scholarly journals Increased Serum IL 6 Associated With Mortality and Cognitive Impairment in Elderly Brazilians

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 120-121
Author(s):  
Marcelo Caldeira ◽  
Milena Brunialti ◽  
Reinaldo Salomão ◽  
Clineu Almada Filho ◽  
Maysa Cendoroglo

Abstract Immunological and inflammatory changes are gaining importance in aging as they are associated with functional limitations and mortality. Chronic inflammation associated with aging (Inflammaging) is a systemic and subclinical condition, characterized by changes in the levels of interleukins such as IL1, IL4, IL6, IL8, IL10 and TNF alpha, associated with genetic, physiological and environmental factors, whose importance is to be directly associated with morbidity and mortality in the elderly. Objective: To evaluate, through a longitudinal study, the relationship between chronic inflammation associated with aging and possible outcomes, such as cognitive changes and mortality in independent oldest old adults. Methods: were evaluated 201 elderly, aged 80 years or older, community residents, with preserved cognition, without acute diseases and with controlled chronic diseases. In a 02 years of interval, laboratory collections of inflammatory markers (IL 1, IL 4, IL6, IL10, TNF alpha and CRP) were performed and outcomes such as cognitive impairment and deaths were evaluated. Results: There was a correlation between increased serum IL6 and cognitive impairment, in the group of women (p-value = 0.008) and in the group All (p-value = 0.022). In the group of men, there was a significant difference between the increase in IL6 values ​​(p-value = 0.028) and CRP (p-value = 0.016) in relation to deaths. Conclusion: The results of this longitudinal study showed and confirmed the positive association between changes in inflammatory markers such as IL6 and outcomes such as cognitive impairment and mortality also in elderly Brazilians.

2019 ◽  
Author(s):  
Ling-Chun Huang ◽  
Sun-Wung Hsieh ◽  
Chun-Hung Chen ◽  
Yuan-Han Yang

Abstract Background Whether antiplatelet agents have a preventive effect on cognitive function after ischemic stroke remains unknown. This study examined the potential effect of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, on cognitive impairment after stroke in an Asian population. Methods A total of 45 patients using cilostazol (100 mg) twice per day were enrolled as the study group and 45 patients using aspirin (100 mg) or clopidogrel (75 mg) daily were enrolled as the control group. Mini-mental state examination and Cognitive Assessment Screening Instrument were administered at the start of the study and after 6 months. Multiple logistic regression analysis was used to estimate the association between the cognitive change and cilostazol use. Results Overall, 60-70% of the patients improved their cognition after 6 months follow up. No significant differences were observed in the cognitive change between the cilostazol and control groups. However, the cilostazol group appeared to perform better in the fluency, language and judgment subdomains. Conclusions In the current study, the clinical course of post stroke cognitive changes was described. Although cilostazol did not make a significant difference in cognitive change after ischemic stroke, it may improve fluency, language and judgment subdomains. These findings should be examined further in randomized clinical trials.


Author(s):  
Jignya Vinodbhai Asari ◽  
Anjali Pushkar Tiwari

Introduction: Pregnant woman experience various physical, emotional, and hormonal changes that may cause anxiety. The anxiety and worries can be decreased by sharing information about the developing child, like foetal body movement. Aim: To assess effect of Foetal Movement Counting (FMC) on prenatal attachment and maternal worries among primigravida mothers. Materials and Methods: A longitudinal study was carried out among primigravida mothers of selected Hospitals of Central Gujarat using proforma of Cranley’s maternal foetal attachment scale and Cambridge worry scale. The study was conducted from March 2019 to July 2020. Eighty participants were recruited by convenient sampling 40 in each study group and control group. The study group were provided with foetal movement chart and the participants were asked to record foetal movements for seven consecutive days, twice a day for 20 minutes. Post assessment of prenatal attachment and maternal worries was done using tools of data collection for both study and control group. Chi- square test was used to test the significance (p-value <0.05). Results: The study results revealed that in study group mean score for prenatal attachment was 79.43 at the start and improved to 101.25 (p-value <0.001) after seven days of FMC. In control group, the mean score for prenatal attachment did not show significant difference pre-test and post-test (74.20 vs 74.85, p-value=0.077). In study group, the mean Cambridge worry scale score was 36.55 which came down to 20.28 (p-value <0.001) after seven days, while in control group it was 41.38 at the beginning and 41.30 after seven days (p-value=0.998). Conclusion: Foetal Movement Counting was found to improve maternal foetal attachment and reduce maternal worries. FMC can be routinely and effectively promoted among the pregnant population to help them achieve a positive pregnancy experience and outcome.


Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 48
Author(s):  
José Carlos Flores ◽  
Esther Gracia-Lavedan ◽  
Yolanda Benavente ◽  
Pilar Amiano ◽  
Dora Romaguera ◽  
...  

Chronic inflammation plays a role in the development of chronic lymphocytic leukaemia (CLL), and diet might modulate chronic inflammation. This study aims to evaluate the association between the dietary inflammatory index (DII®) and CLL. A total of 366 CLL cases and 1643 controls of the Spanish multicase-control (MCC) Spain study were included. The inflammatory potential of the diet was assessed using the energy-adjusted dietary inflammatory index (E-DII) based on 30 items from a validated semi-quantitative food frequency questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models controlling for potential confounders. Overall, a modest, non-statistically significant, positive association was observed between CLL and E-DII scores (OR for a one-unit increase in E-DII: 1.05 (CI 95%: 0.99, 1.12), p-value = 0.09 and by tertiles: ORT2vsT1: 1.20 (CI 95%: 0.90, 1.59); OR T3vsT1: 1.21 (CI 95%: 0.90, 1.62), p trend = 0.21). These results were independent from disease severity (p-het: 0.70), time from diagnosis (p-het: 0.67) and CLL treatment received (p-het: 0.56). No interactions were detected. In conclusion, the consumption of a diet with high pro-inflammatory components was not significantly associated with CLL. Changes towards a more pro-inflammatory dietary pattern in younger generations not included here warrant future research.


2019 ◽  
Vol 7 (8) ◽  
pp. 1314-1319 ◽  
Author(s):  
Valentina Cvejoska-Cholakovska ◽  
Mirjana Kocova ◽  
Vesna Velikj-Stefanovska ◽  
Emilija Vlashki

BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterised by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9646-9646
Author(s):  
Qiuling Shi ◽  
Xin Shelley Wang ◽  
James M. Reuben ◽  
Evan N. Cohen ◽  
Loretta A. Williams ◽  
...  

9646 Background: After 3-months autologous stem cell transplant (AuSCT), a percentage of multiple myeloma (MM) patients during maintenance therapy continue to experience a complex of symptoms related to peripheral neuropathy. This longitudinal study examined these self-reported neuropathy symptoms and identified circulating inflammatory markers associated with high neuropathy-related symptoms. Methods: MM patients (N=51) rated symptom severity on 0-10 scale via the M. D. Anderson symptom Inventory (MDASI) weekly from 3 to 9 months post AuSCT during maintenance therapy. Patient also rated pain on hand or foot in routine clinic visit. A panel of pro- and anti-inflammatory cytokines, receptors, chemokines was evaluated on serum samples by Luminex. Mixed effect analysis was used to describe the changes on cytokines and symptom outcomes across time. Trajectory analysis identified patients that persistently reported higher or lower symptom severity overtime. Results: During the study period, there was no significant reduction on pain in general or on hand/foot, or change in neuropathic symptoms such as numbness/tingling and muscle weakness. Among a third (33%) of patients who was consistently in high pain (mean 5.5), MIP-1a (p=.001) and MCP-1 (p=.032) showed significant decrease. Approximately 40 % had persistently high numbness/tingling (mean 5.2) across the observation period. Compared to low symptom group patients, this high numbness group had significantly higher IL-6 (p=.019) and TNF-alpha (p=.006). High muscle weakness (mean 3.1) was for 69% of the sample. This group had significantly higher CRP (p=.005) and TNF-alpha (p=.001). Conclusions: This is the first longitudinal study that tracked persistent neuropathy-related symptoms for MM patients post AuSCT. Approximately one third reported painful neuropathy, either from induction therapy or ongoing maintenance therapy. High levels of these neuropathy symptoms were associated with higher levels of specific pro-inflammatory markers. This study provided rationale for examining the effectiveness of anti-inflammation as mechanism driven intervention on peripheral neuropathy in this cohort of MM patients.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7025-7025
Author(s):  
Monica Peravali ◽  
Cristiane Gomes-Lima ◽  
Eshetu Tefera ◽  
Mairead Baker ◽  
Mamta Sherchan ◽  
...  

