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Selected AbstractsOccurrence and prognosis of hand eczema in the car industry: results from the PACO follow-up study (PACO II)CONTACT DERMATITIS, Issue 6 2008Christian J. Apfelbacher Background:, Only a few epidemiological studies on hand eczema (HE) in the metalworking industry have been conducted, and no study has attempted a long-term follow-up. Objectives:, In the Prospective Audi Cohort (PACO) II follow-up study, we aimed to estimate burden and prognosis of HE in a car industry setting (follow-up > 10 years). Patients/Methods:, Eligible participants were individuals who had been examined in the original PACO study (1990,1998) and had been followed through until the end of their apprenticeship (n = 1909). Participants were interviewed and underwent dermatological examination. An exposure assessment was carried out according to a pre-defined algorithm. Results:, The follow-up rate was 78.3% (1494/1909). Mean follow-up time was 13.3 [standard deviation 1.3] years. The period prevalence of HE in the follow-up period was 21.0% [95% confidence interval (CI) 19.0,23.1%], yielding a cumulative incidence of 29.3% (95% CI 26.9,31.6%) in the entire study period. HE persisted after the end of apprenticeship in 40.0% (95% CI 33.3,46.7%) of subjects who had had HE during apprenticeship (n = 205). 18.0% (95% CI 15.9,20.1%) developed HE in the follow-up period (n = 1289). Conclusions:, Around 30% of subjects were affected by HE at least once during the study period. HE persisted in 40% of the participants affected during apprenticeship. [source] A brief alcohol intervention for hazardously drinking incarcerated womenADDICTION, Issue 3 2010Michael D. Stein ABSTRACT Objective To test the hypothesis that among hazardously drinking incarcerated women who are returning to the community, a brief alcohol intervention will result in less alcohol use at follow-up relative to standard of care. Methods Eligible participants endorsed hazardous alcohol consumption,four or more drinks at a time on at least 3 separate days in the previous 3 months or a score of 8 or above on the Alcohol Use Disorders Identification Test. Participants were randomized to either an assessment-only condition or to two brief motivationally focused sessions, the first delivered during incarceration, the second 1 month later after community re-entry. Participants recalled drinking behaviors at 3 and 6 months after the baseline interview using a 90-day time-line follow-back method. Results The 245 female participants averaged 34 years of age, and were 71% Caucasian. The mean percentage of alcohol use days in the 3 months prior to incarceration was 51.7% and heavy alcohol use days was 43.9%. Intervention effects on abstinent days were statistically significant at 3 months (odds ratio = 1.96, 95% confidence interval 1.17, 3.30); the percentage of days abstinent was 68% for those randomized to intervention and 57% for controls. At 6 months the effect of the intervention was attenuated and no longer statistically significant. Conclusions Among incarcerated women who reported hazardous drinking, a two-session brief alcohol intervention increased abstinent days at 3 months, but this effect decayed by 6 months. Study participants continued to drink heavily after return to the community. More intensive intervention pre-release and after re-entry may benefit hazardously drinking incarcerated women. [source] Patterns of over-the-counter nicotine gum use: persistent use and concurrent smokingADDICTION, Issue 12 2003Saul Shiffman ABSTRACT Aims To examine the occurrence of persistent use (i.e. use beyond 12 weeks) and concurrent use of nicotine gum with cigarettes among consumers who purchase nicotine gum over-the-counter (OTC). Design Assessment of gum use was conducted in the context of a smoking cessation trial among smokers who purchased Nicorette gum and enrolled in the optional Committed Quitters smoking cessation program. Eligible participants were contacted by telephone 6 weeks and 12 weeks following their self-selected target quit date. Those who reported gum use at 12 weeks were contacted again at week 24. Participants A total of 2655 current smokers who purchased nicotine gum and enrolled in a clinical efficacy trial of the Committed Quitters program. Measurements Detailed information on smoking and gum use, including frequency of use, amount used and reasons for use was obtained