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Liddle L, Monaghan C, Burleigh MC, Baczynska KA, Muggeridge DJ, Easton C. Reduced nitric oxide synthesis in winter: A potential contributing factor to increased cardiovascular risk. Nitric Oxide 2022; 127:1-9. [PMID: 35792235 DOI: 10.1016/j.niox.2022.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Nitric oxide is a key signalling molecule that elicits a range of biological functions to maintain vascular homeostasis. A reduced availability of nitric oxide is implicated in the progression of cardiovascular diseases and increases the risk of pathogenic events. AIMS To compare the concentration of nitric oxide metabolites in healthy adults between winter and summer months. DESIGN An observational study of healthy adults (age 32 ± 9 years) living in central Scotland. METHODS Thirty-four healthy adults (13 females) were monitored for 7 days in summer and winter to record sunlight exposure (ultraviolet-A (UV-A) radiation), diet, and physical activity. At the end of each phase, blood pressure was measured, and samples of blood and saliva collected. The samples were analysed to determine the concentrations of plasma and salivary nitrate and nitrite and serum 25-hydroxyvitamin D (25(OH)D). RESULTS The participants maintained similar diets in each measurement phase but were exposed to more UV-A radiation (550%) and undertook more moderate-vigorous physical activity (23%) in the summer than in winter. Plasma nitrite (46%) and serum 25(OH)D (59%) were higher and blood pressure was lower in the summer compared to winter months. Plasma nitrite concentration was negatively associated with systolic, diastolic, and mean arterial blood pressure. CONCLUSIONS Plasma nitrite, an established marker of nitric oxide synthesis, is higher in healthy adults during the summer than in winter. This may be mediated by a greater exposure to UV-A which stimulates the release of nitric oxide metabolites from skin stores. While it is possible that seasonal variation in nitric oxide availability may contribute to an increased blood pressure in the winter months, the overall impact on cardiovascular health remains to be determined.
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Affiliation(s)
- Luke Liddle
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK; School of Sport and Health Sciences, St. Luke's Campus, University of Exeter, Exeter, UK
| | - Christopher Monaghan
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK
| | - Mia C Burleigh
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK
| | - Katarzyna A Baczynska
- Laser and Optical Radiation Dosimetry Group, Centre for Radiation, Chemical and Environmental Hazards, UK Health Security Agency, Chilton, UK
| | | | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK.
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2
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Lange SA, Feld J, Kühnemund L, Köppe J, Makowski L, Engelbertz CM, Gerß J, Dröge P, Ruhnke T, Günster C, Freisinger E, Reinecke H. Acute and Long-Term Outcomes of ST-Elevation Myocardial Infarction in Cancer Patients, a 'Real World' Analysis with 175,000 Patients. Cancers (Basel) 2021; 13:cancers13246203. [PMID: 34944823 PMCID: PMC8699199 DOI: 10.3390/cancers13246203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) and cancer are common and serious diseases. As the prognosis and treatment of both diseases has improved, more cancer patients will suffer an AMI. Unfortunately, data on these "double hit" patients is scarce. METHODS From the largest public German health insurance, anonymized data of all patients with pre-existing cancer who were hospitalized due to ST-elevation MI (STEMI) between 2010 and 2017 were analyzed and followed-up until 2018. RESULTS Of 175,262 STEMI patients, 27,213 had pre-existing cancer (15.5%). Most frequent were skin (24.9%), prostate (17.0%), colon (11.0%), breast (10.9%), urinary tract (10.6%), and lung cancer (5.2%). STEMI patients with malignancies were older and presented more often with coronary three-vessel disease, atrial arrhythmias, chronic kidney disease, chronic heart failure, cerebrovascular and peripheral artery disease (PAD, each p < 0.001). They showed more often previous AMI, percutaneous coronary interventions (PCI), cardiac surgery, and stroke (all p < 0.001). Acute PCIs were applied between 2 and 6% less frequently compared to those without cancer. In-hospital adverse events occurred more frequently in cancer. Eight-year survival was 57.3% (95% CI 57.0-57.7%) without cancer and ranged between 41.2% and 19.2% in distinct cancer types. Multivariable Cox regression for all-cause mortality found, e.g., lung cancer (HR 2.04), PAD stage 4-6 (HR 1.78), metastasis (HR 1.72), and previous stroke (HR 1.44) to have the strongest impact (all p < 0.001). CONCLUSION In this large "real world" data, prognosis after STEMI in cancer patients was markedly reduced but differed widely between cancer types. Of note, no withholding of interventional treatments in cancer patients could be observed.
