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Chang YH, Fu CH, Hsu MH, Okoli C, Guo SE. The effectiveness of a transtheoretical model-based smoking cessation intervention for rural smokers: A quasi-experimental longitudinal study. PATIENT EDUCATION AND COUNSELING 2024; 122:108136. [PMID: 38308975 DOI: 10.1016/j.pec.2024.108136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/27/2023] [Accepted: 01/03/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE Cigarette smoking is highly prevalent, despite being a primary preventable cause of disease and mortality. This study examined the effect of a Transtheoretical Model (TTM)-based psychoeducational intervention for smoking cessation (SC) on knowledge, SC-related parameters, and progression through the TTM stages of change among rural smokers. METHODS This quasi-experimental study recruited 200 smokers from an outpatient clinic. The comparison group was recruited before the experimental group to address possible self-selection bias. Structured questionnaires were administered pre- and post-intervention (three months) and at follow-up (six months). RESULTS A generalised estimation equation model indicated that the TTM-based intervention significantly increased participants' SC-knowledge and improved progression through TTM stages by the six-month follow-up. No significant group differences were found in self-efficacy and nicotine dependence scores or daily cigarette consumption. CONCLUSIONS A TTM-based intervention enhances SC-knowledge and fosters progress through change stages. However, it does not directly impact nicotine dependence or cigarette consumption. Outpatient settings may employ TTM-based programmes for SC education and motivation. Detecting anticipated effects may require a longer intervention duration exceeding six months. PRACTICE IMPLICATIONS Such TTM-based programmes may facilitate SC-knowledge and motivation in outpatient settings. Further research to comprehend patients' context and experiences during the stages of change is required.
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Affiliation(s)
- Yin-Hui Chang
- Department of Nursing, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Chiung-Hui Fu
- Department of Nursing, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Mei-Hsiu Hsu
- Department of Nursing, China Medical University Beigang Hospital, Yunlin County, Taiwan
| | - Chizimuzo Okoli
- Tobacco Treatment and Prevention Division, Tobacco Policy Research Program, University of Kentucky College of Nursing, KY, USA
| | - Su-Er Guo
- Department of Nursing and Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), Chiayi County, Taiwan; Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology (CGUST), Chiayi County, Taiwan; Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi County, Taiwan; Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan.
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2
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Huang HH, You GR, Tang SJ, Chang JT, Cheng AJ. Molecular Signature of Long Non-Coding RNA Associated with Areca Nut-Induced Head and Neck Cancer. Cells 2023; 12:cells12060873. [PMID: 36980216 PMCID: PMC10047708 DOI: 10.3390/cells12060873] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/26/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
The areca nut is a high-risk carcinogen for head and neck cancer (HNC) patients in Southeast Asia. The underlying molecular mechanism of areca nut-induced HNC remains unclear, especially regarding the role of long non-coding RNA (lncRNA). This study employed a systemic strategy to identify lncRNA signatures related to areca nut-induced HNC. In total, 84 cancer-related lncRNAs were identified. Using a PCR array method, 28 lncRNAs were identified as being dysregulated in HNC cells treated with areca nut (17 upregulated and 11 downregulated). Using bioinformatics analysis of The Cancer Genome Atlas Head-Neck Squamous Cell Carcinoma (TCGA-HNSC) dataset, 45 lncRNAs were differentially expressed in tumor tissues from HNC patients (39 over- and 6 under-expressions). The integrated evaluation showed 10 lncRNAs dysregulated by the areca nut and altered expression in patients, suggesting that these panel molecules participate in areca nut-induced HNC. Five oncogenic (LUCAT1, MIR31HG, UCA1, HIF1A-AS2, and SUMO1P3) and tumor-suppressive (LINC00312) lncRNAs were independently validated, and three key molecules were further examined. Pathway prediction revealed that LUCAT1, UCA1, and MIR31HG modulate multiple oncogenic mechanisms, including stress response and cellular motility. Clinical assessment showed that these lncRNAs exhibited biomarker potentials in diagnosis (area under the curve = 0.815 for LUCAT1) and a worse prognosis (both p < 0.05, survival analysis). Cellular studies further demonstrated that MIR31HG facilitates areca nut-induced cancer progression, as silencing this molecule attenuated arecoline-induced invasion ability in HNC cells. This study identified lncRNA signatures that play a role in areca nut-induced HNC. These molecules may be further applied in risk assessment, diagnosis, prognosis, and therapeutics for areca nut-associated malignancies.
