86,674 research outputs found
Urinary estrogen metabolites and prostate cancer : a case-control study and meta-analysis
No full textObjective: To investigate prostate cancer (Pca) risk in relation to estrogen metabolism, expressed as urinary 2-hydroxyestrone (2-OHE1), 16α-hydroxyestrone (16α-OHE1) and 2-OHE1 to 16α-OHE1 ratio.
Methods: We conducted a case-control study within the Western New York Health Cohort Study (WNYHCS) from 1996 to 2001. From January 2003 through September 2004, we completed the re-call and follow-up of 1092 cohort participants. Cases (n = 26) and controls (n = 110) were matched on age, race and recruitment period according to a 1:4 ratio. We used the unconditional logistic regression to compute crude and adjusted odds ratios (OR) and 95% confident interval (CI) of Pca in relation to 2-OHE1, 16αOHE1 and 2-OHE1 to 16α-OHE1 by tertiles of urine concentrations (stored in a biorepository for an average of 4 years). We identified age, race, education and body mass index as covariates. We also conducted a systematic review of the literature which revealed no additional studies, but we pooled the results from this study with those from a previously conducted case-control study using the DerSimonian-Laird random effects method.
Results: We observed a non-significant risk reduction in the highest tertile of 2-OHE1 (OR 0.72, 95% CI 0.25-2.10). Conversely, the odds in the highest tertile of 16α-OHE1 showed a non-significant risk increase (OR 1.76 95% CI 0.62-4.98). There was a suggestion of reduced Pca risk for men in the highest tertile of 2-OHE1 to 16α-OHE1 ratio (OR 0.56, 95% CI 0.19-1.68). The pooled estimates confirmed the association between an increased Pca risk and higher urinary levels of 16α-OHE1 (third vs. first tertile: OR 1.82, 95% CI 1.09-3.05) and the protective effect of a higher 2-OHE 1 to 16α-OHE1 ratio (third vs. first tertile: OR 0.53, 95% CI 0.31-0.90).
Conclusion: Our study and the pooled results provide evidence for a differential role of the estrogen hydroxylation pathway in Pca development and encourage further study
Risk factors of anxiety, depression, stress, job burnout, and characteristics of sleep disorders in critical care nurses: An observational study
No full textAim/Objective: The aim of this study was to determine risk factors and associations between anxiety,
depression, stress, and job burnout and describe sleep disorders in critical care nurses.
Setting: Data were collected in six intensive care units.
Methods: A descriptive cross-sectional design was used. Multivariate and univariate regressions were
used to determine significant risk factors. Significance levels were established at p <0.05. We use
Depression Anxiety Stress Scales to determine anxiety, depression, and stress. Work burnout was
detected using the Maslach Burnout Inventory scale, and sleep quality was determined by the Pittsburgh
Sleep Quality Index.
Results: A total of 140 critical care nurses were included. The female gender was associated with high
levels of anxiety (odds ratio [OR] 1⁄4 3.03; 95% confidence interval [CI] 1⁄4 [1.12e8.23]; p 1⁄4 0.029),
depression (OR 1⁄4 10.55; 95% CI 1⁄4 [2.17e51.19]; p 1⁄4 0.003), and stress (OR 1⁄4 2.87; 95% CI 1⁄4 [1.02e8.07];
p 1⁄4 0.045). Multivariate regression showed that critical care nurses with intention of leaving were
exposed to high levels of anxiety (OR 1⁄4 3.65; 95% CI 1⁄4 [1.40e9.53]; p 1⁄4 0.008), depression (OR 1⁄4 6.79;
95% CI 1⁄4 [2.01e22.95]; p 1⁄4 0.002), stress [OR 1⁄4 4.13; 95% CI 1⁄4 [1.49e11.45]; p 1⁄4 0.006), and burnout
(OR 1⁄4 4.15; 95% CI 1⁄4 [1.63e10.56]; p 1⁄4 0.003). Sleep quality is influenced by high latency, low duration,
the use of medications, and daytime dysfunction.