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Affiliation(s)
- Stefan A. Lange
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
- Correspondence: ; Tel.: +49-2551-8343203; Fax: +49-2551-8353204
| | - Jannik Feld
- Institute of Biostatistics and Clinical Research, University of Muenster, D-48149 Muenster, Germany; (J.F.); (J.K.); (J.G.)
| | - Leonie Kühnemund
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
| | - Jeanette Köppe
- Institute of Biostatistics and Clinical Research, University of Muenster, D-48149 Muenster, Germany; (J.F.); (J.K.); (J.G.)
| | - Lena Makowski
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
| | - Christiane M. Engelbertz
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
| | - Joachim Gerß
- Institute of Biostatistics and Clinical Research, University of Muenster, D-48149 Muenster, Germany; (J.F.); (J.K.); (J.G.)
| | - Patrik Dröge
- AOK Research Institute (WIdO), D-10178 Berlin, Germany; (P.D.); (T.R.); (C.G.)
| | - Thomas Ruhnke
- AOK Research Institute (WIdO), D-10178 Berlin, Germany; (P.D.); (T.R.); (C.G.)
| | - Christian Günster
- AOK Research Institute (WIdO), D-10178 Berlin, Germany; (P.D.); (T.R.); (C.G.)
| | - Eva Freisinger
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
| | - Holger Reinecke
- Cardiol, Department of Cardiology I-Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, D-48149 Muenster, Germany; (L.K.); (L.M.); (C.M.E.); (E.F.); (H.R.)
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Halling-Overgaard AS, Thyssen JP. Modifiable risk factors in paediatric atopic dermatitis: is the sun finally shining? Br J Dermatol 2019; 182:263-264. [PMID: 31788788 DOI: 10.1111/bjd.18690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A-S Halling-Overgaard
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
| | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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Mackay DF, Clemens TL, Hastie CE, Cherrie MP, Dibben C, Pell JP. UVA and Seasonal Patterning of 56 370 Myocardial Infarctions Across Scotland, 2000-2011. J Am Heart Assoc 2019; 8:e012551. [PMID: 31747863 PMCID: PMC6912961 DOI: 10.1161/jaha.119.012551] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Abstract
Background Myocardial infarction exhibits seasonal patterning, with higher amplitude at increased latitude. Epidemiological evidence suggests that sunlight is protective against cardiovascular disease, independent of ambient temperature, but ultraviolet B-mediated vitamin D production has been discounted as causal. We aimed to determine whether ultraviolet A is associated with the seasonal patterning of myocardial infarction. Methods and Results Routine hospitalization data were used to determine monthly incidence of myocardial infarction in Scotland between 2000 and 2011. Small-area-level aggregated data were obtained on ambient temperature from the Meteorological Office and ultraviolet A and ultraviolet B irradiance from NASA satellites. Autoregressive distributed lag models were run for ultraviolet A and myocardial infarction, including adjustment for ambient temperature and ultraviolet B. Monthly incidence of myocardial infarction displayed winter peaks and summer troughs superimposed on the underlying trend, with a mean amplitude of 0.31 (95% CI: 0.21, 0.41) myocardial infarctions per 100 000 population per month. Ultraviolet A exposure was inversely associated with myocardial infarction independent of ambient temperature (coefficient, -0.05; 95% CI, -0.09, -0.01; P=0.015) and ultraviolet B UVB (coefficient, -0.05; 95% CI, -0.09, -0.02; P=0.004). Conclusions Further research is required to explore whether an ultraviolet-mediated mechanism different to vitamin D, such as nitric oxide-mediated vasodilatation, may play a causal role in the seasonal and geographical patterning of myocardial infarction.
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Affiliation(s)
- Daniel F. Mackay
- Institute of Health and WellbeingUniversity of GlasgowUnited Kingdom
| | - Tom L. Clemens
- Centre for Research on Environment, Society and HealthSchool of GeosciencesUniversity of EdinburghUnited Kingdom
| | - Claire E. Hastie
- Institute of Health and WellbeingUniversity of GlasgowUnited Kingdom
| | - Mark P.C. Cherrie
- Centre for Research on Environment, Society and HealthSchool of GeosciencesUniversity of EdinburghUnited Kingdom
| | - Chris Dibben
- Institute of GeographyDrummond StreetUniversity of EdinburghUnited Kingdom
| | - Jill P. Pell
- Institute of Health and WellbeingUniversity of GlasgowUnited Kingdom
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5
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Fecker J, Schumacher M, Ohneberg K, Wolkewitz M. Correction of Survival Bias in a Study About Increased Mortality of Heads of Government. AM STAT 2019. [DOI: 10.1080/00031305.2019.1638831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Julian Fecker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Martin Schumacher
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Kristin Ohneberg
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
| | - Martin Wolkewitz
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center—University of Freiburg, Freiburg, Germany
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Scragg R, Rahman J, Thornley S. Association of sun and UV exposure with blood pressure and cardiovascular disease: A systematic review. J Steroid Biochem Mol Biol 2019; 187:68-75. [PMID: 30412763 DOI: 10.1016/j.jsbmb.2018.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/05/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ecological studies show that sun or ultraviolet (UV) exposure have inverse associations with blood pressure (BP) and cardiovascular disease (CVD). Although sunlight is the primary source of vitamin D, recent meta-analyses of clinical trials have not reported a beneficial effect from vitamin D supplementation on BP or CVD. Sunlight may have beneficial effects independent of vitamin D. We carried out a systematic review to appraise the extent and quality of the evidence from human studies. METHODS Observational and interventional studies that measured sun or UV exposure, along with BP or CVD, were selected after searching databases. RESULTS Identified studies could not be combined quantitatively in meta-analysis because of different exposure measures. Solar exposure was inversely associated with BP in 3 out of 4 cross-sectional publications, and with CVD and/or total mortality in 5 out of 6 publications of cohort studies. Two of the cohort studies reported inverse associations between sun exposure and CVD, after adjusting for serum 25-hydroxyvitamin D. Five clinical trials with an appropriate control group were identified, the outcome being BP. Two trials compared UVB with UVA (as control), with only one finding a significant reduction in BP (after 6 weeks). Three trials compared short-term UVA exposure (<30 min) with placebo (or crossover control), of which two reported short-term lowering of BP. CONCLUSION This review has identified a small body of evidence that suggests sun exposure protects against high BP and CVD, but further research is required to determine if this is independent of vitamin D.