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Affiliation(s)
- Hung-Han Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Guo-Rung You
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shang-Ju Tang
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Joseph T. Chang
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (J.T.C.); (A.-J.C.); Tel.: +886-3-328-1200 (J.T.C.); +886-3-2118-800 (A.-J.C.)
| | - Ann-Joy Cheng
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan
- Correspondence: (J.T.C.); (A.-J.C.); Tel.: +886-3-328-1200 (J.T.C.); +886-3-2118-800 (A.-J.C.)
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Real-Time Monitoring of the Cytotoxic and Antimetastatic Properties of Cannabidiol in Human Oral Squamous Cell Carcinoma Cells Using Electric Cell-Substrate Impedance Sensing. Int J Mol Sci 2022; 23:ijms232415842. [PMID: 36555480 PMCID: PMC9785110 DOI: 10.3390/ijms232415842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/19/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Cannabidiol (CBD) is an active natural compound that is extracted from Cannabis sativa. Previous studies show that CBD is a nonpsychotropic compound with significant anticancer effects. This study determines its cytotoxic effect on oral cancer cells and OEC-M1 cells and compares the outcomes with a chemotherapeutic drug, cisplatin. This study has investigated the effect of CBD on the viability, apoptosis, morphology, and migration of OEC-M1 cells. Electric cell-substrate impedance sensing (ECIS) is used to measure the change in cell impedance for cells that are treated with a series concentration of CBD for 24 h. AlamarBlue and annexin V/7-AAD staining assays show that CBD has a cytotoxic effect on cell viability and induces cell apoptosis. ECIS analysis shows that CBD decreases the overall resistance and morphological parameters at 4 kHz in a concentration-dependent manner. There is a significant reduction in the wound-healing recovery rate for cells that are treated with 30 μM CBD. This study demonstrates that ECIS can be used for in vitro screening of new chemotherapy and is more sensitive, functional, and comprehensive than traditional biochemical assays. CBD also increases cytotoxicity on cell survival and the migration of oral cancer cells, so it may be a therapeutic drug for oral cancer.
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Myers AL. Metabolism of the areca alkaloids - toxic and psychoactive constituents of the areca (betel) nut. Drug Metab Rev 2022; 54:343-360. [PMID: 35543097 DOI: 10.1080/03602532.2022.2075010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Areca nut (AN) is consumed by millions of people for its therapeutic and psychoactive effects, making it one of the most widely self-administered psychoactive substances in the world. Even so, AN use/abuse is associated with myriad oral and systemic side effects, affecting most organ systems in the body. Alkaloids abundant in the nut (e.g. arecoline, arecaidine, guvacoline, and guvacine), collectively called the areca alkaloids, are presumably responsible for the major pharmacological effects experienced by users, with arecoline being the most abundant alkaloid with notable toxicological properties. However, the mechanisms of arecoline and other areca alkaloid elimination in humans remain poorly documented. Therefore, the purpose of this review is to provide an in-depth review of areca alkaloid pharmacokinetics (PK) in biological systems, and discuss mechanisms of metabolism by presenting information found in the literature. Also, the toxicological relevance of the known and purported metabolic steps will be reviewed. In brief, several areca alkaloids contain a labile methyl ester group and are susceptible to hydrolysis, although the human esterase responsible remains presumptive. Other notable mechanisms include N-oxidation, glutathionylation, nitrosamine conversion, and carbon-carbon double-bond reduction. These metabolic conversions result in toxic and sometimes less-toxic derivatives. Arecoline and arecaidine undergo extensive metabolism while far less is known about guvacine and guvacoline. Metabolism information may help predict drug interactions with human pharmaceuticals with overlapping elimination pathways. Altogether, this review provides a first-of-its-kind comprehensive analysis of AN alkaloid metabolism, adds perspective on new mechanisms of metabolism, and highlights the need for future metabolism work in the field.
