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PubMed2004

An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients.

BACKGROUND: Hospitalization can significantly disrupt sleeping patterns. In consideration of the previous reports of insomnia and apparent widespread use of benzodiazepines and other hypnotics in hospitalized patients, we conducted a study to assess quality of sleep and hypnotic drug use in our acute care adult patient population. The primary objectives of this study were to assess sleep disturbance and its determinants including the use of drugs with sedating properties. METHODS: This single-centre prospective study involved an assessment of sleep quality for consenting patients admitted to the general medicine and family practice units of an acute care Canadian hospital. A validated Verran and Snyder-Halpern (VSH) Sleep Scale measuring sleep disturbance, sleep effectiveness, and sleep supplementation was completed daily by patients and scores were compared to population statistics. Patients were also asked to identify factors influencing sleep while in hospital, and sedating drug use prior to and during hospitalization was also assessed. RESULTS: During the 70-day study period, 100 patients completed at least one sleep questionnaire. There was a relatively even distribution of males versus females, most patients were in their 8th decade of life, retired, and suffered from multiple chronic diseases. The median self-reported pre-admission sleep duration for participants was 8 hours and our review of PharmaNet profiles revealed that 35 (35%) patients had received a dispensed prescription for a hypnotic or antidepressant drug in the 3-month period prior to admission. Benzodiazepines were the most common sedating drugs prescribed. Over 300 sleep disturbance, effective and supplementation scores were completed. Sleep disturbance scores across all study days ranged 16-681, sleep effectiveness scores ranged 54-402, while sleep supplementation scores ranged between 0-358. Patients tended to have worse sleep scores as compared to healthy non-hospitalized US adults in all three scales. When compared to US non-hospitalized adults with insomnia, our patients demonstrated sleep disturbance and supplementation scores that were similar on Day 1, but lower (i.e. improved) on Day 3, while sleep effectiveness were higher (i.e. better) on both days. There was an association between sleep disturbance scores and the number of chronic diseases, the presence of pain, the use of bedtime tricyclic antidepressants, and the number of chronic diseases without pain. There was also an association between sleep effectiveness scores and the length of hospitalization, the in hospital use of bedtime sedatives and the presence of pain. Finally, an association was identified between sleep supplementation scores and the in hospital use of bedtime sedatives (tricyclic antidepressants and loxapine), and age. Twenty-nine (29%) patients received a prescription for a hypnotic drug while in hospital, with no evidence of pre-admission hypnotic use. The majority of these patients were prescribed zopiclone, lorazepam or another benzodiazepine. CONCLUSIONS: The results of this study reveal that quality of sleep is a problem that affects hospitalized adult medical service patients and a relatively high percentage of these patients are being prescribed a hypnotic prior to and during hospitalization.

Adult↗
PubMed2001

Systemic lupus erythematosus and the risk of malignancy.

The objective of this study was to determine the relative risks of malignancy and of site-specific malignancies in patients with systemic lupus erythematosus (SLE). A cohort of 297 patients (91% Caucasian) with SLE were seen between 1975 and 1994 and followed for a mean of 12 years at the University of Saskatchewan Rheumatic Disease Unit. Expected cancer incidence rates were determined based on Province of Saskatchewan population statistics matched to each study patient for age, sex and calendar year of follow-up. Standardized incidence ratios (SIRs) of observed to expected cancers and 95% confidence intervals (95% CI) were calculated. A total of 27 cases of cancer were observed, whereas only 16.9 were expected (SIR 1.59 (95% CI 1.05-2.32)). For site-specific malignancies, an excess of cancer of the cervix (SIR 8.15 (95% CI 1.63-23.81)) as well as hemopoietic malignancy (SIR 4.9 (95% CI 1.57-11.43)) was found. The hemopoietic cancers were predominantly non-Hodgkin's lymphoma (SIR 7.01 (95% CI 1.88-17.96)). We did not find an association of malignancy with known risk factors, including use of cytotoxic agents. Increased risk of malignancy, notably non-Hodgkin's lymphoma and perhaps cervical cancer, should be regarded as a complication of SLE.

