Age-matched Control Population Research Articles

Polymorphisms of BDNF and CACNA1C are not associated with cognitive functioning in bipolar disorder or healthy controls

ABSTRACTIntroduction: The cause of cognitive dysfunction in bipolar disorder (BD) is not well understood. BDNF and CACNA1C are two susceptibility genes for the disorder that have also been reported to be associated with cognitive deficits in the disorder, but the studies have been small and with conflicting results. We therefore attempted to replicate an association between cognitive dysfunction with the most commonly studied single nucleotide polymorphisms rs6265 and rs1006737.Methods: Regression models with five aggregated cognitive domains derived from a comprehensive test battery and IQ score were run using directly genotyped risk variants of SNPs rs6265 and rs1006737 as predictors with covariates as appropriate. Models were performed in a clinical sample of Swedish patients with BD (N = 114) and sex- and age-matched population controls (N = 104).Results: No significant associations (regardless of correction for multiple testing) between the BDNF and CACNA1C risk variants and cognitive functioning were found in either patients or controls.Conclusions: Our results do not support that the common genetic risk variants in rs6265 and rs1006737 are associated with cognitive dysfunction.

Body Size Changes Among National Collegiate Athletic Association New England Division III Football Players, 1956-2014: Comparison With Age-Matched Population Controls.

Collegiate football programs encourage athletes to pursue high body weights. To examine position-dependent trends over time in body size characteristics among football players in the National Collegiate Athletic Association Division III New England Small College Athletic Conference (NESCAC) from 1956 to 2014 and to compare the observed absolute and relative changes with those in age-matched male population controls. Descriptive laboratory study. Medical school affiliated with a NESCAC institution. Football team rosters from the 10-member NESCAC schools, available as public documents, were analyzed along with body size data from general population males aged 20 to 29 years from the National Health and Nutrition Examination Survey (NHANES). Body weight, height, and calculated body mass index were evaluated using analysis of variance, linear regression, and nonlinear regression to determine the distribution features of size variables and changes associated with time (year), school, and position. Among NESCAC linemen, absolute and relative changes over time in body weight and body mass index exceeded corresponding changes in the NHANES population controls. New England Small College Athletic Conference offensive linemen body weights increased by 37.5% from 1956 to 2014 (192 to 264 lb [86.4 to 118.8 kg]), compared with a 12% increase (164 to 184 lb [73.8 to 82.8 kg]) since 1961 in the NHANES population controls. Body mass index changed in parallel with body weight and exceeded 35 kg/m(2) in more than 30% of contemporary NESCAC offensive linemen. Among skill players in the NESCAC group, time-related changes in body size characteristics generally paralleled those in the NHANES controls. High body weight and body mass indices were evident in offensive linemen, even among those in Division III football programs with no athletic scholarships. These characteristics may be associated with adverse cardiovascular and metabolic outcomes. We need approaches to encourage risk modification in the postfootball lifestyles of these individuals.

Impact of Childhood Maltreatment on the Recognition of Facial Expressions of Emotions.

The development of the explicit recognition of facial expressions of emotions can be affected by childhood maltreatment experiences. A previous study demonstrated the existence of an explicit recognition bias for angry facial expressions among a population of adolescent Sierra Leonean street-boys exposed to high levels of maltreatment. In the present study, the recognition bias for angry facial expressions was investigated in a younger population of street-children and age-matched controls. Participants performed a forced-choice facial expressions recognition task. Recognition bias was measured as participants’ tendency to over-attribute anger label to other negative facial expressions. Participants’ heart rate was assessed and related to their behavioral performance, as index of their stress-related physiological responses. Results demonstrated the presence of a recognition bias for angry facial expressions among street-children, also pinpointing a similar, although significantly less pronounced, tendency among controls. Participants’ performance was controlled for age, cognitive and educational levels and for naming skills. None of these variables influenced the recognition bias for angry facial expressions. Differently, a significant effect of heart rate on participants’ tendency to use anger label was evidenced. Taken together, these results suggest that childhood exposure to maltreatment experiences amplifies children’s “pre-existing bias” for anger labeling in forced-choice emotion recognition task. Moreover, they strengthen the thesis according to which the recognition bias for angry facial expressions is a manifestation of a functional adaptive mechanism that tunes victim’s perceptive and attentive focus on salient environmental social stimuli.

