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1.
Yun Heng Zhou Hong Xia Ma Xiao Xing Shi Yang Liu 《Journal of microbiology, immunology, and infection》2018,51(6):778-783
Objective
We investigated the prevalence of Ureaplasma spp. in semen samples of infertile men in Shanghai, China and evaluated the correlation between the sperm parameters (seminal volume, sperm concentration, progressive motility and non-progressive) and the secretary function in these infectious populations.Methods
Semens were collected from 540 infertile men and 260 fertile control group in shanghai, China and subjected to standard bacterial and Ureaplasma spp. culture. Positive Ureaplasma spp. isolates were further tested by PCR to detect the biovars and serotypes of Ureaplasma spp. Sperm seminological variabilities were analyzed by Computer-Assisted Semen Analysis according to the fifth edition of World Health Organization (WHO) laboratory manual for the examination and processing of human semen. Seminal markers were measured by the automatic analyzer.Results
The prevalence of Ureaplasma spp. in semen specimens was 39.6% (214/540) and 19.2% (50/260) in infertile and control group, respectively. Significant difference was observed between the two groups (P < 0.001). Among all clinical isolates from infertile men (n = 214), 59.3% (n = 127) was Ureaplasma parvum (UPA), 26.2% (n = 56) was Ureaplasma urealyticum (UUR), and 14.5% (n = 31) was mixed species. While those numbers in control group (n = 50) were 64.0% (n = 32), 20.0% (n = 10), 16.0% (n = 8), respectively. There was no significant difference between any two groups (P > 0.05). The progressive motility and the NAG activity of infertile men infected with UPA and mixed species were significantly lower than those of UUR infected subgroup (P < 0.05).Conclusions
The infection of Ureaplasma spp. plays an important pathogenic role in male infertility. UPA has higher pathogenicity on the progressive motility and the secretary function of epididymis than UUR. 相似文献2.
Ching-Yuan Yeh Fu-Der Wang Yu-Chung Chuang Chia-Jui Yang Shiang-Fen Huang Wen-Sung Weng Chun-Hsin Liaw Wang-Huei Sheng 《Journal of microbiology, immunology, and infection》2018,51(6):697-704
Background
Few studies have investigated patients with severe influenza who receive intravenous peramivir for salvage therapy.Methods
We retrospectively analyzed data from 71 patients with severe influenza who received intravenous peramivir therapy in the intensive care units of three medical centers between 2012 and 2016. All patients received oseltamivir or zanamivir before the administration of peramivir.Results
A total of 44 men and 27 women with a median age of 55 years were enrolled. Fifty-five (78%) had underlying comorbidities and 57 (80%) patients were infected with influenza type A. Forty-four (62%) patients survived and 27 (38%) died. Five patients (7%) had attributable adverse events, including elevated hepatic aminotransferase levels (n = 2), hyperbilirubinemia (n = 2), leukopenia (n = 1), and skin rash (n = 1). Multivariable logistic regression analysis revealed that initial bacteremia (odds ratio [OR], 27.59; 95% confidence interval [95% CI], 2.36–322.07; P = 0.008) and septic shock (OR, 8.00; 95% CI, 1.69–37.90; P = 0.009) were the independent predictors of mortality. However, there was also a trend towards a positive correlation between mortality and steroid use (OR, 11.29; 95% CI, 0.67–188.86; P = 0.092).Conclusion
As a salvage therapy, intravenous peramivir provided a survival rate of 62% and was well tolerated in patients with severe influenza. The initiation of effective antiviral treatment as early as possible within 48 h is recommended for hospitalized patients. 相似文献3.
