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1.
Front Med (Lausanne) ; 9: 1005121, 2022.
Article in English | MEDLINE | ID: mdl-36457565

ABSTRACT

Despite the impact of the Coronavirus Disease 2019 (COVID-19) pandemic, vaccine hesitancy remains common in the general public and patients with Inflammatory Bowel Diseases (IBD). We sought to examine the reasons for vaccine hesitancy in patients with IBD. In this case-control study, we performed a retrospective chart review of 1,349 IBD patients and 215 non-IBD patients seen at University of Maryland Medical Center, a tertiary referral medical center, between March 2020 and October 2021. Data obtained included demographics, vaccination records, disease history, number of IBD-related surgeries, and IBD medications. 813/1,349 (60.3%) IBD patients received at least one dose of either the Pfizer/BioNTech, Moderna, or Johnson & Johnson vaccines. In a multivariate logistic regression, COVID vaccination was found to be positively associated with older age (p-value = 1.65e-5), female sex (p = 0.00194), Asian and White races (p = 0.02330, 0.00169), number of clinic visits (p = 1.11e-08), and biologic use (p = 7.82e-5). There was no association between vaccination and other types of vaccination nor with the use of other IBD medications. There was a negative association between vaccination status and the total number of IBD related surgeries (p = 0.02857). In non-IBD patients, only the number of clinic visits was positively associated with COVID-19 vaccination. Although the majority of IBD patients are immunosuppressed, COVID-19 vaccination rate was only 60.3%. Younger adults, males, African Americans, and those requiring IBD-related surgeries were less likely to receive COVID-19 vaccine. Healthcare providers need to recognize these potential risk factors for COVID-19 vaccine hesitancy.

2.
JAMA Cardiol ; 6(9): 1013-1022, 2021 09 01.
Article in English | MEDLINE | ID: mdl-34076677

ABSTRACT

Importance: Unexplained sudden cardiac death (SCD) describes SCD with no cause identified. Genetic testing helps to diagnose inherited cardiac diseases in unexplained SCD; however, the associations between pathogenic or likely pathogenic (P/LP) variants of inherited cardiomyopathies (CMs) and arrhythmia syndromes and the risk of unexplained SCD in both White and African American adults living the United States has never been systematically examined. Objective: To investigate cases of unexplained SCD to determine the frequency of P/LP genetic variants of inherited CMs and arrhythmia syndromes. Design, Setting, and Participants: This genetic association study included 683 African American and White adults who died of unexplained SCD and were included in an autopsy registry. Overall, 413 individuals had DNA of acceptable quality for genetic sequencing. Data were collected from January 1995 to December 2015. A total of 30 CM genes and 38 arrhythmia genes were sequenced, and variants in these genes, curated as P/LP, were examined to study their frequency. Data analysis was performed from June 2018 to March 2021. Main Outcomes and Measures: The frequency of P/LP variants for CM or arrhythmia in individuals with unexplained SCD. Results: The median (interquartile range) age at death of the 413 included individuals was 41 (29-48) years, 259 (62.7%) were men, and 208 (50.4%) were African American adults. A total of 76 patients (18.4%) with unexplained SCD carried variants considered P/LP for CM and arrhythmia genes. In total, 52 patients (12.6%) had 49 P/LP variants for CM, 22 (5.3%) carried 23 P/LP variants for arrhythmia, and 2 (0.5%) had P/LP variants for both CM and arrhythmia. Overall, 41 P/LP variants for hypertrophic CM were found in 45 patients (10.9%), 9 P/LP variants for dilated CM were found in 11 patients (2.7%), and 10 P/LP variants for long QT syndrome were found in 11 patients (2.7%). No significant difference was found in clinical and heart characteristics between individuals with or without P/LP variants. African American and White patients were equally likely to harbor P/LP variants. Conclusions and Relevance: In this large genetic association study of community cases of unexplained SCD, nearly 20% of patients carried P/LP variants, suggesting that genetics may contribute to a significant number of cases of unexplained SCD. Our findings regarding both the association of unexplained SCD with CM genes and race-specific genetic variants suggest new avenues of study for this poorly understood entity.


Subject(s)
Black or African American , Death, Sudden, Cardiac/pathology , Genetic Association Studies/methods , Heart Diseases/complications , Registries , White People , Adult , Autopsy , Death, Sudden, Cardiac/ethnology , Death, Sudden, Cardiac/etiology , Female , Follow-Up Studies , Genetic Testing , Heart Diseases/ethnology , Heart Diseases/genetics , Humans , Incidence , Male , Middle Aged , Retrospective Studies , United States/epidemiology
3.
Faraday Discuss ; 150: 101-11; discussion 113-60, 2011.
Article in English | MEDLINE | ID: mdl-22457946

ABSTRACT

We have developed a high power optical centrifuge for measuring the spectroscopy of molecules in extreme rotational states. The optical centrifuge has a pulse energy that is more than 2 orders of magnitude greater than in earlier instruments. The large pulse energy allows us to drive substantial number densities of molecules to extreme rotational states in order to measure new spectroscopic transitions that are not accessible with traditional methods. Here we demonstrate the use of the optical centrifuge for measuring IR transitions of N2O from states that have been inaccessible until now. In these studies, the optical centrifuge drives N2O molecules into states with J ~ 200 and we use high resolution transient IR probing to measure the appearance of population in states with J = 93-99 that result from collisional cooling of the centrifuged molecules. High resolution Doppler broadened line profile measurements yield information about the rotational and translational energy distributions in the optical centrifuge.

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