Adolescent↗
PubMed1975

Parental characteristics in relation to diagnosis and neurological status in childhood psychosis.

Twenty-six psychotic children were examined by means of psychological tests and EEGs. The parents of these patients were also tested with the EPI and the Grid Test of Thought Disorder. The mothers of children with the symptom of autism tended to have some cognitive disorganization, which was less common in the mothers of children without the symptom. The extraversion and neuroticism scores of all parents were not markedly different from population statistics. The incidence of EEG abnormality in the children was high and not related to diagnosis or other criteria. These findings are interpreted as providing suggestive evidence for a two-factor theory of childhood psychosis. It is postulated that a neurological disorder is a necessary condition for the development of such a disorder; and that a second process related to parental characteristics is also involved, which has the effect of determining the particular symptomatic manifestations seen in the psychotic child.

Autistic Disorder↗
PubMed1981

Evaluation and testing of in vitro labeled technetium Tc-99m red blood cells in two animal models for neonatal RBC volume determinations.

The present study was designed to evaluate the red blood cell (RBC) radiolabeling technique utilizing the short half-lived radionuclide technetium-99m and to compare the results with the well-recognized standard chromium-51 method. The procedure was evaluated in a canine and a newborn lamb model utilizing dual radionuclide labeling and counting techniques. With the express purpose of providing a significant radiation dose reduction, the procedure presented was adapted for utilization in a neonatal patient population. Statistical analysis of the data revealed that there was no significant difference in the radiolabeling efficiency for the two methods (Cr-51, 86.6%; Tc-99m, 92.4%). Assessment of the in vitro stability for technetium-99m RBCs showed that less than a 4% loss of radiolabel from the RBC was seen in a 4-hr time span in the canine model (15 min, 90.5%; 2 hr, 88.9%; 4 hr, 86.6%) when compared to the 15 min equilibrium sample. Evaluation of newborn lamb RBC volumes showed that the technetium-99m RBC volume did not significantly differ from the chromium-51 labeling technique (Cr-51, 24.0 ml/kg; Tc-99m, 23.2 ml/kg). Summarization of the whole-body radiation dose showed that greater than a 30-fold reduction in absorbed dose was achieved in the newborn (Cr-51, 30.0 mrad; Tc-99m, 0.9 mrad). The modified procedure presented for the radiolabeling of the RBC with the short half-lived radionuclide technetium-99m provides a technique comparable to the utilized standard chromium-51 RBC method, yet with a large reduction in absorbed radiation dose. This procedure is presented as a superior technique for the determination of pediatric RBC volumes.

Animals↗
PubMed2006

Alterations in plasma complement levels after human ischemic stroke.

OBJECTIVE: Stroke is a leading cause of morbidity and mortality in the United States. Recent animal studies have implicated the complement system in cerebral ischemia/reperfusion injury and suggest that complement inhibition may improve stroke outcomes. To assess the applicability of these findings to humans, we evaluated the characteristics and time course of human complement activation after stroke. METHODS: We compared peripheral blood levels of complement factor 3a (C3a), 5a (C5a), and sC5b-9 drawn from 15 patients on poststroke Days 1, 2, 3, 7, 14, 21, and 28 to age-, race/ethnicity-, and sex-matched controls from the same population. Statistical analysis was performed using unpaired Mann-Whitney nonparametric tests with Bonferroni correction. All data is presented as the mean +/- standard deviation. RESULTS: Mean C3a concentrations showed significant early elevations in stroke patients relative to matched controls (controls: 1080 +/- 189 ng/ml; Day 1: 1609 +/- 422 ng/ml, P = 0.0008; Day 3: 1520 +/- 317 ng/ml, P = 0.0005; Day 7: 1526 +/- 386 ng/ml, P = 0.001). C3a was also significantly elevated on Day 28 (1448 +/- 386 ng/ml, P = 0.004). Before poststroke Day 7, mean C5a levels did not differ significantly from controls. However, beginning on Day 7 and continuing through Day 14, there were significant elevations in C5a (controls: 3.33 +/- 2.1 ng/ml; day 7: 6.86 +/- 3.5 ng/ml, P = 0.005; Day 14: 7.65 +/- 4.6 ng/ml, P = 0.004). Mean sC5b-9 concentrations showed early depressions that reached significance on Days 1 and 2 (controls: 275.6 +/- 107 ng/ml; Day 1: 167.0 +/- 108 ng/ml, P = 0.006; Day 2: 156.3 +/- 80.0 ng/ml, P = 0.005) and did not differ significantly from controls at any other time point. CONCLUSION: C3a is acutely elevated after human ischemic stroke, C5a shows delayed elevations 7 to 14 days after cerebral ischemia, and sC5b-9 is acutely depressed after stroke. Together, these data confirm complement activation after stroke and suggest that this activation is a heterogeneous process, with varying responses for different components.

