Serum magnesium and calcium levels in relation to ischemic stroke : Mendelian randomization study

ObjectiveTo determine whether serum magnesium and calcium concentrations are causally associated with ischemic stroke or any of its subtypes using the mendelian randomization approach.MethodsAnalyses were conducted using summary statistics data for 13 single-nucleotide polymorphisms robustly associated with serum magnesium (n = 6) or serum calcium (n = 7) concentrations. The corresponding data for ischemic stroke were obtained from the MEGASTROKE consortium (34,217 cases and 404,630 noncases).ResultsIn standard mendelian randomization analysis, the odds ratios for each 0.1 mmol/L (about 1 SD) increase in genetically predicted serum magnesium concentrations were 0.78 (95% confidence interval [CI] 0.69-0.89; p = 1.3 7 10-4) for all ischemic stroke, 0.63 (95% CI 0.50-0.80; p = 1.6 7 10-4) for cardioembolic stroke, and 0.60 (95% CI 0.44-0.82; p = 0.001) for large artery stroke; there was no association with small vessel stroke (odds ratio 0.90, 95% CI 0.67-1.20; p = 0.46). Only the association with cardioembolic stroke was robust in sensitivity analyses. There was no association of genetically predicted serum calcium concentrations with all ischemic stroke (per 0.5 mg/dL [about 1 SD] increase in serum calcium: odds ratio 1.03, 95% CI 0.88-1.21) or with any subtype.ConclusionsThis study found that genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke but found no significant association of genetically higher serum calcium concentrations with any ischemic stroke subtype

Age at first birth in women is genetically associated with increased risk of schizophrenia

Prof. Paunio on PGC:n jäsenPrevious studies have shown an increased risk for mental health problems in children born to both younger and older parents compared to children of average-aged parents. We previously used a novel design to reveal a latent mechanism of genetic association between schizophrenia and age at first birth in women (AFB). Here, we use independent data from the UK Biobank (N = 38,892) to replicate the finding of an association between predicted genetic risk of schizophrenia and AFB in women, and to estimate the genetic correlation between schizophrenia and AFB in women stratified into younger and older groups. We find evidence for an association between predicted genetic risk of schizophrenia and AFB in women (P-value = 1.12E-05), and we show genetic heterogeneity between younger and older AFB groups (P-value = 3.45E-03). The genetic correlation between schizophrenia and AFB in the younger AFB group is -0.16 (SE = 0.04) while that between schizophrenia and AFB in the older AFB group is 0.14 (SE = 0.08). Our results suggest that early, and perhaps also late, age at first birth in women is associated with increased genetic risk for schizophrenia in the UK Biobank sample. These findings contribute new insights into factors contributing to the complex bio-social risk architecture underpinning the association between parental age and offspring mental health.Peer reviewe

A scoping review of sexual transmission related HIV research among key populations in Malaysia: Implications for interventions across the HIV care cascade

The Malaysian government has committed to ‘Fast Tracking the HIV Response’ to achieve UNAIDS 2030 targets to end AIDS. The epidemic is concentrated among key populations and has shifted from people who inject drugs to HIV infection through sexual transmission among men who have sex with men, sex workers and transgender people. The aim of this scoping review was to examine social and behavioural research published since 2005 that can inform understanding of each stage of the 90:90:90 treatment cascade (as proposed by UNAIDS), including HIV risk behaviours and testing practices that precede entry. We found a concentration of studies related to predictors or correlates of HIV infections (mostly among men who have sex with men) and a shortfall in literature pertaining to sex workers or transgender people. While several studies examined factors associated with HIV testing, only one examined uptake of antiretroviral therapy and two explored issues of treatment adherence. No study examined broader care and support of people living with HIV. To scale-up effective programmes and apprise investment to achieve the ambitious targets set-out in the Malaysian National HIV/AIDS Strategic Plan, a combination of comprehensive strategic information and evidence generated through primary research is critical

Dementia prevention: The time to act is now

"A multilayered action plan is needed for a substantial, timely and sustained investment in dementia prevention

Avaliação dos fatores associados a infecções recorrentes e/ou graves em pacientes com síndrome de Down

OBJETIVOS: avaliar as características epidemiológicas, clínicas e laboratoriais de pacientes com síndrome de Down e infecções recorrentes e/ou graves, bem como avaliar a presença de imunodeficiência nesta população. MÉTODOS: foram avaliados, através de protocolo epidemiológico, clínico e laboratorial, incluindo aspectos imunológicos, pacientes com diagnóstico de síndrome de Down, através de estudo cromossômico, com queixa de infecções recorrentes e/ou graves, acompanhados no Ambulatório de Alergia e Imunologia do Departamento de Pediatria da FMUSP, no período de 1990 a 1999. RESULTADOS: a distribuição entre sexos foi 1,6M : 1F, com idade variando entre um ano e 12 anos e 10 meses (média de 2a7m). Do total de 45 casos avaliados, 40 referiam infecções recorrentes, e cinco, sepse. Dos pacientes com infecções recorrentes, 31 preenchiam os critérios adotados de infecção de repetição, sendo as pneumonias e as rinofaringites as infecções mais referidas. Cardiopatias foram encontradas em 62,2% dos casos, sendo mais prevalentes nas crianças com pneumonias de repetição. Quanto aos parâmetros imunológicos, encontrou-se dois casos com deficiência de IgG2, dois com baixo número de linfócitos CD4+, e outros dois com redução de resposta proliferativa a mitógenos. Cinco casos apresentaram redução da atividade de células NK. Soropositividade para citomegalovírus foi encontrada em 22 de 36 casos avaliados (61,1%). CONCLUSÃO: embora os dados aqui relatados sejam específicos para esta população, ressaltam a necessidade da pesquisa de imunodeficiência em pacientes com síndrome de Down que mantenham processos infecciosos após o adequado controle das patologias associadas