Subjects Odds Ratio Research Articles

Cumulative cigarette tar exposure and lung cancer risk among Japanese smokers.

Tar concentration in cigarette brands is chronologically decreasing in the USA and Japan. However, studies investigating lung cancer risk with cumulative tar exposure in Western and Asian countries are insufficient. To investigate the risk of lung cancer with cumulative cigarette tar exposure, we conducted a case-control study among Japanese current smokers. This study used data from the US-Japan lung cancer joint study in 1993-1998. A total of 282 subjects with histologically confirmed lung cancer and 162 hospital and 227 community controls were included in the study, and two control groups were combined. The information regarding tar concentration was obtained from the published documents and additional estimation using the equation of regression. Cumulative tar concentration was calculated by multiplying the annual value of brand-specific tar concentration by years of smoking. The odds ratios and 95% confidence intervals for lung cancer with cumulative tar exposure were estimated using a logistic model. The odds ratios for lung cancer with both lower (1-59.8×105mg) and higher (>59.8×105mg) total cumulative tar exposure were statistically significant (3.81, 2.23-6.50 and 11.64, 6.56-20.67, respectively) with increasing trend (P<0.001). The stratification analysis showed higher odds ratios in subjects with higher cumulative tar exposure regardless of inhalation, duration of smoking filtered cigarettes and histological type. This study showed that cumulative tar exposure is a dose-dependent indicator for lung cancer risk, and low-tar exposure was still associated with increased cancer risk.

Short sleep is associated with higher prevalence and increased predicted risk of cardiovascular diseases in an Iranian population: Fasa PERSIAN Cohort Study

Cardiovascular disease (CVD) is the leading cause of death worldwide. One common factor that may affect CVD risk factors is sleep disturbance. The factors influencing an individual’s sleep may vary among different cultures. The current study investigated sleep quality and quantity in the Fasa cohort population as an Iranian population. In a cross-sectional study using the Fasa PERSIAN cohort study data, 10,129 subjects aged 35–70 were entered. Self-reported sleep duration and cardiovascular events were recorded. The Framingham risk score (FRS) is used to predict cardiovascular events. Adjusted logistic regression showed significant odds ratios in subjects who sleep less than 6 hours for CVD (OR = 1.23; 95% CI:1.03–1.48), coronary heart disease (CHD) (OR = 1.21; 95% CI:1.009–1.46), and hypertension (HTN) (OR = 1.37; 95% CI:1.16–1.62). Higher risk profiles were also seen in the FRS for short sleepers. The highest significant odds ratios in FRS profiles in the intermediate high-risk group compared with the low-risk group were (1.44; 95% CI:1.18–1.75) in CVD and (1.48; 95% CI:1.16–1.88) in CHD risk score profiles. It can be suggested that participants with short durations of sleep had significantly higher CVD, HTN prevalence, and 10-year FRS. Participants with long sleep durations had no increase in CVD, CHD, myocardial infarction (MI), or HTN prevalence. MI prevalence was at the lowest level in subjects who got 8 to 8.9 hours of sleep.

Diabetes, subclinical atherosclerosis and multiple cardiovascular risk factors in hard-to-reach asymptomatic patients.

To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26-62.69), 32.30 (confidence interval = 7.41-140.82) and 47.12 (confidence interval = 10.35-214.66) times, respectively. There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.

Factors associated with dental pain related to last dental visit among adult patients.

Most dental visits are made to seek dental care to relieve dental pain. However, the factors associated with behavior regarding dental visits due to pain are not fully understood. The objective of this study was to assess the factors associated with dental pain related to last dental visit among adults. The data was obtained from a cross-sectional study conducted on adults, aged 18-69 years, who visited public and private dental clinics in Dammam, Saudi Arabia. A pilot-tested, self-administered questionnaire was employed for data collection. Dental pain related to last dental visit was a dependent variable in the study. Gender, age, nationality, income and education levels, time since last dental attendance, type of dental clinic visited, and chronic systemic disease were important independent variables. The Pearson's χ2 test and multiple logistic regression analysis were used. The participants returned 671 questionnaires. Most of the participants were females (75.4%), and the majority (68.0%) attended private dental clinics. The prevalence of dental pain as the reason of last dental visit was 70.4%. A logistic regression model showed that odds ratio for subjects who visited the dentist due to pain in ≤1 year was 0.34 (95% CI = 0.24, 0.49) compared with patients who visited the dentist in >1 year. Similarly, male gender (OR = 0.64; 95% CI = 0.42, 0.97) subjects aged ≤35 years (OR = 0.61; 95% CI = 0.40, 0.95) were less likely to make pain-related dental appointments than females and individuals over 35 years. The respondents who attended private dental clinics were 1.56 (95% CI = 1.12, 2.37) times more likely to visit the dentist because of pain than those who attended a public clinic. Delayed dental visits, female gender, age over 35 years, and private clinic attendance were significant factors associated with dental consultations motivated by pain.

