scholarly journals P1439DO PATIENTS ON DIALYSIS AGE FASTER THAN HEALTHY ADULTS BASED ON TELOMERE LENGTH; A BIOLOGICAL MARKER OF AGEING AND MORTALITY?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Vasantha Muthuppalaniappan ◽  
Kieran McCafferty ◽  
Muhammad Yaqoob

Abstract Background and Aims Telomere length (TL) is an emerging novel biomarker of ageing and survival. Telomere shortening to a critical limit is associated with replicative senescence and cell death; a process accelerated by oxidative stress and chronic inflammation. This process is often observed among patients with end stage kidney disease (ESKD). This predisposes them to increased morbidity and mortality in comparison to their normal counterparts when matched for age and gender. The exact reason for premature ageing in this cohort remains poorly understood and there is a need for further investigations into biomarkers of ageing to help understand the process. The aim of the study was to investigate if patients with ESKD in comparison to healthy controls had an increased biological age based on telomere length measurements. Method This was a single centre prospective, observational, cohort study among eligible dialysis patients and healthy controls. The healthy control group consisted of potential living donors. Patients were recruited as per the study protocol. Recruited patients on HD had their blood sampled prior to their mid-week dialysis session while potential live donors and PD patients had their blood sampled at outpatient clinics. Whole blood was immediately isolated for peripheral blood mononuclear cells (PBMC). Genomic DNA was extracted from PBMC to measure relative telomere length (rTL) by quantitative real-time polymerase chain reaction according to the modified Cawthon protocol. Baseline demographic data and 1-year mortality were obtained from electronic patient records. Results A total of 336 patients (125 patients on HD, 114 patients on PD and 100 healthy controls) had their baseline rTL measured between the period of December 2015 to July 2018. Inter assay CV for rTL assay was 4.86%. Mean age of the dialysis cohort was 54.3 with an age range between 23-83 years. Mean age of control cohort was 44.5 with an age range between 20-75years. There were 87 and 56 females in the dialysis and control cohort respectively. Age was significantly associated with TL in a multivariate regression model in both the dialysis (p<0.001) and control group (p<0.001). There was no significant difference in mean TL between gender in the healthy cohort in our study p=0.778. However, mean TL was higher in females than in males among dialysis patients, p=0.007. Mean TL of control and dialysis group was 2.23 ± 0.33 and 2.11 ± 0.34 respectively. The difference in TL between the groups was significant, p=0.006. However, a multivariate analysis of TL adjusted for age and gender was not significant, p=0.875. This was due to the control cohort consisting of younger recruits in comparison to the dialysis cohort. TL was not significantly different between HD and PD patients. There were 10 deaths in 365 days with no loss of follow up throughout the study period. All the deaths were in the dialysis cohort. There was no significant association found between TL and mortality outcomes but the direction of effect i.e shorter TL was associated with increased risk of death. Conclusion This study failed to show any difference between TL between dialysis patients and controls to demonstrate that patients on dialysis age faster. This does not preclude current evidence suggesting that dialysis patients do have an accelerated ageing in comparison to healthy cohort but merely that our study has shown that TL may not be the ideal biomarker of ageing to demonstrate this difference. In fact, increasing animal studies have found that the rate of change in TL over a period of time is a better representation of ageing. The study also identified no association between TL and 1-year mortality as there were only 10 deaths within the 1 year of follow up. This may be largely due to a short duration of follow up and it may be interesting to evaluate TL and 5-year mortality data in this cohort in future.

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4005-4005 ◽  
Author(s):  
Tamar Berger ◽  
Yakir Moshe ◽  
Shilo Yaari ◽  
Ilana Hellmann ◽  
Adina Aviram ◽  
...  

