• 【非髋关节周围骨质疏松性骨折:流行病学和意义。】 复制标题 收藏 收藏
    DOI:10.2478/10004-1254-59-2008-1850 复制DOI
    作者列表:Korsić M,Grazio S
    BACKGROUND & AIMS: :Fractures are the most serious consequence of osteoporosis. Non-vertebral and non-hip fractures are seldom recognised as important, even though they account for the majority of all fractures. The most prevalent localisations are distal radius, proximal humerus, ribs, clavicle, and the pelvis. According to the results from large phase III clinical trials for placebo groups, their incidence ranges from 4.9 % to 12.0 %. Hospital morbidity data in Croatia in 2006 show that peripheral non-hip fractures ranked among the leading fifteen injuries, accounting for 23.7 % of all injuries in patients aged 60 years and above. Risk factors for non-hip and non-vertebral fractures are similar to other osteoporotic fractures, and the main are low bone mineral density and earlier fractures. Quality of life is considerably affected by these fractures, and medical costs are very high, soaring as high as 36.9% of all national medical costs in the USA. Non-vertebral non-hip fractures need more attention, which was also recognised by the European regulatory bodies that approve use of anti-osteoporotic drugs.
    背景与目标: :骨折是骨质疏松症最严重的后果。尽管非椎骨和非髋骨骨折占所有骨折的大部分,但很少被认为是重要的。最普遍的定位是radius骨远端,肱骨近端,肋骨,锁骨和骨盆。根据安慰剂组大型III期临床试验的结果,其发生率在4.9%至12.0%之间。 2006年克罗地亚的医院发病率数据显示,周围的非髋关节骨折在前15名患者中排名最高,占60岁及60岁以上患者受伤总数的23.7%。非髋关节和非椎骨骨折的危险因素与其他骨质疏松性骨折相似,主要是骨密度低和早期骨折。这些骨折严重影响了生活质量,医疗费用很高,高达美国所有国家医疗费用的36.9%。非椎骨非髋关节骨折需要引起更多关注,欧洲监管机构也认可使用抗骨质疏松药物。
  • 【1999年至2010年,加拿大北部侵袭性肺炎球菌疾病的流行病学。】 复制标题 收藏 收藏
    DOI:10.3402/ijch.v72i0.21606 复制DOI
    作者列表:Helferty M,Rotondo JL,Martin I,Desai S
    BACKGROUND & AIMS: INTRODUCTION:The International Circumpolar Surveillance network is a population-based surveillance system that collects data on invasive pneumococcal disease (IPD) in Northern Canada. A 7-valent pneumococcal conjugate vaccine was first introduced in some regions of Northern Canada in 2002, followed by 10-valent (2009) and 13-valent (PCV-13) vaccines (2010). A 23-valent polysaccharide (PPV-23) vaccine was first introduced in 1988 for special populations and adults aged 65 years and older. To describe the epidemiology in the context of pneumococcal vaccination programs, we analysed surveillance data from Northern Canada from 1999 to 2010. METHODS:A standardized case report form capturing demographic and clinical information was completed for all IPD cases in Northern Canada meeting the national case definition. Isolates were sent to a reference laboratory for confirmation, serotyping and antimicrobial resistance testing. Both laboratory and epidemiological data were sent to the Public Health Agency of Canada for analysis. Population denominators were obtained from Statistics Canada. RESULTS:From 1999 to 2010, 433 IPD cases were reported (average 36 cases per year). Incidence was greatest among infants aged < 2 years and among those aged 65 years and older, with an average annual incidence of 133 and 67 cases per 100,000 population, respectively. After a peak in incidence in 2008, rates among infants have declined. Incidence rates varied from 2 to 16 times greater, depending on the year, among Aboriginals compared to non-Aboriginals. Hospitalization was reported in 89% of all cases and the case fatality ratio was 6.0%. Clinical manifestations varied, with some patients reporting > 1 manifestation. Pneumonia was the most common (70%), followed by bacteremia/septicaemia (30%) and meningitis (8%). Approximately, 42% of cases aged < 2 years in 2009 and 2010 had serotypes covered by the PCV-13. In addition, the majority (89%) of serotypes isolated in cases aged 65 years and older were included in the PPV-23 vaccine. CONCLUSION:IPD continues to be a major cause of disease in Northern Canadian populations, with particularly high rates among infants and Aboriginals. Continued surveillance is needed to determine the impact of conjugate pneumococcal vaccine programs. Additional studies investigating factors that predispose infants and Aboriginal peoples would also be beneficial.
