scholarly journals Inverse association of falciparum positivity with endemic Burkitt lymphoma is robust in analyses adjusting for pre-enrollment malaria in the EMBLEM case-control study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sally Peprah ◽  
Martin D. Ogwang ◽  
Patrick Kerchan ◽  
Steven J. Reynolds ◽  
Constance N. Tenge ◽  
...  
Keyword(s):  
Burkitt Lymphoma ◽  
Blood Film ◽  
Malaria Treatment ◽  
Inverse Association ◽  
Recent Infection ◽  
Thick Blood Film ◽  
Study Results ◽  
Community Controls ◽  
Stratified Analysis ◽  
Enrollment Factors

Abstract Background Falciparum and endemic Burkitt lymphoma (eBL) are co-endemic in Africa, but the malaria experience in eBL patients is unknown. A lower prevalence of falciparum has been reported in eBL patients, but those results are anecdotally attributed to pre-enrollment anti-malaria treatment. Methods We studied 677 eBL patients and 2920 community controls aged 0–15 years enrolled in six regions in Uganda, Tanzania, and Kenya during 2010–2016. Falciparum was diagnosed using thick blood film microscopy (TFM) and antigen-capture rapid diagnostic tests (RDTs). Guardians of the children answered a 40-item structured questionnaire about their child’s pre-enrollment lifetime malaria history and treatment, demographics, socioeconomics, animal exposures, fevers, and hospitalizations. We utilized exploratory factor analysis to reduce the 40 questionnaire variables into six factors, including Inpatient malaria and Outpatient malaria factors that were surrogates of pre-enrollment anti-malaria treatment. The six factors accounted for 83–90% of the variance in the questionnaire data. We calculated odds ratios and 95% confidence intervals (OR 95% CI) of association of eBL with falciparum positivity, defined as positive both on TFM or RDTs, or only RDTs (indicative of recent infection) or TFM (indicative of current falciparum infection) versus no infection, using multivariable logistic regression, controlling for group of age (0–2, 3–5, 6–8, 9–11 and 12–15 years), sex, and study site and the afore-mentioned pre-enrollment factors. Results The prevalence of falciparum infection was 25.6% in the eBL cases and 45.7% in community controls (aOR = 0.43, 95% CI: 0.40, 0.47; P < 0.0001). The results were similar for recent falciparum infection (6.9% versus 13.5%, aOR = 0.44, 95% CI: 0.38, 0.50; P < 0.0001) and current falciparum infection (18.7% versus 32.1%, aOR = 0.47, 95% CI: 0.43, 0.51; P < 0.0001). These aORs for any, recent and current falciparum infection did not change when we adjusted for pre-enrollment factors (aORs = 0.46, =0.44, and = 0.51, respectively) were significantly lower in stratified analysis for any infection in children < 5 years (aOR = 0.46; 95% CI: 0.29, 0.75) or ≥ 10 years (aOR = 0.47; 95% CI: 0.32, 0.71). Conclusion Our study results reduce support for pre-enrollment antimalaria treatment as a sole explanation for the observed lower falciparum prevalence in eBL cases and open a space to consider alternative immunology-based hypotheses.

Introduction to lymphopoiesis

2020 ◽  
pp. 5263-5269
Author(s):  
Caron A. Jacobson ◽  
Nancy Berliner
Keyword(s):  
Bone Marrow ◽  
Lymph Node ◽  
Lupus Erythematosus ◽  
Viral Infections ◽  
Lymph Node Biopsy ◽  
Blood Film ◽  
Lymphoproliferative Disorders ◽  
Recent Infection ◽  
Serological Studies ◽  
Epstein Barr

