Relation of Anthropometric Measurements to Ovarian Cancer Risk in a Population-based Case–control Study (United States)

Objective To examine the relationship between anthropometric measures and ovarian cancer by menopausal status. Methods We analyzed data from a population-based case–control study comprised of 700 incident cases of epithelial ovarian cancer and 5,943 population controls from Massachusetts and Wisconsin enrolled between 1993 and 2001. In a telephone interview, information was gathered on established ovarian cancer risk factors, as well as adult height and age-specific body weight. Logistic regression was used to estimate multivariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for body mass index (BMI) throughout life. Results Recent BMI had no significant association with ovarian cancer risk (P-trend 0.14 for continuous BMI), after adjustment for age and other ovarian cancer risk factors. However, a non-significant positive association (overall P-trend 0.08) was observed for BMI at age 20; the risk estimate comparing a body mass of >25 kg/m2 to the lowest quintile (≤18.88 kg/m2) was moderately but non-significantly elevated (OR 1.46; 95% CI 0.92, 2.31). Conclusion Results of this study suggest that maintenance of a lean body mass, particularly in early adult life, may decrease ovarian cancer risk.     

Optimization of CO2 Sorption onto Spent Shale with Diethylenetriamine (DETA) and Ethylenediamine (EDA)

A novel technique was employed to optimize the CO₂ sorption performance of spent shale at elevated pressure–temperature (PT) conditions. Four samples of spent shale prepared from the pyrolysis of oil shale under an anoxic condition were further modified with diethylenetriamine (DETA) and ethylenediamine (EDA) through the impregnation technique to investigate the variations in their physicochemical characteristics and sorption performance. The textural and structural properties of the DETA- and EDA- modified samples revealed a decrease in the surface area from tens of m²/g to a unit of m²/g due to the amine group dispersing into the available pores, but the pore sizes drastically increased to macropores and led to the creation of micropores. The N–H and C–N bonds of amine noticed on the modified samples exhibit remarkable affinity for CO₂ sequestration and are confirmed to be thermally stable at higher temperatures by thermogravimetric (TG) analysis. Furthermore, the maximum sorption capacity of the spent shale increased by about 100% with the DETA modification, and the equilibrium isotherm analyses confirmed the sorption performance to support heterogenous sorption in conjunction with both monolayer and multilayer coverage since they agreed with the Sips, Toth, Langmuir, and Freundlich models. The sorption kinetics confirm that the sorption process is not limited to diffusion, and both physisorption and chemisorption have also occurred. Furthermore, the heat of enthalpy reveals an endothermic reaction observed between the CO₂ and amine-modified samples as a result of the chemical bond, which will require more energy to break down. This investigation reveals that optimization of spent shale with amine functional groups can enhance its sorption behavior and the amine-modified spent shale can be a promising sorbent for CO₂ sequestration from impure steams of the natural gas.     

Epicardial adipose tissue is increased in patients with systemic lupus erythematosus

ObjectiveMorbidity and mortality secondary to premature cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) remain significant issues. The pathogenesis of CVD in SLE patients has not been fully explored. Epicardial adipose tissue (EAT) is believed to contribute to atherosclerosis development, through a paracrine and systemic inflammatory effect. We measured EAT volume in 162 SLE patients and 86 matched controls to assess the association of EAT with markers of atherosclerosis, cardiovascular risk and immunoactivation.MethodsClinical and laboratory characteristics collected included anthropomorphic measures, disease activity and damage indices, blood pressure measurement, lipid profile, inflammatory indices, adipokine levels and measures of adiposity. Coronary artery calcium (CAC) and EAT volume were measured using non-contrast cardiac computed tomography.ResultsEAT volume was greater in patients with SLE [(mean ± SD) 96.8 ± 45.9 cm³] than controls (78.2 ± 40.7 cm³; P = 0.001). The EAT volume was 31% larger (95% CI, 16.5%–47.4%) in SLE patients than controls (P < 0.001 adjusted for age, sex, and race; after additional adjustment for waist circumference P = 0.007). Within SLE patients, after adjusting for age, race, sex, and waist circumference, EAT volume was associated with cumulative corticosteroid dose (P = 0.007), current corticosteroid use (P < 0.001), HDL cholesterol (P = 0.033), and triglycerides (P = 0.005). EAT was significantly correlated with CAC score (P < 0.001), but the association was attenuated after adjustment for Framingham risk score (P = 0.051).ConclusionThe increased EAT volume seen in SLE patients is associated with corticosteroid use. Corticosteroids could have adverse cardiovascular effects in SLE via an increase in EAT volume, a marker of risk in the general population.     

Discontinuation rate of Implanon and its associated factors among women who ever used Implanon in Dale District,Southern Ethiopia

Background

Early discontinuation of the Implanon contraceptive method and reasons for such discontinuation remains a major concern for family planning programs. In less developed countries, contraceptive discontinuation due to health concerns is generally higher, these complaints are often related to service quality. Significant numbers of women become exposed to conception after discontinuation and accidental pregnancies that end up with abortion & stillbirth. The aim of this study was to assess the early discontinuation rate of Implanon and identify its associated factors among women who ever used Implanon in 2016 in Dale district, Southern Ethiopia.

Methods

Community based cross-sectional study design was conducted from January to February, 2017. A total number of 711 women who ever used Implanon in 2016 were selected using multistage sampling. The data were entered and cleaned in Epi Info and analyzed using SPSS. Multivariate logistic regression analysis was used to determine the effect of factors on the outcome variables. Finally, the results were presented using adjusted odds ratio (AOR) & confidence interval of 95%.

