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1.
BMC Genomics ; 25(1): 838, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39242559

RESUMEN

Fishmeal and fish oil have been the main sources of protein and fatty acid for aquaculture fish. However, their increasing price and low sustainability have led the aquafeed industry to seek sustainable alternative feedstuffs to meet the nutritional requirements of fish and improve their health and performance. Plant proteins have been successfully used to replace fishery derivatives in aquafeeds, but the presence of anti-nutritional substances is a potential drawback of this approach. Thus, it has been reported that phytate breakdown can be caused by feed supplementation with exogenous phytase. The inclusion of microalgae has been proposed to improve gut functionality in fish fed diets with a high vegetable protein content. The aim of this study was to evaluate the effect on the growth and gut microbiota of European seabass (Dicentrarchus labrax) juveniles of a diet containing a blend of microalgae (Arthrospira platensis and Nannochloropsis gaditana) and different concentrations of phytase. An 83-day feeding trial was conducted, comprising four experimental diets with 2.5% microalgae and 500, 1,000, 2,000, or 10,000 phytase units (FTU)/kg feed and a microalgae- and phytase-free control diet. At the end of the trial, a significantly increased body weight was observed in fish fed the diet with the highest phytase concentration (10,000 FTU/kg) versus controls, although the gut bacterial composition did not differ from controls in alpha or beta diversity with either majority (Weighted UniFrac) or minority bacterial strains (Unweighted UniFrac). In comparison to the control group, the groups fed diets with 1,000 or 2,000 FTU/kg diets had a lower alpha diversity (Shannon's diversity index), while those fed diets with 500 FTU/kg or 1,000 FTU/kg showed distinct clusters in beta diversity (involving minority ASVs). According to these findings, the diet containing the 2.5% microalgae blend with 10,000 FTU/kg may be useful to increase the aquafeed quality and sustain the growth performance of juvenile European seabass.


Asunto(s)
6-Fitasa , Alimentación Animal , Lubina , Suplementos Dietéticos , Microbioma Gastrointestinal , Microalgas , Animales , 6-Fitasa/metabolismo , Lubina/crecimiento & desarrollo , Lubina/metabolismo , Microbioma Gastrointestinal/efectos de los fármacos , Alimentación Animal/análisis , Acuicultura/métodos
2.
Med Sci Sports Exerc ; 2024 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-39231694

RESUMEN

PURPOSE: This study compared the effects of off- and on-bike resistance training (RT) on endurance cycling performance as well as muscle strength, power and structure. METHODS: Well-trained male cyclists were randomly assigned to incorporate two sessions/week of off- (full squats, n = 12) or on-bike (all-out efforts performed against very high resistances and thus at very low cadences, n = 12) RT during 10 weeks, with all RT-related variables [number of sessions, sets, and repetitions, duration of recovery periods, and relative loads (70% of one-repetition maximum)] matched between the two groups. A third, control group (n = 13) did not receive any RT stimulus but all groups completed a cycling training regime of the same volume and intensity. Outcomes included maximum oxygen uptake (V̇O2max), off-bike muscle strength (full squat) and on-bike ('pedaling') muscle strength and peak power capacity (Wingate test), dual-energy X-ray absorptiometry-determined body composition (muscle/fat mass), and muscle structure (cross-sectional area, pennation angle). RESULTS: No significant within/between-group effect was found for V̇O2max. Both the off- (mean Δ = 2.6-5.8%) and on-bike (4.5-7.3%) RT groups increased squat and pedaling-specific strength parameters after the intervention compared to the control group (-5.8--3.9%) (p < 0.05) with no significant differences between them. The two RT groups also increased Wingate performance (4.1% and 4.3%, respectively, vs. -4.9% in the control group, p ≤ 0.018), with similar results for muscle cross-sectional area (2.5% and 2.2%, vs. -2.3% in the control group, p ≤ 0.008). No significant within/between-group effect was found for body composition. ConclusionsThe new proposed on-bike RT could be an effective alternative to conventional off-bike RT training for improving overall and pedaling-specific muscle strength, power, and muscle mass.

