Age-difference

年龄差异
  • 文章类型: Journal Article
    根据初始诊断年龄,心脏结节病(CS)患者的临床特征和心血管事件的风险尚不清楚。
    本研究是对ILLUMINATE-CS注册表的子分析,这是一个回顾,2001年至2017年间纳入CS患者的多中心登记。根据初次诊断CS时的年龄将患者分为三组。该研究比较了CS诊断时的临床背景和不同年龄段的心脏事件发生率。
    本研究共分析了511名患者。在基线中,老年患者更可能是女性。高血压病史,心力衰竭入院,房室传导阻滞在年龄较大的患者中更为常见。所有年龄组的室性心律失常病史和左心室射血分数无明显差异。在3.2[IQR:1.7-4.2]年的中位随访期内,35人死亡,56例心力衰竭住院,观察到98例致命的室性心律失常。老年患者全因死亡和心力衰竭住院发生率明显增高(p<0.001),而室性心律失常的发生率在各年龄组间无显著差异(p=0.74)。
    在CS患者中,与其他年龄组相比,老年患者全因死亡和心力衰竭住院的风险更高;然而,所有年龄组的室性心律失常风险相当.
    UNASSIGNED: Clinical characteristics and the risk of cardiovascular events in patients with cardiac sarcoidosis (CS) according to the age of initial diagnosis are unclear.
    UNASSIGNED: This study is a sub-analysis of the ILLUMINATE-CS registry, which is a retrospective, multicenter registry that enrolled patients with CS between 2001 and 2017. Patients were divided into three groups according to the tertile of age at the time of initial diagnosis of CS. The study compared the clinical background at the time of CS diagnosis and the incidence rate of cardiac events across age categories.
    UNASSIGNED: A total of 511 patients were analyzed in this study. In baseline, older patients were more likely to be female. History of hypertension, heart failure admission, and atrioventricular block were more common in patients with older age. There was no significant difference in the history of ventricular arrhythmias and left ventricular ejection fraction among all age groups. During a median follow-up period of 3.2 [IQR: 1.7-4.2] years, 35 deaths, 56 heart failure hospitalization, and 98 fatal ventricular arrhythmias was observed. The incidence rate of all-cause death and heart failure hospitalization was significantly higher in patients with older age (p < 0.001), while there was no significant difference in the incidence rate of ventricular arrhythmia among age groups (p = 0.74).
    UNASSIGNED: In patients with CS, the risk of all-cause death and heart failure hospitalization was higher in older patients compared with other age groups; however, the risk of ventricular arrhythmia was comparable across all age groups.
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  • 文章类型: Journal Article
    背景:脓毒症是对感染的压倒性反应,伴随着高发病率和死亡率。它需要紧急干预,以改善结果。静脉免疫球蛋白(IVIG)被认为是脓毒症患者的潜在治疗方法。由于人群特征的变异性,IVIG作为脓毒症辅助治疗的试验结果相互矛盾。不同研究中的国家地理和药物剂型。
    方法:对截至1月发表的合格研究进行了系统的文章搜索,2023年31日,通过PubMed,Embase,Cochrane图书馆和中国国家知识基础设施数据库。纳入的文章采用严格的纳入和排除标准进行筛选。根据不同的IVIG类型进行亚组分析,年龄和经济区域。所有分析均使用ReviewManager5.4进行。评估研究质量和偏倚风险。
    结果:总计,纳入了31项随机对照试验,样本量为6,276名参与者。IVIG可以降低死亡率(RR0.86,95%CI:0.77-0.95,p=0.005),住院时间(MD-4.46,95%CI:-6.35至-2.57,p=0.00001),和APACHEII评分(MD-1.65,95%CI:-2.89至-0.63,p=0.001)。此外,结果表明,富含IgM的IVIG可有效治疗脓毒症(RR0.55,95%CI:0.40-0.76;p=0.0003),而标准IVIG无效(RR0.91,95%CI:0.81-1.02,p=0.10)。IVIG降低新生儿死亡率的效果尚无定论(RR0.93,95%CI:0.81-1.05,p=0.24),但它在降低成人脓毒症死亡率方面发挥了重要作用(RR0.70,95%CI:0.57-0.86,p=0.0006).此外,来自不同经济区域的分组,它表明IVIG对高收入国家(RR0.89,95%CI:0.79-0.99,p=0.03)和中等收入国家(RR0.49,95%CI:0.28-0.84,p=0.01)的败血症有效,而低收入国家则无获益(RR0.56,95%CI:0.27-1.14,p=0.11).
    结论:有足够的证据支持IVIG降低脓毒症死亡率。富含IgM的IVIG对成人和新生儿败血症均有效,而标准IVIG仅对成人败血症有效。IVIG治疗脓毒症在高收入和中等收入国家已经显示出疗效,但在低收入国家仍有争议。未来需要更多的随机对照试验来确认在低收入国家IVIG治疗脓毒症的真正临床潜力。
    Sepsis is an overwhelming reaction to infection that comes with high morbidity and mortality. It requires urgent interventions in order to improve outcomes. Intravenous immunoglobulins (IVIG) are considered as potential therapy in sepsis patients. Results of trials on IVIG as adjunctive therapy for sepsis have been conflicting due to the variability in population characteristics, country geography and drug dosage form in different studies.
    A systematic article search was performed for eligible studies published up to January, 31, 2023, through the PubMed, Embase, Cochrane Library and Chinese National Knowledge Infrastructure database. The included articles were screened by using rigorous inclusion and exclusion criteria. Subgroup analyses were conducted according to different IVIG types, ages and economic regions. All analyses were conducted using Review Manager 5.4. Quality of studies and risk of bias were evaluated.
