Publications by authors named "Michael Kundi"

293 Publications

Impact of gene variants on iron overload, overall survival and leukemia-free survival in myelodysplastic syndromes.

Am J Cancer Res 2021 1;11(3):955-967. Epub 2021 Mar 1.

Department of Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna Vienna 1090, Austria.

Although iron overload is a clinical challenge, little is known about the clinical impact of -variants in myelodysplastic syndromes (MDS) to date. We analyzed the status in 167 MDS patients and 494 healthy controls. One or more of the 3 -variants (H63D, C282Y, S65C) were found in 65/167 (38.9%) MDS patients and in 164/494 (33.2%) controls. At diagnosis, the median serum ferritin levels were higher in MDS patients with -variants (409 µg/L; range: 23-7415) compared to those without -variants (346.5 µg/L; range: 10-5450) (P=0.62). Moreover, '-mutated' patients had a slightly faster increase in serum ferritin in follow up examinations. The percentage of patients with -variants was higher in refractory anemia (RA) (22/53=41.5%) or RA with ring sideroblasts (RARS) (17/39=43.6%) compared to RA with excess of blasts (RAEB) (16/46=34.8%) or RAEB in transformation (RAEB-T) (5/17=29.4%). Differences were also detectable when comparing low- and high-risk MDS variants defined by the World Health Organization classification. There was no significant correlation between -variants and MDS-related somatic mutations. Progression-free survival was substantially longer in patients with -variants compared to those without -variants H63D and C282Y (P=0.089). Together, the -variants H63D and C282Y are frequently detected in Austrian MDS patients. These patients have substantially higher ferritin levels at diagnosis, accumulate iron slightly faster and have a better progression-free survival than non-mutated patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7994158PMC
March 2021

Significant impact of nationwide SARS-CoV-2 lockdown measures on the circulation of other respiratory virus infections in Austria.

J Clin Virol 2021 04 16;137:104795. Epub 2021 Mar 16.

Center for Virology, Medical University Vienna, Vienna, Austria.

Background: Since the worldwide spread of SARS-CoV-2, different European countries reacted with temporary national lockdowns with the aim to limit the virus transmission in the population. Also Austria started a lockdown of public life in March 2020.

Objectives: In this study we investigated whether the circulation of different respiratory virus infections in Austria, as assessed by the established respiratory virus surveillance system, is affected by these measures as well and may reflect the success of the lockdown in limiting respiratory virus transmission.

Study Design: Sentinel data obtained for influenza virus, respiratory syncytial virus, human metapneumovirus and rhinovirus cases were analyzed and compared between the season 2019/2020 and the five previous seasons.

Results: We observed a rapid and statistically significant reduction of cumulative cases for all these viruses within short time after the lockdown in March 2020, compared to previous seasons (each p < 0.001). Also, sentinel screening for SARS-CoV-2 infections was performed and a decrease of SARS-CoV-2 was seen after the lockdown. While for the seasonally occurring viruses as influenza, respiratory syncytial virus or human metapneumovirus the lockdown led to the end of the annual epidemics, a re-increase of rhinovirus infections was observed after liberalization of numerous lockdown measures.

Conclusions: Our data provide evidence that occurrence of different respiratory virus infections reflect not only the efficiency of lockdown measures taken against SARS-CoV-2 but it shows also the effects of lockdown releases on the transmission of respiratory viruses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcv.2021.104795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962988PMC
April 2021

Compression treatment in acute symptomatic proximal deep venous thrombosis - Results of a worldwide survey.

Phlebology 2021 Mar 21:2683555211003801. Epub 2021 Mar 21.

Private Practice Phlebology & Dermatology, Bonn, Germany and Department of Dermatology, University of Cologne, Köln, Germany.

Objectives: The aim of this study was to illustrate how compression is performed worldwide in proximal DVT and if compression management has changed recently.

Methods: A global online survey, consisting of 36 questions, was used. The survey was solicited from membership lists of Union Internationale de Phlébologie (UIP) membership societies. For differences between the continents in comparison to Western Europe odds ratios and 95% Confidence Intervals (95%CI) where calculated.

Results: We received 626 answers from 41 countries. Compression is routinely used in proximal DVT in all regions (82.8%). 81.4% start compression immediately after diagnosis. In the acute phase of DVT reduction of pain and swelling (91.7%) and PTS prevention (66.2%) are the main reasons for compression. 33.2% recently changed their compression management with 43.5% starting compression earlier and 7.0% later.

Conclusions: Compression is still used routinely in proximal DVT in addition to anticoagulation. The changes in international guidelines towards the non-routine use of compression in proximal DVT have not caused significant changes in DVT management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/02683555211003801DOI Listing
March 2021

Health Symptoms Related to Pesticide Use in Farmers and Laborers of Ecological and Conventional Banana Plantations in Ecuador.

Int J Environ Res Public Health 2021 01 27;18(3). Epub 2021 Jan 27.

Department of Environmental Health, Center for Public Health, Medical University Vienna, 1090 Wien, Austria.

Conventional banana farming is pesticide-intensive and leads to high exposure of farmworkers. Ecuador is the world's biggest exporter of bananas. In this field study in 5 communities in Ecuador, we recorded potentially pesticide-associated subjective health symptoms in farmworkers and compared pesticide users to workers in organic farming. With one exception, symptom rates were always higher in the pesticide-exposed group. Significance was reached in 8 out of 19 investigated symptoms with the highest odds ratios (and smallest -values) for local irritation like skin and eye irritation (OR = 3.58, CI 1.10-11.71, and 4.10, CI 1.37-12.31, respectively) as well as systemic symptoms like dizziness (OR = 4.80, CI 1.55-14.87) and fatigue (OR = 4.96, CI 1.65-14.88). Moreover, gastrointestinal symptoms were reported more frequently by pesticide users: nausea (OR = 7.5, CI 1.77-31.77) and diarrhea (OR = 6.43, CI 1.06-30.00). The majority of farmworkers were not adequately protected from pesticide exposure. For example, only 3 of 31 farmworkers that had used pesticides recently reported using gloves and only 6 reported using masks during active spraying. Improved safety measures and a reduction in pesticide use are necessary to protect the health of banana farmworkers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18031126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908553PMC
January 2021

Cytogenetic and molecular aberrations and worse outcome for male patients in systemic mastocytosis.

