Odds Radios Research Articles

Associations of dietary advanced glycation end products with liver steatosis via vibration controlled transient elastography in the United States: a nationwide cross-sectional study.

Large population-based studies for the associations between dietary advanced glycation end products (dAGEs) intake and liver steatosis remain lacking. It is necessary to clarify the relationship of dAGEsintake with liver steatosis through the National Health and Nutrition Survey (NHANES). A total of 5856 participants in the NHANES 2017-2018 were included. The dietary AGEs intake, including ε-(carboxymethyl)lysine(CML), Nε-(1-carboxyethyl)lysine (CEL), and Nδ-(5-hydro-5-methyl-4-imidazolon-2-yl)-ornithine (MG-H1) were estimated using the combination of ultra-performance LC-tandem MS dietary AGEs database and two 24-h dietary recall interviews. Liver steatosis was assessed by controlled attenuation parameter via transient elastography. Logistic regression model was adopted to explore the relationships between dAGEs intake and hepatic steatosis. Compared with individuals of total dAGEs, CML, MG-H1 in the lowest tertile, those in the highest tertile had highest risk of hepatic steatosis, and the corresponding odds radios(ORs) (95% confidence interval(CI)) were 1.37 (1.01, 1.84), 1.36 (1.04,1.78) and 1.40 (1.06, 1.85), respectively. Subgroups analysis found that the positive association between dAGEs, CML, CEL and MG-H1 and hepatic steatosis appeared stronger in subjects with obesity and those with abnormal waist circumference (WC). There was a positive correlation between dAGEs, CML, MG-H1, and hepatic steatosis, and this association mainly existed in subjects with obesity and those with abnormal WC. Dietary AGEs restriction might be of high priority for subjects with obesity for the prevention of fatty liver disease. Further longitudinal studies are required to confirm the causal associations and explore the potential mechanisms.

Longitudinal associations of body mass index and abdominal circumference with back pain among community-dwelling adults: data from the Osteoarthritis Initiative

BACKGROUND CONTEXTBack pain is the most common musculoskeletal problem in both developed and developing countries. The prevalence and burden of back pain increases with age, and the management of back pain becomes increasingly important in the context of global aging. There is increasing evidence that obesity is a modifiable risk factor for musculoskeletal pain in different locations. Understanding the role of obesity in back pain holds great potential for improving understanding of the mechanisms of back pain and for developing new preventive and therapeutic approaches. PURPOSETo evaluate the role of weight, body mass index (BMI) and abdominal circumference (AC) in risk of back pain over 96 months. DESIGNProspective cohort study. PATIENT SAMPLEThe sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who had or were at increased risk for knee Osteoarthritis. OUTCOME MEASURESOutcome variables included the presence, severity, and frequency of back pain, using the past 30 days as the time frame. METHODSLongitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none, rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person and with-person components. Data analyses were performed using mixed-effects logistic (for presence of back pain) or ordered logistic regression (for severity and frequency of back pain) models. ResultsBack pain was reported in 58% of participants at baseline; 70% of those without back pain had incident back pain over 96 months. Both between-person (average value across a participant's all measurements) and within-person (deviations from the participant's average) effects of weight and BMI increased risk of presence, severity, and frequency of back pain (Odds radios (OR) per kg/m2: 1.010–1.046, p<.05) in females but not males, with statistically significant weight*sex and BMI*sex interactions. Similar findings were observed for between-person effects of AC on back pain, and the within-person effect of AC was only associated with back pain severity (OR per cm: 1.009, 95% confidence interval 1.002–1.017, p=.019) in females. CONCLUSIONSGreater average weight and BMI and increases in them increased odds of presence, severity, and frequency of back pain over 96 months in middle aged and older women but not men. Only average AC increased odds of back pain over time, in women. These findings suggest that preventing obesity and slowing weight gain is important for the management of back pain.

Radiation (RT)-Associated Kidney Injury in Pediatric Cancer Patients: Results from the Pediatric Normal Tissue Effects in the Clinical (PENTEC) Genitourinary (GU) Task Force

