Predicting Colonoscopy Screening Behavior and Future Screening Intentions for African Americans Older than 50 Years

Abstract

African Americans experience a disproportionate burden of morbidity and mortality from colorectal cancer, which may be due to low adherence to screening recommendations. Previous studies have found relationships between decision-making factors and screening behavior, but few have looked at both cognitive and affective factors or within a specifically African American sample. To better understand determinants that drive screening behavior, this study examines affective, cognitive, and social variables as predictors of colonoscopy in an age-eligible African American population. Participants completed surveys assessing affective associations with colonoscopy, perceived benefits and barriers, self-efficacy, knowledge, fear of colonoscopy, perceived risk, and colorectal cancer worry and fear. Regression analysis was used to model decision-making constructs as predictors of screening behavior/intentions. Affective, cognitive, and health care experience variables predicted colonoscopy completion and intentions. Provider-level factors and previous cancer screenings predicted prior screening only, but not intentions. Affective and cognitive components of perceived risk were associated with decreased likelihood of colonoscopy behavior, but increased likelihood of colonoscopy intentions. These findings suggest that colonoscopy decision making involves a complex array of both cognitive and affective determinants. This work extends our knowledge of colorectal cancer screening decision making by evaluating the effects of these multiple determinants on screening behavior in an African American sample. Future work exploring the interplay of affect and cognitions as influences on colonoscopy decision making and how health care experiences may moderate this effect is needed to develop effective intervention approaches and reduce screening disparities.     

Baicalein reduces lipopolysaccharide-induced inflammation via suppressing JAK/STATs activation and ROS production

Objective

To investigate the precise molecular mechanisms by which baicalein exerts beneficial biochemical activities in RAW264.7 macrophages treated with LPS.

Materials and methods

RAW264.7 cells were cultured in the absence or presence of baicalein together with or without LPS. iNOS and COX-2 expression were measured by western blot and RT-PCR analyses. TNF-α, IL-1β, and IL-6 were determined by using double-antibody sandwich ELISA. Phosphorylations of JAK1 and JAK2, and of STAT1 and STAT3 were detected by western blotting. Nuclear translocation of STAT1 and STAT3 was visualized by confocal microscopy. ROS production was detected by ROS assay.

Results

Baicalein significantly reduced the phosphorylation of STAT1 and STAT3 and the phosphorylation of JAK1 and JAK2, but without affecting MAPKs phosphorylation in LPS-stimulated RAW264.7 cells. Baicalein suppressed the nuclear translocation of STAT1 and STAT3 and inhibited production of iNOS upon LPS-stimulation, resulting in the inhibition of releases of NO and pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α, in a dose-dependent manner. In addition, we found that baicalein reduced the LPS-induced accumulation of ROS, confirming that baicalein serves as an antioxidant.

Conclusions

Our results suggested that suppressing JAK/STATs activation and interfering with ROS production might contribute to the anti-inflammatory action of baicalein in macrophages.     

Role of anti-allergic agents on attenuating transfusion reactions in adults: A systematic review and meta-analysis

BackgroundAnti-allergic agents (e.g. dexamethasone, chlorpheniramine or promethazine) are commonly administered to patients prior to blood product transfusions. However, the use of these agents is largely experience-based instead of evidence-based. This meta-analysis aimed to explore the evidence behind using anti-allergic agents to attenuate transfusion reactions.Materials and MethodsThe Pubmed, EMBASE, Cochrane Library, Wanfang, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biomedical literature (CMB) databases were all queried for related articles. Data from groups treated with and without anti-allergic agents were collected for meta-analysis using RevMan 5.3. Baseline characteristics and univariate statistics between groups were compared using SPSS 19.0.ResultsEight eligible articles (six case control studies and two randomized controlled trials, all with high risks of bias) were identified (22060 total cases). Administered anti-allergic agents in these studies only included dexamethasone, chlorpheniramine or promethazine. Baseline characteristics showed no significant age or gender differences between treatment or control groups. There were no significant differences between the pooled experimental or control groups (for each of the three medications) in terms of fever, pruritis, rash, airway spasm or overall transfusion reaction rates.ConclusionThere is no evidence that dexamethasone, chlorpheniramine or promethazine can prevent transfusion reactions. Avoiding the arbitrary use of such anti-allergic agents before blood transfusions may potentially avoid needless adverse drug reactions.     

儿童Lowe综合征OCRL基因突变2例报告

目的探讨儿童Lowe综合征的临床特点和基因特征。方法分析2例Lowe综合征患儿的临床资料和OCRL基因检测结果,并复习相关文献。结果 2例患儿均为男性,均存在小分子蛋白尿、高钙尿症、佝偻病和肾结石。例2患儿还有轻度代谢性酸中毒、糖尿和隐睾症。例1患儿生后不久发现有视力异常和先天性白内障,并行手术治疗,同时存在精神运动发育落后,头颅磁共振成像(MRI)示胼胝体发育不良。例2患儿就诊时肾外症状不明显,但眼科检查发现有先天性白内障,头颅MRI示脑发育低下、脑白质髓鞘化延迟,且随访过程中逐渐出现智力发育落后。OCRL基因检测发现2个突变,例1为剪切位点突变NG 008638.1:g.46846-46848del TAA/ins C,例2为缺失移码突变NM000276.3:c.321del C,两种突变以前文献均未报道。结论 Lowe综合征的诊断主要通过临床表现和OCRL基因检测,对于有先天性白内障、肾小管病变的患儿需要与Lowe综合征鉴别。本研究发现2个OCRL基因的新突变。     

脾动脉头端动脉瘤的外科治疗11例报告

目的探讨脾动脉头端真性动脉瘤的切除方法以及血管重建方法,总结临床治疗经验。方法回顾性总结2000年1月—2013年6月作者收治的11例资料,均经彩色超声、CT和血管造影检查证实脾动脉头端真性动脉瘤。肝动脉脾脏动脉远端自体静脉移植1例;肾下主动脉—脾动脉人工血管转流7例;动脉瘤、脾脏切除2例,多发动脉瘤切除、脾动脉结扎、脾切除1例。结果手术后10~14天治愈出院,随访1~14年,9例存活,2例死亡,其中1例主脾转流后2年死于急性心肌梗死,1例动脉瘤切除、脾切除后5年死于急性脑出血。7例主脾转流中,1例术后2年吻合口逐渐狭窄,术后6年完全闭塞,但一直无脾脏梗死,脾脏供血由胃短血管及其侧枝提供;余6例主脾转流和1例自体血管移植者未见吻合口狭窄或假性动脉瘤。结论脾动脉头端真性动脉瘤切除、脾动脉血管重建是一种较好的治疗方案。