BackgroundRespiratory syncytial virus (RSV) infection in older adults is recognized as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.MethodsThis international prospective observational cohort study is part of REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited before two independent RSV-seasons through general practitioner's offices. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV-season. . ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV-illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV-ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930).ResultsWe recruited 1040 participants (527 in season 2017–2018, 513 in season 2018–2019) with a median age of 75 years (range 60–100). 1023 (99%) lived independently at home at baseline. RSV-illness incidence was 4.2% (22/527) and 7.2% (37/513) in the respective seasons. RSV-illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalized or died from RSV-illness. In the 36 patients with PCR confirmed RSV-ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11/36 (31%) of cases. RSV-ARTI could not clinically be differentiated from all other ARTI based on symptoms.ConclusionThis European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care is often justified when RSV is suspected in family practice.
Background:The potential for cancer-testis (CT) antigens as targets for immunotherapy in cancer patients has been heavily investigated, and currently cancer vaccine trials based on the CT antigens, MAGE-A3 and NY-ESO-1, are being carried out.Methods:We used specific q-RT-PCR assays to analyse the expression of the CT genes MAGE-A3, NY-ESO-1 (CTAG1B), LAGE-1 (CTAG2) and PRAME in a panel of bladder tumours from 350 patients with long-term follow-up and detailed treatment information.Results:Overall, 43% of the tumours expressed MAGE-A3, 35% expressed NY-ESO-1, 27% expressed LAGE-1 and 20% expressed PRAME. In all, 56% of the tumours expressed at least one of the CT genes analysed. Univariate Cox regression analysis of CT gene expression in non-muscle-invasive tumours showed that expression of MAGE-A3 (P=0.026), LAGE-1 (P=0.001) and NY-ESO-1 (P=0.040) was significantly associated with a shorter progression-free survival. In addition, we found that patients with tumours expressing PRAME responded poorly to chemotherapy (P=0.02, χ2-test).Conclusion:Cancer-testis genes are frequently expressed in bladder cancer and especially in tumours of high stage and grade. In addition, the CT gene expression may have both prognostic and predictive value. Development of specific immunotherapy against the CT antigens in bladder cancer may ultimately increase patient survival.
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