Lymphoproliferative disorders occur when the normal mechanisms of control of proliferation of lymphocytes break down, resulting in autonomous, uncontrolled proliferation of lymphoid cells and typically leading to lymphocytosis and/or lymphadenopathy, and sometimes to involvement of extranodal sites (e.g. bone marrow). These include (1) malignant—clonal in nature, resulting from the uncontrolled proliferation of a single transformed cell (e.g. lymphoma); (2) nonmalignant—polyclonal lymphoproliferative disorders may result from conditions including (a) infections—lymphocytosis is commonly caused by viral infections (e.g. Epstein–Barr virus (EBV)), lymphadenopathy is a common feature of a very wide variety of infections; and (b) reactive—conditions such as systemic lupus erythematosus and sarcoidosis frequently cause lymphadenopathy. Distinguishing between the lymphoproliferative disorders clinically and pathologically is not always easy. Clinical assessment—when eliciting the history of a patient with suspected lymphoproliferation, particular note should be taken of their general health, the type and duration of any constitutional symptoms, and any episodes of recent infection/exposure to drugs/travel. Thorough examination of all lymph node sites is required, as is careful examination of the oropharynx, tonsils, skin, spleen, and liver. Investigation—whenever a lymphoproliferative disorder is suspected, the key initial investigation is the full blood count and examination of the blood film, sometimes augmented by immunocytochemistry and flow cytometry. Depending on clinical context, other investigations may include (1) serological studies for viral pathogens; (2) serological studies for rheumatological disease; (3) imaging for mediastinal and intra-abdominal lymphadenopathy; (4) bone marrow examination; and—if no diagnosis is apparent—(5) lymph node biopsy.

scholarly journals Hair Glucocorticoids as a Biomarker for Endogenous Cushing’s Syndrome: Validation in Two Independent Cohorts

2019 ◽  
Vol 109 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Mesut Savas ◽  
Vincent L. Wester ◽  
Yolanda B. de Rijke ◽  
German Rubinstein ◽  
Stephanie Zopp ◽  
...  
Keyword(s):  
Cushing’S Syndrome ◽  
Scalp Hair ◽  
Area Under The Curve ◽  
Population Based ◽  
Cushing's Syndrome ◽  
Diagnostic Efficacy ◽  
Study Results ◽  
Community Controls ◽  
Cutoff Threshold ◽  
Control Study

Background/Aims: The current diagnostic workup of Cushing’s syndrome (CS) requires various tests which only capture short-term cortisol exposure, whereas patients with endogenous CS generally have elevated cortisol levels over longer periods of time. Scalp hair assessment has emerged as a convenient test in capturing glucocorticoid concentrations over long periods of time. The aim of this multicenter, multinational, prospective, case-control study was to evaluate the diagnostic efficacy of scalp hair glucocorticoids in screening of endogenous CS. Methods: We assessed the diagnostic performances of hair cortisol (HairF), hair cortisone (HairE), and the sum of both (sumHairF+E), as measured by a state-of-the-art LC-MS/MS technique, in untreated patients with confirmed endogenous CS (n = 89) as well as in community controls (n = 295) from the population-based Lifelines cohort study. Results: Both glucocorticoids were significantly elevated in CS patients when compared to controls. A high diagnostic efficacy was found for HairF (area under the curve 0.87 [95% CI: 0.83–0.92]), HairE (0.93 [0.89–0.96]), and sumHairF+E (0.92 [0.88–0.96]) (all p < 0.001). The participants were accurately classified at the optimal cutoff threshold in 86% of the cases (81% sensitivity, 88% specificity, and 94% negative predictive value [NPV]) by HairF, in 90% of the cases (87% sensitivity, 90% specificity, and 96% NPV) by HairE, and in 87% of the cases (86% sensitivity, 88% specificity, and 95% NPV) by the sumHairF+E. HairE was shown to be the most accurate in differentiating CS patients from controls. Conclusion: Scalp hair glucocorticoids, especially hair cortisone, can be seen as a promising biomarker in screening for CS. Its convenience in collection and workup additionally makes it feasible for first-line screening.

scholarly journals Legume Consumption and Cardiometabolic Health

2019 ◽  
Vol 10 (Supplement_4) ◽  
pp. S437-S450
Author(s):  
Nerea Becerra-Tomás ◽  
Christopher Papandreou ◽  
Jordi Salas-Salvadó
Keyword(s):  
Randomized Clinical Trials ◽  
Disease Risk ◽  
Cardiometabolic Health ◽  
Inverse Association ◽  
Cvd Risk ◽  
Potential Health ◽  
Published Evidence ◽  
Wide Range ◽  
Meta Analyses ◽  
Stratified Analysis

ABSTRACT Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.

