Number Of First-degree Relatives Research Articles

The Burden of Chronic Diseases with the Status of Family Medical History Among Older Adults in India.

This study aims to assess and compare the prevalence of chronic diseases by the first-degree Family Medical History (FMH) and also explores the relationship between FMH and selected Non-communicable diseases (NCDs) among older adults in India. The present study collated secondary data from the Longitudinal Ageing Study in India (LASI, 2017-18). The eligible respondents for the analysis of this study were aged 45years and above, where the final study sample consistedof 65,562 older adults across all Indian states and union territories. The LASI dataset collected responses onself-reported diseases: Hypertension, Stroke, Heart disease, Cancer, and Diabetes. These diseases have a high prevalence among the population and are considered in the present study. Along with disease status, respondents' first-degree relatives FMH were used to fulfil the objective. Descriptive statistical analysis and multiple logistic regression techniques were used to accomplish the objectives analysis. This approach was chosen due to the binary nature of our primary dependent variables. The study found that the prevalence of selected NCDs was considerably higher among older adults with FMH than those without FMH. It revealed that NCDs and the status of FMH of parents and siblings were significantly associated. Based on the multivariate-adjusted model, we foundsignificantly higher odds for developing the NCDs when the respondents have FMH among at least one of the first-degree relative. The likelihood among those with FMHof having hypertension (AOR: 2.058), diabetes (AOR: 2.94), heart diseases (AOR: 2.39), stroke (AOR: 1.62) and cancer (AOR: 2.32) was higher compared to no FMH of respective diseases. Similarly, significant associations were observed according to the different stratification of the number offirst-degree relatives FMH. The present study demonstrated that first-degree relatives FMH is indeed a dominant associated risk factor for chronic disease among the older adults of India. This study supports the promotion of a disease history tool for chronic disease prevention and early detection approaches as a valuable measure of NCD risk. Public health practitioners can take several steps to access FMH and incorporate FMH into public health programs for the screening of the risk population.

Novel subtype of obesity influencing the outcomes of sleeve gastrectomy: Familial aggregation of obesity.

Differences in the preoperative characteristics and weight loss outcomes after sleeve gastrectomy (SG) between patients with familial aggregation of obesity (FAO) and patients with sporadic obesity (SO) have not been elucidated. To explore the impact of SG on weight loss and the alleviation of obesity-related comorbidities in individuals with FAO. A total of 193 patients with obesity who underwent SG were selected. Patients with FAO/SO were matched 1:1 by propensity score matching and were categorized into 4 groups based on the number of first-degree relatives with obesity (1SO vs 1FAO, 2SO vs 2FAO). The baseline characteristics, weight loss outcomes, prevalence of obesity-related comorbidities and incidence of major surgery-related complications were compared between groups. We defined FAO as the presence of two or more first-degree relatives with obesity. Patients with FAO did not initially show significant differences in baseline data, short-term postoperative weight loss, or obesity-related comorbidities when compared to patients with SO preoperatively. However, distinctions between the two groups became evident at the two-year mark, with statistically significant differences in both percentage of total weight loss (P = 0.006) and percentage of excess weight loss (P < 0.001). The FAO group exhibited weaker remission of type 2 diabetes mellitus (T2DM) (P = 0.031), hyperlipidemia (P = 0.012), and non-alcoholic fatty liver disease (NAFLD) (P = 0.003) as well as a lower incidence of acid reflux (P = 0.038). FAO patients is associated with decreased mid-to-long-term weight loss outcomes; the alleviation of T2DM, hyperlipidemia and NAFLD; and decreased incidence of acid reflux postoperatively.

Association of inflammatory bowel disease in first-degree relatives with risk of colorectal cancer: A nationwide case-control study in Sweden.

