Risk of sexual dysfunction with progestin-based contraceptives in women of child-bearing age

PURPOSE

To examine whether there is a positive association between sexual dysfunction (SD) and different types of progestin-based contraceptives.

METHODS

Nested case-control study in women of child-bearing age (15-45 years) from the IQVIA® Ambulatory electronic medical record database from 2008 to 2018. Cases defined by diagnosis of sexual dysfunction identified by international classification for disease clinical modification code 9th and 10th. Each case was matched to four controls and rates of prescriptions of the following were compared: levonorgestrel intra-uterine device (IUD), progestin, and ethinyl estradiol (EE) combined oral contraceptive (COC) formulations including levonorgestrel, norgestimate, drospirenone, desogestrel, norethindrone, and norgestrel; etonogestrel vaginal ring; and medroxyprogesterone injection.

RESULTS

Overall, 6689 cases of patients with SD were matched to 26,756 matched controls. Compared with matched controls, more subjects with SD used levonorgestrel IUD (OR 1.24, 95% CI 1.08-1.44), EE-levonorgestrel COC (OR 1.18, 95% CI 1.00-1.41), EE-drospirenone (OR 1.28, 95% CI 1.00-1.67), and medroxyprogesterone (OR 1.38, 95% CI 1.12-1.70). The use of norgestrel exhibited a protective effect (OR 0.83, 95% CI 0.73-0.95). When using the EE-levonorgestrel COC as a comparator, norgestrel users exhibited a protective effect (OR 0.70, 95% CI 0.57-0.87) while no other contraceptives showed a statistically significant difference in association with SD.

CONCLUSION

Our study found an increase in the use of levonorgestrel (COC and IUD), drospirenone, and medroxyprogesterone in subjects with SD. The risk of contraceptives did not differ when compared with oral levonorgestrel. The small association size and lack of difference between drug formulations suggest a minimal impact of progestin-based contraceptives on sexual dysfunction.

[Prevention of blindness and ophthalmic epidemiology in China over the past 70 years]

Prevention of blindness is of paramount importance for eye care and health care in China. In the past 70 years, we have embraced a lot of advancements in practice, manpower and landmark studies for the prevention of blindness and development of ophthalmic epidemiology. This summary is dedicated to our predecessors and successors for their contributions to the progress of ophthalmology in China, particularly workers in the field of prevention of blindness and ophthalmic epidemiology. Congratulations on the 70th anniversary of Chinese Journal of Ophthalmology. (Chin J Ophthalmol, 2020, 56: 561-566).

Validity of self-reported cancer: Comparison between self-report versus cancer registry records in the Geelong Osteoporosis Study

BACKGROUND

Determining the validity of self-reported data is important. The aim of this study was to assess the validity of self-reported cancer and investigate factors associated with accurate reporting in men and women.

METHODS

Study participants (n = 1727) from the Geelong Osteoporosis Study, located in south-eastern Australia, were utilised. Self-reported cancer data were compared to Victorian Cancer Registry records. Age, socioeconomic status (SES), education and time between cancer diagnosis and study appointment were investigated as factors associated with accuracy of self-report.

RESULTS

There were 142 participants who self-reported a cancer and 135 with a VCR record. Comparing self-report to any registry record, sensitivity was 63.7 %, specificity 96.5 %, PPV 60.6 %, NPV 96.9 %, and overall agreement ĸ0.588. Comparing exact-match records, sensitivity was 58.8 %, specificity 95.5 %, PPV 49.3 %, NPV 96.9 % and overall agreement ĸ0.499. In logistic regression models, post-secondary education was independently associated with accuracy of any (OR 1.72, 95 % CI 1.10-2.70) and exact-match (OR 1.59, 95 % CI 1.05-2.42) self-report, compared to cancer registry record. For any cancer, being aged >70 years was inversely associated with accuracy (OR 0.24, 95 % CI 0.15-0.38). Likewise, for matched cancer reporting, those aged 60-70 years (OR 0.51, 95 %CI 0.30-0.88) and >70 years (OR 0.23, 95 % CI 0.15-0.35) were less accurate. No other significant associations were detected.

CONCLUSION

Results suggest moderate agreement between self-report and registry data for any cancer among men and women. However, when comparing self-report to registry data for exact-match cancer type, level of overall agreement deteriorated. Self-report cancer data may be acceptable for determining a history of cancer, although, is less accurate in identifying history of specific cancer types documented in registry-based data.

The Mexican Cognitive Aging Ancillary Study (Mex-Cog): Study Design and Methods

OBJECTIVE

Describe the protocol sample and instruments of the Cognitive Aging Ancillary Study in Mexico (Mex-Cog). The study performs an in-depth cognitive assessment in a subsample of older adults of the ongoing Mexican Health and Aging Study (MHAS). The Mex-Cog is part of the Harmonized Cognitive Assessment Protocol (HCAP) design to facilitate cross-national comparisons of the prevalence and trends of dementia in aging populations around the world, funded by the National Institute on Aging (NIA).

