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[PMID]:29297077
[Au] Autor:Purnell TS; Luo X; Cooper LA; Massie AB; Kucirka LM; Henderson ML; Gordon EJ; Crews DC; Boulware LE; Segev DL
[Ad] Endereço:Division of Transplantation, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
[Ti] Título:Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014.
[So] Source:JAMA;319(1):49-61, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Over the past 2 decades, there has been increased attention and effort to reduce disparities in live donor kidney transplantation (LDKT) for black, Hispanic, and Asian patients with end-stage kidney disease. The goal of this study was to investigate whether these efforts have been successful. Objective: To estimate changes over time in racial/ethnic disparities in LDKT in the United States, accounting for differences in death and deceased donor kidney transplantation. Design, Setting, and Participants: A secondary analysis of a prospectively maintained cohort study conducted in the United States of 453 162 adult first-time kidney transplantation candidates included in the Scientific Registry of Transplant Recipients between January 1, 1995, and December 31, 2014, with follow-up through December 31, 2016. Exposures: Race/ethnicity. Main Outcomes and Measures: The primary study outcome was time to LDKT. Multivariable Cox proportional hazards and competing risk models were constructed to assess changes in racial/ethnic disparities in LDKT among adults on the deceased donor kidney transplantation waiting list and interaction terms were used to test the statistical significance of temporal changes in racial/ethnic differences in receipt of LDKT. The adjusted subhazard ratios are estimates derived from the multivariable competing risk models. Data were categorized into 5-year increments (1995-1999, 2000-2004, 2005-2009, 2010-2014) to allow for an adequate sample size in each analytical cell. Results: Among 453 162 adult kidney transplantation candidates (mean [SD] age, 50.9 [13.1] years; 39% were women; 48% were white; 30%, black; 16%, Hispanic; and 6%, Asian), 59 516 (13.1%) received LDKT. Overall, there were 39 509 LDKTs among white patients, 8926 among black patients, 8357 among Hispanic patients, and 2724 among Asian patients. In 1995, the cumulative incidence of LDKT at 2 years after appearing on the waiting list was 7.0% among white patients, 3.4% among black patients, 6.8% among Hispanic patients, and 5.1% among Asian patients. In 2014, the cumulative incidence of LDKT was 11.4% among white patients, 2.9% among black patients, 5.9% among Hispanic patients, and 5.6% among Asian patients. From 1995-1999 to 2010-2014, racial/ethnic disparities in the receipt of LDKT increased (P < .001 for all statistical interaction terms in adjusted models comparing white patients vs black, Hispanic, and Asian patients). In 1995-1999, compared with receipt of LDKT among white patients, the adjusted subhazard ratio was 0.45 (95% CI, 0.42-0.48) among black patients, 0.83 (95% CI, 0.77-0.88) among Hispanic patients, and 0.56 (95% CI, 0.50-0.63) among Asian patients. In 2010-2014, compared with receipt of LDKT among white patients, the adjusted subhazard ratio was 0.27 (95% CI, 0.26-0.28) among black patients, 0.52 (95% CI, 0.50-0.54) among Hispanic patients, and 0.42 (95% CI, 0.39-0.45) among Asian patients. Conclusions and Relevance: Among adult first-time kidney transplantation candidates in the United States who were added to the deceased donor kidney transplantation waiting list between 1995 and 2014, disparities in the receipt of live donor kidney transplantation increased from 1995-1999 to 2010-2014. These findings suggest that national strategies for addressing disparities in receipt of live donor kidney transplantation should be revisited.
[Mh] Termos MeSH primário: Disparidades em Assistência à Saúde/etnologia
Falência Renal Crônica/etnologia
Transplante de Rim/tendências
Doadores Vivos
[Mh] Termos MeSH secundário: Adulto
Afroamericanos
Americanos Asiáticos
Estudos de Coortes
Grupo com Ancestrais do Continente Europeu
Feminino
Disparidades em Assistência à Saúde/tendências
Hispano-Americanos
Seres Humanos
Estimativa de Kaplan-Meier
Falência Renal Crônica/cirurgia
Transplante de Rim/mortalidade
Masculino
Meia-Idade
Estados Unidos/epidemiologia
Listas de Espera
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19152


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[PMID]:29410289
[Au] Autor:Xu Y; Ren J; Ye H
[Ad] Endereço:Department of Medical Genetics and Developmental Biology, School of Basic Medical Sciences, Beijing Institute for Brain Disorders, Center of Schizophrenia, Capital Medical University, Beijing 100069, China. Electronic address: xuyl@ccmu.edu.cn.