Hong-Yi Lee Yu-Chia Hsieh Ching-Chuan Liu Yi-Chuan Huang Kuang-Yi Chang Hsin Chi Luan-Yin Chang Yhu-Chering Huang Li-Min Huang 《Journal of microbiology, immunology, and infection》2018,51(2):199-206
Background
In Taiwan, the age group with the greatest incidence of invasive pneumococcal disease is 2–5 years of age, which is different from other countries. This study was conducted to identify risk factors and different 13-valent pneumococcal conjugate vaccine (PCV13) schedules associated with vaccine-type invasive pneumococcal pneumonia (IPP) despite prior vaccination.Methods
A case–control study was conducted prospectively between August 2012 and December 2015 at five participating medical centers. The study enrolled children <15 years of age who were admitted to one of the five medical centers for CAP. Blood samples and acute-phase serum specimens were collected and Streptococcus pneumoniae was identified by using a real-time polymerase-chain-reaction (RT-PCR) assay targeting the lytA gene.Results
A total of 25 children diagnosed with vaccine-type IPP and 124 controls were enrolled. Vaccine-type IPP occurred in 6 (28.6%), 14 (24.1%), and 5 (7.1%) children receiving vaccines on a not-age-appropriate schedule (n = 21), primary infant schedule (n = 58), and toddler catch-up schedule (n = 70) (P = 0.008), respectively. Of 25 children, the mean age at disease onset was 36 ± 11 months; serotype 19A was responsible for 84% (21/25).Conclusion
After adjustment for confounding factors, the risk of vaccine-type IPP was significantly higher among children receiving vaccines on a not-age-appropriate schedule, or on a primary infant schedule, compared with children receiving vaccines on a toddler catch-up schedule. Duration of vaccine immunity should be investigated to direct strategies for maintaining individual and population immunity against pneumococcal disease. 相似文献4.
Selma Pekgor Cevdet Duran Ruhuşen Kutlu Ibrahim Solak Ahmet Pekgor Mehmet Ali Eryilmaz 《Journal of the National Medical Association》2018,110(6):606-613
Objective
To assess visceral adiposity index (VAI) as a sign of cardio-vascular diseases (CVD) in hypothyroidism patients and to compare CVD risks in overt or subclinical hypothyroidism patients.Materials and methods
Sixty-eight hypothyroidism patients (29 with overt and 39 with subclinical hypothyroidism) and 33 age- and gender-matched control patients were included. VAI levels were calculated with the following formula: (waist circumference (WC)/[36.58+(1.89xbody mass index (BMI))])x[(triglyceride (TG) (mmol/L)/0.81)x(1.52xhigh-density lipoprotein cholesterol (HDL-cholesterol) (mmol/L))] and (WC/[39.68+(1.88xBMI)])x[(TG (mmol/L)/1.03)x(1.31xHDL-cholesterol (mmol/L))], respectively.Results
While body weight (p < 0.01), BMI (p < 0.01), TG and VAI levels (p < 0.01) were higher in hypothyroidism patients than controls, HDL-cholesterol levels were lower (p = 0.02). When patients were divided to groups as subclinical (n = 39) and overt hypothyroidism (n = 29) and compared with each other and controls (n = 33), body weight (p = 0.02 and p = 0.02, respectively), BMI (p = 0.01 and p < 0.01, respectively) and TG (p < 0.01 and p = 0.03, respectively) were higher in overt and subclinical hypothyroidism groups than controls. HDL-cholesterol was lower only in the group with overt hypothyroidism than controls (p = 0.01). Although found similar to each other in overt and subclinical hypothyroidism groups, VAI levels were observed to be higher in both groups than controls (p < 0.01 and p = 0.02, respectively). In correlation analysis, a positive correlation was determined between thyroid stimulating hormone (TSH), BMI and VAI levels (p = 0.03 and p < 0.01, respectively).Conclusions
Due to the association between increased VAI levels, and metabolic syndrome and CVDs, we consider that several measures should be promptly taken to decrease these risk factors, and further studies with a larger sample size should be performed. 相似文献5.
Melishia Bansa Darryl Brown Daniela DeFrino Nicholas Mahoney Alexandria Saulsberry Monika Marko-Holguin Joshua Fogel Tracy R.G. Gladstone Benjamin W. Van Voorhees 《Journal of the National Medical Association》2018,110(2):130-142
Background
This study explored the implementation of Chicago Urban Resiliency Building (CURB), a randomized clinical trial designed as an Internet-based primary care depression prevention intervention for urban African American and Latino adolescents.Methods
We utilized a mixed methods analysis to explore four aims. First, we estimated the percent of at-risk adolescents that were successfully screened. Second, we examined clinic site factors and performance. Third, primary care providers (n = 10) and clinic staff (n = 18) were surveyed to assess their knowledge and attitudes about the intervention. Fourth, clinic staff (nursing and medical assistant) interviews were analyzed using thematic analysis to gather perspectives of the implementation process.Results
We found that the estimated percent of at-risk adolescents who were successfully screened in each clinic varied widely between clinics with a mean of 14.48%. Daily clinic communication was suggestive of greater successful screening. Feasibility of screening was high for both primary care providers and clinic staff. Clinic staff exit interviews indicated the presence of community barriers that inhibited successful implementation of the intervention.Conclusion
This study shares the challenges and successes for depression screening and implementing Internet-based mental health interventions for urban racial/ethnic minority adolescents in primary care settings. 相似文献6.
