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Sample records for 10-fold increased risk

  1. Splenectomy Causes 10-Fold Increased Risk of Portal Venous System Thrombosis in Liver Cirrhosis Patients.

    PubMed

    Qi, Xingshun; Han, Guohong; Ye, Chun; Zhang, Yongguo; Dai, Junna; Peng, Ying; Deng, Han; Li, Jing; Hou, Feifei; Ning, Zheng; Zhao, Jiancheng; Zhang, Xintong; Wang, Ran; Guo, Xiaozhong

    2016-07-19

    BACKGROUND Portal venous system thrombosis (PVST) is a life-threatening complication of liver cirrhosis. We conducted a retrospective study to comprehensively analyze the prevalence and risk factors of PVST in liver cirrhosis. MATERIAL AND METHODS All cirrhotic patients without malignancy admitted between June 2012 and December 2013 were eligible if they underwent contrast-enhanced CT or MRI scans. Independent predictors of PVST in liver cirrhosis were calculated in multivariate analyses. Subgroup analyses were performed according to the severity of PVST (any PVST, main portal vein [MPV] thrombosis >50%, and clinically significant PVST) and splenectomy. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS Overall, 113 cirrhotic patients were enrolled. The prevalence of PVST was 16.8% (19/113). Splenectomy (any PVST: OR=11.494, 95%CI=2.152-61.395; MPV thrombosis >50%: OR=29.987, 95%CI=3.247-276.949; clinically significant PVST: OR=40.415, 95%CI=3.895-419.295) and higher hemoglobin (any PVST: OR=0.974, 95%CI=0.953-0.996; MPV thrombosis >50%: OR=0.936, 95%CI=0.895-0.980; clinically significant PVST: OR=0.935, 95%CI=0.891-0.982) were the independent predictors of PVST. The prevalence of PVST was 13.3% (14/105) after excluding splenectomy. Higher hemoglobin was the only independent predictor of MPV thrombosis >50% (OR=0.952, 95%CI=0.909-0.997). No independent predictors of any PVST or clinically significant PVST were identified in multivariate analyses. Additionally, PVST patients who underwent splenectomy had a significantly higher proportion of clinically significant PVST but lower MELD score than those who did not undergo splenectomy. In all analyses, the in-hospital mortality was not significantly different between cirrhotic patient with and without PVST. CONCLUSIONS Splenectomy may increase by at least 10-fold the risk of PVST in liver cirrhosis independent of severity of liver dysfunction.

  2. Carboxylation of cytosine (5caC) in the CG dinucleotide in the E-box motif (CGCAG|GTG) increases binding of the Tcf3|Ascl1 helix-loop-helix heterodimer 10-fold.

    PubMed

    Golla, Jaya Prakash; Zhao, Jianfei; Mann, Ishminder K; Sayeed, Syed K; Mandal, Ajeet; Rose, Robert B; Vinson, Charles

    2014-06-27

    Three oxidative products of 5-methylcytosine (5mC) occur in mammalian genomes. We evaluated if these cytosine modifications in a CG dinucleotide altered DNA binding of four B-HLH homodimers and three heterodimers to the E-Box motif CGCAG|GTG. We examined 25 DNA probes containing all combinations of cytosine in a CG dinucleotide and none changed binding except for carboxylation of cytosine (5caC) in the strand CGCAG|GTG. 5caC enhanced binding of all examined B-HLH homodimers and heterodimers, particularly the Tcf3|Ascl1 heterodimer which increased binding ~10-fold. These results highlight a potential function of the oxidative products of 5mC, changing the DNA binding of sequence-specific transcription factors.

  3. Experiencing discrimination increases risk taking.

    PubMed

    Jamieson, Jeremy P; Koslov, Katrina; Nock, Matthew K; Mendes, Wendy Berry

    2013-02-01

    Prior research has revealed racial disparities in health outcomes and health-compromising behaviors, such as smoking and drug abuse. It has been suggested that discrimination contributes to such disparities, but the mechanisms through which this might occur are not well understood. In the research reported here, we examined whether the experience of discrimination affects acute physiological stress responses and increases risk-taking behavior. Black and White participants each received rejecting feedback from partners who were either of their own race (in-group rejection) or of a different race (out-group rejection, which could be interpreted as discrimination). Physiological (cardiovascular and neuroendocrine) changes, cognition (memory and attentional bias), affect, and risk-taking behavior were assessed. Significant participant race × partner race interactions were observed. Cross-race rejection, compared with same-race rejection, was associated with lower levels of cortisol, increased cardiac output, decreased vascular resistance, greater anger, increased attentional bias, and more risk-taking behavior. These data suggest that perceived discrimination is associated with distinct profiles of physiological reactivity, affect, cognitive processing, and risk taking, implicating direct and indirect pathways to health disparities.

  4. Ego depletion increases risk-taking.

    PubMed

    Fischer, Peter; Kastenmüller, Andreas; Asal, Kathrin

    2012-01-01

    We investigated how the availability of self-control resources affects risk-taking inclinations and behaviors. We proposed that risk-taking often occurs from suboptimal decision processes and heuristic information processing (e.g., when a smoker suppresses or neglects information about the health risks of smoking). Research revealed that depleted self-regulation resources are associated with reduced intellectual performance and reduced abilities to regulate spontaneous and automatic responses (e.g., control aggressive responses in the face of frustration). The present studies transferred these ideas to the area of risk-taking. We propose that risk-taking is increased when individuals find themselves in a state of reduced cognitive self-control resources (ego-depletion). Four studies supported these ideas. In Study 1, ego-depleted participants reported higher levels of sensation seeking than non-depleted participants. In Study 2, ego-depleted participants showed higher levels of risk-tolerance in critical road traffic situations than non-depleted participants. In Study 3, we ruled out two alternative explanations for these results: neither cognitive load nor feelings of anger mediated the effect of ego-depletion on risk-taking. Finally, Study 4 clarified the underlying psychological process: ego-depleted participants feel more cognitively exhausted than non-depleted participants and thus are more willing to take risks. Discussion focuses on the theoretical and practical implications of these findings.

  5. Immorally obtained principal increases investors’ risk preference

    PubMed Central

    Chen, Jiaxin; He, Guibing

    2017-01-01

    Capital derived from immoral sources is increasingly circulated in today’s financial markets. The moral associations of capital are important, although their impact on investment remains unknown. This research aims to explore the influence of principal source morality on investors’ risk preferences. Three studies were conducted in this regard. Study 1 finds that investors are more risk-seeking when their principal is earned immorally (through lying), whereas their risk preferences do not change when they invest money earned from neutral sources after engaging in immoral behavior. Study 2 reveals that guilt fully mediates the relationship between principal source morality and investors’ risk preferences. Studies 3a and 3b introduce a new immoral principal source and a new manipulation method to improve external validity. Guilt is shown to the decrease the subjective value of morally flawed principal, leading to higher risk preference. The findings show the influence of morality-related features of principal on people’s investment behavior and further support mental account theory. The results also predict the potential threats of “grey principal” to market stability. PMID:28369117

  6. Increasing tsunami risk awareness via mobile application

    NASA Astrophysics Data System (ADS)

    Leelawat, N.; Suppasri, A.; Latcharote, P.; Imamura, F.; Abe, Y.; Sugiyasu, K.

    2017-02-01

    In the information and communication technology era, smartphones have become a necessity. With the capacity and availability of smart technologies, a number of benefits are possible. As a result, designing a mobile application to increase tsunami awareness has been proposed, and a prototype has been designed and developed. The application uses data from the 2011 Great East Japan Tsunami. Based on the current location determined by a GPS function matched with the nearest point extracted from the detailed mesh data of that earlier disaster, the application generates the inundation depth at the user’s location. Thus, not only local people but also tourists visiting the affected areas can understand the risks involved. Application testing has been conducted in an evacuation experiment involving both Japanese and foreign students. The proposed application can be used as a supplementary information tool in tsunami evacuation drills. It also supports the idea of smart tourism: when people realize their risks, they possess risk awareness and hence can reduce their risks. This application can also be considered a contribution to disaster knowledge and technology, as well as to the lessons learned from the practical outcome.

  7. Increased cancer risk among Swedish female alcoholics.

    PubMed

    Sigvardsson, S; Hardell, L; Przybeck, T R; Cloninger, R

    1996-03-01

    We evaluated site-specific cancer risks in alcoholic women. We identified 15,508 alcoholic women from the records of the Temperance Boards in Sweden and obtained a comparison group by selecting for each alcoholic woman one female individual matched for region and day of birth. We obtained incidence data from the Swedish Cancer Registry. We found an increased relative risk (RR) for any cancer [RR = 1.6; 95% confidence interval (CI) = 1.5-1.8]; site-specific risks were increased for tongue (RR = 8.5; 95% CI = 2.0-37), mouth (RR = 12; 95% CI = 1.6-92), tonsil (RR = 11; 95% CI = 1.4-85), hypopharynx (RR = 9.0; 95% CI = 1.1-71), larynx (RR = 7.0; 95% CI = 0.9-57), liver (RR = 4.6; 95% CI = 1.8-12), pancreas (RR = 2.7; 95% CI = 1.6-4.6), lung (RR = 5.0; 95% CI = 3.3-7.5), breast (RR = 1.4; 95% CI = 1.2-1.7), cervix uteri (RR = 3.9; 95% CI = 2.8-5.4), and vulva, vagina, and unspecified female genital organs (RR = 4.0; 95% CI = 1.3-12). We found a decreased risk for malignant melanoma of the skin (RR = 0.5; 95% CI = 0.3-1.0). Since this was a register study, the results may be confounded by differences in smoking, dietary habits, and/or other factors in the cohort of alcoholic women and the comparison group.

  8. Cesarean Delivery Rates Vary 10-Fold Among US Hospitals; Reducing Variation May Address Quality, Cost Issues

    PubMed Central

    Kozhimannil, Katy Backes; Law, Michael R.; Virnig, Beth A.

    2013-01-01

    Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteen-fold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordination of maternity care, more data collection and measurement, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting. PMID:23459732

  9. Increased leukemia risk in Chernobyl cleanup workers

    Cancer.gov

    A new study found a significantly elevated risk for chronic lymphocytic leukemia among workers who were engaged in recovery and clean-up activities following the Chernobyl power plant accident in 1986.

  10. Dysthymia increases the risk of temporomandibular disorder

    PubMed Central

    Lin, Shang-Lun; Wu, Shang-Liang; Ko, Shun-Yao; Lu, Ching-Hsiang; Wang, Diew-Wei; Ben, Ren-Jy; Horng, Chi-Ting; Yang, Jung-Wu

    2016-01-01

    Abstract Numerous studies have investigated the relationship between depression and temporomandibular disorders (TMD), but the conclusions remain vague. The aim of this study was to examine the causal effect between depression and TMD. The reporting of this study conforms to the STROBE statement. In this retrospective cohort study, all samples were recruited from a representative subdataset of 1 million insured persons for the year 2005 Longitudinal Health Insurance Database, who were randomly selected from all beneficiaries enrolled in the National Health Insurance program of Taiwan. We used a propensity score and stratified 926,560 patients into 2 groups (propensity1 = 588,429 and propensity2 = 338,131) and 4 cohorts (propensity1 with depression = 18,038, propensity1 without depression = 570,391, propensity2 with depression = 38,656, propensity2 without depression = 299,475) to detect the development of TMD among the depressive and nondepressive patients between 2004 and 2013. The positive correlative factors of TMD included female, total number of times seeking medical advice (TTSMA) for anxiety state, TTSMA for generalized anxiety disorder, TTSMA for mandible fracture, and TTSMA for unspecified anomaly of jaw size. The propensity2 group was represented by elder and female-predominant patients who used more psychiatric health resources. Among 3 types of depression, only dysthymia (so-called chronic depression) had a causal impact on TMD in the propensity 2 group. In the propensity 2 group, the hazard ratio of dysthymia for TMD measured by Cox's regression was 1.64 (95% confidence interval 1.28–2.09), after adjusting for demographic factors, psychiatric comorbidities, and maxillofacial confounders. The first-onset mean time of TMD as the consequence of dysthymia was 3.56 years (sd = 2.74, min = 0.08, median = 2.99, max = 9.73). This study demonstrates that dysthymia increases the risk of TMD in elderly and female

  11. Bullying increased suicide risk: prospective study of Korean adolescents.

    PubMed

    Kim, Young Shin; Leventhal, Bennett L; Koh, Yun-Joo; Boyce, W Thomas

    2009-01-01

    This study examines the independent impact of bullying on suicide risk. Bullying was assessed by peer nomination in a prospective study of 1,655 7th and 8th grade Korean students, and suicide by youth self-report. Odds Ratios (ORs) of bullying for suicidal risks were computed, controlling for other suicide risk factors. Victim-Perpetrators and female Victims at baseline showed increased risk for persistent suicidality (OR: 2.4-9.8). Male Incident Victims exhibited increased risk for suicidal behaviors and ideations (OR = 4.4, 3.6). Female Persistent Perpetrators exhibited increased risks for suicidal behaviors; male Incident Perpetrators had increased risk for suicidal ideations (OR = 2.7, 2.3). Baseline-only male Victim-Perpetrators showed increased risk for suicidal ideations. (OR = 6.4). Bullying independently increased suicide risks.

  12. [IBD and increased risk of cancer: what is the reality?].

    PubMed

    Beaugerie, Laurent

    2014-03-01

    Inflammatory bowel diseases can favour the occurrence of colon cancer while their treatments can increase the risk of certain other cancers. The doctor's skill lies in striking the right benefit-risk balance of the treatments.

  13. Does vasectomy increase the risk of atherosclerosis?

    PubMed

    Clarkson, T B; Alexander, N J

    1980-11-15

    exacerbation is persistent antibody production after vasectomy in response to sperm antigens. The continuing leakage of soluble sperm antigens favors antigenemia and the development of circulating immune complexes, which in turn damage the vascular endothelium. The exact mechanism remains unclear. The accumulated data to show that vasectomy is a risk factor for atherosclerosis in 2 species of nonhuman primates.

  14. HIV DNA Reservoir Increases Risk for Cognitive Disorders in cART-Naïve Patients

    PubMed Central

    Valcour, Victor G.; Ananworanich, Jintanat; Agsalda, Melissa; Sailasuta, Napapon; Chalermchai, Thep; Schuetz, Alexandra; Shikuma, Cecilia; Liang, Chin-Yuan; Jirajariyavej, Supunee; Sithinamsuwan, Pasiri; Tipsuk, Somporn; Clifford, David B.; Paul, Robert; Fletcher, James L. K.; Marovich, Mary A.; Slike, Bonnie M.; DeGruttola, Victor; Shiramizu, Bruce

    2013-01-01

    Objectives Cognitive impairment remains frequent in HIV, despite combination antiretroviral therapy (cART). Leading theories implicate peripheral monocyte HIV DNA reservoirs as a mechanism for spread of the virus to the brain. These reservoirs remain present despite cART. The objective of this study was to determine if the level of HIV DNA in CD14+ enriched monocytes predicted cognitive impairment and brain injury. Methods We enrolled 61 cART-naïve HIV-infected Thais in a prospective study and measured HIV DNA in CD14+ enriched monocyte samples in a blinded fashion. We determined HAND diagnoses by consensus panel and all participants underwent magnetic resonance spectroscopy (MRS) to measure markers of brain injury. Immune activation was measured via cytokines in cerebrospinal fluid (CSF). Results The mean (SD) age was 35 (6.9) years, CD4 T-lymphocyte count was 236 (139) and log10 plasma HIV RNA was 4.8 (0.73). Twenty-eight of 61 met HAND criteria. The log10 CD14+ HIV DNA was associated with HAND in unadjusted and adjusted models (p = 0.001). There was a 14.5 increased odds ratio for HAND per 1 log-value of HIV DNA (10-fold increase in copy number). Plasma CD14+ HIV DNA was associated with plasma and CSF neopterin (p = 0.023) and with MRS markers of neuronal injury (lower N-acetyl aspartate) and glial dysfunction (higher myoinositol) in multiple brain regions. Interpretation Reservoir burden of HIV DNA in monocyte-enriched (CD14+) peripheral blood cells increases risk for HAND in treatment-naïve HIV+ subjects and is directly associated with CSF immune activation and both brain injury and glial dysfunction by MRS. PMID:23936155

  15. Does using marijuana increase the risk for developing schizophrenia?

    PubMed

    Evins, A Eden; Green, Alan I; Kane, John M; Murray, Robin M

    2013-04-01

    As more US states and other countries consider legalizing marijuana, clinicians need to know the possible effects of this drug. Research has shown a connection between marijuana use and an increased risk for schizophrenia in young people who are vulnerable to developing psychosis. An international panel of experts addresses topics such as risk factors for schizophrenia, the potency and effects of cannabis use on adolescents, the effects of concurrent drug use with cannabis on schizophrenia risk, and current attitudes toward marijuana.

  16. Inhaled corticosteroids and the increased risk of pneumonia.

    PubMed

    Marzoratti, Lucía; Iannella, Hernán A; Waterer, Grant W

    2013-08-01

    Recently it has been suggested that there is a causal association between the use of inhaled corticosteroids (ICSs) and the risk of developing pneumonia in patients with chronic obstructive pulmonary disease (COPD). An increased risk of pneumonia associated with ICS use has been seen in trials with different design, different study populations and with evidence of a dose-response relationship. However, as none of these clinical trials were originally designed to assess pneumonia risk, radiographic confirmation of pneumonia was not always obtained. The extent to which pneumonia events have been confounded with acute exacerbations of COPD is unclear. As increased pneumonia events were not associated with increased mortality it remains unclear what the clinical significance of these findings are. Further complicating the association between ICSs and pneumonia is that meta-analyses restricted to budesonide trials have not shown an increased risk of pneumonia, and no association has been seen in patients with asthma. A number of mechanisms by which ICSs could increase the risk of pneumonia have been proposed, principally related to their immunosuppressive effect. Well-designed clinical trials with predefined endpoints and objective pneumonia definitions are needed before the real risk of pneumonia conferred by ICSs can be established. In the meantime, it seems reasonable to reduce ICSs given to COPD patients to the lowest effective doses, reduce the risk in individual patients by ensuring appropriate vaccination and to be vigilant for the possibility of pneumonia in patients with COPD on ICSs as they largely overlap with those of an acute exacerbation.

  17. Intensive Hemodialysis and Potential Risks With Increasing Treatment.

    PubMed

    Kraus, Michael A; Kansal, Sheru; Copland, Michael; Komenda, Paul; Weinhandl, Eric D; Bakris, George L; Chan, Christopher T; Fluck, Richard J; Burkart, John M

    2016-11-01

    Although intensive hemodialysis (HD) can address important clinical problems, increasing treatment also introduces risks. In this review, we assess risks pertaining to 6 domains: vascular access complications, infection, mortality, loss of residual kidney function, solute balance, and patient and care partner burden. In the Frequent Hemodialysis Network (FHN) trials, short daily and nocturnal schedules increased the incidence of access complications, although the incidence of access loss was not statistically higher. Observational studies indicate that infection-related hospitalization is an ongoing challenge with short daily HD. Excess risk may be catalyzed by poor infection control practices in the home setting in which intensive HD is typically delivered, but with fixed probability of bacterial contamination per cannulation, greater treatment frequency necessarily increases the risk for infectious complications. Buttonhole cannulation may increase the risk for metastatic infections. However, intensive HD in the home setting is associated with lower risk for infection than peritoneal dialysis. Data regarding mortality are equivocal. With extended follow-up of individuals in the FHN trials, short daily HD was associated with lower risk relative to the usual schedule, whereas nocturnal HD was associated with higher risk. In many, but not all, observational studies, short daily HD has been associated with lower risk than both in-center HD and peritoneal dialysis; however, observational studies are subject to unmeasured confounding. Intensive HD can accelerate the loss of residual kidney function in new dialysis patients with substantial urine output and can deplete solutes (eg, phosphorus) to the extent that supplementation is necessary. Finally, intensive HD may increase burden on patients and caregivers, possibly leading to technique failure. Some of these problems might be addressed with careful monitoring, so that relevant interventions (eg, antibiotics

  18. People with Increased Risk of Eye Damage from UV Light

    MedlinePlus

    ... With Increased Risk of Eye Damage from UV Light Written by: Shirley Dang Apr. 30, 2014 Everyone ... photosensitivity, though the reaction is rare. People with light-colored eyes Have blue or green eyes? Cover ...

  19. Can shrub cover increase predation risk for a desert rodent?

    USGS Publications Warehouse

    Schooley, R.L.; Sharpe, Peter B.

    1996-01-01

    Previous research indicates that predation risk may influence activity patterns, habitat partitioning, and community structure of nocturnal desert rodents. Shrub microhabitat is typically considered safer than open microhabitat for these small mammals. We investigated predation risk for Townsend's ground squirrels (Spermophilus townsendii), which are diurnal desert rodents that detect predators visually and use burrows for refuge. Our results suggested that shrub cover may increase risk for these squirrels by decreasing their ability to escape from predators. Our field experiment indicated that running speeds of juvenile squirrels were lower in shrub (Ceratoides lanata) habitat than in open areas. Shrub cover was also associated with shorter predator-detection distances (mammalian and avian) and fewer refuges (burrow entrances per hectare) than in open areas in one year but not in another. Our study demonstrated that the visual and locomotive obstruction of vegetative cover may increase predation risk for diurnal desert rodents and that elements of habitat-dependent risk may be temporally dynamic.

  20. Increased social distance makes people more risk-neutral.

    PubMed

    Sun, Qingzhou; Liu, Yongfang; Zhang, Huanren; Lu, Jingyi

    2016-09-29

    Individuals are consistently observed to be risk-averse over gains and risk-seeking over losses. This study examined whether increased social distance would change these behavioral patterns. To test our hypothesis, social distance was manipulated by asking the participants to make decisions either for themselves or for another person (Experiment 1), either for a known person or for an unknown person (Experiment 2), and either for a close friend or for a distant friend (Experiment 3). The results of Experiments 1 and 3 showed that increased social distance made people more risk-neutral, and such an effect was stronger in the gain domain than in the loss domain. However, the effect of social distance was not observed in Experiment 2. These findings suggest that risk preferences are influenced by the social distance between decision makers and beneficiaries.

  1. Parameters Pointing at an Increased Risk for Contralateral Hip Fractures

    PubMed Central

    Moll, Maria A.; Joeris, Alexander; Goldhahn, Joerg; Blauth, Michael

    2016-01-01

    Background: Early identification of hip fracture (HF) patients bearing an increased risk for a contralateral occurrence would allow providing preventive measures timely. Objectives: To summarize the available evidence describing risk scores, prognostic instruments, or (groups of) parameters predicting contralateral HFs at the time point of the first fracture. Methods/Systematic Review: Articles were identified through searches in MEDLINE and Scopus from inception to April 2014, checking of reference lists of the included studies and reviews. One reviewer assessed all articles for inclusion and abstracted the data. Uncertain cases were discussed and decided with a second reviewer. Salient study and population characteristics were abstracted for each article. Studies reporting the association of a set of risk factors for second HFs were further examined and compared. The number of studies reporting on a risk parameter was assessed. Results: Searches identified 3560 records, and 47 studies were included in this review. There was a large spectrum of study designs, patient populations, and follow-up periods. Among 11 studies reporting on a set of parameters, female gender was assessed most commonly (7 times), followed by age (5) and parameters of general health, vision, and stroke (each 4 times). We were unable to depict stringent patterns of risk parameters to be used for decision making in clinical practice. Conclusions: The findings of this article call for a conjoint effort to achieve an expert consensus regarding a critical set of parameters for a risk instrument identifying patients bearing an increased risk for contralateral HFs early. PMID:26929857

  2. The increasing risk of Lyme disease in Canada.

    PubMed

    Bouchard, Catherine; Leonard, Erin; Koffi, Jules Konan; Pelcat, Yann; Peregrine, Andrew; Chilton, Neil; Rochon, Kateryn; Lysyk, Tim; Lindsay, L Robbin; Ogden, Nicholas Hume

    2015-07-01

    There is an increasing risk of Lyme disease in Canada due to range expansion of the tick vector, Ixodes scapularis. The objectives of this article are to i) raise public awareness with the help of veterinarians on the emerging and expanding risk of Lyme disease across Canada, ii) review the key clinical features of Lyme disease in dogs, and iii) provide recommendations for veterinarians on the management of Lyme disease in dogs.

  3. Increasing resilience through participative flood risk map design

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven; Spira, Yvonne; Stickler, Therese

    2013-04-01

    In recent years, an increasing number of flood hazards has shown to the European Commission and the Member States of the European Union the importance of flood risk management strategies in order to reduce losses and to protect the environment and the citizens. Exposure to floods as well as flood vulnerability might increase across Europe due to the ongoing economic development in many EU countries. Thus even without taking climate change into account an increase of flood disasters in Europe might be foreseeable. These circumstances have produced a reaction in the European Commission, and a Directive on the Assessment and Management of Flood Risks was issued as one of the three components of the European Action Programme on Flood Risk Management. Floods have the potential to jeopardise economic development, above all due to an increase of human activities in floodplains and the reduction of natural water retention by land use activities. As a result, an increase in the likelihood and adverse impacts of flood events is expected. Therefore, concentrated action is needed at the European level to avoid severe impacts on human life and property. In order to have an effective tool available for gathering information, as well as a valuable basis for priority setting and further technical, financial and political decisions regarding flood risk mitigation and management, it is necessary to provide for the establishment of flood risk maps which show the potential adverse consequences associated with different flood scenarios. So far, hazard and risk maps are compiled in terms of a top-down linear approach: planning authorities take the responsibility to create and implement these maps on different national and local scales, and the general public will only be informed about the outcomes (EU Floods Directive, Article 10). For the flood risk management plans, however, an "active involvement of interested parties" is required, which means at least some kind of multilateral

  4. Circadian misalignment increases cardiovascular disease risk factors in humans

    PubMed Central

    Morris, Christopher J.; Purvis, Taylor E.; Hu, Kun; Scheer, Frank A. J. L.

    2016-01-01

    Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show—by using two 8-d laboratory protocols—that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8–15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3–29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk. PMID:26858430

  5. Circadian misalignment increases cardiovascular disease risk factors in humans.

    PubMed

    Morris, Christopher J; Purvis, Taylor E; Hu, Kun; Scheer, Frank A J L

    2016-03-08

    Shift work is a risk factor for hypertension, inflammation, and cardiovascular disease. This increased risk cannot be fully explained by classic risk factors. One of the key features of shift workers is that their behavioral and environmental cycles are typically misaligned relative to their endogenous circadian system. However, there is little information on the impact of acute circadian misalignment on cardiovascular disease risk in humans. Here we show-by using two 8-d laboratory protocols-that short-term circadian misalignment (12-h inverted behavioral and environmental cycles for three days) adversely affects cardiovascular risk factors in healthy adults. Circadian misalignment increased 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP) by 3.0 mmHg and 1.5 mmHg, respectively. These results were primarily explained by an increase in blood pressure during sleep opportunities (SBP, +5.6 mmHg; DBP, +1.9 mmHg) and, to a lesser extent, by raised blood pressure during wake periods (SBP, +1.6 mmHg; DBP, +1.4 mmHg). Circadian misalignment decreased wake cardiac vagal modulation by 8-15%, as determined by heart rate variability analysis, and decreased 24-h urinary epinephrine excretion rate by 7%, without a significant effect on 24-h urinary norepinephrine excretion rate. Circadian misalignment increased 24-h serum interleukin-6, C-reactive protein, resistin, and tumor necrosis factor-α levels by 3-29%. We demonstrate that circadian misalignment per se increases blood pressure and inflammatory markers. Our findings may help explain why shift work increases hypertension, inflammation, and cardiovascular disease risk.

  6. Women with cardiovascular disease have increased risk of osteoporotic fracture.

    PubMed

    Chen, Jian Sheng; Hogan, Chris; Lyubomirsky, Greg; Sambrook, Philip N

    2011-01-01

    This study investigated whether women with cardiovascular disease (CVD) would have an increased risk of fractures as osteoporosis and CVD share many common risk factors. From February 2006 to January 2007, 17,033 women aged ≥50 years (mean 71.8, range 50-106) were recruited by 1,248 primary care practitioners and interviewed by trained nurses. For each woman, 10-year probability of a future major osteoporotic fracture was estimated using the World Health Organization Fracture Risk Assessment Tool (FRAX). The study showed that the 10-year probability of a major osteoporotic fracture was higher for 6,219 CVD women compared to 10,814 non-CVD women after adjustment for age, BMI, current smoking, and alcohol use (adjusted geometric means 14.3 and 13.8%, respectively; P < 0.001). With regard to high risk of fracture (i.e., 10-year probability ≥ 20%), the adjusted odds ratio for CVD was 1.23 (95% CI 1.13-1.35, P < 0.001). However, compared to non-CVD women, CVD women were more likely to report a previous fracture, to have a secondary osteoporosis, and to use glucocorticoids. Among the 4,678 women who were classified as having a high fracture risk, current use rate of bone-related medications (i.e., any one of bisphosphonates, raloxifene, PTH, vitamin D, calcium, or hormone therapy) was 50.2% in the CVD group and 56.9% in the non-CVD group. Women with CVD were at increased risk of fracture partly due to bone-specific risk factors such as history of previous fracture, use of glucocorticoids, and secondary osteoporosis. This risk is not being treated appropriately by primary health physicians.

  7. Increasing risk of great floods in a changing climate

    USGS Publications Warehouse

    Milly, P.C.D.; Wetherald, R.T.; Dunne, K.A.; Delworth, T.L.

    2002-01-01

    Radiative effects of anthropogenic changes in atmospheric composition are expected to cause climate changes, in particular an intensification of the global water cycle with a consequent increase in flood risk. But the detection of anthropogenically forced changes in flooding is difficult because of the substantial natural variability; the dependence of streamflow trends on flow regime further complicates the issue. Here we investigate the changes in risk of great floods - that is, floods with discharges exceeding 100-year levels from basins larger than 200,000 km2 - using both streamflow measurements and numerical simulations of the anthropogenic climate change associated with greenhouse gases and direct radiative effects of sulphate aerosols. We find that the frequency of great floods increased substantially during the twentieth century. The recent emergence of a statistically significant positive trend in risk of great floods is consistent with results from the climate model, and the model suggests that the trend will continue.

  8. Increasing Risk Awareness: The Coastal Community Resilience Index

    ERIC Educational Resources Information Center

    Thompson, Jody A.; Sempier, Tracie; Swann, LaDon

    2012-01-01

    As the number of people moving to the Gulf Coast increases, so does the risk of exposure to floods, hurricanes, and other storm-related events. In an effort to assist communities in preparing for future storm events, the Coastal Community Resilience Index was created. The end result is for communities to take actions to address the weaknesses they…

  9. Does Childhood Disability Increase Risk for Child Abuse and Neglect?

    ERIC Educational Resources Information Center

    Leeb, Rebecca T.; Bitsko, Rebecca H.; Merrick, Melissa T.; Armour, Brian S.

    2012-01-01

    In this article we review the empirical evidence for the presumptions that children with disabilities are at increased risk for child maltreatment, and parents with disabilities are more likely to perpetrate child abuse and neglect. Challenges to the epidemiological examination of the prevalence of child maltreatment and disabilities are…

  10. Rare disaster information can increase risk-taking

    NASA Astrophysics Data System (ADS)

    Newell, Ben R.; Rakow, Tim; Yechiam, Eldad; Sambur, Michael

    2016-02-01

    The recent increase in the frequency and impact of natural disasters highlights the need to provide the public with accurate information concerning disaster prevalence. Most approaches to this problem assume that providing summaries of the nature and scale of disasters will lead people to reduce their exposure to risk. Here we present experimental evidence that such ex post `news reports’ of disaster occurrences can increase the tolerance for risk-taking (which implies that rare events are underweighted). This result is robust across several hundred rounds of choices in a simulated microworld, persists even when the long-run expected value of risky choices is substantially lower than safe choices, and is contingent on providing risk information about disasters that have been (personally) experienced and those that have been avoided (`forgone’ outcomes). The results suggest that augmenting personal experience with information summaries of the number of adverse events (for example, storms, floods) in different regions may, paradoxically, increase the appeal of a disaster-prone region. This finding implies a need to communicate long-term trends in severe climatic events, thereby reinforcing the accumulation of events, and the increase in their associated risks, across time.

  11. Charter Schools and the Risk of Increased Segregation

    ERIC Educational Resources Information Center

    Rotberg, Iris C.

    2014-01-01

    This article examines a wide array of research on the link between school choice programs and student segregation and draws implications for the Obama Administration's policy promoting the national expansion of charter schools. The research demonstrates how the proliferation of charter schools risks increasing current levels of segregation…

  12. Increased risk of oesophageal adenocarcinoma among upstream petroleum workers

    PubMed Central

    Kirkeleit, Jorunn; Riise, Trond; Bjørge, Tone; Moen, Bente E; Bråtveit, Magne; Christiani, David C

    2013-01-01

    Objectives To investigate cancer risk, particularly oesophageal cancer, among male upstream petroleum workers offshore potentially exposed to various carcinogenic agents. Methods Using the Norwegian Registry of Employers and Employees, 24 765 male offshore workers registered from 1981 to 2003 was compared with 283 002 male referents from the general working population matched by age and community of residence. The historical cohort was linked to the Cancer Registry of Norway and the Norwegian Cause of Death Registry. Results Male offshore workers had excess risk of oesophageal cancer (RR 2.6, 95% CI 1.4 to 4.8) compared with the reference population. Only the adenocarcinoma type had a significantly increased risk (RR 2.7, 95% CI 1.0 to 7.0), mainly because of an increased risk among upstream operators (RR 4.3, 95% CI 1.3 to 14.5). Upstream operators did not have significant excess of respiratory system or colon cancer or mortality from any other lifestyle-related diseases investigated. Conclusion We found a fourfold excess risk of oesophageal adenocarcinoma among male workers assumed to have had the most extensive contact with crude oil. Due to the small number of cases, and a lack of detailed data on occupational exposure and lifestyle factors associated with oesophageal adenocarcinoma, the results must be interpreted with caution. Nevertheless, given the low risk of lifestyle-related cancers and causes of death in this working group, the results add to the observations in other low-powered studies on oesophageal cancer, further suggesting that factors related to the petroleum stream or carcinogenic agents used in the production process might be associated with risk of oesophageal adenocarcinoma. PMID:19858535

  13. Increased Risk of Dementia Among Sleep-Related Movement Disorders

    PubMed Central

    Lin, Chun-Chieh; Chou, Chung-Hsing; Fan, Yu-Ming; Yin, Jiu-Haw; Chung, Chi-Hsiang; Chien, Wu-Chien; Sung, Yueh-Feng; Tsai, Chia-Kuang; Lin, Guan-Yu; Lin, Yu-Kai; Lee, Jiunn-Tay

    2015-01-01

    Abstract Sleep-related movement disorders (SRMD) are sleep disorders. As poor sleep quality is associated with cognitive impairment, we hypothesized that SRMD patients were exposed to a great risk for developing dementia. The present study was aimed to retrospectively examine the association of SRMD and dementia risk. A retrospective longitudinal study was conducted using the data obtained from the Longitudinal Health Insurance Database (LHID) in Taiwan. The study cohort enrolled 604 patients with SRMD who were initially diagnosed and 2416 patients who were randomly selected and age/gender matched with the study group. SRMD, dementia, and other confounding factors were defined according to International Classification of Diseases Clinical Modification Codes. Cox proportional-hazards regressions were employed to examine adjusted hazard ratios (HR) after adjusting with confounding factors. Our data revealed that patients with SRMD had a 3.952 times (95% CI = 1.124–4.767) higher risk to develop all-cause dementia compared with individuals without SRMD. The results showed that SRMD patients aged 45 to 64 exhibited highest risk of developing all-cause dementia (HR: 5.320, 95% CI = 1.770–5.991), followed by patients age ≥65 (HR: 4.123, 95% CI = 2.066–6.972) and <45 (HR: 3.170, 95% CI = 1.050–4.128), respectively. Females with SRMD were at greater risk to develop all-cause dementia (HR: 4.372, 95% CI = 1.175–5.624). The impact of SRMD on dementia risk was progressively increased by various follow-up time intervals (<1 year, 1–2 years, and ≥2 years). The results suggest that SRMD is linked to an increased risk for dementia with gender-dependent and time-dependent characteristics. PMID:26705224

  14. Financing increasing flood risk: evidence from millions of buildings

    NASA Astrophysics Data System (ADS)

    Jongman, B.; Koks, E. E.; Husby, T. G.; Ward, P. J.

    2014-01-01

    The effectiveness of disaster risk management and financing mechanisms depends on the accurate assessment of current and future hazard exposure. The increasing availability of detailed data offers policy makers and the insurance sector new opportunities to understand trends in risk, and to make informed decisions on the ways to deal with these trends. In this paper we show how comprehensive property level information can be used for the assessment of exposure to flooding on a national scale, and how this information can contribute to discussions on possible risk financing practices. The case-study used is the Netherlands, which is one of the countries most exposed to flooding globally, and which is currently undergoing a debate on strategies for the compensation of potential losses. Our results show that flood exposure has increased rapidly between 1960 and 2012, and that the growth of the building stock and its economic value in flood prone areas has been higher than in not flood prone areas. We also find that property values in flood prone areas are lower than those in not flood prone areas. We argue that the increase in the share of economic value located in potential flood prone areas can have a negative effect on the feasibility of private insurance schemes in the Netherlands. The methodologies and results presented in this study are relevant for many regions around the world where the effects of rising flood exposure create a challenge for risk financing.

  15. Increasing flood exposure in the Netherlands: implications for risk financing

    NASA Astrophysics Data System (ADS)

    Jongman, B.; Koks, E. E.; Husby, T. G.; Ward, P. J.

    2014-05-01

    The effectiveness of disaster risk management and financing mechanisms depends on an accurate assessment of current and future hazard exposure. The increasing availability of detailed data offers policy makers and the insurance sector new opportunities to understand trends in risk, and to make informed decisions on ways to deal with these trends. In this paper we show how comprehensive property level information can be used for the assessment of exposure to flooding on a national scale, and how this information provides valuable input to discussions on possible risk financing practices. The case study used is the Netherlands, which is one of the countries most exposed to flooding globally, and which is currently undergoing a debate on strategies for the compensation of potential losses. Our results show that flood exposure has increased rapidly between 1960 and 2012, and that the growth of the building stock and its economic value in flood-prone areas has been higher than in non-flood-prone areas. We also find that property values in flood-prone areas are lower than those in non-flood-prone areas. We argue that the increase in the share of economic value located in potential flood-prone areas can have a negative effect on the feasibility of private insurance schemes in the Netherlands. The methodologies and results presented in this study are relevant for many regions around the world where the effects of rising flood exposure create a challenge for risk financing.

  16. Acrolein Exposure Is Associated With Increased Cardiovascular Disease Risk

    PubMed Central

    DeJarnett, Natasha; Conklin, Daniel J.; Riggs, Daniel W.; Myers, John A.; O'Toole, Timothy E.; Hamzeh, Ihab; Wagner, Stephen; Chugh, Atul; Ramos, Kenneth S.; Srivastava, Sanjay; Higdon, Deirdre; Tollerud, David J.; DeFilippis, Andrew; Becher, Carrie; Wyatt, Brad; McCracken, James; Abplanalp, Wes; Rai, Shesh N.; Ciszewski, Tiffany; Xie, Zhengzhi; Yeager, Ray; Prabhu, Sumanth D.; Bhatnagar, Aruni

    2014-01-01

    Background Acrolein is a reactive aldehyde present in high amounts in coal, wood, paper, and tobacco smoke. It is also generated endogenously by lipid peroxidation and the oxidation of amino acids by myeloperoxidase. In animals, acrolein exposure is associated with the suppression of circulating progenitor cells and increases in thrombosis and atherogenesis. The purpose of this study was to determine whether acrolein exposure in humans is also associated with increased cardiovascular disease (CVD) risk. Methods and Results Acrolein exposure was assessed in 211 participants of the Louisville Healthy Heart Study with moderate to high (CVD) risk by measuring the urinary levels of the major acrolein metabolite—3‐hydroxypropylmercapturic acid (3‐HPMA). Generalized linear models were used to assess the association between acrolein exposure and parameters of CVD risk, and adjusted for potential demographic confounders. Urinary 3‐HPMA levels were higher in smokers than nonsmokers and were positively correlated with urinary cotinine levels. Urinary 3‐HPMA levels were inversely related to levels of both early (AC133+) and late (AC133−) circulating angiogenic cells. In smokers as well as nonsmokers, 3‐HPMA levels were positively associated with both increased levels of platelet–leukocyte aggregates and the Framingham Risk Score. No association was observed between 3‐HPMA and plasma fibrinogen. Levels of C‐reactive protein were associated with 3‐HPMA levels in nonsmokers only. Conclusions Regardless of its source, acrolein exposure is associated with platelet activation and suppression of circulating angiogenic cell levels, as well as increased CVD risk. PMID:25099132

  17. Puumala virus infections in Finland: increased occupational risk for farmers.

    PubMed

    Vapalahti, K; Paunio, M; Brummer-Korvenkontio, M; Vaheri, A; Vapalahti, O

    1999-06-15

    Puumala hantavirus, transmitted by bank voles (Clethrionomys glareolus), causes a mild-type hemorrhagic fever with renal syndrome. The disease is common in Finland and is considered an occupational hazard for farmers, but the actual risk has not been assessed by analytical studies. Data on 5,132 serologically confirmed Puumala virus infections during 1989-1994 were analyzed, and cases among farmers and the population living in similar conditions were compared. The farmers contracted the disease earlier and more often than did the comparison group. In the province of Mikkeli with the highest incidence (70/100,000), the risk ratio was 5.1 (95% confidence interval (CI) 3.0-8.4) for 20- to 29-year-old farmers; in the older age groups, the risk was still increased but the risk ratios were lower. The peak incidence in the comparison group was 10 years later (age group 30-39 years). For the whole country, the result was similar although less marked. The average risk ratio adjusted by age, sex, and geographic variation was 1.7 (95% CI 1.5-1.8) for the whole country and 1.9 (95% CI 1.5-2.3) for the Mikkeli province, where 80% of Puumala virus infections among young farmers could be estimated to be attributable to occupation.

  18. Increased Risk Taking in Relation to Chronic Stress in Adults

    PubMed Central

    Ceccato, Smarandita; Kudielka, Brigitte M.; Schwieren, Christiane

    2016-01-01

    Chronic stress is a public health problem that affects a significant part of the population. While the physiological damage it causes is under ongoing scrutiny, its behavioral effects have been overlooked. This is one of the first studies to examine the relation between chronic stress and decision-making, using a standard lottery paradigm. We measured risk taking in the gain domain through binary choices between financially incentivized lotteries. We then measured self-reported chronic stress with the Trier Inventory for the Assessment of Chronic Stress (TICS). We additionally collected hair samples in a subsample of volunteers, in order to quantify accumulation of the stress hormone cortisol. We discovered a significant positive, though modest, correlation between self-reported chronic stress and risk taking that is stronger for women than for men. This confirms part of the findings in acute stress research that show a connection between higher stress and increased risk taking. However, unlike the biologically-based results from acute stress research, we did not identify a significant relation between hair cortisol and behavior. In line with previous literature, we found a clear gender difference in risk taking and self-reports: women generally take less risk and report slightly higher stress levels than men. We conclude that perceived chronic stress can impact behavior in risky situations. PMID:26858663

  19. Increased risk of idiopathic chronic pancreatitis in cystic fibrosis carriers.

    PubMed

    Cohn, Jonathan A; Neoptolemos, John P; Feng, Jinong; Yan, Jin; Jiang, Zefei; Greenhalf, William; McFaul, Christopher; Mountford, Roger; Sommer, Steve S

    2005-10-01

    Cystic fibrosis (CF) is a recessive disease caused by mutations of the CF transmembrane conductance regulator (CFTR) gene. The risk of idiopathic chronic pancreatitis (ICP) is increased in individuals who have CFTR genotypes containing a CF-causing mutation plus a second pathogenic allele. It is unknown whether the risk of ICP is increased in CF carriers who have one CF-causing mutation plus one normal allele. In this study, 52 sporadic cases of ICP were ascertained through the European Registry of Hereditary Pancreatitis and Familial Pancreatic Cancer. Individuals with pathogenic cationic trypsinogen mutations were excluded. DNA was comprehensively tested for CFTR mutations using a robotically enhanced, multiplexed, and highly redundant form of single-strand conformation polymorphism (SSCP) analysis followed by DNA sequencing. Fifteen subjects had a total of 18 pathogenic CFTR alleles. Eight subjects had common CF-causing mutations. This group included seven CF carriers in whom the second CFTR allele was normal (4.3 times the expected frequency, P=0.0002). Three subjects had compound heterozygotes genotypes containing two pathogenic alleles (31 times the expected frequency, P<0.0001). A variant allele of uncertain significance (p.R75Q) was detected in eight of the 52 ICP subjects and at a similar frequency (13/96) in random donors. ICP differs from other established CFTR-related conditions in that ICP risk is increased in CF carriers who have one documented normal CFTR allele. Having two CFTR mutations imparts a higher relative risk, while having only one mutation imparts a higher attributable risk.

  20. Extreme Geohazards: Reducing the Disaster Risk and Increasing Resilience

    NASA Astrophysics Data System (ADS)

    Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Marsh, Stuart; Campus, Paola

    2013-04-01

    Extreme geohazards have the potential to escalate the global sustainability crisis and put us close to the boundaries of the safe operating space for humanity. Exposure of human assets to geohazards has increased dramatically in recent decades, and the sensitivity of the built environment and the embedded socio-economic fabric have changed. We are putting the urban environment, including megacities, in harm's way. Paradoxically, innovation during recent decades, in particular, urban innovation, has increased the disaster risk and coupled this risk to the sustainability crisis. Only more innovation can reduce disaster risk and lead us out of the sustainability crisis. Extreme geohazards (volcanic eruptions, earthquakes, tsunamis) that occurred regularly throughout the last few millennia mostly did not cause major disasters because population density was low and the built environment was not sprawling into hazardous areas to the same extent as today. Similar extreme events today would cause unparalleled damage on a global scale and could worsen the sustainability crisis. Simulation of these extreme hazards under present conditions can help to assess the disaster risk. The Geohazards Community of Practice of the Group on Earth Observations (GEO) with support from the European Science Foundation is preparing a white paper assessing the contemporary disaster risks associated with extreme geohazards and developing a vision for science and society to engage in deliberations addressing this risk (see http://www.geohazcop.org/projects/extgeowp). Risk awareness and monitoring is highly uneven across the world, and this creates two kinds of problems. Firstly, potential hazards are much more closely monitored in wealthy countries than in the developing world. But the largest hazards are global in nature, and it is critical to get as much forewarning as possible to develop an effective response. The disasters and near-misses of the past show that adherence to scientific

  1. The increasing risk of poverty across the American life course.

    PubMed

    Sandoval, Daniel A; Rank, Mark R; Hirschl, Thomas A

    2009-11-01

    This article extends the emerging body of life course research on poverty by empirically identifying the incidence, chronicity, and age pattern of American poverty and how these dimensions have changed during the period 1968-2000. Using the Panel Study of Income Dynamics, we construct a series of life tables that estimate the risk of poverty for adults during their 20s, 30s, 40s, 50s, 60s, and 70s, and compare these estimates for Americans in the 1970s, 1980s, and 1990s. Our empirical results suggest that the risk of acute poverty increased substantially, particularly in the 1990s. This observed increase was especially pronounced for individuals in their 20s, 30s, and 40s; for all age groups with respect to extreme poverty; and for white males. On the other hand, the risk of chronic poverty declined during the 1990s (as measured by the percentage of the poor who experienced five or more years of poverty within a 10-year interval). The results in this article tell a very different story than the Census Bureau's yearly cross-sectional rates, which have shown little overall change in the U.S. poverty rate during this 30-year period. In contrast, a life course approach reveals a rising economic risk of acute poverty for individuals, one that is consistent with recent observations and research suggesting that a growing number of Americans will eventually find themselves in an economically precarious position.

  2. The increased risk of joint venture promotes social cooperation.

    PubMed

    Wu, Te; Fu, Feng; Zhang, Yanling; Wang, Long

    2013-01-01

    The joint venture of many members is common both in animal world and human society. In these public enterprizes, highly cooperative groups are more likely to while low cooperative groups are still possible but not probable to succeed. Existent literature mostly focuses on the traditional public goods game, in which cooperators create public wealth unconditionally and benefit all group members unbiasedly. We here institute a model addressing this public goods dilemma with incorporating the public resource foraging failure risk. Risk-averse individuals tend to lead a autarkic life, while risk-preferential ones tend to participate in the risky public goods game. For participants, group's success relies on its cooperativeness, with increasing contribution leading to increasing success likelihood. We introduce a function with one tunable parameter to describe the risk removal pattern and study in detail three representative classes. Analytical results show that the widely replicated population dynamics of cyclical dominance of loner, cooperator and defector disappear, while most of the time loners act as savors while eventually they also disappear. Depending on the way that group's success relies on its cooperativeness, either cooperators pervade the entire population or they coexist with defectors. Even in the later case, cooperators still hold salient superiority in number as some defectors also survive by parasitizing. The harder the joint venture succeeds, the higher level of cooperation once cooperators can win the evolutionary race. Our work may enrich the literature concerning the risky public goods games.

  3. The Increasing Risk of Poverty Across the American Life Course

    PubMed Central

    SANDOVAL, DANIEL A.; RANK, MARK R.; HIRSCHL, THOMAS A.

    2009-01-01

    This article extends the emerging body of life course research on poverty by empirically identifying the incidence, chronicity, and age pattern of American poverty and how these dimensions have changed during the period 1968–2000. Using the Panel Study of Income Dynamics, we construct a series of life tables that estimate the risk of poverty for adults during their 20s, 30s, 40s, 50s, 60s, and 70s, and compare these estimates for Americans in the 1970s, 1980s, and 1990s. Our empirical results suggest that the risk of acute poverty increased substantially, particularly in the 1990s. This observed increase was especially pronounced for individuals in their 20s, 30s, and 40s; for all age groups with respect to extreme poverty; and for white males. On the other hand, the risk of chronic poverty declined during the 1990s (as measured by the percentage of the poor who experienced five or more years of poverty within a 10-year interval). The results in this article tell a very different story than the Census Bureau’s yearly cross-sectional rates, which have shown little overall change in the U.S. poverty rate during this 30-year period. In contrast, a life course approach reveals a rising economic risk of acute poverty for individuals, one that is consistent with recent observations and research suggesting that a growing number of Americans will eventually find themselves in an economically precarious position. PMID:20084826

  4. The Increased Risk of Joint Venture Promotes Social Cooperation

    PubMed Central

    Wu, Te; Fu, Feng; Zhang, Yanling; Wang, Long

    2013-01-01

    The joint venture of many members is common both in animal world and human society. In these public enterprizes, highly cooperative groups are more likely to while low cooperative groups are still possible but not probable to succeed. Existent literature mostly focuses on the traditional public goods game, in which cooperators create public wealth unconditionally and benefit all group members unbiasedly. We here institute a model addressing this public goods dilemma with incorporating the public resource foraging failure risk. Risk-averse individuals tend to lead a autarkic life, while risk-preferential ones tend to participate in the risky public goods game. For participants, group's success relies on its cooperativeness, with increasing contribution leading to increasing success likelihood. We introduce a function with one tunable parameter to describe the risk removal pattern and study in detail three representative classes. Analytical results show that the widely replicated population dynamics of cyclical dominance of loner, cooperator and defector disappear, while most of the time loners act as savors while eventually they also disappear. Depending on the way that group's success relies on its cooperativeness, either cooperators pervade the entire population or they coexist with defectors. Even in the later case, cooperators still hold salient superiority in number as some defectors also survive by parasitizing. The harder the joint venture succeeds, the higher level of cooperation once cooperators can win the evolutionary race. Our work may enrich the literature concerning the risky public goods games. PMID:23750204

  5. Significant increase of Echinococcus multilocularis prevalence in foxes, but no increased predicted risk for humans.

    PubMed

    Maas, M; Dam-Deisz, W D C; van Roon, A M; Takumi, K; van der Giessen, J W B

    2014-12-15

    The emergence of the zoonotic tapeworm Echinococcus multilocularis, causative agent of alveolar echinococcosis (AE), poses a public health risk. A previously designed risk map model predicted a spread of E. multilocularis and increasing numbers of alveolar echinococcosis patients in the province of Limburg, The Netherlands. This study was designed to determine trends in the prevalence and worm burden of E. multilocularis in foxes in a popular recreational area in the southern part of Limburg to assess the risk of infection for humans and to study the prevalence of E. multilocularis in dogs in the adjacent city of Maastricht. Thirty-seven hunted red foxes were tested by the intestinal scraping technique and nested PCR on colon content. Additionally, 142 fecal samples of domestic dogs from Maastricht were analyzed by qPCR for the presence of E. multilocularis. In foxes, a significantly increased prevalence of 59% (95% confidence interval 43-74%) was found, compared to the prevalence of 11% (95% CI 7-18%) in 2005-2006. Average worm burden increased to 37 worms per fox, the highest since the first detection, but consistent with the prediction about the parasite population for this region. Updated prediction on the number of AE cases did not lead to an increase in previous estimates of human AE cases up to 2018. No dogs in the city of Maastricht tested positive, but results of questionnaires showed that deworming schemes were inadequate, especially in dogs that were considered at risk for infection.

  6. Genetic variants in CETP increase risk of intracerebral hemorrhage

    PubMed Central

    Falcone, Guido J.; Phuah, Chia‐Ling; Radmanesh, Farid; Brouwers, H. Bart; Battey, Thomas W. K.; Biffi, Alessandro; Peloso, Gina M.; Liu, Dajiang J.; Ayres, Alison M.; Goldstein, Joshua N.; Viswanathan, Anand; Greenberg, Steven M.; Selim, Magdy; Meschia, James F.; Brown, Devin L.; Worrall, Bradford B.; Silliman, Scott L.; Tirschwell, David L.; Flaherty, Matthew L.; Kraft, Peter; Jagiella, Jeremiasz M.; Schmidt, Helena; Hansen, Björn M.; Jimenez‐Conde, Jordi; Giralt‐Steinhauer, Eva; Elosua, Roberto; Cuadrado‐Godia, Elisa; Soriano, Carolina; van Nieuwenhuizen, Koen M.; Klijn, Catharina J. M.; Rannikmae, Kristiina; Samarasekera, Neshika; Salman, Rustam Al‐Shahi; Sudlow, Catherine L.; Deary, Ian J.; Morotti, Andrea; Pezzini, Alessandro; Pera, Joanna; Urbanik, Andrzej; Pichler, Alexander; Enzinger, Christian; Norrving, Bo; Montaner, Joan; Fernandez‐Cadenas, Israel; Delgado, Pilar; Roquer, Jaume; Lindgren, Arne; Slowik, Agnieszka; Schmidt, Reinhold; Kidwell, Chelsea S.; Kittner, Steven J.; Waddy, Salina P.; Langefeld, Carl D.; Abecasis, Goncalo; Willer, Cristen J.; Kathiresan, Sekar; Woo, Daniel; Rosand, Jonathan

    2016-01-01

    Objective In observational epidemiologic studies, higher plasma high‐density lipoprotein cholesterol (HDL‐C) has been associated with increased risk of intracerebral hemorrhage (ICH). DNA sequence variants that decrease cholesteryl ester transfer protein (CETP) gene activity increase plasma HDL‐C; as such, medicines that inhibit CETP and raise HDL‐C are in clinical development. Here, we test the hypothesis that CETP DNA sequence variants associated with higher HDL‐C also increase risk for ICH. Methods We performed 2 candidate‐gene analyses of CETP. First, we tested individual CETP variants in a discovery cohort of 1,149 ICH cases and 1,238 controls from 3 studies, followed by replication in 1,625 cases and 1,845 controls from 5 studies. Second, we constructed a genetic risk score comprised of 7 independent variants at the CETP locus and tested this score for association with HDL‐C as well as ICH risk. Results Twelve variants within CETP demonstrated nominal association with ICH, with the strongest association at the rs173539 locus (odds ratio [OR] = 1.25, standard error [SE] = 0.06, p = 6.0 × 10−4) with no heterogeneity across studies (I 2 = 0%). This association was replicated in patients of European ancestry (p = 0.03). A genetic score of CETP variants found to increase HDL‐C by ∼2.85mg/dl in the Global Lipids Genetics Consortium was strongly associated with ICH risk (OR = 1.86, SE = 0.13, p = 1.39 × 10−6). Interpretation Genetic variants in CETP associated with increased HDL‐C raise the risk of ICH. Given ongoing therapeutic development in CETP inhibition and other HDL‐raising strategies, further exploration of potential adverse cerebrovascular outcomes may be warranted. Ann Neurol 2016;80:730–740 PMID:27717122

  7. Clothing increases the risk of indirect ballistic fractures

    PubMed Central

    2013-01-01

    Background Current literature has shown the mechanism of how indirect fractures occur but has not determined what factors increase the risks of such fractures. The objective of this study is thus to determine the effect of clothing and soft tissue thickness on the risk of indirect fracture formation. Methods Twenty-five fresh red deer femora embedded in ballistic gelatine were shot with varying distances off their medial cortex with a 5.56 × 45 mm North Atlantic Treaty Organization (NATO) bullet while being filmed with a slow-motion video. We compared the effect of two different gelatine depths and the effect of denim cloth laid onto the impact surface of the moulds. Results Bullet passage in thinner moulds failed to cause fracture because the bullet exited the mould before a large expanding temporary cavity was produced. Clothing dramatically altered the size and depth of the expanding cavity, as well as increased lateral pressures, resulting in more severe fractures with greater bullet distances from the bone that can cause fracture. Conclusions Clothing increases the risk of indirect fracture and results in larger, more superficial temporary cavities, with greater lateral pressures than are seen in unclothed specimens, resulting in more comminuted fractures. Greater tissue depth affords the 5.56 × 45 mm NATO a chance to yaw and thus develop an enlarging temporary cavity that is sufficient to cause fracture. PMID:24267379

  8. Modeling Linkage Disequilibrium Increases Accuracy of Polygenic Risk Scores.

    PubMed

    Vilhjálmsson, Bjarni J; Yang, Jian; Finucane, Hilary K; Gusev, Alexander; Lindström, Sara; Ripke, Stephan; Genovese, Giulio; Loh, Po-Ru; Bhatia, Gaurav; Do, Ron; Hayeck, Tristan; Won, Hong-Hee; Kathiresan, Sekar; Pato, Michele; Pato, Carlos; Tamimi, Rulla; Stahl, Eli; Zaitlen, Noah; Pasaniuc, Bogdan; Belbin, Gillian; Kenny, Eimear E; Schierup, Mikkel H; De Jager, Philip; Patsopoulos, Nikolaos A; McCarroll, Steve; Daly, Mark; Purcell, Shaun; Chasman, Daniel; Neale, Benjamin; Goddard, Michael; Visscher, Peter M; Kraft, Peter; Patterson, Nick; Price, Alkes L

    2015-10-01

    Polygenic risk scores have shown great promise in predicting complex disease risk and will become more accurate as training sample sizes increase. The standard approach for calculating risk scores involves linkage disequilibrium (LD)-based marker pruning and applying a p value threshold to association statistics, but this discards information and can reduce predictive accuracy. We introduce LDpred, a method that infers the posterior mean effect size of each marker by using a prior on effect sizes and LD information from an external reference panel. Theory and simulations show that LDpred outperforms the approach of pruning followed by thresholding, particularly at large sample sizes. Accordingly, predicted R(2) increased from 20.1% to 25.3% in a large schizophrenia dataset and from 9.8% to 12.0% in a large multiple sclerosis dataset. A similar relative improvement in accuracy was observed for three additional large disease datasets and for non-European schizophrenia samples. The advantage of LDpred over existing methods will grow as sample sizes increase.

  9. Modeling Linkage Disequilibrium Increases Accuracy of Polygenic Risk Scores

    PubMed Central

    Vilhjálmsson, Bjarni J.; Yang, Jian; Finucane, Hilary K.; Gusev, Alexander; Lindström, Sara; Ripke, Stephan; Genovese, Giulio; Loh, Po-Ru; Bhatia, Gaurav; Do, Ron; Hayeck, Tristan; Won, Hong-Hee; Ripke, Stephan; Neale, Benjamin M.; Corvin, Aiden; Walters, James T.R.; Farh, Kai-How; Holmans, Peter A.; Lee, Phil; Bulik-Sullivan, Brendan; Collier, David A.; Huang, Hailiang; Pers, Tune H.; Agartz, Ingrid; Agerbo, Esben; Albus, Margot; Alexander, Madeline; Amin, Farooq; Bacanu, Silviu A.; Begemann, Martin; Belliveau, Richard A.; Bene, Judit; Bergen, Sarah E.; Bevilacqua, Elizabeth; Bigdeli, Tim B.; Black, Donald W.; Bruggeman, Richard; Buccola, Nancy G.; Buckner, Randy L.; Byerley, William; Cahn, Wiepke; Cai, Guiqing; Campion, Dominique; Cantor, Rita M.; Carr, Vaughan J.; Carrera, Noa; Catts, Stanley V.; Chambert, Kimberly D.; Chan, Raymond C.K.; Chen, Ronald Y.L.; Chen, Eric Y.H.; Cheng, Wei; Cheung, Eric F.C.; Chong, Siow Ann; Cloninger, C. Robert; Cohen, David; Cohen, Nadine; Cormican, Paul; Craddock, Nick; Crowley, James J.; Curtis, David; Davidson, Michael; Davis, Kenneth L.; Degenhardt, Franziska; Del Favero, Jurgen; DeLisi, Lynn E.; Demontis, Ditte; Dikeos, Dimitris; Dinan, Timothy; Djurovic, Srdjan; Donohoe, Gary; Drapeau, Elodie; Duan, Jubao; Dudbridge, Frank; Durmishi, Naser; Eichhammer, Peter; Eriksson, Johan; Escott-Price, Valentina; Essioux, Laurent; Fanous, Ayman H.; Farrell, Martilias S.; Frank, Josef; Franke, Lude; Freedman, Robert; Freimer, Nelson B.; Friedl, Marion; Friedman, Joseph I.; Fromer, Menachem; Genovese, Giulio; Georgieva, Lyudmila; Gershon, Elliot S.; Giegling, Ina; Giusti-Rodrguez, Paola; Godard, Stephanie; Goldstein, Jacqueline I.; Golimbet, Vera; Gopal, Srihari; Gratten, Jacob; Grove, Jakob; de Haan, Lieuwe; Hammer, Christian; Hamshere, Marian L.; Hansen, Mark; Hansen, Thomas; Haroutunian, Vahram; Hartmann, Annette M.; Henskens, Frans A.; Herms, Stefan; Hirschhorn, Joel N.; Hoffmann, Per; Hofman, Andrea; Hollegaard, Mads V.; Hougaard, David M.; Ikeda, Masashi; Joa, Inge; Julia, Antonio; Kahn, Rene S.; Kalaydjieva, Luba; Karachanak-Yankova, Sena; Karjalainen, Juha; Kavanagh, David; Keller, Matthew C.; Kelly, Brian J.; Kennedy, James L.; Khrunin, Andrey; Kim, Yunjung; Klovins, Janis; Knowles, James A.; Konte, Bettina; Kucinskas, Vaidutis; Kucinskiene, Zita Ausrele; Kuzelova-Ptackova, Hana; Kahler, Anna K.; Laurent, Claudine; Keong, Jimmy Lee Chee; Lee, S. Hong; Legge, Sophie E.; Lerer, Bernard; Li, Miaoxin; Li, Tao; Liang, Kung-Yee; Lieberman, Jeffrey; Limborska, Svetlana; Loughland, Carmel M.; Lubinski, Jan; Lnnqvist, Jouko; Macek, Milan; Magnusson, Patrik K.E.; Maher, Brion S.; Maier, Wolfgang; Mallet, Jacques; Marsal, Sara; Mattheisen, Manuel; Mattingsdal, Morten; McCarley, Robert W.; McDonald, Colm; McIntosh, Andrew M.; Meier, Sandra; Meijer, Carin J.; Melegh, Bela; Melle, Ingrid; Mesholam-Gately, Raquelle I.; Metspalu, Andres; Michie, Patricia T.; Milani, Lili; Milanova, Vihra; Mokrab, Younes; Morris, Derek W.; Mors, Ole; Mortensen, Preben B.; Murphy, Kieran C.; Murray, Robin M.; Myin-Germeys, Inez; Mller-Myhsok, Bertram; Nelis, Mari; Nenadic, Igor; Nertney, Deborah A.; Nestadt, Gerald; Nicodemus, Kristin K.; Nikitina-Zake, Liene; Nisenbaum, Laura; Nordin, Annelie; O’Callaghan, Eadbhard; O’Dushlaine, Colm; O’Neill, F. Anthony; Oh, Sang-Yun; Olincy, Ann; Olsen, Line; Van Os, Jim; Pantelis, Christos; Papadimitriou, George N.; Papiol, Sergi; Parkhomenko, Elena; Pato, Michele T.; Paunio, Tiina; Pejovic-Milovancevic, Milica; Perkins, Diana O.; Pietilinen, Olli; Pimm, Jonathan; Pocklington, Andrew J.; Powell, John; Price, Alkes; Pulver, Ann E.; Purcell, Shaun M.; Quested, Digby; Rasmussen, Henrik B.; Reichenberg, Abraham; Reimers, Mark A.; Richards, Alexander L.; Roffman, Joshua L.; Roussos, Panos; Ruderfer, Douglas M.; Salomaa, Veikko; Sanders, Alan R.; Schall, Ulrich; Schubert, Christian R.; Schulze, Thomas G.; Schwab, Sibylle G.; Scolnick, Edward M.; Scott, Rodney J.; Seidman, Larry J.; Shi, Jianxin; Sigurdsson, Engilbert; Silagadze, Teimuraz; Silverman, Jeremy M.; Sim, Kang; Slominsky, Petr; Smoller, Jordan W.; So, Hon-Cheong; Spencer, Chris C.A.; Stahl, Eli A.; Stefansson, Hreinn; Steinberg, Stacy; Stogmann, Elisabeth; Straub, Richard E.; Strengman, Eric; Strohmaier, Jana; Stroup, T. Scott; Subramaniam, Mythily; Suvisaari, Jaana; Svrakic, Dragan M.; Szatkiewicz, Jin P.; Sderman, Erik; Thirumalai, Srinivas; Toncheva, Draga; Tooney, Paul A.; Tosato, Sarah; Veijola, Juha; Waddington, John; Walsh, Dermot; Wang, Dai; Wang, Qiang; Webb, Bradley T.; Weiser, Mark; Wildenauer, Dieter B.; Williams, Nigel M.; Williams, Stephanie; Witt, Stephanie H.; Wolen, Aaron R.; Wong, Emily H.M.; Wormley, Brandon K.; Wu, Jing Qin; Xi, Hualin Simon; Zai, Clement C.; Zheng, Xuebin; Zimprich, Fritz; Wray, Naomi R.; Stefansson, Kari; Visscher, Peter M.; Adolfsson, Rolf; Andreassen, Ole A.; Blackwood, Douglas H.R.; Bramon, Elvira; Buxbaum, Joseph D.; Børglum, Anders D.; Cichon, Sven; Darvasi, Ariel; Domenici, Enrico; Ehrenreich, Hannelore; Esko, Tonu; Gejman, Pablo V.; Gill, Michael; Gurling, Hugh; Hultman, Christina M.; Iwata, Nakao; Jablensky, Assen V.; Jonsson, Erik G.; Kendler, Kenneth S.; Kirov, George; Knight, Jo; Lencz, Todd; Levinson, Douglas F.; Li, Qingqin S.; Liu, Jianjun; Malhotra, Anil K.; McCarroll, Steven A.; McQuillin, Andrew; Moran, Jennifer L.; Mortensen, Preben B.; Mowry, Bryan J.; Nthen, Markus M.; Ophoff, Roel A.; Owen, Michael J.; Palotie, Aarno; Pato, Carlos N.; Petryshen, Tracey L.; Posthuma, Danielle; Rietschel, Marcella; Riley, Brien P.; Rujescu, Dan; Sham, Pak C.; Sklar, Pamela; St. Clair, David; Weinberger, Daniel R.; Wendland, Jens R.; Werge, Thomas; Daly, Mark J.; Sullivan, Patrick F.; O’Donovan, Michael C.; Kraft, Peter; Hunter, David J.; Adank, Muriel; Ahsan, Habibul; Aittomäki, Kristiina; Baglietto, Laura; Berndt, Sonja; Blomquist, Carl; Canzian, Federico; Chang-Claude, Jenny; Chanock, Stephen J.; Crisponi, Laura; Czene, Kamila; Dahmen, Norbert; Silva, Isabel dos Santos; Easton, Douglas; Eliassen, A. Heather; Figueroa, Jonine; Fletcher, Olivia; Garcia-Closas, Montserrat; Gaudet, Mia M.; Gibson, Lorna; Haiman, Christopher A.; Hall, Per; Hazra, Aditi; Hein, Rebecca; Henderson, Brian E.; Hofman, Albert; Hopper, John L.; Irwanto, Astrid; Johansson, Mattias; Kaaks, Rudolf; Kibriya, Muhammad G.; Lichtner, Peter; Lindström, Sara; Liu, Jianjun; Lund, Eiliv; Makalic, Enes; Meindl, Alfons; Meijers-Heijboer, Hanne; Müller-Myhsok, Bertram; Muranen, Taru A.; Nevanlinna, Heli; Peeters, Petra H.; Peto, Julian; Prentice, Ross L.; Rahman, Nazneen; Sánchez, María José; Schmidt, Daniel F.; Schmutzler, Rita K.; Southey, Melissa C.; Tamimi, Rulla; Travis, Ruth; Turnbull, Clare; Uitterlinden, Andre G.; van der Luijt, Rob B.; Waisfisz, Quinten; Wang, Zhaoming; Whittemore, Alice S.; Yang, Rose; Zheng, Wei; Kathiresan, Sekar; Pato, Michele; Pato, Carlos; Tamimi, Rulla; Stahl, Eli; Zaitlen, Noah; Pasaniuc, Bogdan; Belbin, Gillian; Kenny, Eimear E.; Schierup, Mikkel H.; De Jager, Philip; Patsopoulos, Nikolaos A.; McCarroll, Steve; Daly, Mark; Purcell, Shaun; Chasman, Daniel; Neale, Benjamin; Goddard, Michael; Visscher, Peter M.; Kraft, Peter; Patterson, Nick; Price, Alkes L.

    2015-01-01

    Polygenic risk scores have shown great promise in predicting complex disease risk and will become more accurate as training sample sizes increase. The standard approach for calculating risk scores involves linkage disequilibrium (LD)-based marker pruning and applying a p value threshold to association statistics, but this discards information and can reduce predictive accuracy. We introduce LDpred, a method that infers the posterior mean effect size of each marker by using a prior on effect sizes and LD information from an external reference panel. Theory and simulations show that LDpred outperforms the approach of pruning followed by thresholding, particularly at large sample sizes. Accordingly, predicted R2 increased from 20.1% to 25.3% in a large schizophrenia dataset and from 9.8% to 12.0% in a large multiple sclerosis dataset. A similar relative improvement in accuracy was observed for three additional large disease datasets and for non-European schizophrenia samples. The advantage of LDpred over existing methods will grow as sample sizes increase. PMID:26430803

  10. Increased Risk of Chronic Fatigue Syndrome Following Atopy

    PubMed Central

    Yang, Tse-Yen; Kuo, Haung-Tsung; Chen, Hsuan-Ju; Chen, Chih-Sheng; Lin, Wei-Ming; Tsai, Shin-Yi; Kuo, Chua-Nan; Kao, Chia-Hung

    2015-01-01

    Abstract Several hypotheses have been proposed to explain the etiopathogenesis of chronic fatigue syndrome (CFS), including immune dysregulation. However, few population-based prospective cohort studies have been conducted on CFS and atopy. We investigated the relationship between atopy and CFS by using a population-based cohort study. In this prospective, population-based cohort study of the National Health Insurance Research Database, we identified 42,558 patients with atopy and 170,232 patients without atopy from 2005 to 2007 with follow-up to 2011. The incidence rates and risks for CFS were estimated using Cox proportion hazards regression. The overall incidence rate of CFS was higher in the atopy cohort compared with the nonatopy cohort (1.37 versus 0.87 per 1000 person-year), with an adjusted hazard ratio of 1.48 (95% confidence interval 1.30–1.69). The risk of CFS in the atopy cohort increased 1.47- to 1.50-fold for each nonexisting comorbidity. Patients with numerous atopic symptoms exhibited a biological gradient of increasing risk for CFS, and the risk changed significantly after adjustment for age, sex, and comorbidities, increasing from 1.46- to 2.59-fold. We revealed that atopy is associated with CFS, particularly in patients with numerous atopic syndromes. The actual mechanism for CFS development in patients with atopy remains unclear and requires further investigation. We recommend researching the subsequent fatigue symptom in patients with atopy, particularly those with multiple atopic syndromes. PMID:26200644

  11. An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity

    PubMed Central

    Simopoulos, Artemis P.

    2016-01-01

    In the past three decades, total fat and saturated fat intake as a percentage of total calories has continuously decreased in Western diets, while the intake of omega-6 fatty acid increased and the omega-3 fatty acid decreased, resulting in a large increase in the omega-6/omega-3 ratio from 1:1 during evolution to 20:1 today or even higher. This change in the composition of fatty acids parallels a significant increase in the prevalence of overweight and obesity. Experimental studies have suggested that omega-6 and omega-3 fatty acids elicit divergent effects on body fat gain through mechanisms of adipogenesis, browning of adipose tissue, lipid homeostasis, brain-gut-adipose tissue axis, and most importantly systemic inflammation. Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC) membrane phospholipids, whereas high omega-3 RBC membrane phospholipids decrease the risk of obesity. Recent studies in humans show that in addition to absolute amounts of omega-6 and omega-3 fatty acid intake, the omega-6/omega-3 ratio plays an important role in increasing the development of obesity via both AA eicosanoid metabolites and hyperactivity of the cannabinoid system, which can be reversed with increased intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A balanced omega-6/omega-3 ratio is important for health and in the prevention and management of obesity. PMID:26950145

  12. An Increase in the Omega-6/Omega-3 Fatty Acid Ratio Increases the Risk for Obesity.

    PubMed

    Simopoulos, Artemis P

    2016-03-02

    In the past three decades, total fat and saturated fat intake as a percentage of total calories has continuously decreased in Western diets, while the intake of omega-6 fatty acid increased and the omega-3 fatty acid decreased, resulting in a large increase in the omega-6/omega-3 ratio from 1:1 during evolution to 20:1 today or even higher. This change in the composition of fatty acids parallels a significant increase in the prevalence of overweight and obesity. Experimental studies have suggested that omega-6 and omega-3 fatty acids elicit divergent effects on body fat gain through mechanisms of adipogenesis, browning of adipose tissue, lipid homeostasis, brain-gut-adipose tissue axis, and most importantly systemic inflammation. Prospective studies clearly show an increase in the risk of obesity as the level of omega-6 fatty acids and the omega-6/omega-3 ratio increase in red blood cell (RBC) membrane phospholipids, whereas high omega-3 RBC membrane phospholipids decrease the risk of obesity. Recent studies in humans show that in addition to absolute amounts of omega-6 and omega-3 fatty acid intake, the omega-6/omega-3 ratio plays an important role in increasing the development of obesity via both AA eicosanoid metabolites and hyperactivity of the cannabinoid system, which can be reversed with increased intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A balanced omega-6/omega-3 ratio is important for health and in the prevention and management of obesity.