Impact of a 7-Day Field Training on Oral Health Condition in Japan Ground Self-Defense Force Personnel.

In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions. In this study, we investigated the impact of a 7-day field training on the oral health status of JGSDF personnel by comparing their oral condition before and just after training. The participants were 59 male and 3 female JGSDF personnel undergoing a 7-day field training. All personnel provided informed written consent to participate, and this study was approved by the ethics committee of the Kagoshima University Graduate School of Medical and Dental Sciences. Oral health behaviors before and during the training period were surveyed using a self-administered questionnaire. Dental caries was assessed before training in terms of decayed, missing and filled teeth (DMFT), and periodontal condition was examined before and immediately after training using the community periodontal index (CPI). The presence of eight species of bacteria in dental plaque, including commensal streptococci that are early colonizers on the tooth surface, cariogenic bacteria, and periodontopathic bacteria, was determined using real-time polymerase chain reaction. We also assessed antibacterial factors and a stress marker in saliva samples. Sample collection was performed before and just after training. In addition to difference analysis between groups, logistic regression analysis was performed to examine the association between each health behavior and periodontal deterioration. The frequency of toothbrushing decreased, and snacking increased during the training period. Thirty-five personnel (56.5%) showed an increase in individual CPI code, and 57 personnel (91.9%) showed deterioration in the CPI code in 1 or more sextants after training (Figure 1). Toothbrushing frequency was significantly associated with CPI deterioration; the odds ratio in subjects who did not brush their teeth was 7.51 compared to those who brushed at least once during the training period. Severe periodontal deterioration was observed in the high-DMFT group (Figure 2), and toothbrushing frequency during the training period decreased more in this group compared to the low-DMFT group. The percentages of Streptococcus sanguinis and Streptococcus gordonii increased significantly after the training period suggesting dental plaque maturation, and an increase in S. sanguinis was associated with toothbrushing frequency. The lactoferrin concentration in saliva increased significantly after training. We demonstrated periodontal deterioration in JGSDF personnel after a 7-day training. Behavioral changes, especially discontinuation of regular toothbrushing, fostered dental plaque maturation, resulting in inflammatory changes in participants' periodontal condition. The results indicate the importance of performing toothbrushing at least once over a 7-day training period for prevention of periodontal deterioration. The regimen could be applicable to evacuees from disasters because they are under conditions of stress that may limit oral hygiene activity.

Participation inequality in the National General Health Examination based on enterprise size

BackgroundHealth examinations are performed so that diseases can be identified and treated earlier. Several studies have evaluated the determinants of participation in health examinations including cancer screening, but few have evaluated the relationship between the size of the enterprise and their participation in Workers’ General Health Examinations (WGHE). The aim of the present study was to estimate the association of WGHE participation with the size of the enterprise and the type of policyholder.MethodsThe eligible population from 2006 through 2013 was extracted from the National Health Insurance Service (NHIS) database. The population size ranged from 14–17 million. After adjustment for age and gender, multiple logistic regression analysis was performed to estimate the odds ratios of participating in the WGHE (by age group) based on the type of policyholder (reference: public officers) and the size of the enterprise (reference: enterprise size ≥300 employees), respectively.ResultsWorkers employed at enterprises with <50 persons were less likely to participate in WGHEs than those employed at enterprises with ≥300 persons. After policyholders were stratified by type (non-office workers vs. public officers), a disparity in the WGHE participation rate was found between the different types of policyholders at enterprises with <50 employees (reference: those employed at enterprises with ≥300 employees); the odds ratios for subjects in their 40s and 50s were 0.2–0.3 for non-office workers vs. 0.8–2.0 for public officers.ConclusionWorkplace policyholders at small enterprises comprised a vulnerable group less likely to participate in WGHEs. Efforts should be made to raise the WGHE participation rate among the vulnerable employees belonging to small enterprises, as well as among their dependents.