Background
The clinical characteristics of patients with chronic obstructive pulmonary disease overlapped with bronchial asthma (COPD-BA) have not been discussed thoroughly.Objective
To reveal the clinical features of patients with COPD-BA, to evaluate the risk factors of COPD-BA, and to provide suggestions for COPD individualized therapy.Methods
A retrospective observational study was performed. A total of 182 patients with COPD (90 with COPD-BA and 92 with pure COPD) were recruited in the study. Information on the following items was collected: demographics, clinical manifestations, complications, laboratory findings, other histories, and inpatient treatments during exacerbation.Results
A total of 182 patients were diagnosed with COPD, with 90 (49.45%) being classified as having COPD-BA. Patients with COPD-BA were more likely to be female (P = .004) and experienced more severe respiratory exacerbations (P = .04) despite being younger (P = .008). Those patients at onset of recurrent cough and sputum production were younger (P = .001). Significantly, a positive asthmatic family history (P = .03) was observed. Patients with COPD-BA usually had higher level of total serum IgE (although no differences were observed), had higher positive rates of the serum specific IgE (P = .004), and were more like to have an allergic history (P = .003). Allergic factor was the risk factor of COPD-BA (odds ratio, 4.477). During hospitalization, patients with COPD-BA tended to be treated with systemic corticosteroids (P = .008).Conclusion
Patients with COPD-BA were characterized by persistent airflow limitation with unique clinical features. Allergic factor was associated with the presence of asthmatic characteristics in patients with COPD. When hospitalized for exacerbation, the individualized therapy for COPD-BA might include the use of corticosteroids systemically. 相似文献7.
Shih-Wen Ting Chen-Hsiang Lee Jien-Wei Liu 《Journal of microbiology, immunology, and infection》2018,51(5):621-628
Background/purpose
A substantial number of carbapenem-resistant Gram-negative bacilli (CR GNB) have been identified among the etiologic multidrug-resistant GNB in healthcare-associated infections. For achieving a better therapeutic outcome by minimizing inappropriate empirical antibiotic treatment before blood culture and susceptibility testing results are available, it is very important to identify patients who are at risk for the development of CR GNB bacteremia.Methods
Retrospective analysis of propensity-score matched (PSM) adult patients with CR GNB bacteremia (PSM-group 1 [n = 95]) and those with non-CR GNB bacteremia (PSM-group 2 [n = 190]).Results
PSM-group 1 was found to a significantly longer length of hospital stay (27 vs. 18 days; p < 0.001) after emerging GNB bacteremia and a higher 30-day all-cause mortality rate (27.4% vs. 5.8%; p < 0.001), when compared with PSM-2 group. Independent risk factors for the acquisition of CR GNB bacteremia were previous exposure to an antipseudomonal penicillin (odds ratio [OR] = 3.58; 95% confidence interval [CI] = 1.30–9.90), an antipseudomonal cephalosporin (OR = 3.49; 95% CI = 1.09–11.24), and a carbapenem (OR = 3.60; 95% CI = 1.37–9.47), and longer length of hospital stay before the development of GNB bacteremia (OR = 1.03; 95% CI = 1.01–1.05).Conclusion
Risk factors for acquisition of CR GNB bacteremia identified in this study each may serve as a reminder alerting clinicians to hospitalized patients at risk for CR GNB bacteremia requiring appropriate antibiotic coverage, and in these circumstances, combined antibiotics may be used until antimicrobial de-escalation/adjustment is clearly indicated by the subsequently identified pathogenic GNB and its susceptibility profile. 相似文献8.
