المؤلفون: Capodici, Angelo, Mocciaro, Gabriele, Gori, Davide, Masini, Alice, Sanmarchi, Francesco, Fiore, Matteo, Coa, Angela, Castagna, Gisele, Gardner, Christopher, Guaraldi, Federica, Landry, Matthew

المصدر: PLoS ONE. 19(5)

مصطلحات موضوعية: Humans, Neoplasms, Diet, Vegetarian, Cardiovascular Diseases, Risk Factors, Diet, Vegan

الوصف: CONTEXT: Cardiovascular diseases (CVDs) and cancer are the two main leading causes of death and disability worldwide. Suboptimal diet, poor in vegetables, fruits, legumes and whole grain, and rich in processed and red meat, refined grains, and added sugars, is a primary modifiable risk factor. Based on health, economic and ethical concerns, plant-based diets have progressively widespread worldwide. OBJECTIVE: This umbrella review aims at assessing the impact of animal-free and animal-products-free diets (A/APFDs) on the risk factors associated with the development of cardiometabolic diseases, cancer and their related mortalities. DATA SOURCES: PubMed and Scopus were searched for reviews, systematic reviews, and meta-analyses published from 1st January 2000 to 31st June 2023, written in English and involving human subjects of all ages. Primary studies and reviews/meta-analyses based on interventional trials which used A/APFDs as a therapy for people with metabolic diseases were excluded. DATA EXTRACTION: The umbrella review approach was applied for data extraction and analysis. The revised AMSTAR-R 11-item tool was applied to assess the quality of reviews/meta-analyses. RESULTS: Overall, vegetarian and vegan diets are significantly associated with better lipid profile, glycemic control, body weight/BMI, inflammation, and lower risk of ischemic heart disease and cancer. Vegetarian diet is also associated with lower mortality from CVDs. On the other hand, no difference in the risk of developing gestational diabetes and hypertension were reported in pregnant women following vegetarian diets. Study quality was average. A key limitation is represented by the high heterogeneity of the study population in terms of sample size, demography, geographical origin, dietary patterns, and other lifestyle confounders. CONCLUSIONS: Plant-based diets appear beneficial in reducing cardiometabolic risk factors, as well as CVDs, cancer risk and mortality. However, caution should be paid before broadly suggesting the adoption of A/AFPDs since the strength-of-evidence of study results is significantly limited by the large study heterogeneity alongside the potential risks associated with potentially restrictive regimens.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6n93h62sTest

المؤلفون: Erica Franceschini, Valentina Menozzi, Vera Todisco, Mariachiara Pellegrino, Samuele Cantergiani, Andrea Dessilani, Anna Spadoni, Federico Romani, Alice Mazzocchi, Antonella Santoro, Marianna Meschiari, Adriana Cervo, Andrea Gilioli, Francesca Bettelli, Giulia Fregni‐Serpini, Antonella Grottola, Anna Candoni, Giovanni Guaraldi, Mario Sarti, Mario Luppi, Cristina Mussini

المصدر: eJHaem, Vol 5, Iss 3, Pp 505-515 (2024)

مصطلحات موضوعية: COVID‐19, hematological malignancies, serostatus, Diseases of the blood and blood-forming organs, RC633-647.5

الوصف: Abstract Background Patients with hematological malignancies (HM) have a high risk of severe coronavirus disease 2019 (COVID‐19), also in the Omicron period. Material and methods Retrospective single‐center study including HM patients with severe acute respiratory syndrome Coronavirus 2 (SARS‐CoV2) infection from January 2022 to March 2023. Study outcomes were respiratory failure (RF), mechanical ventilation (MV), and COVID‐related mortality, comparing patients according to SARS‐CoV2 serology. Results Note that, 112 patients were included: 39% had negative SARS‐CoV2 serology. Seronegative were older (71.5 vs. 65.0 years, p = 0.04), had more often a lymphoid neoplasm (88.6% vs. 69.1%, p = 0.02), underwent anti‐CD20 therapy (50.0% vs. 30.9% p = 0.04) and had more frequently a severe disease (23.0% vs. 3.0%, p = 0.02) than seropositive. Kaplan‐Meier showed a higher risk for seronegative patients for RF (p = 0.014), MV (p = 0.044), and COVID‐related mortality (p = 0.021). Negative SARS‐CoV2 serostatus resulted in a risk factor for RF (hazards ratio [HR] 2.19, 95% confidence interval [CI] 1.03–4.67, p = 0.04), MV (HR 3.37, 95% CI 1.06–10.68, p = 0.04), and COVID‐related mortality (HR 4.26, 95% CI 1.09–16.71, p = 0.04). Conclusions : HM patients with negative SARS‐CoV2 serology, despite vaccinations and previous infections, have worse clinical outcomes compared to seropositive patients in the Omicron era. The use of serology for SARS‐CoV2 diagnosis could be an easy tool to identify patients prone to developing complications.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2688-6146Test