    背景与目标: 简介:国际环极监视网络是一个基于人群的监视系统,收集加拿大北部的侵袭性肺炎球菌疾病(IPD)数据。 2002年在加拿大北部的某些地区首次引入了7价肺炎球菌结合疫苗,随后是10价(2009)和13价(PCV-13)疫苗(2010)。 1988年,针对特殊人群和65岁及以上的成年人首次引入了23价多糖(PPV-23)疫苗。为了描述肺炎球菌疫苗接种计划中的流行病学,我们分析了加拿大北部1999年至2010年的监测数据。
    方法:完成了加拿大北部符合国家病例定义的所有IPD病例的标准化病例报告表,包括人口统计和临床信息。将分离物送到参考实验室进行确认,血清分型和抗菌素耐药性测试。实验室和流行病学数据均已发送至加拿大公共卫生局进行分析。人口分母来自加拿大统计局。
    结果:从1999年到2010年,报告了433例IPD病例(平均每年36例)。在2岁以下的婴儿中和65岁及65岁以上的婴儿中,发病率最高,每10万人中的年平均发病率分别为133和67例。在2008年发病率达到峰值之后,婴儿的发病率有所下降。与非土著居民相比,土著居民的发病率每年变化2到16倍。据报告,所有病例中有89%住院,病死率为6.0%。临床表现各不相同,有些患者报告> 1种表现。肺炎是最常见的(70%),其次是菌血症/败血病(30%)和脑膜炎(8%)。在2009年和2010年,年龄小于2岁的病例中约有42%具有PCV-13覆盖的血清型。此外,PPV-23疫苗中包括65岁及65岁以上的大多数血清型(89%)。
    结论:在加拿大北部人群中,IPD仍然是导致疾病的主要原因,婴儿和土著居民中IPD的发病率特别高。需要继续监测以确定结合的肺炎球菌疫苗计划的影响。进一步调查易患婴儿和原住民的因素也将是有益的。
  • 【临床流行病学的现有数据来源:丹麦医学遗传疾病研究注册机构。】 复制标题 收藏 收藏
    DOI:10.2147/CLEP.S45228 复制DOI
    作者列表:Nguyen-Nielsen M,Svensson E,Vogel I,Ehrenstein V,Sunde L
    BACKGROUND & AIMS: :Denmark has an extensive collection of national and regional medical registries. There are many advantages to registry-based research when investigating genetic diseases which, due to their rarity, can be difficult to identify. In this study, we aimed to provide an updated overview of Danish registries for medical genetic conditions and describe how data linkage across registries can be used to collect data on genetic diseases at the individual level and at the family level. We present a list of medical genetic registries in Denmark at the national level, data sources from the departments of clinical genetics and other specialized centers, and project-specific data sources. We also summarize key general registries, such as the Danish National Registry of Patients, the Danish Medical Birth Registry, and the Civil Registration System, which are renowned for their comprehensive and high quality data, and are useful supplemental data sources for genetic epidemiology research. We describe the potential for data linkage across multiple registries, which allows for access to medical histories with follow-up time spanning birth to death. Finally, we provide a brief introduction to the Danish epidemiological research setting and legalities related to data access. The Danish collection of medical registries is a valuable resource for genetic epidemiology research.
    背景与目标: :丹麦拥有大量的国家和地区医疗注册机构。基于注册表的研究在调查遗传疾病时有许多优势,由于其稀有性,可能难以识别。在这项研究中,我们旨在提供有关医学遗传状况的丹麦注册管理机构的最新概述,并描述如何将各个注册管理机构之间的数据链接用于收集个人和家庭一级的遗传疾病数据。我们提供了丹麦国家一级的医学遗传注册机构清单,来自临床遗传学部门和其他专门中心的数据来源,以及针对特定项目的数据来源。我们还总结了关键的一般注册机构,例如丹麦国家患者注册中心,丹麦医疗出生注册中心和民事注册系统,这些机构以其全面而高质量的数据而著称,并且是遗传流行病学研究的有用补充数据源。我们描述了跨多个注册表的数据链接的潜力,这允许访问具有从出生到死亡的后续时间的医疗历史记录。最后,我们简要介绍了丹麦的流行病学研究背景以及与数据访问相关的合法性。丹麦医学注册资料库是遗传流行病学研究的宝贵资源。
  • 【小儿偏头痛的诊断和流行病学。】 复制标题 收藏 收藏
    DOI:10.1097/00019052-199706000-00011 复制DOI
    作者列表:Lipton RB
    BACKGROUND & AIMS: :Pediatric migraine differs from adult migraine in its epidemiology and symptom profile. Recent studies demonstrate the need to revise diagnostic criteria for pediatric migraine, demonstrate its epidemiology and suggest that its prevalence is increasing. These studies support the need for clinical trials to assess the utility of emerging therapies for pediatric migraine.