Gabriel S. Tajeu Jewell Halanych Lucia Juarez Jeff Stone Irena Stepanikova Alexander Green Andrea L. Cherrington 《Journal of the National Medical Association》2018,110(5):464-472
Background
Racial bias is associated with suboptimal healthcare treatment for minorities. Research focuses on bias among physicians rather than non-physician healthcare staff (e.g., receptionists). Patients spend considerable amounts of time with non-physician staff. Therefore, we investigate differences in implicit and explicit racial bias by healthcare staff race and occupation using the Implicit Association Test and Modern Racism Scale, respectively.Methods
Staff (n = 107) were recruited using the Alabama based Primary Care Research Coalition. Occupation was categorized into “medical doctors/registered nurses” (MD/RN) and “non-MD/RN” (e.g., receptionists).Results
Implicit bias scores were higher among whites compared with blacks (0.62, ?0.04, respectively; p < 0.01). Among whites, non-MD/RNs demonstrated more pro-white implicit bias compared with MD/RNs (0.67, 0.44, respectively; p < 0.01). Whites had higher explicit bias scores than blacks (17.7, 12.3, respectively; p < 0.01).Conclusion
Non-MD/RNs should not be overlooked for cultural competency training, and efforts are needed to reduce racial bias among healthcare workers identified as having higher levels of bias. 相似文献9.
David L. Murphy Stephanie H. Oberfoell Stacy A. Trent Andrew J. French Daniel J. Kim David B. Richards 《中华民国医用超音波学会杂志》2017,25(2):96-100
Objective
To validate an ocular phantom as a realistic educational tool utilizing in vivo and phantom optic nerve sheath (ONS) images obtained by ultrasound.Methods
This prospective study enrolled 51 resident physicians from the Denver Health Residency in Emergency Medicine (EM) and 10 ultrasound fellowship-trained EM attending physicians. Participants performed optic nerve sheath diameter (ONSD) measurements on five in vivo and five phantom ocular ultrasound images and rated the realism of each image on a 5-point Likert scale. Chi-square analysis was performed to evaluate the subjective “realness” of in vivo and phantom images.Results
Sixty-one participants performed ONSD measurements. Mean Likert scale values were 3.43 (95% confidence interval: 3.31–3.55) for in vivo images and 3.41 (95% confidence interval: 3.28–3.54) for phantom images. There was no statistical difference in subjective “realness” between in vivo and phantom ONSD ultrasound images among EM residents. Ultrasound fellowship-trained EM attending physicians aptly differentiated between in vivo (p < 0.01) and phantom (p < 0.01) images, as compared with EM residents.Conclusion
Our ocular phantom simulates in vivo posterior ocular anatomy. EM resident physicians found the phantom indistinguishable from in vivo images. Our ONS model provides an inexpensive and realistic educational tool to teach bedside ONSD sonography. 相似文献10.
Brock H. Medsker Bronwyn K. Brew Erick Forno Henrik Olsson Cecilia Lundholm Yueh-Ying Han Edna Acosta-Pérez Glorisa J. Canino Catarina Almqvist Juan C. Celedón 《Annals of allergy, asthma & immunology》2017,118(1):55-60.e1
Background
Little is known about the joint effects of maternal asthma and maternal depression on childhood asthma.Objective
To examine whether maternal depression and maternal asthma lead to greater risk of childhood asthma than maternal asthma alone.Methods
Cross-sectional studies of children (6–14 years old) in San Juan, Puerto Rico (n = 655) and Sweden (n = 6,887) were conducted. In Puerto Rico, maternal depressive symptoms were defined using the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire. In Sweden, maternal physician-diagnosed depression was derived from national registries, and maternal depressive symptoms were defined using an abbreviated CES-D questionnaire. Childhood asthma was defined as physician-diagnosed asthma plus current wheeze (in Puerto Rico) or plus medication use (in Sweden). Logistic regression was used for multivariable analysis.Results
Compared with Puerto Rican children whose mothers had neither asthma nor depressive symptoms, those whose mothers had asthma but no depressive symptoms had 3.2 times increased odds of asthma (95% confidence interval [CI] = 2.1–4.8) and those whose mothers had asthma and depressive symptoms had 6.5 times increased odds of asthma (95% CI = 3.3–13.0). Similar results were obtained for maternal depression and maternal asthma in the Swedish cohort (odds ratio for maternal asthma without maternal depression = 2.8, 95% CI = 2.1–3.7; odds ratio for maternal asthma and maternal depression = 4.0, 95% CI = 1.7–9.6). Although the estimated effect of maternal asthma on childhood asthma was increased when maternal depressive symptoms (Puerto Rico) or maternal depression (Sweden) was present, there were no statistically significant additive interactions.Conclusion
Maternal depression can further increase the risk of asthma in children whose mothers have a history of asthma. 相似文献11.