7025 Background: ICPi cause various irAE with thyroid dysfunction as a commonly reported abnormality. There is increasing evidence showing positive association with development of irAE and survival. However, prior trials with ICPi had underrepresentation of minorities with <5% African Americans (AA). Methods: We retrospectively reviewed patients (pts) with stage IV solid malignancies treated with PD1/PDL1 blockers between 1/2013-12/2018 across MedStar Georgetown Cancer Institute facilities. Pts treated with CTLA-4 inhibitors were excluded. Progression free survival (PFS) and overall survival (OS) were primary endpoints and were calculated using Kaplan-Meier methods and Wilcoxon rank sum test for comparison. Results: 293 pts met eligibility criteria. 91 pts (31%) had any grade irAE; most common AE were endocrine (40.7%) specifically TSH elevation, dermatological (23.1%) and rheumatologic (18.7%). Proportion of irAE was significantly higher in Caucasians versus AA (60.4% vs 30.8%), in pts with low PDL1, lower LDH, older age, and those who had more treatment cycles with ICPi. Rate of progression was lower in pts with irAE (30.8% vs 46.0%, p-0.0140). Median PFS (5.8 vs 3.0 months (mo), p- 0.0204) and OS (17.1 vs 7.2 mo, p value- <0.0001) were higher with irAE. Statistically significant difference in OS (17.1 vs 8.6 mo, p- 0.0002) but not in PFS (5.8 vs 3.3 mo, p: 0.0545) was noted with endocrine irAE. No differences in survival were observed among other commonly reported irAE. Differences in survival among subgroups of pts with irAE are detailed in table. Conclusions: Development of irAE positively correlated with improved PFS and OS as reported in previous studies. To our knowledge, this is the first study observing differences in OS favoring endocrine AE and Caucasian race. These factors may be potential surrogate markers of prognosis pending replication of these results in large-scale studies. [Table: see text]


2022 ◽  
Vol 8 (1) ◽  
pp. 30-34
Author(s):  
Fildza Intan Rizkia ◽  
Chandra Calista ◽  
Suryani Gunadharma ◽  
Asep Nugraha Hermawan ◽  
Lisda Amalia ◽  
...  

Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analyzed using the Mann-Whitney U test. Results: There were 428 subjects eligible for this study, with 207 subjects categorized as first ischemic stroke group and 221 subjects categorized as recurrent ischemic stroke group. There was a statistically significant difference in MMSE scores between the first ischemic stroke patients (24.90 ± 4.64) and recurrent ischemic stroke patients (22.85 ± 4.64 ) with a p value of 0.002. Conclusion: Recurrent ischemic stroke patients had lower MMSE scores than the first ischemic stroke patients. Clinicians should be more aware in detecting early cognitive impairment in stroke patients and in preventing the incidence of recurrent stroke.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Michael Pan ◽  
Tariq Azam ◽  
Husam Shadid ◽  
Hanna Berlin ◽  
Chelsea Meloche ◽  
...  