4.
Artículo en Inglés | MEDLINE | ID: mdl-39259377

RESUMEN

This study investigates the postbiotic potential of extracellular products (ECPs) from Bacillus pumilus strains cultivated on microalgae-supplemented media. We assessed enzymatic and antimicrobial activities to select ECPs that enhance the digestive processes in gilthead seabream. Additionally, we explored the in vitro enzymatic capacity of the chosen postbiotics to hydrolyze macromolecules in microalgae. Finally, a feeding trial was conducted to determine the in vivo effects of the ECPs on Sparus aurata. In vitro enzymatic assays demonstrated diverse hydrolytic capacities among ECPs. All conditions exhibited antimicrobial activity against Photobacterium damselae subsp. piscicida, with variation in inhibitory effects against Vibrio harveyi and Tenacibaculum maritimum. Furthermore, in vitro assays revealed differences in protein hydrolysis and soluble protein concentration, influencing amino acid and reducing sugar release from microalgal biomass. These analyses facilitated a selection to test ECPs in vivo. Lastly, the in vivo experiment revealed no differences in the growth performance, nutrient utilization, and general metabolism of S. aurata fed the experimental diets. Dietary inclusion of postbiotics increased the activity of key digestive enzymes in fish compared to the control group, and particularly, values increased significantly when the fish were fed with the ECP-nanoparticulate-supplemented diet. In conclusion, the inclusion of microalgae in the culture media significantly influences the activity of extracellular products from B. pumilus strains, as evidenced in both in vitro and in vivo assays.

5.
Biomolecules ; 14(9)2024 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-39334851

RESUMEN

Natural products play a crucial role in drug development, addressing the escalating microbial resistance to antibiotics and the treatment of emerging diseases. Progress in genome sequencing techniques, coupled with the development of bioinformatics tools and the exploration of uncharted habitats, has highlighted the biosynthetic potential of actinomycetes. By in silico screening for diazo-related gene genomes from twelve Streptomyces strains isolated from Attini leaf-cutting ants, the new crx biosynthetic gene cluster (BGC) was identified in Streptomyces sp. CS057. This cluster, highly conserved in several Streptomyces strains, contains genes related to diazo group formation and genes for the biosynthesis of 3,4-AHBA. By overexpressing the LuxR-like regulatory gene crxR1, we were able to activate the crx cluster, which encodes the biosynthesis of three 3,4-AHBA-derived compounds that we named crexazones (CRXs). The chemical structure of crexazones (CRXs) was determined by LC-DAD-HRMS-based dereplication and NMR spectroscopic analyses and was found to correspond to two known compounds, 3-acetamido-4-hydroxybenzoic acid (CRX1) and the phenoxazinone texazone (CRX3), and a novel 3,4-AHBA-containing compound herein designated as CRX2. Experimental proof linking the crx BGC to their encoded compounds was achieved by generating mutants in selected crx genes.


Asunto(s)
Familia de Multigenes , Streptomyces , Streptomyces/genética , Streptomyces/metabolismo , ortoaminobenzoatos/metabolismo , ortoaminobenzoatos/química , Genoma Bacteriano
7.
Nutrients ; 16(18)2024 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-39339705

RESUMEN

Malnutrition is common in chronic obstructive pulmonary disease (COPD) patients and is associated with worse lung function and greater severity. This review by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) addresses the nutritional management of adult COPD patients, focusing on Morphofunctional Nutritional Assessment and intervention in clinical practice. A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, followed by critical appraisal based on Scottish Intercollegiate Guidelines Network (SIGN) guidelines. Recommendations were graded according to the European Society for Clinical Nutrition and Metabolism (ESPEN) system. The results were discussed among GARIN members, with consensus determined using a Likert scale. A total of 24 recommendations were made: 2(A), 6(B), 2(O), and 14(GPP). Consensus exceeded 90% for 17 recommendations and was 75-90% for 7. The care of COPD patients is approached from a nutritional perspective, emphasizing nutritional screening, morphofunctional assessment, and food intake in early disease stages. Nutritional interventions include dietary advice, recommendations on food group intake, and the impact of specialized nutritional treatment, particularly oral nutritional supplements. Other critical aspects, such as physical activity and quality of life, are also analyzed. These recommendations provide practical guidance for managing COPD patients nutritionally in clinical practice.