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Affiliation(s)
- Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand.
| | - Juma Rahman
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Simon Thornley
- School of Population Health, University of Auckland, Auckland, New Zealand
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Weller RB. The health benefits of UV radiation exposure through vitamin D production or non-vitamin D pathways. Blood pressure and cardiovascular disease. Photochem Photobiol Sci 2018; 16:374-380. [PMID: 28009890 DOI: 10.1039/c6pp00336b] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The detrimental effects of ultraviolet radiation are well known. Skin cancer, photo-aging, and induction or exacerbation of photosensitive dermatoses have been the focus of most photobiological research since 1928 when Findlay confirmed the carcinogenicity of ultraviolet radiation using a murine model of skin cancer. The epidemiological, mechanistic and clinical trial data have enabled the classification by the International Agency for Research on Cancer of ultraviolet radiation as a Group 1 ('sufficient evidence') carcinogen for human skin. Public health advice in most developed countries with a pale-skinned population following this has advocated limiting exposure to sunlight through use of clothing, sunblock and behavioural alterations. Despite this plethora of data, one striking omission is evidence that ultraviolet radiation shortens life, and as I will lay out in this chapter, epidemiological and now mechanistic data suggest that UV may have significant benefits on health and in particular cardiovascular health.
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Affiliation(s)
- Richard B Weller
- MRC Centre for Inflammation Research, University of Edinburgh, UK.
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8
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Song F, Chen ST, Li X, Han J. Personal history of keratinocyte carcinoma is associated with reduced risk of death from invasive melanoma in men. J Am Acad Dermatol 2018; 78:957-963. [PMID: 29317282 DOI: 10.1016/j.jaad.2017.12.075] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/19/2017] [Accepted: 12/25/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Previous studies have found an increased risk for invasive cutaneous melanoma (CM) among those with a history of keratinocyte carcinoma (KC). OBJECTIVE The aim of this study was to evaluate the risk of CM death after KC. METHODS The study was based on the Health Professionals Follow-up Study. A Cox proportional hazards model was used to examine the hazard ratio (HR) of death due to CM associated with personal history of KC among the entire study population (primary analysis) and among participants with invasive CM (secondary analysis), respectively. RESULTS We documented a total of 908 participants with invasive CM over a total of 0.7 million person-years of follow-up. Among all participants, the risk for development of either lethal or nonlethal invasive CM increased for those with a history of KC. The risk for death due to melanoma based on KC history was not significantly increased, with an HR of 1.53 (95% confidence interval, 0.95-2.46). In the case-only analysis, those with a history of KC had a significantly lower risk for death due to melanoma than those with no such history (HR, 0.60; 95% confidence interval, 0.35-0.94). LIMITATIONS Because the population covered by the Health Professionals Follow-up Study consists exclusively of male health professionals, the results of this study may not be extended to the entire population. CONCLUSION Personal history of KC is associated with a decreased risk for melanoma-specific death among male patients with invasive CM.
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Affiliation(s)
- Fengju Song
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
| | - Steven T Chen
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xin Li
- Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana
| | - Jiali Han
- Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China; Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana.