METHODS

The study protocol consists of a cognitive assessment instrument for the target subject and an informant questionnaire. All cognitive measures were selected and adapted by a team of experts from different ongoing studies following criteria to warrant reliable and comparable cognitive instruments. The informant questionnaire is from the 10/66 Dementia Study in Mexico.

RESULTS

A total of 2,265 subjects aged 55-104 years participated, representing a 70% response rate. Validity analyses showed the adequacy of the content validity, proper quality-control procedures that sustained data integrity, high reliability, and internal structure.

CONCLUSIONS

The Mex-Cog study provides in-depth cognitive data that enhances the study of cognitive aging in two ways. First, linking to MHAS longitudinal data on cognition, health, genetics, biomarkers, economic resources, health care, family arrangements, and psychosocial factors expands the scope of information on cognitive impairment and dementia among Mexican adults. Second, harmonization with other similar studies around the globe promotes cross-national studies on cognition with comparable data. Mex-Cog data is publicly available at no cost to researchers.

Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

Background

To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM).

Methods

Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA.

Results

A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust.

Conclusions

There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other’s incidence.

[Epidemiological investigation of 169 inpatients with high-voltage electrical burns on the wrist]

Objective: To analyze the epidemiological characteristics of inpatients with high-voltage electrical burns on the wrist in Beijing Jishuitan Hospital (hereinafter referred to as the author's unit), so as to provide reference for the prevention and treatment of high-voltage electrical burns on the wrist. Methods: The medical records of inpatients suffered from high-voltage electrical burns on the wrist in the author's unit from January 2008 to December 2019 were collected. The patients' gender, age, population category, injury situation, injury season, total burn area, electrical burn type on the wrist of the affected limbs, the time from injury to first flap/myocutaneous flap transplantation, vascular reconstruction and flap/myocutaneous flap transplantation of the affected limbs, the total amputation rate of the affected limbs and the amputation rate of the affected limbs with type Ⅲelectrical burns on the wrist, the number of operation, postoperative infection rate of flap/myocutaneous flap, length of hospital stay, hospitalization expense, and treatment outcome were retrospectively analyzed. Comparison of the aforementioned statistical items between patients admitted from January 2008 to December 2013 (hereinafter referred to as the pre-stage) and January 2014 to December 2019 (hereinafter referred to as the post-stage) except gender, the total amputation rate of the affected limbs, treatment outcome were performed. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and Wilcoxon rank-sum test. Results: During the 12 years, a total of 169 patients with high-voltage electrical burns on the wrist were admitted to the author's unit, including 162 males and 7 females, aged (35±13) years, and 75.15% (127/169) of patients were 21-50 years old. The top three groups in population category from high to low were workers, migrant workers, and primary and secondary school students, accounting for 48.52% (82/169), 28.99% (49/169), and 9.47% (16/169), respectively. At work of non-electric power accounted for 47.93% (81/169) and ranked the first in the proportion of injury situation. The injury occurred mostly in summer and autumn, accounting for 39.05% (66/169) and 28.99% (49/169), respectively. About 65.09% (110/169) of the patients were with total burn area less than 10% total body surface area. There were totally 216 affected limbs with high-voltage electrical burns on the wrist, of which the numbers of wrist with type Ⅲ and type Ⅳ injury were 25 (11.57%) and 21 (9.72%), respectively. The time from injury to first flap/myocutaneous flap transplantation was 6.00 (3.75, 8.00) d. There were 45 affected limbs operated with vascular reconstruction, 75 affected limbs transplanted with pedicled axial flap, and 86 affected limbs transplanted with free flap/myocutaneous flap. The total amputation rate of affected limbs was 12.96% (28/216), and the amputation rate of the affected limbs with type Ⅲ electrical burns on the wrist was 28% (7/25). The number of operation was 4 (3, 5) times, the postoperative infection rate of flap/myocutaneous flap was 7.18% (13/181), the hospitalization time was 39.00 (25.00, 50.00) d, and the hospitalization cost was 123 553.00 (50 656.50, 216 003.00) yuan. Compared with those of the pre-stage, the time from injury to first flap/myocutaneous flap transplantation was significantly shortened (Z=-4.038, P<0.01), the ratio of free flap/myocutaneous flap transplantation on affected limbs was significantly increased (χ(2)=13.478, P<0.01), the ratio of pedicled axial flap transplantation on affected limbs was significantly decreased (χ(2)=10.242, P<0.01), the number of operation was significantly reduced (Z=-5.903, P<0.01), the postoperative infection rate of flap/myocutaneous flap was significantly decreased (χ(2)=4.492, P<0.05), the length of hospital stay was significantly shortened (Z=-2.723, P<0.01), and the hospitalization expense was significantly decreased among patients hospitalized in the post-stage (Z=-2.121, P<0.05). The other items were close between patients hospitalized in the pre-stage and those in the post-stage. Conclusions: Men were more likely than women to suffer from high-voltage electrical burns on the wrist in the author's unit. Young workers and migrant workers may be the key groups for the prevention of high-voltage electrical burns on the wrist. It is very important to strengthen the management of high voltage safety education for non-electric power staff, warn and protect the surrounding area of high voltage environment, and prohibit non staff for entering the high voltage environment, especially in summer and autumn. In the last 6 years, the patients with high-voltage electrical burns on the wrist may benefit from the active vascular reconstruction at early stage and free flap/myocutaneous flap repair in the author's unit.