Theranostics 2021 1;11(1):292-303. Epub 2021 Jan 1.

Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.

In systemic mastocytosis (SM), the clinical features and survival vary greatly. Patient-related factors determining the outcome in SM are largely unknown. We examined the impact of sex on the clinical features, progression-free survival (PFS), and overall survival (OS) in 3403 patients with mastocytosis collected in the registry of the European Competence Network on Mastocytosis (ECNM). The impact of cytogenetic and molecular genetic aberrations on sex differences was analyzed in a subset of patients. Of all patients enrolled, 55.3% were females. However, a male predominance was found in a subset of advanced SM (AdvSM) patients, namely SM with an associated hematologic neoplasm (SM-AHN, 70%; 0.001). Correspondingly, organomegaly (male: 23% female: 13%, 0.007) was more, whereas skin involvement (male: 71% female: 86%, 0.001) was less frequent in males. In all patients together, OS ( 0.0001) was significantly inferior in males, and also within the WHO sub-categories indolent SM, aggressive SM (ASM) and SM-AHN. PFS was significantly ( 0.0002) worse in males when all patients were grouped together; due to low numbers of events, this significance persisted only in the subcategory smoldering SM. Finally, prognostically relevant cytogenetic abnormalities (10% 5%, 0.006) or molecular aberrations (// profile; 63% 40%, 0.003) were more frequently present in males. Male sex has a major impact on clinical features, disease progression, and survival in mastocytosis. Male patients have an inferior survival, which seems related to the fact that they more frequently develop a multi-mutated AdvSM associated with a high-risk molecular background.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7150/thno.51872DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681091PMC
January 2021

Air Pollution Is Associated with COVID-19 Incidence and Mortality in Vienna, Austria.

Int J Environ Res Public Health 2020 12 11;17(24). Epub 2020 Dec 11.

Center for Public Health, Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria.

We determined the impact of air pollution on COVID-19-related mortality and reported-case incidence, analyzing the correlation of infection case numbers and outcomes with previous-year air pollution data from the populations of 23 Viennese districts. Time at risk started in a district when the first COVID-19 case was diagnosed. High exposure levels were defined as living in a district with an average (year 2019) concentration of nitrogen dioxide (NO) and/or particulate matter (PM10) higher than the upper quartile (30 and 20 µg/m, respectively) of all districts. The total population of the individual districts was followed until diagnosis of or death from COVID-19, or until 21 April 2020, whichever came first. Cox proportional hazard regression was performed after controlling for percentage of population aged 65 and more, percentage of foreigners and of persons with a university degree, unemployment rate, and population density. PM10 and NO were significantly and positively associated with the risk of a COVID-19 diagnosis (hazard ratio (HR) = 1.44 and 1.16, respectively). NO was also significantly associated with death from COVID-19 (HR = 1.72). Even within a single city, higher levels of air pollution are associated with an adverse impact on COVID-19 risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17249275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764269PMC
December 2020

Linking cross-reactivity clusters of food and respiratory allergens in PAMD@ to asthma and duration of allergy.

World Allergy Organ J 2020 Dec 21;13(12):100483. Epub 2020 Nov 21.

Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria.

Background: Component resolved diagnosis, recently redefined as precision allergy medicine diagnosis - PAMD@, may help understanding allergic cross-reactivity patterns among polysensitized patients and their clinical implication.

Objective: We aimed to investigate similarities among allergens by empirically determining the occurrence of co-sensitization patterns and to relate them to clinical features, in particular to asthma.

Methods: A retrospective cohort study in 1057 participants suspected to have allergic sensitization was performed in Vienna. To define cross-reactivity patterns, cluster analysis for 671 patients who showed reaction to at least one of the allergens in ISAC112 was performed and followed by multivariate logistic regression analysis to relate clusters and clinical symptoms, in particular current asthma.

Results: We determined 18 cross-reactivity clusters, comprising of 6 food, 10 respiratory, and 2 other clusters of allergens. Overall, 14% of the cohort patients were positive for 1 cross-reactivity cluster and 23% to 2 or more clusters. Multisensitized patients who were sensitized to PR-10 allergen proteins in addition to Bermuda timothy grass pollen clusters showed the highest association with asthma (odds ratio, 4.22 and 95% CI: 2.32-7.68) and an increase of 10 years of the duration of allergy increased the odds for a combined sensitization to PR-10 cluster and Bermuda-timothy cluster by 1.27 (95% CI: 1.06-1.53).

Conclusion: Similarities among IgE positivity patterns determined by ISAC112 revealed 18 cross-reactivity clusters. This PAMD@ approach allowed prediction of clinical features and revealed that certain cross-reactivity patterns are related to duration of allergic symptoms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.waojou.2020.100483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691607PMC
December 2020

Dynamics of CD4 T Cell and Antibody Responses in COVID-19 Patients With Different Disease Severity.

Front Med (Lausanne) 2020 11;7:592629. Epub 2020 Nov 11.

Center for Virology, Medical University of Vienna, Vienna, Austria.

Disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ranges from mild illness to severe respiratory disease and death. In this study, we determined the kinetics of viral loads, antibody responses (IgM, IgG, neutralization) and SARS-CoV-2-specific CD4 T cells by quantifying these parameters in 435 serial respiratory and blood samples collected from a cohort of 29 COVID-19 patients with either moderate or severe disease during the whole period of hospitalization or until death. Remarkably, there was no significant difference in the kinetics and plateau levels of neutralizing antibodies among the groups with different disease severity. In contrast, the dynamics of specific CD4 T cell responses differed considerably, but all patients with moderate or severe disease developed robust SARS-CoV-2-specific responses. Of note, none of the patients had detectable cross-reactive CD4 T cells in the first week after symptom onset, which have been described in 20-50% of unexposed individuals. Our data thus provide novel insights into the kinetics of antibody and CD4 T cell responses as well as viral loads that are key to understanding the role of adaptive immunity in combating the virus during acute infection and provide leads for the timing of immune therapies for COVID-19.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2020.592629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686651PMC
November 2020

Use of micronucleus assays for the prediction and detection of cervical cancer: a meta-analysis.

Carcinogenesis 2020 Oct;41(10):1318-1328

Department of Internal Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.

Cervical cancer (CC) is the fourth most common cancer in women; the survival rates depend strongly on its early detection. The Pap test is the most frequently used diagnostic tool, but due to its limited sensitivity/specificity, additional screening tests are needed. Therefore, we evaluated the use of micronucleus (MN) assays with cervical cells for the prediction and diagnosis of CC. MN reflects structural and numerical chromosomal aberrations. A search was performed in Pubmed, Scopus, Thomson ISI and Google Scholar. Subsequently, meta-analyses were performed for different grades of abnormal findings in smears and biopsies from patients which were diagnosed with CC. Results of 21 studies in which findings of MN experiments were compared with data from Pap tests show that higher MN frequencies were found in women with abnormal cells that are indicative for increased cancer risks. MN frequency ratios increased in the order inflammation (2.1) < ASC-US and ASC-H (3.3) < LGSIL (4.4) < HGSIL (8.4). Furthermore, results are available from 17 investigations in which MN were scored in smears from patients with neoplasia. MN rates increased with the degree of neoplasia [CIN 1 (4.6) < CIN 2 (6.5) and CIN 3 (10.8)] and were significantly higher (8.8) in CC patients. Our meta-analysis indicates that the MN assay, which is easy to perform in combination with Pap tests, may be useful for the detection/prediction of CC. However, standardization (including definition of the optimal cell numbers and stains) and further validation is necessary before the MN test can be implemented in routine screening.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/carcin/bgaa087DOI Listing
October 2020

Reply to "Acid inhibitors and allergy: comorbidity, causation and confusion".

Nat Commun 2020 08 7;11(1):3949. Epub 2020 Aug 7.

Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel, 1090, Vienna, Vienna, Austria.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41467-020-17830-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7414906PMC
August 2020

Apparent intracellular Helicobacter pylori detected by immunohistochemistry - the missing link in eradication failure.

Clin Infect Dis 2020 Jun 22. Epub 2020 Jun 22.

Division for Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.

Background: Helicobacter (H.) pylori is primarily an extracellularly living bacterium. However, seemingly intracellular occurrence can often be detected by immunohistochemical stains. Considering antimicrobial resistance, we investigated the impact of the apparent intracellular H. pylori (aiHp) on treatment failure of first-line triple therapies.

Methods: Gastric biopsies of 814 H. pylori infected patients naïve for treatment were analyzed before and after eradication therapy by immunohistochemistry. Thereof, 373 received treatment consisting of amoxicillin, clarithromycin and PPI (AC/PPI). Availability of PCR-based clarithromycin susceptibility test results from pre-treatment gastric biopsies was a pre-condition for matching 52 aiHp to 52 non-aiHp cases within the AC/PPI-group.

Results: AiHp were detected mostly in low counts predominantly in corpus, rarely in antrum biopsies (95.2% vs. 24.6%); they were found in 497 (61%) of all patients and in 192 of 373 patients (51.5%) in the AC/PPI-group. The eradication rate in aiHp vs. non-aiHp cases was 44.4% vs. 72.9% in the entire sample and 45.3% vs. 66.8% in the AC/PPI-group. Among the 104 paired patients, respective values were 46.2% vs. 78.8%; in clarithromycin susceptible cases 60.6% vs. 91.9%. Both aiHp and resistance to clarithromycin proved to be highly significant (p≤0.001) and independent predictors of eradication failure. Twelve of 13 aiHp cases with a clarithromycin sensitive strain, who failed eradication, developed resistance to the antibiotic.

Conclusions: AiHp found by immunohistochemical staining especially in corpus biopsies proved to be a risk factor for failure of first-line triple therapies; occurrence of aiHp should be considered with regard to therapy options.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/cid/ciaa839DOI Listing
June 2020

Nature Relatedness of Recreational Horseback Riders and Its Association with Mood and Wellbeing.

Int J Environ Res Public Health 2020 06 10;17(11). Epub 2020 Jun 10.

Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria.

Connectedness to nature and nature contact can provide many benefits to humans, like stress reduction, recovery from illness, and increased positive emotions. Likewise, recreational horseback riding is a widespread sports activity with the potential to enhance physical and psychological health. Yet, the influence of connectedness to nature on the wellbeing of older aged recreational horseback riders has not been investigated so far. The aim of the present study therefore was to explore the relationship between nature relatedness and physical, psychological and social wellbeing and happiness. The study sample was composed of Austrian recreational horseback riders aged 45 years and older, who were compared with dog owners and people without pets ( = 178). We found significantly higher nature relatedness, significantly higher overall wellbeing and a significantly better mood rating in recreational horseback riders compared to people without pets and similar scores compared to dog owners. Physical wellbeing is correlated with overall nature relatedness in horseback riders and dog owners, but no correlation was found in people without pets. A structural equation model shows a direct relationship between nature relatedness and mood in horseback riders and an indirect relationship through pet attachment in dog owners. The results suggest the activity with horses and dogs in nature environments is a source of wellbeing, enjoyment, self-confidence and social contacts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17114136DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312614PMC
June 2020

A New Strategy Toward B Cell-Based Cancer Vaccines by Active Immunization With Mimotopes of Immune Checkpoint Inhibitors.