Serum IGF-1 is higher in patients with idiopathic normal pressure hydrocephalus than in the population

BackgroundHypopituitarism has been reported in patients with idiopathic normal pressure hydrocephalus (iNPH), which could enhance characteristic symptoms like impaired wakefulness, gait, body balance, and subcortical cognitive deterioration. PurposeTo compare basal serum levels of pituitary and sex hormones and serum insulin-like growth factor-1 (S-IGF-1) in patients with iNPH and an age-matched control population, and to correlate the preoperative hormone levels with symptoms and signs pre-operatively and three months after surgery. MethodsA cross-sectional case control design was used. Patients diagnosed with iNPH, n=108 (65 men and 43 women, mean age 72.3years), were consecutively included during 2006–2011 at Sahlgrenska University Hospital, Gothenburg, Sweden. S-TSH, S-free T4, S-FSH, S-LH, S-prolactin, plasma ACTH, S-testosterone, S-oestradiol and S-IGF-1 were examined. Symptoms and signs were scored using the iNPH scale score. Population controls, n=146, were recruited from the WHO MONICA project, Gothenburg in 2008. ResultsMen and women with iNPH had higher S-IGF-1 than controls (p<0.001). Women with iNPH had lower S-TSH (p=0.016) than controls, but the frequency of levothyroxine substitution was similar. Among men, a higher level of S-IGF-1 was associated with milder symptoms, while higher levels of S-FSH and S-LH were associated with more severe symptoms. ConclusionsPatients with iNPH did not have lower levels of pituitary or sex hormones but presented with higher levels of S-IGF-1, compared with healthy, age-matched controls. Higher S-IGF-1 in men was related to milder mental and physical symptoms and signs.

Facial Scanning With a Digital Camera

We hypothesize that patients with primary angle closure (PAC) have common significant facial characteristics that set them apart from an age-matched, sex-matched, and race-matched control population. The primary objective of this study was to test whether a 3-dimensional (3D) camera could pick up these differences in order to differentiate PAC patients from controls. A total of 55 patients with PAC and 38 controls were included in the study. Cases and controls had their facial photographs taken using a 3-dimensional digital camera (3dMdFace System). The facial features in the captured photographs were analyzed using a computer software (Neural Network Toolbox). A regression formula was devised to show whether these facial parameters could be used to distinguish between patients and controls. Thirteen facial parameters were measured, and using a regression formula and neural network classification we were able to mathematically distinguish patients from controls using this method of screening. PAC patients have distinct facial features that may be differentiated from those of normal individuals mathematically using 3D photography. There is potential for this 3D facial scanning technology in screening for PAC in the general population.

Caring for the adult survivor of Hodgkin lymphoma: highlighting the need for care coordination.

Caring for the adult survivor of Hodgkin lymphoma: highlighting the need for care coordination.

Childhood leukemia and 50 Hz magnetic fields: findings from the Italian SETIL case-control study.

We report on an Italian case-control study on childhood leukemia and exposure to extremely low frequency magnetic fields (ELF-MF). Eligible for inclusion were 745 leukemia cases, aged 0–10 years at diagnosis in 1998–2001, and 1475 sex- and age-matched population controls. Parents of 683 cases and 1044 controls (92% vs. 71%) were interviewed. ELF-MF measurements (24–48 h), in the child’s bedroom of the dwelling inhabited one year before diagnosis, were available for 412 cases and 587 controls included in the main conditional regression analyses. The magnetic field induction was 0.04 μT on average (geometric mean), with 0.6% of cases and 1.6% of controls exposed to >0.3 μT. The impact of changes in the statistical model, exposure metric, and data-set restriction criteria was explored via sensitivity analyses. No exposure-disease association was observed in analyses based on continuous exposure, while analyses based on categorical variables were characterized by incoherent exposure-outcome relationships. In conclusion, our results may be affected by several sources of bias and they are noninformative at exposure levels >0.3 μT. Nonetheless, the study may contribute to future meta- or pooled analyses. Furthermore, exposure levels among population controls are useful to estimate attributable risk.