الوصول الحر: https://doaj.org/article/4437cebfa5944842951cc2afa51631c4Test

المؤلفون: Giacomo Urbinati, Ilaria Cani, Marco Currò Dossi, Simone Longhi, Samuela Carigi, Christian Gagliardi, Elena Biagini, Nazzareno Galiè, Pietro Cortelli, Pietro Guaraldi

المصدر: Frontiers in Neurology, Vol 15 (2024)

مصطلحات موضوعية: hereditary transthyretin amyloidosis, patisiran, p.Ile88Leu, TTR, familial amyloid polyneuropathy, transthyretin amyloid cardiomyopathy, Neurology. Diseases of the nervous system, RC346-429

الوصف: ObjectivesEvidence on the activity of patisiran therapy in specific subgroups of patients with hereditary transthyretin amyloidosis variant (ATTRv) is still scarce. This prospective real-world study was designed to provide the first in-depth clinical data on the effectiveness of patisiran in patients with ATTRv reporting the p.Ile88Leu variant, the most widespread variant in the Emilia-Romagna regional area, which has been less represented in previous clinical trials.Patients and methodsThis prospective study evaluated all the patients with genetically proven ATTRv (p.Ile88Leu) and polyneuropathy treated with patisiran in the Emilia-Romagna referral centers for ATTRv (Institute of Neurological Sciences in Bologna and Division of Neurology in Rimini) from March 2021 to April 2023. All subjects underwent clinical and neurological evaluations at baseline and after 9–12 months of treatment.ResultsA total of 22 patients were included in the study; the median age was 73 years (IQR: 9), the age at diagnosis was 72 years (IQR: 10), and the disease duration was 1.6 years (IQR: 2.3). We observed stability of all considered neurological and cardiological parameters at 9–12 months after the beginning of patisiran treatment.ConclusionOur findings support the clinical data regarding the effectiveness of patisiran in stabilizing the disease course and extend this activity to the subset of patients with the p.Ile88Leu variant.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fneur.2024.1415851/fullTest; https://doaj.org/toc/1664-2295Test

الوصول الحر: https://doaj.org/article/6d48eaa8280b4f93b36312858de5a918Test

المؤلفون: Yu, Xiaoying, Lobo, Judith D, Sundermann, Erin, Baker, Darren J, Tracy, Russell P, Kuchel, George A, Stephenson, Kathryn E, Letendre, Scott L, Brew, Bruce, Cysique, Lucette A, Dale, Sannisha K, Wallen, Chelsie, Kunisaki, Ken M, Guaraldi, Giovanni, Milic, Jovana, Winston, Alan, Moore, David J, Margolick, Joseph B, Erlandson, Kristine M

المصدر: AIDS Research and Human Retroviruses. 39(1)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Infectious Diseases, Aging, HIV/AIDS, Infection, Good Health and Well Being, Humans, Aged, HIV Infections, Pandemics, Quality of Life, COVID-19, HIV, aging, biological mechanism, quality of life, delivery of care, Virology, Clinical sciences

الوصف: People with HIV on combination antiretroviral therapy (ART) have longer life expectancy and are increasingly experiencing age-related comorbidities. Thus, aging with HIV has become a central issue in clinical care and research, which has been particularly challenging with the intersection of the ongoing coronavirus (COVID)-19 pandemic. Since 2009, the International Workshop on HIV and Aging has served as a multidisciplinary platform to share research findings from cross-disciplinary fields along with community advocates to address critical issues in HIV and aging. In this article, we summarize the key oral presentations from the 12th Annual International Workshop on HIV and Aging, held virtually on September 23rd and 24th, 2021. The topics ranged from basic science research on biological mechanisms of aging to quality of life and delivery of care under the COVID-19 pandemic. This workshop enriched our understanding of HIV and aging under the COVID-19 pandemic, identified challenges and opportunities to combat the impact of COVID-19 on HIV communities, and also provided updated research and future directions of the field to move HIV and aging research forward, with the ultimate goal of successful aging for older people with HIV.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/0zz7p79mTest

المؤلفون: Federica Guaraldi, Marco Montalti, Davide Gori

المصدر: International Journal of Health Policy and Management, Vol 12, Iss Issue 1, Pp 1-4 (2023)

