Les patients HIV controllers (HIC) constituent un groupe de patients rares, infectés par le VIH-1 et contrôlant spontantément la réplication virale sur le long terme sans traitement anti-rétroviral. ...Néanmoins, une inflammation chronique de bas grade existe chez une partie de ces patients, et pourrait conduire à des taux plus élevés d’événements non-classant SIDA (ENCS) que chez les patients contrôlant la réplication virale sous traitement antirétroviral (TARV).
555 patients ont été analysés : 227 patients HIC naïfs de TARV (infection par le VIH-1 connue depuis ≥5 ans et au moins 5 dernières charges virales consécutives (CV) <400 copies ARN VIH/mL) inclus dans la cohorte ANRS CODEX, et 328 patients ayant initié un TARV ≤1 mois après le diagnostic de primo-infection VIH-1 (inclus dans la cohorte ANRS PRIMO), avec une CV indétectable dans les 12 mois suivant l’initiation du TARV et pendant au moins 5 ans. La période prospective d’observation de la survenue d’évènements débutait respectivement à l’inclusion dans CODEX pour les patients HIC, et 5 ans après l’inclusion dans PRIMO pour les patients sous TARV. Les taux d’incidence (IR) des premiers ENCS ont été comparés entre les HIC et les patients sous TARV. Les facteurs déterminants les ENCS ont été évalués à l’aide de modèles de régression de Cox.
Pendant toute la période d’observation, 68 (30,0 %) HIC et 62 (18,9 %) patients sous TARV ont présenté au moins un ENCS (nombre total de 88 et 76 ENCS, respectivement). Les événements les plus fréquemment observés dans les 2 cohortes étaient des infections non classant SIDA (54,6 et 32,9 % respectivement pour les patients à HIC et sous TARV), pour la majorité des infections non sévères et ne nécessitant pas d’hospitalisation. Aucune différence pour les événements cardiovasculaires ou psychiatriques n’a été observée. Les taux d’incidence des ENCS toutes causes confondues étaient de 7,8 5,9-9,6 pour 100 personnes-années (PA) et de 5,2 3,9-6,4 pour 100 PA chez les HIC et les patients sous TARV, respectivement Incidence Rate Ratio (IRR)=1,5 (95 % Intervalle de confiance (IC), 1,1-2,2). Après ajustement pour la cohorte, les caractéristiques démographiques, immunologiques et les co-infections par les hépatites virales, le seul facteur associé indépendamment à l’occurrence des ENCS était l’âge (≥43 vs. <43) ans au début du contrôle virologique (IRR=1,7 1,1-2,6).
Les patients HIV controllers présentaient plus d’évènements non-classant SIDA que les patients sous TARV, principalement des infections non-classantes SIDA généralement bénignes. L’âge était le seul autre facteur associé indépendamment à la survenue d’ENCS, quels que soient les paramètres immuno-virologiques. Ces résultats ne plaident pas pour un élargissement de l’indication du TARV chez les HIC mais plutôt d’une approche au cas par cas, tenant compte des éléments cliniques tels que les ENCS et les comorbidités.
Philadelphia-positive (Ph(+)) B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is a genetically heterogeneous disease with a very poor prognosis. In this study, we analyzed the frequency of ...supernumerary Ph, trisomy 8, monosomy 7, and del(9p21) by FISH and its relationship with the characteristics of the disease, in 46 BCR/ABL(+) adult BCP-ALL patients. The frequency of supernumerary Ph, trisomy 8, monosomy 7 and del(9p21) was 30%, 20%, 15%, and 24%, respectively. Although all patients displayed a BII/common phenotype, supernumerary Ph and trisomy 8 were associated with higher expression of CD19 and CD22 and of CD19, CD34, CD45, and HLA-DR, respectively; in turn, cases with monosomy 7 showed lower CD19, CD22, CD34, and cCD79a and del(9p21)(+) blasts were CD13(-) and CD33(-). Overall, similar clinical and hematological features were observed at presentation, independently of the underlying genetic abnormalities. However, relapse-free survival (RFS) was significantly shorter in cases with supernumerary Ph, trisomy 8, and del(9p21), the latter being the most powerful independent prognostic factor for RFS.
Abstract
Introduction
Although there is evidence that women benefit very much more than men from resynchronization therapies even with narrower QRSs, the clinical practice guidelines for heart ...failure do not contemplate a different attitude taking into account gender.
Objective
The aim of this study is to analyze the clinical trials and registries on which the recommendations of the guidelines are based.
Methods
We selected in the bibliography of the 2021 European heart failure guidelines the registries and clinical essays and analyzed them attending to gender perspective according to the following questions:
Is gender treated as a primary variable? Is gender treated as a secondary variable?
Is there a differentiated analysis by sex? Are side effects described differently by sex?
What is the proportion of women in the study?
Results
We analyzed 16 articles. The proportion of women is between 15 and 25%. Only 6 in 16 articles reported a differentiated analysis by sex and there was only one article that differentiated side effects according to sex.