Asunto(s)
Desnutrición , Evaluación Nutricional , Enfermedad Pulmonar Obstructiva Crónica , Enfermedad Pulmonar Obstructiva Crónica/dietoterapia , Enfermedad Pulmonar Obstructiva Crónica/terapia , Humanos , Estado Nutricional , Terapia Nutricional/métodos , Calidad de Vida
8.
J Nat Prod ; 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39332023

RESUMEN

Genome analysis of Kutzneria sp. CA-103260 revealed a putative lipopeptide-encoding biosynthetic gene cluster (BGC) that was cloned into a bacterial artificial chromosome (BAC) and heterologously expressed in Streptomyces coelicolor M1152. As a result, a novel cyclic lipo-tetrapeptide containing two diaminopropionic acid residues and an exotic N,N-acetonide ring, kutzneridine A (1), was isolated and structurally characterized. Evaluation of the extraction conditions and isotope-labeling chemical modifications showed that the acetonide ring originated from acetone during isolation. The BGC was analyzed in silico and a biosynthetic pathway to 1 was proposed. Kutzneridine A displayed remarkable antibacterial activity against methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci.

9.
BMC Plant Biol ; 24(1): 905, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39350020

RESUMEN

BACKGROUND: Polymorphisms are common in nature, but they are rarely shared among closely related species. Polymorphisms could originate through convergence, ancestral polymorphism, or introgression. Although shared neutral genomic variation across species is commonplace, few examples of shared functional traits exist. The blue-orange petal color polymorphisms in two closely related species, Lysimachia monelli and L. arvensis were investigated with UV-vis reflectance spectra, flavonoid biochemistry, and transcriptome comparisons followed by climate niche analysis. RESULTS: Similar color morphs between species have nearly identical reflectance spectra, flavonoid biochemistry, and ABP gene expression patterns. Transcriptome comparisons reveal two orange-specific genes directly involved in both blue-orange color polymorphisms: DFR-2 specificity redirects flux from the malvidin to the pelargonidin while BZ1-2 stabilizes the pelargonidin with glucose, producing the orange pelargonidin 3-glucoside. Moreover, a reduction of F3'5'H expression in orange petals also favors pelargonidin production. The climate niches for each color morph are the same between the two species for three temperature characteristics but differ for four precipitation variables. CONCLUSIONS: The similarities in reflectance spectra, biochemistry, and ABP genes suggest that a single shift from blue-to-orange shared by both lineages is the most plausible explanation. Our evidence suggests that this persistent flower color polymorphism may represent an ancestrally polymorphic trait that has transcended speciation, yet future analyses are necessary to confidently reject the alternative hypotheses.


Asunto(s)
Flores , Polimorfismo Genético , Primulaceae , Flores/genética , Primulaceae/genética , Pigmentación/genética , Antocianinas/metabolismo , Antocianinas/genética , Color , Transcriptoma , Flavonoides/metabolismo , Especificidad de la Especie , Clima , Regulación de la Expresión Génica de las Plantas , Lysimachia
10.
Materials (Basel) ; 17(16)2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39203191

RESUMEN

Corrosion deterioration of materials is a major problem affecting economic, safety, and logistical issues, especially in the aeronautical sector. Detecting the correct corrosion type in metal alloys is very important to know how to mitigate the corrosion problem. Electrochemical noise (EN) is a corrosion technique used to characterize the behavior of different alloys and determine the type of corrosion in a system. The objective of this research is to characterize by EN technique different aeronautical alloys (Al, Ti, steels, and superalloys) using different analysis methods such as time domain (visual analysis, statistical), frequency domain (power spectral density (PSD)), and frequency-time domain (wavelet decomposition, Hilbert Huang analysis, and recurrence plots (RP)) related to the corrosion process. Optical microscopy (OM) is used to observe the surface of the tested samples. The alloys were exposed to 3.5 wt.% NaCl and H2SO4 solutions at room temperature. The results indicate that HHT and recurrence plots are the best options for determining the corrosion type compared with the other methods due to their ability to analyze dynamic and chaotic systems, such as corrosion. Corrosion processes such as passivation and localized corrosion can be differentiated when analyzed using HHT and RP methods when a passive system presents values of determinism between 0.5 and 0.8. Also, to differentiate the passive system from the localized system, it is necessary to see the recurrence plot due to the similarity of the determinism value. Noise impedance (Zn) is one of the best options for determining the corrosion kinetics of one system, showing that Ti CP2 and Ti-6Al-4V presented 742,824 and 939,575 Ω·cm2, while Rn presented 271,851 and 325,751 Ω·cm2, being the highest when exposed to H2SO4.