  13. Schooling Increases Risk Exposure for Fish Navigating Past Artificial Barriers

    PubMed Central

    Lemasson, Bertrand H.; Haefner, James W.; Bowen, Mark D.

    2014-01-01

    Artificial barriers have become ubiquitous features in freshwater ecosystems and they can significantly impact a region's biodiversity. Assessing the risk faced by fish forced to navigate their way around artificial barriers is largely based on assays of individual swimming behavior. However, social interactions can significantly influence fish movement patterns and alter their risk exposure. Using an experimental flume, we assessed the effects of social interactions on the amount of time required for juvenile palmetto bass (Morone chrysops × M. saxatilis) to navigate downstream past an artificial barrier. Fish were released either individually or in groups into the flume using flow conditions that approached the limit of their expected swimming stamina. We compared fish swimming behaviors under solitary and schooling conditions and measured risk as the time individuals spent exposed to the barrier. Solitary fish generally turned with the current and moved quickly downstream past the barrier, while fish in groups swam against the current and displayed a 23-fold increase in exposure time. Solitary individuals also showed greater signs of skittish behavior than those released in groups, which was reflected by larger changes in their accelerations and turning profiles. While groups displayed fission-fusion dynamics, inter-individual positions were highly structured and remained steady over time. These spatial patterns align with theoretical positions necessary to reduce swimming exertion through either wake capturing or velocity sheltering, but diverge from any potential gains from channeling effects between adjacent neighbors. We conclude that isolated performance trials and projections based on individual behaviors can lead to erroneous predictions of risk exposure along engineered structures. Our results also suggest that risk perception and behavior may be more important than a fish's swimming stamina in artificially modified systems. PMID:25268736

  14. Schooling increases risk exposure for fish navigating past artificial barriers.

    PubMed

    Lemasson, Bertrand H; Haefner, James W; Bowen, Mark D

    2014-01-01

    Artificial barriers have become ubiquitous features in freshwater ecosystems and they can significantly impact a region's biodiversity. Assessing the risk faced by fish forced to navigate their way around artificial barriers is largely based on assays of individual swimming behavior. However, social interactions can significantly influence fish movement patterns and alter their risk exposure. Using an experimental flume, we assessed the effects of social interactions on the amount of time required for juvenile palmetto bass (Morone chrysops × M. saxatilis) to navigate downstream past an artificial barrier. Fish were released either individually or in groups into the flume using flow conditions that approached the limit of their expected swimming stamina. We compared fish swimming behaviors under solitary and schooling conditions and measured risk as the time individuals spent exposed to the barrier. Solitary fish generally turned with the current and moved quickly downstream past the barrier, while fish in groups swam against the current and displayed a 23-fold increase in exposure time. Solitary individuals also showed greater signs of skittish behavior than those released in groups, which was reflected by larger changes in their accelerations and turning profiles. While groups displayed fission-fusion dynamics, inter-individual positions were highly structured and remained steady over time. These spatial patterns align with theoretical positions necessary to reduce swimming exertion through either wake capturing or velocity sheltering, but diverge from any potential gains from channeling effects between adjacent neighbors. We conclude that isolated performance trials and projections based on individual behaviors can lead to erroneous predictions of risk exposure along engineered structures. Our results also suggest that risk perception and behavior may be more important than a fish's swimming stamina in artificially modified systems.

  15. CKD increases the risk of age-related macular degeneration.

    PubMed

    Liew, Gerald; Mitchell, Paul; Wong, Tien Yin; Iyengar, Sudha K; Wang, Jie Jin

    2008-04-01

    Age-related macular degeneration is the leading cause of irreversible blindness in the United States and often coexists with chronic kidney disease. Both conditions share common genetic and environmental risk factors. A total of 1183 participants aged 54+ were examined in the population-based, prospective cohort Blue Mountains Eye Study (Australia) to determine if chronic kidney disease increases the risk of age-related macular degeneration. Moderate chronic kidney disease (estimated glomerular filtration rate < 60 ml/min per 1.73 m(2) based on the Cockcroft-Gault equation) was present in 24% of the population (286 of 1183). The 5-yr incidence of early age-related macular degeneration was 3.9% in participants with no/mild chronic kidney disease (35 of 897) and 17.5% in those with moderate chronic kidney disease (50 of 286). After adjusting for age, sex, cigarette smoking, hypertension, complement factor H polymorphism, and other risk factors, persons with moderate chronic kidney disease were 3 times more likely to develop early age-related macular degeneration than persons with no/mild chronic kidney disease (odds ratio = 3.2; 95% confidence interval, 1.8 to 5.7, P < 0.0001). Each SD (14.8 ml/min per 1.73 m(2)) decrease in Cockcroft-Gault estimated glomerular filtration rate was associated with a doubling of the adjusted risk for early age-related macular degeneration (odds ratio = 2.0; 95% confidence interval, 1.5 to 2.8, P < 0.0001). In conclusion, persons with chronic kidney disease have a higher risk of early age-related macular degeneration, suggesting the possibility of shared pathophysiologic mechanisms between the two conditions.

  16. Can In Utero Exposures Program an Increased Risk for ...

    EPA Pesticide Factsheets

    In the early 1990's, David Barker and his colleagues studied the relationship between the incidence of coronary heart disease and birth weight in a population of adult men and women in Hertfordshire, England. They found an inverse correlation between the incidence of coronary heart disease and birth weight -the lower the weight at birth, the higher the risk of coronary heart disease in adulthood. Importantly, this was not simply a problem of low birth weight or premature birth, as the inverse relationship was evident among full-term births within a normal birth weight range (i.e., 5-10 pounds). Subsequent studies by this group and others expanded the range of adult diseases inversely correlated with birth weight to include hypertension, diabetes, and obesity. These are components of the metabolic syndrome, and all contribute to increased risk of coronary heart disease. Since that time, a number of studies around the world have corroborated these findings. The

  17. Increased risk of stroke in contact dermatitis patients

    PubMed Central

    Chang, Wei-Lun; Hsu, Min-Hsien; Lin, Cheng-Li; Chan, Po-Chi; Chang, Ko-Shih; Lee, Ching-Hsiao; Hsu, Chung-Yi; Tsai, Min-Tein; Yeh, Chung-Hsin; Sung, Fung-Chang

    2017-01-01

    Abstract Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke. We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000–2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts. The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P < 0.01). The multivariable Cox method analyzed adjusted hazard ratios (aHRs) were 1.12 (95% confidence interval [CI], 1.05–1.19) for all stroke types and 1.12 (95% CI, 1.05–1.20) for ischemic stroke and 1.11 (95% CI, 0.94–1.30) for hemorrhagic stroke. The age-specific aHR of stroke for contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03–1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15–1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07–1.27) and 1.09 (95% CI, 1.00–1.18) for men and women, respectively. This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further. PMID:28272195

  18. The increasing threat of Pseudomonas aeruginosa high-risk clones.

    PubMed

    Oliver, Antonio; Mulet, Xavier; López-Causapé, Carla; Juan, Carlos

    2015-01-01

    The increasing prevalence of chronic and hospital-acquired infections produced by multidrug-resistant (MDR) or extensively drug-resistant (XDR) Pseudomonas aeruginosa strains is associated with significant morbidity and mortality. This growing threat results from the extraordinary capacity of this pathogen for developing resistance through chromosomal mutations and from the increasing prevalence of transferable resistance determinants, particularly those encoding carbapenemases or extended-spectrum β-lactamases (ESBLs). P. aeruginosa has a nonclonal epidemic population structure, composed of a limited number of widespread clones which are selected from a background of a large quantity of rare and unrelated genotypes that are recombining at high frequency. Indeed, recent concerning reports have provided evidence of the existence of MDR/XDR global clones, denominated high-risk clones, disseminated in hospitals worldwide; ST235, ST111, and ST175 are likely those more widespread. Noteworthy, the vast majority of infections by MDR, and specially XDR, strains are produced by these and few other clones worldwide. Moreover, the association of high-risk clones, particularly ST235, with transferable resistance is overwhelming; nearly 100 different horizontally-acquired resistance elements and up to 39 different acquired β-lactamases have been reported so far among ST235 isolates. Likewise, MDR internationally-disseminated epidemic strains, such as the Liverpool Epidemic Strain (LES, ST146), have been noted as well among cystic fibrosis patients. Here we review the population structure, epidemiology, antimicrobial resistance mechanisms and virulence of the P. aeruginosa high-risk clones. The phenotypic and genetic factors potentially driving the success of high-risk clones, the aspects related to their detection in the clinical microbiology laboratory and the implications for infection control and public health are also discussed.

  19. Ascorbate increases human oxaluria and kidney stone risk.

    PubMed

    Massey, Linda K; Liebman, Michael; Kynast-Gales, Susan A

    2005-07-01

    Currently, the recommended upper limit for ascorbic acid (AA) intake is 2000 mg/d. However, because AA is endogenously converted to oxalate and appears to increase the absorption of dietary oxalate, supplementation may increase the risk of kidney stones. The effect of AA supplementation on urinary oxalate was studied in a randomized, crossover, controlled design in which subjects consumed a controlled diet in a university metabolic unit. Stoneformers (n = 29; SF) and age- and gender-matched non-stoneformers (n = 19; NSF) consumed 1000 mg AA twice each day with each morning and evening meal for 6 d (treatment A), and no AA for 6 d (treatment N) in random order. After 5 d of adaptation to a low-oxalate diet, participants lived for 24 h in a metabolic unit, during which they were given 136 mg oxalate, including 18 mg 13C2 oxalic acid, 2 h before breakfast; they then consumed a controlled very low-oxalate diet for 24 h. Of the 48 participants, 19 (12 stoneformers, 7 non-stoneformers) were identified as responders, defined by an increase in 24-h total oxalate excretion > 10% after treatment A compared with N. Responders had a greater 24-h Tiselius Risk Index (TRI) with AA supplementation (1.10 +/- 0.66 treatment A vs. 0.76 +/- 0.42 treatment N) because of a 31% increase in the percentage of oxalate absorption (10.5 +/- 3.2% treatment A vs. 8.0 +/- 2.4% treatment N) and a 39% increase in endogenous oxalate synthesis with treatment A than during treatment N (544 +/- 131 A vs. 391 +/- 71 micromol/d N). The 1000 mg AA twice each day increased urinary oxalate and TRI for calcium oxalate kidney stones in 40% of participants, both stoneformers and non-stoneformers.

  20. Possible Risk Factors for Increased Suicide Following Bariatric Surgery

    PubMed Central

    Mitchell, James E.; Crosby, Ross; de Zwaan, Martina; Engel, Scott; Roerig, James; Steffen, Kristine; Gordon, Kathryn H.; Karr, Trisha; Lavender, Jason; Wonderlich, Steve

    2015-01-01

    There is a growing research literature suggesting that there may be elevated risk of suicide following bariatric surgery. Most of the data reported thus far has been cross-sectional and observational, and very little is known about the possible specific causal variables involved. The purpose of this report is to review this literature and to review possible risk factors for increased suicidal risk following bariatric surgery, in order to delineate future research directions. First a variety of medical, biological, and genetic factors, including the persistence of recurrence of medical comorbidities after bariatric surgery, the disinhibition and impulsivity secondary to changes in the absorption of alcohol, hypoglycemia, as well as pharmacokinetic changes that may affect the absorption of various medications including antidepressant medications are reviewed. Also reviewed are possible mediating factors involving changes in various peptidergic systems such as GLP-1 and Ghrelin. A number of psychosocial issues that might be involved are discussed, including lack of improvement in quality of life after surgery, continued or recurrent physical mobility restrictions, persistence or recurrence of sexual dysfunction and relationship problems, low self-esteem, and a history of child maltreatment. Inadequate weight loss or weight regain are also discussed. Possible theoretical models involved and directions for research are suggested. PMID:23404774

  1. Alcohol Use Disorder Increases the Risk of Irritable Bowel Disease

    PubMed Central

    Hsu, Tai-Yi; He, Guan-Yi; Wang, Yu-Chiao; Chen, Chih-Yu; Wang, Shih-Hao; Chen, Wei-Kung; Kao, Chia-Hung

    2015-01-01

    Abstract Alcohol use disorder (AUD) is considered a possible risk factor for irritable bowel syndrome (IBS); however, previous studies investigating the association between AUD and IBS have yielded inconsistent results. The study investigated whether AUD increases the risk of IBS by using a population-based database in Taiwan. This retrospective matched-cohort study included the health insurance claims data of 56,355 AUD inpatients and 225,420 randomly selected controls by frequency-matched for sex, age, and index year. Cox proportional hazards regression analysis was performed to measure the risk of IBS among AUD patients compared with non-AUD patients. During the follow-up period, the incidence rate ratio (IRR) of IBS had 12.3-fold (95% CI: 11.9–12.7) in the AUD patients than non-AUD patients and the adjusted hazard ratio (aHR) for IBS in the AUD patients was 5.51 (95% CI: 4.36–6.96). For several comorbidities, the risk of IBS was significantly higher in the AUD patients than in non-AUD patients, with aHRs of 2.14 (95% confidence interval [CI]: 1.19–3.84), 2.05 (95% CI: 1.06–3.96), and 2.91 (95% CI: 1.26–6.72) for sleep disorders, acute pancreatitis, and hepatitis B, respectively. When we stratified the severity of AUD according to the length of hospital stay, the aHRs exhibited a significant correlation (P < 0.001) with severity, yielding aHRs of 3.24 (95% CI: 2.49–4.22), 11.9 (95% CI: 8.96–15.9), and 26.1 (95% CI: 19.4–35.2) for mild, moderate, and severe AUD, respectively. The risk of IBS was higher among AUD patients, and increased with the length of hospital stay. PMID:26705226

  2. Pneumoconiosis increases the risk of congestive heart failure

    PubMed Central

    Yen, Chia-Ming; Lin, Cheng-Li; Lin, Ming-Chia; Chen, Huei-Yong; Lu, Nan-Han; Kao, Chia-Hung

    2016-01-01

    Abstract The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF). We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m3). The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m3). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21–1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group. Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease. PMID:27336897

  3. Modifiable risk factors for increased arterial stiffness in outpatient nephrology.

    PubMed

    Elewa, Usama; Fernandez-Fernandez, Beatriz; Alegre, Raquel; Sanchez-Niño, Maria D; Mahillo-Fernández, Ignacio; Perez-Gomez, Maria Vanessa; El-Fishawy, Hussein; Belal, Dawlat; Ortiz, Alberto

    2015-01-01

    Arterial stiffness, as measured by pulse wave velocity (PWV), is an independent predictor of cardiovascular events and mortality. Arterial stiffness increases with age. However, modifiable risk factors such as smoking, BP and salt intake also impact on PWV. The finding of modifiable risk factors may lead to the identification of treatable factors, and, thus, is of interest to practicing nephrologist. We have now studied the prevalence and correlates of arterial stiffness, assessed by PWV, in 191 patients from nephrology outpatient clinics in order to identify modifiable risk factors for arterial stiffness that may in the future guide therapeutic decision-making. PWV was above normal levels for age in 85/191 (44.5%) patients. Multivariate analysis showed that advanced age, systolic BP, diabetes mellitus, serum uric acid and calcium polystyrene sulfonate therapy or calcium-containing medication were independent predictors of PWV. A new parameter, Delta above upper limit of normal PWV (Delta PWV) was defined to decrease the weight of age on PWV values. Delta PWV was calculated as (measured PWV) - (upper limit of the age-adjusted PWV values for the general population). Mean±SD Delta PWV was 0.76±1.60 m/sec. In multivariate analysis, systolic blood pressure, active smoking and calcium polystyrene sulfonate therapy remained independent predictors of higher delta PWV, while age, urinary potassium and beta blocker therapy were independent predictors of lower delta PWV. In conclusion, arterial stiffness was frequent in nephrology outpatients. Systolic blood pressure, smoking, serum uric acid, calcium-containing medications, potassium metabolism and non-use of beta blockers are modifiable factors associated with increased arterial stiffness in Nephrology outpatients.

  4. Thyroid Cancer Risk Is Not Increased in Diabetic Patients

    PubMed Central

    Tseng, Chin-Hsiao

    2012-01-01

    -steroidal anti-inflammatory drugs might be associated with a significantly lower risk. Conclusions There is a lack of an overall association between diabetes and thyroid cancer, but patients with diabetes duration <5 years have a significantly lower risk. Sulfonylurea may increase the risk of thyroid cancer. PMID:23300866

  5. Calcium intake increases risk of prostate cancer among Singapore Chinese

    PubMed Central

    Butler, Lesley M.; Wong, Alvin S.; Koh, Woon-Puay; Wang, Renwei; Yuan, Jian-Min; Yu, Mimi C.

    2010-01-01

    Consumption of dairy products, the primary source of calcium in Western diets, has been found to be positively associated with prostate cancer. In an Asian diet, non-dairy foods are the major contributors of calcium. Thus, a study of dietary calcium and prostate cancer in Asians can better inform on whether calcium, as opposed to other dairy components is responsible for the dairy foods-prostate cancer association. We examined calcium intake and prostate cancer risk among 27,293 men of the Singapore Chinese Health Study that was established between 1993 and 1998. As of December 31, 2007, 298 incident prostate cancer cases had been diagnosed among the cohort members. Diet was assessed at baseline with a validated 165-item food frequency questionnaire. It is hypothesized that there is greater net absorption of calcium in smaller individuals. Therefore, the calcium-prostate cancer association was also assessed in stratified analyses by median body mass index (BMI). Vegetables were the largest contributor of daily calcium intake in the study population. Overall, we observed a modest, statistically nonsignificant 25% increase in prostate cancer risk for the 4th (median = 659 mg/day) versus 1st (median=211 mg/day) quartiles of calcium intake after adjustment for potential confounders. The association became considerably stronger and achieved statistical significance (hazard ratio=2.03; 95% confidence interval: 1.23, 3.34; P for trend=0.01) for men with below median (22.9 kg/m2) BMI. Dietary calcium may be a risk factor for prostate cancer even at relatively low intake. PMID:20516117

  6. Analysis of factors that increase motorcycle rider risk compared to car driver risk.

    PubMed

    Keall, Michael D; Newstead, Stuart

    2012-11-01

    As in other parts of the Western world, there is concern in New Zealand about increasing popularity of motorcycles because of potential increases in road trauma. This study sought to identify important factors associated with increased risk for motorcyclists to inform potential policy approaches to reduce motorcyclist injury, such as changes to motorcyclist licensing, training and education. Using data extracted from a register of all New Zealand licensed motor vehicles that were matched to crash data, statistical models were fitted to examine patterns of motorcycle risk in comparison with small cars. These showed generally elevated risks for motorcyclists compared to cars, but particularly elevated risks for motorcycle owners aged in their 20s or who lived in more urbanised settings. In crashes, motorcyclists have little protection from injury, putting the motorcyclist at high risk of injury. When comparing new motorcycles with new cars, the odds of fatal or serious injury to a motorcycle rider involved in an injury crash were almost eight times the odds for a car driver.

  7. Risk Factors Associated with Increased Morbidity in Living Liver Donation

    PubMed Central

    Candido, Helry L.; da Fonseca, Eduardo A.; Feier, Flávia H.; Pugliese, Renata; Benavides, Marcel A.; Silva, Enis D.; Gordon, Karina; de Abreu, Marcelo Gama; Canet, Jaume; Chapchap, Paulo; Neto, Joao Seda

    2015-01-01

    Living donor liver donation (LDLD) is an alternative to cadaveric liver donation. We aimed at identifying risk factors and developing a score for prediction of postoperative complications (POCs) after LDLD in donors. This is a retrospective cohort study in 688 donors between June 1995 and February 2014 at Hospital Sírio-Libanês and A.C. Camargo Cancer Center, in São Paulo, Brazil. Primary outcome was POC graded ≥III according to the Clavien-Dindo classification. Left lateral segment (LLS), left lobe (LL), and right lobe resections (RL) were conducted in 492 (71.4%), 109 (15.8%), and 87 (12.6%) donors, respectively. In total, 43 (6.2%) developed POCs, which were more common after RL than LLS and LL (14/87 (16.1%) versus 23/492 (4.5%) and 6/109 (5.5%), resp., p < 0.001). Multivariate analysis showed that RL resection (OR: 2.81, 95% CI: 1.32 to 3.01; p = 0.008), smoking status (OR: 3.2, 95% CI: 1.35 to 7.56; p = 0.012), and blood transfusion (OR: 3.15, 95% CI: 1.45 to 6.84; p = 0.004) were independently associated with POCs. RL resection, intraoperative blood transfusion, and smoking were associated with increased risk for POCs in donors. PMID:26788361

  8. Risk Factors Associated with Increased Morbidity in Living Liver Donation.

    PubMed

    Candido, Helry L; da Fonseca, Eduardo A; Feier, Flávia H; Pugliese, Renata; Benavides, Marcel A; Silva, Enis D; Gordon, Karina; de Abreu, Marcelo Gama; Canet, Jaume; Chapchap, Paulo; Neto, Joao Seda

    2015-01-01

    Living donor liver donation (LDLD) is an alternative to cadaveric liver donation. We aimed at identifying risk factors and developing a score for prediction of postoperative complications (POCs) after LDLD in donors. This is a retrospective cohort study in 688 donors between June 1995 and February 2014 at Hospital Sírio-Libanês and A.C. Camargo Cancer Center, in São Paulo, Brazil. Primary outcome was POC graded ≥III according to the Clavien-Dindo classification. Left lateral segment (LLS), left lobe (LL), and right lobe resections (RL) were conducted in 492 (71.4%), 109 (15.8%), and 87 (12.6%) donors, respectively. In total, 43 (6.2%) developed POCs, which were more common after RL than LLS and LL (14/87 (16.1%) versus 23/492 (4.5%) and 6/109 (5.5%), resp., p < 0.001). Multivariate analysis showed that RL resection (OR: 2.81, 95% CI: 1.32 to 3.01; p = 0.008), smoking status (OR: 3.2, 95% CI: 1.35 to 7.56; p = 0.012), and blood transfusion (OR: 3.15, 95% CI: 1.45 to 6.84; p = 0.004) were independently associated with POCs. RL resection, intraoperative blood transfusion, and smoking were associated with increased risk for POCs in donors.

  9. Increasing water temperature and disease risks in aquatic systems: climate change increases the risk of some, but not all, diseases.

    PubMed

    Karvonen, Anssi; Rintamäki, Päivi; Jokela, Jukka; Valtonen, E Tellervo

    2010-11-01

    Global warming may impose severe risks for aquatic animal health if increasing water temperature leads to an increase in the incidence of parasitic diseases. Essentially, this could take place through a temperature-driven effect on the epidemiology of the disease. For example, higher temperature may boost the rate of disease spread through positive effects on parasite fitness in a weakened host. Increased temperature may also lengthen the transmission season leading to higher total prevalence of infection and more widespread epidemics. However, to date, general understanding of these relationships is limited due to scarcity of long-term empirical data. Here, we present one of the first long-term multi-pathogen data sets on the occurrence of pathogenic bacterial and parasitic infections in relation to increasing temperatures in aquatic systems. We analyse a time-series of disease dynamics on two fish farms in northern Finland from 1986 to 2006. We first demonstrate that the annual mean water temperature increased significantly on both farms over the study period and that the increase was most pronounced in the late summer (July-September). Second, we show that the prevalence of infection (i.e. proportion of fish tanks infected each year) increased with temperature. Interestingly, this pattern was observed in some of the diseases (Ichthyophthirius multifiliis, Flavobacterium columnare), whereas in the other diseases, the pattern was the opposite (Ichthyobodo necator) or absent (Chilodonella spp.). These results demonstrate the effect of increasing water temperature on aquatic disease dynamics, but also emphasise the importance of the biology of each disease, as well as the role of local conditions, in determining the direction and magnitude of these effects.

  10. Does avian conspicuous colouration increase or reduce predation risk?

    PubMed

    Ruiz-Rodríguez, M; Avilés, J M; Cuervo, J J; Parejo, D; Ruano, F; Zamora-Muñoz, C; Sergio, F; López-Jiménez, L; Tanferna, A; Martín-Vivaldi, M

    2013-09-01

    Animals often announce their unprofitability to predators through conspicuous coloured signals. Here we tested whether the apparently conspicuous colour designs of the four European Coraciiformes and Upupiformes species may have evolved as aposematic signals, or whether instead they imply a cost in terms of predation risk. Because previous studies suggested that these species are unpalatable, we hypothesized that predators could avoid targeting them based on their colours. An experiment was performed where two artificial models of each bird species were exposed simultaneously to raptor predators, one painted so as to resemble the real colour design of these birds, and the other one painted using cryptic colours. Additionally, we used field data on the black kite's diet to compare the selection of these four species to that of other avian prey. Conspicuous models were attacked in equal or higher proportions than their cryptic counterparts, and the attack rate on the four species increased with their respective degree of contrast against natural backgrounds. The analysis of the predator's diet revealed that the two least attacked species were negatively selected in nature despite their abundance. Both conspicuous and cryptic models of one of the studied species (the hoopoe) received fewer attacks than cryptic models of the other three species, suggesting that predators may avoid this species for characteristics other than colour. Globally, our results suggest that the colour of coraciiforms and upupiforms does not function as an aposematic signal that advises predators of their unprofitability, but also that conspicuous colours may increase predation risk in some species, supporting thus the handicap hypothesis.

  11. Reducing Cascading Failure Risk by Increasing Infrastructure Network Interdependence

    DOE PAGES

    Korkali, Mert; Veneman, Jason G.; Tivnan, Brian F.; ...

    2017-03-20

    Increased coupling between critical infrastructure networks, such as power and communication systems, has important implications for the reliability and security of these systems. To understand the effects of power-communication coupling, several researchers have studied models of interdependent networks and reported that increased coupling can increase vulnerability. However, these conclusions come largely from models that have substantially different mechanisms of cascading failure, relative to those found in actual power and communication networks, and that do not capture the benefits of connecting systems with complementary capabilities. In order to understand the importance of these details, this paper compares network vulnerability in simplemore » topological models and in models that more accurately capture the dynamics of cascading in power systems. First, we compare a simple model of topological contagion to a model of cascading in power systems and find that the power grid model shows a higher level of vulnerability, relative to the contagion model. Second, we compare a percolation model of topological cascading in coupled networks to three different models of power networks coupled to communication systems. Again, the more accurate models suggest very different conclusions than the percolation model. In all but the most extreme case, the physics-based power grid models indicate that increased power-communication coupling decreases vulnerability. This is opposite from what one would conclude from the percolation model, in which zero coupling is optimal. Only in an extreme case, in which communication failures immediately cause grid failures, did we find that increased coupling can be harmful. Together, these results suggest design strategies for reducing the risk of cascades in interdependent infrastructure systems.« less

  12. Increased Risk of Postthoracotomy Pain Syndrome in Patients with Prolonged Hospitalization and Increased Postoperative Opioid Use

    PubMed Central

    Jacob, Adam K.; Passe, Melissa A.; Mantilla, Carlos B.

    2016-01-01

    Background. Postthoracotomy pain syndrome (PTPS) is unfortunately very common following thoracotomy and results in decreased quality of life. The purpose of this retrospective study was to determine perioperative patient, surgical, and analgesic characteristics associated with the development of PTPS. Methods. Sixty-six patients who presented to the Mayo Clinic Rochester Pain Clinic were diagnosed with PTPS 2 months or more after thoracotomy with postoperative epidural analgesia. These patients were matched with sixty-six control patients who underwent thoracotomy with postoperative epidural analgesia and were never diagnosed with PTPS. Results. Median (IQR) hospital stay was significantly different between control patients (5 days (4, 6)) compared with PTPS patients (6 days (5, 8)), P < 0.02. The total opioid equivalent utilized in oral morphine equivalents in milligrams for the first three days postoperatively was significantly different between control patients and PTPS patients. The median (IQR) total opioid equivalent utilized was 237 (73, 508) for controls and 366 (116, 874) for PTPS patients (P < 0.005). Conclusion. Patients with a prolonged hospital stay after thoracotomy were at an increased risk of developing PTPS, and this is a novel finding. Patients who utilize higher oral morphine equivalents for the first 3 days were also at increased risk for PTPS. PMID:27340565

  13. Who Is at Increased Risk of Health Problems during Pregnancy?

    MedlinePlus

    ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Research Goals Activities and Advances ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications ...

  14. Increased Flooding Risk - Accelerating Threat and Stakeholder Response

    NASA Astrophysics Data System (ADS)

    Atkinson, L. P.; Ezer, T.; De Young, R.; McShane, M. K.; McFarlane, B.

    2012-12-01

    projects, and "…subsidence …. is not well-documented". Studies sponsored by the City of Norfolk for example suggest massive tidal barriers. Flood insurance - Flood insurance is available only from the National Flood Insurance Program (NFIP), not from private insurers. NFIP has a current deficit of about 18B, which is estimated to increase by about 2B annually. The rates are subsidized and do not reflect the true risk of coastal flooding and do not incorporate the likelihood of future sea-level rise. In effect, the subsidy promotes increased building on the coast, leading to increased deficits in the tax-payer financed program. Risk-based flood insurance pricing would lead to less coastal development, therefore decreasing the tax base of the community. Stakeholder needs - Planning for increased flooding due to sea level rise extends 50 to 100 years given the lifetime of infrastructure. Planners need guidance and error estimates. To make adequate predictions for users we must understand the various components of sea level rise including subsidence, global sea level rise and regional and local dynamic sea level rise. Predictions of regional sea level rise will be presented in the context of existing infrastructure such as NASA research facilities and the city of Norfolk, Virginia.

  15. Extreme Geohazards: Reducing Disaster Risk and Increasing Resilience

    NASA Astrophysics Data System (ADS)

    Plag, Hans-Peter; Stein, Seth; Brocklebank, Sean; Jules-Plag, Shelley; Campus, Paola

    2014-05-01

    Extreme natural hazards have the potential to cause global disasters and to lead to an escalation of the global sustainability crisis. Floods and droughts pose threats that could reach planetary extent, particularly through secondary economic and social impacts. Earthquakes and tsunamis cause disasters that could exceed the immediate coping capacity of the global economy, particularly in hazardous areas containing megacities, that can be particularly vulnerable to natural hazards if proper emergency protocols and infrastructures are not set in place. Recent events illustrate the destruction extreme hazards can inflict, both directly and indirectly, through domino effects resulting from the interaction with the built environment. Unfortunately, the more humanity learns to cope with relatively frequent (50 to 100 years) natural hazard events, the less concerns remain about the low-probability (one in a few hundred or more years) high-impact events. As a consequence, threats from low-probability extreme floods, droughts, and volcanic eruptions are not appropriately accounted for in Disaster Risk Reduction (DRR) discussions. With the support of the European Science Foundation (ESF), the Geohazards Community of Practice (GHCP) of the Group on Earth Observations (GEO) has developed a White Paper (WP) on the risk associated with low-probability, high-impact geohazards. These events are insufficiently addressed in risk management, although their potential impacts are comparable to those of a large asteroid impact, a global pandemic, or an extreme drought. The WP aims to increase awareness of the risk associated with these events as a basis for a comprehensive risk management. Extreme geohazards have occurred regularly throughout the past, but mostly did not cause major disasters because the exposure of human assets to such hazards and the global population density were much lower than today. The most extreme events during the last 2,000 years would cause today unparalleled

  16. [Calcium supplementation and the possible increase in cardiovascular risk].

    PubMed

    Montero Sáez, Abelardo; Formiga, Francesc; Pujol Farriols, Ramón

    2013-01-01

    The primary goal of osteoporosis treatment is to prevent the occurrence of fragility fractures, and thereby reduce morbidity and mortality. Among the various approaches to the treatment of this disease include ensuring proper calcium intake and to obtain adequate levels of vitamin D. Virtually all clinical trials with drugs used to treat osteoporosis systematically include calcium and vitamin D supplements. In light of the recent publication of clinical trials and meta-analyses, a possible increase in cardiovascular risk, particularly in the form of a myocrdial infarction, is hypothesised in patients taking calcium supplements. However, data published to date are inconclusive. Until the development of new scientific evidence, it seems reasonable to recommend, whenever practicable and individualized for each patient, increasing calcium intake with food and reserve supplements for patients with very low calcium intake in the diet. It would also be advisable for the administration of total daily dose to be fractionated throughout the day and with meals, and to obtain appropriate levels of vitamin D (25-hydroxycholecalciferol or calcidiol), along with the basic treatment for osteoporosis that is decided to be prescribed to patients.

  17. 8x8 and 10x10 Hyperspace Representations of SU(3) and 10-fold Point-Symmetry Group of Quasicrystals

    NASA Astrophysics Data System (ADS)

    Animalu, Alexander

    2012-02-01

    In order to further elucidate the unexpected 10-fold point-symmetry group structure of quasi-crystals for which the 2011 Nobel Prize in chemistry was awarded to Daniel Shechtman, we explore a correspondence principle between the number of (projective) geometric elements (points[vertices] + lines[edges] + planes[faces]) of primitive cells of periodic or quasi-periodic arrangement of hard or deformable spheres in 3-dimensional space of crystallography and elements of quantum field theory of particle physics [points ( particles, lines ( particles, planes ( currents] and hence construct 8x8 =64 = 28+36 = 26 + 38, and 10x10 =100= 64 + 36 = 74 + 26 hyperspace representations of the SU(3) symmetry of elementary particle physics and quasicrystals of condensed matter (solid state) physics respectively, As a result, we predict the Cabibbo-like angles in leptonic decay of hadrons in elementary-particle physics and the observed 10-fold symmetric diffraction pattern of quasi-crystals.

  18. Dyslipidemia is associated with an increased risk of nephrolithiasis.

    PubMed

    Masterson, James H; Woo, Jason R; Chang, David C; Chi, Thomas; L'Esperance, James O; Stoller, Marshall L; Sur, Roger L

    2015-02-01

    The pathophysiology of nephrolithiasis is multifactorial. Obesity, diabetes mellitus and hypertension are implicated in its formation. Dyslipidemia (DLD) recently has received attention as well. Congruent with a vascular etiology in stone formation, DLD theoretically would predispose patients to nephrolithiasis. We investigated a possible association of DLD with nephrolithiasis. A random cohort of 60,000 patients was established by collecting the first 5,000 patient charts per month in the year 2000. After excluding pediatric patients, a retrospective study was performed by reviewing age, sex, comorbidities, and last patient follow-up. Median lipid laboratory levels also were reviewed. Descriptive statistics were performed as well as Cox proportional-hazards regression analysis, and univariate and multivariate analyses. 52,184 (22,717 women/29,467 men) patient charts were reviewed. The average age was 31.0 ± 15.2 years. On univariate analysis, DLD was associated with nephrolithiasis with a hazard ratio (HR) of 2.2 [Confidence Interval (CI), 1.9-2.5; p < 0.001] and on multivariate analysis HR = 1.2 (1.0-1.5; p = 0.033). Low-density lipoprotein and triglycerides had no association with stone disease. Patients with high-density lipoprotein (HDL) values <45 for men and <60 for women had an HR of 1.4 (1.1-1.7, 95% CI, p = 0.003) on univariate analysis and on multivariate analysis; HR = 1.27 (1.03-1.56; p = 0.024) for nephrolithiasis. DLD was associated with an increased risk of stone disease though the only specific lipid panel associated with lower nephrolithiasis was HDL. Clinicians should consider obtaining lipid levels with the intent that treatment could potentially not only mitigate atherosclerotic disease but also decrease nephrolithiasis risk.

  19. Anthropogenic Warming Has Increased Drought Risk In California

    NASA Astrophysics Data System (ADS)

    Diffenbaugh, N. S.; Swain, D. L.; Touma, D. E.

    2015-12-01

    California is currently in the midst of a record-setting drought. The drought began in 2012 and now includes the lowest calendar-year and 12-mo precipitation, the highest annual temperature, and the most extreme drought indicators on record. The extremely warm and dry conditions have led to acute water shortages, groundwater overdraft, critically low streamflow, and enhanced wildfire risk. Analyzing historical climate observations from California, we find that precipitation deficits in California were more than twice as likely to yield drought years if they occurred when conditions were warm. We find that although there has not been a substantial change in the probability of either negative or moderately negative precipitation anomalies in recent decades, the occurrence of drought years has been greater in the past two decades than in the preceding century. In addition, the probability that precipitation deficits co-occur with warm conditions and the probability that precipitation deficits produce drought have both increased. Climate model experiments with and without anthropogenic forcings reveal that human activities have increased the probability that dry precipitation years are also warm. Further, a large ensemble of climate model realizations reveals that additional global warming over the next few decades is very likely to create ˜100% probability that any annual-scale dry period is also extremely warm. We therefore conclude that anthropogenic warming is increasing the probability of co-occurring warm-dry conditions like those that have created the acute human and ecosystem impacts associated with the "exceptional" 2012-2014 drought in California.

  20. Anthropogenic warming has increased drought risk in California

    PubMed Central

    Diffenbaugh, Noah S.; Swain, Daniel L.; Touma, Danielle

    2015-01-01

    California is currently in the midst of a record-setting drought. The drought began in 2012 and now includes the lowest calendar-year and 12-mo precipitation, the highest annual temperature, and the most extreme drought indicators on record. The extremely warm and dry conditions have led to acute water shortages, groundwater overdraft, critically low streamflow, and enhanced wildfire risk. Analyzing historical climate observations from California, we find that precipitation deficits in California were more than twice as likely to yield drought years if they occurred when conditions were warm. We find that although there has not been a substantial change in the probability of either negative or moderately negative precipitation anomalies in recent decades, the occurrence of drought years has been greater in the past two decades than in the preceding century. In addition, the probability that precipitation deficits co-occur with warm conditions and the probability that precipitation deficits produce drought have both increased. Climate model experiments with and without anthropogenic forcings reveal that human activities have increased the probability that dry precipitation years are also warm. Further, a large ensemble of climate model realizations reveals that additional global warming over the next few decades is very likely to create ∼100% probability that any annual-scale dry period is also extremely warm. We therefore conclude that anthropogenic warming is increasing the probability of co-occurring warm–dry conditions like those that have created the acute human and ecosystem impacts associated with the “exceptional” 2012–2014 drought in California. PMID:25733875

  1. Anthropogenic warming has increased drought risk in California.

    PubMed

    Diffenbaugh, Noah S; Swain, Daniel L; Touma, Danielle

    2015-03-31

    California is currently in the midst of a record-setting drought. The drought began in 2012 and now includes the lowest calendar-year and 12-mo precipitation, the highest annual temperature, and the most extreme drought indicators on record. The extremely warm and dry conditions have led to acute water shortages, groundwater overdraft, critically low streamflow, and enhanced wildfire risk. Analyzing historical climate observations from California, we find that precipitation deficits in California were more than twice as likely to yield drought years if they occurred when conditions were warm. We find that although there has not been a substantial change in the probability of either negative or moderately negative precipitation anomalies in recent decades, the occurrence of drought years has been greater in the past two decades than in the preceding century. In addition, the probability that precipitation deficits co-occur with warm conditions and the probability that precipitation deficits produce drought have both increased. Climate model experiments with and without anthropogenic forcings reveal that human activities have increased the probability that dry precipitation years are also warm. Further, a large ensemble of climate model realizations reveals that additional global warming over the next few decades is very likely to create ∼ 100% probability that any annual-scale dry period is also extremely warm. We therefore conclude that anthropogenic warming is increasing the probability of co-occurring warm-dry conditions like those that have created the acute human and ecosystem impacts associated with the "exceptional" 2012-2014 drought in California.

  2. Increased Dietary Inflammatory Index (DII) Is Associated With Increased Risk of Prostate Cancer in Jamaican Men

    PubMed Central

    Shivappa, Nitin; Jackson, Maria D.; Bennett, Franklyn; Hébert, James R.

    2015-01-01

    Purpose Prostate cancer is the most common non-skin malignancy; and it accounts for the most cancer deaths among Jamaican males. Diet has been implicated in the etiology of prostate cancer, including through its effects on inflammation. Method We examined the association between a newly developed dietary inflammatory index (DII) and prostate cancer in a case-control study of 40-80 year-old Jamaican males. A total of 229 incident cases and 250 controls attended the same urology out-patient clinics at 2 major hospitals and private practitioners in the Kingston, Jamaica Metropolitan area between March 2005 and July 2007. The DII was computed based on dietary intake assessed using a previously validated food frequency questionnaire (FFQ) that was expanded to assess diet and cancer in this Jamaican population. Multivariable logistic regression was used to estimate odds ratios, with DII as continuous and expressed as quartiles. Logistic regression analysis adjusted for age, total energy intake, education, body mass index (BMI), smoking status, physical activity and family history of prostate cancer. Results Men in the highest quartile of the DII were at higher risk of prostate cancer [odds ratio (OR) = 2.39; 95% confidence interval (CI) =1.14–5.04 (Ptrend = 0.08)] compared to men in the lowest DII quartile. Conclusion These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for prostate cancer in Jamaican men. PMID:26226289

  3. Factors Predicting Adherence to Risk Management Behaviors of Women at Increased Risk for Developing Lymphedema

    PubMed Central

    Sherman, Kerry A.; Miller, Suzanne M.; Roussi, Pagona; Taylor, Alan

    2014-01-01

    Purpose Lymphedema affects 20-30% of women following breast cancer treatment. However, even when women are informed, they do not necessarily adhere to recommended lymphedema self-management regimens. Utilizing the Cognitive-Social Health Information Processing framework, we assessed cognitive and emotional factors influencing adherence to lymphedema risk management. Methods Women with breast cancer who had undergone breast and lymph node surgery were recruited through the Fox Chase Cancer Centre breast clinic. Participants (N=103) completed measures of lymphedema-related perceived risk, beliefs and expectancies, distress, self-regulatory ability to manage distress, knowledge, and adherence to risk management behaviors. They then received the American Cancer Society publication “Lymphedema: What Every Woman with Breast Cancer Should Know”. Cognitive and affective variables were reassessed at 6- and 12-months post-baseline. Results Maximum likelihood multilevel model analyses indicated that overall adherence increased over time, with significant differences between baseline and 6- and 12- month assessments. Adherence to wearing gloves was significantly lower than that for all other behaviors except electric razor use. Distress significantly decreased, and knowledge significantly increased, over time. Greater knowledge, higher self-efficacy to enact behaviors, lower distress, and higher self-regulatory ability to manage distress were associated with increased adherence. Conclusions Women who understand lymphedema risk management and feel confident in managing this risk are more likely to adhere to recommended strategies. These factors should be rigorously assessed as part of routine care to ensure that women have the self-efficacy to seek treatment and the self-regulatory skills to manage distress, which may undermine attempts to seek medical assistance. PMID:24970542

  4. Therapy for triggered acute risk prevention in subjects at increased cardiovascular risk.

    PubMed

    Tofler, Geoffrey H; Spinaze, Monica; Shaw, Elizabeth; Buckley, Thomas

    2013-06-15

    Heavy physical exertion, emotional stress, heavy meals, and respiratory infection transiently increase the risk of myocardial infarction, sudden cardiac death, and stroke; however, it remains uncertain how to use this information for disease prevention. We determined whether it was feasible for those with either risk factors for cardiovascular disease (CVD) or known CVD to take targeted medication for the hazard duration of the triggering activity to reduce their risk. After a run-in of 1 month, 20 subjects (12 women and 8 men) aged 68.6 years (range 58 to 83) recorded for 2 months all episodes of physical and emotional stress, heavy meal consumption, and respiratory infection. For each episode, the subjects were instructed to take either aspirin 100 mg and propranolol 10 mg (for physical exertion and emotional stress) or aspirin 100 mg alone (for respiratory infection and heavy meal consumption) and to record their adherence. Adherence with taking the appropriate medication was 86% according to the diary entries, with 15 of 20 subjects (75%) achieving ≥80% adherence. Propranolol taken before exertion reduced the peak heart rate compared with similar exercise during the run-in period (118 ± 21 vs 132 ± 16 beats/min, p = 0.016). Most subjects (85%) reported that it was feasible to continue taking the medication in this manner. In conclusion, it is feasible for those with increased CVD risk to identify potential triggers of acute CVD and to take targeted therapy at the time of these triggers.

  5. Menarche Increases Relapse Risk in Pediatric Multiple Sclerosis

    PubMed Central

    Lulu, Sabeen; Graves, Jennifer; Waubant, Emmanuelle

    2015-01-01

    Background Multiple sclerosis (MS) predominantly affects women with a sex ratio of 3:1 in contrast with a 1:1 sex ratio seen in pre-pubertal onset. Thus, puberty may influence MS risk differentially in males and females. How puberty may be associated with MS clinical features and disease course remains unknown. Objective To determine the association of menarche with disease course in girls with MS. Methods This is a longitudinal retrospective study from the UCSF Regional Pediatric MS Center database. We categorized patients by time of disease onset: pre-menarche, peri-menarche and post-menarche. Poisson regression models were used for within subject relapse analyses offset by follow-up time. Results Seventy six girls were included (pre-menarche onset=17; peri-menarche onset=9; post-menarche onset=50). Age of menarche was similar in all groups (Kruskal-Wallis p=0.19). Relapse rate was the same in all three groups during first 2 years of follow-up. In girls with follow-up overlapping at least two time periods, within-subject analyses showed increased relapses during peri-menarche compared to post-menarche period (adjusted IRR=8.5, 95%CI 2.5–28.7, p=0.001). Conclusion Pubertal status may influence MS course at least in female patients. Understanding how puberty influences MS clinical features may offer new insights in important factors regulating disease processes. PMID:25948626

  6. Global risk of big earthquakes has not recently increased.

    PubMed

    Shearer, Peter M; Stark, Philip B

    2012-01-17

    The recent elevated rate of large earthquakes has fueled concern that the underlying global rate of earthquake activity has increased, which would have important implications for assessments of seismic hazard and our understanding of how faults interact. We examine the timing of large (magnitude M≥7) earthquakes from 1900 to the present, after removing local clustering related to aftershocks. The global rate of M≥8 earthquakes has been at a record high roughly since 2004, but rates have been almost as high before, and the rate of smaller earthquakes is close to its historical average. Some features of the global catalog are improbable in retrospect, but so are some features of most random sequences--if the features are selected after looking at the data. For a variety of magnitude cutoffs and three statistical tests, the global catalog, with local clusters removed, is not distinguishable from a homogeneous Poisson process. Moreover, no plausible physical mechanism predicts real changes in the underlying global rate of large events. Together these facts suggest that the global risk of large earthquakes is no higher today than it has been in the past.

  7. Global risk of big earthquakes has not recently increased

    PubMed Central

    Shearer, Peter M.; Stark, Philip B.

    2012-01-01

    The recent elevated rate of large earthquakes has fueled concern that the underlying global rate of earthquake activity has increased, which would have important implications for assessments of seismic hazard and our understanding of how faults interact. We examine the timing of large (magnitude M≥7) earthquakes from 1900 to the present, after removing local clustering related to aftershocks. The global rate of M≥8 earthquakes has been at a record high roughly since 2004, but rates have been almost as high before, and the rate of smaller earthquakes is close to its historical average. Some features of the global catalog are improbable in retrospect, but so are some features of most random sequences—if the features are selected after looking at the data. For a variety of magnitude cutoffs and three statistical tests, the global catalog, with local clusters removed, is not distinguishable from a homogeneous Poisson process. Moreover, no plausible physical mechanism predicts real changes in the underlying global rate of large events. Together these facts suggest that the global risk of large earthquakes is no higher today than it has been in the past. PMID:22184228

  8. Increased risk of muscle tears below physiological temperature ranges

    PubMed Central

    Scott, E. E. F.; Hamilton, D. F.; Wallace, R. J.; Muir, A. Y.

    2016-01-01

    Objectives Temperature is known to influence muscle physiology, with the velocity of shortening, relaxation and propagation all increasing with temperature. Scant data are available, however, regarding thermal influences on energy required to induce muscle damage. Methods Gastrocnemius and soleus muscles were harvested from 36 male rat limbs and exposed to increasing impact energy in a mechanical test rig. Muscle temperature was varied in 5°C increments, from 17°C to 42°C (to encompass the in vivo range). The energy causing non-recoverable deformation was recorded for each temperature. A measure of tissue elasticity was determined via accelerometer data, smoothed by low-pass fifth order Butterworth filter (10 kHz). Data were analysed using one-way analysis of variance (ANOVA) and significance was accepted at p = 0.05. Results The energy required to induce muscle failure was significantly lower at muscle temperatures of 17°C to 32°C compared with muscle at core temperature, i.e., 37°C (p < 0.01). During low-energy impacts there were no differences in muscle elasticity between cold and warm muscles (p = 0.18). Differences in elasticity were, however, seen at higher impact energies (p < 0.02). Conclusion Our findings are of particular clinical relevance, as when muscle temperature drops below 32°C, less energy is required to cause muscle tears. Muscle temperatures of 32°C are reported in ambient conditions, suggesting that it would be beneficial, particularly in colder environments, to ensure that peripheral muscle temperature is raised close to core levels prior to high-velocity exercise. Thus, this work stresses the importance of not only ensuring that the muscle groups are well stretched, but also that all muscle groups are warmed to core temperature in pre-exercise routines. Cite this article: Professor A. H. R. W. Simpson. Increased risk of muscle tears below physiological temperature ranges. Bone Joint Res 2016;5:61–65. DOI: 10

  9. Human Adenovirus 36 Infection Increased the Risk of Obesity

    PubMed Central

    Xu, Mei-Yan; Cao, Bing; Wang, Dong-Fang; Guo, Jing-Hui; Chen, Kai-Li; Shi, Mai; Yin, Jian; Lu, Qing-Bin

    2015-01-01

    .19; 95%CI: −0.31, 0.70; PI: −2.10, 2.49), which had no significantly statistical difference (P = 0.453). HAdV-36 infection increased the risk of obesity. HAdV-36 also increased the risk of weight gain in adults, which was not observed in children. PMID:26705235

  10. Do oral contraceptives increase risk of contracting HIV?

    PubMed

    1988-12-01

    Some clinicians claim that the potential association between oral contraceptive (OC) use and HIV infection is cause for concern. A study of prostitutes conducted in Kenya showed OC use to be the single most common cofactor in sexually transmitted human immunodeficiency virus infection. A similar study conducted in the US was unable to confirm an association. In the Kenya study, 123 HIV seronegative prostitutes in Nairobi were followed for 54 months and assessed for seroconversion to HIV and occurrence of sexually transmitted diseases. 91% of the women who seroconverted were using OCs; 73% of the women who remained seronegative were using OCs. Demographic features, sexual behavior, number of daily sex partners, and parenteral exposure were not related to seroconversion. No significant associations were found between HIV infection and sexual activity and condom use. Independent associations were found between seroconversion and OC use, genital ulcer disease (GUD), and chlamydia trachomatis infections. It is possible that OCs increase the risk of acquiring chlamydia because cervical ectropion creates a greater exposure of columnar epithelium to infecting agents. The multicenter, cross-sectional, collaborative study of 638 prostitutes in 8 areas of the US found that HIV infection was totally unrelated to OC use. Prostitutes with no evidence of intravenous drug use were studied. 5% of the women were found to be infected with HIV. The most common variables associated with HIV infection were seromarkers for hepatitis B and syphilis and sex with "nonpaying partners." About 80% of the prostitutes reported using condoms regularly with clients; only 16% used condoms with their boyfriends or husbands. About 30% (194) of the prostitutes reported they had used OCs for at least 1 month out of the past 5 years. 9 of those women (4.6%) were positive for HIV. Of 444 prostitutes who had never used OC during the past 5 years, 21 or 4.73% were HIV positive.

  11. Cannabis Use: Signal of Increasing Risk of Serious Cardiovascular Disorders

    PubMed Central

    Jouanjus, Emilie; Lapeyre‐Mestre, Maryse; Micallef, Joelle

    2014-01-01

    Background Cannabis is known to be associated with neuropsychiatric problems, but less is known about complications affecting other specified body systems. We report and analyze 35 recent remarkable cardiovascular complications following cannabis use. Methods and Results In France, serious cases of abuse and dependence in response to the use of psychoactive substances must be reported to the national system of the French Addictovigilance Network. We identified all spontaneous reports of cardiovascular complications related to cannabis use collected by the French Addictovigilance Network from 2006 to 2010. We described the clinical characteristics of these cases and their evolution: 1.8% of all cannabis‐related reports (35/1979) were cardiovascular complications, with patients being mostly men (85.7%) and of an average age of 34.3 years. There were 22 cardiac complications (20 acute coronary syndromes), 10 peripheral complications (lower limb or juvenile arteriopathies and Buerger‐like diseases), and 3 cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery). In 9 cases, the event led to patient death. Conclusions Increased reporting of cardiovascular complications related to cannabis and their extreme seriousness (with a death rate of 25.6%) indicate cannabis as a possible risk factor for cardiovascular disease in young adults, in line with previous findings. Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated. Practitioners should be aware that cannabis may be a potential triggering factor for cardiovascular complications in young people. PMID:24760961

  12. Study finds increases in risk of leukemias related to treatment

    Cancer.gov

    A new study describes the pattern of risk for chemotherapy-related acute myeloid leukemia among adult cancer survivors over the past three decades who have previously been treated with chemotherapy for other cancers. These patterns coincide with major shi

  13. The H50Q Mutation Induces a 10-fold Decrease in the Solubility of α-Synuclein*

    PubMed Central

    Porcari, Riccardo; Proukakis, Christos; Waudby, Christopher A.; Bolognesi, Benedetta; Mangione, P. Patrizia; Paton, Jack F. S.; Mullin, Stephen; Cabrita, Lisa D.; Penco, Amanda; Relini, Annalisa; Verona, Guglielmo; Vendruscolo, Michele; Stoppini, Monica; Tartaglia, Gian Gaetano; Camilloni, Carlo; Christodoulou, John; Schapira, Anthony H. V.; Bellotti, Vittorio

    2015-01-01

    The conversion of α-synuclein from its intrinsically disordered monomeric state into the fibrillar cross-β aggregates characteristically present in Lewy bodies is largely unknown. The investigation of α-synuclein variants causative of familial forms of Parkinson disease can provide unique insights into the conditions that promote or inhibit aggregate formation. It has been shown recently that a newly identified pathogenic mutation of α-synuclein, H50Q, aggregates faster than the wild-type. We investigate here its aggregation propensity by using a sequence-based prediction algorithm, NMR chemical shift analysis of secondary structure populations in the monomeric state, and determination of thermodynamic stability of the fibrils. Our data show that the H50Q mutation induces only a small increment in polyproline II structure around the site of the mutation and a slight increase in the overall aggregation propensity. We also find, however, that the H50Q mutation strongly stabilizes α-synuclein fibrils by 5.0 ± 1.0 kJ mol−1, thus increasing the supersaturation of monomeric α-synuclein within the cell, and strongly favors its aggregation process. We further show that wild-type α-synuclein can decelerate the aggregation kinetics of the H50Q variant in a dose-dependent manner when coaggregating with it. These last findings suggest that the precise balance of α-synuclein synthesized from the wild-type and mutant alleles may influence the natural history and heterogeneous clinical phenotype of Parkinson disease. PMID:25505181

  14. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease

    PubMed Central

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-01-01

    Abstract To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531–534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19–142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03–1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events. PMID:27100415

  15. Increased genetic risk for obesity in premature coronary artery disease.

    PubMed

    Cole, Christopher B; Nikpay, Majid; Stewart, Alexandre F R; McPherson, Ruth

    2016-04-01

    There is ongoing controversy as to whether obesity confers risk for CAD independently of associated risk factors including diabetes mellitus. We have carried out a Mendelian randomization study using a genetic risk score (GRS) for body mass index (BMI) based on 35 risk alleles to investigate this question in a population of 5831 early onset CAD cases without diabetes mellitus and 3832 elderly healthy control subjects, all of strictly European ancestry, with adjustment for traditional risk factors (TRFs). We then estimated the genetic correlation between these BMI and CAD (rg) by relating the pairwise genetic similarity matrix to a phenotypic covariance matrix between these two traits. GRSBMI significantly (P=2.12 × 10(-12)) associated with CAD status in a multivariate model adjusted for TRFs, with a per allele odds ratio (OR) of 1.06 (95% CI 1.042-1.076). The addition of GRSBMI to TRFs explained 0.75% of CAD variance and yielded a continuous net recombination index of 16.54% (95% CI=11.82-21.26%, P<0.0001). To test whether GRSBMI explained CAD status when adjusted for measured BMI, separate models were constructed in which the score and BMI were either included as covariates or not. The addition of BMI explained ~1.9% of CAD variance and GRSBMI plus BMI explained 2.65% of CAD variance. Finally, using bivariate restricted maximum likelihood analysis, we provide strong evidence of genome-wide pleiotropy between obesity and CAD. This analysis supports the hypothesis that obesity is a causal risk factor for CAD.

  16. Drugged Driving: Increased Traffic Risks Involving Licit and Illicit Substances

    ERIC Educational Resources Information Center

    Pilkinton, Melinda W.; Robertson, Angela; McCluskey, D. Lee

    2013-01-01

    Driving under the influence of drugs poses risks for traffic safety. Most research attention has been focused on the most prevalent drugs of abuse, such as alcohol, illegal drugs, and prescription drugs with high abuse potential. The objectives of this study were to determine the types of drugs used by convicted DUI offenders on the day of their…

  17. Do Chronic Conditions Increase Young Children's Risk of Being Maltreated?

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; Mackey-Bilaver, Lucy

    2008-01-01

    Objective: To examine whether and to what extent specific chronic health conditions place young children at risk of maltreatment. Methods: The study used a sample of Illinois children (born between January 1990 and March 1996) who were through age 3 continuously enrolled in Medicaid, a public health insurance program for low-income families. The…

  18. What increases the risk of malnutrition in Parkinson's disease?

    PubMed

    Tomic, Svetlana; Pekic, Vlasta; Popijac, Zeljka; Pucic, Tomislav; Petek, Marta; Kuric, Tihana Gilman; Misevic, Sanja; Kramaric, Ruzica Palic

    2017-04-15

    Parkinson's disease (PD) patients are at a higher risk of malnutrition. The prevalence has been estimated to 0-24%, while 3%-60% of PD patients are reported to be at risk of malnutrition. To date, there is no clear explanation for malnutrition in these patients. The aim of this study was to determine the prevalence of malnutrition and to analyze factors that influence its appearance. The Mini Nutritional Assessment (MNA) was used to determine normal nutritional status; at risk of malnutrition; and already malnourished status. The Unified Parkinson's Disease Rating Scale (UPDRS) parts III and IV, Hoehn and Yahr scale (H&Y scale), Beck Depression Inventory (BDI), Mini Mental State Examination (MMSE), Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale - eating part (QUIP-RS) and Mini Nutritional Assessment (MNA) were used to evaluate the factors affecting patient nutritional status. Out of 96 patients, 55,2% were at risk of malnutrition, while 8,3% had already been malnourished. Age, H&Y scale, UPDRS part III, 'off' periods and depression influence negatively on MNA. More patients with 'off' periods were rigor dominant. Thyroid gland hormone therapy was related to malnutrition, while patients with normal nutritional status used ropinirole more often than pramipexole. Factors affecting nutritional status are age, motor symptoms and stage severity, 'off' states, rigidity dominant type with 'off' states, and thyroid hormone replacement therapy. Ropinirole exhibited the possible 'protective' effect against malnutrition.

  19. Increased Risk of Injury in Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Lee, Li-Ching; Harrington, Rebecca A.; Chang, Jen Jen; Connors, Susan L.

    2008-01-01

    The objective of this study was to examine injury risk in children with autism, ADD/ADD, learning disability, psychopathology, or other medical conditions. Children aged 3-5 years who participated in the National Survey of Children's Health were included. Six study groups were analyzed in this report: autism (n=82), ADD/ADHD (n=191), learning…

  20. Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

    Cancer.gov

    According to a January 28, 2011 article in the Journal of the National Cancer Institute, women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later.

  1. Increased Risk of Ischemic Stroke in Young Nasopharyngeal Carcinoma Patients

    SciTech Connect

    Lee, Ching-Chih; Su, Yu-Chieh; Ho, Hsu-Chueh; Hung, Shih-Kai; Lee, Moon-Sing; Chiou, Wen-Yen; Chou, Pesus; Huang, Yung-Sung

    2011-12-01

    Purpose: Radiation/chemoradiotherapy-induced carotid stenosis and cerebrovascular events in patients with nasopharyngeal carcinoma (NPC) can cause severe disability and even death. This study aimed to estimate the risk of ischemic stroke in this patient population over more than 10 years of follow-up. Methods and Materials: The study cohorts consisted of all patients hospitalized with a principal diagnosis of NPC (n = 1094), whereas patients hospitalized for an appendectomy during 1997 and 1998 (n = 4376) acted as the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the stroke-free survival rate between the two cohorts after adjusting for possible confounding and risk factors. Results: Of the 292 patients with ischemic strokes, 62 (5.7%) were from the NPC cohort and 230 (5.3%) were from the control group. NPC patients ages 35-54 had a 1.66 times (95% CI, 1.16-2.86; p = 0.009) higher risk of ischemic stroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. There was no statistical difference in ischemic stroke risk between the NPC patients and appendectomy patients ages 55-64 years (hazard ratio = 0.87; 95% CI, 0.56-1.33; p = 0.524) after adjusting for other factors. Conclusions: Young NPC patients carry a higher risk for ischemic stroke than the general population. Besides regular examinations of carotid duplex, different irradiation strategies or using new technique of radiotherapy, such as intensity modulated radiation therapy or volumetric modulated arc therapy, should be considered in young NPC patients.

  2. Increase risk of allergic diseases in patients with ankylosing spondylitis

    PubMed Central

    Chang, Wei-Pin; Kuo, Chun-Nan; Kuo, Li-Na; Wang, Yao-Tung; Perng, Wuu-Tsun; Kuo, Ho-Chang; Wei, James Cheng-Chung

    2016-01-01

    Abstract Th2 and Th17 cells are both associated with developing ankylosing spondylitis (AS) and asthma. Th2 cells are also associated with allergic rhinitis and atopic dermatitis (AD). The prevalence of such allergic diseases in AS patients is unknown. In this study, we intended to study the risk of allergic diseases in a 10-year follow-up population of newly diagnosed patients with AS. We used a nationwide 10-year population-based database retrieved from the Longitudinal Health Insurance Database 2005 (LHID2005) in Taiwan. The study cohort comprised 857 patients with AS who had at least 1 claim of inpatient admission or at least 2 claims of ambulatory visit. The comparison cohort consisted of 4285 randomly selected subjects matched with AS group at a ratio of 5:1. We used Cox proportional-hazards regression to determine the 10-year disease-free survival rates after adjusting for potentially confounding factors. The AS patients had a 1.31 times greater risk of developing asthma within 10 years of diagnosis when compared with non-AS age- and sex-matched subjects, after adjusting for other risk factors (95% confidence interval = 1.00–1.75). But the difference was not significantly different. The AS patients also had a 1.46 times and a 1.22 times greater risk of developing allergic rhinitis and AD significantly. AS patients also had a lower allergic disease-free survival rate compared to non-AS group. Our results showed that patients with AS had a higher risk of developing allergic diseases later in life. PMID:27828843

  3. Increased Risk of Fatal Infections in Women Starting Peritoneal Dialysis

    PubMed Central

    Ros, Silvia; Remón, Cesar; Qureshi, Abdul Rashid; Quiros, Pedro; Lindholm, Bengt; Carrero, Juan Jesús

    2013-01-01

    ♦ Background and Objectives: Although cardiovascular disease (CVD) is an important cause of morbidity and mortality in patients with end-stage renal disease, non-CVD causes account for more than 50% of total deaths. We previously showed that, compared with men, women starting dialysis— both hemodialysis and peritoneal dialysis (PD)—have higher non-CVD mortality rates. Here, we evaluate sex-specific outcomes in a large cohort of incident PD patients. ♦ Methods: Incident de novo PD patients from the Andalusian SICATA Registry for 1999 - 2010, with follow-up until 31 December 2010 or up to 5 years, were investigated for fatal outcomes. Causes of death were extracted from medical records. The analysis used traditional and competing-risk Cox models for all-cause and cause-specific mortality in men and women, correcting in the competing-risk models for the events of kidney transplantation and transfer to hemodialysis. ♦ Results: A total of 1458 patients (57% men; mean overall age: 55.3 ± 17.0 years) initiated PD in Andalusia during the study period. During follow-up, 350 deaths, 355 renal transplantation procedures, and 331 transfers to hemodialysis were recorded. Vascular disease and diabetic nephropathy were the most frequent causes of kidney failure in men; other causes were more common in women. In the traditional Cox model, both sexes showed a similar all-cause mortality risk [crude hazard ratio (HR): 0.90; 95% confidence interval (CI): 0.72 to 1.12]. However, with respect to specific causes of death, women showed a borderline lower risk of both CVD (crude HR: 0.71; 95% CI: 0.50 to 0.99) and non-CVD mortality from other than infection (crude HR: 0.81; 95% CI: 0.57 to 1.15). In contrast, the risk of death from infection was almost doubled in women compared with men (crude HR: 1.92; 95% CI: 1.15 to 3.20), a finding that held true after multivariate adjustment for age, primary renal disease, period of inclusion, and initial PD modality (adjusted HR: 1.76; 95

  4. Increasing Effectiveness and Efficiency Through Risk-Based Deployments

    DTIC Science & Technology

    2015-12-01

    research into the experiences of other entities with risk-based deployment methodologies. 14. SUBJECT TERMS aviation security, Transportation...imaging technology BDO behavior detection officer CATA civil aviation threat assessment CHDS Center for Homeland Defense and Security COTS...little to no threat to aviation .”1 The TSA has the opportunity to continue this evolution, and address calls from the Government Accountability Office

  5. Increased Risk of Depressive Disorder following Cholecystectomy for Gallstones

    PubMed Central

    Chen, Chao-Hung; Lin, Herng-Ching; Lee, Cha-Ze

    2015-01-01

    Background Prior studies indicate a possible association between depression and cholecystectomy, but no study has compared the risk of post-operative depressive disorders (DD) after cholecystectomy. This retrospective follow-up study aimed to examine the relationship between cholecystectomy and the risk of DD in patients with gallstones in a population-based database. Methods Using ambulatory care data from the Longitudinal Health Insurance Database 2000, 6755 patients who received a first-time principal diagnosis of gallstones at the emergency room (ER) were identified. Among them, 1197 underwent cholecystectomy. Each patient was then individually followed-up for two years to identify those who were later diagnosed with DD. Cox proportional hazards regressions were performed to estimate the risk of developing DD between patients with gallstone who did and those who did not undergo cholecystectomy. Results Of 6755 patients with gallstones, 173 (2.56%) were diagnosed with DD during the two-year follow-up. Among patients who did and those who did not undergo cholecystectomy, 3.51% and 2.36% later developed depressive disorder, respectively. After adjusting for the patient’s sex, age and geographic location, the hazard ratio (HR) of DD within two years of gallstone diagnosis was 1.43 (95% CI, 1.02–2.04) for patients who underwent cholecystectomy compared to those who did not. Females, but not males, had a higher the adjusted HR of DD (1.61; 95% CI, 1.08–2.41) for patients who underwent cholecystectomy compared to those who did not. Conclusions There is an association between cholecystectomy and subsequent risk of DD among females, but not in males. PMID:26053886

  6. Periodontal disease increases risk for chronic obstructive pulmonary disease.

    PubMed

    Ledić, Karla; Marinković, Sonja; Puhar, Ivan; Spalj, Stjepan; Popović-Grle, Sanja; Ivić-Kardum, Marija; Samarzija, Miroslav; Plancak, Darije

    2013-09-01

    The aim of this study was to explore whether a periodontal disease could be a risk indicator for a chronic obstructive pulmonary disease (COPD). The examined group comprised 93 patients with COPD (mean age 65.8 years). The control group comprised 43 systemically healthy individuals (mean age 62.1 years). Respiratory and periodontal conditions were examined in both groups. COPB subjects had significantly worse periodontal conditions than controls (p < 0.05) with regard to each parameter of periodontal condition, except for gingival inflammation. COPD patients had higher Plaque Index than control patients (82.84 +/- 22.81 vs. 57.15 +/- 26.96; p < 0.001), higher periodontal depth (3.02 +/- 0.92 vs. 2.57 +/- 0.79 mm; p = 0.007), higher gingival recession (1.97 +/- 1.09 vs. 0.91 +/- 0.79 mm; p < 0.001), and higher mean clinical attachment loss (CAL) (4.12 +/- 1.74 vs. 2.91 +/- 1.27 mm; p < 0.001). Multiple logistic regression model, after controlling for other risk indicators, showed that periodontal disease, presented as CAL > or = 4 mm at > or = 60% sites, was associated with odds ratio of 3.2 (95% CI 1.0-9.8) for the COPB group. Data suggest that periodontal disease could be a risk indicator for COPD.

  7. Increased risk of osteoporosis in patients with erectile dysfunction

    PubMed Central

    Wu, Chieh-Hsin; Lu, Ying-Yi; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Feng-Ji; Lin, Chih-Lung

    2016-01-01

    Abstract In this study, we aimed to investigate the risk of osteoporosis in patients with erectile dysfunction (ED) by analyzing data from the Taiwan National Health Insurance Research Database (NHIRD). From the Taiwan NHIRD, we analyzed data on 4460 patients aged ≥40 years diagnosed with ED between 1996 and 2010. In total, 17,480 age-matched patients without ED in a 1:4 ratio were randomly selected as the non-ED group. The relationship between ED and the risk of osteoporosis was estimated using Cox proportional hazard regression models. During the follow-up period, 264 patients with ED (5.92%) and 651 patients without ED (3.65%) developed osteoporosis. The overall incidence of osteoporosis was 3.04-fold higher in the ED group than in the non-ED group (9.74 vs 2.47 per 1000 person-years) after controlling for covariates. Compared with patients without ED, patients with psychogenic and organic ED were 3.19- and 3.03-fold more likely to develop osteoporosis. Our results indicate that patients with a history of ED, particularly younger men, had a high risk of osteoporosis. Patients with ED should be examined for bone mineral density, and men with osteoporosis should be evaluated for ED. PMID:27368024

  8. Increased risk of vertebral fracture in patients with rheumatoid arthritis

    PubMed Central

    Chen, Bin; Cheng, Guangqi; Wang, Hantao; Feng, Yu

    2016-01-01

    Abstract The relationship between rheumatoid arthritis and risk of vertebral fracture has been reported by several observational studies. However, there is no higher-level evidence study, such as meta-analysis, that has investigated the relationship, and its mechanisms are not yet fully clear. This meta-analysis aimed to provide a summary of an observational study of the relationship between rheumatoid arthritis and the risk of vertebral fractures. Relevant studies were identified by searching PubMed and EMBASE databases (up to August 1, 2016). We included published observational studies (cohort or case-control design) evaluating the relationship between rheumatoid arthritis and the risk of vertebral fractures. Two reviewers searched and abstracted the data independently. Relative risks (RRs) with 95% confidence intervals (CIs) were used throughout the whole analysis. Seven observational studies (2 cohort studies, 2 nested case-control studies, and 3 case-control studies) were included in this meta-analysis. The results showed that the pooled RR of vertebral fracture for individuals with rheumatoid arthritis was 2.34 (95% CI 2.05–2.63, I2 = 35.4%, P for heterogeneity = 0.16). Further subgroup analysis by sex showed that the pooled RRs for both women and men, and only women were 2.14 (95% CI 1.47–2.8, I2 = 48.5%, P for heterogeneity = 0.12) and 2.39 (95% CI 2.07–2.70, I2 = 34%, P for heterogeneity = 0.22), respectively. Subgroup analysis by study design showed that the pooled RRs for cohort studies, nested case-control studies, and case-control studies were 2.31 (95% CI 1.95–2.67, I2 = 4.8%, P for heterogeneity = 0.31), 1.89 (95% CI 1.01–2.77, I2 = 72.1%, P for heterogeneity = 0.06), and 2.62 (95% CI 2.04–3.91, I2 = 26.1%, P for heterogeneity = 0.26), respectively. Based on our meta-analysis, rheumatoid arthritis should be regarded as an independent risk factor of vertebral fracture. Further studies are

  9. Does Apolipoprotein E Genotype Increase Risk of Postoperative Delirium?

    PubMed Central

    Vasunilashorn, Sarinnapha; Ngo, Long; Kosar, Cyrus M.; Fong, Tamara G.; Jones, Richard N.

    2015-01-01

    Objectives To determine whether Apolipoprotein E (ApoE) is associated with postoperative delirium incidence, severity, and duration in older patients free of dementia at baseline. Design, Setting, Participants We examined 557 non-demented patients age ≥70 undergoing major non-cardiac surgery enrolled in the Successful Aging after Elective Surgery (SAGES) Study. Measurements We considered three ApoE measures: ε2, ε4 carriers vs. non-carriers, and a three-category ApoE measure. Delirium was determined using the Confusion Assessment Method (CAM) and chart review. We used generalized linear models to estimate the association between ApoE and delirium incidence, severity (peak CAM Severity [CAM-S] score), and days. Results ApoE ε2 and ε4 was present in 15% and 19% respectively, and postoperative delirium occurred in 24%. Among patients with delirium, the mean peak CAM-S score was 8.0 (standard deviation 4), with most patients experiencing one or two delirium days (51% or 28%, respectively). After adjusting for age, sex, surgical procedure, and preoperative cognitive function, ApoE ε4 and ε2 carrier status were not associated with postoperative delirium: RR for ε4=1.0, 95% confidence interval (CI) 0.7-1.5 and RR for ε2=0.9, 95% CI 0.6-1.4. No association between ApoE and delirium severity or number of delirium days was observed. Conclusions In older surgery patients free of dementia, our findings do not support the hypothesis that the ApoE genotype does not confer either risk or protection in postoperative delirium incidence, severity, or duration. Thus, an important genetic risk factor for Alzheimer's Disease does not affect risk of delirium. PMID:26238230

  10. Epilepsy and multiple sclerosis: Increased risk among progressive forms.

    PubMed

    Martínez-Juárez, Iris E; López-Meza, Elmer; González-Aragón, Maria del Carmen Fernández; Ramírez-Bermúdez, Jesús; Corona, Teresa

    2009-04-01

    Multiple sclerosis (MS) patients are at higher risk for epilepsy. Epilepsy was frequent among our MS patients (6.55%). Progressive MS forms were associated with higher incidence of epilepsy (p=0.021). Partial motor seizures were observed in five patients (62.5%) and generalized tonic-clonic in three (37.5%). Electroencephalogram (EEG) revealed epileptic activity in 62.5%. A high percentage of MS patients with epilepsy (37.5%) reported intoxication as the most severe form of adverse effect of antiepileptic therapy.

  11. Forecasting Disease Risk for Increased Epidemic Preparedness in Public Health

    PubMed Central

    Myers, M.F.; Rogers, D.J.; Cox, J.; Flahault, A.; Hay, S.I.

    2011-01-01

    Emerging infectious diseases pose a growing threat to human populations. Many of the world’s epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector–environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development. PMID:10997211

  12. Smoking increases the risk of relapse after successful tuberculosis treatment

    PubMed Central

    d’Arc Lyra Batista, Joanna; de Fátima Pessoa Militão de Albuquerque, Maria; de Alencar Ximenes, Ricardo Arraes; Rodrigues, Laura Cunha

    2008-01-01

    Background Recent tobacco smoking has been identified as a risk factor for developing tuberculosis, and two studies which have investigated its association with relapse of tuberculosis after completion of treatment had conflicting results (and did not control for confounding). The objective of this study was to investigate risk factors for tuberculosis relapse, with emphasis on smoking. Methods A cohort of newly diagnosed TB cases was followed up from their discharge after completion of treatment (in 2001–2003) until October 2006 and relapses of tuberculosis ascertained during that period. A case of relapse was defined as a patient who started a second treatment during the follow up. Results Smoking (OR 2.53, 95% CI 1.23–5.21) and living in an area where the family health program was not implemented (OR 3.61, 95% CI 1.46–8.93) were found to be independently associated with relapse of tuberculosis. Conclusions Our results establish that smoking is associated with relapse of tuberculosis even after adjustment for the socioeconomic variables. Smoking cessation support should be incorporated in the strategies to improve effectiveness of Tuberculosis Control Programs. PMID:18556729

  13. Consequences of Weight Cycling: An Increase in Disease Risk?

    PubMed Central

    STROHACKER, KELLEY; CARPENTER, KATIE C.; MCFARLIN, BRIAN K.

