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Terms modified by Lower Age Selected AbstractsExposure to the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers from 3 populations with different risks of lung cancerINTERNATIONAL JOURNAL OF CANCER, Issue 10 2009Kiersten S. Derby Abstract Native Hawaiian smokers are at higher risk and Japanese-American smokers at lower risk of lung cancer (LC), compared with white smokers, even after accounting for smoking history. Because variation in carcinogen exposure/metabolism may occur separately of smoking amount, we compared urinary biomarkers of uptake and detoxification of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK),a potent lung carcinogen,among 578 smokers in these ethnic/racial groups in Hawaii. We measured the NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and its glucuronide (NNAL-Gluc) and examined total NNAL (NNAL + NNAL-Gluc) and the NNAL detoxification ratio (NNAL-Gluc:NNAL). Native Hawaiians and Japanese,Americans had lower age- and sex-adjusted mean total NNAL, compared with whites. When further adjusting for urinary nicotine equivalents (the sum of nicotine, cotinine, trans -3,-hydroxycotinine and their respective glucuronides), only the difference between Japanese,Americans and whites was eliminated. Therefore, consistent with their lower LC risk, a lower cigarette smoke exposure explains the lower NNK dose of Japanese,Americans, but it does not explain that of Native Hawaiians. The mean detoxification ratio was also lower in Native Hawaiians and Japanese,Americans, compared with whites, even after adjusting for nicotine equivalents (p < 0.0001). Lower NNAL glucuronidation in Native Hawaiians might contribute to their increased LC risk; however, this is inconsistent with the low glucuronidation ratio similarly observed in the low-risk Japanese-American group and because Native Hawaiians had lower total NNAL levels. Thus, exposure and detoxification of NNK are unlikely to explain, by themselves, the differences in LC risk among the 3 populations studied. © 2009 UICC [source] Subjective cognitive complaints, neuropsychological performance, affective and behavioural symptoms in non-demented patientsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 1 2008Roberto Gallassi Abstract Objective Subjective cognitive complaints (SCC) have been previously investigated to establish whether they are risk factors for dementia, but no clear-cut conclusions have emerged. In this study non-demented patients with SCC were studied and the neuropsychological findings, affective and behavioural aspects and parameters with the highest correct classifications in discriminating patients who had only SCC but no objective clinical and neuropsychological impairment, i.e. no cognitive impairment (NCI) patients and those with objective neuropsychological deficits, namely patients with mild cognitive (MCI) were analyzed. Methods Consecutive non-demented outpatients with SCC were enrolled of over 9 months and examined using neuropsychological tests and scales for depression, anxiety and behaviour. Clinical criteria and neuropsychological test results were used to classify patients into groups of NCI, MCI and subtypes of MCI. Results Ninety-two patients with SCC were included; 49 of them had objective deficits (MCI patients), whereas 43 were without any clinical and cognitive impairment (NCI patients). These patients had lower age, higher education and better general cognitive indices than MCI patients who had higher caregiver distress, depression and irritability. The combination of a battery for mental deterioration and for behavioural memory assessment were the most discriminative in differentiating the two groups. Conclusions An objective cognitive impairment, reaching the criteria for a MCI diagnosis, was present in almost half of patients having SCC. MCI patients have more behavioural disturbances than NCI subjects. SCC should not be underestimated and appropriate neuropsychological assessment is required to reassure subjects with normal results and to identify patients with MCI. Copyright © 2007 John Wiley & Sons, Ltd. [source] Coping strategies and health-related quality of life among spouses of continuous ambulatory peritoneal dialysis, haemodialysis, and transplant patientsJOURNAL OF ADVANCED NURSING, Issue 6 2000Ragny Lindqvist RN PhD Coping strategies and health-related quality of life among spouses of continuous ambulatory peritoneal dialysis, haemodialysis and transplant patients In the study reported here 55 spouses of patients living with end-stage renal disease (ESRD) were investigated with respect to coping strategies and health-related quality of life. Findings from the study were compared to two random samples of the Swedish