<h3>Purpose/Objective(s)</h3> RT-Associated kidney injury is a complication in children treated for cancer. Reported injury includes mildly elevated serum markers, decreased glomerular filtration rate, hypertension, abnormal renal imaging and rarely, renal failure. Through systematic review of available studies, The PENTEC GU task force aims to model the relationships between RT dose and chronic kidney disease (CKD). <h3>Materials/Methods</h3> We conducted a PubMed search of peer-reviewed reports from 1990-2017 evaluating pediatric CKD and RT. 2048 articles were retrieved with 98 fully reviewed. 19 contained whole kidney data for modeling but no article met criteria for partial kidney modeling. However, a 2021 investigation contained usable partial kidney data by Green et al. (JASN 2021). We used the National Kidney Foundation's (NKF) stages for CKD toxicity. Partial kidney dose was modeled from the odds radios (OR) reported in a St. Jude Lifetime Cohort Study (SJLCS) with coefficients in a logistic regression model calculated. The intercepts of the logistic regression models were obtained directly from the investigators. As only V5 and V10 were statistically significant in the SJLCS, we limited our partial kidney model to these doses. <h3>Results</h3> Normal Tissue Complication Rates ≥ 5%, expressed as EQD2 (equivalent doses, 2 Gy/fx) for whole kidney exposures occurred at 8.5, 10.2 and 14.5 Gy for NKF grades ³ 1, ³ 2, and ³ 3, respectively. Conventional Wilms whole abdominal RT (WAI) of 10.5 Gy in 6 fractions had risks of ³ grade 2 toxicity ∼ 4%, and ³ grade 3 toxicity ∼ 1%. For fractionated 12 Gy total body RT (TBI) those risks were 8%, and < 3%, respectively. Data did not support modeling with chemotherapy. Partial kidney modeling from 439 survivors of the SJLCS who received RT (median age 7.3 yrs) showed that 5 or 10 Gy RT to 100% kidney gave a <5% risk of grades 3-5 (severe) toxicity with 1500 mg/m2 carboplatin or no chemo. With 480 mg/m2 cisplatin, a 3% risk of severe toxicity occurred without RT, and a 5% risk when 26% kidney received ≥ 10 Gy. With 63 gm/m2 of ifosfamide, a 5% risk of severe toxicity occurred with no RT, and a 10% toxicity risk occurred when 42% kidney received ≥ 10 Gy. <h3>Conclusion</h3> In patients with Wilms, the risk of toxicity from 10.5 Gy of WAI is low. For 11-12 Gy fractionated TBI with various chemotherapies, the risk of severe toxicity is low but low-grade toxicity is not uncommon. In our partial kidney modeling of RT in the absence of chemo, or with only carboplatin, 10 Gy RT can be delivered to the entire kidney with a low risk of severe CKD. Cisplatin and ifosfamide, however, significantly increase the risk of CKD and decrease the tolerable RT dose. A better understanding of chemo effects, and dose-response-curves for regional renal injury will facilitate optimal use of tools such as IMRT and protons.

A network meta-analysis for efficacies and toxicities of different concurrent chemoradiotherapy regimens in the treatment of locally advanced non-small cell lung cancer

BackgroundConcurrent chemoradiotherapy (CCRT) has become the cornerstone of treatment for patients with locally advanced non-small cell lung cancer (LA-NSCLC). The aim of this study was to compare the efficacies and toxicities of different CCRT regimens in the treatment of LA-NSCLC by adopting a network meta-analysis (NMA).MethodsAn exhaustive search of PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted to identify relevant studies from inception to October 1, 2020. Direct and indirect evidence was combined to calculate the odds radios (ORs) and 95% confidence intervals (CIs), as well as to plot the surface under the cumulative ranking (SUCRA) curves. Cluster analyses were adopted to compare the efficacies and toxicities of different CCRT regimens according to the similarity of 2 variables. Publication bias was detected by comparison-adjusted funnel plots.ResultsTwenty-two studies were enrolled in this NMA, including 18 regimens: CCRT (cisplatin + etoposide), CCRT (carboplatin + paclitaxel), CCRT (pemetrexed + carboplatin), CCRT (pemetrexed + cisplatin), CCRT (docetaxel + cisplatin), CCRT (S-1 + cisplatin), CCRT (mitomycin + vindesine + cisplatin), CCRT (cisplatin + vinorelbine), CCRT (cisplatin), CCRT (etoposide + cisplatin + amifostine), RT, CCRT (5-FU), CCRT (paclitaxel + cisplatin), CCRT (irinotecan + carboplatin), CCRT (nedaplatin), CCRT (carboplatin + etoposide), CCRT (paclitaxel), and CCRT (carboplatin). The results indicated that the regimens with CCRT (cisplatin + etoposide), CCRT (carboplatin + paclitaxel), CCRT (pemetrexed + cisplatin), CCRT (S-1 + cisplatin), and CCRT (cisplatin + vinorelbine) had relatively better efficacies compared with other regimens. As for toxicities of different CCRT regimens, the CCRT (carboplatin + paclitaxel), CCRT (pemetrexed + cisplatin), and CCRT (docetaxel + cisplatin) were relatively lower.ConclusionsOur study demonstrated that CCRT (pemetrexed + cisplatin) and CCRT (carboplatin + paclitaxel) might be the best options for the treatment of LA-NSCLC, and CCRT (pemetrexed + cisplatin) had the highest 3-year overall survival (OS) rate.

