Home About us Contact
|
Home About us Contact | ||
|
|
||
Pack Years (pack + year)
Selected AbstractsNonsteroidal antiinflammatory drug use and risk of bladder cancer in the health professionals follow-up studyINTERNATIONAL JOURNAL OF CANCER, Issue 10 2007Jeanine M. Genkinger Abstract Nonsteroidal antiinflammatory drugs (NSAIDs) use, particularly aspirin, may lower the risk of several cancers, including bladder. NSAIDs may reduce development of bladder tumors by decreasing inflammation, inhibiting cycloxygenase-2, inhibiting proliferation and inducing apoptosis of cancer cells. However, acetaminophen, a major metabolite of phenacetin, may be positively associated with bladder cancer risk. Results from case-control studies on NSAIDs and acetaminophen use and bladder cancer risk are inconsistent. We investigated the association between NSAID and acetaminophen use and bladder cancer risk in a large cohort of US males. Among 49,448 men in the Health Professionals Follow-Up Study, 607 bladder cancer cases were confirmed during 18 years of follow-up. Relative risks (RR) and 95% confidence intervals (CI) were calculated by Cox proportional hazards models. Multivariate RR were adjusted for age, current smoking status, pack years, geographic region and fluid intake. No significant associations were observed for regular aspirin (,2 tablets per week), (RR = 0.99, 95% CI 0.83,1.18), ibuprofen (RR = 1.11, 95% CI 0.81,1.54), acetaminophen (RR = 0.96, 95% CI 0.67,1.39) or total NSAID use (not including acetaminophen; RR = 1.01, 95% CI 0.85,1.20) and bladder cancer risk compared with nonuse. Consistent use (over 6 years) of aspirin, ibuprofen, acetaminophen and total NSAIDs, compared to nonuse, was not associated with bladder cancer risk. No association was observed between aspirin frequency and dose and bladder cancer risk. We observed no effect-modification by smoking, age or fluid intake. Our results suggest that regular NSAID or acetaminophen use has no substantial impact on bladder cancer risk among men. © 2007 Wiley-Liss, Inc. [source] Characteristics of skin aging in Korean men and womenINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2005J. H. Chung Introduction Korea is located between Japan and Mainland China. The people of these three countries have similar appearances and it is difficult to differentiate between them. Although the population of Asia is more than half of the total population of the Earth, the inherent characteristics of Asian skin have not been well investigated. Commercial markets for cosmetics and drugs for photoaged skin are rapidly expanding in many Asian countries. Therefore, many investigators in the field of dermatology and cosmetology have become interested in brown Asian skin. Clinical characteristics of skin aging and photoaging in Asians Skin aging can be divided into two basic processes: intrinsic aging and photoaging [1]. Intrinsic aging is characterized by smooth, dry, pale, and finely wrinkled skin, whereas photoaging, which indicates premature skin aging in chronically photodamaged skin, is characterized by severe wrinkling and irregular pigmentation. The pattern of wrinkling in Asians seems to differ from that in Caucasians. Asians have coarser, thicker and deep wrinkles, particularly in the forehead, perioral and Crow's foot areas. In contrast, Caucasians usually have relatively fine cheek and Crow's foot wrinkles. The reasons for these differences are not known and need further investigation. There are racial, ethnic and genetic differences, and differences of skin structure and function, between the brown skin of Asians and the white skin of Caucasians. As Asian skin is more pigmented, acute and chronic cutaneous responses to UV irradiation differ from those in white skin. Many people believe, based on clinical impressions, that the main process of photoaging in Asians involves pigmentary changes, rather than wrinkling. However, no study has been performed to confirm this belief. Risk factors for skin wrinkles and their relative risks in Korean skin [2] Various factors such as age, sun-exposure, and smoking are known to be important risk factors for wrinkles. However, the relative risks of each factor on wrinkles in the brown skin of Asians have not been investigated, and they could differ from those in Caucasians. An evaluation system for skin wrinkling is necessary for Asian skin [3]. Thus, we