general population (n = 454, and n = 1200). The study design was correlational and comparative. Coping was measured by the Jalowiec Coping Scale, and quality of life (QoL) by the Swedish Health-Related Quality of Life Survey (SWED-QUAL). Data were analysed using a number of statistical tests including Pearson's product moment correlations, Student's t -test and two way ANOVAs. The combined sample of spouses used significantly more optimistic and palliative coping than the general population, but less confrontative, self-reliant, evasive and emotive coping. In the study fatalistic, evasive and emotive coping was associated with low perceived efficiency in handling various aspects of the partners' situation. The male spouses used significantly less optimistic, supportive and palliative coping than did the female spouses. The spouses of transplant patients had better overall quality of life than the continuous ambulatory peritoneal dialysis and haemodialysis spouse groups, most likely due to the lower age of the former group. The study findings suggest that emotive, evasive and fatalistic coping are less than optimal ways to deal with problems occasioned by the partner's treatment. [source] Evidence for Increased Clinical Severity of Familial and Sporadic Paget's Disease of Bone in Campania, Southern Italy,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 12 2006Domenico Rendina Abstract The analysis of 236 Italian patients with Paget's bone disease showed higher clinical severity and greater frequency of neoplastic degeneration among patients who live or descend from individuals living in the Campania region (southern Italy). A prevalent involvement of the spine and the skull, the sites preferentially involved in giant cell tumors complicating Paget's disease, was also shown in familial cases from this geographical region. Introduction: The Campania region in southern Italy has been recently indicated as a high prevalence area for Paget's disease of bone (PDB), and most pagetic families with multiple occurrence of neoplasms in affected members were from this geographical region. Materials and Methods: We evaluated the PDB epidemiological characteristics in 125 patients from Campania in comparison with 111 patients from other Italian regions. Twenty-three patients from Campania and 26 patients from other Italian areas had at least one first-degree relative affected by PDB (familial cases). The remaining patients made up the sporadic cases. Results: Among subjects from Campania, the patients in the familial group tended to come from larger families and showed at diagnosis higher serum total alkaline phosphatase, larger extension of disease, and earlier mean age with respect to patients with PDB of the sporadic group. The skull, spine, and humerus were the sites preferentially involved in the familial cases. In contrast, no such differences were observed between familial and sporadic PDB cases among patients from the other geographical areas, except for a lower age at diagnosis. An increased PDB clinical severity was finally observed in the PDB cohort from Campania in comparison with patients from other Italian regions. Neoplastic degeneration of pagetic bones (osteosarcoma and giant cell tumor) was exclusively observed in patients with polyostotic PDB from Campania. Conclusions: We showed a higher clinical severity of PDB with occurrence of neoplastic degeneration in the high prevalence area of Campania, with its maximum expression in cases with familial disease. This peculiar pattern might be traced to genetic predisposition and/or to the abnormal impact of a still undefined environmental trigger. [source] Drinking and Alcohol-Related Harm Among New Zealand University Students: Findings From a National Web-Based SurveyALCOHOLISM, Issue 2 2009Kypros Kypri Background:, Alcohol-related harm is pervasive among college students in the United States of America and Canada, where a third to half of undergraduates binge drink at least fortnightly. There have been no national studies outside North America. We estimated the prevalence of binge drinking, related harms, and individual risk factors among undergraduates in New Zealand. Methods:, A web survey was completed by 2,548 undergraduates (63% response) at 5 of New Zealand's 8 universities. Drinking patterns and alcohol-related problems in the preceding 4 weeks were measured. Drinking diaries for the preceding 7 days were completed. Multivariate analyses were used to identify individual risk factors. Results:, A total of 81% of both women and men drank in the previous 4 weeks, 37% reported 1 or more binge episodes in the last week, 14% of women and 15% of men reported 2+ binge episodes in the last week, and 68% scored in the hazardous range (4+) on the