    2009-01-01

    Research indicates that weight cycling, or “yo-yo dieting” is a common occurrence in overweight and obese populations. The long term negative health consequences of weight cycling are debated and it is unclear whether or not this weight change pattern poses a greater disease risk compared to obesity maintenance. This review discusses the prevalence of weight cycling and physiological alterations occurring during weight loss that promotes weight regain. We also discuss the effect weight regain has upon adipose tissue in terms of rate and type of accumulation. Also within this review are discussions surrounding the previously published literature based upon human and rodent research. We focus on previous limitations and difference in experimental design that have perhaps resulted in mixed findings concerning independent effects of weight cycling on health parameters. The final purpose of this review is to discuss future directions in evaluating the pro-inflammatory response to weight cycling in order to compare the disease risk compared to obesity maintenance. PMID:25429313

  14. Forecasting disease risk for increased epidemic preparedness in public health

    NASA Technical Reports Server (NTRS)

    Myers, M. F.; Rogers, D. J.; Cox, J.; Flahault, A.; Hay, S. I.

    2000-01-01

    Emerging infectious diseases pose a growing threat to human populations. Many of the world's epidemic diseases (particularly those transmitted by intermediate hosts) are known to be highly sensitive to long-term changes in climate and short-term fluctuations in the weather. The application of environmental data to the study of disease offers the capability to demonstrate vector-environment relationships and potentially forecast the risk of disease outbreaks or epidemics. Accurate disease forecasting models would markedly improve epidemic prevention and control capabilities. This chapter examines the potential for epidemic forecasting and discusses the issues associated with the development of global networks for surveillance and prediction. Existing global systems for epidemic preparedness focus on disease surveillance using either expert knowledge or statistical modelling of disease activity and thresholds to identify times and areas of risk. Predictive health information systems would use monitored environmental variables, linked to a disease system, to be observed and provide prior information of outbreaks. The components and varieties of forecasting systems are discussed with selected examples, along with issues relating to further development.

  15. PSCA rs2294008 Polymorphism with Increased Risk of Cancer

    PubMed Central

    Geng, Peiliang; Li, Jianjun; Wang, Ning; Ou, Juanjuan; Xie, Ganfeng; Liu, Chen; Zhao, Xiaoxin; Xiang, Lisha; Liao, Yunmei; Liang, Houjie

    2015-01-01

    Background Published data on the association between PSCA rs2294008 polymorphism and cancer risk have implicated inconclusive results. To determine the relationship and to precisely assess the effect size estimate of the association, we performed a meta-analysis. Methods We searched published literature in Embase and PubMed databases using the search terms “PSCA”, “prostate stem cell antigen”, “variants”, “polymorphism”, “polymorphisms”, and “cancer”. A total of 21 eligible articles were retrieved, with 27, 197 cancer cases and 48, 237 controls. Results On the whole, we found the association between PSCA rs2294008 polymorphism and cancer risk was statistically significant: TT vs CC: OR = 1.18, 95% CI, 1.10 to 1.27; TT + CT vs CC: OR = 1.08, 95% CI, 1.05 to 1.10; TT vs CT + CC: OR = 1.14, 95% CI, 1.07 to 1.21; T vs C: OR = 1.10, 95% CI, 1.06 to 1.14; CT vs CC: OR = 1.10, 95% CI, 1.06 to 1.13. Stratified analyses in cancer type and ethnicity showed similar results. Conclusions Based on the statistical evidence, we can draw a conclusion that the rs2294008 polymorphism of PSCA gene is likely to play a role in cancer carcinogenesis, especially in gastric cancer and bladder cancer. PMID:26308216

  16. Residual Antibiotics Disrupt Meat Fermentation and Increase Risk of Infection

    PubMed Central

    Kjeldgaard, Jette; Cohn, Marianne T.; Casey, Pat G.; Hill, Colin; Ingmer, Hanne

    2012-01-01

    ABSTRACT Fermented sausages, although presumed safe for consumption, sometimes cause serious bacterial infections in humans that may be deadly. Not much is known about why and when this is the case. We tested the hypothesis that residual veterinary antibiotics in meat can disrupt the fermentation process, giving pathogenic bacteria a chance to survive and multiply. We found that six commercially available starter cultures were susceptible to commonly used antibiotics, namely, oxytetracycline, penicillin, and erythromycin. In meat, statutorily tolerable levels of oxytetracycline and erythromycin inhibited fermentation performance of three and five of the six starter cultures, respectively. In model sausages, the disruption of meat fermentation enhanced survival of the pathogens Escherichia coli O157:H7 and Salmonella enterica serovar Typhimurium compared to successful fermentations. Our work reveals an overlooked risk associated with the presence of veterinary drugs in meat. PMID:22930338

  17. Dysfunctional nitric oxide signalling increases risk of myocardial infarction.

    PubMed

    Erdmann, Jeanette; Stark, Klaus; Esslinger, Ulrike B; Rumpf, Philipp Moritz; Koesling, Doris; de Wit, Cor; Kaiser, Frank J; Braunholz, Diana; Medack, Anja; Fischer, Marcus; Zimmermann, Martina E; Tennstedt, Stephanie; Graf, Elisabeth; Eck, Sebastian; Aherrahrou, Zouhair; Nahrstaedt, Janja; Willenborg, Christina; Bruse, Petra; Brænne, Ingrid; Nöthen, Markus M; Hofmann, Per; Braund, Peter S; Mergia, Evanthia; Reinhard, Wibke; Burgdorf, Christof; Schreiber, Stefan; Balmforth, Anthony J; Hall, Alistair S; Bertram, Lars; Steinhagen-Thiessen, Elisabeth; Li, Shu-Chen; März, Winfried; Reilly, Muredach; Kathiresan, Sekar; McPherson, Ruth; Walter, Ulrich; Ott, Jurg; Samani, Nilesh J; Strom, Tim M; Meitinger, Thomas; Hengstenberg, Christian; Schunkert, Heribert

    2013-12-19

    Myocardial infarction, a leading cause of death in the Western world, usually occurs when the fibrous cap overlying an atherosclerotic plaque in a coronary artery ruptures. The resulting exposure of blood to the atherosclerotic material then triggers thrombus formation, which occludes the artery. The importance of genetic predisposition to coronary artery disease and myocardial infarction is best documented by the predictive value of a positive family history. Next-generation sequencing in families with several affected individuals has revolutionized mutation identification. Here we report the segregation of two private, heterozygous mutations in two functionally related genes, GUCY1A3 (p.Leu163Phefs*24) and CCT7 (p.Ser525Leu), in an extended myocardial infarction family. GUCY1A3 encodes the α1 subunit of soluble guanylyl cyclase (α1-sGC), and CCT7 encodes CCTη, a member of the tailless complex polypeptide 1 ring complex, which, among other functions, stabilizes soluble guanylyl cyclase. After stimulation with nitric oxide, soluble guanylyl cyclase generates cGMP, which induces vasodilation and inhibits platelet activation. We demonstrate in vitro that mutations in both GUCY1A3 and CCT7 severely reduce α1-sGC as well as β1-sGC protein content, and impair soluble guanylyl cyclase activity. Moreover, platelets from digenic mutation carriers contained less soluble guanylyl cyclase protein and consequently displayed reduced nitric-oxide-induced cGMP formation. Mice deficient in α1-sGC protein displayed accelerated thrombus formation in the microcirculation after local trauma. Starting with a severely affected family, we have identified a link between impaired soluble-guanylyl-cyclase-dependent nitric oxide signalling and myocardial infarction risk, possibly through accelerated thrombus formation. Reversing this defect may provide a new therapeutic target for reducing the risk of myocardial infarction.

  18. Do Child Abuse and Maltreatment Increase Risk of Schizophrenia?

    PubMed Central

    Sideli, Lucia; Mule, Alice; La Barbera, Daniele

    2012-01-01

    Introduction IntroductionaaAlthough childhood abuse is a recognised risk factor for depression, post-traumatic stress disorder, and substance misuse, its role in the aetiology of psychotic disorder remained controversial. This is in part because the putative effect of childhood trauma on psychosis has been mostly evaluated by small, cross sectional, uncontrolled studies that raised methodological issues. Methods Papers concerning the association between childhood trauma and psychotic disorders (to November, 2011) were identified using a comprehensive search of PubMed, Psychinfo, and Scopus and analysing reference list of relevant papers. A narrative synthesis was used to summarise results. Results An association between childhood abuse and psychotic symptoms was consistently reported by large cross sectional surveys with an effect ranging from 1.7 to 15. However, we cannot conclude that the relationship is causal as lack of longitudinal studies prevent us from fully excluding alternative explanations such as reverse causality. Gender, cannabis use, and depressive and post-traumatic stress disorder symptoms appear to moderate the effect of childhood trauma on psychotic disorders. However, specificity of childhood abuse in psychotic disorders and, particularly, in schizophrenia has not been demonstrated. Conclusion Although the association between childhood abuse and psychosis has been replicated, the etiological role of such early adversity has yet to be fully clarified. So far none of the studies reported support the hypothesis that childhood abuse is either sufficient or necessary to develop a psychotic disorder. It seems likely that any effect of childhood abuse on schizophrenia needs to be understood in terms of genetic susceptibility and interaction with other environmental risk factors. PMID:22707958

  19. Increased Waist-to-height Ratio May Contribute to Age-related Increase in Cardiovascular Risk Factors

    PubMed Central

    Akhlaghi, Masoumeh; Kamali, Majid; Dastsouz, Farideh; Sadeghi, Fatemeh; Amanat, Sassan

    2016-01-01

    Background: The risk of cardiovascular diseases (CVDs) increases with age. The objective was to determine whether lifestyle and dietary behaviors and anthropometric measures, which are affected by these behaviors, contribute to the increase of CVD risk factors across age categories of 20–50-year-old. Methods: In a cross-sectional design, 437 adults aged 20–50-year-old were selected from households living in Shiraz. Risk factors of CVD, including body mass index (BMI), waist-to-height ratio (WHtR), blood pressure, fasting blood glucose (FBG), serum triglycerides, total cholesterol, and low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively) as well as lifestyle behaviors (physical activity and smoking), dietary habits, and food intakes were assessed across the age categories of 20–29, 30–39, and 40–50 years. Linear regression was used to examine the contribution of different variables to the age-related increase of CVD risk factors. Results: All CVD risk factors, except for HDL-C, significantly increased across age categories. Older subjects had healthier dietary habits and food intakes, but they possessed nonsignificantly lower physical activity and higher smoking rate compared to younger adults. Adjusting for physical activity, smoking, and BMI did not change the significant positive association between age and CVD risk factors but adjusting for WHtR disappeared associations for blood pressure, triglycerides, and metabolic syndrome although significant associations remained for FBG and total and LDL-C. Conclusions: Age-related increase of CVD risk factors occurred independent of lifestyle habits. WHtR, but not BMI, may partially contribute to the age-related increase in CVD risk factors. PMID:27195100

  20. Increased risk of suicide under intrathecal ziconotide treatment? - a warning.

    PubMed

    Maier, Christoph; Gockel, Hans-Helmut; Gruhn, Kai; Krumova, Elena K; Edel, Marc-Andreas

    2011-01-01

    Despite some other known psychiatric adverse effects, ziconotide is recommended for intrathecal pain treatment with a good efficacy and safety. Although some hints in previous studies are apparent, a higher suicidality has not been accepted as a treatment risk of ziconotide treatment by the investigators in the former randomized controlled trials so far. We present two cases supporting the suspicion of ziconotide-induced suicidality. Both showed no depressive symptoms at the time of treatment initiation. One patient performed suicide under low-dose (cumulative dosage: 779μg) 4 weeks after the onset of intrathecal ziconotide treatment despite sufficient pain relief. Another female patient with a history of depression, but free of symptoms under antidepressive medication since more than 15 years, developed severe suicidal ideation 2 months after ziconotide treatment (cumulative dosage: about 2900μg) with rapid recovery after drug discontinuation. The patient, who has completed suicide, had earlier given rise to discuss a potential depressive disorder, however, this diagnosis was scrapped, but the second patient had a clear history of depression. These cases substantiate the suspicion of a causal relationship between ziconotide and suicidality even in symptom-free patients with a history of depression. Therefore, a comprehensive psychiatric evaluation is unavoidable before and during ziconotide treatment.

  1. Chronic vitamin C deficiency increases the risk of cardiovascular diseases.

    PubMed

    Ginter, E

    2007-01-01

    The studies on experimental animals (guinea pigs, monkeys, fish) have confirmed the important role of ascorbic acid deficiency in the development of hypercholesterolemia and atherosclerosis, but the clinical experience is not quite uniform. Metaanalyses of randomized controlled trials performed on subjects without established vitamin C-deficiency conclud that the evidence of the presence or absence of benefits derived from the ability of ascorbic acid to prevent cardiovascular diseases is not sufficient. This review is an outline of numerous clinical, epidemiological and prospective studies that have found a positive role of vitamin C in the prevention of atherosclerosis. If we admit the possibility that vitamin C deficiency is a significant risk factor of atherogenesis, due to ethical reasons it is impossible to perform long-term controlled trials on subjects with proved vitamin C deficiency, to recommend them not to change their nutrition and lifestyle, and to administer placebo to the control group. Therefore the proof of atherogenic effect of chronic vitamin C deficiency is limited to indirect evidence only. In this review many new data on the positive effects of ascorbic acid on human cardiovascular system are summarized and the mechanisms of its protective influence on blood vessels are discussed (Fig.5, Ref. 45). Full Text (Free, PDF) www.bmj.sk.

  2. Reducing Cascading Failure Risk by Increasing Infrastructure Network Interdependence

    PubMed Central

    Korkali, Mert; Veneman, Jason G.; Tivnan, Brian F.; Bagrow, James P.; Hines, Paul D. H.

    2017-01-01

    Increased interconnection between critical infrastructure networks, such as electric power and communications systems, has important implications for infrastructure reliability and security. Others have shown that increased coupling between networks that are vulnerable to internetwork cascading failures can increase vulnerability. However, the mechanisms of cascading in these models differ from those in real systems and such models disregard new functions enabled by coupling, such as intelligent control during a cascade. This paper compares the robustness of simple topological network models to models that more accurately reflect the dynamics of cascading in a particular case of coupled infrastructures. First, we compare a topological contagion model to a power grid model. Second, we compare a percolation model of internetwork cascading to three models of interdependent power-communication systems. In both comparisons, the more detailed models suggest substantially different conclusions, relative to the simpler topological models. In all but the most extreme case, our model of a “smart” power network coupled to a communication system suggests that increased power-communication coupling decreases vulnerability, in contrast to the percolation model. Together, these results suggest that robustness can be enhanced by interconnecting networks with complementary capabilities if modes of internetwork failure propagation are constrained. PMID:28317835

  3. Reducing Cascading Failure Risk by Increasing Infrastructure Network Interdependence.

    PubMed

    Korkali, Mert; Veneman, Jason G; Tivnan, Brian F; Bagrow, James P; Hines, Paul D H

    2017-03-20

    Increased interconnection between critical infrastructure networks, such as electric power and communications systems, has important implications for infrastructure reliability and security. Others have shown that increased coupling between networks that are vulnerable to internetwork cascading failures can increase vulnerability. However, the mechanisms of cascading in these models differ from those in real systems and such models disregard new functions enabled by coupling, such as intelligent control during a cascade. This paper compares the robustness of simple topological network models to models that more accurately reflect the dynamics of cascading in a particular case of coupled infrastructures. First, we compare a topological contagion model to a power grid model. Second, we compare a percolation model of internetwork cascading to three models of interdependent power-communication systems. In both comparisons, the more detailed models suggest substantially different conclusions, relative to the simpler topological models. In all but the most extreme case, our model of a "smart" power network coupled to a communication system suggests that increased power-communication coupling decreases vulnerability, in contrast to the percolation model. Together, these results suggest that robustness can be enhanced by interconnecting networks with complementary capabilities if modes of internetwork failure propagation are constrained.

  4. Reducing Cascading Failure Risk by Increasing Infrastructure Network Interdependence

    NASA Astrophysics Data System (ADS)

    Korkali, Mert; Veneman, Jason G.; Tivnan, Brian F.; Bagrow, James P.; Hines, Paul D. H.

    2017-03-01

    Increased interconnection between critical infrastructure networks, such as electric power and communications systems, has important implications for infrastructure reliability and security. Others have shown that increased coupling between networks that are vulnerable to internetwork cascading failures can increase vulnerability. However, the mechanisms of cascading in these models differ from those in real systems and such models disregard new functions enabled by coupling, such as intelligent control during a cascade. This paper compares the robustness of simple topological network models to models that more accurately reflect the dynamics of cascading in a particular case of coupled infrastructures. First, we compare a topological contagion model to a power grid model. Second, we compare a percolation model of internetwork cascading to three models of interdependent power-communication systems. In both comparisons, the more detailed models suggest substantially different conclusions, relative to the simpler topological models. In all but the most extreme case, our model of a “smart” power network coupled to a communication system suggests that increased power-communication coupling decreases vulnerability, in contrast to the percolation model. Together, these results suggest that robustness can be enhanced by interconnecting networks with complementary capabilities if modes of internetwork failure propagation are constrained.

  5. Estimating Potential Increased Bladder Cancer Risk Due to Increased Bromide Concentrations in Sources of Disinfected Drinking Waters.

    PubMed

    Regli, Stig; Chen, Jimmy; Messner, Michael; Elovitz, Michael S; Letkiewicz, Frank J; Pegram, Rex A; Pepping, T J; Richardson, Susan D; Wright, J Michael

    2015-11-17

    Public water systems are increasingly facing higher bromide levels in their source waters from anthropogenic contamination through coal-fired power plants, conventional oil and gas extraction, textile mills, and hydraulic fracturing. Climate change is likely to exacerbate this in coming years. We estimate bladder cancer risk from potential increased bromide levels in source waters of disinfecting public drinking water systems in the United States. Bladder cancer is the health end point used by the United States Environmental Protection Agency (EPA) in its benefits analysis for regulating disinfection byproducts in drinking water. We use estimated increases in the mass of the four regulated trihalomethanes (THM4) concentrations (due to increased bromide incorporation) as the surrogate disinfection byproduct (DBP) occurrence metric for informing potential bladder cancer risk. We estimate potential increased excess lifetime bladder cancer risk as a function of increased source water bromide levels. Results based on data from 201 drinking water treatment plants indicate that a bromide increase of 50 μg/L could result in a potential increase of between 10(-3) and 10(-4) excess lifetime bladder cancer risk in populations served by roughly 90% of these plants.

  6. Increased risk of obstructive pulmonary disease in tunnel workers

    PubMed Central

    Ulvestad, B.; Bakke, B.; Melbostad, E.; Fuglerud, P.; Kongerud, J.; Lund, M. B.

    2000-01-01

    BACKGROUND—Tunnel workers are exposed to gases and particles from blasting and diesel exhausts. The aim of this study was to assess the occurrence of respiratory symptoms and airflow limitation in tunnel workers and to relate these findings to years of exposure.
METHODS—Two hundred and twelve tunnel workers and a reference group of 205 other heavy construction workers participated in a cross sectional investigation. Exposure measurements were carried out to demonstrate the difference in exposure between the two occupational groups. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were applied. Atopy was determined by a multiple radioallergosorbent test (RAST). Radiological signs of silicosis were evaluated. Respiratory symptoms and lung function were studied in relation to years of exposure and adjusted for smoking habits and atopy.
RESULTS—Compared with the reference subjects the tunnel workers had a significant decrease in forced vital capacity (FVC) % predicted and forced expiratory volume in one second (FEV1) % predicted when related to years of exposure. Adjusted FEV1 decreased by 17 ml for each year of tunnel work exposure compared with 0.5 ml in outdoor heavy construction workers. The tunnel workers also reported significantly higher occurrence of respiratory symptoms. The prevalence of chronic obstructive pulmonary disease (COPD) was 14% in the tunnel workers compared with 8% in the reference subjects.
CONCLUSION—Exposure to dust and gases from diesel exhaust, blasting, drilling and rock transport in tunnel work enhances the risk for accelerated decline in FEV1, respiratory symptoms, and COPD in tunnel workers compared with other heavy construction workers.

 PMID:10722766

  7. Warming increases the risk of civil war in Africa.

    PubMed

    Burke, Marshall B; Miguel, Edward; Satyanath, Shanker; Dykema, John A; Lobell, David B

    2009-12-08

    Armed conflict within nations has had disastrous humanitarian consequences throughout much of the world. Here we undertake the first comprehensive examination of the potential impact of global climate change on armed conflict in sub-Saharan Africa. We find strong historical linkages between civil war and temperature in Africa, with warmer years leading to significant increases in the likelihood of war. When combined with climate model projections of future temperature trends, this historical response to temperature suggests a roughly 54% increase in armed conflict incidence by 2030, or an additional 393,000 battle deaths if future wars are as deadly as recent wars. Our results suggest an urgent need to reform African governments' and foreign aid donors' policies to deal with rising temperatures.

  8. Restaurant Cooking Trends and Increased Risk for Campylobacter Infection

    PubMed Central

    Jones, Anna K.; Rigby, Dan; Burton, Michael; Millman, Caroline; Williams, Nicola J.; Jones, Trevor R.; Wigley, Paul; Cross, Paul

    2016-01-01

    In the United Kingdom, outbreaks of Campylobacter infection are increasingly attributed to undercooked chicken livers, yet many recipes, including those of top chefs, advocate short cooking times and serving livers pink. During 2015, we studied preferences of chefs and the public in the United Kingdom and investigated the link between liver rareness and survival of Campylobacter. We used photographs to assess chefs’ ability to identify chicken livers meeting safe cooking guidelines. To investigate the microbiological safety of livers chefs preferred to serve, we modeled Campylobacter survival in infected chicken livers cooked to various temperatures. Most chefs correctly identified safely cooked livers but overestimated the public’s preference for rareness and thus preferred to serve them more rare. We estimated that 19%–52% of livers served commercially in the United Kingdom fail to reach 70°C and that predicted Campylobacter survival rates are 48%–98%. These findings indicate that cooking trends are linked to increasing Campylobacter infections. PMID:27314748

  9. Warming increases the risk of civil war in Africa

    PubMed Central

    Burke, Marshall B.; Miguel, Edward; Satyanath, Shanker; Dykema, John A.; Lobell, David B.

    2009-01-01

    Armed conflict within nations has had disastrous humanitarian consequences throughout much of the world. Here we undertake the first comprehensive examination of the potential impact of global climate change on armed conflict in sub-Saharan Africa. We find strong historical linkages between civil war and temperature in Africa, with warmer years leading to significant increases in the likelihood of war. When combined with climate model projections of future temperature trends, this historical response to temperature suggests a roughly 54% increase in armed conflict incidence by 2030, or an additional 393,000 battle deaths if future wars are as deadly as recent wars. Our results suggest an urgent need to reform African governments' and foreign aid donors' policies to deal with rising temperatures. PMID:19934048

  10. Steroid contraceptive use and cervical dysplasia: increased risk of progression.

    PubMed

    Stern, E; Forsythe, A B; Youkeles, L; Coffelt, C F

    1977-06-24

    In a prospective study of women with dysplasia of the cervix, there was an increase in severity of dysplasia and of conversion to cancer in situ in users of the contraceptive pill compared with users of other contraceptive methods. There was a delay in this adverse response. Nonreversal of dysplasia within the first 6 months of pill use is predictive of progression after prolonged exposure.

  11. Thinking Concretely Increases the Perceived Likelihood of Risks: The Effect of Construal Level on Risk Estimation.

    PubMed

    Lermer, Eva; Streicher, Bernhard; Sachs, Rainer; Raue, Martina; Frey, Dieter

    2016-03-01

    Recent findings on construal level theory (CLT) suggest that abstract thinking leads to a lower estimated probability of an event occurring compared to concrete thinking. We applied this idea to the risk context and explored the influence of construal level (CL) on the overestimation of small and underestimation of large probabilities for risk estimates concerning a vague target person (Study 1 and Study 3) and personal risk estimates (Study 2). We were specifically interested in whether the often-found overestimation of small probabilities could be reduced with abstract thinking, and the often-found underestimation of large probabilities was reduced with concrete thinking. The results showed that CL influenced risk estimates. In particular, a concrete mindset led to higher risk estimates compared to an abstract mindset for several adverse events, including events with small and large probabilities. This suggests that CL manipulation can indeed be used for improving the accuracy of lay people's estimates of small and large probabilities. Moreover, the results suggest that professional risk managers' risk estimates of common events (thus with a relatively high probability) could be improved by adopting a concrete mindset. However, the abstract manipulation did not lead managers to estimate extremely unlikely events more accurately. Potential reasons for different CL manipulation effects on risk estimates' accuracy between lay people and risk managers are discussed.

  12. Expanding scale, increasing risk: population as an environmental issue.

    PubMed

    Engelman, R

    1994-11-01

    Rather than blaming our environmental problems on population growth alone or on dramatic increases in per capita consumption and rather than making dire predictions about the collapse of resources such as food supplies, it should be recognized that population growth puts pressure on the carrying capacity of the planet simply by increasing human activity. The environmental indicators which cause concern about the future include the fact that productivity has been sapped in almost 11% of the earth's surface, that 15.4 million hectares of tropical rain forest disappeared each year during the 1980s, that 1.7 billion people lack access to adequate drinking water, that pollution has depleted the ozone shield and threatens global warming, and that each year 27,000 species become extinct. The deforestation of Easter Island, which occurred as population grew between the 5th or 6th century and 1500 A.D., is an example of an ecosystem destroyed by population growth. When events like this happened in the past, people either colonized other places or survived in smaller numbers. However, today the world is full, and successful migration depends upon the good will of the receiving community (which is usually in short supply). As humanity concentrates in urban areas, emerging diseases will continue to take their toll. Researchers are attempting to develop models and identify mechanisms to contribute to our understanding of the many indirect ways that population affects the environment. Complicating factors include the fact that wealthier nations have a disproportionate (to their population numbers) effect on the environment and the fact that some ecosystems or resource bases are more vulnerable than others. In the meantime, population momentum will assure that population will continue to grow at unprecedented rates before it stabilizes when fertility declines outpace mortality declines. This stabilization is necessary to halt and ultimately reverse environmental degradation. This

  13. Selenium deficiency risk predicted to increase under future climate change.

    PubMed

    Jones, Gerrad D; Droz, Boris; Greve, Peter; Gottschalk, Pia; Poffet, Deyan; McGrath, Steve P; Seneviratne, Sonia I; Smith, Pete; Winkel, Lenny H E

    2017-03-14

    Deficiencies of micronutrients, including essential trace elements, affect up to 3 billion people worldwide. The dietary availability of trace elements is determined largely by their soil concentrations. Until now, the mechanisms governing soil concentrations have been evaluated in small-scale studies, which identify soil physicochemical properties as governing variables. However, global concentrations of trace elements and the factors controlling their distributions are virtually unknown. We used 33,241 soil data points to model recent (1980-1999) global distributions of Selenium (Se), an essential trace element that is required for humans. Worldwide, up to one in seven people have been estimated to have low dietary Se intake. Contrary to small-scale studies, soil Se concentrations were dominated by climate-soil interactions. Using moderate climate-change scenarios for 2080-2099, we predicted that changes in climate and soil organic carbon content will lead to overall decreased soil Se concentrations, particularly in agricultural areas; these decreases could increase the prevalence of Se deficiency. The importance of climate-soil interactions to Se distributions suggests that other trace elements with similar retention mechanisms will be similarly affected by climate change.

  14. DNA immunization perturbs lipid metabolites and increases risk of atherogenesis.

    PubMed

    Yang, Fu; Yan, Shikai; Wang, Fang; He, Ying; Guo, Yingjun; Zhou, Qi; Wang, Yue; Zhang, Xiaoying; Zhang, Weidong; Sun, Shuhan

    2008-02-01

    In addition to conventional vaccination, DNA-mediated immunization has been developed as an alternative approach in the prevention and treatment of different infectious diseases, including hepatitis B. To define sets of serum protein and metabolite biomarkers that could be employed to determine the efficacy and safety of DNA vaccines, an integrated multiple systems biology approach was undertaken on mice immunized with DNA vaccine, recombinant protein, plasmid vector, and phosphate-buffered solution. Their sera were analyzed by two-dimensional electrophoresis and HPLC coupled with time-of-flight mass spectrometry. We detected an increase in phytosphingosine, dihydrosphingosine, palmitoylcarnitine, and ceramide in the sera of DNA-vaccinated mice. Several protein molecules were found to be altered in DNA-vaccinated mice, including apolipoprotein A-I precursor. Taken together, these results indicated that DNA vaccine stimulated hepatic sphingolipid synthesis, which may have altered the structure of circulating lipoproteins and promoted atherogenesis. This study also underscores the power of metabolomics and proteomics in the definition of DNA-vaccine-mediated metabolic phenotypes.

  15. Selenium deficiency risk predicted to increase under future climate change

    PubMed Central

    Jones, Gerrad D.; Droz, Boris; Greve, Peter; Gottschalk, Pia; Poffet, Deyan; McGrath, Steve P.; Seneviratne, Sonia I.; Smith, Pete; Winkel, Lenny H. E.

    2017-01-01

    Deficiencies of micronutrients, including essential trace elements, affect up to 3 billion people worldwide. The dietary availability of trace elements is determined largely by their soil concentrations. Until now, the mechanisms governing soil concentrations have been evaluated in small-scale studies, which identify soil physicochemical properties as governing variables. However, global concentrations of trace elements and the factors controlling their distributions are virtually unknown. We used 33,241 soil data points to model recent (1980–1999) global distributions of Selenium (Se), an essential trace element that is required for humans. Worldwide, up to one in seven people have been estimated to have low dietary Se intake. Contrary to small-scale studies, soil Se concentrations were dominated by climate–soil interactions. Using moderate climate-change scenarios for 2080–2099, we predicted that changes in climate and soil organic carbon content will lead to overall decreased soil Se concentrations, particularly in agricultural areas; these decreases could increase the prevalence of Se deficiency. The importance of climate–soil interactions to Se distributions suggests that other trace elements with similar retention mechanisms will be similarly affected by climate change. PMID:28223487

  16. Neural Vulnerability Factors that Increase Risk for Future Weight Gain

    PubMed Central

    Stice, Eric; Yokum, Sonja

    2015-01-01

    Theorists have proposed several neural vulnerability factors that may increase overeating and consequent weight gain. Early cross-sectional imaging studies could not determine whether aberrant neural responsivity was a precursor or consequence of overeating. However, recent prospective imaging studies examining predictors of future weight gain and response to obesity treatment, and repeated-measures imaging studies before and after weight gain and loss have advanced knowledge of etiologic processes and neural plasticity resulting from weight change. The present article reviews evidence from prospective studies using imaging and behavioral measures reflecting neural function, as well as randomized experiments with humans and animals that are consistent or inconsistent with five neural vulnerability theories for excessive weight gain. Extant data provide strong support for the incentive sensitization theory of obesity and moderate support for the reward surfeit theory, inhibitory control deficit theory, and dynamic vulnerability model of obesity, which attempted to synthesize the former theories into a single etiologic model. However, existing data provide only minimal support for the reward deficit theory. Findings are synthesized into a new working etiologic model that is based on current scientific knowledge. Important directions for future studies, which have the potential to support or refute this working etiologic model, are delineated. PMID:26854866

  17. Acidic beverages increase the risk of in vitro tooth erosion.

    PubMed

    Ehlen, Leslie A; Marshall, Teresa A; Qian, Fang; Wefel, James S; Warren, John J

    2008-05-01

    Acidic beverages are thought to increase the potential for dental erosion. We report pH and titratable acidities (ie, quantity of base required to bring a solution to neutral pH) of beverages popular in the United States and lesion depths in enamel and root surfaces after beverage exposure, and we describe associations among pH, titratable acidity, and both enamel and root erosive lesion depths. The pH of 100% juices, regular sodas, diet sodas, and sports drinks upon opening and the titratable acidity both upon opening and after 60 minutes of stirring were measured. Enamel and root surfaces of healthy permanent molars and premolars were exposed to individual beverages (4 enamel and 4 root surfaces per beverage) for 25 hours, and erosion was measured. Statistical analyses included 2-sample t tests, analyses of variance with post hoc Tukey studentized range test; and Spearman rank correlation coefficients. All beverages were acidic; the titratable acidity of energy drinks was greater than that of regular and diet sodas that were greater than that of 100% juices and sports drinks (P < .05). Enamel lesion depths after beverage exposures were greatest for Gatorade, followed by those for Red Bull and Coke that were greater than those for Diet Coke and 100% apple juice (P < .05). Root lesion depths were greatest for Gatorade, followed by Red Bull, Coke, 100% apple juice, and Diet Coke (P < .05). Lesion depths were not associated with pH or titratable acidity. Beverages popular in the United States can produce dental erosion.

  18. Increasing pesticide-resistant ectoparasitic infections may increase pesticide poisoning risks in children.

    PubMed

    Diaz, James H

    2008-01-01

    Head louse and scabies mite infestations are common among pre-school and school-age children, and topical pesticides are frequently prescribed to treat such conditions. Ectoparasite resistance to the safest and most commonly prescribed pyrethrin/pyrethroid pesticides for ectoparasitic infections has, however, been increasing since the 1980s. The increasing resistance of these arthropods to the safest pesticides may lead to greater use of more toxic, alternative pesticides to control infestations and to prevent institutional outbreaks. MEDLINE and Cochrane searches, 1966-2008, were conducted to assess the impact of increasing pesticide resistance on prescribing practices for ectoparasitic infections and to describe the evolving global epidemiology of pediatric poisonings by more toxic pediculicides and miticides, including carbamates, organochlorines, and organophosphates. Pharmacists, physicians, and poison control personnel should be fully informed about increasing pesticide resistance among the most commonly encountered ectoparasites of children and the institutionalized and be prepared to prevent and to treat accidental home and institutional pesticide poisonings with more toxic pesticides.

  19. Literature review on cancer risk in children born after fertility treatment suggests increased risk of haematological cancers.

    PubMed

    Reigstad, Marte M; Oldereid, Nan B; Omland, Anne K; Storeng, Ritsa

    2017-01-27

    Medically assisted fertility treatment, including assisted reproductive technology (ART), is increasingly being used and the subsequent child health outcomes are of interest. Some studies have suggested an elevated risk of somatic morbidity, while others have reported an elevated cancer risk. This review summarises the literature on fertility treatments and childhood cancer, based on 23 cohort and case-control studies.

  20. Potential increased risk of cancer from commonly used medications: an umbrella review of meta-analyses

    PubMed Central

    Ioannidis, J. P. A.; Zhou, Y.; Chang, C. Q.; Schully, S. D.; Khoury, M. J.; Freedman, A. N.

    2014-01-01

    Several commonly used medications have been associated with increased cancer risk in the literature. Here, we evaluated the strength and consistency of these claims in published meta-analyses. We carried out an umbrella review of 74 meta-analysis articles addressing the association of commonly used medications (antidiabetics, antihyperlipidemics, antihypertensives, antirheumatics, drugs for osteoporosis, and others) with cancer risk where at least one meta-analysis in the medication class included some data from randomized trials. Overall, 51 articles found no statistically significant differences, 13 found some decreased cancer risk, and 11 found some increased risk (one reported both increased and decreased risks). The 11 meta-analyses that found some increased risks reported 16 increased risk estimates, of which 5 pertained to overall cancer and 11 to site-specific cancer. Six of the 16 estimates were derived from randomized trials and 10 from observational data. Estimates of increased risk were strongly inversely correlated with the amount of evidence (number of cancer cases) (Spearman's correlation coefficient = −0.77, P < 0.001). In 4 of the 16 topics, another meta-analysis existed that was larger (n = 2) or included better controlled data (n = 2) and in all 4 cases there was no statistically significantly increased risk of malignancy. No medication or class had substantial and consistent evidence for increased risk of malignancy. However, for most medications we cannot exclude small risks or risks in population subsets. Such risks are unlikely to be possible to document robustly unless very large, collaborative studies with standardized analyses and no selective reporting are carried out. PMID:24310915

  1. Understanding children's injury-risk behavior: wearing safety gear can lead to increased risk taking.

    PubMed

    Morrongiello, Barbara A; Walpole, Beverly; Lasenby, Jennifer

    2007-05-01

    The present study examined whether school-age children show risk compensation and engage in greater risk taking when wearing safety gear compared to when not doing so when running an obstacle course containing hazards that could lead to physical injury. Because sensation seeking has been shown to influence risk taking, this child attribute was also assessed and related to risk compensation. Children 7-12 years of age were videotaped navigating the obstacle course twice, once wearing safety gear and once without safety gear, with reverse directions used to minimize possible practice effects. The time it took the child to run through the course and the number of reckless behaviors (e.g., falls, trips, bumping into things) that the child made while running the course were compared for the gear and no-gear conditions. Results indicated that children went more quickly and behaved more recklessly when wearing safety gear than when not wearing gear, providing evidence of risk compensation. Moreover, those high in sensation seeking showed greater risk compensation compared with other children. Implications for childhood injury prevention are discussed.

  2. Knowledge and accuracy of perceived personal risk in underserved women who are at increased risk of breast cancer.

    PubMed

    Cyrus-David, Mfon S

    2010-12-01

    The state of knowledge and personal risk perception among women who are underserved or racial minorities at increased risk of breast cancer (BC) who may be eligible for chemoprevention is limited. The BC knowledge and accuracy of perceived personal risk of a cross-sectional study population of such women residing in the greater Houston Texas area were assessed. The majority had below average knowledge scores and perceived risk inaccurately. The lesser educated were also less knowledgeable. Educational interventions targeted towards this population would enhance their knowledge of BC and empower them to make informed decisions about BC chemoprevention.

  3. Rapid weather changes are associated with increased ischemic stroke risk: a case-crossover study.

    PubMed

    Rakers, Florian; Schiffner, Rene; Rupprecht, Sven; Brandstädt, Antje; Witte, Otto W; Walther, Mario; Schlattmann, Peter; Schwab, Matthias

    2016-02-01

    Observational studies focusing on absolute meteorological values suggest an association between meteorological parameters and stroke risk but these results are inconsistent and conflicting. Since changes in weather can provoke atrial fibrillation, we examined the association between rapid weather changes and stroke risk in 1694 patients with determinable onset of stroke symptoms in a case-crossover study in central Germany. Days one to three before stroke onset were classified as hazard periods and day seven as the respective control period. Risk of ischemic stroke in relation to 24 h differences in mean ambient temperature, relative humidity and atmospheric pressure was determined. The association between temperature and stroke risk appears to be close to linear with an increase in stroke risk of 11 % (odds ratio 1.11, 95 % confidence interval 1.01-1.22) for each 2.9 °C temperature decrease over 24 h. In individuals with a higher cardiovascular risk, stroke risk increased by 30 % (1.30, 1.06-1.61). Risk for cardioembolic strokes increased by 26 % (1.26, 1.06-1.50). Rapid positive or negative changes in relative humidity (>5 %) and atmospheric pressure (>10 hPa) increased stroke risk by a maximum of 30 % (1.30, 1.02-1.66) and 63 % (1.63, 1.10-2.42). In individuals with a higher cardiovascular risk, rapid changes in atmospheric pressure were associated with a four-times higher stroke risk (4.56, 1.26-16.43). Our results suggest that rapid decreases in ambient temperature and rapid changes in relative humidity and atmospheric pressure increase stroke risk under temperate climate conditions. Individuals with a high cardiovascular risk profile seem to be at greater risk.

  4. Breast cancer patients with dense breasts do not have increased death risk

    Cancer.gov

    High mammographic breast density, which is a marker of increased risk of developing breast cancer, does not seem to increase the risk of death among breast cancer patients, according to a study led by Gretchen L. Gierach, Ph.D., NCI. Image shows physician

  5. Do statins increase and Mediterranean diet decrease the risk of breast cancer?

    PubMed Central

    2014-01-01

    Background Physical exercise and healthy dietary habits are recommended to prevent breast cancer. Discussion Increased intake of omega-3 fatty acids associated with decreased omega-6 - resulting in higher omega-3 to omega-6 ratio compared with Western-type diet - is inversely associated with breast cancer risk. The modernized Mediterranean diet with high omega-3 to omega-6 ratio, high fiber and polyphenol intake, and consumption of low-glycemic index foods reduces overall cancer risk and specifically breast cancer risk. It has been suggested that consuming no more than one alcoholic drink per day, preferably wine, is preferable. Eliminating environmental contaminants, including endocrine disruptors, and favoring organic foods to increase polyphenol intake and the omega-3 to omega-6 ratios were also shown to be beneficial. Cholesterol-lowering statins may decrease antitumor defenses; are toxic for the mitochondria; decrease the omega-3 to omega-6 ratio; increase body mass index, insulin resistance and diabetic risk; and have been associated with an increased breast cancer risk. Summary Therefore, as well as making lifestyle changes to decrease breast cancer risk, we argue that physicians should carefully consider (and often avoid) therapies that may increase breast cancer or diabetes risk in high-risk women and women who wish to decrease their breast cancer risk. PMID:24903828

  6. Do Parent–Adolescent Discrepancies in Family Functioning Increase the Risk of Hispanic Adolescent HIV Risk Behaviors?

    PubMed Central

    CORDOVA, DAVID; HUANG, SHI; LALLY, MEGHAN; ESTRADA, YANNINE; PRADO, GUILLERMO

    2014-01-01

    In the family-based prevention science literature, family functioning, defined as positive parenting, parental involvement, family cohesion, family communication, parental monitoring of peers, and parent–adolescent communication, has been shown to ameliorate HIV risk behaviors in Hispanic youth. However, the majority of studies have relied solely on parent or adolescent reports and we know very little about parent–adolescent family functioning discrepancies. Therefore, the purpose of this study was to examine whether and to what extent parent–adolescent discrepancies in family functioning increased the risk of HIV risk behaviors, including substance use and sexual risk behaviors, and whether these associations vary as a function of acculturation and youth gender. A total of 746 Hispanic 8th grade youth and their primary caregivers were included in the study. Structural equation modeling findings indicate that parent–adolescent family functioning discrepancies are associated with an increased risk of Hispanic adolescent HIV risk behaviors, including lifetime and past 90-day alcohol and illicit drug use, and early sex initiation. In addition, study findings indicate that results vary by acculturation and youth gender. Findings are discussed in the context of existing family-based research and practice in preventing and reducing HIV risk behaviors among Hispanic youth and their families. PMID:24617745

  7. Increased peripheral vascular disease risk progressively constrains perfusion adaptability in the skeletal muscle microcirculation.

    PubMed

    Frisbee, Jefferson C; Butcher, Joshua T; Frisbee, Stephanie J; Olfert, I Mark; Chantler, Paul D; Tabone, Lawrence E; d'Audiffret, Alexandre C; Shrader, Carl D; Goodwill, Adam G; Stapleton, Phoebe A; Brooks, Steven D; Brock, Robert W; Lombard, Julian H

    2016-02-15

    To determine the impact of progressive elevations in peripheral vascular disease (PVD) risk on microvascular function, we utilized eight rat models spanning "healthy" to "high PVD risk" and used a multiscale approach to interrogate microvascular function and outcomes: healthy: Sprague-Dawley rats (SDR) and lean Zucker rats (LZR); mild risk: SDR on high-salt diet (HSD) and SDR on high-fructose diet (HFD); moderate risk: reduced renal mass-hypertensive rats (RRM) and spontaneously hypertensive rats (SHR); high risk: obese Zucker rats (OZR) and Dahl salt-sensitive rats (DSS). Vascular reactivity and biochemical analyses demonstrated that even mild elevations in PVD risk severely attenuated nitric oxide (NO) bioavailability and caused progressive shifts in arachidonic acid metabolism, increasing thromboxane A2 levels. With the introduction of hypertension, arteriolar myogenic activation and adrenergic constriction were increased. However, while functional hyperemia and fatigue resistance of in situ skeletal muscle were not impacted with mild or moderate PVD risk, blood oxygen handling suggested an increasingly heterogeneous perfusion within resting and contracting skeletal muscle. Analysis of in situ networks demonstrated an increasingly stable and heterogeneous distribution of perfusion at arteriolar bifurcations with elevated PVD risk, a phenomenon that was manifested first in the distal microcirculation and evolved proximally with increasing risk. The increased perfusion distribution heterogeneity and loss of flexibility throughout the microvascular network, the result of the combined effects on NO bioavailability, arachidonic acid metabolism, myogenic activation, and adrenergic constriction, may represent the most accurate predictor of the skeletal muscle microvasculopathy and poor health outcomes associated with chronic elevations in PVD risk.

  8. Peers Increase Adolescent Risk Taking by Enhancing Activity in the Brain's Reward Circuitry

    ERIC Educational Resources Information Center

    Chein, Jason; Albert, Dustin; O'Brien, Lia; Uckert, Kaitlyn; Steinberg, Laurence

    2011-01-01

    The presence of peers increases risk taking among adolescents but not adults. We posited that the presence of peers may promote adolescent risk taking by sensitizing brain regions associated with the anticipation of potential rewards. Using fMRI, we measured brain activity in adolescents, young adults, and adults as they made decisions in a…

  9. Ethnic Differences in Knowledge and Attitudes about BRCA1 Testing in Women at Increased Risk.

    ERIC Educational Resources Information Center

    Hughes, Chanita; Gomez-Caminero, Andres; Benkendorf, Judith; Kerner, Jon; Isaacs, Claudine; Barter, James; Lerman, Caryn

    1997-01-01

    Knowledge about the inheritance of breast cancer and attitudes about genetic testing for breast-ovarian cancer susceptibility in women at increased risk were studied in Caucasian and African-American women (N=407). Participants had at least one first-degree relative with cancer. Differences in knowledge and attitudes toward risk may be attributed…

  10. Genetic predisposition to higher blood pressure increases risk of incident hypertension and cardiovascular diseases in Chinese.

    PubMed

    Lu, Xiangfeng; Huang, Jianfeng; Wang, Laiyuan; Chen, Shufeng; Yang, Xueli; Li, Jianxin; Cao, Jie; Chen, Jichun; Li, Ying; Zhao, Liancheng; Li, Hongfan; Liu, Fangcao; Huang, Chen; Shen, Chong; Shen, Jinjin; Yu, Ling; Xu, Lihua; Mu, Jianjun; Wu, Xianping; Ji, Xu; Guo, Dongshuang; Zhou, Zhengyuan; Yang, Zili; Wang, Renping; Yang, Jun; Yan, Weili; Gu, Dongfeng

    2015-10-01

    Although multiple genetic markers associated with blood pressure have been identified by genome-wide association studies, their aggregate effect on risk of incident hypertension and cardiovascular disease is uncertain, particularly among East Asian who may have different genetic and environmental exposures from Europeans. We aimed to examine the association between genetic predisposition to higher blood pressure and risk of incident hypertension and cardiovascular disease in 26 262 individuals in 2 Chinese population-based prospective cohorts. A genetic risk score was calculated based on 22 established variants for blood pressure in East Asian. We found the genetic risk score was significantly and independently associated with linear increases in blood pressure and risk of incident hypertension and cardiovascular disease (P range from 4.57×10(-3) to 3.10×10(-6)). In analyses adjusted for traditional risk factors including blood pressure, individuals carrying most blood pressure-related risk alleles (top quintile of genetic score distribution) had 40% (95% confidence interval, 18-66) and 26% (6-45) increased risk for incident hypertension and cardiovascular disease, respectively, when compared with individuals in the bottom quintile. The genetic risk score also significantly improved discrimination for incident hypertension and cardiovascular disease and led to modest improvements in risk reclassification for cardiovascular disease (all the P<0.05). Our data indicate that genetic predisposition to higher blood pressure is an independent risk factor for blood pressure increase and incident hypertension and cardiovascular disease and provides modest incremental information to cardiovascular disease risk prediction. The potential clinical use of this panel of blood pressure-associated polymorphisms remains to be determined.

  11. Smoking and increased Alzheimer’s disease risk: A review of potential mechanisms

    PubMed Central

    Durazzo, Timothy C.; Mattsson, Niklas; Weiner, Michael W.

    2014-01-01

    Background Cigarette smoking has been linked with both increased and decreased risk for Alzheimer’s disease (AD). This is relevant for the US military because the prevalence of smoking in the military is approximately 11% higher than in civilians. Methods Systematic review of published studies on the association between smoking and increased risk for AD, and preclinical and human literature on the relationships between smoking, nicotine exposure and AD-related neuropathology. Original data from comparisons of smoking and never-smoking cognitively normal elders on in vivo amyloid imaging are also presented. Results Overall, the literature indicates that former/active smoking is related to a significantly increased risk for AD. Cigarette smoke/smoking is associated with AD neuropathology in preclinical models and humans. Smoking-related cerebral oxidative stress is a potential mechanism promoting AD pathophysiology and increased risk for AD. Conclusions A reduction in the incidence of smoking will likely reduce the future prevalence of AD. PMID:24924665

  12. Are antiepileptic drugs used in the treatment of migraine associated with an increased risk of suicidality?

    PubMed

    Kanner, Andres M

    2011-06-01

    Three antiepileptic drugs (AEDs), valproic acid, gabapentin, and topiramate (TPM), are used frequently in the prophylactic treatment of migraines. In December 2008, the US Food and Drug Administration issued a warning suggesting that the use of all AEDs is associated with an increased risk of suicidal ideation and behavior. This warning has been received by the medical community with great skepticism, and the validity of the findings of the meta-analysis that led to its publication has been questioned because of various methodological problems. Yet, migraine by itself is associated with an increased risk of suicidal ideation and behavior as well as with an increased risk of psychiatric disorders that facilitate the development of suicidal behavior. Furthermore, TPM has been associated with psychiatric adverse events that potentially could result in suicidal ideation and behavior. In this article, we review data to determine whether the AEDs used in the prevention of migraine are associated with an increased risk of suicidality.

  13. Newly Diagnosed Anemia Increases Risk of Parkinson's disease: A Population-Based Cohort Study.

    PubMed

    Hong, Chien Tai; Huang, Yao Hsien; Liu, Hung Yi; Chiou, Hung-Yi; Chan, Lung; Chien, Li-Nien

    2016-07-14

    Anemia and low hemoglobin have been identified to increase Parkinson's disease (PD) risk. This population-based cohort study investigated PD risk in newly diagnosed anemic patients by using data from the Taiwan National Health Insurance Research Database. All newly diagnosed anemic patients (n = 86,334) without a history of stroke, neurodegenerative diseases, traumatic brain injury, major operations, or blood loss diseases were enrolled. A cohort of nonanemic controls, 1:1 matched with anemic patients on the basis of the demographics and pre-existing medical conditions, was also included. Competing risk analysis was used to evaluate PD risk in anemic patients compared with that in their matched controls. The adjusted hazard ratio (aHR) of PD risk in the anemic patients was 1.36 (95% confidence interval [CI]: 1.22-1.52, p < 0.001). Iron deficiency anemia (IDA) patients tended to exhibit a higher PD risk (aHR: 1.49; 95% CI: 1.24-1.79, p < 0.001). Furthermore, Iron supplement did not significantly affect the PD risk: the aHRs for PD risk were 1.32 (95% CI: 1.07-1.63, p < 0.01) and 1.86 (95% CI: 1.46-2.35, p < 0.001) in IDA patients with and without iron supplementation, respectively. The population-based cohort study indicated newly diagnosed anemia increases PD risk.

  14. Why are kids with lupus at an increased risk of cardiovascular disease?

    PubMed

    Quinlan, Catherine; Marks, Stephen D; Tullus, Kjell

    2016-06-01

    Juvenile-onset systemic lupus erythematosus (SLE) is an aggressive multisystem autoimmune disease. Despite improvements in outcomes for adult patients, children with SLE continue to have a lower life expectancy than adults with SLE, with more aggressive disease, a higher incidence of lupus nephritis and there is an emerging awareness of their increased risk of cardiovascular disease (CVD). In this review, we discuss the evidence for an increased risk of CVD in SLE, its pathogenesis, and the clinical approach to its management.

  15. Increased peripheral vascular disease risk progressively constrains perfusion adaptability in the skeletal muscle microcirculation

    PubMed Central

    Butcher, Joshua T.; Frisbee, Stephanie J.; Olfert, I. Mark; Chantler, Paul D.; Tabone, Lawrence E.; d'Audiffret, Alexandre C.; Shrader, Carl D.; Goodwill, Adam G.; Stapleton, Phoebe A.; Brooks, Steven D.; Brock, Robert W.; Lombard, Julian H.

    2015-01-01

    To determine the impact of progressive elevations in peripheral vascular disease (PVD) risk on microvascular function, we utilized eight rat models spanning “healthy” to “high PVD risk” and used a multiscale approach to interrogate microvascular function and outcomes: healthy: Sprague-Dawley rats (SDR) and lean Zucker rats (LZR); mild risk: SDR on high-salt diet (HSD) and SDR on high-fructose diet (HFD); moderate risk: reduced renal mass-hypertensive rats (RRM) and spontaneously hypertensive rats (SHR); high risk: obese Zucker rats (OZR) and Dahl salt-sensitive rats (DSS). Vascular reactivity and biochemical analyses demonstrated that even mild elevations in PVD risk severely attenuated nitric oxide (NO) bioavailability and caused progressive shifts in arachidonic acid metabolism, increasing thromboxane A2 levels. With the introduction of hypertension, arteriolar myogenic activation and adrenergic constriction were increased. However, while functional hyperemia and fatigue resistance of in situ skeletal muscle were not impacted with mild or moderate PVD risk, blood oxygen handling suggested an increasingly heterogeneous perfusion within resting and contracting skeletal muscle. Analysis of in situ networks demonstrated an increasingly stable and heterogeneous distribution of perfusion at arteriolar bifurcations with elevated PVD risk, a phenomenon that was manifested first in the distal microcirculation and evolved proximally with increasing risk. The increased perfusion distribution heterogeneity and loss of flexibility throughout the microvascular network, the result of the combined effects on NO bioavailability, arachidonic acid metabolism, myogenic activation, and adrenergic constriction, may represent the most accurate predictor of the skeletal muscle microvasculopathy and poor health outcomes associated with chronic elevations in PVD risk. PMID:26702145

  16. Interactions between physical and psychosocial risk factors at work increase the risk of back disorders: an epidemiological approach

    PubMed Central

    Devereux, J. J.; Buckle, P. W.; Vlachonikolis, I. G.

    1999-01-01

    OBJECTIVES: To investigate the possible interactions between physical and psychosocial risk factors at work that may be associated with self reported back disorders. METHODS: 891 of 1514 manual workers, delivery drivers, technicians, customer services computer operators, and general office staff reported risk factors at work and back disorders with a self administered questionnaire (59% return rate). Of the 869 respondents with a valid questionnaire, 638 workers were classified in to one of four exposure groups: high physical and high psychosocial; high physical and low psychosocial; low physical and high psychosocial; and low physical and low psychosocial. Low physical and low psychosocial was used as an internal reference group. The exposure criteria were derived from existing epidemiological publications and models for physical and psychosocial work factors. The frequency and amplitude of lifting and the duration spent sitting while experiencing vibration were used as physical exposure criteria. Ordinal values of mental demands, job control, and social support from managers and coworkers were used as psychosocial exposure criteria. RESULTS: The highest increase in risk was found in the high physical and high psychosocial exposure group for symptoms of back disorders. In the crude and multivariate analyses, a departure from an additive risk model was found for the 7 day prevalence of symptoms of a low back disorder and also for a recurrent back disorder not present before the current job but also experienced in the past 7 days. CONCLUSION: This study suggests that an interaction between physical and psychosocial risk factors at work may exist to increase the risk of self reported back disorders. Ergonomic prevention strategies that aim to minimise the risks of symptoms of work related back disorders should not only focus on physical but also on psychosocial risk factors at work. The greatest benefits are likely to be realised when both physical and psychosocial

  17. [New populations at increased cardiovascular risk: Cardiovascular disease in dermatological diseases].

    PubMed

    Godoy-Gijón, Elena; Meseguer-Yebra, Carmen; Palacio-Aller, Lucía; Godoy-Rocati, Diego Vicente; Lahoz-Rallo, Carlos

    2016-01-01

    The increased cardiovascular risk in some dermatological diseases has been demonstrated in recent decades. Diseases such as psoriasis and systemic lupus erythematosus are currently included in the guidelines for prevention of cardiovascular disease. Other diseases such as androgenic alopecia, polycystic ovary syndrome, hidradenitis suppurativa or lichen planus have numerous studies that point to an increased risk, however, they have not been included in these guidelines. In this article we review the evidence supporting this association, in order to alert the clinician to the need for greater control in cardiovascular risk factors in these patients.

  18. Quantification of increased flood risk due to global climate change for urban river management planning.

    PubMed

    Morita, M

    2011-01-01

    Global climate change is expected to affect future rainfall patterns. These changes should be taken into account when assessing future flooding risks. This study presents a method for quantifying the increase in flood risk caused by global climate change for use in urban flood risk management. Flood risk in this context is defined as the product of flood damage potential and the probability of its occurrence. The study uses a geographic information system-based flood damage prediction model to calculate the flood damage caused by design storms with different return periods. Estimation of the monetary damages these storms produce and their return periods are precursors to flood risk calculations. The design storms are developed from modified intensity-duration-frequency relationships generated by simulations of global climate change scenarios (e.g. CGCM2A2). The risk assessment method is applied to the Kanda River basin in Tokyo, Japan. The assessment provides insights not only into the flood risk cost increase due to global warming, and the impact that increase may have on flood control infrastructure planning.

  19. Maternal smoking and increased risk of sudden infant death syndrome: a meta-analysis.

    PubMed

    Zhang, Kui; Wang, Xianmin

    2013-05-01

    Maternal smoking is detrimental to the development of fetuses and neonates. This meta-analysis was performed to measure the accumulated association of sudden infant death syndrome (SIDS) risk with both prenatal and postnatal maternal smoking. The odds ratio (OR) corresponding to the 95% confidence interval (CI) was used to assess the associations between maternal smoking and SIDS risk. The statistical heterogeneity among studies was assessed with the Q-test and I(2) statistics. The data for this meta-analysis were available from 35 case-control studies. The prenatal and postnatal maternal smoking was associated with a significantly increased risk of SIDS (OR=2.25, 95% CI=2.03-2.50 for prenatal maternal smoking analysis, and OR=1.97, 95% CI=1.77-2.19 for postnatal maternal smoking analysis, respectively) by random effects model. After stratified analyses, regardless of prenatal or postnatal smoking, heavy cigarette consumption increased the risk of SIDS and significantly elevated SIDS risk was found to be associated with co-sleeping with postnatal smoking mothers. Our results suggested that maternal smoking were associated with elevated SIDS risk, the effects were dose-dependent. In addition, SIDS risk was significantly increased in infants co-sleeping with postnatal smoking mothers.

  20. Development of a Fire Risk Model to Identify Areas of Increased Potential for Fire Occurrences.

    PubMed

    Lehna, Carlee; Speller, Amanda; Hanchette, Carol; Fahey, Erin; Coty, Mary-Beth

    2016-01-01

    The purposes of this study were to use geographic information systems to create a cartographic risk model predicting areas of increased potential for fire occurrences and to validate the model. Seven literature-identified risk factors associated with burn injury were older than 65 years, non-white race, below high school education, low socioeconomic status, rented housing, year home built, and home value. Geographic information system methods were used in risk factor model development. Model validation occurred using residential county fire dispatch data and statistical analysis. Areas of high and severe risk were primarily located in the northwestern and central county regions. A strong correlation (r = .66) was found between risk model scores and fire incidence rates. Significant differences in mean fire rates by risk category (F (187,3) = 87.58, P < .0001) were found, with the exception of the low and medium risk categories. Fire incidence rates among census tracts showed positive spatial autocorrelation (Moran's I = 0.542, P < .0001) producing a map showing a significant cluster of high fire incidence in the northwestern region. The risk model has potential to lead to more targeted and effective fire prevention education programs. Such models would allow fire departments to focus limited resources in areas of highest fire risk.

  1. Normal breast physiology: the reasons hormonal contraceptives and induced abortion increase breast-cancer risk.

    PubMed

    Lanfranchi, Angela

    2014-01-01

    A woman gains protection from breast cancer by completing a full-term pregnancy. In utero, her offspring produce hormones that mature 85 percent of the mother's breast tissue into cancer-resistant breast tissue. If the pregnancy ends through an induced abortion or a premature birth before thirty-two weeks, the mother's breasts will have only partially matured, retaining even more cancer-susceptible breast tissue than when the pregnancy began. This increased amount of immature breast tissue will leave the mother with more sites for cancer initiation, thereby increasing her risk of breast cancer. Hormonal contraceptives increase breast-cancer risk by their proliferative effect on breast tissue and their direct carcinogenic effects on DNA. Hormonal contraceptives include estrogen-progestin combination drugs prescribed in any manner of delivery: orally, transdermally, vaginally, or intrauterine. This article provides the detailed physiology and data that elucidate the mechanisms through which induced abortion and hormonal contraceptives increase breast-cancer risk.

  2. Does Potassium Citrate Medical Therapy Increase the Risk of Calcium Phosphate Stone Formation?

    NASA Astrophysics Data System (ADS)

    Leitao, Victor; Haleblian, George E.; Robinson, Marnie R.; Pierre, Sean A.; Sur, Roger L.; Preminger, Glenn M.

    2007-04-01

    Potassium citrate has been extensively used in the treatment of recurrent nephrolithiasis. Recent evidence suggests that it may contribute to increasing urinary pH and, as such, increase the risk of calcium phosphate stone formation. We performed a retrospective review of our patients to further investigate this phenomenon.

  3. Strategic responses by hospitals to increased financial risk in the 1980s.

    PubMed Central

    Friedman, B.; Farley, D.

    1995-01-01

    OBJECTIVE. This research addresses the following types of responses by hospitals to increased financial risk: (a) increases in prices to privately insured patients (testing separately the effects of risk from the effects of "cost-shifting" that depends on level of Medicare payment in relation to case mix-adjusted cost); (b) changes in service mix offered and selectivity in acceptance of patients to reduce risk; and (c) efforts to reduce variation in resource use for those patients admitted. DATA SOURCES. The database includes a national panel of over 400 hospitals providing information from patient discharge abstracts, hospital financial reports, and county level information over the period 1980-1987. STUDY DESIGN. Econometric methods suitable to panel data are implemented, with tests for pooling, hospital-specific fixed effects, and possible problems of selection bias. PRINCIPAL FINDINGS. The prices paid by private insurers to a particular hospital were affected by the changes in risk imposed by Medicare prospective payment, the generosity of Medicare payment, state rate regulation, and ability of the hospital to bear risk. The risk-weighted measure of case mix did not respond to changes in payment policy, but other variables reflecting the management of care after admission to reduce risk did change in the predicted directions. CONCLUSIONS. Some of the findings in this article are relevant to current Medicare policies that involve risk-sharing, for instance, special allowances for "outlier" patients with unusually high cost, and for sole community hospitals. The first type of allowance appears successful in preserving access to care, while the second type is not well justified by the findings. State rate regulation programs were associated not only with lower hospital prices but also with less risk reduction behavior by hospitals. The design of regulation as a sort of risk-pooling arrangement across payers and hospitals may be attractive to hospitals and help

  4. The racing-game effect: why do video racing games increase risk-taking inclinations?

    PubMed

    Fischer, Peter; Greitemeyer, Tobias; Morton, Thomas; Kastenmüller, Andreas; Postmes, Tom; Frey, Dieter; Kubitzki, Jörg; Odenwälder, Jörg

    2009-10-01

    The present studies investigated why video racing games increase players' risk-taking inclinations. Four studies reveal that playing video racing games increases risk taking in a subsequent simulated road traffic situation, as well as risk-promoting cognitions and emotions, blood pressure, sensation seeking, and attitudes toward reckless driving. Study 1 ruled out the role of experimental demand in creating such effects. Studies 2 and 3 showed that the effect of playing video racing games on risk taking was partially mediated by changes in self-perceptions as a reckless driver. These effects were evident only when the individual played racing games that reward traffic violations rather than racing games that do not reward traffic violations (Study 3) and when the individual was an active player of such games rather than a passive observer (Study 4). In sum, the results underline the potential negative impact of racing games on traffic safety.

  5. Genetically predicted longer telomere length is associated with increased risk of B-cell lymphoma subtypes.

    PubMed

    Machiela, Mitchell J; Lan, Qing; Slager, Susan L; Vermeulen, Roel C H; Teras, Lauren R; Camp, Nicola J; Cerhan, James R; Spinelli, John J; Wang, Sophia S; Nieters, Alexandra; Vijai, Joseph; Yeager, Meredith; Wang, Zhaoming; Ghesquières, Hervé; McKay, James; Conde, Lucia; de Bakker, Paul I W; Cox, David G; Burdett, Laurie; Monnereau, Alain; Flowers, Christopher R; De Roos, Anneclaire J; Brooks-Wilson, Angela R; Giles, Graham G; Melbye, Mads; Gu, Jian; Jackson, Rebecca D; Kane, Eleanor; Purdue, Mark P; Vajdic, Claire M; Albanes, Demetrius; Kelly, Rachel S; Zucca, Mariagrazia; Bertrand, Kimberly A; Zeleniuch-Jacquotte, Anne; Lawrence, Charles; Hutchinson, Amy; Zhi, Degui; Habermann, Thomas M; Link, Brian K; Novak, Anne J; Dogan, Ahmet; Asmann, Yan W; Liebow, Mark; Thompson, Carrie A; Ansell, Stephen M; Witzig, Thomas E; Tilly, Hervé; Haioun, Corinne; Molina, Thierry J; Hjalgrim, Henrik; Glimelius, Bengt; Adami, Hans-Olov; Roos, Göran; Bracci, Paige M; Riby, Jacques; Smith, Martyn T; Holly, Elizabeth A; Cozen, Wendy; Hartge, Patricia; Morton, Lindsay M; Severson, Richard K; Tinker, Lesley F; North, Kari E; Becker, Nikolaus; Benavente, Yolanda; Boffetta, Paolo; Brennan, Paul; Foretova, Lenka; Maynadie, Marc; Staines, Anthony; Lightfoot, Tracy; Crouch, Simon; Smith, Alex; Roman, Eve; Diver, W Ryan; Offit, Kenneth; Zelenetz, Andrew; Klein, Robert J; Villano, Danylo J; Zheng, Tongzhang; Zhang, Yawei; Holford, Theodore R; Turner, Jenny; Southey, Melissa C; Clavel, Jacqueline; Virtamo, Jarmo; Weinstein, Stephanie; Riboli, Elio; Vineis, Paolo; Kaaks, Rudolph; Boeing, Heiner; Tjønneland, Anne; Angelucci, Emanuele; Di Lollo, Simonetta; Rais, Marco; De Vivo, Immaculata; Giovannucci, Edward; Kraft, Peter; Huang, Jinyan; Ma, Baoshan; Ye, Yuanqing; Chiu, Brian C H; Liang, Liming; Park, Ju-Hyun; Chung, Charles C; Weisenburger, Dennis D; Fraumeni, Joseph F; Salles, Gilles; Glenn, Martha; Cannon-Albright, Lisa; Curtin, Karen; Wu, Xifeng; Smedby, Karin E; de Sanjose, Silvia; Skibola, Christine F; Berndt, Sonja I; Birmann, Brenda M; Chanock, Stephen J; Rothman, Nathaniel

    2016-04-15

    Evidence from a small number of studies suggests that longer telomere length measured in peripheral leukocytes is associated with an increased risk of non-Hodgkin lymphoma (NHL). However, these studies may be biased by reverse causation, confounded by unmeasured environmental exposures and might miss time points for which prospective telomere measurement would best reveal a relationship between telomere length and NHL risk. We performed an analysis of genetically inferred telomere length and NHL risk in a study of 10 102 NHL cases of the four most common B-cell histologic types and 9562 controls using a genetic risk score (GRS) comprising nine telomere length-associated single-nucleotide polymorphisms. This approach uses existing genotype data and estimates telomere length by weighing the number of telomere length-associated variant alleles an individual carries with the published change in kb of telomere length. The analysis of the telomere length GRS resulted in an association between longer telomere length and increased NHL risk [four B-cell histologic types combined; odds ratio (OR) = 1.49, 95% CI 1.22-1.82,P-value = 8.5 × 10(-5)]. Subtype-specific analyses indicated that chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) was the principal NHL subtype contributing to this association (OR = 2.60, 95% CI 1.93-3.51,P-value = 4.0 × 10(-10)). Significant interactions were observed across strata of sex for CLL/SLL and marginal zone lymphoma subtypes as well as age for the follicular lymphoma subtype. Our results indicate that a genetic background that favors longer telomere length may increase NHL risk, particularly risk of CLL/SLL, and are consistent with earlier studies relating longer telomere length with increased NHL risk.

  6. Metabolic syndrome is associated with increased breast cancer risk: a systematic review with meta-analysis.

    PubMed

    Bhandari, Ruchi; Kelley, George A; Hartley, Tara A; Rockett, Ian R H

    2014-01-01

    Background. Although individual metabolic risk factors are reported to be associated with breast cancer risk, controversy surrounds risk of breast cancer from metabolic syndrome (MS). We report the first systematic review and meta-analysis of the association between MS and breast cancer risk in all adult females. Methods. Studies were retrieved by searching four electronic reference databases [PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and ProQuest through June 30, 2012] and cross-referencing retrieved articles. Eligible for inclusion were longitudinal studies reporting associations between MS and breast cancer risk among females aged 18 years and older. Relative risks and 95% confidence intervals were calculated for each study and pooled using random-effects models. Publication bias was assessed quantitatively (Trim and Fill) and qualitatively (funnel plots). Heterogeneity was examined using Q and I (2) statistics. Results. Representing nine independent cohorts and 97,277 adult females, eight studies met the inclusion criteria. A modest, positive association was observed between MS and breast cancer risk (RR: 1.47, 95% CI, 1.15-1.87; z = 3.13; p = 0.002; Q = 26.28, p = 0.001; I (2) = 69.55%). No publication bias was observed. Conclusions. MS is associated with increased breast cancer risk in adult women.

  7. Risk perception, risk management and safety assessment: what can governments do to increase public confidence in their vaccine system?

    PubMed

    MacDonald, Noni E; Smith, Jennifer; Appleton, Mary

    2012-09-01

    For decades vaccine program managers and governments have devoted many resources to addressing public vaccine concerns, vaccine risk perception, risk management and safety assessment. Despite ever growing evidence that vaccines are safe and effective, public concerns continue. Education and evidence based scientific messages have not ended concerns. How can governments and programs more effectively address the public's vaccine concerns and increase confidence in the vaccine safety system? Vaccination hesitation has been attributed to concerns about vaccine safety, perceptions of high vaccine risks and low disease risk and consequences. Even when the public believes vaccines are important for protection many still have concerns about vaccine safety. This overview explores how heuristics affect public perception of vaccines and vaccine safety, how the public finds and uses vaccine information, and then proposes strategies for changes in the approach to vaccine safety communications. Facts and evidence confirming the safety of vaccines are not enough. Vaccine beliefs and behaviours must be shaped. This will require a shift in the what, when, how and why of vaccine risk and benefit communication content and practice. A change to a behavioural change strategy such as the WHO COMBI program that has been applied to disease eradication efforts is suggested.

  8. The relationship between pediatric nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children.

    PubMed

    Gökçe, Selim; Atbinici, Zehra; Aycan, Zehra; Cınar, Hasibe Gökçe; Zorlu, Pelin

    2013-02-01

    To investigate the relationship between nonalcoholic fatty liver disease and cardiovascular risk factors and increased risk of atherosclerosis in obese children. The study included 80 consecutive obese children who were stratified into group 1 [ultrasonographically diagnosed with NAFLD (n = 50)] and group 2 [not diagnosed with NAFLD (n = 30)]. The control group included 30 healthy children. The groups were compared in terms of clinical cardiovascular risk factors and carotid intimal medial thickness (CIMT) (as a marker of atherosclerosis) measured using B-mode ultrasound. Mean body mass index (BMI) and blood pressure (BP), as well as the frequency of dyslipidemia, metabolic syndrome (MetS), and insulin resistance (IR), were similar in groups 1 and 2. Mean BMI and triglyceride (TG) levels, and the frequency of IR and MetS, increased significantly as the grade of steatosis increased. Mean CIMT in group 1 was significantly greater than that in the control group (P < 0.01). There was a positive correlation between CIMT and age, BP, and BMI in groups 1 and 2. In addition, CIMT was correlated with TG, low high-density lipoprotein (HDL) cholesterol, MetS, and IR only in group 1. Linear regression analysis between CIMT and age, BP, BMI, TG level, HDL cholesterol level, IR, MetS, and grade of steatosis yielded a significant difference only for grade of steatosis. Cardiovascular risk factors are more impressive and CIMT was significantly higher in group 1 than in group 2 and the control group, indicating that they are associated with greater risk of atherosclerosis and future adverse cardiovascular events.

  9. Effects of increased paternal age on sperm quality, reproductive outcome and associated epigenetic risks to offspring.

    PubMed

    Sharma, Rakesh; Agarwal, Ashok; Rohra, Vikram K; Assidi, Mourad; Abu-Elmagd, Muhammad; Turki, Rola F

    2015-04-19

    Over the last decade, there has been a significant increase in average paternal age when the first child is conceived, either due to increased life expectancy, widespread use of contraception, late marriages and other factors. While the effect of maternal ageing on fertilization and reproduction is well known and several studies have shown that women over 35 years have a higher risk of infertility, pregnancy complications, spontaneous abortion, congenital anomalies, and perinatal complications. The effect of paternal age on semen quality and reproductive function is controversial for several reasons. First, there is no universal definition for advanced paternal ageing. Secondly, the literature is full of studies with conflicting results, especially for the most common parameters tested. Advancing paternal age also has been associated with increased risk of genetic disease. Our exhaustive literature review has demonstrated negative effects on sperm quality and testicular functions with increasing paternal age. Epigenetics changes, DNA mutations along with chromosomal aneuploidies have been associated with increasing paternal age. In addition to increased risk of male infertility, paternal age has also been demonstrated to impact reproductive and fertility outcomes including a decrease in IVF/ICSI success rate and increasing rate of preterm birth. Increasing paternal age has shown to increase the incidence of different types of disorders like autism, schizophrenia, bipolar disorders, and childhood leukemia in the progeny. It is thereby essential to educate the infertile couples on the disturbing links between increased paternal age and rising disorders in their offspring, to better counsel them during their reproductive years.

  10. Drug-induced long QT syndrome increases the risk of drowning.

    PubMed

    Vincenzi, Frank F

    2016-02-01

    There is strong evidence linking inherited long QT syndromes with an increased risk of drowning due to fatal arrhythmias in the water. Drug-induced long QT syndrome (DILQTS) is hypothesized to increase the risk of drowning by similar mechanisms. It is suggested that QT prolongation caused by a drug or drugs, when combined with the autonomic conflict associated with the mammalian dive reflex and/or the cold shock reflex, sets up conditions that may result in a sudden fatal arrhythmia while in water - thus an increased risk of drowning related to a drug-induced prolongation of the QT interval. Many widely used drugs prolong the QT interval thus raising a drug safety issue that needs confirmation or refutation.

