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PubMed2005

The association between admission for poisoning with paracetamol or other weak analgesics and subsequent admission for psychiatric disorder: a Danish nationwide case-control study.

BACKGROUND: Many cases of paracetamol poisoning are with suicidal intent, but the association between paracetamol poisoning and subsequent psychiatric disorder is unknown. AIM: To examine the association between poisoning with paracetamol or other weak analgesics and subsequent psychiatric disorder. METHODS: The study was set in a nested case-control design and based on nationwide Danish registers. We identified all patients diagnosed with schizophrenia, affective disorder or eating disorder in 1994-1998 and matched population controls. We estimated the relative risk of these psychiatric disorders after admission for paracetamol or nonparacetamol poisoning, adjusting for income, employment and marital status. RESULTS: We included 12,603 cases with psychiatric disorder, and 1.2% had a diagnosis of poisoning compared with 0.2% of the 252,060 matched population controls. Compared with those with no diagnoses of weak analgesic poisoning, the risk of schizophrenia increased 3.9-fold after paracetamol poisoning, and 2.0-fold after nonparacetamol poisoning. The risk of affective disorder increased 12.2-fold after paracetamol poisoning and 2.6-fold after nonparacetamol poisoning. The risk of eating disorder increased 5.0-fold after paracetamol poisoning, and 2.2-fold after nonparacetamol poisoning. The risk of a diagnosis of psychiatric disorder was very high immediately after poisoning and remained increased for more than 10 years. CONCLUSIONS: Paracetamol poisoning is a strong risk marker for psychiatric disorder, particularly affective disorders.

Adolescent↗
PubMed1999

Pregnancy outcome after successful external cephalic version.

OBJECTIVE: Recent studies have suggested that the rate of cesarean delivery in patients who have undergone a successful external cephalic version is higher than expected. This study compares the incidence of cesarean delivery in patients who underwent successful external cephalic version and patients with primary cephalic presentations. STUDY DESIGN: We identified and reviewed the charts of 92 patients who underwent a successful external cephalic version. We identified a control population of 184 patients from the delivery room logs. We collected outcome data and information on additional risk factors that may affect cesarean delivery rates. RESULTS: There were no significant differences between study and control populations. There was no significant difference in the cesarean delivery rate between study patients (22.8%) and control patients (23.4%). CONCLUSIONS: We could not demonstrate a significant increase in the cesarean delivery rate for women who underwent successful external cephalic version in comparison with patients in labor with primary cephalic presentations.

Adult↗
PubMed2000

HLA-C and guttate psoriasis.

BACKGROUND: Psoriasis is a heterogeneous disease in its clinical expression. Both genetic and environmental factors are thought to contribute to the pathogenesis of the inflammatory and hyperproliferative components of the typical skin lesions. Predisposing genetic influences include associations with human leucocyte antigens (HLA) of which that with HLA-Cw6 is the strongest. Guttate psoriasis is a specific clinical manifestation of psoriasis frequently associated with group A beta-haemolytic streptococcal throat infection. OBJECTIVES: We set out to determine whether further clinical subdivision of psoriasis is associated with tighter correlation with HLA-C alleles. PATIENTS/METHODS: We determined the HLA-C locus genotype of 29 caucasian patients with guttate psoriasis presenting consecutively with guttate psoriasis associated with a history of a sore throat and/or an antistreptolysin O titre > 200 IU mL-1. Polymerase chain reaction typing using sequence-specific primers was used to detect all known HLA-C alleles. These data were compared with a control population of 604 random caucasian cadaver donors. RESULTS: All patients (100%) with guttate psoriasis carried the Cw*0602 allele compared with 20% of the control population (odds ratio = infinity; 95% confidence limits 25.00-infinity; Pcorrected < 0.0000002). CONCLUSIONS: This result is consistent with HLA-Cw*0602 playing a part directly in the pathogenesis of guttate psoriasis.

Adolescent↗
PubMed1999

Apolipoprotein E promoter polymorphism and sporadic Alzheimer's disease in a Japanese population.