Epidemiology and regional differences of acute poisonings of eight cities in Gyeonggi-do province in Korea using data from the National Emergency Department Information System of Korea

OBJECTIVE

We aimed to analyze the differences in epidemiological aspects and clinical courses of acute poisonings in each region of the Gyeonggi-do province in Korea.

METHODS

This retrospective study analyzed data from the National Emergency Department Information System of Korea. We retrospectively reviewed cases of acute poisonings between April 2006 and March 2015 recorded at 13 emergency departments in eight different cities of Gyeonggi-do province in Korea. The differences in the incidence, age distribution, causative agent, and clinical course of poisonings among regions were the main outcomes measured.

RESULTS

The proportion of poisonings in the ≤9 age group was high in Yongin (17.44%) and that in ≥65 age group was high in Gwangmyeong (21.76%). The proportion of cases involving carbon monoxide was high in Ansan (8.82%) in patients hospitalized and the proportion of cases involving pesticides was high in Pyeongtaek (52.78%) in patients admitted to the intensive care unit. The admission rate of poisoned patients was high in Osan (36.02%).

CONCLUSION

In this study, differences in the characteristics of poisoned patients between 8 cities were noted. Therefore, hospitals need to arrange treatment resources for poisoned patients according to the characteristics of the specific region. The.

RESULTS

of this study may serve as evidence for new strategies to prepare for the acute poisonings in hospitals.

Hospital admission for complicated diverticulitis is increasing in Italy, especially in younger patients: a national database study

BACKGROUND

Epidemiological studies show an increasing trend of hospitalization for acute diverticulitis (AD), but data regarding the trend in hospitalization for complicated AD in Italy are scarce. The aim of this study was to analyze the Italian trend in hospitalization for complicated AD, from 2008 to 2015.

METHODS

Using the Italian Hospital Information System, we identified all patients with complicated colonic AD as a discharge diagnosis. Age- and sex-specific rates for AD as well as type of hospital admission (emergency/elective), type of complication (peritonitis, obstruction, bleeding, abscess, fistula, perforation, sepsis) and type of treatment (medical/surgical), were analyzed.

RESULTS

A total of 41,622 patients with a discharge diagnosis of complicated AD were identified. Over the study period the admission rate grew from 8.8 to 11.8 per 100,000 inhabitants. The hospitalization rate was highest for patients ≥ 70 years, but the increase in the admission rate was higher among patients aged ≤ 60 years. There were more males in the group < 60 years and more females in the group ≥ 60 years old. The rate of emergency admissions associated with surgery showed a significant mean annual increase (+ 3.9% per year) in the rate of emergency admissions associated with surgery, whereas elective admissions for surgery remained stable. Peritonitis was the most frequent complication (35.5%). The rate of surgery increased in AD complicated by peritonitis (+ 5.1% per year), abscess (+ 5.8% per year) and decreased for obstruction (- 1.8% per year).

CONCLUSIONS

From 2008 to 2015, we documented an increasing rate of hospitalization for complicated AD, especially for younger patients, with an increase in surgery for peritonitis and abscess. Further studies are needed to clearly assess the risk factors for complications and risk of surgery.

[Epidemiological investigation of 511 adult inpatients with gas burns]