Histopathological Findings and Proliferative Activity of Canine Sebaceous Gland Tumours with a Predominant Reserve Cell Population

Sebaceous gland tumours represent the third most common skin tumours in dogs, but diagnostic criteria for tumours with basal differentiation (i.e. sebaceous epithelioma) are poorly defined and there is lack of correlation with biological behaviour. The aim of this study was to identify the main histological criteria associated with malignancy in 30 canine sebaceous gland tumours with a predominant reserve cell population. For each case, tumour proliferative activity was assessed by determining mitotic index and the Ki67/MIB-1 index. Additional histological features included endophytic or exophytic growth, proportion of reserve/intermediate/mature cells, connection to the epidermis, nuclear characteristics, peripheral invasion, neoplastic emboli and necrosis. Mitotic and Ki67 indexes were variable, but correlated (R = 0.66; P < 0.001), and both were significantly higher in infiltrative tumours (P = 0.018 and P < 0.001, respectively). No significant difference in histological features was observed between tumours comprised of more or less than 90% reserve cells, nor among tumours showing proliferative activity in sebocytes. This study suggests that high proliferative activity and peripheral invasion should be considered the most significant parameters for the differentiation between benign and malignant sebaceous gland tumours. Furthermore, the incidence of circumanal gland and testicular tumours in these dogs was significantly higher compared with an age-matched control population, suggesting a potential androgen-related pathway for the tumourigenesis of canine sebaceous gland neoplasms.

Tubal Ligation and Salpingectomy and the Risk of Epithelial Ovarian Cancer and Borderline Ovarian Tumors

Objective According to the recent theories on the ovarian cancer origin, any protective effect of tubal ligation may vary with histologic subtype of ovarian cancer. Furthermore, bilateral salpingectomy may represent an opportunity for surgical prevention of serous ovarian cancer. Design Nationwide register-based case–control study. Setting Denmark during 1982–2011. Population Cases were all Danish women diagnosed with epithelial ovarian cancer (n = 13 241) or borderline ovarian tumor (n = 3605) in the study period. Age-matched female population controls were randomly selected by risk set sampling. We required that cases and controls have no previous cancer and that controls have no previous bilateral oophorectomy. Methods Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders. Main outcome measures Epithelial ovarian cancer and borderline ovarian tumors stratified according to histology. Results Tubal ligation reduced overall epithelial ovarian cancer risk (odds ratios 0.87; 95% confidence interval 0.78–0.98). We observed significant risk variation according to histology (p = 0.003) with the strongest risk reductions associated with endometrioid cancer (odds ratios 0.66; 95% confidence interval 0.47–0.93) and epithelial ovarian cancer of “other” histology (odds ratios 0.60; 95% confidence interval 0.43–0.83). Tubal ligation was not associated with risk of borderline ovarian tumors. Finally, bilateral salpingectomy reduced epithelial ovarian cancer risk by 42% (odds ratios 0.58; 95% confidence interval 0.36–0.95). Conclusions We confirmed that tubal ligation reduces the risk of epithelial ovarian cancer and particularly endometrioid cancer. To our knowledge, this is the first observational publication to report on salpingectomy and ovarian cancer risk and our promising findings warrant further investigation.

Premature ejaculation is associated with glycemic control in Type 1 diabetes.

Premature ejaculation (PE) is the most common male sexual dysfunction. Its prevalence in Type 1 diabetes is unknown. The aim of this study was to assess the prevalence of PE in Type 1 diabetes and the influence of glycemic control on ejaculatory function. One hundred Type 1 diabetic male patients (age < 40 years) and 51 age-matched nondiabetic control subjects were evaluated for PE. A subgroup of 30 diabetic patients (20 with PE and 10 without) were also evaluated for blood glucose variability. The presence of PE was assessed with the premature ejaculation diagnostic tool (PEDT) and the self-estimated intravaginal ejaculatory latency time (IELT). Glucose variability was evaluated by continuous glucose monitoring for a 7-day period with a DexCom G4 CGM system: the mean amplitude of glycemic excursions (MAGEs), low (LBGI) and high (HBGI) blood glucose indices, and the standard deviation of blood glucose (BGSD) were calculated. PE prevalence did not differ significantly between the two groups: pathological values of the PEDT score (>8) and IELT score (<1 minute) were recorded in 24 out of 100 diabetic patients (24%) and in 12 out of 51 controls (23.5%). There were significant associations between hemoglobin A1c and the PEDT score (r = 0.27; P = 0.006) and IELT (r = -0.3; P = 0.01). In the subgroup assessed for glucose variability, the PEDT score was associated with LBGI (r = 0.43; P = 0.01), but not with BGSD (r = 0.1, P = 0.6), MAGE (r = -0.1; P = 0.4), or HBGI (r = 0.1; P = 0.6). Our results show a similar prevalence of PE in young male patients with Type 1 diabetes and in the age-matched control population; in diabetic patients with PE, a higher glycemic variability in the hypoglycemic domain is significantly associated with the PEDT score.