    背景与目标: :小儿偏头痛的流行病学和症状特征与成人偏头痛不同。最近的研究表明,有必要修改小儿偏头痛的诊断标准,证明其流行病学,并表明其患病率正在增加。这些研究支持需要进行临床试验以评估新兴疗法对小儿偏头痛的效用。
  • 【伊朗阿尔茨海默氏病的流行病学和危险因素:系统评价。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Navipour E,Neamatshahi M,Barabadi Z,Neamatshahi M,Keykhosravi A
    BACKGROUND & AIMS: Background:Alzheimer's disease is a chronic disease characterized by a progressive decline in mental abilities and quality of life alongside behavioral abnormalities associated with high economic burden. The purpose of this study was to investigate epidemiology and risk factors of Alzheimer's disease in Iran. Methods:In this systematic review study, both Persian and English-language databases including Medline, Google Scholar, PubMed, web of science and Magiran were searched using following keywords: epidemiology, Alzheimer, dementia and Iran without time limit up to 2017. Thirty articles abstract out of 50 studies related to this topics, were reviewed. Of which 12 full text entered into the quality assessment process and finally, four articles were selected for inclusion in this study and their results was extracted. Results:The total sample size of the 4 selected studies was 2781. The prevalence of Alzheimer's disease in the current study was estimated to be 2.3% in the population of 67-78 years old. Age, genetics, depression and hypertension were determined as the risk factors for Alzheimer's disease, while daily listening to music, meeting weekly with friends and daily intake of vitamin E were considered as the factors with protective role in this disease. Conclusion:Alzheimer's disease is one of the main causes of functional dependence and mortality in the elderly people. Lifestyle changes and multiple mental activities in elderly increases the cognitive ability of these population, which will reduce direct and indirect costs of this disease.
    背景与目标: 背景:阿尔茨海默氏病是一种慢性疾病,其特征是精神能力和生活质量逐渐下降,同时伴随着与高经济负担相关的行为异常。这项研究的目的是调查伊朗的阿尔茨海默氏病的流行病学和危险因素。
    方法:在这项系统评价研究中,使用以下关键词搜索了包括Medline,Google Scholar,PubMed,web of science和Magiran在内的波斯语和英语数据库,这些流行病学,阿尔茨海默氏症,痴呆症和伊朗均无期限限制,截至2017年。三十篇文章回顾了与该主题相关的50篇研究的摘要。其中12篇全文进入了质量评估流程,最后,选择了4篇文章纳入本研究,并提取了其结果。
    结果:所选的4项研究的总样本量为2781。在本研究中,阿尔茨海默氏病的患病率在67-78岁的人群中估计为2.3%。年龄,遗传,抑郁和高血压被确定为阿尔茨海默氏病的危险因素,而每天听音乐,每周与朋友见面和每日摄入维生素E被认为是该疾病的保护性因素。
    结论:阿尔茨海默氏病是老年人功能依赖和死亡的主要原因之一。老年人的生活方式改变和多种精神活动增加了这些人群的认知能力,这将减少这种疾病的直接和间接费用。
  • 【咖啡的摄入量和膀胱癌的风险:来自BLadder癌症流行病学和营养决定因素(BLEND)国际研究的12个队列研究的501,604名参与者的汇总分析。】 复制标题 收藏 收藏
    DOI:10.1007/s10654-019-00597-0 复制DOI
    作者列表:Yu EYW,Dai Y,Wesselius A,van Osch F,Brinkman M,van den Brandt P,Grant EJ,White E,Weiderpass E,Gunter M,Hemon B,Zeegers MP
    BACKGROUND & AIMS: :Recent epidemiological studies have shown varying associations between coffee consumption and bladder cancer (BC). This research aims to elucidate the association between coffee consumption and BC risk by bringing together worldwide cohort studies on this topic. Coffee consumption in relation to BC risk was examined by pooling individual data from 12 cohort studies, comprising of 2601 cases out of 501,604 participants. Pooled multivariate hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were obtained using multilevel Weibull regression models. Furthermore, dose-response relationships were examined using generalized least squares regression models. The association between coffee consumption and BC risk showed interaction with sex (P-interaction < 0.001) and smoking (P-interaction = 0.001). Therefore, analyses were stratified by sex and smoking. After adjustment for potential confounders, an increased BC risk was shown for high (> 500 ml/day, equivalent to > 4 cups/day) coffee consumption compared to never consumers among male smokers (current smokers: HR = 1.75, 95% CI 1.27-2.42, P-trend = 0.002; former smokers: HR = 1.44, 95% CI 1.12-1.85, P-trend = 0.001). In addition, dose-response analyses, in male smokers also showed an increased BC risk for coffee consumption of more than 500 ml/day (4 cups/day), with the risk of one cup (125 ml) increment as 1.07 (95% CI 1.06-1.08). This research suggests that positive associations between coffee consumption and BC among male smokers but not never smokers and females. The inconsistent results between sexes and the absence of an association in never smokers indicate that the associations found among male smokers is unlikely to be causal and is possibly caused by residual confounding of smoking.