A recent observation has shown that a common polymorphism (-491 A) in the promoter of apolipoprotein E (APOE) was associated with an increased risk for Alzheimer's disease (AD) in European decent. Moreover, the promoter with -491 A showed higher transcriptional activity than that with -491 T. To investigate the further contribution of the polymorphism to the etiology of sporadic AD, we evaluated associations between Japanese AD and -491 A/T polymorphism of APOE. There was no significant difference between these cases and controls. The percentage of the homozygote of -491 A allele (AA) among the Japanese control population was significantly higher than that among the Spanish control population. The APOE promoter genotype frequencies may be influenced by the ethnic background. Our study failed to confirm any relationship between -491 A/T polymorphism and AD. Thus, we conclude that the APOE promoter polymorphism does not represent an additional risk factor for AD in Japanese populations.

Age of Onset↗
PubMed1991

Common infections in the history of cancer patients and controls.

The association between the frequency of manifest infectious diseases and cancer risk was investigated in a case-control study at Heidelberg, FRG. A total of 255 cases with carcinomas of the stomach, colon, rectum, breast, and ovary, as well as 255 population controls and 230 hospital controls were interviewed using a standard questionnaire. Controls were matched to the cases for age, sex, and region of residence at the time of the interview. A history of common colds or gastroenteric influenza prior to the interview was found to be associated with a decreased cancer risk. Thus the odds ratios for "three or more common colds per year (on average)" versus "no common cold within the last 5 years prior to the interview" were 0.18 (95% CI = 0.05-0.69) and 0.23 (95% CI = 0.06-0.89) relative to population controls and hospital controls, respectively. There was no apparent relationship between childhood infections or other diseases reported in the earlier history, and cancer risk. While the findings are supported by previous studies and fit well into the results of other fields of cancer research, a conclusive interpretation and biological explanation cannot yet be given.

Adult↗
PubMed2006

Y-chromosome haplogroups and susceptibility to azoospermia factor c microdeletion in an Italian population.

BACKGROUND: A limited number of studies aimed at investigating the possible association of Y-chromosome haplogroups with microdeletions of the azoospermia factors (AZFs) or with particular infertile phenotypes, but definitive conclusions have not been attained. The main confounding elements in these association studies are the small sample sizes and the lack of homogeneity in the geographical origin of studied populations, affecting, respectively, the statistical power and the haplogroup distribution. MATERIALS AND METHODS: To assess whether some Y-chromosome haplogroups are predisposing to, or protecting against, azoospermia factor c (AZFc; b2/b4) deletions, 31 north Italian patients carrying the AZFc b2/b4 microdeletion were characterised for 8 Y-chromosome haplogroups, and compared with the haplogroup frequency shown by a north Italian population without the microdeletion (n = 93). RESULTS AND DISCUSSION: A significant difference was observed between the two populations, patients with microdeletions showing a higher frequency of the E haplogroup (29.3% vs 9.7%, p<0.01). The geographical homogeneity of the microdeleted samples and of the control population, controlled at microgeographical level, allows the possibility that the geographical structure of the Y genetic variability has affected our results to be excluded. CONCLUSION: Thus, it is concluded that in the north Italian population Y-chromosome background affects the occurrence of AZFc b2/b4 deletions.

Adult↗
PubMed1990

Cholelithiasis in inflammatory bowel disease. A case-control study.