Clinicopathological and prognostic significance of NM23 expression in patients with non-small cell lung cancer: A systematic review and meta-analysis.

Background:There is a heated debate on the clinicopathological features and prognostic significance with non-metastasis 23 (NM23) expression in patients with non-small cell lung cancer (NSCLC). Thus, we conducted this meta-analysis to evaluate the clinicopathological features and prognostic significance of NM23 for NSCLC patients.Methods:Pubmed, Embase, and Web of Science were exhaustively searched to identify relevant studies published prior to March, 2020. Odds radios (ORs) and hazard radios with 95% confidence intervals (CIs) were calculated to summarize the statistics of clinicopathological and prognostic assessments. Q-test and I2-statistic were utilized to assess heterogeneity across the included studies. We also performed subgroup analyses and meta-regression analyses to identify the source of heterogeneity. Publication bias was detected by Begg and Egger tests. Sensitivity analysis was used to value the stability of our results. All the data were analyzed using statistical packages implemented in R version 4.0.5.Results:Data from a total of 3170 patients from 36 studies were extracted. The meta-analysis revealed that low expression of NM23 was correlated with higher risk of NSCLC (OR = 4.35; 95% CI: 2.76–6.85; P < .01), poorer tumor node metastasis (TNM) staging (OR = 1.39; 95% CI: 1.01–1.90; P = .04), poorer differentiation degree (OR = 1.37; 95% CI: 1.01–1.86; P = .04), positive lymph node metastasis (OR = 1.83; 95% CI: 1.22–2.74; P < .01), lung adenocarcinoma (OR = 1.45; 95% CI: 1.20–1.75; P < .01), and poorer 5-year overall survival (OS) rate (hazard radio = 2.33; 95%CI: 1.32–4.11; P < .01). The subgroup analyses and meta-regression analyses suggested that the “Publication year”, “Country”, “Sample size”, and “Cutoff value” might be the source of heterogeneity in TNM staging, differentiation degree, and lymph node metastasis. Both Begg test and Egger test verified that there were publication bias in 5-year OS rate. Sensitivity analysis supported the credibility of the results.Conclusion:The reduced NM23 expression is strongly associated with higher risk of NSCLC, higher TNM staging, poorer differentiation degree, positive lymph node metastasis, lung adenocarcinoma, and poorer 5-year OS rate in NSCLC patients, which indicated that NM23 could serve as a biomarker predicating the clinicopathological and prognostic significance of NSCLC.

Smoking behaviours and attitudes towards campus-wide tobacco control policies among staff and students: a cross-sectional survey at the University of Birmingham

BackgroundTobacco control policies have potential to be an effective strategy for the reduction of smoking prevalence and secondhand smoke (SHS) exposure in tertiary educational settings worldwide. The aims of this study were to collect baseline data among staff and students, to measure smoking behaviours and attitudes towards introduction of campus-wide tobacco control policies within a UK higher education setting.MethodsCross-sectional study using data collected by web-based questionnaire administered to employed staff and enrolled students (undergraduate/postgraduate) at the University of Birmingham from May 2016 to April 2017. Information was obtained regarding demographic characteristics, tobacco usage patterns and attitudes towards a revised campus tobacco control policy using a 21-item survey tool. Logistic regression analyses were used to explore associations between participant characteristics and support for smoke-free or tobacco-free campus policy options, evaluated by crude and adjusted Odds Radios (OR) after controlling for confounding factors (significance level: P < 0.05).ResultsA total of 934 survey responses were received, of whom 780 participants provided complete information on staff or student status and were included in the present analysis. Current smoking prevalence was 14% (N = 109; 95% confidence interval (CI) 11.6–16.6). Overall, 66.3% (95% CI: 62.9–69.7) of participants supported a smoke-free campus; 68.5% (95% CI: 65.2–71.8) endorsed restrictions for tobacco sales and just under half of respondents (47.3%; 95% CI: 43.8–50.9) supported a ban for electronic cigarettes/vaping device use on campus. Smoking status was an independent predictor of support for tobacco control, with the lowest level of support for a smoke-free campus among daily (adjusted OR 0.02; 95% CI: 0.01–0.05) and intermittent smokers (adjusted OR 0.06; 95% CI: 0.02–0.16).ConclusionsOverall, the majority of staff and students participating in this baseline survey supported implementation of a smoke-free or comprehensive tobacco-free campus policy. These findings may inform the development and future implementation of a revised tobacco control policy at the university which reflects contemporary attitudes and considers a broad range of implementation issues, including behaviour change and environmental adaptations.