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9
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Wehner MR, Cidre Serrano W, Nosrati A, Schoen PM, Chren MM, Boscardin J, Linos E. All-cause mortality in patients with basal and squamous cell carcinoma: A systematic review and meta-analysis. J Am Acad Dermatol 2018; 78:663-672.e3. [PMID: 29146125 PMCID: PMC5886016 DOI: 10.1016/j.jaad.2017.11.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 08/29/2017] [Accepted: 11/07/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND There are varying reports of the association of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) with mortality. OBJECTIVE To synthesize the available information on all-cause mortality after a diagnosis of BCC or SCC in the general population. METHODS We searched PubMed (1966-present), Web of Science (1898-present), and Embase (1947-present) and hand-searched to identify additional records. All English articles that reported all-cause mortality in patients with BCC or SCC were eligible. We excluded case reports, case series, and studies in subpopulations of patients. Random effects model meta-analyses were performed separately for BCC and SCC. RESULTS The searches yielded 6538 articles, and 156 were assessed in a full-text review. Twelve studies met the inclusion criteria, and 4 were included in the meta-analysis (encompassing 464,230 patients with BCC and with 175,849 SCC), yielding summary relative mortalities of 0.92 (95% confidence interval, 0.83-1.02) in BCC and 1.25 (95% confidence interval, 1.17-1.32) in SCC. LIMITATIONS Only a minority of studies controlled for comorbidities. There was significant heterogeneity in meta-analysis (χ2P < .001, I2 > 98%), but studies of SCC were qualitatively concordant: all showed statistically significant increased relative mortality. CONCLUSIONS We found that patients with SCC are at higher risk for death from any cause compared with the general population.
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Affiliation(s)
- Mackenzie R Wehner
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Wilmarie Cidre Serrano
- Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Stanford University, Stanford, California
| | - Adi Nosrati
- Dermatology Service, Veterans Affairs Medical Center, San Francisco, California; Department of Dermatology, University of California, San Francisco, California
| | | | - Mary-Margaret Chren
- Dermatology Service, Veterans Affairs Medical Center, San Francisco, California; Department of Dermatology, University of California, San Francisco, California
| | - John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
| | - Eleni Linos
- Department of Dermatology, University of California, San Francisco, California.
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The effects of two different doses of ultraviolet-A light exposure on nitric oxide metabolites and cardiorespiratory outcomes. Eur J Appl Physiol 2018. [PMID: 29516257 PMCID: PMC5959980 DOI: 10.1007/s00421-018-3835-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Purpose The present study investigated different doses of ultraviolet-A (UV-A) light on plasma nitric oxide metabolites and cardiorespiratory variables. Methods Ten healthy male participants completed three experimental conditions, 7 days apart. Participants were exposed to no light (CON); 10 J cm2 (15 min) of UV-A light (UVA10) and 20 J cm2 (30 min) of UV-A light (UVA20) in a randomized order. Plasma nitrite [NO2−] and nitrate [NO3−] concentrations, blood pressure (BP), and heart rate (HR) were recorded before, immediately after exposure and 30 min post-exposure. Whole body oxygen utilization (\documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}}{\rm O}_{2}$$\end{document}V˙O2), resting metabolic rate (RMR) and skin temperature were recorded continuously. Results None of the measured parameters changed significantly during CON (all P > 0.05). \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}}{\rm O}_{2}$$\end{document}V˙O2 and RMR were significantly reduced immediately after UVA10 (P < 0.05) despite no change in plasma [NO2−] (P > 0.05). Immediately after exposure to UVA20, plasma [NO2−] was higher (P = 0.014) and \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}}{\rm O}_{2}$$\end{document}V˙O2 and RMR tended to be lower compared to baseline (P = 0.06). There were no differences in [NO2−] or \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}}{\rm O}_{2}$$\end{document}V˙O2 at the 30 min time point in any condition. UV-A exposure did not alter systolic BP, diastolic BP or MAP (all P > 0.05). UV-A light did not alter plasma [NO3−] at any time point (all P > 0.05). Conclusions This study demonstrates that a UV-A dose of 20 J cm2 is necessary to increase plasma [NO2−] although a smaller dose is capable of reducing \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}}{\rm O}_{2}$$\end{document}V˙O2 and RMR at rest. Exposure to UV-A did not significantly reduce BP in this cohort of healthy adults. These data suggest that exposure to sunlight has a meaningful acute impact on metabolic function.
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Botyar M, Khoramroudi R. Ultraviolet radiation and its effects on pregnancy: A review study. J Family Med Prim Care 2018; 7:511-514. [PMID: 30112299 PMCID: PMC6069651 DOI: 10.4103/jfmpc.jfmpc_311_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Seasons and Vitamin D are factors that are directly and indirectly related to ultraviolet (UV) radiations and can affect pregnancy. Therefore, the present study aims at investigating the effects of being exposed to direct UV radiation during pregnancy period and its effects on fetal growth, premature birth, and high blood pressure. This study was conducted by searching different websites such as Medline, Embase, ProQuest, Global Health, Google Scholar, and Scopus. Of the 430 papers found, between 1985 and 2017, seventeen related articles were used. The results showed that being exposed to UV radiation during the first 3 months of pregnancy is associated with improved fetal growth and causes high blood pressure during pregnancy. The literature shows that being women exposure to UV radiation had beneficial effects on fetal growth and blood pressure during pregnancy period. However, since this issue has not been extensively studied in the past, the results from previous studies should be generalized with extreme care and caution. Therefore, it is suggested that further studies be carried out in this area.
