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91.
Gender differences in clinical progression of HIV-1-infected individuals during long-term highly active antiretroviral therapy 总被引:3,自引:0,他引:3
Nicastri E Angeletti C Palmisano L Sarmati L Chiesi A Geraci A Andreoni M Vella S;Italian Antiretroviral Treatment Group 《AIDS (London, England)》2005,19(6):577-583
OBJECTIVE: To assess gender differences in the long-term clinical, virological and immunological outcomes during highly active antiretroviral therapy (HAART). METHODS: This longitudinal observational multicentre study followed 2460 HIV-infected patients who had begun a protease inhibitor-based regimen for a median period of 43 months. Outcome measures were virological suppression (< 500 copies/ml), confirmed virological rebound after suppression, and death or new AIDS-defining illness (ADI). RESULTS: At baseline, 690 female patients (28.0%) had significantly lower age, higher prevalence of heterosexual contact and lower prevalence of intravenous drug use as risk factors for HIV infection compared with males. Furthermore, females had a lower number of AIDS-defining illnesses, higher CD4 cell counts and lower viral loads.No gender differences were reported in terms of proportion of patients achieving viral suppression or exhibiting rebound after achieving viral suppression. Female patients experienced reduced clinical progression during follow-up compared with males (P = 0.008) by Kaplan-Meier analysis; however this difference was not significant in an adjusted analysis. In a multivariate model, the interaction between gender and risk factor for HIV or viral load showed that female drug users and female patients with a baseline HIV RNA viral load of 10(4)-10(5) copies/ml had a favourable clinical outcome compared with males (P = 0.035 and P = 0.015, respectively). CONCLUSION: No differences were found between genders in terms of virological and immunological outcomes during long-term HAART. Nevertheless, a lower risk of clinical progression was reported among female patients with intermediate baseline viral load than in males. 相似文献
92.
Manuel Zorzi Nicola Gennaro Giulia Capodaglio Emanuele Damiano Luca Urso Salvatore Pucciarelli Laura Memo Eva Carpin Mariachiara Corti Massimo Rugge Ugo Fedeli 《Digestive and liver disease》2019,51(2):304-309
Background
Growing evidence suggests that colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) reduces CRC incidence and surgical resection rates.Aims
To compare trends in surgery for proximal and distal CRC among Italian regions at different stages of screening implementation.Methods
From the National Hospital Discharge Database we selected hospitalizations with CRC resection of residents aged 50–74 years during 2002–2014, and computed surgery rates for the 8 most populous Italian regions with/without a screening program.Results
In regions with screening, implemented around 2006–2007, the annual percent change (APC) of distal CRC resection was +1.7 (95% confidence interval ?1.0, 4.4) during 2002–2007 and ?9.1 (?10.6, ?7.7) during 2007–2014. No significant change was observed in regions without screening. The APC for proximal colon resection in regions with screening was +5.8 (2.5, 9.0) during 2002–2007 and ?4.1 (?5.8, ?2.4) during 2007–2014, while in regions without screening surgical rates increased through the whole study period. Compared to 2002, in 2014 distal CRC resection rates were greatly reduced in regions with screening, reaching values similar to proximal CRC resection.Conclusion
Following the implementation of screening programs surgery rates steeply decreased, confirming the deep impact of FIT-based screening on the burden of CRC. 相似文献93.
Giavoli C Libé R Corbetta S Ferrante E Lania A Arosio M Spada A Beck-Peccoz P 《The Journal of clinical endocrinology and metabolism》2004,89(11):5397-5401
The aim of the study was to evaluate the hypothalamus-pituitary-adrenal (HPA) axis in patients (nine males, three females; mean age +/- sem 51 +/- 2 yr) with adult-onset GH deficiency (GHD) due to surgically treated pituitary tumors with preserved HPA function and without evidence of tumor recurrence before and during recombinant human (rh) GH replacement therapy (duration 31 +/- 6 months). HPA function was assessed by urinary free cortisol and morning serum cortisol levels as well as cortisol responses to 1 mug ACTH test (n = 7 patients) or insulin tolerance test (n = 5 patients) before and during rhGH therapy, the cut-off for the diagnosis of hypoadrenalism being a cortisol peak less than 18 microg/dl (<500 nmol/liter) after stimulatory tests. Serum cortisol and urinary free cortisol levels were significantly lower on therapy than before [7.6 +/- 0.8 vs. 11.5 +/- 0.9 microg/dl (208 +/- 22 vs. 317 +/- 24 nmol/liter), P < 0.01, and 19.6 +/- 2.5 vs. 32.2 +/- 3.2 microg per 24 h (54 +/- 7 vs. 89 +/- 9 nmol per 24 h), P < 0.05, respectively], whereas no change in cortisol-binding globulin levels was observed. Cortisol peak after either ACTH test or insulin tolerance test was lower on rhGH therapy than before [15.9 +/- 1.5 vs. 20.2 +/- 1.1 microg/dl (437 +/- 43 vs. 557 +/- 31), P = 0.01, and 13.1 +/- 2.6 vs. 20.4 +/- 1.4 microg/dl (362 +/- 71 vs. 564 +/- 37 nmol/liter), P = 0.03, respectively]. Accordingly, central hypoadrenalism was detected in nine of 11 patients. In conclusion, low GH and IGF-I levels, likely enhancing the conversion of cortisone to cortisol, may mask a condition of central hypoadrenalism. Therefore, the reassessment of HPA function in GHD patients during rhGH therapy is mandatory. 相似文献
94.