[Ti] Título:Association between variations in the disrupted in schizophrenia 1 gene and schizophrenia: A meta-analysis.
[So] Source:Gene;651:94-99, 2018 Apr 20.
[Is] ISSN:1879-0038
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Schizophrenia is a severe psychiatric disorder. Genetic and functional studies have strongly implicated the disrupted in schizophrenia 1 gene (DISC1) as a candidate susceptibility gene for schizophrenia. Moreover, recent association studies have indicated that several DISC1 single nucleotide polymorphisms (SNPs) are associated with schizophrenia. However, the association is hardly replicate in different ethnic group. Here, we performed a meta-analysis of the association between DISC1 SNPs and schizophrenia in which the samples were divided into subgroups according to ethnicity. Both rs3738401 and rs821616 showed not significantly association with schizophrenia in the Caucasian, Asian, Japanese or Han Chinese populations.
[Mh] Termos MeSH primário: Proteínas do Tecido Nervoso/genética
Polimorfismo de Nucleotídeo Único
Esquizofrenia/genética
[Mh] Termos MeSH secundário: Grupo com Ancestrais do Continente Asiático/genética
Grupo com Ancestrais do Continente Europeu/genética
Estudos de Associação Genética
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (DISC1 protein, human); 0 (Nerve Tissue Proteins)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE


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[PMID]:28859290
[Au] Autor:Troester MA; Sun X; Allott EH; Geradts J; Cohen SM; Tse CK; Kirk EL; Thorne LB; Mathews M; Li Y; Hu Z; Robinson WR; Hoadley KA; Olopade OI; Reeder-Hayes KE; Earp HS; Olshan AF; Carey LA; Perou CM
[Ad] Endereço:Department of Epidemiology, Lineberger Comprehensive Cancer Center; Department of Pathology and Lab Medicine, Department of Nutrition (EHA), and Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC; Dana Farber Cancer Institute, Harvard University, Boston, MA; Center
[Ti] Título:Racial Differences in PAM50 Subtypes in the Carolina Breast Cancer Study.
[So] Source:J Natl Cancer Inst;110(2), 2018 Feb 01.
[Is] ISSN:1460-2105
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: African American breast cancer patients have lower frequency of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-negative disease and higher subtype-specific mortality. Racial differences in molecular subtype within clinically defined subgroups are not well understood. Methods: Using data and biospecimens from the population-based Carolina Breast Cancer Study (CBCS) Phase 3 (2008-2013), we classified 980 invasive breast cancers using RNA expression-based PAM50 subtype and recurrence (ROR) score that reflects proliferation and tumor size. Molecular subtypes (Luminal A, Luminal B, HER2-enriched, and Basal-like) and ROR scores (high vs low/medium) were compared by race (blacks vs whites) and age (≤50 years vs > 50 years) using chi-square tests and analysis of variance tests. Results: Black women of all ages had a statistically significantly lower frequency of Luminal A breast cancer (25.4% and 33.6% in blacks vs 42.8% and 52.1% in whites; younger and older, respectively). All other subtype frequencies were higher in black women (case-only odds ratio [OR] = 3.11, 95% confidence interval [CI] = 2.22 to 4.37, for Basal-like; OR = 1.45, 95% CI = 1.02 to 2.06, for Luminal B; OR = 2.04, 95% CI = 1.33 to 3.13, for HER2-enriched). Among clinically HR+/HER2- cases, Luminal A subtype was less common and ROR scores were statistically significantly higher among black women. Conclusions: Multigene assays highlight racial disparities in tumor subtype distribution that persist even in clinically defined subgroups. Differences in tumor biology (eg, HER2-enriched status) may be targetable to reduce disparities among clinically ER+/HER2- cases.