    背景与目标: :最近的流行病学研究表明,咖啡摄入量与膀胱癌(BC)之间存在各种关联。这项研究旨在通过汇集有关该主题的全球队列研究来阐明咖啡消费与不列颠哥伦比亚省风险之间的关联。通过汇总12项队列研究的个人数据,检查了与BC风险相关的咖啡消费量,其中包括501,604名参与者中的2601例。使用多级Weibull回归模型获得具有相应95%置信区间(CI)的汇总多元风险比(HRs)。此外,使用广义最小二乘回归模型检查了剂量反应关系。咖啡消费与BC风险之间的相关性显示出与性别(P-互动<0.001)和吸烟(P-互动= 0.001)的相互作用。因此,分析按性别和吸烟进行了分层。在对潜在的混杂因素进行调整之后,与男性吸烟者(从业者:HR = 1.75,95%CI 1.27)中从不喝咖啡相比,高咖啡摄入量(> 500 ml /天,相当于> 4杯/天)的BC风险增加。 -2.42,P-趋势= 0.002;前吸烟者:HR = 1.44,95%CI 1.12-1.85,P-趋势= 0.001)。此外,男性吸烟者的剂量反应分析还显示,BC摄入咖啡的风险增加到每天500毫升/天(4杯/天)以上,每杯咖啡(125毫升)的风险增加1.07(95%) CI 1.06-1.08)。这项研究表明,男性吸烟者中咖啡消费与BC之间呈正相关,但从不吸烟者和女性之间。性别之间的不一致结果和从不吸烟者之间没有关联,这表明在男性吸烟者中发现的关联不太可能是因果关系,并且可能是由残留的吸烟混杂引起的。
  • 【坚持西方饮食模式和罹患膀胱癌的风险:膀胱癌流行病学和营养决定因素国际研究的13个队列研究的汇总分析。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.33173 复制DOI
    作者列表:
    BACKGROUND & AIMS: :Little is known about the association of diet with risk of bladder cancer. This might be due to the fact that the majority of studies have focused on single food items, rather than dietary patterns, which may better capture any influence of diet on bladder cancer risk. We aimed to investigate the association between a measure of Western dietary pattern and bladder cancer risk. Associations between adherence to a Western dietary pattern and risk of developing bladder cancer were assessed by pooling data from 13 prospective cohort studies in the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study and applying Cox regression analysis. Dietary data from 580 768 study participants, including 3401 incident cases, and 577 367 noncases were analyzed. A direct and significant association was observed between higher adherence to a Western dietary pattern and risk of bladder cancer (hazard ratio (HR) comparing highest with lowest tertile scores: 1.54, 95% confidence interval (CI): 1.37, 1.72; P-trend = .001). This association was observed for men (HR comparing highest with lowest tertile scores: 1.72; 95% CI: 1.51, 1.96; P-trend = .001), but not women (P-het = .001). Results were consistent with HR above 1.00 after stratification on cancer subtypes (nonmuscle-invasive and muscle-invasive bladder cancer). We found evidence that adherence to a Western dietary pattern is associated with an increased risk of bladder cancer for men but not women.
    背景与目标: :饮食与膀胱癌风险的关系知之甚少。这可能是由于以下事实:大多数研究都集中于单一食物而不是饮食模式,这样可以更好地捕捉饮食对膀胱癌风险的任何影响。我们旨在研究西方饮食习惯与膀胱癌风险之间的关系。通过汇总“膀胱癌流行病学和营养决定因素”(BLEND)研究中13项前瞻性队列研究的数据并应用Cox回归分析,评估了遵守西方饮食习惯与罹患膀胱癌的风险之间的关联。分析了来自580×768个研究参与者的饮食数据,包括3401例事件病例和577×367个非病例。遵守西式饮食方式与罹患膀胱癌的风险之间存在直接且显着的关联(危险比(HR),最高和最低三分位数:1.54,95%置信区间(CI):1.37,1.72; P趋势) = .001)。男性中观察到这种关联(HR比较最高和最低三分得分:1.72; 95%CI:1.51、1.96; P趋势= .001),而女性则没有(P-het = .001)。结果与癌症亚型(非肌肉浸润性和肌肉浸润性膀胱癌)分层后高于1.00的HR一致。我们发现有证据表明,坚持西方饮食方式与男性而非女性患膀胱癌的风险增加有关。
  • 【口腔和口咽癌的全球流行病学。】 复制标题 收藏 收藏
    DOI:10.1016/j.oraloncology.2008.06.002 复制DOI
    作者列表:Warnakulasuriya S
    BACKGROUND & AIMS: :This review presents data on incidence, mortality, survival and trends in cancers of the lip, oral cavity and oropharynx using available recent data sources around the world. Oral and pharyngeal cancer, grouped together, is the sixth most common cancer in the world. The review focuses primarily on several high-risk countries in an attempt to gain insight into the geographic variations in the incidence of this cancer in the globe and to relate the high incidence in some populations to their life style. With an estimated half a million cases around the globe and the rising trends reported in some populations, particularly in the young, urgent public health measures are needed to reduce the incidence and mortality of oral and oropharyngeal cancer.