developed an eight-point photographic scale for assessing wrinkles in both Korean genders [2]. This scale can probably be applied to the populations of other Asian countries, at least to the Japanese and Chinese. The pattern of wrinkles in both genders appears to be similar. Age Age is an important risk factor for wrinkling in Asians, as in Caucasians. Korean subjects in their 60s showed a 12-fold increased risk of wrinkling, while subjects in their 70s have a 56-fold increased risk compared with young age group. UV light It is well known that the UV component in sunlight can cause and accelerate photoaging. The pigmented skin of Asian may better protect skin from acute and chronic UV damage. However, we found a strong association between sun-exposure and the development of wrinkling in Koreans. It was found that sun exposure of more than 5 h per day was associated with a 4.8-fold increased risk in wrinkling versus less than 2 h of sun-exposure in Koreans. Estrogen deficiency Korean females have more wrinkles than men, after controlling for age, sun exposure, and smoking, it was found that they have a 3.6-fold increased risk of developing wrinkles than their male counterparts [2]. It has also been reported, that the relative risk for wrinkling in women is higher than in men as for in white Caucasians [4]. The reason why women show more wrinkles remains to be determined. It is possible that a reduction in skin collagen because of estrogen deficiency in postmenopausal woman may aggravate wrinkling severity. Korean women with more than 10 years since menopause showed a 3.9-fold higher risk of wrinkling than the women 5 years of beyond menopause [5]. We demonstrated that women with a history of HRT have a significantly lower risk, more specifically, one fifth of the risk of facial wrinkling relative to those who had no history of HRT. Interestingly, we found that wrinkle severity significantly increased with an increasing number of full term pregnancies. The relative risk for severe wrinkling is increased by approximately 1.8-fold per full term pregnancy. Smoking It is known that smoking causes skin wrinkling in Caucasians, and that it plays no role in Blacks [6, 7]. Koreans with have a smoking history of more than 30 pack years showed a more than 2.8-fold increased risk of wrinkles [2]. The relative risks of wrinkles associated with a 30,50 pack-years history of smoking were 2.8- and 5.5-fold, respectively. Dyspigmentation in Asian skin To follow pigmentary changes, six photographic standards for both genders were developed for Korean skin, to produce a 6-point scale [2, 8]. Hyperpigmented spots, mostly lentigines, were prominent among women, while seborrheic keratosis tended to be more prominent in men. Seborrheic keratosis in Korean men Seborrheic keratoses (SKs) are benign cutaneous tumors. They have diverse clinical and histopathological appearances and are very common in the elderly (over 50 years old). The etiology of SKs is not well understood, although patients with a great number of lesionsshow a familial trait with an autosomal dominant pattern, and human papilloma virus has been suggested as possible cause because of verrucous appearance of the lesions. Exposure to sunlight has been suggested to be a risk factor for SKs. However, there is still some debate in terms of the role of sunlight. Recently, we have investigated the clinical characteristics of SKs and relationship between SKs and sunlight exposure in Korean males [9]. The prevalence of SKs in Koreans increases with age; it rose from 78.9% at 40 years, to 93.9% at 50 years and 98.7% in those over 60 years. Exposed areas, i.e. the face, neck and dorsum of the hands, demonstrate a significant increase in the prevalence of SKs by decade, whereas partly exposed areas, although SKs tended to increase in prevalence with age, this trend was not significant. When the estimated body surface area (BSA) is taken into account, the number of SKs on both the face and dorsum of the hands (0.51 ± 0.08 per 1% BSA) was over-represented compared with the trunk. SKs were also concentrated on the neck (0.38 ± 0.07 per 1% BSA) and in the V-area (0.47 ± 0.09 per 1% BSA). Outer forearms also showed 3-fold more SKs per unit area than neighboring arms and inner forearms, which are classified as partly exposed area (0.09 ± 0.02, 0.03 ± 0.01, respectively). The total area covered by SKs on exposed