Incident alopecia areata and vitiligo in adult women with atopic dermatitis: Nurses’ Health Study 2

We aimed to determine the risk of alopecia areata (AA) and vitiligo associated with atopic dermatitis (AD) in a large cohort of US women, the Nurses’ Health Study 2. We used logistic regression to calculate age‐ and multivariate‐adjusted odds ratios to determine the risk of incident AA and vitiligo associated with AD diagnosed in or before 2009. A total of 87 406 and 87 447 participants were included in the AA and vitiligo analyses, respectively. A history of AD in 2009 was reported in 11% of participants. There were 147 incident cases of AA and 98 incident cases of vitiligo over 2 years of follow‐up. AD was associated with increased risk of developing AA (OR 1.80, 95% CI 1.18–2.76) and vitiligo (OR 2.14, 95% CI 1.29–3.54) in multivariate models. In this study of US women, AD was associated with increased risk of incident vitiligo and AA in adulthood.     

Relationships of mental disorders and weight status in the Korean adult population

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.     

Prevalence of anxiety and depression during pregnancy in a private setting sample

Summary Objectives: To estimate the prevalence and risk factors for antenatal anxiety (AA) and antenatal depression (AD). Methods: We performed a cross sectional study of 432 women attending a private clinic in the city of Osasco, S?o Paulo, from 5/27/1998 to 5/13/2002. The following instruments were used: Spielberger state-trait anxiety inventory (STAI), Beck depression inventory (BDI), and a questionnaire for socio-demographic and obstetric data. Inclusion criteria were: pregnant women with no past or present history of depression, psychiatric treatment, alcohol or drug abuse and no clinical and obstetric complications. The prevalence of AA, according to STAI, and AD, according to Beck Inventory, were estimated with 95% confidence intervals (95% CI). Odds ratios and 95% CI were used to examine the association between AA and AD and exposures variables. Results: The prevalence of AA, state and trait were 59.5 (95 CI%: 54.8:64.1%) and 45.3% (95% CI: 40.6:50.0), respectively. The prevalence of AD was 19.6 (95% CI:15.9:23.4). In the multivariate analysis, AA-trait (OR: 5.26; 95% CI 2.17:12.5, p < 0.001), AA-state (OR: 2.27; 95% CI 1.08:4.76, p = 0.02) and AD (OR: 2.43; 95% CI 1.40:4.34, p = 0.002) were associated with lower women’s educational level. AA-trait (OR: 3.43; 95% CI 1.68:7.00, p = 0.001), AA-state (OR: 2.22; CI 95% 1.09:4.53, p = 0.02) and AD (OR: 2.82; CI 95% 1.35:5.97, p = 0.005) were also associated with not being married. AA-trait was associated with lower women’s income (OR: 2.22; 95% CI 0.98:5.26, p = 0.05) and not being white (OR: 1.7; 95% CI 1.00:2.91, p = 0.04), while AD was associated with lower couple’s income (OR: 2.43; 95% CI 1.40:4.34, p = 0.001) and greater number of previous abortions (OR: 2.21; 95% CI 1.23:3.97, p = 0.009). Conclusions: Prevalence of AA and AD were high in this sample of women attending a private care setting, particularly AA state and trace. AA and AD were associated with similar socio-demographic and socio-economic risk factors, suggesting some common environmental stressors may be involved.     

Meta-analysis of the association of a functional serotonin transporter promoter polymorphism with alcohol dependence.

The neurotransmitter serotonin (5-HT) has been shown to regulate alcohol consumption in both animals and humans. Since activity of the 5-HT transporter protein (5-HTT) regulates 5-HT levels, the gene encoding this protein may contribute to the risk of alcohol dependence (AD). Studies of the association to AD of a functional insertion-deletion polymorphism in the 5-HTT-linked promoter region (5-HTTLPR) have yielded inconsistent results. We conducted a meta-analysis of data from 17 published studies (including 3,489 alcoholics and 2,325 controls) investigating the association between 5-HTTLPR alleles and AD. The frequency of the short (S) allele at 5-HTTLPR was significantly associated with AD [odds ratio (OR) = 1.18, 95% CI = 1.03-1.33). Moreover, a greater association with the S allele was seen among individuals with AD complicated by either a co-morbid psychiatric condition or an early-onset or more severe AD subtype [OR = 1.34 (95% CI = 1.11-1.63)]. Allelic variation at 5-HTTLPR contributes to risk for AD, with the greatest effect observed among individuals with a co-occurring clinical feature.     