    背景与目标: :这项综述利用全球可用的最新数据,提供了有关唇,口腔和口咽癌的发病率,死亡率,存活率和趋势的数据。合并在一起的口腔癌和咽癌是世界第六大最常见的癌症。这篇综述主要关注几个高风险国家,以期洞察全球这种癌症的发病率的地理差异,并将某些人群中的高发病率与其生活方式联系起来。据估计,全球有五百万例病例,而且某些人群,特别是年轻人群中报告有上升趋势,急需采取紧急公共卫生措施以减少口腔癌和口咽癌的发病率和死亡率。
  • 【马耳他致病性脑膜炎奈瑟氏球菌B血清型亚型的流行病学:引入基于PorA的疫苗的意义。】 复制标题 收藏 收藏
    DOI:10.1016/j.vaccine.2008.08.059 复制DOI
    作者列表:Pace D,Cuschieri P,Galea Debono A,Attard-Montalto S
    BACKGROUND & AIMS: OBJECTIVE:To describe the epidemiology of the serosubtypes of Neisseria meningitidis serogroup B (MenB) in the most densely populated area in Europe and to review the MenB Porin A (PorA) based outer membrane vesicle (OMV) vaccines that could provide the broadest protection. STUDY DESIGN AND SETTING:Active surveillance of invasive meningococcal disease in a population of 400,000 inhabitants in Malta from 1999 to 2006. Serogroup B isolates were serosubtyped and analysed by age and year. The suitability of OMV vaccines was then assessed. RESULTS:Laboratory confirmation of invasive meningococcal disease was obtained in 48% (79/163) of notified cases. Serogroup B caused the majority of invasive meningococcal disease (76%, 60/79) with the greatest disease burden occurring in 0-14-year-old children (73%, 44/60). MenC caused 14% (11/79) of cases. The most prevalent MenB serotype:serosubtype combination was B:4:P1.19,15 which constituted 59% (34/58) of all phenotypeable MenB isolates. The PorA epitopes P1.15 and P1.19, detected in 74% (43/58) of isolates, were significantly more prevalent than serosubtypes with other PorA epitopes (chi(2): 7.18, P<0.01). CONCLUSION:An assessment of the usefulness of a MenB OMV vaccine in Malta requires further research. The wild-type OMV vaccine developed by the Finlay Institute (FI) in Cuba could potentially be used to control an outbreak with a MenB P1.19,15 clone. A multivalent OMV vaccine would however be needed for broader protection against the endemic heterogenous MenB strains. A serogroup B vaccine incorporating more conserved proteins than PorA would be more suitable for comprehensive control of meningococcal B disease.