Front Immunol 2020 27;11:895. Epub 2020 May 27.

Center for Pathophysiology, Infectiology and Immunology, Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria.

Therapeutic monoclonal antibodies (mAbs), targeting tumor antigens, or immune checkpoints, have demonstrated a remarkable anti-tumor effect against various malignancies. However, high costs for mono- or combination therapies, associated with adverse effects or possible development of resistance in some patients, warrant further development and modification to gain more flexibility for this immunotherapy approach. An attractive alternative to passive immunization with therapeutic antibodies might be active immunization with mimotopes (B-cell peptides) representing the mAbs' binding epitopes, to activate the patient's own anti-tumor immune response following immunization. Here, we identified and examined the feasibility of inducing anti-tumor effects following active immunization with a mimotope of the immune checkpoint programmed cell death 1 (PD1), alone or in combination with a Her-2/neu B-cell peptide vaccine. Overlapping peptides spanning the extracellular domains of human PD1 (hPD1) were used to identify hPD1-derived mimotopes, using the therapeutic mAb Nivolumab as a proof of concept. Additionally, for evaluation in a tumor mouse model, a mouse PD1 (mPD1)-derived mimotope was identified using an anti-mPD1 mAb with mPD1/mPDL-1 blocking capacity. The identified mimotopes were characterized by assays, including a reporter cell-based assay, and their anti-tumor effects were evaluated in a syngeneic tumor mouse model stably expressing human Her-2/neu. The identified PD1-derived mimotopes were shown to significantly block the mAbs' capacity in inhibiting the respective PD1/PD-L1 interactions. A significant reduction in tumor growth was observed following active immunization with the mPD1-derived mimotope, associated with a significant reduction in proliferation and increased apoptotic rates in the tumors. Particularly, combined vaccination with the mPD1-derived mimotope and a multiple B-cell epitope Her-2/neu vaccine potentiated the vaccine's anti-tumor effect. Our results suggest active immunization with mimotopes of immune checkpoint inhibitors either as monotherapy or as combination therapy with tumor-specific vaccines, as a new strategy for cancer treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fimmu.2020.00895DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266955PMC
April 2021

Obesity and Sex Affect the Immune Responses to Tick-Borne Encephalitis Booster Vaccination.

Front Immunol 2020 27;11:860. Epub 2020 May 27.

Institute of Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, Vienna, Austria.

Obesity has dramatically increased over the last 30 years and reaches according to World Health Organization dimensions of a global epidemic. The obesity-associated chronic low-level inflammation contributes to severe comorbidities and directly affects many immune cells leading to immune dysfunction and increased susceptibility to infections. Thus, prophylaxis against vaccine-preventable diseases is crucial, yet the responsiveness to several vaccines is unclear under obesity. In order to assess the responsiveness to tick-borne encephalitis (TBE) vaccine, we revaccinated 37 obese individuals and 36 normal-weight controls with a licensed TBE vaccine. Metabolic, hormonal, and immunologic profiles along with vaccine-specific humoral and cellular immune responses were evaluated in sera and peripheral blood mononuclear cells (PBMCs) before, 1 week, 4 weeks, and 6 months after TBE booster. Obese adults had significantly increased metabolic (triglycerides, cholesterol ratios, leptin, insulin) and proinflammatory (C-reactive protein) parameters. They showed stronger initial increase of TBE-specific Ab titers (d7_d28) followed by a significantly faster decline after 6 months, which correlated with high body mass index and leptin and insulin levels. The fold increase of Ab-titer levels was significantly higher in obese compared to control males and linked to reduced testosterone levels. Obesity also affected cellular responses: PBMCs of the obese vaccinees had elevated interleukin 2 and interferon γ levels upon antigen stimulation, indicating a leptin-dependent proinflammatory T1 polarization. The expansion of total and naive B cells in obese might explain the initial increase of Ab titers, whereas the reduced B-memory cell and plasma blast generation could be related to fast Ab decline with a limited maintenance of titers. Among T follicular helper cell (Tfh) cells, the Tfh17 subset was significantly expanded particularly in obese males, where we observed a strong initial Ab increase. Systemic but not local vaccine side effects were more frequent in obese subjects as a possible consequence of their low-grade proinflammatory state. In summary, TBE booster vaccination was effective in obese individuals, yet the faster Ab decline could result in a reduced long-term protection. The sex-based differences in vaccine responses indicate a complex interplay of the endocrine, metabolic, and immune system during obesity. Further studies on the long-term protection after vaccination are ongoing, and also evaluation of primary vaccination against TBE in obese individuals is planned. NCT04017052; https://clinicaltrials.gov/ct2/show/NCT04017052.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fimmu.2020.00860DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7266951PMC
April 2021

Postnatal Acculturative Stress and 'Doing the Month' Among East Asian Women in Austria: Revisiting Acculturation Theories From a Qualitative Perspective.

Front Psychol 2020 14;11:977. Epub 2020 May 14.

Center for Public Health, Medical University of Vienna, Vienna, Austria.