Objective: To analyze the epidemiological characteristics of adult inpatients with gas burns in the Department of Burns of Hwa Mei Hospital of University of Chinese Academy of Sciences (hereinafter referred to as the author's unit) , so as to provide evidence for the prevention of gas burn. Methods: Medical records of all inpatients with flame burns admitted to the author's unit from January 2011 to December 2017 were collected. The percentage of adult inpatients with gas burns in total inpatients with flame burns in the same period, and their gender, age, injury season, accident place, burn severity, common compound injury, complication, population caliber, education, industry, as well as the pre-injury disease and prognosis of elderly inpatients with gas burns were retrospectively analyzed. In addition, the age, accident place, education, and industry of the floating population in the adult inpatients with gas burns were analyzed separately and compared with the total population of adult inpatients with gas burns in 7 years. Data were processed with chi-square test or Fisher's exact probability test (Monte Carlo algorithm). Results: During the 7 years, 1 490 inpatients with flame burns were admitted to the author's unit, among which 511 were adult inpatients with gas burns, accounting for 34.30%. The number of adult inpatients with gas burns increased gradually during the 7 years, but its percentage in the total inpatients with flame burns during the same period showed no significant difference (χ(2)=7.087, P>0.05). Among the 511 adult inpatients with gas burns (hereinafter referred to as the patients in this group), there were 315 males and 196 females, with a male/female ratio of 1.61 to 1.00, and the middle-aged patients were the most, up to 270 cases, accounting for 52.84%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in gender and age (χ(2)=54.810, 27.832, P<0.01). Among the patients in this group, most were injured in summer, totally 251 cases, accounting for 49.12%, and the accident place was mainly at home, totally 388 cases, accounting for 75.93%. The distribution of adult inpatients with gas burns during the 7 years was significantly different in injury season (χ(2)=42.254, P<0.01), but not in accident place (χ(2)=6.782, P>0.05). The patients in this group were mainly with moderate burns (237 cases, accounting for 46.38%), and the distribution trend of burn severity of adult inpatients with gas burns was basically the same during the 7 years (χ(2)=19.680, P>0.05); 176 patients (34.44%) were accompanied by inhalation injury, and 30 patients (5.87%) were accompanied by blast injury of lung; post injury complications occurred in 20 patients (3.91%). In the elderly inpatients with gas burns, 44.44% (32/72) were accompanied by pre-injury basic diseases, and the proportion of death or unhealed reached 18.06% (13/72). Most of the patients in this group were permanent residents (358 cases, accounting for 70.06%) and received secondary education (304 cases, accounting for 59.49%), and the majority of them were engaged in manufacturing/construction (138 cases, accounting for 27.01%), self-employed business (90 cases, accounting for 17.61%), and catering (90 cases, accounting for 17.61%) industries. The distribution of adult inpatients with gas burns during the 7 years was significantly different in population caliber, education, and occupation (χ(2)=17.496, 29.898, 88.896, P<0.05 or P<0.01). Among the patients of this group, the floating population were mainly young (90 cases, accounting for 58.82%) and middle-aged (62 cases, accounting for 40.52%), with main accident place at home (97 cases, accounting for 63.40%), generally received secondary education (101 cases, accounting for 66.01%), and were mainly engaged in manufacturing/construction (71 cases, accounting for 46.41%), self-employed business (26 cases, accounting for 16.99%), and catering (20 cases, accounting for 13.07%) industries. Compared with the total adult inpatients with gas burns in 7 years, the floating population were younger, more injured in the workplace, and more concentrated in industry (χ(2)=42.924, 9.390, 27.819, P<0.01). Conclusions: Gas burn was the leading injury cause of inpatients with flame burns in the author's unit, which mainly occurred in summer and at home; the patients were mainly male, young and middle-aged, and permanent residents, most of which were with moderate burn, often accompanied by inhalation injury. Most of the patients were of secondary education, engaged in manufacturing/construction, self-employed business, and catering industries, among which the floating population were younger, more injured in the workplace, and more concentrated in industry. In order to prevent gas burn, we should pay more attention to the propaganda and education of gas safety among young and middle-aged men, floating population, retired old people and housewives, especially in summer, we should do a good job in gas safety inspection at home. In addition, we should urge enterprises to further strengthen the supervision of production safety.

[Epidemiological study of occupational diseases in Gansu province, China in 2010-2017]

Objective: To analyze the epidemiological characteristics of occupational diseases in Gansu Province, China in 2010-2017, and to provide a scientific basis for the prevention and control of occupational diseases. Methods: The cluster sampling method was adopted to make statistical analysis of 1339 cases of occupational disease reported by "occupational disease and occupational health information monitoring system" in Gansu province from 2010 to 2017, to investigate the diseases, regions and industries of occupational diseases in June 2018. Results: A total of 1339 cases of occupational diseases (39 types, 8 classes) were diagnosed and reposed in 2010-2017. The three most frequent diseases were pneumoconiosis (87.53%, 1172/1339), occupational poisonings (5.83%, 78/1339), and occupational ear, nose, and throat (ENT) diseases (3.14%, 42/1339). The cases of silicosis accounted for 54.61% (640/1172) of all cases of pneumoconiosis, the second was coalworker pneumoconiosis, which accounted for 38.57% (452/1172). In the cases of occupational poisonings, 32.05% (25/78) suffered from carbon monoxide poisoning. Patients with occupational diseases were reported in 14 districts of Gansu, mostly in Lanzhou (27.52%, 347/1261), Jinchang (16.57%, 209/1261), and Baiyin (14.20%, 179/1261). The reported cases are mainly concentrated in mining (71.56%, 468/654) and manufacturing (21.87%, 143/654), the types of state-owned economy (55.63%, 692/1244) and private economy (33.68%, 419/1244), large (43.41%, 540/1244) and small enterprises (35.21%, 438/1244) in 2010-2017 in Gansu. Conclusion: The pneumoconiosis caused by silicious and coal dust and the occupational poisonings caused by carbon monoxide seem to be the main occupational hazards in Gansu province. Occupational diseases occur in all districts of Guangzhou and in various industries. The state-owned economy and private sector, large and small enterprises should be the focuses of occupational health supervision.

Rheumatoid arthritis is associated with early tooth loss: results from Korea National Health and Nutrition Examination Survey V to VI

BACKGROUND/AIMS

To examine the association between rheumatoid arthritis (RA) and periodontitis or tooth loss.