11.
Nurs Crit Care ; 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39140297

RESUMEN

BACKGROUND: Intensive care unit (ICU) patients are at an increased risk of ocular surface injuries because of various factors such as reduced tear production and impaired protective mechanisms. Despite the significance of ocular care in ICU settings, there is a lack of consensus on effective interventions, leading to inadequate prevention of ocular surface disease (OSD). AIM: This systematic review aimed to assess the effectiveness of nursing eye care in preventing OSD in ICU patients. Secondary objectives included identifying primary risk factors for ocular injuries and examining the most effective preventive methods. STUDY DESIGN: A systematic review following PRISMA guidelines was conducted, encompassing a literature search, article selection, quality assessment and data synthesis. Studies meeting inclusion criteria were observational studies and clinical trials, focusing on adults admitted to ICUs under sedation and receiving mechanical ventilation. RESULTS: Of 3545 initially identified articles, 12 studies met inclusion criteria. These studies involved a total of 1853 participants. Various interventions were assessed, including saline rinsing, lubricating drops, gel lubricants, occlusion with polyethylene dressing, passive blinking and eyelid closure with tape. Moist chamber occlusion every 6 h combined with gel lubrication emerged as the most effective method in preventing OSD. CONCLUSIONS: Gel lubrication along with moist chamber occlusion proved to be the most effective strategy in preventing ocular injuries in ICU patients. Conversely, the routine use of physiological saline was associated with increased severity of corneal lesions. Properly defined protocols and well-trained nursing teams are crucial for reducing ocular injuries in ICU settings. RELEVANCE TO CLINICAL PRACTICE: The findings underscore the importance of implementing evidence-based eye care protocols in ICUs, emphasizing the use of gel lubrication and ocular surface protection to mitigate the risk of OSD. This highlights the need for comprehensive training programmes for ICU nursing staff to ensure optimal ocular care delivery.

12.
J Clin Med ; 13(15)2024 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-39124678

RESUMEN

Background/Objectives: Early identification of patients at risk of developing severe acute pancreatitis (SAP) is still an issue. Dynamic assessment of clinical and laboratory parameters within the first 48 h of admission may offer valuable insights into the prediction of unfavorable outcomes such as SAP and death. Methods: A prospective observational study was conducted on a cohort of patients admitted for AP at a tertiary referral hospital. Clinical and laboratory data were collected on admission and at 48 h. Patients were classified based on the Revised Atlanta classification. Logistic regression analysis was performed to identify independent risk factors for SAP. Likelihood ratios and post-test probabilities were calculated to assess the clinical usefulness of predictive markers. Results: 227 patients were included, with biliary etiology being the most common and a prevalence of SAP and death of 10.7% and 5.7%, respectively. BISAP ≥ 2 on admission, presence of SIRS after 48 h, rise in heart rate over 20 bpm, and any increase in BUN after 48 h were independent risk factors for SAP. The combination of these factors increased the post-test probability of SAP and death, with BISAP ≥ 2 combined with the presence of SIRS after 48 h showing the highest probability (82% and 73%, respectively). Conclusions: Dynamic assessment of BUN, heart rate, and SIRS within the first 48 h of admission can aid in predicting the development of SAP and death in patients with AP. These findings underscore the importance of continuous monitoring, although multicenter studies are warranted to refine predictive models for SAP.

14.
Cogn Neurodyn ; 18(4): 1507-1524, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39104700

RESUMEN

Laboratory data from conflict tasks, e.g. Simon and Eriksen tasks, reveal differences in response time distributions under different experimental conditions. Only recently have evidence accumulation models successfully reproduced these results, in particular the challenging delta plots with negative slopes. They accomplish this with explicit temporal dependencies in their structure or activation functions. In this work, we introduce an alternative approach to the modeling of decision-making in conflict tasks exclusively based on inhibitory dynamics within a dual-route architecture. We consider simultaneous automatic and controlled drift diffusion processes, with the latter inhibiting the former. Our proposed Dual-Route Evidence Accumulation Model (DREAM) achieves equivalent performance to previous works in fitting experimental response time distributions despite having no time-dependent functions. The model can reproduce conditional accuracy functions and delta plots with positive and negative slopes. The implications of these results, including an interpretation of the parameters and potential links to perceptual representations, are discussed. We provide Python code to fit DREAM to experimental data. Supplementary Information: The online version contains supplementary material available at 10.1007/s11571-023-09990-8.