A Meta-Analytic Comparison of Cerebral Blood Flow As Measured By MRI in Children with Sickle Cell Disease Versus Healthy Controls

Stroke and its neurocognitive sequelae are devastating complications of sickle cell disease (SCD). Cerebral blood flow (CBF), a measure of tissue specific blood flow in the brain, is a key part of cerebral metabolism, and can provide insight into the pathophysiology of the neurologic complications of SCD. Previous work suggests that CBF is elevated in SCD patients compared to healthy controls (HC). Elevated CBF likely represents a compensatory mechanism to maintain cerebral oxygen delivery and metabolism in the setting of decreased arterial oxygen content secondary to chronic anemia. Previous studies are limited by small sample size and variations in imaging technique, making meta-analysis an alluring method for obtaining large numbers of participants to determine and compare population norms. Therefore, we performed a systematic meta-analysis to establish normal CBF values as measured by arterial spin labeled perfusion MR imaging (ASL) in pediatric HC and SCD populations, hypothesizing that CBF would be elevated in children with SCD when compared to a HC cohort.A systematic literature search was performed in 02/2014 for the HC cohort, and 06/2014 for the SCD cohort in Medline, Embase, and CINAHL. Whole brain cerebral blood flow (WB-CBF) measurements obtained by ASL in participants from 1 - 18 years (yr) were necessary for inclusion in both cohorts, and a diagnosis of hemoglobin SS or hemoglobin S-Beta thalassemia null for inclusion in the SCD cohort. ASL is the preferred imaging modality for CBF in pediatrics because ASL non-invasively measures CBF without the use of an exogenous contrast agent or ionizing radiation exposure. Data was excluded from the HC cohort if a medical disorder known to affect CBF was reported. Analysis included determination of mean WB-CBF values weighted by the inverse variance with 95% confidence intervals (CI) stratified by mean age, which was categorized as 1-9 yr and 9-18 yr secondary to known CBF changes throughout development. Statistical heterogeneity, or between-study variability, was assessed with Cochrane’s Χ2 and I2. An I2 value greater than 30% was used as the threshold for analysis with a random-effects model. A funnel plot of the effect estimates versus the sample size for each individual study was used to assess for publication bias. Metaregression was used to determine the contribution of covariates to between-study heterogeneity in measurements of WB-CBF. All analyses were performed with STATA 13.1 (College Station, Texas) using the METAN software package.The literature search produced 155 articles for HC patients, and 12 articles for SCD patients; 8 publications met the inclusion and exclusion criteria for the HC cohort (89 children) and 4 publications for SCD cohort (92 children). Between the ages of 1 – 9 yr, mean WB-CBF in HC children was 67.6 ml/100 g/min (95% CI 37.9, 97.2), and mean WB-CBF in children with SCD was 117.0 ml/100 g/min (95%CI 48.7, 185.4). Between the ages of 10 – 18 yr, mean WB-CBF in HC children was 60.8 ml/100 g/min (95% CI 37.7, 83.9), and mean WB-CBF in children with SCD was 68.4 ml/100 g/min (95% CI 50.5, 86.3) (figures 1 and 2). The difference between the two cohorts is not statistically significant because of overlapping CI. The CochraneÕs X2 was significant with a p < 0.001 in all 4 analysis, with the I2 for each analysis ranging from 93.1% - 98.9%, indicating significant between-study heterogeneity. Mean age, ASL labeling technique, MRI vendor, and magnet strength, were not significant predictors of between-study heterogeneity within the HC cohort after controlling for multiple comparisons with the Bonferroni correction. Metaregression analysis of the SCD cohort could not be performed secondary to insufficient number of studies. Visual inspection of funnel plots did not provide evidence of publication bias.Mean WB-CBF as determined by meta-analysis in younger SCD patients is higher than mean WB-CBF in HC children, with little difference seen in older children. These findings suggest that younger children with SCD require increased compensation via elevated CBF to maintain cerebral oxygen metabolism when compared to older children. The significant between-study heterogeneity and wide CI illustrate a need to standardize the ASL technique for CBF measurement within pediatric HC and SCD populations, and the importance of including an age-matched control population when measuring CBF in SCD children. [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Seminal megavesicle in autosomal dominant polycystic kidney disease