    背景与目标: 目的:描述欧洲人口最稠密地区脑膜炎奈瑟氏菌血清群B(MenB)血清型的流行病学,并审查基于MenB Porin A(PorA)的外膜囊泡(OMV)疫苗,该疫苗可提供最广泛的保护。
    研究设计与背景:从1999年到2006年,马耳他40万居民中的侵袭性脑膜炎球菌疾病的主动监测。对血清B型分离株进行血清亚型分析,并按年龄和年份进行分析。然后评估了OMV疫苗的适用性。
    结果:48%(79/163)的通报病例中获得了侵袭性脑膜炎球菌疾病的实验室确认。血清群B导致大多数浸润性脑膜炎球菌疾病(76%,60/79),最大的疾病负担发生在0-14岁的儿童中(73%,44/60)。 MenC导致14%(11/79)的案件。最流行的MenB血清型:血清亚型组合是B:4:P1.19,15,占所有可表型MenB分离株的59%(34/58)。在74%(43/58)的分离物中检测到的PorA表位P1.15和P1.19明显比其他PorA表位的血清亚型普遍(chi(2):7.18,P <0.01)。
    结论:评估马耳他的MenB OMV疫苗的有效性需要进一步研究。古巴Finlay研究所(FI)开发的野生型OMV疫苗可能具有MenB P1.19,15克隆,可用于控制暴发。但是,将需要多价OMV疫苗来更广泛地防御地方性异种MenB毒株。含有比PorA更多保守蛋白的B血清群疫苗更适合全面控制B型脑膜炎球菌。
  • 【评论:外行流行病学中的预防悖论-罗斯再访。】 复制标题 收藏 收藏
    DOI:10.1093/ije/30.3.442 复制DOI
    作者列表:Hunt K,Emslie C
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【特邀评论:社会流行病学的路径和病理。】 复制标题 收藏 收藏
    DOI:10.1093/aje/kwt144 复制DOI
    作者列表:Oakes JM
    BACKGROUND & AIMS: :The article by professors Galea and Link in this issue of the Journal (Am J Epidemiol. 2013;178(6):843-849) is an important contribution to the field of social epidemiology. Their 6 paths provide ample fodder for reflection, debate, and advancement. Although I agree with the thrust and spirit of their recommendations, I argue that if social epidemiology is to advance and become not just more popular but also more useful, we social epidemiologists need to first address our disciplinary pathologies. Among other things, we must embrace macro-to-micro transitions, understand and act on the principles of effect identification, conduct many more experiments, and train students to be not researchers but scientists.
    背景与目标: :Galea和Link教授在本期杂志上发表的文章(Am J Epidemiol。2013; 178(6):843-849)对社会流行病学领域做出了重要贡献。他们的6条道路为反思,辩论和进步提供了充足的饲料。尽管我同意他们的建议的主旨和精神,但我认为,如果社会流行病学要发展并不仅变得流行,而且变得更加有用,那么我们社会流行病学家需要首先解决我们的学科病态。除其他事项外,我们必须接受从宏观到微观的转变,了解效果识别的原理并采取行动,进行更多的实验,并训练学生不是研究人员而是科学家。
  • 【甲醛致癌性研究:30年,并且一直在研究其作用方式,流行病学和癌症风险评估。】 复制标题 收藏 收藏
    DOI:10.1177/0192623312466459 复制DOI
    作者列表:Swenberg JA,Moeller BC,Lu K,Rager JE,Fry RC,Starr TB
    BACKGROUND & AIMS: :Formaldehyde is a widely used high production chemical that is also released as a byproduct of combustion, off-gassing of various building products, and as a fixative for pathologists and embalmers. What is not often realized is that formaldehyde is also produced as a normal physiologic chemical in all living cells. In 1980, chronic inhalation of high concentrations of formaldehyde was shown to be carcinogenic, inducing a high incidence of nasal squamous cell carcinomas in rats. Some epidemiologic studies have also found increased numbers of nasopharyngeal carcinoma and leukemia in humans exposed to formaldehyde that resulted in formaldehyde being considered a Known Human Carcinogen. This article reviews the data for rodent and human carcinogenicity, early Mode of Action studies, more recent molecular studies of both endogenous and exogenous DNA adducts, and epigenetic studies. It goes on to demonstrate the power of these research studies to provide critical data to improve our ability to develop science-based cancer risk assessments, instead of default approaches. The complexity of constant physiologic exposure to a known carcinogen requires that new ways of thinking be incorporated into determinations of cancer risk assessment for formaldehyde, other endogenous carcinogens, and the role of background endogenous DNA damage and mutagenesis.
