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Effects of COVID-19 Lockdown on Nutritional, Functional and Frailty Biomarkers of People Living in Nursing Homes. A Prospective Study. 新冠肺炎封锁对养老院居民营养、功能和脆弱生物标志物的影响。前瞻性研究。
Pub Date : 2023-10-01 Epub Date: 2023-05-15 DOI: 10.1177/10998004231176249
Adriana C De Souza Oliveira, María Gómez Gallego, Carmelo Gómez Martínez, Rosa López Mongil, Jorge Moreno Molina, Juan José Hernández Morante, Paloma Echevarría Pérez

Background: Nursing home residences suffered a lockdown from the beginning of the COVID-19 pandemic. The present study prospectively evaluates the frailty, functional, and nutritional statuses of nursing home residents.

Methods: Three hundred and one residents from three nursing homes took part in the study. Frailty status was measured using the FRAIL scale. Functional status was evaluated using the Barthel Index. Additionally, Short Physical Performance Batter (SPPB), SARC-F, hand-grip strength, and gait speed were also evaluated. Nutritional status was determined using the mini nutritional assessment test (MNA) and several anthropometrical and biochemical markers.

Results: Mini Nutritional Assessment test scores decreased in 20% throughout the confinement (p < .001). Barthel index, SPPB and SARC-F scores also decreased, although to a lesser extent, reflecting a decrease in functional capacity. However, both anthropometric parameters, hand grip strength and gait speed, remained stable throughout confinement (p > .050 in all cases). Morning cortisol secretion significantly decreased by 40% from baseline to post-confinement. A significant reduction in daily cortisol variability was observed, which may suggest increased distress. Fifty-six residents died during the period of confinement (81.4% survival rate). Sex, FRAIL and Barthel Index scores were significant predictors of resident survival.

Conclusion: After the first COVID-19 blockade, several alterations in residents' frailty markers were observed, which were small and potentially reversible. However, many of the residents were pre-frail after the lockdown. This fact highlights the need for preventive strategies to reduce the impact of future social and physical stressors on these vulnerable individuals.

背景:从新冠肺炎大流行开始,养老院住宅就处于封锁状态。本研究前瞻性地评估了疗养院居民的虚弱、功能和营养状况。方法:来自三家养老院的311名居民参加了这项研究。使用FRAIL量表测量虚弱状态。使用Barthel指数评估功能状态。此外,还评估了短打、严重急性呼吸系统综合征、握力和步态速度。使用迷你营养评估测试(MNA)和几种人体测量和生物化学标志物来确定营养状况。结果:在整个禁闭期间,迷你营养评估测试得分下降了20%(p。001)。Barthel指数、SPPB和严重急性呼吸系统综合征-综合征评分也有所下降,尽管程度较小,反映出功能能力下降。然而,在整个禁闭期间,抓握力和步态速度这两个人体测量参数都保持稳定(在所有情况下均p>0.05)。从基线到分娩后,早晨皮质醇分泌量显著下降了40%。观察到每日皮质醇变异性显著降低,这可能表明痛苦加剧。56名居民在禁闭期间死亡(存活率81.4%)。性别、FRAIL和Barthel指数得分是居民生存率的重要预测因素。结论:在第一次新冠肺炎封锁后,观察到居民虚弱标志物的几种变化,这些变化很小,可能是可逆的。然而,许多居民在封锁后都处于虚弱状态。这一事实突显了预防策略的必要性,以减少未来社会和身体压力对这些弱势群体的影响。
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引用次数: 2
SARS-Cov-2 Infection and Seroconversion Rates in Healthcare Providers Prior to COVID-19 Vaccine Rollout. 新冠肺炎疫苗推出前医疗保健提供者的SARS-Cov-2感染和血清转化率。
Pub Date : 2023-10-01 Epub Date: 2023-03-04 DOI: 10.1177/10998004231161632
Sanghyuk S Shin, Miriam Bender, Delphine C Malherbe, Hannah Vasquez, Brianna M Doratt, Ilhem Messaoudi

Objective: A 6-month longitudinal surveillance study of asymptomatic healthcare providers (HCP) was carried out at a large urban academic medical center in the United States to assess whether their job occupation with higher exposure risks to SARS-CoV-2 would equate with higher risk of contracting COVID-19 at the beginning of the pandemic before COVID-19 vaccines were available.