[Mh] Termos MeSH primário: Afroamericanos
Neoplasias da Mama/química
Neoplasias da Mama/etnologia
Grupo com Ancestrais do Continente Europeu
RNA Neoplásico/análise
Receptor ErbB-2/análise
Receptores Estrogênicos/análise
Receptores de Progesterona/análise
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/genética
Neoplasias da Mama/patologia
Proliferação Celular
Feminino
Seres Humanos
Meia-Idade
Recidiva
Carga Tumoral
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RNA, Neoplasm); 0 (Receptors, Estrogen); 0 (Receptors, Progesterone); EC 2.7.10.1 (ERBB2 protein, human); EC 2.7.10.1 (Receptor, ErbB-2)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1093/jnci/djx135


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[PMID]:28468785
[Au] Autor:Olubowale OT; Safford MM; Brown TM; Durant RW; Howard VJ; Gamboa C; Glasser SP; Rhodes JD; Levitan EB
[Ad] Endereço:Department of Biostatistics, University of Alabama at Birmingham, AL drshoby@uab.edu.
[Ti] Título:Comparison of Expert Adjudicated Coronary Heart Disease and Cardiovascular Disease Mortality With the National Death Index: Results From the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study.
[So] Source:J Am Heart Assoc;6(5), 2017 May 03.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The National Death Index (NDI) is widely used to detect coronary heart disease (CHD) and cardiovascular disease (CVD) deaths, but its reliability has not been examined recently. METHODS AND RESULTS: We compared CHD and CVD deaths detected by NDI with expert adjudication of 4010 deaths that occurred between 2003 and 2013 among participants in the REGARDS (REasons for Geographic And Racial Differences in Stroke) cohort of black and white adults in the United States. NDI derived CHD mortality had sensitivity 53.6%, specificity 90.3%, positive predictive value 54.2%, and negative predictive value 90.1%. NDI-derived CVD mortality had sensitivity 73.4%, specificity 84.5%, positive predictive value 70.6%, and negative predictive value 86.2%. Among NDI-derived CHD and CVD deaths, older age (odds ratios, 1.06 and 1.04 per 1-year increase) was associated with a higher probability of disagreement with the adjudicated cause of death, whereas among REGARDS adjudicated CHD and CVD deaths a history of CHD or CVD was associated with a lower probability of disagreement with the NDI-derived causes of death (odds ratios, 0.59 and 0.67, respectively). CONCLUSIONS: The modest accuracy and differential performance of NDI-derived cause of death may impact CHD and CVD mortality statistics.
[Mh] Termos MeSH primário: Afroamericanos
Doença das Coronárias/etnologia
Doença das Coronárias/mortalidade
Grupo com Ancestrais do Continente Europeu
Acidente Vascular Cerebral/etnologia
Acidente Vascular Cerebral/mortalidade
[Mh] Termos MeSH secundário: Idoso
Causas de Morte
Doença das Coronárias/diagnóstico
Feminino
Disparidades nos Níveis de Saúde
Seres Humanos
Masculino
Meia-Idade
Sistema de Registros
Reprodutibilidade dos Testes
Fatores de Risco
Acidente Vascular Cerebral/diagnóstico
Fatores de Tempo
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:28468784
[Au] Autor:Kalbaugh CA; Kucharska-Newton A; Wruck L; Lund JL; Selvin E; Matsushita K; Bengtson LGS; Heiss G; Loehr L
[Ad] Endereço:Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, NC corey_kalbaugh@med.unc.edu.
[Ti] Título:Peripheral Artery Disease Prevalence and Incidence Estimated From Both Outpatient and Inpatient Settings Among Medicare Fee-for-Service Beneficiaries in the Atherosclerosis Risk in Communities (ARIC) Study.
[So] Source:J Am Heart Assoc;6(5), 2017 May 03.