METHODS

The study used data from the fifth and sixth Korea National Health and Nutrition Examination Surveys conducted from 2010 to 2015. RA was defined as participant-reported physician-diagnosed RA that was being treated. Periodontitis and the number of natural teeth were determined by dental examination. Periodontitis was defined according to the community periodontal index (periodontal probing depth ≥ 4 mm). The association between RA and periodontitis or tooth loss was examined after controlling for confounding variables (e.g., age, smoking status, socioeconomic status, dental caries, frequency of toothbrushing, body mass index, alcohol consumption, and diabetes) in men and women. Subgroup analyses stratified by age were also performed.

RESULTS

The study enrolled 20,297 participants aged ≥ 19 years (157 RA patients and 20,140 non-RA controls). There was no association between RA and periodontitis or tooth loss in men and women. Subgroup analyses in those aged < 60 years revealed a non-significant association between RA and periodontitis (adjusted odds ratio, 1.53; p = 0.162), but they revealed a significant association between RA and tooth loss (adjusted β, 0.20; p = 0.042).

CONCLUSION

RA was not associated with periodontitis, but was associated with tooth loss in younger adults. Younger RA patients are more likely to suffer tooth loss than general younger population; thus dental management is required.

[Analysis of the prevalence of blindness and major blinding diseases in China]

With the growth of the global population and the acceleration of the aging process, the situation of blindness all over the world is increasingly severe. According to the latest data published by the Vision Loss Expert Group in 2017, there were an estimated 36 million blind people worldwide in 2015. The 66(th) World Health Assembly has endorsed the "Universal eye health: a global action plan 2014-2019" , which aims to reduce the prevalence of avoidable visual impairment by 25% by 2019 from the baseline of 2010. As a country with the largest number of blind people in the world, China has an arduous task of preventing and treating eye diseases.This review article summarizes and analyzes the relevant literature on the prevalence of blindness, the main blinding diseases and prevention measures in China, so as to provide reference materials for ophthalmologists to better carry out eye health work and reduce the number of blind people in China. (Chin J Ophthalmol, 2019, 55:625-628).

[Occupational acute mixed gas poisoning due to improper disposal of hazardous waste]

Objective: To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment. Methods: An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed. Results: The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged. Conclusion: The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.

[Emphasizing the standardized use of cycloplegics in the epidemiological studies of myopia]

The prevalence of myopia in China is extraordinarily high, and much attention has been paid to the epidemiological studies related to myopia. Epidemiological investigations can be used to understand the incidence and prevalence of myopia, its epidemiological characteristics and the related risk factors. At present, there are many articlespublished in China on epidemiological surveys of myopia. However, the criteria for cycloplegic regimes are not uniform, the age limit is not definite, and cycloplegics are even not used in some researches. Lack of or insufficient cycloplegia is associated with overestimation of the prevalence of myopia and underestimation of hyperopia and leads to inaccurate assessment of risk factors. In this article, we propose standardized methods for cycloplegia in the epidemiological investigations of myopia in China by reviewing different types of cycloplegic regimes commonly used and the effects on different age groups. This will help to obtain the accurate incidence and prevalence of myopia, promote the interconnection and increase comparabilityof research data, improve the accuracy of assessing related risk factors and provide scientific evidence for the prevention and control of myopia. (Chin J Ophthalmol, 2019, 55: 561-564).

[Analysis on the alterative trend of colorectal cancer mortality from 1999 to 2015 in Tianjin of China]

Objective: To investigate the mortality of colorectal cancer and its trend from 1999 to 2015 in Tianjin, China, and to explore the mortality features in different populations in order to provide data for prevention and control strategies of colorectal cancer. Methods: Colorectal cancer mortality data between 1999 and 2015 were collected from Tianjin population - based mortality surveillance system maintained by the Tianjin Centers for Disease Control and Prevention (CDC). Population data of permanent residents were collected from Tianjin Municipal Public Security Bureau. The number of new cases and deaths, incidence [including crude incidence, age-adjusted standardized incidence and 95% confidence interval (95% CI)], and mortality (including crude mortality, age-adjusted standardized mortality and 95% CI) of colorectal cancer were calculated. Standardized incidence and mortality of colorectal cancer were calculated using the Segi's world standard population, adjusted with age and gender. JoinPoint regression and Cochran-Armitage trend test were used to determine the statistical significance of differences in mortality trend. Results: A total of 31 376 new onset cases and 14 893 death cases of colorectal cancer were observed in Tianjin from 1999 to 2015. Colorectal cancer incidence increased from 1999 to 2015 with a standardized rate from 9.66/100 000 to 15.36/100 000 [annual percent change(APC)=3.48%, Z=23.21, P<0.001]. Colorectal cancer mortality increased from 1999 to 2015 with a standardized rate from 5.18/100 000 to 6.11/100 000 (APC=1.24%, Z=5.69, P<0.001). Both showed an increasing trend. The death proportion of colon cancer increased (39.67% in 1999 and 50.33% in 2015), while the death proportion of rectal caner decreased (60.33% in 1999 and 48.57% in 2015). The median age of colorectal cancer onset fluctuated steadily around 66 years old (APC=0.16, T=1.75, P=0.100); the median age of death increased from 69 to 73 years old (APC=0.43, T=8.81, P<0.001). From 1999 to 2015, the mortality of colorectal cancer showed a downward trend (all P<0.05) in the age groups of <35 and 35-44 years, while an upward trend (all P<0.05) in the age groups of 45-54 years, 55-64 years and ≥ 65 years. Colorectal cancer mortality in males increased with a standardized rate of 5.53/100 000 in 1999 to 7.33/100 000 in 2015(APC=2.29%, Z=7.86, P<0.001), while colorectal cancer mortality in females flatted with a standardized rate of 4.83/100 000 in 1999 to 4.89/100 000 in 2015 (APC=0.10%, Z=-0.30, P=0.752). Colorectal cancer mortality increased with a standardized rate of 6.75/100 000 in 1999 to 7.33/100 000 in 2015 (APC=0.54%, Z=1.98, P=0.048) in urban areas and of 3.18/100 000 in 1999 to 4.38/100 000 in 2015 (APC=2.47, Z=6.46, P<0.001) in rural areas, whose differences were significant. Standardized mortality rate in rural area was lower but the rising velocity was faster as compared to urban area. Conclusions: Crude mortality and standardized mortality of colorectal cancer increase from 1999 to 2015 in Tianjin population. The people of elder, male and urban area have higher mortality. The mortality in people of male and rural area presents a faster rising state. Further efforts to reduce colorectal cancer mortality in Tianjin are needed to prevention and control of colorectal cancer.