Methods: A longitudinal cohort study design was used to collect and analyze immunological and virological monitoring data and self-report survey assessments of personal protective equipment (PPE) availability, adherence to infection control guidelines, and time spent on COVID-19 wards.

Results: Among 289 eligible participants, SARS-CoV-2 exposure risk was high with 48-69% participants working in COVID-19 units and more than 30% of them caring for COVID-19 patients. However, the seroconversion rate was low with only 2.1% of participants developing humoral or cellular immunity against SARS-CoV-2.

Conclusion: Our study findings suggest that, for this HCP cohort working at a large urban academic medical center, a low incidence of SARS-CoV-2 infection could be maintained under conditions of strict infection prevention protocols and reliable PPE availability.

目的:在美国一家大型城市学术医疗中心对无症状医疗服务提供者(HCP)进行了为期6个月的纵向监测研究,以评估他们在新冠肺炎疫苗上市之前,接触SARS-CoV-2风险较高的工作职业是否等同于在大流行开始时感染新冠肺炎的风险较高。方法:采用纵向队列研究设计,收集和分析免疫学和病毒学监测数据,以及对个人防护设备(PPE)可用性、感染控制指南的遵守情况和新冠肺炎病房时间的自我报告调查评估。结果:在289名符合条件的参与者中,SARS-CoV-2暴露风险较高,其中48-69%的参与者在新冠肺炎单位工作,其中30%以上的参与者照顾新冠肺炎患者。然而,血清转化率很低,只有2.1%的参与者对严重急性呼吸系统综合征冠状病毒2型产生体液或细胞免疫。
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引用次数: 0
Apelin and Visfatin Expression in Placental Tissue in Women With Preeclampsia and Overweight/Obesity. Apelin和Visfatin在先兆子痫和超重/肥胖妇女胎盘组织中的表达。
Pub Date : 2023-10-01 Epub Date: 2023-05-28 DOI: 10.1177/10998004231178835
Ana Paula Dos Santos Xavier Braga, Diana Matos Silva, Deborah de Farias Lelis, Rogério Estevam Farias, Alanna Fernandes Paraíso, Sérgio Henrique Sousa Santos, Andrea Maria Eleutério de Barros Lima Martins, João Marcus Oliveira Andrade

Background: Preeclampsia (PE) is a multifunctional and multisystem disorder. Several factors favor the development of PE, including obesity. Cytokines are also expressed in the placenta, predisposing to local alterations that favor the development of distinct pathological processes, including PE. This study aimed to evaluate the apelin and visfatin mRNA expression in the placental tissue of women with preeclampsia and overweight/obesity and correlates with maternal and fetal variables.

Methods: A cross-sectional analytical study was performed with 60 pregnant women and their newborns. Clinical, anthropometric, and laboratory variables were collected. Placental tissue samples were obtained, and the apelin and visfatin mRNA expression levels were assessed by qRT-PCR.

Results: The main findings evidenced lower levels of apelin expression in overweight/obese women, accompanied by a negative correlation with BMI and pre-pregnancy weight; a higher expression of apelin was also observed in women with late PE and no personal history of PE. For visfatin levels, higher expression levels were observed in women with late PE and term delivery. Furthermore, a positive correlation was observed between visfatin levels and fetal anthropometric parameters, such as weight, length, and head circumference.

Conclusion: Apelin levels were less expressed in overweight/obese women. Apelin and visfatin levels were correlated/associated with maternal-fetal variables.