Cholelithiasis is considered an extraintestinal manifestation of Crohn's ileitis but has not been associated with ulcerative colitis. To evaluate if an increased risk of cholelithiasis exists in patients with ulcerative colitis, biliary ultrasonography was performed on 159 patients with inflammatory bowel disease, 114 patients with ulcerative colitis, and 45 patients with Crohn's disease. A control population of 2453 residents of the town near the authors' institute was also studied. An echographic survey of gallstones was performed on the control subjects, who participated in the Multicentrica Italiana Colelitiasi (MICOL). Seventeen patients with inflammatory bowel disease had gallstones (10.7 percent), 11 patients with ulcerative colitis had gallstones (9.6 percent), and 6 patients with Crohn's disease had gallstones (13.3 percent). In the control population, diagnosis of cholelithiasis was made in 239 subjects (9.7 percent). An estimate of the relative risk (odds ratio) of gallstones in ulcerative colitis and Crohn's disease and also in 4 subgroups formed on the basis of the extent of disease (total ulcerative colitis, partial ulcerative colitis, Crohn's disease with ileitis, Crohn's disease without ileitis) with respect to the general population was calculated using logistic regression with gallstones, sex, age, and body mass index as independent variables and inflammatory bowel disease as a dependent variable. The author's findings show an increased risk of gallstones in both patients with Crohn's disease (odds ratio = 3.6; 95 percent confidence limits = 1.2 - 10.4; P = 0.02) and patients with ulcerative colitis (odds ratio = 2.5; 95 percent confidence limits = 1.2 - 5.2; P = 0.01). The risk was highest in patients with Crohn's disease involving the distal ileum (odds ratio = 4.5; 95 percent confidence limits = 1.5 - 14.1; P = 0.009) and in patients with total ulcerative colitis extending to the cecum (odds ratio = 3.3; 95 percent confidence limits = 1.3 - 8.6; P = 0.01). These results confirm that there is an increased risk of gallstones in Crohn's ileitis but they show that there also exists an increased risk in patients with total ulcerative colitis.

Adult↗
PubMed1990

Prevalence of metallothioneinuria among the population living in the Kakehashi River basin in Japan--an epidemiological study.

An epidemiological study to evaluate cadmium-induced renal dysfunction by urinary metallothionein levels was carried out in an environmentally-exposed Japanese population. The study population consisted of 3168 men and women from a cadmium-polluted area who were 50 years and older and 291 individuals from a non-polluted area. The mean metallothionein levels in urine of the control population were 138.2 +/- 2.1 and 198.6 +/- 1.9 microgram/g creatinine for men and women, respectively. The corresponding values for the cadmium-exposed population were 157.8 +/- 2.2 and 248.0 +/- 2.2. The 97.5% upper limits for men in the control population was determined to be 638 and for women 693 microgram MT/g creatinine. Based on these values as the cut-off levels, the prevalence of metallothioneinuria was calculated to be 4.6% in men and 8.4% in women from the cadmium-polluted area. Further selection of the population, based on life-time residence in the polluted area accompanied with the consumption of cadmium-containing rice, showed an even greater prevalence of metallothioneinuria: 5.4% in men and 10.9% in women of all ages. The prevalence of metallothioneinuria increased with age and duration of residence in the polluted area. These results suggest that metallothioneinuria can be used as an indicator of renal dysfunction due to environmental cadmium exposure.

Age Factors↗
PubMed1993

Population studies of the fragile X: a molecular approach.

The fragile X mutation can now be recognised by a variety of molecular techniques. We report a pilot screening survey of a population of children with mental impairment in which we used Southern blotting methods to detect the fragile X mutation, augmented by cytogenetic studies on children whose phenotype suggested a possible chromosome abnormality. There were 873 children with special educational needs in our survey and 310 fulfilled our criteria for testing. A sample was obtained from 254, of whom four were found to have a full fra(X) mutation (delta L) and none to have a premutation. The number of CGG repeats in our population of X chromosomes was measured by PCR analysis and the genotype at the closely linked polymorphic locus FRAXAC1 established. The distribution of CGG repeat numbers was very similar to that of the control population reported by Fu et al and the distribution of FRAXAC1 alleles almost identical to that of the control population reported by Richards et al. Among the non-fragile X chromosomes, we found a very significant correlation between the size of the CGG repeat and the FRAXAC1 genotype. There was a dearth of A and D genotypes in subjects with a small number of CGG repeats and an excess of the A genotype in those with a large number of CGG repeats. These observations are considered in the light of the reported disequilibrium between the A (and possibly also the D) genotype and the fra(X) mutation.

Adolescent↗
PubMed2006

Lung cancer risks in relation to vegetable and fruit consumption and smoking.