This study aims to assess the association between inflammatory bowel disease (IBD) history in first-degree relatives (FDRs) and colorectal cancer (CRC) risk. We conducted a nationwide case-control study in Sweden among 69 659 CRC cases and 343 032 non-CRC controls matched on age, sex, birth year and residence county. Through linkage of multi-generation register and the nationwide ESPRESSO (Epidemiology Strengthened by histoPathology Reports in Sweden) cohort, we ascertained IBD diagnoses among parents, full siblings and offspring of the index individuals. Odds ratios (ORs) of CRC associated with IBD family history were calculated using conditional logistic regression. 2.2% of both CRC cases (1566/69659) and controls (7676/343027) had ≥1 FDR with IBD history. After adjusting for family history of CRC, we observed no increased risk of CRC in FDRs of IBD patients (OR, 0.96; 95%CI, 0.91-1.02). The null association was consistent according to IBD subtype (Crohn's disease or ulcerative colitis), number of FDRs with IBD (1 or ≥ 2), age at first IBD diagnosis in FDRs (<18, 18-39, 40-59 or ≥60 years), maximum location/extent of IBD or FDR relation (parent, sibling or offspring). The null association remained for early-onset CRC (diagnosed at age <50 years). In conclusion, IBD history in FDRs was not associated with an increased risk of CRC. Our findings suggest that extra screening for CRC may not be needed in the offspring, siblings or parents of IBD patients, and strengthen the theory that it is the actual inflammation or atypia of the colon in IBD patients that confers the increased CRC risk.

Exploring Clinical Risk Factors for Breast Cancer Among American Indian Women.

ObjectiveVery little is known about the breast cancer risk profile among American Indian women. Previous research shows that the proportion of American Indian/Alaska Native women with baseline characteristics (commonly known breast cancer risk factors) differs from other ethnicities. This retrospective case control study was designed to the explore the association of these factors among American Indian women with and without breast cancer.MethodsCases and controls were retrospectively selected from the medical records of American Indian women who obtained their health care from Quentin N. Burdick Memorial Health Care Facility (Indian Health Service) in Belcourt, ND. For each woman with breast cancer (n = 141), two controls were selected when possible (n = 278). Risk factors examined included woman's age, age at first live birth, age of menarche, the number of previous benign breast biopsies, the total number of first-degree relatives with breast cancer, body mass index and parity. Odds ratios and 95% confidence intervals were calculated using logistic regression.ResultsMany of the associations found among American Indian women who obtained their health care from Quentin N. Burdick Memorial Health Care Facility (Indian Health Service) in Belcourt, ND, between risk factors commonly identified in other populations and breast cancer were weakly positive. Nulliparity was the only risk factor to consistently show a positive significant association (OR = 2.87, 95% CI 1.16–0.7.12).ConclusionDisparities in breast cancer incidence, mortality and screening among Northern Plains American Indian emphasize the need to better understand the risk factors associated with breast cancer in this population. Based on the results of this study, the value of current risk prediction models in American Indian communities is uncertain and clinicians should be cautious in using these models to inform American Indian patients of their risk for breast cancer.

Risk of colorectal cancer in first degree relatives of patients with colorectal polyps: nationwide case-control study in Sweden

ObjectiveTo assess the risk of colorectal cancer (CRC) in first degree relatives (parents and full siblings) of patients with precursor lesions (polyps) for CRC.DesignCase-control study.SettingLinkage to the multi-generation register and...

Reduced cortical gyrification in the posteromedial cortex in unaffected relatives of schizophrenia patients with high genetic loading

Although abnormal cortical gyrification has been consistently reported in patients with schizophrenia, whether gyrification abnormalities reflect a genetic risk for the disorder remains unknown. This study investigated differences in cortical gyrification between unaffected relatives (URs) with high genetic loading for schizophrenia and healthy controls (HCs) to identify potential genetic vulnerability markers. A total of 50 URs of schizophrenia patients and 50 matched HCs underwent T1-weighted magnetic resonance imaging to compare whole-brain gyrification using the local gyrification index (lGI). Then, the lGI clusters showing significant differences were compared between the UR subgroups based on the number of first-degree relatives with schizophrenia to identify the effect of genetic loading on cortical gyrification changes. The URs exhibited significantly lower cortical gyrification than the HCs in clusters including medial parieto-occipital and cingulate regions comprising the bilateral precuneus, cuneus, pericalcarine, lingual, isthmus cingulate, and posterior cingulate gyri. Moreover, URs who had two or more first-degree relatives with schizophrenia showed greater gyrification reductions in these clusters than those who had at least one first-degree relative with schizophrenia. Our findings of reduced gyrification in URs, which are consistent with accumulated evidence of hypogyria observed in regions showing patient-control differences in previous studies, highlight that such hypogyria in posteromedial regions may serve as a genetic vulnerability marker and reflect early neurodevelopmental abnormalities resulting from a genetic risk for schizophrenia.