Aged↗
PubMed2000

A modeling framework for estimating children's residential exposure and dose to chlorpyrifos via dermal residue contact and nondietary ingestion.

To help address the Food Quality Protection Act of 1996, a physically based probabilistic model has been developed to quantify and analyze dermal and nondietary ingestion exposure and dose to pesticides. The Residential Stochastic Human Exposure and Dose Simulation Model for Pesticides (Residential-SHEDS) simulates the exposures and doses of children contacting residues on surfaces in treated residences and on turf in treated residential yards. The simulations combine sequential time-location-activity information from children's diaries with microlevel videotaped activity data, probability distributions of measured surface residues and exposure factors, and pharmacokinetic rate constants. Model outputs include individual profiles and population statistics for daily dermal loading, mass in the blood compartment, ingested residue via nondietary objects, and mass of eliminated metabolite, as well as contributions from various routes, pathways, and media. To illustrate the capabilities of the model framework, we applied Residential-SHEDS to estimate children's residential exposure and dose to chlorpyrifos for 12 exposure scenarios: 2 age groups (0-4 and 5-9 years); 2 indoor pesticide application methods (broadcast and crack and crevice); and 3 postindoor application time periods (< 1, 1-7, and 8-30 days). Independent residential turf applications (liquid or granular) were included in each of these scenarios. Despite the current data limitations and model assumptions, the case study predicts exposure and dose estimates that compare well to measurements in the published literature, and provides insights to the relative importance of exposure scenarios and pathways.

Administration, Cutaneous↗
PubMed1997

Motion thresholds can be predicted from contrast discrimination.

The detection thresholds for oscillatory motion and flicker were compared across a wide range of pedestal contrasts, spatial frequencies, and temporal frequencies in both foveal and peripheral vision. Motion and flicker stimuli were both generated by summation of a counterphase test grating with a static pedestal grating. For the oscillatory motion task the test and the pedestal were presented 90 deg out of phase to each other, whereas for flicker the two gratings were presented in phase. Since detection of both stimuli would depend on the same test stimulus, detection thresholds could be similar even though the tasks differ. Although there was a slight elevation in flicker detection thresholds compared with motion thresholds, our main finding is that oscillatory motion and flicker thresholds for suprathreshold sinusoidal gratings are similar. This finding supports the idea that motion and flicker have a common underlying detection mechanism. Our finding that flicker thresholds are slightly higher than jitter thresholds indicates that the contrast gain control (or saturating energy transducer) has a weak phase dependence. The ability to discriminate motion from flicker was elevated relative to their detection thresholds, particularly at high temporal frequencies. We offer two models to account for this behavior. The discrimination of motion from flicker may require a temporal comparison of the outputs of directionally selective filters tuned to opposite directions or to the population statistics of a bank of separable mechanisms.

Contrast Sensitivity↗
PubMed2003

Temporal differences in the regional twinning rates in Sweden after 1750.