Self-reported symptoms of uninvestigated dypepsia among University staff in Ilorin, Nigeria

Objectives: Dyspepsia is a common gastrointestinal (GI) symptom which impacts negatively on quality of life, workplace efficiency and overall productivity. Many studies on dyspepsia in our environment are hospital based, but being a complaint frequently treated first by self-medication before presentation to the hospital, such studies may underestimate its prevalence. The objective of the study was to determine the prevalence of the dyspepsia and its associated factors among administrative staff of the College of Health Sciences, University of Ilorin, Nigeria.Methods: This was a cross-sectional study. Pretested structured, close-ended, interviewer-administered questionnaires were administered to 53 administrative staff selected across the different units by stratified random sampling. The questionnaire obtained information about subject's experiences of dyspeptic symptoms and presence of associated factors such as family history, non-steroidal anti-inflammatory drugs (NSAIDS), tobacco and alcohol use, and presence of diabetes mellitus (DM).Results: The prevalence of uninvestigated dyspepsia among the respondents was 37.5%. Age was significantly predictive of the occurrence of dyspepsia among the subjects Odds Ratio- 1.46, 95% Confidence Interval (1.042-2.045) P=0.03. Use of NSAIDS, presence of DM, family history and tobacco use were not predictive of occurrence of dyspepsia.Conclusion: The prevalence of dyspepsia is high among respondents in the study.Keywords: Dyspepsia, prevalence, university, Nigeria

Associations between hypo-HDL cholesterolemia and cardiometabolic risk factors in middle-aged men and women: Independence of habitual alcohol drinking, smoking and regular exercise

ObjectiveHypo-HDL cholesterolemia is a potent cardiovascular risk factor, and HDL cholesterol level is influenced by lifestyles including alcohol drinking, smoking and regular exercise. The aim of this study was to clarify the relationships between hypo-HDL cholesterolemia and cardiovascular risk factors and to determine whether or not these relationships depend on the above-mentioned lifestyles. MethodsThe subjects were 3456 men and 2510 women (35–60 years of age) showing low HDL cholesterol levels (<40mg/dl for men and <50mg/dl for women) and their age-matched control subjects showing normal HDL cholesterol levels. Each cardiometabolic risk factor was compared between the groups with and without hypo-HDL cholesterolemia. Data for hypo-HDL cholesterolemic subjects not having habits of alcohol drinking, smoking and regular exercise (men, n=333; women, n=1410) and their age-matched control subjects were also analysed. ResultsBoth in men and in women of overall subjects and subjects without histories of alcohol drinking, smoking and regular exercise, odds ratios of subjects with hypo-HDL cholesterolemia vs. subjects with normo-HDL cholesterolemia for high body mass index, high waist-to-height ratio, high triglycerides, high lipid accumulation product and multiple risk factors (three or more out of obesity, hypertension, dyslipidaemia and diabetes) were significantly higher than the reference level of 1.00. These associations in overall subjects were found when the above habits were adjusted. ConclusionsHypo-HDL cholesterolemic men and women have adverse cardiovascular profiles, such as obesity, hypertriglyceridemia and multiple risk factors, independently of age, alcohol drinking, smoking and regular exercise.

Functional Priorities in Persons with Spinal Cord Injury: Using Discrete Choice Experiments To Determine Preferences.

Major goals of rehabilitation and health interventions in people with spinal cord injury (SCI) are to improve functional independence, increase social participation, and enhance quality of life (QOL). Determining functional areas perceived by consumers as most important can assist in research prioritization, planning for delivery of health services, and policy development. Five high priority areas of functioning for the SCI population (arm/hand use, walking, bladder/bowel control, sexual function, and relief of pain) were chosen to determine the preferences for these five attributes. A discrete choice experiment was conducted involving 151 persons with SCI sampled from Australia and the United States of America. Consistent with prior research, arm/hand function had the highest preference, with odds ratios of subjects being 44-76% more likely to choose arm/hand function over the other four functions. Preference for normal arm/hand function was found to be significantly more preferred by the group with paraplegia compared with those with tetraplegia; that is, retaining and not trading off existing arm/hand function for other improved functions. There were no significant differences found in preferences between bladder/bowel function and walking or elimination of pain, although walking was preferred in earlier (≤ 10) post-injury years and pain amelioration became more important with a longer duration (>10 years) post-injury. Sexual function had the lowest preference when traded against the other four functions. Understanding the functional preferences of persons with SCI will help to inform future research design, as well as enabling successful translation of research into practice and health policy, meeting the needs of people with SCI.