Do Pediatric Patients With Anterior Cruciate Ligament Tears Have a Higher Rate of Familial Anterior Cruciate Ligament Injury?

Background:Several studies have examined the anterior cruciate ligament (ACL) injury history among relatives of patients undergoing ACL reconstruction (ACLR), but they have primarily analyzed adults with variable results.Hypothesis:We hypothesized that he rate of familial ACL injuries among pediatric patients with ACL tears would be greater than that among pediatric patients with uninjured knees.Study Design:Cohort study; Level of evidence, 3.Methods:Pediatric patients (≤18 years of age) who underwent ACLR between January 2009 and May 2016 were contacted to complete a questionnaire on subsequent complications and family history of ACL tears. A control cohort was recruited from children with uninjured knees seen in the concussion clinic of our institution. Binary logistic regression was used to determine the factors predictive of having a familial ACL tear history or complications.Results:Overall, 450 pediatric patients with primary ACL tears were included. Age at the time of surgery was 14.9 ± 2.2 years with a follow-up of 4.3 ± 2.1 years. When compared with 267 control patients, those with an ACL tear reported a higher rate of first-degree relatives with an ACL injury history (25.1% vs 12.0%; P < .001). In multivariate analysis, children with ACL injury had nearly 3 times (odds ratio [OR], 2.7) higher odds of having a first-degree relative with an ACL tear (95% CI, 1.7-4.2; P < .001). Patients were stratified by the number of first-degree relatives with ACL tears: no relatives, 1 relative, or ≥2 relatives. Children with ≥2 first-degree relatives were more likely to sustain a postoperative graft failure (OR, 5.1; 95% CI 1.7-15.2; P = .003) or a complication requiring surgical intervention (OR, 7.5; 95% CI, 2.6-22.0; P < .001).Conclusion:A family history of ACL injury is more likely in pediatric patients with ACL tears than in uninjured children. Further, patients undergoing primary ACLR as well as a strong family history of ACL tears are more likely to sustain a postoperative graft rupture or complication requiring surgery.

Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial

SummaryBackgroundSkin barrier dysfunction precedes eczema development. We tested whether daily use of emollient in the first year could prevent eczema in high-risk children.MethodsWe did a multicentre, pragmatic, parallel-group, randomised controlled trial in 12 hospitals and four primary care sites across the UK. Families were approached via antenatal or postnatal services for recruitment of term infants (at least 37 weeks' gestation) at high risk of developing eczema (ie, at least one first-degree relative with parent-reported eczema, allergic rhinitis, or asthma, diagnosed by a doctor). Term newborns with a family history of atopic disease were randomly assigned (1:1) to application of emollient daily (either Diprobase cream or DoubleBase gel) for the first year plus standard skin-care advice (emollient group) or standard skin-care advice only (control group). The randomisation schedule was created using computer-generated code (stratified by recruiting centre and number of first-degree relatives with atopic disease) and participants were assigned to groups using an internet-based randomisation system. The primary outcome was eczema at age 2 years (defined by UK working party criteria) with analysis as randomised regardless of adherence to allocation for participants with outcome data collected, and adjusting for stratification variables. This trial is registered with ISRCTN, ISRCTN21528841. Data collection for long-term follow-up is ongoing, but the trial is closed to recruitment.Findings1394 newborns were randomly assigned to study groups between Nov 19, 2014, and Nov 18, 2016; 693 were assigned to the emollient group and 701 to the control group. Adherence in the emollient group was 88% (466 of 532) at 3 months, 82% (427 of 519) at 6 months, and 74% (375 of 506) at 12 months in those with complete questionnaire data. At age 2 years, eczema was present in 139 (23%) of 598 infants with outcome data collected in the emollient group and 150 (25%) of 612 infants in the control group (adjusted relative risk 0·95 [95% CI 0·78 to 1·16], p=0·61; adjusted risk difference –1·2% [–5·9 to 3·6]). Other eczema definitions supported the results of the primary analysis. Mean number of skin infections per child in year 1 was 0·23 (SD 0·68) in the emollient group versus 0·15 (0·46) in the control group; adjusted incidence rate ratio 1·55 (95% CI 1·15 to 2·09).InterpretationWe found no evidence that daily emollient during the first year of life prevents eczema in high-risk children and some evidence to suggest an increased risk of skin infections. Our study shows that families with eczema, asthma, or allergic rhinitis should not use daily emollients to try and prevent eczema in their newborn.FundingNational Institute for Health Research Health Technology Assessment.