When twinning rates are studied, maternal age and parity should be considered. Data on parity are seldom available. We studied information about the mean parity, using the gross reproduction rate, the total fertility rate and the crude birth rate. These are strongly correlated with the mean parity. The crude birth rate is more readily available than the gross reproduction rate or the total fertility rate. Earlier studies have shown that it is difficult to model variations in the twinning rate with data for the macrolevel. In this study these findings are explained by theoretical analyses and illustrated by empirical data. Sweden, having the oldest continuous population statistics and high twinning rates, offers excellent possibilities for analyses of the twinning rate. We considered data for the counties of Gotland, Alvsborg and Stockholm and the city of Stockholm from 1749 to 1960 and for Sweden until 1996. For Alvsborg, the twinning rate was low for the whole period, showing no statistically significant decreasing trend. It is mainly about 11-14 per thousand, which is only 50-60% of the twinning rate in Gotland in the 18th century. In Gotland, in the county of Stockholm, in the city of Stockholm and in Sweden as a whole, the decreasing trends in the twinning rate were statistically significant. The decreasing twinning rates converge towards the low twinning rate of Alvsborg. After standardization of the twinning rate, the differences remained and the low rate in Alvsborg could not be explained by maternal age.

Birth Rate↗
PubMed2006

Partial hemi-resurfacing of the hip joint--a new approach to treat local osteochondral defects?

There is currently renewed interest in articular resurfacing for the treatment of damaged hip-joint cartilage. In contrast to these implants, which involve endoprosthetic replacement of both articulating surfaces, we present a new joint-preserving technique that allows treatment of local osteochondral defects of the femoral head by partial hemi-resurfacing. In this study we describe the operative and technical aspects and problems for partial hemi-resurfacing of the hip joint and critically discuss indications for this procedure in one case. To guarantee an adequate view of the situs, we recommend a surgical approach involving trochanter flip osteotomy, followed by surgical dislocation of the hip joint. Besides partial hemi-resurfacing of the osteochondral defect, this approach allows treatment of associated labral tears and cartilage defects of the hip joint at the same time. For adequate implant fixation, good bone quality is required. Furthermore, osteochondral defects of limited extent and excellent patient compliance are essential for clinical success. In particular, prominence of the implant has to be avoided, which can lead to an irregular joint surface and may induce further cartilage destruction. Long-term studies on statistical populations will show if partial articular hemi-resurfacing is a bone-preserving and useful therapeutic alternative to hemi-resurfacing caps in the treatment of osteochondral hip-joint defects, especially in young patients.

Adult↗
PubMed1992

Alcohol education as primary prevention in health care.

The purpose of this survey research was to identify practicing nurses' knowledge about the biophysiological and psychosocial components of alcohol and its pharmacological effects. Additionally, data were gathered with the intent of assisting nurses in the early identification of and intervention with individuals at risk for the disease of alcoholism. The study consisted of a convenience sample of 298 practicing nurses employed by community hospitals that had been identified as having no specific treatment program for chemical dependency. The investigation obtained self-reported information by means of a questionnaire. The instrument elicited both demographics and the answers to 25 fixed alternative questions designed to obtain information in nine topic areas. Findings indicated that 66% of the nurses incorrectly answered questions aimed at correlating population statistics to the disease of alcoholism and its physiological effects. Questions about knowledge of the pharmacological properties of alcohol were answered incorrectly by 93% of the participants. One-way analysis of variance was computed to compare the total score for each of the variables listed. Conclusions document a critical need for increased alcohol education in basic nursing programs. Content related to the pharmacological properties, the disease concept and the biophysiological and psychosocial effects of alcohol should be included in curriculum design.

Adult↗
PubMed2006

Enhanced fluorescence cell imaging with metal-coated slides.