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Holliman G, Lowe D, Cohen H, Felton S, Raj K. Ultraviolet Radiation-Induced Production of Nitric Oxide:A multi-cell and multi-donor analysis. Sci Rep 2017; 7:11105. [PMID: 28894213 PMCID: PMC5593895 DOI: 10.1038/s41598-017-11567-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/15/2017] [Indexed: 12/31/2022] Open
Abstract
Increasing evidence regarding positive effects of exposure to sunlight has led to suggestions that current advice may be overly weighted in favour of avoidance. UV-A has been reported to lower blood pressure, possibly through nitric oxide (NO) production in skin. Here, we set out to investigate effects of UV-A and solar-simulated radiation on the potential source of dermal NO, the effective doses and wavelengths, the responsiveness of different human skin cells, the magnitude of inter-individual differences and the potential influence of age. We utilised isogenic keratinocytes, microvascular endothelial cells, melanocytes and fibroblasts isolated from 36 human skins ranging from neonates to 86 years old. We show that keratinocytes and microvascular endothelial cells show greatest NO release following biologically relevant doses of UV-A. This was consistent across multiple neonatal donors and the effect is maintained in adult keratinocytes. Our observations are consistent with a bi-phasic mechanism by which UV-A can trigger vasodilatory effects. Analyses of NO-production spectra adds further evidence that nitrites in skin cells are the source of UV-mediated NO release. These potentially positive effects of ultraviolet radiation lend support for objective assessment of environmental influence on human health and the idea of “healthy sun exposure”.
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Affiliation(s)
- Graham Holliman
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards,Public Health England (PHE), Chilton, Oxfordshire, OX11 0RQ, United Kingdom.
| | - Donna Lowe
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards,Public Health England (PHE), Chilton, Oxfordshire, OX11 0RQ, United Kingdom
| | - Howard Cohen
- Elizabeth House, 515 Limpsfield Road, Warlingham, Surrey, CR6 9LF, United Kingdom
| | - Sarah Felton
- Oxford University Hospitals NHS Foundation Trust, Old Road, Oxford, OX3 7LJ, United Kingdom
| | - Ken Raj
- Radiation Effects Department, Centre for Radiation, Chemical and Environmental Hazards,Public Health England (PHE), Chilton, Oxfordshire, OX11 0RQ, United Kingdom
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Megaw L, Clemens T, Dibben C, Weller R, Stock S. Pregnancy outcome and ultraviolet radiation; A systematic review. ENVIRONMENTAL RESEARCH 2017; 155:335-343. [PMID: 28264782 DOI: 10.1016/j.envres.2017.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/11/2017] [Accepted: 02/21/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. OBJECTIVES To investigate the effects of UV exposure on pregnancy; specifically fetal growth, preterm birth and hypertensive complications. METHODS We conducted a systematic review of Medline, EMBASE, DoPHER, Global Health, ProQuest Public Health, AustHealth Informit, SCOPUS and Google Scholar to identify 537 citations, 8 of which are included in this review. This review was registered on PROSPERO and a. narrative synthesis is presented following PRISMA guidance. RESULTS All studies were observational and assessed at high risk of bias. Higher first trimester UV was associated with and improved fetal growth and increased hypertension in pregnancy. Interpretation is limited by study design and quality. Meta-analysis was precluded by the variety of outcomes and methods. DISCUSSION The low number of studies and risk of bias limit the validity of any conclusions. Environmental health methodological issues are discussed with consideration given to design and analytical improvements to further address this reproductive environmental health question. CONCLUSIONS The evidence for UV having benefits for pregnancy hypertension and fetal growth is limited by the methodological approaches utilized. Future epidemiological efforts should focus on improving the methods of modeling and linking widely available environmental data to reproductive health outcomes.
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Affiliation(s)
- Lauren Megaw
- School of Women's and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia, Australia; Edinburgh Tommy's Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
| | - Tom Clemens
- School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian, United Kingdom.
| | - Chris Dibben
- School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian, United Kingdom.
| | - Richard Weller
- MRC Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
| | - Sarah Stock
- School of Women's and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia, Australia; Edinburgh Tommy's Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, United Kingdom.