A U-shaped relationship between alcohol consumption and cardiometabolic index in middle-aged men.

BackgroundCardiometabolic index (CMI) is a new index for discriminating diabetes. The purpose of this study was to determine whether CMI is affected by habitual alcohol drinking.MethodsThe subjects were 21572 men (35-60 years) receiving annual health checkups. They were divided by average daily ethanol consumption into non-, light (<22 g), moderate (≥22 and < 44 g), heavy (≥44 and < 66 g) and very heavy (≥66 g) drinkers. Relationship between alcohol intake and CMI was investigated with adjustment for age and histories of smoking and regular exercise.ResultsLog-transformed CMI was significantly lower in light, moderate and heavy drinkers than in nondrinkers and was lowest in light drinkers, while there was no significant difference in log-transformed CMI of nondrinkers and very heavy drinkers. Odds ratio vs. nondrinkers for high CMI was significantly lower than the reference level of 1.00 in light, moderate and heavy drinkers and was lowest in light drinkers but was not significantly different from the reference level in very heavy drinkers. Odds ratio of subjects with vs. those without high CMI for hyperglycemia was significantly higher than the reference level in all of the alcohol groups and was significantly lower in moderate drinkers but was not significantly different in the other drinker groups when compared with the nondrinker group.ConclusionThere is a U-shaped relationship between alcohol consumption and CMI, and moderate drinking but not excessive drinking attenuates the association between CMI and hyperglycemia.

Association Study of Cathepsin D Gene Polymorphism in Iranian Patients with Sporadic Late-Onset Alzheimer's Disease

One of the most prevalent forms of dementia is Alzheimer's disease (AD). Complex inheritance and multifactorial patterns of late-onset AD (LOAD) along with its heterogeneity are due to the presence of different AD-predisposing genes with different influence on disease development among various populations. A key event in the pathogenesis of AD is the deposition of β-amyloid peptide, which is derived from the amyloid precursor protein by β- and γ-secretases. Cathepsin D (CTSD) is an acid protease with β- and γ-secretase-like features in vitro. An exonic C→T polymorphism at position 224 of the CTSD gene (rs: 17571) has been shown to be associated with the enzyme function of CTSD and with AD. Two studies in the German population reported a strong association of this polymorphism with an increased risk of developing AD, while other studies did not confirm this observation. We tested for this association in a case-control study in 100 Iranian sporadic LOAD patients based on diagnostic criteria of DSM-IV-TR and NINCDS-ADRDA and in 100 normal controls without any personal and family history of AD or other related dementias. Polymerase chain reaction-restriction fragment length polymorphism was set up to detect this polymorphism. Our study demonstrated that T-carrying genotype frequency in AD patients is significantly higher than in controls and there was a 2.5-fold increased risk for developing AD in the T-carrying genotype compared to C/C genotype (odds ratio = 2.5, p = 0.010). The odds ratio for subjects with the apolipoprotein E ε4 (APOE ε4) allele was 2.91 (p = 0.003) and carriers of the CTSD T and APOE ε4 alleles had a 6.25-fold increased risk of the disease (p = 0.0). Our results indicate that CTSD genotype is associated with the disease and a combination of the above risk factors significantly alters the risk for developing AD.

AB1314 Involvement in medical decisions and alexithymia among patients with rheumatoid arthritis

BackgroundThere is little research on the impact of emotion regulation on patient participation in rheumatology. Alexithymia is a well researched conceptualization of dysfunctional emotion regulation, characterised by difficulties in identifying...