AUDIT consumption subscale. A mean of 1.8 (95% confidence interval 1.4, 2.3) distinct alcohol-related risk behaviors or harmful consequences were reported, e.g., 33% had a blackout, 6% had unprotected sex, and 5% said they were physically aggressive toward someone, in the preceding 4 weeks. Drink-driving or being the passenger of a drink-driver in the last 4 weeks was reported by 9% of women and 11% of men. Risk factors for frequent binge drinking included: lower age, earlier age of drinking onset, monthly or more frequent binge drinking in high school, and living in a residential hall or a shared house (relative to living with parents). These correlates were similar to those identified in U.S. and Canadian studies. Conclusions:, Strategies are needed to reduce the availability and promotion of alcohol on and around university campuses in New Zealand. Given the high prevalence of binge drinking in high school and its strong association with later binge drinking, strategies aimed at youth drinking are also a priority. In universities, high-risk drinkers should be identified and offered intervention early in their undergraduate careers. [source] Cytokine responses to mitogen and Schistosoma haematobium antigens are different in children with distinct infection historiesPARASITE IMMUNOLOGY, Issue 10 2001Janet T. Scott Prevalence of Schistosoma haematobium infection in children from two neighbouring villages in Zimbabwe was 77·1% and 40·3%, respectively. The age-intensity data indicated peak intensities of infection at a lower age in the high prevalence village. This study investigated whether the difference in infection histories was reflected in a difference in cytokine profiles between children resident in these two villages. Blood samples were taken to assay for cytokine secretion 1 year after treatment for schistosomiasis. They were cultured with phytohaemagglutinin (PHA), schistosome egg antigens (SEA) or cultured without stimulant and tested for the presence of interleukin (IL)-4, IL-5, IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF) and IFN-,. Blood samples from children from the low prevalence village were more likely to produce IL-4 (P < 0·0001) and produced higher levels of IFN-, (P < 0·02) and GM-CSF (P < 0·03) when cultured with PHA for 24 h. Residence in the high prevalence village was associated with production of IL-10 (P < 0·006) and GM-CSF (P < 0·04) in response to culture with SEA and IL-5 (P < 0·02) with PHA for 48 h. The interaction between age and village was not significant for these results; however, there was a significant interaction between age and village for IL-5 detected in blood samples cultured with PHA for 24 h (P < 0·01). These results concur with previous observations that major patterns of cytokine production can be related to immunosuppression, but also indicate an underlying pattern which reflects the importance of history of infection to the immune response. [source] Predictive factors of self-medicated drug use among the Spanish adult populationPHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 2 2008P. Carrasco-Garrido PhD Abstract Purpose Our study aimed at describing the prevalence of self-medicated drug use among the Spanish adult population and to identify the predictive factors of such self-medication in Spain. Methods Descriptive, cross-sectional study covering the Spanish adult population, using data drawn from the 2003 Spanish National Health Survey (ENSS). A total of 19,514 subjects were analysed. The independent variables were socio-demographic and health-related, and the dependent variable was self-medicated drug use. Using logistic multivariate regression models we have estimated the independent effect of each of these variables on the self-medicated consumption. Results The 18.1% of all Spaniards indulge in self-medication. Our study shows that 45% of all cold and influenza medication and 39.4% of analgesics consumed by the population involve self-medication. It should be stressed here that 17.7% of persons who took antibiotics did so in the form of self-medication. The variables that were independently and significantly associated with a greater probability of self-medicated consumption were: sex; lower age; higher educational level; consumption of alcohol; smoking habit; use of alternative medical products; absence of chronic disease and a positive perception of health. Conclusions In Spain, the prevalence of self-medicated drug use is higher in women than men. In our population, the influence of unhealthy lifestyles, such as alcohol and tobacco consumption, is related to a higher likelihood of self-medication. Copyright © 2007 John Wiley & Sons, Ltd. [source] Secular trend in age at menarche in indigenous and nonindigenous women in ChileAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2010X.M. Ossa Objectives: To estimate the secular trend in age at menarche, comparing indigenous and nonindigenous women, and its relationship with socio-demographic, family and nutritional factors. Methods: A study (historical cohorts) of 688 indigenous and nonindigenous women, divided into four birth cohorts (1960,69, 1970,79, 1980,89, and 1990,96) in an area in central southern Chile was carried out. Data and measurements were collected by health professionals using a previously validated questionnaire. Age at menarche was self-reported (recall). Adjusted differences among cohorts were estimated using a multivariate regression model. Results: A secular trend (P < 0.001) in age at menarche was found in both ethnic groups, with no significant differences between them (P > 0.05). In an adjusted model, a reduction in age at menarche was estimated at 3.7 months per decade between 1960 and 1990. This trend was moderated by higher socio-economic level, smaller number of siblings, and cohabitation with a single parent during infancy. Conclusions: The trend has occurred in a steady progression over time in indigenous women, whereas in nonindigenous women, it was slow initially but has accelerated in recent years. Nonindigenous women have maintained a slightly lower age of menarche than their indigenous counterparts. Am. J. Hum. Biol. 22:688-694, 2010. © 2010 Wiley-Liss, Inc. [source] Unipolar depression with racing thoughts: A bipolar spectrum disorder?PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2005FRANCO BENAZZI md Abstract Major depressive disorder (MDD) with racing/crowded thoughts is understudied. Kraepelin classified ,depression with flight of ideas' in the mixed states of his manic-depressive insanity. The aim of the study was to test whether MDD with racing/crowded thoughts was close to bipolar disorders. Consecutive 379 bipolar-II disorder (BP-II) and 271 MDD depressed outpatients were interviewed using the Structured Clinical Interview for DSM-IV, the Hypomania Interview Guide, and the Family History Screen, by a senior psychiatrist in a private practice. Intra-depression hypomanic symptoms were systematically assessed. Mixed depression was defined as a major depressive episode (MDE) plus three or more intra-MDE hypomanic symptoms. MDD with racing/crowded thoughts was compared to MDD without racing/crowded thoughts on classic bipolar validators (young onset age, many recurrences, atypical and mixed depression, bipolar family history). Frequency of MDD with racing/crowded thoughts was 56.4%. MDD with racing/crowded thoughts, versus MDD without racing/crowded thoughts, had significantly lower age at onset, more MDE severity, more psychotic, melancholic, atypical, and mixed depressions, and more bipolar family history. Of the intra-MDE hypomanic symptoms, irritability, psychomotor agitation and distractibility were significantly more common in MDD with racing/crowded thoughts. Compared to BP-II on bipolar validators, validators were less common in MDD with racing/crowded thoughts. MDD with racing/crowded thoughts seemed to be a severe variant of MDD. MDD with racing/crowded thoughts versus MDD without racing/crowded thoughts, and versus BP-II, had significant differences on bipolar validators, suggesting that it may lie along a continuum linking MDD without racing/crowded thoughts and BP-II. [source] Intra-episode hypomanic symptoms during major depression and their correlatesPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2004FRANCO BENAZZI md Abstract Recent studies have shown that 40,50% of major depressive disorders (MDD) may become bipolar with time. Intra-episode hypomanic symptoms in MDD may be a first step in this shift. The purpose of the present study was to find factors associated with intra-episode hypomanic symptoms in MDD. Two hundred and forty-three consecutive MDD outpatients were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV), Clinician Version (SCID-CV), as modified by Benazzi and Akiskal (J. Affect. Disord. 2003; 73: 33,38). History of hypomania and presence of hypomanic symptoms during major depressive episode (MDE) were systematically assessed. Intra-episode hypomanic symptoms were defined as an MDE combined with three or more hypomanic symptoms, following Akiskal and Benazzi (J. Affect. Disord. 