at each of the three follow-up assessments. Findings At the 24-week assessment, 6% of participants reported current use of nicotine gum (i.e. persistent use). Those engaging in persistent use averaged 4.7 (SD = 2.5) days of gum use per week and 3.2 (SD = 3.5) pieces of gum per day. Sixty-six per cent of persistent users reported at week 24 that they were not currently smoking, and 67% of persistent users reported they were using gum to establish or maintain abstinence. At the 6-, 12- and 24-week assessments, 14%, 10% and 2% of participants, respectively, reported current use of nicotine gum and current cigarette smoking (i.e. concurrent users). Those concurrent users reported at the 12-week follow-up that they did so an average of 4.4 (SD = 2.1) days per week, that they chewed an average of 2.6 (SD = 3.5) pieces of nicotine gum per day and that they smoked an average of 8.7 (SD = 8.6) cigarettes per day. Conclusion Extended use of nicotine gum is rare. Concurrent use with cigarettes is uncommon. In both cases, the amount of gum use is small. OTC marketing of nicotine gum does not appear to have increased use contrary to labeling nor resulted in patterns of use that should warrant clinical or public health concerns. [source] Quality of Life While Dying: A Qualitative Study of Terminally Ill Older MenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2003Elizabeth K. Vig MD Objectives: To characterize the experience of quality of life while dying from the perspective of terminally ill men. Design: Descriptive study involving semistructured interviews. Setting: Patients attending clinics at two university-affiliated medical centers were interviewed in a private conference room or in their homes. Participants: Twenty-six men identified by their physicians as having terminal heart disease or cancer. Eligible participants acknowledged that they had serious illness. Measurements: The interview contained open-ended questions such as: "What are the most important things in your life right now?" The interview also contained closed-ended questions about symptom intensity, presence of depressed mood, and other items related to overall quality of life. The open-ended questions were tape-recorded, transcribed, and analyzed using grounded theory methods. The closed-ended questions were analyzed using descriptive statistics. Results: Participants believed that death was near. Participants saw engaging in hobbies and other enjoyable activities as an alternative to moving into the final stage of illness, in which they saw themselves as actively dying. They admitted to occasionally ignoring prescribed diets; these actions improved their overall quality of life but worsened symptoms. New symptoms brought concerns about progression to active dying. They anticipated what their dying would be like and how it would affect others. Participants believed that their actions in the present could improve the quality of their dying and lessen the burden of their deaths on others. Many participants therefore were preparing for death by engaging in such tasks as putting their finances in order and planning their funerals, to relieve anticipated burden on loved ones. Conclusion: To help terminally ill patients plan for the end of life, clinicians are encouraged to become familiar with their patients' experiences of living with terminal illness, to identify each patient's unique priorities, and to incorporate that information into care plans aimed at maximizing quality of life at the end of life. [source] Ergonomic risk factors for low back pain in North Carolina crab pot and gill net commercial fishermenAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2009Kristen L. Kucera PhD Abstract Background The objective of this research was to determine the association between LBP that limited or interrupted fishing work and ergonomic low back stress measured by (1) self-reported task and (2) two ergonomic assessment methods of low back stress. Methods Eligible participants were from a cohort of North Carolina commercial fishermen followed for LBP in regular clinic visits from 1999 to 2001 (n,=,177). Work history, including crab pot and gill net fishing task frequency, was evaluated in a telephone questionnaire (n,=,105). Ergonomic exposures were measured in previous study of 25 fishermen using two methods. The occurrence rate of LBP that limited or interrupted fishing work since last visit (severe LBP) was evaluated