Longitudinal Analysis of Particulate Air Pollutants and Adolescent Delinquent Behavior in Southern California

Animal experiments and cross-sectional human studies have linked particulate matter (PM) with increased behavioral problems. We conducted a longitudinal study to examine whether the trajectories of delinquent behavior are affected by PM_2.5 (PM with aerodynamic diameter ≤ 2.5 μm) exposures before and during adolescence. We used the parent-reported Child Behavior Checklist at age 9-18 with repeated measures every ~2-3 years (up to 4 behavioral assessments) on 682 children from the Risk Factors for Antisocial Behavior Study conducted in a multi-ethnic cohort of twins born in 1990-1995. Based on prospectively-collected residential addresses and a spatiotemporal model of ambient air concentrations in Southern California, monthly PM_2.5 estimates were aggregated to represent long-term (1-, 2-, 3-year average) exposures preceding baseline and cumulative average exposure until the last assessment. Multilevel mixed-effects models were used to examine the association between PM_2.5 exposure and individual trajectories of delinquent behavior, adjusting for within-family/within-individual correlations and potential confounders. We also examined whether psychosocial factors modified this association. The results sμggest that PM_2.5 exposure at baseline and cumulative exposure during follow-up was significantly associated (p < 0.05) with increased delinquent behavior. The estimated effect sizes (per interquartile increase of PM_2.5 by 3.12-5.18 μg/m³) were equivalent to the difference in delinquency scores between adolescents who are 3.5-4 years apart in age. The adverse effect was stronger in families with unfavorable parent-to-child relationships, increased parental stress or maternal depressive symptoms. Overall, these findings sμggest long-term PM_2.5 exposure may increase delinquent behavior of urban-dwelling adolescents, with the resulting neurotoxic effect aggravated by psychosocial adversities.

[Analysis on trend of leukemia mortality from 1999 to 2015 in Tianjin, China]

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [t=7.09, P<0.001, annual percent change (APC)=1.30%] and the standardized mortality rate decreased from 3.15/100 000 to 3.01/100 000 (t=-2.95, P=0.006, APC=-0.65%). Special attention should be focused on children, the elderly, males and rural residents.

[Prevalence of asthma in Latin America. Critical look at ISAAC and other studies]

Currently, the ISAAC (International Study of Asthma and Allergies in Childhood) project is a global approach to assess the prevalence of asthma and other allergies in different latitudes. One of the great advantages of this project is that it compares using the same methodology, the prevalence of asthma in more than 50 cities during the same period of time, nevertheless the reproducibility of these results when compared with other studies of prevalence in each region has not been evaluated. In this review we aim to compare the epidemiological data provided by the ISAAC against the data identified in some regional cohort studies and by means of a critical evaluation to highlight the main similarities and to analyze the differences between these epidemiological data.

Occupational Risk Factors for Prostate Cancer: A Meta-analysis

Prostate cancer is the second most common cancer in men worldwide. There are many occupational factors that have been suggested to cause prostate cancer. Our aim was to evaluate the evidence for causality by a literature review of occupational factors. We searched literature in Medline and SCOPUS from 1966 to June 30, 2015 to identify occupational risk factors for prostate cancer. The following risk factors were selected: farmers/agricultural workers, pesticides - whole group, and separately organophosphate and organochlorine pesticides, carbamates and triazines, cadmium, chromium, cutting fluids, acrylonitrile, rubber manufacturing, whole body vibration, shift work, flight personnel, ionizing radiation, and occupational physical activity. For each factor a literature search was performed and presented as meta-analysis of relative risk and heterogeneity (Q and I2 index). A total of 168 original studies met the inclusion criteria with 90,688 prostate cancer cases. Significantly increased risks were observed for the following occupational exposures: pesticides (metaRR = 1.15, 95% confidence interval [CI] = 1.01-1.32; I2 = 84%), and specifically group of organochlorine pesticides (meta relative risk [metaRR] = 1.08, 95% CI = 1.03-1.14; I2 = 0%), chromium (metaRR = 1.19, 95% CI = 1.07-1.34; I2 = 31%), shift work (metaRR = 1.25, 95% CI = 1.05-1.49; I2 = 78%) and pilots (metaRR = 1.41, 95% CI = 1.02-1.94; I2 = 63%) and occupational physical activity in cohort studies (metaRR = 0.87, 95% CI = 0.81-0.94; I2 = 0%). The literature review supports a causal association for a few of the previously suggested factors.