Acculturative stress is a phenomenon describing negative emotions experienced by immigrants in their socio-cultural and psychological adaptation process to the host society's dominant culture and its population. Acculturative stress is assumed to be one the reasons for higher prevalence of postnatal depression among immigrant women compared to non-immigrant women. Theories and models of acculturation and coping strategies suggest that certain cultural orientations or behaviors could mitigate acculturative stress and postnatal depression. Nevertheless, quantitative studies applying these theories have so far revealed inconsistent results. Given this background, we ask: what can a qualitative study of immigrant women's postnatal experiences tell us about the interrelationships between immigrant mothers' acculturation behaviors or cultural orientations, and maternal psychological health? Particularly, we explore the postnatal experiences of Chinese and Japanese women who gave birth in Austria, focusing on their experiences and behaviors influenced by their heritage culture's postnatal practices ( and ). Theoretically, we apply Berry's acculturation model through a focus on what we call 'Postnatal Acculturative Stress' (PAS). By doing so, we identify factors that prevent or mitigate PAS. Another aim of this article is to critically reassess Berry's model in the context of postnatal care and maternal psychological health. Data were analyzed using a combination of deductive and inductive method through the application of directed content analysis and phenomenological approach. Women's postnatal experiences were summarized as an 'unexpected solitary struggle in the midst of dual identity change' in four specific domains: postnatal rest and diet, social support, feelings toward significant others and identity. Preventive and mitigating factors against PAS included trust (in self and one's health beliefs) and mutual respectful relationships with and between the significant others. The application of Berry's acculturation model provided a useful framework of analysis. Nevertheless, the multifarious complexity involved in the process of acculturation as well as different power dynamics in the family and healthcare settings makes it difficult to draw causal relationships between certain acculturation behaviors or cultural orientations with specific health outcomes. Health professionals should be aware of the complex psychosocial processes, contexts as well as social environment that shape immigrants' acculturative behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fpsyg.2020.00977DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240129PMC
May 2020

Nitrogen-Dioxide Remains a Valid Air Quality Indicator.

Int J Environ Res Public Health 2020 05 25;17(10). Epub 2020 May 25.

Department of Environmental Health, Center for Public Health, Medical University Vienna, 1090 Vienna, Austria.

In epidemiological studies, both spatial and temporal variations in nitrogen dioxide (NO) are a robust predictor of health risks. Compared to particulate matter, the experimental evidence for harmful effects at typical ambient concentrations is less extensive and not as clear for NO. In the wake of the "Diesel emission scandal-Dieselgate", the scientific basis of current limit values for ambient NO concentrations was attacked by industry lobbyists. It was argued that associations between NO levels and medical endpoints were not causal, as NO in older studies served as a proxy for aggressive particulate matter from incineration processes. With the introduction of particle filters in diesel cars, NO would have lost its meaning as a health indicator. Austria has a high percentage of diesel-powered cars (56%). If, indeed, associations between NO concentrations and health risks in previous studies were only due to older engines without a particle filter, we should expect a reduction in effect estimates over time as an increasing number of diesel cars on the roads were outfitted with particle filters. In previous time series studies from Vienna over shorter time intervals, we have demonstrated distributed lag effects over days up to two weeks and previous day effects of NO on total mortality. In a simplified model, we now assess the effect estimates for moving 5-year periods from the beginning of NO monitoring in Vienna (1987) until the year 2018 of same and previous day NO on total daily mortality. Contrary to industry claims of a spurious, no longer valid indicator function of NO, effect estimates remained fairly stable, indicating an increase in total mortality of previous day NO by 0.52% (95% CI: 0.35-0.7%) per 10 µg/m change in NO concentration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17103733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277805PMC
May 2020

Environmental tobacco smoke exposure during pregnancy affects complications and birth outcomes in women with and without asthma.

BMC Pregnancy Childbirth 2020 May 20;20(1):314. Epub 2020 May 20.

Department of Obstetrics and Gynecology, Mobini Hospital, Sabzevar University of Medical Sciences, Sabzevar, Iran.

Background: It is known that environmental tobacco smoke (ETS) has adverse effects on pregnancy and birth outcomes. We aimed to assess the impact of ETS in pregnant women with and without asthma.

Methods: A cohort study was conducted from August 2014 to June 2015 enrolling 1603 pregnant women during their 2nd trimester. Data on tobacco exposure were collected at first visit and women were followed through pregnancy till postpartum.

Results: Of the 1603 women, 231 reported passive smoking, 223 non-asthmatics and 8 asthmatics. Women exposed to ETS during pregnancy were more likely to have an infant admitted to the pediatric ward (10.8% vs. 6.5%, p = 0.026) and to have low one- and five-minute Apgar scores (1 min: 6.1% vs. 2.6%, p = 0.011; 5 min: 2.2% vs. 0.7%, p = 0.039). Complications of pregnancy were also elevated in women exposed to ETS (53.7% vs. 42.3%, p = 0.002). Asthma had no additional effect beyond the impact of ETS except for cesarean sections that were more frequent in women with asthma exposed to ETS.

Conclusions: Due to the small number of women with asthma exposed to ETS, combined effects of asthma and ETS were only found for cesarean sections. Still counseling of pregnant women about adverse effects of ETS should consider women's asthma as an additional reason to avoid ETS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12884-020-03000-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240917PMC
May 2020

Microarray-Based Detection of Allergen-Reactive IgE in Patients with Mastocytosis.

J Allergy Clin Immunol Pract 2020 09 26;8(8):2761-2768.e16. Epub 2020 Apr 26.

Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria. Electronic address:

Background: Because of a high risk to develop fatal anaphylaxis, early detection of immunoglobulin E (IgE)-dependent allergy is of particular importance in patients with mastocytosis.

Objective: We examined whether microarray-based screening for allergen-reactive IgE (allergen-chip) is a sensitive and robust approach to detect specific IgE in patients with mastocytosis.

Methods: Sera for 42 patients were analyzed, including 4 with cutaneous mastocytosis, 2 with mastocytosis in the skin, and 36 with systemic mastocytosis. In addition, sera from an age- and sex-matched control cohort (n = 42) were analyzed.