in a generalized Poisson regression model. Results Predictors of severe LBP included fishing with crew members and a previous history of severe LBP. Among crab pot and gill net fishermen (n,=,89), running pullers or net reels, sorting catch, and unloading catch were associated with an increased rate of LBP. Percent of time in forces >20 lb while in non-neutral trunk posture, spine compression >3,400 N, and National Institute of Occupational Safety and Health lifting indices >3.0 were associated with LBP. Conclusions Tasks characterized by higher (unloading boat and sorting catch) and lower (running puller or net reel) ergonomic low back stress were associated with the occurrence of severe LBP. History of LBP, addition of crew members, and self-selection out of tasks were likely important contributors to the patterns of low back stress and outcomes we observed. Based on the results of this study, a participatory ergonomic intervention study is currently being conducted to develop tools and equipment to decrease low back stress in commercial crab pot fishing. Am. J. Ind. Med. 52:311,321, 2009. © 2009 Wiley-Liss, Inc. [source] Emergency Department Sickle Cell Assessment of Needs and Strengths (ED-SCANS), a Focus Group and Decision Support Tool Development ProjectACADEMIC EMERGENCY MEDICINE, Issue 8 2010Paula Tanabe PhD ACADEMIC EMERGENCY MEDICINE 2010; 17:848,858 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, A decision support tool may guide emergency clinicians in recognizing assessment, analgesic and overall management, and health service delivery needs for patients with sickle cell disease (SCD) in the emergency department (ED). We aimed to identify data and process elements important in making decisions regarding evaluation and management of adult patients in the ED with painful episodes of SCD. Methods:, Qualitative methods using a series of focus groups and grounded theory were used. Eligible participants included adult clients with SCD and emergency physicians and nurses with a minimum of 1 year of experience providing care to patients with SCD in the ED. Patients were recruited in conjunction with annual SCD meetings, and providers included clinicians who were and were not affiliated with sickle cell centers. Groups were conducted until saturation was reached and included a total of two patient groups, three physician groups, and two nurse groups. Focus groups were held in New York, Durham, Chicago, New Orleans, and Denver. Clinician participants were asked the following three questions to guide the discussion: 1) what information would be important to know about patients with SCD in the ED setting to effectively care for them and help you identify patient analgesic, treatment, and referral needs? 2) What treatment decisions would you make with this information? and 3) What characteristics would a decision support tool need to have to make it meaningful and useful? Client participants were asked the same questions with rewording to reflect what they believed providers should know to provide the best care and what they should do with the information. All focus groups were audiotaped and transcribed. The constant comparative method was used to analyze the data. Two coders independently coded participant responses and identified focal themes based on the key questions. An investigator and assistant independently reviewed the transcripts and met until the final coding structure was determined. Results:, Forty-seven individuals participated (14 persons with SCD, 16 physicians, and 17 nurses) in a total of seven different groups. Two major themes emerged: acute management and health care utilization. Major subthemes included the following: physiologic findings, diagnostics, assessment and treatment of acute painful episodes, and disposition. The most common minor subthemes that emerged included past medical history, presence of a medical home (physician or clinic), individualized analgesic treatment plan for treatment of painful episodes, history of present illness, medical home follow-up available, patient-reported analgesic treatment that works, and availability of analgesic prescription at discharge. Additional important elements in treatment of acute pain episodes included the use of a standard analgesic protocol, need for fluids and nonpharmacologic interventions, and the assessment of typicality of pain presentation. The patients' interpretation of the need for