area also became significantly larger with aging than on intermittently exposed areas. These results indicate that exposure to sunlight might be related to SK growth. Our results indicated that excessive sun exposure is an independent risk factor of SKs. After controlling for age, smoking, and skin type, subjects with a sun exposure history of more than 6 hours per day showed a 2.28-fold increased risk of having severe SKs (n , 6) compared with those exposed for less that 3 h per day. These findings indicated that sun-exposure may play an important role in SK development. In summary, SKs are very common in Korean males and represent one of the major pigmentary problems. SKs concentrate on exposed skin, especially on the face and dorsum of the hands. Both age and lifetime cumulative sunlight exposure are important contributing factors and may work in a synergistic manner. Conclusion Many people tend to believe that wrinkles are not a prominent feature of Asian photoaged skin, and that dyspigmentation is a major manifestation in Asian skin. Contrary to this impression, wrinkling is also a major problem in the photoaged skin of Asians, and Korean people showing severe pigmentary changes usually tend to have severe wrinkles. In conclusion, the wrinkling patterns and pigmentary changes of photoaged skin in East Asians differ from those of Caucasians, and the relative risks of aggravating factors may be different from those of Caucasian skin. References 1.,Gilchrest, B.A. Skin aging and photoaging: an overview. J. Am. Acad. Dermatol. 21, 610,613 (1989). 2.,Chung, J.H. et al. Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color. Arch. Dermatol. 137, 1043,1051 (2001). 3.,Griffiths, C.E. et al. A photonumeric scale for the assessment of cutaneous photodamage. Arch. Dermatol. 128, 347,351 (1992). 4.,Ernster, V.L. et al. Facial wrinkling in men and women, by smoking status. Am. J. Public Health. 85, 78,82 (1995). 5.,Youn, C.S. et al. Effect of pregnancy and menopause on facial wrinkling in women. Acta Derm. Venereol. 83, 419,424 (2003). 6.,Kadunce, D.P. et al. Cigarette smoking: risk factor for premature facial wrinkling. Ann. Intern. Med. 114, 840,844 (1991). 7.,Allen, H.B., Johnson, B.L. and Diamond, S.M. Smoker's wrinkles? JAMA. 225, 1067,1069 (1973). 8.,Chung, J.H. Photoaging in Asians. Photodermatol. Photoimmunol. Photomed. 19, 109,121 (2003). 9.,Kwon, O.S. et al. Seborrheic keratosis in the Korean males: causative role of sunlight. Photodermatol. Photoimmunol. Photomed. 19, 73,80 (2003). [source] Predictors of disability among Filipinos with knee osteoarthritisINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2008Ester G. Penserga Abstract Aims: This study aims to describe the level of disability of Filipino patients with knee osteoarthritis (OA) in relation to common risk factors. Methodology: This is a cross-sectional analytic study. Patients with knee osteoarthritis diagnosed using the American College of Rheumatology criteria for the classification of knee OA, seen at East Avenue Medical Center, using the Quezon City, Philippines, were entered by convenient sampling. The Western Ontario and McMaster Universities (WOMAC (va) 3.1 Tagalog Version) osteoarthritis index was used. Self-reported disability was measured by the function subscale of the WOMAC OA index and used as the dependent variable. Independent variables assessed as possible risk factors affecting disability were age, sex, weight, height, body mass index (BMI), education (in years), number of comorbidities present, smoking status (pack years), duration of knee OA, pain and stiffness. Categories of disability were identified as high, moderate and low. Analyses of the data were performed using Statistical Package for the Social Sciences (SPSS) version 13. Results: Eighty-five subjects were included in the study. The mean disability score was 674.1 ± 318.81 (moderate disability). Chi-square tests showed that the categories or levels of disability are not significantly dependent on the categorical variables. Significant direct correlations were seen between mean disability and weight (r = 0.260, P = 0.016), pain (r = 0.574, P = 0.000), and stiffness (r = 0.616, P = 0.000). Conclusion: This is the first study analysing the relationship between disability and specific risk factors among Filipino patients with knee OA. Self-reported disability of knee OA in the