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Abstract Introduction: Single nucleotide polymorphisms (SNPs) in the BDNF, COMT, CBR1 and CCK genes have been associated with the process of fear extinction in humans. Since fear extinction plays a key role in recovering from psychological trauma, there is a possibility that these genes modulate the risk of developing post-traumatic stress disorder (PTSD). Objective: To assess unilocus and multilocus associations between SNPs in the BDNF, COMT, CBR1 and CCK genes and the risk of developing PTSD. Materials and methods: 129 inhabitants of the municipality of Itagüí, Colombia, who had experienced psychological trauma at least once, were genotyped for these polymorphisms (38 cases of PTSD and 91 controls). Logistic regression was used to perform unilocus and multilocus association tests for single SNPs and existing SNP-SNP genotypic combinations. Results: No unilocus associations were found, but interactions between the BDNF and CBR1 genes and between the COMT and CCK genes were observed. Of these interactions, the genotypic combinations that behaved as risk factors were AG-AA (OR=13.52, p<0.05) in the BDNF-CBR1 interaction, and TC-AA (OR=13.70, p<0.05) in the CCK-COMT interaction. Conclusions: The two pairs of interacting polymorphisms found in this study could act additively and generate a greater risk of developing PTSD after suffering psychological trauma. People who have a single allele have a lower risk of developing PTSD than those who have two alleles in the interacting genes.
Resumen Introducción. Los polimorfismos de un solo nucleótido (SNP, por su sigla en inglés) en los genes BDNF, COMT, CBR1 y CCK han sido asociados con el proceso de extinción del miedo en humanos. Dado que la extinción del miedo es clave para la recuperación del trauma psicológico, es posible que estos genes modulen el riesgo de desarrollar trastorno de estrés postraumático (TEPT). Objetivo. Evaluar las asociaciones unilocus y multilocus entre los SNP en los genes BDNF, COMT, CBR1 y CCK y el riesgo de desarrollar TEPT. Materiales y métodos. 129 habitantes del municipio de Itagüí, Colombia, que habían experimentado trauma psicológico al menos una vez, fueron genotipificados para estos polimorfismos (38 casos de TEPT y 91 controles). Se realizaron pruebas de asociación unilocus y multilocus por regresión logística para SNP únicos y las combinaciones genotípicas SNP-SNP existentes. Resultados. No se encontraron asociaciones unilocus, pero se observaron interacciones entre BDNF y CBR1, y CCK y COMT. De estas interacciones, las combinaciones genotípicas que se comportaron como factores de riesgo fueron AG-AA (OR=13.52, p<0.05) de BDNF-CBR1 y TC-AA (OR=13.70, p<0.05) de CCK-COMT. Conclusiones: Los dos pares de polimorfismos en interacción encontrados en el presente estudio podrían actuar de forma aditiva y generar un mayor riesgo de desarrollar TEPT después de sufrir trauma psicológico. Quienes portan un solo alelo tienen un menor riesgo de desarrollar el trastorno que quienes portan dos alelos en genes que interactúan entre sí.
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Humans , Stress Disorders, Post-Traumatic , Risk Factors , Polymorphism, Single Nucleotide , Extinction, PsychologicalABSTRACT
Breast cancer is first ranking malignancies in Iraq. Family history of cancer is an important factor for cancer occurrence and development in next generation. The study aimed to determine the validity of family history of cancer by population-based and clinic-based family registries, evaluate the concurrence of cancer affected by family history in their first-, and second-degree relatives. An observational studies of total 62 relatives membered of 44 Iraqi breast cancer families were included. We conducted study at period between December 2018 and June 2019. Data collected according NCCN Genetic Testing Criteria for Hereditary Breast and Ovarian Cancer Syndrome. Risk ratio (RR) used to evaluating predilection of family cancer risk. We addressed forty-four Iraqi breast cancer families who have sixty-two members with cancer. The age mean±SD was 51.8±12.6, and median=48.5 years. Meanwhile the age mean±SD= 51.6±11.9 years for relatives. M:F ratio equal to 3:1. Sister, mother and aunt/uncle were most common relative affected. Breast cancer represented the most frequent types found in 46.7% of patients. Mothers (RR=1.313), and/or sisters (RR=1.6), lead to increased risk of cancer development in other family members or next generation. The first degree relatives recorded more than the second degree relatives. This is the first study conducting in Iraq dealing with cancer risk at the level of families. The age of patients didn't differ from age at diagnosis, concluding there is no active screening programs run through Iraqi families. Sister, mother and aunt/uncle are the most relatives affect. The 1st-degree relatives more frequent than the 2nd-degree. Breast cancer represented the most common types found members studied. Mothers and sisters have highly risk ratio for developing family cancer among other individuals.