[Is] ISSN:2047-9980
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Outpatient ascertainment of peripheral artery disease (PAD) is rarely considered in the measurement of PAD clinical burden; therefore, the clinical burden of PAD likely has been underestimated while contributing to a decreased awareness of PAD in comparison to other circulatory system disorders. METHODS AND RESULTS: The purpose of this study was to estimate the age-standardized annual period prevalence and incidence of PAD in the outpatient and inpatient settings using data from the Atherosclerosis Risk in Communities (ARIC) study linked with Centers for Medicare and Medicaid Services claims. The majority (>70%) of all PAD encounters occurred in the outpatient setting. The weighted mean age-standardized prevalence and incidence of outpatient PAD was 11.8% (95% CI 11.5-12.1) and 22.4 per 1000 person-years (95% CI 20.8-24.0), respectively. Black patients had higher weighted mean age-standardized prevalence (15.6%; 95% CI 14.6-16.4) compared with white patients (11.4%; 95% CI 11.1-11.7). Black women had the highest weighted mean age-standardized prevalence (16.9%; 95% CI 16.0-17.8). Black patients also had a higher incidence rate of PAD (31.3 per 1000 person-years; 95% CI 27.3-35.4) compared with white patients (25.4 per 1000 person-years; 95% CI 23.5-27.3). PAD prevalence and incidence did not differ by sex alone. CONCLUSIONS: This study provides comprehensive estimates of PAD in the inpatient and outpatient settings where the majority of PAD burden was found. PAD is an important circulatory system disorder similar in prevalence to stroke and coronary heart disease.
[Mh] Termos MeSH primário: Assistência Ambulatorial
Planos de Pagamento por Serviço Prestado
Medicare
Admissão do Paciente
Doença Arterial Periférica/epidemiologia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Afroamericanos
Distribuição por Idade
Idoso
Assistência Ambulatorial/economia
Comorbidade
Grupo com Ancestrais do Continente Europeu
Planos de Pagamento por Serviço Prestado/economia
Feminino
Custos Hospitalares
Seres Humanos
Incidência
Masculino
Medicare/economia
Admissão do Paciente/economia
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/economia
Doença Arterial Periférica/etnologia
Prevalência
Fatores de Risco
Distribuição por Sexo
Fatores de Tempo
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE


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[PMID]:29351564
[Au] Autor:Naran NH; Haagensen M; Crowther NJ
[Ad] Endereço:Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
[Ti] Título:Steatosis in South African women: How much and why?
[So] Source:PLoS One;13(1):e0191388, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Globally, steatosis is the commonest type of liver pathology and is closely associated with obesity and the metabolic syndrome. Obesity is common in urban African females but no data is available on hepatic fat content in this population group when compared to other ethnic groups. The aim of this study was therefore to compare hepatic fat content in woman from different ethnic groups in South Africa and to characterise the principle determinants of liver fat. MATERIALS AND METHODS: A convenience sample of 106 (48 Indian, 29 African and 29 Caucasian) female volunteers aged 20-60 years and having no history of cardiometabolic disorders were recruited. Hepatic fat was determined from CT scans using the liver-spleen attenuation ratio (LAR), which decreases with increasing levels of hepatic fat. Anthropometric and cardiometabolic parameters were measured with insulin resistance determined using the HOMA index and dysglycaemia defined as fasting glucose ≥5.60 mmol/L. RESULTS: The African subjects had significantly lower hepatic fat content (LAR as median [interquartile range]: 1.35 [1.28, 1.41]) than the Indian (1.22 [1.10, 1.35]; p<0.005) and Caucasian (1.27 [1.16, 1.33]; p<0.05) females even though they had significantly higher BMIs than both groups (p<0.0005 and p<0.05, respectively). Linear regression showed that: subcutaneous abdominal fat was a significant (unstandardised ß = 0.007; p = 0.03) negative, whilst insulin resistance (ß = -0.97; p = 0.01) and dysglycaemia (ß = -3.58; p = 0.01) were significant positive determinants of liver fat; higher hepatic fat levels in subjects with the metabolic syndrome were explained by insulin resistance and dysglycaemia. DISCUSSION: African ethnicity is associated with low liver fat content. Subcutaneous abdominal fat protects against steatosis, possibly by acting as a triglyceride reservoir. Insulin resistance and dysglycaemia lead to greater hepatic fat deposition and explain higher liver fat levels in subjects with the metabolic syndrome. These observations must be further investigated in longitudinal surveys.