背景:子痫前期是一种多功能、多系统的疾病。有几个因素有利于体育运动的发展,包括肥胖。细胞因子也在胎盘中表达,易发生局部改变,有利于不同病理过程的发展,包括PE。本研究旨在评估先兆子痫和超重/肥胖妇女胎盘组织中apelin和visfatin mRNA的表达,并与母体和胎儿变量相关。方法:对60名孕妇及其新生儿进行横断面分析研究。收集临床、人体测量和实验室变量。获得胎盘组织样本,并通过qRT-PCR评估apelin和visfatin mRNA的表达水平。结果:主要发现超重/肥胖女性的apelin表达水平较低,并与BMI和孕前体重呈负相关;在晚期PE和无PE病史的女性中也观察到apelin的高表达。就内脂素水平而言,在晚期PE或足月分娩的女性中观察到更高的表达水平。此外,观察到内脂蛋白水平与胎儿的人体测量参数(如体重、身长和头围)呈正相关。结论:Apelin水平在超重/肥胖女性中表达较少。Apelin和内脂蛋白水平与母胎变量相关。
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引用次数: 0
Aquatic Exercise Impact on Pain Intensity, Disability and Quality of Life in Adults with Low Back Pain: A Systematic Review and Meta-analysis. 水上运动对成人腰痛患者疼痛强度、残疾和生活质量的影响:系统综述和荟萃分析。
Pub Date : 2023-10-01 Epub Date: 2023-03-06 DOI: 10.1177/10998004231162327
Fatemeh Heidari, Nasser Mohammad Rahimi, Reza Aminzadeh

Background: Low back pain is a common, multifaceted disorder that directly affects diverse aspects of people's lives in terms of health, personal and social lives. A variety of pathological disorders, including low back pain, may benefit from hydrotherapy.

Objective: This study aimed to systematically analyze the efficacy of aquatic exercise on pain intensity, disability, and quality of life among adults with low back pain.

Data sources: A systematic search was conducted in PubMed, Web of Science, Medline, and Scopus up to February 2023 for randomized controlled trials (RCTs) that which examined the impact of aquatic exercise. The most relevant articles were selected based on research criteria. The PEDro scale was applied to assess the quality of the included studies. Review Manager 5.3 was used for conducting all analyses.

Study selection: Out of 856 articles, 14 RCTs (n = 484 participants; 257 in the experimental groups and 227 in the control groups) met our inclusion criteria.

Results: Pooled results illustrated that aquatic exercises significantly reduced pain (mean differences (MD): -3.82; p < 0.00,001), improved disability (standardized mean differences (SMD): 1.65; p < 0.00,001), and improved quality of life in both the physical component score (mean difference (MD), 10.13; p < 0.00,001) and the mental component score (MD, 6.45; p < 0.0001) when compared with a control group.

Conclusion: The current review showed that aquatic exercise regimens were effective among adults with low back pain. High-quality clinical investigations are still needed to support the use of therapeutic aquatic exercise in a clinical setting.

背景:腰痛是一种常见的多方面疾病,直接影响人们生活的各个方面,包括健康、个人和社会生活。包括腰痛在内的各种病理性疾病都可以从水疗中受益。目的:本研究旨在系统分析水上运动对成人腰痛患者疼痛强度、残疾和生活质量的影响。数据来源:截至2023年2月,在PubMed、Web of Science、Medline和Scopus上对随机对照试验(RCT)进行了系统搜索,以检查水上运动的影响。根据研究标准选择了最相关的文章。PEDro量表用于评估纳入研究的质量。Review Manager 5.3用于进行所有分析。研究选择:在856篇文章中,14篇随机对照试验(n=484名参与者;实验组257篇,对照组227篇)符合我们的纳入标准。结果:汇总结果表明,水上运动显著减轻了疼痛(平均差异(MD):-3.82;p 0.00001)、残疾改善(标准化平均差(SMD):1.65;p 0.00001),并且在两个身体成分得分方面改善了生活质量(平均差(MD),10.13;p 0.00001)和精神成分得分(MD 6.45;p 0.0001)。结论:目前的综述表明,水上运动方案对患有腰痛的成年人是有效的。仍然需要高质量的临床研究来支持在临床环境中使用治疗性水上运动。
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引用次数: 0
DNA Methylation Patterns of Glucocorticoid Pathway Genes in Preterm Birth Among Black Women. 黑人妇女早产时糖皮质激素途径基因的DNA甲基化模式。
Pub Date : 2022-10-01 Epub Date: 2022-05-05 DOI: 10.1177/10998004221099253
Alexandra L Nowak, Cindy M Anderson, Jodi L Ford, Amy Mackos, Joyce Ohm, Nadia Saadat, Alai Tan, Yihong Zhao, Dawn P Misra, Carmen Giurgescu