Fluorescence labeling is the prevailing imaging technique in cell biology research. When they involve statistical investigations on a large number of cells, experimental studies require both low magnification to get a reliable statistical population and high contrast to achieve accurate diagnosis on the nature of the cells' perturbation. Because microscope objectives of low magnification generally yield low collection efficiency, such studies are limited by the fluorescence signal weakness. To overcome this technological bottleneck, we proposed a new method based on metal-coated substrates that enhance the fluorescence process and improve collection efficiency in epifluorescence observation and that can be directly used with a common microscope setup. We developed a model based on the dipole approximation with the aim of simulating the optical behavior of a fluorophore on such a substrate and revealing the different mechanisms responsible for fluorescence enhancement. The presence of a reflective surface modifies both excitation and emission processes and additionally reshapes fluorescence emission lobes. From both theoretical and experimental results, we found the fluorescence signal emitted by a molecular cyanine 3 dye layer to be amplified by a factor approximately 30 when fluorophores are separated by a proper distance from the substrate. We then adapted our model to the case of homogeneously stained micrometer-sized objects and demonstrated mean signal amplification by a factor approximately 4. Finally, we applied our method to fluorescence imaging of dog kidney cells and verified experimentally the simulated results.

Cell Culture Techniques↗
PubMedDate not supplied

[Individual and ecological factors related to the geographical variability of psychological distress among small areas: a multilevel analysis in Catalonia, Spain].

BACKGROUND: To know the geographic distribution of the prevalence of psychological distress is important for mental health services planning. This study is aimed at identifying the individual factors and those related to the area of residence which may explain the geographic variability of psychological distress (by healthcare districts) in Catalonia. METHODS: The data was taken from the 1994 Catalonian Health Survey and from the 1996 Catalonia population statistics. The prevalence of psychological distress is estimated by age and sex and by healthcare district. In a two-level logic regression model, a study is made of the relationship between the individual variables (first level: health survey n = 12,455) and those of the area of residence (second level: the healthcare district, n = 46) to the geographic distribution of the prevalence of psychological distress. RESULTS: The significant variables at individual level are in men: age (45-64 years OR: 0.63 y > 64 years OR: 0.22), working status (no work OR: 1.60), number of chronic diseases (CD) (CD = 1 OR: 1.75 CD = 2 OR: 2.06 CD = 3-5 OR: 3.36 and CD > 5 OR: 8.9). In women: age (25-44 years OR: 0.63 45-64 years OR: 0.45 and > 64 years OR: 0.32), working status (no work OR: 1.30), number of chronic diseases (CD = 1 OR: 1.75 CD = 2 OR: 2.44 CD = 3-5 OR: 4.09 and CD > 5 OR: 11.14), and also the kind of parental household in women (single-parental OR: 1.42). The variables at the level of the area of residence are in migration (men OR: 1.55 and women OR: 1.68) and unemployment (men OR: 1.07 and women OR: 1.06). CONCLUSIONS: The individual factors do not suffice to explain the geographical variability of the prevalence of psychological distress, but the characteristics of the area of residence are also important.

Adolescent↗
PubMed2007

Cost effectiveness of palivizumab for respiratory syncytial virus prophylaxis in high-risk children: a UK analysis.

OBJECTIVE: To assess the cost effectiveness of palivizumab (a preventative treatment against severe respiratory syncytial virus [RSV] infection) in children at high risk of hospitalisation, i.e. preterm infants < or = 35 weeks gestation, children with bronchopulmonary dysplasia (BPD) and children with congenital heart disease (CHD). METHODS: A decision tree model was developed employing data sources from the published literature, palivizumab clinical trials, official UK price/tariff lists and national population statistics. The comparator was no prophylaxis. The primary perspective of the study was that of the UK NHS. In a societal perspective scenario analysis, the future lost productivity of a child resulting from RSV-related mortality (indirect costs) was also included. The cost of administration of palivizumab, hospital care for RSV infections and the cost of asthma treatment were included. The analysis was based on a lifetime follow-up period in order to capture the impact of palivizumab on long-term morbidity and mortality resulting from an RSV infection. The primary efficacy outcome in the palivizumab clinical trials was the number of RSV hospitalisations avoided, which was extrapolated to effectiveness outcomes, i.e. number of life-years gained and number of QALYs. Costs and effects were discounted by 3.5%. RESULTS: In preterm infants and children with BPD, prophylaxis with palivizumab compared with no prophylaxis had an incremental cost-effectiveness ratio (ICER) of 7042 pounds/QALY without discounting outcomes, increasing to 16,720 pounds/QALY after discounting. In babies with CHD, the use of palivizumab resulted in an ICER of 2427 pounds/QALY without discounting outcomes and 6664 pounds/QALY after discounting. One-way sensitivity analyses and probabilistic sensitivity analyses confirmed the robustness of the model. A scenario analysis showed that the inclusion of indirect costs leads to further improvement in the cost-effectiveness outcomes for palivizumab. CONCLUSION: This study suggests that palivizumab prophylaxis against severe RSV infection in children at high risk may be cost effective from the NHS perspective (vs no prophylaxis), and that the positive clinical and economic benefits may persist beyond one RSV season.