  11. Increased Wildfire Risk Driven by Climate and Development Interactions in the Bolivian Chiquitania, Southern Amazonia

    PubMed Central

    Devisscher, Tahia; Anderson, Liana O.; Aragão, Luiz E. O. C.; Galván, Luis; Malhi, Yadvinder

    2016-01-01

    Wildfires are becoming increasingly dominant in tropical landscapes due to reinforcing feedbacks between land cover change and more severe dry conditions. This study focused on the Bolivian Chiquitania, a region located at the southern edge of Amazonia. The extensive, unique and well-conserved tropical dry forest in this region is susceptible to wildfires due to a marked seasonality. We used a novel approach to assess fire risk at the regional level driven by different development trajectories interacting with changing climatic conditions. Possible future risk scenarios were simulated using maximum entropy modelling with presence-only data, combining land cover, anthropogenic and climatic variables. We found that important determinants of fire risk in the region are distance to roads, recent deforestation and density of human settlements. Severely dry conditions alone increased the area of high fire risk by 69%, affecting all categories of land use and land cover. Interactions between extreme dry conditions and rapid frontier expansion further increased fire risk, resulting in potential biomass loss of 2.44±0.8 Tg in high risk area, about 1.8 times higher than the estimates for the 2010 drought. These interactions showed particularly high fire risk in land used for ‘extensive cattle ranching’, ‘agro-silvopastoral use’ and ‘intensive cattle ranching and agriculture’. These findings have serious implications for subsistence activities and the economy in the Chiquitania, which greatly depend on the forestry, agriculture and livestock sectors. Results are particularly concerning if considering the current development policies promoting frontier expansion. Departmental protected areas inhibited wildfires when strategically established in areas of high risk, even under drought conditions. However, further research is needed to assess their effectiveness accounting for more specific contextual factors. This novel and simple modelling approach can inform fire

  12. Increased Wildfire Risk Driven by Climate and Development Interactions in the Bolivian Chiquitania, Southern Amazonia.

    PubMed

    Devisscher, Tahia; Anderson, Liana O; Aragão, Luiz E O C; Galván, Luis; Malhi, Yadvinder

    2016-01-01

    Wildfires are becoming increasingly dominant in tropical landscapes due to reinforcing feedbacks between land cover change and more severe dry conditions. This study focused on the Bolivian Chiquitania, a region located at the southern edge of Amazonia. The extensive, unique and well-conserved tropical dry forest in this region is susceptible to wildfires due to a marked seasonality. We used a novel approach to assess fire risk at the regional level driven by different development trajectories interacting with changing climatic conditions. Possible future risk scenarios were simulated using maximum entropy modelling with presence-only data, combining land cover, anthropogenic and climatic variables. We found that important determinants of fire risk in the region are distance to roads, recent deforestation and density of human settlements. Severely dry conditions alone increased the area of high fire risk by 69%, affecting all categories of land use and land cover. Interactions between extreme dry conditions and rapid frontier expansion further increased fire risk, resulting in potential biomass loss of 2.44±0.8 Tg in high risk area, about 1.8 times higher than the estimates for the 2010 drought. These interactions showed particularly high fire risk in land used for 'extensive cattle ranching', 'agro-silvopastoral use' and 'intensive cattle ranching and agriculture'. These findings have serious implications for subsistence activities and the economy in the Chiquitania, which greatly depend on the forestry, agriculture and livestock sectors. Results are particularly concerning if considering the current development policies promoting frontier expansion. Departmental protected areas inhibited wildfires when strategically established in areas of high risk, even under drought conditions. However, further research is needed to assess their effectiveness accounting for more specific contextual factors. This novel and simple modelling approach can inform fire and land

  13. Increasing Prevalence, Changes in Diagnostic Criteria, and Nutritional Risk Factors for Autism Spectrum Disorders

    PubMed Central

    Neggers, Yasmin H.

    2014-01-01

    The frequency of autism spectrum disorders (ASD) diagnoses has been increasing for decades, but researchers cannot agree on whether the trend is a result of increased awareness, improved detection, expanding definition, or an actual increase in incidence or a combination of these factors. Though both genetic and multiple environmental risk factors have been studied extensively, many potentially modifiable risk factors including nutritional and immune function related risk factors such as vitamin D, folic acid, and metabolic syndrome have not received sufficient attention. Several recent studies have put forward hypotheses to explain the mechanism of association between both folic acid and vitamin D and autism. A continuous rise in the prevalence of autism in the USA has coincided with a significant enhancement of maternal folate status with FDA mandated folic acid fortification of certain foods starting in 1998. There is also a growing body of research that suggests that vitamin D status either in utero or early in life may be a risk for autism. In this communication, controversies regarding increase in estimate of prevalence, implications of changes in definition, and possible association between some modifiable nutritional risk factors such as folic acid and vitamin D and ASD will be discussed. PMID:24967269

  14. Assessing the increasing flood risk in the Niger River: Climate change, land use change or increasing vulnerability?

    NASA Astrophysics Data System (ADS)

    Aich, Valentin; Kone, Bakary; Müller, Eva N.; Hattermann, Fred F.

    2014-05-01

    The Niger River in West Africa experiences a strong increase of flood risk during the past decades. The evaluation of the three most extensive databases on floods in Africa (NatCat database of Munich Re, Dartmouth Flood Observatory, International disaster database EM-DAT) shows a strong increasing trend in the annual number of people affected by floods in the Niger basin. The reason for this trend is controversial as it goes along with a decrease of mean precipitation. In the ongoing debate many studies identify land use change as cause for the increase in extreme discharges in Sahelian rivers and deny an increase of extreme rainfall. Other studies focus more on the vulnerability of an increasing population, which leads to more and more people affected. However, quantitative approaches on the extreme discharges in the Niger basin are rare. In order to assess the floods systematically, we analyze long time series for 10 gauging stations along the Niger River with state of the art statistical methods. By means of change-point analysis coupled with trend analysis, wavelet analysis and non-stationary generalized extreme value functions (NSGEV) we are able to identify decadal changes and changing probability distributions of flood occurrence along the Niger. The results in the basins differ substantially, depending on the source region of the flood. We differentiate between the Guinean flood, originating from precipitation in the Guinean highland and the Red flood, originating from rains in the Sahelian part of the basin. We find significant changes of frequency in floods since the 80s, but only for the Red flood. The peaks of the Guinean flood recovered since the droughts of the 70s/ 80s, but do not reach the level of the 50s/ 60s. In addition, the NSGEV reveals that the probability for extreme floods has increased for the Red flood, but rather decreased for the Guinean flood in the past decade. These results indicate that the increase in vulnerability is at least not

  15. Increased 10-year cardiovascular disease and mortality risk scores in asymptomatic patients with calcium oxalate urolithiasis.

    PubMed

    Aydin, Hasan; Yencilek, Faruk; Erihan, Ismet Bilger; Okan, Binnur; Sarica, Kemal

    2011-12-01

    Both the prevalence of cardiovascular risk factors and event rate are increased in patients with urolithiasis. Screening is recommended to all patients who have high cardiovascular risk. The aim of this study was to document 10-year risk of cardiovascular disease and mortality in asymptomatic patients with urolithiasis. Consecutive 200 patients with calcium oxalate urolithiasis were compared with 200 age- and sex-matched healthy controls. Ten-year cardiovascular disease risk was calculated with the Framingham Risk Score and mortality risk with SCORE risk score. Calcium, oxalate, and citrate excretion were studied as urinary stone risk factors. The results indicate that patients with urolithiasis had higher total cholesterol (p < 0.0001), lower HDL-cholesterol (p < 0.0001), and higher systolic blood pressure (p < 0.0001) and hsCRP (p < 0.0001) compared with controls. Patients with urolithiasis had a higher Framingham Risk Scores [OR 8.36 (95% CI 3.81-18.65), p = 0.0001] and SCORE risk score [OR 3.02 (95% CI 1.30-7.02), p = 0.0006] compared with controls. The Framingham and SCORE risk score were significantly correlated with urinary calcium (p = 0.0001, r = 0.460, and p = 0.005, r = 0.223, respectively) and oxalate excretion (p = 0.0001, r = 0.516, p = 0.001, r = 0.290, respectively). In multiple linear regression analysis, urinary calcium and oxalate excretion, age, sex, total cholesterol, HDL-cholesterol, hsCRP and smoking were the independent predictors of 10-year cardiovascular disease risk and urinary calcium and oxalate excretion, age, sex, total cholesterol, fasting blood glucose for 10-year cardiovascular mortality. In conclusion, patients with calcium oxalate urolithiasis carry high risk of cardiovascular disease and mortality. All patients should be screened at the initial diagnosis of urolithiasis for the risk factors.

  16. Screening for increased cardiometabolic risk in primary care: a systematic review

    PubMed Central

    den Engelsen, Corine; Koekkoek, Paula S; Godefrooij, Merijn B; Spigt, Mark G; Rutten, Guy E

    2014-01-01

    Background Many programmes to detect and prevent cardiovascular disease (CVD) have been performed, but the optimal strategy is not yet clear. Aim To present a systematic review of cardiometabolic screening programmes performed among apparently healthy people (not yet known to have CVD, diabetes, or cardiometabolic risk factors) and mixed populations (apparently healthy people and people diagnosed with risk factor or disease) to define the optimal screening strategy. Design and setting Systematic review of studies performed in primary care in Western countries. Method MEDLINE, Embase, and CINAHL databases were searched for studies screening for increased cardiometabolic risk. Exclusion criteria were studies designed to assess prevalence of risk factors without follow-up or treatment; without involving a GP; when fewer than two risk factors were considered as the primary outcome; and studies constrained to ethnic minorities. Results The search strategy yielded 11 445 hits; 26 met the inclusion criteria. Five studies (1995–2012) were conducted in apparently healthy populations: three used a stepwise method. Response rates varied from 24% to 79%. Twenty-one studies (1967–2012) were performed in mixed populations; one used a stepwise method. Response rates varied from 50% to 75%. Prevalence rates could not be compared because of heterogeneity of used thresholds and eligible populations. Observed time trends were a shift from mixed to apparently healthy populations, increasing use of risk scores, and increasing use of stepwise screening methods. Conclusion The optimal screening strategy in primary care is likely stepwise, in apparently healthy people, with the use of risk scores. Increasing public awareness and actively involving GPs might facilitate screening efficiency and uptake. PMID:25267047

  17. Increasing Level of Leisure Physical Activity Could Reduce the Risk of Hip Fracture in Older Women

    PubMed Central

    Rong, Ke; Liu, Xiao-yu; Wu, Xu-hua; Li, Xiao-liu; Xia, Qing-quan; Chen, Jiong; Yin, Xiao-fan

    2016-01-01

    Abstract We carried out the study to investigate and quantitatively assess the potential association between current level of physical activity and the risk of osteoporosis hip fracture in older women. Relevant publications before October 2015 were identified using the PubMed and Ovid searching tools. A dose–response meta-analysis was carried out to combine and analysis results. Fourteen prospective studies were included in the meta-analysis. A general analysis of 9 studies showed a significant inverse relationship between increasing level of physical activity and risk of hip fracture in older women [relative risk (RR) = 0.93, 95% confidence interval (95% CI): 0.91–0.96]. The result of a sensitivity analysis was consistent with the general analysis (RR = 0.94, 95% CI: 0.93–0.96). The association between increasing level of physical activity and risk of wrist fracture was not statistically significant in a general analysis of three studies (RR = 1.004, 95% CI: 0.98–1.03). A potential direct association between increasing level of physical activity and risk of wrist fracture was observed after removing 1 study with the greatest weight (RR = 1.01, 95% CI: 1.00–1.03). No significant publication bias was observed in our analysis. Our results show that increasing level of physical activity within an appropriate range may reduce the risk of hip fracture but not the risk of wrist fracture in older women. PMID:26986111

  18. Obesity increases the risk of end-stage renal disease among living kidney donors.

    PubMed

    Locke, Jayme E; Reed, Rhiannon D; Massie, Allan; MacLennan, Paul A; Sawinski, Deirdre; Kumar, Vineeta; Mehta, Shikha; Mannon, Roslyn B; Gaston, Robert; Lewis, Cora E; Segev, Dorry L

    2017-03-01

    Determining candidacy for live kidney donation among obese individuals remains challenging. Among healthy non-donors, body mass index (BMI) above 30 is associated with a 16% increase in risk of end-stage renal disease (ESRD). However, the impact on the ESRD risk attributable to donation and living with only one kidney remains unknown. Here we studied the risk of ESRD associated with obesity at the time of donation among 119 769 live kidney donors in the United States. Maximum follow-up was 20 years. Obese (BMI above 30) live kidney donors were more likely male, African American, and had higher blood pressure. Estimated risk of ESRD 20 years after donation was 93.9 per 10 000 for obese; significantly greater than the 39.7 per 10 000 for non-obese live kidney donors. Adjusted for age, sex, ethnicity, blood pressure, baseline estimated glomerular filtration rate, and relationship to recipient, obese live kidney donors had a significant 86% increased risk of ESRD compared to their non-obese counterparts (adjusted hazard ratio 1.86; 95% confidence interval 1.05-3.30). For each unit increase in BMI above 27 kg/m(2) there was an associated significant 7% increase in ESRD risk (1.07, 1.02-1.12). The impact of obesity on ESRD risk was similar for male and female donors, African American and Caucasian donors, and across the baseline estimated glomerular filtration rate spectrum. These findings may help to inform selection criteria and discussions with persons considering living kidney donation.

  19. Electrocardiograms of Menopausal Women With Coronary Heart Disease or at Increased Risk for Its Occurrence

    PubMed Central

    Wenger, Nanette K.; Mischke, Jennifer M.; Schroeder, Rolf; Schroeder, Klaus; Collins, Peter; Grady, Deborah; Kornitzer, Marcel; Mosca, Lori; Barrett-Connor, Elizabeth

    2011-01-01

    Little is known about electrocardiographic (ECG) characteristics of menopausal women with or at increased risk of coronary heart disease (CHD). Data from 10,101 participants in the Raloxifene Use for The Heart (RUTH) trial were used to correlate baseline ECG abnormalities with clinical characteristics. Baseline characteristics that were statistically significantly associated (p ≤ 0.05) with ECG findings in univariate analyses were used to derive multivariate model selection. Of 59% normal electrocardiograms, 50% were from women with CHD and 69% from women at increased risk of CHD. In the women with CHD, 59% reported a previous myocardial infarction (MI); 43% had a normal electrocardiogram, and 49% had a definite ECG Q-wave MI. Women in the increased-risk group had not reported a previous MI, yet 11% had a definite ECG Q-wave MI. Of women reporting hypertension, 35% had ECG evidence of left ventricular hypertrophy, but 58% did not have an abnormal electrocardiogram. Significantly more women with diabetes in the increased-risk and documented CHD cohorts had abnormal electrocardiograms (p < 0.01 for the 2 cohorts). Percent abnormal electrocardiograms increased with increasing age (55 to 64, 65 to 74, and ≥75 years, p < 0.01) in all cohorts. Angina and coronary artery bypass graft surgery, but not percutaneous coronary intervention, predicted an abnormal electrocardiogram. In conclusion, there were high percentages of normal electrocardiograms in the increased-risk and documented CHD groups of RUTH participants, with substantial discrepancy between MI history and ECG MI documentation, and increasing age was the predominant correlate with an abnormal electrocardiogram in all 3 cohorts. PMID:21094358

  20. Gene polymorphisms involved in folate and methionine metabolism and increased risk of sporadic colorectal adenocarcinoma.

    PubMed

    Guimarães, José Luiz Miranda; Ayrizono, Maria de Lurdes; Coy, Cláudio Saddy Rodrigues; Lima, Carmen Silvia Passos

    2011-10-01

    This pilot study has compared the polymorphic genotype frequencies of methylenetetrahydrofolate reductase (MTHFR A1298C and C677T), methionine synthase (MTR A2756G), methionine synthase reductase (MTRR A66G), and thymidylate synthase (TS 2R/3R) in 113 patients with sporadic colorectal adenocarcinoma (SCA) and 188 healthy blood donors, used as matched controls. The aim was to assess the role of these genotypes in the increased risk of SCA among the southeastern Brazilian population. Carriers of genotype MTRR 66GG, or the combined variants MTHFR 1298AC + CC plus 677CT + TT, or MTHFR 677CT + TT plus MTR 2756AG + GG, or MTHFR 1298AC + CC plus 677CT + TT plus MTR 2756AG + GG, or yet, MTHFR 1298AC + CC plus 677CT + TT plus MTRR 66AG + GG, respectively, showed an increased risk of the order of 1.99-, 3.26-, 2.22-, 10.92-, and 14.88-fold of developing SCA when compared with carriers of the other studied polymorphic genotypes, whether in isolation or in combination. In addition, individuals with the MTHFR 677CT + TT or the MTR 2756AG + GG genotypes had a 2.12- and a 1.42-fold increased risks of SCA onset before 50 years of age. African-Brazilians with the MTRR 66GG genotype had a 1.98-fold increased risk of SCA while individuals with the MTR 2756AG + GG and the MTHFR 677CT + TT genotypes showed a 2.11- and a 1.62-fold increased risk of undifferentiated and advanced tumors at diagnosis, respectively. Carriers of genotype MTHFR 1298AC + CC or MTHFR 1298AC + CC plus MTRR 66AG + GG had a 1.42- and a 3.07-fold increased risk of rectal tumor, respectively. Additionally, carriers of MTHFR 677CT + TT or MTHFR 677CT + TT plus TS 2R/3R + 3R/3R had a 1.55- and a 5.39-fold increased risk for colon tumor, respectively, in comparison with carriers of the wild genotypes. These data suggest that all polymorphisms coding for folate and methionine-dependent enzymes, particularly when present in combination with

  1. Prolonged clot lysis time increases the risk of a first but not recurrent venous thrombosis.

    PubMed

    Karasu, Alev; Baglin, Trevor P; Luddington, Roger; Baglin, Caroline A; van Hylckama Vlieg, Astrid

    2016-03-01

    The role of the fibrinolytic system in the development of venous thrombosis (VT) is unclear. We studied the risk of first and recurrent VT associated with reduced fibrinolysis, as measured by clot lysis time (CLT). We also studied the relationship between CLT and thrombin generation to determine if any relationship between CLT and VT was affected by thrombin generation. Analyses were performed in the Thrombophilia Hypercoagulability Environmental risk for Venous Thromboembolism Study, a two-centre population-based case-control study, including 579 patients and 338 controls, with patients followed from the event to determine incidence of recurrent VT. Hypofibrinolysis was associated with a 1·8-fold increased risk of a first VT [95% confidence interval (CI) 1·2-2·7]. Adjustment for sex, age, study location and Endogenous Thrombin Potential (ETP) did not change the result. The risk of VT was 2·9-fold increased when the 90th percentiles of prolonged CLT and high ETP were combined, with the highest risk for unprovoked first events (Odds Ratio = 4·2, 95% CI 1·3-13·5). In the follow-up study the Hazard Ratio for a recurrent VT associated with hypofibrinolysis was 1·5 (95% CI 0·9-2·6). A weak dose response effect was observed in relation to prolongation of CLT and recurrent VT. Although hypofibrinolysis constitutes a risk factor for a first VT, an association with recurrence is, at best, weak.

  2. Excessive alcohol consumption increases risk taking behaviour in travellers to Cusco, Peru.

    PubMed

    Cabada, Miguel M; Mozo, Karen; Pantenburg, Birte; Gotuzzo, Eduardo

    2011-03-01

    The risks associated with alcohol intoxication are rarely discussed during pre-travel counselling. However, alcohol immoderation abroad may increase the exposure to health risks. Few studies have addressed alcohol consumption and risk taking behaviour in travellers to South America. From October to December of 2004, travellers leaving the city of Cusco in Peru were asked to fill out anonymous questionnaires regarding demographics, self-reported alcohol consumption, illness and risk behaviour for sexually-transmitted infection (STI) and travellers diarrhoea. Most travellers (87.2%) consumed alcohol and 20.4% reported inebriation in Cusco. Those admitting inebriation were more likely to be male, single, <26 years old, and travelling alone or with friends. Travellers who admitted inebriation and fell ill while in Cusco were more likely to seek medical attention, change itinerary, and report decreased satisfaction with the trip experience. In the multivariate analysis, inebriation was independently associated with reporting higher numbers of unsafe food choices, illicit drug use, and risky sexual activity. It is concluded that alcohol intoxication during travel was associated with increased risk taking behaviour for common travel related conditions. Although travel related illnesses were not associated with inebriation, some markers of illness severity were more often reported by those who admitted intoxication. Risk for heavy alcohol use abroad should be assessed during the pre-travel visit in certain groups and appropriate counselling should be provided.

  3. Does maternal psychopathology increase the risk of pre-schooler obesity? A systematic review.

    PubMed

    Benton, Pree M; Skouteris, Helen; Hayden, Melissa

    2015-04-01

    The preschool years may be a critical period for child obesity onset; however, literature examining obesity risk factors to date has largely focused on school-aged children. Several links have been made between maternal depression and childhood obesity risks; however, other types of maternal psychopathology have been widely neglected. The aim of the present review was to systematically identify articles that examined relationships between maternal psychopathology variables, including depressive and anxiety symptoms, self-esteem and body dissatisfaction, and risks for pre-schooler obesity, including weight outcomes, physical activity and sedentary behaviour levels, and nutrition/diet variables. Twenty articles meeting review criteria were identified. Results showed positive associations between maternal depressive symptoms and increased risks for pre-schooler obesity in the majority of studies. Results were inconsistent depending on the time at which depression was measured (i.e., antenatal, postnatal, in isolation or longitudinally). Anxiety and body dissatisfaction were only measured in single studies; however, both were linked to pre-schooler obesity risks; self-esteem was not measured by any studies. We concluded that maternal depressive symptoms are important to consider when assessing risks for obesity in preschool-aged children; however, more research is needed examining the impact of other facets of maternal psychopathology on obesity risk in pre-schoolers.

  4. HFE C282Y homozygotes are at increased risk of breast and colorectal cancer

    PubMed Central

    Osborne, Nicholas J.; Gurrin, Lyle C; Allen, Katrina J.; Constantine, Clare C; Delatycki, Martin B.; McLaren, Christine E.; Gertig, Dorota M; Anderson, Gregory J; Southey, Melissa C; Olynyk, John K; Powell, Lawrie W.; Hopper, John L; Giles, Graham G; English, Dallas R

    2013-01-01

    The evidence that mutations in the HFE gene are associated with increased cancer risk is inconsistent. The Melbourne Collaborative Cohort Study is a prospective cohort study that commenced recruitment in 1990. Participants of born in Australia, New Zealand, the United Kingdom or Ireland (n = 28,509) were genotyped for the HFE C282Y variant. Incident cancers were ascertained from Australian cancer registries during an average of 14 years follow up. Hazard ratios, confidence intervals and p-values were obtained from separate Cox regression analyses for colorectal, breast and prostate cancers, all other solid cancers and all cancers. Compared with those with no C282Y variant, C282Y homozygotes were at increased risk of colorectal cancer (HR 2·28; 95% CI 1·22, 4·25; p = 0.01) and female C282Y homozygotes were at increased risk of developing breast cancer (HR 2·39; 95% CI 1·24, 4·61; p = 0.01) but male C282Y homozygotes were not at increased risk for prostate cancer (HR 0·96; 95% CI 0·43, 2·15; p = 0.92). C282Y/H63D compound heterozygotes were not at increased risk for colorectal cancer, (HR 1 27; 95% CI 0·80, 2·01); breast cancer, (HR 1·16; 95% CI 0·74, 1·84); or prostate cancer (HR 1·08; 95% CI 0·68, 1·70). Conclusion HFE C282Y homozygotes have twice the risk of colorectal and breast cancer compared with those without the C282Y variant. PMID:20099304

  5. Social and economic factors of the natural risk increasing: estimation of the Russian regions

    NASA Astrophysics Data System (ADS)

    Petrova, E.

    2004-04-01

    This study is an attempt to assess quantitatively social and economic factors that determine vulnerability of Russian regions to natural risk, to trace the space differences of the considered factors, and to group the regions by their similarity. In order to indicate the regional differences in social and economic development, equipment condition, dangerous substances accumulation, and social trouble four the most suitable parameters were estimated, including the per capita production of Gross Regional Product (GRP), capital consumption, volume of total toxic waste, and crime rate. Increase of the first parameter causes vulnerability reducing, the increase of the last three causes its increasing. Using multidimensional cluster analysis five types of regions were found for Russia according to similarity of the considered parameters. These types are characterized with higher value of a single (rarely two) chosen parameter, which seems to be sufficient enough to affect natural risks increasing in these regions in near future. Only few regions belonging to the fifth type proved to have rather high value of GRP and relatively low values of the other parameters. The negative correlation was found between a number of natural disasters (ND) and the per capita GRP in case when some parameters reached anomalously high value. The distinctions between regions by prevailing different parameters, which result in natural risk increasing, help risk management to find directions where to focus on.

  6. Physical Activity and Brain Function in Older Adults at Increased Risk for Alzheimer’s Disease

    PubMed Central

    Smith, J. Carson; Nielson, Kristy A.; Woodard, John L.; Seidenberg, Michael; Rao, Stephen M.

    2013-01-01

    Leisure-time physical activity (PA) and exercise training are known to help maintain cognitive function in healthy older adults. However, relatively little is known about the effects of PA on cognitive function or brain function in those at increased risk for Alzheimer’s disease through the presence of the apolipoproteinE epsilon4 (APOE-ε4) allele, diagnosis of mild cognitive impairment (MCI), or the presence of metabolic disease. Here, we examine the question of whether PA and exercise interventions may differentially impact cognitive trajectory, clinical outcomes, and brain structure and function among individuals at the greatest risk for AD. The literature suggests that the protective effects of PA on risk for future dementia appear to be larger in those at increased genetic risk for AD. Exercise training is also effective at helping to promote stable cognitive function in MCI patients, and greater cardiorespiratory fitness is associated with greater brain volume in early-stage AD patients. In APOE-ε4 allele carriers compared to non-carriers, greater levels of PA may be more effective in reducing amyloid burden and are associated with greater activation of semantic memory-related neural circuits. A greater research emphasis should be placed on randomized clinical trials for exercise, with clinical, behavioral, and neuroimaging outcomes in people at increased risk for AD. PMID:24961307

  7. Genetically Determined Amerindian Ancestry Correlates with Increased Frequency of Risk Alleles for Systemic Lupus Erythematosus

    PubMed Central

    Sanchez, E; Webb, R; Rasmussen, A.; Kelly, J.A; Riba, L.; Kaufman, K.M.; Garcia-de la Torre, I.; Moctezuma, J.F.; Maradiaga-Ceceña, M.A.; Cardiel, M.; Acevedo, E.; Cucho-Venegas, M.; Garcia, M.A.; Gamron, S.; Pons-Estel, B.A.; Vasconcelos, C.; Martin, J.; Tusié-Luna, T.; Harley, J.B.; Richardson, B.; Sawalha, A.H.; Alarcón-Riquelme, M.E.

    2011-01-01

    Objectives To analyze if genetically determined Amerindian ancestry predicts the increased presence of risk alleles of known susceptibility genes for systemic lupus erythematosus. Methods Single nucleotide polymorphisms within 16 confirmed genetic susceptibility loci for SLE were genotyped in a set of 804 Mestizo lupus patients and 667 Mestizo normal healthy controls. In addition, 347 admixture informative markers were genotyped. Individual ancestry proportions were determined using STRUCTURE. Association analysis was performed using PLINK, and correlation of the presence of risk alleles with ancestry was done using linear regression. Results A meta-analysis of the genetic association of the 16 SNPs across populations showed that TNFSF4, STAT4, PDCD1, ITGAM, and IRF5 were associated with lupus in a Hispanic-Mestizo cohort enriched for European and Amerindian ancestry. In addition, two SNPs within the MHC region, previously associated in a genome-wide association study in Europeans, were also associated in Mestizos. Using linear regression we predict an average increase of 2.34 risk alleles when comparing a lupus patient with 100% Amerindian ancestry to an SLE patient with 0% American Indian Ancestry (p<0.0001). SLE patients with 43% more Amerindian ancestry are predicted to carry one additional risk allele. Conclusion Amerindian ancestry increased the number of risk alleles for lupus. PMID:20848568

  8. Placental genetic variations in circadian clock-related genes increase the risk of placental abruption

    PubMed Central

    Qiu, Chunfang; Gelaye, Bizu; Denis, Marie; Tadesse, Mahlet G; Enquobahrie, Daniel A; Ananth, Cande V; Pacora, Percy N; Salazar, Manuel; Sanchez, Sixto E; Williams, Michelle A

    2016-01-01

    The genetic architecture of placental abruption (PA) remains poorly understood. We examined variations in SNPs of circadian clock-related genes in placenta with PA risk. We also explored placental and maternal genomic contributions to PA risk. Placental genomic DNA samples were isolated from 280 PA cases and 244 controls. Genotyping was performed using the Illumina Cardio-MetaboChip. We examined 116 SNPs in 13 genes known to moderate circadian rhythms. Logistic regression models were fit to estimate odds ratios (ORs). The combined effect of multiple SNPs on PA risk was estimated using a weighted genetic risk score. We examined independent and joint associations of wGRS derived from placental and maternal genomes with PA. Seven SNPs in five genes (ARNTL2, CRY2, DEC1, PER3 and RORA), in the placental genome, were associated with PA risk. Each copy of the minor allele (G) of a SNP in the RORA gene (rs2899663) was associated with a 30% reduced odds of PA (95% CI 0.52-0.95). The odds of PA increased with increasing placental-wGRS (Ptrend<0.001). The ORs were 1.00, 2.16, 3.24 and 4.48 across quartiles. Associations persisted after the maternal-wGRS was included in the model. There was evidence of an additive contribution of placental and maternal genetic contributions to PA risk. Participants with placental- and maternal-wGRS in the highest quartile, compared with those in the lowest quartile, had a 15.57-fold (95% CI 3.34-72.60) increased odds of PA. Placental variants in circadian clock-related genes are associated with PA risk; and the association persists after control of genetic variants in the maternal genome. PMID:27186326

  9. Vitamin Supplementation Increases Risk of Subclinical Mastitis in HIV-Infected Women123

    PubMed Central

    Arsenault, Joanne E.; Aboud, Said; Manji, Karim P.; Fawzi, Wafaie W.; Villamor, Eduardo

    2010-01-01

    Subclinical mastitis is common in HIV-infected women and is a risk factor for mother-to-child transmission of HIV. The purpose of this study was to examine the effect of vitamin supplementation [vitamin A + β-carotene, multivitamins (B complex, C, and E), or multivitamins, including vitamin A + β-carotene] on the risk of subclinical mastitis during the first 2 y postpartum among HIV-infected women. The study was a randomized, placebo-controlled, clinical trial including 674 HIV-infected, antiretroviral naïve Tanzanian women who were recruited during pregnancy and followed-up after delivery. Breast milk samples were obtained approximately every 3 mo. Any subclinical mastitis was defined as a ratio of the sodium to potassium (Na:K) breast milk concentrations > 0.6 and further classified as either moderate (Na:K ≥ 0.6 and ≤ 1) or severe (Na:K > 1.0). Fifty-eight percent of women had at least 1 episode of any subclinical mastitis. Women assigned to multivitamins (B complex, C, and E) had a 33% greater risk of any subclinical mastitis (P = 0.005) and a 75% greater risk of severe subclinical mastitis (P = 0.0006) than women who received the placebo. Vitamin A + β-carotene also increased the risk of severe subclinical mastitis by 45% (P = 0.03). Among women with CD4+ T-cell counts ≥ 350 cells/μL, multivitamin intake resulted in a 49% increased risk of any subclinical mastitis (P = 0.006); by contrast, there were no treatment effects among women with CD4+ T-cell counts < 350 cells/μL (P- interaction for treatment × CD4+ T-cell count = 0.10). Supplementation of HIV-infected women with vitamins increased the risk of subclinical mastitis. PMID:20739447

  10. Low ADAMTS13 activity is associated with an increased risk of ischemic stroke.

    PubMed

    Sonneveld, Michelle A H; de Maat, Moniek P M; Portegies, Marileen L P; Kavousi, Maryam; Hofman, Albert; Turecek, Peter L; Rottensteiner, Hanspeter; Scheiflinger, Fritz; Koudstaal, Peter J; Ikram, M Arfan; Leebeek, Frank W G

    2015-12-17

    ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin motif repeats 13) has antithrombotic properties because it cleaves von Willebrand factor (VWF) in smaller, less active multimers. The aim of our study was to investigate prospectively the association between ADAMTS13 activity and ischemic stroke. We included 5941 individuals ≥55 years without a history of stroke or transient ischemic attack (TIA) of the Rotterdam Study, a population-based cohort study. ADAMTS13 activity was measured at inclusion with the FRETS-VWF73 assay and VWF antigen (VWF:Ag) levels by enzyme-linked immunosorbent assay. We assessed the association among ADAMTS13 activity, VWF:Ag levels, and ischemic stroke by Cox proportional hazard analysis. The added value of ADAMTS13 activity above the traditional risk factors for ischemic stroke risk prediction was examined by the C-statistic and the net reclassification improvement index (NRI). All individuals were followed for incident stroke or TIA. Over a median follow-up time of 10.7 years (56,403 total person-years), 461 participants had a stroke, 306 of which were ischemic. After adjustment for cardiovascular risk factors, individuals with ADAMTS13 activity in the lowest quartile had a higher risk of ischemic stroke (absolute risk, 7.3%) than did those in the reference highest quartile (absolute risk, 3.8%; hazard ratio, 1.65; 95% confidence interval [CI], 1.16-2.32). Adding ADAMTS13 to the model in prediction of ischemic stroke, increased the C-statistic by 0.013 (P = .003) and provided 0.058 (95% CI, -0.002 to 0.119) NRI. Low ADAMTS13 activity is associated with the risk of ischemic stroke and improves the accuracy of risk predictions for ischemic stroke beyond traditional risk factors.

  11. Obesity and Diabetes: The Increased Risk of Cancer and Cancer-Related Mortality

    PubMed Central

    LeRoith, Derek

    2015-01-01

    Obesity and type 2 diabetes are becoming increasingly prevalent worldwide, and both are associated with an increased incidence and mortality from many cancers. The metabolic abnormalities associated with type 2 diabetes develop many years before the onset of diabetes and, therefore, may be contributing to cancer risk before individuals are aware that they are at risk. Multiple factors potentially contribute to the progression of cancer in obesity and type 2 diabetes, including hyperinsulinemia and insulin-like growth factor I, hyperglycemia, dyslipidemia, adipokines and cytokines, and the gut microbiome. These metabolic changes may contribute directly or indirectly to cancer progression. Intentional weight loss may protect against cancer development, and therapies for diabetes may prove to be effective adjuvant agents in reducing cancer progression. In this review we discuss the current epidemiology, basic science, and clinical data that link obesity, diabetes, and cancer and how treating obesity and type 2 diabetes could also reduce cancer risk and improve outcomes. PMID:26084689

  12. Enduring increased risk of developing depression and mania in patients with dementia

    PubMed Central

    Nilsson, F; Kessing, L; Sorensen, T; Andersen, P; Bolwig, T

    2002-01-01

    Objective: To investigate the time relation between dementia and major affective disorders (major depression and mania). Methods: Register linkage study of the Danish Hospital Register and the Danish Psychiatric Central Research Register, to establish study cohorts of patients with dementia and control groups (osteoarthritis or diabetes) on first discharge from hospital. Follow up of cohorts was for up to 21 years. Hazard of death was allowed for by the use of competing risks models. Results: Patients with dementia had an increased risk of being admitted to hospital for major depression or mania during the course of the illness. The incidence remained elevated throughout the rest of the patient's life. Conclusions: Patients with dementia have an increased risk of developing depression or mania. Proper treatment of affective disorders in patients with dementia is important in reducing suffering and costs. PMID:12082043

  13. Anticipating divine protection? Reminders of god can increase nonmoral risk taking.

    PubMed

    Kupor, Daniella M; Laurin, Kristin; Levav, Jonathan

    2015-04-01

    Religiosity and participation in religious activities have been linked with decreased risky behavior. In the current research, we hypothesized that exposure to the concept of God can actually increase people's willingness to engage in certain types of risks. Across seven studies, reminders of God increased risk taking in nonmoral domains. This effect was mediated by the perceived danger of a risky option and emerged more strongly among individuals who perceive God as a reliable source of safety and protection than among those who do not. Moreover, in an eighth study, when participants were first reminded of God and then took a risk that produced negative consequences (i.e., when divine protection failed to materialize), participants reported feeling more negatively toward God than did participants in the same situation who were not first reminded of God. This research contributes to an understanding of the divergent effects that distinct components of religion can exert on behavior.

  14. Increased risk of lung cancer, non-Hodgkin's lymphoma, and leukemia following Hodgkin's disease

    SciTech Connect

    van Leeuwen, F.E.; Somers, R.; Taal, B.G.; van Heerde, P.; Coster, B.; Dozeman, T.; Huisman, S.J.; Hart, A.A.

    1989-08-01

    The risk of second cancers (SCs) was assessed in 744 patients with Hodgkin's disease (HD) admitted to The Netherlands Cancer Institute from 1966 to 1983. Sixty-nine SCs were observed one month or more after start of first treatment. These included 14 cases of lung cancer, nine cases of non-Hodgkin's lymphoma (NHL), 16 cases of leukemia, and six cases of the myelodysplastic syndrome (MDS). The median interval between the diagnosis of HD and that of second lung cancer, NHL, and leukemia was 8.1, 13.3, and 5.7 years, respectively. The overall relative risks (RR) (observed/expected (O/E) ratios) of developing lung cancer, NHL, and leukemia were 4.9 (95% confidence limit (CL), 2.7 to 8.2), 31.0 (95% CL, 14.2 to 58.9) and 45.7 (95% CL, 26.1 to 74.2), respectively. At 15 years the cumulative risk of developing an SC amounted to 20.6% +/- 2.9%. The 15-year estimates of lung cancer, NHL, and leukemia were 6.2% +/- 1.9%, 5.9% +/- 2.1% and 6.3% +/- 1.7%, respectively. Increased lung cancer risk following HD has not frequently been clearly demonstrated before; that we were able to demonstrate such risk may be due to the completeness of follow-up over long periods that could be achieved in this study. Excess lung cancer risk was only noted in treatment regimens with radiotherapy (RT); also, all lung cancers arose in irradiation fields. Excess risk of leukemia was only found in treatment regimens involving chemotherapy (CT). For NHL, combined modality treatment was shown to be the most important risk factor. Risk of lung cancer and NHL increased with time since diagnosis. A time-dependent covariate analysis (Cox model) performed on leukemia and MDS showed an increasing risk with intensity of CT, age (greater than 40 years), and a splenectomy.

  15. Extreme precipitation events and increased risk of campylobacteriosis in Maryland, U.S.A.

    PubMed

    Soneja, Sutyajeet; Jiang, Chengsheng; Romeo Upperman, Crystal; Murtugudde, Raghu; S Mitchell, Clifford; Blythe, David; Sapkota, Amy R; Sapkota, Amir

    2016-08-01

    Consumption of contaminated poultry, raw milk and water are significant risk factors for Campylobacter infection. Previous studies also have investigated the association between weather (temperature and precipitation) and increased risk of campylobacteriosis, but limited information exists regarding the impacts of extreme heat and precipitation events on campylobacteriosis risk, and how such risk may differentially impact coastal communities. We obtained Campylobacter case data 2002-2012; n=4804) from the Maryland Foodborne Diseases Active Surveillance Network (FoodNet). We identified extreme heat and extreme precipitation events during this time (2002-2012) using location and calendar day specific thresholds (95th percentile for extreme heat and 90th percentile for extreme precipitation) that were computed based on a 30-year baseline (1960-1989). We linked these datasets using GIS and used negative binomial generalized estimating equations adjusted for demographic confounders to calculate the association between exposure to extreme events and risk of campylobacteriosis in Maryland. We observed that a one-day increase in exposure to extreme precipitation events was associated with a 3% increase in risk of campylobacteriosis in coastal areas of Maryland (Incidence Rate Ratio (IRR): 1.03, 95% confidence interval (CI): 1.01, 1.05), but such an association was not observed in noncoastal areas. Furthermore, the risk associated with extreme precipitation events was considerably higher during La Niña periods (IRR: 1.09, 95% CI: 1.05, 1.13), while there was no evidence of elevated risk during El Niño or ENSO Neutral periods. Exposure to extreme heat events was not associated with an increased risk of campylobacteriosis, except during La Niña periods (IRR: 1.04, 95% CI: 1.01, 1.08). Extreme precipitation events could result in flooding within coastal areas that may bring water contaminated with bacterial pathogens (originating from sources such as septic systems

  16. Increased Risk for Multidrug-Resistant Tuberculosis in Migratory Workers, Armenia

    PubMed Central

    Crape, Byron; Grigoryan, Ruzanna; Martirosyan, Hripsime; Petrosyan, Varduhi

    2015-01-01

    To understand use of tuberculosis (TB) services for migrant workers, we conducted a cross-sectional census of 95 migrant workers with TB from Armenia by using medical record reviews and face-to-face interviews. Prolonged time between diagnosis and treatment, treatment interruption, and treatment defaults caused by migrant work might increase the risk for multidrug-resistant TB. PMID:25695488

  17. Increasing Threat of Brucellosis to Low-Risk Persons in Urban Settings, China

    PubMed Central

    Chen, Shouyi; Zhang, Hao; Liu, Xiaoning; Wang, Wenjing; Hou, Shuiping; Li, Tingting; Zhao, Shuoxian; Yang, Zhicong

    2014-01-01

    Cases of brucellosis were diagnosed in 3-month-old twins and their mother. An epidemiologic survey suggested that raw sheep or goat meat might be the source of Brucella melitensis infection. This finding implies that the increasing threat of brucellosis might affect low-risk persons in urban settings in China. PMID:24377827

  18. When Combined with Chemotherapy, Bevacizumab Is Associated with Increased Risk of Death

    Cancer.gov

    Cancer patients who receive the targeted therapy bevacizumab (Avastin) in combination with chemotherapy are at increased risk of serious side effects that may lead to death, according to a meta-analysis of 16 clinical trials that was published February 2,

  19. One Debt-Financing Option May Increase Risk of College Bankruptcies

    ERIC Educational Resources Information Center

    Basken, Paul

    2008-01-01

    A common type of variable-rate financing has suddenly increased the risk of bankruptcy for an unknown number of colleges, said two experts at credit-rating agencies. The threat affects mostly less-wealthy colleges that have used variable-rate bonds either to get a better price when borrowing or because they lacked bond ratings and had little other…

  20. Study Finds Small Increase in Cancer Risk after Childhood CT Scans

    Cancer.gov

    A study published in the June 6, 2012, issue of The Lancet shows that radiation exposure from computed tomography (CT) scans in childhood results in very small but increased risks of leukemia and brain tumors in the first decade after exposure.

  1. Child food insecurity increases risks posed by household food insecurity to young children's health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The US Food Security Scale (USFSS) measures household and child food insecurity (CFI) separately. Our goal was to determine whether CFI increases risks posed by household food insecurity (HFI) to child health and whether the Food Stamp Program (FSP) modifies these effects. From 1998 to 2004, 17,158 ...

  2. Further deliberating the relationship between do-not-resuscitate and the increased risk of death

    PubMed Central

    Chen, Yen-Yuan; Chen, Yih-Sharng; Chu, Tzong-Shinn; Lin, Kuan-Han; Wu, Chau-Chung

    2016-01-01

    Few studies have examined the outcome of do-not-resuscitate (DNR) patients in surgical intensive care units (SICUs). This study deliberated the association between a DNR decision and the increased risk of death methodologically and ethically. This study was conducted in three SICUs. We collected patients’ demographic characteristics, clinical characteristics, and the status of death/survival at SICU and hospital discharge. We used Kaplan–Meier survival curves to compare the time from SICU admission to the end of SICU stay for the DNR and non-DNR patients. Differences in the Kaplan-Meier curves were tested using log-rank tests. We also conducted a Cox proportional hazards model to account for the effect of a DNR decision on mortality. We found that having a DNR order was associated with an increased risk of death during the SICU stay (aRR = 2.39, p < 0.01) after adjusting for severity of illness upon SICU admission and other confounding variables. To make the conclusion that a DNR order is causally related to an increased risk of death, or that a DNR order increases the risk of death is absolutely questionable. By clarifying this key point, we expect that the discussion of DNR between healthcare professionals and patients/surrogate decision-makers will not be hampered or delayed. PMID:26987301

  3. Experimental evidence of a potentially increased thrombo-embolic disease risk by domestic electromagnetic field exposure.

    PubMed

    Caprani, A; Richert, A; Flaud, P

    2004-05-01

    We have used the EaHy926 endothelial cell line, able to secrete both pro and anti-aggregant platelet agents, as a model for thrombo-embolic diseases. We experimentally established, by comparing these two secretions with or without a Faraday cage, that the environmental electromagnetic field significantly increases the thrombo-embolic risks in this endothelial cell line.

  4. THE INTERSECTION OF INDEPENDENT LIES: INCREASING REALISM IN ECOLOGICAL RISK ASSESSMENT

    EPA Science Inventory

    In 1966, Levins presented a philosophical discussion on making inference about populations using clusters of models. In this article we provide an overview of model inference in ecological risk assessment, discuss the benefits and trade-offs of increasing model realism, show the...

  5. Increase Return on Investment of Software Development Life Cycle by Managing the Risk - A Case Study

    DTIC Science & Technology

    2015-04-01

    Image designed by Diane Fleischer INCREASE RETURN on Investment of Software Development Life Cycle by Managing the Risk —A Case Study...for increasing the return on investment during the Software Development Life Cycle (SDLC) through selected quantitative analyses employing both the...defect rate, return on investment (ROI), software development life cycle (SDLC) DE FE N SE A C Q U IS IT IO N UN IVERSITY ALU M N I A SSO C IATIO N R

  6. A multi-stage anti-predator response increases information on predation risk.

    PubMed

    Hemmi, Jan M; Pfeil, Andreas

    2010-05-01

    Optimal escape theory generally assumes that animals have accurate information about predator distance and direction of approach. To what degree such information is available depends not only on the prey's sensory capabilities but also on its behaviour. The structure of behaviour can strongly constrain or support the gathering of information. The ability of animals to collect and process information is therefore an important factor shaping predator avoidance strategies. Fiddler crabs, like many prey animals, escape predators in a multi-step sequence. In their initial response, they do not have accurate information about a predator's distance and approach trajectory and are forced to base their response decision on incomplete information that is not strictly correlated with risk. We show here that fiddler crabs gather qualitatively different visual information during successive stages of their escape sequence. This suggests that multi-stage anti-predator behaviours serve not only to successively reduce risk but also to increase the quality of information with regards to the actual risk. There are countless reasons why prey animals are not able to accurately assess risk. By concentrating on sensory limitations, we can quantify such information deficits and investigate how improving risk assessment helps prey optimise the balance between predation risk and escape costs.

  7. Traditional marijuana, high‐potency cannabis and synthetic cannabinoids: increasing risk for psychosis

    PubMed Central

    Murray, Robin M.; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta

    2016-01-01

    Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose‐response relationship between the level of use and the risk of later psychosis. High‐potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co‐administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high‐potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high‐potency cannabis and synthetic cannabinoids. PMID:27717258

  8. High Birth Weight Increases the Risk for Bone Tumor: A Systematic Review and Meta-Analysis.

    PubMed

    Chen, Songfeng; Yang, Lin; Pu, Feifei; Lin, Hui; Wang, Baichuan; Liu, Jianxiang; Shao, Zengwu

    2015-09-09

    There have been several epidemiologic studies on the relationship between high birth weight and the risk for bone tumor in the past decades. However, due to the rarity of bone tumors, the sample size of individual studies was generally too small for reliable conclusions. Therefore, we have performed a meta-analysis to pool all published data on electronic databases with the purpose to clarify the potential relationship. According to the inclusion and exclusion criteria, 18 independent studies with more than 2796 cases were included. As a result, high birth weight was found to increase the risk for bone tumor with an Odds Ratio (OR) of 1.13, with the 95% confidence interval (95% CI) ranging from 1.01 to 1.27. The OR of bone tumor for an increase of 500 gram of birth weight was 1.01 (95% CI 1.00-1.02; p = 0.048 for linear trend). Interestingly, individuals with high birth weight had a greater risk for osteosarcoma (OR = 1.22, 95% CI 1.06-1.40, p = 0.006) than those with normal birth weight. In addition, in the subgroup analysis by geographical region, elevated risk was detected among Europeans (OR = 1.14, 95% CI 1.00-1.29, p = 0.049). The present meta-analysis supported a positive association between high birth weight and bone tumor risk.

  9. Veterinary surgeons and suicide: a structured review of possible influences on increased risk.

    PubMed

    Bartram, D J; Baldwin, D S

    2010-03-27

    Veterinary surgeons are known to be at a higher risk of suicide compared with the general population. There has been much speculation regarding possible mechanisms underlying the increased suicide risk in the profession, but little empirical research. A computerised search of published literature on the suicide risk and influences on suicide among veterinarians, with comparison to the risk and influences in other occupational groups and in the general population, was used to develop a structured review. Veterinary surgeons have a proportional mortality ratio (PMR) for suicide approximately four times that of the general population and around twice that of other healthcare professions. A complex interaction of possible mechanisms may occur across the course of a veterinary career to increase the risk of suicide. Possible factors include the characteristics of individuals entering the profession, negative effects during undergraduate training, work-related stressors, ready access to and knowledge of means, stigma associated with mental illness, professional and social isolation, and alcohol or drug misuse (mainly prescription drugs to which the profession has ready access). Contextual effects such as attitudes to death and euthanasia, formed through the profession's routine involvement with euthanasia of companion animals and slaughter of farm animals, and suicide 'contagion' due to direct or indirect exposure to suicide of peers within this small profession are other possible influences.

  10. Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis.

    PubMed

    Murray, Robin M; Quigley, Harriet; Quattrone, Diego; Englund, Amir; Di Forti, Marta

    2016-10-01

    Epidemiological evidence demonstrates that cannabis use is associated with an increased risk of psychotic outcomes, and confirms a dose-response relationship between the level of use and the risk of later psychosis. High-potency cannabis and synthetic cannabinoids carry the greatest risk. Experimental administration of tetrahydrocannabinol, the active ingredient of cannabis, induces transient psychosis in normal subjects, but this effect can be ameliorated by co-administration of cannabidiol. This latter is a constituent of traditional hashish, but is largely absent from modern high-potency forms of cannabis. Argument continues over the extent to which genetic predisposition is correlated to, or interacts with, cannabis use, and what proportion of psychosis could be prevented by minimizing heavy use. As yet, there is not convincing evidence that cannabis use increases risk of other psychiatric disorders, but there are no such doubts concerning its detrimental effect on cognitive function. All of the negative aspects are magnified if use starts in early adolescence. Irrespective of whether use of cannabis is decriminalized or legalized, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.

  11. A Western Dietary Pattern Increases Prostate Cancer Risk: A Systematic Review and Meta-Analysis

    PubMed Central

    Fabiani, Roberto; Minelli, Liliana; Bertarelli, Gaia; Bacci, Silvia

    2016-01-01

    Dietary patterns were recently applied to examine the relationship between eating habits and prostate cancer (PC) risk. While the associations between PC risk with the glycemic index and Mediterranean score have been reviewed, no meta-analysis is currently available on dietary patterns defined by “a posteriori” methods. A literature search was carried out (PubMed, Web of Science) to identify studies reporting the relationship between dietary patterns and PC risk. Relevant dietary patterns were selected and the risks estimated were calculated by a random-effect model. Multivariable-adjusted odds ratios (ORs), for a first-percentile increase in dietary pattern score, were combined by a dose-response meta-analysis. Twelve observational studies were included in the meta-analysis which identified a “Healthy pattern” and a “Western pattern”. The Healthy pattern was not related to PC risk (OR = 0.96; 95% confidence interval (CI): 0.88–1.04) while the Western pattern significantly increased it (OR = 1.34; 95% CI: 1.08–1.65). In addition, the “Carbohydrate pattern”, which was analyzed in four articles, was positively associated with a higher PC risk (OR = 1.64; 95% CI: 1.35–2.00). A significant linear trend between the Western (p = 0.011) pattern, the Carbohydrate (p = 0.005) pattern, and the increment of PC risk was observed. The small number of studies included in the meta-analysis suggests that further investigation is necessary to support these findings. PMID:27754328

  12. Rare, Evolutionarily Unlikely Missense Substitutions in ATM Confer Increased Risk of Breast Cancer

    PubMed Central

    Tavtigian, Sean V.; Oefner, Peter J.; Babikyan, Davit; Hartmann, Anne; Healey, Sue; Le Calvez-Kelm, Florence; Lesueur, Fabienne; Byrnes, Graham B.; Chuang, Shu-Chun; Forey, Nathalie; Feuchtinger, Corinna; Gioia, Lydie; Hall, Janet; Hashibe, Mia; Herte, Barbara; McKay-Chopin, Sandrine; Thomas, Alun; Vallée, Maxime P.; Voegele, Catherine; Webb, Penelope M.; Whiteman, David C.; Sangrajrang, Suleeporn; Hopper, John L.; Southey, Melissa C.; Andrulis, Irene L.; John, Esther M.; Chenevix-Trench, Georgia

    2009-01-01

    The susceptibility gene for ataxia telangiectasia, ATM, is also an intermediate-risk breast-cancer-susceptibility gene. However, the spectrum and frequency distribution of ATM mutations that confer increased risk of breast cancer have been controversial. To assess the contribution of rare variants in this gene to risk of breast cancer, we pooled data from seven published ATM case-control mutation-screening studies, including a total of 1544 breast cancer cases and 1224 controls, with data from our own mutation screening of an additional 987 breast cancer cases and 1021 controls. Using an in silico missense-substitution analysis that provides a ranking of missense substitutions from evolutionarily most likely to least likely, we carried out analyses of protein-truncating variants, splice-junction variants, and rare missense variants. We found marginal evidence that the combination of ATM protein-truncating and splice-junction variants contribute to breast cancer risk. There was stronger evidence that a subset of rare, evolutionarily unlikely missense substitutions confer increased risk. On the basis of subset analyses, we hypothesize that rare missense substitutions falling in and around the FAT, kinase, and FATC domains of the protein may be disproportionately responsible for that risk and that a subset of these may confer higher risk than do protein-truncating variants. We conclude that a comparison between the graded distributions of missense substitutions in cases versus controls can complement analyses of truncating variants and help identify susceptibility genes and that this approach will aid interpretation of the data emerging from new sequencing technologies. PMID:19781682

  13. Early sepsis does not increase the risk of late sepsis in very low birth weight neonates

    PubMed Central

    Wynn, James L.; Hansen, Nellie I.; Das, Abhik; Cotten, C. Michael; Goldberg, Ronald N.; Sánchez, Pablo J.; Bell, Edward F.; Van Meurs, Krisa P.; Carlo, Waldemar A.; Laptook, Abbot R.; Higgins, Rosemary D.; Benjamin, Daniel K.; Stoll, Barbara J.

    2012-01-01

    Objective To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). Study design Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through December 2009 who survived >72 hours and were cared for within the NICHD Neonatal Research Network. Sepsis was defined by growth of bacteria or fungi in a blood culture obtained ≤72 hr of birth (EOS) or >72 hr (LOS) and antimicrobial therapy for ≥5 days or death <5 d while receiving therapy. Regression models were used to assess risk of death or LOS by 120d and LOS by 120d among survivors to discharge or 120d, adjusting for gestational age and other covariates. Results Of 34,396 infants studied 504 (1.5%) had EOS. After adjustment, risk of death or LOS by 120d did not differ overall for infants with EOS compared with those without EOS [RR:0.99 (0.89-1.09)] but was reduced in infants born at <25wk gestation [RR:0.87 (0.76-0.99), p=0.048]. Among survivors, no difference in LOS risk was found overall for infants with versus without EOS [RR:0.88 (0.75-1.02)], but LOS risk was shorter in infants with BW 401-750 g who had EOS [RR:0.80 (0.64-0.99), p=0.047]. Conclusions Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function. PMID:23295144

  14. Increasing risk of cataract in HCV patients receiving anti-HCV therapy: A nationwide cohort study

    PubMed Central

    Lin, Shih-Yi; Lin, Cheng-Li; Ju, Shu-Woei; Wang, I-Kuan; Lin, Cheng-Chieh; Lin, Chih-Hsueh; Hsu, Wu-Huei

    2017-01-01

    Purpose Hepatitis C virus (HCV) infection is associated with increased systemic oxidative stress, which leads to cardiovascular events, diabetes, and chronic kidney disease. Similarly, cataract is also associated with increased oxidative stress. The association between HCV infection and increased risk of cataract remains unclear. Methods A total of 11,652 HCV-infected patients and 46,608 age- and sex-matched non-HCV infected patients were identified during 2003–2011. All patient data were tracked until a diagnosis of cataract, death, or the end of 2011. Cumulative incidences and hazard ratios (HRs) were calculated. Results The mean follow-up durations were 5.29 and 5.86 years for the HCV and non-HCV cohorts, respectively. The overall incidence density rate for cataract was 1.36 times higher in the HCV cohort than in the non-HCV cohort (1.86 and 1.37 per 100 person-y, respectively). After adjusting for age, sex, comorbidities of diabetes, hypertension, hyperlipidemia, asthma, chronic obstructive pulmonary disease, coronary artery disease, and anxiety, patients with HCV infection had an increased risk of cataract compared with those without HCV infection [adjusted HR = 1.23, 95% confidence interval (CI) = 1.14–1.32]. HCV-infected patients receiving interferon–ribavirin therapy had a 1.83 times higher (95% CI = 1.40–2.38) risk of cataract than non-HCV infected patients did. Conclusion HCV infection, even without the complication of cirrhosis, is associated with an increased risk of cataract, and this risk is higher in HCV-infected patients undergoing interferon–ribavirin therapy. PMID:28264004

  15. Worldwide Increasing Incidence of Thyroid Cancer: Update on Epidemiology and Risk Factors

    PubMed Central

    Frasca, Francesco; Regalbuto, Concetto; Squatrito, Sebastiano; Vigneri, Riccardo

    2013-01-01

    Background. In the last decades, thyroid cancer incidence has continuously and sharply increased all over the world. This review analyzes the possible reasons of this increase. Summary. Many experts believe that the increased incidence of thyroid cancer is apparent, because of the increased detection of small cancers in the preclinical stage. However, a true increase is also possible, as suggested by the observation that large tumors have also increased and gender differences and birth cohort effects are present. Moreover, thyroid cancer mortality, in spite of earlier diagnosis and better treatment, has not decreased but is rather increasing. Therefore, some environmental carcinogens in the industrialized lifestyle may have specifically affected the thyroid. Among potential carcinogens, the increased exposure to medical radiations is the most likely risk factor. Other factors specific for the thyroid like increased iodine intake and increased prevalence of chronic autoimmune thyroiditis cannot be excluded, while other factors like the increasing prevalence of obesity are not specific for the thyroid. Conclusions. The increased incidence of thyroid cancer is most likely due to a combination of an apparent increase due to more sensitive diagnostic procedures and of a true increase, a possible consequence of increased population exposure to radiation and to other still unrecognized carcinogens. PMID:23737785

  16. No increased risk of early revision during the implementation phase of new cup designs

    PubMed Central

    Björk, Mathias; Nemes, Szilard; Rolfson, Ola; Jolbäck, Per; Kärrholm, Johan

    2016-01-01

    Background and purpose — In Sweden, less than 5% of patients who undergo total hip arthroplasty (THA) have revision. Younger patients have an increased risk of revision. New prosthetic designs are being introduced in order to improve outcomes further. We investigated whether the introductory phase of new cup designs would increase the revision rate. Patients and methods — All THAs and first-time cup revisions performed from 1993 through 2011 were identified in the Swedish Hip Arthroplasty Register. The 15 types of cups used in more than 500 operations and inserted in more than 50 cases in each hospital (n = 52,903) were selected. All cups were given an order number, based on the order in which the cup had been inserted at each hospital. The influence of order number on the risk of revision was analyzed in a regression model, which was adjusted for potentially confounding demographic and surgical data. Revision within 2 years for all reasons (n = 940) was used as primary endpoint. Changes in the risk of revision based on the order number were analyzed using a spline. Results — The order number of the cup had no influence on the risk of early revision (p ≥ 0.7). Categorizing the order number using cutoff values obtained from the splines did not result in any statistically significant changes in risk of revision (p ≥ 0.2). Interpretation — We did not find any increased risk of early revision during the implementation phase of new cup designs. This finding is unexpected, and partly conflicts with data from other registries. The structured and stepwise introduction of new prosthesis designs, facilitated by the annual feedback from the Swedish Hip Arthroplasty Register, may partly explain this discrepancy. PMID:27168095

  17. Intakes of red meat, processed meat, and meat mutagens increase lung cancer risk.

    PubMed

    Lam, Tram Kim; Cross, Amanda J; Consonni, Dario; Randi, Giorgia; Bagnardi, Vincenzo; Bertazzi, Pier Alberto; Caporaso, Neil E; Sinha, Rashmi; Subar, Amy F; Landi, Maria Teresa

    2009-02-01

    Red and processed meat intake may increase lung cancer risk. However, the epidemiologic evidence is inconsistent and few studies have evaluated the role of meat mutagens formed during high cooking temperatures. We investigated the association of red meat, processed meat, and meat mutagen intake with lung cancer risk in Environment And Genetics in Lung cancer Etiology, a population-based case-control study. Primary lung cancer cases (n = 2,101) were recruited from 13 hospitals within the Lombardy region of Italy examining approximately 80% of the cases from the area. Noncancer population controls (n = 2,120), matched to cases on gender, residence, and age, were randomly selected from the same catchment area. Diet was assessed in 1,903 cases and 2,073 controls and used in conjunction with a meat mutagen database to estimate intake of heterocyclic amines (HCA) and benzo(a)pyrene (BaP). Multivariable odds ratios (OR) and 95% confidence intervals (95% CI) for sex-specific tertiles of intake were calculated using unconditional logistic regression. Red and processed meat were positively associated with lung cancer risk (highest-versus-lowest tertile: OR, 1.8; 95% CI, 1.5-2.2; P trend < 0.001 and OR, 1.7; 95% CI, 1.4-2.1; P trend < 0.001, respectively); the risks were strongest among never smokers (OR, 2.4; 95% CI, 1.4-4.0; P trend = 0.001 and OR, 2.5; 95% CI, 1.5-4.2; P trend = 0.001, respectively). HCAs and BaP were significantly associated with increased risk of lung cancer. When separated by histology, significant positive associations for both meat groups were restricted to adenocarcinoma and squamous cell carcinoma but not small cell carcinoma of the lung. In summary, red meat, processed meat, and meat mutagens were independently associated with increased risk of lung cancer.

  18. CREB1 gene polymorphisms combined with environmental risk factors increase susceptibility to major depressive disorder (MDD).

    PubMed

    Wang, Peng; Yang, Yanjie; Yang, Xiuxian; Qiu, Xiaohui; Qiao, Zhengxue; Wang, Lin; Zhu, Xiongzhao; Sui, Hong; Ma, Jingsong

    2015-01-01

    Major depressive disorder (MDD) is one of the most severe psychiatric disorders. The objective of this study was to explore the effects of CREB1 gene polymorphisms on risk of developing MDD and the joint effects of gene-environment interactions. Genotyping was performed by Taqman allelic discrimination assay among 586 patients and 586 healthy controls. A significant impact on rs6740584 genotype distribution was found for childhood trauma (P = 0.015). We did not find an association of CREB1 polymorphisms with MDD susceptibility. However, we found a significantly increased risk associated with the interactions of CREB1 polymorphisms and drinking (OR = 11.67, 95% CI = 2.52-54.18; OR = 11.52, 95% CI = 2.55-51.95 for rs11904814; OR = 4.18, 95% CI = 1.87-9.38; OR = 5.02, 95% CI = 2.27-11.14 for rs6740584; OR = 7.58, 95% CI = 2.05-27.98; OR = 7.59, 95% CI = 2.12-27.14 for rs2553206; OR = 8.37, 95% CI = 3.02-23.23; OR = 7.84, 95% CI = 2.93-20.98 for rs2551941). We also noted that CREB polymorphisms combined with family harmony and childhood trauma conferred increased susceptibility for MDD. In conclusion, polymorphisms in the CREB gene may not be independently associated with MDD risk, but they are likely to confer increased susceptibility by interacting with environmental risk factors in the Chinese population.

  19. Increased risk of death with congenital anomalies in the offspring of male semiconductor workers.

    PubMed

    Lin, Ching-Chun; Wang, Jung-Der; Hsieh, Gong-Yih; Chang, Yu-Yin; Chen, Pau-Chung

    2008-01-01

    Female workers in the semiconductor industry have higher risks of subfertility and spontaneous abortion, but no studies exploring male-mediated developmental toxicity have been published. This study aimed to investigate whether the offspring of male workers employed in the semiconductor manufacturing industry had an increased risk of death with congenital anomalies. The 6,834 male workers had been employed in the eight semiconductor companies in Taiwan between 1980 and 1994. We identified the live born children with or without congenital anomalies of the workers using the National Birth and Death Registries from the Department of Health, Taiwan. Multiple logistic regression models were used to estimate the odds ratios (OR) of birth outcomes and deaths, controlling for infant sex, maternal age, and paternal education. A total of 5,702 children were born to male workers during the period 1980-1994. There were increased risks of deaths with congenital anomalies (adjusted OR, 3.26; and 95% confidence interval [CI], 1.12-9.44) and heart anomalies (OR, 4.15; 95% CI, 1.08-15.95) in the offspring of male workers who were employed during the two months before conception. We found evidence of a possible link between paternal preconception exposure of semiconductor manufacturing and an increased risk of congenital anomalies, especially of the heart. The possible etiological basis needs to be corroborated in further research.

  20. CREB1 gene polymorphisms combined with environmental risk factors increase susceptibility to major depressive disorder (MDD)

    PubMed Central

    Wang, Peng; Yang, Yanjie; Yang, Xiuxian; Qiu, Xiaohui; Qiao, Zhengxue; Wang, Lin; Zhu, Xiongzhao; Sui, Hong; Ma, Jingsong

    2015-01-01

    Major depressive disorder (MDD) is one of the most severe psychiatric disorders. The objective of this study was to explore the effects of CREB1 gene polymorphisms on risk of developing MDD and the joint effects of gene-environment interactions. Genotyping was performed by Taqman allelic discrimination assay among 586 patients and 586 healthy controls. A significant impact on rs6740584 genotype distribution was found for childhood trauma (P = 0.015). We did not find an association of CREB1 polymorphisms with MDD susceptibility. However, we found a significantly increased risk associated with the interactions of CREB1 polymorphisms and drinking (OR = 11.67, 95% CI = 2.52-54.18; OR = 11.52, 95% CI = 2.55-51.95 for rs11904814; OR = 4.18, 95% CI = 1.87-9.38; OR = 5.02, 95% CI = 2.27-11.14 for rs6740584; OR = 7.58, 95% CI = 2.05-27.98; OR = 7.59, 95% CI = 2.12-27.14 for rs2553206; OR = 8.37, 95% CI = 3.02-23.23; OR = 7.84, 95% CI = 2.93-20.98 for rs2551941). We also noted that CREB polymorphisms combined with family harmony and childhood trauma conferred increased susceptibility for MDD. In conclusion, polymorphisms in the CREB gene may not be independently associated with MDD risk, but they are likely to confer increased susceptibility by interacting with environmental risk factors in the Chinese population. PMID:25755794

  1. Apolipoprotein E polymorphisms increase the risk of post-stroke depression

    PubMed Central

    Li, Xue-bin; Wang, Jie; Xu, An-ding; Huang, Jian-min; Meng, Lan-qing; Huang, Rui-ya; Wang, Jun-li

    2016-01-01

    Recent reports have shown that apolipoprotein E (APOE) polymorphisms are involved in neurodegenerative disease. However, it is unclear whether APOE affects post-stroke depression. Accordingly, we hypothesized that APOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study (including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction) to determine possible association between APOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our findings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast, APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These results suggest that the APOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and that APOE rs429358-C allele genotypes may be detrimental to recovery of nerve function after stoke. Indeed, these findings provide clinical data for future post-stroke depression gene interventions. PMID:28123423

  2. Associations between sleep loss and increased risk of obesity and diabetes.

    PubMed

    Knutson, Kristen L; Van Cauter, Eve

    2008-01-01

    During the past few decades, sleep curtailment has become a very common in industrialized countries. This trend for shorter sleep duration has developed over the same time period as the dramatic increase in the prevalence of obesity and diabetes. Evidence is rapidly accumulating to indicate that chronic partial sleep loss may increase the risk of obesity and diabetes. Laboratory studies in healthy volunteers have shown that experimental sleep restriction is associated with an adverse impact on glucose homeostasis. Insulin sensitivity decreases rapidly and markedly without adequate compensation in beta cell function, resulting in an elevated risk of diabetes. Prospective epidemiologic studies in both children and adults are consistent with a causative role of short sleep in the increased risk of diabetes. Sleep curtailment is also associated with a dysregulation of the neuroendocrine control of appetite, with a reduction of the satiety factor, leptin, and an increase in the hunger-promoting hormone, ghrelin. Thus, sleep loss may alter the ability of leptin and ghrelin to accurately signal caloric need, acting in concert to produce an internal misperception of insufficient energy availability. The adverse impact of sleep deprivation on appetite regulation is likely to be driven by increased activity in neuronal populations expressing the excitatory peptides orexins that promote both waking and feeding. Consistent with the laboratory evidence, multiple epidemiologic studies have shown an association between short sleep and higher body mass index after controlling for a variety of possible confounders.

  3. Associations between sleep loss and increased risk of obesity and diabetes

    PubMed Central

    Knutson, Kristen L.; Van Cauter, Eve

    2015-01-01

    During the past few decades, sleep curtailment has become a very common behavior in industrialized countries. This trend for shorter sleep duration has developed over the same time period as the dramatic increase in the prevalence of obesity and diabetes. There is rapidly accumulating evidence to indicate that chronic partial sleep loss may increase the risk of obesity and diabetes. Laboratory studies in healthy volunteers have shown that experimental sleep restriction is associated with an adverse impact on glucose homeostasis. Insulin sensitivity decreases rapidly and markedly without adequate compensation in beta cell function, resulting in an elevated risk of diabetes. Prospective epidemiologic studies in both children and adults are consistent with a causative role of short sleep in the increased risk of diabetes. Sleep curtailment is also associated with a dysregulation of the neuroendocrine control of appetite, with a reduction of the satiety factor leptin and an increase in the hunger-promoting hormone ghrelin. Thus, sleep loss may alter the ability of leptin and ghrelin to accurately signal caloric need, acting in concert to produce an internal misperception of insufficient energy availability. The adverse impact of sleep deprivation on appetite regulation is likely to be driven by increased activity in neuronal populations expressing the excitatory peptides orexins that promote both waling and feeding. Consistent with the laboratory evidence, multiple epidemiologic studies have shown an association between short sleep and higher body mass index after controlling for a variety of possible confounders. PMID:18591489

  4. Climate change will increase the naturalization risk from garden plants in Europe

    PubMed Central

    Wessely, Johannes; Bossdorf, Oliver; Dawson, Wayne; Essl, Franz; Gattringer, Andreas; Klonner, Günther; Kreft, Holger; Kuttner, Michael; Moser, Dietmar; Pergl, Jan; Pyšek, Petr; Thuiller, Wilfried; van Kleunen, Mark; Weigelt, Patrick; Winter, Marten; Dullinger, Stefan; Beaumont, Linda

    2016-01-01

    Abstract Aim Plant invasions often follow initial introduction with a considerable delay. The current non‐native flora of a region may hence contain species that are not yet naturalized but may become so in the future, especially if climate change lifts limitations on species spread. In Europe, non‐native garden plants represent a huge pool of potential future invaders. Here, we evaluate the naturalization risk from this species pool and how it may change under a warmer climate. Location Europe. Methods We selected all species naturalized anywhere in the world but not yet in Europe from the set of non‐native European garden plants. For this subset of 783 species, we used species distribution models to assess their potential European ranges under different scenarios of climate change. Moreover, we defined geographical hotspots of naturalization risk from those species by combining projections of climatic suitability with maps of the area available for ornamental plant cultivation. Results Under current climate, 165 species would already find suitable conditions in > 5% of Europe. Although climate change substantially increases the potential range of many species, there are also some that are predicted to lose climatically suitable area under a changing climate, particularly species native to boreal and Mediterranean biomes. Overall, hotspots of naturalization risk defined by climatic suitability alone, or by a combination of climatic suitability and appropriate land cover, are projected to increase by up to 102% or 64%, respectively. Main conclusions Our results suggest that the risk of naturalization of European garden plants will increase with warming climate, and thus it is very likely that the risk of negative impacts from invasion by these plants will also grow. It is therefore crucial to increase awareness of the possibility of biological invasions among horticulturalists, particularly in the face of a warming climate. PMID:28111525

  5. Excessive Daytime Sleepiness Increases the Risk of Motor Vehicle Crash in Obstructive Sleep Apnea

    PubMed Central

    Ward, Kim L.; Hillman, David R.; James, Alan; Bremner, Alexandra P.; Simpson, Laila; Cooper, Matthew N.; Palmer, Lyle J.; Fedson, Annette C.; Mukherjee, Sutapa

    2013-01-01

    Study Objectives: (1) To describe the incidence rate of motor vehicle crashes (MVCs) in patients with obstructive sleep apnea (OSA); and (2) to investigate MVC risk factors in OSA patients. Methods: A retrospective case-series observational study was conducted using data from the West Australian Sleep Health Study at a tertiary hospital-based sleep clinic. Participants were patients (N = 2,673) referred for assessment of suspected sleep disordered breathing. Questionnaire data were collected including age, sex, years of driving, near-misses and MVCs, sleepiness, and consumption of alcohol and caffeinated drinks. Overnight laboratory-based polysomnography was performed using standard methodology.1 Poisson univariate and negative binomial multivariable regression models were used to investigate associations between risk factors and MVC and near-miss risk in patients with untreated OSA. Results: In patients with untreated OSA, the crash rate was 0.06 MVC/person-year compared with the general community crash rate of 0.02 MVC/person-year. The rate ratio comparing very sleepy men with normal men was 4.68 (95% CI 3.07, 7.14) for near-misses and 1.27 (95% CI 1.00, 1.61) for crashes, after adjusting for confounders. In women there was a significant association with sleepiness score (p = 0.02) but no dose effect across quartiles. Conclusions: Untreated OSA is associated with an increased risk of near-misses in men and women and an increased risk of MVCs in very sleepy men. There is a strong association between excessive daytime sleepiness and increased report of near-misses. Our data support the observation that it is those patients with increased sleepiness regardless of OSA severity who are most at risk. Citation: Ward KL; Hillman DR; James A; Bremner AP; Simpson L; Cooper MN; Palmer LJ; Fedson AC; Mukherjee S. Excessive daytime sleepiness increases the risk of motor vehicle crash in obstructive sleep apnea. J Clin Sleep Med 2013;9(10):1013-1021. PMID:24127145

  6. Social isolation induces autophagy in the mouse mammary gland: link to increased mammary cancer risk.

    PubMed

    Sumis, Allison; Cook, Katherine L; Andrade, Fabia O; Hu, Rong; Kidney, Emma; Zhang, Xiyuan; Kim, Dominic; Carney, Elissa; Nguyen, Nguyen; Yu, Wei; Bouker, Kerrie B; Cruz, Idalia; Clarke, Robert; Hilakivi-Clarke, Leena

    2016-10-01

    Social isolation is a strong predictor of early all-cause mortality and consistently increases breast cancer risk in both women and animal models. Because social isolation increases body weight, we compared its effects to those caused by a consumption of obesity-inducing diet (OID) in C57BL/6 mice. Social isolation and OID impaired insulin and glucose sensitivity. In socially isolated, OID-fed mice (I-OID), insulin resistance was linked to reduced Pparg expression and increased neuropeptide Y levels, but in group-housed OID fed mice (G-OID), it was linked to increased leptin and reduced adiponectin levels, indicating that the pathways leading to insulin resistance are different. Carcinogen-induced mammary tumorigenesis was significantly higher in I-OID mice than in the other groups, but cancer risk was also increased in socially isolated, control diet-fed mice (I-C) and G-OID mice compared with that in controls. Unfolded protein response (UPR) signaling (GRP78; IRE1) was upregulated in the mammary glands of OID-fed mice, but not in control diet-fed, socially isolated I-C mice. In contrast, expression of BECLIN1, ATG7 and LC3II were increased, and p62 was downregulated by social isolation, indicating increased autophagy. In the mammary glands of socially isolated mice, but not in G-OID mice, mRNA expressions of p53 and the p53-regulated autophagy inducer Dram1 were upregulated, and nuclear p53 staining was strong. Our findings further indicated that autophagy and tumorigenesis were not increased in Atg7(+/-) mice kept in social isolation and fed OID. Thus, social isolation may increase breast cancer risk by inducing autophagy, independent of changes in body weight.