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14
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Perroud HA, Dagatti MS, Amigot B, Levit GP, Tomat MF, Morosano ME, Masoni AM, Pezzotto SM. The association between osteoporotic hip fractures and actinic lesions as a biomarker for cumulative sun exposure in older people-a retrospective case-control study in Argentina. J Bone Miner Metab 2017; 35:324-329. [PMID: 27038989 DOI: 10.1007/s00774-016-0759-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/16/2016] [Indexed: 01/01/2023]
Abstract
The aim of this study was to analyze the association between the presence of actinic lesions (solar keratosis and non-melanoma skin cancer) and osteoporotic hip fractures in older patients. Both pathologies are common conditions in this age group. Since cumulative sun exposure is difficult to quantify, the presence of actinic lesions can be used to indirectly analyze the association between ultraviolet radiation and osteoporotic hip fractures. This was an observational case-control study. We reviewed the centralized medical records of patients with hip fracture (cases, n = 51) and patients with other diseases hospitalized in the same institution and period (controls, n = 59). The mean age of the patients was 80 ± 8.3 years (range 50-103 years). Differences in maternal hip fracture history were found between cases and controls (14.8 and 8 %, respectively; p = 0.047). Falls history in the past year was higher in cases than in controls (p < 0.0001). Actinic lesions were observed in 32.7 % of patients (prevalence rate 23.5 % in cases, 40.7 % in controls; p = 0.04). When considering patients with actinic lesions, controls have a higher FRAX score compared with cases. Although sun exposure is recommended for bone health, it represents a risk factor for actinic lesions. The presence of actinic lesions may indicate a lower osteoporotic hip fracture risk. A balance between adequate lifetime sun exposure and protection against its adverse effects is required for each patient, in the context of geographic location.
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Affiliation(s)
- H A Perroud
- Area Instrumental Metodología de la Investigación Científica, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Rosario (UNR), Santa Fe 3100, 2000, Rosario, Argentina
- Instituto de Genética Experimental FCM, UNR, Rosario, Argentina
| | - M S Dagatti
- Area Instrumental Metodología de la Investigación Científica, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Rosario (UNR), Santa Fe 3100, 2000, Rosario, Argentina
- Cátedra de Dermatología, FCM, UNR, Rosario, Argentina
| | - B Amigot
- Policlínico PAMI II, Rosario, Argentina
| | - G P Levit
- Policlínico PAMI II, Rosario, Argentina
- Cátedra de Clínica Médica, FCM, UNR, Rosario, Argentina
| | - M F Tomat
- Cátedra de Química Biológica, FCM, UNR, Rosario, Argentina
| | - M E Morosano
- Cátedra de Química Biológica, FCM, UNR, Rosario, Argentina
| | - A M Masoni
- Area Instrumental Metodología de la Investigación Científica, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Rosario (UNR), Santa Fe 3100, 2000, Rosario, Argentina
- Cátedra de Química Biológica, FCM, UNR, Rosario, Argentina
| | - S M Pezzotto
- Area Instrumental Metodología de la Investigación Científica, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Rosario (UNR), Santa Fe 3100, 2000, Rosario, Argentina.
- Consejo de Investigaciones, UNR, Rosario, Argentina.
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15
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Wainwright L, Parisi A, Downs N. Concurrent evaluation of personal damaging and beneficial UV exposures over an extended period. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 170:188-196. [DOI: 10.1016/j.jphotobiol.2017.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 04/10/2017] [Accepted: 04/12/2017] [Indexed: 12/27/2022]
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16
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Barton V, Armeson K, Hampras S, Ferris LK, Visvanathan K, Rollison D, Alberg AJ. Nonmelanoma skin cancer and risk of all-cause and cancer-related mortality: a systematic review. Arch Dermatol Res 2017; 309:243-251. [PMID: 28285366 DOI: 10.1007/s00403-017-1724-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/02/2017] [Accepted: 02/14/2017] [Indexed: 12/27/2022]
Abstract
Some reports suggest that a history of nonmelanoma skin cancer (NMSC) may be associated with increased mortality. NMSCs have very low fatality rates, but the high prevalence of NMSC elevates the importance of the possibility of associated subsequent mortality from other causes. The variable methods and findings of existing studies leave the significance of these results uncertain. To provide clarity, we conducted a systematic review to characterize the evidence on the associations of NMSC with: (1) all-cause mortality, (2) cancer-specific mortality, and (3) cancer survival. Bibliographic databases were searched through February 2016. Cohort studies published in English were included if adequate data were provided to estimate mortality ratios in patients with-versus-without NMSC. Data were abstracted from the total of eight studies from independent data sources that met inclusion criteria (n = 3 for all-cause mortality, n = 2 for cancer-specific mortality, and n = 5 for cancer survival). For all-cause mortality, a significant increased risk was observed for patients with a history of squamous cell carcinoma (SCC) (mortality ratio estimates (MR) 1.25 and 1.30), whereas no increased risk was observed for patients with a history of basal cell carcinoma (BCC) (MRs 0.96 and 0.97). Based on one study, the association with cancer-specific mortality was stronger for SCC (MR 2.17) than BCC (MR 1.15). Across multiple types of cancer both SCC and BCC tended to be associated with poorer survival from second primary malignancies. Multiple studies support an association between NMSC and fatal outcomes; the associations tend to be more potent for SCC than BCC. Additional investigation is needed to more precisely characterize these associations and elucidate potential underlying mechanisms.
