Does pizza protect against cancer?

We analyzed the potential role of pizza on cancer risk, using data from an integrated network of case-control studies conducted in Italy between 1991 and 2000. Cancer sites were: oral cavity and pharynx (598 cases), esophagus (304 cases), larynx (460 cases), colon (1,225 cases) and rectum (728 cases). Controls were 4,999 patients admitted for acute, non-neoplastic conditions to the same hospital network as cases. Odds ratios for regular pizza consumers were 0.66 (95% confidence interval, CI = 0.47-0.93) for oral and pharyngeal cancer, 0.41 (95% CI = 0.25-0.69) for oesophageal, 0.82 (95% CI = 0.56-1.19) for laryngeal, 0.74 (95% CI = 0.61-0.89) for colon and 0.93 (95% CI = 0.75-1.17) for rectal cancer. Pizza appears therefore to be a favorable indicator of risk for digestive tract neoplasms in this population.     

A synthetic pentasaccharide for the prevention of deep-vein thrombosis after total hip replacement

BACKGROUND: Venous thromboembolism is a frequent complication of total hip replacement. The pentasaccharide Org31540/SR90107A, a highly selective, indirect inhibitor of activated factor X, is the first of a new class of synthetic antithrombotic agents. To determine the optimal dose for phase 3 studies, we conducted a dose-ranging study in which Org31540/SR90107A was compared with a low-molecular-weight heparin, enoxaparin, in patients undergoing total hip replacement. METHODS: In a double-blind study, patients were randomly assigned to postoperative administration of one of five daily doses of Org31540/SR90107A, given once daily, or to 30 mg of enoxaparin, given every 12 hours. Treatment was continued for 10 days or until bilateral venography was performed after a minimum of 5 days. RESULTS: Of 933 patients treated, 593 were eligible for the efficacy analysis. With Org31540/SR90107A a dose effect was observed (P=0.002), with rates of venous thromboembolism of 11.8 percent, 6.7 percent, 1.7 percent, 4.4 percent, and 0 percent for the groups assigned to 0.75 mg, 1.5 mg, 3.0 mg, 6.0 mg, and 8.0 mg of the drug, respectively, as compared with a rate of 9.4 percent in the enoxaparin group. The reduction in the risk of venous thromboembolism was 82 percent for the 3.0-mg Org31540/SR90107A group (P=0.01) and 29 percent for the 1.5-mg group (P=0.51). Enrollment in the 6.0-mg and 8.0-mg Org31540/SR90107A groups was discontinued because of bleeding complications. Major bleeding occurred 3.5 percent less frequently in the 0.75-mg group (P=0.01) and 3.0 percent less frequently in the 1.5-mg group (P=0.05) than in the enoxaparin group (in which the rate was similar to that in the 3.0-mg group). CONCLUSIONS: A synthetic pentasaccharide, Org31540/SR90107A, has the potential to improve significantly the risk-benefit ratio for the prevention of venous thromboembolism, as compared with low-molecular-weight heparin.     

Physical activity and risk of ovarian cancer: an Italian case-control study

The relationship between physical activity and the risk of ovarian cancer was analyzed using data from a case-control study conducted between 1992 and 1999 in Italy. Cases were 1,031 women with incident, histologically confirmed, invasive epithelial ovarian cancer and controls were 2,411 women admitted to hospital for acute non-neoplastic, non-hormonal conditions. Compared to women with the lowest level of occupational physical activity, the ORs of ovarian cancer obtained adjusting for center, year of interview and age for women with the highest level of physical activity were 0.70, 0.52 and 0.64 (all statistically significant) respectively, at ages 15-19, 30-39 and 50-59 years, with significant trends in risk for the 2 youngest age groups. The corresponding ORs became 0.89, 0.67 and 0.76 after further allowance for several co-variates of ovarian cancer, including education, which was positively associated with cancer risk. No significant association was found with leisure-time physical activity though the risk was below unity in women with the highest level of activity. The multivariate OR was 0.44 for women with the highest level of combined occupational plus leisure-time physical activity. The inverse relationship between occupational physical activity and ovarian cancer risk was not heterogeneous across strata of selected co-variates.     