Dietary inflammatory index and risk of gynecological cancers: a systematic review and meta-analysis of observational studies

OBJECTIVE

There has been growing body of literatures showing that chronic inflammation might play an important role in cancer development. This meta-analysis aimed to assess the association between the dietary inflammation index (DII) score and gynecological cancers.

METHODS

A systematic search of PubMed, EMBASE and Web of Science up until October 20, 2018 was carried out to retrieve all related cohort and case-control studies. The summary risk assessments were pooled using random-effects models. The dose-response relationship was estimated by linear relationship model.

RESULTS

Twelve case-control studies (10,774 cases/15,958 controls) and six prospective cohort studies (330,363 participants/23,133 incident cases) were included in this meta-analysis. The pooled adjusted relative risk (RR) of gynecological cancers for the highest DII category compared to the lowest category was 1.38, (95% confidence intervals [CIs], 1.21-1.56, p<0.001]. A positive dose-response relationship was also noticed. Stratified by study design indicated that, the pooled RRs was significantly higher for case-control studies than cohort studies (p for interaction<0.001), for studies conducted among participants with body mass index (BMI) ≥25 kg/m² than participants with BMI <25 kg/m² (p for interaction=0.026), among participants with ovarian cancer and endometrial cancer than participants with breast cancer (p for interaction = 0.038). Meta-regression analysis further confirmed that study design significantly contributed to inter-study heterogeneity (p<0.001).

CONCLUSION

This meta-analysis suggests that elevated DII is independently associated with a higher risk of gynecological cancers, especially patients with ovarian cancer and endometrial cancer and among obese participants.

Epidemiologic study of type 2 diabetes mellitus and metabolic syndrome in rural population of kurdistan province, Iran, in 2011-2017

BACKGROUND

Metabolic syndrome is a serious health problem and is associated with an increased risk of type 2 diabetes and cardiovascular disease. The aim of this study was to determine the status of these two diseases in the rural population of Kurdistan province, west of Iran.

METHODS

In this cross sectional study, 10,496 villagers of Kurdistan province during the period from March 2011 to February 2017 were selected through randomized systematic sampling. Required information was collected using pre-made check list and the examinations were performed. The data were analyzed with SPSS v22 software using chi-square test.

RESULTS

In the present study, the mean age of the population was 46.0 ± 14.13 y/o and 49.2% people were male and 50.8% were female. The prevalence of metabolic syndrome was 22.1% and for type 2 diabetes the prevalence was 19.6%. Hypertension was significantly higher in women (p < 0.001). There was a significant difference between the two sexes in terms of waist circumference, type 2 diabetes and metabolic syndrome. There was a significant difference between age groups with hypertension, waist circumference, type 2 diabetes and metabolic syndrome (p < 0.001) and a significant relationship between educational status with hypertention, waist circumference, type 2 diabetes and metabolic syndrome (p < 0.001). The results also showed that the relationships between age group and gender with BMI was significant (P < 0.001).

CONCLUSION

The prevalence of diabetes in the rural population of Kordestan province is moderate but it has a high prevalence in metabolic syndrome. Educational and healthcare interventions seem to be necessary to reduce these prevalences, especially among women and in older ages.

The prevalence of allergic diseases in school children of metropolitan city in Indonesia shows a similar pattern to that of developed countries

Background

The prevalence of allergy among Surabaya school children is currently unknown.

Objective

To identify the prevalence of the common allergic sensitization and allergic diseases among school children and undergraduate students in suburban of Surabaya by epidemiologic data collection.

Methods

A multistage simple random sampling was done to select 5 primary schools, 8 secondary schools (4 of junior high schools and senior high schools, respectively), and 1 university from 5 districts in Surabaya city. Out of 550 invited respondents, 499 (128 primary school, 221 secondary school, and 150 undergraduate) respondents gave their consent. A complete personal history, allergic symptoms, environmental exposure of common allergens was obtained from interview and the physical examinations were performed. Skin prick test (SPT) was done using 45 different allergen extracts. Total serum IgE and specific IgE radioallergosorbent test levels were measured for respondents with allergic manifestations.

Results

There was an increasing SPT positivity among study respondents, from primary school, secondary school, to undergraduate students (21.90%, 28.95%, to 45.30% respectively). Cockroach (42.85%) and fungi/mold spore (42.85%) were the most common allergens in primary school children. House dust mites was the most common allergen in secondary school (63.16%) and undergraduate students (58.82%). Urticaria and rhinitis were the commonest allergic diseases manifestation. History of atopy was positive in 60.79% of the allergic respondents.