Intrauterine exposures and risk of endometriosis

BACKGROUND: Intrauterine environmental exposures have been adversely associated with male reproductive health in contrast to limited investigation of such exposures and female reproductive health. METHODS: To address this research gap, a cohort comprising 84 women aged 18-40 years undergoing laparoscopy was recruited prior to surgery and followed through the post-operative period for endometriosis diagnosis. Women were interviewed about environmental exposures and those of their mothers while pregnant with them (use of alcohol, caffeinated beverages and cigarettes). Endometriosis was diagnosed in 32 women from the laparoscopy cohort; 52 women had no endometriosis visualized. Using unconditional logistic regression, odds ratios (OR) and 95% confidence intervals (CIs) were estimated for the intrauterine exposures adjusting for potential confounders. RESULTS: No significant associations were seen between intrauterine exposure to alcohol or caffeine and a diagnosis of endometriosis. Adjusting for age, significant reductions in odds of an endometriosis diagnosis were observed for intrauterine cigarette exposure both in the absence (OR 0.22, 95% CI 0.06-0.82) or presence (OR 0.05, 95% CI 0.01-0.42) of women's current smoking. CONCLUSIONS: While speculative, in utero cigarette exposure may be associated with a lower risk of surgically diagnosed adult-onset endometriosis, possibly as a result of alterations in hormonal milieu or pathologic angiogensis.     

Maternal smoking in pregnancy and birth defects: a systematic review based on 173 687 malformed cases and 11.7 million controls

BACKGROUND ; There is uncertainty over whether maternal smoking is associated with birth defects. We conducted the first ever comprehensive systematic review to establish which specific malformations are associated with smoking. METHODS ; Observational studies published 1959-2010 were identified (Medline), and included if they reported the odds ratio (OR) for having a non-chromosomal birth defect among women who smoked during pregnancy compared with non-smokers. ORs adjusted for potential confounders were extracted (e.g. maternal age and alcohol), otherwise unadjusted estimates were used. One hundred and seventy-two articles were used in the meta-analyses: a total of 173 687 malformed cases and 11 674 332 unaffected controls. RESULTS ; Significant positive associations with maternal smoking were found for: cardiovascular/heart defects [OR 1.09, 95% confidence interval (CI) 1.02-1.17]; musculoskeletal defects (OR 1.16, 95% CI 1.05-1.27); limb reduction defects (OR 1.26, 95% CI 1.15-1.39); missing/extra digits (OR 1.18, 95% CI 0.99-1.41); clubfoot (OR 1.28, 95% CI 1.10-1.47); craniosynostosis (OR 1.33, 95% CI 1.03-1.73); facial defects (OR 1.19, 95% CI 1.06-1.35); eye defects (OR 1.25, 95% CI 1.11-1.40); orofacial clefts (OR 1.28, 95% CI 1.20-1.36); gastrointestinal defects (OR 1.27, 95% CI 1.18-1.36); gastroschisis (OR 1.50, 95% CI 1.28-1.76); anal atresia (OR 1.20, 95% CI 1.06-1.36); hernia (OR 1.40, 95% CI 1.23-1.59); and undescended testes (OR 1.13, 95% CI 1.02-1.25). There was a reduced risk for hypospadias (OR 0.90, 95% CI 0.85-0.95) and skin defects (OR 0.82, 0.75-0.89). For all defects combined the OR was 1.01 (0.96-1.07), due to including defects with a reduced risk and those with no association (including chromosomal defects). CONCLUSIONS ; Birth defects that are positively associated with maternal smoking should now be included in public health educational materials to encourage more women to quit before or during pregnancy.     