Association of Glasgow Coma Scale with Total Homocysteine Levels in Patients with Hemorrhagic Stroke

2019 ◽  
Vol 75 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Dapeng Dai ◽  
Yong Sun ◽  
Chengzhang Liu ◽  
Houxun Xing ◽  
Binyan Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Hemorrhagic Stroke ◽  
Final Analysis ◽  
Inverse Association ◽  
Severe Damage ◽  
Coma Scale ◽  
Total Homocysteine ◽  
The Mean ◽  
Stratified Analysis

Objectives: We aimed to evaluate the association between Glasgow Coma Scale (GCS) and total homocysteine (tHcy) levels and examine the possible effect modifiers in patients with hemorrhagic stroke. Methods: A total of 1,516 participants with hemorrhagic stroke and having the complete data on baseline GCS and tHcy measurements were included in the final analysis. Results: The mean (SD) of age, tHcy, and GCS levels were 61.5 (11.3) years, 17.0 (10.3) μmol/L, and 13.9 (2.2), respectively. Compared with participants with severe damage (GCS <9), those with mild damage (GCS ≥13) had significantly lower transformed tHcy levels (β = –2.46; 95% CI –4.80 to –0.12). Consistently, a significantly lower transformed tHcy levels were found in participants with mild damage (GCS ≥13; β = –1.37; 95% CI –2.66 to –0.08) compared with those with moderate to severe damage (GCS <13). In the stratified analysis, a stronger inverse association between GCS categories (≥13 vs. <13) and tHcy concentrations was observed in ever smokers (vs. never; p for interaction = 0.045), and in participants with systolic blood pressure (SBP) ≥160 mm Hg (vs. <160 mm Hg; p for interaction = 0.031), or total cholesterol (TC) ≥5.2 mmol/L (vs. <5.2 mmol/L; p for interaction = 0.025). Conclusion: There was an inverse association between GCS level and tHcy concentration among patients with hemorrhagic stroke, especially in ever smokers or in participants with higher SBP or TC levels.

scholarly journals Increased Blood Retinol Levels Are Associated With a Reduced Risk of TIA or Stroke in an Adult Population: Lifestyle Factors- and CVDs-Stratified Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Linjuan Guo ◽  
Ying Huang ◽  
Rong Wan ◽  
Yang Shen ◽  
Kui Hong
Keyword(s):  
Adult Population ◽  
The United States ◽  
Lifestyle Factors ◽  
Inverse Association ◽  
Cross Sectional ◽  
Chronic Respiratory Diseases ◽  
Age Related ◽  
Multivariable Analyses ◽  
Ischemic Attack ◽  
Stratified Analysis

Background: Data on the existing evidence for the association between blood retinol and transient ischemic attack (TIA)/stroke risk are limited, and the results are inconclusive. This study aimed to further assess the associations between the blood retinol levels and the risk of TIA/stroke after controlling the lifestyle factors and age-related confounders.Methods: The cross-sectional data from 1,113 individuals (aged 34–84 years old) were obtained from the Midlife in the United States (MIDUS) study. The multivariable analyses were performed to investigate the association of blood retinol levels with ever and currently TIA/stroke.Results: There was an inverse association between the blood retinol levels and the risk of ever TIA or stroke (for per 1 μmol/L adjusted odds ration [OR]: 0.93; 95% CI: 0.89–0.97; for per 1-SD adjusted OR: 0.89; 95% CI: 0.83–0.96) and currently diagnosed TIA or stroke (for per 1 μmol/L adjusted OR: 0.91; 95% CI: 0.87–0.96; for per 1-SD adjusted OR: 0.84; 95% CI: 0.80–0.91) after controlling the lifestyle factors and age-related confounders. The significance of these associations was maintained after a sensitivity analysis and involving “ever chronic respiratory diseases” as a covariate. Moreover, the stratified analyses suggested that the inverse associations could be affected by overweight [body mass index (BMI) ≥ 28, kg/m2], hypertension, and diabetes.Conclusions: A significant inverse association between blood retinol and the risk of TIA or stroke was found. This inverse association did not change even after adjustment for many potential confounders. Moreover, the potential protective effect of retinol on TIA/stroke could be blunted by overweight [BMI ≥ 28, kg/m2], hypertension, and diabetes.

