Austin journal of public health and epidemiology最新文献

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Determination of IgG Response Profile in SARS-CoV-2 Patients Using a Multiplex Serological Assay 多重血清学检测法测定严重急性呼吸系统综合征冠状病毒2型患者的IgG反应谱

Austin journal of public health and epidemiology

Pub Date : 2021-05-18 DOI: 10.26420/austinjpublichealthepidemiol.2021.1096

E. Brochot, Souplet, P. Follet, P. Ponthieu, C. Olivier, G. Even, C. Audebert, R. Malbec

Background: Beyond the diagnosis of SARS-CoV-2 infection, tools delivering a global picture of the patients’ humoral response may be of interest for the comprehension of the disease severity and the assessment of the patients’ protection for vaccination strategy. Objectives: Here we use a commercial multiplex serological immunoassay CoViDiag®, based on an array of five different antigens of the virus (the Nucleocapsid, the Spike 1 and Spike 2 subunits, and the RBD and NTD domains of the Spike), to investigate the profile of the IgG humoral response for patients with recent SARS-CoV-2 infection depending on the disease severity outcome, or the time post-PCR. Results: No cross-reaction was observed with the four other seasonal coronaviruses (100% specificity, 0/28). 100% (20/20) of the hospitalized patients PCR-positive to SARS-CoV-2 presented detectable levels of IgGs. 14 days post-PCR diagnosis, 92.3% of the patients, PCR-positive, that did not required hospitalization are presenting IgG (36/39). Interestingly for CoViDiag-positive samples, detectable levels of anti-RBD were found mainly in hospitalized patients (85%, 17/20), while the presence of anti-S1 (60.9%, 28/46) combined with the absence of anti-RBD (6.5%, 3/46) was more characteristic of nonhospitalized patients. Screening campaign group lacked both anti-S1 (18.2%, 4/22) and anti-RBD (4.5%, 1/22). Conclusion: The CoViDiag® IgG assay could be used to evaluate patients’ immunization and improve their management.

背景：除了诊断严重急性呼吸系统综合征冠状病毒2型感染外，提供患者体液反应全局图的工具可能对理解疾病严重程度和评估患者对疫苗接种策略的保护感兴趣。目的：在这里，我们使用商业多重血清学免疫测定CoViDiag®，基于病毒的五种不同抗原（核衣壳、刺突1和刺突2亚基以及刺突的RBD和NTD结构域），根据疾病严重程度的结果，研究近期严重急性呼吸系统综合征冠状病毒2型感染患者的IgG体液反应谱，或PCR后的时间。结果：未观察到与其他四种季节性冠状病毒的交叉反应（特异性100%，0/28）。100%（20/20）的严重急性呼吸系统综合征冠状病毒2型PCR阳性住院患者出现可检测的IgG水平。在PCR诊断后14天，92.3%的PCR阳性患者（不需要住院治疗）出现IgG（36/39）。有趣的是，对于CoViDiag阳性样本，可检测到的抗RBD水平主要在住院患者中发现（85%，17/20），而抗S1的存在（60.9%，28/46）与抗RBD的缺失（6.5%，3/46）更具非住院患者的特征。筛选运动组同时缺乏抗S1（18.2%，4/22）和抗RBD（4.5%，1/22）。结论：CoViDiag®IgG检测可用于评估患者的免疫情况，提高患者的管理水平。

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引用次数: 0

Obesity and SARS-CoV-2 Infection a Multifaceted Interplay - Adipose Tissue Inflammation, Adipokine Disbalance and Immunity 肥胖与SARS-CoV-2感染是多方面的相互作用——脂肪组织炎症、脂肪因子失衡和免疫

Austin journal of public health and epidemiology

Pub Date : 2021-05-11 DOI: 10.26420/austinpublichealth.2021.1013

Cherneva Rv, D. Valev, Cherneva Zv

Overweight and obesity are the most common comorbidities in SARSCoV- 2 patients, requiring hospitalization in intensive care units. The multifaceted nature of obesity including its effects on respiratory mechanics and immunity can fundamentally alter the pathogenesis of acute respiratory distress syndrome and pneumonia, which are the major causes of death due to SARS-CoV-2 infection. Most coronaviruses overcome host antiviral defense, and the pathogenicity of the virus is related to its capacity to suppress host immunity. Hyperleptinemia, insulin resistance and adipose tissue inflammation are hallmarks of obesity, which is associated with a leptin and insulin resistant state. Leptin regulates appetite and metabolism and through the Jak/STAT and Akt pathways modulates T cell number and function; insulin receptor signaling is closely engaged in T cell proliferation, whereas low garde adipose tissue inflammation provokes aberrant inflammasome activation. The review discusses these phenomena. It presents the reasons for susceptibility to respiratory viral infections in obese patients, as well as, the immunomodulatory effects of obesity to the outcome.