population studied was strongly related to pain scores, weight and joint stiffness scores. [source] Relationship of cigarette smoking to the subgingival microbiotaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2001A. D. Haffajee Abstract Background: The relationship of cigarette smoking to the composition of the subgingival microbiota is not clear. Some studies indicated higher levels of certain species in smokers, while other studies failed to detect differences in the microbiota between subjects with different smoking histories. Thus, the purpose of the present investigation was to examine the prevalence, proportions and levels of the subgingival species in adult subjects who were current, past or never smokers. Method: 272 adult subjects ranging in age from 20,86 years with at least 20 teeth were recruited for study. Smoking history was obtained using a questionnaire. Clinical measures were taken at 6 sites per tooth at all teeth excluding third molars at a baseline visit. Subgingival plaque samples were taken from the mesial surface of all teeth excluding third molars in each subject at baseline and assayed individually for counts of 29 subgingival species using checkerboard DNA-DNA hybridization. Subjects were subset according to smoking history into never (n=124), past (n=98) and current smokers (n=50). Uni-variate and multi-variate analyses were used to seek associations between smoking category and the counts, proportions and prevalence of subgingival species. Results: Greater differences were observed for the prevalence (% of sites colonized) of the test species in the 3 smoking groups than were observed for counts or proportions of total counts. Members of the orange and red complexes including E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis and T. denticola were significantly more prevalent in current smokers than in the other 2 groups. The difference in prevalence between smokers and non-smokers was due to greater colonization at sites with pocket depth <4 mm. Stepwise multiple linear regression analysis indicated that combinations of the prevalence of 5 microbial species and pack years accounted for 44% of the variance for mean pocket depth (p<0.000001), while the prevalence of 3 microbial taxa along with age, pack years, current smoking and gender accounted for 31% of the variance in mean attachment level (p<0.000001). The difference in prevalence between current and never smokers of all members of the red complex and 8 of 12 members of the orange complex was significantly greater in the maxilla than in the mandible. Conclusions: The major difference between the subgingival microbiota in subjects with different smoking history was in the prevalence of species rather than counts or proportions. The greater extent of colonization in smokers appeared to be due to greater colonization at pocket depths <4 mm. Differences in colonization patterns between current and never smokers were greater in the maxilla than in the mandible. Zusammenfassung Grundlagen: Die Beziehung zwischen dem Zigarettenrauchen und der Zusammensetzung der subgingivalen Mikroflora ist nicht klar. Einige Studien verweisen auf höhere Titer von bestimmten Spezies bei Rauchern, während andere Studien keine Unterschiede in der Mikroflora zwischen Personen mit unterschiedlichem Raucher- oder Nichtraucherverhalten nachweisen konnten. Daher war der Zweck der vorliegenden Studie die Untersuchung von Prävalenz, Anteil und Titer der subgingivalen Spezies bei erwachsenen Patienten, die zur Zeit, früher oder niemals Raucher waren. Methode: Für die Studie wurden 272 erwachsene Patienten im Alter zwischen 20 und 86 Jahren und wenigstens 20 Zähnen rekrutiert. Die Anamnese des Rauchverhaltens wurde under Verwendung eines Fragebogens durchgeführt. Bei einer Eingangsuntersuchung erfolgten die klinischen Messungen an 6 Stellen pro Zahn bei allen Zähnen außer den dritten Molaren. Bei der Eingangsuntersuchung wurden, bei allen Zähnen außer den dritten Molaren, von den Mesialflächen subgingivale Plaqueproben entnommen. Für die einzelnen Flächen wurde die Anzahl von 29 subgingivalen Spezies mittels Schachbrett-DNA-DNA-Hybridisierung bestimmt. Die Patienten wurden entsprechend der Rauchervorgeschichte in folgende Gruppen eingeteilt: niemals (n=124), früher (n=98) und zur Zeit (n=50). Um Assoziationen zwischen den Rauchkategorien und der Anzahl, dem Anteil und der