Familiar Risk Research Articles

PATHOPHYSIOLOGICALASPECTS OF ARTERIAL HYPERTENSION TO INHABITANTS OF ZUBIN POTOK

<p>Artrial hypertension is a very serious social-medical probleme as such has an epidemic characteristics according to high prevalence at incidence frequency disease of young, a high death rate, there is also a somewhat difficult erly diagnosis at the early stages of illnes due to unspecified clinical examination in majority of diseased. On the basis of etiology, arterial hypertension is divived into: primary (essential) and secondary (symptomatologic). According to the current criteria, primary arterial hypertension is considered to be all the cases where etiology cannot identify only the cause or a specific structural change in a organ. It instead causes a larger number of etiological factors by their group actions which are called risk factors.Including the secondary hypertension all cases at arterial hypertension are classified und there can be seen a specific structural change in an organ and disorder of it's function. The aim of our work was to determinate which were the familiar risk factors in development of arterial hypertension and it's domination to inhabitants of Zubin Potok considering high prevalence of arterial hypertension out of 6500 inhabitants in the infirmary of Zubin Potok, 2450 patients are registrated with arterial hypertension. Examination is performed to 100 patients with primary arterial hypertension by prospectus analysis which are registrated consecutively in the interval of two months by biochemicals parametars, a height of systolic and dyastolic arterial pressure and BMI. By means of questionnaire the rest of risk factors are gathered with a piece of data smoking, alchoholism and stress. During the examination we determined that the most typics risk factor is disorder of metabolism of lypoproteins, and important pathothysiological mechanism in development of arterial hypertension is reduction of HDLcholesterol, which can be one of indirect indentifier of oxidative stress.</p>

The ‘Pokemon’ (ZBTB7) Gene: No Evidence of Association with Sporadic Breast Cancer

It has been proposed that the excess of familiar risk associated with breast cancer could be explained by the cumulative effect of multiple weakly predisposing alleles. The transcriptional repressor FBI1, also known as Pokemon, has recently been identified as a critical factor in oncogenesis. This protein is encoded by the ZBTB7 gene. Here we aimed to determine whether polymorphisms in ZBTB7 are associated with breast cancer risk in a sample of cases and controls collected in hospitals from North and Central Spanish patients. We genotyped 15 SNPs in ZBTB7, including the flanking regions, with an average coverage of 1 SNP/2.4 Kb, in 360 sporadic breast cancer cases and 402 controls. Comparison of allele, genotype and haplotype frequencies between cases and controls did not reveal associations using Pearson's chi-square test and a permutation procedure to correct for multiple test. In this, the first study of the ZBTB7 gene in relation to, sporadic breast cancer, we found no evidence of an association.

Propofol Sedation in Outpatient Colonoscopy by Trained Practice Nurses Supervised by the Gastroenterologist: a Prospective Evaluation of over 3000 Cases

Propofol has several advantages for sedation in endoscopic procedures. Sedation administered by anaesthesiologists is associated with high costs. In this study the safety of propofol sedation administered by trained practice nurses under the supervision of the gastroenterologist in a cohort of outpatients of an ambulatory practice for gastroenterology in Germany is evaluated. During a period of 21 months all patients referred to colonoscopy were eligible for this prospective observational study. The familiar CRC risk of the individuals, indication, completeness and results of the colonoscopy were registered together with the dose of propofol used. Propofol was administered by intermittent intravenous bolus titration by trained practice nurses under supervision of the gastroenterologist. Oxygen saturation, heart rate and blood pressure were recorded constantly during the procedure and adverse cardiopulmonary events were monitored by the endoscopy team. A respiratory event was defined as an episode of apnoea or laryngospasm requiring assisted ventilation. 23 % of the patients received supplemental oxygen. A total of 3641 colonoscopies were recorded. 33 individuals were sedated with midazolam and were excluded from the evaluation. 3610 individuals were sedated with propofol (119 +/- 39 mg, mean dose +/- S. D.). 40 % of the procedures were performed as combined gastroscopy and colonoscopy. The cecum was reached in 99 % of the colonoscopies. Respiratory events occurred in five patients (0.14 %). Assisted ventilation in all cases was performed by mask ventilation. Bradycardia (HF < 60/min) and arterial hypotension (RR < 90 mmHg) occurred in 0.5 and 0.3 % of the colonoscopies, respectively, but medical intervention was necessary only in 0.2 % for both types of event. Minor events of hypoxaemia were observed in 51 patients (1.4 %), but only 1/3 of these events occurred in patients supplemented with oxygen. Propofol can be administered safely for ambulatory colonoscopy by trained practice nurses, with careful monitoring under supervision of the gastroenterologist.