Conclusions
Gender analysis should be mandatory in all the clinical essays carried out in the future. Guidelines should consider different recommendations according to gender. Being excluded or infrarrepresented in studies could conditionate a discrimination to women not only now but also in the future when the algorithms of artificial intelligence condition the decisions we make in the different pathologies
Funding Acknowledgement
Type of funding sources: None.
Introduction and Aims: Non-alcoholic fatty liver disease (NAFLD) is a spectrum of diseases ranging from simple steatosis without inflammation or fibrosis to nonalcoholic steatohepatitis and in the ...Western countries has become one of the most prevalent chronic liver diseases related to metabolic and lipid alterations. Cholesteryl ester transfer protein (CETP) participates in high density lipoprotein (HDL)-cholesterol metabolism. The aim of our study was to investigate the influence of polymorphism (rs1800777) of CETP gene on liver histological changes, biochemical parameters, and serum adipokines levels in patients with NAFLD. Material and Methods: A population of 90 patients with NAFLD was recruited in a cross-sectional study. A biochemical analysis (glucose, c-reactive protein, insulin, homeostasis model assessment-insulin resistance, total cholesterol, low density lipoprotein (LDL)-cholesterol, HDL-cholesterol, triglycerides blood, and adipokines (leptin, adiponectin, and resistin) was realized. Genotype of polymorphism (rs1800777) of CETP gene was studied. Results: Eighty-three patients (92.2%) had the genotype GG (wild type group) and 7 patients (7.8%) had the genotype GA (n = 7) or AA (n = 0; mutant type group). Patients with A allele show significant decrease in liver biochemistry parameters – Alanine amino transferase (delta 10.1 ± 9.9 UI/L; p = 0.01), aspartate aminotransferase activity (delta 13.3 ± 9.5 UI/L; p = 0.02), and gammaglutamine transferase levels (delta 39 ± 30.1 UI/L; p = 0.01). Logistic regression analysis indicated that subjects with A-allele carriers were associated with a decreased risk of lobulillar inflammation (OR 0.18, 95% CI 0.04–0.95, p = 0.04) and a decreased risk of steatosis (OR 0.13, 95% CI 0.02–0.89, p = 0.04). Conclusions: A variant of the polymorphism rs1800777 of CETP gene is independently associated with the presence of steatosis and lobulillar inflammation in subjects with proven biopsy NAFLD.
The role of ADIPOQ gene rs266729 variants on weight loss after a dietary intervention are still unclear.
To analyze the effects of the ADIPOQ gene rs266729 variant n weight loss, cardiovascular risk ...factors, and adiponectin levels after two hypocaloric diets with different dietary fatty profiles.
A population of 362 obese patients was enrolled in a randomized clinical trial with two diets (Diet M, monounsaturated fat-enriched diet, and Diet P, polyunsaturated-fat enriched diet). Anthropometric measurements, an assessment of nutritional intake, and biochemical tests were performed at baseline and after 12 weeks.
Weight loss was similar with both diets. After Diet M, only subjects with CC genotype showed significant improvements in total cholesterol (CC vs. CG±GG) (−9.0±1.1mU/L vs. −4.5±2.4mg/dL, p=0.01), LDL cholesterol (−6.0±1.1mg/dL vs. −3.0±0.9mg/dL, p=0.03), glucose (−4.7±1.1mg/dL vs. −0.6±0.5mg/dL, p=0.01), and insulin levels (−2.6±1.0mU/L vs. −0.7±0.3mU/L, p=0.02) and in HOMA-IR (−0.5±0.2 units vs. −0.2±0.4 units, p=0.03). The same improvement was reported after Diet P in all parameters, including total cholesterol (CC vs. CG±GG) (−8.0±1.2mU/L vs. −2.1±1.4mg/dL, p=0.02), LDL cholesterol (−7.3±1.2mg/dL vs. −2.1±0.8mg/dL, p=0.02), glucose (−3.2±0.1mg/dL vs. −0.2±0.5mg/dL, p=0.01), and insulin levels (−2.5±1.0mU/L vs. −1±0.6mU/L, p=0.02) and HOMA-IR (−0.5±0.1 units vs. −0.3±0.4 units, p=0.02). Only subjects with CC genotype showed significant increases in adiponectin levels after both diets: (Diet M: 10.3±2.0ng/dL vs. Diet P: 9.3±2.9ng/dL, p=0.43).
The CC genotype of ADIPOQ gene rs266729 variant is associated to increased adiponectin levels and decreases in LDL cholesterol, glucose, insulin, and HOMA-IR levels after weight loss.
El papel de las variantes del gen ADIPOQ en la pérdida de peso después de una intervención dietética sigue sin estar claro.
Nuestro objetivo fue analizar los efectos de la variante rs266729 del gen ADIPOQ sobre la pérdida de peso, los factores de riesgo cardiovascular y los niveles de adiponectina después de 2 dietas hipocalóricas con diferentes perfiles de grasas en la dieta.