16.
Eur J Obstet Gynecol Reprod Biol ; 301: 181-185, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39151253

RESUMEN

OBJECTIVE: The Kielland's forceps is the most used forceps for assisting rotational operative births. There are various maneuvers described for blade insertion. Among these, the most used ones are the direct, first posterior, and wandering maneuver. The objective of this study was to compare these three maneuvers using a simulator. STUDY DESIGN: In this experimental study, 144 rotational forceps-assisted births were conducted using a simulation model, with 72 starting in a right occiput-transverse position and 72 in a left occiput-transverse position. Each of the three maneuvers (direct, first posterior, or wandering) for blade insertion was performed 48 times by a total of 6 operators, comprising 3 obstetricians with over 10 years of experience and 3 trainees. The assessment of forceps application included evaluating the placement of the blades in terms of asymmetry and the distance from the lock to the posterior fontanelle. Additionally, the study evaluated the number of reinsertions and relocations required, the perceived difficulty of the procedure, and the operator's level of experience. RESULTS: There were no statistically significant differences in terms of asymmetry with the three maneuvers. Regarding the distance from the lock to the posterior fontanelle, the best results were obtained with the direct maneuver. There were no differences in the number of reinsertions, relocations, and the perceived difficulty by the operators among the three maneuvers. Experienced obstetricians had better outcomes in terms of the need for reinsertions. CONCLUSION: The direct maneuver offer advantages in the insertion of blades for rotational forceps.


Asunto(s)
Forceps Obstétrico , Humanos , Femenino , Embarazo , Extracción Obstétrica/instrumentación , Extracción Obstétrica/métodos , Entrenamiento Simulado/métodos , Competencia Clínica
17.
Nutrients ; 16(16)2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39203769

RESUMEN

The aim of our cross-sectional and longitudinal study is to assess the relationship between daytime and night-time sleep duration and health-related quality of life (HRQoL) in adults with metabolic syndrome after a 1-year healthy lifestyle intervention. Analysis of the data from 2119 Spanish adults aged 55-75 years from the PREDIMED-Plus study was performed. Sleep duration was assessed using a wrist-worn accelerometer. HRQoL was measured using the SF-36 questionnaire. Linear regression models adjusted for socioeconomic and lifestyle factors and morbidity were developed. In cross-sectional analyses, participants with extreme night-time sleep duration categories showed lower physical component summary scores in Models 1 and 2 [ß-coefficient (95% confidence interval) <6 h vs. 7-9 h: -2, 3 (-3.8 to -0.8); p = 0.002. >9 h vs. 7-9 h: -1.1 (-2.0 to -0.3); p = 0.01]. Participants who sleep less than 7 h a night and take a nap are associated with higher mental component summary scores [ß-coefficient (95% confidence interval) 6.3 (1.3 to 11.3); p = 0.01]. No differences between night-time sleep categories and 12-month changes in HRQoL were observed. In conclusion, in cross-sectional analyses, extremes in nocturnal sleep duration are related to lower physical component summary scores and napping is associated with higher mental component summary scores in older adults who sleep less than 7 h a night.


Asunto(s)
Síndrome Metabólico , Calidad de Vida , Sueño , Humanos , Anciano , Persona de Mediana Edad , Masculino , Femenino , Estudios Longitudinales , Sueño/fisiología , Síndrome Metabólico/psicología , Síndrome Metabólico/epidemiología , Estudios Transversales , España/epidemiología , Factores de Tiempo , Encuestas y Cuestionarios , Acelerometría , Estilo de Vida Saludable , Duración del Sueño
18.
Head Neck ; 2024 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-39162231

RESUMEN

Induction chemotherapy (IC) recently gained importance for treatment of sinonasal undifferentiated carcinoma (SNUC). We analyzed our SNUC cases and performed a meta-analysis with focus on survival-rates stratified by treatment. SNUC cases at our institution were retrospectively evaluated. A systematic literature review was conducted to analyze treatment and outcome of SNUC. To calculate 5-year and 2-year overall survival (OS), individual patient data (IPD) were analyzed using Kaplan-Meier estimators and Cox proportional hazard regression to identify associations between types of therapy and survival. A random effects model for pooled estimates of 5-year survival was applied to studies without IPD data. Five-year OS of our SNUC cases (n = 9) was 44.4%. The IPD analysis (n = 192) showed a significantly better 5-year OS for patients who received induction chemotherapy (72.6% vs. 44.5%). The pooled 5-year OS of 13 studies identified in the literature search was 43.8%. IC should be considered in every patient diagnosed with SNUC.

