Aims Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disorder that not only affects peripheral joints but also increases the risk for cardiovascular disease (CVD) and mortality. Heart failure (HF) appears to be one of the most important contributors to the excess mortality risk among patients with RA. We assessed the incidence of HF in patients with RA compared with age-matched and sex-matched non-RA subjects, after accounting for traditional cardiovascular risk factors and clinical ischemic heart disease. Methods and results We performed an aggregate analysis on three studies of RA patients having listed manifestations of HF. We performed a meta-regression analysis to evaluate the incidence of HF in RA patients with increased age and noted for any gender correlation. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using both fixed-effects and random-effects models. In the cumulative analysis of 5, 220, 883 patients, the incidence of HF was noted to be almost twofold higher in patients with RA compared with a matched control population (
Background: Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there is minimal investigation of the gender relationship to radiation-induced CAD events and the resulting cardiovascular (CV) events/mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin's Lymphoma (HL) patients. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this systematic review and network meta-analysis. OVID, Cochrane Central Register of Controlled Trials via the Wiley Interface, Web of Science Core Collection, MEDLINE, EMBASE, and Google Scholar were investigated to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. Ten studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events/mortality. The secondary outcome was all-cause mortality. Metaregression for age was also performed. Results: Of 13,975 patients, including 41% females and 59% males, CV events/mortality were noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p < 0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p < 0.023). On meta-regression analysis, elderly populations have a higher rate of mortality, which was even higher for women than men (coefficient = 0.0458, p = 0.0374). Conclusions: Women have a higher rate of R-CAD related CV events/mortality and all-cause mortality compared to men amongst radiation-treated patients. These data highlight the need for increased surveillance to better monitor for R-CAD in female patients treated with mantle or mediastinal radiation.
Mathematical models analyzing tumor-immune interactions provide a framework by which to address specific scenarios in regard to tumor-immune dynamics. Important aspects of tumor-immune surveillance to consider is the elimination of tumor cells from a host's cell-mediated immunity as well as the implications of vaccines derived from synthetic antigen. In present studies, our mathematical model examined the role of synthetic antigen to the strength of the immune system. The constructed model takes into account accepted knowledge of immune function as well as prior work done by de Pillis et al. All equations describing tumor-immune growth, antigen presentation, immune response, and interaction rates were numerically simulated with MATLAB. Here, our work shows that a robust immune response can be generated if the immune system recognizes epitopes that are between 8 to 11 amino acids long. We show through mathematical modeling of how synthetic tumor vaccines can be utilized to mitigate a developing cancer.utilized mice that were inoculated with chemically-induced cancer cells; such cells lacked the capability to metastasize within a host. Over time, this led to the development of cancer-specific immunity in the recipient mice. This discovery provided the evidence needed for Ehrlich's hypothesis. Such experiments demonstrated that it is essential to have the presence of an antigen to elicit an immune response in the host, because if no distinctive structures exist, then no recognition would be established [9]. F. Macfarlane Burnet and Lewis Thomas, well-known immunologists during the 20 th century, hypothesized that for immunosurveillance to exist, lymphocytes would need to act aggressively akin to sentinels to recognize and eliminate a cancer threat. The cancer immunosurveillance theory revolves around three transitions states, denoted as "E's" [9]:• Elimination-The establishment of a strong cancer surveillance network by both the innate and adaptive immune system that seeks to eliminate cancer populations.• Equilibrium-The long-term process of combat between a cancer population and a host's immunosurveillance network.• Escape-The overpowering of cancer surveillance network by strong tumor variants, which results in host death.
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