Clinical Factors Associated With Gastric Cancer in Individuals With Lynch Syndrome

Lynch syndrome is the most common inherited cause of gastrointestinal cancer and increases risk for a variety of malignancies, including gastric cancer. We aimed to identify clinical factors associated with gastric cancer in carriers of germline variants causing Lynch syndrome. We collected data from 52,758 consecutive individuals tested for genetic variants associated with Lynch syndrome from June 2006 through July 2013 at a commercial laboratory. We obtained clinical and demographic data, as well as information on personal and family histories of cancer (first- and second-degree relatives) from forms completed by ordering providers. We performed multivariate logistic regression to identify clinical factors associated with gastric cancer in carriers of mutations that cause Lynch syndrome (pathogenic mutations). After we excluded individuals with missing clinical data (n= 1664) or with multiple pathogenic mutations (n= 8), we analyzed data from 51,086 individuals. Of these, 3828 persons carried pathogenic mutations (1346 with mutations in MLH1, 1639 with mutations in MSH2, 670 with mutations in MSH6, 145 with mutations in PMS2, and 28 with mutations in EPCAM). Of the 3828 carriers of pathogenic mutations, 41 (1.1%) had a previous gastric cancer and 350 (9.1%) had 1 or more first- or second-degree relatives with gastric cancer. In multivariate analysis, male sex (odds ratio [OR], 2.82; 95% CI, 1.48-5.38), older age (OR, 2.07 per 10 years; 95% CI, 1.64-2.61), mutations in MLH1 (OR, 6.53; 95% CI, 1.50-28.42) or MSH2 (OR, 5.23 compared to mutations in MSH6, PMS2, or EPCAM; 95% CI, 1.21-22.71), and number of first-degree relatives with gastric cancer (OR, 2.52; 95% CI, 1.42-4.45), but not second-degree relatives (OR, 1.12; 95% CI, 0.40-3.18) were independently associated with gastric cancer among carriers of pathogenic mutations. In an analysis of data from almost 4000 carriers of Lynch syndrome-associated mutations, we found history of gastric cancer to be independently associated with male sex, older age, mutations in MLH1 or MSH2, and number of first-degree relatives with gastric cancer. These findings suggest that personalized, risk-stratified approaches to gastric cancer surveillance may be appropriate for individuals with Lynch syndrome-associated mutations.

“RELATIVE” RISK OF ACL RE-INJURY

Background Several studies have examined ACL injury history among relatives of patients undergoing ACL reconstruction, but they have primarily analyzed adult populations with variable results. Additionally, few studies have examined concomitant injuries or post-operative outcomes among pediatric patients with a family history of ACL tear. Therefore, the purpose of this study was to identify the proportion of pediatric ACL patients with a first degree relative who had suffered an ACL tear while also examining concomitant meniscal or ligamentous injuries and subsequent complication rates. Methods 1009 patients who underwent ACL reconstruction at an urban tertiary care children’s hospital between January 2009 and May 2016 were contacted via email and/or telephone and asked to complete a follow-up survey. Data collected included subsequent complications – including graft rupture, contralateral ACL injury, and meniscus tears – along with information regarding any relatives who had suffered an ACL tear. Patient medical records were reviewed to determine the age of the patient at the time of surgery as well as concomitant meniscus and ligamentous injuries at the time of injury. Results 425 patients who underwent primary ACL reconstruction completed the survey. The mean age at surgery was 15.0? 2.4 years with a mean follow-up time of 4.6? 2.1 years. Patients were stratified into three groups by the number of first degree relatives (parent or sibling) who had an ACL tear history: no relatives, one relative, or more than one relative. 101 respondents (23.8%) reported at least one first degree relative who had previously torn an ACL. 15 (3.5%) had more than one first degree relative with an ACL tear. There were no differences in the age at time of surgery or the number of concomitant meniscus and ligamentous injuries suffered across the three stratified groups. While children with zero or one affected first degree relative had similar rates of graft failure (11.4% and 9.3%, respectively), those with two or more affected first-degree relatives had a significantly higher graft failure rate (40.0%, p=0.003). There were no differences in the number of post-operative contralateral ACL tears (p=0.438) or meniscus tears (p=0.477) across the groups. When these complications were analyzed together as one outcome, patients with more than one affected first-degree relative suffered more combined graft ruptures, contralateral ACL tears, and meniscal tears (53.3%) than patients with zero (21.9%) or only one affected first degree relative (22.1%, p=0.02). This group of patients also suffered more total complications that required surgical intervention (66.7%) than patients with zero (21.0%) or only one affected first degree family member (22.1%, p&lt;0.001). Conclusion/Significance Patients undergoing primary ACL reconstruction who have a strong family history of ACL tear appear more likely to suffer a post-operative graft rupture and suffer a complication requiring surgery.