19.
PLoS One ; 19(7): e0298503, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38990849

RESUMEN

Intolerance of Uncertainty (IU) is thought to lead to maladaptive behaviours and dysfunctional decision making, both in the clinical and healthy population. The seminal study reported by Luhmann and collaborators in 2011 showed that IU was negatively associated with choosing a delayed, but more certain and valuable, reward over choosing an immediate, but less certain and valuable, reward. These findings have been widely disseminated across the field of personality and individual differences because of their relevance to understand the role of IU in maladaptive behaviours in anxiety-related disorders. We conducted a study to replicate and extend Luhmann et al.'s results with a sample of 313 participants, which exceeded the size necessary (N = 266) to largely improve the statistical power of the original study by using the small telescopes approach. The results of our well powered study strongly suggest that the relationship between IU and the tendency to prefer an immediate, but less certain and less valuable reward is virtually negligible. Consequently, although this relationship cannot be definitely discarded, we conclude that it cannot be detected with Luhmann et al.'s (2011) decision-making task.


Asunto(s)
Toma de Decisiones , Recompensa , Humanos , Incertidumbre , Masculino , Femenino , Adulto , Adulto Joven , Persona de Mediana Edad , Adolescente
20.
JAMA Ophthalmol ; 142(8): 750-758, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-38990568

RESUMEN

Importance: The involvement of chronic inflammation in the pathogenesis of age-related macular degeneration (AMD) opens therapeutic possibilities to AMD management. Objective: To determine whether Janus kinase inhibitors (JAKis) are associated with a reduced risk of AMD development in patients with autoimmune diseases. Design, Setting, and Participants: This retrospective observational cohort study used administrative claims data from Merative MarketScan research databases (Commercial and Medicare Supplemental) and Optum Clinformatics Data Mart databases between January 1, 2010, and January 31, 2022. Patients with autoimmune diseases satisfying study eligibility criteria and who received JAKi treatment (9126 in MarketScan and 5667 in Optum) were propensity score matched (1:1) to identical numbers of study-eligible patients who received non-JAKi-based immunotherapy. Exposure: Treatment duration of 6 months or longer. Main Outcomes and Measures: Incidence rates of AMD (exudative and nonexudative) over the first 6 to 18 months of treatment were determined, and bayesian Poisson regression models were used to estimate incidence rate ratios, 95% CIs, and posterior probabilities of AMD. Results: After matching, female sex represented the majority of the patient population in both MarketScan and Optum (14 019/18 252 [76.6%] and 8563/3364 [75.2%], respectively in the JAKi patient population). More than 60% of the patient population was older than 55 years of age in both cohorts. Over the specified treatment period, a 49% relative reduction in incidence of AMD was observed among patients who received JAKi therapy (10/9126 events; adjusted incidence rate ratio [AIRR], 0.51; 95% CI, 0.19-0.90) vs those who received non-JAKi therapy (43/9126 events; AIRR, 1 [reference]) in MarketScan, and a 73% relative reduction in incidence of AMD was observed among patients who received JAKi therapy (3/5667 events; AIRR, 0.27; 95% CI, 0.03-0.74) vs those who received non-JAKi therapy (21/5667 events; AIRR, 1 [reference]) in Optum. The absolute percentage reductions were 0.36% (MarketScan) and 0.32% (Optum), favoring patients who received JAKi therapy. Posterior probabilities of the adjusted risk being less than unity were 97.6% (MarketScan) and 98.9% (Optum) for those who received JAKi therapy vs those who received non-JAKi therapy in MarketScan and Optum, respectively. Conclusions and Relevance: JAKi use may be associated with a reduced risk of incident AMD in US adults with major autoimmune diseases. The absolute percentage reduction is consistent with a potential role for JAKi in this population. Future studies with long-term follow-up are recommended to investigate the association between JAKi use and incident AMD in other disease indications. Investigation into the role of systemic inflammation and JAK-signal transducers and activators of transcription signaling in AMD may improve understanding of the pathophysiology of AMD and lead to new treatment options.


Asunto(s)
Enfermedades Autoinmunes , Inhibidores de las Cinasas Janus , Degeneración Macular , Humanos , Femenino , Masculino , Estudios Retrospectivos , Enfermedades Autoinmunes/tratamiento farmacológico , Enfermedades Autoinmunes/epidemiología , Anciano , Incidencia , Persona de Mediana Edad , Inhibidores de las Cinasas Janus/uso terapéutico , Degeneración Macular/tratamiento farmacológico , Degeneración Macular/epidemiología , Degeneración Macular/diagnóstico , Estados Unidos/epidemiología , Factores de Riesgo , Anciano de 80 o más Años , Bases de Datos Factuales
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