1852 A MULTICENTRIC RANDOMIZED CONTROLLED STUDY COMPARING SURGICAL AND PHARMACOLOGICAL THERAPY TO TREAT MIXED URINARY INCONTINENCE

INTRODUCTION AND OBJECTIVES: Mixed urinary incontinence (MUI) defined as the combination of stress and urge incontinence accounts for approximately 33% of all cases of incontinence in women. No consensus exist in literature either medical or surgical treatment has to be proposed first and the usual attitude to treat the dominant symptom first is not supported by any evidence and often disappointing. Our aim to determine the most effective strategy and sequence of therapy between surgery and anticholinergics in females suffering from mild to severe MUI. METHODS: 66 women were included in a prospective multicentre randomized study with an optimal cross over. In phase 1 of the study patients were randomized into two groups: TVT-O (J&J Women’s Health) procedure or Oxytrol patch (Paladin) 3.9 mg/Q3D for 12 weeks. In phase 2 patients not satisfied with the result of their initial treatment were offered a cross over. Our primary outcome was 24h pad test. Cure was defined by a 24-h pad test of 8 g or less. Improvement was defined by a reduction of pad weight 25% in comparison to base line and failure less 25% reduction of pad weight. The follow-up was 56 weeks. RESULTS: 66 patients were randomised and 62 patients completed the study. In phase 1, 31 patients received Oxytrol treatment and 31 patients TVT-O procedure. At 12 weeks, 64% (20/31) of patients having had TVT-O as first line were satisfied (80% (16/20) cured). Only 16% (5/31) patients having had Oxytrol as first line were satisfied (20% (1/5) cured). At 12 weeks, the odds ratio for subjects in TVT-O group to be satisfied and cured were respectively 11.57 times (11.57, 95% CI 2.93-45.67, p 0.05) and 8.03 times (8.03, 95% CI 2.93-45.67, p 0.05) higher than those in Oxytol group. At 12 weeks, 84% (26/31) of patients who started with Oxytrol crossed over to TVT-O and 61,5% (16/26) were cured at 56 weeks after surgical procedure. Only 35% (11/31) of patients who started with TVT-O crossed over to Oxytrol and 18% (2/11) were cured at 56 weeks. CONCLUSIONS: Patients with moderate to severe MUI treated surgically in first line have statistically better chance to be cured in comparison to a patient treated pharmacologically.

Radiation-Related Risk of Basal Cell Carcinoma: A Report From the Childhood Cancer Survivor Study

Basal cell carcinoma (BCC) is the most common malignancy in the United States. Ionizing radiation is an established risk factor in certain populations, including cancer survivors. We quantified the association between ionizing radiation dose and the risk of BCC in childhood cancer survivors. Participants in the Childhood Cancer Survivor Study who reported a BCC (case subjects, n = 199) were matched on age and length of follow-up to three study participants who had not developed a BCC (control subjects, n = 597). The radiation-absorbed dose (in Gy) to the BCC location was calculated based on individual radiotherapy records using a custom-designed dosimetry program. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between demographic and treatment factors, therapeutic radiation dose, and surrogate markers of sun sensitivity (skin and hair color) and the risk of BCC. A linear dose-response model was fitted to evaluate the excess odds ratio per Gy of radiation dose. Among case subjects, 83% developed BCC between the ages of 20 and 39 years. Radiation therapy, either alone or in combination with chemotherapy, was associated with an increased risk of BCC compared with no chemotherapy or radiation. The odds ratio for subjects who received 35 Gy or more to the skin site vs no radiation therapy was 39.8 (95% CI = 8.6 to 185). Results were consistent with a linear dose-response relationship, with an excess odds ratio per Gy of 1.09 (95% CI = 0.49 to 2.64). No other treatment variables were statistically significantly associated with an increased risk of BCC. Radiation doses to the skin of more than 1 Gy are associated with an increased risk of BCC.

P-glycoprotein Polymorphisms Predict Antidepressant Dose to Remit

P-glycoprotein Polymorphisms Predict Antidepressant Dose to Remit. Original hypothesis and empirical study by: Dr Ajeet Bhagat Singh (DOB 24-01-1973) 'Singh Patent 1' Patent Application Number: 2012201179 Abstract The P-glycoprotein (Pgp) transporter is a key component of the blood brain barrier (BBB). Many antidepressants are subject to Pgp efflux. Functional polymorphisms of the gene encoding Pgp may influence CNS bioavailability of antidepressants subject to efflux. Single nucleotide polymorphisms (SNPs) at rs1045642 (C3435T) of the Pgp gene have been associated with efflux pump efficiency. This may help explain inter-individual variation in antidepressant dose needed to remit. In this study 113 patients with DSM-IV major depressive disorder (MDD) and of either Caucasian or Chinese heritage where treated with escitalopram (ESCIT) or venlafaxine (VEN) in a naturalistic setting over 8 weeks. 17-item Hamilton Depression Rating Scale (HDRS) scale was assessed serially and blind to genotype. SNP rs1045642(C3435T) of the Pgp gene along with two SNPs previously reported to be in linkage disequilibrium (LD) with it (rs2032582 and rsl 128503) where genotyped. Hepatic P450 2D6 and 2C19 metaboliser status and 5-HTTLPR genotype were controlled for along with demographic and clinical factors. 12.5% of VEN treated subjects with CC allele at rs1045642(C3435T) remitted compared to 73.3% for TT subjects odds ratio (OR) = 6.69 (p=0.006). This was significant with Bonferroni correction. ESCIT average dose needed to remit was 24mg for subjects carrying the TC allele and only 11mg for subjects carrying the TT allele (p = 0.0001) at rs1045642(C3435T). These are these first known data indicating antidepressant dose needed to remit can be predicted by a Pgp SNP. This has potential clinical implications for initial dose selection and sooner remission from MDD.

