Multiple primary (even in situ) melanomas in a patient pose significant risk to family members

BackgroundWe aimed at assessing familial risk of melanoma by considering a detailed family history of multiple primary (invasive/in situ) melanomas (MPM), stratified by histology and location.MethodsAmong 65,429 melanoma patients diagnosed in 1958–2010 in the Swedish Family-Cancer Database, there were 4248 patients with familial melanoma. A detailed family history of MPM was investigated by number of melanomas in one first-degree relative (FDR) and in ⩾2 FDRs. Familial melanoma risk was assessed by standardised incidence ratios (SIRs) comparing those with family history of melanoma to those without. Combining invasive/in situ melanoma was due to essentially identical familial risks.ResultsFor one affected FDR, familial risk increased from SIR = 2.2 (95% confidence interval (CI) = 2.2–2.3) for single melanoma to 16.3 (9.5–26.1) for ⩾5 melanomas, while for ⩾2 affected FDRs, the risk increased from 5.5 (4.8–6.2) for single melanoma to 23.9 (13.6–38.8) for ⩾2 melanomas. Significantly higher familial risks for superficial spreading melanoma (SSM) [2.5 (2.3–2.6)] than lentigo maligna melanoma (LMM) [1.8 (1.6–2.1)], and for multiple parts [5.3 (3.1–8.4)] and trunk [2.6 (2.5–2.8)] than head/neck [2.0 (1.8–2.2)] were observed. Only at head/neck, significantly higher risk for SSM [2.4 (1.9–3.0)] than LMM [1.6 (1.4–1.8)] was noted.ConclusionWe found, for the first time, that familial risks were similar for two/three melanomas in one FDR or for a single melanoma in ⩾2 FDRs and, higher familial risks for SSM than LMM occurred only at head/neck. This study provides new evidence for genetic counselling in melanoma, suggesting the need for considering not only the number of affected family members but also the diagnosis of MPM (even in situ) in relatives.     

Noninvasively measured radial pressure wave analysis provides insight into cardiovascular changes during pregnancy and menopause

ObjectivePregnancy and menopause are significant life events associated with major changes in female hormone levels and changes in cardiovascular health. The role of estrogen in influencing cardiovascular risk is an ongoing research topic. Many studies have provided evidence that radial pressure wave characteristics are an important indicator to consistently and independently predict cardiovascular events. The aim of this study was to investigate if radial pressure wave analysis provided statistical insights into the physiological variations due to pregnancy and menopause. Furthermore, the study investigated how these variations could serve as an indicator for cardiovascular risks. As the radial pulse measurement is non-invasive and speedy, it may be helpful in evaluating cardiovascular changes and risk during these transitions.Materials and methodA total of 702 randomly selected female subjects (90 pregnant and 97 post-menopausal), aged 20–59, enrolled in the study. The visit measured the subject's hemodynamic parameters including heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP) and radial pressure waves. SBP and DBP were evaluated by an automatic blood pressure monitor. Radial pressure wave data were continuously recorded for 12-s using a TD01C pulse measuring instrument. Spectrum analysis of the radial pressure wave was performed to evaluate the first five harmonic components (C1–C5).ResultsA comparison of pregnant women to non-pregnant women showed C3 and C5 were lower. Heart rate C2 and C4 were higher in pregnant women. A comparison of women pre-menopausal and post-menopausal showed no significant difference in SBP or DBP. Menopause significantly changed the C1 and C4 radial pressure wave harmonics. An increase in C1 and a decrease in C4 were observed.Conclusion and discussionThis study provided further clinical evidence to support the hemodynamic model that describes the cardiovascular changes and risks related to the harmonic components of the pulse spectrum. Beyond blood pressure, the effects of menopause on the radial pressure wave, especially on hemodynamic index C4, independent of age and BMI, may explain increased post-menopausal cardiovascular risk. This and past studies collectively suggest that radial pressure wave components may be an indicator of a female body's ability to supply oxygen and nutrients. Harmonic analysis of the radial pressure wave may provide additional insights into the underlying mechanism of the cardiovascular changes over the lifespan of a woman.     