Retrospective analysis of 99 male autosomal dominant polycystic kidney disease (ADPKD) patients compared to an age-matched control population showed seminal vesicle ectasia >10 mm (megavesicle) in 23% (23/99) of ADPKD patients that was not present in any controls (P<.0001). Median (range) seminal vesicle convoluted tubule diameter in ADPKD patients was 4.2 (1.7–30) mm compared to 3.1 (1.7–6.8) mm in controls (P<.0001). Discrete cysts were identified in four ADPKD patients but in none of the control population (P=.12). Seminal megavesicles may explain the infertility sometimes observed in male ADPKD patients.

Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: a nationwide case-control study.

According to the recent theories on the ovarian cancer origin, any protective effect of tubal ligation may vary with histologic subtype of ovarian cancer. Furthermore, bilateral salpingectomy may represent an opportunity for surgical prevention of serous ovarian cancer. Nationwide register-based case-control study. Denmark during 1982-2011. Cases were all Danish women diagnosed with epithelial ovarian cancer (n=13241) or borderline ovarian tumor (n=3605) in the study period. Age-matched female population controls were randomly selected by risk set sampling. We required that cases and controls have no previous cancer and that controls have no previous bilateral oophorectomy. Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders. Epithelial ovarian cancer and borderline ovarian tumors stratified according to histology. Tubal ligation reduced overall epithelial ovarian cancer risk (odds ratios 0.87; 95% confidence interval 0.78-0.98). We observed significant risk variation according to histology (p=0.003) with the strongest risk reductions associated with endometrioid cancer (odds ratios 0.66; 95% confidence interval 0.47-0.93) and epithelial ovarian cancer of "other" histology (odds ratios 0.60; 95% confidence interval 0.43-0.83). Tubal ligation was not associated with risk of borderline ovarian tumors. Finally, bilateral salpingectomy reduced epithelial ovarian cancer risk by 42% (odds ratios 0.58; 95% confidence interval 0.36-0.95). We confirmed that tubal ligation reduces the risk of epithelial ovarian cancer and particularly endometrioid cancer. To our knowledge, this is the first observational publication to report on salpingectomy and ovarian cancer risk and our promising findings warrant further investigation.

The sense-of-coherence predicts health-related quality of life and emotional distress but not disability in Parkinson's disease.

BackgroundPersonality traits are deemed important in many fields of Medicine. The present study aimed at evaluating i) the presence of Sense-of-Coherence (SOC) in patients suffering from Parkinson’s Disease (PD) in comparison with an age-matched general control population, ii) the influence of SOC on health-related variables, such as depression and anxiety, quality of life (Qol), and activities of daily living (ADL).MethodsSOC was measured in 50 PD patients and in 50 matched controls enrolled in cross-sectional study. The other clinical measures included: Mini Mental State Examination (MMSE), Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Well-being Index (WHO-5), Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of ADL (BI). Data were analysed with univariate statistics and loglinear adjusted regression models.ResultsNo difference emerged between PD and controls on socio-demographic and SOC. A statistically significant positive correlation was found between SOC and Qol (0.40, p < 0.004) and a negative significant correlation between SOC and emotional distress (−0.37, p < 0.008). The multivariate regression analysis confirmed the negative effect of SOC on total emotional distress (−3%, p = 0.01) and positive effect on Qol (2%, p = 0.01). SOC and BI were uncorrelated.ConclusionsSOC is predictive of QoL and emotional distress in PD, whereas no evidence of a predictive effect for disability could be found. These results support only partially, the Salutogenic Theory in PD, i.e. a strong SOC positively influences psychosocial health, but does not influence physical health.