Long-term outcomes of endoscopic submucosal dissection and comparison to surgery for superficial esophageal squamous cancer: a systematic review and meta-analysis.

Aim:The aim of this study was to investigate the long-term outcomes of endoscopic submucosal dissection (ESD) for superficial esophageal squamous cancer.Methods:A literature search was conducted using PubMed, ProQuest and Cochrane Library databases. Primary outcomes were overall survival, disease-specific survival and recurrence-free survival at 5 years. Secondary outcomes included adverse events, recurrence and metastasis. Hazard ratios were calculated based on time to events for survival analysis, and odds radios were used to compare discrete variables.Results:A total of 3796 patients in 21 retrospective studies, including 5 comparative studies for ESD and esophagectomy were enrolled. The invasion depth was 52.0% for M1–M2, 43.2% for M3–SM1 and 4.7% for SM2 or deeper. The 5-year survival rate was: overall survival 87.3%, disease-specific survival 97.7%, and recurrence-free survival 85.1%, respectively. Pooled local recurrence of ESD was 1.8% and metastasis was 3.3%. In terms of the comparison between ESD and esophagectomy, there was no difference in the overall survival (86.4% versus 81.8%, hazard ratio = 0.66, 95% CI = 0.39–1.11) as well as disease-specific and recurrence-free survival. In addition, ESD was associated with fewer adverse events (19.8 % versus 44.0%, odds ratio = 0.3, 95% CI = 0.23–0.39).Conclusions:For superficial esophageal squamous cancer, ESD may be considered as the primary treatment of for mucosal lesions, and additional treatment should be available for submucosal invasive cancers.

Long-term effects of radiation prior to surgery and chemotherapy on survival of esophageal cancer undergoing surgery.

Esophageal cancer (EC) is one of the most common cancers in the world, with continuously growing diagnoses and morbidity. Because it is still unclear how to choose the best treatment for EC patients, a multimodal treatment is necessary to improve the prospect of the malignancy, including a sequence of surgery, chemotherapy, and radiotherapy, whether alone or combination. Therefore, this paper aims to analyze the effect of the sequence of chemotherapy, radiotherapy, and surgery on the prognosis and survival rate of patients with EC.The Surveillance, Epidemiology, and End Results (SEER) database was used to extract a dataset of patients who were diagnosed with EC from 1973 to 2015, with follow-up data for 6 years after diagnosis. The data were analyzed using correlation analysis, logistic regression Cox regression, and Kaplan–Meier analysis.EC patients who had radiation prior to surgery and chemotherapy had a better prognosis than the cases without chemotherapy. Based on univariate logistic regression, the odds radios of vital status recoded for “radiation prior to surgery combined with chemotherapy” is the lowest one among the 8 groups classified by radiation sequence with surgery and chemotherapy (P < .001). Further, radiation prior to surgery and chemotherapy is an independent prognostic factor for better survival among EC patients.In conclusion, in the treatment of EC, administering radiation prior to surgery and chemotherapy is better than no radiotherapy, perioperative radiotherapy, postoperative radiotherapy, and other combinations without chemotherapy.

Association of Dietary Energy Intake or Obesity with Hypertension: Results from Two Population-based Studies (P18-014-19)

ObjectivesWe aimed to investigate the association of dietary energy intake or obesity with the prevalence of hypertension, and explored the potential mediators in this relationship. MethodsWe conducted a comprehensive and in-depth assessment in the cross-sectional survey of the US National Health and Nutrition Examination Survey (NHANES) four cross-sectional cohorts (2005–2006, 2007–2008, 2009–2010, and 2011–2012) of 17,746 participants aged 20–74 years, and validated the significant findings in the China Health and Nutrition Survey (CHNS, 2004–2011) of 31,582 subjects. We validated whether insulin resistance (IR), fasting glucose (FG), total cholesterol (TC) or triglyceride (TG) levels could play a mediation role in the association of dietary energy intake or obesity with hypertension. ResultsWe found that the relationship between dietary energy intake and prevalence of hypertension in the NHANES is U-shaped (P for quadratic = 0.002). Compared to the participants in the third quintile category of dietary energy intake, the multivariable odds radios (OR) in the first and fifth quintile category were 1.33 (1.10–1.61) and 1.13 (0.96–1.33), respectively. We observed the prevalence of hypertension in obese and abdominal obesity participants were both significantly higher than normal subjects (all P-values < 0.001), the multivariable ORs in NHANES is 3.23 (2.78–3.76) and 2.31 (2.08–2.57), in CHNS is 4.78 (4.31–5.30) and 2.71 (2.54–2.90). Mediation analyses consistently indicated that the associations between obesity and abdominal obesity with hypertension were mediated mainly by IR as measured by the homeostasis model (HOMA2-IR), followed by FG, TG and TC in the two studies. The proportions via the mediation of insulin/HOMA2-IR was 28.41∼36.74%, FG was 10.43∼12.63%, TG was 6.24∼8.55% and TC was 0.57∼0.66%, respectively. ConclusionsIn this study, the relationships between obesity and abdominal obesity with the risk of hypertension were both significantly positive. Meanwhile, consuming more and less dietary energy were both risk factors of hypertension. Funding SourcesThis work was supported by funds from the National Natural Science Foundation of China (81573134 81202,282) received by Xiaoyan Wu. Supporting Tables, Images and/or Graphs▪▪▪