[Mh] Termos MeSH primário: Fígado Gorduroso/patologia
[Mh] Termos MeSH secundário: Tecido Adiposo/diagnóstico por imagem
Tecido Adiposo/patologia
Adulto
Grupo com Ancestrais do Continente Africano
Antropometria
Índice de Massa Corporal
Estudos Transversais
Grupo com Ancestrais do Continente Europeu
Fígado Gorduroso/diagnóstico por imagem
Fígado Gorduroso/metabolismo
Feminino
Seres Humanos
Resistência à Insulina
Modelos Lineares
Fígado/diagnóstico por imagem
Fígado/patologia
Síndrome Metabólica/diagnóstico por imagem
Síndrome Metabólica/metabolismo
Síndrome Metabólica/patologia
Meia-Idade
África do Sul
Gordura Subcutânea Abdominal/diagnóstico por imagem
Gordura Subcutânea Abdominal/patologia
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191388


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[PMID]:29321194
[Au] Autor:Seibert TM; Fan CC; Wang Y; Zuber V; Karunamuni R; Parsons JK; Eeles RA; Easton DF; Kote-Jarai Z; Al Olama AA; Garcia SB; Muir K; Grönberg H; Wiklund F; Aly M; Schleutker J; Sipeky C; Tammela TL; Nordestgaard BG; Nielsen SF; Weischer M; Bisbjerg R; Røder MA; Iversen P; Key TJ; Travis RC; Neal DE; Donovan JL; Hamdy FC; Pharoah P; Pashayan N; Khaw KT; Maier C; Vogel W; Luedeke M; Herkommer K; Kibel AS; Cybulski C; Wokolorczyk D; Kluzniak W; Cannon-Albright L; Brenner H; Cuk K; Saum KU; Park JY; Sellers TA; Slavov C; Kaneva R; Mitev V; Batra J; PRACTICAL Consortium*
[Ad] Endereço:Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA tseibert@ucsd.edu amdale@ucsd.edu.
[Ti] Título:Polygenic hazard score to guide screening for aggressive prostate cancer: development and validation in large scale cohorts.
[So] Source:BMJ;360:j5757, 2018 01 10.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To develop and validate a genetic tool to predict age of onset of aggressive prostate cancer (PCa) and to guide decisions of who to screen and at what age. DESIGN: Analysis of genotype, PCa status, and age to select single nucleotide polymorphisms (SNPs) associated with diagnosis. These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive PCa (that is, not eligible for surveillance according to National Comprehensive Cancer Network guidelines; any of Gleason score ≥7, stage T3-T4, PSA (prostate specific antigen) concentration ≥10 ng/L, nodal metastasis, distant metastasis). The resulting polygenic hazard score is an assessment of individual genetic risk. The final model was applied to an independent dataset containing genotype and PSA screening data. The hazard score was calculated for these men to test prediction of survival free from PCa. SETTING: Multiple institutions that were members of international PRACTICAL consortium. PARTICIPANTS: All consortium participants of European ancestry with known age, PCa status, and quality assured custom (iCOGS) array genotype data. The development dataset comprised 31 747 men; the validation dataset comprised 6411 men. MAIN OUTCOME MEASURES: Prediction with hazard score of age of onset of aggressive cancer in validation set. RESULTS: In the independent validation set, the hazard score calculated from 54 single nucleotide polymorphisms was a highly significant predictor of age at diagnosis of aggressive cancer (z=11.2, P<10 ). When men in the validation set with high scores (>98th centile) were compared with those with average scores (30th-70th centile), the hazard ratio for aggressive cancer was 2.9 (95% confidence interval 2.4 to 3.4). Inclusion of family history in a combined model did not improve prediction of onset of aggressive PCa (P=0.59), and polygenic hazard score performance remained high when family history was accounted for. Additionally, the positive predictive value of PSA screening for aggressive PCa was increased with increasing polygenic hazard score. CONCLUSIONS: Polygenic hazard scores can be used for personalised genetic risk estimates that can predict for age at onset of aggressive PCa.