Tiffani J. Johnson Angela M. Ellison George Dalembert Jessica Fowler Menaka Dhingra Kathy Shaw Said Ibrahim 《Journal of the National Medical Association》2017,109(3):156-163
Objective
Despite known benefits of diversity, certain racial/ethnic groups remain underrepresented in academic pediatrics. Little research exists regarding unconscious racial attitudes among pediatric faculty responsible for decisions on workforce recruitment and retention in academia. This study sought to describe levels of unconscious racial bias and perceived barriers to minority recruitment and retention among academic pediatric faculty leaders.Methods
Authors measured unconscious racial bias in a sample of pediatric faculty attending diversity workshops conducted at local and national meetings in 2015. A paper version of the validated Implicit Association Test (IAT) measured unconscious racial bias. Subjects also reported perceptions about minority recruitment and retention.Results
Of 68 eligible subjects approached, 58 (85%) consented and completed the survey with IAT. Of participants, 83% had leadership roles and 93% were involved in recruitment. Participants had slight pro-white/anti-black bias on the IAT (M = 0.28, SD = 0.49). There were similar IAT scores among participants in leadership roles (M = 0.33, SD = 0.47) and involved in recruitment (M = 0.28, SD = 0.43). Results did not differ when comparing participants in local workshops to the national workshop (n = 36, M = 0.29, SD = 0.40 and n = 22, M = 0.27, SD = 0.49 respectively; p = 0.88). Perceived barriers to minority recruitment and retention included lack of minority mentors, poor recruitment efforts, and lack of qualified candidates.Conclusions
Unconscious pro-white/anti-black racial bias was identified in this sample of academic pediatric faculty and leaders. Further research is needed to examine how unconscious bias impacts decisions in academic pediatric workforce recruitment. Addressing unconscious bias and perceived barriers to minority recruitment and retention represent opportunities to improve diversity efforts. 相似文献12.
Kimberly S. Johnson Kevin L. Thomas Sandro O. Pinheiro Laura P. Svetkey 《Journal of the National Medical Association》2018,110(4):305-313
Background
Disparities in health and healthcare are widely documented for underrepresented racial and ethnic populations across a spectrum of diseases and care settings. An evidence base for addressing racial and ethnic disparities in health and healthcare requires investigators trained to conduct health disparities research.Objective
To increase knowledge, stimulate interest, teach skills to evaluate and conduct, and foster collaborations in health disparities research.Design
We designed, implemented and evaluated a Health Disparities Research Curriculum (HDRC).Participants were early-stage investigators.Intervention
HDRC included twelve monthly sessions during 2015–2016. Instructors were mostly HDR investigators. Sessions combined didactic presentations, discussions, small group activities, and participant presentations.Measures
Pre- and post-surveys to assess participants' perceptions of knowledge and skills.Results
Of 21 enrollees, 13 were from under-represented groups and 14 were women. Four reported some prior training in HDR, and 12 reported currently conducting HDR.Among the 12 participants who completed both the pre and post HDRC survey, initially the most commonly cited barriers to pursuing HDR were lack of knowledge (N = 6) and funding (N = 7). In the post-survey, the number citing lack of knowledge decreased (N = 2) and the number listing lack of funding increased (N = 9). There were increases in the number of participants reporting increased knowledge of HDR methods (pre-post: 4 vs. 8) and competence to design (3 vs. 7) and implement (2 vs. 9) HDR research.Conclusions
The Duke HDRC augments efforts to reduce health disparities by providing training in HDR for young investigators. Our data indicate that the course was feasible, well-received, and increased perceived knowledge and competence. HDRC and similar courses may increase the quantity, quality and scope of HDR and thus move us closer to health equity. 相似文献13.