MRI in the Early Detection of Breast Cancer in Women with High Genetic Risk

Women with BRCA1 or BRCA2 germline mutations have an elevated risk of developing breast and/or ovarian cancer. Because of the early onset of the disease, screening of this group of women should start at an earlier age than in the general population. The association of breast magnetic resonance imaging (BMRI) and ultrasonography (US) with mammography (MX) and clinical breast examination (CBE) in the regular surveillance of these individuals has been proposed and seems to improve the early detection of breast cancer. Within a multicenter study started by the Istituto Superiore di Sanità (Rome), at the Istituto Nazionale Tumori of Milan (INT) we enrolled 116 women at high genetic risk for breast cancer; they were either BRCA1 or BRCA2 mutation carriers or had a strong family history of breast cancer. They underwent CBE, MX, US and BMRI once a year. Between June 2000 and April 2005, at INT 12 cancers were detected among the 116 screened individuals (10%). In this subgroup, 1 patient refused BMRI and in 2 cases US was not performed. With BMRI we found 11 cancers and 6 of them were detectable only by this technique. In these 6 cases, the size of the disease was less than 1 cm and MX was false negative due to irregularly nodular parenchyma in 4 cases and scar tissue or prosthesis in the other 2. US was not performed in 2 cases and was false negative in 4 cases. Three false positive results were found with BMRI: 1 case was considered suspect but related to hormonal influences; 1 case with the same pattern was sent for second-look US, which gave a negative result and BMRI review after 6 months showed normalization of the parenchyma; in the third case histology revealed the presence of adenosis. No false positive results were registered for MX. The aim of secondary prevention is the detection of cancer at its earliest stage. BMRI screening in women with BRCA1 or BRCA2 mutations or at high familiar risk appears to be highly sensitive and may detect mammographically occult disease. The accuracy of MR imaging is higher than that of conventional imaging but the technique is flawed by a lower specificity. In order to avoid unnecessary biopsies we believe that the combination of BMRI and conventional imaging can be very useful in screening women with a high genetic risk of breast cancer, especially with second-look evaluation by means of US when BMRI yields the only positive diagnostic result. Second-look US has been demonstrated to be of critical importance both in recognizing false positive BMRI results and in guiding biopsies, when necessary.

High-density screening of the Zbtb7gene in breast cancer patients

It has been proposed that the excess of the familiar risk associated with breast cancer could be explaining by multiple weakly predisposing alleles. Hence there is much interest in the search for low-penetrance genes/variants for breast cancer, which exist with high prevalence in the general population. Maeda and colleagues [1] recently identified the transcriptional repressor FBI1, which they called Pokemon (POK erythroid myeloid ontogenic factor), as a critical factor in oncogenesis. This protein is codified by the ZBTB7 gene ('zing finger and BTB domain containing 7'; GeneID, 51341). Mouse embyronic fibroblasts lacking Zbtb7 were completely refractory to oncogene-mediated cellular transformation. Conversely, FBI1 overexpression led to overt oncogenic transformation both in vitro and in vivo in transgenic mice. FBI1 can specifically repress the transcription of the tumor suppressor gene ARF (600160). Maeda and colleagues [1] found that FBI1 is aberrantly overexpressed in human cancers, and its expression levels predict biologic behavior and clinical outcome. On the other hand, tissue microarray analysis (TMA) in breast carcinomas has revealed high levels of Pokemon expression in a subset of these tumors. In addition, the genomic region where the ZBTB7 gene resides (19p13.3) is a hotspot for chromosomal translocations [2]. ZBTB7 is therefore a good candidate for a breast cancer low-penetrance gene. We aim to determine whether common polymorphisms (frequency ≥ 10%) in the ZBTB7 gene are associated with breast cancer risk in Spanish patients. A set of 22 validated binary SNP polymorphisms were selected from public databases (e.g. HapMap) and private databases (e.g. Celera and RealSNP) according to criteria of coverage (average 1 SNP/1.7 kb). These SNPs cover the flanking regions (10,000 bp), including the promoter region, introns, and coding non-synonymous SNPs. About 550 cases and 550 controls have been genotyped. Genotyping was performed using the MassARRAY SNP genotyping system (Sequenom Inc., San Diego, CA, USA). To our knowledge, this is the first time that the ZBTB7 gene has been analyzed in breast cancer patients. The results will be presented at the time of the congress and will be interpreted in the light of the worldwide population study shown in another presentation from the same authors.