hospital admission also ranked high. Conclusions:, Participants identified several areas that are important in the assessment, management, and disposition decisions that may help guide best practices for SCD patients in the ED setting. [source] The burden and determinants of dysmenorrhoea: a population-based survey of 2262 women in Goa, IndiaBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2006V Patel Objective, To describe the prevalence and determinants of dysmenorrhoea, the most common menstrual complaint, in a community in India. Design, Cross-sectional survey. Setting, Catchment area of primary health centre in Goa, India. Population, Three thousand women aged 18,45 years randomly selected. A total of 2494 women consented to participate (83.1%). Methods, Eligible participants were asked standardised questions regarding menstrual complaints over the past 12 months, and socio-demographic, psychosocial and reproductive risk factors. Vaginal or urine specimens were collected for the diagnosis of reproductive tract infections. Main outcome measures, Dysmenorrhoea of moderate to severe intensity. Results, A total of 2262 women were eligible. More than half reported dysmenorrhoea; moderate to severe dysmenorrhoea was reported by 755 participants (33.4%, 95% CI 31.4,35.4). There was a linear association between severity of pain and impact (medication and taking rest) and the onset of pain (premenstrual onset associated with more severe pain). On multivariate analyses, the risk of moderate,severe dysmenorrhoea was associated with the experience of violence (OR 2.23, 95% CI 1.5,34); other somatic complaints (OR 3.67, 95% CI 2.7,4.9 for highest somatoform symptom score category compared with the lowest); gynaecological complaints (non-menstrual lower abdominal pain: OR 1.78, 95% CI 1.3,2.3; dysuria: OR 1.98, 1.4,2.7); menorrhagia (OR 1.92, 95% CI 1.4,2.6); and illiteracy (OR 1.32, 95% CI 1.0,1.7). Having had a pregnancy (OR 0.53, 95% CI 0.4,0.7), older age of menarche (OR 0.70, 95% CI 0.5,0.9, for age >14 compared with <13 years) and older age (OR 0.43, 0.3,0.6 for age 40,50, compared with 18,24 years) were protective. Conclusions, The burden of dysmenorrhoea is greater than any other gynaecological complaint, and is associated with significant impact. Social disadvantage, co-morbidity with other somatic syndromes and reproductive factors are determinants of this complaint. [source] The outcome of a rapid hepatitis B vaccination programme in a methadone treatment clinicADDICTION, Issue 2 2010Parameswaran Ramasamy ABSTRACT Aim Injecting drug users are a high-risk population for hepatitis B (HBV), but are difficult to engage in vaccination programmes. This study examines the completion rates of a HBV vaccination schedule and seroconversion in a group of patients in methadone maintenance treatment. Methods Patients at a public methadone maintenance programme in Sydney, Australia, were screened for viral hepatitis (hepatitis A, B and C) and offered a rapid HBV vaccination schedule (0, 1 and 2 months). Hepatitis B surface antibody (antiHBs) was retested on completion of the vaccination schedule. Results A total of 143 patients [71.3% male, mean age 33.1 (standard deviation ± 8.3)] enrolled in the project. Forty-nine per cent of patients were HAV antibody (Ab) positive, 81.1% hepatitis C virus (HCV) antibody (Ab) positive and 38.9% antiHBs positive. Exposure to multiple hepatitis viruses was common, with 24.5% testing positive for all three viruses. Seventy-three (83%) of the 88 antiHBs negative patients completed the vaccination schedule. Post-vaccination serology indicated a seroconversion rate of 75.4% (55 of 73) of completors, or 62.5% of eligible participants (55 of 88). Conclusion While there was a high rate of completion of the rapid vaccination schedule in this population, a moderate seroconversion rate was achieved. Further work is required to identify an optimal vaccination schedule in opioid substitution patients. [source] Knowledge of heart attack symptoms in a community survey of VictoriaEMERGENCY MEDICINE AUSTRALASIA, Issue 3 2002Karen L Smith Abstract Objective: To ascertain the level of knowledge of heart attack symptoms in the Victorian public. Methods: This was a cross sectional telephone survey conducted during 2000,01. The questionnaire contained sections regarding participant demographics and knowledge of heart attack symptoms. Results: A total of 1489 people completed