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Affiliation(s)
- Virginia Barton
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
| | - Kent Armeson
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Laura K Ferris
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | - Anthony J Alberg
- Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
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17
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Apalla Z, Nashan D, Weller RB, Castellsagué X. Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches. Dermatol Ther (Heidelb) 2017; 7:5-19. [PMID: 28150105 PMCID: PMC5289116 DOI: 10.1007/s13555-016-0165-y] [Citation(s) in RCA: 231] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Indexed: 12/26/2022] Open
Abstract
Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer. Key case studies are presented that highlight the practic challenges of choosing the most appropriate treatment for patients with skin cancer. Thirdly, we consider the potential risks and benefits of increased sun exposure. However, this is discussed in terms of the possibility that the avoidance of sun exposure in order to reduce the risk of skin cancer may be less important than the reduction in all-cause mortality as a result of the potential benefits of increased exposure to the sun. Finally, we consider common questions on human papillomavirus infection.
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Affiliation(s)
- Zoe Apalla
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Dorothée Nashan
- Teaching Hospital of the University of Münster, Münster, Germany
| | | | - Xavier Castellsagué
- Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Catalonia, Spain
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18
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Abstract
PURPOSE OF REVIEW Textbook theory holds that blood pressure (BP) is regulated by the brain, by blood vessels, or by the kidney. Recent evidence suggests that BP could be regulated in the skin. RECENT FINDINGS The skin holds a complex capillary counter current system, which controls body temperature, skin perfusion, and apparently systemic BP. Epidemiological data suggest that sunlight exposure plays a role in controlling BP. Ultraviolet A radiation produces vasodilation and a fall in BP. Keratinocytes and immune cells control blood flow in the extensive countercurrent loop system of the skin by producing nitric oxide, a key regulator of vascular tone. The balance between hypoxia-inducible factor-1α and hypoxia-inducible factor-2α activity in keratinocytes controls skin perfusion, systemic thermoregulation, and systemic BP by nitric oxide-dependent mechanisms. Furthermore, the skin accumulates Na which generates a barrier to promote immunological host defense. Immune cells control skin Na metabolism and the clearance of Na via the lymphatic system. Reduced lymphatic clearance increases BP. SUMMARY Apart from the well-known role of the brain, blood vessels, and the kidney, the skin is important for systemic BP control in humans and in experimental animals.
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19
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Egeberg A, Hansen P, Gislason G, Skov L, Thyssen J. Decreased risk of hypertension in subjects with skin cancers - another salubrious effect of sunlight? J Eur Acad Dermatol Venereol 2015; 30:e176-e177. [DOI: 10.1111/jdv.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Egeberg
- Department of Cardiology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Department of Dermato-Allergology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - P.R. Hansen
- Department of Cardiology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - G.H. Gislason
- Department of Cardiology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - L. Skov
- Department of Dermato-Allergology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - J.P. Thyssen
- Department of Dermato-Allergology; Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
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20
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Wright F, Weller RB. Risks and benefits of UV radiation in older people: More of a friend than a foe? Maturitas 2015; 81:425-31. [DOI: 10.1016/j.maturitas.2015.05.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 05/11/2015] [Indexed: 12/17/2022]
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21
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Abstract
Although the standard recommendation is to exclude person-time not at risk (ie, time during which the outcome could not have occurred) from the denominators of disease rates, there are scenarios where person-time not at risk should be included. In particular, we draw an analogy between including person-time not at risk and intention-to-treat (ITT) analyses of randomized trials, and excluding person-time not at risk and compliance-corrected analysis of these same trials. Excluding person-time not at risk is appropriate when addressing questions of the biologic or mechanistic effects of an exposure, whereas the ITT-type approach typically addresses questions regarding the effect of an exposure under observed compliance patterns. The choice of approach directly affects the causal question being addressed and subsequent inference, with potential implications for public health. When interested in estimating treatment effects that allow and account for potential noncompliance, or where the exposure may be associated with the time at risk, we argue that person-time not at risk should be included. In the case of time to pregnancy, although the ITT-type analysis may underestimate the biological fecundity of the population, it may also yield an answer to a question that is of more interest to couples trying to become pregnant.
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22
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Immortal person-time bias in the association between herpes zoster and survival following autologous stem cell transplantation. Bone Marrow Transplant 2015; 50:878-9. [PMID: 25822225 DOI: 10.1038/bmt.2015.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Ferrie JE, Ebrahim S. Sun exposure and longevity: a blunder involving immortal time. Int J Epidemiol 2015; 43:639-44. [PMID: 25050434 DOI: 10.1093/ije/dyu108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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24
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Lucas RM, Norval M, Neale RE, Young AR, de Gruijl FR, Takizawa Y, van der Leun JC. The consequences for human health of stratospheric ozone depletion in association with other environmental factors. Photochem Photobiol Sci 2015; 14:53-87. [DOI: 10.1039/c4pp90033b] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Ozone depletion, climate and human health.
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Affiliation(s)
- R. M. Lucas
- National Centre for Epidemiology and Population Health
- The Australian National University
- Canberra 2601
- Australia
- Telethon Kids Institute
| | - M. Norval
- Biomedical Sciences
- University of Edinburgh Medical School
- Edinburgh EH8 9AG
- UK
| | - R. E. Neale
- QIMR Berghofer Medical Research Institute
- Brisbane 4029
- Australia
| | - A. R. Young
- King's College London (KCL)
- St John's Institute of Dermatology
- London SE1 9RT
- UK
| | - F. R. de Gruijl
- Department of Dermatology
- Leiden University Medical Centre
- NL-2300 RC Leiden
- The Netherlands
| | - Y. Takizawa
- Akita University Graduate School of Medicine
- Akita Prefecture
- Japan
- National Institute for Minamata Diseases
- Kumamoto Prefecture
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25
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Brøndum-Jacobsen P, Nordestgaard BG, Nielsen SF, Benn M. Authors' response to: skin cancer as a marker of sun exposure. Int J Epidemiol 2014; 43:1992-3. [PMID: 25335502 DOI: 10.1093/ije/dyu211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter Brøndum-Jacobsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Sune F Nielsen
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen and Department of Clinical Biochemistry, Gentofte Hospital, Denmark
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26
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27
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Brøndum-Jacobsen P, Nordestgaard BG, Nielsen SF, Benn M. Authors' Response to: Skin cancer as a marker of sun exposure--a case of serious immortality bias. Int J Epidemiol 2014; 43:972-3. [PMID: 24894097 DOI: 10.1093/ije/dyu102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Peter Brøndum-Jacobsen
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, DenmarkDepartment of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, DenmarkDepartment of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, Denmark
| | - Sune F Nielsen
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, Denmark
| | - Marianne Benn
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, DenmarkDepartment of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark and Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, Denmark
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28
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Lange T, Keiding N. Skin cancer as a marker of sun exposure: a case of serious immortality bias. Int J Epidemiol 2014; 43:971. [PMID: 24894096 DOI: 10.1093/ije/dyu100] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Theis Lange
- Department of Biostatistics, Institute of Public Health, University of Copenhagen, Denmark
| | - Niels Keiding
- Department of Biostatistics, Institute of Public Health, University of Copenhagen, Denmark
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29
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Hanley JA, Foster BJ. Avoiding blunders involving 'immortal time'. Int J Epidemiol 2014; 43:949-61. [PMID: 24760815 PMCID: PMC4052143 DOI: 10.1093/ije/dyu105] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2014] [Indexed: 11/14/2022] Open
Affiliation(s)
- James A Hanley
- Department of Epidemiology, Biostatistics, and Occupational Health and Department of Pediatrics, Montreal Children's Hospital, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Bethany J Foster
- Department of Epidemiology, Biostatistics, and Occupational Health and Department of Pediatrics, Montreal Children's Hospital, Faculty of Medicine, McGill University, Montreal, QC, CanadaDepartment of Epidemiology, Biostatistics, and Occupational Health and Department of Pediatrics, Montreal Children's Hospital, Faculty of Medicine, McGill University, Montreal, QC, Canada
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30
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Affiliation(s)
- Martin Feelisch
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Shelley Gorman
- Telethon Institute for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Richard B Weller
- University of Edinburgh, MRC Centre for Inflammation Research, Edinburgh, UK.
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31
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UVA irradiation of human skin vasodilates arterial vasculature and lowers blood pressure independently of nitric oxide synthase. J Invest Dermatol 2014; 134:1839-1846. [PMID: 24445737 DOI: 10.1038/jid.2014.27] [Citation(s) in RCA: 179] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/06/2013] [Accepted: 11/12/2013] [Indexed: 02/06/2023]
Abstract
The incidence of hypertension and cardiovascular disease (CVD) correlates with latitude and rises in winter. The molecular basis for this remains obscure. As nitric oxide (NO) metabolites are abundant in human skin, we hypothesized that exposure to UVA may mobilize NO bioactivity into the circulation to exert beneficial cardiovascular effects independently of vitamin D. In 24 healthy volunteers, irradiation of the skin with two standard erythemal doses of UVA lowered blood pressure (BP), with concomitant decreases in circulating nitrate and rises in nitrite concentrations. Unexpectedly, acute dietary intervention aimed at modulating systemic nitrate availability had no effect on UV-induced hemodynamic changes, indicating that cardiovascular effects were not mediated via direct utilization of circulating nitrate. UVA irradiation of the forearm caused increased blood flow independently of NO synthase (NOS) activity, suggesting involvement of pre-formed cutaneous NO stores. Confocal fluorescence microscopy studies of human skin pre-labeled with the NO-imaging probe diaminofluorescein 2 diacetate revealed that UVA-induced NO release occurs in a NOS-independent, dose-dependent manner, with the majority of the light-sensitive NO pool in the upper epidermis. Collectively, our data provide mechanistic insights into an important function of the skin in modulating systemic NO bioavailability, which may account for the latitudinal and seasonal variations of BP and CVD.
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