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Humans , Breast Neoplasms/diagnosis , Family , Genetic Testing , Siblings , Hereditary Breast and Ovarian Cancer Syndrome/diagnosis , Genetic Background , Medical History Taking/statistics & numerical data , Odds RatioABSTRACT
Dengue is the most rapidly spreading mosquito-borneviral disease in the world, associated with high morbidityand mortality. It is caused by the transmission of thedengue virus (DENV) through the bite of the infectedmosquito vector, Aedes aegypti. There are 4 serotypes ofDENV (1–4), and all of them circulate in Singapore.Pre-adolescents and young adults are at the highest riskof dengue in this region. In Singapore, the dengue vaccineis approved for the prevention of dengue caused by DENV1–4 in individuals aged 12–45 years living in endemic areas.The vaccine is effective in reducing symptomatic, severeand hospitalised dengue, with clear benefits inseropositive individuals.
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<b>Objective: </b>Elderly patients commonly experience adverse drug events (ADEs) owing to their poor drug metabolizing and excretion ability, and these often cause multiple organ dysfunction syndrome. Therefore, it is important that we identify the adverse drug events early on during prognosis. We searched for oral medicines that might exacerbate the prognosis of ADEs in elderly patients.<br><b>Methods: </b>The objects under analysis were oral medicines that were registered in the Japanese Adverse Drug Event Report database (JADER). The associations between the elderly/non-elderly patients and exacerbation risk/non-exacerbation risk were analyzed by risk ratios (RR). The signal detection of exacerbation risk was defined as 95% confidence interval of lower limit of risk ratio>1 and χ<sup>2</sup>≥4.<br><b>Results: </b>The oral medicines that might markedly exacerbate the prognosis of ADEs in the elderly patients in comparison with the ADEs of young patients included 84 items, of which 63 have not been described as potentially inappropriate medicines in all guidelines for medical treatment of the elderly patients.<br><b>Conclusion: </b>In this study, while we could not search for oral medicines having a high risk of ADEs, we were able to search for oral medicines that might exacerbate the prognosis of ADEs in elderly patients. This result could contribute to the proper use of medicines in the elderly patients.
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Objetivo: identificar quais dos fatores clássicos (material, desenho, superfície do implante, hospedeiro, técnica cirúrgica, protocolo de carga) possuem significado estatístico no prognóstico dos implantes. Material e métodos: uma busca eletrônica foi realizada no sistema PubMed/Medline até junho de 2015 com palavras-chave representativas dos estimadores, combinadas por operadores booleanos. Foram incluídos estudos clínicos contendo amostras com pelo menos 50 pacientes e 100 implantes, mínimo de um ano de acompanhamento, apresentando os estimadores obtidos através de modelo de Cox (Hazard ratio) ou regressão logística (Odds ratio, Risk ratio). O desfecho primário foi a falha do implante. Resultados: das 871 referências iniciais, foram selecionadas 20 após leitura integral, com mais de dez mil pacientes e mais de 30 mil implantes. Nos artigos com modelo de Cox, foram identificados o tabagismo (valores entre 1,04 e 3,9), o diâmetro (valores HR entre 1,72 e 6,35) e o comprimento (valores HR entre 0,8 e 2,7) do implante, as técnicas cirúrgicas específicas para melhorar o leito receptor (HR entre 2 e 5), os protocolos de carga (HR entre 0,1 e 9,7), o operador (HR=4,2; um estudo) e a maxila (HR=10; um estudo). Nos artigos com regressão logística, foram identificados os maiores valores de risco para implantes de largo diâmetro (OR=4,25; um estudo), implantes colocados na região posterior da maxila (OR=6,83; um estudo) e ausência de gengiva queratinizada (OR=4,7; um estudo). Conclusão: os fatores têm frequência variada, dependem da homogeneidade das amostras e nem sempre demonstram significado estatístico. Possíveis explicações podem ser atribuídas para as falhas. Mesmo assim, a documentação clínica detalhada continua fundamental para anteciparmos problemas em áreas estratégicas.