the questionnaire (79% of eligible participants). The mean number of correct heart attack symptoms was 2.5 (95% CI 2.45, 2.60) (median three out of 10). Only 4.2% of participants reported at least five correct symptoms and 4.1% could not report any symptoms. A total of 84.6% of respondents reported chest pain as a symptom of heart attack. Conclusions: The Victorian public appears to lack the knowledge of the varied range of heart attack symptoms. Methods of disseminating information regarding symptoms and ways to reduce prehospital delay need to be devised, particularly methods which target the older ,at risk' population. [source] Incidence of Loss of Ability to Walk 400 Meters in a Functionally Limited Older PopulationJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2004Milan Chang PhD Objectives: To assess the incidence of and factors related to nondisabled but functionally limited older adults aged 75 to 85 years losing the ability to walk 400 m. Design: Observational study with average follow-up of 21 months. Setting: Community. Participants: At baseline, 101 persons with objective signs of functional limitations and intact cognitive function agreed to participate in the study. Of these, 81 were able to walk 400 m at baseline, and 62 participated in the follow-up examination. Measurements: Mobility disability was defined as an inability to complete a 400-m walk test. At baseline, eligible participants (n=81) had the ability to walk 400 m, scored between 4 and 9 on the Short Physical Performance Battery (SPPB; range 0,12), and scored 18 or more on the Mini-Mental State Examination. Demographics, difficulty in daily activities, disease status, behavioral risk factors, and muscle strength were assessed at baseline and follow-up. Results: Of 62 persons at follow-up, 21 (33.9%) developed incident mobility disability. The strongest predictors of loss of mobility were the time to complete the 400-m walk at baseline (odds ratio (OR)=1.6 per 1-minute difference, 95% confidence interval (CI)=1.04,2.45), and decline in SPPB score over the follow-up (OR=1.4 per 1-point difference, 95% CI=1.01,1.92). Conclusion: Older persons with functional limitations have a high rate of loss of ability to walk 400 m. The 400-m walk test is a highly relevant, discrete outcome that is an ideal target for testing preventive interventions in vulnerable older populations. [source] Serum 25-hydroxyvitamin D and IgE , a significant but nonlinear relationshipALLERGY, Issue 4 2009E. Hyppönen Background:, Hormonal vitamin D system affects the determination of T-cell responses. It is unknown if there is an association between vitamin D status and allergic conditions. Our aim was to investigate differences in serum IgE concentrations by vitamin D status [measured by 25(OH)D] and by a genetic variation in a key vitamin D activation enzyme (CYP27B1) previously shown to be associated with type 1 diabetes. Methods:, 9377 participants in the 1958 British birth cohort completed a biomedical assessment at 45 years of age ; 7288 eligible participants had data on 25(OH)D and IgE, with 6429 having further information on CYP27B1 genotype (,1260C>A). Results:, There was a nonlinear association between 25(OH)D and IgE (P -value for curvature = 0.0001). Compared with the reference group with the lowest IgE concentrations [25(OH)D 100,125 nmol/l], IgE concentrations were 29% higher (95% CI 9,48%) for participants with the 25(OH)D <25 nmol/l, and 56% higher (95% CI 17,95%) for participants with 25(OH)D >135 nmol/l (adjusted for sex, month, smoking, alcohol consumption, time spent outside, geographical location, social class, PC/TV time, physical activity, body mass index and waist circumference). CYP27B1 genotype was associated with both 25(OH)D (difference for A vs. C allele: 1.88%, 95% CI 0.37,3.4%, P = 0.01) and IgE concentrations (,6.59%, ,11.6% to ,1.42%, P = 0.01). Conclusions:, These data suggest that there may be a threshold effect with both low and high 25(OH)D levels associated with elevated IgE concentrations. The same CYP27B1 allele that is protective of diabetes was associated with increased IgE concentrations. [source] Rotigotine improves restless legs syndrome: A 6-month randomized, double-blind, placebo-controlled trial in the United States,,§MOVEMENT DISORDERS, Issue 11 2010Wayne A. Hening MD Abstract This randomized, double-blinded, placebo-controlled trial (NCT00135993) assessed efficacy and safety of the