Antibodies, Monoclonal↗
PubMed2004

Association of vitamin D binding protein variants with chronic mucus hypersecretion in Iceland.

BACKGROUND: Previous studies of vitamin D binding protein (VDBP, also known as group-specific component, Gc, encoded by the GC gene) have implicated two gene variants, GC*2 and GC*1F, as possible contributors with chronic obstructive pulmonary disease (COPD) protection and susceptibility, respectively. The objective of this study was to examine the association of VDBP to different subtypes of COPD. STUDY DESIGN: The association of the various GC genotypes to the COPD phenotype was examined in Icelandic COPD patients who were followed by pulmonary physicians at the University Hospital of Iceland. METHODS: All patients were genotyped for the known alleles of the GC gene. The single nucleotide polymorphisms (SNPs) were identified by a restriction fragment length polymorphism procedure. Study power was estimated based on allele frequencies of the variants, and risk ratios were calculated from the prevalence of genotypes in the affected group divided by its prevalence in the control population. Statistical analyses were performed using the 2-tailed Fisher's Exact Test and chi(2) test, where appropriate. PATIENT GROUP: One hundred and two COPD patients and 183 controls, together with 46 asthma patients and 48 patients with chronic mucous hypersecretion (CMH) were examined. MAIN OUTCOME MEASURE AND RESULTS: The results demonstrate similar allele and genotype frequencies of GC in COPD patients overall and healthy controls. However, there was a higher prevalence of genotypes carrying a GC*1F allele and lower prevalence of genotypes with a GC*2 allele in the CMH patients than in controls. This difference was most notable in the homozygous form: 8.3% vs 1.1% for the GC*1F/*1F, and 0.0% vs 7.6% for the GC*2/*2 genotypes, respectively. When controlled for smoking, only the non-smoking CMH patients demonstrated a significantly altered frequency of the GC*1F/*1F genotype (p = 0.0001). The prevalence of the GC*2/*2 genotype was also significantly lower in patients with bronchial hypersecretion with airflow obstruction compared with the control group (2.9% vs 7.6%). Taken together, these results demonstrate that the GC*1F and GC*2 alleles are associated with sputum hypersecretion in individuals who are at increased risk of developing COPD.

Asthma↗
PubMed2006

The role of unbound drug in pharmacokinetics/pharmacodynamics and in therapy.

The evolution of research on drug protein binding is discussed with the unbound concentration (Cu) and the unbound fraction (fu) as protagonists. Particular attention is paid to the mechanisms via which alterations in binding affect the pharmacokinetics (PK) and the effect, or independently the pharmacodynamics (PD). Apart from albumin, the important alpha-acid glycoprotein (AGP), as well as specific drug classes and applications in the clinic and development (routine monitoring, cancer and HIV therapy, allometry) are addressed. The flaws with the classical method of indirectly calculating the Cu or the unbound PK/PD parameters, based on the fu in vitro, are related to the intrinsic complexity and variability in the outcomes. Increased focus is urged on directly estimating the unbound PK/PD and also on using population statistical methods.