Conclusion: Females were exposed to a higher risk of developing mental health problems such as anxiety, depression, and stress than men. The intention to leave was an independent predictor of anxiety,
depression, and stress. Characteristics such as high sleep latency, low duration, use of medications, and
daytime dysfunction have a negative impact on sleep quality. Early detection of mental health would
allow nursing managers to implement nonpharmacological preventive interventions to improve wellbeing at wor
Intravoxel incoherent motion diffusion-weighted imaging for oropharyngeal squamous cell carcinoma: Correlation with human papillomavirus Status
No full textPurpose: To investigate the relationships between imaging parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and HPV status in oropharyngeal squamous cell carcinoma (OPSCC). Materials and Methods: 73 patients with a new diagnosis of OPSCC were enrolled in the present study. MRI including IVIM-DWI with nine b value (range 0–800 s/mm2) was acquired in all patients. Primary tumor (PT) and the largest metastatic lymph node (LN), if present, were volumetrically contoured and the tissue diffusion coefficient Dt, perfusion fraction f and perfusion-related diffusion coefficient D* were estimated by a bi-exponential fit. The apparent diffusion coefficient (ADC) was also estimated by a mono-exponential fit. The predictive power of the most relevant patient/tumor characteristics and image-based features in determining the HPV status was assessed. Results: 67 PTs and 67 metastatic LNs were analyzed. Significant differences in ADC and Dt values among HPV-positive and HPV-negative patients were found for PTs (p = 0.003 and p < 0.001, respectively), while a trend toward significance in Dt was reported for LNs (p = 0.066). The perfusion-related parameters, f, D* and D*× f, were not related to HPV status. The best predictive model for HPV positivity was obtained combining alcohol intake and smoke habits with Dt values of PTs (accuracy = 80.8%, sensitivity = 85.7%, specificity = 64.7%). Conclusion: Significant correlations were found between IVIM-DWI and HPV status in OPSCCs. The perfusion-free diffusion coefficient, Dt, may better reflect the HPV-related tumor differences compared to ADC, whereas the perfusion-related parameters were not able to reliably discriminate HPV-positive from HPV-negative OPSCC
The effects of metformin on endogenous androgens and SHBG in women : a systematic review and meta-analysis
No full textObjectives Elevated circulating androgens are risk factors for several chronic, metabolic and reproductive disorders. Metformin is an insulin-sensitizing agent that may lower androgen levels. To evaluate the effects of metformin on endogenous androgens and SHBG levels in women, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing metformin with placebo or no treatment. Data source We used OVID to search MEDLINE, EMBASE and CENTRAL until March 2007. Review methods Two reviewers independently extracted data on methodological quality, participants, interventions and outcomes of interest. Our a priori primary outcome was post-treatment measurements. In a secondary analysis, we evaluated the difference between the pre- and post-treatment levels. We computed the weighted mean difference (WMD) as a measure of effect for each outcome using the DerSimonian-Laird random effects method. We used the I2 statistic to assess heterogeneity and explored its causes in subgroup analyses of features related to participants' characteristics and study design. Based on a regression model, we conducted sensitivity analyses by investigating the use of placebo as a predictor of effect size. Results Twenty RCTs fulfilled the inclusion criteria. Pooled WMDs in post-treatment levels between the metformin and control group were -0·31 nmol/l (95% CI -0·65 to 0·03) for total testosterone (TT), 0·10 pmol/l (95% CI -0·89 to 1·10) for free testosterone (FT), 0·14 μmol/l (95% CI -0·34 to 0·62) for dehydroepiandrosteronesulfate (DHEAS), -0·60 nmol/l (95% CI -1·67 to 0·46) for androstenedione (AND) and 5·88 nmol/l (95% CI 2·01-9·75) for SHBG. Pooled WMDs of the pre- to post-treatment differences (i.e. with adjustment for baseline hormone levels) were -0·38 (95% CI -0·51 to -0·25) for TT, -2·71 (95% CI -10·35 to 4·93) for FT, -0·50 (95% CI -0·83 to -0·16) for DHEAS, -1·39 (95% CI -2·30 to -0·49) for AND and 6·63 (95% CI 2·32-10·94) for SHBG. In subgroup analyses, features related to the administered treatment (i.e. metformin as a single agent or as part of combined regimens) partly explained the heterogeneity. Sensitivity analyses of studies using placebo showed similar results to those not using placebo. Conclusions Our systematic review and meta-analysis provides evidence of metformin-induced changes in circulating androgens and SHBG levels in women but the quality of evidence is not high. However, there are no data from RCTs regarding these effects in postmenopausal women or healthy premenopausal women. High-quality RCTs are required to evaluate whether metformin has effects on surrogate markers and patient-important outcomes in these patient groups
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
[Newspaper Clipping: Author Claims Evidence of Second JFK Assassin #1]
No full textNewspaper article titled "Author Claims Evidence of Second JFK Assassin." The article states that author Richard J. Whalen concluded "that there is circumstantial evidence to support the theory of a second assassin in the shooting of President John F. Kennedy.
Magnesium deficiency affects the pentylenetetrazol-induced convulsions in magnesium-deprived rats.