Abstract P4-10-08: Family history of breast cancer and mammographic density in premenopausal women

Abstract Introduction: Mammographic density and family history of breast cancer (FHBC) are independent risk factors for breast cancer. Women with dense breasts have a 4-6-fold increased risk of breast cancer and women with FHBC have a 1.5-3-fold increased risk of breast cancer. However, there is little data on the associations of FHBC with mammographic density, especially in premenopausal women. To address this, we investigated the associations of FHBC in first-degree relatives with mammographic density in premenopausal women. Methods: We used data from 375 cancer-free premenopausal women who were during routine screening mammography at Washington University in St. Louis in 2016. We used Volpara to measure volumetric measures of density including volumetric percent density, dense volume, and non-dense volume. We collected data on first-degree relatives (mother, sister) and numbers of first degree relatives (0, 1, ≥2) with a positive FHBC. We used multivariable linear regression model, adjusted for age, BMI, parity, race, age at menarche, and alcohol consumption, to determine the associations of FHBC and log-transformed volumetric percent density, dense volume, and non-dense volume. Beta coefficients (β) were evaluated and back transformed for easier interpretation. Results: The mean age of participants was 47.5 years (range=32-58). The mean BMI was 30.8 kg/m2 (range =17.9-63.1). Volumetric percent density was 25% (p-value&amp;lt;0.001) higher in women who had a FHBC compared with women who had no FHBC. The associations appeared confined to women with a positive family history in mothers but not those with a positive family history in sisters. Volumetric percent density was 31% higher (p-value&amp;lt;0.001) among women with a positive FHBC in mothers compared to those without a positive FHBC in mothers, but 8% higher (p-value=0.45) among women with a positive FHBC in sisters compared to those without a positive FHBC in sisters. The associations of FHBC with dense volume were similar to those of volumetric percent density in all the analyses. For instance, dense volume was 16% (p-value=0.006) higher in women who had a FHBC compared with women who had no FHBC. Table 1.Associations of family history of breast cancer (FHBC) and volumetric percent density (VPD), and dense volume (DV) in 375 premenopausal women*.FHBCNVPD (%) DV (cm3 ) Beta (95% CI)P-valueBeta (95% CI)P-valueNo275Ref Ref Yes871.25 (1.12,1.41)&amp;lt;0.0011.16 (1.04,1.29)0.007Unknown131.00 (0.76,1.30)0.990.74 (0.58,0.95)0.017*Adjusted for age, BMI, parity, race, age at menarche, and alcohol consumption. Conclusions: Premenopausal women with a first-degree FHBC have higher volumetric percent density. Our findings could help identify high-risk women who may benefit from targeted screening. Citation Format: Han Y, Zong X, Colditz GA, Toriola AT. Family history of breast cancer and mammographic density in premenopausal women [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-08.