Is CCTV a Social Benefit? A Psychometric Study of Perceived Social Risk

This study utilises psychometrics to quantitatively measure the social risk perception of a CCTV system, using spatial representation and multi-dimensional scaling. The psychometric measure presents the system as one of low dread and familiar risk. Multi-dimensional scaling presents the underlying dimensions of the system as a low sense of risk perception and low perceived community risk exposure. The CCTV system presents an acceptable social risk that outweighs community concern. However, it appears that the community maintains social concern over CCTV. Increases in the risk characteristics of control and involuntary exposure are demonstrated, although increased CCTV exposure does not change the overall sense of social risk. The CCTV system occupies a relatively safe and non-adversarial social position, supported by the community. But the risk characteristics indicate that there are underlying social concerns, that CCTV may not yet have found its true social risk perception measure and that social support is not necessarily robust.

Microalbuminuria, glycemic control, and blood pressure predicting outcome in diabetes type 1 and type 2

After years of controversy, there is no doubt that poor glycemic control is the main and fundamental basis for development of albuminuria and renal lesions in diabetes. Blood pressure elevation usually comes secondarily, at least in type 1 diabetes, but in type 2 diabetes, microalbuminuria and some blood pressure elevation may be present already with the diagnosis of diabetes, along with dyslipidemia. Genetic factors have been proposed to be important, and so far, analysis of genotypes has no place in clinical practice [1–3]. In many studies, microalbuminuria along with blood pressure elevation, even minor, is crucial to the later outcome of patients, and also regarding strategy for treatment. When microalbuminuria is found along with increased blood pressure, the prognosis is even poorer than with only one of these abnormalities present in the patients. Indeed, high blood pressure may be part of the family history of some patients and, therefore, again emerging as a familiar risk factor, although only relevant to few patients.

Improving the Odds for Avoiding Dementia in Advanced Age

Improving the Odds for Avoiding Dementia in Advanced Age

Risk aversion and risk loving in the small: a decomposition of the multivariate risk premium

AbstractThis note proposes a decomposition of the familiar scalar multivariate risk premium into components which can be easily interpreted in the context of consumer theory. The premium under consideration is the standard one used to ascertain the impact of price and income risk on consumer welfare. This proposed premium decomposition allows for a more intuitive identification of the detrimental and beneficial effects that arise from income and price risk. As an illustrative example, this decomposition is used to ascertain the welfare effects arising from the price fluctuations experienced by UK households over the period 1963–97.

