CMV plasma DNAemia and risk of cancer among HIV-infected patients: A case–control study nested in the ANRS CO3 Aquitaine Cohort,France, 2002–2007

BackgroundCMV reactivation, which enhances immune senescence, could be associated with a higher risk of cancer.ObjectivesWe compared the prevalence of positive CMV DNAemia in HIV-infected patients with and without cancer.Study designThis case–control study, nested in the ANRS-CO3 Aquitaine Cohort, included patients with a first diagnosis of cancer (2002–2007) as cases. Two controls were matched per case.Cancer risk was estimated using conditional logistic regression models, an Odds Ratio (OR) of 2 could be detected with 80% power. The variables considered were: ≥1 positive CMV DNAemia, CD4+ and CD8+ counts, HIV plasma load. Plasma CMV DNA was retrospectively quantified within the 3-year period preceding the endpoint.ResultsThe 143 cases (93 non-AIDS-related and 50 AIDS-related cancers) and 284 controls had a median age of 47 years (IQR: 41–56). At the time of diagnosis or censorship, for cases and controls, median values were respectively, for CD4+ count: 327 cells/mm³ (IQR: 164–514) and 416 (IQR: 275–582), and for HIV plasma load: 2.6 log₁₀ copies/mL (IQR: 1.7–4.7) and 1.7 log₁₀ copies/mL (IQR: 1.7–3.3). We performed 2056 CMV PCR; 14 cases (9.8% [95% CI: 4.9–14.7]) and 19 controls (6.7% [CI: 3.8–9.6]) presented ≥1 positive PCR. CMV DNAemia was not associated with the risk of cancer (unadjusted and adjusted p-values = 0.19 and 0.54, respectively). HIV load >500 copies/mL was independently associated with a higher risk of cancer (OR = 2.02; p = 0.002; 95% CI: 1.29–3.17).ConclusionThis large case–control study did not show any differential exposure to positive CMV plasma DNAemia between cancer cases and controls.     

Number of children and change in markers of metabolic health over 9-years in men and women. Data from the DESIR study

Aim

Parity is associated with an increased risk of coronary heart disease and type 2 diabetes, possibly mediated by long-term modification of metabolic health. Studying associations between the number of children with health and disease in men in addition to women allows for differentiation between the social and lifestyle influences of child-rearing, and the biological influences of childbearing. We sought to determine whether the number of children is associated with the incidence of raised fasting glucose (fasting plasma glucose ≥ 6.1 mmol/L) and changes in glucose, insulin, insulin resistance and β-cell function over 9-years.

Methods

Analysis of 1798 women and 1737 men from the DESIR study.

Results

The number of children was associated with change in fasting glucose for women (P_trend = 0.02) and men (P_trend = 0.03), and increased incidence of raised fasting glucose by 30% (95% CI: 15, 47%) per child for men, but not women (3% [95% CI: −8, 15%]). There was a J-shaped association between number of children and change in insulin (P = 0.01) and insulin resistance (P = 0.005) for women, and a reduction in β-cell function in parous women (P = 0.07). Men with children had increases in insulin (P = 0.02), insulin resistance (P = 0.02), and β-cell function (P = 0.07).

Conclusions

The number of children a person has is associated with changes in metabolic health indices long after childbirth for both men and women. The distinct gender differences in deterioration of metabolic health indices emphasize that childbearing and child-rearing are likely to have differential influences on metabolic health.     

An update in the management of obesity: the weight of CNS targets

Obesity is one of the most important and disturbing global epidemic that affects humans, with more than 2 billion people overweight and 700 million obese predicted for 2015 by the World Health Organization. Obesity treatment represents then one of the most exciting challenges for the academic researchers and the pharmaceutical industry. But to date, this community failed to develop safe and effective treatments with a good risk/benefit profile. Indeed, most of the drugs previously used as anti-obesity agents have been withdrawn from the market for safety issues, and therapeutic options in form of a medication are currently very limited. This last decade however, new advances in our understanding of central pathways controlling food intake, body weight and energy homeostasis have led to the discovery of new molecular targets that could provide interesting options in the fight against obesity. This review aims to be an overview of the new patents exploiting the anorexigenic properties of the central catabolic pathways or aimed at blocking the orexigenic effects of the anabolic pathways, in the hope to develop new anti-obesity drugs.     

Biomechanical analysis of polypropylene prosthetic implants for hernia repair: an experimental study

Background

Although polypropylene (PP) is the most common biomaterial used for ventral and inguinal hernia repairs, its mechanical properties remain obscure.

Methods

Retraction, solidity, and elasticity of 3 large pore-size monofilament PP prostheses, 1 heavy-weight PP (HWPP), a second low-weight PP, and a third coated with atelocollagen were evaluated in a rabbit incisional hernia model. A small pore-size multifilament PP implant (MPP) also was tested.

Results

Unlike pore size, the weight of the prosthesis was not an influencing factor for retraction. Atelocollagen coating reduced retraction (P < .05). HWPP and MPP were less likely to rupture (P < .05). HWPP had comparatively better elasticity (P < .05), whereas MPP supported the greatest elastic force (P < .05). Nevertheless, the amount of shrinkage of MPP (30% of the original size) made this prosthesis unusable.

Conclusions

In this study, HWPP presented the most advantageous biomechanical compromise for hernia surgery.