[Mh] Termos MeSH primário: Detecção Precoce de Câncer/métodos
Calicreínas/análise
Polimorfismo de Nucleotídeo Único/genética
Antígeno Prostático Específico/análise
Neoplasias da Próstata/sangue
Neoplasias da Próstata/genética
[Mh] Termos MeSH secundário: Idade de Início
Idoso
Estudos de Coortes
Intervalo Livre de Doença
Grupo com Ancestrais do Continente Europeu/genética
Genótipo
Seres Humanos
Masculino
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Valor Preditivo dos Testes
Neoplasias da Próstata/diagnóstico
Medição de Risco
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Nm] Nome de substância:
EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5757


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[PMID]:28450031
[Au] Autor:Soneji S; Tanner NT; Silvestri GA; Lathan CS; Black W
[Ad] Endereço:Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Geisel School of Medicine at Dartmouth, Lebanon, NH; Norris Cotton Cancer Center, Lebanon, NH. Electronic address: samir.soneji@dartmouth.edu.
[Ti] Título:Racial and Ethnic Disparities in Early-Stage Lung Cancer Survival.
[So] Source:Chest;152(3):587-597, 2017 09.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Black patients with lung cancer diagnosed at early stages-for which surgical resection offers a potential cure-experience worse overall survival than do their white counterparts. We undertook a population-based study to estimate the racial and ethnic disparity in death from competing causes and assessed its contribution to the gap in overall survival among patients with early-stage lung cancer. METHODS: We collected survival time data for 105,121 Hispanic, non-Hispanic Asian, non-Hispanic black, and non-Hispanic white patients with early-stage (IA, IB, IIA, and IIB) lung cancer diagnosed between 2004 and 2013 from the Surveillance, Epidemiology, and End-Results registries. We modeled survival time using competing risk regression and included as covariates sex, age at diagnosis, race/ethnicity, stage at diagnosis, histologic type, type of surgical resection, and radiation sequence. RESULTS: Adjusting for demographic, clinical, and treatment characteristics, non-Hispanic blacks experienced worse overall survival compared with non-Hispanic whites (adjusted hazard ratio [aHR], 1.05; 95% CI, 1.02-1.08), whereas Hispanics and non-Hispanic Asians experienced better overall survival (aHR, 0.93; 95% CI, 0.89-0.98; and aHR, 0.82; 95% CI, 0.79-0.86, respectively). Worse survival from competing causes of death, such as cardiovascular disease and other cancers-rather than from lung cancer itself-led to the disparity in overall survival among non-Hispanic blacks (adjusted relative risk, 1.07; 95% CI, 1.02-1.12). CONCLUSIONS: Narrowing racial and ethnic disparities in survival among patients with early-stage lung cancer will rely on more than just equalizing access to surgical resection and will need to include better management and treatment of smoking-related comorbidities and diseases.
[Mh] Termos MeSH primário: Grupos Étnicos/estatística & dados numéricos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Disparidades nos Níveis de Saúde
Neoplasias Pulmonares/etnologia
Neoplasias Pulmonares/mortalidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Masculino
Meia-Idade
Estadiamento de Neoplasias
Programa de SEER
Taxa de Sobrevida
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29406039
[Au] Autor:Chedid V; Rosenblatt E; Gandhi KK; Dhalla S; Nandwani MC; Stein EM; Clarke JO
[Ad] Endereço:Department of Internal Medicine, Division of Gastroenterology & Hepatology, Mayo Clinic Rochester, Rochester, Minnesota. Electronic address: chedid.victor@mayo.edu.
[Ti] Título:The Effect of Race in Patients with Achalasia Diagnosed With High-Resolution Esophageal Manometry.