Leonardo Frazzoni Franco Radaelli Cristiano Spada Alessandro Mussetto Marzio Frazzoni Liboria Laterza Emanuele Rondonotti Marina La Marca Rocco Maurizio Zagari Stefania Piccirelli Franco Bazzoli Carlo Fabbri Mauro Manno Giovanni Aragona Gianpiero Manes Pietro Occhipinti Sergio Cadoni Cesare Hassan Lorenzo Fuccio 《Digestive and liver disease》2021,53(2):224-230
BackgroundColonoscopy demands a considerable amount of resources, and little is known about its diagnostic yield among inpatients.AimsTo assess indications, diagnostic yield and findings of colonoscopy for inpatients, and to identify risk factors for relevant findings and cancer.MethodsMulticentre, prospective, observational study including 12 hospitals. Consecutive adult inpatients undergoing colonoscopy were evaluated from February through November 2019.Results1,302 inpatients underwent colonoscopy. Diagnostic yield for relevant findings and cancer was 586 (45%) and 112 (8.6%), respectively. Adequate colon cleansing was achieved in 896 (68.8%) patients. Split-dose/same-day regimen was adopted in 847 (65%) patients. Factors associated to relevant findings were age ≥70 years (RR 1.32), male gender (RR 1.11), blood loss (RR 1.22) and adequate cleansing (RR 1.63). Age ≥70 years (RR 2.08), no previous colonoscopy (RR 2.69) and split-dose/same-day regimen (RR 1.59) significantly increased cancer detection. Implementing adequate cleansing and split-dose/same-day regimen in all patients would increase the diagnostic yield for any relevant findings and cancer from 43% to 70% and from 6% to 10%, respectively.ConclusionRelevant colorectal diseases and cancer were frequent among inpatients. Factors associated with detection of relevant findings were identified. Adequate colon cleansing and split-dose/same-day regimen significantly increased colonoscopy diagnostic yield. 相似文献
95.
The major drug of abuse among teenagers in the United States continues to be ethanol (EtOH), but use is seen in children as
young as nine. In the studies reported here, the impact of EtOH on biologic and hormonal parameters of puberty was assessed
in female rats. Rats were fed a liquid diet containing EtOH, pair fed an identical liquid diet containing dextrimaltose instead
of EtOH, or fed a liquid diet not containing EtOH ad libitum. Feeding was started at 21, 25, or 28 d of age. EtOH markedly
delayed the age at vaginal opening (34.5±0.5 d in controls vs 48.5±2.4 d in EtOH animals; p<0.001), delayed the age at first estrous (40.9±0.6 d in controls vs 61.2±2.6 d in EtOH animals; p<0.001), increased the length of the estrous cycle, and decreased the number of proestrous days. EtOH, concomitant with reduced
ovarian and uterine weight, decreased serum estradiol and progesterone. Associated with these changes in ovarian hormones
there was a selective increase in follicle-stimulating hormone, but not luteinizing hormone. EtOH consistently reduced insulin-like
growth factor-1. In general, EtOH-induced disruption was more severe the younger the animals were at the start of feeding.
Opiate receptor blockade with naltrexone completely prevented the EtOH-induced delay in vaginal opening. The impact of EtOH
on female puberty is dramatic, is an emerging public health problem, and deserves more study. 相似文献
96.
97.
Giuseppe Stabile Antoine Lepillier Ermenegildo De Ruvo Marco Scaglione Matteo Anselmino Frederic Sebag Domenico Pecora Mark Gallagher Mariano Rillo Graziana Viola Luca Rossi Valerio De Santis Maurizio Landolina Antonello Castro Massimo Grimaldi Nicolas Badenco Maurizio Del Greco Antonio De Simone Ennio Pisan Salim Abbey Filippo Lamberti Antonio Pani Giulio Zucchelli Giuseppe Sgarito Daniela Dugo Emanuele Bertaglia Teresa Strisciuglio Francesco Solimene 《Journal of cardiovascular electrophysiology》2020,31(7):1694-1701
98.
Bonomo Giulio Bertani Giulio A. Carrabba Giorgio G. Ferrante Emanuele Pluderi Mauro Guastella Claudio Pignataro Lorenzo Rampini Paolo Mantovani Giovanna Locatelli Marco 《Pituitary》2020,23(5):552-557
Pituitary - The aim of the present study is to assess the predictive value of the suprasellar volume (SSV) of nonfunctioning pituitary adenomas (NFPAs) for visual field (VF) impairment in order to... 相似文献
99.