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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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| 3. |
- Krustrup, P., et al.
(författare)
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The Yo-Yo IE2 Test: Physiological Response for Untrained Men versus Trained Soccer Players
- 2015
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Ingår i: Medicine and Science in Sports and Exercise. - : Ovid Technologies (Wolters Kluwer Health). - 0195-9131. ; 47:1, s. 100-108
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study aimed to examine the physical capacity and physiological response to the Yo-Yo Intermittent Endurance level 2 test (IE2) for untrained individuals (UTR) and trained male soccer players (TR) and to investigate the determinants of intense intermittent exercise performance. Methods Thirty-four healthy UTR males and 15 age-matched TR performed a maximal incremental treadmill test and a Yo-Yo IE2 test. Muscle biopsies and blood samples were obtained, and heart rate (HR) was measured before, during, and after tests. Results UTR had a 67% lower (P < 0.01) Yo-Yo IE2 performance (665 271 vs 2027 +/- 298 m; effect size (ES), 4.8), 34% lower VO2max (P < 0.01), and 19% lower resting muscle glycogen (P < 0.05) than those of TR. Blood lactate concentration and HR during the first 560 m of the Yo-Yo IE2 test were higher (P < 0.01) in UTR than those in TR (560 m, 7.4 +/- 2.8 vs 2.4 +/- 0.8 mM; ES, 1.7-2.8; 188 +/- 11 vs 173 +/- 8 bpm; ES, 0.9-1.5), with no differences at exhaustion. Time >95% HRmax was lower (P < 0.01) in UTR than that in TR (1.0 +/- 1.1 vs 6.3 +/- 2.9 min; ES, 3.1). Mean rates of muscle creatine phosphate utilization (16.5 +/- 9.5 vs 4.3 +/- 2.7 mmolkg(-1) d.wmin(-1)), muscle lactate accumulation (16.8 +/- 9.1 vs 4.2 +/- 2.9 mmolkg(-1) d.w.min(-1)), and glycogen breakdown (29.6 +/- 14.2 vs 7.7 +/- 5.4 mmolkg(-1) d.w.min(-1)) were fourfold higher (P < 0.01; ES, 1.4-1.7) in UTR than those in TR. For UTR, correlations (P < 0.01) were observed between Yo-Yo IE2 performance and VO2max (r = 0.77), incremental treadmill test performance (r = 0.79), and muscle citrate synthase activity (r = 0.57) but not for TR (r = -0.12 to 0.50; P > 0.05). Conclusions The Yo-Yo IE2 test was shown to possess high construct validity by showing large differences in performance, HR, and anaerobic metabolism between UTR and TR. In addition, VO2max seemed to be important for intermittent exercise performance in UTR but not for TR.
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