    In total, 31 randomized controlled trials were included with a sample size of 6,276 participants. IVIG could reduce the mortality (RR 0.86, 95% CI: 0.77-0.95, p = 0.005), the hospital stay (MD - 4.46, 95% CI: - 6.35 to - 2.57, p = 0.00001), and the APACHE II scores (MD - 1.65, 95% CI: - 2.89 to - 0.63, p = 0.001). Additionally, the results showed that IgM-enriched IVIG was effective in treating sepsis (RR 0.55, 95% CI: 0.40 - 0.76; p = 0.0003), while standard IVIG failed to be effective (RR 0.91, 95% CI: 0.81-1.02, p = 0.10). And the effect of IVIG in reducing neonatal mortality was inconclusive (RR 0.93, 95% CI: 0.81-1.05, p = 0.24), but it played a large role in reducing sepsis mortality in adults (RR 0.70, 95% CI: 0.57-0.86, p = 0.0006). Besides, from the subgroup of different economic regions, it indicated that IVIG was effective for sepsis in high-income (RR 0.89, 95% CI: 0.79-0.99, p = 0.03) and middle-income countries (RR 0.49, 95% CI: 0.28-0.84, p = 0.01), while no benefit was demonstrated in low-income countries (RR 0.56, 95% CI: 0.27-1.14, p = 0.11).
    There is sufficient evidence to support that IVIG reduces sepsis mortality. IgM-enriched IVIG is effective in both adult and neonatal sepsis, while standard IVIG is only effective in adult sepsis. IVIG for sepsis has shown efficacy in high- and middle-income countries, but is still debatable in low-income countries. More RCTs are needed in the future to confirm the true clinical potential of IVIG for sepsis in low-income countries.
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  • 文章类型: Journal Article
    This study investigated the effect of maternal care on adolescent ethanol consumption, sensitivity to ethanol-induced hypnosis, as well as gonadal hormones and γ-aminobutyric acid type-A (GABAA ) systems. Long Evans rat dams were categorized by maternal licking/grooming (LG) frequency into High- and Low-LG mothers. Both female and male offspring from Low-LG rats demonstrated a greater sensitivity to ethanol-induced hypnosis in the loss-of-righting-reflex test at ethanol doses of 3.0 and 3.5 g/kg during late-adolescence (postnatal Day 50) but not at mid-adolescence (postnatal Day 42). However, we found no effect of maternal care on consumption of a 5% ethanol solution in a two-bottle choice test. We further investigated the association between the observed variations in sensitivity to ethanol-induced hypnosis and baseline hormonal levels in males. In male offspring from Low-LG mothers compared to High-LG mothers, baseline plasma corticosterone and progesterone levels were higher. GABAA α1 and δ subunit expressions were also higher in the cerebral cortex of Low-LG males but lower in the cerebellar synaptosomal fraction. Early environmental influences on adolescent sensitivity to ethanol-induced hypnosis, consumption, and preference may be mediated by gonadal hormones and possibly through GABAergic functions.
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  • 文章类型: Journal Article
    背景:异性恋夫妇中的年龄差异(Adiff)可能会影响女性HPV阳性和患宫颈癌(CC)的风险。
    方法:我们在IARC多中心病例对照研究(中位年龄:48岁)的6个国家的1495例和1358例对照妇女中,评估了首次和当前性伴侣关系中的Adiff与CC和HPV感染风险之间的关系。
    结果:第一个伙伴关系中的大阿迪夫与CC风险增加相关(OR≥3vs.≤2年=1.49,CI:1.26-1.75);纠正第一次性交年龄后,这种关联消失了(OR=1.03,0.86-1.24)。当前伙伴关系中的Adiff与HPV阳性之间的关系相反(OR≥3与≤2年=0.59,0.41-0.86),并且不受对性混淆的调整的影响。Adiff对CC风险和HPV阳性的影响在不同年龄组和国家是一致的。
    结论:首次性伴侣关系中CC风险与大Adiff之间的关联主要由首次性交时的年龄小来解释。相反,当前伴侣关系中的Adiff与HPV阳性之间的负相关性可能与男性伴侣的传染性随年龄而降低有关.对性伴侣关系中Adiff的研究有助于阐明不同人群中的HPV循环。
    BACKGROUND: Age difference (Adiff) within a heterosexual couple may influence a woman\'s risk of being HPV-positive and developing cervical cancer (CC).
    METHODS: We assessed the relationship between Adiff within the first and current sexual partnership and risk of CC and HPV infection in 1495 cases and 1358 control women from 6 countries included in IARC\'s multicentric case-control study (median age: 48 years).
    RESULTS: Large Adiff within the first partnerships was associated with increased CC risk (OR≥3 vs. ≤2 years=1.49, CI: 1.26-1.75); this association disappeared after correction for age at first sexual intercourse (OR=1.03, 0.86-1.24). The relationship between Adiff within the current partnership and HPV-positivity was opposite (OR≥3 vs. ≤2 years=0.59, 0.41-0.86) and not affected by adjustment for sexual confounding. The influences of Adiff on CC risk and HPV-positivity were consistent across age groups and countries.
    CONCLUSIONS: The association between CC risk and large Adiff in the first sexual partnership is mostly explained by young age at first intercourse. Conversely, the negative association between Adiff in current partnership and HPV-positivity is probably related to decreased infectiousness of the male partner with age. The study of Adiff in sexual partnerships helps elucidate HPV circulation in different populations.
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