Functional Foxp3 polymorphisms and the susceptibility to cancer: An update meta-analysis.

Background:Forkhead box P3 (Foxp3) plays important roles in the development and pathogensis of cancer. To investigate the association of 3 polymorphisms of Foxp3 (rs3761548, rs 3761549 and rs2280883) and cancer risk, an updated meta-analysis was performed.Methods:Around 11 studies including 4344 cancer patients and 4665 healthy controls were selected for this meta-analysis. There were nine studies with 3783 cases and 4096 controls for rs3761548, 4 studies with 1669 cases and 1613 controls for rs3761549 and 4 studies with 1821 cases and 1799 controls for rs2280883. Odds radios (ORs) and 95% confidence intervals (CIs) were used to evaluate the cancer risk.Results:Meta-analysis showed that rs3761548 was associated with an increased cancer risk in the overall population under the recessive model (AA vs CA + CC: OR = 1.45, 95%CI = 1.03–2.02, P = .03). No association was found between rs3761549, rs2280883 polymorphisms, and cancer susceptibility in the overall population. Nonetheless, in the genotyping methods subgroup analysis of rs2280883, a lower risk of cancer was found in studies using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) under the allelic model (C vs T: OR = 0.70, 95%CI = 0.52–0.95, P = .02), heterozygote model (TC vs TT: OR = 0.60, 95%CI = 0.41–0.87, P = .008) and dominant model (CC + TC vs TT: OR = 0.63, 95%CI = 0.45–0.90, P = .01). In the subgroup analysis by cancer types showed C allele or TC carriers were insusceptible to cancer under 3 genetic models (C vs T: OR = 0.78, 95%CI = 0.64–0.95, P = .01; TC vs TT: OR = 0.50, 95%CI = 0.32–0.79, P = .003; CC + TC vs TT: OR = 0.64, 95%CI = 0.51–0.82, P < .001).Conclusion:Our results suggest that rs3761548 polymorphism is associated with cancer risk.

Efficacy of different chemotherapy regimens in treatment of advanced or metastatic pancreatic cancer: A network meta-analysis.

We performed a network meta-analysis (NMA) to compare the short- and long-term efficacy of Gemcitabine, Gemcitabine + S-1 (tegafur), Gemcitabine + nab-paclitaxel, Gemcitabine + Capecitabine, Gemcitabine + Cisplatin, FOLFIRINOX (oxaliplatin + irinotecan + fluorouracil + leucovorin), Gemcitabine + oxaliplatin, Gemcitabine + irinotecan, Gemcitabine + Exatecan, Gemcitabine + pemetrexed, Gemcitabine + 5-FU, and S-1 in treating advanced or metastatic pancreatic cancer (PC). The odds radios (OR) or weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRA) were evaluated by a combination of direct evidence and indirect evidence. In total twenty studies were included in this paper. For short-term efficacy, the overall response rate (ORR) was lower for patients treated with Gemcitabine compared with Gemcitabine + S-1, Gemcitabine + Cisplatin, Gemcitabine + irinotecan and S-1. The ORR for FOLFIRINOX was higher compared with Gemcitabine, Gemcitabine + Capecitabine and Gemcitabine + Cisplatin. The disease control rate (DCR) for Gemcitabine was lower compared with Gemcitabine + S-1, Gemcitabine + Cisplatin, and FOLFIRINOX. For long-term efficacy, the 12-month overall survival (OS) rate for FOLFIRINOX was higher compared with Gemcitabine, Gemcitabine + Capecitabine, Gemcitabine + Cisplatin, Gemcitabine + irinotecan, Gemcitabine + Exatecan, and Gemcitabine + pemetrexed. The SUCRA revealed that FOLFIRINOX was relatively better in both short- and long-term efficacy, while Gemcitabine was relatively poorer. In both short- and long-term efficacy, FOLFIRINOX had the best short- and long-term efficacy among the 12 chemotherapy regimens while efficacy of Gemcitabine was relatively poorer in the treatment of advanced or metastatic PC.