No full textA group of 11 young albino rats was fed with a Mg2+ free diet. After a few days, the animals showed typical signs of Mg2+ deficiency, consisting in skin vasodilation, red conjunctiva and hair loss. Pentylenetetrazol (50 mg/kg i.p.) injected in these rats, 6 and 12 days after the beginning of the diet, elicited a more severe convulsive activity compared with that shown by a control group of 12 rats. These results suggest that a Mg2+ deficiency, though not necessarily responsible for the convulsive activity, may contribute to facilitate an epileptic episode or may lead to more severe convulsions. The possibility of a more powerful activation of the NMDA receptors in Mg2+ deficiency is discussed
Oxcarbazepine monotherapy in patients with brain tumor-related epilepsy : open-label pilot study for assessing the efficacy, tolerability and impact on quality of life
No full textWe conducted a prospective, observational study to verify the efficacy, tolerability and impact on quality of life, mood and global neurocognitive performances of oxcarbazepine monotherapy in patients with brain tumor-related epilepsy (BTRE). Patients were followed for 12 months. We recruited 25 patients (11 females 14 males; mean age 49.7) affected with BTRE (17 de novo patients and 7 in monotherapy with other antiepileptics) and introduced oxcarbazepine monotherapy because of uncontrolled seizures and/or side effects. At first visit, patients underwent neurological examination, Qolie 31P V2, EORTC QLQC30, Zung self-depression rating scale (ZSDRS) and adverse events profile. A seizure diary was given to each patient. Follow-up duration was 1-12 months (mean 7.1 months, 5 patients died and 10 dropped out). Totals of 16 patients underwent both chemotherapy and radiotherapy, 4 chemotherapy only, 1 radiotherapy only, and 4 did not undergo any systemic therapy. Mean dosage of oxcarbazepine was 1,230 mg/day (min 600, max 2,100 mg/ day). McNemar's test showed a significant difference in seizure freedom rate (P = 0.002) between baseline and final follow-up in the intent-to-treat population. Six patients (24%) had serious side effects and one patient (4%) mild. Logistic regression revealed that, in our study, chemotherapy and radiotherapy did not affect the efficacy of OXC in seizure outcome (P = 0.658). The test evaluation at final follow-up showed a significant improvement in ZSDRS (P = 0.011) and no change over time. Oxcarbazepine seems to be efficacious in controlling seizures and in improving mood in patients with BTRE, but special caution should be taken when it is administered during radiotherapy
The Children's Sleep Habits Questionnaire: Identification of sleep dimensions, normative values, and associations with behavioral problems in Italian preschoolers
No full textObjective: To study the use of the Children's Sleep Habits Questionnaire (CSHQ) to evaluate sleep problems dimensions, norm values, and association of sleep problems with behavioral problems in Italian preschoolers. Design: Sleep dimensions in CSHQ were investigated via parallel and principal component analyses, norm and at-risk values were investigated by exploring the association between CSHQ and the CBCL sleep problems scale, and bivariate associations between CSHQ and internalizing and externalizing behavioral problems were computed. Participants: A total of 725 mothers of preschool children (mean age = 4.59 years; SD = 0.97 years; range: 3-6 years) from 10 kindergartens in Central Italy. Measurements: CSHQ together with the Child Behavior Checklist 1 1⁄2-5 (CBCL). Results: The analyses suggested the existence of 7 sleep dimensions, which were meaningfully interpretable. The CSHQ total score had good internal consistency and showed strong associations with the sleep problems scale of the CBCL. Children scoring in the normative range of the CBCL sleep problems scale had a mean value at the CSHQ total score of 47.03 (6.42), children scoring in the borderline and clinical range (4.4%) of 57.13 (5.11). Moderate associations were found between CSHQ total score and internalizing and CBCL externalizing behavioral problems. Conclusions: CSHQ values were higher than those reported in other countries and with school-age children, but only a small number of children belonged to the at-risk group based on CBCL norms for the sleep problems scale. CSHQ moderately and comparably correlated with internalizing and externalizing problems. The CSHQ is a meaningful tool for the investigation of sleep problems in Italian preschoolers. Given the heterogeneity of item frequencies at a dimension level, considering scores along items and dimensions might be more informative at a clinical and applied level
Maternal dispositional mindfulness and mother–child relationship: The mediating role of emotional control during parenting
No full textBackground: The literature supports the role of parental dispositional mindfulness on parent–child relationship quality. However, little is known about the connection between these two aspects. Objective: The aim of this study was to investigate whether emotion regulation during parenting, that is, the ability to control negative emotions, mediated the association between parental dispositional mindfulness and parent–child relationship quality. The study also explored the moderation role of child age on the association between parental dispositional mindfulness and parent's ability to control negative emotions during parenting. Methods: Participants were 635 mothers of children aged between 12 months and 5 years. Mothers completed self-report questionnaires to measure maternal dispositional mindfulness, mother–child relationship quality and maternal control of negative emotions during parenting. Results: Results showed that maternal ability to control negative emotions during parenting partially mediated the association between maternal dispositional mindfulness and mother–child relationship quality. Moreover, the moderation role of child age indicated that the association between maternal dispositional mindfulness and maternal ability to control negative emotions during parenting was stronger for older children's mothers. Conclusion: Dispositional mindfulness has a protective role for the quality of parenting and the mother–child relationship. Theoretical and practical implications are discussed
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