The interleukin-10-1082 promoter polymorphism and cancer risk: a meta-analysis

Interleukin-10 (IL-10) is a multifunctional cytokine with both immunosuppressive and anti-angiogenic properties and play an important role in the pathogenesis of cancer. IL-10-1082A>G polymorphism is the most extensively studied polymorphism in the IL-10 gene in cancer susceptibility. To date, a number of case-control studies were conducted to investigate the association between IL-10-1082A>G polymorphism and cancer risk in humans. However, the association between the IL-10-1082A>G polymorphism and cancer risk is still ambiguous. In an effort to solve this controversy, we performed a meta-analysis based on 61 case-control studies, including 14,499 cancer cases and 16,967 controls. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. In the stratified analyses by specific cancer type, increased risk was found in lung cancer (OR = 3.16, 95% CI = 1.16-8.63 for GA versus AA; OR = 2.07, 95% CI = 1.16-3.70 for GG versus AA; OR = 3.17, 95% CI = 1.31-7.68 for GA/GG versus AA) and non-Hodgkin's lymphoma (OR = 1.18, 95% CI = 1.02-1.36 for GA versus AA; OR = 1.17, 95% CI = 1.02-1.35 for GA/GG versus AA). The meta-analysis also indicated that the variant genotypes were associated with a moderately increased risk in Asians in all genetic models (OR = 1.80, 95% CI = 1.17-2.76 for GA versus AA; OR = 3.32, 95% CI = 1.62-6.82 for GG versus AA; OR = 1.67, 95% CI = 1.07-2.60 for GA/GG versus AA; OR= 2.93, 95% CI = 1.43-6.03 for GG versus AA/GA). The meta-analysis suggested that the IL-10-1082A>G polymorphism was associated with increased risk of cancer in Asians and lung cancer and non-Hodgkin's lymphoma. To draw comprehensive and true conclusions, more researches with larger numbers of worldwide participants are needed to examine associations between IL-10-1082A>G polymorphism and cancer risk.     

Estrogen receptor beta gene variants are associated with increased risk of Alzheimer's disease in women

We investigated the association of five intronic single-nucleotide polymorphism (SNP) at the estrogen receptor beta (ESR2) gene locus and the susceptibility of developing Alzheimer's disease (AD) in 387 subjects with clinically diagnosed probable AD and 467 cognitively normal individuals derived from eastern Finland. According to our results, variation in the ESR2 gene is associated with an increased risk of AD in women, whereas it does not contribute to the disease susceptibility in men. More specifically, in women, the allele T and the genotype T/T of two of the studied ESR2 gene SNPs (SNP2 and SNP3) were more frequent in AD women than in cognitively normal control women (P=0.012 and P=0.016, respectively). The ESR2 SNP2 T/T genotype and the SNP3 T/T genotype were associated with a significant, nearly two-fold increase in the risk of AD in women (OR=1.87, 95% CI=1.21-2.90), and remained significant after adjustment with the APOE genotype and age (OR=1.63, 95% CI, 1.00-1.68). The combined effect of the ESR2 SNP2 T/T or SNP3 T/T genotype and female gender increases the risk of the disease (OR=3.2, 95% CI=1.3-7.7). Consistent with these results, also the frequency of the haplotype containing the two above ESR2 gene risk alleles was elevated in AD women (P=0.027, OR=1.3, 95% CI=1.02-1.65). Results show that variation in ESR2 gene may be linked with increased AD susceptibility and furthermore, this association is gender specific.     

Caesarean section delivery and the risk of allergic disorders in childhood

BACKGROUND: The composition of the intestinal flora in young children, if unfavourable, may increase the susceptibility to allergic disorders. Beneficial intestinal microbes originate from the maternal vaginal tract and thus are more likely to be transferred during vaginal births than during Caesarean sections (C-sections). OBJECTIVE: To determine whether children born by C-section have a different risk of allergic disorders compared with those delivered vaginally. We also tested the hypothesis that the risk of allergic disorders is highest for children born after 'repeat C-sections'. METHODS: A retrospective cohort study of 8,953 children aged 3-10 years. Children diagnosed with allergic rhinoconjunctivitis (AR), asthma, atopic dermatitis (AD), or food allergies were identified from the Kaiser Permanente Northwest Region electronic records. The children's sex, birth weight, birth order, postnatal exposure to antibiotics as well as the mothers' age, ethnicity, education, marital status, smoking status during pregnancy, and use of asthma or hayfever medications were identified through the mothers' medical records or through the Oregon Birth Registry. RESULTS: The risk of being diagnosed with AR was significantly higher in the children born by C-section than in those delivered vaginally: adjusted odds ratio (OR)=1.37%, 95% confidence interval (CI)=1.14-1.63. Delivery by C-section was also associated with the subsequent diagnosis of asthma (OR=1.24%, 95% CI=1.01-1.53); this association was gender specific, with a positive association restricted to girls (OR for asthma in girls: OR=1.53%, 95% CI=1.11-2.10; in boys: OR=1.08%, 95% CI=0.81-1.43). There was no significant association between mode of delivery and AD. If children born in a 'repeat C-section' were considered separately the risk of being diagnosed with AR increased further (OR=1.78%, 95% CI=1.34-2.37). The same increase was noted for asthma in girls (OR=1.83%, 95% CI=1.13-2.97) but not in boys. CONCLUSION: Caesarean sections may be associated with an increased risk of developing AR in childhood.     