2003; 73: 113,122). Major depressive disorder with intra-episode hypomanic symptoms (MDD + H) was compared to MDD without hypomanic symptoms on classic bipolar validators. It was found that MDD + H (usually irritability, distractibility, racing thoughts, psychomotor agitation, and more talkativeness) was present in 32.5% of patients. Patients with MDD + H versus MDD had significantly lower age at onset, more atypical depressions, and more bipolar family history. Recurrences were not significantly different. Multivariate logistic regression found that bipolar family history and atypical depression were significantly and independently associated with MDD + H. Findings suggest that MDD + H may be associated with a bipolar vulnerability. Duration of illness and recurrences do not seem to be important for the onset of MDD + H. Bipolar genetic vulnerability seems to be required for onset of intra-episode hypomanic symptoms in MDD. Intra-episode hypomanic symptoms might be the first step of a process leading to the switch of MDD to bipolar disorders. Predicting the switch might have important treatment implications, because antidepressants used alone may worsen the course of bipolar disorders. Prospective studies are required to support these findings and hypotheses. [source] REVIEW OF THE EXTENT TO WHICH ORCHIDOPEXY IS PERFORMED AT THE OPTIMAL AGE: IMPLICATIONS FOR HEALTH SERVICESANZ JOURNAL OF SURGERY, Issue 11 2008Christine J. P. Bruijnen Background: In recent decades, the recommended age for orchidopexy for primary undescended testes has decreased, in the expectation that this might improve subsequent fertility. The aim of this study was to investigate whether this is reflected in a reduction in the age at which orchidopexies are carried out, and the implications for child health services. Methods: All boys who underwent an orchidopexy for an undescended testis carried out by the Christchurch-based paediatric surgical service between January 1997 and December 2007 were identified through a prospectively collected database. They were analysed according to the age at time of operation and year of surgery to determine whether there was any trend over time. The proportions of children younger than 2 years and between 2 and 5 years of age were calculated for each year. Results: In total, 788 boys underwent orchidopexies for primary undescended testes, with 335 (42.5%) boys having surgery before the age of 2 (mean age 54.3 months, median 31.1 months). During the whole 11-year period, there was no significant change in age at orchidopexy, whereas from 2003, a significant trend towards lower age at operation (Spearman's rank ,0.1112, P = 0.0071) and a significant increase in the proportion of boys having surgery before the age of 2 (Spearman's rank 0.9000, P = 0.0374) were seen. Conclusions: Although there has been a modest reduction in the mean age of orchidopexy since 2003, overall, the mean age at orchidopexy remains well above the recommended optimal age, implying that more attention should be paid towards earlier diagnosis and referral for primary undescended testes. [source] HLA,DRB1 genotype associations in 793 white patients from a rheumatoid arthritis inception cohort: Frequency, severity, and treatment biasARTHRITIS & RHEUMATISM, Issue 9 2002James F. Fries Objective The HLA,DRB1 "shared epitope" (SE) genotypes are associated with rheumatoid arthritis (RA), but it remains controversial whether the association is with incidence, severity, or both, whether there are associations in seronegative patients, and whether different DRB1 alleles that contain the SE have similar effects on RA susceptibility and/or severity. The present study was undertaken to study these issues in a large cohort of patients with RA. Methods White patients with RA of <6 months' duration (n = 793) were enrolled in an inception cohort. HLA,DRB1 typing was performed, and patients were categorized into 21 DRB1 genotype groups. The disability index of the Health Assessment Questionnaire was the primary outcome measure. Results DRB1 associations in seronegative RA patients closely resembled those in controls. Of seropositive patients, 21% had 2 copies of the epitope, 52% had 1 copy, and 27% had none. However, not all genotypes with 1 copy were associated with increased susceptibility; for example, frequencies of DRB1*0404/X and *01/X did not differ from those in controls. Absolute differences between seropositive RA patients and controls were greatest for DRB1*0401 homozygosity (3.8% versus 0.8%, respectively) and *0401/0404 heterozygosity (4.7% versus 1.0%). DRB1*0404 was increased in frequency in seropositive RA but, unlike *0401, an increased frequency was seen only with 2 epitope copies. The relatively rare DRB1*10 had an unexpected association with seropositive RA, being present in 1.7% of seropositive RA patients and 0.7% of controls, and also showed a trend toward association with greater disease severity. The presence of 2 epitope copies was associated with increased frequency of seropositivity and younger age at disease onset, not with disease severity. Treatment indication bias was substantial and may have accounted