In a case-control study on lung cancer, risk was analysed in relation to smoking habits and frequency of vegetable and fruit consumption. Lung cancer cases in West Sweden and population controls were interviewed using a questionnaire where the frequency of consumption of dietary items and smoking habits were assessed. The material presented comprises 177 female and 359 male confirmed cases of lung cancer and 916 population controls. There was a dose-response relationship in regard to the number of cigarettes smoked and the number of years smoked, the latter factor being more important. After adjustment for number of cigarettes smoked/day and number of years smoked, the risk for those who seldom consumed vegetables was about twice of that among those who consumed vegetables frequently, both among nonsmokers, smokers and former smokers. This risk increase in relation to vegetable consumption also was present for different smoking categories. A similar tendency, although less pronounced, was found for fruit consumption. The results demonstrate that dietary factors are related to the risk for lung cancer, although smoking is the dominant risk factor.

Adolescent↗
PubMed1996

Thrombogenesis in mitral regurgitation and aortic stenosis.

The exact mechanisms for thrombus formation in patients with valvular heart disease have not been clearly defined. Abnormalities in plasma coagulation factors indicative of a prothrombotic state may in part account for the risk of stroke and thromboembolism in such patients. The aim of this study was, therefore, to determine the effects of mitral regurgitation (MR) and aortic stenosis (AS) on plasma fibrinogen or fibrin D-dimer levels as indices of a thrombogenic (or prothrombotic) state. A total of 25 patients with valve disease in sinus rhythm were studied: 12 patients (all women; mean age fifty-five years, sem 3.3) with MR; and 13 patients (7 men, 6 women; mean age fifty-seven years, sem 3.5) with AS were studied. Patients with MR had a median plasma fibrinogen that was significantly elevated when compared with female population values (median difference 0.62 g/L; 95% confidence intervals (CI) 0.27 to 1.05, P = 0.0016). However, these patients had a median plasma fibrin D-dimer that was lower than that for population controls (median difference 21 ng/mL; 95% CI 0 to 38, P = 0.05). Patients with aortic valve disease had a median plasma fibrinogen that was significantly increased when compared with population controls (median difference 0.82 g/L; 95% CI 0.34 to 1.24, P = 0.001). These patients had a plasma fibrin D-dimer level that was similar to population values (median difference 3 ng/mL; 95% CI -25 to 22, P = 0.80). Patients with MR or AS have higher plasma fibrinogen levels when compared with "normal" population values, suggesting possible hemorheologic abnormalities in these patients. Subjects with MR had lower plasma fibrin D-dimer levels, suggesting lesser intravascular clotting, consistent with clinical echocardiographic studies. Subjects with AS had plasma fibrin D-dimer levels similar to the "normal" population values, suggestive of a different pathophysiological mechanism for thromboembolism. These findings add to an improved understanding of the relationship between clinical observations and the significance of plasma fibrinogen and fibrin D-dimer levels in thrombogenesis.

Aortic Valve Stenosis↗
PubMed2001

Inbreeding changes the shape of the genetic covariance matrix in Drosophila melanogaster.

The pattern of genetic covariation among traits (the G matrix) plays a central role in determining the pattern of evolutionary change from both natural selection and random genetic drift. Here we measure the effect of genetic drift on the shape of the G matrix using a large data set on the inheritance of wing characteristics in Drosophila melanogaster. Fifty-two inbred lines with a total of 4680 parent-offspring families were generated by one generation of brother-sister mating and compared to an outbred control population of 1945 families. In keeping with the theoretical expectation for a correlated set of additively determined traits, the average G matrix of the inbred lines remained proportional to the outbred control G matrix with a proportionality constant approximately equal to (1 - F), where F is the inbreeding coefficient. Further, the pattern of covariance among the means of the inbred lines induced by inbreeding was also proportional to the within-line G matrix of the control population with a constant very close to the expectation of 2F. Although the average G of the inbred lines did not show change in overall structure relative to the outbred controls, separate analysis revealed a great deal of variation among inbred lines around this expectation, including changes in the sign of genetic correlations. Since any given line can be quite different from the outbred control, it is likely that in nature unreplicated drift will lead to changes in the G matrix. Thus, the shape of G is malleable under genetic drift, and the evolutionary response of any particular population is likely to depend on the specifics of its evolutionary history.

Animals↗
PubMed2005

Risk factors for adverse perinatal outcomes in imprisoned pregnant women: a systematic review.