مصطلحات موضوعية: vaccine hesitancy, compulsory vaccination, childhood vaccinations, Public aspects of medicine, RA1-1270

الوصف: Vaccine hesitancy (VH) has risen significantly during the COVID-19 pandemic, becoming a major global health concern. VH is characterized by the delay or refusal of vaccination despite its availability. Various frameworks have been developed to understand the complex factors influencing VH, with attitudes, beliefs, and external influences being the most significant. The surge in VH has reignited the debate on the best approach to address it: persuasive/educational or coercive. Attwell and Hannah studied the political and social reasons behind the adoption of mandatory vaccination in four jurisdictions (Italy, France, Australia, and California) due to declining vaccine coverage below the safety threshold. However, these methods may foster parental disbeliefs and opposition to vaccination campaigns. To combat VH, it is crucial to systematically assess its determinants within specific contexts and population groups. Increasing awareness about vaccination benefits, engaging with social media, and employing tailored strategies can foster spontaneous adherence to vaccination programs, eliminating the need for coercive measures.

وصف الملف: electronic resource

العلاقة: https://www.ijhpm.com/article_4463_72517a4bede9715b1807ec7d51ae313a.pdfTest; https://doaj.org/toc/2322-5939Test

الوصول الحر: https://doaj.org/article/37f27e3245724c1ca0605bde2e99676eTest

المؤلفون: Juliana Nunes Ramos, Max Roberto Batista Araújo, Paulo Victor Pereira Baio, Lincoln Oliveira Sant’Anna, João Flávio Carneiro Veras, Érica Miranda Damásio Vieira, Mireille Ângela Bernardes Sousa, Carlos Henrique Camargo, Cláudio Tavares Sacchi, Karoline Rodrigues Campos, Marlon Benedito Nascimento Santos, Sérgio Bokermann, Luige Biciati Alvim, Louisy Sanches dos Santos, Ana Luiza de Mattos-Guaraldi, Verônica Viana Vieira

المصدر: BMC Genomic Data, Vol 24, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Corynebacterium rouxii, Corynebacterium diphtheriae complex, Non-toxigenic, Virulence factors, Resistance genes, CRISPR-Cas system, Genetics, QH426-470

الوصف: Abstract Background Corynebacterium diphtheriae complex was formed by the species C. diphtheriae, Corynebacterium ulcerans and Corynebacterium pseudotuberculosis in the recent past. In addition to C. diphtheriae, C. ulcerans and C. pseudotuberculosis species can carry the tox gene, which encodes diphtheria toxin. Currently, three new species have been included in the complex: Corynebacterium rouxii, Corynebacterium silvaticum, and Corynebacterium belfantii. C. rouxii is derived from the ancient Belfanti biovar of C. diptheriae. We provide the complete genome sequences of two non-toxigenic strains C. rouxii isolated from a cat with a purulent infection in Brazil. The taxonomic status and sequence type, as well as the presence of resistance and virulence genes, and CRISPR-Cas system were additionally defined. Results The genomes showed an average size of 2.4 Mb and 53.2% GC content, similar to the type strain of the species deposited in Genbank/NCBI. Strains were identified as C. rouxii by the rMLST database, with 95% identity. ANI and DDH in silico were consistent with values above the proposed cut-off points for species limit, corroborating the identification of the strains as C. rouxii. MLST analyses revealed a new ST, which differs from ST-537 only by the fusA allele. No horizontal transfer resistance gene was predicted in both genomes and no mutation was detected in the constitutive genes gyrA and rpoB. Some mutations were found in the seven penicillin-binding proteins (PBPs) detected. The tox gene was not found, but its regulatory gene dtxR was present. Among the predicted virulence genes are those involved in iron uptake and adherence, in addition to the DIP0733 protein involved in epithelial cell adhesion and invasion. The CRISPR-Cas type I-E system was detected in both genomes, with 16 spacer sequences each. Of them, half are unknown according to the databases used, indicating that there is an unexplored reservoir of corynebacteriophages and plasmids. Conclusions This is the first genomic study of C. rouxii reported in Brazil. Here we performed taxonomic analysis and the prediction of virulence factors. The genomic analyses performed in this study may help to understand the potential pathogenesis of non-toxigenic C. rouxii strains.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2730-6844Test