Risk of uterine leiomyomata in relation to tobacco, alcohol and caffeine consumption in the Black Women's Health Study

BACKGROUND: Tobacco, alcohol and caffeine consumption may influence risk of uterine leiomyomata via changes in ovarian function or hormone metabolism. METHODS: We prospectively assessed the relation of these exposures to risk of self-reported uterine leiomyomata in the Black Women's Health Study. From 1997 to 2001, we followed 21,885 premenopausal women with intact uteri and no prior myoma diagnosis. Cox regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: During 73,426 person-years of follow-up, 2177 incident cases of uterine leiomyomata confirmed by ultrasound (n = 1920) or hysterectomy (n = 257) were reported. Cigarette smoking was not associated with risk of uterine leiomyomata. Risk was positively associated with years of alcohol consumption and current consumption of alcohol, particularly beer. Relative to non-drinkers, multivariate IRRs for beer consumption of < 1, 1-6 and 7+ drinks/week were 1.11 (95% CI 0.98-1.27), 1.18 (95% CI 1.00-1.40) and 1.57 (95% CI 1.17-2.11), respectively. Heavy coffee and caffeine consumption were not associated with risk overall, but IRRs were increased among women aged < 35 years. CONCLUSIONS: In US black women, risk of uterine leiomyomata was positively associated with current consumption of alcohol, particularly beer. Cigarette smoking and caffeine consumption were unrelated to risk overall.     

Obstructive sleep apnea treatment and dementia risk in older adults

Study ObjectivesTo examine associations between positive airway pressure (PAP) therapy, adherence and incident diagnoses of Alzheimer’s disease (AD), mild cognitive impairment (MCI), and dementia not otherwise specified (DNOS) in older adults.MethodsThis retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65 and older, with an obstructive sleep apnea (OSA) diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes (AD [n = 1,057], DNOS [n = 378], and MCI [n = 443]) that were newly identified between 2011 and 2013. PAP treatment was defined as the presence of at least one durable medical equipment (Healthcare Common Procedure Coding System [HCPCS]) code for PAP supplies. PAP adherence was defined as at least two HCPCS codes for PAP equipment, separated by at least 1 month. Logistic regression models, adjusted for demographic and health characteristics, were used to estimate associations between PAP treatment or adherence and new AD, DNOS, and MCI diagnoses.ResultsIn this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75 years. The majority (78%) of beneficiaries with OSA were prescribed PAP (treated), and 74% showed evidence of adherent PAP use. In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (odds ratio [OR] = 0.78, 95% confidence interval [95% CI]: 0.69 to 0.89; and OR = 0.69, 95% CI: 0.55 to 0.85). Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR = 0.82, 95% CI: 0.66 to 1.02). PAP adherence was associated with lower odds of incident diagnoses of AD (OR = 0.65, 95% CI: 0.56 to 0.76).ConclusionsPAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults. Results suggest that treatment of OSA may reduce the risk of subsequent dementia.     

Functional status and use of health care services: longitudinal study on the older adult population in Spain