Functional miR-146a, miR-149, miR-196a2 and miR-499 polymorphisms and the susceptibility to hepatocellular carcinoma: An updated meta-analysis

Single nucleotide polymorphisms of miRNAs play important roles in the pathogenesis of hepatocellular carcinoma (HCC). To evaluate the association between four common miRNAs (miR-146a rs2910164; miR-149 rs2292832; miR-196a2 rs11614913 and miR-499 rs3746444) and HCC risk, an updated meta-analysis was performed. 32 studies including 12,405 HCC cases and 15,056 controls were used for this meta-analysis. There were 22 studies with 7894 cases and 10,221 controls for miR-146a, 9 studies with 2684 HCC cases and 3464 controls for miR-149, 17 studies with 6937 cases and 8217 controls for miR-196a2 and 16 studies with 4158 cases and 5264 controls for miR-499. Odds radios (ORs) and 95% confidence intervals (CIs) were used to assess the HCC risk. Meta-analysis showed that miR-146a was associated with HCC risk under the heterozygote model (OR=1.10, 95%CI=1.03-1.17, P=0.007), whereas no association was found in Caucasian using all genetic models. For miR-196a2 polymorphism, an increased risk of HCC was observed based on four models (C vs T: OR=1.15, 95%CI=1.05-1.26, P=0.003; CC vs TT: OR=1.35, 95%CI=1.12-1.63, P=0.002; CC+CT vs TT: OR=1.20, 95%CI=1.04-1.37, P=0.01 and CC vs CT+TT: OR=1.23, 95%CI=1.06-1.42, P=0.006). Association of miR-499 with HCC risk was only detected in the subgroup of studies which did not use polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) under the allelic, heterozygote and dominant models. However, negative results were obtained for the association of miR-149 and HCC susceptibility. Our results suggest that miR-146a and miR-196a2 polymorphisms are associated with increased risk of HCC, especially in Asian.

Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study.

BackgroundNon-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors.MethodsA nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15–64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs).ResultsThe prevalence of hypertension was 30.1 % (95 % CI: 28.4–31.8) in males and 29.8 % (28.5–31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m2 for males and 23.0 (5.1) kg/m2 for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1–3.3, females: OR = 2.3; 2.0–2.7) and high waist circumference (males: OR = 3.4; 1.8–6.8, females: OR = 2.7; 2.2–3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension.ConclusionsThe prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will most likely be on rise. Studies on effectiveness on interventions are needed, and policies to reduce the burden of NCD risk factors should be implemented if proven effective in similar settings.

Association of STAT6 variants with asthma risk: A systematic review and meta-analysis

A large number of studies have reported that the genetic variants in STAT6 gene may be implicated in susceptibility to asthma, but with inconsistent results. Therefore, the aim of this meta-analysis was to determine the likelihood of developing asthma for the individuals with different STAT6 variants. The database including Pubmed, Embase and CNKI (Chinese National Knowledge Infrastructure) were searched to find the relevant papers. Data were extracted by two independent reviewers and the odds radios (ORs) were pooled with 95% confidence intervals (CIs), using random effect or fixed effect models as appropriate, to indicate the risk of asthma for different STAT6 variants. The heterogeneity and bias were tested for each pooled result. Data from 19 studies were pooled that reported associations of rs324015, rs71802646 and rs324011 in STAT6 gene with asthma risk. The results demonstrated that 13GT and short GT in rs71802646 were both associated with increased risk of asthma in overall analysis (OR=1.26 for 13GT and 1.30 for short GT). Further, subgroup analysis showed an increased risk of asthma in Asian population with 13GT (OR=1.21), 14GT (OR=1.97) and short GT (OR=1.27). Besides, 13GT, 14GT and short GT all contributed to higher risk of atopic asthma, with OR 1.50, 2.21 and 1.65 respectively. However, rs324015 (G>A) appeared to be associated with decreased risk for atopic asthma (with OR=0.83, 0.68 and 0.79 for A, AA and AA+AG respectively). Both overall and subgroup analyses indicated no effect of rs324011 on asthma risk. In conclusion, our meta-analyses suggest that short GT repeats of rs71802646 in STAT6 contribute to higher risk for asthma, while rs324015 may have a protective effect on atopic asthma.