Prävalenz der subgingivalen Spezies herauszufinden wurden eine uni-variate und multi-variate Analyse verwendet. Ergebnisse: Es wurden größere Unterschiede zwischen den 3 Gruppen hinsichtlich der Prävalenz der Testspezies (% der Taschen die kolonisiert waren) beobachtet als bei der Anzahl oder dem Anteil an der Gesamtzahl der Keime beobachtet wurde. Die Prävalenz der Keime des orangen und roten Komplexes einschließlich. E. nodatum, F. nucleatum ss vincentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis und T. denticola war bei den aktuellen Rauchern stärker prävalent als in den anderen beiden Gruppen. Die Differenz in der Prävalenz zwischen Rauchern und Nichrauchern wurde verursacht durch eine stärkere Kolonisation in Taschen mit einer Taschentiefe <4 mm. Die schrittweise multiple lineare Regressionsanalyse zeigte, dass Kombinationen der Prävalenz von 5 mikrobiellen Spezies und der Packungsjahre für 44% der Varianz der mittleren Taschentiefe verantwortlich waren (p<0.000001), während die Prävalenz von 3 mikrobiellen Taxa zusammen mit Alter, Packungsjahre, Raucherstatus und Geschlecht für 31% der Varizna im mittleren Attachmentniveau verantwortlich waren (p<0.000001). Die Differenz in der Prävalenz zwischen den aktuellen Rauchern und den die niemals rauchten war für alle Keime der roten Komplexes und 8 von 12 Keimen des orangen Komplexes im Oberkiefer signifikant größer als im Unterkiefer. Schlussfolgerung: Der Hauptunterschied zwischen der subgingivalen Mikroflora bei Patienten mit unterschiedlicher Rauchervorgeschichte lag mehr bei der Prävalenz der Spezies als bei der Anzahl der Keime oder den Anteilen an der Gesamtflora. Das größere Maß an Kolonisation bei den Rauchern schien durch eine stärkere Kolonisation in Taschen <4 mm verursacht zu sein. Differenzen im Kolonisationsmuster zwischen aktuellen Rauchern und Nichtrauchern die niemals rauchten waren im Oberkiefer größer als im Unterkiefer. Résumé Origine, but: La relation entre l'usage de la cigarette et la composition de la microflore sous gingivale n'est pas claire. Certaines études indiquent d'importants niveaux de certaines espèces chez les fumeurs, alors que d'autres études n'arrivent pas à détecter de différences dans la micrflore entre des sujets ayant des histoires tabagiques différentes. Aussi, le propos de cette recherche est d'examiner la prévalence, les proportions et le niveau des espèces sous gingivales chez des sujets adultes fumeurs, anciens fumeurs ou non-fumeurs. Méthodes: 272 sujets adultes, âgès de 20 à 86 ans, ayant au moins 20 dents furent recrutés pour l'étude. L'histoire tabagique fut obtenue à l'aide d'un questionnaire. Des mesures cliniques furent prises sur 6 sites par dents, sur toutes les dents à l'exception des troisièmes molaires lors de la première visite. Des échantillons de plaque sous gingivale étaient prélevés sur la face mésiale de chaque dent à l'exception des troisièmes molaires chez chaque sujet lors de la première visite et individuellement testés pour le comptage de 29 espèces sousgingivales par hybridisation en damier ADN-ADN. Les sujets étaient groupés en sous ensembles en fonction de leur histoire tabagique en non-fumeurs (n=124), ancien fumeurs (n=98), et fumeurs (n=50). Des analyses monovariées et multivariées furent utilisées pour rechercher des associations entre les catégories de fumerus et les comptages, proportions et prévalences des espèces bactériennes. Résultats: De plus grandes différences étaient observées pour la prévalence (% de sites colonisés) des expèces testées dans les 3 groupes, que pour le comptage ou la proportion des comptages totaux. Les membres des complexes orange et rouge dont E. nodatum, F. nucléatum ss vicentii, P. intermedia, P. micros, P. nigrescens, B. forsythus, P. gingivalis, et T. denticolaétait significativement plus prévalent chez les fumeurs que dans les 2 autres groupes. La différence de prévalence entre les fumeurs et les non-fumeurs était due à une plus grande colonisation des sites dont la profondeur de poche était <4 mm. L'analyse par régression linéaire multiple stepwise indiquait que les combinaisons de la prévalence de 5 espèces microbiennes et les paquets-années comptaient pour 44% de la variance pour la moyenne de profondeur de poche (p<0.000001), alors que la prévalence de 3 taxons microbiens avec l'âge, les paquets-années, le tabagisme présent et le sexe comptaient pour 31% de la