Aakash A. Bavishi Leslie C. Grammer Jacqueline Pongracic Karen Rychlik Rajesh Kumar Phyllis Zee Paul A. Greenberger Anna B. Fishbein 《Annals of allergy, asthma & immunology》2017,118(1):103-107
Background
Circadian rhythms underlie many immune responses and allergic diseases. Subcutaneous immunotherapy (SCIT) can result in adverse reactions; however, it is unclear whether such reactions have a diurnal pattern.Objective
To assess whether the timing of SCIT affects the rate of adverse reactions.Methods
This study was a retrospective medical record review of adult patients (n = 289) who received SCIT at the Northwestern Medical Faculty Foundation, Chicago, Illinois, during a 10-year period (2004–2014). Injections were given in the outpatient setting. There were a total of 17,457 injections with 574 reactions. Covariates included age, sex, median income, asthma status, vial contents, number of injections, and previous immunotherapy reactions. Logistical regression was used to calculate the odds of having a reaction with time of SCIT administration as the primary determinate.Results
Immunotherapy reactions occurred more frequently after afternoon or evening (pm) injections (328/8721 = 3.8%) vs morning (am) injections (246/8736 = 2.8%), (χ2 = 12.26, P < .01). Systemic reactions, defined as World Allergy Organization grade 1 or higher, did not have diurnal variation (59/8721 = 0.67% for pm vs am 56/8736 = 0.64% for morning; χ2 = 0.08; P = .77). pm injections resulted in higher odds of reaction compared with am injection in a fully adjusted logistic regression model (odds ratio = 1.43; 95% confidence interval, 1.20–1.70; P < .01). When considering time as 4 categories, the highest odds of reaction were noted for the period from 15:01 to 17:30 (odds ratio, 1.55; 95% confidence interval, 1.21–2.00; P < .01).Conclusion
pm injections of SCIT are associated with increased cutaneous reaction rates when compared with am injections. In patients experiencing bothersome local reactions, it may be beneficial to administer SCIT in the morning. 相似文献14.
Anna L. Chien Ji Qi Radhika Grandhi Tamia Harris-Tryon Noori Kim Min Soo Jang Omolara Olowoyeye Diane Kuhn Sherry Leung Barbara M. Rainer Flora Poon Sabrina Sisto Alessi César Jean Suh Nancy Cheng Ginette A. Okoye Sewon Kang 《Journal of the National Medical Association》2018,110(6):534-539
Background
Increased photoprotection by natural melanin allows for African-Americans to be less impacted by photoaging than Caucasians. However, less is known about chronological aging in this population.Objective
To create a photonumeric scale for African-Americans to evaluate chronological skin aging and to explore contributing elements to intrinsic aging.Methods
Standardized photographs of the upper inner arm were taken from 75 African-American participants. Five participants were chosen as standards to create a 9-point photonumeric scale (0 = none, 8 = most severe). The scale was utilized by three blinded dermatologists to independently rate participants' photographs.Results
The interrater agreements were 0.768 (95% CI: 0.671–0.834) for trial 1 and 0.725 (0.608–0.794) for trial 2. The intrarater agreements were 0.757 (0.596–0.875), 0.850 (0.771–0.903), and 0.790 (0.686–0.855) for the three raters. Averaged chronological aging scores were correlated with participants' survey responses, which revealed age as a significant predictor (r = 0.72, p < 0.001).Limitation
Our study was limited by the sample size, although the number of study participants was similar on a investigation in Caucasians.Conclusion
This study created the first reliable photonumeric scale for chronologic skin aging in African-Americans and found increased age and greater BMI as contributors to intrinsic skin aging phenotype in this population. 相似文献15.