Results: In 15 of 42 patients with mastocytosis (35.7%), specific IgE was detected by allergen-chip profiling. Ves v 5 and Bet v 1 were the most frequently detected allergens (Ves v 5: 16.7% of patients; Bet v 1: 11.9% of patients). Allergen reactivity was confirmed by demonstrating upregulation of CD203c on blood basophils upon exposure to the respective allergen(s) in these patients. Specific IgE was identified by chip studies in 11 of 26 patients with mastocytosis with mediator-related symptoms (42.3%) and in 4 of 14 patients with mastocytosis without symptoms (28.6%). In the cohort with known allergy, 9 of 9 patients (100%) had a positive allergen-chip result. In patients with mastocytosis without a known allergy (n = 31), the chip identified 6 positive cases (19.5%). The prevalence of chip-positive patients was slightly lower in the mastocytosis group (35.7%) compared with age- and sex-matched controls (40.5%).

Conclusions: Although specific IgE may not be detectable in all sensitized patients with mastocytosis, allergy chip-profiling is a reliable screening approach for the identification of patients with mastocytosis suffering from IgE-dependent allergies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jaip.2020.04.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7116130PMC
September 2020

Heterogeneity of Circulating Influenza Viruses and Their Impact on Influenza Virus Vaccine Effectiveness During the Influenza Seasons 2016/17 to 2018/19 in Austria.

Front Immunol 2020 17;11:434. Epub 2020 Mar 17.

Centre of Virology, Medical University Vienna, Vienna, Austria.

The constantly changing pattern in the dominance of viral strains and their evolving subclades during the seasons substantially influences influenza vaccine effectiveness (IVE). In order to further substantiate the importance of detailed data of genetic virus characterization for IVE estimates during the seasons, we performed influenza virus type and subtype specific IVE estimates. IVE estimates were assessed using a test-negative case-control design, in the context of the intraseasonal changes of the heterogeneous mix of circulating influenza virus strains for three influenza seasons (2016/17 to 2018/19) in Austria. Adjusted overall IVE over the three seasons 2016/17, 2017/18, and 2018/19 were -26, 39, and 63%, respectively. In accordance with the changing pattern of the circulating strains a broad range of overall and subtype specific IVEs was obtained: A(H3N2) specific IVE ranged between -26% for season 2016/17 to 58% in season 2018/19, A(H1N1)pdm09 specific IVE was 25% for the season 2017/18 and 65% for the season 2018/19 and Influenza B specific IVE for season 2017/18 was 45%. The results obtained in our study over the three seasons demonstrate the increasingly complex dynamic of the ever changing genetic pattern of the circulating influenza viruses and their influence on IVE estimates. This emphasizes the importance of detailed genetic virus surveillance for reliable IVE estimates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fimmu.2020.00434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7092378PMC
March 2021

Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study.

Neuroepidemiology 2020 20;54(4):343-355. Epub 2020 Mar 20.

Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain,

Background: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study.

Methods: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors.

Results: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest.

Conclusions: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000506131DOI Listing
March 2020

Pet Attachment and Wellbeing of Older-Aged Recreational Horseback Riders.

Int J Environ Res Public Health 2020 03 13;17(6). Epub 2020 Mar 13.

Center for Public Health, Medical University Vienna, Kinderspitalgasse 15/1, 1090 Vienna, Austria.

The aim of the study was to determine if and how emotional attachment to their animal of older-aged (45+) horseback riders affects their physical, psychological and social wellbeing in comparison to dog owners. Overall, 124 individuals 45+ years answered questionnaires about pet attachment and wellbeing. Comparisons were carried out using a general linear model with activity group (rider/dog owner) as the main variable of interest. Horseback riders had no significantly lower pet attachment scores compared to dog owners. Gender differences of pet attachment were found in riders, with women having higher love factor scores. Self-reported mood during activities with the animal was significantly correlated with overall pet attachment, pet love and personal growth by contact with the pet in both, riders and dog owners. We observed no correlation of physical wellbeing during and after the activity with the animal and overall pet attachment in dog owners and horseback riders. Psychological wellbeing during the activity was significantly correlated with overall pet attachment in riders and social wellbeing during the activity in both groups. Recreational horseback riders nearly reach pet attachment scores of dog owners, increasing social and psychological wellbeing in a manner similar to that in dog owners.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17061865DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143422PMC
March 2020

Selenium, Zinc, and Manganese Status in Pregnant Women and Its Relation to Maternal and Child Complications.

Nutrients 2020 Mar 10;12(3). Epub 2020 Mar 10.

Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.

Micronutrients, as essential components of prenatal care, are important to reduce the risk for maternal and child morbidity and mortality by lowering pregnancy-related complications. The present study aimed to investigate the status of the trace elements, i.e., selenium, zinc, and manganese in pregnant and non-pregnant women from a developing country and to evaluate its relationship with maternal and child complications. Selenium, zinc, and manganese concentrations were measured in the blood serum of 80 pregnant women and compared with 40 non-pregnant healthy controls. The quantitative analyses of trace elements were performed by using the inductively coupled plasma-optical emission spectrometry (ICP-OES) method. The information about the dietary habits of the study participants was recorded by using a food frequency questionnaire. The results showed significant lower selenium and zinc levels in pregnant women as compared to the controls (2.26 ± 1.09 vs. 2.76 ± 1.15 µmol/L, = 0.031; 21.86 ± 7.21 vs. 29.54 ± 7.62 µmol/L, < 0.001) respectively, with no difference in manganese concentrations (1.40 ± 0.09 vs.1.38 ± 0.09 log nmol/L, = 0.365). Regarding maternal and child complications, higher manganese levels were associated with an increased odds ratio for maternal complications (OR = 3.175, CI (95%) 1.631-6.181; = 0.038). Consumption of dairy products was associated with lower selenium and manganese values. Pregnant women showed a lower serum selenium and zinc status, and in addition elevated serum manganese concentrations, which might be associated with a higher risk for maternal pregnancy/birth complications, although more studies are necessary to evaluate this association.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu12030725DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146474PMC
March 2020

Clinical presentation of young people (10-24 years old) with brain tumors: results from the international MOBI-Kids study.

J Neurooncol 2020 Apr 3;147(2):427-440. Epub 2020 Mar 3.

ISGlobal, Barcelona, Spain.

