Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition

Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992–2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00–1.26), with no detected heterogeneity across countries (p_homogeneity = 0.42). This risk increased linearly with duration of use (p_trend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97–1.43), which was heterogeneous across countries (p_homogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.     

Hybridization of the 18 alpha-satellite probe to chromosome 1 revealed in PGD

Although the chromosome 18 alpha-satellite probe is considered to have a very low polymorphism rate, the routine use of this probe in prenatal diagnosis revealed rare variants in size and copy number of these sequences. A polymorphic signal was detected in preimplantation genetic diagnosis (PGD) for aneuploidy, in a patient with repeated early miscarriages. A third small signal of chromosome 18 alpha-satellite probe was observed in two of four evaluated embryos. Hybridization to the woman's metaphasic lymphocytes revealed that the small signal was localized in the pericentromeric region of chromosome 1. Reanalysis of blastomeres with telomeric probes for chromosome 18q confirmed the presence of only two copies of chromosome 18. Options for verifying PGD analysis results, to prevent misdiagnosis in cases of suspected polymorphism, are discussed. Although some authors speculate about a possible role of heterochromatin polymorphism in infertility, this rare polymorphism of 18 alpha-satellite sequences is in itself probably a normal variant. This is the third report of a cross-hybridization of the chromosome 18 alpha-satellite probe and the first report of the localization of the polymorphic 18 alpha-satellite signal to chromosome 1.     

Regional differences in men attending a sexual health clinic in Sydney for premature ejaculation

IntroductionPrevious investigation from UK sexual health clinics has suggested that men from Central Asian and Middle Eastern backgrounds are more likely to present with premature ejaculation (PE) than men from Western backgrounds. This interesting finding requires replication, especially in populations from other countries.AimThe current study aimed to determine whether men who had sought treatment for PE from a community sexual health clinic were more likely to come from Central Asian and Middle Eastern backgrounds than from Western backgrounds.Main Outcome MeasuresDemographic and clinical data were collected retrospectively from patient files over a 3-year period. Patient-defined ethnicity for outpatients seeking psychological interventions for PE was compared to the ethnicity of those attending for other sexual dysfunctions and also to local population census data.MethodClinical files for 215 men seeking psychological interventions for sexual dysfunctions at an urban sexual health clinic in Sydney were examined. Men were included in the study if they reported being born in one of two regional groups: Western countries or Middle Eastern/Central Asian countries. The rates of men seeking help for PE vs. other sexual dysfunctions were compared between these two regional groups and were compared with the representation of each region in the broader sexual health service as well as the local population.ResultsRelative to men born in Western regions, men from Central Asian/Middle Eastern countries were more likely to present with PE than with other sexual dysfunctions. The proportion of men from Central Asian/Middle Eastern countries presenting with PE was considerably higher than expected for the population attending the sexual health clinic or the broader local community.ConclusionConsistent with previous research, Asian and Middle Eastern men living in a Western society appear to be more likely than Western men to report difficulties with PE. Frewen A, Rapee RM, Bowden P, and Lagios K. Regional differences in men attending a sexual health clinic in Sydney for premature ejaculation.     

How reliable is MRCP with an SS-FSE sequence at 3.0 T: comparison between SS-FSE BH and 3D-FSE BH ASSET sequences

PurposeThe purpose of the present study was to evaluate the visibility and the image quality of the biliary and pancreatic duct system on magnetic resonance cholangiopancreatography (MRCP) images based on two breath-hold (BH) methods using array spatial sensitivity technique: a single-shot fast spin-echo (SS-FSE) sequence and a three-dimensional single slab fast spin-echo (3D-FSE) sequence.Materials and methodsIn the present prospective comparative study, 47 patients (22 male and 25 female, mean age=50 years, age range=22–82 years) that were referred for MRCP during a 12-month period are included. All of them were referred with suspected pancreaticobiliary disease. All patients underwent MRCP with both a SS-FSE BH sequence and a 3D-FSE BH sequence. Qualitative evaluation regarding the depiction of three segments of the pancreaticobiliary tree and the frequency of artifacts was performed. Two radiologists graded each sequence of the obtained studies in a blinded fashion. Quantitative evaluation including calculation of relative signal intensity (rSI) and relative contrast (RC) ratios at seven segments of the pancreaticobiliary tree between fluid-filled ductal structures and organ parenchyma at the same ductal segments was performed. In order to evaluate the parameters' differences of the two sequences, either in qualitative or in quantitative analysis, the Wilcoxon paired signed-rank test was performed.ResultsOn quantitative evaluation, both rSI and RC ratios of all segments of the pancreaticobiliary tree at SS-FSE BH sequence were higher than those at 3D-FSE BH sequences. This finding was statistically significant (P< .01). On qualitative evaluation, the two radiologists found intrahepatic ducts and pancreatic ducts to be better visualized with SS-FSE BH than with 3D-FSE BH sequence. This finding was statistically significant (P< .02). One of them found extrahepatic ducts to be significantly better visualized with SS-FSE BH sequence. Moreover, the frequency of artifacts was lower in the SS-FSE sequence, a finding that was of statistical significance. Interobserver agreement analysis found at least substantial agreement (κ>0.60) between the two radiologists.ConclusionThe SS-FSE sequence is performed faster and significantly improves image quality; thus, it should be included into the routine MRCP sequence protocol at 3.0 T. Furthermore, we recommended SS-FSE BH MRCP examination to be applied to uncooperative patients or patients in emergency because of its short acquisition time (1 s).     

Effective strategies for coping with paranoid thoughts: A qualitative investigation

The study outlines the effective coping strategies that people with paranoid ideas utilize in dealing with distressing paranoid thoughts. All texts sent to and uploaded onto the “coping tips” section of the paranoidthoughts.com website, as a response to a call for people with paranoid thoughts to share their coping strategies, were thematically analyzed. The themes produced were subsequently mapped onto the main categories that emerged from the literature on coping with paranoid delusions. Contributors to the website were found to employ a variety of direct strategies for coping with paranoid ideas, which, in accordance with the relevant literature, can be grouped to approach coping strategies, which involve rational coping and activity-based strategies, detachment coping strategies, including distraction and engagement in activity, and finally interpersonal/social coping strategies, which include social support and social control of ideas. They were also found to utilize various indirect strategies of coping with paranoid ideas and the ensuing distress through seeking quality of life, physical health care, and strategic planning of one’s life. The study largely confirms the well-documented range of strategies employed for coping directly with paranoid thoughts. The role of self-care in buffering or easing the effects of paranoid thoughts on one’s mental state and life seems to be neglected and could provide a direction for future studies of coping with paranoia.     

Is there any relationship between cytokine spectrum of breast milk and occurence of eosinophilic colitis?

Aim: The aim of our study was to analyse cytokine composition of human milk and its relationship to the development of eosinophilic colitis (EC). Methods: Cytokines were measured by ELISA method in breast milk of 20 mothers of infants who developed EC and 20 controls. Results: We found significantly higher concentrations of interferon‐gamma (IFN‐gamma) (Th1 cytokine) in breast milk received by EC infants compared to controls (p = 0.0004). In contrary, IL‐18 (Th1‐inducing cytokine) was significantly higher in breast milk received by healthy infants comparing to EC infants (p = 0.001). Regulatory cytokine transforming growth factor beta1 (TGF‐beta1) showed higher concentrations in breast milk received by healthy infants, although the difference from EC group was not significant (p = 0.072). Conclusion: The results of our study showed that infants with EC were receiving breast milk with a possibly risky cytokine pattern indicating cytokine imbalance, impaired immunoregulation and the early Th1 shift.