超重和肥胖是SARSCoV- 2患者最常见的合并症，需要在重症监护病房住院治疗。肥胖的多面性，包括其对呼吸力学和免疫的影响，可以从根本上改变急性呼吸窘迫综合征和肺炎的发病机制，这是SARS-CoV-2感染导致死亡的主要原因。大多数冠状病毒都能克服宿主的抗病毒防御，病毒的致病性与其抑制宿主免疫的能力有关。高瘦素血症、胰岛素抵抗和脂肪组织炎症是肥胖的标志，这与瘦素和胰岛素抵抗状态有关。瘦素调节食欲和新陈代谢，并通过Jak/STAT和Akt通路调节T细胞的数量和功能;胰岛素受体信号密切参与T细胞增殖，而低脂肪组织炎症引起异常炎性体激活。本文对这些现象进行了讨论。它提出了肥胖患者对呼吸道病毒感染易感性的原因，以及肥胖对结果的免疫调节作用。

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引用次数: 0

« What a Catch! »: A Case Report on Denial and Myocardial Infarction “好一个捕手!”»:否认与心肌梗死1例报告

Austin journal of public health and epidemiology

Pub Date : 2021-04-14 DOI: 10.26420/austinjpublichealthepidemiol.2021.1095

A. Naviaux, Émilie Banse, Antoine Guédès, P. Janne, M. Gourdin

Coronary disease has long been associated with different behavioral patterns (Pattern A, D) and denial mechanisms. Denial can take various forms that put the coronary patient at risk during the whole course of his illness [1,2]. Objective This case shows to what extent denial mechanisms can interfere in the relationship between some coronary patients and their caregivers. Case Presentation Roger, - now deceased - would have been 95 this year and had two heart attacks. His first infarction was anteroseptal, while his second was an inferior infarct. He suffers from coronary disease and has a history of unstable angina. He had a double coronary bypass (saphenous vein graft on left anterior descending artery and right coronary artery.). Heart wise, when we met him, he was currently symptom-free but presented a dyspnea of grade II to III. He denied any ongoing chest pain even during moderate effort. We assessed Roger in the context of his heart surgery. We met him in Intensive Care Unit both before and after the intervention. During the postoperative phase, he described his second heart attack. He really enjoyed telling us the story of his second infarction, which occurred while he was already on antianginal medication (i.e. Cedocard®). It all started while he was angling during the weekend. Roger had been fishing for several hours but had not caught anything. He was upset and about to leave (Pattern A typical impatience) [1-3] when all of a sudden, he felt his line snapping tight for a split second: a line bite! The trout was, allegedly, huge, and his fishing rod was too light to land the fish in one go. Being a strategic angler, Roger decided to wear the fish down and to slowly bring it back to shore so that he could scoop it with his landing net. While doing so, he felt the first angina pain occurring and persisting. He tried to reach for his tablets in his pocket but could not manage as his hand was already benumbed. He explained: « At that stage, I told myself: Roger, it’s you or the trout! » Well, he went for the trout! He landed the fish first (after a one-hour struggle) and only then agreed to go to hospital in emergency (if this term remains appropriate in such a context).