Function of telomere in aging and age related diseases

Telomeres consist of specialized non-coding DNA repeat sequences. They are essential for preserving the integrity of the genome during cancer development, senescence. Mammalian telomeres might have 1–50 kb of telomeric DNA, which becomes 40–200 base pairs shorter after per cell cycle, and becomes 5–8 kilobase shorter during senescence. There are many studies on the correlation of telomere length and aging rate. However, as the differences in the methods used in the studies and the scarcity of prospective studies, factors affecting telomere length are not really well understood. Some of the age related diseases may develop due to telomere dysfunction and telomere shortness. The short telomere structure detected in both peripheral blood leukocytes and cells of the disease-related tissue has the feature of being a predictive marker for many age-related diseases. It is expected that with future research, telomere length analysis is expected to enter clinical practice.     

Five-year survival of patients after out-of-hospital cardiac arrest depending on age

Patient's age belongs to the independent prognostic factors of patients after out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the influence of age on 5-year survival in professionally cardio-pulmonary resuscitated patients with “primary cardiac” etiology OHCA. In this analysis of prospective multi-centric study, from April 1, 2002 until August 31, 2004, a total of 560 patients were included (aged 16-97 years) from the East Bohemian region, for whom a professional cardio-pulmonary resuscitation for OHCA was attempted. In the age subgroup <70 years there were 307 patients and in the age subgroup ≥70 years there were 253 patients. Of the subgroup <70 years, 29 patients (10%) survived to year 5 (58% from the 50 patients surviving to day 30), and in the subgroup ≥70 years, we had 4 patients surviving to year 5 (2%) (29% from the 14 patients surviving to day 30), respectively (Fisher‘s exact test; comparison in the all resuscitated patients: p < 0.001, in the population surviving to day 30: p = 0.071). In conclusion, there was a trend towards a worse outcome in 5-year survival following OHCA in the patients aged ≥70 years. Nevertheless, these data support that prognosis OHCA of elders is not associated with universal dismal outcome.     

Local ancestry at APOE modifies Alzheimer's disease risk in Caribbean Hispanics

IntroductionAlthough the relationship between APOE and Alzheimer's disease (AD) is well established in populations of European descent, the effects of APOE and ancestry on AD risk in diverse populations is not well understood.MethodsLogistic mixed model regression and survival analyses were performed in a sample of 3067 Caribbean Hispanics and 3028 individuals of European descent to assess the effects of APOE genotype, local ancestry, and genome-wide ancestry on AD risk and age at onset.ResultsAmong the Caribbean Hispanics, individuals with African-derived ancestry at APOE had 39% lower odds of AD than individuals with European-derived APOE, after adjusting for APOE genotype, age, and genome-wide ancestry. While APOE E2 and E4 effects on AD risk and age at onset were significant in the Caribbean Hispanics, they were substantially attenuated compared with those in European ancestry individuals.DiscussionThese results suggest that additional genetic variation in the APOE region influences AD risk beyond APOE E2/E3/E4.     

PICC导管尖端位置走形异常与患者年龄的相关性分析

目的分析我院51例PICC导管尖端位置走形异常与患者年龄的关系。方法采用回顾性分析,对我院2014年3月-2015年2月实施的661例PICC置管患者根据年龄段分成7个组,对其数据进行分析。结果 661例PICC置管患者中导管异位51例,异位率为7.7%,随着年龄的增长异位率逐渐增高。结论 PICC导管异位与患者年龄有关。     

Structure of Drug Use and Drug Definition among Youth

Five thousand West-German soldiers anwered a questionnaire on personal drug use, evaluation of substances regarding their being drugs, and illness-value ascribed to heavy drug use. A partial correspondence between the structures of drug use and drug definition was found. Beer and wine consumption were clearly differentiated. Mentally, cannabis and hard liquor were placed on comparable levels. A wholesale approach to alcohol consumption, and exclusive categorization of cannabis as a fashion drug, lumped together with hallucinogens and opiates. seem unwarranted.     

Urban health advantage or urban health penalty? Urban-rural disparities in age trajectories of physiological health among Chinese middle-aged and older women and men

During the past decades, China has experienced rapid urbanization and aging. This study investigated sex-stratified urban-rural disparities in age trajectories of physiological health in China. We obtained data from 21686 individuals aged 45 years or above from 2011 baseline survey of the China Health and Retirement Longitudinal Study (CHARLS) and the 2015 follow-up. It examined 11 biomarkers of physiological health classified into four summary indices: cardiovascular index, metabolic index, inflammation index, and allostatic load. This study found that the “urban health penalty” approach dominates the “urban health advantage” approach in middle and early old age, but the dominance of the “urban health penalty” approach is offset or even reversed by the “urban health advantage” approach in older age.