Patient evaluation of early discharge after hip arthroplasty: development of a measure and comparison of three centres with differing durations of stay

Objective: We compared patients’ evaluation of care between a surgical unit with a rapid discharge policy and two comparison units to test the hypothesis that the centre with rapid discharge has outcomes that are not inferior to those of the comparison sites. Design: Cross-sectional cohort study. Subjects: Consecutive consenting patients undergoing primary hip arthroplasty during 12 months in: a unit that had reduced postoperative stay to median three days; a specialised orthopaedic surgery treatment centre with median stay of five days; a traditional unit with median stay of six days (N = 316, 125, 119, respectively). Methods: Six weeks postoperatively, patients completed a specially developed questionnaire measuring their evaluation of care and recovery, together with measures of function and quality of life for validation purposes. Results: Factor analysis of questionnaire responses identified two independent components of patients’ evaluation: problems in staff care and problems in physical recovery. Neither component was impaired in the unit with rapid discharge: similar proportions of patients reported recovery problems in each site (odds radios (ORs) for the two comparators versus unit with rapid discharge: 0.96, 1.18); and more patients reported care problems in the two comparator sites (ORs 2.97, 2.16). Conclusion: Duration of stay after primary hip arthroplasty can be reduced to three days without intensive pre- or postoperative care, without detriment to patient evaluation.

Incontinencia urinaria a los 2 meses posparto. Persistencia de los síntomas a los 6 y 12 meses

ObjectivesTo determine the prevalence of urinary incontinence (UI) 2 months after delivery as well as the factors associated with delivery and pregnancy. To determine the persistence of UI at 6 and 12 months after delivery among women with UI at 2 months after delivery. Material and methodsWe performed an observational, prospective, longitudinal study with follow-up at 2, 6 and 12 months after inclusion in the study during hospital admission for delivery in the Vic General Hospital, the basic general hospital in the region of Osona (central Catalonia). Women who delivered live newborns at term between 1 January, 2001 and 31 March, 2002 were included. During admission for delivery, data were gathered on 707 women (age, parity, body mass index, symptoms of incontinence during pregnancy), type of delivery (vaginal, cesarean) and fetuses (weight, head circumference). At 2 months after delivery, 531 women were seen by a gynecologists to detect and establish a clinical diagnosis of UI through a specific protocol.Women were asked whether they had involuntary leaks of urine. Women with UI symptoms underwent a pelvic examination and a pad test was requested. Women with UI at 2 months after delivery were called for further clinical evaluation at 6 months. All women with persistent symptoms at the 6-month visit were contacted by telephone at 12 months. The prevalence of UI at 2 months after delivery was calculated and the persistence of symptoms at 6 and 12 months of delivery was determined. The association of IU at 2 months of delivery with maternal, fetal, and delivery-related factors was analyzed by obtaining odds radios (OR) and confidence intervals. ResultsOf the 531 women seen 2 months after delivery, 41 were diagnosed with UI. At 12 months after delivery, 11 (26.8%) of the 41 women with UI had persistent symptoms. The prevalence of UI at 2 months after delivery was 7.7% (95% CI, 5.6- 10.3). A logistic regression model for UI at 2 months (dependent variable), in which the independent variables of type of delivery, maternal age, and weight and head circumference of the newborn were introduced, revealed that UI was associated with vaginal delivery (OR=14.4; 95% CI, 1.9-107.2). ConclusionsVaginal delivery is a known risk factor for UI and our results confirm the impact of this route of delivery in clinical practice in a general hospital. Although severe cases persist, there is substantial reduction in symptoms in the first 12 months.

Musculoskeletal Pain, Disability and Quality of Life among Retired Dancers

The aim of this study was to examine the long-term effects of professional dancing by comparing the prevalence of musculoskeletal complaints between retired dancers and the general population. A structured questionnaire on the history of regional pains, disability, and overall health was mailed to all available retired members of the Finnish National Ballet (n = 37) and to all retired members of the Union of Finnish Dance Artists (n = 32). An age-matched pool of non-dancer controls (n = 631) was chosen from the Health 2000-Survey to represent the general Finnish population. Disability, overall health and quality of life were assessed using the Visual Analogue Scale (VAS). Differences in the occurrence of musculoskeletal complaints between dancers and controls were analyzed with a logistic regression model. The relative risks were evaluated as odds radios (OR) with 95% confidence intervals. Adjusted mean values of VAS scores were estimated using a generated linear model. The mean age of the ballet dancers was 59 years (range: 49 to 71 years) and that of the modern dancers 50 years (range: 42 to 62 years). Adjusted for age and sex, the risk, OR (95% CI in brackets), of walking difficulty or limping because of hip pain during the past month was 2.9 (1.3-6.3) in the retired dancers (ballet and modern combined) compared with the general population. With similar adjustments, the OR for a knee complaint was 3.7 (1.8-7.5) in the former dancer group in comparison to the controls. The risk of suffering from walking difficulty or limping because of hip or knee pain is significantly increased in dancers as compared to non-dancing controls. The walking difficulty and limping because of hip and knee pain are noteworthy symptoms when assessing a former dancers musculoskeletal health.