长期以来，冠心病与不同的行为模式（模式A、D）和否认机制有关。否认可以采取各种形式，使冠状动脉患者在整个病程中处于危险之中[1，2]。目的本病例表明，否认机制在多大程度上会干扰一些冠状动脉患者及其护理人员之间的关系。病例介绍罗杰，现已去世，今年本应95岁，曾两次心脏病发作。他的第一个梗死是前间隔梗死，而他的第二个梗死是下间隔梗死。他患有冠状动脉疾病，有不稳定型心绞痛病史。他接受了双冠状动脉搭桥术（左前降支和右冠状动脉上的隐静脉移植术）。从心脏角度来看，当我们见到他时，他目前没有症状，但出现了II至III级呼吸困难。即使在中等程度的努力中，他也否认有任何持续的胸痛。我们在罗杰心脏手术的背景下对他进行了评估。干预前后，我们都在重症监护室见到了他。在术后阶段，他描述了自己的第二次心脏病发作。他真的很喜欢告诉我们他的第二次梗死的故事，这是在他已经在服用抗心脏病药物（即Cedocard®）时发生的。这一切都是从他周末钓鱼时开始的。罗杰已经钓鱼好几个小时了，但什么也没钓到。他很沮丧，正要离开（典型的不耐烦）[1-3]突然，他感觉到自己的线在一瞬间绷紧了：线被咬了！据称，这条鳟鱼体型巨大，他的鱼竿太轻，无法一次将鱼钓上岸。作为一名有策略的垂钓者，罗杰决定把鱼拖下水，慢慢地把它带回岸边，这样他就可以用落网把它捞起来。在这样做的时候，他感觉到第一次心绞痛的疼痛正在发生并持续。他试着伸手去拿口袋里的药片，但由于手已经弯曲，他无法控制。他解释道：“在那个阶段，我告诉自己：罗杰，是你还是鳟鱼！»嗯，他去钓鳟鱼了！他先把鱼弄上岸（经过一个小时的挣扎），然后才同意在紧急情况下去医院（如果这个词在这种情况下仍然合适的话）。

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引用次数: 1

Point-of-Use Water Treatment Methods and the Microbiological Quality of Drinking Water in a Peri-Urban Community of Bonendale, Douala IV, Cameroon 喀麦隆杜阿拉四省博南代尔市城郊社区用水点处理方法和饮用水微生物质量

Austin journal of public health and epidemiology

Pub Date : 2021-02-18 DOI: 10.26420/AUSTINJPUBLICHEALTHEPIDEMIOL.2021.1093

H. Ngouakam, J. FruCho, B. Tientche, Estuary Academic, Cameroon Insam

Background: The study aimed at assessing the knowledge of Bonendale populations related to safe drinking water; determine the microbiological quality and the household treatment practices of drinking water at the point of use (PoU). Methods: The study was descriptive and cross-sectional, conducted between November 2017 and November 2018 in Bonendale, Douala IV. A systematic random sampling method was used to select 237 households. Results: The main source of drinking water in the study population was dug wells (64.9%). The major activity around the boreholes was agriculture 50% (6/12) while agriculture and livestock rearing were practiced around 34.3% (12/35) and 42.8% (15/35) of dug wells respectively. Nearly half 110 (46.4%) of respondents had a good knowledge of physical properties of drinking water. Fifty-nine water samples out of a total of 60 tested (98.3%) were contaminated by coliform bacteria. Analysis of water samples indicated that 47.6% (10/21) of dug wells, 37.0% (10/27) of Camwater, and 41.2% (5/12) of boreholes had a total coliform count varying between 101-1000 CFU/100mL. And only a single Camwater water sample 1 (137%) had a coliform count of 0 CFU/100mL. Conclusion: These findings indicated the poor microbiological quality of point water used by Bonendale populations representing an important potential health risk of water-borne diseases. The results also reveal that a very high proportion of households treat their PoU before drinking.

背景:本研究旨在评估Bonendale人口对安全饮用水的认识;确定饮用水使用点的微生物质量和家庭处理方法。方法:采用描述性和横断面研究方法，于2017年11月至2018年11月在杜阿拉四省博南代尔市进行，采用系统随机抽样方法选取237户。结果:研究人群的主要饮水来源为挖井(64.9%)。钻孔周围主要活动为农业占50%(6/12)，农业和畜牧业分别占34.3%(12/35)和42.8%(15/35)。近一半(46.4%)的受访者对饮用水的物理性质有很好的了解。60个水样中有59个(98.3%)被大肠菌群污染。水样分析表明，47.6%(10/21)的挖井、37.0%(10/27)的Camwater和41.2%(5/12)的钻孔的总大肠菌群数量在101 ~ 1000 CFU/100mL之间。Camwater水样1(137%)的大肠菌群计数为0 CFU/100mL。结论:这些发现表明Bonendale人群使用的点水微生物质量差，是水传播疾病的重要潜在健康风险。结果还显示，非常高比例的家庭在饮酒前处理他们的PoU。

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引用次数: 0

Is Climate Change Contributing to Food Insecurity and Poor Health Outcomes in Mozambique? 气候变化是否导致莫桑比克粮食不安全和健康状况不佳?