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Affiliation(s)
- Alan L Myers
- Department of Diagnostic and Biomedical Sciences, School of Dentistry, The University of Texas Health Science Center, Houston, TX, USA
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Chang HC, Chang TH, Kang HY, Chen YW, Chen SP, Wang MC, Liang J. Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116813. [PMID: 35682395 PMCID: PMC9180367 DOI: 10.3390/ijerph19116813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023]
Abstract
Largely conducted in Western developed nations, research on community health screening has mainly been of limited duration. This study aims to ascertain the predictors of retention in a community health screening program, involving multiple admission cohorts over a 9-year period in Taiwan. Retention is defined as the participation in subsequent waves of health screening after being recruited for an initial screening. Data came from a prospective cohort study, named "Landseed Integrated Outreaching Neighborhood Screening (LIONS)", in Taiwan. This research retrieved 5901 community-dwelling Taiwanese adults aged 30 and over from LIONS and examined their retention in three follow-ups during 2006-2014. Generalized estimating equations were employed to evaluate retention over time as a function of social determinants, health behaviors, and health conditions. Being middle-aged, higher education, and regular exercise were positively associated with retention. Conversely, smoking, betel-nut chewing, psychiatric disorder, hypertension, type 2 diabetes mellitus, stroke, and a longer time interval since enrollment were negatively associated with retention. Furthermore, retention rates varied substantially across admission cohorts with more recent cohorts having a lower rate of retention (aOR = 0.33-0.83). Greater attention needs to be directed to retention over time and variations across admission cohorts. Additionally, those who are in either younger or older age groups and have chronic diseases or unhealthy behaviors should be targeted with greater efforts.
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Affiliation(s)
- Huan-Cheng Chang
- Division of Family Medicine, Department of Community Medicine, Landseed International Hospital, Taoyuan 324609, Taiwan; (H.-C.C.); (H.-Y.K.); (S.-P.C.)
| | - Ting-Huan Chang
- Department of Medical Education, Research and Quality Management, Landseed International Hospital, Taoyuan 324609, Taiwan;
| | - Hsiao-Yen Kang
- Division of Family Medicine, Department of Community Medicine, Landseed International Hospital, Taoyuan 324609, Taiwan; (H.-C.C.); (H.-Y.K.); (S.-P.C.)
| | - Yu-Wei Chen
- Department of Neurology, Landseed International Hospital, Taoyuan 324609, Taiwan;
| | - Sheng-Pyng Chen
- Division of Family Medicine, Department of Community Medicine, Landseed International Hospital, Taoyuan 324609, Taiwan; (H.-C.C.); (H.-Y.K.); (S.-P.C.)
| | - Mei-Chin Wang
- Community Health Development Center, Department of Community Medicine, Landseed International Hospital, Taoyuan 324609, Taiwan;
| | - Jersey Liang
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
- Correspondence: ; Tel.: +1-734-936-1303; Fax: +1-734-764-4338
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Ning Y, Wang Q, Ding Y, Zhao W, Jia Z, Wang B. Barriers and facilitators to physical activity participation in patients with head and neck cancer: a scoping review. Support Care Cancer 2022; 30:4591-4601. [PMID: 35032199 DOI: 10.1007/s00520-022-06812-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with head and neck cancer (HNC) usually experienced disfigurement, dysfunction, and psychosocial distress, leading to a decline in their quality of life. Physical activity (PA) is recommended for such patients. Despite the proven benefits of participating in PA, the compliance of patients with HNC is still poor. Hence, the factors influencing PA participation and adherence in patients with HNC need to be explored. OBJECTIVES This study aimed to (1) identify barriers and enablers of PA in adult patients living with HNC and (2) map barriers and facilitators to the Capability-Opportunity-Motivation-Behavior (COM-B) model. ELIGIBILITY CRITERIA Types of studies: Studies with qualitative, quantitative, and mixed designs were included in this review. TYPES OF PARTICIPANTS The current review takes into account patients with HNC aged 18 years or above. Types of interventions: This review considered all studies focusing on full-body PA. TYPES OF OUTCOMES This scoping review focused on studies examining health behavior, patients' compliance, and facilitators and/or barriers to PA engagement. Five databases (Ovid Medline, Ovid Embase, CINAHL, Cochrane Library, and PsycINFO) were searched following the methodology for scoping reviews from inception to July 2021. DATA EXTRACTION The extracted data included author(s)/year of publication, country, main purpose of the study, sample size/disease site and stage, methodology and methods, type of treatment, and main findings/barriers, or facilitators. RESULTS A total of 22 studies were finally selected. The top three barriers were physical-related issues, time pressures, and low motivation or interest. Most facilitators included perceived psychological, health, and social benefits and preference for the model of PA. The most frequent COM-B model components were physical capability, automatic motivation, and physical opportunity. CONCLUSIONS Patients with HNC have unique facilitators and barriers to participating in PA. Interventions must leverage facilitators and limit barriers to exercise so as to increase compliance with exercise. Future studies should test the effectiveness of behavioral change measures based on the factors influencing the COM-B model.