Prospective randomised open-label comparison of danaparoid with dextran 70 in the treatment of heparin-induced thrombocytopaenia with thrombosis: a clinical outcome study

AIM: To compare clinical outcomes in a randomised comparison of treatment with danaparoid sodium (a heparinoid), or dextran 70, for heparin-induced thrombocytopaenia (HIT) plus thrombosis. METHODS: Forty-two patients with recent thrombosis and a clinical diagnosis of probable HIT who presented at ten Australian hospitals during a study period of six and one half years were randomly assigned to open-label treatment with intravenous danaparoid or dextran 70, each combined with oral warfarin. Thirty-four patients (83%) had a positive platelet aggregation or 14C-serotonin release test for HIT antibody. Twenty-five received danaparoid as a bolus injection of 2400 anti-Xa units followed by 400 units per hour for 2 h, 300 units per hour for 2 h, and then 200 units per hour for five days. Seventeen received 1000 mL dextran 70 on day one and then 500 mL on days 2-5. Patients were reviewed daily for clinical evidence of thrombus progression or resolution, fresh thrombosis or embolism, bleeding or other complications. The primary trial endpoint was the proportion of thromboembolic events with complete clinical resolution by the time of discharge from hospital. RESULTS: With danaparoid, there was complete clinical recovery from 56% of thromboembolic events compared to 14% after dextran 70 (Odds Ratio 10.53, 95% Confidence Interval 1.6-71.4; p = 0.02). Clinical recovery with danaparoid was complete or partial in 86% of thromboembolic events compared with 53% after dextran 70 (Odds Ratio 4.55, 95% Confidence Interval 1.2-16.7; p = 0.03). Overall clinical effectiveness of danaparoid was rated as high or moderate in 88% of patients compared with 47% for dextran 70 (p = 0.01). One patient given danaparoid died of thrombosis compared with three patients given dextran 70. The platelet count returned to normal after a mean of 6.7 days with danaparoid and 7.3 days with dextran 70. There was no major bleeding with either treatment. CONCLUSION: danaparoid plus warfarin treatment for HIT with thrombosis is effective, safe, and superior to dextran 70 plus warfarin.     

Towards the safer use of warfarin I: an overview

There has been an exponential increase of warfarin usage in the community since several large and well-designed clinical trials have consistently found that warfarin can safely prevent embolic stroke in people with atrial fibrillation. Safe and effective warfarin treatment requires a case-by-case evaluation of each patient's clinical condition and risk factors for bleeding. It also demands a therapeutic partnership where patients can accept an educated responsibility for managing their own condition. This requires mutually understood plans for ongoing management, including dose adjustment and responses to under- or overdose and to bleeding complications.     

Body weight and risk of soft-tissue sarcoma.

The relation between body mass (BMI) and soft-tissue sarcoma (STS) risk was evaluated in a case-control study from Northern Italy based on 217 incident STS and 1297 hospital controls. The risk of STS rose with BMI, with multivariate odds ratios of 3.49 (95% confidence interval (CI) 1.06-11.55) among men and 3.26 (95% CI 1.27-8.35) among women with a BMI > 30 kg m(-2) compared to those with BMI < or = 20 kg m(-2).     