H.E. Mansour M.A. Abdullrhman S.A. Mobasher Reem El Mallah Nouran Abaza F. Hamed Adham Aboul Fotouh Khalil 《中华民国医用超音波学会杂志》2017,25(1):40-46
Background
In the past 2 decades, there has been increasing interest in calprotectin. It is released and detected in serum and body fluids as a potentially useful clinical inflammatory marker. The protein has been described in synovial tissue in rheumatoid arthritis (RA) patients, specifically in the lining layer adjacent to the cartilage–pannus junction, which is the primary site of cartilage destruction and bone erosion. Assessment of inflammatory activity in RA is of pivotal importance for the optimal treatment. Our aim in this study is to measure the serum calprotectin levels in RA patients and to assess its association—if there is any—with disease activity score and radiological findings using the musculoskeletal ultrasound.Patients and methods
In our case control study, we included 44 RA patients (Group I) and 20 age- and sex-matched healthy volunteers who served as the control group (Group II). Both groups were subjected to full history taking and thorough clinical examination. Assessment of RA disease activity state was done for all RA patients using the Disease Activity Score 28. Laboratory investigations included the measurement of complete blood cell count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anticitrullinated peptide antibodies, kidney, liver functions; serum calprotectin levels were determined using enzyme-linked immunosorbent assay and radiological joint assessment was done using musculoskeletal ultrasound score.Results
There was a statistically significant elevation of serum calprotectin levels among RA patients when compared with healthy controls. Statistically significant correlations were also found between serum calprotectin and the ultrasound grading score, Disease Activity Score 28, and erythrocyte sedimentation rate, which reflect the degree of inflammatory activity in the affected joints in RA patients. Moreover, the study yielded a significant correlation between serum calprotectin levels and rheumatoid autoantibodies (rheumatoid factor and anticitrullinated peptide antibodies), which are strong predictors of the aggressiveness of the disease. Serum calprotectin at a cutoff level of 93.9 μg/dL had 88.6% sensitivity and 100% specificity for diagnosis of RA.Conclusion
Calprotectin was found to have high association with laboratory and ultrasonography markers of inflammation in RA patients, so it is recommended for use as a marker of inflammatory activity in RA patients especially for the follow-up of patients on biological therapy to assess its efficacy. 相似文献16.
Background
The reported associations of blood lipid profiles with asthma are ambiguous.Objective
To explore the association between asthma and the serum levels of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).Methods
A systematic search was performed in the PubMed, MEDLINE, Cochrane Library, and Chinese Biomedical Literature databases. Ten studies were identified. We divided these studies into 2 subgroups according to age: children (<18 years old) and adults (≥18 years old).Results
In children, the asthma group had lower HDL-C levels (weighted mean difference, ?3.44; 95% confidence interval [CI], ?5.83 to ?1.04; P = .005) compared with the nonasthma group, whereas the serum levels of LDL-C in these 2 groups were not statistically different. In contrary, in adults, the asthma group had higher LDL-C levels (weighted mean difference, 8.95; 95% confidence interval, 3.55–14.35; P = .001) compared with the nonasthma group, whereas the HDL-C levels were not statistically different.Conclusion
There is a significant association between asthma and the serum levels of HDL-C and LDL-C. Moreover, this association differs in children and adults. 相似文献17.
Rita Amaral Ana C. Carneiro Gustavo Wandalsen João A. Fonseca Dirceu Sole 《Annals of allergy, asthma & immunology》2017,118(5):551-556.e2
Background
The Control of Allergic Rhinitis and Asthma Test for Children (CARATKids) assesses asthma and allergic rhinitis control in children younger than 12 years.Objective
To validate the Brazilian Portuguese version of the CARATKids and to define the cutoff values for identifying uncontrolled disease.Methods
Children aged 6 to 12 years with asthma and allergic rhinitis were studied (n = 102). CARATKids, childhood Asthma Control Test (cACT), total nasal symptom score (TNSS), and visual analog scale (VAS) scores were obtained at baseline and after 4 to 6 weeks. Internal consistency, test-retest reliability, responsiveness, and validity of the Brazilian CARATKids were assessed according to the Consensus-based Standards for the Selection of Health Measurements Instruments checklist. The minimal clinically important difference (MCID) was evaluated using distribution and anchor methods. Spearman correlations were used to compare CARATKids scores with external measures of control. Receiver operating characteristic curve analysis was performed to establish cutoff values.Results
Fifty children completed both visits. The Cronbach α and intraclass correlation coefficient of CARATKids were 0.81 and 0.85, respectively. The Guyatt responsiveness index was ?1.34, and within-patient change in clinically unstable patients (n = 31) was significant (P = .02). As for cross-sectional and longitudinal validity, correlation coefficients ranged from 0.58 to 0.77 (P < .001) and 0.30 to 0.57 (P < .05), respectively. The estimated MCID for CARATKids was 3. The optimal cutoffs (sensitivity and specificity) to exclude uncontrolled and controlled disease were 3 or less (97% and 67%) and 6 or greater (56% and 96%), respectively.Conclusion
CARATKids is a reliable and valid tool to assess asthma and allergic rhinitis control in Brazilian children. A score of 6 or higher on CARATKids identifies uncontrolled disease, and a score of 3 or lower excludes poor disease control. 相似文献18.