Anthropometric Indices of School Children and Familiar Risk Factors

Background. Overweight in adolescence predicts adverse health effects in adulthood. We carried out a primary school health program and assessed children's growth and body composition. Methods. Were screened 869 (448 M, 421 F) primary school children: height, weight, four skinfolds, and four circumferences were measured. A family-reported questionnaire was used to determine family composition, history, and lifestyle. Results. Age was 118 ± 5 months, BMI 18 ± 3 kg/m 2. No difference by gender was observed as for BMI or blood pressure. Girls had higher skinfold thickness at the biceps (BCF), triceps (TCF), subscapular (SSF), and suprailiac (SIF) areas ( P < 0.001), hip and thigh circumferences ( P < 0.01), body fat percentage ( P < 0.001). Boys had higher waist circumference ( P < 0.01), waist/thigh ratio, and conicity index ( P < 0.001). Offspring BMI was correlated with birth weight ( P < 0.05), parental BMI and scholarship level ( P < 0.001), children blood pressure ( P < 0.001), and hours per day spent in television viewing ( P < 0.01). Family history for diabetes was associated with higher BMI, SSF, waist circumference ( P < 0.05), and upper thigh ( P < 0.01). Family history for hypertension was associated with higher SSF/TCF ratio ( P < 0.05). Conclusions. Three of 869 children had BMI >30 kg/m 2 (2 boys and 1 girl), 33 had BMI >25 kg/m 2 (17 boys and 16 girls). The percentages of children who could be considered overweight (BMI ≥95 th percentile of age- and sex-specific NHANES I reference data) were boys, 10.0%, and girls, 9.3%. Anthropometric and anamnestic data on child and family yield more accurate estimates of risk profile: fat distribution seems relevant for metabolic and cardiovascular disorders.

Prevención familiar del consumo de drogas

Objectivefamily prevention of drugs misuse is at an elementary stage in Spain. Despite it’s important role, the development of this tactic is deficient. In fact, now–a-days there are not evaluated models of universal, selective and indicated family prevention, able to adjust to the various familiar risk profiles regarding drugs use. This situation is quite different in the USA, where family prevention is receiving a considerable support from public authorities. Material and methodsreview of the literature concerning familiar etiology of drugs misuse, including English publications, in order to identify evaluated family prevention programmes with good empirical credit. Resultspractical implications of the programmes analysed are presented, grouped in seven parts: i) preventive agents and trainers, ii) family recruitment iii) incentives, iv) education and training sessions for families, v) components and contents of the programmes, vi) other methodological aspects of the intervention, viii) materials and viii) results. Conclusionsthe programs of drug family consumption prevention well assessed prove that they can improve important areas of the family functions and of fathers and children behaviour.

Biomedical characteristics of nine year old school children and their relationship with familiar risk factors for obesity and cardiovascular disease

Biomedical characteristics of nine year old school children and their relationship with familiar risk factors for obesity and cardiovascular disease

Predictors of intrusive thoughts and avoidance in women with family histories of breast cancer.

Having a family history of cancer is an important predictor of lifetime cancer risk. Individuals with family histories of cancer have been reported to experience symptoms of general distress and to have frequent intrusive thoughts and avoidance regarding cancer. To date, little is known about predictors of such distress. A relation between perception of cancer risk and distress has been suggested, but the possibility that prior cancer-related events may contribute to distress in these women has received little attention. The major aim of the study was to examine the contribution of the past experience of the death of a parent from cancer to distress in women at familiar risk for breast cancer. Women with family histories of breast cancer (Risk Group, N = 46) were assessed on the day of their yearly mammography screening and four to eight weeks after normal result notification in order to confirm the generalizability of their distress. Their levels of intrusive thoughts, avoidance, and perceived lifetime risk for breast cancer were significantly higher than those of women with no family histories of cancer who were not undergoing mammography (Comparison Group, N = 43), and this was true on both assessment days. Among the women in the Risk Group, those whose parent(s) had died of cancer had the highest levels of intrusive thoughts, avoidance, and perceived risk. Results suggested that perceived risk mediated the effect of this event on intrusive thoughts and avoidance regarding breast cancer. The findings are discussed in terms of theories of cognitive responses to traumatic and stressful life events. Implications for future research and interventions are discussed.

D107 Cardiovascular response to the handgrip in children: influence of the familiar cardiovascular risk and the body mass index

D107 Cardiovascular response to the handgrip in children: influence of the familiar cardiovascular risk and the body mass index

Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals

Objective: To conduct an in-depth examination of the environmental and behavioral circumstances associated with falls and near-falls experienced by elderly individuals and to evaluate the usefulness of reenactment as a method for studying falls. Design: Observational and self-report data of incidents were obtained through a reenactment procedure. Environmental characteristics were documented with physical measurements, visual inspection, and photography. Setting: Incidents occurred inside participants' homes, and reenactments were conducted at incident sites. Participants: Subjects were 15 community-dwelling, relatively healthy individuals, age 70 to 81 years. Main Outcome Measures: Incidents were analyzed to determine patterns of interaction of individuals' personal characteristics, environmental use behaviors, and environmental characteristics. Results: Seven patterns were identified: collisions in the dark, failing to avoid temporary hazards, preoccupation with temporary conditions, frictional variations between shoes and floor coverings, excessive environmental demands, habitual environmental use, and inappropriate environmental use. Conclusions: There is a dynamic interaction between environmental conditions and behavior involving use of the environment and its implications for falls in older people. Although some incidents involved familiar environmental and behavioral risk factors, less familiar factors also were critical contributors to the incidents. Successful elimination of these factors is likely to be closely related to an individual's perception that an environmental or environmental use problem is correctable, motivation to undertake changes in the environment, and a desire to integrate changes into daily activities.

The need for a theory of evidential weight

AbstractThere is a familiar risk of antinomy if fromxisEand p(xisH/xisE) =rit is permissible to infer p(xisH) =r, and what Carnap (1950) called “The requirement of total evidence” will not prevent such antinomies satisfactorily. What is needed instead is a properly developed theory of evidential weight.

Familiar risk of colorectal neoplasia and discrete polyposis: [formula omitted], L. Bonelli, L. Varesco, H. Aste and P. Strigini. Natl. Inst for Cancer Research (IST), Genova, Italy

Familiar risk of colorectal neoplasia and discrete polyposis: [formula omitted], L. Bonelli, L. Varesco, H. Aste and P. Strigini. Natl. Inst for Cancer Research (IST), Genova, Italy

Risk Factors for Trypanosoma cruzi Infection among Children in Central Brazil: A Case-Control Study in Vector Control Settings

This population-based case-control study was conducted in northern Goias State, central Brazil, in rural settings under vector control surveillance. One hundred forty-nine children seropositive for Trypanosoma cruzi antibodies, selected in a cross-sectional survey carried out in village schools, were compared with 298 seronegative classmate controls matched for age, sex, and place of residence. Information on potential environmental, familiar, and social economic risk factors for T. cruzi infection was collected during household visits, and interviews with parents and entomologic inspections of domestic and peridomestic environments were conducted. The presence of triatomines in dwellings or evidence of triatomine colonization was found to be statistically associated with seropositivity in children. The presence of exuviae and a report of triatomines indoors or outdoors by householders in the past were strong predictors of an infected child. Children from seropositive mothers had a 3.9-fold increase in the risk of having anti-T. cruzi antibodies after adjusting for the confounding variables, including triatomine capture, mother's age, and family size in multivariate analysis. Parent's report of vector presence showed a 97.7% sensitivity in identifying a dwelling with at least one seropositive child. The possibility of transplacental T. cruzi transmission and its implication for Chagas' disease control were considered.

Preventing falls in the elderly

Objective: To conduct an in-depth examination of the environmental and behavioral circumstances associated with falls and near-falls experienced by elderly individuals and to evaluate the usefulness of reenactment as a method for studying falls.Design: Observational and self-report data of incidents were obtained through a reenactment procedure. Environmental characteristics were documented with physical measurements, visual inspection, and photography.Setting: Incidents occurred inside participants' homes, and reenactments were conducted at incident sites.Participants: Subjects were 15 community-dwelling, relatively healthy individuals, age 70 to 81 years.Main Outcome Measures: Incidents were analyzed to determine patterns of interaction of individuals' personal characteristics, environmental use behaviors, and environmental characteristics.Results: Seven patterns were identified: collisions in the dark, failing to avoid temporary hazards, preoccupation with temporary conditions, frictional variations between shoes and floor coverings, excessive environmental demands, habitual environmental use, and inappropriate environmental use.Conclusions: There is a dynamic interaction between environmental conditions and behavior involving use of the environment and its implications for falls in older people. Although some incidents involved familiar environmental and behavioral risk factors, less familiar factors also were critical contributors to the incidents. Successful elimination of these factors is likely to be closely related to an individual's perception that an environmental or environmental use problem is correctable, motivation to undertake changes in the environment, and a desire to integrate changes into daily activities.