Abstract 561: A natural copy number variant in the GAEC1 oncogene is associated with breast cancer susceptibility

Abstract The recently discovered GAEC1 oncogene, located at 7q22, has been found to be amplified in esophageal and colorectal cancers and is associated with altered clinical characteristics in those diseases. Amplification studies in these cancers showed variation in copy number in normal tissues, indicating a potential natural copy number variant (CNV) of GAEC1. In this research, the presence of such a CNV and its association with sporadic breast cancer development was tested in a population of 190 Caucasian women with breast cancer and a population of age, sex and ethnicity matched controls. Data produced by qPCR confirmed the presence of a CNV for GAEC1 in both cancer and control populations, with three common copy number types and several uncommon values, representing up to a 64-fold difference in GAEC1 copies. In addition, Chi-square analysis of copy number types indicated that increased GAEC1 copy number is associated with cancer development. This includes analysis using only the common copy number types (p=0.05) as well as considering all genotypes on a High/Low gene dosage basis (p=0.03). Overall risk for breast cancer was found to be slightly increased in high dose individuals (OR 1.552 (95% CI 1.035-2.338)). These results indicate that GAEC1 may be an important gene in the development of breast cancer, and that examination of its copy number in patient DNA may be a useful addition to genetic risk markers in sporadic cases. Citation Format: Vinod Gopalan, Robert A. Smith, Suja Pillai, Lyn R. Griffiths, Alfred K-Y Lam. A natural copy number variant in the GAEC1 oncogene is associated with breast cancer susceptibility. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 561. doi:10.1158/1538-7445.AM2014-561

A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass*.

Coronary artery bypass surgery, performed with or without cardiopulmonary bypass, is frequently followed by postoperative cognitive decline. Near-infrared spectroscopy is commonly used to assess cerebral tissue oxygenation, especially during cardiac surgery. Recent studies have suggested an association between cerebral desaturation and postoperative cognitive dysfunction. We therefore studied cerebral oxygen desaturation, defined as area under the cerebral oxygenation curve < 40% of > 10 min.%, with respect to cognitive performance at 4 days (early) and 3 months (late) postoperatively, compared with baseline, using a computerised cognitive test battery. We included 60 patients, of mean (SD) age 62.8 (9.4) years, scheduled for elective coronary artery bypass grafting, who were randomly allocated to surgery with or without cardiopulmonary bypass. Cerebral desaturation occurred in only three patients and there was no difference in cerebral oxygenation between the two groups at any time. Among patients who received cardiopulmonary bypass, 18 (62%) had early cognitive decline, compared with 16 (53%) in the group without cardiopulmonary bypass (p = 0.50). Three months after surgery, 11 patients (39%) in the cardiopulmonary bypass group displayed cognitive dysfunction, compared with four (14%) in the non-cardiopulmonary bypass group (p = 0.03). The use of cardiopulmonary bypass was identified as an independent risk factor for the development of late cognitive dysfunction (OR 6.4 (95% CI 1.2-33.0) p = 0.027. In conclusion, although cerebral oxygen desaturation was rare in our population, postoperative cognitive decline was common in both groups, suggesting that factors other than hypoxic neuronal injury are responsible.

Incidence of diabetes among patients with colorectal cancer.