for some of these effects. HLA,DRB1*0401/0404 was found much more frequently in men and in patients with a lower age at disease onset, and there was a trend toward a higher frequency of *0404/0401 in women. Conclusion This large inception cohort study confirms previously identified major associations and provides additional insights. Only one dominant association was found: *0401, which differs from other SE alleles in a single Lys-for-Arg substitution. The association of the rare DRB1*10 allele has not previously been postulated. Sex associations were confirmed. Associations with seronegative RA were not seen. Not all genotypes containing an SE copy showed increased susceptibility to RA. The association of SE genotypes found in this study related to disease susceptibility rather than severity. [source] The prevalence and related risk factors of anxiety and depression symptoms among Chinese pregnant women in ShanghaiAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2009Yong-Xia QIAO Objective: To investigate the prevalence of anxiety and depression of the pregnant women during the prenatal period, and provide information for further epidemiological study. Methods: With ethics committee approval, a total of 527 recruited pregnant women from the Department of Obstetrics and Gynecology, Tongji University Medical School were selected at four hospitals that affiliated to the University. By applying a self-designed questionnaire for hospital anxiety and depression (HAD) scale, we evaluated anxious and depressive symptoms in these women. Results: The prevalence rates of anxiety and depression in these Chinese pregnant women during prenatal period were 6.8% and 4.8%, respectively, whereas the co-prevalence rate of both anxiety and depression was 3.4%, and anxiety and/or depression 15.0%. The relationship between the prevalence rate of anxiety/depression and the age distribution was proven negatively correlated (,2 = 1.478, P = 0.016) by the trend chi-squared test. Among all three groups, the prevalence rate of anxiety and depression was highest in the group of below 20 years old, lowest in the group of over 30 years old, and in-between in the group of 20 to 30 years old. Logistic regression analysis showed that lower age was a risk factor (odds ratio (OR) = 10.094, 95% confidence interval (CI): 1.418~71.838). Meanwhile, poor educational background (OR = 1.929, 95%CI: 1.101~3.379) was a relevant risk factor as well. Conclusions: We suggest that introduction of psychological health instruction programs for pregnant women, especially the younger ones, should be strengthened. Besides, the essential intervention measures may be applied if necessary. [source] Age of Onset as a Discriminator Between Alcoholic Subtypes in a Treatment-Seeking Outpatient PopulationTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2000Bankole A. Johnson M.D., Ph.D. Subtyping alcoholics may provide a more accurate guide as to the course and character of the disease. Classifications of different ages of onset of problem drinking have so far resulted in categorical inconsistencies. In the past, hospital-based alcoholics have over-represented those most severely ill, and comprehensive evaluations of psychopathology for discriminating between alcoholic subtypes have been infrequent. In a heterogeneous treatment-seeking, outpatient, alcoholic population, we tested the hypothesis that age of onset represents a continuum of disease, and that greater severity of psychopathology is associated with lower ages of onset. Using a standard questionnaire, 253 male and female treatment-seeking alcoholics were stratified according to specific ages of onset: a) <20 years; b) 20,25 years, and c) >25 years. These age of onset groups were compared on alcohol severity and craving, family history, childhood behavior, personality, hostility, overt aggression, mood, and social functioning. Symptom severity and age of onset were negatively correlated, and the 20,25-year onset group usually had intermediate scores. The <20 year onset group was characterized by greater severity of alcohol-related problems, family history, childhood behavioral problems, craving, hostility, antisocial traits, mood disturbance, and poor social functioning. Alcoholics with an earlier age of onset have relatively greater psychopathology than those of later onset. While the preponderance of psychopathology among those in the <20-year onset group could be conceptualized as a clinical "subtype," such a characterization would not define an entirely homogenous category. Yet, this clinical characterization would be clinically important if specific age of onset levels were found to be differentially sensitive to pharmacological and/or psychological treatments. [source] | ||||||||||