Introduction: There have been concerns that NSAID use may worsen outcomes in coronavirus disease 2019 (COVID-19) through upregulation of the ACE2 receptor used by the SARS-CoV-2 virus for cell entry. Hypothesis: We sought to determine whether prior use of NSAIDs in patients hospitalized with COVID-19 is associated with worse in-hospital outcomes. Methods: The Michigan Medicine Covid-19 Cohort (M 2 C 2 ) is an ongoing prospective observational study in which detailed clinical, laboratory and outcomes data were collected from chart review of consecutive adult patients hospitalized for COVID-19. Patients who were positive for SARS-CoV-2 infection but without symptoms of COVID-19 were not included in this cohort. We identified 553 patients who presented to University of Michigan Hospital between March 1 st and May 1 st for COVID-19, of whom 519 had data on whether they took NSAIDs prior to hospitalization. We examined the association between NSAID use and outcomes during their hospitalization. Results: 52 (10.0%) patients were taking NSAIDs prior to hospitalization (NSAID group; mean age 55.8 [SD 15.2]; 46.2% men) and 467 (90.0%) were not taking NSAIDs (non-NSAID group; mean age 61 [SD 16.0]; 57.7% men). There was no significant difference between the inflammatory markers on presentation to hospital between groups including CRP (median 8.0 vs median 9.7, p-value 0.79), procalcitonin (median 0.18 vs median 0.21, p-value 0.66), d-dimer (median 0.90 vs median 1.25, p-value 0.12), and IL-6 (median 36.7 vs median 49.3, p-value 0.43). All-cause mortality was not significantly different between the NSAID and non-NSAID groups (11.5% vs 16.8%, p-value 0.36) and neither was the risk of ICU admission (46.2% vs 48.9%, p-value 0.62). Conclusions: Among patients presenting to hospital with COVID-19, prior use of NSAIDs was not associated with significantly different levels of inflammatory markers on admission and was also not associated with significantly different mortality or rates of ICU admission.


2020 ◽  
Vol 4 (1) ◽  
pp. 379-391
Author(s):  
Alexander Andreev ◽  
Burak Erdinc ◽  
Kiran Shivaraj ◽  
Julia Schmutz ◽  
Olga Levochkina ◽  
...  

Background: Dementia is a spectrum of neurological diseases characterized by memory impairment and cognitive decline with the pathogenesis and effective management remaining elusive. Several studies have identified a correlation between anemia and Alzheimer’s disease and related dementias (ADRD); however, anemia subtypes and association with ADRD have yet to be studied conclusively. Objective: To study an association between ADRD and anemia of chronic inflammation. Methods: We conducted a retrospective case-control study of the patients, diagnosed with ADRD at Brookdale Hospital. Pair-wise comparisons between means of controls and cases in terms of iron studies and laboratory results were performed using a Mann–Whitney U test. Pair-wise comparisons between anemia subgroups (moderate and severe) were performed using a Two Sample proportion Z-Test, where for each couple of normally distributed population. Results: There was a total of 4,517 (1,274 ADRD group; 3,243 Control group) patients. There was significant difference in hemoglobin 10.15 versus 11.04 [p-value <0.001]. Iron studies showed a significant difference in ferritin 395±488.18 versus 263±1023.4 [p < 0.001], total iron binding capacity 225±84.08 versus 266±82.30 [p < 0.001] and serum iron level 64±39.34 versus 53±41.83 [p < 0.001]. Folic acid and vitamin B12 levels were normal in both groups. Severe and moderate anemia in the ADRD group were respectively 6.2% [95% CI: 4.2–8.4] and 13% [95% CI: 9.8–16.2] higher. Overall, incidence of moderate-to-severe anemia was found to be 19% higher in ADRD group [95% CI: 15.8–22.1]. Conclusion: We demonstrated an association between ADRD and anemia of chronic inflammation independent of age, renal function, and HgbA1C levels.


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