Anna L. Chien Ji Qi Radhika Grandhi Noori Kim Sabrina Sisto Alessi César Tamia Harris-Tryon Min Soo Jang Omolara Olowoyeye Diane Kuhn Sherry Leung Barbara M. Rainer Flora Poon Jean Suh Nancy Cheng Ginette A. Okoye Sewon Kang 《Journal of the National Medical Association》2018,110(2):176-181
Background
African–Americans are less affected by photoaging than lighter skin individuals. Although scales for photoaging have been developed for Caucasians and Asians, no scale exists for African–Americans.Aim
To develop a photonumeric scale for photoaging and to determine factors that contribute to photoaging in African–Americans.Methods
Five participants' photographs were selected as standards to create a 9-point photonumeric scale (0 = none, 8 = most severe). Three blinded dermatologists used the scale to grade the remaining participants' photographs.Results
Interrater reliabilities were 0.775 (95% CI: 0.635, 0.880) for trial 1 and 0.832 (0.747, 0.883) for trial 2. Intrarater reliabilities, assessed over a 1 week interval, were 0.863 (0.727, 0.940), 0.928 (0.890, 0.954), and 0.866 (0.739, 0.935) for the three graders, indicating strong agreement. Photoaging scores were then correlated with participants' survey on lifestyle factors, which yielded age as a significant predictor (r = 0.91, p < 0.001). Furthermore, multiple regression model to predict facial photoaging (adjusted R2 = 0.849) selected age (b1 = 0.111, p < 0.001), sun exposure (b2 = 0.206, p = 0.014), and gender (b2 = ?0.388, p = 0.063) as the most important variables.Conclusions
A reliable photonumeric scale for photoaging in African Americans was developed. Age, sun exposure, and male gender were found to be contributory factors to photoaging. 相似文献19.
Christopher Couch Tim Franxman Matthew Greenhawt 《Annals of allergy, asthma & immunology》2017,118(5):591-596.e3
Background
Characteristics and outcomes of tree nut (TN) oral food challenges (OFCs) in patients with TN allergy or sensitization alone are poorly studied.Objective
To determine the relation between TN sensitization levels and OFC outcomes.Methods
Open TN OFCs performed from 2007 through 2015 at a referral center were analyzed to compare outcome based on skin prick test (SPT) wheal size, food-specific immunoglobulin E (sIgE), peanut co-allergy, and TN sensitization only vs TN allergy with sensitization to other TNs. Delayed OFC was defined as longer than 12 months from the time of an sIgE level lower than 2 kUA/L.Results
Overall passage rate was 86% for 156 TN OFCs in 109 patients (54 almond, 28 cashew, 27 walnut, 18 hazelnut, 14 pecan, 13 pistachio, and 2 Brazil nut). Passage rates were 76% (n = 67) in patients with a history of TN allergy who were challenged to another TN to which they were sensitized and 91% (n = 65) in those with TN sensitization only (mean sIgE 1.53 kUA/L; range 0.35–9.14). Passage rates were 89% (n = 110 of 124) for a TN sIgE level lower than 2 kUA/L and 69% (11 of 16) for a TN sIgE level of at least 2 kUA/L. In 44 challenges in patients with peanut allergy and TN co-sensitization, the TN OFC passage rate was 96%. In 41 TN OFCs with a TN SPT wheal size of at least 3 mm, 61% passed, with a mean wheal size of 4.8 mm (range 3–11) in those passing vs 9 mm (range 3–20) in those failing.Conclusion
TN challenges are frequently passed in patients with TN sensitization with or without a history of TN reactivity despite a TN SPT wheal of at least 3 mm or a TN sIgE level of at least 2 kUA/L. Nearly all patients with peanut allergy and TN co-sensitization passed the TN challenge, questioning the clinical relevance of “co-allergy.” 相似文献20.
Stephanie L. Mawhirt Luz S. Fonacier Rose Calixte Mark Davis-Lorton Marcella R. Aquino 《Annals of allergy, asthma & immunology》2017,118(1):73-79