BACKGROUND: Follow-up studies on the association between functional status and use of health care services among the older people are scarce and have studied only a few types of service. OBJECTIVE: To examine prospectively the relationship between limitation in instrumental activities of daily living (IADL) and utilization of a wide variety of health care services among older adults in Spain. METHODS: Prospective study from 2001 to 2003 of a cohort of 2806 persons, representative of the non-institutionalized Spanish population aged 60 years and over. Limitation in IADL was measured in 2001 using the Lawton and Brody's test. Data on the use of health care services were collected in 2003 and classified into home services (home visits by physicians and nurses) and non-home services (visits to primary care physicians, visits to hospital specialists, hospital admissions, emergency care, and influenza vaccination). Analyses were performed with logistic regression and adjusted for the main confounders. RESULTS: Compared to men with no limitation in IADL, a higher percentage of those with limitation in one IADL in 2001 made use of both home (odds ratio [OR] 2.64; 95% confidence interval [95% CI] 1.73-4.03) and non-home services (OR 2.02; 95% CI 1.04-3.93) in the period 2001-2003. Limitation in one IADL among women was associated with a greater utilization of home services (OR 1.50; 95% CI 1.05-2.14) and visits to hospital specialists (OR 1.61; 95% CI 1.21-2.15). In women, however, a greater number of limited IADL at baseline was inversely associated with visits to primary care physicians in the 2-year follow-up (p for linear trend <0.001). CONCLUSION: Population aging will increase the demand for health services in general, and for home services in particular.     

Factors associated with determinants of sexual functioning in midlife women

OBJECTIVES: The present study was conducted to assess the associations between a woman's passionate love for her partner and sexual satisfaction and demographic factors, health and life-style characteristics, menopausal status, and menopausal symptoms. METHODS: A cross-sectional study was conducted among women (40-60 years) residing in Maryland (n = 846). chi(2)-tests were performed to evaluate the associations between each of the outcome variables (sexual satisfaction and passionate love for the partner) and predictor/independent variables. Logistic regression analysis was performed to determine whether significant associations from chi(2) analyses remained significant after adjustment for confounders. RESULTS: Older age (adjusted odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01, 1.07), higher education (OR 1.47; 95% CI 1.09, 1.99), and alcohol intake (OR 1.42; 95% CI 1.03, 1.95) were associated with low passion for the partner. Older age was also a significant predictor of low sexual satisfaction (OR 1.04; 95% CI 1.01, 1.07). Women experiencing vaginal dryness had higher odds of low passion for partner (OR 1.67; 95% CI 1.21, 1.31) and low sexual satisfaction (OR 1.58; 95% CI 1.14, 2.20) than women not experiencing vaginal dryness. CONCLUSIONS: Older age, higher education, alcohol intake, and vaginal dryness are significantly associated with lower levels of passionate love for the partner, while older age and vaginal dryness are significantly associated with lower levels of sexual satisfaction in midlife women.     

Association of RIP2 gene polymorphisms and systemic lupus erythematosus in a Chinese population

The aim of this study was to investigate the association of receptor interacting protein 2 (RIP2) single-nucleotide polymorphisms (SNPs) with susceptibility to systemic lupus erythematosus (SLE) in a Chinese population. A case-control study was performed on the SNPs rs16900617 and rs16900627 in 590 Chinese SLE patients and 660 healthy controls. These SNPs were typed by TaqMan allele discrimination assays. We found a significant association of rs16900617 G allele [odds ratio (OR) = 0.54, 95% confidence interval (CI) 0.41-0.72] and rs16900627 G allele (OR = 1.28, 95% CI 1.04-1.58) with SLE. Significant differences in genotype frequency distribution were also found in SLE and control individuals (rs16900617: AG versus AA, OR = 0.59, 95% CI 0.44-0.81; GG versus AA, OR = 0.08, 95% CI 0.01-0.65; AG + GG versus AA, OR = 0.55, 95% CI 0.41-0.75; rs16900627: AG versus AA, OR = 1.51, 95% CI 1.17-1.93; AG + GG versus AA, OR = 1.43, 95% CI 1.13-1.82). Analysis of the haplotypes revealed that two haplotypes of AG and GA were also significantly associated with SLE (OR = 1.37, 95% CI 1.11-1.70; OR = 0.60, 95% CI 0.45-0.79). Our findings suggest that the RIP2 gene polymorphisms may be associated with susceptibility to SLE in the Chinese population.     

