Meningococcal disease (MD) remains an important infectious cause of life threatening infection in both industrialized and resource poor countries. Genetic factors influence both occurrence and severity of presentation, but the genes responsible are largely unknown. We performed a genome-wide association study (GWAS) examining 5,440,063 SNPs in 422 Spanish MD patients and 910 controls. We then performed a meta-analysis of the Spanish GWAS with GWAS data from the United Kingdom (combined cohorts: 897 cases and 5,613 controls; 4,898,259 SNPs). The meta-analysis identified strong evidence of association (P-value ≤ 5 × 10−8) in 20 variants located at the CFH gene. SNP rs193053835 showed the most significant protective effect (Odds Ratio (OR) = 0.62, 95% confidence interval (C.I.) = 0.52–0.73; P-value = 9.62 × 10−9). Five other variants had been previously reported to be associated with susceptibility to MD, including the missense SNP rs1065489 (OR = 0.64, 95% C.I.) = 0.55–0.76, P-value = 3.25 × 10−8). Theoretical predictions point to a functional effect of rs1065489, which may be directly responsible for protection against MD. Our study confirms the association of CFH with susceptibility to MD and strengthens the importance of this link in understanding pathogenesis of the disease.
Conclusions This analysis indicates that PI is a valid and reliable instrument which can be effectively used to monitor safety conditions at workplaces. Commercial janitors are an important group of low wage, largely immigrant workers who face significant potential risks at work, and yet have only been minimally studied for occupational injury and illness. Anecdotal reports from a local union representing commercial janitors in the Seattle area suggest pressures on the industry have produced a dramatic increase in workload over the past few years, raising the possibility of increased injury and illness. A cross sectional survey was designed to assess a range of exposures among commercial janitors including both union (n = 275) and non-union (n-75) sectors, and using a group of security guards (n-75) as controls. A novel participatory approach to data collection was developed, utilising workers to recruit subjects and conduct interviews in three languages, using electronic data collection tools linked to an internet-based database. Further, a novel subjective workload scale was adopted, and changes in workload and injury and illness rates over the past three years were assessed. Exposures assessed include general workload, musculoskeletal stressors, chemical use, as well as psychosocial risks such as work stress, safety climate, discriminatory management practices and work-life balance. Outcomes included acute injury, musculoskeletal pain, pulmonary and dermatological symptoms, and sleep disturbance. Initial results indicate a significant increase in workload with 28.5% reporting >7 on a 10 point scale two years ago, up to 35% in the current year. A concomitant increase in injuries was similarly observed. The paper describes the approach to data collection and describes rates of exposure and health and safety outcomes by group. Measures adopted to validate the self-reported conditions are also described. Background and Objective Cadmium (Cd) exposure, like Itaiitai disease, may present with erythropoietin (EPO) hypoproduction, and associated erythroid abnormalities. Anemia may be associated with toxic metal (Cd and lead) poisoning with interaction with essential trace elements (iron, zinc, copper) in humans. We aimed at assessing the relationship among erythrocyte parameters (EP), anemia (hemoglobin < 12 g/dL) and blood Cd (BCd) among adult residents in an environmentally high-exposed community near electroplating industry area. Methods A total of 1,062 residents were included through stratified random sampling by three age groups (35-44, 45-54, and 55-64 years) and gender from an electroplating-related metal contaminated area located in central Taiwan during 2002~2005. B-Cd levels were measured by an ELAN 6100 inductively coupled plasma-mass spectrometer (ICP-MS). Multiple logistic regression models were used for test the association between anemia and B-Cd with serum ferritin taken into account. Results B-Cd levels was negatively associated with the red blood cell (RBC) count, mean cell hemoglobin (MCH), and...
Background The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. Methods We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. Results We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78–.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. Conclusions When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.
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