BACKGROUND: Imprisoned pregnant women constitute an important obstetric group about whom relatively little is known. This systematic review was conducted to identify the risk factors associated with adverse pregnancy outcome present in this group of women. METHODS: The review was conducted according to a prespecified protocol. Studies of any design were included if they described information on any of the pre-specified risk factors. We calculated the results as summary percentages or odds ratios where data was available on both cases and population controls. RESULTS: The search strategy identified 27 relevant papers of which 13 met the inclusion criteria, involving 1504 imprisoned pregnant women and 4571 population control women. Imprisoned women are more likely to be single, from an ethnic minority, and not to have completed high school. They are more likely to have a medical problem which could affect the pregnancy outcome and yet less likely to receive adequate antenatal care. They are also more likely to smoke, drink alcohol to excess and take illegal drugs. CONCLUSION: Imprisoned women are clearly a high risk obstetric group. These findings have important implications for the provision of care to this important group of women.

Adult↗
PubMed1996

Fibrinogen and fibrin D-dimer levels in paroxysmal atrial fibrillation: evidence for intermediate elevated levels of intravascular thrombogenesis.

Because abnormalities in hemostatic factors may in part account for the risk of stroke and thromboembolism in atrial fibrillation, we measured plasma fibrinogen and fibrin D-dimer levels in 33 patients (18 men and 15 women, mean age 60.8 +/- 1.4 years [mean +/- SEM]) with paroxysmal atrial fibrillation (PAF) and 12 patients (3 men and 9 women, mean age 51.0 +/- 4.2 years) with paroxysmal supraventricular tachycardia (PSVT). Levels of these markers were compared to levels in (1) patients with chronic atrial fibrillation; (2) hospital controls (age-matched [age +/- 5 years] and sex-matched patients in sinus rhythm with coronary artery disease and normal left ventricular function); and (3) healthy population controls in sinus rhythm. Patients with PAF had intermediate levels of median plasma fibrinogen and fibrin D-dimer when compared to patients with chronic atrial fibrillation and controls in sinus rhythm (both p < 0.001). There was no relation with atrial size or ventricular function on echocardiography. Patients with PSVT had plasma fibrinogen and fibrin D-dimer levels that were similar to the median levels of the population controls, suggesting that there was no excess in thrombogenesis. These findings are consistent with the hypothesis that atrial fibrillation is related to the increases in plasma fibrinogen and fibrin D-dimer levels. Patients with PAF have intermediate levels of these markers, a finding that is consistent with the intermediate risk of thromboembolism in such patients.

Aged↗
PubMed2001

Isolated echogenic foci in the fetal heart: do they increase the risk of trisomy 21 in a population previously screened by nuchal translucency?

OBJECTIVES: To confirm the hypothesis that isolated cardiac echogenic foci at the second-trimester anomaly scan do not influence our current calculation of risk of trisomy 21 in individual pregnancies, which is based on maternal age and nuchal translucency thickness at 11-14 weeks. DESIGN: Observational study in a fetal medicine unit. METHODS: In a general pregnant population undergoing first-trimester nuchal translucency screening, data from 239 singleton pregnancies with isolated cardiac echogenic foci at the second-trimester anomaly scan were compared with those of a control group of 7449 pregnancies with normal anomaly scans. Prevalence of trisomy 21 was determined in both groups. Following the anomaly scan, the individual risks of trisomy 21 were calculated by adjusting the previous risk based on maternal age and first-trimester nuchal translucency. We assumed that echogenic foci did not alter each individual risk calculation. The expected number of cases of Down syndrome in both groups was then calculated from the sum of probabilities of each individual affected fetus. The observed number of cases was compared with the expected number in both study and control populations. RESULTS: There was no statistically significant difference between the prevalence of trisomy 21 in the study group (no cases) and in the control population (three cases). From individual risk calculations, observing no cases of trisomy 21 in the study group was the most likely event if echogenic foci did not increase the risk of this chromosomal abnormality (P = 0.62). CONCLUSION: The finding of isolated echogenic foci at the time of the 20 week-scan does not significantly change the risks of trisomy 21 if background risk and previous nuchal translucency measurements are taken into account in the individual risk calculation. We suggest that no further adjustments to risk should be used.