dopamine agonist rotigotine in the treatment of idiopathic restless legs syndrome (RLS) over a 6-month maintenance period. A total of 505 eligible participants with moderate to severe RLS (IRLS sum score , 15) were randomly assigned to five groups to receive either placebo or rotigotine (0.5, 1, 2, or 3 mg/24 hr) delivered by once-daily transdermal patch (fixed-dose regimen). The two co-primary efficacy parameters decreased from baseline to end of maintenance in IRLS sum score and in clinical global impressions (CGI-1) score. On both primary measures, 2 and 3 mg/24 hr rotigotine was superior to placebo (P < 0.001). Adjusted treatment differences to placebo for the IRLS sum score were ,4.5 (95% CI: ,6.9, ,2.2) for 2 mg/24 hr rotigotine, ,5.2 (95% CI: ,7.5, ,2.9) for 3 mg/24 hr rotigotine, and for CGI item 1 ,0.65 (95% CI: ,1.0, ,0.3) and ,0.9 (95% CI: ,1.3, ,0.5) for the 2 and 3 mg/24 hr doses, respectively. Skin reactions (27%) and known dopaminergic side effects such as nausea (18.1%) and headache (11.6%) were mostly mild or moderate in rotigotine subjects. Rotigotine transdermal patches releasing 2 to 3 mg/24 hr significantly reduced the severity of RLS symptoms. Treatment efficacy was maintained throughout the 6-month double-blind period. © 2010 Movement Disorder Society [source] 44-55-66-PM, a Mnemonic That Improves Retention of the Ottawa Ankle and Foot Rules: A Randomized Controlled TrialACADEMIC EMERGENCY MEDICINE, Issue 8 2010FRCPC, Jocelyn Gravel MD ACADEMIC EMERGENCY MEDICINE 2010; 17:859,864 © 2010 by the Society for Academic Emergency Medicine Abstract Objectives:, Studies have suggested that poor knowledge of the Ottawa Ankle Rules (OAR) limits its clinical impact. This study evaluated the ability of a mnemonic to improve knowledge of the OAR. Methods:, This was a single-blind randomized controlled trial performed among residents and medical students doing a pediatric emergency medicine rotation. At baseline, all participants were tested for their baseline knowledge of the OAR. The intervention was a standardized information sheet providing a mnemonic of the OAR (44-55-66-PM), while control subjects received its classic description. Block randomization (medical student vs. type of resident) was used. Each participant answered the same questionnaire at the end of rotation (3 weeks later) and via a Web-based survey 5 to 9 months postrandomization. Main outcome measures were knowledge of the components of the ankle rule based on a 13-item criterion grid and the foot rule based on a 10-item criterion grid. All questionnaires were marked at the end of the study by two reviewers blinded to the randomization. Discrepancies in final scores were resolved by consensus. Student's t-test was performed to compare mean scores on the evaluation between groups using an intention-to-treat approach. Results:, Among the 206 eligible participants, 96 medical students and 94 residents were recruited and agreed to participate. Primary outcomes were measured in 95% of the participants at 3 weeks postrandomization and in 72% on the long-term follow-up. Participants in both groups were similar with regard to baseline characteristics and prior knowledge of the OAR. Both groups showed improvement in their knowledge of the rule during the study period. At mid-term, knowledge of the OAR was similar for the ankle components (score for mnemonic 10.9; control 10.2; 95% confidence interval [CI] for difference = ,0.3 to 1.7) and for the foot (mnemonic 7.6 vs. control 7.5; 95% CI for difference = ,0.7 to 0.9). On the long term, randomization to the mnemonic was associated with a better knowledge of the OAR as demonstrated by a higher score for the ankle component (mnemonic 10.1 vs. control 8.9; 95% CI for difference = 0.6 to 1.8) and for the foot (mnemonic 7.8 vs. control 6.5; 95% CI for difference = 0.8 to 1.9). Conclusions:, Mid-term knowledge of the OAR drastically improved for all participants of the study. The use of the mnemonic 44-55-66-PM was associated with a better long-term knowledge of the OAR among medical students and residents. The improvement in knowledge of the OAR among the control group highlights the importance of using controlled trials for studies evaluating knowledge transfer. [source] Prevalence and impact of musculoskeletal disorders in New Zealand nurses, postal workers and office workersAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2009Helen Harcombe Abstract Objectives: To describe the prevalence, characteristics and impact of musculoskeletal disorders (MSDs) in New Zealand nurses, postal workers and office workers. Methods: A postal survey asked participants about MSDs, (low back, neck, shoulder, elbow, wrist/hand or knee pain lasting longer than one day), and demographic, physical and psychosocial factors. Nurses were randomly selected from the Nursing Council database, postal workers from their employer's database and office workers from the 2005 electoral roll. Results: The response rate of potentially eligible participants was 58% (n=443). Participants were aged 20,59 years; 86% were female. Over the 12 months prior to the survey 88% of respondents had at least one MSD lasting longer than a day and 72% reported an MSD present for at least seven days. Of the 1,003 MSDs reported, 18% required time off work and 24% required modified work duties. In the month prior to the survey 17% of MSDs made functional tasks difficult or impossible. Low back, neck and shoulder pain prevalence did not differ by occupation. Postal workers had the highest prevalence of elbow and wrist/hand pain; nurses of knee pain. Conclusions: The high prevalence of MSDs among these workers indicates that they are indeed in ,at risk' occupations. In each occupational group MSDs encompass a range of anatomical sites, however the overall pattern of MSDs differs by occupation. MSDs have a significant impact on activities at work and home. Implications: Primary and secondary prevention strategies should encompass a range of anatomical sites and specifically target different occupational groups. [source] Lipids, lipoproteins and the risk of benign prostatic hyperplasia in community-dwelling menBJU INTERNATIONAL, Issue 3 2008J. Kellogg Parsons OBJECTIVE To examine the associations of serum lipids and lipoproteins with benign prostatic hyperplasia (BPH) in community-dwelling men. SUBJECTS AND METHODS This analysis was conducted within the Rancho Bernardo Study, a prospective, community-based cohort study. BPH was defined as a history of prostate surgery for other than cancer, or a medical diagnosis of BPH. Logistic regression modelling, with adjustments for age and stratification by diabetes diagnosis, was used to estimate the odds ratio (OR) of BPH associated with fasting serum concentrations of total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and the triglyceride to HDL ratio. RESULTS Among 531 eligible participants, 259 (48%) reported BPH and 272 (52%) reported no BPH. Men with BPH, with a mean (range) age of 75.8 (76.1,80.1) years, were older than men without BPH , at 72.7 (72.4,74.0) years. There were no significant associations of total cholesterol (P trend, 0.52), HDL cholesterol (0.56), triglycerides (0.30), or triglyceride to HDL ratio (0.13) with the risk of BPH. In a subset analysis in men with diabetes, those in the highest tertile (>133 mg/dL) of LDL cholesterol, compared with those in the lowest tertile (<110 mg/dL), were four times more likely to have BPH (odds ratio 4.00, 95% confidence interval 1.27,12.63, P trend 0.02). These results were not explained by the use of statins. CONCLUSIONS In these community-dwelling men, higher serum LDL was associated with a greater risk of BPH among diabetics. These data suggest that diabetic men with increased LDL cholesterol are at greater risk of BPH. This observation is consistent with the concept that cardiac risk factors are involved with the pathogenesis of BPH. [source] Lens opacity and refractive influences on the measurement of retinal vascular fractal dimensionACTA OPHTHALMOLOGICA, Issue 6 2010Haitao Li Acta Ophthalmol. 2010: 88: e234,e240 Abstract. Purpose:, To examine the influence of lens opacity and refraction on the measurement of retinal vascular fractal dimension (Df). Methods:, Optic disc photographs (right eyes) of 3654 baseline Blue Mountains Eye Study participants (aged 49,97 ) were digitized. Retinal vascular Df was quantified using a computer-based program. Summated severity scores for nuclear, cortical and posterior subcapsular (PSC) cataract were assessed from lens photographs. Refraction data were converted to spherical equivalent refraction (SER), as sum spherical plus 0.5 cylinder power. Axial length was measured at 10-year follow-up examinations using an IOL master. Results:, Mean Df of the retinal vasculature was 1.444 ± 0.023 for 2859 eligible participants. Increasing lens opacity scores