Analysis of the incidence in malignant neoplasms in firstdegree relatives of probands with glial brain tumors

The article presents a simplified analytical method of evaluating the cancer incidence in first-degree relatives with glial brain tumors. The method is based on the use of population cancer incidence rates in the Belarus population and the estimated numbers of first-degree relatives in the time interval corresponding to the average life span in the Belarus population. This method was employed to analyze the cancer incidence in the patients of first-degree relatives who were treated at the N.N. Alexandrov National Cancer Centre. Their diagnosis was the glial brain tumor. The number of the investigated first-degree relatives was 1012, of them 502 were males and 510 – females. As of December 31, 2015, this group had 63 cases of malignant neoplasms. According to the findings of the analysis performed, the first-degree relatives are at an increased risk for brain, rectum, thyroid and corpus uteri cancers. However, the statistically significant risk was found only for brain cancer incidence. The standardized incidence rate in first-degree relatives was 3.39 for this site (95 % CI 1.10–7.92), which is consistent with the data obtained by specialists of other countries (USA, Sweden and others).The agreement of the standardized incidence values suggests that the simplified analytical method provides an adequate account of the incidence among the patients of first-degree relatives with an established diagnosis of malignant neoplasm.

High prevalence of humoral autoimmunity in first-degree relatives of Mexican type 1 diabetes patients

To assess the prevalence of autoantibodies (Aab) to insulin (IAA), glutamic acid decarboxylase 65 (GADA) and insulinoma antigen 2 (IA-2A), as well as human leukocyte antigen (HLA) class II alleles, in first degree relatives (FDR) of Mexican patients with type 1 diabetes (T1D), and to explore whether these parameters mirror the low incidence of T1D in the Mexican population. Aab titers were determined by ELISA in 425 FDR, 234 siblings, 40 offspring and 151 parents of 197 patients with T1D. Typing of HLA-DR and -DQ alleles was performed in 41 Aab-positive FDR using polymerase chain reaction with allele-specific oligotyping. Seventy FDR (16.47%) tested positive for Aab. The siblings (19.2%) and the offspring (25%) had significantly higher prevalence of Aab than the parents (9.9%). GADA was the most frequent Aab. Almost half of the Aab-positive FDR had two different Aab (45.7%), and none tested positive for three Aab. The highest prevalence of Aab was found among women in the 15-29years age group. Moreover, the positivity for two Aab was significantly more frequent among females. A considerable number of FDR (48.8%) carried the susceptible HLA-DR3, -DR4, -DQB1*0201 or -DQB1*0302 alleles, but almost none had the high risk genotype HLA-DR3/DR4. FDR of Mexican T1D patients have high prevalence of islet Aab, comparable to countries with the highest incidence of T1D. However, Aab positivity does not seem to be associated with HLA risk genotypes, which may have an impact on the low incidence of T1D in Mexico.

Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study.

A previous genetic study has suggested that schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) share common disease-associated genes. However, whether individuals with first-degree relatives (FDRs) with schizophrenia have a higher risk of these major psychiatric disorders requires further investigation. This study used Taiwan's National Health Insurance Research Database and identified 151 650 patients with schizophrenia and 227 967 individuals with FDRs with schizophrenia. The relative risks (RRs) of schizophrenia and other major psychiatric disorders were assessed in individuals with FDRs with schizophrenia. The individuals with FDRs with schizophrenia exhibited higher RRs (95% confidence interval) of major psychiatric disorders, namely schizophrenia (4.76, 4.65-4.88), bipolar disorder (3.23, 3.12-3.35), major depressive disorder (2.05, 2.00-2.10), ASD (2.55, 2.35-2.77) and ADHD (1.31, 1.25-1.37) than were found in the total population. Several sensitivity analyses were conducted to confirm these results. A dose-dependent relationship was observed between the risks of major psychiatric disorders and the numbers of FDRs with schizophrenia. The increased risks of major psychiatric disorders were consistent in different family relationships, namely among parents, offspring, siblings and twins. Our study supports the familial dose-dependent co-aggregation of schizophrenia, bipolar disorder, major depressive disorder, ASD and ADHD, and our results may prompt governmental public health departments and psychiatrists to focus on the mental health of individuals with FDRs with schizophrenia.