Preterm birth (PTB; <37 weeks gestation) rates have increased for 5 of the last 6 consecutive years in the United States. These rates are particularly alarming for U.S. non-Hispanic Black women who give birth prematurely at 1.5 times the rate of non-Hispanic White women. Previous research suggests that psychological stress is associated with PTB in Black women. However, the biological pathways by which stress alters birth timing are not clear. We examined DNA methylation (DNAm) in peripheral blood leukocytes in 6 glucocorticoid, stress-related genes in 44 (22 PTB; 22 term birth) pregnant Black women. Four cytosine-phosphate-guanine (CpG) sites were identified as differentially methylated (p < 0.05) between women with PTB and women with term births. The ability to identify stress-related biological markers that are associated with PTB among Black women would provide a critical step toward decreasing the PTB disparity among these women. Future studies should include larger sample sizes and gene expression analyses of the stress-related biological pathways to PTB.

患有PTB的妇女和足月分娩的妇女之间的早产(PTB;p<0.05)。在黑人女性中识别与PTB相关的压力相关生物标志物的能力将为减少这些女性之间的PTB差异迈出关键一步。未来的研究应该包括更大的样本量和PTB应激相关生物途径的基因表达分析。
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引用次数: 0
Inflammatory, Oxidative Stress, and Cardiac Damage Biomarkers and Radiation-Induced Fatigue in Breast Cancer Survivors. 癌症乳腺癌幸存者的炎症、氧化应激和心脏损伤生物标志物与辐射诱导的疲劳。
Pub Date : 2022-10-01 Epub Date: 2022-05-07 DOI: 10.1177/10998004221098113
Alexi Vasbinder, Hilaire Thompson, Oleg Zaslavksy, Susan R Heckbert, Nazmus Saquib, Aladdin H Shadyab, Rowan T Chlebowski, Lisa Warsinger Martin, Electra D Paskett, Kerryn W Reding

Purpose: Studies examining biomarkers associated with fatigue in breast cancer survivors treated with radiation are limited. Therefore, we examined the longitudinal association between serum biomarkers and post-breast cancer fatigue in survivors treated with radiation: [oxidative stress] 8-hydroxyguanosine, myeloperoxidase; [inflammation] interleukin-6 (IL-6), c-reactive protein, growth differentiation factor-15 (GDF-15), placental growth factor, transforming growth factor-beta, [cardiac damage] cystatin-C, troponin-I.

Methods: In a secondary analysis, we included participants from the Women's Health Initiative if they had: a previous breast cancer diagnosis (stages I-III), no prior cardiovascular diseases, pre-and post-breast cancer serum samples drawn approximately 3 years apart, and fatigue measured using the Short-Form 36 vitality subscale at both serum collections. Biomarkers were measured using ELISA or RT-qPCR and modeled as the log2 post-to pre-breast cancer ratio.

Results: Overall, 180 women with a mean (SD) age of 67.0 (5.5) years were included. The mean (SD) vitality scores were 66.2 (17.2) and 59.7 (19.7) pre- and post-breast cancer, respectively. Using multivariable weighted linear regression, higher biomarker ratios of cystatin-C, IL-6, and GDF-15 were associated with a lower vitality score (i.e., higher fatigue). For example, for each 2-fold difference in cystatin-C biomarker ratio, the vitality score was lower by 7.31 points (95% CI: -14.2, -0.45).

Conclusion: Inflammatory and cardiac damage biomarkers are associated with fatigue in breast cancer survivors treated with radiation; however, these findings should be replicated in a larger sample. Biomarkers could be measured in clinical practice or assessed in risk prediction models to help identify patients at high risk for fatigue.