Trends in the Prevalence of Major Depressive Disorder by Sociodemographic Factors in Korea: Results from Nationwide General Population Surveys in 2001, 2006, and 2011

BackgroundThis study investigated trends in the prevalence of major depressive disorder (MDD) by sociodemographic factors in South Korea.MethodsNational samples of the general population aged 18 years or older collected from the nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001 (n = 6,206), 2006 (n = 6,466), and 2011 (n = 5,986) were used. For MDD diagnosis, we conducted face-to-face interviews using the Korean version of the Composite International Diagnostic Interview. We performed logistic regression analyses stratified by gender, after adjusting for other sociodemographic variables, to calculate the 2006-to-2001 odds ratio (OR) and 2011-to-2001 OR by subgroups of sociodemographic factors to explore the association of MDD prevalence with sociodemographic factors over time.ResultsThe prevalence of MDD in the general population of South Korea increased steadily from 2001, to 2006, and to 2011 (1.6%, 2.5%, and 3.1%, respectively). Among the men, the prevalence of MDD continued to increase significantly in 18–29 years of age group (2006: adjusted OR [AOR], 3.32; 2011: AOR, 7.42), at-risk drinking group (2006: AOR, 3.56; 2011: AOR, 4.77), and not living with a partner group (2006: AOR, 3.24; 2011: AOR, 3.25). Meanwhile, among the women, the prevalence of MDD continued to significantly increase in the below-average household income group (2006: AOR, 2.58; 2011: AOR, 2.59), at-risk drinking group (2006: AOR, 2.02; 2011: AOR, 2.47), and unemployed group (2006: AOR, 1.48; 2011: AOR, 2.04).ConclusionThis study may provide significant information for public policymakers to allocate sufficient health resources on MDD to vulnerable groups, particularly, men aged 18–29 years and women living in households with below-average income, and for clinicians to develop appropriate screening and treatment modalities for MDD.     

Identifying correlates of suicide attempts in suicidal ideators: a population-based study

BACKGROUND: Identification of factors that distinguish between ideators who act on their suicidal thoughts from those who do not is an important clinical and research objective. METHOD: We examined correlates of suicide attempts in suicidal ideators, members of a French-Canadian, school-based cohort. Suicidal thoughts were evaluated in adolescence and early adulthood in the total sample of suicidal ideators, who were then stratified into subgroups consisting of persistent ideators, male ideators and female ideators. RESULTS: In addition to persistent suicidal ideas [odds ratios (ORs) 2.1-2.8], Axis I psychopathology, female gender and childhood sexual abuse (CSA) were the most consistent correlates of suicide attempts. Externalizing disorders were significant contributors in persistent ideators [drug misuse: OR 2.8, 95% confidence interval (CI) 1.1-6.9] and in male ideators in particular (disruptive disorders: OR 5.9, 95% CI 2.2-16.0). In women, psychiatric co-morbidity also had a significant effect (OR 1.6, 95% CI 1.1-2.1). CSA was of relevance in both women (OR 1.2, 95% CI 1.1-1.4) and persistent ideators (OR 1.3, 95% CI 1.1-1.5). Personality traits showed gender-specific contribution with affective instability (OR 1.1, 95% CI 1.01-1.1) and anxiousness (OR 1.3, 95% CI 1.1-1.7) contributing in men and disruptive aggression (OR 1.1, 95% CI 1.03-1.3) in women. CONCLUSIONS: Correlates of suicide attempts in suicidal ideators vary as a function of the persistence of suicidal ideas and gender. This heterogeneity across subgroups of suicidal ideators may be attributed, at least in part, to differences between the sexes, early environmental adversity, maladaptive personality, and psychiatric symptoms. Further exploration and continued prospective follow-up is necessary to examine these possibilities.     

Eczema, atopy and allergen exposure in adults: a population-based study

BACKGROUND: There are few published studies on geographical variation in prevalence of eczema in adults or its association with recognised risk factors for allergic disease. OBJECTIVE: To describe the geographical variation in prevalence of eczema in adults, assess the associations with sociodemographic risk factors, serum-specific IgE and IgG, and exposure to allergen. METHODS: A community-based sample of 8206 adults aged 27-56 years, in 25 European centres and Portland, USA, provided questionnaire information on symptoms of eczema. Serum-specific IgE to house dust mite (HDM), cat, grass and Cladosporium, and IgG and IgG4 to HDM and cat were measured. Mattress levels of mite and cat allergen were assessed. RESULTS: Overall prevalence of eczema was 7.1% (range between countries of 2.2-17.6%). Eczema was associated with female gender [odds ratio (OR) 1.25; 95% confidence interval (CI) (1.01-1.55)], family history of atopic disease (OR 1.43; 95% CI 1.18-1.74), IgE sensitization to at least one allergen (OR 1.50; 95% CI 1.19-1.90), particularly Cladosporium (OR 3.65; 95% CI 1.81-7.37), and total IgE. Eczema was negatively associated with age and no clear associations were observed with sibship size, mattress mite and cat allergen levels or with cat and HDM-specific IgG or IgG4. CONCLUSIONS: There is geographical variation in the prevalence of eczema in adults both within and between countries. Although the disease is associated with IgE sensitization, in this study it was not related to mattress mite or cat allergen levels.     