Result

Early Implanon discontinuation rate in this study was 160 (23.4%) with a mean duration of Implanon use of 9.6?±?2.5 months. The main reasons for discontinuation of Implanon were 55 (34.4%) the facing of side effects. Factors for discontinuation of Implanon were women age 20–24 years (AOR =. 44 (95% CI: 23-. 85), 25–29 years (AOR =. 52 (95% CI: 27-. 96), 35+ years, (AOR =. 08 (95% CI: 02-. 41), less likely to discontinue. Women who weren’t counseled about the side effects during Implanon insertion were 1.93 times (AOR?=?1.93 (95% CI: 1.27–2.93), women who didn’t satisfied by the service (AOR?=?2.55(CI: 95%: 1.63–3.97), women who didn’t appointed for follow up (AOR?=?3.13 (CI: 95%: 2.0–4.95), women who didn’t choose the method by themselves (AOR?=?1.83 (CI: 95%: 1.18–2.83) and women who didn’t have information on family planning before Implanon insertion (AOR?=?1.52 (CI: 95%: 1.1–2.28) were the predictors of Implanon discontinuation.

Conclusions

Implanon discontinuation rate in this study area was high. Appropriate counseling prior to insertion and proper follow up, autonomous choice will improve the continuation rate of Implanon.

     

Increased augmentation index in rheumatoid arthritis and its relationship to coronary artery atherosclerosis

OBJECTIVE: Arterial stiffness, assessed by the augmentation index and pulse wave velocity, is an independent risk factor for cardiovascular disease. Rheumatoid arthritis (RA) is associated with accelerated atherosclerosis and increased cardiovascular mortality. We examined the hypothesis that augmentation index and pulse wave velocity are increased in RA, and are related to coronary artery atherosclerosis. METHODS: We measured augmentation index and brachial pulse wave velocity in 117 patients with RA [57 with early (< 6 yrs) and 60 with late disease (> 10 yrs)] and 65 healthy controls. Coronary artery calcification was measured by electron beam computed tomography. Augmentation index and pulse wave velocity were compared in patients with early RA, late RA, and controls, and the association with coronary atherosclerosis was examined. RESULTS: Patients with late RA had a higher augmentation index (median 33.8%, interquartile range 27.5% 37.0%) than those with early disease (median 27.5%, IQR 21.0% 34.0%) (p = 0.008) and controls (median 27.0%, IQR 20.4% 33.0%) (p < 0.001). After adjusting for height and cardiovascular risk factors, the association between late disease and augmentation index remained significant (p = 0.02). Augmentation index was associated with coronary calcification score (rs = 0.19, p = 0.046), and the association was marginal after adjustment for cardiovascular risk factors, disease status, and disease activity (p = 0.09). There was no significant difference in brachial pulse wave velocity among patients with late (9.2 +/- 1.7 m/s) and early RA (9.1 +/- 1.6 m/s) and controls (8.9 +/- 1.5 m/s) (p = 0.78). CONCLUSION: Patients with RA have increased augmentation index independent of cardiovascular risk factors. Augmentation index was associated with coronary artery calcification in patients with RA; this was attenuated after adjusting for cardiovascular risk factors.     

Inflammatory mechanisms affecting the lipid profile in patients with systemic lupus erythematosus

OBJECTIVE: Increased low density lipoprotein (LDL) cholesterol and triglycerides, and decreased high density lipoprotein (HDL) cholesterol concentrations are associated with adverse cardiovascular risk in the general population. Patients with systemic lupus erythematosus (SLE) have an altered lipid profile characterized by increased triglycerides and decreased HDL cholesterol concentrations. We examined the relationships between lipid concentrations, cytokines, and inflammatory markers in patients with SLE. METHODS: Fasting lipid concentrations, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured in 110 patients with SLE. Disease activity was quantified by the SLE Disease Activity Index (SLEDAI), and disease damage by the Systemic Lupus International Collaborating Clinics (SLICC) score. Concentrations of circulating tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), and insulin were measured and insulin sensitivity calculated. RESULTS: Lower concentrations of HDL cholesterol were independently associated with higher ESR (p < 0.001), IL-6 (p = 0.02), SLEDAI (p = 0.04), and TNF-alpha (p = 0.04) after adjustment for age, sex, race, body mass index, insulin sensitivity, and current use of corticosteroids or hydroxychloroquine. Triglyceride concentrations were associated with higher CRP concentrations (p = 0.02) and SLICC score (p = 0.04). CONCLUSION: Deleterious changes in lipid profile are independently associated with higher concentrations of markers and mediators of inflammation and disease activity and damage in patients with SLE.     

Preventing glycaemic relapse in recently controlled type 2 diabetes patients: a randomised controlled trial

Aims/hypothesis  

After achieving glycaemic control, many type 2 diabetic patients relapse to clinically significant levels of hyperglycaemia. We sought to determine the optimal frequency of telephone contact by nurse practitioners that was necessary to prevent glycaemic relapse.     

Mood disorders in the elderly

Mood disorders in the elderly are a growing source of morbidity and mortality. Unfortunately, mood disorders in later life frequently are not diagnosed and treated. Appropriate, prompt diagnosis and treatment of late-life mood disorders can significantly improve the quality of life of patients and families and may prove life saving. Current treatments can help most older adults with mood disorders. Future treatments are promising, particularly for those with treatment-resistant depression.