Objective: to identify which of the classic factors (implant material, design, surface; host, surgical technique, loading protocol) can have a statistical significance on dental implant prognosis. Material and methods: an electronic search at the PubMed/Medline was made until June 2015 with representative keywords combined by Boolean operators. Clinical studies with at least 50 patients and 100 implants, 1 year of follow-up, having statistical estimators such as Cox model (Hazard ratio) or logistic regression (Odds ratio, Risk ratio) analyses were included. The primary outcome was implant failure. Results: of the 871 retrieved records, 20 references were finally selected, summing up more than 10 thousand patients and 30 thousand dental implants. For articles using the Cox´s model, tobacco (HR values between 1.04 to 3.9), diameter (HR between 1.72 to 6.35), and implant length (HR between 0.8 to 2.7); specific surgical techniques to improve the recipient bed (HR between 2 and 5), loading protocols (HR from 0.1 to 9.7), the operator (HR=4.2, one study), and the maxillary arch (HR=10, 1 study) were identified. For articles containing logistic regression, the highest chance values were identified for large diameter implants (OR=4.25, one study), implants at the posterior maxillary region (OR=6.83, one study), and the lack of keratinized gingiva (OR=4.7, one study). Conclusion: these factors have a varied frequency, depend on sample´s homogeneity, and not always provide statistical meaning. Possible explanations can be attributed to failures. Even thus, a detailed clinical documentation remains mandatory to anticipate problems in strategic areas.
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Humans , Dental Implantation , Odds Ratio , Survival Analysis , PrognosisABSTRACT
Introduction More than half of the malaria cases reported in the Americas are from the Brazilian Amazon region. While malaria is considered endemic in this region, its geographical distribution is extremely heterogeneous. Therefore, it is important to investigate the distribution of malaria and to determine regions whereby action might be necessary. Methods Changes in malaria indicators in all municipalities of the Brazilian Amazon between 2003-2004 and 2008-2009 were studied. The malaria indicators included the absolute number of malaria cases and deaths, the bi-annual parasite incidence (BPI), BPI ratios and differences, a Lorenz curve and Gini coefficients. Results During the study period, mortality from malaria remained low (0.02% deaths/case), the percent of municipalities that became malaria-free increased from 15.6% to 31.7%, and the Gini coefficient increased from 82% to 87%. In 2003, 10% of the municipalities with the highest BPI accumulated 67% of all malaria cases, compared with 2009, when 10% of the municipalities (with the highest BPI) had 80% of the malaria cases. Conclusions This study described an overall decrease in malaria transmission in the Brazilian Amazon region. As expected, an increased heterogeneity of malaria indicators was found, which reinforces the notion that a single ...
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Humans , Malaria/epidemiology , Brazil/epidemiology , Incidence , Topography, MedicalABSTRACT
The association of Hashimoto's thyroiditis (HT) with papillary thyroid cancer (PTC) has been still under debate. Some suggest that these two are positively correlated, whereas other studies report no relationship. We performed a systematic literature review of original studies to investigate the correlation between HT and PTC. The existing data provide inconsistent evidence favoring a causal relationship between HT and PTC. The average prevalence rate of PTC in patients with HT was 1.2% in 8 fine needle aspiration (FNA) studies of 18,023 specimens and 27.6% in 8 archival thyroidectomy studies of 9884 specimens. The risk ratio of PTC in HT specimens ranged from 0.39 to 1.00 in the FNA group (average RR 0.69) in contrast to 1.15 to 4.16 from thyroidectomy studies (average RR 1.59). Population-based fine needle aspiration biopsy studies report no relationship, whereas many of the studies using thyroidectomy specimens report a positive relationship, possibly related to selection bias. Several studies identified a few biomolecular markers, including the PI3K/Akt pathway, RET/PTC gene rearrangements, p63 protein, and loss of heterozygosity of hOGG1, that are potentially involved in neoplastic transformation from HT to PTC. So far, no causal genetic linkage has been confirmed. PTC with concurrent HT is associated with female gender, young age, less aggressive disease such as small tumor size, less frequent capsular invasion and nodal metastasis, and better outcome. However, more prospective studies with long term follow-up are needed to further elucidate this relationship and prognosis. Careful observation and follow-up of HT patients is recommended, especially those with nodular variants.
Subject(s)
Female , Humans , Biopsy , Biopsy, Fine-Needle , Gene Rearrangement , Genetic Linkage , Loss of Heterozygosity , Neoplasm Metastasis , Odds Ratio , Prevalence , Prognosis , Selection Bias , Thyroid Gland , Thyroid Neoplasms , Thyroidectomy , ThyroiditisABSTRACT
En la generación de evidencias que surgen del seguimiento de pacientes, obtenidas a partir de los estudios epidemiológicos, el riesgo relativo (RR) y el riesgo absoluto (RA) son expresiones que se utilizan para cuantificar la asociación entre un factor de exposición y un evento de salud. Sendas expresiones son de variables dicotómicas. Permiten establecer la intensidad y la dirección de la asociación a través de la obtención de la probabilidad de ocurrencia del evento para cada nivel del factor de exposición. El cálculo, su interpretación y sus aplicaciones son ejemplificados.
In epidemiology, relative risk and absolute risk are expressions of measuring of the association between binary variables. In a direct way, they allow to settle down, the intensity of the relationship and to describe the probability of damage for the exposure variable. Their applications are described.