    背景与目标: :甲醛是一种广泛使用的高产量化学品,也作为燃烧,各种建筑产品的除气副产物释放出来,并作为病理学家和防腐剂的固定剂释放。人们并不经常意识到,甲醛在所有活细胞中也作为正常的生理化学物质产生。在1980年,长期吸入高浓度的甲醛被证明是致癌的,从而导致大鼠鼻鳞状细胞癌的高发病率。一些流行病学研究还发现,暴露于甲醛的人体中鼻咽癌和白血病的数量增加,导致甲醛被认为是已知的人类致癌物。本文回顾了啮齿动物和人类致癌性的数据,早期的作用方式研究,内源性和外源性DNA加合物的最新分子研究以及表观遗传学研究。它继续证明了这些研究研究提供关键数据的能力,从而提高了我们开发基于科学的癌症风险评估的能力,而不是默认方法。持续不断地生理暴露于已知致癌物的复杂性要求将新的思维方式纳入甲醛,其他内源性致癌物的癌症风险评估以及背景内源性DNA损伤和诱变作用的确定中。
  • 【阿拉伯联合酋长国老年人创伤的流行病学。】 复制标题 收藏 收藏
    DOI:10.1016/j.archger.2007.08.018 复制DOI
    作者列表:Adam SH,Eid HO,Barss P,Lunsjo K,Grivna M,Torab FC,Abu-Zidan FM
    BACKGROUND & AIMS: :The mechanisms and outcome of trauma in hospitalized elderly patients were studied. The data of Al-Ain Hospital Trauma Registry were prospectively collected over a period of 3 years (2003-2006). All elderly trauma-patients above 60 years who were admitted to surgical ward or who died on arrival were studied. Demography of patients, mechanism of injury, Injury Severity Score (ISS), hospital stay and mortality were analyzed. There were 121 patients (70 males and 51 females). Mean (range) age was 69 years (60-100), 42% were United Arab Emirates (UAE) nationals. The two most common mechanisms of injury were falls (55%) followed by road traffic collisions (RTC) (32%). The median (range) ISS of the group was 5 (1-34). The ISS median (interquartile range) of falling down, RTC, and fall from height were 4 (4-9), 6 (4-10), and 8 (5-9), respectively (p=0.31). Forty-one percentage of injuries occurred at home. The mean (range) hospital stay was 12.4 (1-150) days. Six patients (5%) were admitted to the intensive care unit. Overall mortality was 6% (7 patients), of whom 5 were pedestrians hit by cars. We concluded that low-energy trauma from falls was the most common cause of injury in the elderly. Mortality was high mainly from pedestrian injuries.
    背景与目标: :研究了住院老年患者的创伤机理和转归。前瞻性地收集了3年(2003-2006年)的Al-Ain医院创伤登记处的数据。研究对象是所有60岁以上的老年创伤患者,他们都被送进了外科病房或在抵达时死亡。分析患者的人口统计学,损伤机制,损伤严重度评分(ISS),住院时间和死亡率。有121例患者(男性70例,女性51例)。平均(年龄)年龄为69岁(60-100岁),阿拉伯联合酋长国(UAE)国民为42%。两种最常见的伤害机制是跌倒(55%),其次是道路交通碰撞(RTC)(32%)。该组的中位(范围)ISS为5(1-34)。 ISS下降,RTC和从高度下降的中位数(四分位间距)分别为4(4-9),6(4-10)和8(5-9)(p = 0.31)。百分之四十一的受伤是在家中发生的。平均住院时间为12.4(1-150)天。重症监护病房收治了6例患者(5%)。总死亡率为6%(7位患者),其中5位是行人被汽车撞到。我们得出的结论是,跌倒引起的低能量创伤是老年人受伤的最常见原因。死亡率高主要是由于行人受伤。
  • 【多种超氧化物歧化酶1 / splicing因子丝氨酸丙氨酸15变异与糖尿病性肾病的发生和发展有关:糖尿病控制和并发症糖尿病干预和并发症的流行病学G】 复制标题 收藏 收藏
    DOI:10.2337/db07-1059 复制DOI
    作者列表:
    BACKGROUND & AIMS: BACKGROUND:Despite familial clustering of nephropathy and retinopathy severity in type 1 diabetes, few gene variants have been consistently associated with these outcomes. RESEARCH DESIGN AND METHODS:We performed an individual-based genetic association study with time to renal and retinal outcomes in 1,362 white probands with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Specifically, we genotyped 1,411 SNPs that capture common variations in 212 candidate genes for long-term complications and analyzed them for association with the time from DCCT baseline to event for renal and retinal outcomes using multivariate Cox proportion hazards models. To address multiple testing and assist interpretation of the results, false discovery rate q values were calculated separately for each outcome. RESULTS:We observed association between rs17880135 in the 3' region of superoxide dismutase 1 (SOD1) and the incidence of both severe nephropathy (hazard ratio [HR] 2.62 [95% CI 1.64-4.18], P = 5.6 x 10(-5), q = 0.06) and persistent microalbuminuria (1.82 [1.29-2.57], P = 6.4 x 10(-4), q = 0.46). Sequencing and fine-mapping identified additional SOD1 variants, including rs202446, rs9974610, and rs204732, which were also associated (P < 10(-3)) with persistent microalbuminuria, whereas rs17880135 and rs17881180 were similarly associated with the development of severe nephropathy. Attempts to replicate the findings in three cross-sectional case-control studies produced equivocal results. We observed no striking differences between risk genotypes in serum SOD activity, serum SOD1 mass, or SOD1 mRNA expression in lymphoblastoid cell lines. CONCLUSIONS:Multiple variations in SOD1 are significantly associated with persistent microalbuminuria and severe nephropathy in the DCCT/EDIC study.