Abstract Introduction: The phase III RATIFY study (Stone et al, NEJM 2017) demonstrated that the addition of the FLT3 inhibitor midostaurin to intensive induction and consolidation courses improves outcome in younger FLT3-positive AML patients. The toxicity and efficacy profile of adding midostaurin to chemotherapy in patients not originally included in the RATIFY study is unknown. We sought to characterize midostaurin use in a 'real-world' setting. Methods: Patients (>18 years) with FLT3-positive AML (ITD/TKD) were eligible to receive midostaurin through the Novartis extended access program that was launched in Israel in April 2016. In order to control for toxicity and efficacy outcomes in the midostaurin-treated patients, a historical control cohort was created that included patients with FLT3-positive AML from 2 participating centers that were not treated with midostaurin (all patients diagnosed after January 2015). Data were extracted from electronic patient records and were collected from several medical centers in Israel. Base-line characteristics, disease- and patient- specific parameters as well as relapse-rates and overall survival were analyzed and compared between the midostaurin treated and untreated cohorts. We used Cox regression to analyze predictors for survival. This study was approved by the Institutional Review Board. Results: Thirty-five patients were included in the analysis. The median age of the patients was 62 years (range 27-78); 40% and 20% of patients were over the age of 65 and 70 years, respectively. FLT3-ITD mutations were detected in 32 patients (91%) and 3 patients had TKD mutations (9%). Eight patients (23%) had secondary leukemia, 83% had normal karyotype and 57% were NPM1-mutated. No differences were noted between the midostaurin-treated group (n=21) and the historical control cohort (n=14) in terms of age, gender, leukemia ontogeny, cytogenetics, presenting blood counts, extramedullary involvement, performance status and comorbidity scales. More patients in the midostaurin group were found to be NPM1-mutated (66 vs. 44%, p=0.03). Furthermore, no differences were noted between the groups in terms of daunorubicin dose for induction (45, 60 and 90 mg/m2/dayin 20, 30 and 50% of patients, respectively), number of consolidations (median number of cycles - 2), cytarabine dose or allogeneic transplantation rate (45 and 36% in the midostaurin and control group, respectively). The full 14 day midostaurin course was given in most patients during induction (73%). In 5 patients midostaurin was initiated only at the post-induction courses due to technical delays in drug supply. Only 4 patients experienced dose reductions or interruptions during therapy: 3 during induction (septic shock, drug interaction and QT prolongation) and 1 during consolidation (new onset atrial fibrillation). Toxicity was comparable between the cohorts. Febrile neutropenia during induction was noted in 95 and 93% of patients in the midostaurin and control groups, respectively. Time to neutrophil and platelet recovery were also comparable (25 vs. 24 days and 24 vs. 20 days in the midostaurin and control groups respectively). Other toxicities were uncommon and not significantly different between the groups. CR/CRi rates were 85% and 58% in the midostaurin and control cohorts, respectively (p=0.17). The median follow-up time for surviving patients in the midostaurin and control cohorts were 426 and 517 days, respectively (p=0.55). During follow-up, 7 deaths occurred in the midostaurin group and 9 in the control arm. Median survival was not reached for the midostaurin treated group and was 281 days for the control group (Figure 1, p=0.42). Nine and 6 patients in remission relapsed in the midostaurin and control group, respectively, translating into a relapse-rate of 53% and 86%, respectively (p=0.19). No difference in early death rate was noted between the groups. The only factor that significantly affected overall survival in the COX-regression analysis was white blood cell count at diagnosis (p=0.03). Conclusions: In the off-trial setting, midostaurin is administered across all age groups and various FLT3-positive subtypes. In this 'real-life' setting, midostaurin is well tolerated and does not significantly add to the toxicity of chemotherapy. Longer follow-up and more patients are needed to assess the efficacy of adding midostaurin to chemotherapy in this group of patients. Figure 1. Figure 1. Disclosures Ofran: Novartis: Other: Served on a Novartis advisory board.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Suju Wang ◽  
Wenyang Hao ◽  
Chunxiao Xu ◽  
Daofeng Ni ◽  
Zhiqiang Gao ◽  
...  