Conclusion

The prevalence of allergic sensitization among school children and undergraduate students in Surabaya suburb areas were increased compared to previous estimates in 1998. While house dust mites are known as important allergens, surprisingly cockroach was the common allergen among the younger school children.

[Analysis of common pathogens and epidemiological characteristics of acute bacterial meningitis cases in Shandong Province]

Objective: To analyze epidemiological characteristics of acute bacterial meningitis (ABM) cases and the common pathogens infected in Jinan, Shandong Province. Methods: Epidemiological and clinical informations and cerebrospinal fluid (CSF) and blood specimens of acute meningitis/encephalitis syndrome (AMES) cases (total 3 918 cases) were collected in the six sentinel hospitals from 2013 to 2016. neisseria meningitidis (Nm), streptococcus pneumoniae (Sp) and haemophilus influenza (Hi) were detected by the methods of real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), bacterial culture and latex agglutination. χ(2) test was used to compare ABM cases with different feasures, and compare the difference of Nm, Sp and Hi cases in clinical and epidemiological characteristics. Results: A total of 479 cases were diagnosed as ABM from 2013 to 2016, 82 cases of which were laboratory confirmed, including 54 cases infected with Nm, 25 cases infected with Sp, and 3 cases infected with Hi. The disease course in different age groups of ABM cases has statistically difference (χ(2)=40.95, P<0.001). The disease course of under 6 (63.6%, 161/253) and 7 to 17 (55.9%, 33/59) years old ABM cases mainly required 14-28 days, and over 18 years old cases mainly required less than 14 days (59.9%, 100/167). For Nm cases, there was a main onset period from October to March (75.9%, 41/54); on the disease course, under 6 (81.0%, 17/21) and 7 to 17 (16/18) years old cases mainly required less than 14 days, while over 18 years old cases mainly required 14-28 days (8/15), and there was a statistically difference in different age groups (χ(2)=8.44, P=0.015). For Sp cases, the major onset period was from December to May (84.0%, 21/25); on the disease course, all of under 6 and 7 to 17 years old cases were required 14-28 days, while over 18 years old cases mainly required less than 14 days (9/17), and there was a statistically difference in different age groups (χ(2)=6.62, P=0.037). 91.0% of the ABM cases (436/479) were healed or improvement, with the relatively higher ratio in under 6 (94.9%, 240/253) and 7 to 17 (98.3%, 58/59) years old groups, and poorer ratio in over 18 years old group (82.6%, 138/167), and the difference was significant in different age groups (χ(2)=22.77, P<0.001). For Nm, Sp and Hi cases, the ratio of cases that were healed or improvement were 87.0% (47/54), 92.0% (23/25) and 3/3, respectively, and there were no death cases. Conclusion: ABM cases were found mostly in under 18 years old group in Jinan, Shandong Province, and the bigger age group had poor prognosis. Nm was the major pathogen causing ABM, followed by Sp and Hi. Distinguished differences of epidemiological characteristics were found on ABM cases suffered with different pathogens infected.

Community-Based Study Recruitment of American Indian Cigarette Smokers and Electronic Cigarette Users

Data on the effectiveness of strategies for the recruitment of American Indians (AIs) into research is needed. This study describes and compares methods for identifying and recruiting AI tobacco users into a pilot study. Community-based strategies were used to recruit smokers (n = 35), e-cigarette users (n = 28), and dual users (n = 32) of AI descent. Recruitment was considered proactive if study staff contacted the individual at a pow wow, health fair, or vape shop and participation on-site or reactive if the individual contacted the study staff and participation occurred later. Screened, eligible, participated and costs and time spent were compared with Chi square tests. To understand AI descent, the relationship between number of AI grandparents and AI blood quantum was examined. Number of participants screened via the proactive strategy was similar to the reactive strategy (n = 84 vs. n = 82; p-value = 0.8766). A significantly greater proportion of individuals screened via the proactive than the reactive strategy were eligible (77 vs. 50%; p-value = 0.0002) and participated (75 vs. 39%; p-value = < 0.0001). Per participant cost and time estimated for the proactive strategy was $89 and 87 min compared to $79 and 56 min for the reactive strategy. Proportion at least half AI blood quantum was 32, 33, and 70% among those with 2, 3, and 4 AI grandparents, respectively (p = 0.0017). Proactive strategies resulted in two-thirds of the sample, but required more resources than reactive strategies. Overall, we found both strategies were feasible and resulted in the ability to reach sample goals. Lastly, number of AI biological grandparents may be a good, non-invasive indicator of AI blood quantum.

[Multicenter epidemiological investigation of hospitalized elderly, young and middle-aged patients with severe burn]

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ(2)=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ(2)=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ(2)=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ(2)=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ(2)=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ(2)=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ(2)=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ(2)=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ(2)=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ(2)=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ(2) values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ(2)=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ(2)=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ(2)=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ(2)=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ(2)=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ(2)=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ(2)=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ(2)=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ(2)=4.178, P=0.243). Conclusions: There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.