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11.
PB Shetty H Tang BO Tayo AC Morrison CL Hanis DC Rao JH Young ER Fox E Boerwinkle RS Cooper NJ Risch X Zhu;the Candidate Gene Association Resource 《Journal of hypertension》2012,30(10):1970-1976
OBJECTIVE:: Genetic variants in 296 genes in regions identified through admixture mapping of hypertension, BMI, and lipids were assessed for association with hypertension, blood pressure (BP), BMI, and high-density lipoprotein cholesterol (HDL-C). METHODS:: This study identified coding SNPs identified from HapMap2 data that were located in genes on chromosomes 5, 6, 8, and 21, wherein ancestry association evidence for hypertension, BMI, or HDL-C was identified in previous admixture mapping studies. Genotyping was performed in 1733 unrelated African-Americans from the National Heart, Lung and Blood Institute's Family Blood Pressure Project, and gene-based association analyses were conducted for hypertension, SBP, DBP, BMI, and HDL-C. A gene score based on the number of minor alleles of each SNP in a gene was created and used for gene-based regression analyses, adjusting for age, age, sex, local marker ancestry, and BMI, as applicable. An individual's African ancestry estimated from 2507 ancestry-informative markers was also adjusted for to eliminate any confounding due to population stratification. RESULTS:: CXADR (rs437470) on chromosome 21 was associated with SBP and DBP with or without adjusting for local ancestry (P?0.0006). F2RL1 (rs631465) on chromosome 5 was associated with BMI (P?=?0.0005). Local ancestry in these regions was associated with the respective traits as well. CONCLUSION:: This study suggests that CXADR and F2RL1 likely play important roles in BP and obesity variation, respectively; and these findings are consistent with those of other studies, so replication and functional analyses are necessary. 相似文献
12.
Hong Chee Chew Arjun Iyer Mark Connellan Sarah Scheuer Jeanette Villanueva Ling Gao Mark Hicks Michelle Harkness Claudio Soto Andrew Dinale Priya Nair Alasdair Watson Emily Granger Paul Jansz Kavitha Muthiah Andrew Jabbour Eugene Kotlyar Anne Keogh Kumud Dhital 《Journal of the American College of Cardiology》2019,73(12):1447-1459
Background
Transplantation of hearts retrieved from donation after circulatory death (DCD) donors is an evolving clinical practice.Objectives
The purpose of this study is to provide an update on the authors’ Australian clinical program and discuss lessons learned since performing the world’s first series of distantly procured DCD heart transplants.Methods
The authors report their experience of 23 DCD heart transplants from 45 DCD donor referrals since 2014. Donor details were collected using electronic donor records (Donate Life, Australia) and all recipient details were collected from clinical notes and electronic databases at St. Vincent’s Hospital.Results
Hearts were retrieved from 33 of 45 DCD donors. A total of 12 donors did not progress to circulatory arrest within the pre-specified timeframe. Eight hearts failed to meet viability criteria during normothermic machine perfusion, and 2 hearts were declined due to machine malfunction. A total of 23 hearts were transplanted between July 2014 and April 2018. All recipients had successful implantation, with mechanical circulatory support utilized in 9 cases. One case requiring extracorporeal membrane oxygenation subsequently died on the sixth post-operative day, representing a mortality of 4.4% over 4 years with a total follow-up period of 15,500 days for the entire cohort. All surviving recipients had normal cardiac function on echocardiogram and no evidence of acute rejection on discharge. All surviving patients remain in New York Heart Association functional class I with normal biventricular function.Conclusions
DCD heart transplant outcomes are excellent. Despite a higher requirement for mechanical circulatory support for delayed graft function, primarily in recipients with ventricular assist device support, overall survival and rejection episodes are comparable to outcomes from contemporary brain-dead donors. 相似文献13.
Preston L. Visser Priya Loess Elizabeth L. Jeglic Jameson K. Hirsch 《Stress and health》2013,29(1):82-88
Depression is a significant public health problem for young adults of college age, and negative life events exacerbate risk. Not all individuals who experience negative life events, however, report depressive symptoms, perhaps owing to protective characteristics. We examined one such characteristic, trait hope, a goal‐oriented construct, as a potential moderator of the association between negative life events and depressive symptoms in an ethnically diverse sample of 386 college students. In support of our hypotheses, negative life events were significantly associated with greater levels of depressive symptoms, and higher levels of hope attenuated this relationship, such that those with greater hope reported fewer depressive symptoms related to potentially traumatic events. The moderating effect of hope did not differ across ethnic groups. Our findings have implications for managing the sequelae of negative life events, including depression. Cognitive–behavioural interventions tailored to help young adults identify and attain important life goals might help to overcome psychopathology associated with life stress. Copyright © 2012 John Wiley & Sons, Ltd. 相似文献
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Priya Palta G. Page R. L. Piferi J. M. Gill M. J. Hayat A. B. Connolly S. L. Szanton 《Journal of urban health》2012,89(2):308-316
Hypertension affects a large proportion of urban African-American older adults. While there have been great strides in drug
development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction
(MBSR) has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American
older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based
program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based
program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years
old and residents of a low-income senior residence. All participants were African-American, and one was male. Twenty participants
were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood
pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention.