Objective(s). The purpose of this study was to explore the effectiveness of wideband acoustic immittance (WAI) in the diagnosis of otosclerosis by comparing the differences in the energy reflectance (ER) of WAI between patients with otosclerosis and age- and gender-matched normal hearing controls in the Chinese population. Methods. Twenty surgically confirmed otosclerotic ears were included in the otosclerotic group. The ER of WAI at ambient and peak pressures, resonance frequency, and 226-Hz tympanogram were collected prior to surgery using a Titan hearing test platform (Interacoustics A/S, Middelfart, Denmark). All diagnoses of otosclerosis in the tested ear were confirmed by surgery after the measurements. Thirteen normal adults (26 ears) who were age- and gender-matched with the otosclerotic patients were included as the control group. Results. At peak pressure, the ERs of otosclerotic patients were higher than those of the control group for frequencies less than 4,000Hz and were lower for frequencies greater than 4,000Hz. In addition, within the analyzed frequencies, the differences observed at 2,520Hz was statistically significant (p<0.05/16=0.003, Bonferroni corrected). At ambient pressure, the differences observed at 1,260 and 6,350Hz were statistically significant (p<0.05/16=0.003, Bonferroni corrected). Although the differences between the otosclerotic and control groups exhibited similar trends to those in studies implemented in Caucasian populations, the norms in the present study in the control group were different from those in the Caucasian populations, suggesting racial differences in WAI test results. Regarding the middle ear resonance frequency, no significant difference was observed between the two groups (P>0.05). Conclusion. WAI can provide valuable information for the diagnosis of otosclerosis in the Chinese population. Norms and diagnostic criteria corresponding to the patient’s racial group are necessary to improve the efficiency of WAI in the diagnosis of otosclerosis.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jaime Céspedes ◽  
German Briceño ◽  
Michael Farkouh ◽  
Rajesh Vedanthan ◽  
Martha Leal ◽  
...  

Introduction: Educational programs for children can increase uptake of healthy lifestyle behaviors. However, the impact of educational programs in preschool-aged children in low- and middle-income countries is not known. We conducted a five month educational intervention in preschool facilities (PF) in Bogota, Colombia, to assess changes in preschooler’s knowledge, attitudes and habits (KAH) towards healthy eating and living an active lifestyle. Methods: We conducted a cluster, randomized, controlled trial, and randomly assigned 14 PF in Bogota to a five-month educational intervention (7 PF) or to usual curriculum (7 PF). The intervention included classroom activities and use of printed material and videos. A total of 1216 pre-school children, 928 parents, and 120 teachers participated. A structured survey was used to evaluate changes in KAH with a weighted total score (WTS). The primary outcome was change in children's WTS, and the secondary outcomes were change in parents’ and teachers' WTS. The control PF were provided the intervention after the initial evaluation. To assess sustainability, we evaluated both intervention and control groups at 18 months. Results: At 6 months, children in the intervention group showed 10.9% increase in WTS vs. 5.3% in controls, p<0.001, after adjustment for cluster, sex, age and teachers' educational level. Among parents, the equivalent results were 8.9% and 3.1%, respectively, p< 0.001, and among teachers 9.4% and 2.5%, p=0.06. At the 18-month extended follow-up, both the intervention and control children showed a significant further increase in WTS, p<0.001 (Figure 1). In parents and teachers in the intervened group, there was no significant increase in WTS, p=0.7417, and p=0.1197. In the control group, there was an increase in WTS in teachers but not in parents, p=0.001, and p=0.4239. Conclusion: A preschool based intervention, aimed at changing KAH related to healthy diet and active lifestyle, is feasible, efficacious and sustainable up to 18 months in very young children in Colombia.


2018 ◽  
Vol 44 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Martín Bedolla-Barajas ◽  
Norma Angélica Pulido-Guillén ◽  
Bolívar Vivar-Aburto ◽  
Jaime Morales-Romero ◽  
José Raúl Ortiz-Peregrina ◽  
...  

ABSTRACT Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.


2019 ◽  
Vol 45 (1) ◽  
pp. 29-34
Author(s):  
Li-ching Chang ◽  
I-ming Tsai

The present study compared early dental implant failure rates between patients with and without orthodontic treatment before dental implantation. The data of adults who had undergone dental implantation between January 2007 and December 2016 were analyzed retrospectively. A total of 124 subjects with 255 implants were divided into a treatment group (46 subjects, 85 teeth) consisting of patients who had undergone implant surgery after orthodontic treatment and a control group of patients who had not undergone preimplant orthodontic treatment. Implants that failed before permanent crown fabrication were defined as failures. No significant differences in gender or age were found between the treatment group and controls. No significant differences were found in implant failure rates in either jaw between the treatment and control groups. However, the failure rate was still higher in the treatment group (14.81%) than in the control group (3.28%) for the maxilla. Results of this study demonstrate an increased implant failure rate only in the maxilla of patients who underwent orthodontic treatment before dental implantation, especially implant surgery combined with a sinus lift procedure. Further study with a larger sample size and longer follow-up period is necessary to confirm results of the present study and identify other confounding factors.


