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- Shepherd, L., et al.
(författare)
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Infection-related and -unrelated malignancies, HIV and the aging population
- 2016
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Ingår i: HIV Medicine. - : Wiley. - 1464-2662 .- 1468-1293. ; 17:8, s. 590-600
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: HIV-positive people have increased risk of infection-related malignancies (IRMs) and infection-unrelated malignancies (IURMs). The aim of the study was to determine the impact of aging on future IRM and IURM incidence. Methods: People enrolled in EuroSIDA and followed from the latest of the first visit or 1 January 2001 until the last visit or death were included in the study. Poisson regression was used to investigate the impact of aging on the incidence of IRMs and IURMs, adjusting for demographic, clinical and laboratory confounders. Linear exponential smoothing models forecasted future incidence. Results: A total of 15 648 people contributed 95 033 person-years of follow-up, of whom 610 developed 643 malignancies [IRMs: 388 (60%); IURMs: 255 (40%)]. After adjustment, a higher IRM incidence was associated with a lower CD4 count [adjusted incidence rate ratio (aIRR) CD4 count < 200 cells/μL: 3.77; 95% confidence interval (CI) 2.59, 5.51; compared with ≥ 500 cells/μL], independent of age, while a CD4 count < 200 cells/μL was associated with IURMs in people aged < 50 years only (aIRR: 2.51; 95% CI 1.40–4.54). Smoking was associated with IURMs (aIRR: 1.75; 95% CI 1.23, 2.49) compared with never smokers in people aged ≥ 50 years only, and not with IRMs. The incidences of both IURMs and IRMs increased with older age. It was projected that the incidence of IRMs would decrease by 29% over a 5-year period from 3.1 (95% CI 1.5–5.9) per 1000 person-years in 2011, whereas the IURM incidence would increase by 44% from 4.1 (95% CI 2.2–7.2) per 1000 person-years over the same period. Conclusions: Demographic and HIV-related risk factors for IURMs (aging and smoking) and IRMs (immunodeficiency and ongoing viral replication) differ markedly and the contribution from IURMs relative to IRMs will continue to increase as a result of aging of the HIV-infected population, high smoking and lung cancer prevalence and a low prevalence of untreated HIV infection. These findings suggest the need for targeted preventive measures and evaluation of the cost−benefit of screening for IURMs in HIV-infected populations.
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- Caja, M., et al.
(författare)
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Provenance of siliciclastic and hybrid turbiditic arenites of the Eocene Hecho Group,Spanish Pyrenees : implications for the tectonic evolution of a foreland basin
- 2010
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Ingår i: Basin Research. - : Wiley. - 0950-091X .- 1365-2117. ; 22:2, s. 157-180
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Tidskriftsartikel (refereegranskat)abstract
- The Eocene Hecho Group turbidite system of the Aínsa-Jaca foreland Basin (southcentral Pyrenees) provides an excellent opportunity to constrain compositional variations within the context of spatial and temporal distribution of source rocks during tectonostratigraphic evolution of foreland basins. The complex tectonic setting necessitated the use of petrographic, geochemical and multivariate statistical techniques to achieve this goal. The turbidite deposits comprise four unconformity-bounded tectonostratigraphic units (TSU), consisting of quartz-rich and feldspar-poor sandstones, calclithites rich in extrabasinal carbonates and hybrid arenites dominated by intrabasinal carbonates. The sandstones occur exclusively in TSU-2, whereas calclithites and hybrid arenites occur in the overlying TSU-3, TSU-4 and TSU-5. The calclithites were deposited at the base of each TSU and hybrid arenites in the uppermost parts. Extrabasinal carbonate sources were derived from the fold-and-thrust belt (mainly Cretaceous and Palaeocene limestones). Conversely, intrabasinal carbonate grains were sourced from foramol shelf carbonate factories. This compositional trend is attributed to alternating episodes of uplift and thrust propagation (siliciclastic and extrabasinal carbonates supplies) and subsequent episodes of development of carbonate platforms supplying intrabasinal detrital grains. The quartz-rich and feldspar-poor composition of the sandstones suggests derivation from intensely weathered cratonic basement rocks during the initial fill of the foreland basin. Successive sediments (calclithites and hybrid arenites) were derived from older uplifted basement rocks (feldspar-rich and, to some extent, rock fragments-rich sandstones), thrust-and-fold belt deposits and from coeval carbonate platforms developed at the basin margins. This study demonstrates that the integration of tectono-stratigraphy, petrology and geochemistry of arenites provides a powerful tool to constrain the spatial and temporal variation in provenance during the tectonic evolution of foreland basins.
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