Association between family history and the risk of hypertension in rural districts of Hanzhong in Shaanxi province

Objective: To understand the prevalence of hypertension and quantitative relationship between family history and the risk of hypertension among rural residents living in Hanzhong District, Shaanxi province. Methods: A multistage random sampling survey was conducted. Data on the characteristics related to hypertension were collected and physical examination was conducted. Logistic regression was used to analyze the relationship between family history and hypertension. Results: A total number of 2 817 rural residents aged 18-80 with complete information were recruited. The crude prevalence of hypertension was 33.7%. Results from the logistic regression analysis showed that the OR was 2.06 (95% CI: 1.70-2.50) between family histories with or without hypertension. When the first-degree relatives were with the degrees of family history of hypertention as Ⅰ, Ⅱ or Ⅲ, the OR values of hypertension appeared as 1.83 (95% CI: 1.47-2.27), 2.94 (95% CI: 2.09-4.13) and 4.48 (95% CI: 2.17-9.27) respectively. Either father or mother having the positive family history of hypertension, the corresponding OR values appeared as 2.50 (95% CI: 1.84-3.40), 1.61(95% CI: 1.22-2.12) seen in mothers. However, when both father and mother having the family history of hypertention, the OR value was seen 2.82 (95%CI: 1.76-4.51) in the mothers. Conclusion: Family history appeared as a risk factor for hypertension. The number of first-degree relatives with positive family history showed a dose-response relationship to the occurrence of hypertension. Family history in both father or mother might further affect the incidence of hypertension.

Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomised controlled trial

BackgroundAtopic eczema (AE) is a common skin problem that impairs quality of life and is associated with the development of other atopic diseases including asthma, food allergy and allergic rhinitis. AE treatment is a significant cost burden for health care providers. The purpose of the trial is to investigate whether daily application of emollients for the first year of life can prevent AE developing in high-risk infants (first-degree relative with asthma, AE or allergic rhinitis).MethodsThis is a protocol for a pragmatic, two-arm, randomised controlled, multicentre trial. Up to 1400 term infants at high risk of developing AE will be recruited through the community, primary and secondary care in England. Participating families will be randomised in a 1:1 ratio to receive general infant skin-care advice, or general skin-care advice plus emollients with advice to apply daily to the infant for the first year of life. Families will not be blinded to treatment allocation. The primary outcome will be a blinded assessment of AE at 24 months of age using the UK Working Party Diagnostic Criteria for Atopic Eczema. Secondary outcomes are other definitions of AE, time to AE onset, severity of AE (EASI and POEM), presence of other allergic diseases including food allergy, asthma and hay fever, allergic sensitisation, quality of life, cost-effectiveness and safety of the emollients. Subgroup analyses are planned for the primary outcome according to filaggrin genotype and the number of first-degree relatives with AE and other atopic diseases. Families will be followed up by online and postal questionnaire at 3, 6, 12 and 18 months with a face-to-face visit at 24 months. Long-term follow-up until 60 months will be via annual questionnaires.DiscussionThis trial will demonstrate whether skin-barrier enhancement through daily emollient for the first year of life can prevent AE from developing in high-risk infants. If effective, this simple and cheap intervention has the potential to result in significant cost savings for health care providers throughout the world by preventing AE and possibly other associated allergic diseases.Trial registrationISRCTN registry; ID: ISRCTN21528841. Registered on 25 July 2014.

Family History and Stroke Risk in China: Evidence from a Large Cohort Study.

Background and Purpose Large cohort studies on relationship between family history of stroke (FHS) and stroke risk are lacking in Asians. We aimed to systematically evaluate the association of FHS with stroke risk in a cohort study of 0.5 million Chinese adults. Methods Information about FHS was self-reported. The median follow-up time was 7.16 years and the end-point of follow-up was incident stroke, which was entered directly into the China Kadoorie Biobank system. Multivariate analyses were performed with Cox proportional hazards model, and interaction analyses were carried using likelihood-ratio tests. Results Compared with participants without FHS, the hazard ratio (HR) (95% confidence interval, CI) of stroke for participants with FHS was 1.50 (1.46-1.55). The HRs increased with the number of first degree relatives with stroke (HRs=1.41, 1.98 and 2.47 for 1, 2 and ≥3 relatives, respectively, Ptrend <0.001). The HRs were 1.57 (95% CI: 1.50-1.66) and 1.49 (95% CI: 1.45-1.54) for sibling history and parental history, respectively. Similar associations with offspring stroke risk were observed between paternal history (HR=1.48, 95% CI: 1.43-1.54) and maternal history (HR=1.49, 95% CI: 1.43-1.55). Moreover, significant interactions were detected between FHS and health-risk behaviors (tobacco smoking and alcohol drinking). Conclusions FHS is an independent risk factor for stroke in Chinese. The more first degree relatives are affected by stroke, the higher are individuals’ risk of suffering from stroke. The management of the health-risk behaviors for reducing stroke should be highlighted, especially for the individuals with FHS.