Mental disorders in medical inpatients and the association to severity of illness, self-rated physical disability, and health perception

In a study of 294 consecutive medical inpatients, the authors assessed a subsample of 157 patients for psychiatric diagnoses using an extensive semistructured interview, Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Patients rated their health and physical functioning, and medical consultants assessed them for chronic and life-threatening diseases. A life-threatening condition increased odds for having a psychiatric diagnosis by 3.1 times (95% Confidence Interval (CI): 1.03-9.1), while a chronic medical disease had no such impact (OR=1.1; 95% CI: 0.5-2.3). In women, mental disorders were strongly associated with self-rated disability (OR=6.7; 95% CI: 1.6-27.8) and self-rated health (OR=9.4; 95% CI: 2.7-32.4). This association was absent in men (OR(disability)=0.7; 95% CI: 0.2-2.7; OR(health)=1.6; 95% CI: 0.6-4.7). Analyses included adjustment for age and gender.     

Atopic dermatitis is not independently associated with nonfatal myocardial infarction or stroke among US women

We aimed to determine the association between atopic dermatitis (AD) and cardiovascular events in the Nurses' Health Study 2, a cohort of US women. We used logistic regression models to calculate age‐ and multivariate‐adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between history of AD and nonfatal MI and nonfatal stroke. Of the 78 702 participants in our analysis, 7916 (10%) had a history of AD. There were 392 and 391 cases of nonfatal MI and stroke, respectively. AD was not associated with MI in age‐ or multivariate‐adjusted analyses. AD was significantly associated with stroke in the age‐adjusted analysis (OR 1.38, 95% CI 1.03–1.85). This was no longer significant in multivariate models that adjusted for hypertension, hypercholesterolemia and diabetes (OR 1.31, 95% CI 0.98–1.76) and atopic comorbidities (OR 1.17, 95% CI 0.86–1.58). AD was not independently associated with nonfatal MI or stroke in this study.     

Effect of maternal HIV and malaria infection on pregnancy and perinatal outcome in Zimbabwe

OBJECTIVE: To investigate the effect of isolated or concomitant infection with malaria and HIV on pregnancy and neonatal outcome. METHODS: Data were collected on pregnant women admitted during the rainy seasons in the obstetric division of a district referral hospital in northern Zimbabwe in 2000 and 2001. The effects of malaria and HIV infection were determined by multivariate analysis. RESULTS: The prevalence of HIV seropositivity and symptomatic malaria in 986 pregnant women was 8.3% and 14.7%, respectively. HIV-infected women were more likely to develop malaria attacks during pregnancy than seronegative women (odds ratio [OR] = 3.96, 95% confidence interval (CI): 2.42-6.46). Malaria and HIV infections were associated with increased risk of stillbirth (OR = 4.74, 95% CI: 1.34-16.78) and preterm delivery (OR = 4.10, 95% CI: 2.17-7.75), respectively. They were independently associated with increased risk of low birth weight (malaria: OR = 10.09, 95% CI: 6.50-15.65; HIV: OR = 3.16, 95% CI: 1.80-5.54) and very low birth weight (malaria: OR = 5.04, 95% CI: 1.00-25.43; HIV: OR = 10.74, 95% CI: 2.12-54.41), low Apgar score (malaria: OR = 4.45, 95% CI: 1.42-13.94; HIV: OR = 5.94, 95% CI: 1.66-21.30), and fetal growth restriction (malaria: OR = 3.98, 95% CI: 2.51-6.30; HIV: OR = 4.07, 95% CI: 2.40-6.92). Dual infection with malaria and HIV was associated with increased risk of maternal, perinatal, and early infant death. CONCLUSIONS: Women with single HIV or malaria infection have a significantly increased risk of adverse outcomes of pregnancy and childbirth. Dual infection has additional detrimental effects on maternal and infant survival in an area where HIV and malaria coexist.