2020 ◽  
Vol 34 (4) ◽  
pp. 346-354
Author(s):  
Michele Honicky ◽  
João Paulo Zattar ◽  
Mariana Saciloto ◽  
Mariana Abe Vicente Cavagnari ◽  
Claudia Nodari ◽  
...  

Introduction: Immunomodulator glutamine and probiotic Lactobacillus at certain doses have beneficial effects by modulation of the immune system and may assist in the integrity of therespiratory system. However, studies about the effects of glutamine or Lactobacillus pool on the prevention and control of asthma in children are still scarce. The aim of study was to evaluate the effect of the use of glutamine and Lactobacillus pool on the attenuation of clinical asthma symptoms in children. Methods: Longitudinal study, 45 children with medical diagnosis of asthma distributed in three groups: control group (C), glutamine group (G), Lactobacillus group (L). Group G was supplemented with L-glutamine powder (0.3 g/kg/day). Group L used a pool of Lactoba- cillus (Lactobacillus casei, paracasei, rhamnosus, acidophilus and Bifidobacterium lactis) (2 g/day). Group C received no glutamine or Lactobacillus pool. Clinical characteristics and symptoms of respiratory diseases were assessed by study-specific anamnesis and ISSAC Questionnaire (to obtain diagnostic scores and asthma symptoms) for 4 months. To test for differences between groups, the ANOVA test with Tukey post-hoc test was used. It was considered significant p <0.05. Results: Initial ISSAC score was (C=8.67±1.77, L=7.80±1.52 and G=8.00 ± 1.46, p=0.31). At the first follow-up, the ISSAC score indicated that group G had improvement in the clinical characteristics of asthma (C=6.47±2.29, L = 5.07±2.28, G = 4.00±1.73, p <0.05), as also occurred in the following months until the last follow-up (C=5.93±2.28, L=5.13±2.13, G=4.00±1.96, p<0.05). After supplementation, group G presented lower mean duration of asthma attack (p=0.01), lower number of asthma attack (p<0.05), lower prevalence of typical asthma symptoms, as cough and wheezing (p<0.05). Conclusion: Glutamine supplementation attenuated the typical asthma symptoms, while the use of Lactobacillus pool did not attenuate the symptoms. Glutamine may be a new strategy for prevention and control of asthma in children.


2022 ◽  
Author(s):  
Forouzandeh Soleimanian-Boroujeni ◽  
Negin Badihian ◽  
Shervin Badihian ◽  
Vahid Shaygannejad ◽  
Yousef Gorji

Abstract Introduction: Psychological interventions are shown to be effective in migraine, but not utilized routinely yet. We aimed to evaluate the efficacy of transdiagnostic cognitive behavioral therapy (TCBT) on people with migraine (PwM). Method: This study was conducted on 40 PwM aged 20-50 years. We randomly assigned participants to two groups of intervention, receiving 10 sessions of TCBT, and control. Days with headache, headache severity, migraine-related disability and effects on daily life, number of pain-relivers taken for headache, depression, and anxiety were assessed pre-intervention, post-intervention (three-month follow-up), and one-month after TCBT termination (four-month follow-up).Results: Thirty-five participants suffering moderate to severe migraine completed the study (16 and 19 in TCBT and control groups, respectively). TCBT improved all measured items between study time-points (p<0.05) in the intervention group, while such an improvement was not observed in the control group. Between group comparisons revealed superiority of TCBT group compared to the control group in most measured items at three- and four-month follow-ups (p<0.05).Conclusion: Ten sessions of TCBT improved migraine severity, associated disability, anxiety, and depression in PwM, with persistent effects after one month of therapy termination. TCBT is an affordable, practical, and feasible intervention to be utilized for PwM.Protocol registration: The study protocol was registered in clinicaltrial.gov (NCT03701477) prior to enrollment.


Salmand ◽  
2021 ◽  
Vol 15 (4) ◽  
pp. 484-495
Author(s):  
Maryam Moradi ◽  
◽  
Hamideh Mohammadzadeh ◽  
Reza Noori ◽  
Kokab Basiri Moghadam ◽  
...  