  7. Climate Change Is Increasing the Risk of the Reemergence of Malaria in Romania

    PubMed Central

    Bodale, Ilie; Florescu, Simin-Aysel; Roman, Constantin; Acatrinei, Dumitru

    2016-01-01

    The climatic modifications lead to global warming; favouring the risk of the appearance and development of diseases are considered until now tropical diseases. Another important factor is the workers' immigration, the economic crisis favouring the passive transmission of new species of culicidae from different areas. Malaria is the disease with the widest distribution in the globe. Millions of people are infected every year in Africa, India, South-East Asia, Middle East, and Central and South America, with more than 41% of the global population under the risk of infestation with malaria. The increase of the number of local cases reported in 2007–2011 indicates that the conditions can favour the high local transmission in the affected areas. In the situation presented, the establishment of the level of risk concerning the reemergence of malaria in Romania becomes a priority. PMID:27847824

  8. Low-trauma fractures indicate increased risk of hip fracture in frail older people.

    PubMed

    Chen, Jian Sheng; Cameron, Ian D; Simpson, Judy M; Seibel, Markus J; March, Lyn M; Cumming, Robert G; Lord, Stephen R; Sambrook, Philip N

    2011-02-01

    This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n = 953), the nonhip fracture group (n = 194), and the hip fracture group (n = 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p = .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture.

  9. Lupus Risk Variant Increases pSTAT1 Binding and Decreases ETS1 Expression

    PubMed Central

    Lu, Xiaoming; Zoller, Erin E.; Weirauch, Matthew T.; Wu, Zhiguo; Namjou, Bahram; Williams, Adrienne H.; Ziegler, Julie T.; Comeau, Mary E.; Marion, Miranda C.; Glenn, Stuart B.; Adler, Adam; Shen, Nan; Nath, Swapan K.; Stevens, Anne M.; Freedman, Barry I.; Tsao, Betty P.; Jacob, Chaim O.; Kamen, Diane L.; Brown, Elizabeth E.; Gilkeson, Gary S.; Alarcón, Graciela S.; Reveille, John D.; Anaya, Juan-Manuel; James, Judith A.; Sivils, Kathy L.; Criswell, Lindsey A.; Vilá, Luis M.; Alarcón-Riquelme, Marta E.; Petri, Michelle; Scofield, R. Hal; Kimberly, Robert P.; Ramsey-Goldman, Rosalind; Joo, Young Bin; Choi, Jeongim; Bae, Sang-Cheol; Boackle, Susan A.; Graham, Deborah Cunninghame; Vyse, Timothy J.; Guthridge, Joel M.; Gaffney, Patrick M.; Langefeld, Carl D.; Kelly, Jennifer A.; Greis, Kenneth D.; Kaufman, Kenneth M.; Harley, John B.; Kottyan, Leah C.

    2015-01-01

    Genetic variants at chromosomal region 11q23.3, near the gene ETS1, have been associated with systemic lupus erythematosus (SLE), or lupus, in independent cohorts of Asian ancestry. Several recent studies have implicated ETS1 as a critical driver of immune cell function and differentiation, and mice deficient in ETS1 develop an SLE-like autoimmunity. We performed a fine-mapping study of 14,551 subjects from multi-ancestral cohorts by starting with genotyped variants and imputing to all common variants spanning ETS1. By constructing genetic models via frequentist and Bayesian association methods, we identified 16 variants that are statistically likely to be causal. We functionally assessed each of these variants on the basis of their likelihood of affecting transcription factor binding, miRNA binding, or chromatin state. Of the four variants that we experimentally examined, only rs6590330 differentially binds lysate from B cells. Using mass spectrometry, we found more binding of the transcription factor signal transducer and activator of transcription 1 (STAT1) to DNA near the risk allele of rs6590330 than near the non-risk allele. Immunoblot analysis and chromatin immunoprecipitation of pSTAT1 in B cells heterozygous for rs6590330 confirmed that the risk allele increased binding to the active form of STAT1. Analysis with expression quantitative trait loci indicated that the risk allele of rs6590330 is associated with decreased ETS1 expression in Han Chinese, but not other ancestral cohorts. We propose a model in which the risk allele of rs6590330 is associated with decreased ETS1 expression and increases SLE risk by enhancing the binding of pSTAT1. PMID:25865496

  10. Does cooking with vegetable oils increase the risk of chronic diseases?: a systematic review.

    PubMed

    Sayon-Orea, Carmen; Carlos, Silvia; Martínez-Gonzalez, Miguel A

    2015-04-01

    Overweight/obesity, CVD and type 2 diabetes are strongly associated with nutritional habits. High consumption of fried foods might increase the risk of these disorders. However, it is not clear whether the use of vegetables oils for cooking increases the risk of chronic diseases. We systematically searched for published studies that assessed the association between vegetable oil consumption including fried food consumption and the risk of overweight/obesity or weight gain, T2DM or the metabolic syndrome, and CVD or hypertension in the following databases: PubMed; Web of Science; Google Scholar. Keywords such as 'fried food' or 'vegetable oil' or 'frying' or 'frying oils' or 'dietary fats' and 'weight gain' or 'overweight' or 'obesity' or 'CHD' or 'CVD' or 'type 2 diabetes' or 'metabolic syndrome' were used in the primary search. Additional published reports were obtained through other sources. A total of twenty-three publications were included based on specific selection criteria. Based on the results of the studies included in the present systematic review, we conclude that (1) the myth that frying foods is generally associated with a higher risk of CVD is not supported by the available evidence; (2) virgin olive oil significantly reduces the risk of CVD clinical events, based on the results of a large randomised trial that included as part of the intervention the recommendation to use high amounts of virgin olive oil, also for frying foods; and (3) high consumption of fried foods is probably related to a higher risk of weight gain, though the type of oil may perhaps modify this association.

  11. Epistasis between COMT and MTHFR in maternal-fetal dyads increases risk for preeclampsia.

    PubMed

    Hill, Lori D; York, Timothy P; Kusanovic, Juan P; Gomez, Ricardo; Eaves, Lindon J; Romero, Roberto; Strauss, Jerome F

    2011-01-31

    Preeclampsia is a leading cause of perinatal morbidity and mortality. This disorder is thought to be multifactorial in origin, with multiple genes, environmental and social factors, contributing to disease. One proposed mechanism is placental hypoxia-driven imbalances in angiogenic and anti-angiogenic factors, causing endothelial cell dysfunction. Catechol-O-methyltransferase (Comt)-deficient pregnant mice have a preeclampsia phenotype that is reversed by exogenous 2-methoxyestradiol (2-ME), an estrogen metabolite generated by COMT. 2-ME inhibits Hypoxia Inducible Factor 1α, a transcription factor mediating hypoxic responses. COMT has been shown to interact with methylenetetrahydrofolate reductase (MTHFR), which modulates the availability of S-adenosylmethionine (SAM), a COMT cofactor. Variations in MTHFR have been associated with preeclampsia. By accounting for allelic variation in both genes, the role of COMT has been clarified. COMT allelic variation is linked to enzyme activity and four single nucleotide polymorphisms (SNPs) (rs6269, rs4633, rs4680, and rs4818) form haplotypes that characterize COMT activity. We tested for association between COMT haplotypes and the MTHFR 677 C → T polymorphism and preeclampsia risk in 1103 Chilean maternal-fetal dyads. The maternal ACCG COMT haplotype was associated with reduced risk for preeclampsia (P = 0.004), and that risk increased linearly from low to high activity haplotypes (P = 0.003). In fetal samples, we found that the fetal ATCA COMT haplotype and the fetal MTHFR minor "T" allele interact to increase preeclampsia risk (p = 0.022). We found a higher than expected number of patients with preeclampsia with both the fetal risk alleles alone (P = 0.052) and the fetal risk alleles in combination with a maternal balancing allele (P<0.001). This non-random distribution was not observed in controls (P = 0.341 and P = 0.219, respectively). Our findings demonstrate a role for both maternal and fetal COMT in preeclampsia

  12. Transcobalamin II Receptor Polymorphisms Are Associated with Increased Risk for Neural Tube Defects

    PubMed Central

    Pangilinan, Faith; Mitchell, Adam; VanderMeer, Julie; Molloy, Anne M.; Troendle, James; Conley, Mary; Kirke, Peadar N.; Sutton, Marie; Sequeira, Jeffrey M.; Quadros, Edward V.; Scott, John M.; Mills, James L.; Brody, Lawrence C.

    2014-01-01

    Objective: Women who have low cobalamin (vitamin B12) levels are at increased risk for having children with neural tube defects (NTDs). The transcobalamin II receptor (TCblR) mediates uptake of cobalamin into cells. We evaluated inherited variants in the TCblR gene as NTD risk factors. Methods: Case-control and family-based tests of association were used to screen common variation in TCblR as genetic risk factors for NTDs in a large Irish group. A confirmatory group of NTD triads was used to test positive findings. Results: We found two tightly linked variants associated with NTDs in a recessive model: TCblR rs2336573 (G220R) (pcorr=0.0080, corrected for multiple hypothesis testing) and TCblR rs9426 (pcorr =0. 0279). These variants were also associated with NTDs in a family-based test prior to multiple test correction (log-linear analysis of a recessive model: rs2336573 (G220R) (RR=6.59, p=0.0037) and rs9426 (RR=6.71, p=0.0035)). We describe a copy number variant (CNV) distal to TCblR and two previously unreported exonic insertion-deletion polymorphisms. Conclusions: TCblR rs2336573 (G220R) and TCblR rs9426 represent a significant risk factor in NTD cases in the Irish population. The homozygous risk genotype was not detected in nearly one thousand controls, indicating this NTD risk factor may be of low frequency and high penetrance. Nine other variants are in perfect LD with the associated SNPs. Additional work is required to identify the disease-causing variant. Our data suggest that variation in TCblR plays a role in NTD risk and that these variants may modulate cobalamin metabolism. PMID:20577008

  13. Clarifying the role of personality dispositions in risk for increased gambling behavior

    PubMed Central

    Cyders, Melissa A.; Smith, Gregory T.

    2008-01-01

    The current study clarifies the role of personality for increased gambling behaviors. The authors compared five traits, each involving a different disposition to rash action, predicting increased gambling behavior across the transition into college life. The authors sampled 418 college students (75% female; median age 18.0 years) across their freshman year. Participants completed the UPPS-P scale and measures to assess gambling and risky behavior participation. SEM analyses showed that although the disposition to engage in rash action when in an unusually positive mood (positive urgency), lack of planning, and sensation seeking all related to both gambling behavior and general risky behavior (e.g., mountain climbing) cross-sectionally, only positive urgency predicted longitudinal increases in gambling behavior and only sensation seeking predicted longitudinal increases in general risky behaviors. Beginning college students high in positive urgency are at increased risk to increase their gambling behavior in college. PMID:19088857

  14. The effect of increased genetic risk for Alzheimer's disease on hippocampal and amygdala volume.

    PubMed

    Lupton, Michelle K; Strike, Lachlan; Hansell, Narelle K; Wen, Wei; Mather, Karen A; Armstrong, Nicola J; Thalamuthu, Anbupalam; McMahon, Katie L; de Zubicaray, Greig I; Assareh, Amelia A; Simmons, Andrew; Proitsi, Petroula; Powell, John F; Montgomery, Grant W; Hibar, Derrek P; Westman, Eric; Tsolaki, Magda; Kloszewska, Iwona; Soininen, Hilkka; Mecocci, Patrizia; Velas, Bruno; Lovestone, Simon; Brodaty, Henry; Ames, David; Trollor, Julian N; Martin, Nicholas G; Thompson, Paul M; Sachdev, Perminder S; Wright, Margaret J

    2016-04-01

    Reduction in hippocampal and amygdala volume measured via structural magnetic resonance imaging is an early marker of Alzheimer's disease (AD). Whether genetic risk factors for AD exert an effect on these subcortical structures independent of clinical status has not been fully investigated. We examine whether increased genetic risk for AD influences hippocampal and amygdala volumes in case-control and population cohorts at different ages, in 1674 older (aged >53 years; 17% AD, 39% mild cognitive impairment [MCI]) and 467 young (16-30 years) adults. An AD polygenic risk score combining common risk variants excluding apolipoprotein E (APOE), and a single nucleotide polymorphism in TREM2, were both associated with reduced hippocampal volume in healthy older adults and those with MCI. APOE ε4 was associated with hippocampal and amygdala volume in those with AD and MCI but was not associated in healthy older adults. No associations were found in young adults. Genetic risk for AD affects the hippocampus before the clinical symptoms of AD, reflecting a neurodegenerative effect before clinical manifestations in older adults.

  15. The effect of increased genetic risk for Alzheimer’s disease on hippocampal and amygdala volume

    PubMed Central

    Lupton, Michelle K.; Strike, Lachlan; Hansell, Narelle K.; Wen, Wei; Mather, Karen A.; Armstrong, Nicola J.; Thalamuthu, Anbupalam; McMahon, Katie L.; de Zubicaray, Greig I.; Assareh, Amelia A.; Simmons, Andrew; Proitsi, Petroula; Powell, John F.; Montgomery, Grant W.; Hibar, Derrek P.; Westman, Eric; Tsolaki, Magda; Kloszewska, Iwona; Soininen, Hilkka; Mecocci, Patrizia; Velas, Bruno; Lovestone, Simon; Brodaty, Henry; Ames, David; Trollor, Julian N.; Martin, Nicholas G.; Thompson, Paul M.; Sachdev, Perminder S.; Wright, Margaret J.

    2016-01-01

    Reduction in hippocampal and amygdala volume measured via structural magnetic resonance imaging is an early marker of Alzheimer’s disease (AD). Whether genetic risk factors for AD exert an effect on these subcortical structures independent of clinical status has not been fully investigated. We examine whether increased genetic risk for AD influences hippocampal and amygdala volumes in case-control and population cohorts at different ages, in 1674 older (aged >53 years; 17% AD, 39% mild cognitive impairment [MCI]) and 467 young (16–30 years) adults. An AD polygenic risk score combining common risk variants excluding apolipoprotein E (APOE), and a single nucleotide polymorphism in TREM2, were both associated with reduced hippocampal volume in healthy older adults and those with MCI. APOE ɛ4 was associated with hippocampal and amygdala volume in those with AD and MCI but was not associated in healthy older adults. No associations were found in young adults. Genetic risk for AD affects the hippocampus before the clinical symptoms of AD, reflecting a neurodegenerative effect before clinical manifestations in older adults. PMID:26973105

  16. Recent victimization increases risk for violence in justice-involved persons with mental illness.

    PubMed

    Sadeh, Naomi; Binder, Renée L; McNiel, Dale E

    2014-04-01

    A large body of research has examined relationships between distal experiences of victimization and the likelihood of engaging in violence later in life. Less is known about the influence of recent violent victimization on risk for violence perpetration. To our knowledge, this is the first study to examine prospectively whether recent victimization in adulthood increases the risk of future violence. Specifically, the present study assessed the incremental validity of recent violent victimization in the prediction of future violence in a sample of justice-involved adults with serious mental illness. The study examined (a) whether recent experiences of violent victimization (i.e., within 6 months of the baseline assessment) predicted a greater likelihood of perpetrating violence in the next year, and (b) whether inclusion of recent victimization enhanced the predictive validity of a model of violence risk in a sample of justice-involved adults with severe mental illness (N = 167). Hierarchical logistic regression analyses indicated that exposure to recent violent victimization at the baseline assessment predicted a greater likelihood of engaging in violent behavior during the year follow-up period. Additionally, recent exposure to violence at the baseline assessment continued to explain a significant amount of variance in a model of future violence perpetration above the variance accounted for by well-established violence risk factors. Taken together, the findings suggest that recent victimization is important to consider in understanding and evaluating risk of violence by persons with mental disorders who are involved in the criminal justice system.

  17. Grey matter networks in people at increased familial risk for schizophrenia.

    PubMed

    Tijms, Betty M; Sprooten, Emma; Job, Dominic; Johnstone, Eve C; Owens, David G C; Willshaw, David; Seriès, Peggy; Lawrie, Stephen M

    2015-10-01

    Grey matter brain networks are disrupted in schizophrenia, but it is still unclear at which point during the development of the illness these disruptions arise and whether these can be associated with behavioural predictors of schizophrenia. We investigated if single-subject grey matter networks were disrupted in a sample of people at familial risk of schizophrenia. Single-subject grey matter networks were extracted from structural MRI scans of 144 high risk subjects, 32 recent-onset patients and 36 healthy controls. The following network properties were calculated: size, connectivity density, degree, path length, clustering coefficient, betweenness centrality and small world properties. People at risk of schizophrenia showed decreased path length and clustering in mostly prefrontal and temporal areas. Within the high risk sample, the path length of the posterior cingulate cortex and the betweenness centrality of the left inferior frontal operculum explained 81% of the variance in schizotypal cognitions, which was previously shown to be the strongest behavioural predictor of schizophrenia in the study. In contrast, local grey matter volume measurements explained 48% of variance in schizotypy. The present results suggest that single-subject grey matter networks can quantify behaviourally relevant biological alterations in people at increased risk for schizophrenia before disease onset.

  18. Cardiovascular risk and the use of oral contraceptives.

    PubMed

    Kaminski, Pawel; Szpotanska-Sikorska, Monika; Wielgos, Miroslaw

    2013-01-01

    The use of combined oral contraceptives (COCs) is associated with approximately 2-fold and over 4-fold increased relative risks of arterial and venous thromboembolic events, respectively. The highest risk of venous thromboembolism occurs in the first year of use (OR: 4.17) and is reduced to 2.76 over baseline risk after 4 years of therapy. The risk of myocardial infarction does not correlate to the length of therapy and disappears after treatment termination. Most of women, using COCs, have low absolute cardiovascular risks and benefits outweigh the risk associated with this method of birth control. However, in some cases, COCs may be contraindicated due to excessively increased cardiovascular risks. Current users of COCs, older than 35 years, appear to show an estimated 2.5-fold and 10-fold increased risk of venous thromboembolism in comparison to younger than 35 years COCs non-users and users, respectively. COCs users, who are current smokers, have 10-fold increased risk of myocardial infarction, whereas the risk of stroke increases nearly 3-fold. The presence of poorly controlled hypertension is associated with approximately 3-fold increased risks of myocardial infarction and ischemic stroke, while the risk of haemorrhagic stroke rises 15-fold. In women suffering from hypertension, discontinuation of COCs may improve blood pressure control. Women, who had their blood pressure measured before COCs use, have 2-2.5-fold decreased risk of myocardial infarction and ischaemic stroke. In women with multiple cardiovascular risk factors the use of progestogen-only contraceptives (POCs) should be considered. POC therapy is associated with substantially less risk of cardiovascular events than COCs.

  19. Lifetime Increased Cancer Risk in Mice Following Exposure to Clinical Proton Beam–Generated Neutrons

    SciTech Connect

    Gerweck, Leo E. Huang, Peigen; Lu, Hsiao-Ming; Paganetti, Harald; Zhou, Yenong

    2014-05-01

    Purpose: To evaluate the life span and risk of cancer following whole-body exposure of mice to neutrons generated by a passively scattered clinical spread-out Bragg peak (SOBP) proton beam. Methods and Materials: Three hundred young adult female FVB/N mice, 152 test and 148 control, were entered into the experiment. Mice were placed in an annular cassette around a cylindrical phantom, which was positioned lateral to the mid-SOBP of a 165-MeV, clinical proton beam. The average distance from the edge of the mid-SOBP to the conscious active mice was 21.5 cm. The phantom was irradiated with once-daily fractions of 25 Gy, 4 days per week, for 6 weeks. The age at death and cause of death (ie, cancer and type vs noncancer causes) were assessed over the life span of the mice. Results: Exposure of mice to a dose of 600 Gy of proton beam–generated neutrons, reduced the median life span of the mice by 4.2% (Kaplan-Meier cumulative survival, P=.053). The relative risk of death from cancer in neutron exposed versus control mice was 1.40 for cancer of all types (P=.0006) and 1.22 for solid cancers (P=.09). For a typical 60 Gy dose of clinical protons, the observed 22% increased risk of solid cancer would be expected to decrease by a factor of 10. Conclusions: Exposure of mice to neutrons generated by a proton dose that exceeds a typical course of radiation therapy by a factor of 10, resulted in a statistically significant increase in the background incidence of leukemia and a marginally significant increase in solid cancer. The results indicate that the risk of out-of-field second solid cancers from SOBP proton-generated neutrons and typical treatment schedules, is 6 to 10 times less than is suggested by current neutron risk estimates.

  20. Maternal dyslipidemia during pregnancy may increase the risk of preterm birth: A meta-analysis.

    PubMed

    Jiang, Shuying; Jiang, Jingxin; Xu, Hongwei; Wang, Shuojia; Liu, Zeyu; Li, Minchao; Liu, Hui; Zheng, Shuangshuang; Wang, Lijuan; Fei, Ying; Li, Xiawei; Ding, Yongfeng; Wang, Zhaopin; Yu, Yunxian

    2017-02-01

    Epidemiological studies have reported an inconsistent relationship between maternal lipid levels and preterm birth (PTB). We performed this meta-analysis to evaluate the association between maternal dyslipidemia and PTB. Overall, three nested case-control studies and eight cohort studies were eligible. Effect estimates [odds ratio(OR)/relative risk] were pooled using a fixed-effects or a random-effects model. Subgroup and metaregression analyses were conducted to evaluate the sources of heterogeneity. Eleven studies involving 13,025 pregnant women were included. Compared with pregnant women with normal lipid levels, the women with elevated levels of lipids had an increased risk of PTB, and the pooled OR was 1.68 [95% confidence interval (CI): 1.25-2.26)]; meanwhile, women with lower levels of lipids also had a trend of an increased risk of PTB (OR=1.52, 95% CI=0.60-3.82). The pooled ORs for elevated levels of total cholesterol, triglycerides, low density lipoprotein-cholesterol, and lower levels of high density lipoprotein-cholesterol were 1.71 (95% CI: 1.05-2.79), 1.55 (95% CI: 1.13-2.12), 1.19 (95% CI: 0.95-1.48), and 1.33 (95% CI: 1.14-1.56), respectively. The present meta-analysis found that maternal dyslipidemia during pregnancy, either the elevated total cholesterol or triglycerides, was associated with an increased risk of PTB. These findings indicate that a normal level of maternal lipid during pregnancy may reduce the risk of PTB.

  1. Association of polymorphisms of the xeroderma pigmentosum complementation group F gene with increased glioma risk.

    PubMed

    Zhou, W K; Huang, L Y; Hui, L; Wang, Z W; Jin, B Z; Zhao, X L; Zhang, X Z; Wang, J X; Wang, J C; Wang, R Z

    2014-05-16

    We aimed to investigate the role of 4 single nucleotide polymorphisms of the xeroderma pigmentosum complementation group F (XPF) gene (rs3136038, rs1799798, rs1800067, and rs2276466) in glioma, and the roles of gene-gene interactions in the risk of developing this type of cancer. We collected samples from 225 glioma cases and 262 controls and genotyped the rs3136038, rs1799798, rs1800067, and rs2276466 polymorphisms using a 384-well plate format with the Sequenom MassARRAY platform. Individuals carrying the rs1800067 GG genotype were more likely to have an increased risk of glioma when compared with carriers of the A/A genotype in a co-dominant model, with an odds ratio (OR) [95% confidence interval (CI)] of 2.85 (1.14-7.76). However, we did not find an association with increased risk of glioma for the polymorphisms rs3136038, rs1799798, and rs2276466 in XPF. The combination genotype of the rs1800067 G allele and the rs2276466 G allele was associated with a moderate risk of glioma (OR = 1.71, 95%CI = 1.02-2.87). Our study suggests that the rs1800067 genetic variant of XPF functions in the development of glioma.

  2. Estimation of cancer risks and benefits associated with a potential increased consumption of fruits and vegetables.

    PubMed

    Reiss, Richard; Johnston, Jason; Tucker, Kevin; DeSesso, John M; Keen, Carl L

    2012-12-01

    The current paper provides an analysis of the potential number of cancer cases that might be prevented if half the U.S. population increased its fruit and vegetable consumption by one serving each per day. This number is contrasted with an upper-bound estimate of concomitant cancer cases that might be theoretically attributed to the intake of pesticide residues arising from the same additional fruit and vegetable consumption. The cancer prevention estimates were derived using a published meta-analysis of nutritional epidemiology studies. The cancer risks were estimated using U.S. Environmental Protection Agency (EPA) methods, cancer potency estimates from rodent bioassays, and pesticide residue sampling data from the U.S. Department of Agriculture (USDA). The resulting estimates are that approximately 20,000 cancer cases per year could be prevented by increasing fruit and vegetable consumption, while up to 10 cancer cases per year could be caused by the added pesticide consumption. These estimates have significant uncertainties (e.g., potential residual confounding in the fruit and vegetable epidemiologic studies and reliance on rodent bioassays for cancer risk). However, the overwhelming difference between benefit and risk estimates provides confidence that consumers should not be concerned about cancer risks from consuming conventionally-grown fruits and vegetables.

  3. Increased Subsequent Risk of Peptic Ulcer Diseases in Patients With Bipolar Disorders.

    PubMed

    Hsu, Yi-Chao; Hsu, Chih-Chao; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Wang, Yu-Chiao; Kao, Chia-Hung

    2015-07-01

    Previous studies have reported that patients with bipolar disorders (BDs) exhibit increased physical comorbidity and psychological distress. Studies have shown that schizophrenia and anxiety increase the risk of peptic ulcer diseases (PUDs). Therefore, we conducted this study to determine the association between these 2 diseases and examine the possible risk factors. We used patients diagnosed with BDs from the Taiwan National Health Insurance Research Database. A comparison cohort comprising patients without BDs was frequency matched by age, sex, and comorbidities, and the occurrence of PUDs was evaluated in both the cohorts. The BD and non-BD cohort consisted of 21,060 patients with BDs and 84,240 frequency-matched patients without BDs, respectively. The incidence of PUDs (hazard ratio, 1.51; 95% confidence interval, 1.43-1.59; P < 0.001) was higher among the patients with BDs than the control patients. Cox models showed that irrespective of comorbidities, BDs were an independent risk factor for PUDs. Patients with BDs exhibit a substantially higher risk for developing PUDs. According to our data, we suggest that, following a diagnosis of BD, practitioners could notice the occurrence of PUD and associated prevention. Further prospective clinical studies investigating the relationship between BDs and PUDs are warranted.

  4. Knee injuries account for the sports-related increased risk of knee osteoarthritis.

    PubMed

    Thelin, N; Holmberg, S; Thelin, A

    2006-10-01

    Increased risk of osteoarthritis has been found among athletes active in different kinds of sports. Knee injury is an established risk factor for knee osteoarthritis. In this population-based case-control study we investigated the risk of knee osteoarthritis with respect to sports activity and previous knee injuries. A total of 825 cases with x-ray-verified femorotibial osteoarthritis were identified at six hospitals in southern Sweden. The cases were matched (age, sex and residential area) with 825 controls from the general population. Mailed questionnaire data on sports activity for more than 1 year after the age of 16, knee injuries and confounding variables (weight, height, heredity, smoking and occupation) were collected and analyzed using logistic regression models. The response frequency was 89%. Among men knee osteoarthritis was related to soccer (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1-2.2), ice hockey (OR 1.9, 95% CI 1.2-3.0) and tennis (OR 2.0, 95% CI 1.1-3.8) but not to track and field sports, cross-country skiing, and orienteering. After adjustment for confounding variables soccer and ice hockey remained significantly related to knee osteoarthritis, but after adjustment for knee injuries no significant relation remained. The sports-related increased risk for knee osteoarthritis was explained by knee injuries.

  5. Human Epistatic Interaction Controls IL7R Splicing and Increases Multiple Sclerosis Risk.

    PubMed

    Galarza-Muñoz, Gaddiel; Briggs, Farren B S; Evsyukova, Irina; Schott-Lerner, Geraldine; Kennedy, Edward M; Nyanhete, Tinashe; Wang, Liuyang; Bergamaschi, Laura; Widen, Steven G; Tomaras, Georgia D; Ko, Dennis C; Bradrick, Shelton S; Barcellos, Lisa F; Gregory, Simon G; Garcia-Blanco, Mariano A

    2017-03-23

    Multiple sclerosis (MS) is an autoimmune disorder where T cells attack neurons in the central nervous system (CNS) leading to demyelination and neurological deficits. A driver of increased MS risk is the soluble form of the interleukin-7 receptor alpha chain gene (sIL7R) produced by alternative splicing of IL7R exon 6. Here, we identified the RNA helicase DDX39B as a potent activator of this exon and consequently a repressor of sIL7R, and we found strong genetic association of DDX39B with MS risk. Indeed, we showed that a genetic variant in the 5' UTR of DDX39B reduces translation of DDX39B mRNAs and increases MS risk. Importantly, this DDX39B variant showed strong genetic and functional epistasis with allelic variants in IL7R exon 6. This study establishes the occurrence of biological epistasis in humans and provides mechanistic insight into the regulation of IL7R exon 6 splicing and its impact on MS risk.

  6. African American Children At-Risk of Increasingly Conflicted Teacher-Student Relationships in Elementary School.

    PubMed

    Spilt, Jantine; Hughes, Jan N

    Previous studies found different trajectories of conflicted relationships with teachers predictive of academic underachievement. However, little is known about what places children at risk for atypical conflict trajectories. This follow-up study examines whether African American ethnicity, IQ, and SES are unique predictors of teacher-student conflict trajectories taking into account sociobehavioral predictors, including aggression and prosocial behavior. The study included the same ethnically diverse sample of 657 academically at-risk children in which previously four latent growth classes of conflict trajectories (grades 1-5) predictive of underachievement were identified. In this follow-up study, 6 predictors were examined: African American ethnicity, SES, IQ (independent assessment), Inhibitory control (performance measure), and Aggression and Prosocial behavior (peer assessment). The results demonstrated that African American ethnicity, but not IQ and SES, uniquely predicted atypical conflict trajectories, while controlling for sociobehavioral predictors. African American children were at risk of increasingly conflicted relationships with elementary school teachers, which has been found to increase the risk of academic underachievement in middle school.

  7. African American Children At-Risk of Increasingly Conflicted Teacher-Student Relationships in Elementary School

    PubMed Central

    Spilt, Jantine; Hughes, Jan N.

    2015-01-01

    Previous studies found different trajectories of conflicted relationships with teachers predictive of academic underachievement. However, little is known about what places children at risk for atypical conflict trajectories. This follow-up study examines whether African American ethnicity, IQ, and SES are unique predictors of teacher-student conflict trajectories taking into account sociobehavioral predictors, including aggression and prosocial behavior. The study included the same ethnically diverse sample of 657 academically at-risk children in which previously four latent growth classes of conflict trajectories (grades 1-5) predictive of underachievement were identified. In this follow-up study, 6 predictors were examined: African American ethnicity, SES, IQ (independent assessment), Inhibitory control (performance measure), and Aggression and Prosocial behavior (peer assessment). The results demonstrated that African American ethnicity, but not IQ and SES, uniquely predicted atypical conflict trajectories, while controlling for sociobehavioral predictors. African American children were at risk of increasingly conflicted relationships with elementary school teachers, which has been found to increase the risk of academic underachievement in middle school. PMID:26819492

  8. Not Just an Urban Phenomenon: Uninsured Rural Trauma Patients at Increased Risk for Mortality

    PubMed Central

    Ahmed, Azeemuddin; Harland, Karisa K.; Hoffman, Bryce; Liao, Junlin; Choi, Kent; Skeete, Dionne; Denning, Gerene

    2015-01-01

    Introduction National studies of largely urban populations showed increased risk of traumatic death among uninsured patients, as compared to those insured. No similar studies have been done for major trauma centers serving rural states. Methods We performed retrospective analyses using trauma registry records from adult, non-burn patients admitted to a single American College of Surgeons-certified Level 1 trauma center in a rural state (2003–2010, n=13,680) and National Trauma Data Bank (NTDB) registry records (2002–2008, n=380,182). Risk of traumatic death was estimated using multivariable logistic regression analysis. Results We found that 9% of trauma center patients and 27% of NTDB patients were uninsured. Overall mortality was similar for both (~4.5%). After controlling for covariates, uninsured trauma center patients were almost five times more likely to die and uninsured NTDB patients were 75% more likely to die than commercially insured patients. The risk of death among Medicaid patients was not significantly different from the commercially insured for either dataset. Conclusion Our results suggest that even with an inclusive statewide trauma system and an emergency department that does not triage by payer status, uninsured patients presenting to the trauma center were at increased risk of traumatic death relative to patients with commercial insurance. PMID:26587084

  9. Steroids prevent engraftment syndrome after autologous hematopoietic stem cell transplantation without increasing the risk of infection.

    PubMed

    Mossad, S; Kalaycio, M; Sobecks, R; Pohlman, B; Andresen, S; Avery, R; Rybicki, L; Jarvis, J; Bolwell, B

    2005-02-01

    Engraftment syndrome (ES) following autologous hematopoietic stem cell transplantation (AHSCT) is characterized by fever and rash. In January 2002, we instituted steroid prophylaxis for ES from day +4 to +14. This study was conducted to assess whether this practice increased the risk of infection. In total, 194 consecutive patients were reviewed, 111 did not receive steroid prophylaxis (group A), and 83 did (group B). Initial antimicrobial prophylaxis was the same in both groups. There were no significant differences between groups in age, gender, race, prior radiation therapy, number of prior chemotherapy regimens, disease status at transplant, mobilization regimen, days of leukopheresis, CD34(+) cell dose, and days to platelet and neutrophil engraftment. Group B had significantly fewer patients with non-Hodgkin's lymphoma and multiple myeloma, shorter median duration from diagnosis to transplant, lower risk of ES, and shorter mean length of hospital stay. The incidence of early and late microbiologically confirmed infections was not significantly different between groups. Types of infections and types of organisms identified were similar in both groups. Hospital readmission rates were similar in both groups. Steroid prophylaxis significantly decreases the risk of ES following AHSCT, and is associated with shortened hospitalization, without increasing risk of infection.

  10. Small Increases in Plasma Sodium Are Associated with Higher Risk of Mortality in a Healthy Population

    PubMed Central

    Oh, Se Won; Baek, Seon Ha; An, Jung Nam; Goo, Ho Suk; Kim, Sejoong; Na, Ki Young; Chae, Dong Wan; Kim, Suhnggwon

    2013-01-01

    Elevated blood pressure (BP) is the most common cause of cardiovascular disease. Salt intake has a strong influence on BP, and plasma sodium (pNa) is increased with progressive increases in salt intake. However, the associations with pNa and BP had been reported inconsistently. We evaluated the association between pNa and BP, and estimated the risks of all-cause-mortality according to pNa levels. On the basis of data collected from health checkups during 1995-2009, 97,009 adult subjects were included. Positive correlations between pNa and systolic BP, diastolic BP, and pulse pressure (PP) were noted in participants with pNa ≥138 mM/L (P<0.001). In participants aged ≥50 yr, SBP, DBP, and PP were positively associated with pNa. In participants with metabolic syndrome components, the differences in SBP and DBP according to pNa were greater (P<0.001). A cumulative incidence of mortality was increased with increasing pNa in women aged ≥50 yr during the median 4.2-yr-follow-up (P<0.001). In women, unadjusted risks for mortality were increased according to sodium levels. After adjustment, pNa ≥145 mM/L was related to mortality. The positive correlation between pNa and BP is stronger in older subjects, women, and subjects with metabolic syndrome components. The incidence and adjusted risks of mortality increase with increasing pNa in women aged ≥50 yr. PMID:23853486

  11. Increased risk of hospitalization for ultrarapid metabolizers of cytochrome P450 2D6

    PubMed Central

    Takahashi, Paul Y; Ryu, Euijung; Pathak, Jyotishman; Jenkins, Gregory D; Batzler, Anthony; Hathcock, Matthew A; Black, John Logan; Olson, Janet E; Cerhan, James R; Bielinski, Suzette J

    2017-01-01

    Background Cytochrome P450 2D6 (CYP2D6) is responsible for the metabolism of clinically used drugs and other environmental exposures, but it is unclear whether the CYP2D6 phenotype is associated with adverse health outcomes. The aim was to determine the association of CYP2D6 phenotype with the risk of hospitalization or an emergency department (ED) visit among a group of primary care patients. Methods In this study, 929 adult patients underwent CYP2D6 testing. The primary outcome was risk of hospitalization or an ED visit from January 2005 through September 2014. CYP2D6 genotypes were interpreted as 1 of 7 clinical phenotypes, from ultrarapid to poor metabolizer, and patients with the extensive metabolizer phenotype were used as the reference group. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for finding the association of CYP2D6 phenotypes with the risk of hospitalization or an ED visit by using Cox proportional hazard models and adjusting for age and sex. Results The median age was 49 years (interquartile range, 46–52 years); 74% of patients had 3 or fewer chronic conditions, 285 had at least 1 hospitalization, and 496 had at least 1 ED visit. The risk of hospitalization was higher among patients who were ultrarapid metabolizers compared to extensive metabolizers (47% vs 30%; HR, 1.69; 95% CI, 1.11–2.57), as was the risk of an ED visit (62% vs 49%; HR, 1.50; 95% CI, 1.05–2.14). For poor metabolizers compared to extensive metabolizers, there was no difference in the risk of hospitalization (HR, 0.95; 95% CI, 0.58–1.56), but there was an increase in the risk of an ED visit (HR, 1.38; 95% CI, 0.96–1.98) (the difference was not statistically significant). Conclusion We found an increased risk of hospitalization or an ED visit among ultrarapid compared to extensive CYP2D6 metabolizers. Further research identifying the mechanisms of the association and ultimate clinical utility is warranted. PMID:28243137

  12. Leptospirosis risk increases with changes in species composition of rat populations.

    PubMed

    Theuerkauf, Jörn; Perez, Julie; Taugamoa, Alefosio; Niutoua, Iasinito; Labrousse, Didier; Gula, Roman; Bogdanowicz, Wieslaw; Jourdan, Hervé; Goarant, Cyrille

    2013-04-01

    Rats are major reservoirs of leptospirosis and considered as a main threat to biodiversity. A recent introduction of Rattus rattus to the island of Futuna (Western Polynesia) provided the opportunity to test if a possible change in species composition of rat populations would increase the risk of leptospirosis to humans. We trapped rodents on Wallis and Futuna and assessed Leptospira carriage in 357 rodents (Rattus norvegicus, R. rattus, Rattus exulans, and Mus domesticus) from 2008 to 2012. While Leptospira prevalence in rodents and the composition of rat populations on Futuna fluctuated with rainfall, the biomass of Leptospira-carrying rodents has been continuously rising from 2008 to 2012. Our results suggest that the introduction of R. rattus increases the risk to humans being infected with leptospirosis by rats.

  13. Increased risk of lung cancer mortality among residents near an asbestos product manufacturing plant.

    PubMed

    Kumagai, Shinji; Kurumatani, Norio; Tsuda, Toshihide; Yorifuji, Takashi; Suzuki, Etsuji

    2010-01-01

    We investigated whether individuals exposed to asbestos by living near an asbestos-manufacturing facility experienced increased lung cancer mortality. We studied a neighborhood around such a plant in the central Japanese city of Hashima. From 1943 to 1991 this plant produced insulation and packing material using amosite- and chrysotile-type asbestos fibers. The study group was comprised of 577 households. We obtained demographic information by a questionnaire and determined the underlying cause of death for deceased household members from death certificates. Using hourly meteorological data from local observatories, we estimated relative asbestos concentrations in the plant's vicinity, determined the quartile boundaries, and designated each study subject's quartile of ambient exposure. Finally, we calculated standardized mortality ratios to evaluate the association of residential asbestos with lung cancer risk. Our findings strongly suggest that neighborhood asbestos exposure can increase the risk of lung cancer mortality in men and probably in women.

  14. Significantly increased risk of carotid atherosclerosis with arsenic exposure and polymorphisms in arsenic metabolism genes

    SciTech Connect

    Hsieh, Yi-Chen; Lien, Li-Ming; Chung, Wen-Ting; Hsieh, Fang-I; Hsieh, Pei-Fan; Wu, Meei-Maan; Tseng, Hung-Pin; Chiou, Hung-Yi; Chen, Chien-Jen

    2011-08-15

    Individual susceptibility to arsenic-induced carotid atherosclerosis might be associated with genetic variations in arsenic metabolism. The purpose of this study is to explore the interaction effect on risk of carotid atherosclerosis between arsenic exposure and risk genotypes of purine nucleoside phosphorylase (PNP), arsenic (+3) methyltransferase (As3MT), and glutathione S-transferase omega 1 (GSTO1) and omega 2 (GSTO2). A community-based case-control study was conducted in northeastern Taiwan to investigate the arsenic metabolic-related genetic susceptibility to carotid atherosclerosis. In total, 863 subjects, who had been genotyped and for whom the severity of carotid atherosclerosis had been determined, were included in the present study. Individual well water was collected and arsenic concentration determined using hydride generation combined with flame atomic absorption spectrometry. The result showed that a significant dose-response trend (P=0.04) of carotid atherosclerosis risk associated with increasing arsenic concentration. Non-significant association between genetic polymorphisms of PNP Gly51Ser, Pro57Pro, As3MT Met287Thr, GSTO1 Ala140Asp, and GSTO2 A-183G and the risk for development of carotid atherosclerosis were observed. However, the significant interaction effect on carotid atherosclerosis risk was found for arsenic exposure (>50 {mu}g/l) and the haplotypes of PNP (p=0.0115). A marked elevated risk of carotid atherosclerosis was observed in subjects with arsenic exposure of >50 {mu}g/l in drinking water and those who carried the PNP A-T haplotype and at least either of the As3MT risk polymorphism or GSTO risk haplotypes (OR, 6.43; 95% CI, 1.79-23.19). In conclusion, arsenic metabolic genes, PNP, As3MT, and GSTO, may exacerbate the formation of atherosclerosis in individuals with high levels of arsenic concentration in well water (>50 {mu}g/l). - Highlights: {yields}Arsenic metabolic genes might be associated with carotid atherosclerosis. {yields

  15. Irritable Bowel Syndrome Increases the Risk of Epilepsy: A Population-Based Study.

    PubMed

    Chen, Chien-Hua; Lin, Cheng-Li; Kao, Chia-Hung

    2015-09-01

    An abnormal interaction in the brain-gut axis is regarded as the cause of irritable bowel syndrome (IBS). We attempted to determine the association between IBS and subsequent development of epilepsy.A total of 32,122 patients diagnosed with IBS between 2000 and 2011 were identified from the Longitudinal Health Insurance Database as the study cohort, and 63,295 controls were randomly selected from the insurants without IBS and frequency-matched according to age, sex, and index year as the comparison cohort. Both cohorts were followed up until the end of 2011 to measure the incidence of epilepsy. We analyzed the risks of epilepsy using Cox proportional hazards regression models.The IBS patients had greater cumulative incidence of epilepsy than the cohort without IBS (log-rank test, P < 0.001 and 2.54 versus 1.86 per 1000 person-years). The IBS cohort had a higher risk of epilepsy after adjusting for age, sex, diabetes, hypertension, stroke, coronary artery disease, head injury, depression, systemic lupus erythematosus, brain tumor, and antidepressants usage (adjusted hazard ratio [aHR]: 1.30, 95% confidence interval [CI]: 1.17-1.45). Stratified by the presence of other risk factors, the relative risk was also greater for patients with (aHR: 1.25, 95% CI: 1.10-1.41) or without other risk factors (aHR: 1.68, 95% CI: 1.35-2.10) in the IBS cohort than for those in the non-IBS cohort. The age-specific relative risk of epilepsy in the IBS cohort was greater than that in the non-IBS cohort for both 35 to 49 age group and 50 to 64 age group (age ≤ 34, aHR:1.31, 95% CI: 0.93-1.85; age 35-49, aHR: 1.43, 95% CI: 1.12-1.83; age 50-64, aHR: 1.56, 95% CI: 1.27-1.91). However, there was no difference between patients > 65 years with IBS and those without IBS (aHR: 1.11, 95% CI: 0.94-1.31).This population-based cohort study revealed that IBS increases the risk of developing epilepsy. However, IBS may be less influential than other risk factors. Further study is necessary to

  16. Inhaled corticosteroids and the increased risk of pneumonia: what's new? A 2015 updated review.

    PubMed

    Iannella, Hernan; Luna, Carlos; Waterer, Grant

    2016-06-01

    There is a considerable amount of evidence that supports the possibility of an increased risk of pneumonia associated with prolonged use of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD). However, as yet, no statistically significant increase in pneumonia-related 30-day mortality in patients on ICS has been demonstrated. The lack of objective pneumonia definitions and radiological confirmations have been a major source of bias, because of the similarities in clinical presentation between pneumonia and acute exacerbations of COPD. One of the newer fluticasone furoate studies overcomes these limitations and also provides an assessment of a range of doses, suggesting that the therapeutic window is quite narrow and that conventional dosing has probably been too high, although the absolute risk may be different compared to other drugs. Newer studies were not able to rule out budesonide as responsible for pneumonia, as previous evidence suggested, and there is still need for evidence from head-to-head comparisons in order to better assess possible intra-class differences. Although the exact mechanisms by which ICS increase the risk of pneumonia are not fully understood, the immunosuppressive effects of ICS on the respiratory epithelium and the disruption of the lung microbiome are most likely to be implicated. Given that COPD represents such a complex and heterogeneous disease, attempts are being made to identify clinical phenotypes with clear therapeutic implications, in order to optimize the pharmacological treatment of COPD and avoid the indiscriminate use of ICS. If deemed necessary, gradual withdrawal of ICS appears to be well tolerated. Vaccination against pneumococcus and influenza should be emphasized in patients with COPD receiving ICS. Physicians should keep in mind that signs and symptoms of pneumonia in COPD patients may be initially indistinguishable from those of an exacerbation, and that patients with COPD

  17. Increasing Treatment Seeking Among at-Risk Service Members Returning from Warzones

    DTIC Science & Technology

    2016-03-01

    SUPPLEMENTARY NOTES 14. ABSTRACT We propose a randomized controlled clinical trial of 1,200 military service members who are at increased risk for suicide but...by phone, and has been shown to promote treatment-seeking including in a preliminary study of OEF/OIF Veterans with elevated posttraumatic stress ...n/a INTRODUCTION TO SPECIFIC AIMS Reducing suicide is a national priority and an urgent concern within the Department

  18. The polypill: An effective approach to increasing adherence and reducing cardiovascular event risk.

    PubMed

    Bramlage, Peter; Sims, Helen; Minguet, Joan; Ferrero, Carmen

    2017-02-01

    Background Despite a wide range of medications being available for the prevention of cardiovascular events such as stroke, myocardial infarction and mortality in both a primary and secondary setting, patient adherence to complex therapy regimens involving different drug classes remains low worldwide. Combining antiplatelet, antihypertensive, lipid-lowering and potentially further drugs into one 'polypill' has the potential to increase adherence, thereby reducing risk factors to a greater extent and for a longer duration. The World Health Organization has recently highlighted increased adherence as a key development need for reducing cardiovascular disease. Methods Recent clinical trial data regarding adherence, reductions in cardiovascular risk and outcomes, safety and tolerability and the cost-effectiveness of the polypill approach are summarised and reviewed. In addition, ongoing trials and the questions they intend to answer are considered. References were retrieved from a PubMed literature search (date range 1990-2016) using the terms 'polypill', 'cardiovascular events' and 'adherence', and selected based on relevance. The website www.clinicaltrials.gov was also consulted for the identification of ongoing trials. Conclusions To date, the polypill approach has been conclusively shown to increase adherence relative to usual care in all patients, with those in a primary care setting or with poor baseline adherence potentially standing to benefit most. Concomitant risk factor reductions have also been suggested. However, whether this translates into a reduction in cardiovascular events and generates good cost-effectiveness in a given healthcare environment is currently under further investigation.

  19. Osteoporosis Health Beliefs of Women with Increased Risk of the Female Athlete Triad

    PubMed Central

    Nguyen, Vu H.; Wang, Ze; Okamura, Stephanie M.

    2014-01-01

    Women with increased risk of the female athlete triad (Triad) are more susceptible to osteoporosis compared to other women. The study included 65 women with increased risk of the Triad who had their osteoporosis health beliefs measured to assess their concern for the disease. Participants were female collegiate cross-country runners at different levels of competition, including National Association of Intercollegiate Athletics (NAIA) and National Collegiate Athletic Association (NCAA) Divisions III, II, and I. Although these participants have an increased risk of the Triad and are more susceptible to osteoporosis, on a scale of 1 to 5, results showed that they had low to moderate perceived susceptibility to osteoporosis with a mean score as high as 2.81 and moderate perceived severity of osteoporosis with a mean score as high as 3.38. A statistically significant difference in perceived susceptibility to osteoporosis was found between female collegiate cross-country runners in the NAIA and those in the NCAA DIII. Reasons that could explain relatively low levels of concern for osteoporosis in female collegiate cross-country runners and reasons for significant differences in perceived susceptibility to osteoporosis are given, and recommendations for health education and intervention to help care for this population are provided. PMID:24734207

  20. Osteoporosis health beliefs of women with increased risk of the female athlete triad.

    PubMed

    Nguyen, Vu H; Wang, Ze; Okamura, Stephanie M

    2014-01-01

    Women with increased risk of the female athlete triad (Triad) are more susceptible to osteoporosis compared to other women. The study included 65 women with increased risk of the Triad who had their osteoporosis health beliefs measured to assess their concern for the disease. Participants were female collegiate cross-country runners at different levels of competition, including National Association of Intercollegiate Athletics (NAIA) and National Collegiate Athletic Association (NCAA) Divisions III, II, and I. Although these participants have an increased risk of the Triad and are more susceptible to osteoporosis, on a scale of 1 to 5, results showed that they had low to moderate perceived susceptibility to osteoporosis with a mean score as high as 2.81 and moderate perceived severity of osteoporosis with a mean score as high as 3.38. A statistically significant difference in perceived susceptibility to osteoporosis was found between female collegiate cross-country runners in the NAIA and those in the NCAA DIII. Reasons that could explain relatively low levels of concern for osteoporosis in female collegiate cross-country runners and reasons for significant differences in perceived susceptibility to osteoporosis are given, and recommendations for health education and intervention to help care for this population are provided.

  1. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease

    PubMed Central

    Zanoni, Paolo; Khetarpal, Sumeet A.; Larach, Daniel B.; Hancock-Cerutti, William F.; Millar, John S.; Cuchel, Marina; DerOhannessian, Stephanie; Kontush, Anatol; Surendran, Praveen; Saleheen, Danish; Trompet, Stella; Jukema, J. Wouter; De Craen, Anton; Deloukas, Panos; Sattar, Naveed; Ford, Ian; Packard, Chris; Majumder, Abdullah al Shafi; Alam, Dewan S.; Di Angelantonio, Emanuele; Abecasis, Goncalo; Chowdhury, Rajiv; Erdmann, Jeanette; Nordestgaard, Børge G.; Nielsen, Sune F.; Tybjærg-Hansen, Anne; Schmidt, Ruth Frikke; Kuulasmaa, Kari; Liu, Dajiang J.; Perola, Markus; Blankenberg, Stefan; Salomaa, Veikko; Männistö, Satu; Amouyel, Philippe; Arveiler, Dominique; Ferrieres, Jean; Müller-Nurasyid, Martina; Ferrario, Marco; Kee, Frank; Willer, Cristen J.; Samani, Nilesh; Schunkert, Heribert; Butterworth, Adam S.; Howson, Joanna M. M.; Peloso, Gina M.; Stitziel, Nathan O.; Danesh, John; Kathiresan, Sekar; Rader, Daniel J.

    2016-01-01

    Scavenger receptor BI (SR-BI) is the major receptor for high-density lipoprotein (HDL) cholesterol (HDL-C). In humans, high amounts of HDL-C in plasma are associated with a lower risk of coronary heart disease (CHD). Mice that have depleted Scarb1 (SR-BI knockout mice) have markedly elevated HDL-C levels but, paradoxically, increased atherosclerosis. The impact of SR-BI on HDL metabolism and CHD risk in humans remains unclear. Through targeted sequencing of coding regions of lipid-modifying genes in 328 individuals with extremely high plasma HDL-C levels, we identified a homozygote for a loss-of-function variant, in which leucine replaces proline 376 (P376L), in SCARB1, the gene encoding SR-BI. The P376L variant impairs posttranslational processing of SR-BI and abrogates selective HDL cholesterol uptake in transfected cells, in hepatocyte-like cells derived from induced pluripotent stem cells from the homozygous subject, and in mice. Large population-based studies revealed that subjects who are heterozygous carriers of the P376L variant have significantly increased levels of plasma HDL-C. P376L carriers have a profound HDL-related phenotype and an increased risk of CHD (odds ratio = 1.79, which is statistically significant). PMID:26965621

  2. Risk of inhibitor development in mild haemophilia A increases with age.

    PubMed

    Mauser-Bunschoten, E P; Den Uijl, I E M; Schutgens, R E G; Roosendaal, G; Fischer, K

    2012-03-01

    Mild haemophilia A is a rare disease with a relatively mild phenotype. Treatment with factor VIII (FVIII) is indicated after trauma or for surgery only. FVIII infusion may result in the development of inhibiting antibodies against FVIII. This study describes the relation between age and other risk factors for inhibitor development in mild haemophilia. A retrospective cohort study was conducted among all patients with mild haemophilia (FVIII 0.05-0.40 IU mL(-1)) registered at the van Creveldkliniek, University Medical Centre Utrecht, The Netherlands. Data on peak treatment with FVIII, gene mutation and history of inhibitor development were obtained from patient files from the period between 1st January 1970 and 31st December 2009. A total of 231 out of 297 (78%) patients had at least one exposure to FVIII, of whom 14 (6.1%) developed an inhibitor to FVIII at a median age of 66 years after a median of 50 exposure days (ED). Age at first exposure, age at peak treatment, number of peak treatments and Arg593Cys mutation were significantly associated with the development of an inhibitor, while continuous infusion with FVIII was not. Although the incidence of inhibitors in mild haemophilia is low, it increases with age and peak treatments. With increasing age patients with mild haemophilia will suffer from co-morbidity more frequently, requiring surgical interventions and exposing them to an increased risk of inhibitor development. Especially patients with a change of arginine in cysteine at 593 are at risk for inhibitor development.

  3. Rare variant in scavenger receptor BI raises HDL cholesterol and increases risk of coronary heart disease.

    PubMed

    Zanoni, Paolo; Khetarpal, Sumeet A; Larach, Daniel B; Hancock-Cerutti, William F; Millar, John S; Cuchel, Marina; DerOhannessian, Stephanie; Kontush, Anatol; Surendran, Praveen; Saleheen, Danish; Trompet, Stella; Jukema, J Wouter; De Craen, Anton; Deloukas, Panos; Sattar, Naveed; Ford, Ian; Packard, Chris; Majumder, Abdullah al Shafi; Alam, Dewan S; Di Angelantonio, Emanuele; Abecasis, Goncalo; Chowdhury, Rajiv; Erdmann, Jeanette; Nordestgaard, Børge G; Nielsen, Sune F; Tybjærg-Hansen, Anne; Schmidt, Ruth Frikke; Kuulasmaa, Kari; Liu, Dajiang J; Perola, Markus; Blankenberg, Stefan; Salomaa, Veikko; Männistö, Satu; Amouyel, Philippe; Arveiler, Dominique; Ferrieres, Jean; Müller-Nurasyid, Martina; Ferrario, Marco; Kee, Frank; Willer, Cristen J; Samani, Nilesh; Schunkert, Heribert; Butterworth, Adam S; Howson, Joanna M M; Peloso, Gina M; Stitziel, Nathan O; Danesh, John; Kathiresan, Sekar; Rader, Daniel J

    2016-03-11

    Scavenger receptor BI (SR-BI) is the major receptor for high-density lipoprotein (HDL) cholesterol (HDL-C). In humans, high amounts of HDL-C in plasma are associated with a lower risk of coronary heart disease (CHD). Mice that have depleted Scarb1 (SR-BI knockout mice) have markedly elevated HDL-C levels but, paradoxically, increased atherosclerosis. The impact of SR-BI on HDL metabolism and CHD risk in humans remains unclear. Through targeted sequencing of coding regions of lipid-modifying genes in 328 individuals with extremely high plasma HDL-C levels, we identified a homozygote for a loss-of-function variant, in which leucine replaces proline 376 (P376L), in SCARB1, the gene encoding SR-BI. The P376L variant impairs posttranslational processing of SR-BI and abrogates selective HDL cholesterol uptake in transfected cells, in hepatocyte-like cells derived from induced pluripotent stem cells from the homozygous subject, and in mice. Large population-based studies revealed that subjects who are heterozygous carriers of the P376L variant have significantly increased levels of plasma HDL-C. P376L carriers have a profound HDL-related phenotype and an increased risk of CHD (odds ratio = 1.79, which is statistically significant).

  4. CYP2B6*6 is associated with increased breast cancer risk.

    PubMed

    Justenhoven, Christina; Pentimalli, Daniela; Rabstein, Sylvia; Harth, Volker; Lotz, Anne; Pesch, Beate; Brüning, Thomas; Dörk, Thilo; Schürmann, Peter; Bogdanova, Natalia; Park-Simon, Tjoung-Won; Couch, Fergus J; Olson, Janet E; Fasching, Peter A; Beckmann, Matthias W; Häberle, Lothar; Ekici, Arif; Hall, Per; Czene, Kamilla; Liu, Janjun; Li, Jingmei; Baisch, Christian; Hamann, Ute; Ko, Yon-Dschun; Brauch, Hiltrud

    2014-01-15

    The cytochrome P450 2B6 (CYP2B6) is involved in the metabolism of testosterone. Functional changes in this enzyme may influence endogenous hormone exposure, which has been associated with risk of breast cancer. To assess potential associations between two functional polymorphisms CYP2B6_516_G>T (rs3745274) and CYP2B6_785_A>G (rs2279343) and breast cancer risk, we established a specific matrix-assisted laser desorption/ionization time-of-flight mass spectrometry assay. The GENICA breast cancer case-control study showed associations between the variant genotypes CYP2B6_516_TT and CYP2B6_785_GG and breast cancer risk with odds ratios (ORs) of 1.34 (p = 0.001) and 1.31 (p = 0.002), respectively. A similar effect was observed for carriers of the CYP2B6_516_T allele in a validation study including four independent studies from Germany, Sweden and USA. In a pooled analysis of all five studies involving 4,638 breast cancer cases and 3,594 controls of European ancestry, carriers of the CYP2B6_516_G and the CYP2B6_785_G variant had an increased breast cancer risk with ORs of 1.10 (p = 0.027) and 1.10 (p = 0.031), respectively. We conclude that the genetic variants CYP2B6_516_G and CYP2B6_785_G (designated CYP2B6*6), which are known to decrease activity of the CYP2B6 enzyme, contribute to an increased breast cancer risk.

  5. Cardiac Disease Increases Risk of Non-amnestic Mild Cognitive Impairment: Stronger impact in women

    PubMed Central

    Roberts, Rosebud O.; Geda, Yonas E.; Knopman, David S.; Cha, Ruth H.; Pankratz, V. Shane; Boeve, Bradley F.; Tangalos, Eric G.; Ivnik, Robert J.; Mielke, Michelle M.; Petersen, Ronald C.

    2012-01-01

    Objective Non-amnestic mild cognitive impairment (naMCI), a putative precursor of vascular and other non-Alzheimer’s disease dementias, is hypothesized to have a vascular etiology. We investigated the association of cardiac disease with amnestic (aMCI) and non-amnestic (naMCI) MCI. Design A prospective, population-based, cohort study with a median 4.0 years of follow-up. Setting Olmsted County, Minnesota. Participants Participants were evaluated at baseline and every 15 months using the Clinical Dementia Rating scale, a neurological evaluation, and neuropsychological testing. A diagnosis of normal cognition, MCI, or dementia was made by consensus. Cardiac disease at baseline was assessed from the participant’s medical records. Main outcome measures Incident MCI, aMCI, naMCI. Results Among 1,450 subjects free of MCI or dementia at baseline, 366 developed MCI. Cardiac disease was associated with an increased risk of naMCI (hazard ratio [HR] 95% confidence interval; 1.77 [1.16–2.72]). However, the association varied by sex (P for interaction = .02). Cardiac disease was associated with an increased risk of naMCI (HR, 3.07 [1.58–5.99]) in women, but not in men (HR, 1.16 [0.68–1.99]. Cardiac disease was not associated with any MCI or aMCI. Conclusion Cardiac disease is an independent risk factor for naMCI, within sex comparisons showed a stronger association in women. Prevention and management of cardiac disease and vascular risk factors may reduce the risk of naMCI. PMID:23358884

  6. Obesity Early in Adulthood Increases Risk but Does Not Affect Outcomes of Hepatocellular Carcinoma

    PubMed Central

    Hassan, Manal M.; Abdel-Wahab, Reham; Kaseb, Ahmed; Shalaby, Ahmed; Phan, Alexandria T.; El-Serag, Hashem B.; Hawk, Ernest; Morris, Jeff; Raghav, Kanwal Pratap Singh; Lee, Ju-Seog; Vauthey, Jean-Nicolas; Bortus, Gehan; Torres, Harrys A.; Amos, Christopher I.; Wolff, Robert A.; Li, Donghui

    2015-01-01

    BACKGROUND & AIMS Despite the significant association between obesity and several cancers, it has been difficult to establish an association between obesity and hepatocellular carcinoma (HCC). Patients with HCC often have ascites, making it a challenge to accurately determine body mass index (BMI), and many factors contribute to the development of HCC. We performed a case–control study to investigate whether obesity early in adulthood affects risk, age of onset, or outcomes of patients with HCC. METHODS We interviewed 622 patients newly diagnosed with HCC from January 2004 through December 2013, along with 660 healthy controls (frequency-matched by age and sex) to determine weights, heights, and body sizes (self-reported) at various ages before HCC development or enrollment as controls. Multivariable logistic and Cox regression analyses were performed to determine the independent effects of early obesity on risk for HCC and patient outcomes, respectively. BMI was calculated, and patients with a BMI ≥30 kg/m2 were considered obese. RESULTS Obesity in early adulthood (age, mid-20s to mid-40s) is a significant risk factor for HCC. The estimated odds ratios (OR) and 95% confidence intervals (CI) were 2.6 (1.4–4.4), 2.3 (1.2–4.4), and 3.6 (1.5–8.9) for the entire population, men, and women, respectively. Each unit increase in BMI at early adulthood was associated with a 3.89-month decrease in age at HCC diagnosis (P<.001). Moreover, there is a synergistic interaction between obesity and hepatitis virus infection. However, we found no effect of obesity on the overall survival of patients with HCC. CONCLUSION Early adulthood obesity is associated with increased risk of developing HCC at a young age in the absence of major HCC risk factors, with no effect on outcomes of patients with HCC. PMID:25836985

  7. Hepatitis C virus coinfection independently increases the risk of cardiovascular disease in HIV-positive patients.

    PubMed

    Fernández-Montero, J V; Barreiro, P; de Mendoza, C; Labarga, P; Soriano, V

    2016-01-01

    Patients infected with HIV are at increased risk for cardiovascular disease despite successful antiretroviral therapy. Likewise, chronic hepatitis C virus (HCV) infection is associated with extrahepatic complications, including cardiovascular disease. However the risk of cardiovascular disease has not been formally examined in HIV/HCV-coinfected patients. A retrospective study was carried out to assess the influence of HCV coinfection on the risk of cardiovascular events in a large cohort of HIV-infected patients recruited since year 2004. A composite event of cardiovascular disease was used as an endpoint, including myocardial infarction, angina pectoris, stroke or death due to any of them. A total of 1136 patients (567 HIV-monoinfected, 70 HCV-monoinfected and 499 HIV/HCV-coinfected) were analysed. Mean age was 42.7 years, 79% were males, and 46% were former injection drug users. Over a mean follow-up of 79.4 ± 21 months, 3 patients died due to cardiovascular disease, whereas 29 suffered a first episode of coronary ischaemia or stroke. HIV/HCV-coinfected patients had a greater incidence of cardiovascular disease events and/or death than HIV-monoinfected individuals (4% vs 1.2%, P = 0.004) and HCV-monoinfected persons (4% vs 1.4%, P = 0.5). After adjusting for demographics, virological parameters and classical cardiovascular disease risk factors (smoking, hypertension, diabetes, high LDL cholesterol), both HIV/HCV coinfection (HR 2.91; CI 95%: 1.19-7.12; P = 0.02) and hypertension (HR 3.65; CI 95%: 1.34-9.94; P = 0.01) were independently associated with cardiovascular disease events and/or death in HIV-infected patients. Chronic hepatitis C and hypertension are independently associated with increased cardiovascular disease risk in HIV-infected patients. Therefore, treatment of chronic hepatitis C should be prioritized in HIV/HCV-coinfected patients regardless of any liver fibrosis staging.

  8. Treatment Resistant Epilepsy in Autism Spectrum Disorder: Increased Risk for Females.

    PubMed

    Blackmon, Karen; Bluvstein, Judith; MacAllister, William S; Avallone, Jennifer; Misajon, Jade; Hedlund, Julie; Goldberg, Rina; Bojko, Aviva; Mitra, Nirmala; Giridharan, Radha; Sultan, Richard; Keller, Seth; Devinsky, Orrin

    2016-02-01

    The male:female ratio in autism spectrum disorder (ASD) averages greater than 4:1 while the male:female ratio of ASD with epilepsy averages less than 3:1. This indicates an elevated risk of epilepsy in females with ASD; yet, it is unknown whether phenotypic features of epilepsy and ASD differ between males and females with this comorbidity. The goal of this study is to investigate sex differences in phenotypic features of epilepsy and ASD in a prospective sample of 130 children and young adults with an initial ASD diagnosis and subsequent epilepsy diagnosis. All participants were characterized by standardized diagnostic inventories, parent/caregiver completed questionnaires, and medical/academic record review. Diagnostic classifications of epilepsy, ASD, and intellectual disability were performed by board certified neurologists and a pediatric neuropsychologist. Results demonstrated a lower male:female ratio (1.8:1) in individuals with ASD and treatment-resistant epilepsy relative to those with ASD and treatment-responsive epilepsy (4.9:1), indicating a higher risk of treatment-resistant epilepsy in females. Mild neuroimaging abnormalities were more common in females than males and this was associated with increased risk of treatment-resistance. In contrast, ASD symptom severity was lower in females compared with males. Findings distinguish females with ASD and epilepsy as a distinct subgroup at higher risk for a more severe epilepsy phenotype in the context of a less severe ASD phenotype. Increased risk of anti-epileptic treatment resistance in females with ASD and epilepsy suggests that comprehensive genetic, imaging, and neurologic screening and enhanced treatment monitoring may be indicated for this subgroup. Autism Res 2016, 9: 311-320. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  9. Baroreflex failure increases the risk of pulmonary edema in conscious rats with normal left ventricular function.

    PubMed

    Sakamoto, Kazuo; Hosokawa, Kazuya; Saku, Keita; Sakamoto, Takafumi; Tobushi, Tomoyuki; Oga, Yasuhiro; Kishi, Takuya; Ide, Tomomi; Sunagawa, Kenji

    2016-01-15

    In heart failure with preserved ejection fraction (HFpEF), the complex pathogenesis hinders development of effective therapies. Since HFpEF and arteriosclerosis share common risk factors, it is conceivable that stiffened arterial wall in HFpEF impairs baroreflex function. Previous investigations have indicated that the baroreflex regulates intravascular stressed volume and arterial resistance in addition to cardiac contractility and heart rate. We hypothesized that baroreflex dysfunction impairs regulation of left atrial pressure (LAP) and increases the risk of pulmonary edema in freely moving rats. In 15-wk Sprague-Dawley male rats, we conducted sinoaortic denervation (SAD, n = 6) or sham surgery (Sham, n = 9), and telemetrically monitored ambulatory arterial pressure (AP) and LAP. We compared the mean and SD (lability) of AP and LAP between SAD and Sham under normal-salt diet (NS) or high-salt diet (HS). SAD did not increase mean AP but significantly increased AP lability under both NS (P = 0.001) and HS (P = 0.001). SAD did not change mean LAP but significantly increased LAP lability under both NS (SAD: 2.57 ± 0.43 vs. Sham: 1.73 ± 0.30 mmHg, P = 0.01) and HS (4.13 ± 1.18 vs. 2.45 ± 0.33 mmHg, P = 0.02). SAD markedly increased the frequency of high LAP, and SAD with HS prolonged the duration of LAP > 18 mmHg by nearly 20-fold compared with Sham (SAD + HS: 2,831 ± 2,366 vs. Sham + HS: 148 ± 248 s, P = 0.01). We conclude that baroreflex failure impairs volume tolerance and together with salt loading increases the risk of pulmonary edema even in the absence of left ventricular dysfunction. Baroreflex failure may contribute in part to the pathogenesis of HFpEF.

  10. Is it possible to increase bioavailability but not environmental risk of PAHs in bioremediation?

    PubMed

    Ortega-Calvo, J J; Tejeda-Agredano, M C; Jimenez-Sanchez, C; Congiu, E; Sungthong, R; Niqui-Arroyo, J L; Cantos, M

    2013-10-15

    The current poor predictability of end points associated with the bioremediation of polycyclic aromatic hydrocarbons (PAHs) is a large limitation when evaluating its viability for treating contaminated soils and sediments. However, we have seen a wide range of innovations in recent years, such as an the improved use of surfactants, the chemotactic mobilization of bacterial inoculants, the selective biostimulation at pollutant interfaces, rhizoremediation and electrobioremediation, which increase the bioavailability of PAHs but do not necessarily increase the risk to the environment. The integration of these strategies into practical remediation protocols would be beneficial to the bioremediation industry, as well as improve the quality of the environment.

  11. Increased risk of systemic lupus erythematosus in pregnancy-induced hypertension

    PubMed Central

    Lin, Li-Te; Wang, Peng-Hui; Tsui, Kuan-Hao; Cheng, Jiin-Tsuey; Cheng, Jin-Shiung; Huang, Wei-Chun; Tang, Pei-Ling; Hu, Li-Yu

    2016-01-01

    Abstract Dysregulation of the immune system plays a role in the pathogenesis of both, pregnancy-induced hypertension (PIH) and systemic lupus erythematosus (SLE). It is well known that SLE predisposes to be complicated with PIH. However, few studies have attempted to investigate whether PIH increased subsequent SLE risk. The objectives of this study were to assess the association between PIH and subsequent SLE risk and identify predictive risk factors. Patients with newly diagnosed PIH were selected from the Taiwan National Health Insurance Research Database (NHIRD) and compared with a matched cohort without PIH based on age and the year of delivery. The incidence of new-onset SLE was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013. Among the 23.3 million individuals registered in the NHIRD, 29,091 patients with PIH and 116,364 matched controls were identified. The incidence of SLE was higher among patients with PIH than in the matched controls (incidence rate ratio [IRR] = 4.02, 95% confidence interval [CI] 3.98–4.05, P < 0.0001). The IRR for subsequent SLE development remained significantly higher in all stratifications during the follow-up years. The multivariate Cox regression model was performed and the results showed that PIH may be an independent risk factors for the development of subsequent SLE (hazard ratio [HR] = 2.87, 95% CI 2.07–3.98, P < 0.0001). Moreover, multivariate Cox regression model was used again among the PIH cohort only in order to identify the possible risk factors for subsequent SLE in the population with PIH. Patients with PIH may have higher risk of developing newly diagnosed SLE than those without PIH. In addition, among individuals who have experienced PIH, those younger than 30 years, having experienced preeclampsia/eclampsia, single parity, preterm birth, or chronic kidney disease, may display an increased subsequent risk of SLE. PMID:27472738

  12. Does exposure to agricultural chemicals increase the risk of prostate cancer among farmers?

    PubMed

    Parent, Marie-Elise; Désy, Marie; Siemiatycki, Jack

    2009-01-01

    Several studies suggest that farmers may be at increased risk of prostate cancer. The present analysis, based on a large population-based case-control study conducted among men in the Montreal area in the early 1980's, aim at identifying occupational chemicals which may be responsible for such increases. The original study enrolled 449 prostate cancer cases, nearly 4,000 patients with other cancers, as well as 533 population controls. Subjects were interviewed about their occupation histories, and a team of industrial hygienists assigned their past exposures using a checklist of some 300 chemicals. The present analysis was restricted to a study base of men who had worked as farmers earlier in their lives. There were a total of 49 men with prostate cancers, 127 with other cancers and 56 population controls. We created a pool of 183 controls combining the patients with cancers at sites other than the prostate and the population controls. We then estimated the odds ratio for prostate cancer associated with exposure to each of 10 agricultural chemicals, i.e., pesticides, arsenic compounds, acetic acid, gasoline engine emissions, diesel engine emissions, polycyclic aromatic hydrocarbons from petroleum, lubricating oils and greases, alkanes with >or=18 carbons, solvents, and mononuclear aromatic hydrocarbons. Based on a model adjusting for age, ethnicity, education, and respondent status, there was evidence of a two-fold excess risk of prostate cancer among farmers with substantial exposure to pesticides [odds ratio (OR)=2.3, 95% confidence interval (CI) 1.1-5.1], as compared to unexposed farmers. There was some suggestion, based on few subjects, of increased risks among farmers ever exposed to diesel engine emissions (OR=5.7, 95% CI 1.2-26.5). The results for pesticides are particularly noteworthy in the light of findings from previous studies. Suggestions of trends for elevated risks were noted with other agricultural chemicals, but these are largely novel and need

  13. Estrogen withdrawal, increased breast cancer risk and the KRAS-variant

    PubMed Central

    McVeigh, Terri P; Jung, Song-Yi; Kerin, Michael J; Salzman, David W; Nallur, Sunitha; Nemec, Antonio A; Dookwah, Michelle; Sadofsky, Jackie; Paranjape, Trupti; Kelly, Olivia; Chan, Elcie; Miller, Nicola; Sweeney, Karl J; Zelterman, Daniel; Sweasy, Joann; Pilarski, Robert; Telesca, Donatello; Slack, Frank J; Weidhaas, Joanne B

    2015-01-01

    The KRAS-variant is a biologically functional, microRNA binding site variant, which predicts increased cancer risk especially for women. Because external exposures, such as chemotherapy, differentially impact the effect of this mutation, we evaluated the association of estrogen exposures, breast cancer (BC) risk and tumor biology in women with the KRAS-variant. Women with BC (n = 1712), the subset with the KRAS-variant (n = 286) and KRAS-variant unaffected controls (n = 80) were evaluated, and hormonal exposures, KRAS-variant status, and pathology were compared. The impact of estrogen withdrawal on transformation of isogenic normal breast cell lines with or without the KRAS-variant was studied. Finally, the association and presentation characteristics of the KRAS-variant and multiple primary breast cancer (MPBC) were evaluated. KRAS-variant BC patients were more likely to have ovarian removal pre-BC diagnosis than non-variant BC patients (p = 0.033). In addition, KRAS-variant BC patients also appeared to have a lower estrogen state than KRAS-variant unaffected controls, with a lower BMI (P < 0.001). Finally, hormone replacement therapy (HRT) discontinuation in KRAS-variant patients was associated with a diagnosis of triple negative BC (P < 0.001). Biologically confirming our clinical findings, acute estrogen withdrawal led to oncogenic transformation in KRAS-variant positive isogenic cell lines. Finally, KRAS-variant BC patients had greater than an 11-fold increased risk of presenting with MPBC compared to non-variant patients (45.39% vs 6.78%, OR 11.44 [3.42–37.87], P < 0.001). Thus, estrogen withdrawal and a low estrogen state appear to increase BC risk and to predict aggressive tumor biology in women with the KRAS-variant, who are also significantly more likely to present with multiple primary breast cancer. PMID:25961464

  14. Increased risk of herpes zoster in children with cancer: A nationwide population-based cohort study.

    PubMed

    Lin, Hsiao-Chuan; Chao, Yu-Hua; Wu, Kang-Hsi; Yen, Ting-Yu; Hsu, Yu-Lung; Hsieh, Tsung-Hsueh; Wei, Hsiu-Mei; Wu, Jhong-Lin; Muo, Chih-Hsin; Hwang, Kao-Pin; Peng, Ching-Tien; Lin, Cheng-Chieh; Li, Tsai-Chung

    2016-07-01

    Herpes zoster is rare in healthy children, but immunocompromised persons have an increased risk of herpes zoster and severe diseases. Considering the very limited information on herpes zoster in children with cancer, we performed a nationwide population-based cohort study to estimate the incidence of herpes zoster in children with cancer and to explore the association between the 2 diseases.Data were obtained from the National Health Research Institutes Database in Taiwan. A total of 4432 children with newly diagnosed cancer between 2000 and 2007 were identified as the cancer cohort, and 17,653 children without cancer frequency-matched by sex and age at entry were considered the noncancer cohort. The association between herpes zoster and childhood cancer was determined.Children with cancer had a higher risk of herpes zoster. The incidence rate of herpes zoster was higher in the cancer cohort than in the noncancer cohort (20.7 vs 2.4 per 10,000 person-years; IRR = 8.6; 95% CI = 4.8-15.6). The cumulative incidence was significantly higher in the cancer cohort (P < 0.0001). Leukemia, lymphoma, and solid tumor were all associated with the increased risk, and leukemia had the highest magnitude of strength of association.This nationwide population-based cohort study demonstrated that children with cancer were associated with an increased risk of herpes zoster. In addition to early antiviral treatment, vaccination with heat-treated zoster vaccine or adjuvanted subunit vaccine could be an appropriate policy to decrease the incidence in children with cancer.