were associated with significant reduction in Df (, = ,0.0030, p < 0.0001). Both cortical and PSC cataract involving central lens area were associated with reduced Df, after controlling for confounding factors (ptrend , 0.0105). Increasing myopia severity was associated with reduced Df after adjusting for lens opacity scores and other confounders (ptrend < 0.0001). The slope of Df decrease per SER reduction was 0.0040 in eyes with SER , ,4D, compared to ,0.0016 in eyes with SER > ,4D. For axial length quintiles, there were no significant differences in mean Df in all groups except a reduction in the fifth quintile (axial length ,24.15 mm) (all p < 0.05). Conclusion:, Ocular media opacity independently influenced retinal vascular Df measurement, but we found no evidence supporting any refractive axial magnification effect on this measure. Myopic refraction ,,4D was associated with a reduction in Df, suggesting rarefaction of retinal vasculature associated with high myopia. [source] Risk factors for primary open-angle glaucoma in a Burmese population: the Meiktila Eye StudyCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 8 2007Robert J Casson FRANZCO Abstract Purpose:, To report the risk factors associated with primary open-angle glaucoma (POAG) in the Burmese population. Methods:, The Meiktila Eye study, a population-based cross-sectional study, included inhabitants 40 years of age and over from villages in the Meiktila District. Of 2481 eligible participants identified, 2076 participated in the study and sufficient examination data to diagnose glaucoma in at least one eye was obtained in 1997 participants. The ophthalmic examination included slit-lamp examination, tonometry, gonioscopy and dilated stereoscopic fundus examination. Definitions adhered to the International Society for Geographic and Epidemiological Ophthalmology's recommendations. Univariate and multivariate analyses of potential risk factors were performed. Results:, The overall prevalence of POAG was 2.0% (95% CI 0.9,3.1). In the univariate analysis, increasing age (P = 0.024), spherical equivalent (P = 0.01), axial length (P = 0.023) and intraocular pressure (IOP; P < 0.001) were significantly associated with POAG. And in the multivariate analysis, myopia <0.5 D (P = 0.049), increasing age and IOP (P < 0.001) were significant risk factors for POAG. Conclusion:, POAG in this Burmese population was associated with increasing age, axial myopia and IOP. [source] Rehabilitation of olfaction post-laryngectomy: a randomised control trial comparing clinician assisted versus a home practice approachCLINICAL OTOLARYNGOLOGY, Issue 1 2010E. Ward Clin. Otolaryngol. 2010, 35, 39,45. Objectives:, To determine (i) the prevalence of impaired olfaction in a group of individuals post-laryngectomy, and (ii) whether intensive, clinician-supported training of the Nasal Airflow Inducing Manoeuvre (NAIM) was more effective at improving olfactory acuity than intensive, home practice over a 6-week period. Designs:, Cohort study followed by a randomised control trial of two treatments over a 6-week period with a 3-month review. Participants:, Olfactory acuity was evaluated in 43 laryngectomy patients. Results revealed 95% had impaired olfactory acuity (anosmic or hyposmic). From this group 40 eligible participants with reduced olfactory acuity were then randomly assigned into either the clinician-supported or home practice treatment group. Main outcome measures:, Olfactory acuity and functional impact measures relating to olfactory acuity (participation restriction, wellbeing/distress). Results:, Although olfactory acuity significantly improved in both treatment groups following 6 weeks of therapy, results indicated significantly greater improvement in the clinician-assisted group immediately post-treatment. By 3 months, post-treatment effects were maintained. Both modes of treatment improved levels of patient wellbeing, however, only the clinician-assisted mode made a significant positive effect on levels of perceived participation restriction. Conclusion:, Reduced olfactory acuity is prevalent post-laryngectomy. Olfactory acuity can be significantly improved using either 6 weeks of clinician-assisted or home practice using the NAIM manoeuvre, although the current data suggest that intensive clinician-assisted treatment can assist patients to improve more rapidly and have a positive impact on functional state. [source] | ||||||||||