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1.
J Clin Med ; 11(17)2022 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-36078913

RESUMEN

COVID-19 has severely affected the population of patients with end stage renal disease. Current data have proved a two-dose vaccination schedule against SARS-CoV-2 to be effective among dialyzed patients. There are limited data on the longevity and modulating factors of humoral response after vaccination. We performed a prospective longitudinal cohort study to determine longevity of the humoral response after SARS-CoV-2 vaccine. The study included 191 adult patients on hemodialysis and peritoneal dialysis. All participants had been vaccinated with three doses, either with BNT162b2 (Pfizer-BioNTech) (n = 109) or mRNA-1273 (Moderna) (n = 82). Anti-spike protein receptor-binding domain antibodies (anti-S IgG) were assessed using SARS-CoV-2 (RBD) IgG ELISA EIA-6150 IVD assay at baseline, on the 21st day and 43rd day, before a booster dose and two weeks thereafter. We found that before vaccination, 37.7% of the cohort had anti-S IgG titres concordant with seroconversion. After two-dose vaccination, seroconversion occurred in 97% of patients. The booster dose evoked a ~12-fold increase in antibody level. Obesity increased more than two-fold the odds for a decrease in anti-S IgG. Previous COVID-19 infection enhanced longevity of the humoral response following vaccination. In patients with previous COVID-19 infection, the BNT162b2 vaccine was associated with a higher odds of anti-S IgG waning compared to the mRNA-1273 vaccine. In conclusion, we report that obesity predisposes patients to protective antibody waning, hybrid immunity enhances odds for higher anti-S IgG concentrations and vaccine efficacy may be influenced by previous SARS-CoV-2 infection. The results might provide a rationale for vaccination protocol design.

2.
JAAPA ; 35(2): 39-41, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-35076438

RESUMEN

ABSTRACT: Kratom, a tropical plant and dietary supplement with dose-dependent effects, has physiologic effects similar to opioids as well as stimulant effects. Kratom, like all dietary supplements, is not regulated in the United States and its effects have raised potential and safety concerns. This article describes a patient who presented to the ED with jaundice and acute liver injury, which after a thorough exclusion of alternative causes was attributed to kratom use.


Asunto(s)
Estimulantes del Sistema Nervioso Central , Mitragyna , Analgésicos Opioides , Suplementos Dietéticos/efectos adversos , Humanos , Hígado , Estados Unidos
3.
Kardiol Pol ; 64(6): 573-80; discussion 581-2, 2006 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16810573

RESUMEN

INTRODUCTION: Women before menopause are thought to be relatively safe from cardiovascular disease due to the protective effects of oestrogens, although one may question this opinion with regards to women with many typical risk factors. However, because of the shortage of data concerning prevalence of risk factors in young women, it is not known whether this phenomenon is confined to a limited group or affects many women. AIM: The purpose of this study was to determine the prevalence of either typical risk factors of atherosclerosis or emotional disturbances that might increase the probability of coronary artery disease in young women. METHODS: The study group involved 62 premenopausal women with a sense of well-being (regular menstruations, activity of serum follicle stimulating hormone < 15 IU/L). Mean age of women was 43.5 years. Total cholesterol, LDL and HDL fractions, triglyceride, lipoprotein (a) and homocysteine concentrations were examined and body mass index was calculated. A psychological examination assessing depression and neuroticism intensity was also performed. RESULTS: Total cholesterol concentration (mean values +/- SD, expressed as mg%, percentage of abnormal results are given in brackets) was 206.3+/-35.8 (67.2), LDL cholesterol 124.3+/-30.2 (55.1), HDL cholesterol HDL 62.5+/-14.8 (6.9), triglyceride 101+/-60.1 (13.8), lipoprotein (a) 18.9+/-17.5 (44.8). Body mass index was 25.2+/-4.1 (41.3). History of smoking was positive in 27.4% and 6.5% of examined women had arterial hypertension. Coexistence of 4 to 5 aforementioned risk factors was noted in 27.4% of studied subjects. Mean homocysteine concentration was 10.7+/-2.1 micromol/L, while 41.3% of subjects had levels above the threshold of 11 micromol/l, commonly considered pathological. Symptoms of depression and neuroticism were seen in 30.5% and 22.5% of women, respectively. CONCLUSIONS: This pilot study of young women demonstrated that, in contrary to popular belief, this population is vulnerable to cardiovascular disease due to high prevalence of many risk factors.


Asunto(s)
Aterosclerosis/epidemiología , Colesterol/sangre , Estado de Salud , Hipertensión/epidemiología , Premenopausia/fisiología , Adulto , Aterosclerosis/fisiopatología , Comorbilidad , Femenino , Homocisteína/sangre , Humanos , Hipertensión/fisiopatología , Lipoproteínas/sangre , Persona de Mediana Edad , Obesidad/epidemiología , Proyectos Piloto , Polonia/epidemiología , Prevalencia , Factores de Riesgo , Triglicéridos/sangre
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