目的:对接受辐射治疗的癌症幸存者中与疲劳相关的生物标志物的研究有限。因此,我们研究了接受辐射治疗的幸存者的血清生物标志物与乳腺癌症后疲劳之间的纵向关联:[氧化应激]8-羟基鸟苷,髓过氧化物酶;[炎症]白细胞介素-6(IL-6)、c-反应蛋白、生长分化因子-15(GDF-15)、胎盘生长因子、转化生长因子-β、[心脏损伤]胱天蛋白酶-c、肌钙蛋白I,间隔约3年抽取的癌症前和后血清样本,并在两种血清采集中使用Short-Form36活力分量表测量疲劳。使用ELISA或RT-qPCR测量生物标志物,并将其建模为log2乳腺癌后与乳腺癌前的比值。结果:总体而言,纳入了180名平均(SD)年龄为67.0(5.5)岁的女性。癌症前后的平均(SD)活力得分分别为66.2(17.2)和59.7(19.7)。使用多变量加权线性回归,胱抑素-C、IL-6和GDF-15的生物标志物比率越高,活力评分越低(即疲劳程度越高)。例如,对于胱氨酸-C生物标志物比率的每2倍差异,活力评分降低7.31分(95%CI:-14.2,-0.45)。结论:在接受辐射治疗的癌症幸存者中,炎症和心脏损伤生物标志物与疲劳有关;然而,这些发现应该在更大的样本中复制。生物标志物可以在临床实践中进行测量,也可以在风险预测模型中进行评估,以帮助识别疲劳高危患者。
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引用次数: 3
Translational Genomic Research: The Association between Genetic Profiles and Cognitive Functioning or Cardiac Function Among Breast Cancer Survivors Completing Chemotherapy. 转化基因组研究:完成化疗的癌症乳腺癌幸存者的基因图谱与认知功能或心脏功能之间的关联。
Pub Date : 2022-10-01 Epub Date: 2022-05-02 DOI: 10.1177/10998004221094386
Jong Y Park, Cecile A Lengacher, Richard R Reich, Hyun Y Park, Junmin Whiting, Anh Thy Nguyen, Carmen Rodríguez, Hongdao Meng, Sara Tinsley, Katterine Chauca, Liliana Gordillo-Casero, Trudy Wittenberg, Anisha Joshi, Katherine Lin, Roohi Ismail-Khan, John V Kiluk, Kevin E Kip

Introduction: Emerging evidence suggests that Chemotherapy (CT) treated breast cancer survivors (BCS) who have "risk variants" in genes may be more susceptible to cognitive impairment (CI) and/or poor cardiac phenotypes. The objective of this preliminary study was to examine whether there is a relationship between genetic variants and objective/subjective cognitive or cardiac phenotypes. Methods and Analysis: BCS were recruited from Moffitt Cancer Center, Morsani College of Medicine, AdventHealth Tampa and Sarasota Memorial Hospital. Genomic DNA were collected at baseline for genotyping analysis. A total of 16 single nucleotide polymorphisms (SNPs) from 14 genes involved in cognitive or cardiac function were evaluated. Three genetic models (additive, dominant, and recessive) were used to test correlation coefficients between genetic variants and objective/subjective measures of cognitive functioning and cardiac outcomes (heart rate, diastolic blood pressure, systolic blood pressure, respiration rate, and oxygen saturation). Results: BCS (207 participants) with a mean age of 56 enrolled in this study. The majority were non-Hispanic white (73.7%), married (63.1%), and received both CT and radiation treatment (77.3%). Three SNPs in genes related to cognitive functioning (rs429358 in APOE, rs1800497 in ANKK1, rs10119 in TOMM40) emerged with the most consistent significant relationship with cognitive outcomes. Among five candidate SNPs related to cardiac functioning, rs8055236 in CDH13 and rs1801133 in MTHER emerged with potential significant relationships with cardiac phenotype. Conclusions: These preliminary results provide initial targets to further examine whether BCS with specific genetic profiles may preferentially benefit from interventions designed to improve cognitive and cardiac functioning following CT.

