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  • 1
    Publication Date: 2015-12-04
    Description: Objective: To evaluate socioeconomic disadvantage in prevalence, awareness and control of diabetes in universal coverage healthcare system. Methods: Data from the fifth KNHNES (2010–12) were analyzed. The sample included 10 208 individuals with diabetes aged ≥30 years. Diabetes was defined by (i) a self-reported previous diagnosis of diabetes made by a physician, (ii) the current use of oral hypoglycaemic agents and/or insulin or (iii) fasting plasma glucose ≥126 mg/dl. Subjects who were first diagnosed by the survey were classified as ‘undiagnosed’. Inadequate control was defined as HbA1c ≥6.5%. Results: It was estimated that 26.4% of subjects with diabetes were not aware of their condition and 73.1% of cases of diabetes were not adequately controlled. Inequalities in socioeconomic status were related to the diabetes prevalence in both men and women. Educational level was not predictive of diagnosis or control in men or women, whereas lower household income level was associated with diagnosis in men only. Conclusions: This widespread lack of awareness and inadequate control underscore the need for intensive efforts in these domains. Monitoring is expected to highlight the gaps in the preventive and care services offered to the most vulnerable individuals and it may induce governments and practitioners to address these issues.
    Print ISSN: 1101-1262
    Electronic ISSN: 1464-360X
    Topics: Medicine
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  • 2
    Publication Date: 2016-04-29
    Description: The toll-like receptors (TLRs) are important innate receptors recognizing potentially pathogenic material. However, they also play a significant role in the development of Alzheimer’s disease, cancer, autoimmunity and the susceptibility to viral infections. Macrophages are essential for an effective immune response to foreign material and the resolution of inflammation. In these studies, we examined the impact of different TLR ligands on macrophage cell function. We demonstrate that stimulation of all TLRs tested increases the phagocytosis of apoptotic cells by macrophages. TLR7 and TLR9 ligation decreased the levels of the surface co-expression molecules CD86 and MHCII, which was associated with a concomitant reduction in antigen presentation and proliferation of T cells. This down-regulation in macrophage function was not due to an increase in cell death. In fact, exposure to TLR7 or TLR9 ligands promoted cell viability for up to 9 days, in contrast to TLR3 or TLR4. Additionally, macrophages exposed to TLR7/TLR9 ligands had a significantly lower ratio of Il-12/Il-10 mRNA expression compared with those treated with the TLR4 ligand, LPS. Taken together, these data demonstrate that TLR7/TLR9 ligands push the macrophage into a phagocytic long-lived cell, with a decreased capacity of antigen presentation and reminiscent of the M2 polarized state.
    Print ISSN: 0953-8178
    Electronic ISSN: 1460-2377
    Topics: Medicine
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  • 3
    Publication Date: 2015-03-11
    Description: BACKGROUND Insulin resistance has an important role in the pathogenesis of hypertension. We hypothesized that impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) which represents insulin resistance would predict the development of hypertension. METHODS A total of 4,039 subjects without hypertension or diabetes (1,847 men and 2,192 women; age 49.9±8.2 years), from the Ansan-Ansung cohorts within the Korean Genome Epidemiology Study, were enrolled in 2001–2002 and restudied in 2005–2006. The association between the incidence of hypertension and IFG, IGT, or other metabolic factors was studied. RESULTS During the 4-year follow-up period, 582 of the 4,039 subjects developed hypertension. At baseline, the prevalence of abdominal obesity, dyslipidemia, and IGT was higher in subjects who became hypertensive compared to those that remained normotensive. The prevalence of IFG was not significantly different between the 2 groups. In a multivariate analysis, abdominal obesity and high serum triglyceride were significant risk factors for the development of hypertension. Neither IFG nor IGT were significantly associated with new-onset hypertension. Although the risk of hypertension was higher with the number of metabolic components present at baseline, IFG and IGT were not significant components compared to other metabolic components, especially when abdominal obesity was taken into account. CONCLUSIONS While metabolic syndrome components related to insulin resistance present at baseline are important risk factors of hypertension, we conclude that coexisting metabolic component, mainly abdominal obesity, rather than IFG and IGT have more predictive value for determining the development of hypertension in a Korean population.
    Print ISSN: 0895-7061
    Electronic ISSN: 1879-1905
    Topics: Medicine
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  • 4
    Publication Date: 2016-04-29
    Description: Motivation: Illustrating how HIV-1 is transmitted and how it evolves in the following weeks is an important step for developing effective vaccination and prevention strategies. It is currently possible through DNA sequencing to account for the diverse array of viral strains within an infected individual. This provides an unprecedented opportunity to pinpoint when each patient was infected and which viruses were transmitted. Results: Here we develop a mathematical tool for early HIV-1 evolution within a subject whose infection originates either from a single or multiple viral variants. The shifted Poisson mixture model (SPMM) provides a quantitative guideline for segregating viral lineages, which in turn enables us to assess when a subject was infected. The infection duration estimated by SPMM showed a statistically significant linear relationship with that by Fiebig laboratory staging ( P = 0.00059) among 37 acutely infected subjects. Our tool provides a functional approach to understanding early genetic diversity, one of the most important parameters for deciphering HIV-1 transmission and predicting the rate of disease progression. Availability and implementation: SPMM, webserver, is available at http://www.hayounlee.org/web-tools.html. Contact: hayoun@usc.edu Supplementary information: Supplementary data are available at Bioinformatics online.
    Print ISSN: 1367-4803
    Electronic ISSN: 1460-2059
    Topics: Biology , Computer Science , Medicine
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  • 5
    Publication Date: 2015-12-04
    Description: Background : Certain factors originating from the perinatal and childhood periods are suspected of contributing to the recent increasing trend of childhood type 1 diabetes (T1D) incidence. This study sought to investigate the relationships between various perinatal and childhood risk factors and T1D incidence in young children (〈10 years). Methods : We used a nested case-control design based on 1 478 573 live births born in 2000–05 in Taiwan. Cases were 632 incident cases of T1D between 2000 and 2008. Ten matched controls for each case were randomly selected. Information on various perinatal risk factors was also identified from claim data. Multiple conditional logistic regression was employed to estimate odds ratio (OR) and 95 confidence interval (CI) of T1D. Results : Childhood infection was significantly associated with an increased risk of T1D (OR = 1.46, 95% CI = 1.23–1.73). Increased risk of T1D was also noted in children born to younger mothers (〈25 years) (OR = 1.94, 95% CI = 1.34–2.81), older fathers (〉30 years) (OR = 1.56 (95% CI = 1.16–2.10) to 1.57 (95% CI = 1.19–2.05), mothers with Caesarean section (CS) (OR = 2.35, 95% CI = 1.52–3.64), and mothers with gestational diabetes mellitus (OR = 4.36, 95% CI = 2.76–7.77). Fathers with T1D (OR = 7.36, 95% CI = 1.02–57.21) or type 2 diabetes (OR = 1.54, 95% CI = 1.04–2.26) were observed to substantially increase the risk of offspring T1D. Conclusions : Certain modifiable perinatal factors such as infection and CS may predispose incidence of T1D in young children.
    Print ISSN: 1101-1262
    Electronic ISSN: 1464-360X
    Topics: Medicine
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