Introduction: We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24).

Methods: Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location.

Results: Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays.

Conclusions: This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11060-020-03437-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136306PMC
April 2020

Increasing Frequency of Antenatal Care Visits May Improve Tetanus Toxoid Vaccination Coverage in Pregnant Women in Pakistan.

Hum Vaccin Immunother 2020 07 2;16(7):1529-1532. Epub 2020 Mar 2.

Department of Environmental Health, Center for Public Health, Medical University Vienna , Vienna, Austria.

Objective: Maternal and neonatal tetanus (MNT) elimination in low-income countries is a major aim of public health endeavors, due to poor vaccination status, lack of antenatal care, and unhygienic birth practices. The objective of this study, thus, was to assess the present state and factors associated with maternal tetanus toxoid (TT) vaccination in Pakistan.

Methods: Overall, 80 pregnant women (26 ± 4 y) during their last trimester were recruited from the district hospital Khanewal, Pakistan. The prevalence of vaccination was ascertained through clinical interviews and examination of health records from each participant. A questionnaire-based interview was conducted to assess the education level, antenatal visits, and sociodemographic variables related to vaccination coverage. A generalized linear model was used for statistical analyses.

Results: Seventy-nine percent of pregnant women were vaccinated with two doses of TT vaccine, while 16% of women were unvaccinated. Overall, 66% of pregnant women received two or more antenatal visits. Two and more than two antenatal visits during pregnancy were associated with significantly increased odds ratios for sufficient TT vaccination (OR = 1.60, CI [95%] 1.34-1.92 and OR = 1.61, CI [95%] 1.32-1.97, respectively) as compared to no or only one antenatal visit.

Conclusion: Regular antenatal care can improve vaccination coverage during pregnancy. Hence, reducing barriers for visiting antenatal care facilities could be key to reach the goal for MNT elimination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/21645515.2019.1705693DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482883PMC
July 2020

Indicators of Genotoxicity in Farmers and Laborers of Ecological and Conventional Banana Plantations in Ecuador.

Int J Environ Res Public Health 2020 02 24;17(4). Epub 2020 Feb 24.

Department of Environmental Health, Center for Public Health, Medical University, 1090 Vienna, Austria.

Banana farming represents an important segment of agricultural production in Ecuador. The health of farmworkers might be compromised by the extensive use of pesticides in plantations applied under poorly regulated conditions. Due to an increased awareness of pesticide-related problems for nature, as well as for worker and consumer health, ecological farming has been established in some plantations of Ecuador. We set out to investigate the occupational health of workers in both conventional and ecological farming. Nuclear anomalies in buccal epithelial cells were used as short-term indicators for genotoxicity and a potentially increased cancer risk in the two groups of farmworkers. By application of the Buccal Micronucleus Cytome Assay (BMCA), we found the frequency of micronuclei in conventional pesticide using farmworkers significantly increased by 2.6-fold, and other nuclear anomalies significantly increased by 24% to 80% (except pyknosis with a non-significant increase of 11%) compared to the farmworkers on ecological plantations. These results demonstrate that ecological farming may provide an alternative to extensive pesticide use with significantly reduced indicators of cancer risk. In conventional farming, improvements in education and instruction regarding the safe handling of pesticides and protective equipment, as well as regulatory measures, are urgently needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17041435DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068563PMC
February 2020

Smoking causes induction of micronuclei and other nuclear anomalies in cervical cells.

Int J Hyg Environ Health 2020 05 20;226:113492. Epub 2020 Feb 20.

Institute of Cancer Research, Medical University of Vienna, Vienna, Austria. Electronic address:

Introduction: Smoking is an independent cause of cervical cancer, which is the 4th most common malignancy in women. It is currently not known if tobacco consumption causes chromosomal damage (which is a hallmark of human cancer) in cervical cells and if age and the hormonal status have an impact on tobacco induced genetic instability in the cervix.

Methods: We conducted a study with pre- and post-menopausal women smokers and never-smokers (25/group). Smokers consumed 30 light/medium cigarettes/day and were matched with the non-smoking group. Cervical cells were analyzed for induction of micronuclei (MN) which are caused by structural/numerical chromosomal aberrations; additionally, other nuclear anomalies reflecting genomic instability and cytotoxicity were scored. Furthermore, the frequencies of basal cells were recorded which reflect the mitotic activity of the mucosa.

Results: MN and other abnormalities were increased in both groups of smokers. The effects were most pronounced in postmenopausal smokers (i.e. 2-fold higher) compared to premenopausal smokers. Also the number of basal cells (indicative for cell proliferation) was clearly enhanced in older women. Tar and nicotine had no detectable impact on chromosomal damage but a clear association with pack-years was observed.

Conclusions: Smoking increased chromosomal instability, cytotoxicity and induced cell divisions in cervical mucosa cells of pre- and post-menopausal women. The effects were more pronounced in the latter group indicating a higher risk for diseases (including cancer) that are causally related to DNA damage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijheh.2020.113492DOI Listing
May 2020

Impact of flavivirus vaccine-induced immunity on primary Zika virus antibody response in humans.

PLoS Negl Trop Dis 2020 02 4;14(2):e0008034. Epub 2020 Feb 4.

Center for Virology, Medical University of Vienna, Vienna, Austria.

Background: Zika virus has recently spread to South- and Central America, causing congenital birth defects and neurological complications. Many people at risk are flavivirus pre-immune due to prior infections with other flaviviruses (e.g. dengue virus) or flavivirus vaccinations. Since pre-existing cross-reactive immunity can potentially modulate antibody responses to Zika virus infection and may affect the outcome of disease, we analyzed fine-specificity as well as virus-neutralizing and infection-enhancing activities of antibodies induced by a primary Zika virus infection in flavivirus-naïve as well as yellow fever- and/or tick-borne encephalitis-vaccinated individuals.