Austin journal of public health and epidemiology

Pub Date : 2021-01-19 DOI: 10.26420/austinjpublichealthepidemiol.2021.1092

Macassa G, M. E, Francisco Jdc

Climate change poses a considerable threat to food security, with potentially existential economic, political and social outcomes for the entire humanity. The impact will be especially severe in low and middle-income countries that are struggling to meet the needs of a growing population. This mini-review aims to contribute to the global and, specifically, the Mozambican debate on the potential impact of climate change on food security and how it might affect the health of current and future generations. In Mozambique, climate change has already had an impact on food security and in some instances, it is exacerbating already existing diseases such as diarrhoea, malaria and cholera. However, more research is needed using empirical data that will shed light on the potential pathways and mechanisms of climate change, and its relationship with food insecurity and health outcomes. Furthermore, to ensure that climate change does not worsen the prevalence of food insecurity that is currently ravaging the country, Mozambique needs to implement all the adaptation and mitigation strategies, which have already been approved and adopted in the national climate change plan.

气候变化对粮食安全构成了相当大的威胁，可能给全人类带来生存的经济、政治和社会后果。这种影响在中低收入国家尤其严重，这些国家正在努力满足不断增长的人口的需求。这项小型审查旨在促进全球，特别是莫桑比克关于气候变化对粮食安全的潜在影响以及它可能如何影响当代人和子孙后代健康的辩论。在莫桑比克，气候变化已经对粮食安全产生了影响，在某些情况下，它正在加剧腹泻、疟疾和霍乱等现有疾病。然而，还需要利用经验数据进行更多的研究，以阐明气候变化的潜在途径和机制，以及它与粮食不安全和健康结果的关系。此外，为了确保气候变化不会加剧目前正在肆虐该国的粮食不安全状况，莫桑比克需要实施国家气候变化计划中已经批准和通过的所有适应和缓解战略。

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引用次数: 1

Non-Hispanic Black Americans' Diminished Protective Effects of Educational Attainment and Employment against Cardiometabolic Diseases: NHANES 1999-2016. 非西班牙裔美国黑人受教育程度和就业对心脏代谢疾病的保护作用减弱:NHANES 1999-2016。

Austin journal of public health and epidemiology

Pub Date : 2021-01-01 Epub Date: 2021-10-04

Hossein Zare, Shervin Assari

Background: While socioeconomic status (SES) indicators such as educational attainment and employment are among the major drivers of health and illness, the health returns of SES indicators may differ across racial groups. Built on Marginalization related Diminished Returns framework (MDRs) that refers to weaker health effects of SES indicators for marginalized and minoritized groups than non-Hispanic White people, we conducted this study with two aims: First to test the association between educational attainment and employment with cardiometabolic diseases (CMDs), and second, to test racial variation in these associations.

Methods: This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES 1999-2016) data. Participants included 29,230 adults who were either non-Hispanic White or non-Hispanic Black. Race, demographic factors (age and sex, and marital status), SES (educational attainment and employment), behaviors (smoking, drinking, and exercise), health insurance, and CMDs (diabetes, stroke, hypertension, and congestive heart failure) were measured. Weighted Poisson regression models were used in Stata to adjust for the complex sample design of the NHANES. Models without and with interactions were performed in the pooled sample. We also ran race-stratified models.

Results: Overall, high educational attainment and employment showed inverse associations with some CMDs. As documented by statistical interactions between race and our SES indicators, we observed weaker inverse associations between educational attainment and employment with some CMDs. Race-stratified models also confirmed our main analysis. However, the results varied across CMD conditions.

Conclusion: We observe that SES indicators such as educational attainment and employment have differential associations for racial groups. Compared to non-Hispanic White people, non-Hispanic Black people remain at CMDs risk across the full SES spectrum. This finding is in line with the MDRs framework and may be due to the structural racism, social stratification, and Marginalization of non-Hispanic Black Americans.