Una población de 362 pacientes obesos se incluyeron en un ensayo clínico aleatorizado con 2 dietas (dieta M: dieta enriquecida con grasas monoinsaturadas y dieta P: dieta enriquecida con grasas poliinsaturadas). Antes y tras 12 semanas, se realizó una evaluación antropométrica, evaluación de la ingesta nutricional y un análisis bioquímico.
La pérdida de peso fue similar con ambas dietas. Después de la dieta M, solo los sujetos con genotipo CC mostraron una mejoría significativa en el colesterol total (CC vs. CG±GG) (−9,0±1,1mU/l vs. −4,5±2,4mg/dl; p=0,01), colesterol LDL (−6,0±1,1mg/dl vs. −3,0±0,9mg/dl; p=0,03), glucosa (−4,7±1,1mg/dl vs. −0,6±0,5mg/dl; p=0,01), niveles de insulina (−2,6±1,0mU/l vs. −0,7±0,3mU/l; p=0,02) y HOMA-IR (−0,5±0,2 unidades vs. −0,2±0,4 unidades; p=0,03). La misma mejora en todos los parámetros se informó después de la dieta P; niveles de colesterol total (CC vs. CG±GG) (−8,0±1,2mU/l vs. −2,1±1,4mg/dl; p=0,02), colesterol LDL (−7,3±1,2mg/dl vs. −2,1±0,8mg/dl; p=0,02), glucosa (−3,2±0,1mg/dl vs. −0,2±0,5mg/dl; p=0,01), niveles de insulina (−2,5±1,0mU/l vs. −1±0,6mU/l; p=0,02) y HOMA-IR (−0,5±0,1 unidades vs. −0,3±0,4 unidades; p=0,02). Solo los sujetos con genotipo CC mostraron un aumento significativo de los niveles de adiponectina después de ambas dietas: (dieta M: 10,3±2,0ng/dl vs. dieta P: 9,3±2,9ng/dl; p=0,43).
El genotipo CC de la variante rs266729 del gen ADIPOQ se asocia con aumentos en los niveles de adiponectina y disminución del colesterol LDL, glucosa, insulina y HOMA-IR tras la pérdida de peso.
Most political bargaining in the U.S. system has two features which are constitutionally mandated: (1) only one actor can make a formal proposal, and (2) he or she can make an indefinite number of ...proposals. Existing work in economics and political science ignores at least one of these features. I construct a model incorporating both of these components of political bargaining. The main finding of this article is that time preferences and the number of periods have no effect on the equilibrium policy outcomes, which are identical to those first stated by Romer and Rosenthal in a one‐period model. This result suggests that impatience and time preferences may not be key features of political bargaining. This model has implications for constitutional and statutory rules regarding bargaining: it can be applied to presidential appointments, legislation, citizen initiatives, vetoes and filibusters (e.g., Krehbiel's pivotal politics model), and term limits.
Here, we report the draft genome sequence of
sp. strain V23, a bacterium isolated from accretion ice of the subglacial Lake Vostok (3,592 meters below the surface). This genome makes possible the ...study of ancient and psychrophilic genes and proteins from a subglacial environment isolated from the surface for at least 15 million years.
Background and objectives: the aim of the present investigation was to describe the association of this single nucleotide polymorphism (SNP) with fasting glucose levels, serum adipokine levels and ...diabetes mellitus. Methods: the study involved a population of 1,002 adult obese subjects. Measurements of anthropometric parameters, blood pressure, fasting blood glucose, C-reactive protein (CRP), insulin concentration, insulin resistance (HOMA-IR), HOMA-B, lipid profi le and adipocytokines levels were performed. Genotype of MTNR1B gene polymorphism (rs10830963) was evaluated. Results: fasting glucose levels (GG: 101.5 ± 19.1 mg/dl vs GT: 103.5 ± 8.1 units vs TT: 107.2 ± 8.0 mg/dl; p = 0.01) and HOMA-IR (GG: 3.1 ± 1.6 units vs GT: 3.4 ± 1.1 units vs TT: 3.7 ± 1.0 units; p = 0.02) were higher in subjects with GG genotype than in other genotypes. Total adiponectin levels (CC: 20.5 ± 8.4 ng/dl vs CG: 21.8 ± 5.4 ng/dl vs GG: 15.4 ± 1.4 ng/dl; p = 0.02) and HOMA-B (CC: 2.3 ± 0.8 units vs CG: 2.2 ± 1.1 units vs GG: 1.9 ± 0.9 units; p = 0.01) were lower in subjects with GG genotype than GC or CC genotypes. Logistic regression analysis showed an increased risk of hyperglicemia (OR = 1.31, 95% CI = 1.12-2.78, p = 0.03) and diabetes mellitus (OR = 1.37, 95% CI = 1.14-2.86, p = 0.04). Conclusions: this study showed that the MTNR1B rs10830963 polymorphism was associated with increased fasting glucose levels, HOMA-IR, and risk of DM2. This SNP was associated with decreased adiponectin levels and HOMA-B.
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