Prevalencia del uso de teléfonos móviles durante la conducción de vehículos

ObjectiveTo estimate the prevalence of mobile telephone use while driving vehicles in the city of Lleida (Spain). MethodsA random sample of 1536 cars passing through six intersections regulated by traffic lights in Lleida were selected (three with urban traffic and three with interurban traffic). Cyclists, motorcyclists and driving school cars were excluded. The variables studied were mobile telephone use, age, (18-40; 41-60; >61), sex, the presence of passengers, type of intersection (urban traffic/interurban traffic), day of the week (working day/weekend or holiday) and hour of the day (rush hour/non-rush hour). The prevalence of mobile telephone use was calculated in percentages with a 95% CI. The relationship among the dependent variable (mobile telephone use) and the other independent variables was studied using odds radios (OR) and 95% CI. ResultsA total of 1536 direct observations were made and mobile telephone use was detected in 50 drivers. The prevalence was 3.3 (95% CI, 2.4-4.3). The prevalence was higher in men (OR = 2.2; 95% CI, 1.0-5.7), in drivers aged more than 60 years old (OR = 2.2; 95% CI, 0.5-8,4) and in those aged 18-40 years old (OR =1.5; 95% CI, 0.8-3.0), in unaccompanied drivers (OR = 3.0; 95% CI, 1.5-6.3), in urban intersections (OR = 2.7; 95% CI, 1.2-5.9), on workdays (OR = 2.0; 95% CI, 0.9-4.4) and at the rush hour (OR =1.4; 95% CI, 0.8-2.4). ConclusionsThe prevalence of mobile telephone use while driving vehicles can be considered high, because of the increase in car accidents. The profile of drivers using mobile telephones corresponds to men aged 18-40 years or more than 61 years, in urban intersections, without passengers, during workdays and at the rush hour. We recommend the implementation of measures to decrease the use of mobile telephones while driving.

Optic disc hemorrhages in a population with and without signs of glaucoma

This study aimed to determine the prevalence and associations of optic disc hemorrhage in a well-defined older Australian population. The study design was a population-based, cross-sectional study. A total of 3654 persons 49 years of age or older, representing 88% of permanent residents from an area west of Sydney, participated in the study. Participants underwent a detailed eye examination. The diagnosis of optic disc hemorrhage was made from masked photographic grading; disc hemorrhages were subclassified as flame or blot in shape. Open-angle glaucoma was diagnosed from matching visual field loss and optic disc rim thinning. The overall prevalence of disc hemorrhage in either or both eyes was 1.4%. Disc hemorrhage prevalence was higher in women (odds radios [OR], 1.9; confidence interval [CI], 1.0-3.5) and increased with age (OR, 2.2 per decade; CI, 1.7-2.8 per decade). The overall prevalence in subjects with open-angle glaucoma was 13.8% (8% in high-pressure glaucoma and 25% in low-pressure glaucoma) and 1.5% in subjects with ocular hypertension. Disc hemorrhages were associated with increasing intraocular pressure (OR, 1.7 per 5 mmHg; CI, 1.3-2.3 per 5 mmHg), pseudoexfoliation (OR, 3.5; CI, 1.1-11.8), diabetes (OR, 2.9; CI, 1.4-6.3), and increasing systolic blood pressure (OR, 1.1 per 10 mmHg; CI, 1.0-1.3) after adjusting for age and gender. Among subjects without open-angle glaucoma, disc hemorrhages were more frequent in eyes with larger vertical cup-disc ratios and in subjects with a history of typical migraine headache (OR, 2.2; CI, 1.1-4.6). No associations were found among subjects with a history of vascular events, smoking, regular aspirin use, or myopia. Disc hemorrhage prevalence in this population is higher than that in the two previous population-based reports. Although the strong association of disc hemorrhage with open-angle glaucoma was confirmed (particularly low-pressure glaucoma), most disc hemorrhages (70%) were found in participants without definite signs of glaucoma.