الوصول الحر: https://doaj.org/article/e8b1f6037a9441f2b2edefd7256b8cd5Test

المؤلفون: Marianna Meschiari, Shaniko Kaleci, Martina Del Monte, Andrea Dessilani, Antonella Santoro, Francesco Scialpi, Erica Franceschini, Gabriella Orlando, Adriana Cervo, Morselli Monica, Fabio Forghieri, Claudia Venturelli, Enrico Ricchizzi, Johanna Chester, Mario Sarti, Giovanni Guaraldi, Mario Luppi, Cristina Mussini

المصدر: Antimicrobial Resistance and Infection Control, Vol 12, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Vancomycin resistant Enterococcus, Hematological, Risk factors, Infectious and parasitic diseases, RC109-216

الوصف: Abstract Background Vancomycin-resistant enterococcus (VRE) was the fastest growing pathogen in Europe in 2022 (+ 21%) but its clinical relevance is still unclear. We aim to identify risk factors for acquired VRE rectal colonization in hematological patients and evaluate the clinical impact of VRE colonization on subsequent infection, and 30- and 90-day overall mortality rates, compared to a matched control group. Methods A retrospective, single center, case–control matched study (ratio 1:1) was conducted in a hematological department from January 2017 to December 2020. Case patients with nosocomial isolation of VRE from rectal swab screening (≥ 48 h) were matched to controls by age, sex, ethnicity, and hematologic disease. Univariate and multivariate logistic regression compared risk factors for colonization. Results A total of 83 cases were matched with 83 controls. Risk factors for VRE colonization were febrile neutropenia, bone marrow transplant, central venous catheter, bedsores, reduced mobility, altered bowel habits, cachexia, previous hospitalization and antibiotic treatments before and during hospitalization. VRE bacteraemia and Clostridioides difficile infection (CDI) occurred more frequently among cases without any impact on 30 and 90-days overall mortality. Vancomycin administration and altered bowel habits were the only independent risk factors for VRE colonization at multivariate analysis (OR: 3.53 and 3.1; respectively). Conclusions Antimicrobial stewardship strategies to reduce inappropriate Gram-positive coverage in hematological patients is urgently required, as independent risk factors for VRE nosocomial colonization identified in this study include any use of vancomycin and altered bowel habits. VRE colonization and infection did not influence 30- and 90-day mortality. There was a strong correlation between CDI and VRE, which deserves further investigation to target new therapeutic approaches.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-2994Test

الوصول الحر: https://doaj.org/article/a2300806355440d183454dfa15285bf0Test

المؤلفون: Alice Zhabokritsky, Marina Klein, Mona Loutfy, Giovanni Guaraldi, Nisha Andany, Silvia Guillemi, Julian Falutz, Gordon Arbess, Darrell H. S. Tan, Sharon Walmsley

المصدر: Frontiers in Medicine, Vol 11 (2024)

مصطلحات موضوعية: HIV, multimorbidity, non-communicable diseases, quality of life, stigma, Medicine (General), R5-920

الوصف: IntroductionThe life expectancy of people living with HIV receiving effective combination antiretroviral therapy is approaching that of the general population and non AIDS-defining age-related comorbidities are becoming of greater concern. In order to support healthy aging of this population, we set out to explore the association between multimorbidity (defined as presence of 2 or more non AIDS-defining comorbidities) and quality of life (QoL).MethodsWe performed a cross-sectional analysis using data from the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study, a Canadian cohort of people living with HIV age 65 years and older. Study participants completed two QoL modules, the general QoL and health related QoL (HR-QoL).Results433 participants were included in the analysis with a median age of 69 years (interquartile range, IQR 67–72). The median number of comorbidities among study participants was 3 (IQR 2–4), with 78% meeting the definition of multimorbidity. General QoL scores (median 66, IQR 58–76) were lower than HR-QoL scores (median 71, IQR 61–83) and were not associated with multimorbidity after adjusting for age, sex, relationship status, household income, exercise, tobacco smoking history, malnutrition, time since HIV diagnosis, and HIV-related stigma. In contrast, multimorbidity was associated with lower HR-QoL (adjusted β = −4.57, 95% CI −8.86, −0.28) after accounting for the same variables. Several social vulnerabilities (not having a partner, low household income), health behaviours (lower engagement in exercise, smoking), and HIV-related factors (HIV stigma, longer time since HIV diagnosis) were also associated with lower QoL.DiscussionOverall, our study demonstrated a high burden of multimorbidity among older adults living with HIV in Canada, which has a negative impact on HR-QoL. Interventions aimed at preventing and managing non-AIDS-defining comorbidities should be assessed in people living with HIV to determine whether this can improve their HR-QoL.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fmed.2024.1380731/fullTest; https://doaj.org/toc/2296-858XTest