393 Background: Emerging data show an increasingly recognized risk of colorectal cancer (CRC) in patients with type 2 diabetes (DM) likely due to common biologic pathways. Few data are available on DM incidence among patients with CRC. Our objective was to determine whether patients with CRC have a higher incidence of DM compared to those without CRC. Methods: We conducted a population-based retrospective cohort study in Ontario, Canada, using administrative databases comparing the incidence of DM among all CRC patients identified in the Ontario Cancer registry from Jan 1, 2002 to Dec 31, 2011 with an age-matched control population without CRC. We used Cox proportional hazard to study the association. We modeled the effect of CRC on the cause-specific hazard of developing DM and censored subjects at the time of a competing event. Subgroup analysis was performed on patients receiving chemotherapy vs. not, metastatic disease vs. not and colon vs. rectal cancer. Results: We identified 39,707 persons with CRC and 198,535 controls. The mean age was 68 and 48.6% were female. We found an overall DM incidence of 8.7% over a mean follow up time of 4.8 years. On multivariable analysis, the effect of CRC on the instantaneous hazard of the DM incidence varied over time, and thus we estimated instantaneous hazard ratios (IHR) for years 1-5 of follow up. The risk of DM among CRC patients was significantly higher than controls for at least five years post CRC diagnosis. The overall DM incidence was higher in patients with no metastasis (10.6% vs 8.6%, p&lt;0.01), and lower in patients who received chemotherapy (8.0% vs 9.0%, p&lt;0.01). Conclusions: This is among the first study to report an increased DM incidence among CRC survivors. This association may be due to common risk factors rather than a treatment effect, as the risk remains elevated for at least five years post diagnosis. The hazard may be underestimated, as patients with advanced cancer may not be formally diagnosed with DM. These results strengthen our understanding of the common biologic pathway of both diseases and have major implications for survivorship care in patients with CRC. [Table: see text]

Diabetes mellitus and suicide.

Relationship of diabetes mellitus (DM) with metal health disorders such as depression has been explored extensively in the published literatures. However, association of diabetes mellitus with suicidal tendencies has been evaluated less extensively. The present narrative review aimed to assess the literature relating to diabetes mellitus and suicide. As a part of the review, Pubmed and Google Scholar databases were searched for English language peer reviewed published studies with keywords relating to diabetes and suicide. Additional references were identified using cross-references. The available literature suggests that suicidal ideas and attempts are more frequent in patients with diabetes mellitus than healthy or medically ill controls. Although, a few studies report evidence to the contrary. Suicide accounts for a large proportion of deaths in patients with diabetes mellitus type I (T1DM), and their mortality rate is higher than that of age matched control population. Psychological morbidity, including depression, precedes suicidal ideas and attempts; though many other factors can be hypothesized to impact and modulate this association. A common method of suicide attempt in patients with diabetes includes uses of high doses of insulin and its congeners or medications to treat the disease. Regular screening and prompt treatment of depression and suicidality is suggested for patients with DM.

Statin use and risk of prostate cancer: A Danish population-based case-control study, 1997–2010

Purpose: Conflicting evidence has suggested that statins possess chemopreventive properties against prostate cancer (PCa). Therefore, we examined the association between statin use and risk of PCa in a Denmark-based case-control study. Materials and methods: We identified 42,480 patients diagnosed with incident PCa during 1997–2010 from a national cancer registry. Five age-matched population controls (n=212,400) were selected for each case using risk-set sampling. Statin use from 1996 to the index date was obtained from the National Prescription Registry. Odds ratios (ORs) adjusted for age, comorbidity, non-steroidal anti-inflammatory drug use, and educational level for PCa associated with statin use, were computed using conditional logistic regression. Analyses were stratified by duration of statin use (0–1, 2–4, 5–9, or ≥10 years), stage of PCa (localized or advanced), and type of statin used (lipophilic or hydrophilic). Results: In total, 7915 patients (19%) and 39,384 controls (19%) redeemed statin prescriptions prior to the index date. Overall, statin users had a 6% lower risk of PCa compared with non-users [adjusted OR (ORa), 0.94; 95% confidence interval (CI), 0.91–0.97]. Risk estimates did not differ substantially by duration or type of statin used. Slightly larger statin use-associated risk reductions were observed for advanced PCa (ORa, 0.90; 95% CI, 0.85–0.96) and with statin use ≥10 years (ORa, 0.78; 95% CI, 0.65–0.95). Conclusion: Statin use was associated with a risk reduction overall (6%) and, specifically with advanced PCa (10%). Differences in diagnostic measures and residual confounding by socioeconomic parameters may have influenced our results.

Does marriage protect against hospitalization with pneumonia? A population-based case-control study.

BackgroundTo reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle.Patients and methodsIn this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark’s Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs) for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children.ResultsThe study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7%) or never married (13% versus 11%). Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively) compared with married (3%) and widowed (6%) patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25–1.33) among divorced; 1.15 (95% CI: 1.12–1.17) among widowed; and 1.33 (95% CI: 1.29–1.37) among never-married individuals as compared with those who were married.ConclusionMarried individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients.