Depression as a risk factor for ischaemic heart disease in men: population based case-control study

OBJECTIVE: To determine the relation between depression, anxiety, and use of antidepressants and the onset of ischaemic heart disease. DESIGN: Population based case-control study. SETTING: All 5623 patients registered with one general practice. SUBJECTS: 188 male cases with ischaemic heart disease matched by age to 485 male controls without ischaemic heart disease; 139 female cases with ischaemic heart disease matched by age to 412 female controls. MAIN OUTCOME MEASURE: Adjusted odds ratios calculated by conditional logistic regression. RESULTS: The risk of ischaemic heart disease was three times higher among men with a recorded diagnosis of depression than among controls of the same age (odds ratio 3.09; 95% confidence interval 1.33 to 7.21; P=0.009). This association persisted when smoking status, diabetes, hypertension, and underprivileged area (UPA(8)) score were included in a multivariate model (adjusted 2.75; 1.13 to 6.69; P=0.03). Men with depression within the preceding 10 years were three times more likely to develop ischaemic heart disease than were the controls (3.13; 1.27 to 7.70; P=0.01). Men with ischaemic heart disease had a higher risk of subsequent depression [corrected] than men without ischaemic heart disease (adjusted 2.34; 1.34 to 4.10; P=0.003). Depression was not a risk factor for ischaemic heart disease in women on multivariate analysis (adjusted 1.34; 0.70 to 2.56; P=0.38). Anxiety and subsequent ischaemic heart disease were not significantly associated in men or women. CONCLUSION: Depression may be an independent risk factor for ischaemic heart disease in men, but not in women.     

Obesity as a metabolic risk factor

On the basis of the results of clinico-experimental examinations and of animal experiments the importance of obesity as metabolic factor of risk is confirmed and hereby the diabetes mellitus as well as cardiovascular effects are particularly taken into consideration. Conclusions are made relevant to practice and it is particularly referred to the central position of the B-cells for the pathogenesis of diabetes as well as to prophylactic and early therapeutic measures.     

Depression as a risk factor or prodromal feature for dementia? Findings in a population-based sample of Swedish twins.

This study tested whether history of depression is associated with an increased likelihood of dementia, and whether a first depressive episode earlier in life is associated with increased dementia risk, or whether only depressive episodes close in time to dementia onset are related to dementia. Depression information came from national hospital discharge registries, medical history, and medical records. Dementia was diagnosed clinically. In case–control results, individuals with recent registry-identified depression were 3.9 times more likely than those with no registry-identified depression history to have dementia, whereas registry-identified depression earlier in life was not associated with dementia risk. Each 1-year increase in time between depression onset and dementia onset or equivalent age decreased the likelihood of dementia by 8.4%. In co-twin control analyses, twins with prior depression were 3.0 times more likely to have dementia than their nondepressed twin partners, with a similar age of depression gradient. These findings suggest that after partially controlling for genetic influences, late-life depression for many individuals may be a prodrome rather than a risk factor for dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anticardiolopin antibodies as a risk factor in stroke

The level of anticardiolipin antibodies (aCL) in sera of 53 patients with ischemic cerebrovascular disease aged 35-55 years with mean age 48.4 +/- 5.03, was studied using a solid phase enzyme immunosorbent assay (ELISA). The investigation was done half year after the ischemic stroke. The control group consisted of 21 healthy participants matched for age and sex. The presence of aCL was found in sera of 17 persons (32.1%), in 9 it was IgG class antibodies. It was indicated that the risk of repeated cerebral ischemic events was relatively higher in aCL positive patients than in aCL negative. Relapses were found in 6 aCL positive patients (35.3%) (in 5 cases from the group of 9 IgG positive) and in 2 persons (5.6%) aCL negative patients. The existence of aCL can be helpful to determine pathogenesis of the disease and its prognosis.     

Radon as a risk factor for extra-pulmonary tumours

Most divers and diving medicine specialists know that application of normobaric oxygen as first aid after a bubble disease incident is highly effective. However, as yet technical difficulties acted as a deterrent to using normobaric oxygen at the diving site. This can now be overcome by a newer technique. To be efficient, any therapy of bubble disease should follow three main principles: maximal partial pressure of inhaled oxygen (i.e. 100 kpa in normobaric, and 280 kpa in hyperbaric conditions); minimal partial pressure of inhaled nitrogen, which should ideally be near zero; immediate start of therapy, if possible at the diving site, but not later than 2 hours after the onset of the first symptoms. However, it has to be borne in mind that for an efficient normobaric oxygenation (100%), the standard apparatus design without oxygen reservoir is obsolete, for it offers at most 40% oxygen to the lungs. Currently the following technical approaches for an efficient normobaric oxygenation are available: open one-way systems with tightly fitting mask and oxygen reservoir bag (type Ambu or Leardal, etc.); open systems with on-demand regulation and tightly fitting mouth piece (type SCUBA, or Bird-respirator); closed systems with CO2 absorber (type oxygen rebreathing diving gear). The closed system is a genuine technical advance, because it needs 15 times less oxygen than open systems (about 90 liters oxygen for a 3-hours oxygenation run). Such an apparatus is thus of light weight, far less cumbersome, and nevertheless highly efficient. The therapy should start immediately at the site of the mishap and be maintained during the transport to the next HBO-unit (usually 3 to 6 hours).(ABSTRACT TRUNCATED AT 250 WORDS)     