Career choice and place of graduation among physicians in Norway

Objective. To investigate to what extent a physician's place of graduation is associated with the physician choosing a career as a general practitioner (GP), and identify factors in the curriculum that could predict a general practice career. Design. Cross-sectional study based on the membership database of the Norwegian Medical Association. Setting. Physicians working in Norway who graduated from four domestic medical schools, five other countries, and three groups of countries. Physicians were categorized according to their main professional activity as GPs, hospital physicians, and researchers. Subjects. A total of 2836 medical physicians who were working in Norway during 2010 and graduated from medical school between 2002 and 2005. Main outcome measures. Percentage and odds ratio for subjects working as a GP in Norway during 2010. Descriptive data for pre-graduate general practice education in Norwegian medical schools were also analysed. Results. Compared with the University of Oslo, there was a significantly higher proportion of GPs among physicians who had graduated from Denmark (OR 2.9, 95% CI 1.9–4.5), Poland (OR 2.0, 95% CI 1.4–2.9), Sweden (OR 1.8, 95% CI 1.0–3.1), and Trondheim (Norway) (OR 1.5, 95% CI 1.1–2.0). Across the four Norwegian medical schools, there were significant associations between choosing a general practice career and the sum of pre-graduate educational hours regarding general practice, general practice preceptorship, and the number of GP teachers. Conclusion. The physician's place of graduation appears to be associated with career choice. The universities’ total contribution in pre-graduate general practice education may be associated with future GP career choice.

갑상선암 초음파검사이행 의도에 영향을 미치는 요인

본 연구는 갑상선암 초음파검사이행 의도에 영향을 미치는 요인들을 규명하기 위해 시도하였다. 자료는 2010년 12월 13일부터 2011년 1월 31일까지 서울에 소재한 한 종합병원에 내원한 검진자 205명을 대상으로 설문 및 면접조사로 도출하였다. 연구결과 첫째, 건강습관에 따른 갑상선암 초음파검사이행 의도는 본인의 건강이 양호하다는 경우 수검의도가 있는 응답자가 85.5%로 수검의도가 없는 응답자의 70.0%보다 유의하게 높았다(<TEX>$X^2$</TEX>=6.73 p<.01). 둘째 갑상선암 초음파검사이행 의도의 영향요인은 본인이 건강하다는 사람이 그렇지 않은 사람에 비해 2.53배 수검의도가 유의하게 높았다(95% Cl=1.39-12.7). 결론적으로 건강행태를 실천하지 않는 사람들의 갑상선암 초음파검사이행 의도를 높이기 위한 교육적 접근이 필요하다. 갑상선암 예방에 대한 지식을 높일 수 있는 적극적인 홍보도 수행되어야 할 것이다. This study was attempted to identify the effect of thyroid cancer on ultrasonographic intention. Data was surveyed using interview and questionnaires by 205 subjects in a general hospital who was located in Seoul from December 13, 2010 to January 31, 2011. The results were as follows ; First, in the good self-conscious health status, 85.5% of the subjects had an intention for thyroid cancer ultrasonography according health habit was significantly higher than 70.0% of the subjects didn't have an intention for thyroid cancer ultrasonography(<TEX>$X^2$</TEX>=6.73 p<.01). Secondly, the odds ratio of subjects with a good self-conscious health status was 2.53, had a higher intention to participate in thyroid ultrasonography than subjects with a poor self-conscious health status(95% Cl=1.39-12.7). In conclusion, we need to provide education to subjects in poorer health so that they will also participate in thyroid cancer ultrasonography. Active promotion should also be performed to elevate knowledge about the prevention of thyroid cancer.