Adult↗
PubMed1993

Evaluation of exposure reducing measures on parameters of genetic risk in a population occupationally exposed to coal fly ash.

In a previous study we found increased SCE frequencies in peripheral blood lymphocytes (PBLs) of workers occupationally exposed in a coal fly ash processing industry, as compared to a non-exposed control population. Shortly after this study, measures were taken in this plant to reduce fly ash levels. The objective of the present study, conducted 2 years later in the same plants, was to evaluate the effect of these measures with respect to genotoxic risk. A group of 18 male workers of the coal fly ash processing industry agreed to participate in the study. The control population consisted of 18 male workers from a flour processing industry, who were matched for age and smoking behavior. In contrast to our previous study, no increased SCE frequencies were found in PBLs of workers potentially exposed to coal fly ash when compared to the control group (mean SCEs: 6.4 +/- 1.2 and 7.0 +/- 0.9, respectively). In addition, no differences were observed between the exposed and control groups for frequencies of gene mutations at the hypoxanthine guanine phosphoribosyltransferase (hprt) locus in PBLs, for micronucleus frequencies using the cytokinesis block method, or for urinary mutagen excretion measured with Salmonella typhimurium tester strains TA98 and TA97 with and without metabolic activation. In smokers, however, SCE frequencies in PBLs were significantly increased in comparison to non-smokers (7.1 +/- 1.1 vs. 6.1 +/- 0.5; P < 0.005), as was 24-h urinary mutagen excretion measured with strain TA98 with S9 mix (2373 +/- 1870 vs. 156 +/- 211; P < 0.001) and with TA98 with S9 mix and beta-glucuronidase/arylsulfatase (2361 +/- 1958 vs. 538 +/- 396; P < 0.005). In addition, hprt variant frequencies in PBLs were higher in smokers than in non-smokers (15.0 +/- 23.5 x 10(-6)6 vs. 2.6 +/- 2.8 x 10(-6); P < 0.05). No differences were observed for micronucleus induction between smokers and non-smokers. It is concluded that the protective measures taken in the coal fly ash processing plant appear to have been sufficient, since an effect of exposure to coal fly ash on parameters of genetic risk was not found any longer.

Adult↗
PubMed2003

The association between atrial septal aneurysm and mitral valve prolapse in patients with recent stroke and normal carotid arteries.

BACKGROUND: The association between mitral valve prolapse (MVP) and cryptogenic stroke is controversial. The Atrial Septal Aneurysm Multicenter Italian (ASA-MI) Study is a prospective multicenter study evaluating the prevalence of atrial septal aneurysm (ASA) in patients with a recent stroke and normal carotid arteries. The aim of the present research was to evaluate the frequency of ASA and its association with MVP in the stroke population and in the subgroup of young patients (< 55 years) included in the ASA-MI Study. METHODS: The study group included 245 of the 606 patients referred for transesophageal echocardiography (168 men and 77 women, mean age 65.7 +/- 21 years). All patients were selected on the basis of a recent episode of unexplained cerebral ischemia and were included in the study if they had normal carotid arteries. The control population included 245 patients (mean age 64.7 +/- 23 years) who underwent transesophageal echocardiographic evaluation during the same period for indications other than cerebral ischemia. The subgroup of young patients (< 55 years) included 90 patients (61 men and 29 women, mean age 49 +/- 5 years). RESULTS: The prevalence of MVP was 18% (95% confidence interval 8 to 21%) in the stroke population and 15% (95% confidence interval 7 to 20%) in the control population (chi 2 = 2.1, p = NS). The prevalence of MVP did not differ between young stroke patients (28.8%) and young controls (20%) (chi 2 = 0.835, p = 0.3). MVP was not significantly associated with stroke. We found an association between ASA and MVP: there was a higher incidence of MVP in stroke patients with an ASA than in patients without stroke or an ASA (40.9 vs 25%, p < 0.05). There was also a higher frequency of MVP associated with ASA in the group of young patients than in all patients of the ASA-MI Study (28.8 vs 18%, chi 2 = 20.313, p < 0.001). CONCLUSIONS: We found an association between ASA and MVP in patients with recent stroke and this association bore a higher risk of cerebral events than in patients without these abnormalities.

Adult↗