Animals↗
PubMed2001

Effect of multislice CT technology on scanner productivity.

OBJECTIVE: In this study we analyzed the impact of multislice CT technology on scanner productivity in a tertiary care medical center. MATERIALS AND METHODS: We compared the productivity of two diagnostic CT scanners during the periods January 1 to August 31, 1999 (when both scanners had single-slice CT capability) and January 1 to August 31, 2000 (when one of these scanners was replaced with a multislice CT scanner). The scanners were used primarily for outpatients during the day shift and for inpatients during the evening shift; the demand for CT services was stable. For this analysis, we queried the hospital's radiology information system and identified the number of CT examinations performed during the two analysis periods. We also determined the examination mix, including proportion of enhanced and unenhanced examinations and the anatomic region examined, to ensure comparable patient populations. Statistical analysis was performed. RESULTS: The number of CT studies performed on the two scanners increased by 1772 (13.1%) from 13,548 (before multislice CT) to 15,320 (when multislice CT was available). The number of examinations enhanced with contrast media increased from 52% to 65%. Between 9:00 A.M. and 5:00 P.M., the number of CT examinations was similar on the single-slice scanners in the two periods (p > 0.05). However, in the period when multislice CT was available, the number of studies performed on the multislice scanner (5919) was 51.9% higher than those performed using the single-slice scanner (3896) (p < 0.0006). CONCLUSION: Using a multislice CT scanner leads to an increase in CT productivity, even though multislice studies are performed using more complicated protocols than are used on a single-slice CT scanner.

Efficiency↗
PubMed2006

Age-period-cohort analysis of female breast cancer mortality in Korea.

BACKGROUND: Although breast cancer in women remains relatively rare in Korea, its incidence and mortality figures are increasing, consistent with the increasing risk observed in successive generations of Korean women. The aim of the current study was to examine time trends of breast-cancer mortality during the period 1984-2003 in Korea, assessing the importance of the effects of age, period and birth cohort as risk factors. METHODS: Data on the annual number of deaths due to female breast cancer and on female population statistics from 1984 to 2003 were obtained from the Korean National Statistical Office. A log-linear Poisson age-period-cohort model was used to estimate age, period and cohort effects. RESULTS: The trend of breast cancer mortality was explained by an age-cohort model based on goodness of fit, even though the significance of the cohort effect was marginal (p=0.08) after adjusting for age. The risk of breast cancer death was found to increase with age after adjusting for the cohort effect, and it was different from the cross-sectional age curve. Also, breast cancer mortality increased along with the birth cohort. CONCLUSIONS: Even though the cohort effect was found to have a marginally significant effect on breast cancer mortality, it is expected to be more significant in the future given the recent on-going changes in diet and reproductive behavior shown by Korean women.

Adult↗
PubMed1990

Comparison of Candida albicans adherence to human corneocytes from various populations.

Epidemiological data indicate that patients suffering from diabetes, hypothyroidism, obesity, or following prolonged treatment with antibiotics, corticosteroids or oral contraceptives, have an increased tendency to develop cutaneous candidiasis. Since it is generally believed that attachment of microorganisms to host cells is an initial step in the evolution of infection, the aim of the present study was to investigate whether cells from susceptible individuals have increased capacity to bind the fungus. Corneocytes collected from the forearms of individuals of these susceptible groups were exposed in vitro to Candida albicans and adhesion to the cells was evaluated in comparison with adherence to cells from a non-susceptible population. Adherence in vitro was assayed microscopically and evaluated quantitatively by two parameters: 1) percentage of adherence - number of corneocytes with adhering yeasts on their surface, and 2) the total number of adhered yeasts. Results of the study revealed that the mean percentage of adherence and the mean total number of yeasts adhering to cells from individuals of the susceptible populations was twice as high as values in a healthy population. Statistical analysis of the data by Student's t-test indicated that the difference was significant (p less than 0.001).

Adult↗