[So] Source:Am J Med Sci;355(2):126-131, 2018 Feb.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The advent of the Chicago Classification for esophageal motility disorders allowed for clinically reproducible subgrouping of patients with achalasia based on manometric phenotype. However, there are limited data with regards to racial variation using high-resolution esophageal manometry (HREM). The aim of our study was to evaluate the racial differences in patients with achalasia diagnosed with HREM using the Chicago Classification. We evaluated the clinical presentation, treatment decisions and outcomes between blacks and non-blacks with achalasia to identify potential racial disparities. MATERIALS AND METHODS: We performed a retrospective review of consecutive patients referred for HREM at a single tertiary referral center from June 2008 through October 2012. All patients diagnosed with achalasia on HREM according to the Chicago Classification were included. Demographic, clinical and manometric data were abstracted. All studies interpreted before the Chicago Classification was in widespread use were reanalyzed. Race was defined as black or non-black. Patients who had missing data were excluded. Proportions were compared using chi-squared analysis and means were compared using the Student's t-test. RESULTS: A total of 1,268 patients underwent HREM during the study period, and 105 (8.3%) were manometrically diagnosed with achalasia (53% female, mean age: 53.8 ± 17.0 years) and also met the aforementioned inclusion and exclusion criteria. A higher percentage of women presented with achalasia in blacks as compared to whites or other races (P < 0.001). Non-blacks were more likely to present with reflux than blacks (P = 0.01), while blacks were more likely to be treated on the inpatient service than non-blacks (P < 0.001). There were no other significant differences noted in clinical presentation, treatment decisions and treatment outcomes among blacks and non-blacks. CONCLUSIONS: Our study highlights possible racial differences between blacks and non-blacks, including a higher proportion of black women diagnosed with achalasia and most blacks presenting with dysphagia. There is possibly a meaningful interaction of race and sex in the development of achalasia that might represent genetic differences in its pathophysiology. Further prospective studies are required to identify such differences.
[Mh] Termos MeSH primário: Afroamericanos
Acalasia Esofágica/diagnóstico
Acalasia Esofágica/fisiopatologia
Acalasia Esofágica/terapia
Grupo com Ancestrais do Continente Europeu
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Manometria
Meia-Idade
Estudos Retrospectivos
Fatores Sexuais
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE


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[PMID]:29289265
[Au] Autor:Qi R; Chen LYC; Park S; Irvine R; Seidman MA; Kelsall JT; Collins D; Yin V; Slack GW; Mattman A; Lam E; Carruthers MN
[Ad] Endereço:Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
[Ti] Título:Utility of Serum IgG4 Levels in a Multiethnic Population.
[So] Source:Am J Med Sci;355(1):61-66, 2018 01.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: IgG4-related disease (IgG4-RD) is a recently recognized condition defined by characteristic histopathologic findings in affected organs. Serum IgG4 concentration is often but not always elevated. The sensitivity and specificity of serum IgG4 vary greatly across studies and has been anecdotally associated to ethnicity. Our study was conducted to investigate the difference in serum IgG4 levels between Asian and non-Asian patients with IgG4-RD. METHODS: This is a single-center retrospective study of 26 Asian and 10 non-Asian patients with histologically confirmed IgG4-RD. Serum IgG4 levels, clinical features and other laboratory findings were compared between the 2 groups, 31 Asian and 11 non-Asian patients with non-IgG4-RD rheumatic diseases were randomly identified to evaluate test characteristics of serum IgG4 measurement. RESULTS: Median serum IgG4 at time of diagnosis was significantly higher in Asian (median = 11.2g/L, interquartile range: 4.6-19.7) than non-Asian patients (median = 2.9g/L, interquartile range: 0.7-5.4, P = 0.0094), as well as the median serum IgG and total protein. Asian patients had more eosinophilia and polyclonal hypergammaglobulinemia than non-Asian patients (P = 0.016 and 0.001, respectively). Test sensitivity was higher in Asian (96%) than non-Asian patients (67%), whereas test specificity was higher in non-Asian patients (91% versus 71%). CONCLUSION: Asian patients with IgG4-RD have more exuberant serum IgG4, IgG and polyclonal hypergammaglobulinemia than non-Asian patients; the mechanism of this difference requires further study. These findings have significant clinical importance and must be accounted for in the diagnostic workup of patients in multiethnic settings.
[Mh] Termos MeSH primário: Árabes
Grupo com Ancestrais do Continente Asiático/etnologia
Doenças Autoimunes/sangue
Doenças Autoimunes/etnologia
Grupo com Ancestrais do Continente Europeu/etnologia
Hispano-Americanos
Imunoglobulina G/sangue
[Mh] Termos MeSH secundário: Idoso
Biomarcadores/sangue
Estudos de Coortes
Grupos Étnicos
Feminino
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biomarkers); 0 (Immunoglobulin G)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180101
[St] Status:MEDLINE



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