Risk of other Cancers in Families with Melanoma: Novel Familial Links

A family history of cutaneous melanoma (‘melanoma’) is a well-established risk factor for melanoma. However, less is known about the possible familial associations of melanoma with other discordant cancers. A risk for discordant cancer may provide useful information about shared genetic and environmental risk factors and it may be relevant background data in clinical genetic counseling. Using the Swedish Family-Cancer Database, we assessed the relative risk (RR) for any cancer in families with increasing numbers of first-degree relatives diagnosed with melanoma, including multiple melanoma, and in reverse order RR for melanoma in families of multiple discordant cancers. Close to 9% of melanoma was familial; among these 92% were in 2-case families and 8% in families with 3 cases or more. Cancers that were associated with melanoma, in at least two independent analyses, included breast, prostate, colorectal, skin and nervous system cancers. Other associations included cancer of unknown primary, acute myeloid leukemia/myelofibrosis and Waldenström macroglobulinemia/myeloma. Significant results, which appear biologically plausible, were also obtained for rare nasal melanoma and mesothelioma. Although small samples sizes and multiple comparisons were of concern, many of the above associations were internally consistent and provide new diverse leads for discordant familial association of melanoma.

Diagnosis of primary headache in children younger than 6 years: A clinical challenge.

Background Criteria defined by the International headache Society are commonly used for the diagnosis of the different headache types in both adults and children. However, some authors have stressed some limits of these criteria when applied to preschool age. Objective Our study aimed to describe the characteristics of primary headaches in children younger than 6 years and investigate how often the International Classification of Headache Disorders (ICHD) criteria allow a definitive diagnosis. Methods This retrospective study analysed the clinical feature of 368 children younger than 6 years with primary headache. Results We found that in our patients the percentage of undefined diagnosis was high when either the ICHD-II or the ICHD-III criteria were used. More than 70% of our children showed a duration of their attacks shorter than 1 hour. The absence of photophobia/phonophobia and nausea/vomiting significantly correlate with tension-type headache (TTH) and probable TTH. The number of first-degree relatives with migraine was positively correlated to the diagnosis of migraine in the patients ( p < 0.001). Conclusions Our study showed that the ICHD-III criteria are difficult to use in children younger than 6 years. The problem is not solved by the reduction of the lowest duration limit for the diagnosis of migraine to 1 hour, as was done in the ICHD-II.

Yield of Screening Colonoscopy in First-degree Relatives of Patients With Serrated Polyposis Syndrome

We aimed to evaluate the diagnostic yield of screening colonoscopies in first-degree relatives (FDRs) of patients with serrated polyposis syndrome (SPS). Patients with SPS are at an increased risk for colorectal cancer. Although inheritance patterns are unknown, FDRs of these patients have an increased risk for both colorectal cancer and SPS. Prospective studies evaluating the yield of screening colonoscopies in this group are however scarce. This information would be useful to evaluate a possible mode of inheritance and to investigate whether screening colonoscopies are justified in this group. FDR of patients with SPS were invited to undergo colonoscopy. The diagnostic yield was expressed by the number of FDRs with at least 1 significant polyp relative to the total number of included FDRs. Significant polyps were defined adenomas, traditional serrated adenomas, sessile serrated adenoma/polyp, or proximal hyperplastic polyp. Tissue specimens were reviewed by one expert pathologist. Seventy-seven FDRs underwent colonoscopy (median age 52 y; interquartile range, 41 to 60). Colorectal cancer was not diagnosed. One or more significant polyps were detected in 43% of FDRs. No differences based on age, gender, or familial relationship were observed in the detection of polyps. Seven first-degree (9%) relatives had multiple polyps (≥5). Eleven (14%) FDRs fulfilled SPS WHO-criterion 2, of whom 1 sibling also met SPS WHO-criterion 3. The yield of a single screening colonoscopy in FDRs of patients with serrated polyposis is substantial, warranting a colonoscopy screening program for these individuals.