性。方法该研究采用横断面设计,涉及雅加达南部66名60岁及以上的受试者。通过测量身体质量指数(BMI)、肺功能(FEV1、FVC、FEV1/FVC)和心肺耐力的最大摄氧量(VO2max)来收集数据。数据分析使用SPSS v.25中的简单和多元线性回归检验,p<0.05。结果在66名老年人中,57.6%的人肥胖。受试者的肺功能表现为限制性(33.3%)、阻塞性(6.1%)和限制与阻塞的结合(1.5%)。此外,平均VO2最大值为12.2 mL/kg/min。多元线性回归分析显示,BMI和FEV1/FVC与VO2 max显著相关(â=-0.56;95%CI=-0.81-(-)0.31;p=0.000;â=0.09;95%CI=0.01-0.18;p=0.028)。BMI是影响VO2max的最大危险因素(β=-0.46)。结论BMI和FEV1/FVC与VO2max有显著相关性,BMI是影响老年女性心肺耐力的最大危险因子。
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引用次数: 2
Morning hypertension for stroke and cardiovascular: clinical pearls for primary care 晨间高血压治疗中风和心血管疾病:初级保健的临床珍珠
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-12-06 DOI: 10.18051/univmed.2021.v40.270-278
A. Rasyid, Elvan Wiyarta
Hypertension is the world’s leading cause of mortality and morbidity. One of the phenomena that commonly occur in hypertensive as well as normotensive patients, is morning hypertension. Blood pressure (BP) follows a diurnal rhythm, reaching its highest level during the morning hours and dropping to the lowest level at midnight. Transient increases in BP in morning hypertension plus persistent stressors within 24 hours are thought to increase target organ damage and trigger cardiovascular events. Therefore, ambulatory BP monitoring or morning home BP monitoring is recommended as a strong predictor of cardiovascular events. There are two types of morning hypertension according to its underlying mechanisms; the first one is called nocturnal hypertensive morning hypertension, and the other one is morning-surge hypertension. Numerous studies have proved that this phenomenon often leads to several acute cardiovascular events, such as stroke, coronary artery disease, and peripheral artery disease. To prevent these complications, cost-effective management is needed, especially for identifying accurate diagnostic tools, as well as creating specific regimens. Therefore, to achieve appropriate management of hypertension, including morning hypertension, long-acting antihypertensive drugs should be used, at full doses and in the form of combination therapy. The clinical usefulness of antihypertensive drugs with specific mechanisms for morning BP or split or timed dosing of long-acting drugs in controlling morning BP remains under investigation. More studies are needed, especially looking for other clinical evidence of the benefits of lowering BP in the morning. Home BP monitoring is recommended as a good choice for BP measurements, especially in the primary care setting.
高血压是世界上导致死亡和发病的主要原因。早晨高血压是高血压患者和正常高血压患者共同发生的现象之一。血压(BP)遵循昼夜节律,在早晨达到最高水平,在午夜降至最低水平。早晨高血压患者血压短暂升高加上24小时内持续的应激源被认为会增加靶器官损伤并引发心血管事件。因此,推荐动态血压监测或早晨家庭血压监测作为心血管事件的有力预测指标。根据其潜在机制,有两种类型的早晨高血压;第一种是夜间高血压,晨间高血压,另一种是晨间高血压。大量研究证明,这种现象常常导致多种急性心血管事件,如中风、冠状动脉疾病和外周动脉疾病。为了预防这些并发症,需要采取具有成本效益的管理措施,特别是在确定准确的诊断工具以及制定具体方案方面。因此,为了实现高血压,包括晨高血压的适当管理,应使用长效降压药,以全剂量和联合治疗的形式。具有特定清晨血压机制的抗高血压药物或分次或定时给药的长效药物在控制清晨血压方面的临床有效性仍在研究中。需要更多的研究,特别是寻找早晨降低血压的益处的其他临床证据。家庭血压监测建议作为血压测量的好选择,特别是在初级保健设置。
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引用次数: 0
Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS 病毒载量作为抗逆转录病毒治疗的艾滋病毒/艾滋病患者逆转录酶抑制剂耐药突变的危险因素
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-11-30 DOI: 10.18051/univmed.2021.v40.243-253
H. Hutapea, T. N. Kridaningsih, Khoirul Huda Prasetyo, M. Antwi
Background The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA).MethodsThis was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents’ medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression.ResultsThe multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) and viral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance.ConclusionThis study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA.
人类免疫缺陷病毒1型(HIV-1)是印度尼西亚人口面临的主要传染病。抗逆转录病毒治疗(ART)的成功受到耐药性突变(DRM)出现的威胁。本研究的目的是确定CD4计数、CD4计数变化、病毒载量、治疗依从性和存在DRM的HIV/AIDS (PLWHA)患者的治疗史之间的关系。方法这是一项横断面研究,涉及269名接受抗逆转录病毒(ARV)治疗至少6个月的成年人。逆转录酶(RT)基因在病毒载量为100 ~ 1000拷贝/mL的样品上部分扩增,采用RT巢式PCR法测定DRM和多态性的频率。测序采用Sanger法,BioEdit编辑。编辑后的序列提交到http://hivdb.stanford.edu进行DRM测定。采用简单logistic回归和多元logistic回归分析被调查者的医疗资料、CD4计数、病毒载量和DRM。结果多因素logistic回归分析显示CD4计数与糖尿病有显著相关性(aOR=12.47;95% ci: 1.45 -107.39;p=0.023)和研究时的病毒载量(aOR=29.56;95% ci: 3.47-251.52;p=0.002),受访者中存在DRM。ARV替代史与DRM的存在无关。共有17人(6.3%)携带HIV-1 DRM,其中M184V/I(11个序列)是NNRTI耐药的最常见模式,K103(9个序列)是NNRTI耐药的最常见模式。结论本研究表明,研究时的病毒载量是PLWHA中DRM存在的最重要决定因素。
{"title":"Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS","authors":"H. Hutapea, T. N. Kridaningsih, Khoirul Huda Prasetyo, M. Antwi","doi":"10.18051/univmed.2021.v40.243-253","DOIUrl":"https://doi.org/10.18051/univmed.2021.v40.243-253","url":null,"abstract":"Background The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA).\u0000MethodsThis was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents’ medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression.\u0000ResultsThe multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) and viral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance.\u0000ConclusionThis study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44949739","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}
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Universa Medicina
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