  15. Increased risk of community-acquired pneumonia in COPD patients with comorbid cardiovascular disease

    PubMed Central

    Lin, Sheng-Hao; Perng, Diahn-Warng; Chen, Ching-Pei; Chai, Woei-Horng; Yeh, Chin-Shui; Kor, Chew-Teng; Cheng, Shih-Lung; Chen, Jeremy JW; Lin, Ching-Hsiung

    2016-01-01

    Background and objective COPD patients with community-acquired pneumonia (CAP) have worse clinical outcomes, as compared to those without COPD. Cardiovascular disease (CVD) is a common comorbidity for COPD patients. Whether COPD with comorbid CVD will increase the risk of CAP is not well investigated. The incidence and factors associated with CAP in COPD patients with and without CVD were analyzed. Methods The medical records of patients with newly diagnosed COPD between 2007 and 2010 were reviewed. The patients’ characteristics, medical history of CVD, occurrence of CAP, and type of medication were recorded. Kaplan–Meier curves were used to assess the differences in cumulative incidence of CAP. Cox’s proportional hazards regression model was used to determine the adjusted hazard ratios with 95% confidence intervals in relation to factors associated with CAP in COPD patients with and without CVD. Results Among 2,440 patients, 475 patients (19.5%) developed CAP during the follow-up period. COPD patients who developed CAP were significantly older, had lower forced expiratory volume in 1 second, frequent severe exacerbation and comorbid CVD, as well as received inhaled corticosteroid (ICS)-containing therapy than those without CAP. The cumulative incidence of CAP was higher in COPD patients with CVD compared to those without CVD. Patients who received ICS-containing therapy had significantly increased risk of developing CAP compared to those who did not. Conclusion For patients with COPD, comorbid CVD is an independent risk factor for developing CAP. ICS-containing therapy may increase the risk of CAP among COPD patients. PMID:27980402

  16. [Does the use of cannabis increase the risk for psychosis and the development of schizophrenia?].

    PubMed

    Jonsson, Arnar Jan; Birgisdottir, Hera; Sigurdsson, Engilbert

    2014-09-01

    Over the past 30 years evidence has been growing that cannabis use increases the risk for psychosis which could develop into schizophrenia in a proportion of cases. Over the past decade many studies have been published which clarify the association between cannabis use and psychosis. The aim of this review is to examine this association. A systematic search yielded 14 cohort studies carried out in 9 cohorts and 9 case-control studies. When the results of these studies are taken together they unambiguously support that cannabis use is an independent risk factor for psychosis and may also give rise to chronic psychotic disorders like schizophrenia. A dose dependent link is present because more frequent use associates with greater risk. The studies also show that cannabis-use in adolescence is associated with greater risk of developing psychosis than commencing the use of cannabis in adulthood. Further studies are needed to explain this association since psychotic disorders take years to evolve and it remains difficult to measure both the explanatory and the response variable and their complex relationship. The results emphasize the need to enhance public knowledge on the possible consequences of cannabis use and the fact that it cannot be predicted who will experience transient psychosis and who will develop a chronic psychotic disorder.

  17. Y chromosome polymorphisms may contribute to an increased risk of male-induced unexplained recurrent miscarriage.

    PubMed

    Wang, Yan; Li, Gang; Zuo, Man-Zhen; Li, Hai-Rong; Fang, Jun-Hua; Quan, Dan-Dan; Huang, Lu; Peng, Ping-Ping

    2017-02-09

    Objective: This study aims to explore the relationship between the Y chromosome polymorphisms (1qh+, inv(9), 9qh+, 16qh+, group D/G, Yqh- and Yqh+) and the risk of unexplained recurrent miscarriage (URM).Methods: A total of 507 couples with URM were recruited as case group and 465 healthy couples as control group. The Y chromosome polymorphisms of the male individuals were analyzed with the G-banding technique, and the results of the chromosome G-banding analysis were determined using the International Naming Standards of Human Genetics (ISCN). Logistic regression analysis was used to analyze risk factors of URM.Results: The detection rate of Y chromosome polymorphisms in the case group (12.03%) was higher than that in the control group (2.15%). Y chromosome polymorphisms were detected at significantly higher rates in the case group than in the control group. Using the normal Y chromosomes in individuals of the case group as reference, the partners of their counterparts were more likely to experience miscarriage. The couples who were Y chromosome polymorphism carriers had shorter gestational age, increased frequency of URM and longer average interval between pregnancies. The results of logistic regression analysis revealed that Y chromosome polymorphisms, shorter gestational age, a higher frequency of miscarriage and longer pregnancy interval were independent risk factors for URM.Conclusions: Y chromosome polymorphisms may be associated with the risk of URM and may play an important role in the development of URM.

  18. The increasing importance of risk assessment and management in environmental decision-making

    SciTech Connect

    Jaksch, J.A.

    1992-06-01

    Because environmental problems are growing and resources for dealing with them are shrinking, the environmental movement is witnessing an evolutionary shift toward greater emphasis on the use of risk assessment and management tools in setting environmental standards, determining levels of cleanup and deciding environmental program funding priorities. This change has important ramifications for the Department of Energy (DOE) and its national laboratories in terms of the costs of weapons facilities cleanup, the types of cleanup technology that will be emphasized and the way the DOE programs will be run. Other Federal agencies responsible for cleanup operations [e.g., the Environmental Protection Agency (EPA) and the Department of Defense (DOD)] will be similarly affected. This paper defines risk management and risk assessment and explains why these concepts will be of growing importance in the 1990s. It also defines other relevant terms. The paper develops a rationale for why risk assessment and management will be of increasing importance in environmental decision-making in the 1990s and beyond.

  19. Increased risk of essential tremor in migraine: A population-based retrospective cohort study

    PubMed Central

    Lau, Chi-Ieong; Lin, Che-Chen; Chen, Hsuan-Ju; Wang, Han-Cheng; Chen, Wei-Hung

    2017-01-01

    Purpose To examine the long-term risk of essential tremor (ET) in migraine. Methods Using population-based administrative data from a subset of the National Health Insurance Research Database (NHIRD) of Taiwan, we identified 22,696 newly diagnosed migraineurs (mean age 44.5 years) and a matched migraine-free cohort of 90,784 individuals in the period 2000–2008. Multivariable Cox proportional hazards regression analysis was conducted for assessing the ET risk for the migraine cohort compared to the migraine-free cohort. Results After adjusting for covariates, the migraine cohort had a 1.83-fold increased risk (95% CI 1.50–2.23) of subsequent ET in comparison to the migraine-free cohort (8.97 vs. 4.81 per 10,000 person-years). In the subgroup analysis, patients with migraine were associated with higher risks of ET, regardless of gender, age or the existence of comorbidities. Conclusion Our findings demonstrated an association between migraine and ET, suggesting a possible shared pathophysiology underpinning both disorders. PMID:28288163

  20. Increased risk of cancer in radon-exposed miners with elevated frequency of chromosomal aberrations.

    PubMed

    Smerhovsky, Zdenek; Landa, Karel; Rössner, Pavel; Juzova, Dagmar; Brabec, Marek; Zudova, Zdena; Hola, Nora; Zarska, Hana; Nevsimalova, Emilie

    2002-02-15

    In spite of the extensive use of cytogenetic analysis of human peripheral blood lymphocytes in the biomonitoring of exposure to various mutagens and carcinogens, the long-term effects of an increased frequency of chromosomal aberrations in individuals are still uncertain. Few epidemiologic studies have addressed this issue, and a moderate risk of cancer in individuals with an elevated frequency of chromosomal aberrations has been observed. In the present study, we analyzed data on 1323 cytogenetic assays and 225 subjects examined because of occupational exposures to radon (range of exposure from 1.7 to 662.3 working level month (WLM)). Seventy-five subjects were non-smokers. We found 36 cases of cancer in this cohort. Chromatid breaks were the most frequently observed type of aberrations (mean frequency 1.2 per 100 cells), which statistically significantly correlated with radon exposure (Spearman's correlation coefficient R=0.22, P<0.001). Also, the frequency of aberrant cells (median of 2.5%) correlated with radon exposure (Spearman's correlation coefficient R=0.16, P<0.02). Smoking and silicosis were not associated with results of cytogenetic analyses. The Cox regression models, which accounted for the age at time of first cytogenetic assay, radon exposure, and smoking showed strong and statistically significant associations between cancer incidence and frequency of chromatid breaks and frequency of aberrant cells, respectively. A 1% increase in the frequency of aberrant cells was paralleled by a 62% increase in risk of cancer (P<0.000). An increase in frequency of chromatid breaks by 1 per 100 cells was followed by a 99% increase in risk of cancer (P<0.000). We obtained similar results when we analyzed the incidence of lung cancer and the incidence other than lung cancer separately. Contrary to frequency of chromatid breaks and frequency of aberrant cells, the frequency of chromatid exchanges, and chromosome-type aberrations were not predictive of cancer.

  1. Secondhand tobacco smoke exposure is associated with increased risk of failed implantation and reduced IVF success

    PubMed Central

    Benedict, Merle D.; Missmer, Stacey A.; Vahratian, Anjel; Berry, Katharine F.; Vitonis, Allison F.; Cramer, Daniel W.; Meeker, John D.

    2011-01-01

    BACKGROUND Infertility and early pregnancy loss are prevalent as is exposure to secondhand tobacco smoke (STS). Previous research has suggested a relationship between STS exposure and early pregnancy loss, but studies have been limited by small study sizes and/or imprecise methods for exposure estimation. IVF allows for the collection of follicular fluid (FF), the fluid surrounding the pre-ovulatory oocyte, which may be a more biologically relevant sample media than urine or serum in studies of early reproduction. METHODS In a retrospective analysis of a prospective cohort study, we measured cotinine in FF collected during 3270 IVF treatment cycles from 1909 non-smoking women between 1994 and 2003 to examine the relationship between STS exposure and implantation failure. RESULTS In adjusted models, we found a significant increase in the risk of implantation failure among women exposed to STS compared with those unexposed [odds ratio (OR) = 1.52; 95% confidence interval (CI) = 1.20–1.92; risk ratio (RR) = 1.17; 95% CI = 1.10–1.25]. We also found a significant decrease in the odds for a live birth among STS-exposed women (OR = 0.75; 95% CI = 0.57–0.99; RR = 0.81; 95% CI = 0.66–0.99). CONCLUSIONS Female STS exposure, estimated through the measurement of cotinine in FF, is associated with an increased risk of implantation failure and reduced odds of a live birth. PMID:21771769

  2. Increased Risk of Asthma in Children with ADHD: Role of Prematurity and Maternal Stress during Pregnancy

    PubMed Central

    Grizenko, Natalie; Osmanlliu, Esli; Fortier, Marie-Ève; Joober, Ridha

    2015-01-01

    Objective: ADHD and asthma are prevalent conditions in childhood, with complex pathophysiology involving genetic-environmental interplay. The study objective is to examine the prevalence of asthma in our ADHD population and explore factors that may increase the risk of developing asthma in children with ADHD. Methods: We retrospectively analyzed the presence of maternal stress during pregnancy and history of asthma in 201 children diagnosed with ADHD. Results: Chi-square analysis indicated significant higher presence of asthma in our ADHD sample compared to Quebec children, χ2(1, N = 201) = 15.37, P<0.001. Only prematurity and stress during pregnancy significantly predicted asthma in a logistic regression model, χ2(2)=23.70, P<0.001, with odds ratios of 10.6 (95% CI: 2.8–39.5) and 3.2 (95% CI: 1.4–7.3), respectively. Conclusion: Children with ADHD have a higher prevalence of asthma than the general Quebec pediatric population. Children with ADHD born prematurely and/or those whose mothers experienced stress during pregnancy have a significantly increased risk of developing asthma. The study highlights the importance of potentially offering social and psychological support to mothers who experienced stress during pregnancy and/or are at risk of delivering prematurely. PMID:26379722

  3. Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

    PubMed

    Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

    2016-01-01

    This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus.

  4. Localised Badger Culling Increases Risk of Herd Breakdown on Nearby, Not Focal, Land

    PubMed Central

    Bielby, Jon; Vial, Flavie; Woodroffe, Rosie; Donnelly, Christl A.

    2016-01-01

    Bovine tuberculosis is an important disease affecting the UK livestock industry. Controlling bovine tuberculosis (TB) is made more complex by the presence of a wildlife host, the Eurasian badger, Meles meles. Repeated large-scale badger culls implemented in the Randomised Badger Culling Trial (RBCT) were associated with decreased cattle risks inside the culling area, but also with increased cattle risks up to the 2km outside the culling area. Intermediate reductions in badger density, as achieved by localised reactive culling in the RBCT, significantly increased cattle TB. Using a matched-pairs case-control study design (n = 221 pairs of cattle herds), we investigated the spatial scale over which localised badger culling had its biggest impact. We found that reactive badger culling had a significant positive association with the risk of cattle TB at distances of 1-3km and 3-5km, and that no such association existed over shorter distances (<1km). These findings indicate that localised badger culls had significant negative effects, not on the land on which culling took place, but, perhaps more importantly, on adjoining lands and farms. PMID:27749934

  5. Fasting increases risk for onset of binge eating and bulimic pathology: a 5-year prospective study.

    PubMed

    Stice, Eric; Davis, Kendra; Miller, Nicole P; Marti, C Nathan

    2008-11-01

    Although adolescent girls with elevated dietary restraint scores are at increased risk for future binge eating and bulimic pathology, they do not eat less than those with lower restraint scores. The fact that only a small proportion of individuals with elevated dietary restraint scores develop bulimic pathology suggests that some extreme but rare form of dietary restriction may increase risk for this disturbance. The authors tested the hypothesis that fasting (going without eating for 24 hr for weight control) would be a more potent predictor of binge eating and bulimic pathology onset than dietary restraint scores using data from 496 adolescent girls followed over 5 years. Results confirmed that only 23% of participants with elevated dietary restraint scores reported fasting. Furthermore, fasting generally showed stronger and more consistent predictive relations to future onset of recurrent binge eating and threshold/subthreshold bulimia nervosa over 1- to 5-year follow-up relative to dietary restraint, though the former effects were only significantly stronger than the latter for some comparisons. Results provide preliminary support for the hypothesis that fasting is a stronger risk factor for bulimic pathology than is self-reported dieting.

  6. Cortisol and testosterone increase financial risk taking and may destabilize markets.

    PubMed

    Cueva, Carlos; Roberts, R Edward; Spencer, Tom; Rani, Nisha; Tempest, Michelle; Tobler, Philippe N; Herbert, Joe; Rustichini, Aldo

    2015-07-02

    It is widely known that financial markets can become dangerously unstable, yet it is unclear why. Recent research has highlighted the possibility that endogenous hormones, in particular testosterone and cortisol, may critically influence traders' financial decision making. Here we show that cortisol, a hormone that modulates the response to physical or psychological stress, predicts instability in financial markets. Specifically, we recorded salivary levels of cortisol and testosterone in people participating in an experimental asset market (N = 142) and found that individual and aggregate levels of endogenous cortisol predict subsequent risk-taking and price instability. We then administered either cortisol (single oral dose of 100 mg hydrocortisone, N = 34) or testosterone (three doses of 10 g transdermal 1% testosterone gel over 48 hours, N = 41) to young males before they played an asset trading game. We found that both cortisol and testosterone shifted investment towards riskier assets. Cortisol appears to affect risk preferences directly, whereas testosterone operates by inducing increased optimism about future price changes. Our results suggest that changes in both cortisol and testosterone could play a destabilizing role in financial markets through increased risk taking behaviour, acting via different behavioural pathways.

  7. Cortisol and testosterone increase financial risk taking and may destabilize markets

    PubMed Central

    Cueva, Carlos; Roberts, R. Edward; Spencer, Tom; Rani, Nisha; Tempest, Michelle; Tobler, Philippe N.; Herbert, Joe; Rustichini, Aldo

    2015-01-01

    It is widely known that financial markets can become dangerously unstable, yet it is unclear why. Recent research has highlighted the possibility that endogenous hormones, in particular testosterone and cortisol, may critically influence traders’ financial decision making. Here we show that cortisol, a hormone that modulates the response to physical or psychological stress, predicts instability in financial markets. Specifically, we recorded salivary levels of cortisol and testosterone in people participating in an experimental asset market (N = 142) and found that individual and aggregate levels of endogenous cortisol predict subsequent risk-taking and price instability. We then administered either cortisol (single oral dose of 100 mg hydrocortisone, N = 34) or testosterone (three doses of 10 g transdermal 1% testosterone gel over 48 hours, N = 41) to young males before they played an asset trading game. We found that both cortisol and testosterone shifted investment towards riskier assets. Cortisol appears to affect risk preferences directly, whereas testosterone operates by inducing increased optimism about future price changes. Our results suggest that changes in both cortisol and testosterone could play a destabilizing role in financial markets through increased risk taking behaviour, acting via different behavioural pathways. PMID:26135946

  8. Utilization of Public Health Service Increased Risk Donors Yields Equivalent Outcomes in Liver Transplantation.

    PubMed

    Fleetwood, V A; Lusciks, J; Poirier, J; Hertl, M; Chan, E Y

    2016-01-01

    Background. The PHS increased risk donor (IRD) is underutilized in liver transplantation. We aimed to examine the posttransplant outcomes in recipients of increased-risk organs. Methods. We analyzed 228,040 transplants in the Organ Procurement and Transplantation Network database from 2004 to 2013. Endpoints were graft failure and death. Results were controlled for demographics and comorbidities. Statistical analysis utilized Fisher's test and logistic regression. Results. 58,816 patients were identified (5,534 IRD, 53,282 non-IRD). IRDs were more frequently male (69.2% versus 58.3%, p < 0.001), younger (34 versus 39, p < 0.001), and less likely to have comorbidities (p < 0.001). Waitlist time was longer for IRD graft recipients (254 versus 238 days, p < 0.001). All outcomes were better in the IRD group. Graft failure (23.6 versus 27.3%, p < 0.001) and mortality (20.4 versus 22.3%, p = 0.001) were decreased in IRD graft recipients. However, in multivariate analysis, IRD status was not a significant indicator of outcomes. Conclusion. This is the first study to describe IRD demographics in liver transplantation. Outcomes are improved in IRD organ recipients; however, controlling for donor and recipient comorbidities, ischemia time, and MELD score, the differences lose significance. In multivariate analysis, use of IRD organs is noninferior, with similar graft failure and mortality despite the infectious risk.

  9. Peri-operative radiation exposure: Are overweight patients at increased risks?

    PubMed

    Dalgleish, S; Hince, A; Finlayson, D F

    2015-12-01

    The aim of this study was to identify if there was a correlation between body mass index (BMI) and intra-operative radiation exposure. A retrospective review of 81 patients who had sliding hip screw fixation for femoral neck fractures in one year was completed, recording body mass index (BMI), screening time, dose area product (DAP), American Society of Anesthesiologists (ASA) grade, seniority of operating surgeon and complexity of the fracture configuration. There was a statistically significant correlation between dose area product and BMI. There was no statistically significant relationship between screening time and BMI. There was no statistical difference between ASA grade, seniority of surgeon, or complexity of fracture configuration and dose area product. Simulated stochastic risks were increased for overweight patients. Overweight patients are exposed to increased doses of radiation regardless of length of screening time. Surgeons and theatre staff should be aware of the increased radiation exposure during fixation of fractures in overweight patients and, along with radiographers, ensure steps are taken to minimise these risks. Whilst such radiation dosages may have little adverse effect for individual patients, these findings may be of more relevance and concern to staff that will be exposed to increased radiation.

  10. Does Drought Increase the Risk of Insects Developing Behavioral Resistance to Systemic Insecticides?

    PubMed

    Khodaverdi, Haleh; Fowles, Trevor; Bick, Emily; Nansen, Christian

    2016-10-01

    Increases in severity and frequency of drought periods, average global temperatures, and more erratic fluctuations in rainfall patterns due to climate change are predicted to have a dramatic impact on agricultural production systems. Insect pest populations in agricultural and horticultural systems are also expected to be impacted, both in terms of their spatial and temporal distributions and in their status as pest species. In this opinion-based article, we discuss how indirect effects of drought may adversely affect the performance of systemic insecticides and also lead to increased risk of insect pests developing behavioral insecticide resistance. We hypothesize that more pronounced drought will decrease uptake and increase the magnitude of nonuniform translocation of systemic insecticides within treated crop plants, and that may have two concurrent consequences: 1) reduced pesticide performance, and 2) increased likelihood of insect pests evolving behavioral insecticide resistance. Under this scenario, pests that can sense and avoid acquisition of lethal dosages of systemic insecticides within crop plants will have a selective advantage. This may lead to selection for insect behavioral avoidance, so that insects predominantly feed and oviposit on portions of crop plants with low concentration of systemic insecticide. Limited research has been published on the effect of environmental variables, including drought, on pesticide performance, but we present and discuss studies that support the hypothesis described above. In addition, we wish to highlight the importance of studying the many ways environmental factors can affect, directly and indirectly, both the performance of insecticides and the risk of target insect pests developing resistance.

  11. Do Polybrominated Diphenyl Ethers (PBDEs) Increase the Risk of Thyroid Cancer?

    PubMed Central

    Zhang, Yawei; Guo, Grace L.; Han, Xuesong; Zhu, Cairong; Kilfoy, Briseis A.; Zhu, Yong; Boyle, Peter; Zheng, Tongzhang

    2008-01-01

    An increased incidence of thyroid cancer has been reported in many parts of the world including the United States during the past several decades. Recently emerging evidence has demonstrated that polyhalogenated aromatic hydrocarbons (PHAHs), particularly polybrominated diphenyl ethers (PBDEs), alter thyroid hormone homeostasis and cause thyroid dysfunction. However, few studies have been conducted to test whether exposure to PBDEs and other PHAHs increases the risk of thyroid cancer. Here, we hypothesize that elevated exposure to PHAHs, particularly PBDEs, increases the risk of thyroid cancer and may explain part of the increase in incidence of thyroid cancer during the past several decades. In addition, genetic and epigenetic variations in metabolic pathway genes may alter the expression and function of metabolic enzymes which are involved in the metabolism of endogenous thyroid hormones and the detoxification of PBDEs and other PHAHs. Such variation may result in different individual susceptibilities to PBDEs and other PHAHs and the subsequent development of thyroid cancer. The investigation of this hypothesis will lead to an improved understanding of the role of PBDEs and other PHAHs in thyroid tumorigenesis and may provide a real means to prevent this deadly disease. PMID:19122824

  12. Trans-Resveratrol Alters Mammary Promoter Hypermethylation in Women at Increased Risk for Breast Cancer

    PubMed Central

    Zhu, Weizhu; Qin, Wenyi; Zhang, Ke; Rottinghaus, George E.; Chen, Yin-Chieh; Kliethermes, Beth; Sauter, Edward R.

    2012-01-01

    Trans-resveratrol, present in high concentration in the skin of red grapes and red wine, has a dose-dependent antiproliferative effect in vitro, prevents the formation of mammary tumors, and has been touted as a chemopreventive agent. Based upon in vitro studies demonstrating that trans-resveratrol downregulates the expression of 1) DNA methyltransferases and 2) the cancer promoting prostaglandin (PG)E2, we determined if trans-resveratrol had a dose-related effect on DNA methylation and prostaglandin expression in humans. Thirty-nine adult women at increased breast cancer risk were randomized in double-blind fashion to placebo, 5 or 50 mg trans-resveratrol twice daily for 12 wk. Methylation assessment of 4 cancer-related genes (p16, RASSF-1α, APC, CCND2) was performed on mammary ductoscopy specimens. The predominant resveratrol species in serum was the glucuronide metabolite. Total trans-resveratrol and glucuronide metabolite serum levels increased after consuming both trans-resveratrol doses (P < .001 for both). RASSF-1α methylation decreased with increasing levels of serum trans-resveratrol (P = .047). The change in RASSF-1α methylation was directly related to the change in PGE2 (P = .045). This work provides novel insights into the effects of trans-resveratrol on the breast of women at increased breast cancer risk, including a decrease in methylation of the tumor suppressor gene RASSF-1α. Because of the limited sample size, our findings should be validated in a larger study. PMID:22332908

  13. Edge Effects along a Seagrass Margin Result in an Increased Grazing Risk on Posidonia australis Transplants

    PubMed Central

    Statton, John; Gustin-Craig, Samuel; Dixon, Kingsley W.; Kendrick, Gary A.

    2015-01-01

    A key issue in habitat restoration are the changes in ecological processes that occur when fragments of habitat are lost, resulting in the persistence of habitat-degraded margins. Margins often create or enhance opportunities for negative plant-herbivore interactions, preventing natural or assisted re-establishment of native vegetation into the degraded area. However, at some distance from the habitat margin these negative interactions may relax. Here, we posit that the intensity of species interactions in a fragmented Posidonia australis seagrass meadow may be spatially dependent on proximity to the seagrass habitat edge, whereby the risk of grazing is high and the probability of survival of seagrass transplants is low. To test this, transplants were planted 2 m within the meadow, on the meadow edge at 0m, and at 2m, 10m, 30m, 50m and 100m distance from the edge of the seagrass meadow into the unvegetated sand sheet. There was an enhanced grazing risk 0-10m from the edge, but decreased sharply with increasing distances (>30m). Yet, the risk of grazing was minimal inside the seagrass meadow, indicating that grazers may use the seagrass meadow for refuge but are not actively grazing within it. The relationship between short-term herbivory risk and long-term survival was not straightforward, suggesting that other environmental filters are also affecting survival of P. australis transplants within the study area. We found that daily probability of herbivory was predictable and operating over a small spatial scale at the edge of a large, intact seagrass meadow. These findings highlight the risk from herbivory can be high, and a potential contributing factor to seagrass establishment in restoration programs. PMID:26465926

  14. [Genetic counseling and DNA testing in patients with increased risks for malignant melanoma].

    PubMed

    Itin, P H; Fistarol, S K

    2003-08-01

    There are numerous risk factors for the development of malignant melanoma. It has been documented that genetic predisposition exists but exogenous factors are also very important. In familial melanomas it has been well established that mutation in the CDKN2A gene which is located at chromosome 9 leads to a marked risk for malignant melanoma. This tumor-suppressor gene is important for the regulation of the cell cycle and mutation in this gene is associated also with an increased rate of pancreas cancer. The penetrance of this mutation is influenced by UV-energy. In addition it has been shown that a second cluster for the familial atypical nevus syndrome is located at chromosome 1p36. Patients with the rare disease xeroderma pigmentosum have a defect in the DNA-repair mechanism inherited in an autosomal recessive trait and therefore develop within the first 20 years of life numerous malignant skin tumours including malignant melanomas. But also in non-syndromic patients a decrease of DNA-repair ability may occur. It has been shown recently that reduced DNA-repair ability is an independent risk factor for malignant melanoma and may contribute to susceptibility to sunlight-induced melanoma among the general population. Other constitutional risk factors for the development of malignant melanoma are fair skin, red hair and blue eyes. The most important exogenous risk factor is UV-exposition. Extensive and repetitive sunburns before the age of 15 years are especially predisposing to malignant melanoma. The most important preventive measures are continuous sun-protection including avoidance of sun in noon time on tropical and subtropical places, wearing a hut and sunglasses and application of sun-screens with high sun-protection factor. Furthermore a regular check for changing moles is indicated in persons with multiple atypical nevi or a familial melanoma syndrome. Nowadays molecular genetic screenings are available within research projects for members of melanoma

  15. The risk for breast cancer is not evidently increased in women with hyperprolactinemia

    PubMed Central

    Romijn, J. A.; de Boer, A.; Vandenbroucke, J. P.

    2009-01-01

    The question has been raised whether hyperprolactinemia in humans is associated with an excess risk for breast cancer. We aimed to assess the risk of breast cancer in a previously defined large cohort of patients treated for idiopathic hyperprolactinemia or prolactinomas. Based on the pattern of drug prescriptions we identified 11,314 subjects in the PHARMO network with at least one dispensing of dopamine agonists between 1996 and 2006. Of these, 1,607 subjects were considered to have dopamine agonist—treated hyperprolactinemia based on the prescribing pattern. For the present analysis, we included only women (n = 1,342). Patients with breast cancer were identified by hospital discharge codes. Data on breast cancer incidence in the Netherlands were derived from the Dutch cancer registry. Standardized mortality ratio (SMR) was the measure of outcome to assess the association between hyperprolactinemia and breast cancer. The 1,342 patients accounted for a total of 6,576 person years. Eight patients with breast cancer during follow-up were identified. Indirect standardization with incidence proportions from the general Dutch population revealed a 7.47 expected cases. The calculated SMR for breast cancer risk in patients treated hyperprolactinemia was 1.07 (95% confidence interval 0.50–2.03). In conclusion, there is no clear evidence for increased breast cancer risk in female patients treated for either idiopathic hyperprolactinemia or prolactinomas. The uncertainty about the exact risk that is due to the relatively low number of breast cancer cases, should be overcome by pooling results in a future meta-analysis. PMID:20012697

  16. Physiotherapists working in clinics have increased risk for new-onset spine disorders

    PubMed Central

    Liao, Jen-Chieh; Ho, Chung-Han; Chiu, Haw-Yen; Wang, Yu-Lin; Kuo, Li-Chieh; Liu, Cheng; Wang, Jhi-Joung; Lim, Sher-Wei; Kuo, Jinn-Rung

    2016-01-01

    Abstract Health care professionals are known to have a high risk for work-related musculoskeletal disorders. However, the information on the risk of new-onset spine-related musculoskeletal disorders (SRMDs) in health care professionals is insufficient. This study aimed to investigate new-onset spine disorder associations among physical, occupational, and pharmacy health care professionals working in different workplaces. Taiwan's National Health Insurance Research Database for registered medical personnel claims from 2000 to 2011 was analyzed. An age- and sex-matched longitudinal cohort study of 7448 subjects (1682 physiotherapists, 1682 occupational therapists [OTs], and 3724 pharmacists) with or without new-onset spine disorders was conducted. The hazard ratios for the development of new-onset spine disorders were estimated among these 3 groups. The overall percentage of new-onset SRMD for physiotherapists is 32.12. The median time from obtaining a registered license to developing SRMD is 1.94 years. The log-rank test showed that physiotherapists have the least possibility of having a SRMD-free rate (P < 0.0001). The Cox model showed that physiotherapists have a higher risk of new-onset SRMD (hazard ratio: 1.65, 95% confidence interval: 1.48–1.84, P < 0.0001) compared with OTs and pharmacists. Physiotherapists working in clinics have a 2.40-fold increased risk of developing SRMD (95% confidence interval: 1.97–2.92, P < 0.0001) relative to OTs and pharmacists. This may be the first study regarding new-onset SRMD in physiotherapists based on a powerful nationwide population-based database. We conclude that working in clinics is a potential risk for new-onset SRMD in physiotherapists. Therefore, we suggest that physiotherapists should pay more attention to this issue to prevent the development of spine disorders. PMID:27512853

  17. Genetic polymorphisms associated with increased risk of developing chronic myelogenous leukemia

    PubMed Central

    Bruzzoni-Giovanelli, Heriberto; González, Juan R.; Sigaux, François; Villoutreix, Bruno O.; Cayuela, Jean Michel; Guilhot, Joëlle; Preudhomme, Claude; Guilhot, François; Poyet, Jean-Luc; Rousselot, Philippe

    2015-01-01

    Little is known about inherited factors associated with the risk of developing chronic myelogenous leukemia (CML). We used a dedicated DNA chip containing 16 561 single nucleotide polymorphisms (SNPs) covering 1 916 candidate genes to analyze 437 CML patients and 1 144 healthy control individuals. Single SNP association analysis identified 139 SNPs that passed multiple comparisons (1% false discovery rate). The HDAC9, AVEN, SEMA3C, IKBKB, GSTA3, RIPK1 and FGF2 genes were each represented by three SNPs, the PSM family by four SNPs and the SLC15A1 gene by six. Haplotype analysis showed that certain combinations of rare alleles of these genes increased the risk of developing CML by more than two or three-fold. A classification tree model identified five SNPs belonging to the genes PSMB10, TNFRSF10D, PSMB2, PPARD and CYP26B1, which were associated with CML predisposition. A CML-risk-allele score was created using these five SNPs. This score was accurate for discriminating CML status (AUC: 0.61, 95%CI: 0.58–0.64). Interestingly, the score was associated with age at diagnosis and the average number of risk alleles was significantly higher in younger patients. The risk-allele score showed the same distribution in the general population (HapMap CEU samples) as in our control individuals and was associated with differential gene expression patterns of two genes (VAPA and TDRKH). In conclusion, we describe haplotypes and a genetic score that are significantly associated with a predisposition to develop CML. The SNPs identified will also serve to drive fundamental research on the putative role of these genes in CML development. PMID:26474455

  18. Gout increases risk of fracture: A nationwide population-based cohort study.

    PubMed

    Tzeng, Huey-En; Lin, Che-Chen; Wang, I-Kuan; Huang, Po-Hao; Tsai, Chun-Hao

    2016-08-01

    There is still debate on whether high uric acid increases bone mineral density (BMD) against osteoporotic fracture or bone resorption caused by gout inflammation. This study aimed to evaluate whether gout offers a protective effect on bone health or not. We conducted a nationwide population-based retrospective cohort study to evaluate the association between gout history and risk factors of fracture.A retrospective cohort study was designed using the claim data from Longitudinal Health Insurance Database (LHID). A total of 43,647 subjects with gout and a cohort of 87,294 comparison subjects without gout were matched in terms of age and sex between 2001 and 2009, and the data were followed until December 31, 2011. The primary outcome of the study was the fracture incidence, and the impacts of gout on fracture risks were analyzed using the Cox proportional hazards model.After an 11-year follow-up period, 6992 and 11,412 incidents of fracture were reported in gout and comparison cohorts, respectively. The overall incidence rate of fracture in individuals with gout was nearly 23%, which was higher than that in individuals without gout (252 vs 205 per 10,000 person-years) at an adjusted hazard ratio of 1.17 (95% confidence interval = 1.14-1.21). Age, sex, and fracture-associated comorbidities were adjusted accordingly. As for fracture locations, patients with gout were found at significant higher fracture risks for upper/lower limbs and spine fractures. In gout patient, the user of allopurinol or benzbromarone has significantly lower risk of facture than nonusers.Gout history is considered as a risk factor for fractures, particularly in female individuals and fracture sites located at the spine or upper/lower limbs.

  19. Puberty dysregulation and increased risk of disease in adult life: possible modes of action.

    PubMed

    Mantovani, Alberto; Fucic, Aleksandra

    2014-04-01

    Puberty is the developmental window when the final maturation of body systems is orchestrated by hormones; lifelong sex-related differences and capacity to interact with the environment are defined during this life stage. Increased incidence in a number of chronic, multifactorial diseases could be related to environmental exposures during puberty: however, insight on the susceptibility of the peripubertal period is still limited. The estrogen/androgen balance is a crucial axis in harmonizing the whole pubertal development, pointing out the significance of exposures to endocrine disruptors. Besides the reproductive system, endocrine-related perturbations may affect the maturation of skeleton, adipose tissues, brain, immune system, as well as cancer predisposition. Thus, risk assessment of environmental stressors should duly consider specific aspects of the pubertal window. Besides endocrine-related mechanisms, suggested research priorities include signaling molecules (e.g., kisspeptins, dopamine) as xenobiotic targets and disturbances of specific pubertal methylation processes potentially involved in neurobehavioral disorders and cancer risk in adulthood.

  20. Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients?

    PubMed Central

    Lupo, Molly; Dains, Joyce E.; Madsen, Lydia T.

    2015-01-01

    Historically, randomized controlled trials (RCTs) have shown an increased risk of recurrence and mortality among women who have used primarily oral HRT after breast cancer. However, many of these studies have had design flaws that may impact the findings. Numerous investigators have concluded that additional RCTs should be performed, but because of ethical issues and logistic challenges, large-scale RCTs are unlikely. Thus, the authors conducted an integrative review investigating recurrence and mortality data among breast cancer survivors who have used hormone replacement therapy (HRT). They recommend a stepwise algorithm for treating vaginal symptoms in breast cancer survivors: (1) start with nonhormonal treatments; (2) progress to a detailed discussion among patients and health-care professionals about the current known risks and benefits of vaginal estrogen; and (3) conclude with mutual decision-making between health-care providers and patients regarding the use of vaginal estrogen treatment. PMID:26705493

  1. Genetic variants and increased risk of meningioma: an updated meta-analysis

    PubMed Central

    Han, Xiao-Yong; Wang, Wei; Wang, Lei-Lei; Wang, Xi-Rui; Li, Gang

    2017-01-01

    Purpose Various genetic variants have been reported to be linked to an increased risk of meningioma. However, no confirmed conclusion has been obtained. The purpose of the study was to investigate potential meningioma-associated gene polymorphisms, based on published evidence. Materials and methods An updated meta-analysis was performed in September 2016. After electronic database searching and study screening, we selected eligible case-control studies and extracted data for meta-analysis, using Mantel–Haenszel statistics. P-values, pooled odds ratios (ORs), and 95% confidence intervals were calculated. Results We finally selected eight genes with ten polymorphisms: MLLT10 rs12770228, CASP8 rs1045485, XRCC1 rs1799782, rs25487, MTHFR rs1801133, rs1801131, MTRR rs1801394, MTR rs1805087, GSTM1 null/present, and GSTT1 null/present. Results of meta-analyses showed that there was increased meningioma risk in case groups under all models of MLLT10 rs12770228 (all OR >1, P<0.001), compared with control groups. Similar results were observed under the allele, homozygote, dominant, and recessive models of MTRR rs1801394 (all OR >1, P<0.05), and the heterozygote and dominant models of MTHFR rs1801131 in the Caucasian population (all OR >1, P<0.05). However, no significantly increased meningioma risks were observed for CASP8 rs1045485, XRCC1 rs25487, rs1799782, MTHFR rs1801133, MTR rs1805087, or GSTM1/GSTT1 null mutations. Conclusion Our updated meta-analysis provided statistical evidence for the role of MLLT10 rs12770228, MTRR rs1801394, and MTHFR rs1801131 in increased susceptibility to meningioma.

  2. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms

    PubMed Central

    Spradley, Frank T.; Palei, Ana C.

    2015-01-01

    Preeclampsia (PE) is a pregnancy-specific disorder typically presenting as new-onset hypertension and proteinuria. While numerous epidemiological studies have demonstrated that obesity increases the risk of PE, the mechanisms have yet to be fully elucidated. Growing evidence from animal and human studies implicate placental ischemia in the etiology of this maternal syndrome. It is thought that placental ischemia is brought about by dysfunctional cytotrophoblast migration and invasion into the uterus and subsequent lack of spiral arteriole widening and placental perfusion. Placental ischemia/hypoxia stimulates the release of soluble placental factors into the maternal circulation where they cause endothelial dysfunction, particularly in the kidney, to elicit the clinical manifestations of PE. The most recognized of these factors are the anti-angiogenic sFlt-1 and pro-inflammatory TNF-α and AT1-AA, which promote endothelial dysfunction by reducing levels of the provasodilator nitric oxide and stimulating production of the potent vasoconstrictor endothelin-1 and reactive oxygen species. We hypothesize that obesity-related metabolic factors increase the risk for developing PE by impacting various stages in the pathogenesis of PE, namely, 1) cytotrophoblast migration and placental ischemia; 2) release of soluble placental factors into the maternal circulation; and 3) maternal endothelial and vascular dysfunction. This review will summarize the current experimental evidence supporting the concept that obesity and metabolic factors like lipids, insulin, glucose, and leptin affect placental function and increase the risk for developing hypertension in pregnancy by reducing placental perfusion; enhancing placental release of soluble factors; and by increasing the sensitivity of the maternal vasculature to placental ischemia-induced soluble factors. PMID:26447211

  3. Increased risk of stroke in contact dermatitis patients: A nationwide population-based retrospective cohort study.

    PubMed

    Chang, Wei-Lun; Hsu, Min-Hsien; Lin, Cheng-Li; Chan, Po-Chi; Chang, Ko-Shih; Lee, Ching-Hsiao; Hsu, Chung-Yi; Tsai, Min-Tein; Yeh, Chung-Hsin; Sung, Fung-Chang

    2017-03-01

    Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke.We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000-2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts.The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P < 0.01). The multivariable Cox method analyzed adjusted hazard ratios (aHRs) were 1.12 (95% confidence interval [CI], 1.05-1.19) for all stroke types and 1.12 (95% CI, 1.05-1.20) for ischemic stroke and 1.11 (95% CI, 0.94-1.30) for hemorrhagic stroke. The age-specific aHR of stroke for contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03-1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15-1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07-1.27) and 1.09 (95% CI, 1.00-1.18) for men and women, respectively.This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further.

  4. Micronutrient-Fortified Rice Can Increase Hookworm Infection Risk: A Cluster Randomized Trial

    PubMed Central

    de Gier, Brechje; Campos Ponce, Maiza; Perignon, Marlene; Fiorentino, Marion; Khov, Kuong; Chamnan, Chhoun; de Boer, Michiel R.; Parker, Megan E.; Burja, Kurt; Dijkhuizen, Marjoleine A.; Berger, Jacques; Polman, Katja; Wieringa, Frank T.

    2016-01-01

    Background Fortification of staple foods is considered an effective and safe strategy to combat micronutrient deficiencies, thereby improving health. While improving micronutrient status might be expected to have positive effects on immunity, some studies have reported increases in infections or inflammation after iron supplementation. Objective To study effects of micronutrient-fortified rice on hookworm infection in Cambodian schoolchildren. Methods A double-blinded, cluster-randomized trial was conducted in 16 Cambodian primary schools partaking in the World Food Program school meal program. Three types of multi-micronutrient fortified rice were tested against placebo rice within the school meal program: UltraRice_original, UltraRice_improved and NutriRice. Four schools were randomly assigned to each study group (placebo n = 492, UltraRice_original n = 479, UltraRice_improved n = 500, NutriRice n = 506). Intestinal parasite infection was measured in fecal samples by Kato-Katz method at baseline and after three and seven months. In a subgroup (N = 330), fecal calprotectin was measured by ELISA as a marker for intestinal inflammation. Results Baseline prevalence of hookworm infection was 18.6%, but differed considerably among schools (range 0%- 48.1%).Micronutrient-fortified rice significantly increased risk of new hookworm infection. This effect was modified by baseline hookworm prevalence at the school; hookworm infection risk was increased by all three types of fortified rice in schools where baseline prevalence was high (>15%), and only by UltraRice_original in schools with low baseline prevalence. Neither hookworm infection nor fortified rice was related to fecal calprotectin. Conclusions Consumption of rice fortified with micronutrients can increase hookworm prevalence, especially in environments with high infection pressure. When considering fortification of staple foods, a careful risk-benefit analysis is warranted, taking into account severity of

  5. The effects of fall-risk-increasing drugs on postural control: a literature review.

    PubMed

    de Groot, Maartje H; van Campen, Jos P C M; Moek, Marije A; Tulner, Linda R; Beijnen, Jos H; Lamoth, Claudine J C

    2013-11-01

    Meta-analyses showed that psychotropic drugs (antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs) and some cardiac drugs (digoxin, type IA anti-arrhythmics, diuretics) are associated with increased fall risk. Because balance and gait disorders are the most consistent predictors of future falls, falls due to use of these so-called fall-risk-increasing drugs (FRIDs) might be partly caused by impairments of postural control that these drugs can induce. Therefore, the effects of FRIDs on postural control were examined by reviewing literature. Electronic databases and reference lists of identified papers were searched until June 2013. Only controlled research papers examining the effects of FRIDs on postural control were included. FRIDs were defined according to meta-analyses as antidepressants, neuroleptics, benzodiazepines, antiepileptic drugs, digoxin, type IA anti-arrhythmics, and diuretics. Ninety-four papers were included, of which study methods for quantifying postural control, and the effects of FRIDs on postural control were abstracted. Postural control was assessed with a variety of instruments, mainly evaluating aspects of body sway during quiet standing. In general, postural control was impaired, indicated by an increase in parameters quantifying body sway, when using psychotropic FRIDs. The effects were more pronounced when people were of a higher age, used psychotropics at higher daily doses, with longer half-lives, and administered for a longer period. From the present literature review, it can be concluded that psychotropic drugs cause impairments in postural control, which is probably one of the mediating factors for the increased fall risk these FRIDs are associated with. The sedative effects of these drugs on postural control are reversible, as was proven in intervention studies where FRIDs were withdrawn. The findings of the present literature review highlight the importance of using psychotropic drugs in the older population only at

  6. MSH3 rs26279 polymorphism increases cancer risk: a meta-analysis

    PubMed Central

    Miao, Hui-Kai; Chen, Li-Ping; Cai, Dong-Ping; Kong, Wei-Ju; Xiao, Li; Lin, Jie

    2015-01-01

    Previous studies have investigated the association of mutS homolog 3 (MSH3) rs26279 G > A polymorphism with the risk of different types of cancers including colorectal cancer, breast cancer, prostate cancer, bladder cancer, thyroid cancer, ovarian cancer and oesophageal cancer. However, its association with cancer remains conflicting. We performed a comprehensive meta-analysis to derive a more precise estimation of the relationship between MSH3 rs26279 G > A polymorphism and cancer susceptibility. Systematically searching the PubMed and EMBASE databases yielded 11 publications with 12 studies of 3282 cases and 6476 controls. The strength of the association was determined by crude odds ratios (OR) and 95% confidence intervals (CI). Overall, pooled risk estimates demonstrated that MSH3 rs26279 G > A was significantly associated with an increased overall cancer risk under all the genetic models (GG vs. AA: OR = 1.27, 95% CI = 1.09-1.48, P = 0.002; AG vs. AA: OR = 1.10, 95% CI = 1.00-1.21, P = 0.045; GG vs. AG + AA: OR = 1.23, 95% CI = 1.06-1.42, P = 0.005; AG + GG vs. AA: OR = 1.13, 95% CI = 1.04-1.24, P = 0.006; G vs. A: OR = 1.13, 95% CI = 1.05-1.20, P = 0.001). The association was more evident for colorectal cancer and breast cancer. Moreover, the significant association was also observed in the following subgroups: Europeans, Asians, population-based studies, hospital-based studies, and studies comprising relatively large sample size (≥ 200). Our meta-analysis results demonstrated that MSH3 rs26279 G > A polymorphism is associated with an increased risk of overall cancer, especially for the colorectal cancer and breast cancer. PMID:26617824

  7. Esophageal Squamous Cell Carcinoma Patients Have an Increased Risk of Coexisting Colorectal Neoplasms

    PubMed Central

    Baeg, Myong Ki; Choi, Myung-Gyu; Jung, Yun Duk; Ko, Sun-Hye; Lim, Chul-Hyun; Kim, Hyung Hun; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang-Woo

    2016-01-01

    Background/Aims Esophageal squamous cell carcinoma (ESCC) and colorectal neoplasms (CRNs) share risk factors. We aimed to investigate whether the CRN risk is increased in ESCC patients. Methods ESCC patients who underwent a colonoscopy within 1 year of diagnosis were retrospectively analyzed. Patients were matched 1:3 by age, gender, and body mass index to asymptomatic controls. CRN was defined as the histological confirmation of adenoma or adenocarcinoma. Advanced CRN was defined as any of the following: ≥3 adenomas, high-grade dysplasia, villous features, tumor ≥1 cm, or adenocarcinoma. The risk factors for both CRN and advanced CRN were evaluated by univariate and multivariate analyses. Results Sixty ESCC patients were compared with 180 controls. The ESCC group had significantly higher numbers of CRNs (odds ratio [OR], 2.311; 95% confidence interval [CI], 1.265 to 4.220; p=0.006) and advanced CRNs (OR, 2.317; 95% CI, 1.185 to 4.530; p=0.013). Significant risk factors for both CRN and advanced CRN by multivariate analysis included ESCC (OR, 2.157, 95% CI, 1.106 to 4.070, p=0.024; and OR, 2.157, 95% CI, 1.045 to 4.454, p=0.038, respectively) and older age (OR, 1.068, 95% CI, 1.032 to 1.106, p<0.001; and OR, 1.065, 95% CI, 1.024 to 1.109, p=0.002, respectively). Conclusions The rates of CRN and advanced CRN are significantly increased in ESCC. Colonos-copy should be considered at ESCC diagnosis. PMID:25963088

  8. Increased risk of cancer after Bell's palsy: a 5-year follow-up study.

    PubMed

    Sheu, Jau-Jiuan; Keller, Joseph J; Lin, Herng-Ching

    2012-11-01

    Reactivation of latent herpes simplex virus (HSV) type I or varicella-zoster virus (VZV) has been recognized as the most common pathomechanism underlying Bell's palsy. There is also increased reactivation of HSV or VZV in patients with immunosuppressed states and in cancer patients. The purpose of this study was to investigate the risk for cancer during a 5-year follow-up period after diagnosis of Bell's palsy by using a population-based dataset in Taiwan. We used data from the "Longitudinal Health Insurance Database". We identified 2,618 patients with Bell's palsy as the study cohort and randomly selected 13,090 patients to be used as a comparison cohort. Cox proportional hazards regression was performed to compare the 5-year risk of subsequent cancer between the study and comparison cohorts. We found that the incidence of cancer was 1.55 (95 % CI 1.35-1.78) per 100 person-years for patients with Bell's palsy and 1.09 (95 % CI 1.02-1.18) per 100 person-years for comparison patients. After censoring cases that died from non-cancer causes during the follow-up period and adjusting for urbanization, monthly income, geographic region, and diabetes, the hazard ratio (HR) for cancer during the 5-year follow-up period for patients with Bell's palsy was 1.43 times that for comparison patients (95 % CI 1.22-1.73). There was a particularly increased risk of oral cancer (HR = 2.49; 95 % CI 1.54-4.03) for patients with Bell's palsy compared with the other patients. We conclude that patients with Bell's palsy were at significant risk of cancer during a 5-year follow-up period after diagnosis.

  9. The human GIMAP5 gene has a common polyadenylation polymorphism increasing risk to systemic lupus erythematosus

    PubMed Central

    Hellquist, Anna; Zucchelli, Marco; Kivinen, Katja; Saarialho‐Kere, Ulpu; Koskenmies, Sari; Widen, Elisabeth; Julkunen, Heikki; Wong, Andrew; Karjalainen‐Lindsberg, Marja‐Liisa; Skoog, Tiina; Vendelin, Johanna; Cunninghame‐Graham, Deborah S; Vyse, Timothy J; Kere, Juha; Lindgren, Cecilia M

    2007-01-01

    Background Several members of the GIMAP gene family have been suggested as being involved in different aspects of the immune system in different species. Recently, a mutation in the GIMAP5 gene was shown to cause lymphopenia in a rat model of autoimmune insulin‐dependent diabetes. Thus it was hypothesised that genetic variation in GIMAP5 may be involved in susceptibility to other autoimmune disorders where lymphopenia is a key feature, such as systemic lupus erythematosus (SLE). Material and methods To investigate this, seven single nucleotide polymorphisms in GIMAP5 were analysed in five independent sets of family‐based SLE collections, containing more than 2000 samples. Result A significant increase in SLE risk associated with the most common GIMAP5 haplotype was found (OR 1.26, 95% CI 1.02 to 1.54, p = 0.0033). In families with probands diagnosed with trombocytopenia, the risk was increased (OR 2.11, 95% CI 1.09 to 4.09, p = 0.0153). The risk haplotype bears a polymorphic polyadenylation signal which alters the 3′ part of GIMAP5 mRNA by producing an inefficient polyadenylation signal. This results in higher proportion of non‐terminated mRNA for homozygous individuals (p<0.005), a mechanism shown to be causal in thalassaemias. To further assess the functional effect of the polymorphic polyadenylation signal in the risk haplotype, monocytes were treated with several cytokines affecting apoptosis. All the apoptotic cytokines induced GIMAP5 expression in two monocyte cell lines (1.5–6 times, p<0.0001 for all tests). Conclusion Taken together, the data suggest the role of GIMAP5 in the pathogenesis of SLE. PMID:17220214

  10. Cooking with biomass increases the risk of depression in pre-menopausal women in India.

    PubMed

    Banerjee, Madhuchhanda; Siddique, Shabana; Dutta, Anindita; Mukherjee, Bidisha; Ranjan Ray, Manas

    2012-08-01

    Cooking with biomass fuel, a common practice in rural India, is associated with a high level of indoor air pollution (IAP). The aim of this study was to investigate whether IAP from biomass burning increases the risk of depression. For this cross-sectional study, we enrolled a group of 952 women (median age 37 years) who cooked regularly with biomass and a control group of 804 age-matched women who cooked with cleaner fuel (liquefied petroleum gas). Depression was assessed using the second edition of Beck's depression inventory (BDI-II). Platelet P-selectin expression was assessed by flow cytometry and platelet serotonin was measured by ELISA. Particulate matter having diameter of less than 10 and 2.5 μm (PM(10) and PM(2.5), respectively) in indoor air was measured by real-time aerosol monitor. Carbon monoxide (CO) in exhaled breath was measured by CO monitor. Compared with the control group, women who cooked with biomass had a higher prevalence of depression and depleted platelet serotonin, suggesting altered serotonergic activity in the brain. In addition, P-selectin expression on platelet surface was up-regulated implying platelet hyperactivity and consequent risk of cardiovascular disease. Biomass-using households had increased levels of PM(10) and PM(2.5), and biomass users had elevated levels of CO in expired air. Controlling potential confounders, cooking with biomass was found to be an independent and strong risk factor for depression. IAP from cooking with biomass is a risk for depression among rural women in their child-bearing age.

  11. Increasing risk of compound flooding from storm surge and rainfall for major US coastal cities

    NASA Astrophysics Data System (ADS)

    Wahl, T.; Jain, S.; Bender, J.; Meyers, S. D.; Luther, M. E.

    2015-12-01

    Flood risk is a well-known facet of natural hazards along the US coastline where nearly 40% of the population resides in its coastal counties. Furthermore, given the heavy reliance on the coastal zone for natural resources and economic activity, flood preparedness and safety is a key element of long-term resilience. A clear understanding of the various flood types and changes in the frequency of their occurrence is critical towards reliable estimates of vulnerability and potential impacts in the near-term as well as into the future. When the two main flood drivers for coastal areas storm surge and heavy precipitation occur in tandem the potential for significant flooding is much greater than from either in isolation. Exploring the probability of these 'compound events' and understanding the processes driving them is essential to mitigate the associated high impact risks. For the contiguous US the likelihood of the joint occurrence of the two phenomena is largely unknown. Here we show - using storm surge and precipitation records spanning the last century - that the risk of compound flooding is higher for the US east and Gulf coasts, relative to the west coast. We also show that the number of compound events has increased significantly over the last century along large coastline stretches including many of the major coastal cities. For New York City - as an example - this increase is attributed to a shift towards storm surge weather patterns also favouring high precipitation. Preliminary analyses reveal that these synoptic scale changes are closely linked to large scale and low frequency climate variations. Our results demonstrate the importance of assessing the risk of compound flooding within the design process of coastal and urban infrastructure in a non-stationary framework and to explore the potential effects of climate change on these high impact events.

  12. Increasing risk of compound flooding from storm surge and rainfall for major US coastal cities

    NASA Astrophysics Data System (ADS)

    Wahl, Thomas; Jain, Shaleen; Bender, Jens; Meyers, Steven; Luther, Mark

    2016-04-01

    Flood risk is a well-known facet of natural hazards along the US coastline where nearly 40% of the population resides in coastal counties. Given the heavy reliance on the coastal zone for natural resources and economic activity, flood preparedness and safety is a key element of long-term resilience. A clear understanding of the various flood types and changes in the frequency of their occurrence is critical towards reliable estimates of vulnerability and potential impacts in the near-term as well as into the future. When the two main flood drivers for coastal areas storm surge and heavy precipitation occur in tandem the potential for significant flooding is much greater than from either in isolation. Exploring the probability of these 'compound events' and understanding the processes driving them is essential to mitigate the associated high impact risks. For the contiguous US the likelihood of the joint occurrence of the two phenomena is largely unknown. Here we show - using storm surge and precipitation records spanning the last century - that the risk of compound flooding is higher for the US east and Gulf coasts, relative to the west coast. We also show that the number of compound events has increased significantly over the last century along large coastline stretches including many of the major coastal cities. For New York City - as an example - this increase is attributed to a shift towards storm surge weather patterns also favouring high precipitation. Preliminary analyses reveal that these synoptic scale changes are closely linked to large scale and low frequency climate variations. Our results demonstrate the importance of assessing the risk of compound flooding within the design process of coastal and urban infrastructure in a non-stationary framework and to explore the potential effects of climate change on these high impact events.

  13. Keep Your Eyes on the Road: Young Driver Crash Risk Increases According to Duration of Distraction

    PubMed Central

    Simons-Morton, Bruce; Guo, Feng; Klauer, Sheila G; Ehsani, Johnathon P; Pradhan, Anuj K

    2014-01-01

    Purpose Secondary task engagement that distracts the driver is a contributing factor to motor vehicle crashes among adults. However, the association between eye glance duration and crash risk with novice teenage drivers has not been determined. Methods Vehicles of 42 newly-licensed teenage drivers were instrumented with cameras, accelerometers, GPS, and other devices. Data were collected continuously for 18 months. Crashes and near crashes (CNCs) were identified by examining highly elevated gravitational force events. Video footage of the 6 seconds prior to each CNC and randomly sampled non-CNC road segments were coded for the duration of eye glances off the forward roadway and the presence of secondary task engagement. The likelihood (odds ratios) of CNC due to eye glance behavior was calculated by comparing the prevalence of secondary task engagement and duration of eyes off road prior to CNC with the prevalence and duration of eyes off road during non-CNC road segments. Results Crash risk increased with the duration of single longest glance during all secondary tasks (OR=3.8 for >2s) and wireless secondary task engagement (OR=5.5 for >2s). Single longest glance provided a more consistent estimate of crash risk than total time eyes off the forward roadway. Conclusions Eyes glances away from forward roadway involving secondary tasks increased the likelihood of CNC. The longer the duration of eye glance away from the road the greater the risk, regardless of type of secondary task. Education and policy discouraging secondary task engagement, particularly for prolonged periods, is warranted. PMID:24759443

  14. Increased risk of lung cancer among different types of professional drivers in Denmark

    PubMed Central

    Hansen, J.; Raaschou-Nielsen, O.; Olsen, J. H.

    1998-01-01

    OBJECTIVES: To study risk of lung cancer among groups of professional drivers probably exposed to different levels of traffic exhaust fumes. METHODS: A nationwide case-control study (1970-89) based on employees comprising 28,744 men with primary lung cancer and incidence density sampled matched controls (1:1). Employment histories were reconstructed back to 1964 for each study subject from the records of a nationwide pension scheme with compulsory membership. Socioeconomic status was derived from the individual job title taken from the national population registry. Information on tobacco smoking habits was available from historical surveys. Relative risks were estimated by odds ratios (ORs) based on conditional logistic regression analyses. RESULTS: In total 2251 of the male lung cancer cases had been employed as bus, lorry, taxi, or unspecified drivers. No significant difference in tobacco smoking habits was found among professional male Danish drivers and the total employed population. The OR for lung cancer adjusted for socioeconomic status was 1.6 (95% confidence interval (95% CI) 1.2 to 2.2) among taxi drivers, who were considered to be exposed to the highest concentrations of vehicle exhaust fumes, and 1.3 (1.2 to 1.5) for bus and lorry drivers. The OR was 1.4 (1.3 to 1.5) for unspecified drivers. The adjusted risk of lung cancer increased significantly with increasing duration of employment as a driver, and the risk was highest for long term taxi drivers with 10 years of lag time (OR 3.0; 1.2 to 6.8). CONCLUSION: Occupational factors, probably exposure to vehicle exhaust, seems to play an important part in the development of lung cancer among drivers.   PMID:9614396

  15. Smoking, Central Adiposity, and Poor Glycemic Control Increase Risk of Hearing Impairment

    PubMed Central

    Cruickshanks, Karen J.; Nondahl, David M.; Dalton, Dayna S.; Fischer, Mary E.; Klein, Barbara E.K.; Klein, Ronald; Nieto, F. Javier; Schubert, Carla R.; Tweed, Ted S.

    2015-01-01

    Objectives To determine associations between smoking, adiposity, diabetes, and other cardiovascular disease (CVD) risk factors and the 15-yr incidence of hearing impairment (HI). Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal population-based cohort study (1993–95 to 2009–2010). Setting Beaver Dam, WI. Participants Participants in the Beaver Dam Eye Study (1988–90; residents of Beaver Dam, WI ages 43–84 years in 1987–88) were eligible for the EHLS. There were 1925 participants with normal hearing at baseline. Measurements 15-year cumulative incidence of HI (pure-tone average (PTA) of hearing thresholds at 0.5, 1, 2 and 4 kHz > 25 decibels Hearing Level (dB HL) in either ear). Cigarette smoking, exercise, and other factors were ascertained by questionnaire. Blood pressure, waist circumference, body mass index and glycosylated hemoglobin were measured. Results Follow-up examinations (≥1) were obtained from 87.2% (n=1678; mean baseline age 61 years). The 15-year cumulative incidence of HI was 56.8%. Adjusting for age and sex, current smoking (Hazard Ratio (HR) =1.31, p=0.048), education (<16 yrs; HR=1.35, p=0.01), waist circumference (HR=1.08 per 10 cm, p=0.017), and poorly controlled diabetes (HR=2.03, p=0.048) were associated with increased risk of HI. Former smokers and people with better controlled diabetes were not at increased risk. Conclusion Smoking, central adiposity and poorly controlled diabetes predicted incident HI. These well-known CVD risk factors, suggest vascular changes may contribute to HI in aging. Interventions targeting reductions in smoking and adiposity, and improved glycemic control in people with diabetes, may help to prevent or delay the onset of HI. PMID:25953199

  16. Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

    PubMed Central

    von Schmidt auf Altenstadt, Joost F.; Hukkelhoven, Chantal W. P. M.; van Roosmalen, Jos; Bloemenkamp, Kitty W. M.

    2013-01-01

    Background Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia and postpartum haemorrhage. Our secondary objective was to identify other risk indicators for postpartum haemorrhage in the Netherlands. Methods A nationwide cohort was used, containing prospectively collected data of women giving birth after 19 completed weeks of gestation from January 2000 until January 2008 (n =  1 457 576). Data were extracted from the Netherlands Perinatal Registry, covering 96% of all deliveries in the Netherlands. The main outcome measure, postpartum haemorrhage, was defined as blood loss of ≥1000 ml in the 24 hours following delivery. The association between pre-eclampsia and postpartum haemorrhage was investigated with uni- and multivariable logistic regression analyses. Results Overall prevalence of postpartum haemorrhage was 4.3% and of pre-eclampsia 2.2%. From the 31 560 women with pre-eclampsia 2 347 (7.4%) developed postpartum haemorrhage, compared to 60 517 (4.2%) from the 1 426 016 women without pre-eclampsia (odds ratio 1.81; 95% CI 1.74 to 1.89). Risk of postpartum haemorrhage in women with pre-eclampsia remained increased after adjusting for confounders (adjusted odds ratio 1.53; 95% CI 1.46 to 1.60). Conclusion Women with pre-eclampsia have a 1.53 fold increased risk for postpartum haemorrhage. Clinicians should be aware of this and use this knowledge in the management of pre-eclampsia and the third stage of labour in order to reach the fifth Millenium Developmental Goal of reducing maternal mortality ratios with 75% by 2015. PMID

  17. Low Serum DHEAS Predicts Increased Fracture Risk in Older Men: The MrOS Sweden Study.

    PubMed

    Ohlsson, Claes; Nethander, Maria; Kindmark, Andreas; Ljunggren, Östen; Lorentzon, Mattias; Rosengren, Björn E; Karlsson, Magnus K; Mellström, Dan; Vandenput, Liesbeth

    2017-03-09

    The adrenal-derived hormones dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) are the most abundant circulating hormones and their levels decline substantially with age. DHEAS is considered an inactive precursor, which is converted into androgens and estrogens via local metabolism in peripheral target tissues. The predictive value of serum DHEAS for fracture risk is unknown. The aim of this study was, therefore, to assess the associations between baseline DHEAS levels and incident fractures in a large cohort of older men. Serum DHEAS levels were analyzed with mass spectrometry in the population-based Osteoporotic Fractures in Men study in Sweden (n = 2568, aged 69 to 81 years). Incident X-ray validated fractures (all, n = 594; non-vertebral major osteoporotic, n = 255; hip, n = 175; clinical vertebral, n = 206) were ascertained during a median follow-up of 10.6 years. DHEAS levels were inversely associated with the risk of any fracture (hazard ratio [HR] per SD decrease = 1.14, 95% confidence interval [CI] 1.05-1.24), non-vertebral major osteoporotic fractures (HR = 1.31, 95% CI 1.16-1.48), and hip fractures (HR = 1.18, 95% CI 1.02-1.37) but not clinical vertebral fractures (HR = 1.09, 95% CI 0.95-1.26) in Cox regression models adjusted for age, body mass index (BMI) and prevalent fractures. Further adjustment for traditional risk factors for fracture, bone mineral density (BMD), and/or physical performance variables as well as serum sex steroid levels only slightly attenuated the associations between serum DHEAS and fracture risk. Similarly, the point estimates were only marginally reduced after adjustment for FRAX estimates with BMD. The inverse association between serum DHEAS and all fractures or major osteoporotic fractures was nonlinear, with a substantial increase in fracture risk (all fractures 22%, major osteoporotic fractures 33%) for those participants with serum DHEAS levels below the median (0.60 μg/mL). In

  18. The APC I1307K allele conveys a significant increased risk for cancer.

    PubMed

    Leshno, Ari; Shapira, Shiran; Liberman, Eliezer; Kraus, Sarah; Sror, Miri; Harlap-Gat, Amira; Avivi, Doran; Galazan, Lior; David, Maayan; Maharshak, Nitsan; Moanis, Serhan; Arber, Nadir; Moshkowitz, Menachem

    2016-03-15

    This study is the first attempt to evaluate the association between the APC I1307K variant and overall cancer risk. It is unique in both its large sample size and in the reliability of data in the control group. The findings described in this article have major implications in terms of identifying asymptomatic individuals who are at increased risk to harbor cancer and therefore targeted to be enrolled in specific early detection and prevention programs. The prevalence of the APC I1307K missense mutation among Ashkenazi Jews is ∼ 6%. Carriers are at an increased risk for colorectal neoplasia. In this study, we examined the association of this variant with non-colorectal cancers. Consecutive 13,013 healthy subjects who underwent screening at the Integrated Cancer Prevention Center between 2006 and 2014 were enrolled. This population was supplemented with 1,611 cancer patients from the same institution. Demographics, medical history, and pathological data were recorded. Mortality data were obtained from the Ministry of Health's registry. The prevalence of APC I1307K in cancer patients and healthy subjects was compared. The APC I1307K variant was detected in 189 (11.8%) cancer patients compared to 614 (4.7%) healthy subjects, reflecting an adjusted age and sex odds ratio (OR) of 2.53 (p < 0.0001). History of two or more cancer types was associated with a positive carrier prevalence (OR = 4.38 p < 0.0001). Males had significantly increased carrier prevalence in lung, urologic, pancreatic, and skin cancers. The carrier prevalence among females was significantly higher only in breast and skin cancers. Female carriers developed cancer at a significantly older age compared to non-carriers (average 62.7 years vs. 57.8, respectively, p = 0.027), had better survival rates (HR = 0.58, p = 0.022) and overall increased longevity (average age of death 78.8 vs. 70.4 years, respectively, p = 0.003). In conclusion, the APC I1307K variant is a reliable marker for overall cancer risk

  19. CTLA-4 and MDR1 polymorphisms increase the risk for ulcerative colitis: A meta-analysis

    PubMed Central

    Zhao, Jia-Jun; Wang, Di; Yao, Hui; Sun, Da-Wei; Li, Hong-Yu

    2015-01-01

    AIM: To evaluate the correlations between cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and multi-drug resistance 1 (MDR1) genes polymorphisms with ulcerative colitis (UC) risk. METHODS: PubMed, EMBASE, Web of Science, Cochrane Library, CBM databases, Springerlink, Wiley, EBSCO, Ovid, Wanfang database, VIP database, China National Knowledge Infrastructure, and Weipu Journal databases were exhaustively searched using combinations of keywords relating to CTLA-4, MDR1 and UC. The published studies were filtered using our stringent inclusion and exclusion criteria, the quality assessment for each eligible study was conducted using Critical Appraisal Skill Program and the resultant high-quality data from final selected studies were analyzed using Comprehensive Meta-analysis 2.0 (CMA 2.0) software. The correlations between SNPs of CTLA-4 gene, MDR1 gene and the risk of UC were evaluated by OR at 95%CI. Z test was carried out to evaluate the significance of overall effect values. Cochran’s Q-statistic and I2 tests were applied to quantify heterogeneity among studies. Funnel plots, classic fail-safe N and Egger’s linear regression test were inspected for indication of publication bias. RESULTS: A total of 107 studies were initially retrieved and 12 studies were eventually selected for meta-analysis. These 12 case-control studies involved 1860 UC patients and 2663 healthy controls. Our major result revealed that single nucleotide polymorphisms (SNPs) of CTLA-4 gene rs3087243 G > A and rs231775 G > A may increase the risk of UC (rs3087243 G > A: allele model: OR = 1.365, 95%CI: 1.023-1.822, P = 0.035; dominant model: OR = 1.569, 95%CI: 1.269-1.940, P < 0.001; rs231775 G > A: allele model: OR = 1.583, 95%CI: = 1.306-1.918, P < 0.001; dominant model: OR = 1.805, 95%CI: 1.393-2.340, P < 0.001). In addition, based on our result, SNPs of MDR1 gene rs1045642 C > T might also confer a significant increases for the risk of UC (allele model: OR = 1.389, 95%CI: 1

  20. Paternal aging and increased risk of congenital disease, psychiatric disorders, and cancer

    PubMed Central

    Conti, Simon L; Eisenberg, Michael L

    2016-01-01

    As couples are increasingly delaying parenthood, the effect of the aging men and women on reproductive outcomes has been an area of increased interest. Advanced paternal age has been shown to independently affect the entire spectrum of male fertility as assessed by reductions in sperm quality and fertilization (both assisted and unassisted). Moreover, epidemiological data suggest that paternal age can lead to higher rates of adverse birth outcomes and congenital anomalies. Mounting evidence also suggests increased risk of specific pediatric and adult disease states ranging from cancer to behavioral traits. While disease states associated with advancing paternal age have been well described, consensus recommendations for neonatal screening have not been as widely implemented as have been with advanced maternal age. PMID:26975491

  1. UV dosage levels in summer: increased risk of ozone loss from convectively injected water vapor.

    PubMed

    Anderson, James G; Wilmouth, David M; Smith, Jessica B; Sayres, David S

    2012-08-17

    The observed presence of water vapor convectively injected deep into the stratosphere over the United States can fundamentally change the catalytic chlorine/bromine free-radical chemistry of the lower stratosphere by shifting total available inorganic chlorine into the catalytically active free-radical form, ClO. This chemical shift markedly affects total ozone loss rates and makes the catalytic system extraordinarily sensitive to convective injection into the mid-latitude lower stratosphere in summer. Were the intensity and frequency of convective injection to increase as a result of climate forcing by the continued addition of CO(2) and CH(4) to the atmosphere, increased risk of ozone loss and associated increases in ultraviolet dosage would follow.

  2. UV Dosage Levels in Summer: Increased Risk of Ozone Loss from Convectively Injected Water Vapor

    NASA Astrophysics Data System (ADS)

    Wilmouth, D. M.; Smith, J. B.; Sayres, D. S.; Anderson, J.

    2012-12-01

    Elevated water vapor concentrations from convective injection have now been observed repeatedly in the lower stratosphere over the United States during the summer. Because both temperature and water vapor concentration set the threshold conditions for initiating the heterogeneous reactions that activate inorganic chlorine, the observed presence of high water vapor can fundamentally change the chemistry of the lower stratosphere by shifting inorganic chlorine into the catalytically active free-radical form, ClO. As a result, significant ozone losses may follow convective injection of water vapor into the stratosphere. The chemical system is highly sensitive to temperature, pressure, aerosol surface area, available inorganic chlorine, and concentration and duration of elevated water vapor. Were the intensity and frequency of convective injection of water vapor to increase as a result of climate forcing by the continued addition of carbon dioxide and methane to the atmosphere, increased risk of ozone loss and associated increases in ultraviolet dosage would follow.