scholarly journals DIAGNOSTICS OF PHARYNX MYCOSIS

2018 ◽  
Vol 3 (1) ◽  
pp. 22-25
Author(s):  
V P Reshetnikova ◽  
L A Baryshevskaya ◽  
O V Zeleva ◽  
M N Popov
Keyword(s):  
Medical Practice ◽  
Upper Airway ◽  
Cost Effective ◽  
Blood Film ◽  
Laboratory Diagnostics ◽  
Complex Method ◽  
Thick Blood Film ◽  
The One ◽  
Opportunistic Pathogenic ◽  
Staphylococcus Spp

Aim - to characterize different methods for diagnosis of mycotic lesions of the pharynx used in medical practice. Materials and methods. This article describes various methods of laboratory diagnostics of tonsillopharyngeal mycosis and their indications; and presents the analysis of 117 adult cases of tonsillopharyngeal mycosis confirmed by the analysis of thick blood film after the incubation in thermoregulator combined with blood agar inoculation. In addition, this method includes a microflora test which in most chronical cases accompanies pharyngeal mycosis. Results. The study revealed relevant advantages of the presented methods of pharynx mycosis diagnostics, which not only detect the presence of mycelium and its morphology, but also evaluate its role in the inflammatory process. In addition, this method includes bacterial culture test that in most chronical cases accompanies pharynx mycosis. Out of 100% only 17.9% of observations (21 patients) showed Candida fungus in parasitic phase as mono-infection, the other 82.1% of cases proved bacterial presence. The most frequent combination was Candida and Streptococcus spp (including pneumococcus) that made up 41.9% of total observations. In 10.3% of cases Staphylococcus spp was detected. Other patients had more than two kinds of microorganisms. The following combinations were revealed: fungi, streptococci and staphylococci in 17.9% cases; fungi and streptococci with Klebsiella and\or Moraxella catarrhalis or other opportunistic pathogenic microflora in 12% cases. Conclusions. The most effective method of research of upper airway mycosis is the one that enables to reveal Candida fungi presence and concentration as well as to identify their status (saprophitic or parasitic) in the patient's body using thick blood microscopy. The value of this method increases with simultaneous evaluation of associated microflora and its relation to macroorganism. Being simple, cost-effective and highly informative, complex method of diagnostics of upper airway mycosis can be widely used in medical practice.

scholarly journals Lower Plasma Magnesium, Measured by Nuclear Magnetic Resonance Spectroscopy, is Associated with Increased Risk of Developing Type 2 Diabetes Mellitus in Women: Results from a Dutch Prospective Cohort Study

2019 ◽  
Vol 8 (2) ◽  
pp. 169 ◽  
Author(s):  
Joëlle C. Schutten ◽  
António W. Gomes-Neto ◽  
Gerjan Navis ◽  
Ron T. Gansevoort ◽  
Robin P.F. Dullaart ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Nuclear Magnetic Resonance ◽  
Type 2 Diabetes Mellitus ◽  
Magnetic Resonance ◽  
Inverse Association ◽  
Increased Risk ◽  
Study Results ◽  
Nuclear Magnetic

Background: Low circulating magnesium (Mg) is associated with an increased risk of developing type 2 diabetes mellitus (T2DM). We aimed to study the performance of a nuclear magnetic resonance (NMR)-based assay that quantifies ionized Mg in EDTA plasma samples and prospectively investigate the association of Mg with the risk of T2DM. Methods: The analytic performance of an NMR-based assay for measuring plasma Mg was evaluated. We studied 5747 subjects free of T2DM at baseline in the Prevention of Renal and Vascular End-stage Disease (PREVEND) study. Results: Passing–Bablok regression analysis, comparing NMR-measured ionized Mg with total Mg measured by the Roche colorimetric assay, produced a correlation of r = 0.90, with a slope of 1.08 (95% CI: 1.00–1.13) and an intercept of 0.02 (95% CI: −0.02–0.08). During a median follow-up period of 11.2 (IQR: 7.7–12.0) years, 289 (5.0%) participants developed T2DM. The association of NMR-measured ionized Mg with T2DM risk was modified by sex (Pinteraction = 0.007). In women, we found an inverse association between Mg and the risk of developing T2DM, independent of adjustment for potential confounders (HR: 1.80; 95% CI: 1.20–2.70). In men, we found no association between Mg and the risk of developing T2DM (HR: 0.90; 95%: 0.67–1.21). Conclusion: Lower NMR-measured plasma ionized Mg was independently associated with a higher risk of developing T2DM in women, but not in men.

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