The pronase resistance of cholesterol-nucleating glycoproteins in human bile

BACKGROUND & AIMS: Many putative pronucleating proteins have been isolated from the biliary concanavalin A (con A)-binding fraction. The pronase resistance of the overall nucleating-promoting activity was almost never taken into consideration. The aim of this study was to identify the major pronase-resistant con A-binding glycoproteins. METHODS: Pronase-treated and -untreated con A-binding glycoproteins were separated on a Superose 12 gel permeation column (Pharmacia, Uppsala, Sweden) and tested in a crystal growth assay. Proteins were identified by amino-terminal sequencing. RESULTS: Con A-binding pronucleating activity eluted in two peaks on the Superose column. This activity was unaltered after pronase treatment. Activity peak I contained too little protein to allow amino-terminal sequencing. In activity peak II, the major pronase-resistant con A-binding glycoproteins were identified as alpha 1-antitrypsin and alpha 1- antichymotrypsin. The 130-kilodalton nucleation promoter was identified as aminopeptidase N, but the full pronase resistance of this protein, reported earlier, was not confirmed. Immunoabsorptive removal of alpha 1-antitrypsin and alpha 1-antichymotrypsin and immunopurification showed that only alpha 1-antichymotrypsin had pronucleating activity. CONCLUSIONS: The pronase resistance of the nucleating-promoting activity of the con A-binding glycoprotein fraction was confirmed. An important part of this activity could be attributed to alpha 1- antichymotrypsin. It is an acute-phase protein, as are many other pronucleating proteins, which might indicate a general mechanism of action in gallstone formation. (Gastroenterology 1996 Jun;110(6):1926-35)     

急性心肌梗死大鼠梗死区血管内皮生长因子和缺氧诱导因子1αmRNA表达及人参皂苷Rg1的干预效应

目的:观察人参皂苷Rg1对急性心肌梗死后血管新生及梗死区血管内皮生长因子和缺氧诱导因子1αmRNA表达的影响及其机制。方法:实验于2005-10/2006-01在中国医科大学附属第一医院循环内科实验室完成。实验分组:健康雄性Wistar大鼠104只,体质量180～220g,随机抽签法分为假手术组8只,对照组、Rg1低剂量治疗组和Rg1高剂量治疗组各32只。实验方法:建立Wistar大鼠急性心肌梗死模型,假手术组开胸不结扎冠状动脉,3d后处死取材;对照组、Rg1低剂量治疗组和Rg1高剂量治疗组分别于术后即刻及术后每天腹腔注射生理盐水1mL、人参皂苷Rg11mg/kg和5mg/kg,术后3,7,10,14d分别取材,每组8只。实验评估:测定血清心肌酶、心肌梗死面积、梗死区微血管密度,逆转录-聚合酶链反应检测梗死区心肌组织血管内皮生长因子和缺氧诱导因子1α的mRNA表达。结果:纳入大鼠104只,均进入结果分析。①人参皂苷Rg1对大鼠心肌酶及心肌梗死面积的影响:Rg1低剂量治疗组、Rg1高剂量治疗组心肌酶较对照组明显降低[(62.25±10.79),(57.64±9.36),(78.63±11.34)μg/L;P<0.05],心肌梗死面积亦明显降低[14d:(12.15±3.68)%,(10.10±3.12)%,(13.94±3.54)%;P<0.05]。②人参皂苷Rg1对大鼠心肌梗死区微血管密度的影响:各组梗死区血管生成数量随着时间的延长呈持续增加的趋势,与对照组比较,差异有显著性意义[Rg1低剂量治疗组14d:(17.29±3.21)个/视野;Rg1高剂量治疗组14d:(23.27±3.42)个/视野;对照组14d:(9.36±3.54)个/视野;P<0.01]。③大鼠心肌梗死区血管内皮生长因子、缺氧诱导因子1αmRNA的表达:心肌梗死后血管内皮生长因子、缺氧诱导因子1αmRNA表达随缺血时间的延长有增高趋势,Rg1低剂量治疗组与Rg1高剂量治疗组明显升高,14d时血管内皮生长因子的增长出现停止或下降[Rg1低剂量治疗组14d:(1.1637±0.1786);Rg1高剂量治疗组14d:(1.7230±0.3102)];而缺氧诱导因子1α继续升高[Rg1低剂量治疗组14d:(1.7263±0.3417);Rg1高剂量治疗组14d:(2.7725±0.3219)]。结论:严重缺血可刺激心肌组织产生大量的血管内皮生长因子、缺氧诱导因子1α,人参皂苷Rg1增加其表达进而刺激心肌梗死区的血管生成,减轻缺血对心肌的损伤。