  3. Glutathione S-transferase alpha 1 risk polymorphism and increased bilateral thalamus mean diffusivity in schizophrenia.

    PubMed

    Spalletta, Gianfranco; Piras, Fabrizio; Gravina, Paolo; Bello, Mario Lo; Bernardini, Sergio; Caltagirone, Carlo

    2012-01-01

    Oxidative damage in brain cells is one of the factors hypothesized to be involved in the pathogenesis of schizophrenia. Glutathione S-transferase (GST) A1*B polymorphism, a genotype associated with a higher risk of oxidative damage, is associated with increased frequency of schizophrenia diagnosis. Thus, here we studied Glutathione S-transferase (GST) A1 polymorphism and diffusion tensor imaging-mean diffusivity (MD) data on deep grey matter brain structures in 56 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR) schizophrenia. Clinical diagnosis and psychopathological symptom severity were assessed by using the Structured Clinical Interview for DSM-IV-TR (SCID-P) and the Scales for Assessment of Positive and Negative Symptoms (SAPS and SANS). Results confirmed that patients with schizophrenia who were carriers of the GSTA1 *B risk allele had an increased MD in bilateral thalami and increased severity of auditory and global hallucinations in comparison with non-B carriers. Thus, oxidative stress associated factors may be implicated in specific mechanisms of schizophrenia such as altered microstructure of the thalami and specific psychopathological features of auditory hallucinations.

  4. Elevated Plasma Homocysteine Level Increased the Risk of Early Renal Impairment in Acute Ischemic Stroke Patients.

    PubMed

    Chen, Jingjuan; Li, Guode; Xu, Zuohang; Zhang, Chengguo; Wang, Yukai; Xie, Haiqun; Shao, Yan; Peng, Lingmei; Lu, Jiancong; Yuan, Dahua

    2017-03-08

    Renal insufficiency is associated with the prognosis of acute ischemic stroke (AIS) and homocysteine (Hcy) levels. This study investigated the association between plasma Hcy levels and renal insufficiency in patients with AIS. A total of 987 patients with AIS who had been treated at the First People's Hospital of Foshan between 2011 and 2014 were retrospectively studied. Based on their cystatin C (Cys C) levels, the patients were divided into the normal renal function group (Cys C ≤ 1.25 mg/L) or the renal impairment group (Cys C > 1.25 mg/L). Multivariate regression analysis was applied to reveal the association between hyperhomocysteinemia (HHcy) and renal impairment. The renal impairment group showed more advanced age of onset, higher percentage of prior stroke and hypertension, higher baseline National Institute of Health Stroke Scale score, lower high-density lipoprotein cholesterol levels, and higher Hcy levels compared with the normal renal function group. A multivariate analysis revealed a relationship between early renal impairment and Hcy levels: an increase of Hcy by 1 μmol/L was associated with an increase of 12-18% of the risk of renal impairment among patients with AIS and HHcy. Patients with AIS and HHcy had a 2.42-3.51 fold increase of the risk of renal impairment compared with patients with normal Hcy level (P < 0.001). In conclusion, patients with stroke and HHcy could be more prone to renal impairment.

  5. Predation risk increases immune response in a larval dragonfly (Leucorrhinia intacta).

    PubMed

    Duong, Tammy M; McCauley, Shannon J

    2016-06-01

    Predators often negatively affect prey performance through indirect, non-consumptive effects. We investigated the potential relationship between predator-induced stress and prey immune response. To test this, we administered a synthetic immune challenge into dragonfly larvae (Leucorrhinia intacta) and assessed a key immune response (level of encapsulation) in the presence and absence of a caged predator (Anax junius) at two temperatures (22 degrees C and 26 degrees C). We hypothesized that immune response would be lowered when predators were present due to lowered allocation of resources to immune function and leading to reduced encapsulation of the synthetic immune challenge. Contrary to our expectations, larvae exposed to caged predators had encapsulated monofilaments significantly more than larvae not exposed to caged predators. Levels of encapsulation did not differ across temperatures, nor interact with predator exposure. Our results suggest that the previously observed increase in mortality of L. intacta exposed to caged predators is not driven by immune suppression. In situations of increased predation risk, the exposure to predator cues may induce higher levels of melanin production, which could lead to physiological damage and high energetic costs. However, the costs and risks of increased allocations to immune responses and interactions with predation stress remain unknown.

  6. Herpes zoster correlates with increased risk of Parkinson's disease in older people

    PubMed Central

    Lai, Shih-Wei; Lin, Chih-Hsueh; Lin, Hsien-Feng; Lin, Cheng-Li; Lin, Cheng-Chieh; Liao, Kuan-Fu

    2017-01-01

    Abstract Little is known on the relationship between herpes zoster and Parkinson's disease in older people. This study aimed to explore whether herpes zoster could be associated with Parkinson's disease in older people in Taiwan. We conducted a retrospective cohort study using the claim data of the Taiwan National Health Insurance Program. There were 10,296 subjects aged 65 years and older with newly diagnosed herpes zoster as the herpes zoster group and 39,405 randomly selected subjects aged 65 years and older without a diagnosis of herpes zoster as the nonherpes zoster group from 1998 to 2010. Both groups were followed up until subjects received a diagnosis of Parkinson's disease. This follow-up design would explore whether subjects with herpes zoster were at an increased risk of Parkinson's disease. Relative risks were estimated by adjusted hazard ratio (HR) and 95% confidence interval (CI) using the multivariable Cox proportional hazards regression model. The incidence of Parkinson's disease was higher in the herpes zoster group than that in the nonherpes zoster group (4.86 vs 4.00 per 1000 person-years, 95% CI 1.14, 1.29). After adjustment for confounding factors, the multivariable Cox proportional hazards regression model revealed that the adjusted HR of Parkinson's disease was 1.17 for the herpes zoster group (95% CI 1.10, 1.25), compared with the nonherpes zoster group. Older people with herpes zoster confer a slightly increased hazard of developing Parkinson's disease when compared to those without herpes zoster. We think that herpes zoster correlates with increased risk of Parkinson's disease in older people. When older people with herpes zoster seek help, clinicians should pay more attention to the development of the cardinal symptoms of Parkinson's disease. PMID:28207515

  7. Higher Circulating Adiponectin Levels Are Associated with Increased Risk of Atrial Fibrillation in Older Adults

    PubMed Central

    Macheret, Fima; Bartz, Traci M.; Djousse, Luc; Ix, Joachim H.; Mukamal, Kenneth J.; Zieman, Susan J.; Siscovick, David S.; Tracy, Russell P.; Heckbert, Susan R.; Psaty, Bruce M.; Kizer, Jorge R.

    2016-01-01

    Background Adiponectin has cardioprotective properties, suggesting that lower levels seen in obesity and diabetes could heighten risk of atrial fibrillation (AF). Among older adults, however, higher adiponectin has been linked to greater incidence of adverse outcomes associated with AF, although recent reports have shown this association to be U-shaped. We postulated that higher adiponectin would be linked to increased risk for AF in older adults in a U-shaped manner. Methods We examined the associations of total and high-molecular-weight (HMW) adiponectin with incident AF among individuals free of prevalent cardiovascular disease (CVD) participating in a population-based cohort study of older adults (n=3190; age=74±5 years). Results During median follow-up of 11.4 years, there were 886 incident AF events. Adjusted cubic splines showed a positive and linear association between adiponectin and incident AF. After adjusting for potential confounders, including amino-terminal pro-B-type natriuretic peptide 1–76, the hazard ratio (95% CI) for AF per SD increase in total adiponectin was 1.14 (1.05–1.24), while that for HMW adiponectin was 1.17 (1.08–1.27). Additional adjustment for putative mediators, including subclinical CVD, diabetes, lipids, and inflammation, did not significantly affect these estimates. Conclusions The present findings demonstrate that higher, not lower, levels of adiponectin are independently associated with increased risk of AF in older adults despite its documented cardiometabolic benefits. Additional work is necessary to determine if adiponectin is a marker of failed counter-regulatory pathways or whether this hormone is directly harmful in the setting of or as a result of advanced age. PMID:25855796

  8. Predictors and outcomes of increases in creatine phosphokinase concentrations or rhabdomyolysis risk during statin treatment

    PubMed Central

    van Staa, Tjeerd P; Carr, Daniel F; O’Meara, Helen; McCann, Gerry; Pirmohamed, Munir

    2014-01-01

    Aim The aim was to evaluate clinical risk factors associated with myotoxicity in statin users. Methods This was a cohort study of patients prescribed a statin in UK primary care practices contributing to the Clinical Practice Research Datalink. Outcomes of interest were creatine phosphokinase (CPK) concentrations and clinical records of rhabdomyolysis. Results The cohort comprised 641 703 statin users. Simvastatin was most frequently prescribed (66.3%), followed by atorvastatin (24.4%). CPK was measured in 127 209 patients: 81.4% within normal range and 0.7% above increased odds ratio (OR) of rhabdomyolysis compared with controls (OR 3.71, 95% CI 1.18, 11.61) and >four times ULN CPK compared with normal CPK (OR 1.28, 95% CI 1.01, 1.60). Rosuvastatin users had higher risk of >four times ULN CPK (OR 1.62, 95% CI 1.22, 2.15) as did patients with larger daily doses of other statin types. A recent clinical record of myalgia was associated with an increased OR of >four times ULN CPK (OR 1.73, 95% CI 1.37, 2.18). In patients who were rechallenged to statins and had repeat CPK measurements after >four times ULN CPK abnormalities, 54.8% of the repeat CPK values were within normal range, 32.1% between one to three times and 13.0% >four times ULN. Conclusions The frequencies of substantive CPK increases and rhabdomyolysis during statin treatment were low, with highest risks seen in those on large daily doses or interacting drugs and on rosuvastatin. CPK measurements appeared to have been done in a haphazard manner and better guidance is needed. PMID:24602118

  9. Does HIV increase the risk of spousal violence in sub-Saharan Africa?

    PubMed

    Chin, Yoo-Mi

    2013-09-01

    Although a positive association is found between HIV prevalence and intimate partner violence, a causal interpretation is hard to establish due to the endogeneity of HIV prevalence. Using the distance from the origin of the virus as an instrument, I find that an exogenous increase in HIV prevalence in a cluster has a sizable positive effect on the risk of physical and sexual violence against women within marriage. The results of this study confirm a gender-specific negative externality of the disease and encourage policy efforts to incorporate services for violence against women into existing HIV programs.

  10. TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

    PubMed Central

    CHEN, Xiao-Hua; GAO, Yun-Chao; ZHANG, Yi; TANG, Zheng-Hao; YU, Yong-Sheng; ZANG, Guo-Qing

    2015-01-01

    Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicansand spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient. PMID:26200971

  11. Increasing risk awareness and facilitating safe sexual activity among older adults in senior housing.

    PubMed

    Gedin, Tonii C; Resnick, Barbara

    2014-01-01

    The prevalence of HIV in older adults is rising. This increase can be attributed to inconsistent condom use, low perceived disease susceptibility, and a sexual health knowledge gap found in older adults. Yet, little to no health promotion for older adults focuses on sex education. This study sought to determine the feasibility of a group-based educational program in senior housing settings and consider the utility of a self-efficacy based group education program on knowledge of disease risk and preventive techniques among older adults living in senior housing.

  12. Increased risk of death with cervical spine immobilisation in penetrating cervical trauma.

    PubMed

    Vanderlan, Wesley B; Tew, Beverly E; McSwain, Norman E

    2009-08-01

    The purpose of this study was to determine if cervical spine immobilisation was related to patient mortality in penetrating cervical trauma. One hundred and ninety-nine patient charts from the Louisiana State University Health Sciences Center New Orleans (Charity Hospital, New Orleans) were examined. Charts were identified by searching the Charity Hospital Trauma Registry from 01/01/1994 to 04/17/2003 for all cases of penetrating cervical trauma. Thirty-five patient deaths were identified. Cervical spine immobilisation was associated with an increased risk of death (p<0.02, odds ratio 2.77, 95% CI 1.18-6.49).

  13. Paternal overweight is associated with increased breast cancer risk in daughters in a mouse model

    PubMed Central

    Fontelles, Camile Castilho; Carney, Elissa; Clarke, Johan; Nguyen, Nguyen M.; Yin, Chao; Jin, Lu; Cruz, M. Idalia; Ong, Thomas Prates; Hilakivi-Clarke, Leena; de Assis, Sonia

    2016-01-01

    While many studies have shown that maternal weight and nutrition in pregnancy affects offspring’s breast cancer risk, no studies have investigated the impact of paternal body weight on daughters’ risk of this disease. Here, we show that diet-induced paternal overweight around the time of conception can epigenetically reprogram father’s germ-line and modulate their daughters’ birth weight and likelihood of developing breast cancer, using a mouse model. Increased body weight was associated with changes in the miRNA expression profile in paternal sperm. Daughters of overweight fathers had higher rates of carcinogen-induced mammary tumors which were associated with delayed mammary gland development and alterations in mammary miRNA expression. The hypoxia signaling pathway, targeted by miRNAs down-regulated in daughters of overweight fathers, was activated in their mammary tissues and tumors. This study provides evidence that paternal peri-conceptional body weight may affect daughters’ mammary development and breast cancer risk and warrants further studies in other animal models and humans. PMID:27339599

  14. Incident major depressive episodes increase the severity and risk of apathy in HIV infection.

    PubMed

    Kamat, Rujvi; Cattie, Jordan E; Marcotte, Thomas D; Woods, Steven Paul; Franklin, Donald R; Corkran, Stephanie H; Ellis, Ronald J; Grant, Igor; Heaton, Robert K

    2015-04-01

    Apathy and depression are inter-related yet separable and prevalent neuropsychiatric disturbances in persons infected with HIV. In the present study of 225 HIV+ persons, we investigated the role of an incident depressive episode in changes in apathy. Participants completed the apathy subscale of the Frontal Systems Behavior Scale during a detailed neuropsychiatric and neuromedical evaluation at visit 1 and again at approximately a 14 month follow-up. The Composite International Diagnostic Interview was used to obtain diagnoses of a new major depressive disorder. At their follow-up visit, participants were classified into four groups depending on their visit 1 elevation in apathy and new major depressive episode (MDE) status. Apathetic participants at baseline with a new MDE (n=23) were at risk for continued, clinically elevated apathy at follow-up, although severity of symptoms did not increase. Of the 144 participants without clinically elevated apathy at visit 1, those who developed a new MDE (n=16) had greater apathy symptomatology at follow-up than those without MDE. These findings suggest that HIV+ individuals, who do not as yet present with elevated apathy, may be at greater risk of elevated psychiatric distress should they experience a new/recurrent depressive episode. Thus, in the context of previous findings, it appears that although apathy and depression are separable constructs, they interact such that a new depressive episode is a risk factor for incident apathy.

  15. Paternal overweight is associated with increased breast cancer risk in daughters in a mouse model.

    PubMed

    Fontelles, Camile Castilho; Carney, Elissa; Clarke, Johan; Nguyen, Nguyen M; Yin, Chao; Jin, Lu; Cruz, M Idalia; Ong, Thomas Prates; Hilakivi-Clarke, Leena; de Assis, Sonia

    2016-06-24

    While many studies have shown that maternal weight and nutrition in pregnancy affects offspring's breast cancer risk, no studies have investigated the impact of paternal body weight on daughters' risk of this disease. Here, we show that diet-induced paternal overweight around the time of conception can epigenetically reprogram father's germ-line and modulate their daughters' birth weight and likelihood of developing breast cancer, using a mouse model. Increased body weight was associated with changes in the miRNA expression profile in paternal sperm. Daughters of overweight fathers had higher rates of carcinogen-induced mammary tumors which were associated with delayed mammary gland development and alterations in mammary miRNA expression. The hypoxia signaling pathway, targeted by miRNAs down-regulated in daughters of overweight fathers, was activated in their mammary tissues and tumors. This study provides evidence that paternal peri-conceptional body weight may affect daughters' mammary development and breast cancer risk and warrants further studies in other animal models and humans.

  16. Yard flooding by irrigation canals increased the risk of West Nile disease in El Paso, Texas

    PubMed Central

    Cardenas, Victor M.; Jaime, Javier; Ford, Paula B.; Gonzalez, Fernando J.; Carrillo, Irma; Gallegos, Jorge E.; Watts, Douglas M.

    2011-01-01

    Purpose To investigate the effects of use of water from irrigation canals to flood residential yards on the risk of West Nile disease in El Paso, Texas. Methods West Nile disease confirmed cases in 2009–2010 were compared with a random sample of 50 residents of the county according to access to and use of water from irrigation canals by subjects or their neighbors, as well as geo-referenced closest distance between their home address and the nearest irrigation canal. A windshield survey of 600 meters around the study subjects’ home address recorded the presence of irrigation canals. The distance from the residence of 182 confirmed cases of West Nile disease reported in 2003–2010 to canals was compared to that of the centroids of 182 blocks selected at random. Results Cases were more likely than controls to report their neighbors flooded their yards with water from canals. Irrigation canals were more often observed in neighborhoods of cases than of controls. Using the set of addresses of 182 confirmed cases and 182 hypothetic controls the authors found a statistically significant inverse relation with risk of West Nile disease. Conclusions Flooding of yards with water from canals increased the risk of West Nile disease. PMID:21943648

  17. Instant ticket purchasing by Ontario baby boomers: increasing risk for problem gamblers.

    PubMed

    Papoff, Katharine M; Norris, Joan E

    2009-06-01

    Instant ticket purchase gambling (ITPG) is pervasive in Ontario and has features that mimic slot machine play. Previous researchers have reported that ITPG is one preferred activity for at-risk/problem gamblers. In the general Canadian population, rate of participation in ITPG is second only to lottery ticket gambling. Both are particularly favored by youth and seniors. The next cohort of seniors will be Canada's baby boomers, one-third of whom live in Ontario. Secondary analysis of Statistics Canada data revealed that adults in this cohort who buy instant gambling tickets (N = 1781) are significantly different from the complete group of their age peers (N = 4266) in number of activities pursued and frequency of involvement. At-risk/problem gambling prevalence was 10.2% amongst Ontario baby boomers who participate in instant ticket gambling, significantly higher than the 6.7% found amongst the total group of baby boom gamblers. For those who reported experiencing one or more of the Canadian Problem Gambling Index indicators for problem gambling (N = 237), 73% were buying instant tickets. Future research should consider cohort effects and explore combinations of preferred gambling activities that may increase risk for problem gambling. Social policy recommendations include the use of all ITPG venues as key locations for promoting awareness of problem gambling treatment services.

  18. Fast Eating Speed Increases the Risk of Endoscopic Erosive Gastritis in Korean Adults

    PubMed Central

    Kim, Min-Kyung; Kim, E-Yeon; Han, Byoung-Duck; Cho, Kyung-Hwan

    2015-01-01

    Background Fast eating or overeating can induce gastrointestinal diseases such as gastritis. However, the association between gastritis and speed of eating is unclear. The aim of this study was to determine whether eating speed is associated with increased risk of endoscopic erosive gastritis (EEG). Methods We carried out a cross-sectional study involving 10,893 adults who underwent a general health checkup between 2007 and 2009. Two groups, EEG patients and EEG-free patients, were compared by using the t-test and the chi-square test. Multiple logistic regression analyses were performed to investigate the association between eating speed and EEG. Results The group with EEG had a higher proportion of males, average age, body mass index, and percentages of current smokers and risky drinkers than those without EEG. After adjusting for anthropometric, social, and endoscopic parameters, the group with the highest eating speed (<5 min/meal) had 1.7 times higher risk for EEG than the group with the lowest eating speed (≥15 min/meal) (odds ratio, 1.71; 95% confidence interval, 1.20-2.45). Conclusion High eating speed is an independent risk factor for EEG. Our results indicate the need for further studies to clarify the role of eating speed in gastritis. PMID:26634096

  19. Characteristics of American Young Adults With Increased Risk for Type 2 Diabetes

    PubMed Central

    Cha, EunSeok; Umpierrez, Guillermo; Kim, Kevin H.; Bello, Morenike K.; Dunbar, Sandra B.

    2013-01-01

    Purpose The purpose of the study was to examine the characteristics of American young adults with increased risk for type 2 diabetes (T2D). Methods Participants ages 18 to 29, overweight/obese, and sedentary were recruited from the metro Atlanta area in the United States. Variables included demographics, anthropometric and clinical variables, and physical activity. Of 107 participants, 3 participants had undiagnosed diabetes and 1 participant did not complete the modifiable activity questionnaire. Thus, 103 young adults remained for the final data analysis. Results Most participants were females and African Americans. About 30% of participants had prediabetes, either impaired fasting glucose, an A1C of 5.7% to 6.4%, or both. Overall, prediabetes young adults were heavier and did less physical activity than Diabetes Prevention Program (DPP) trial participants. In addition, these young adults had a higher prevalence of parental T2D history and lower level of physical activity compared to young adults with normoglycemia. Conclusions Physical activity and parent T2D history are key risk factors for identifying young adults with prediabetes. Multilevel strategies are necessary to raise awareness of diabetes risk and to prevent T2D in young adults. PMID:23640300

  20. Summertime extreme heat events and increased risk of acute myocardial infarction hospitalizations.

    PubMed

    Fisher, Jared A; Jiang, Chengsheng; Soneja, Sutyajeet I; Mitchell, Clifford; Puett, Robin C; Sapkota, Amir

    2017-02-08

    Few studies have examined the association between exposure to extreme heat events and risk of acute myocardial infarction (AMI) or demonstrated which populations are most vulnerable to the effects of extreme heat. We defined extreme heat events as days when the daily maximum temperature (TMAX) exceeded the location- and calendar day-specific 95th percentile of the distribution of daily TMAX during the 30-year baseline period (1960-1989). We used a time-stratified case-crossover design to analyze the association between exposure to extreme heat events and risk of hospitalization for AMI in the summer months (June-August) with 0, 1, or 2 lag days. There were a total of 32,670 AMI hospitalizations during the summer months in Maryland between 2000 and 2012. Overall, extreme heat events on the day of hospitalization were associated with an increased risk of AMI (lag 0 OR=1.11; 95% CI: 1.05-1.17). Results considering lag periods immediately before hospitalization were comparable, but effect estimates varied among several population subgroups. As extreme weather events are expected to become more frequent and intense in response to our changing climate, community-specific adaptation strategies are needed to account for the differential susceptibility across ethnic subgroups and geographic areas.Journal of Exposure Science and Environmental Epidemiology advance online publication, 8 February 2017; doi:10.1038/jes.2016.83.

  1. Increased Risk of Endometriosis in Patients With Lower Genital Tract Infection

    PubMed Central

    Lin, Wu-Chou; Chang, Cherry Yin-Yi; Hsu, Yu-An; Chiang, Jen-Huai; Wan, Lei

    2016-01-01

    Abstract Endometriosis results from the ectopic invasion of endometrial glands and stroma in the peritoneal cavity. The exact etiology of endometriosis is still unknown. It has, however, been shown that there are higher numbers of Escherichia coli in menstrual blood, and higher endotoxin levels in menstrual fluid, as well as, in the peritoneal fluid of patients with endometriosis. In this study, we aimed to determine whether lower genital tract infections could increase the risk of endometriosis. We used the Taiwan National Health Insurance database to conduct a population-based cohort study. We included patients diagnosed with inflammatory diseases of the cervix, vagina, and vulva, and a control group comprising patients matched by age, sex, and comorbidities but without inflammatory diseases of the cervix, vagina, or vulva. A total of 79,512 patients were included in the inflammatory disease group and an equal number of control individuals were selected. The incidence of endometriosis (hazard ratio, 2.01; 95% confidence interval, 1.91–2.12; P < 0.001) was higher among patients than controls. Cox proportional hazards models showed that irrespective of comorbidities, lower genital tract infection was an independent risk factor for endometriosis. Patients with lower genital tract infections exhibit a substantially higher risk for developing endometriosis. PMID:26962775

  2. Incident Major Depressive Episodes increase the severity and risk of apathy in HIV infection

    PubMed Central

    Kamat, Rujvi; Cattie, Jordan E.; Marcotte, Thomas D.; Woods, Steven Paul; Franklin, Donald R.; Corkran, Stephanie H.; Ellis, Ronald J.; Grant, Igor; Heaton, Robert K.

    2015-01-01

    Apathy and depression are inter-related yet separable and prevalent neuropsychiatric disturbances in persons infected with HIV. In the present study of 225 HIV+ persons, we investigated the role of an incident depressive episode in changes in apathy. Participants completed the apathy subscale of the Frontal Systems Behavior Scale during a detailed neuropsychiatric and neuromedical evaluation at visit 1 and again at approximately a 14 month follow-up. The Composite International Diagnostic Interview was used to obtain diagnoses of a new major depressive disorder. At their follow-up visit, participants were classified into four groups depending on their visit 1 elevation in apathy and new major depressive episode (MDE) status. Apathetic participants at baseline with a new MDE (n=23) were at risk for continued, clinically elevated apathy at follow-up, although severity of symptoms did not increase. Of the 144 participants without clinically elevated apathy at visit 1, those who developed a new MDE (n=16) had greater apathy symptomatology at follow-up than those without MDE. These findings suggest that HIV+ individuals, who do not as yet present with elevated apathy, may be at greater risk of elevated psychiatric distress should they experience a new/recurrent depressive episode. Thus, in the context of previous findings, it appears that although apathy and depression are separable constructs, they interact such that a new depressive episode is a risk factor for incident apathy. PMID:25679203

  3. Increased risk of pneumonia associated with angiotensin-converting enzyme (CD143) rs4340 polymorphism.

    PubMed

    Zhang, Xiaofang; Liu, Fangzhu

    2016-08-01

    The study aims to investigate the genetic association between rs4340 polymorphism at intron 16 of the angiotensin-converting enzyme (CD143) gene and pneumonia predisposition. Electronic database of PubMed, Embase, and CNKI (China National Knowledge Infrastructure) was searched for the studies addressing the association between CD143 rs4340 genotypes and pneumonia risk. The odds ratio (OR) with its 95 % confidence interval (CI) was employed to estimate the association. In total, ten case-control studies, including 1239 pneumonia cases and 2400 healthy controls, met the inclusion criteria. Our results showed a significant association between rs4340 SNP and pneumonia risk using the recessive model (OR 1.43, 95 % CI 1.20-1.70). A significantly increased risk was also indicated under the recessive model in Asian populations (OR 1.63, 95 % CI 1.16-2.30), Caucasian populations (OR 1.34, 95 % CI 1.09-1.65), community-acquired pneumonia (OR 1.42, 95 % CI 1.16-1.75) rather than nosocomial pneumonia (OR 1.47, 95 % CI 0.97-2.23). However, further studies with gene-gene and gene-environmental interactions should be considered to confirm this association.

  4. The transcriptome of the implant biopsy identifies donor kidneys at increased risk of delayed graft function.

    PubMed

    Mueller, T F; Reeve, J; Jhangri, G S; Mengel, M; Jacaj, Z; Cairo, L; Obeidat, M; Todd, G; Moore, R; Famulski, K S; Cruz, J; Wishart, D; Meng, C; Sis, B; Solez, K; Kaplan, B; Halloran, P F

    2008-01-01

    Improved assessment of donor organ quality at time of transplantation would help in management of potentially usable organs. The transcriptome might correlate with risk of delayed graft function (DGF) better than conventional risk factors. Microarray results of 87 consecutive implantation biopsies taken postreperfusion in 42 deceased (DD) and 45 living (LD) donor kidneys were compared to clinical and histopathology-based scores. Unsupervised analysis separated the 87 kidneys into three groups: LD, DD1 and DD2. Kidneys in DD2 had a greater incidence of DGF (38.1 vs. 9.5%, p < 0.05) than those in DD1. Clinical and histopathological risk scores did not discriminate DD1 from DD2. A total of 1051 transcripts were differentially expressed between DD1 and DD2, but no transcripts separated DGF from immediate graft function (adjusted p < 0.01). Principal components analysis revealed a continuum from LD to DD1 to DD2, i.e. from best to poorest functioning kidneys. Within DD kidneys, the odds ratio for DGF was significantly increased with a transcriptome-based score and recipient age (p < 0.03) but not with clinical or histopathologic scores. The transcriptome reflects kidney quality and susceptibility to DGF better than available clinical and histopathological scoring systems.

  5. Biochemical failure after radical prostatectomy in intermediate-risk group men increases with the number of risk factors

    PubMed Central

    Furubayashi, Nobuki; Negishi, Takahito; Iwai, Hidenori; Nagase, Kei; Taguchi, Kenichi; Shimokawa, Mototsugu; Nakamura, Motonobu

    2017-01-01

    Introduction: We aimed to determine whether the number and type of risk factors are associated with biochemical recurrence-free survival after radical prostatectomy in men with D’Amico intermediate-risk prostate cancer. Materials and Methods: Between August 1998 and May 2013, 481 Japanese patients underwent antegrade radical prostatectomy. The relationships between the rate of PSA failure after radical prostatectomy and the number and type of risk factors were examined in the intermediate-risk group. Results: According to the D’Amico criteria, the low-, intermediate-, and high-risk groups comprised 107, 222, and 152 patients, respectively. The median follow-up period after surgery was 54.1 months. The 5-year PSA failure-free rates in the low-, intermediate-, and high-risk groups were 96.5%, 88.9%, and 72.6%, respectively (P < 0.001). The 5-year PSA failure-free rate in the intermediate-risk group with one, two, and three intermediate risk factors was 94.9%, 88.4%, and 49.0%, respectively (P < 0.001). The difference between the high- and intermediate-risk group with three intermediate risk factors was statistically significant based on the log-rank test (P = 0.039). Conclusion: The number of intermediate risk factors is significantly associated with the PSA failure-free survival rate after radical prostatectomy in the intermediate-risk group. Patients classified into the intermediate-risk group based on all three intermediate risk factors are less likely to achieve a complete cure through surgery alone. PMID:28197033

  6. Commentary: Air-conditioning as a risk for increased use of healthservices

    SciTech Connect

    Mendell, Mark J.

    2004-06-01

    In this issue of the journal, Preziosi et al. [2004] report the first study to assess differences in the utilization of health care related to the presence of air-conditioning in office workplaces. Although the study was simple and cross-sectional, the data variables from questionnaires, and the findings subject to a variety of questions, the findings are striking enough to deserve clarification. The study used a large random national sample of French women assembled for another purpose (to study antioxidant nutrients and prevention of cancer and cardiovascular disease). Participants reported health services and health events in monthly questionnaires over 1 year, and in one questionnaire in the middle of that period also reported whether air-conditioning was in use at their workplace. Fifteen percent of participants reported air-conditioning at work. Analyses adjusting for age and smoking status of participants found increases in most outcomes assessed: use of specific kinds of physicians, sickness absence, and hospital stays. While the increases in odds ratios (OR) and 95% confidence intervals (CI) were statistically significant for only otorhinolaryngology [OR (95% CI) = 2.33 (1.35-4.04)] and sickness absence [1.70 (1.13-2.58)], other increases were notable--dermatology [1.6 (0.98-2.65)]; hospital stay [1.51 (0.92-2.45)], and pneumonology [2.10 (0.65-6.82)]. The least elevated outcomes were for general practice medicine [0.99 (0.65-1.48)] and global medical visits [1.18 (0.67-2.07)]. [Preziosi et al., 2004 ,(Table 2)] Odds ratios for relatively common health outcomes often lie farther from the null than the risk ratios most useful for quantifying the increase in risk. Risk ratios, or prevalence ratios (PRs, the equivalent measure of effect for cross-sectional data), have seldom been used because of the convenience and availability of logistic regression models that estimate odds ratios. With baseline prevalences ranging up to 85.7% in the data from Preziosi et

  7. Longer genotypically-estimated leukocyte telomere length is associated with increased adult glioma risk

    PubMed Central

    Walsh, Kyle M.; Codd, Veryan; Rice, Terri; Nelson, Christopher P.; Smirnov, Ivan V.; McCoy, Lucie S.; Hansen, Helen M.; Elhauge, Edward; Ojha, Juhi; Francis, Stephen S.; Madsen, Nils R.; Bracci, Paige M.; Pico, Alexander R.; Molinaro, Annette M.; Tihan, Tarik; Berger, Mitchel S.; Chang, Susan M.; Prados, Michael D.; Jenkins, Robert B.; Wiemels, Joseph L.; Samani, Nilesh J.; Wiencke, John K.; Wrensch, Margaret R.

    2015-01-01

    Telomere maintenance has emerged as an important molecular feature with impacts on adult glioma susceptibility and prognosis. Whether longer or shorter leukocyte telomere length (LTL) is associated with glioma risk remains elusive and is often confounded by the effects of age and patient treatment. We sought to determine if genotypically-estimated LTL is associated with glioma risk and if inherited single nucleotide polymorphisms (SNPs) that are associated with LTL are glioma risk factors. Using a Mendelian randomization approach, we assessed differences in genotypically-estimated relative LTL in two independent glioma case-control datasets from the UCSF Adult Glioma Study (652 patients and 3735 controls) and The Cancer Genome Atlas (478 non-overlapping patients and 2559 controls). LTL estimates were based on a weighted linear combination of subject genotype at eight SNPs, previously associated with LTL in the ENGAGE Consortium Telomere Project. Mean estimated LTL was 31bp (5.7%) longer in glioma patients than controls in discovery analyses (P = 7.82×10-8) and 27bp (5.0%) longer in glioma patients than controls in replication analyses (1.48×10-3). Glioma risk increased monotonically with each increasing septile of LTL (O.R.=1.12; P = 3.83×10-12). Four LTL-associated SNPs were significantly associated with glioma risk in pooled analyses, including those in the telomerase component genes TERC (O.R.=1.14; 95% C.I.=1.03-1.28) and TERT (O.R.=1.39; 95% C.I.=1.27-1.52), and those in the CST complex genes OBFC1 (O.R.=1.18; 95% C.I.=1.05-1.33) and CTC1 (O.R.=1.14; 95% C.I.=1.02-1.28). Future work is needed to characterize the role of the CST complex in gliomagenesis and further elucidate the complex balance between ageing, telomere length, and molecular carcinogenesis. PMID:26646793

  8. Increased risk of atrial fibrillation in end-stage renal disease patients on dialysis

    PubMed Central

    Shen, Cheng-Huang; Zheng, Cai-Mei; Kiu, Kee-Thai; Chen, Hsin-An; Wu, Chia-Chang; Lu, Kuo-Cheng; Hsu, Yung-Ho; Lin, Yuh-Feng; Wang, Yuan-Hung

    2016-01-01

    Abstract End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. We used the Taiwan National Health Insurance Research Database to determine the incident AF among peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan. Our ESRD cohort include Taiwan National Health Insurance Research Database, we identified 15,947 patients, who started renal replacement therapy between January 1, 2002 and December 31, 2003. From the same data source, 47,841 controls without ESRD (3 subjects for each patient) were identified randomly and frequency matched by gender, age (±1 year), and the year of the study patient's index date for ESRD between January 1, 2002 and December 31, 2003. During the follow-up period (mean duration: 8–10 years), 3428 individuals developed the new-onset AF. The incidence rate ratios for AF were 2.07 (95% confidence interval [CI] = 1.93–2.23) and 1.78 (95% CI = 1.30–2.44) in HD and PD groups, respectively. After we adjusted for age, gender, and comorbidities, the hazard ratios for the AF risk were 1.46 (95% CI = 1.32–1.61) and 1.32 (95% CI = 1.00–1.83) in HD and PD groups, respectively. ESRD patients with a history of certain comorbidities including hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, heart failure, valvular heart disease, and chronic obstructive pulmonary disease (COPD) have significantly increased risks of AF. This nationwide, population-based study suggests that incidence of AF is increased among dialysis ESRD patients. Furthermore, we have to pay more attention in clinical practice and long-term care for those ESRD patients with a history of certain comorbidities. PMID:27336884

  9. Persistent neutrophilia is a marker for an increased risk of venous thrombosis.

    PubMed

    Kushnir, Margarita; Cohen, Hillel W; Billett, Henny H

    2016-11-01

    In patients with cancer and myeloproliferative disorders, leukocytosis has been associated with an increased venous thromboembolic (VTE) risk. Our goal was to determine whether persistent neutrophilia (PN), not associated with known causes such as malignancies, infections or steroids, is independently associated with VTE. All adult patients with >3 outpatient complete blood counts (CBCs) within 3 years were included. PN was defined as having an absolute neutrophil count >95 % (>2SD) of the population (≥7.8 × 10(9)/L) on at least three CBCs, at least 2 months apart. Separate analyses for neutrophil counts ≥9 × 10(9)/L and ≥10 × 10(9)/L were also performed. Blood counts from inpatients were excluded. Primary outcome was diagnosis of VTE, as determined by ICD-9 codes. Odds ratios were adjusted for diabetes, smoking, obesity, gender, and age. Charlson score was utilized as a morbidity measure. Data on 43,538 outpatients were collected. Although there was no association of VTE with neutrophil counts ≥7.8 × 10(9)/L, patients with ≥9.0 × 10(9)/L neutrophils were twice as likely to be diagnosed with VTE compared to those with normal neutrophil counts (OR 2.0, 95 % CI 1.3, 3.1; p = 0.003). Patients with neutrophil counts ≥10.0 × 10(9)/L were at an even higher risk (OR 2.3, 95 % CI 1.2, 4.8; p = 0.019). Charlson scores significantly modified this risk when incorporated into analysis. Elevated neutrophil counts are associated with an increased risk of venous thrombosis even when they are not due to cancer, infection or steroids. In patients with significant comorbidities, neutrophilia may be a marker of VTE risk.

  10. Longer genotypically-estimated leukocyte telomere length is associated with increased adult glioma risk.

    PubMed

    Walsh, Kyle M; Codd, Veryan; Rice, Terri; Nelson, Christopher P; Smirnov, Ivan V; McCoy, Lucie S; Hansen, Helen M; Elhauge, Edward; Ojha, Juhi; Francis, Stephen S; Madsen, Nils R; Bracci, Paige M; Pico, Alexander R; Molinaro, Annette M; Tihan, Tarik; Berger, Mitchel S; Chang, Susan M; Prados, Michael D; Jenkins, Robert B; Wiemels, Joseph L; Samani, Nilesh J; Wiencke, John K; Wrensch, Margaret R

    2015-12-15

    Telomere maintenance has emerged as an important molecular feature with impacts on adult glioma susceptibility and prognosis. Whether longer or shorter leukocyte telomere length (LTL) is associated with glioma risk remains elusive and is often confounded by the effects of age and patient treatment. We sought to determine if genotypically-estimated LTL is associated with glioma risk and if inherited single nucleotide polymorphisms (SNPs) that are associated with LTL are glioma risk factors. Using a Mendelian randomization approach, we assessed differences in genotypically-estimated relative LTL in two independent glioma case-control datasets from the UCSF Adult Glioma Study (652 patients and 3735 controls) and The Cancer Genome Atlas (478 non-overlapping patients and 2559 controls). LTL estimates were based on a weighted linear combination of subject genotype at eight SNPs, previously associated with LTL in the ENGAGE Consortium Telomere Project. Mean estimated LTL was 31bp (5.7%) longer in glioma patients than controls in discovery analyses (P = 7.82x10-8) and 27bp (5.0%) longer in glioma patients than controls in replication analyses (1.48x10-3). Glioma risk increased monotonically with each increasing septile of LTL (O.R.=1.12; P = 3.83x10-12). Four LTL-associated SNPs were significantly associated with glioma risk in pooled analyses, including those in the telomerase component genes TERC (O.R.=1.14; 95% C.I.=1.03-1.28) and TERT (O.R.=1.39; 95% C.I.=1.27-1.52), and those in the CST complex genes OBFC1 (O.R.=1.18; 95% C.I.=1.05-1.33) and CTC1 (O.R.=1.14; 95% C.I.=1.02-1.28). Future work is needed to characterize the role of the CST complex in gliomagenesis and further elucidate the complex balance between ageing, telomere length, and molecular carcinogenesis.

  11. Vegan proteins may reduce risk of cancer, obesity, and cardiovascular disease by promoting increased glucagon activity.

    PubMed

    McCarty, M F

    1999-12-01

    Amino acids modulate the secretion of both insulin and glucagon; the composition of dietary protein therefore has the potential to influence the balance of glucagon and insulin activity. Soy protein, as well as many other vegan proteins, are higher in non-essential amino acids than most animal-derived food proteins, and as a result should preferentially favor glucagon production. Acting on hepatocytes, glucagon promotes (and insulin inhibits) cAMP-dependent mechanisms that down-regulate lipogenic enzymes and cholesterol synthesis, while up-regulating hepatic LDL receptors and production of the IGF-I antagonist IGFBP-1. The insulin-sensitizing properties of many vegan diets--high in fiber, low in saturated fat--should amplify these effects by down-regulating insulin secretion. Additionally, the relatively low essential amino acid content of some vegan diets may decrease hepatic IGF-I synthesis. Thus, diets featuring vegan proteins can be expected to lower elevated serum lipid levels, promote weight loss, and decrease circulating IGF-I activity. The latter effect should impede cancer induction (as is seen in animal studies with soy protein), lessen neutrophil-mediated inflammatory damage, and slow growth and maturation in children. In fact, vegans tend to have low serum lipids, lean physiques, shorter stature, later puberty, and decreased risk for certain prominent 'Western' cancers; a vegan diet has documented clinical efficacy in rheumatoid arthritis. Low-fat vegan diets may be especially protective in regard to cancers linked to insulin resistance--namely, breast and colon cancer--as well as prostate cancer; conversely, the high IGF-I activity associated with heavy ingestion of animal products may be largely responsible for the epidemic of 'Western' cancers in wealthy societies. Increased phytochemical intake is also likely to contribute to the reduction of cancer risk in vegans. Regression of coronary stenoses has been documented during low-fat vegan diets

  12. Increased Risk of Surgical Site Infection Among Breast-Conserving Surgery Re-Excisions

    PubMed Central

    Olsen, Margaret A.; Nickel, Katelin B.; Margenthaler, Julie A.; Wallace, Anna E.; Mines, Daniel; Miller, J. Philip; Fraser, Victoria J.; Warren, David K.

    2015-01-01

    Purpose To determine the risk of surgical site infection (SSI) after primary breast-conserving surgery (BCS) versus re-excision among women with carcinoma in situ or invasive breast cancer. Methods We established a retrospective cohort of women aged 18–64 years with ICD-9-CM procedure or CPT-4 codes for BCS from 6/29/2004–12/31/2010. Prior insurance plan enrollment of at least 180 days was required to establish the index BCS; subsequent re-excisions within 180 days were identified. SSIs occurring 2–90 days after BCS were identified by ICD-9-CM diagnosis codes. The attributable surgery was defined based on SSI onset compared to the BCS date(s). A chi-square test and generalized estimating equations model were used to compare the incidence of SSI after index and re-excision BCS procedures. Results 23,001 women with 28,827 BCS were identified; 23.2% of women had >1 BCS. The incidence of SSI was 1.82% (418/23,001) for the index BCS and 2.44% (142/5,826) for re-excision BCS (p=0.002). The risk of SSI after re-excision remained significantly higher after accounting for multiple procedures within a woman (odds ratio 1.34, 95% confidence interval, 1.07–1.68). Conclusions Surgeons need to be aware of the increased risk of SSI after re-excision BCS compared to the initial procedure. Our results suggest that risk adjustment of SSI rates for re-excision would allow for better comparison of BCS SSI rates between institutions. PMID:25358666

  13. Increased Risk of Post-Transplant Malignancy and Mortality in Transplant Tourists

    PubMed Central

    Chung, Mu-Chi; Wu, Ming-Ju; Chang, Chao-Hsiang; Muo, Chih-Hsin; Yu, Tung-Min; Ho, Hao-Chung; Shu, Kuo-Hsiung; Chung, Chi-Jung

    2014-01-01

    Abstract Information on post-transplant malignancy and mortality risk in kidney transplant tourists remains controversial and is an important concern. The present study aimed to evaluate the incidence of post-transplant malignancy and mortality risk between tourists and domestic transplant recipients using the claims data from Taiwan's universal health insurance. A retrospective study was performed on 2394 tourists and 1956 domestic recipients. Post-transplant malignancy and mortality were defined from the catastrophic illness patient registry by using the International Classification of Diseases, 9th Revision. Cox proportional hazard regression and Kaplan–Meier curves were used for the analyses. The incidence for post-transplant de novo malignancy in the tourist group was 1.8-fold higher than that of the domestic group (21.8 vs 12.1 per 1000 person-years). The overall cancer recurrence rate was approximately 11%. The top 3 post-transplant malignancies, in decreasing order, were urinary tract, kidney, and liver cancers, regardless of the recipient type. Compared with domestic recipients, there was significant higher mortality risk in transplant tourists (adjusted hazard ratio = 1.2, 95% confidence interval: 1.0–1.5). In addition, those with either pre-transplant or post-transplant malignancies were associated with increased mortality risk. We suggest that a sufficient waiting period for patients with pre-transplant malignancies should be better emphasized to eliminate recurrence, and transplant tourists should be discouraged because of the possibility of higher post-transplant de novo malignancy occurrence and mortality. PMID:25546686

  14. Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline

    PubMed Central

    Franklin, Donald R.; Deutsch, Reena; Woods, Steven P.; Vaida, Florin; Ellis, Ronald J.; Letendre, Scott L.; Marcotte, Thomas D.; Atkinson, J.H.; Collier, Ann C.; Marra, Christina M.; Clifford, David B.; Gelman, Benjamin B.; McArthur, Justin C.; Morgello, Susan; Simpson, David M.; McCutchan, John A.; Abramson, Ian; Gamst, Anthony; Fennema-Notestine, Christine; Smith, Davey M.; Heaton, Robert K.

    2014-01-01

    Objective: While HIV-associated neurocognitive disorders (HAND) remain prevalent despite combination antiretroviral therapy (CART), the clinical relevance of asymptomatic neurocognitive impairment (ANI), the most common HAND diagnosis, remains unclear. We investigated whether HIV-infected persons with ANI were more likely than those who were neurocognitively normal (NCN) to experience a decline in everyday functioning (symptomatic decline). Methods: A total of 347 human participants from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) cohort were NCN (n = 226) or had ANI (n = 121) at baseline. Neurocognitive assessments occurred approximately every 6 months, with median (interquartile range) follow-up of 45.2 (28.7–63.7) months. Symptomatic decline was based on self-report (SR) or objective, performance-based (PB) problems in everyday functioning. Proportional hazards modeling was used to generate risk ratios for progression to symptomatic HAND after adjusting for baseline and time-dependent covariates, including CD4+ T-lymphocyte count (CD4), virologic suppression, CART, and mood. Results: The ANI group had a shorter time to symptomatic HAND than the NCN after adjusting for baseline predictors: adjusted risk ratios for symptomatic HAND were 2.0 (confidence interval [CI] 1.1–3.6; p = 0.02) for SR, 5.8 (CI 3.2–10.7; p < 0.0001) for PB, and 3.2 (CI 2.0–5.0; p < 0.0001) for either SR or PB. Current CD4 and depression were significant time-dependent covariates, but antiretroviral regimen, virologic suppression, and substance abuse or dependence were not. Conclusions: This longitudinal study demonstrates that ANI conveys a 2-fold to 6-fold increase in risk for earlier development of symptomatic HAND, supporting the prognostic value of the ANI diagnosis in clinical settings. Identifying those at highest risk for symptomatic decline may offer an opportunity to modify treatment to delay progression. PMID:24814848

  15. New evidence of increased risk of rhinitis in subjects with COPD: a longitudinal population study

    PubMed Central

    Bergqvist, Joel; Andersson, Anders; Olin, Anna-Carin; Murgia, Nicola; Schiöler, Linus; Bove, Mogens; Hellgren, Johan

    2016-01-01

    Background The aim of this population-based study was to investigate the risk of developing noninfectious rhinitis (NIR) in subjects with chronic obstructive pulmonary disease (COPD). Materials and methods This is a longitudinal population-based study comprising 3,612 randomly selected subjects from Gothenburg, Sweden, aged 25–75 years. Lung function was measured at baseline with spirometry and the included subjects answered a questionnaire on respiratory symptoms. At follow-up, the subjects answered a questionnaire with a response rate of 87%. NIR was defined as symptoms of nasal obstruction, nasal secretion, and/or sneezing attacks without having a cold, during the last 5 years. COPD was defined as a spirometry ratio of forced expiratory volume in 1 second divided by forced vital capacity (FEV1/FVC) <0.7. Subjects who reported asthma and NIR at baseline were excluded from the study. The odds ratios for developing NIR (ie, new-onset NIR) in relation to age, gender, body mass index, COPD, smoking, and atopy were calculated. Results In subjects with COPD, the 5-year incidence of NIR was significantly increased (10.8% vs 7.4%, P=0.005) and was higher among subjects aged >40 years. Smoking, atopy, and occupational exposure to gas, fumes, or dust were also associated with new-onset NIR. COPD, smoking, and atopy remained individual risk factors for new-onset NIR in the logistic regression analysis. Conclusions This longitudinal population-based study of a large cohort showed that COPD is a risk factor for developing NIR. Smoking and atopy are also risk factors for NIR. The results indicate that there is a link present between upper and lower respiratory inflammation in NIR and COPD. PMID:27799760

  16. Does Exposure to Agricultural Chemicals Increase the Risk of Prostate Cancer among Farmers?

    PubMed Central

    Parent, Marie-Élise; Désy, Marie; Siemiatycki, Jack

    2009-01-01

    Several studies suggest that farmers may be at increased risk of prostate cancer. The present analysis, based on a large population-based case-control study conducted among men in the Montreal area in the early 1980’s, aim at identifying occupational chemicals which may be responsible for such increases. The original study enrolled 449 prostate cancer cases, nearly 4,000 patients with other cancers, as well as 533 population controls. Subjects were interviewed about their occupation histories, and a team of industrial hygienists assigned their past exposures using a checklist of some 300 chemicals. The present analysis was restricted to a study base of men who had worked as farmers earlier in their lives. There were a total of 49 men with prostate cancers, 127 with other cancers and 56 population controls. We created a pool of 183 controls combining the patients with cancers at sites other than the prostate and the population controls. We then estimated the odds ratio for prostate cancer associated with exposure to each of 10 agricultural chemicals, i.e., pesticides, arsenic compounds, acetic acid, gasoline engine emissions, diesel engine emissions, polycyclic aromatic hydrocarbons from petroleum, lubricating oils and greases, alkanes with ≥18 carbons, solvents, and mononuclear aromatic hydrocarbons. Based on a model adjusting for age, ethnicity, education, and respondent status, there was evidence of a two-fold excess risk of prostate cancer among farmers with substantial exposure to pesticides [odds ratio (OR)=2.3, 95% confidence interval (CI) 1.1–5.1], as compared to unexposed farmers. There was some suggestion, based on few subjects, of increased risks among farmers ever exposed to diesel engine emissions (OR=5.7, 95% CI 1.2–26.5). The results for pesticides are particularly noteworthy in the light of findings from previous studies. Suggestions of trends for elevated risks were noted with other agricultural chemicals, but these are largely novel and

  17. The 8q24 rs6983267G variant is associated with increased thyroid cancer risk.

    PubMed

    Sahasrabudhe, Ruta; Estrada, Ana; Lott, Paul; Martin, Lynn; Polanco Echeverry, Guadalupe; Velez, Alejandro; Neta, Gila; Takahasi, Meiko; Saenko, Vladimir; Mitsutake, Norisato; Jaeguer, Emma; Duque, Carlos Simon; Rios, Alejandro; Bohorquez, Mabel; Prieto, Rodrigo; Criollo, Angel; Echeverry, Magdalena; Tomlinson, Ian; Carmona, Luis G Carvajal

    2015-10-01

    The G allele of the rs6983267 single-nucleotide polymorphism, located on chromosome 8q24, has been associated with increased risk of several cancer types. The association between rs6983267G and thyroid cancer (TC) has been tested in different populations, mostly of European ancestry, and has led to inconclusive results. While significant associations have been reported in the British and Polish populations, no association has been detected in populations from Spain, Italy and the USA. To further investigate the role of rs6983267G in TC susceptibility, we evaluated rs6983267 genotypes in three populations of different continental ancestry (British Isles, Colombia and Japan), providing a total of 3067 cases and 8575 controls. We detected significant associations between rs6983267G and TC in the British Isles (odds ratio (OR)=1.19, 95% CI: 1.11-1.27, P=4.03×10(-7)), Japan (OR=1.20, 95% CI: 1.03-1.41, P=0.022) and a borderline significant association of similar effect direction and size in Colombia (OR=1.19, 95% CI: 0.99-1.44, P=0.069). A meta-analysis of our multi-ethnic study and previously published non-overlapping datasets, which included a total of 5484 cases and 12 594 controls, confirmed the association between rs6983267G and TC (P=1.23×10(-7), OR=1.13, 95% CI: 1.08-1.18). Our results therefore support the notion that rs6983267G is a bona fide TC risk variant that increases the risk of disease by ∼13%.

  18. 8q24 rs6983267G variant is associated with increased thyroid cancer risk

    PubMed Central

    Sahasrabudhe, Ruta; Estrada, Ana; Lott, Paul; Martin, Lynn; Echeverry, Guadalupe Polanco; Velez, Alejandro; Neta, Gila; Takahasi, Meiko; Saenko, Vladimir; Mitsutake, Norisato; Jaeguer, Emma; Duque, Carlos Simon; Rios, Alejandro; Bohorquez, Mabel; Prieto, Rodrigo; Criollo, Angel; Echeverry, Magdalena; Tomlinson, Ian; Carvajal Carmona, Luis G.

    2015-01-01

    The G allele of the rs6983267 single nucleotide polymorphism, located on chromosome 8q24, has been associated with increased risk of several cancer types. The association between rs6983267G and thyroid cancer has been tested in different populations, mostly of European ancestry, and has led to inconclusive results. While significant associations have been reported in the British and Polish populations, no association has been detected in populations from Spain, Italy and the USA. To further investigate the role of rs6983267G in thyroid cancer susceptibility, we evaluated rs6983267 genotypes in three populations of different continental ancestry (British Isles, Colombia and Japan), providing a total of 3,067 cases and 8,575 controls. We detected significant associations between rs6983267G and thyroid cancer in the British Isles (Odds Ratio, OR= 1.19, 95% confidence interval, CI: 1.11–1.27, P= 4.03 × 10−7), Japan (OR= 1.20, 95% CI: 1.03–1.41, P= 0.022) and a borderline significant association of similar effect direction and size in Colombia (OR= 1.19, 95% CI: 0.99–1.44, P= 0.069). A meta-analysis of our multi-ethnic study and previously published non-overlapping datasets, which included a total of 5,484 cases and 12,594 controls, confirmed the association between rs6983267G and thyroid cancer (P= 1.23 × 10−7, OR= 1.13, 95% CI: 1.07–1.18). Our results therefore support the notion that rs6983267G is a bona fide thyroid cancer risk variant that increases the risk of disease by ~13%. PMID:26290501

  19. Adiponectin plasma levels are increased by atorvastatin treatment in subjects at high cardiovascular risk.

    PubMed

    Blanco-Colio, Luis M; Martín-Ventura, Jose L; Gómez-Guerrero, Carmen; Masramon, Xavier; de Teresa, Eduardo; Farsang, Csaba; Gaw, Allan; Gensini, GianFranco; Leiter, Lawrence A; Langer, Anatoly; Egido, Jesús

    2008-05-31

    Adiponectin can suppress atherogenesis by inhibiting the adherence of monocytes, reducing their phagocytic activity, and suppressing the accumulation of modified lipoproteins in the vascular wall. Contradictory data have been reported about the effect of statins on adiponectin plasma levels. In this work, adiponectin plasma levels were measured in 102 statin-free subjects from the Spanish population of the Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study, a 12-week, prospective, multi-centre, open-label trial which enrolled subjects with coronary heart disease, coronary heart disease-equivalent or a 10-year coronary heart disease risk >20%. Subjects were assigned to atorvastatin (10-80 mg/day) based on low-density lipoprotein (LDL)-cholesterol concentration at screening. For comparison, age and gender-matched blood donors (N=40) were used as controls. Control subjects did not present hypertension, hypercholesterolemia, diabetes, metabolic syndrome and history of cardiovascular diseases. Adiponectin levels were diminished in patients at high cardiovascular risk compared with control subjects [4166 (3661-4740) vs 5806 (4764-7075) ng/ml respectively; geometric mean (95% CI); P<0.0001]. In the whole population, atorvastatin treatment increased adiponectin levels [9.7 (3.2-16.7);% Change (95% CI); P=0.003]. This increment was in a dose-dependent manner; maximal effect observed with atorvastatin 80 mg/d [24.7 (5.7-47.1); P=0.01]. Adiponectin concentrations were positively correlated with high-density lipoprotein-cholesterol both before and after atorvastatin treatment. No association was observed between adiponectin and LDL-cholesterol before and after atorvastatin treatment. In conclusion, atorvastatin increased adiponectin plasma levels in subjects at high cardiovascular risk, revealing a novel anti-inflammatory effect of this drug.

  20. Polymorphisms in prostate stem cell antigen gene rs2294008 increase gastric cancer risk in Chinese.

    PubMed

    Zeng, Zhirong; Wu, Xiaoqin; Chen, Fanggen; Yu, Jun; Xue, Ling; Hao, Yuantao; Wang, Yiming; Chen, Minhu; Sung, Joseph J Y; Hu, Pinjin

    2011-05-01

    A recent genome-wide study identified a strong association between polymorphisms in the prostate stem cell antigen (PSCA) gene and the risk of diffuse-type of gastric cancer in Japanese and Korean population. In this case-control study, we aimed to investigate the possible association between PSCA rs2294008 C/T with clinicopathological features and the prognosis of gastric cancer in a Southern Chinese population. Genotypes of 460 gastric cancer patients and 549 controls were determined by PCR-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing. We found that individuals with at least one copy of the rs2294008T allele (CT or TT genotype) had an increased risk for gastric cancer compared with CC genotype (OR = 1.42, 95% CI = 1.10-1.82, P = 0.006). Further stratification analyses indicated that the effect of PSCA rs2294008T carriers was noteworthy in intestinal type (OR = 1.55, 95% CI = 1.18-2.04, P = 0.002), poorly differentiated (OR = 1.59, 95% CI = 1.19-2.13, P = 0.002), noncardia (OR = 1.55, 95% CI = 1.17-2.04, P = 0.002) subtypes of gastric cancer. Cox proportional hazards analyses demonstrated that TT genotype (HR = 2.12, 95% CI = 1.22-3.69, P = 0.008) as well as TNM staging were prognostic factors of gastric cancer patients. In conclusion, The T allele of PSCA rs2294008 is associated with increased risk of gastric cancer, especially intestinal type, poorly differentiated, early onset, and noncardia gastric cancer in Chinese population. TNM staging and TT genotype might be involved in the prognosis of gastric cancer patients.

  1. Toxicity of Atorvastatin on Pancreas Mitochondria: A Justification for Increased Risk of Diabetes Mellitus.

    PubMed

    Sadighara, Melina; Amirsheardost, Zahra; Minaiyan, Mohsen; Hajhashemi, Valiollah; Naserzadeh, Parvaneh; Salimi, Ahmad; Seydi, Enayatollah; Pourahmad, Jalal

    2017-02-01

    Statins (including atorvastatin) are a widely used class of drugs, and like all medications, they have a potential for adverse effects. Recently, it has been shown that statins also exert side effects on the pancreas. In vitro studies have suggested that this class of drugs induced a reduction in insulin secretion. Also, the use of statins is associated with a raised risk of diabetes mellitus (DM), but the mechanisms underlying statin-induced diabetes are poorly known. Literature data indicate that several statins are able to induce apoptosis signalling. This study was designed to examine the mechanism of atorvastatin on mitochondria obtained from rat pancreas. In our study, mitochondria were obtained from the pancreas and then exposed to atorvastatin and vehicle to investigate probable toxic effects. The results showed that atorvastatin (25, 50, 75, 100 and 125 μM) increased reactive oxygen species (ROS) production, mitochondrial swelling, collapse of mitochondrial membrane potential and cytochrome c release, the orchestrating factor for mitochondria-mediated apoptosis signalling. Atorvastatin also reduced the ATP levels. These results propose that the toxicity of atorvastatin on pancreas mitochondria is a key point for drug-induced apoptotic cell loss in the pancreas and therefore a justification for increased risk of DM.

  2. Obesity-Hypoventilation Syndrome: Increased Risk of Death over Sleep Apnea Syndrome

    PubMed Central

    Castro-Añón, Olalla; Pérez de Llano, Luis A.; De la Fuente Sánchez, Sandra; Golpe, Rafael; Méndez Marote, Lidia; Castro-Castro, Julián; González Quintela, Arturo

    2015-01-01

    Aim To study whether mortality and cardiovascular morbidity differ in non-invasive ventilation (NIV)-treated patients with severe obesity-hypoventilation syndrome (OHS) as compared with CPAP-treated patients with obstructive sleep apnea syndrome (OSAS), and to identify independent predictors of mortality in OHS. Material and methods Two retrospective cohorts of OHS and OSAS were matched 1:2 according to sex, age (±10 year) and length of time since initiation of CPAP/NIV therapy (±6 months). Results Three hundred and thirty subjects (110 patients with OHS and 220 patients with OSAS) were studied. Mean follow-up time was 7±4 years. The five year mortality rates were 15.5% in OHS cohort and 4.5% in OSAS cohort (p< 0.05). Patients with OHS had a 2-fold increase (OR 2; 95% CI: 1.11–3.60) in the risk of mortality and 1.86 fold (OR 1.86; 95% CI: 1.14–3.04) increased risk of having a cardiovascular event. Diabetes, baseline diurnal SaO2 < 83%, EPAP < 7 cmH2O after titration and adherence to NIV < 4 hours independently predicted mortality in OHS. Conclusion Mortality of severe OHS is high and substantially worse than that of OSAS. Severe OHS should be considered a systemic disease that encompasses respiratory, metabolic and cardiovascular components that require a multimodal therapeutic approach. PMID:25671545

  3. Ebola and Marburg virus diseases in Africa: increased risk of outbreaks in previously unaffected areas?

    PubMed

    Changula, Katendi; Kajihara, Masahiro; Mweene, Aaron S; Takada, Ayato

    2014-09-01

    Filoviral hemorrhagic fever (FHF) is caused by ebolaviruses and marburgviruses, which both belong to the family Filoviridae. Egyptian fruit bats (Rousettus aegyptiacus) are the most likely natural reservoir for marburgviruses and entry into caves and mines that they stay in has often been associated with outbreaks of MVD. On the other hand, the natural reservoir for ebola viruses remains elusive; however, handling of wild animal carcasses has been associated with some outbreaks of EVD. In the last two decades, there has been an increase in the incidence of FHF outbreaks in Africa, some being caused by a newly found virus and some occurring in previously unaffected areas such as Guinea, Liberia and Sierra Leone, in which the most recent EVD outbreak occurred in 2014. Indeed, the predicted geographic distribution of filoviruses and their potential reservoirs in Africa includes many countries in which FHF has not been reported. To minimize the risk of virus dissemination in previously unaffected areas, there is a need for increased investment in health infrastructure in African countries, policies to facilitate collaboration between health authorities from different countries, implementation of outbreak control measures by relevant multi-disciplinary teams and education of the populations at risk.

  4. APOBEC3 deletion increases the risk of breast cancer: a meta-analysis

    PubMed Central

    Sun, Meili; Wang, Shuyun; Zhou, Guanzhou; Sun, Yuping

    2016-01-01

    Recently, a deletion in the human apolipoprotein B mRNA-editing enzyme catalytic polypeptide-like 3 (APOBEC3) gene cluster has been associated with a modest increased risk of breast cancer, but studies yielded inconsistent results. Therefore we performed a meta-analysis to derive a more precise conclusion. Six studies including 18241 subjects were identified by searching PubMed and Embase databases from inception to April 2016. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were evaluated under allele contrast, dominant, recessive, homozygous, and heterozygous models. All the analyses suggested a correlation of APOBEC3 deletion with increased breast cancer risk (D vs I: OR = 1.29, 95% CI = 1.23-1.36; D/D+I/D vs I/I: OR = 1.34, 95% CI = 1.26-1.43; D/D vs I/D+ I/I: OR = 1.51, 95% CI = 1.36-1.68; D/D vs I/I: OR = 1.75, 95% CI= 1.56-1.95; I/D vs I/I: OR = 1.28, 95% CI = 1.19-1.36). Stratified analysis by ethnicity showed that the relationship is stronger and more stable in Asians. In summary, our current work indicated that APOBEC3 copy number variations might have a good screening accuracy for breast cancer. PMID:27602762

  5. Increasing risk of compound flooding from storm surge and rainfall for major US cities

    NASA Astrophysics Data System (ADS)

    Wahl, Thomas; Jain, Shaleen; Bender, Jens; Meyers, Steven D.; Luther, Mark E.

    2015-12-01

    When storm surge and heavy precipitation co-occur, the potential for flooding in low-lying coastal areas is often much greater than from either in isolation. Knowing the probability of these compound events and understanding the processes driving them is essential to mitigate the associated high-impact risks. Here we determine the likelihood of joint occurrence of these two phenomena for the contiguous United States (US) and show that the risk of compound flooding is higher for the Atlantic/Gulf coast relative to the Pacific coast. We also provide evidence that the number of compound events has increased significantly over the past century at many of the major coastal cities. Long-term sea-level rise is the main driver for accelerated flooding along the US coastline; however, under otherwise stationary conditions (no trends in individual records), changes in the joint distributions of storm surge and precipitation associated with climate variability and change also augment flood potential. For New York City (NYC)--as an example--the observed increase in compound events is attributed to a shift towards storm surge weather patterns that also favour high precipitation. Our results demonstrate the importance of assessing compound flooding in a non-stationary framework and its linkages to weather and climate.

  6. Does Drought Increase the Risk of Insects Developing Behavioral Resistance to Systemic Insecticides?

    PubMed Central

    Fowles, Trevor; Bick, Emily; Nansen, Christian

    2016-01-01

    Increases in severity and frequency of drought periods, average global temperatures, and more erratic fluctuations in rainfall patterns due to climate change are predicted to have a dramatic impact on agricultural production systems. Insect pest populations in agricultural and horticultural systems are also expected to be impacted, both in terms of their spatial and temporal distributions and in their status as pest species. In this opinion-based article, we discuss how indirect effects of drought may adversely affect the performance of systemic insecticides and also lead to increased risk of insect pests developing behavioral insecticide resistance. We hypothesize that more pronounced drought will decrease uptake and increase the magnitude of nonuniform translocation of systemic insecticides within treated crop plants, and that may have two concurrent consequences: 1) reduced pesticide performance, and 2) increased likelihood of insect pests evolving behavioral insecticide resistance. Under this scenario, pests that can sense and avoid acquisition of lethal dosages of systemic insecticides within crop plants will have a selective advantage. This may lead to selection for insect behavioral avoidance, so that insects predominantly feed and oviposit on portions of crop plants with low concentration of systemic insecticide. Limited research has been published on the effect of environmental variables, including drought, on pesticide performance, but we present and discuss studies that support the hypothesis described above. In addition, we wish to highlight the importance of studying the many ways environmental factors can affect, directly and indirectly, both the performance of insecticides and the risk of target insect pests developing resistance. PMID:27551149

  7. Cervical spine surgery performed in ambulatory surgical centers: Are patients being put at increased risk?

    PubMed Central

    Epstein, Nancy E.

    2016-01-01

    Background: Spine surgeons are being increasingly encouraged to perform cervical operations in outpatient ambulatory surgical centers (ASC). However, some studies/data coming out of these centers are provided by spine surgeons who are part or full owners/shareholders. In Florida, for example, there was a 50% increase in ASC (5349) established between 2000–2007; physicians had a stake (invested) in 83%, and outright owned 43% of ASC. Data regarding “excessive” surgery by ASC surgeon-owners from Idaho followed shortly thereafter. Methods: The risks/complications attributed to 3279 cervical spine operations performed in 6 ASC studies were reviewed. Several studies claimed 99% discharge rates the day of the surgery. They also claimed major complications were “picked up” within the average postoperative observation window (e.g., varying from 4–23 hours), allowing for appropriate treatment without further sequelae. Results: Morbidity rates for outpatient cervical spine ASC studies (e.g. some with conflicts of interest) varied up to 0.8–6%, whereas morbidity rates for 3 inpatient cervical studies ranged up to 19.3%. For both groups, morbidity included postoperative dysphagia, epidural hematomas, neck swelling, vocal cord paralysis, and neurological deterioration. Conclusions: Although we have no clear documentation as to their safety, “excessive” and progressively complex cervical surgical procedures are increasingly being performed in ASC. Furthermore, we cannot rely upon ASC-based data. At least some demonstrate an inherent conflict of interest and do not veridically report major morbidity/mortality rates for outpatient procedures. For now, cervical spine surgery performed in ASC would appear to be putting patients at increased risk for the benefit of their surgeon-owners. PMID:27843687

  8. Does Household Gun Access Increase the Risk of Attempted Suicide?: Evidence from a National Sample of Adolescents

    ERIC Educational Resources Information Center

    Watkins, Adam M.; Lizotte, Alan J.

    2013-01-01

    The aim of this research is to assess if home firearm access increases the risk of nonfatal suicidal attempts among adolescents. Such a gun focus has largely been limited to case-control studies on completed suicides. This line of research has found that household gun access increases the risk of suicide due to features of available firearms…

  9. Evaluation of skin cancer risk for lunar and Mars missions

    NASA Astrophysics Data System (ADS)

    Kim, M. Y.; George, K. A.; Cucinotta, F. A.

    Methods for estimating the probability of excess incidence of skin cancer from space radiation exposure, must consider the variability of skin doses at specific anatomical areas, and the individual factors that may contribute to risk projection models, including skin pigment, and synergistic effects from combined ionizing radiation and UV exposure. Using the multiplicative risk model for transferring the Japanese survivor data to the US population, epidemiological data for the increased risk for skin locations exposed to combined UV and ionizing radiation, and models of space radiation environments, transport, and anatomical shielding, we estimate the skin cancer risk for future lunar and Mars missions. Our model projects that individual variations in the probability for increased skin cancer risk varies more than 10-fold and that an excess cancer risk greater than 1% could occur for astronauts with light skin and hair color exposed to medium class solar particle events during future lunar base operations, or from galactic cosmic rays on Mars missions.

  10. Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers

    PubMed Central

    Chen, J; Chen, Y; Chang, W; Christiani, D

    2005-01-01

    Aims: To examine the association between driving time and changes in haematological markers of increased risks for cardiovascular diseases (CVD). Methods: The authors conducted a cross sectional analysis of baseline data from the Taxi Drivers' Health Study cohort in Taipei, Taiwan. They retrieved information on comorbidity, laboratory tests, age, and anthropometric measures from medical records of 1157 subjects (mean age 44.6 (SD 8.6) years). Whole blood cell (WBC) count was used as the primary haematological marker for increased CVD risk, and platelet count and haematocrit as the secondary markers. Standardised questionnaires were implemented to collect information on demographics, lifestyle, work related physical and psychosocial factors, and driving time profiles. Multiple regression was used to estimate the adjusted effects of driving time on three haematological markers. Results: The mean measured hematological marker was 6656 (SD 1656) cells x106/l for WBC, 47.2 (SD 3.5) % for hematocrit, and 243 (SD 52) cells x109/l for platelets. The driving time was 264 (SD 76) hours/month. Compared with drivers who drove ⩽208 hours/month (1st quartile cut off), drivers who drove >208 hours/month had a higher WBC count (by 317 x106/l; 95% CI 99 to 535), haematocrit (by 0.8%; 95% CI 0.3 to 1.2), and platelets (7.9 x109/l; 95% CI 1.0 to 14.8). After adjusting for conventional CVD risk factors (age, sex, smoking, hypertension, diabetes, and hypercholesterolaemia), obesity, alcohol drinking, regular exercise, and sociodemographics (education, marital status, income, and so on), long driving time was still associated with significant increases in WBC and platelets, whereas the effect on haematocrit was diminished and became statistically non-significant. Additional controls for physical workload, self-perceived job stress, and job dissatisfaction did not alter the associations with increased WBC and platelets. Conclusions: Longitudinal studies are needed to confirm the

  11. Changing the paradigm of organ utilization from PHS increased-risk donors: an opportunity whose time has come?

    PubMed

    Sibulesky, Lena; Javed, Imran; Reyes, Jorge D; Limaye, Ajit P

    2015-09-01

    Approximately 8-11% of all organ donors are classified by Public Health Service (PHS) as increased-risk. The proportion of PHS increased-risk donors is on the rise. At the University of Washington Medical Center, in 2014, the proportion of transplants from PHS increased-risk donors was 28% of liver transplants and 23% of kidney transplants. Nationally, transplant providers have been reluctant to use organs from PHS increased-risk donors because of concern for transmission of HIV, HCV, or HBV. There is also patient apprehension when these organs are being offered, and thus the discard rate of these otherwise good quality organs is high. Because of the organ shortage, preventing underutilization of such organs is essential. We provide data and considerations that should be used to guide the use of organs from PHS increased-risk donors.

  12. Common Sleep Disorders Increase Risk of Motor Vehicle Crashes and Adverse Health Outcomes in Firefighters

    PubMed Central

    Barger, Laura K.; Rajaratnam, Shantha M.W.; Wang, Wei; O'Brien, Conor S.; Sullivan, Jason P.; Qadri, Salim; Lockley, Steven W.; Czeisler, Charles A.