A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood
pressure measurements, controlling for age, education, smoking status, and anti-hypertensive medication use. Effect sizes
were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention
and the outcome variable, blood pressure. Attendance remained >80% in all 8 weeks of both the intervention and the control
groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group
exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this
value was statistically significant (p = 0.020). The average diastolic blood pressure decreased in the intervention group post-intervention, but increased in the
social support group. Individuals in the intervention group exhibited a 16.70-mmHg lower diastolic blood pressure compared
to the social support group post-intervention, and this value was statistically significant (p = 0.003). Older adults are at a time in life when a reflective, stationary intervention, delivered in residence, could be
an appealing mechanism to improve blood pressure. Given our preliminary results, larger trials in this hypertensive study
population are warranted. 相似文献
18.
Duggal P Haque R Roy S Mondal D Sack RB Farr BM Beaty TH Petri WA 《The Journal of infectious diseases》2004,189(3):520-526
BACKGROUND: The association of antibody responses with both innate and acquired immunity to amebiasis indicate that CD4+ T cells play a role in protection against Entamoeba histolytica infection. To test this hypothesis, we compared the genotype frequencies of human leukocyte antigen (HLA) class II alleles in a cohort of Bangladeshi children intensively monitored for E. histolytica infection for a 3-year period. METHODS: Using logistic regression, we calculated the odds of disease by genotype and by haplotype. RESULTS: The DQB1*0601 heterozygous and homozygous genotypes were found in 55% of E. histolytica-negative children but in only 34% of E. histolytica-positive children (overall odds ratio, 2.39; 95% confidence interval [CI], 1.26-4.54). Children who were heterozygous for the DQB1*0601/DRB1*1501 haplotype were 10.1 times (95% CI, 2.02-50.6) more likely to be both E. histolytica negative and serum anti-lectin immunoglobulin G negative at baseline. Other DQB1 and DRB1 alleles (DQB1*0202, DQB1*0301, and DRB1*0701) were not associated with any of the clinical outcomes related to amebiasis. CONCLUSION: A potential protective association was observed with the HLA class II allele DQB1*0601 and the heterozygous haplotype DQB1*0601/DRB1*1501. This association may explain why amebiasis does not occur in some children who are exposed to the parasite and implicates HLA class II-restricted immune responses in protection against E. histolytica infection. 相似文献
19.
Lindsey M. Philpot Priya Ramar Muhamad Y. Elrashidi Tiffany A. Sinclair Jon O. Ebbert 《Mayo Clinic proceedings. Mayo Clinic》2018,93(10):1431-1439
Objective
To evaluate the impact of opioid controlled substance agreements (CSAs) enrollment on health care utilization.Patients and Methods
We retrospectively evaluated health care utilization changes among 772 patients receiving long-term opioid therapy for chronic noncancer pain enrolled in a CSA between July 1, 2015, and December 31, 2015. We ascertained patient characteristics and utilization 12 months before and after CSA enrollment. Decreased utilization was defined as a decrease of 1 or more hospitalizations or emergency department visits and 3 or more outpatient primary and specialty care visits. Multivariate modeling assessed demographic characteristics associated with utilization changes.Results
The 772 patients enrolled in an opioid CSA during the study period had a mean ± SD age of 63.5±14.9 years and were predominantly female, white, and married. The CSA enrollment was associated with decreased outpatient primary care visits (odds ratio [OR], 0.16; 95% CI, 0.14-0.19) and increased diagnostic radiology services (OR, 1.22; 95% CI, 1.02-1.47). After CSA enrollment, patients with greater comorbidity (Charlson Comorbidity Index score >3) were more likely to have reduced hospitalizations (adjusted OR, 2.8; 95% CI, 1.3-6.0; P=.008), reduced outpatient primary care visits (adjusted OR, 2.0; 95% CI, 1.2-3.2; P=.005), and reduced specialty care visits (adjusted OR, 2.0; 95% CI, 1.2-3.3; P=.006).Conclusion
For patients receiving long-term opioid therapy for chronic noncancer pain, CSA enrollment is associated with reductions in primary care visits and increased radiologic service utilization. Patients with greater comorbidity were more likely to have reductions in hospitalizations, outpatient primary care visits, and outpatient specialty clinic visits after CSA enrollment. The observational nature of the study does not allow the conclusion that CSA implementation is the primary reason for these observed changes. 相似文献20.