Parity as a risk factor for cancer cervix

PURPOSE: To analyze the likelihood of perioperative transfusion using the data of the abstracted patient discharge records. MATERIAL AND METHODS: It was studied the data of the records of the pediatric patients in whom were done surgical procedures for 1996. The abstracted patient discharge records are codified according the ICD-9-CM codes. RESULTS: 1,166 pediatric patients were operated, of whom were transfused 25 (2.1%). The transfusion rate was higher in patients less than 3 years old, who were operated with three o more surgical procedures simultaneously, who were admitted newly after the admittance here studied, and patients operated of spine, dorsolumbar spine, pharynx, thorax and mediastinum, central nervous system, colon, vessels and hip. CONCLUSIONS: Given the variability of the transfusion rate, to know it will allow a better planning of the surgical transfusions, the policy of the hospital blood bank and to increase the information to patient about the risk of the elective surgery.     

Smoking as a risk factor for nephropathy in non-insulin-dependent diabetics

This study examines whether there was an association between smoking and nephropathy in patients with non-insulin-dependent diabetes mellitus enrolled in the Appropriate Blood Pressure Control in Diabetes Trial. Sixty-one percent of the patients were smokers; 26% had microalbuminuria, and 14% had overt nephropathy. There was a univariate association between diabetic nephropathy and gender, smoking status, duration of diabetes, hypertension, glycosylated hemoglobin level, creatinine level, body mass index, and cholesterol level. Stepwise logistic regression demonstrated an independent association between smoking and diabetic nephropathy (odds ratio 1. 61; 95% confidence interval 1.01, 2.58). These findings may have important implications for patients with non-insulin-dependent diabetes mellitus who smoke.     

QT interval as a cardiac risk factor in a middle aged population

OBJECTIVE: To evaluate the value of QT interval as a cardiac risk factor in middle aged people. METHODS: The association between QT interval and cardiac risk factors and mortality in a middle aged Finnish population of 5598 men and 5119 women was evaluated over a 23 year follow up. To adjust the QT interval confidently for heart rate, a nomogram was constructed from the baseline electrocardiograms separately for men and women. RESULTS: Nomogram-corrected QT interval (QTNc) prolongation was associated with elevated blood pressure and signs of cardiovascular disease; QTNc shortening was associated with smoking. Over 10% prolongation of QTNc predicted death in men with heart disease: adjusted relative risk (RR) was 2.17 (95% confidence interval 0.67-7.45) for sudden death; 2.12 (1.25-3.59) for total cardiovascular mortality; and 1.92 (1.23-3.00) for all cause mortality. In healthy men the increase in RR was not significant: sudden death, 1.48 (0.67-3.25); total cardiovascular mortality, 1.25 (0.92-1.70); all cause mortality, 1.21 (0.96-1.53). However, healthy men with long QTNc in the lowest heart rate quartile exhibited an RR of 2.75 (1.00-7.40) for sudden death. Over 10% shortened QTNc predicted cardiovascular death in men with heart disease who smoked; RR 3.72 (1.45-9.54). Non-smoking men with short QTNc had low mortality risks irrespective of possible signs of cardiovascular disease. The trends in mortality risks were similar but weaker for women. CONCLUSIONS: In a middle aged population, prolonged QT interval predicts cardiac mortality in men with signs of cardiovascular disease. In women and healthy men this risk is weak and may reflect subclinical heart disease. A shortened QT interval predicts death in men with heart disease who smoke.     

Blood transfusion as a risk factor for non-Hodgkin lymphoma

In a case-control study of 280 out of 426 consecutive patients with a recent diagnosis of non-Hodgkin lymphoma (NHL) and 1827 control subjects, 53 (19%) and 230 (13%) respectively had received blood transfusions 1 year or more before the interview. Using an age- and sex-stratified analysis the odds ratio (OR) for transfusion was 1.74 (95% CI 1.24-2.44). ORs were also determined for transfusions received in the intervals 1-5, 6-15, 16-25 and > or = 26 years before diagnosis. In the interval 6-15 years, the OR for transfusion was 2.83 (95% CI 1.60-4.99) whereas ORs for transfusions received in other intervals were lower and not significantly elevated. Histological diagnoses (Kiel classification) and results of staging procedures were known for 185 patients. For low-grade NHL of nodal B-cell chronic lymphocytic leukaemia (B-CLL) or immunocytoma type, the OR for transfusions was 4.15 (95% CI 1.92-9.01). For low-grade nodal lymphomas of follicle centre cell type and high-grade nodal lymphomas, no relation to transfusions could be demonstrated. For high-grade extranodal lymphoma as sole manifestation, OR for transfusions was 3.27 (95% CI 1.30-8.24). It is concluded that blood transfusion may be a risk factor for NHLs especially those of B-CLL or immunocytoma type and for high-grade extranodal lymphoma.     

Chronically elevated proliferation as a risk factor for neoplasia

Chronic disease conditions that are associated with elevated proliferation are well established as risk factors for cancer development. These may be due to viruses (for example, in the case of hepatitis and liver cancer), bacterial infections, parasite infestation or physical trauma. In addition to these exogenous agents there are also metabolic abnormalities that can contribute, caused by genetic or epigenetic influence. In the latter case, an increase in serum levels of the hormones oestrogen, testosterone and insulin may be of special importance. The present review concentrates attention on factors that induce elevated cell turnover and for which there is epidemiological and/or experimental evidence of a link with neoplasia, with particular stress on the individual organ or tissue level.     

Obesity as a risk factor for certain types of cancer

In conclusion, obesity has been associated with increased risk for a number of different types of cancer. The evidence has been most consistent for endometrial cancer, breast cancer in postmenopausal women, and renal cell cancer. More variable results have been reported for colorectal, prostate and pancreatic cancer. Possible mechanisms by which obesity may influence cancer risk include alteration in hormonal patterns, including sex hormones and insulin, and factors such as the distribution of body fat and changes in adiposity at different ages. The increasing prevalence of obesity in many parts of the world emphasizes the importance of learning more about the relationship between obesity and cancer and the mechanisms involved in their interaction.     

Epithelial anomalies in chronic pancreatitis as a risk factor of pancreatic cancer

BACKGROUND/AIMS: The relationship between chronic pancreatitis and the development of pancreatic cancer is still a matter of dispute. Our aim was to determine the frequency of hyperplastic, metaplastic and dysplastic epithelial anomalies in the course of chronic pancreatitis and the potential steps in their development to malignancy. METHODOLOGY: The study was based on biopsy material of 70 patients with clinically diagnosed advanced chronic pancreatitis, who underwent partial or total pancreatectomy, as well as other operations. The patients were assigned to 2 groups: Group I (n = 41) with calcifying chronic pancreatitis; Group II (n = 29) with other forms of the disease. Histological sections were stained with hematoxylin-eosin, Mallory-azan, Gomori's silver method, and glycosaminoglycans (PAS and Alcian blue staining). Special interest was focused on the type and incidence of epithelial ductal and acinar cell anomalies, and on the degree of parenchymal scarring. RESULTS: Hyperplasia of the ductal epithelium was present in 31.4%, focal squamous metaplasia in 21.4%, mucous metaplasia in 11.1%, cellular dysplasia in 8.6%, dysplastic acinar cell nodules in 21.4%, and "tubular complexes" in 30.0% of all cases. The differences in the frequency of these changes, except for ductal epithelial hyperplasia, were not statistically significant in two comparable groups. Advanced pancreatic fibrosis was associated with epithelial anomalies in 65.7% of all cases. CONCLUSIONS: From the morphological point of view, the adequate prerequisites for the consideration of advanced forms of chronic pancreatitis, independent of type, as a risk factor of pancreatic cancer exist, necessitating the surgical removal of pathological lesions.     

Enterovirus infections as a possible risk factor for myocardial infarction

BACKGROUND: An increasing body of evidence suggests that, in addition to the well-known classic risk factors, some microbial infections may be associated with the development of atherosclerosis and myocardial infarction (MI). The aim of our study was to evaluate the possible role of enteroviral infections in the pathogenesis of MI. METHODS AND RESULTS: Stored sera, collected in Eastern Finland in 1977, from a set of 12 155 randomly selected men and women aged 25 to 64 years were used in prospective, nested case-control study. The study sample comprised 183 men and 81 women with MI and matched controls. The sera were tested for IgG antibodies to a newly identified enterovirus-common (EVC) antigen, to heat-denatured coxsackievirus B5 (CBV-5), and to adenovirus hexon protein. Raw data from enzyme immunoassays were converted to relative units before analysis. In univariate analysis, EVC antibodies were significantly associated with the risk of MI in men (P=0.009) but not in women. Men with MI had a significantly higher mean level of EVC antibodies than matched controls (P=0.014). High antibody levels to EVC were associated with an increased risk of MI in men aged 25 to 49 years (relative risk [RR] 4.34, P<0.001) but not in older men (>50 years of age). Women with MI also showed a trend toward higher antibody levels than control women, but the difference was not statistically significant. Antibody levels to whole CBV-5 or adenovirus hexon protein appeared to be no different among case patients versus control subjects. CONCLUSIONS: If we assume that a high level of EVC antibodies reflects a history of relatively frequent enterovirus infections, the present observation might suggest that enterovirus infections increase the risk of MI at least in middle-aged men. Further studies are needed to understand possible clinical significance of this observation.