Methodology: Antibodies in sera from convalescent Zika patients with and without vaccine-induced immunity were assessed by ELISA with respect to Zika virus-specificity and flavivirus cross-reactivity. Functional analyses included virus neutralization and infection-enhancement. The contribution of IgM and cross-reactive antibodies to these properties was determined by depletion experiments.

Principal Findings: Pre-existing flavivirus immunity had a strong influence on the antibody response in primary Zika virus infections, resulting in higher titers of broadly flavivirus cross-reactive antibodies and slightly lower levels of Zika virus-specific IgM. Antibody-dependent enhancement (ADE) of Zika virus was mediated by sub-neutralizing concentrations of specific IgG but not by cross-reactive antibodies. This effect was potently counteracted by the presence of neutralizing IgM. Broadly cross-reactive antibodies were able to both neutralize and enhance infection of dengue virus but not Zika virus, indicating a different exposure of conserved sequence elements in the two viruses.

Conclusions: Our data point to an important role of flavivirus-specific IgM during the transient early stages of infection, by contributing substantially to neutralization and by counteracting ADE. In addition, our results highlight structural differences between strains of Zika and dengue viruses that are used for analyzing infection-enhancement by cross-reactive antibodies. These findings underscore the possible impact of specific antibody patterns on flavivirus disease and vaccination efficacy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0008034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7021315PMC
February 2020

Iron and Iodine Status in Pregnant Women from A Developing Country and Its Relation to Pregnancy Outcomes.

Int J Environ Res Public Health 2019 11 11;16(22). Epub 2019 Nov 11.

Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.

Birth related complications and comorbidities are highly associated with a poor nutritional status of pregnant women, whereas iron and iodine are among especially important trace elements for healthy maternal and fetal outcomes. The study compares the status of iron, iodine, and related functional parameters in pregnant and non-pregnant women from a developing country and associates the data with pregnancy complications. The concentrations of ferritin, hemoglobin (Hb), total triiodothyronine (TT3), total thyroxine (TT4), and thyroid-stimulating hormone (TSH) were determined in the blood serum of 80 pregnant women at the time of delivery and compared with 40 non-pregnant healthy controls. Spot urine samples were taken to evaluate the urinary iodine concentration (UIC). In pregnant women, ferritin, Hb concentrations, and UIC were significantly lower, and TT4 values were significantly higher compared to controls. Higher Hb levels were tendentially associated with a reduced risk for pregnancy complications (OR = 0.747, CI (95%) 0.556-1.004; = 0.053). Regarding covariates, only previous miscarriages were marginally associated with pregnancy complications. High consumption of dairy products was associated with lower Hb and ferritin values. Our results suggest that pregnant women from a developing country have lower iron status with Hb levels being possibly associated with pregnancy complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph16224414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6888287PMC
November 2019

International prognostic scoring system for mastocytosis (IPSM): a retrospective cohort study.

Lancet Haematol 2019 Dec 31;6(12):e638-e649. Epub 2019 Oct 31.

Department of Internal Medicine I, Division of Hematology and Hemostaseology, and Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria.

Background: The WHO classification separates mastocytosis into distinct variants, but prognostication remains a clinical challenge. The aim of this study was to improve prognostication for patients with mastocytosis.

Methods: We analysed data of the registry of the European Competence Network on Mastocytosis including 1639 patients (age 17-90 years) diagnosed with mastocytosis according to WHO criteria between Jan 12, 1978, and March 16, 2017. Univariate and multivariate analyses with Cox regression were applied to identify prognostic variables predicting survival outcomes and to establish a prognostic score. We validated this International Prognostic Scoring System in Mastocytosis (IPSM) with data of 462 patients (age 17-79 years) from the Spanish network Red Española de Mastocitosis diagnosed between Jan 22, 1998, and Nov 2, 2017.

Findings: The prognostic value of the WHO classification was confirmed in our study (p<0·0001). For patients with non-advanced mastocytosis (n=1380), we identified age 60 years or older (HR 10·75, 95% CI 5·68-20·32) and a concentration of alkaline phosphatase 100 U/L or higher (2·91, 1·60-5·30) as additional independent prognostic variables for overall survival. The resulting scoring system divided patients with non-advanced mastocytosis into three groups: low (no risk factors), intermediate 1 (one risk factor), and intermediate 2 (two risk factors). Overall survival and progression-free survival differed significantly among these groups (p<0·0001). In patients with advanced mastocytosis (n=259), age 60 years or older (HR 2·14, 95% CI 1·42-3·22), a concentration of tryptase 125 ng/mL or higher (1·81, 1·20-2·75), a leukocyte count of 16 × 10 per L or higher (1·88, 1·27-2·79), haemoglobin of 11 g/dL or lower (1·71, 1·13-2·57), a platelet count of 100 × 10 per L or lower (1·63, 1·13-2·34), and skin involvement (0·46, 0·30-0·69) were prognostic variables. Based on these variables, a separate score for advanced mastocytosis with four risk categories was established, with significantly different outcomes for overall survival and progression-free survival (p<0·0001). The prognostic value of both scores was confirmed in 413 patients with non-advanced disease and 49 with advanced mastocytosis from the validation cohort.

Interpretation: The IPSM scores for patients with non-advanced and advanced mastocytosis can be used to predict survival outcomes and guide treatment decisions. However, the predictive value of the IPSM needs to be confirmed in forthcoming trials.

Funding: Austrian Science Fund, Deutsche Forschungsgemeinschaft, Koeln Fortune Program, Charles and Ann Johnson Foundation, Instituto de Salud Carlos III, Fondos FEDER, Research-Foundation Flanders/Fonds Wetenschappelijk Onderzoek, Clinical Research-Fund of the University Hospitals Leuven, and Research-Foundation Flanders/Fonds Wetenschappelijk Onderzoek.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S2352-3026(19)30166-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115823PMC
December 2019