variance pour le niveau d'attache moyen (p<0.000001). La différence de prévalence entre les fumerus en activité et les non-fumeurs (jamais fumé) de tous les membres du complexe rouge et de 8 des 12 membres du complexe orange était significativement plus élevée au maxillaire qu'à la mandibule. Conclusions: La différence majeure entre les microflores sous gingivales chez les sujets ayant des histoires tabagiques différentes se trouvaient dans la prévalence des expèces plutôt que dans leurs quantité ou leurs proportions. La plus grande importance de colonisation chez les fumerus apparaît être dûe à une colonisation plus grande dans les poches <4 mm. Des différences des caractéristiques de colonisation entre les fumerus actifs et les personnes n'ayant jamais fuméétaient plus importantes au maxillaire qu'à la mandibule. [source] Serum levels of matrix metalloproteinase-9, tissue inhibitors of metalloproteinase-1 and their ratio are associated with impaired lung function in the elderly: A population-based studyRESPIROLOGY, Issue 3 2010Inga S. ÓLAFSDÓTTIR ABSTRACT Background and objective: Matrix metalloproteinases (MMP) and their inhibitors, tissue inhibitors of metalloproteinases (TIMP), regulate homeostasis and turnover of the extra cellular matrix. The aim of this study was to investigate the associations of serum MMP-9 and TIMP-1 with lung function. Methods: Spirometry was performed in a population-based sample of 888 subjects aged 70 years. Serum MMP-9 and TIMP-1 concentrations were measured by ELISA. Results: Lower FEV1 values were associated with higher serum levels of MMP-9 (P = 0.001) and TIMP-1 (P < 0.001), and a higher ratio of MMP-9 to TIMP-1 (P = 0.02). These associations were significant after adjustment for gender, weight, height, BMI, current smoking, pack years of smoking and the time for which samples were frozen. After stratification for gender, the associations between FEV1 and MMP-9, TIMP-1, and their ratio, were significant in men but not in women. Conclusions: Lower FEV1 was significantly but weakly associated with higher serum levels of MMP-9, TIMP-1 and a higher MMP-9/TIMP-1 ratio. This association was stronger in men than in women, suggesting a possible role for extracellular matrix remodelling in the development of impaired lung function. These associations may also partly explain the association between low FEV1 and cardiovascular disease. [source] Validation of a screening protocol for identifying low-risk candidates with type 1 diabetes mellitus for kidney with or without pancreas transplantationCLINICAL TRANSPLANTATION, Issue 2 2006Irene W.Y. Ma Abstract: Background: Certain clinical risk factors are associated with significant coronary artery disease in kidney transplant candidates with diabetes mellitus. We sought to validate the use of a clinical algorithm in predicting post-transplantation mortality in patients with type 1 diabetes. We also examined the prevalence of significant coronary lesions in high-risk transplant candidates. Methods: All patients with type 1 diabetes evaluated between 1991 and 2001 for kidney with/without pancreas transplantation were classified as high-risk based on the presence of any of the following risk factors: age ,45 yr, smoking history ,5 pack years, diabetes duration ,25 yr or any ST,T segment abnormalities on electrocardiogram. Remaining patients were considered low risk. All high-risk candidates were advised to undergo coronary angiography. The primary outcome of interest was all-cause mortality post-transplantation. Results: Eighty-four high-risk and 42 low-risk patients were identified. Significant coronary artery stenosis was detected in 31 high-risk candidates. Mean arterial pressure was a significant predictor of coronary stenosis (odds ratio 1.68; 95% confidence interval 1.14,2.46), adjusted for age, sex and duration of diabetes. In 75 candidates who underwent transplantation with median follow-up of 47 months, the use of clinical risk factors predicted all eight deaths. No deaths occurred in low-risk patients. A significant mortality difference was noted between the two risk groups (p=0.03). Conclusions: This clinical algorithm can identify patients with type 1 diabetes at risk for mortality after kidney with/without pancreas transplant. Patients without clinical risk factors can safely undergo transplantation without further cardiac evaluation. [source] | ||||||||||