    2015-01-01

    Study Objectives: Heart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes. Methods: Firefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. Results: A total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29–3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06–2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54–3.66, p < 0.0001), diabetes (1.91, 1.31–2.81, p = 0.0009), depression (3.10, 2.49–3.85, p < 0.0001), and anxiety (3.81, 2.87–5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. Conclusions: Sleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks. Citation: Barger LK, Rajaratnam SM, Wang W, O'Brien CS

  13. Perceptions of the risks and benefits of fish consumption: Individual choices to reduce risk and increase health benefits

    PubMed Central

    Burger, Joanna; Gochfeld, Michael

    2014-01-01

    Studies of fish consumption often focus on awareness of and adherence to advisories, how much fish people eat, and contaminant levels in those fish. This paper examines knowledge and accuracy of risks and benefits of fish consumption among fishers and other recreationists in the New York Bight, indicative of whether they could make sound dietary decisions. While most respondents knew about health risks (70%) and benefits (94%) of consuming fish, far fewer could name specific risks and benefits. Less than 25% of respondents mentioned mercury and less than 15% mentioned that pregnant women and children were at risk. Far fewer people mentioned polychlorinated biphenyls (PCBs). Nearly 70% said it was healthy to eat fish, and 45% were aware that fish were rich in healthful oils. Despite the lack of details about what specific risks and benefits of fish, well over a third did not feel they needed more information. Other respondents had basic questions, but did not pose specific questions about the fish they caught or ate that would have clarified their individual risk-balancing decisions. Knowledge of which fish were high in contaminants did not match the mercury or PCB levels in those fish. There was a disconnect between the information base about specific risks and benefits of fish consumption, levels of mercury and PCBs in fish, and the respondent’s desire for more information. These data indicate that respondents did not have enough accurate information about contaminants in fish to make informed risk-balancing decisions. PMID:19193369

  14. Adolescents at Risk: Depression, Low Academic Performance, Violence, and Alcohol Increase Bolivian Teenagers' Risk of Attempted Suicide

    ERIC Educational Resources Information Center

    Dearden, Kirk A.; De La Cruz, Natalie G.; Crookston, Benjamin T.; Novilla, M. Lelinneth B.; Clark, Matthew

    2005-01-01

    This paper describes the prevalence of depression and suicidal tendencies as well as risk factors for attempted suicide among students in Bolivia. Adolescents 13-18 years old (182 females, 394 males) from randomly selected schools in La Paz completed the Youth Risk Behavior Survey. Frequencies and logistic regression were used to identify…

  15. Increased N6-methyladenosine in Human Sperm RNA as a Risk Factor for Asthenozoospermia.

    PubMed

    Yang, Ying; Huang, Wei; Huang, Jing-Tao; Shen, Fan; Xiong, Jun; Yuan, Er-Feng; Qin, Shan-shan; Zhang, Ming; Feng, Yu-Qi; Yuan, Bi-Feng; Liu, Song-Mei

    2016-04-13

    Male infertility is a worldwide medical problem. Asthenozoospermia is a common cause of infertility. Epigenetic modifications of DNA and histones have been shown to influence human infertility, but no research has explored whether N(6)-methyladenosine (m(6)A) level in RNA is associated with asthenozoospermia. Here, we collected a total of 52 semen samples, including 20 asthenozoospermia patients and 32 healthy controls. An LC-ESI-MS/MS method was used to detect m(6)A contents in sperm RNA, and real-time PCR was performed to determine the mRNA expression of demethylase (FTO, ALKBH5), methyltransferase (METTL3, METTL14, WTAP) and an m(6)A-selective-binding protein (YTHDF2). We found that m(6)A content (p = 0.033) and the mRNA expression of METTL3 (p = 0.016) and METTL14 (p = 0.025) in asthenozoospermia patients were significantly higher than those of controls. Increased m(6)A content was a risk factor for asthenozoospermia (odds ratio (OR) 3.229, 95% confidence interval (CI) 1.178 - 8.853, p = 0.023). Moreover, m(6)A content was correlated with the expression of METTL3 (r = 0.303, p = 0.032) and with sperm motility (progressive motility: r = -0.288, p = 0.038; non-progressive motility: r = -0.293, p = 0.037; immotility: r = 0.387, p = 0.005). Our data suggest that increased m(6)A content is a risk factor for asthenozoospermia and affects sperm motility. Methyltransferases, particularly METTL3, play key roles in increasing m(6)A contents in sperm RNA.

  16. Increased N6-methyladenosine in Human Sperm RNA as a Risk Factor for Asthenozoospermia

    PubMed Central

    Yang, Ying; Huang, Wei; Huang, Jing-Tao; Shen, Fan; Xiong, Jun; Yuan, Er-Feng; Qin, Shan-shan; Zhang, Ming; Feng, Yu-Qi; Yuan, Bi-Feng; Liu, Song-Mei

    2016-01-01

    Male infertility is a worldwide medical problem. Asthenozoospermia is a common cause of infertility. Epigenetic modifications of DNA and histones have been shown to influence human infertility, but no research has explored whether N6-methyladenosine (m6A) level in RNA is associated with asthenozoospermia. Here, we collected a total of 52 semen samples, including 20 asthenozoospermia patients and 32 healthy controls. An LC-ESI-MS/MS method was used to detect m6A contents in sperm RNA, and real-time PCR was performed to determine the mRNA expression of demethylase (FTO, ALKBH5), methyltransferase (METTL3, METTL14, WTAP) and an m6A-selective-binding protein (YTHDF2). We found that m6A content (p = 0.033) and the mRNA expression of METTL3 (p = 0.016) and METTL14 (p = 0.025) in asthenozoospermia patients were significantly higher than those of controls. Increased m6A content was a risk factor for asthenozoospermia (odds ratio (OR) 3.229, 95% confidence interval (CI) 1.178 – 8.853, p = 0.023). Moreover, m6A content was correlated with the expression of METTL3 (r = 0.303, p = 0.032) and with sperm motility (progressive motility: r = −0.288, p = 0.038; non-progressive motility: r = −0.293, p = 0.037; immotility: r = 0.387, p = 0.005). Our data suggest that increased m6A content is a risk factor for asthenozoospermia and affects sperm motility. Methyltransferases, particularly METTL3, play key roles in increasing m6A contents in sperm RNA. PMID:27072590

  17. High Dietary Glycemic Load is Associated With Increased Risk of Colon Cancer

    PubMed Central

    Zelenskiy, Svetlana; Thompson, Cheryl L.; Tucker, Thomas C.; Li, Li

    2014-01-01

    High dietary glycemic load (GL) has been inconsistently associated with risk of colon cancer. We analyzed data for 1,093 incident cases and 1,589 controls in a population-based case-control study of colon cancer to further clarify the GL-colon cancer relationship. GL was assessed using a self-administered food frequency questionnaire. Cases had a significantly higher GL intake (mean = 136.4, SD = 24.5) than controls (mean = 132.8, SD = 25.2) (P = 0.0003). In a multivariate unconditional logistic regression model, the odds ratios (ORs) for colon cancer increased significantly with increasing GL: compared to the bottom quartile of GL, the ORs (95% CI) for the 2nd through the upper quartiles were 1.38 (1.06, 1.80), 1.67 (1.30, 2.13), and 1.61 (1.25, 2.07), respectively (Ptrend < 0.0001). Stratified analyses showed that the association was more pronounced among older participants [ORs (95% CI) for the 2nd through the upper quartiles were 1.35 (0.91, 2.00), 1.87 (1.29, 2.71), 2.02 (1.39, 2.95), respectively] than among younger participants [ORs were 1.46 (1.02, 2.10), 1.53 (1.09, 2.15), and 1.35 (0.96, 1.91), respectively] (Pint = 0.02). Our results provide support for the hypothesis that a diet with high GL increases the risk of colon cancer. PMID:24611536

  18. Temporomandibular disorders in scuba divers-an increased risk during diving certification training.

    PubMed

    Oztürk, Ozmen; Tek, Mustafa; Seven, Hüseyin

    2012-11-01

    The design of a diving regulator's mouthpiece increases the risk of a temporomandibular disorder (TMD) in scuba divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint, causing articular and periarticular disorders. In the current study, the prevalence of TMD in scuba divers triggered during diving certification training is investigated. We also aimed to determine the factors that lead to TMD during diving training and clarify the observation that there is an increased incidence of TMD in inexperienced divers. The study was held between 2006 and 2011. Ninety-seven divers were referred with the complaint of pain around temporomandibular area. The divers were classified according to their diving experience. Symptoms and signs of TMD were graded. Fourteen divers were diagnosed with TMD. Temporomandibular disorder was seen more frequently in inexperienced divers than in experienced divers (P = 0.0434). The most prevalent symptom was an increased effort for mouthpiece gripping. Temporomandibular joint tenderness and trigger point activation were the mostly seen physical signs. Thirteen divers had an improvement with therapy. The increased effort for stabilizing the mouthpiece is a recognized factor in TMD development. Attention must be paid to an association of scuba diving with TMDs, especially in inexperienced divers having a scuba certification training.

  19. Are Children and Adolescents with Food Allergies at Increased Risk for Psychopathology?

    PubMed Central

    Shanahan, Lilly; Zucker, Nancy; Copeland, William E.; Costello, E. Jane; Angold, Adrian

    2014-01-01

    Objective Living with food allergy is a unique and potentially life-threatening stressor that requires constant vigilance to food-related stimuli, but little is known about whether adolescents with food allergies are at increased risk for psychopathology—concurrently and over time. Methods Data came from the prospective-longitudinal Great Smoky Mountains Study. Adolescents (N = 1,420) were recruited from the community, and interviewed up to six times between ages 10 to 16 for the purpose of the present analyses. At each assessment, adolescents and one parent were interviewed using the Child and Adolescent Psychiatric Assessment, resulting in N = 5,165 pairs of interviews. Results Cross-sectionally, food allergies were associated with more symptoms of separation and generalized anxiety, attention deficit and hyperactivity disorder, and anorexia nervosa. Longitudinally, adolescents with food allergy experienced increases in symptoms of generalized anxiety and depression from one assessment to the next. Food allergies were not, however, associated with a higher likelihood of meeting diagnostic criteria for a psychiatric disorder. Conclusion The unique constellation of adolescents’ increased symptoms of psychopathology in the context of food allergy likely reflects an adaptive increase in vigilance rather than cohesive syndromes of psychopathology. Support and guidance from health care providers is needed to help adolescents with food allergies and their caregivers achieve an optimal balance between necessary vigilance and hypervigilance and unnecessary restriction. PMID:25454290

  20. Landscape of Deceased Donors Labeled Increased Risk for Disease Transmission Under New Guidelines.

    PubMed

    Kucirka, L M; Bowring, M G; Massie, A B; Luo, X; Nicholas, L H; Segev, D L

    2015-12-01

    Deceased donors are labeled increased risk for disease transmission (IRD) if they meet certain criteria. New PHS guidelines were recently implemented; the impact of these changes remains unknown. We aimed to quantify the impact of the new guidelines on the proportion of deceased donors labeled IRD, as well as demographic and clinical characteristics. We used Poisson regression with an interaction term for era (new vs. old guidelines) to quantify changes. Under the new guidelines, 19.5% donors were labeled IRD, compared to 10.4%, 12.2%, and 12.3% in the 3 most recent years under the old guidelines (IRR = 1.45, p < 0.001). Increases were consistent across OPOs: 44/59 had an increase in the percent of donors labeled IRD, and 14 OPOs labeled 25% of their donors IRD under the new guidelines (vs. 5 OPOs under the old). African-Americans were 52% more likely to be labeled IRD under the new guidelines (RR = 1.52, p = 0.01). There has been a substantial increase in donors labeled IRD under the new PHS guidelines; it is important to understand the mechanism and consequences to ensure an optimal balance of patient safety and organ utilization is achieved.

  1. Increased risk of chronic wasting disease in Rocky Mountain elk associated with decreased magnesium and increased manganese in brain tissue.

    PubMed

    White, Stephen N; O'Rourke, Katherine I; Gidlewski, Thomas; VerCauteren, Kurt C; Mousel, Michelle R; Phillips, Gregory E; Spraker, Terry R

    2010-01-01

    Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy (TSE) of Rocky Mountain elk in North America. Recent studies suggest that tissue and blood mineral levels may be valuable in assessing TSE infection in sheep and cattle. The objectives of this study were to examine baseline levels of copper, manganese, magnesium, zinc, selenium, and molybdenum in the brains of Rocky Mountain elk with differing prion genotypes and to assess the association of mineral levels with CWD infection. Elk with leucine at prion position 132 had significantly lower magnesium levels than elk with 2 copies of methionine. Chronic wasting disease-positive elk had significantly lower magnesium than control elk. The incorporation of manganese levels in addition to magnesium significantly refined explanatory ability, even though manganese alone was not significantly associated with CWD. This study demonstrated that mineral analysis may provide an additional disease correlate for assessing CWD risk, particularly in conjunction with genotype.

  2. Industrialization and the increasing risk of genome instability in developing countries: nutrigenomics as a promising antidote.

    PubMed

    Anetor, J I

    2010-12-01

    Increased reliance on chemicals in the industrializing developing countries places new demands on them, as they have limited resources to adequately regulate exposure to these chemicals. Majority of the chemicals cause mutation in DNA among others. The consequences of increased exposure to chemicals on the genome and their mitigation by Nutrigenomics, a science concerned with the prevention of genome damage by nutritional factors is poorly recognized in these countries. Growing evidence indicates that genome instability in the absence of overt exposure to genotoxicants is a sensitive marker of nutritional deficiency. Therefore, the increasing prevalence of chemicals in these countries which contribute to genome disturbances and the widespread nutritional deficiency, at least double the risk of genome instability.Environmental pollutants such polychlorobiphenyls, metal fumes, and fly ash, common in these countries are known to increase urinary level of 8-hydroxy deoxyguanosine (8-OHdG), a marker of oxidative DNA damage, precursor of genome instability.Increasing evidence emphasizes the importance of zinc in both genetic stability and function. Zinc deficiency has been linked with oxidative stress, DNA damage and impairment of repair mechanisms as well as risk of cancer. Zinc plays an important role in vitamin A metabolism from which the retinoids are derived. Zinc is also an important component of the p53 protein, a DNA damage sensor which prevents genetic lesions contributing to genome instability.Zinc deficiency ranks among the top 10 leading causes of death in developing countries. A large proportion of the population in these countries ingests less than 50% of the RDA for Zn.This makes this genome protective nutrient among others grossly inadequate. Folate now also recognized for its role in genome stability, is among the nutrients frequently cited as critical to genome stability. Folate deficiency of sub- clinical degree is common. Reduced folate intake causes

  3. Estimating Potential Increased Bladder Cancer Risk Due to Increased Bromide Concentrations in Sources of Disinfected Drinking Waters - slides

    EPA Science Inventory

    Public water systems are increasingly facing higher bromide levels in their source waters from anthropogenic contamination through coal-fired powerplants, conventional oil and gas extraction, and hydraulic fracturing. Climate change is likely to exacerbate this in coming years. W...

  4. Estimating Potential Increased Bladder Cancer Risk Due to Increased Bromide Concentrations in Sources of Disinfected Drinking Waters

    EPA Science Inventory

    Public water systems are increasingly facing higher bromide levels in their source waters from anthropogenic contamination through coal-fired power plants, conventional oil and gas extraction, and hydraulic fracturing. Climate change is likely to exacerbate this in coming years. ...

  5. XPC Polymorphism Increases Risk of Digestive System Cancers: Current Evidence from A Meta-Analysis

    PubMed Central

    Jiang, Xia; Zhou, Li-tao; Zhang, Shan-chun

    2012-01-01

    Objective Xeroderma pigmentosum complementation group C (XPC) participates in the initial recognition of DNA damage during nucleotide excision repair process in global genomic repair. Our meta-analysis was performed to evaluate the association between three polymorphisms (Lys939Gln, PAT+/– and Ala499Val) of XPC gene and risk of digestive system cancers. Methods All the relevant case-control studies published to April 2011 were identified through searching PubMed. Digestive system cancer risk with the three polymorphisms was estimated for each study by odds ratio (OR) with its 95% confidence interval (95% CI). Results We found an increased overall risk for digestive system cancers in all three models of Lys939Gln A>C (AC/CC vs. AA: OR, 1.20; 95% CI, 1.11–1.30; CC vs. AC/AA: OR, 1.24; 95% CI, 1.11–1.39; CC vs. AA: OR, 1.36; 95% CI, 1.21–1.53). When stratified by ethnicity, results remained significant in Asian population (AC/CC vs. AA: OR, 1.18; 95% CI, 1.02–1.37; CC vs. AC/AA: OR, 1.32; 95% CI, 1.1–1.51; CC vs. AA: OR, 1.35; 95% CI, 1.08–1.70), but not for Caucasians. However for Ala499Val C>T, a significant protective effect of T allele was only observed in the dominant model. Otherwise, no significant results were observed for PAT+/–. Conclusion XPC Lys939Gln A>C polymorphism may play an important role in digestive system cancer susceptibility. PMID:23359774

  6. VEGF Promoter Polymorphism Confers an Increased Risk of Pulmonary Arterial Hypertension in a Chinese Population

    PubMed Central

    Zeng, Qingchun; Zhang, Peng; Li, Guoyang; Xie, Qiang; Cheng, Ying

    2017-01-01

    Purpose Evidence on the contribution of genes to the hereditary predisposition to pulmonary arterial hypertension (PAH) is limited. Materials and Methods In this study, we hypothesized that single nucleotide variants in vascular endothelial growth factor (VEGF) gene may alter gene function and expression and may be associated with PAH risk. Five putatively functional loci (rs699947C>A and rs833061T>C in the promoter, rs3025040C>T, rs10434G>A and rs3025053G>A in the 3'-UTR) in the VEGF gene were genotyped and analyzed in a retrospective study of 587 patients with PAH and 736 healthy subjects from southern China. Results We found that the rs833061T>C polymorphism was significantly associated with PAH risk, while the other single nucleotide polymorphisms were not. Compared to carriers with TT genotype, those with rs833061C variant genotype (CT/CC) had an increased risk of PAH (odds ratio=1.47, 95% confidence interval=1.18–1.83, p=0.001). Functional assays indicated that CT/CC variant genotype had significantly higher mRNA levels of VEGF in peripheral blood mononuclear cells than TT genotype (p=0.021). Luciferase reporter assay indicated that having a C allele conferred a significantly higher transcription activity than that with a T allele. Conclusion Our findings suggest that the functional polymorphism rs833061T>C in VEGF gene promoter modulates VEGF expression and may be a valuable biomarker for predicting PAH susceptibility. PMID:28120560

  7. Hypnotics use but not insomnia increased the risk of dementia in traumatic brain injury patients.

    PubMed

    Chiu, Hsiao-Yean; Lin, En-Yuan; Wei, Li; Lin, Jiann-Her; Lee, Hsin-Chien; Fan, Yen-Chun; Tsai, Pei-Shan

    2015-12-01

    This study was intended to determine whether the use of hypnotics is associated with dementia in traumatic-brain-injury (TBI) patients. Data retrieved from the Longitudinal Health Insurance Database 2000. TBI patients who received a diagnosis of insomnia at 2 or more independent examinations after the index date of TBI were included. The comparison cohort consisted of randomly selected TBI patients who were matched to insomnia cohort patients based on sex and age. The 2 cohorts of TBI patients were subsequently divided into the following 4 study groups: hypnotics users with insomnia (TBI-IH, N=599), insomniacs who did not use hypnotics (TBI-I, N=931), hypnotics users without insomnia (TBI-H, N=199), and people without insomnia who did not use hypnotics (TBI-C, N=4271). Cox proportional-hazards regression models were used to determine the difference in dementia-free survival among the 4 study groups, after adjusting for the propensity score. The adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of the TBI-IH and TBI-H groups showed that they had a higher risk of dementia (aHRs: 1.86 and 3.98; 95% CIs: 1.15-3.00 and 2.44-6.47, respectively), compared with that of the TBI-C group. However, the risk of dementia in the TBI-I group was not significantly different from that of the TBI-C group (aHR: 1.36; 95% CI: 0.85-2.19). This study suggests that the use of hypnotics is associated with an increased risk of dementia in TBI patients with or without insomnia, whereas insomnia alone is not.

  8. Increased Risk of Deep Vein Thrombosis and Pulmonary Thromboembolism in Patients With Organophosphate Intoxication

    PubMed Central

    Lim, Yun-Ping; Lin, Cheng-Li; Hung, Dong-Zong; Ma, Wei-Chih; Lin, Yen-Ning; Kao, Chia-Hung

    2015-01-01

    Abstract Organophosphate (OP) poisoning is a critical cause of morbidity and mortality worldwide. We conducted a nationwide longitudinal cohort study to investigate the development of deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) among patients admitted with OP intoxication. We identified patients with OP intoxication by using the Taiwan National Health Insurance Research Database and enrolled 9223 patients who were hospitalized for OP intoxication between 2000 and 2011. OP intoxication was diagnosed based on a clinical assessment and serum acetylcholinesterase levels at the time of hospital admission. Each patient in the OP intoxication cohort was randomly frequency matched with 4 patients without OP intoxication based on their age, sex, and index year (36,892 patients as control cohort), and all patients were observed from the index date until the appearance of a DVT or a PTE event, or until December 31, 2011. We analyzed the risks of DVT and PTE by using Cox proportional hazards regression models that included the demographic variables of sex, age, and comorbidities (eg, hypertension, diabetes, cerebral vascular disease, heart failure, all cancer types, and lower leg fracture or surgery). The results revealed a significantly increased risk of developing DVT among patients with OP poisoning (adjusted hazard ratio [HR] = 1.55; 95% confidence interval [CI] = 1.03–2.34) but not PTE (adjusted HR = 1.44; 95% CI = 0.83–2.52). Among the patients without comorbidities, the OP poisoning patients compared with controls had a higher adjusted HR of 2.12 (95% CI = 1.21–3.71) for DVT. The results of this nationwide cohort study indicate that the risk of developing DVT is markedly higher in patients with OP intoxication compared with that of the general population. PMID:25569651

  9. Increased fracture risk and low bone mineral density in patients with loeys-dietz syndrome.

    PubMed

    Tan, Eric W; Offoha, Roosevelt U; Oswald, Gretchen L; Skolasky, Richard L; Dewan, Ashvin K; Zhen, Gehua; Shapiro, Jay R; Dietz, Harry C; Cao, Xu; Sponseller, Paul D

    2013-08-01

    Loeys-Dietz syndrome is a recently recognized connective tissue disorder with widespread systemic involvement. Little is known about its skeletal phenotype. Our goal was to investigate the risk of fracture and incidence of low bone mineral density in patients with Loeys-Dietz syndrome. We performed a cross-sectional, descriptive, survey-based study with subsequent chart review from July 2011 to April 2012. Fifty-seven patients (26 men, 31 women) with Loeys-Dietz syndrome confirmed by genetic testing completed the survey (average age, 25.3 years; range, 0.9-79.6 years). There were a total of 51 fractures (33 patients): 35 fractures in the upper extremities, 14 in the lower extremities, and two in the spine. Fourteen patients (24.6%) reported two or more fractures. There was a 50% risk of fracture by age 14 years. The incidence of any fracture in this cohort was 3.86 per 100 person-years. Seventeen patients had dual-energy X-ray absorptiometry scans available for review, 11 (64.7%) of whom had at least one fracture. Thirteen included lumbar spine absorptiometry reports; eight (61.5%) indicated low or very low bone mineral density. In the left hip, ten of 14 participants (71.4%) had low or very low bone mineral density. In the left femoral neck, nine of 13 participants (69.2%) had low or very low bone mineral density. The lowest Z- and T-scores were not associated with an increased number of fractures. Patients with Loeys-Dietz syndrome have a high risk of fracture and a high incidence of low bone mineral density.

  10. Exchange of peripherally inserted central catheters is associated with an increased risk for bloodstream infection.

    PubMed

    McCoy, Michael; Bedwell, Susan; Noori, Shahab

    2011-06-01

    It is not uncommon that the peripherally inserted central catheter (PICC) needs to be replaced either due to blockage or migration to a peripheral position. In such circumstances, there are two methods of PICC placement: new-site insertion and exchange by using the old PICC as a guide wire. Our objective was to investigate risk of infection associated with the exchange method. In this retrospective study, data on all PICC insertions in the neonatal intensive care unit in 2004 to 2008 were obtained. In the population who needed removal of existing PICC and insertion of a new one, we compared central line-associated bloodstream infection (CLABSI) within 1 week of insertion between the two insertion methods. Of 1148 PICC insertions reviewed, 164 (103 new-site and 61 exchange insertions) were performed after removal of a blocked/malpositioned PICC and therefore comprised the study population. The rate of CLABSI was higher in the exchange method (9.8% versus 1%, P < 0.007). After adjusting for the confounders, the odds for CLABSI within 7 days of PICC insertion was higher with the exchange method (odds ratio 25.2, 95% confidence interval: 2.17 to 292.98; P = 0.01). In infants, insertion of PICCs using the exchange method carries an increased risk of bloodstream infection.

  11. Actively using clopidogrel correlates with an increased risk of acute pancreatitis in Taiwan.

    PubMed

    Lai, Shih-Wei; Lin, Cheng-Li; Liao, Kuan-Fu

    2015-03-15

    The aim of this study is to assess whether there is an association between clopidogrel use and risk of acute pancreatitis in Taiwan. We conducted a case-control study using the database of the Taiwan National Health Insurance Program from 2000 to 2011. There were 5644 subjects aged 20-84 years with a first-time attack of acute pancreatitis as the case group and 22,576 randomly selected sex-matched and age-matched subjects without acute pancreatitis as the control group. We defined clopidogrel use as "actively using" if the final clopidogrel prescription was filled between 0 and 7 days before the date of diagnosing acute pancreatitis, or "not actively using" if the final clopidogrel prescription was filled ≧ 8 days before the date of diagnosing acute pancreatitis. Subjects who never used clopidogrel were defined as never used. The multivariable logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of acute pancreatitis associated with clopidogrel use. Comparing the subjects actively using clopidogrel to those who never used clopidogrel, the adjusted OR of acute pancreatitis was 8.46 (95%CI 5.25, 13.7). The adjusted OR decreased to 1.16 among subjects not actively using clopidogrel (95%CI 0.95, 1.43). Persons actively using clopidogrel are at an increased risk of acute pancreatitis. Further studies are necessary to prove the causal relationship.

  12. Targeting smokers at increased risk for relapse: treating women and those with a history of depression.

    PubMed

    Smith, Stevens S; Jorenby, Douglas E; Leischow, Scott J; Nides, Mitchell A; Rennard, Stephen I; Johnston, J Andrew; Jamerson, Brenda; Fiore, Michael C; Baker, Timothy B

    2003-02-01

    Some studies have shown that female smokers and smokers with a history of depression have an increased risk of relapse following smoking cessation treatment. This study examined the efficacy of bupropion sustained-release (SR) and the nicotine patch for smoking cessation in subgroups of smokers at possible risk for relapse. Data for this study were from a previously published randomized, double-blind, placebo-controlled clinical trial in which 893 smokers were randomized to four treatment conditions: placebo tablet + placebo patch, placebo tablet + 21 mg/24-hr nicotine patch, 300mg bupropion SR + placebo patch, and 300mg bupropion SR + 21 mg/24-hr nicotine patch. Study medication continued for 8 weeks after the quit day; brief individual cessation counseling was provided during weekly clinic visits. In comparison to the placebo tablet, bupropion SR approximately tripled 1-year non-smoking rates among women and previously depressed individuals. In contrast, the nicotine patch did not significantly improve cessation rates for any group. We conclude that bupropion SR is a first-line treatment for smoking that has the potential to benefit all smokers, especially women and the previously depressed.

  13. Loss of migratory behaviour increases infection risk for a butterfly host

    PubMed Central

    Satterfield, Dara A.; Maerz, John C.; Altizer, Sonia

    2015-01-01

    Long-distance animal migrations have important consequences for infectious disease dynamics. In some cases, migration lowers pathogen transmission by removing infected individuals during strenuous journeys and allowing animals to periodically escape contaminated habitats. Human activities are now causing some migratory animals to travel shorter distances or form sedentary (non-migratory) populations. We focused on North American monarch butterflies and a specialist protozoan parasite to investigate how the loss of migratory behaviours affects pathogen spread and evolution. Each autumn, monarchs migrate from breeding grounds in the eastern US and Canada to wintering sites in central Mexico. However, some monarchs have become non-migratory and breed year-round on exotic milkweed in the southern US. We used field sampling, citizen science data and experimental inoculations to quantify infection prevalence and parasite virulence among migratory and sedentary populations. Infection prevalence was markedly higher among sedentary monarchs compared with migratory monarchs, indicating that diminished migration increases infection risk. Virulence differed among parasite strains but was similar between migratory and sedentary populations, potentially owing to high gene flow or insufficient time for evolutionary divergence. More broadly, our findings suggest that human activities that alter animal migrations can influence pathogen dynamics, with implications for wildlife conservation and future disease risks. PMID:25589600

  14. Loss of migratory behaviour increases infection risk for a butterfly host.

    PubMed

    Satterfield, Dara A; Maerz, John C; Altizer, Sonia

    2015-02-22

    Long-distance animal migrations have important consequences for infectious disease dynamics. In some cases, migration lowers pathogen transmission by removing infected individuals during strenuous journeys and allowing animals to periodically escape contaminated habitats. Human activities are now causing some migratory animals to travel shorter distances or form sedentary (non-migratory) populations. We focused on North American monarch butterflies and a specialist protozoan parasite to investigate how the loss of migratory behaviours affects pathogen spread and evolution. Each autumn, monarchs migrate from breeding grounds in the eastern US and Canada to wintering sites in central Mexico. However, some monarchs have become non-migratory and breed year-round on exotic milkweed in the southern US. We used field sampling, citizen science data and experimental inoculations to quantify infection prevalence and parasite virulence among migratory and sedentary populations. Infection prevalence was markedly higher among sedentary monarchs compared with migratory monarchs, indicating that diminished migration increases infection risk. Virulence differed among parasite strains but was similar between migratory and sedentary populations, potentially owing to high gene flow or insufficient time for evolutionary divergence. More broadly, our findings suggest that human activities that alter animal migrations can influence pathogen dynamics, with implications for wildlife conservation and future disease risks.

  15. Increased Carrying Angle is a Risk Factor for Nontraumatic Ulnar Neuropathy at the Elbow

    PubMed Central

    Wang, Yi-Chian; Chu, Chang-Hung

    2008-01-01

    The literature suggests a possible relationship between carrying angle and nontrauma-related ulnar neuropathy. To confirm that relationship, we asked whether carrying angle is a risk factor in patients with nontrauma-related ulnar neuropathy. We measured the carrying angles of the elbow in 36 patients with a clinically and electrophysiologically confirmed diagnosis of nontraumatic ulnar neuropathy at the elbow and in 50 healthy control subjects. Correlation analysis was performed between carrying angles and parameters of nerve conduction studies, including nerve conduction velocities and amplitudes of muscle and nerve action potentials. The mean carrying angle was greater in the patients than in the control subjects. Females had a greater carrying angle than males. We observed an inverse relationship between carrying angles and motor nerve conduction velocities at cross-elbow segments of the ulnar nerves and with sensory nerve conduction velocities of the distal ulnar nerves. An increased carrying angle of the elbow appears to be an independent risk factor of nontrauma-related ulnar neuropathy. Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18506557

  16. Clinical use of anti-TNF therapy and increased risk of infections

    PubMed Central

    Ali, Tauseef; Kaitha, Sindhu; Mahmood, Sultan; Ftesi, Abdul; Stone, Jordan; Bronze, Michael S

    2013-01-01

    Biologics such as antitumor necrosis factor (anti-TNF) drugs have emerged as important agents in the treatment of many chronic inflammatory diseases, especially in cases refractory to conventional treatment modalities. However, opportunistic infections have become a major safety concern in patients on anti-TNF therapy, and physicians who utilize these agents must understand the increased risks of infection. A literature review of the published data on the risk of bacterial, viral, fungal, and parasitic infections associated with anti-TNF therapy was performed and the clinical presentation, diagnostic tests, management, and prevention of opportunistic infections in patients receiving anti-TNF therapy were reviewed. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from anti-TNF treatments. Patients should be adequately vaccinated when possible and closely monitored for early signs of infection. When serious infections occur, withdrawal of anti-TNF therapy may be necessary until the infection has been identified and properly treated. PMID:23569399

  17. Increased risk of solid renal tumors in lithium-treated patients.

    PubMed

    Zaidan, Mohamad; Stucker, Fabien; Stengel, Bénédicte; Vasiliu, Viorel; Hummel, Aurélie; Landais, Paul; Boffa, Jean-Jacques; Ronco, Pierre; Grünfeld, Jean-Pierre; Servais, Aude

    2014-07-01

    Cystic kidney diseases and toxic interstitial nephritis may be complicated by renal tumors. Long-term lithium intake is associated with tubulointerstitial nephritis and renal cysts but to date such an association with tumors has not been determined. We evaluated this in a retrospective study to determine whether lithium-treated patients were at higher risk of renal tumors compared with lithium-free patients with chronic kidney disease (CKD), and to the general population. Over a 16-year period, 14 of 170 lithium-treated patients had renal tumors, including seven malignant and seven benign tumors. The mean duration of lithium exposure at diagnosis was 21.4 years. The renal cancers included three clear-cell and two papillary renal cell carcinomas, one hybrid tumor with chromophobe and oncocytoma characteristics, and one clear-cell carcinoma with leiomyomatous stroma. The benign tumors included four oncocytomas, one mixed epithelial and stromal tumor, and two angiomyolipomas. The percentage of renal tumors, particularly cancers and oncocytomas, was significantly higher in lithium-treated patients compared with 340 gender-, age-, and estimated glomerular filtration rate (eGFR)-matched lithium-free patients. Additionally, the Standardized Incidence Ratio of renal cancer was significantly higher in lithium-treated patients compared with the general population: 7.51 (95% confidence interval (CI) (1.51-21.95)) and 13.69 (95% CI (3.68-35.06)) in men and women, respectively. Thus, there is an increased risk of renal tumors in lithium-treated patients.

  18. Apolipoprotein E4 Genotype Does Not Increase Risk of HIV-associated Neurocognitive Disorders

    PubMed Central

    Morgan, E.E.; Woods, S.P.; Letendre, S.L.; Franklin, D.R.; Bloss, C.; Goate, A.; Heaton, R.K.; Collier, A.C.; Marra, C.M.; Gelman, B.B.; McArthur, J.C.; Morgello, S.; Simpson, D.M.; McCutchan, J.A.; Ellis, R.J.; Abramson, I.; Gamst, A.; Fennema-Notestine, C.; Smith, D.M.; Grant, I.; Vaida, F.; Clifford, D.B.

    2013-01-01

    This is a cross-sectional, observational study to evaluate the hypothesis that HIV-seropositive (HIV+) apolipoprotein E4 (APOE4) carriers are at increased risk for HIV-associated Neurocognitive Disorders (HAND) compared to APOE4 noncarriers with HIV in the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) Group sample. APOE genotype was determined in 466 CHARTER participants with varying disease stages and histories of antiretroviral treatment who did not have severe psychiatric or medical comorbid conditions that preclude diagnosis of HAND. HAND diagnoses were based on results of comprehensive neurobehavioral evaluation and use of current neuroAIDS diagnostic criteria. HAND status consisting of two levels: neuropsychologically normal status (i.e., no HAND) and any HAND diagnosis (i.e., asymptomatic neurocognitive impairment, minor neurocognitive disorder, HIV-associated dementia). Logistic regression analyses revealed no association between APOE4 carrier status and HAND, and there were no interactions between APOE4 carrier status and ethnicity, age, substance use disorders, duration of infection, or nadir CD4. Results did not differ when analysis was restricted to symptomatic HAND, and no APOE4 gene dose-dependent relationship to HAND emerged. APOE4 status was not associated with concurrent HAND in this large, well-characterized sample. This does not preclude emergence of an association between APOE4 status and HAND as this population ages. Prospective, longitudinal studies are needed to examine APOE4 as a risk factor for neurocognitive decline, incident HAND at older ages, and potential associations with CSF amyloid. PMID:23408335

  19. Applying quality criteria to exposure in asbestos epidemiology increases the estimated risk.

    PubMed

    Burdorf, Alex; Heederik, Dick

    2011-07-01

    Mesothelioma deaths due to environmental exposure to asbestos in The Netherlands led to parliamentary concern that exposure guidelines were not strict enough. The Health Council of the Netherlands was asked for advice. Its report has recently been published. The question of quality of the exposure estimates was studied more systematically than in previous asbestos meta-analyses. Five criteria of quality of exposure information were applied, and cohort studies that failed to meet these were excluded. For lung cancer, this decreased the number of cohorts included from 19 to 3 and increased the risk estimate 3- to 6-fold, with the requirements for good historical data on exposure and job history having the largest effects. It also suggested that the apparent differences in lung cancer potency between amphiboles and chrysotile may be produced by lower quality studies. A similar pattern was seen for mesothelioma. As a result, the Health Council has proposed that the occupational exposure limit be reduced from 10 000 fibres m(-3) (all types) to 250 f m(-3) (amphiboles), 1300 f m(-3) (mixed fibres), and 2000 f m(-3) (chrysotile). The process illustrates the importance of evaluating quality of exposure in epidemiology since poor quality of exposure data will lead to underestimated risk.

  20. Increased risk of agricultural injury among African-American farm workers from Alabama and Mississippi.

    PubMed

    McGwin, G; Enochs, R; Roseman, J M

    2000-10-01

    Research on the epidemiology of agriculture-related injuries has largely ignored African-Americans and farm workers. This cohort study is the first to estimate injury rates and to evaluate prospectively risk factors for agriculture-related injuries and compare them among African-American and Caucasian farmers and African-American farm workers. A total of 1,246 subjects (685 Caucasian owners, 321 African-American owners, and 240 African-American workers) from Alabama and Mississippi were selected from Agricultural Statistics Services databases and other sources and were enrolled between January 1994 and June 1996. Baseline data included detailed demographic, farm and farming, and behavioral information. From January 1994 to April 1998, subjects were contacted biannually to ascertain the occurrence of an agriculture-related injury. Injury rates were 2.9 times (95% confidence interval (CI): 2.0, 4.3) higher for African-American farm workers compared with Caucasian and African-American owners. Part-time farming (relative risk (RR) = 2.0, 95% CI: 1.3, 2.5), prior agricultural injury (RR = 1.5, 95% CI: 1.0, 2.1), and farm machinery in fair/poor condition (RR = 1.8, 95% CI: 1.2, 2.7) were also independently associated with injury rates. The results demonstrate the increased frequency of agricultural injury among farm workers and identify a number of possible ways of reducing them.

  1. Risk of Oxidative Damage to Bone from Increased Iron Stores During Space Flight

    NASA Technical Reports Server (NTRS)

    Zwart, S. R.; Smith, S. M.

    2014-01-01

    Iron stores are increased secondary to neocytolysis of red blood cells and a high dietary intake of iron during space flight. This raises concerns about the risk of excess iron causing oxidative damage in many tissues, including bone. Biomarkers of iron status, oxidative damage, and bone resorption during space flight were analyzed for 23 (16 M/7 F) International Space Station crewmembers as part of the Nutrition SMO project. Up to 5 in-flight blood samples and 24-h urine pools were collected over the course of the 4-6 month missions. Serum iron increased slightly during space flight and was decreased at landing (P < 0.0004). An increase in serum ferritin early in flight (217% in women and 68% in men, P < 0.0004), returning to preflight concentrations at landing, and a decrease in transferrin and transferrin receptors during flight indicated that a transient increase in iron stores occurred. No inflammatory response was observed during flight. The oxidative damage markers 8-hydroxy-2'-deoxyguanosine and prostaglandin F(sub 2(alpha)) were positively correlated (both P < 0.001) with serum ferritin. A greater area under the curve for ferritin during flight was correlated with greater changes in bone mineral density of several bone regions after flight (1). In a separate study (2), a ground-based investigation was conducted that examined the combined effects of radiation exposure and iron overload on sensitivity to radiation injury in several physiological systems in 12-wk male Sprague-Dawley rats. The rats were acclimated to an adequate iron diet (45 mg iron (ferric citrate)/kg diet) for 3 wk and then assigned to one of four groups: adequate iron (Fe) diet/no radiation, adequate Fe diet/ radiation, moderately high Fe diet (650 mg Fe (ferric citrate)/kg diet)/no radiation, and moderately high Fe diet/radiation. Animals remained on the assigned diet for 4 wk. Starting on day 14 of experimental diet treatment, animals were exposed to a fractionated dose (0.375 Gy) of Cs

  2. Hormonal contraception does not increase women's HIV acquisition risk in Zambian discordant couples, 1994–2012

    PubMed Central

    Wall, Kristin M.; Kilembe, William; Vwalika, Bellington; Khu, Naw Htee; Brill, Ilene; Chomba, Elwyn; Johnson, Brent A.; Haddad, Lisa; Tichacek, Amanda; Allen, Susan

    2015-01-01

    testing of sex partners together is critical to establish HIV risk, ascertain couple fertility intentions and counsel appropriately. Implications These findings add to a controversial literature and uniquely address several common design and analytic challenges faced by previous studies. After controlling for confounders, we found no association between hormonal contraception and HIV acquisition risk in women. We support promoting condoms for HIV prevention and increasing the contraceptive method mix to decrease unintended pregnancy. PMID:25708502

  3. A High Dietary Glycemic Index Increases Total Mortality in a Mediterranean Population at High Cardiovascular Risk

    PubMed Central

    Castro-Quezada, Itandehui; Sánchez-Villegas, Almudena; Estruch, Ramón; Salas-Salvadó, Jordi; Corella, Dolores; Schröder, Helmut; Álvarez-Pérez, Jacqueline; Ruiz-López, María Dolores; Artacho, Reyes; Ros, Emilio; Bulló, Mónica; Covas, María-Isabel; Ruiz-Gutiérrez, Valentina; Ruiz-Canela, Miguel; Buil-Cosiales, Pilar; Gómez-Gracia, Enrique; Lapetra, José; Pintó, Xavier; Arós, Fernando; Fiol, Miquel; Lamuela-Raventós, Rosa María; Martínez-González, Miguel Ángel; Serra-Majem, Lluís

    2014-01-01

    Objective Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI) and glycemic load (GL) are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. Material and Methods The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ). We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR) and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. Results We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths). As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15–4.04); P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. Conclusions High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk. PMID:25250626

  4. Nonadherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Truck Crashes

    PubMed Central

    Burks, Stephen V.; Anderson, Jon E.; Bombyk, Matthew; Haider, Rebecca; Ganzhorn, Derek; Jiao, Xueyang; Lewis, Connor; Lexvold, Andrew; Liu, Hong; Ning, Jiachen; Toll, Alice; Hickman, Jeffrey S.; Mabry, Erin; Berger, Mark; Malhotra, Atul; Czeisler, Charles A.; Kales, Stefanos N.

    2016-01-01

    private. Commentary: A commentary on this article appears in this issue on page 961. Citation: Burks SV, Anderson JE, Bombyk M, Haider R, Ganzhorn D, Jiao X, Lewis C, Lexvold A, Liu H, Ning J, Toll A, Hickman JS, Mabry E, Berger M, Malhotra A, Czeisler CA, Kales SN. Nonadherence with employer-mandated sleep apnea treatment and increased risk of serious truck crashes. SLEEP 2016;39(5):967–975. PMID:27070139

  5. Humans have already increased the risk of major disruptions to Pacific rainfall

    NASA Astrophysics Data System (ADS)

    Power, Scott B.; Delage, François P. D.; Chung, Christine T. Y.; Ye, Hua; Murphy, Bradley F.

    2017-02-01

    Intermittent disruptions to rainfall patterns and intensity over the Pacific Ocean lasting up to ~ 1 year have major impacts on severe weather, agricultural production, ecosystems, and disease within the Pacific, and in many countries beyond. The frequency with which major disruptions to Pacific rainfall occur has been projected to increase over the 21st century, in response to global warming caused by large 21st century greenhouse gas emissions. Here we use the latest generation of climate models to show that humans may have contributed to the major disruption that occurred in the real world during the late 20th century. We demonstrate that although marked and sustained reductions in 21st century anthropogenic greenhouse gas emissions can greatly moderate the likelihood of major disruption, elevated risk of occurrence appears locked in now, and for at least the remainder of the 21st century.

  6. Adoption Does Not Increase the Risk of Mortality among Taiwanese Girls in a Longitudinal Analysis

    PubMed Central

    Mattison, Siobhán M.; Brown, Melissa J.; Floyd, Bruce; Feldman, Marcus W.

    2015-01-01

    Adopted children often experience health and well-being disadvantages compared to biological children remaining in their natal households. The degree of genetic relatedness is thought to mediate the level of parental investment in children, leading to poorer outcomes of biologically unrelated children. We explore whether mortality is related to adoption in a historical Taiwanese population where adoption rarely occurred among kin. Using Cox proportional hazards models in which adoption is included as a time-dependent covariate, we show that adoption of girls does not increase the risk of mortality, as previously suggested; in fact, it is either protective or neutral with respect to mortality. These results suggest that socio-structural variables may produce positive outcomes for adopted children, even compared to biological children who remain in the care of their parents. PMID:25923106

  7. Adoption Does Not Increase the Risk of Mortality among Taiwanese Girls in a Longitudinal Analysis.

    PubMed

    Mattison, Siobhán M; Brown, Melissa J; Floyd, Bruce; Feldman, Marcus W

    2015-01-01

    Adopted children often experience health and well-being disadvantages compared to biological children remaining in their natal households. The degree of genetic relatedness is thought to mediate the level of parental investment in children, leading to poorer outcomes of biologically unrelated children. We explore whether mortality is related to adoption in a historical Taiwanese population where adoption rarely occurred among kin. Using Cox proportional hazards models in which adoption is included as a time-dependent covariate, we show that adoption of girls does not increase the risk of mortality, as previously suggested; in fact, it is either protective or neutral with respect to mortality. These results suggest that socio-structural variables may produce positive outcomes for adopted children, even compared to biological children who remain in the care of their parents.

  8. Serum Resistin Levels May Contribute to an Increased Risk of Acute Cerebral Infarction.

    PubMed

    Dong, Xiao-Liu; Xu, Shi-Jun; Zhang, Li; Zhang, Xiu-Qing; Liu, Ting; Gao, Qiu-Yan; Qian, Qing-Qiang; Sun, Bao-Liang; Yang, Ming-Feng

    2017-04-01

    The objective of this study was to investigate the association between serum resistin levels and acute cerebral infarction (ACI). PubMed, SpringerLink, Wiley, EBSCO, Ovid, Web of Science, Wanfang, China National Knowledge Infrastructure, and VIP databases (last updated search in October 2014) were exhaustively searched, and data from the eligible studies were extracted and analyzed to assess the association between serum resistin levels and ACI. STATA software (version 12.0, Stata Corporation, College Station, TX, USA) was utilized for data analysis. Ten studies including 1829 ACI patients and 1557 healthy controls were eligible for inclusion in the meta-analysis. Our major result revealed that ACI patients exhibited higher serum resistin levels compared with healthy controls. Asubgroup analysis based on ethnicity showed a significant association between serum resistin levels and ACI in Asians, but surprisingly not in Caucasians. The results of our meta-analysis suggest that serum resistin levels are associated with an increased risk of ACI.

  9. Increased ultrasonic vocalizations and risk-taking in rat pups of sleep-deprived dams.

    PubMed

    Gulia, Kamalesh K; Patel, Niraj; Kumar, Velayudhan Mohan

    2015-02-01

    Ultrasonic vocalizations (USVs) in rodent pups are analogous to cries in human babies. There is reduction in USVs in pups after experimental deprivation of rapid eye movement sleep of dams during pregnancy. However, the effects of total sleep deprivation on the USVs of newborns and their emotional development are not documented. Male pups born to the rats that underwent total sleep deprivation for 5h during the third trimester made higher vocalizations, when tested on early postnatal days (pnds) in an isolation-paradigm. Their anxiety-related behaviors during pnds 25-28, were tested using elevated plus maze (EPM). In comparison to the control pups, weanlings of sleep-deprived dams made increased entries into the open arms and higher mobility in the EPM. Enhanced distress calls during early pnds and reduction in risk assessment in weanlings indicate a link between the two behaviors. The USVs during ontogeny may provide early signals about altered emotional development.

  10. Humans have already increased the risk of major disruptions to Pacific rainfall

    PubMed Central

    Power, Scott B.; Delage, François P. D.; Chung, Christine T. Y.; Ye, Hua; Murphy, Bradley F.

    2017-01-01

    Intermittent disruptions to rainfall patterns and intensity over the Pacific Ocean lasting up to ∼ 1 year have major impacts on severe weather, agricultural production, ecosystems, and disease within the Pacific, and in many countries beyond. The frequency with which major disruptions to Pacific rainfall occur has been projected to increase over the 21st century, in response to global warming caused by large 21st century greenhouse gas emissions. Here we use the latest generation of climate models to show that humans may have contributed to the major disruption that occurred in the real world during the late 20th century. We demonstrate that although marked and sustained reductions in 21st century anthropogenic greenhouse gas emissions can greatly moderate the likelihood of major disruption, elevated risk of occurrence appears locked in now, and for at least the remainder of the 21st century. PMID:28176783

  11. Early Attachment-Figure Separation and Increased Risk for Later Depression: Potential Mediation by Proinflammatory Processes

    PubMed Central

    Hennessy, Michael B.; Deak, Terrence; Schiml-Webb, Patricia A.

    2009-01-01

    Early maternal separation and other disruptions of attachment relations are known to increase risk for the later onset of depressive illness in vulnerable individuals. It is suggested here that sensitization involving proinflammatory processes may contribute to this effect. This argument is based on: (1) current notions of the role of proinflammatory cytokines in depressive illness; (2) evidence that proinflammatory cytokines mediate depressive-like behavior during separation in a rodent model of infant attachment; and (3) comparisons of the effects of early proinflammatory activation versus maternal separation on later proinflammatory activity and biobehavioral processes related to depression. The possible interaction of proinflammatory processes and corticotropin-releasing factor in the sensitization process is discussed. PMID:20359585

  12. Humans have already increased the risk of major disruptions to Pacific rainfall.

    PubMed

    Power, Scott B; Delage, François P D; Chung, Christine T Y; Ye, Hua; Murphy, Bradley F

    2017-02-08

    Intermittent disruptions to rainfall patterns and intensity over the Pacific Ocean lasting up to ∼ 1 year have major impacts on severe weather, agricultural production, ecosystems, and disease within the Pacific, and in many countries beyond. The frequency with which major disruptions to Pacific rainfall occur has been projected to increase over the 21st century, in response to global warming caused by large 21st century greenhouse gas emissions. Here we use the latest generation of climate models to show that humans may have contributed to the major disruption that occurred in the real world during the late 20th century. We demonstrate that although marked and sustained reductions in 21st century anthropogenic greenhouse gas emissions can greatly moderate the likelihood of major disruption, elevated risk of occurrence appears locked in now, and for at least the remainder of the 21st century.

  13. Are Students with Asthma at Increased Risk for Being a Victim of Bullying in School or Cyberspace? Findings from the 2011 Florida Youth Risk Behavior Survey

    ERIC Educational Resources Information Center

    Gibson-Young, Linda; Martinasek, Mary P.; Clutter, Michiko; Forrest, Jamie

    2014-01-01

    Background: Adolescents with asthma are at risk for psychological and behavioral problems. The aim of this study was to determine whether high school students with asthma are at increased risk for bullying in school and cyberspace, and to explore the role of depressive symptoms in moderating this association. Methods: A secondary data analysis was…

  14. Crop rotations in the sea: Increasing returns and reducing risk of collapse in sea cucumber fisheries

    PubMed Central

    Skewes, Timothy; Murphy, Nicole; Pascual, Ricardo; Fischer, Mibu

    2015-01-01

    Rotational harvesting is one of the oldest management strategies applied to terrestrial and marine natural resources, with crop rotations dating back to the time of the Roman Empire. The efficacy of this strategy for sessile marine species is of considerable interest given that these resources are vital to underpin food security and maintain the social and economic wellbeing of small-scale and commercial fishers globally. We modeled the rotational zone strategy applied to the multispecies sea cucumber fishery in Australia’s Great Barrier Reef Marine Park and show a substantial reduction in the risk of localized depletion, higher long-term yields, and improved economic performance. We evaluated the performance of rotation cycles of different length and show an improvement in biological and economic performance with increasing time between harvests up to 6 y. As sea cucumber fisheries throughout the world succumb to overexploitation driven by rising demand, there has been an increasing demand for robust assessments of fishery sustainability and a need to address local depletion concerns. Our results provide motivation for increased use of relatively low-information, low-cost, comanagement rotational harvest approaches in coastal and reef systems globally. PMID:25964357

  15. Will climate change increase the risk for critical infrastructure failures in Europe due to extreme precipitation?

    NASA Astrophysics Data System (ADS)

    Nissen, Katrin; Ulbrich, Uwe

    2016-04-01

    An event based detection algorithm for extreme precipitation is applied to a multi-model ensemble of regional climate model simulations. The algorithm determines extent, location, duration and severity of extreme precipitation events. We assume that precipitation in excess of the local present-day 10-year return value will potentially exceed the capacity of the drainage systems that protect critical infrastructure elements. This assumption is based on legislation for the design of drainage systems which is in place in many European countries. Thus, events exceeding the local 10-year return value are detected. In this study we distinguish between sub-daily events (3 hourly) with high precipitation intensities and long-duration events (1-3 days) with high precipitation amounts. The climate change simulations investigated here were conducted within the EURO-CORDEX framework and exhibit a horizontal resolution of approximately 12.5 km. The period between 1971-2100 forced with observed and scenario (RCP 8.5 and RCP 4.5) greenhouse gas concentrations was analysed. Examined are changes in event frequency, event duration and size. The simulations show an increase in the number of extreme precipitation events for the future climate period over most of the area, which is strongest in Northern Europe. Strength and statistical significance of the signal increase with increasing greenhouse gas concentrations. This work has been conducted within the EU project RAIN (Risk Analysis of Infrastructure Networks in response to extreme weather).

  16. Vitamin D deficiency induces early signs of aging in human bone, increasing the risk of fracture.

    PubMed

    Busse, Björn; Bale, Hrishikesh A; Zimmermann, Elizabeth A; Panganiban, Brian; Barth, Holly D; Carriero, Alessandra; Vettorazzi, Eik; Zustin, Josef; Hahn, Michael; Ager, Joel W; Püschel, Klaus; Amling, Michael; Ritchie, Robert O

    2013-07-10

    Vitamin D deficiency is a widespread medical condition that plays a major role in human bone health. Fracture susceptibility in the context of low vitamin D has been primarily associated with defective mineralization of collagenous matrix (osteoid). However, bone's fracture resistance is due to toughening mechanisms at various hierarchical levels ranging from the nano- to the microstructure. Thus, we hypothesize that the increase in fracture risk with vitamin D deficiency may be triggered by numerous pathological changes and may not solely derive from the absence of mineralized bone. We found that the characteristic increase in osteoid-covered surfaces in vitamin D-deficient bone hampers remodeling of the remaining mineralized bone tissue. Using spatially resolved synchrotron bone mineral density distribution analyses and spectroscopic techniques, we observed that the bone tissue within the osteoid frame has a higher mineral content with mature collagen and mineral constituents, which are characteristic of aged tissue. In situ fracture mechanics measurements and synchrotron radiation micro-computed tomography of the crack path indicated that vitamin D deficiency increases both the initiation and propagation of cracks by 22 to 31%. Thus, vitamin D deficiency is not simply associated with diminished bone mass. Our analyses reveal the aged nature of the remaining mineralized bone and its greatly decreased fracture resistance. Through a combination of characterization techniques spanning multiple size scales, our study expands the current clinical understanding of the pathophysiology of vitamin D deficiency and helps explain why well-balanced vitamin D levels are essential to maintain bone's structural integrity.

  17. Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes.

    PubMed

    Kanikarla-Marie, Preeti; Jain, Sushil K

    2016-06-01

    Diets that boost ketone production are increasingly used for treating several neurological disorders. Elevation in ketones in most cases is considered favorable, as they provide energy and are efficient in fueling the body's energy needs. Despite all the benefits from ketones, the above normal elevation in the concentration of ketones in the circulation tend to illicit various pathological complications by activating injurious pathways leading to cellular damage. Recent literature demonstrates a plausible link between elevated levels of circulating ketones and oxidative stress, linking hyperketonemia to innumerable morbid conditions. Ketone bodies are produced by the oxidation of fatty acids in the liver as a source of alternative energy that generally occurs in glucose limiting conditions. Regulation of ketogenesis and ketolysis plays an important role in dictating ketone concentrations in the blood. Hyperketonemia is a condition with elevated blood levels of acetoacetate, 3-β-hydroxybutyrate, and acetone. Several physiological and pathological triggers, such as fasting, ketogenic diet, and diabetes cause an accumulation and elevation of circulating ketones. Complications of the brain, kidney, liver, and microvasculature were found to be elevated in diabetic patients who had elevated ketones compared to those diabetics with normal ketone levels. This review summarizes the mechanisms by which hyperketonemia and ketoacidosis cause an increase in redox imbalance and thereby increase the risk of morbidity and mortality in patients.

  18. Niacin Skin Sensitivity Is Increased in Adolescents at Ultra-High Risk for Psychosis

    PubMed Central

    Schäfer, Miriam R.; Milleit, Berko; Langbein, Kerstin; Hipler, Uta-Christina; Milleit, Christine; Klier, Claudia M.; Schlögelhofer, Monika; Holub, Magdalena; Holzer, Ingrid; Berk, Michael; McGorry, Patrick D.; Sauer, Heinrich; Amminger, G. Paul

    2016-01-01

    Background Most studies provide evidence that the skin flush response to nicotinic acid (niacin) stimulation is impaired in schizophrenia. However, only little is known about niacin sensitivity in the ultra-high risk (UHR) phase of psychotic disorders. Methods We compared visual ratings of niacin sensitivity between adolescents at UHR for psychosis according to the one year transition outcome (UHR-T n = 11; UHR-NT n = 55) with healthy controls (HC n = 25) and first episode schizophrenia patients (FEP n = 25) treated with atypical antipsychotics. Results Contrary to our hypothesis niacin sensitivity of the entire UHR group was not attenuated, but significantly increased compared to the HC group, whereas no difference could be found between the UHR-T and UHR-NT groups. As expected, niacin sensitivity of FEP was attenuated compared to HC group. In UHR individuals niacin sensitivity was inversely correlated with omega-6 and -9 fatty acids (FA), but positively correlated with phospholipase A2 (inPLA2) activity, a marker of membrane lipid repair/remodelling. Conclusions Increased niacin sensitivity in UHR states likely indicates an impaired balance of eicosanoids and omega-6/-9 FA at a membrane level. Our findings suggest that the emergence of psychosis is associated with an increased mobilisation of eicosanoids prior to the transition to psychosis possibly reflecting a “pro-inflammatory state”, whereas thereafter eicosanoid mobilisation seems to be attenuated. Potential treatment implications for the UHR state should be further investigated. PMID:26894921

  19. Crop rotations in the sea: Increasing returns and reducing risk of collapse in sea cucumber fisheries.

    PubMed

    Plagányi, Éva Elizabeth; Skewes, Timothy; Murphy, Nicole; Pascual, Ricardo; Fischer, Mibu

    2015-05-26

    Rotational harvesting is one of the oldest management strategies applied to terrestrial and marine natural resources, with crop rotations dating back to the time of the Roman Empire. The efficacy of this strategy for sessile marine species is of considerable interest given that these resources are vital to underpin food security and maintain the social and economic wellbeing of small-scale and commercial fishers globally. We modeled the rotational zone strategy applied to the multispecies sea cucumber fishery in Australia's Great Barrier Reef Marine Park and show a substantial reduction in the risk of localized depletion, higher long-term yields, and improved economic performance. We evaluated the performance of rotation cycles of different length and show an improvement in biological and economic performance with increasing time between harvests up to 6 y. As sea cucumber fisheries throughout the world succumb to overexploitation driven by rising demand, there has been an increasing demand for robust assessments of fishery sustainability and a need to address local depletion concerns. Our results provide motivation for increased use of relatively low-information, low-cost, comanagement rotational harvest approaches in coastal and reef systems globally.

  20. Vitamin D Deficiency Increases the Risk of Adverse Neonatal Outcomes in Gestational Diabetes

    PubMed Central

    Weinert, Letícia Schwerz; Reichelt, Angela Jacob; Schmitt, Leonardo Rauber; Boff, Roberta; Oppermann, Maria Lucia Rocha; Camargo, Joiza Lins; Silveiro, Sandra Pinho

    2016-01-01

    Background Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. Methods 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement. Vitamin D was measured by chemiluminescence and deficiency was defined as < 20 ng/mL. Participants were followed until puerperium and adverse neonatal outcomes were evaluated. Results Newborns of women with vitamin D deficiency had higher incidences of hospitalization in intensive care units (ICU) (32 vs 19%, P = 0.048), of hypoglycemia (any, 17.3 vs 7.1%, P = 0.039requiring ICU, 15.3 vs 3.6%, P = 0.008), and were more frequently small for gestational age (SGA) (17.3 vs 5.9%, P = 0.017). After adjustment, relative risk (RR) for hypoglycemia requiring ICU was 3.63 (95%CI 1.09–12.11) and for SGA was 4.32 (95%CI 1.75–10.66). The incidence of prematurity, jaundice and shoulder dystocia was no statistically different between groups. Conclusions In this cohort of pregnant women with GDM, vitamin D deficiency was associated with a major increase in the incidence of adverse neonatal outcomes such as SGA newborns and neonatal hypoglycemia. PMID:27764194

  1. Female Gender and Diabetes Mellitus Increase the Risk of Recurrence after Laparoscopic Incisional Hernia Repair

    PubMed Central

    McDermott, FD; Coleman, M; Ahmed, Z; Bunni, J; Bunting, D; Elshaer, M; Evans, V; Kimble, A; Kostalas, M; Page, G; Singh, J; Szczebiot, L; Wienand-Barnett, S; Wilkins, A; Williams, O; Newell, P

    2015-01-01

    Background Laparoscopic hernia repair is used widely for the repair of incisional hernias. Few case studies have focussed on purely ‘incisional’ hernias. This multicentre series represents a collaborative effort and employed statistical analyses to provide insight into the factors predisposing to recurrence of incisional hernia after laparoscopic repair. A specific hypothesis (ie, laterality of hernias as well as proximity to the xyphoid process and pubic symphysis predisposes to recurrence) was also tested. Methods This was a retrospective study of all laparoscopic incisional hernias undertaken in six centres from 1 January 2004 to 31 December 2010. It comprised a comprehensive review of case notes and a follow-up using a structured telephone questionnaire. Patient demographics, previous medical/surgical history, surgical procedure, postoperative recovery, and perceived effect on quality of life were recorded. Repairs undertaken for primary ventral hernias were excluded. A logistic regression analysis was then fitted with recurrence as the primary outcome. Results A total of 186 cases (91 females) were identified. Median follow-up was 42 months. Telephone interviews were answered by 115/186 (62%) of subjects. Logistic regression analyses suggested that only female sex (odds ratio (OR) 3.53; 95% confidence interval (CI) 1.39–8.97) and diabetes mellitus (3.54; 1–12.56) significantly increased the risk of recurrence. Position of the defect had no statistical effect. Conclusions These data suggest an increased risk of recurrence after laparoscopic incisional hernia repair in females and subjects with diabetes mellitus. These data will help inform surgeons and patients when considering laparoscopic management of incisional hernias. We recommend a centrally hosted, prospectively maintained national/international database to carry out additional research. PMID:25723687

  2. Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity

    SciTech Connect

    Wang, Jingbo; Cao, Jianzhong; Yuan, Shuanghu; Arenberg, Douglas; Stanton, Paul; Tatro, Daniel; Ten Haken, Randall K.; Kong, Feng-Ming

    2013-03-01

    Purpose: Poor pulmonary function (PF) is often considered a contraindication to definitive radiation therapy for lung cancer. This study investigated whether baseline PF was associated with radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) receiving conformal radiation therapy (CRT). Methods and Materials: NSCLC patients treated with CRT and tested for PF at baseline were eligible. Baseline predicted values of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and diffusion capacity of lung for carbon monoxide (DLCO) were analyzed. Additional factors included age, gender, smoking status, Karnofsky performance status, coexisting chronic obstructive pulmonary disease (COPD), tumor location, histology, concurrent chemotherapy, radiation dose, and mean lung dose (MLD) were evaluated for RILT. The primary endpoint was symptomatic RILT (SRILT), including grade ≥2 radiation pneumonitis and fibrosis. Results: There was a total of 260 patients, and SRILT occurred in 58 (22.3%) of them. Mean FEV1 values for SRILT and non-SRILT patients were 71.7% and 65.9% (P=.077). Under univariate analysis, risk of SRILT increased with MLD (P=.008), the absence of COPD (P=.047), and FEV1 (P=.077). Age (65 split) and MLD were significantly associated with SRILT in multivariate analysis. The addition of FEV1 and age with the MLD-based model slightly improved the predictability of SRILT (area under curve from 0.63-0.70, P=.088). Conclusions: Poor baseline PF does not increase the risk of SRILT, and combining FEV1, age, and MLD may improve the predictive ability.

  3. Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension

    PubMed Central

    Lin, Li-Te; Tsui, Kuan-Hao; Cheng, Jiin-Tsuey; Cheng, Jin-Shiung; Huang, Wei-Chun; Liou, Wen-Shiung; Tang, Pei-Ling

    2016-01-01

    Abstract Pregnancy-induced hypertension (PIH) may be a major predictor of pregnancy-associated intracranial hemorrhage (ICH). However, the relationship between PIH and long-term ICH risk is unknown. The objective of the study was to determine the association between PIH and ICH and to identify the predictive risk factors. Patients with newly diagnosed PIH were recruited from the Taiwan National Health Insurance Research Database. PIH patients were divided into gestational hypertension (GH) and preeclampsia groups. The 2 groups were separately compared with matched cohorts of patients without PIH based on age and date of delivery. The occurrence of ICH was evaluated in both cohorts. The overall observational period was from January 1, 2000 to December 31, 2013. Among the 23.3 million individuals registered in the National Health Insurance Research Database, 28,346 PIH patients, including 7390 with GH and 20,956 with preeclampsia, were identified. The incidences of ICH were increased in both groups (incidence rate ratio [IRR] = 3.72 in the GH group, 95% confidence interval [CI] 3.63–3.81, P < 0.0001 and IRR = 8.21 in the preeclampsia group, 95% CI 8.12–8.31, P < 0.0001, respectively). In addition, according to the results of stratification of follow-up years, both groups were associated with a highest risk of ICH at 1 to 5 years of follow-up (IRR = 11.99, 95% CI 11.16–12.88, P < 0.0001 and IRR = 21.83, 95% CI 21.24–22.44, P < 0.0001, respectively). After adjusting for age, parity, severity of PIH, number of PIH occurrences, gestational age, and comorbidities in the multivariate survival analysis using Cox regression model, age ≥30 years (hazard ratio [HR] 1.99, 95% CI 1.27–3.10, P = 0.0026), patients with preeclampsia (HR 2.18, 95% CI 1.22–3.90, P = 0.0089), multiple PIH occurrences (HR 4.08, 95% CI 1.85–9.01, P = 0.0005), hypertension (HR 4.51, 95% CI 1.89–10.74, P = 0.0007), and obesity (HR 7.21, 95

  4. ToRCH "co-infections" are associated with increased risk of abortion in pregnant women.

    PubMed

    Rasti, Sima; Ghasemi, Fatemeh Sadat; Abdoli, Amir; Piroozmand, Ahmad; Mousavi, Seyed Gholam Abbas; Fakhrie-Kashan, Zohreh

    2016-03-01

    ToRCH infections (toxoplasmosis, rubella, cytomegalovirus and Herpes simplex virus) have long been known to be associated with bad obstetric outcomes. However, little information is available about the impact of ToRCH co-infections on the outcome of pregnancy. Hence, we tested the IgG and IgM antibodies to Toxoplasma gondii, Rubella, Cytomegalovirus and Herpes Simplex Virus among 81 pregnant women with abortion (case group) and 98 pregnant women with normal delivery (control group). In the single-infection model, only CMV-IgM seropositivity was significantly increased in case than control group (25.9% in case and 12.2 % in control, OR = 2.5, P = 0.019). In the co-infection model, 14 patterns were recognized, but two patterns were significantly increased in the case than the control group. Co-infection of T. gondii IgG + CMV IgM was 9.1-fold increased in the case than the control group (8.6% in the case and 1% in control, OR = 9.1; P = 0.024). Also, co-infection of T. gondii IgG + HSV IgG + CMV IgM was 7.7-fold increased in case than the control group (7.4% in case and 1 % in control, OR = 7.7; P = 0.04). Although the OR of other co-infections was higher in the case than the control group, the difference was not statistically significant. These findings indicate that ToRCH co-infections are associated with increased risk of abortion than single infection. Hence, the rates of co-infections should be considered in prenatal screening of ToRCH infections.

  5. Risk factors associated with increased mortality of farmed Pacific oysters in Ireland during 2011.

    PubMed

    Clegg, Tracy A; Morrissey, Teresa; Geoghegan, Fiona; Martin, S Wayne; Lyons, Kieran; Ashe, Seán; More, Simon J

    2014-02-01

    The Pacific oyster, Crassostrea gigas, plays a significant role in the aquaculture industry in Ireland. Episodes of increased mortality in C. gigas have been described in many countries, and in Ireland since 2008. The cause of mortality events in C. gigas spat and larvae is suspected to be multifactorial, with ostreid herpesvirus 1 (OsHV-1, in particular OsHV-1μvar) considered a necessary, but not sufficient, cause. The objectives of the current study were to describe mortality events that occurred in C. gigas in Ireland during the summer of 2011 and to identify any associated environmental, husbandry and oyster endogenous factors. A prospective cohort study was conducted during 2010-2012, involving 80 study batches, located at 24 sites within 17 bays. All 17 bays had previously tested positive for OsHV-1μvar. All study farmers were initially surveyed to gather relevant data on each study batch, which was then tracked from placement in the bay to first grading. The outcome of interest was cumulative batch-level mortality (%). Environmental data at high and low mortality sites were compared, and a risk factor analysis, using a multiple linear regression mixed effects model, was conducted. Cumulative batch mortality ranged from 2% to 100% (median=16%, interquartile range: 10-34%). The final multivariable risk factor model indicated that batches imported from French hatcheries had significantly lower mortalities than non-French hatcheries; sites which tested negative for OsHV-1μvar during the study had significantly lower mortalities than sites which tested positive and mortalities increased with temperature until a peak was reached. There were several differences between the seed stocks from French and non-French hatcheries, including prior OsHV-1μvar exposure and ploidy. A range of risk factors relating to farm management were also considered, but were not found significant. The relative importance of prior OsHV-1μvar infection and ploidy will become clearer

  6. Donor Liver Small Droplet Macrovesicular Steatosis Is Associated With Increased Risk for Recipient Allograft Rejection.

    PubMed

    Choi, Won-Tak; Jen, Kuang-Yu; Wang, Dongliang; Tavakol, Mehdi; Roberts, John P; Gill, Ryan M

    2017-03-01

    Although donor livers with <30% large droplet macrovesicular steatosis (MaS) and/or small droplet MaS (irrespective of percentage) are considered safe to use, this consensus is based on variable definitions of MaS subtypes and/or without a reproducible scoring system. We analyzed 134 donor liver biopsies from allografts transplanted at University of California at San Francisco between 2000 and 2015 to determine whether large and/or small droplet MaS is a risk factor for poor outcomes. Large droplet MaS was defined as a fat droplet occupying greater than one half of an individual hepatocyte, with nuclear displacement, and scored as the percentage of total parenchymal area replaced by large fat droplets on ×40 magnification. Small droplet MaS was defined as 1 to several discrete fat droplets, each occupying less than one half of an individual hepatocyte, and scored as the percentage of remaining hepatocytes (ie, hepatocytes not occupied by large fat droplets) containing small fat droplets on ×200 magnification (ie, small droplet MaS is the percentage of "remaining hepatocytes" with small fat droplets, and "remaining hepatocytes" is defined as 100% minus percent large droplet MaS). Thus, total MaS equals the sum of large and small droplet MaS, which cannot exceed 100%. Electronic medical records were reviewed to determine outcomes. There was an increased risk for acute cellular rejection (hazard ratio=2.5, P=0.0108) and bile duct loss suggestive of chronic ductopenic rejection (hazard ratio=2.4, P=0.0130) in donor livers with ≥30% small droplet MaS. Large droplet MaS (up to 60%) was not associated with adverse outcomes. Patient survival was not adversely affected by steatosis. Excellent agreement on the estimation of large (weighted κ=0.682) and small droplet MaS (weighted κ=0.780) was achieved. Our approach to donor steatosis scoring can identify liver allograft recipients at increased risk for rejection and highlights the importance of distinguishing between

  7. Elevated glycated hemoglobin levels may increase the risk of atrial fibrillation in patients with diabetes mellitus

    PubMed Central

    Yang, Yu-Fan; Zhu, Wen-Qing; Cheng, Kuan; Chen, Qing-Xing; Xu, Ye; Pang, Yang; Liu, Gui-Jian; Ge, Jun-Bo

    2015-01-01

    Background: As the most common cardiac arrhythmia, atrial fibrillation (AF) is always accompanied with various complications if without detection and treatment timely. Blood-based pleiotropic molecule biomarkers have now been popularly applied in clinical detection. We hence performed this meta-analysis to evaluate the correlation of serum glycated hemoglobin (HbA1c) levels with the risk of AF in patients with diabetes mellitus (DM). Methods: Covering myriads of computerized databases, we identified potential relevant studies for statistical analysis. We used a standard reporting form to extract data from each included study. Newcastle-Ottawa Scale (NOS) criteria was used for methodological quality assessment. Statistical analyses were conducted with the STATA statistical software. Results: Six cohort studies in full text fulfilled our inclusion criteria, and following overestimation indicated that serum levels of HbA1c in DM patients with AF was higher than that in DM patients without AF (SMD = 0.67, 95% CI: 0.39-0.94, P < 0.001). Subgroup analyses by sample size and detection method implicated that elevated serum HbA1c levels exhibited significant correlations with an increased risk of AF in DM patients in the large-size subgroup (n ≥ 200), the small-size subgroup (n < 200), the high performance liquid chromatography (HPLC) subgroup and the non-HPLC subgroup (Large-size: SMD = 0.70, 95% CI: 0.38-1.03, P < 0.001; Small-size: SMD = 0.64, 95% CI: 0.09-1.19, P = 0.023; HPLC: SMD = 0.81, 95% CI: 0.49-1.12, P < 0.001; Non-HPLC: SMD = 0.36, 95% CI: 0.04-0.68, P = 0.029; respectively). Conclusion: Elevated serum HbA1c levels may be associated with an increased risk of AF in DM patients, possibly reflecting that serum HbA1c level might be a potential biomarker in the prediction of AF in DM patients. PMID:26064216

  8. Risk assessment tools to identify women with increased risk of osteoporotic fracture: complexity or simplicity? A systematic review.

    PubMed

    Rubin, Katrine Hass; Friis-Holmberg, Teresa; Hermann, Anne Pernille; Abrahamsen, Bo; Brixen, Kim

    2013-08-01

    A huge number of risk assessment tools have been developed. Far from all have been validated in external studies, more of them have absence of methodological and transparent evidence, and few are integrated in national guidelines. Therefore, we performed a systematic review to provide an overview of existing valid and reliable risk assessment tools for prediction of osteoporotic fractures. Additionally, we aimed to determine if the performance of each tool was sufficient for practical use, and last, to examine whether the complexity of the tools influenced their discriminative power. We searched PubMed, Embase, and Cochrane databases for papers and evaluated these with respect to methodological quality using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) checklist. A total of 48 tools were identified; 20 had been externally validated, however, only six tools had been tested more than once in a population-based setting with acceptable methodological quality. None of the tools performed consistently better than the others and simple tools (i.e., the Osteoporosis Self-assessment Tool [OST], Osteoporosis Risk Assessment Instrument [ORAI], and Garvan Fracture Risk Calculator [Garvan]) often did as well or better than more complex tools (i.e., Simple Calculated Risk Estimation Score [SCORE], WHO Fracture Risk Assessment Tool [FRAX], and Qfracture). No studies determined the effectiveness of tools in selecting patients for therapy and thus improving fracture outcomes. High-quality studies in randomized design with population-based cohorts with different case mixes are needed.

  9. Increased Cancer Mortality Risk for NASA's ISS Astronauts: The Contribution of Diagnostic Radiological Examinations

    NASA Technical Reports Server (NTRS)

    Dodge, C.W.; Picco, C. E.; Gonzalez, S. M.; Johnston, S. L.; Van Baalen, M.; Shavers, M.R.

    2009-01-01

    This viewgraph presentation reviews the radiation exposures and risks associated with long-term spaceflight on the International Space Station. NASA's risk model of cancer mortality is also presented.

  10. Exposure to Community Violence: Processes That Increase the Risk for Inner-City Middle School Children

    ERIC Educational Resources Information Center

    Salzinger, Suzanne; Ng-Mak, Daisy S.; Feldman, Richard S.; Kam, Chi-Ming; Rosario, Margaret

    2006-01-01

    An ecologically framed model is presented describing processes accounting for early adolescents' exposure to community violence in high-risk neighborhoods as a function of risk factors in four ecological domains assessed in the prior year. The model was tested for hypothesized pathways along which the combined domains of risk might operate. The…