引言:新出现的证据表明,化疗(CT)治疗的癌症幸存者(BCS)如果基因存在“风险变异”,可能更容易出现认知障碍(CI)和/或不良心脏表型。这项初步研究的目的是检验遗传变异与客观/主观认知或心脏表型之间是否存在关系。方法与分析:BCS来自Moffitt癌症中心、Morsani医学院、AdventHealth Tampa和Sarasota纪念医院。在基线时收集基因组DNA进行基因分型分析。对14个涉及认知或心脏功能的基因中的16个单核苷酸多态性(SNPs)进行了评估。使用三种遗传模型(加性、显性和隐性)来测试遗传变异与认知功能和心脏结果(心率、舒张压、收缩压、呼吸率和血氧饱和度)的客观/主观测量之间的相关系数。结果:BCS(207名参与者),平均年龄56岁,参与本研究。大多数是非西班牙裔白人(73.7%),已婚(63.1%),同时接受CT和放射治疗(77.3%)。与认知功能相关的基因中的三个SNP(APOE中的rs429358,ANKK1中的rs1800497,TOMM40中的rs10119)与认知结果的关系最为一致。在5个与心脏功能相关的候选SNPs中,CDH13中的rs8055236和MTHER中的rs1801133与心脏表型存在潜在的显著关系。结论:这些初步结果为进一步检查具有特定遗传特征的BCS是否可以优先受益于旨在改善CT后认知和心脏功能的干预措施提供了初步目标。
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引用次数: 2
Primer in Genetics and Genomics, Article 2-Advancing Nursing Research With Genomic Approaches. 遗传学和基因组学初级读本,第2条——用基因组学方法推进护理研究。
Pub Date : 2017-03-01 Epub Date: 2017-01-30 DOI: 10.1177/1099800416689822
Hyunhwa Lee, Jessica Gill, Taura Barr, Sijung Yun, Hyungsuk Kim

Purpose: Nurses investigate reasons for variable patient symptoms and responses to treatments to inform how best to improve outcomes. Genomics has the potential to guide nursing research exploring contributions to individual variability. This article is meant to serve as an introduction to the novel methods available through genomics for addressing this critical issue and includes a review of methodological considerations for selected genomic approaches.

Approach: This review presents essential concepts in genetics and genomics that will allow readers to identify upcoming trends in genomics nursing research and improve research practice. It introduces general principles of genomic research and provides an overview of the research process. It also highlights selected nursing studies that serve as clinical examples of the use of genomic technologies. Finally, the authors provide suggestions about how to apply genomic technology in nursing research along with directions for future research.

Conclusions: Using genomic approaches in nursing research can advance the understanding of the complex pathophysiology of disease susceptibility and different patient responses to interventions. Nurses should be incorporating genomics into education, clinical practice, and research as the influence of genomics in health-care research and practice continues to grow. Nurses are also well placed to translate genomic discoveries into improved methods for patient assessment and intervention.

目的:护士调查患者症状变化的原因和对治疗的反应,以告知如何最好地改善结果。基因组学有可能指导护理研究,探索对个体变异性的贡献。这篇文章旨在介绍通过基因组学可用于解决这一关键问题的新方法,并包括对选定基因组方法的方法考虑的综述。方法:这篇综述介绍了遗传学和基因组学的基本概念,使读者能够确定基因组学护理研究的未来趋势,并改进研究实践。它介绍了基因组研究的一般原理,并对研究过程进行了概述。它还强调了选定的护理研究,作为使用基因组技术的临床例子。最后,作者对如何将基因组技术应用于护理研究提出了建议,并对未来的研究方向提出了建议。结论:在护理研究中使用基因组方法可以加深对疾病易感性和不同患者对干预措施反应的复杂病理生理学的理解。随着基因组学在医疗保健研究和实践中的影响力不断扩大,护士应该将基因组学纳入教育、临床实践和研究。护士们也能够很好地将基因组发现转化为改进的患者评估和干预方法。
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引用次数: 10
期刊
Biological research for nursing
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