Prevalence of the metabolic syndrome and its relationship with diabetes mellitus by aging

Introduction. It is important to make a prompt diagnosis of metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebro- vascular diseases and diabetes mellitus (DM). The authors estimated the risk of development of DM by the presence/absence of MetS and age groups.Methods. A cross-sectional study of subjects undergoing intensive health examination was conducted (3149 men aged 30–69 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel (NCEP).Results. The prevalence of DM occurring in association with MetS increased with age; it was 11.9% in subjects with MetS in their 30s, it was 19.8% in subjects with MetS in their 60s. The prevalence of DM among subjects who had one or two components of MetS also increased with age. There was a significant progressive increase of the odds ratio in subjects in their 30s, 40s, 50s and 60s who were judged as having MetS; significant increase of the odds ratio was seen in subjects in their 60s, even in those who were not judged as having MetS.Conclusions. Subjects with MetS show a high prevalence of DM, and the prevalence increased with age in the subjects.

Variants of transcription factor 7-like 2 (TCF7L2) gene predict conversion to type 2 diabetes in the Finnish Diabetes Prevention Study and are associated with impaired glucose regulation and impaired insulin secretion

We investigated the association of variants of the transcription factor 7-like 2 (TCF7L2) gene with: (1) incident diabetes in the Finnish Diabetes Prevention Study (DPS, Study I); (2) type 2 diabetes and impaired glucose regulation (i.e. IGT or IFG) in a cross-sectional study (Study II); and (3) insulin secretion, insulin sensitivity and adipose tissue expression of TCF7L2 in offspring of type 2 diabetic probands (III). Study I (the DPS) included 507 individuals with IGT who were randomly allocated to control and intervention groups and followed for an average of 3.9 years to monitor for progression to diabetes. Study II was a population-based cross-sectional study of 1,766 men, aged 50-70 years, randomly selected from the population of Kuopio, eastern Finland. Study III included 238 non-diabetic offspring of patients with type 2 diabetes. Genotyping of rs12255372 and rs7903146 of TCF7L2 was carried out. In the DPS, the TT genotype of rs12255372 was significantly associated with an adjusted 2.85-fold risk (95% CI 1.17-6.95, p = 0.021) of incident diabetes in the control group, but not in the intervention group. In Study II, the adjusted odds ratio in subjects with the TT genotype was 3.40 (1.45-7.97, p = 0.005) for the comparison of diabetic subjects with normoglycaemic subjects. The T allele of rs12255372 was significantly associated with decreased insulin secretion (Studies II, III). Expression of TCF7L2 in adipose tissue tended to be lower in subjects with the TT risk genotypes of rs12255372 and rs7903146. The variant of rs12255372 of TCF7L2 was associated with incident type 2 diabetes in the DPS and in a separate population-based cross-sectional study. Impaired insulin secretion is likely to be the main cause for our findings.

Flavonoids and the Risk of Renal Cell Carcinoma

Intake of flavonoids has been inversely related to the risk of various common neoplasms, but limited data exist on renal cell carcinoma (RCC). We used data from a case-control study conducted between 1994 and 2002 in four Italian areas to study the relation between major flavonoid classes and RCC. The study included 767 cases with incident, histologically confirmed RCC and 1,534 hospital controls admitted for acute, nonneoplastic conditions and matched with cases by study center, sex, and quinquennia of age. We applied published data on food and beverage content of six major classes of flavonoids to dietary information collected through a validated food frequency questionnaire. After adjustment for major recognized confounding factors and total energy intake, the odds ratios for subjects in the highest versus the lowest quintile of intake were 0.80 [95% confidence interval (95% CI), 0.58-1.11] for total flavonoids, 0.76 (95% CI, 0.56-1.03) for isoflavones, 0.94 (95% CI, 0.60-1.47) for anthocyanidins, 0.77 (95% CI, 0.56-1.06) for flavan-3-ols, 0.90 (95% CI, 0.67-1.21) for flavanones, 0.68 (95% CI, 0.50-0.93) for flavones, and 0.69 (95% CI, 0.50-0.95) for flavonols. Allowance for vegetable and fruit consumption only partly explained these inverse relations. Thus, flavonoids, and particularly flavones and flavonols, may account, at least in part, for the favorable role of plant foods on RCC.