Association between hypertensive disorders complicating pregnancy and risk of placenta accreta: a meta-analysis and systematic review

Objective: Previous studies have reported a positive association between hypertensive disorders complicating pregnancy and placenta accreta. However, whether hypertensive disorders complicating pregnancy associated with placenta accreta is still not clear. The objective was to systematically review the literature to determine a possible association between hypertensive disorders complicating pregnancy and placenta accreta. Methods: A systematic search of PubMed database, the Cochrane Library, Willy Online Library, and ScienceDirect database through 1st December 2015, was conducted. Two authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.3.0. Results: Three studies involving 4174 patients who developed hypertensive disorders complicating pregnancy of a total of 38,004 pregnant women were selected. The result of our meta-analysis revealed that pregnancy induced hypertension was significantly associated with a reduction of placenta accreta (OR = 0.50, 95% CI: 0.30–0.82; heterogeneity: I² = 13%, p = 0.32). Conclusions: Our meta-analysis demonstrated that the risk of placenta accreta is reduced in women with hypertensive disorders complicating pregnancy. Further well-designed studies are warranted to testify the result and explored any potential mechanism association between hypertensive disorders complicating pregnancy and placenta accreta.     

Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China

A cross-sectional study design was applied amongst a random sample (n = 10158) of Chinese adolescents. Self-completed questionnaires, including demographic characteristics, Internet use situation, Youth Internet Addiction Test, Youth Social Support Rating Scale and Zung Self-rating Depression Scale were utilized to examine the study objectives. Among the study population, the prevalence rate of Internet addiction was 10.4%, with 1038 (10.2%) moderately and 21 (0.2%) severely addicted to the Internet. Results from the multivariate logistic regression analyses suggested that a variety of related factors have significant effects on Internet addiction (parental control, per capita annual household income, academic performance, the access to Internet, online activities). The correlation coefficients showed that Internet addiction was negatively correlated with social support and positively associated with depression. Social support had a significant negative predictive effect on Internet addiction. The mediating effect of depression between social support and Internet addiction was remarkable.     

Genetics of common complex diseases: a view from Iceland

In the past decade, large scale genotyping has led to discoveries of numerous sequence variants that confer increased risk of many common complex diseases. Interestingly, a substantial proportion of pioneering genetic work has originated from the small nation of Iceland and has been facilitated by an extensive genealogy database. We provide examples of relevant observations made so far in several major disease categories central to internal medicine practice. Some of these findings offer new mechanistic clues into the pathophysiology of common disorders and may suggest novel approaches in diagnosis and drug therapy. However, a number of unresolved issues remain that will be subject of future research, driven by recent advances in high-throughput sequencing of the genome. At the same time, we are ready to begin transforming the abundant existing genetic data into practical clinical knowledge with the aim of improving the delivery of medical care. The era of precision medicine has arrived.     

Prevalence of mild cognitive impairment and its subtypes in community-dwelling residents aged 65 years or older in Guangzhou,China

BackgroundPrevalence of mild cognitive impairment (MCI) has been reported substantial variations, and mostly in Western countries. Less is known about MCI in the south of China. The study is to estimate the prevalence of MCI and its subtypes in residents aged 65 year or older in community-dwelling residents of Guangzhou, China.MethodsThe study was a community-based, cross-sectional study conducted in rural and urban areas of Guangzhou between April and October 2009. Eight communities were randomly selected using a cluster sampling method. Each elderly was interviewed with Montreal Cognitive Assessment, the Mini-Mental state examination, Auditory Verbal Learning Test, the Clinical Dementia Rating scale et al. MCI was classified as amnestic MCI (a-MCI) or nonamnestic MCI (na-MCI).Results2427 individuals were contacted, but in-person interviews were conducted with 2111 participants. 299 participants with MCI were identified. The prevalence of MCI, a-MCI and na-MCI was 14.2%, 12.2%, 2.0% respectively. The prevalence of MCI and a-MCI increased with age, decreased with education level, and was higher in rural areas than in urban areas. The difference of prevalence of MCI and a-MCI between women with men wasn't statistically significant(MCIχ2 = 1.0, OR 0.9, 95%CI = 0.6-1.2; a-MCIχ2 = 1.0, OR 0.9, 95%CI = 0.6–1.2), when controlling for education by logistic regression analysis.ConclusionsThe results suggest that 14.2% of elderly individuals are affected by MCI in Guangzhou, China. And MCI was dominated by a-MCI. The prevalence of MCI and a-MCI increased with age, decreased with education level, and was higher in the rural population compared to the urban population.     

Is the Gambling Motives Questionnaire really three-dimensional? A proposition of a four-dimensional Gambling Motives Questionnaire – Revised

The aim of the present study was to improve the weaknesses of the three-dimensional Gambling Motives Questionnaire and to examine the psychometric properties and factor structure of the Gambling Motives Questionnaire-Revised. The Gambling Motives Questionnaire was administered to a sample of 418 gamblers (92% men, mean age 19.5 years). Participants completed the Gambling Motives Questionnaire and an additional item tapping boredom, as well as a variety of measures of gambling behavior and gambling problems as criterion measures. Results showed that the Gambling Motives Questionnaire-Revised is better represented as a four-factor structure tapping the following four gambling motives factors; enhancement, coping, social, and self-gratification, Δχ² Δ(df) = 24.76 (3), p < 0.001. Removing two problematic items from the Gambling Motives Questionnaire and adding an extra item tapping boredom also improved the fit of the Gambling Motives Questionnaire-Revised. The subscales enhancement, social, and coping were all significant predictors of variety of gambling behaviors (p < 0.05), whereas enhancement, coping, and self-gratification predicted frequency of gambling behaviors (p < 0.01). Coping and self-gratification predicted loss of control (p < 0.01), whereas self-gratification predicted gambling problems (p < 0.001). The Gambling Motives Questionnaire – Revised, consisting of the four dimensions enhancement motives, social motives, coping motives and self-gratification motives, is a reliable and valid instrument to measuring gambling motives.