Search

Objective. The aim of this study was to validate the classification criteria for cryoglobulinaemic vasculitis (CV).Methods. Twenty-three centres were involved. New patients with CV (group A) and controls, i.e. subjects with serum cryoglobulins but lacking CV based on the gold standard of clinical judgment (group B) and subjects without cryoglobulins but with clinical features that can be observed in the course of CV (group C), were studied. Positivity of serum cryoglobulins was necessary for CV classification. Sensitivity and specificity of the criteria were calculated by comparing group A vs group B. The group A vs group C comparison was done to demonstrate the possible diagnostic utility of the criteria.Results. The study included 268 patients in group A, 182 controls in group B and 193 controls in group C (small vessel vasculitis, 51.8%). The questionnaire (at least 2/3 positive answers) showed 89.0% sensitivity and 93.4% specificity; the clinical item (at least 3/4 clinical involvement) showed 75.7% sensitivity and 89.0% specificity and the laboratory item (at least 2/3 laboratory data) showed 80.2% sensitivity and 62.4% specificity. The sensitivity and specificity of the classification criteria (at least 2/3 positive items) were 89.9% and 93.5%, respectively. The comparison of group A with group C demonstrated the clinical utility of the criteria in differentiating CV from CV mimickers.Conclusion. Classification criteria for CV were validated in a second, large, international study confirming good sensitivity and specificity in a complex systemic disease. [ABSTRACT FROM PUBLISHER]

Background: Studies of the immunogenicity of the killed bivalent whole cell oral cholera vaccine, Shanchol, have been performed in historically cholera-endemic areas of Asia. There is a need to assess the immunogenicity of the vaccine in Haiti and other populations without historical exposure to Vibrio cholerae. Methodology/Principal Findings: We measured immune responses after administration of Shanchol, in 25 adults, 51 older children (6–17 years), and 47 younger children (1–5 years) in Haiti, where cholera was introduced in 2010. A≥4-fold increase in vibriocidal antibody titer against V. cholerae O1 Ogawa was observed in 91% of adults, 74% of older children, and 73% of younger children after two doses of Shanchol; similar responses were observed against the Inaba serotype. A≥2-fold increase in serum O-antigen specific polysaccharide IgA antibody levels against V. cholerae O1 Ogawa was observed in 59% of adults, 45% of older children, and 61% of younger children; similar responses were observed against the Inaba serotype. We compared immune responses in Haitian individuals with age- and blood group-matched individuals from Bangladesh, a historically cholera-endemic area. The geometric mean vibriocidal titers after the first dose of vaccine were lower in Haitian than in Bangladeshi vaccinees. However, the mean vibriocidal titers did not differ between the two groups after the second dose of the vaccine. Conclusions/Significance: A killed bivalent whole cell oral cholera vaccine, Shanchol, is highly immunogenic in Haitian adults and children. A two-dose regimen may be important in Haiti, and other populations lacking previous repeated exposures to V. cholerae. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the relationship between sex hormones and metabolic syndrome (MS) in an Asian population. Methods: A cross-sectional study was conducted in 237 men aged 20-88 years (mean age 52 years). Serum lipids, glucose, insulin, total testosterone (TT), estradiol (E2), sex hormone-binding globulin (SHBG), and dehydroepiandosterone sulfate (DHEA-S) were measured along with body height, weight, waist circumference, and blood pressure. Free testosterone (FT) and bioavailable testosterone (BT) were calculated. Correlations were determined using univariate and multivariate regression analyses. Results: Men with MS had lower levels of TT, BT, FT, SHBG and DHEA-S than men without MS. Multivariate analysis, after adjusting for age and smoking status, indicated that TT (OR: 0.909, 95% CI: 0.836-0.988, p == 0.003) and SHBG (OR: 0.948, 95% CI: 0.913-0.985, p == 0.006) were significantly associated with MS ( R2 == 0.314). TT was associated with waist circumference ( p == 0.008) and abnormal triglycerides level ( p == 0.006); SHBG was associated with blood pressure ( p == 0.003), blood glucose ( p == 0.043) and abnormal triglycerides ( p == 0.048). A significant trend was observed between decreasing levels of TT, BT, FT, and SHBG and increasing numbers of MS components. Conclusion: Results show that serum testosterone and SHBG levels inversely correlate with MS in an Asian population applying the Asian MS definition. [ABSTRACT FROM AUTHOR]

There is increasing evidence that adiponectin has a critical role in the development of breast cancer, but factors that influence adiponectin concentrations have not been well studied. We conducted a cross-sectional study among Asian-American controls who participated in a population-based case-control study of breast cancer. Participants were interviewed in-person and donated a blood specimen. Using multivariate models, we investigated the relationships between serum adiponectin concentrations and lifestyle factors (including adiposity and dietary factors) and serum sex-hormones and growth factors among postmenopausal women who were nonhormone-users at blood draw (n = 196). Adiponectin concentrations were significantly positively associated with green tea intake (P trend = 0.03); levels were 31% higher among those who drank green tea 4 or more times per wk (14.5 ± 1.10 μg/mL) compared with nongreen-tea-drinkers (11.0 ± 1.09 μg/mL); this association remained after adjustment for body mass index (BMI) and waist/hip ratio (WHR), both of which were significantly and inversely associated with adiponectin. Adiponectin concentrations were positively associated with sex-hormone-binding globulin (P trend < 0.0001) and the ratios of total testosterone (T)/total estradiol (E2) (P trend <0.004) after adjustment for BMI and WHR. Confirmation of our findings on green tea and adiponectin is needed. [ABSTRACT FROM AUTHOR]

Objective: To explore the predictive role of pretreatment albumin to globulin ratio (AGR) for prognosis in lung cancer. Methods: A comprehensive literature retrieval was performed in the PubMed, Cochrane Library, Web of Science and EMBASE databases up to May 20, 2019. The pooled hazard ratio (HR) and 95% confidence interval (CI) were applied to assess the correlation of pretreatment AGR with overall survival (OS) and disease-free survival (DFS). Sensitivity analysis was performed to assess the stability of results. Bess's funnel plot and Egger's test were conducted to detect potential publication bias. Results: Eight articles involving 3496 patients were included in our meta-analysis and all studies were from Asian countries. The results demonstrated that a low pretreatment AGR was significantly associated with poor OS (HR = 1.88, 95% CI: 1.49-2.38, P <0.001) and DFS (HR = 2.09, 95% CI: 1.56-2.81, P <0.001) and sensitivity analysis indicated the stability of above results. Publication bias test showed that there were two potentially unpublished articles, but they did not have a significant influence on the results of our meta-analysis. Conclusion: Our study manifested that pretreatment AGR was a reliable predictor for survival and it may contribute to the risk evaluation and therapy strategy formulation of lung cancer patients.