Objectives: Low quality sleep is one of the most common problems in old age. The present study aims to determine the effect of a sleep hygiene education program using Telephone Follow-Up (TFU) method on the sleep quality of the elderly. Methods & Materials: This quasi-experimental study was conducted on 80 eligible elderly people aged 60-74 years who were selected using a systematic random sampling method and were randomly assigned into intervention and control groups. The intervention group received a one-hour face-to-face education session on sleep hygiene. The TFU were carried out two times per week in the first month and once a week in the second month after intervention. The control group received routine care. The data collection tools were a demographic form and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The PSQI was completed for both groups immediately after the second month. Results: There was no statistically significant difference in the mean PSQI score before intervention in the intervention (8.02) and control (7.47) groups (P=0.32), but after the intervention, the mean PSQI score in the intervention group (5.42) was significantly reduced compared to the control group (7.67) (P<0.001). Conclusion: Sleep hygiene education program based on TFU improves the sleep quality of the elderly. It is recommended that health care providers use this method to improve the sleep quality of the elderly.


1986 ◽  
Vol 23 (6) ◽  
pp. 741-749 ◽  
Author(s):  
J. E. Moulton ◽  
L. S. Rosenblatt ◽  
M. Goldman

In a lifetime study, female beagle dogs in a closed colony were administered 226radium and 90strontium. An unirradiated control group was included in the study. A total of 223 of 356 dogs at risk developed 1,112 mammary proliferative growths (hyperplastic nodules and neoplasms). There was no correlation between occurrence and types of lesions in radiation and control groups. The age range for first occurrence of lesions was 10.4 to 13.9 years; hyperplastic nodule and benign mixed tumor occurred 1 to 2 years earlier than other lesions. A multiplicity of growths of similar or different morphological type were common throughout the lifetime of the dog. The female beagles, collectively, developed 244 hyperplastic nodules, 78 adenomas, 694 benign mixed tumors, 78 carcinomas, 14 malignant mixed tumors, and four myoepitheliomas. Proliferations occurred with increasing frequency from the cranial to caudal mammary glands. Metastasis was found in 77% of the dogs with carcinoma. The median time from diagnosis to metastasis was 10 months, but was shorter in dogs with infiltrative carcinoma.


2021 ◽  
Vol 2 (1) ◽  
pp. 37-44
Author(s):  
Yun Liu ◽  
◽  
Li Yan ◽  
Hang Chu ◽  
Dian-Peng Wu ◽  
...  

AIM: To explore whether low myopia would affect cerebral visual functions by comparing perceptual eye position (PEP), fixation stability and stereoacuity tests between low myopic and normal adolescents. METHODS: Totally 120 adolescents matched in age and gender participated in our study. Subjects were divided into three groups according to their refractive states. The cerebral visual functions tested in our study included perceptual eye position (PEP), fixation stability and stereoacuity. Stereoacuity tests involved in our study could be categorized into two parts. The first part was classical stereo tests including Titmus and synoptophore stereo test. The second part was 3D random-dot test for zero-order stereoacuity (hereinafter as zero-order test) at different viewing distances (0.8 m and 1.5 m). RESULTS: The deviation of horizontal PEP was significantly larger in non-anisometropia when compared to control group. Both horizontal and vertical PEP bias pixels were significantly larger in anisometropia group. Both non-anisometropia group and anisometropia group had more trouble in holding their fixation stable. Moreover, anisometropia group had more abnormal results than other two groups. And in zero-order test at 1.5 m, both non-anisometropia and anisometropia had more abnormal results in stereoacuity than control group. The correlation between fixation stability and near stereoacuity (Titmus and zero-order stereoacuity at 0.8 m) was weak and positive. CONCLUSION: Low myopic adolescents still have certain defects in cerebral visual functions. Examinations used in our study are useful in assessing cerebral visual functions. They could provide better follow-up evaluation and solid ground for further specific treatments in treating defects of cerebral visual functions. So far, local retinal environment has been the focus of the development in myopia. Our results suggested that researchers might pay more attention on visual cortex in studying the mechanisms of myopia in the near future.


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