背景:虽然社会经济地位(SES)指标，如受教育程度和就业是健康和疾病的主要驱动因素之一，但社会经济地位指标的健康回报可能因种族群体而异。基于边缘化相关的收益递减框架(mdr)，即社会经济地位指标对边缘化和少数群体的健康影响比非西班牙裔白人弱，我们进行了这项研究，有两个目的:第一，测试受教育程度和就业与心脏代谢疾病(cmd)之间的关联，第二，测试这些关联的种族差异。方法:本横断面研究采用国家健康与营养检查调查(NHANES 1999-2016)数据。参与者包括29,230名非西班牙裔白人或非西班牙裔黑人成年人。测量了种族、人口统计学因素(年龄、性别和婚姻状况)、SES(受教育程度和就业)、行为(吸烟、饮酒和锻炼)、健康保险和CMDs(糖尿病、中风、高血压和充血性心力衰竭)。Stata采用加权泊松回归模型对NHANES的复杂样本设计进行调整。在合并样本中进行了没有相互作用和有相互作用的模型。我们还运行了种族分层模型。结果:总体而言，高学历和就业与某些疾病呈负相关。正如种族和社会经济地位指标之间的统计相互作用所证明的那样，我们观察到教育程度和就业与某些CMDs之间的负相关关系较弱。种族分层模型也证实了我们的主要分析。然而，不同CMD条件下的结果有所不同。结论:我们观察到社会经济地位指标如受教育程度和就业在种族群体中存在差异。与非西班牙裔白人相比，非西班牙裔黑人在整个SES范围内仍有CMDs风险。这一发现与mdr框架一致，可能是由于非西班牙裔美国黑人的结构性种族主义、社会分层和边缘化。

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引用次数: 0

Fentanyl Test Strip Use and Overdose History among Individuals on Medication for Opioid Use Disorder. 芬太尼试纸条的使用和阿片类药物使用障碍个体用药过量史。

Austin journal of public health and epidemiology

Pub Date : 2021-01-01 Epub Date: 2021-12-29

C B Mistler, A O Rosen, W Eger, M M Copenhaver, R Shrestha

Background: The number of deaths from drug overdose in the United States has more than doubled in the past decade. In particular, drug overdose deaths involving fentanyl have doubled every year since 2013. Rapid fentanyl test strips (FTS) are a useful strategy for detecting traces of fentanyl in substances and have received overwhelming support from individuals with opioid-dependence.

Methods: We investigated fentanyl use, knowledge of FTS, willingness to use FTS, and overdose history among a sample of 105 individuals currently on medication for opioid use disorder (MOUD).

Results: Results showed that the majority (63%) of the sample had experienced a non-fatal overdose and that 85% of participants were willing to use FTS. The majority of participants reported concern about fentanyl in their drug supply (70%) and 77% reported likelihood of past unintentional fentanyl use. Of note, only about half (47%) of participants knew of FTS prior to being surveyed, and only 17% reported ever using FTS.

Conclusion: These results expand on previous literature that documents high levels of willingness, yet low uptake of FTS among individuals on MOUD. Widespread education about FTS, in addition to the implementation of the use of FTS, is a highly promising and critical primary prevention alternative to overdose treatment and/or death due to fentanyl.

背景:在过去十年中，美国因药物过量而死亡的人数增加了一倍多。特别是，自2013年以来，涉及芬太尼的药物过量死亡人数每年都翻一番。快速芬太尼试纸(FTS)是检测物质中芬太尼痕迹的有用策略，得到了阿片类药物依赖个体的压倒性支持。方法:我们调查了105名目前正在接受阿片类药物使用障碍(mod)治疗的芬太尼使用情况、FTS知识、使用FTS的意愿和用药过量史。结果:结果显示，大多数(63%)的样本经历了非致命性的过量用药，85%的参与者愿意使用FTS。大多数参与者报告了他们对药物供应中的芬太尼的担忧(70%)，77%的参与者报告了过去无意中使用芬太尼的可能性。值得注意的是，只有大约一半(47%)的参与者在调查前知道FTS，只有17%的人报告使用过FTS。结论:这些结果扩展了先前文献中记录的高水平的意愿，但在mod患者中，FTS的吸收率很低。广泛开展有关FTS的教育，以及实施FTS的使用，是替代芬太尼过量治疗和/或死亡的一种非常有前途和关键的一级预防方法。

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引用次数: 0

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