    背景与目标: 背景:尽管家族性聚集性肾病和视网膜病的严重性在1型糖尿病中,很少有基因变异与这些结果一致相关。
    研究设计和方法:我们进行了一项基于个体的遗传关联研究,研究了来自糖尿病控制与并发症试验/糖尿病干预与并发症流行病学(DCCT / EDIC)研究的1,362名1型糖尿病白人先证者的肾脏和视网膜预后的时间。具体来说,我们对1,411个SNP进行了基因分型,这些SNPs捕获了212个候选基因的长期并发症的常见变异,并使用多变量Cox比例风险模型分析了它们与从DCCT基线到事件发生的时间相关的肾和视网膜结局。为了解决多个测试问题并帮助解释结果,针对每个结果分别计算了错误发现率q值。
    结果:我们观察到超氧化物歧化酶1(SOD1)3'区域中的rs17880135与两种严重肾病的发生率相关(危险比[HR] 2.62 [95%CI 1.64-4.18],P = 5.6 x 10(-5) ),q = 0.06)和持续性微量白蛋白尿(1.82 [1.29-2.57],P = 6.4 x 10(-4),q = 0.46)。测序和精细定位确定了其他SOD1变体,包括rs202446,rs9974610和rs204732,它们也与持续性微量白蛋白尿相关(P <10(-3)),而rs17880135和rs17881180与严重肾病的发展类似。试图在三项横断面病例对照研究中重复研究结果,结果却模棱两可。我们观察到淋巴母细胞样细胞系中血清SOD活性,血清SOD1质量或SOD1 mRNA表达的风险基因型之间没有显着差异。
    结论:在DCCT / EDIC研究中,SOD1的多种变异与持续性微量白蛋白尿和严重肾病显着相关。
  • 【隐球菌性脑膜炎:流行病学,免疫学,诊断和治疗。】 复制标题 收藏 收藏
    DOI:10.1038/nrneurol.2016.167 复制DOI
    作者列表:Williamson PR,Jarvis JN,Panackal AA,Fisher MC,Molloy SF,Loyse A,Harrison TS
    BACKGROUND & AIMS: :HIV-associated cryptococcal meningitis is by far the most common cause of adult meningitis in many areas of the world that have high HIV seroprevalence. In most areas in Sub-Saharan Africa, the incidence of cryptococcal meningitis is not decreasing despite availability of antiretroviral therapy, because of issues of adherence and retention in HIV care. In addition, cryptococcal meningitis in HIV-seronegative individuals is a substantial problem: the risk of cryptococcal infection is increased in transplant recipients and other individuals with defects in cell-mediated immunity, and cryptococcosis is also reported in the apparently immunocompetent. Despite therapy, mortality rates in these groups are high. Over the past 5 years, advances have been made in rapid point-of-care diagnosis and early detection of cryptococcal antigen in the blood. These advances have enabled development of screening and pre-emptive treatment strategies aimed at preventing the development of clinical infection in patients with late-stage HIV infection. Progress in optimizing antifungal combinations has been aided by evaluation of the clearance rate of infection by using serial quantitative cultures of cerebrospinal fluid (CSF). Measurement and management of raised CSF pressure, a common complication, is a vital component of care. In addition, we now better understand protective immune responses in HIV-associated cases, immunogenetic predisposition to infection, and the role of immune-mediated pathology in patients with non-HIV associated infection and in the context of HIV-associated immune reconstitution reactions.
    背景与目标: :与艾滋病毒相关的隐球菌性脑膜炎是迄今为止在世界上许多艾滋病毒血清感染率高的地区中成人脑膜炎的最常见原因。在撒哈拉以南非洲的大多数地区,由于抗病毒治疗的依从性和保留问题,尽管有抗逆转录病毒疗法,但隐球菌性脑膜炎的发病率并未下降。此外,HIV血清阴性个体中的隐球菌性脑膜炎是一个严重的问题:移植受者和其他细胞介导的免疫缺陷的个体中隐球菌感染的风险增加,并且隐球菌病还具有明显的免疫能力。尽管进行了治疗,但这些组的死亡率很高。在过去的5年中,血液中隐球菌抗原的快速即时诊断和早期检测取得了进展。这些进展使得能够开发出旨在预防晚期HIV感染患者临床感染的筛查和抢先治疗策略。通过使用脑脊液(CSF)的连续定量培养评估感染的清除率,有助于优化抗真菌药物的组合。常见并发症CSF压力升高的测量和管理是护理的重要组成部分。此外,我们现在更好地了解了HIV相关病例的保护性免疫反应,感染的免疫遗传倾向性以及非HIV相关感染患者以及HIV相关免疫重建反应中免疫介导的病理学的作用。

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