الوصول الحر: https://doaj.org/article/87c673c76fb949cfad69b0e1b0d84b35Test

المؤلفون: Alessandro Cozzi-Lepri, Vanni Borghi, Salvatore Rotundo, Bianca Mariani, Anna Ferrari, Cosmo Del Borgo, Francesca Bai, Pietro Colletti, Piermauro Miraglia, Carlo Torti, Anna Maria Cattelan, Giovanni Cenderello, Marco Berruti, Carlo Tascini, Giustino Parruti, Simona Coladonato, Andrea Gori, Giulia Marchetti, Miriam Lichtner, Luigi Coppola, Chiara Sorace, Alessandra D'Abramo, Valentina Mazzotta, Giovanni Guaraldi, Erica Franceschini, Marianna Meschiari, Loredana Sarmati, Andrea Antinori, Emanuele Nicastri, Cristina Mussini

المصدر: Frontiers in Medicine, Vol 11 (2024)

مصطلحات موضوعية: casirivimab/imdevimab, COVID-19, mechanical ventilation, mortality, prediction score, SARS-CoV-2, Medicine (General), R5-920

الوصف: IntroductionCasirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm.MethodsThis is a retrospective, observational cohort study conducted in 12 hospitals in Italy. Adult patients who were consecutively hospitalized from November 2021 to February 2022 receiving CAS/IMV were included. A multivariable logistic regression model was used to identify predictors of MV or death by day 28 from treatment initiation, and β-coefficients from the model were used to develop a risk score that was derived by means of leave-one-out internal cross-validation (CV), external CV, and calibration. Secondary outcome was mortality.ResultsA total of 480 hospitalized patients in the training set and 157 patients in the test set were included. By day 28, 36 participants (8%) underwent MV and 28 died (6%) for a total of 58 participants (12%) experiencing the composite primary endpoint. In multivariable analysis, four factors [age, PaO2/FiO2 ratio, lactate dehydrogenase (LDH), and platelets] were independently associated with the risk of MV/death and were used to generate the proposed risk score. The accuracy of the score in the area under the curve (AUC) was 0.80 and 0.77 in internal validation and test for the composite endpoint and 0.87 and 0.86 for death, respectively. The model also appeared to be well calibrated with the raw data.ConclusionThe mortality risk reported in our study was lower than that previously reported. Although CAS/IMV is no longer used, our score might help in identifying which patients are not likely to benefit from monoclonal antibodies and may require alternative interventions.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fmed.2024.1293431/fullTest; https://doaj.org/toc/2296-858XTest

الوصول الحر: https://doaj.org/article/0b97388ee1594886bbcecb9b15b4c631Test

المؤلفون: Giovanni Guaraldi, Jovana Milic, Elena Bacchi, Federica Carli, Marianna Menozzi, Iacopo Franconi, Alessandro Raimondi, Giacomo Ciusa, Valentina Masi, Michela Belli, Stefano Guaraldi, Emanuele Aprile, Maria Mancini, Cristina Mussini, Jordan E. Lake, Kristine M. Erlandson

المصدر: HIV Research & Clinical Practice, Vol 24, Iss 1 (2023)

مصطلحات موضوعية: integrase inhibitors, weight gain, people living with hiv, physical activity, population attributable fractions, Infectious and parasitic diseases, RC109-216

الوصف: Background: Integrase inhibitor (INSTI) use has been associated with greater weight gain (WG) among people living with HIV (PLWH), but it is unclear how this effect compares in magnitude to traditional risk factors for WG. We assessed the population attributable fractions (PAFs) of modifiable lifestyle factors and INSTI regimens in PLWH who experienced a ≥5% WG over follow-up. Methods: In an observational cohort study from 2007 to 2019 at Modena HIV Metabolic Clinic, Italy, ART-experienced but INSTI-naive PLWH were grouped as INSTI-switchers vs non-INSTI. Groups were matched for sex, age, baseline BMI and follow-up duration. Significant WG was defined as an increase of ≥5% from 1st visit weight over follow-up. PAFs and 95% CIs were estimated to quantify the proportion of the outcome that could be avoided if the risk factors were not present. Results: 118 PLWH switched to INSTI and 163 remained on current ART. Of 281 PLWH (74.3% males), mean follow-up was 4.2 years, age 50.3 years, median time since HIV diagnosis 17.8 years, CD4 cell count 630 cells/µL at baseline. PAF for weight gain was the greatest for high BMI (45%, 95% CI: 27–59, p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2578-7470Test

الوصول الحر: https://doaj.org/article/7daac7e0979c4062a16fd479b6993927Test