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Affiliation(s)
- Yan Ning
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Qian Wang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Yongxia Ding
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China.,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Shanxi, Taiyuan, 030001, China
| | - Wenting Zhao
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Zehuan Jia
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China
| | - Binquan Wang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, China. .,Shanxi Key Laboratory of Otolaryngology, Head and Neck Cancer, First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Shanxi, Taiyuan, 030001, China. .,Department of Otolaryngology, Head and Neck Surgery, The First Hospital of Shanxi Medical University, No.85, Jiefang Road South, Taiyuan, 030001, Shanxi, China. .,Research Center for Precision Medicine of Head and Neck Cancer, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
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Real-Time Monitoring the Cytotoxic Effect of Andrographolide on Human Oral Epidermoid Carcinoma Cells. BIOSENSORS 2022; 12:bios12050304. [PMID: 35624605 PMCID: PMC9138648 DOI: 10.3390/bios12050304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022]
Abstract
Andrographolide is an active diterpenoid compound extracted from Andrographis paniculata. It exhibits antiinflammatory and anticancer effects. Previous studies show that it is non-toxic to experimental animals. The leading causes of cancer are chronic inflammation and high blood glucose. This study determines the cytotoxic effect of andrographolide on cellular morphology, viability, and migration for human oral epidermoid carcinoma cell Meng-1 (OEC-M1). We use electric cell-substrate impedance sensing (ECIS) to measure the subsequent overall impedance changes of the cell monolayer in response to different concentrations of andrographolide for 24 h (10–100 µM). The results for exposure of OEC-M1 cells to andrographolide (10–100 µM) for 24 h show a concentration-dependent decrease in the overall measured resistance at 4 kHz. AlamarBlue cell viability assay and annexin V also show the apoptotic effect of andrographolide on OEC-M1 cells. A reduction in wound-healing recovery rate is observed for cells treated with 30 μM andrographolide. This study demonstrates that ECIS can be used for the in vitro screening of anticancer drugs. ECIS detects the cytotoxic effect of drugs earlier than traditional biochemical assays, and it is more sensitive and shows more detail.
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Chang YJ, Muthukumaran RB, Chen JL, Chang HY, Hung YC, Hu CW, Chao MR. Simultaneous determination of areca nut- and tobacco-specific alkaloids in saliva by LC-MS/MS: Distribution and transformation of alkaloids in oral cavity. JOURNAL OF HAZARDOUS MATERIALS 2022; 426:128116. [PMID: 34968842 DOI: 10.1016/j.jhazmat.2021.128116] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Areca nut and tobacco are frequently used in combination. Cigarette smoking and betel quid (BQ) chewing habits impose greater oral cancer risk than either habit alone. Saliva is a better noninvasive diagnostic material as it is in direct contact with oral mucosa and cancerous lesions. This study describes the application of isotope-dilution LC-MS/MS for simultaneous quantitation of five areca nut-specific alkaloids (ASAs) and three tobacco-specific alkaloids (TSAs) in human saliva. With this method, we demonstrate that the distribution of ASAs vary significantly in smokers who chew BQ habitually, due to the hydrolysis of ASAs and metabolic activity in the oral cavity. The alkaline condition formed due to slaked lime in BQ, plays an important role in the distribution of ASAs and TSAs, by catalyzing the hydrolysis of ester forms of ASAs to their respective carboxylic acid forms besides facilitating the TSA (i.e., nicotine) absorption in the oral cavity. Moreover, our results reveal that oral mucosa rather than saliva contributes to the metabolism of ASAs at oral cavity. Less than 2.1% of ASAs were metabolized by saliva, as determined by in vitro test. Our findings may provide a better insight into the pathobiology of oral carcinogenesis due to BQ chewing.
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Affiliation(s)
- Yuan-Jhe Chang
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | | | - Jian-Lian Chen
- School of Pharmacy, China Medical University, Taichung 404, Taiwan
| | - Hsin-Yi Chang
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan
| | - Yu-Cheng Hung
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chiung-Wen Hu
- Department of Public Health, Chung Shan Medical University, Taichung 402, Taiwan.
| | - Mu-Rong Chao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 402, Taiwan; Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan.
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Huang CH, Huang TJ, Lin YC, Lin CN, Chen MY. Factors Associated with Urinary 1-Hydroxypyrene and Malondialdehyde among Adults near a Petrochemical Factory: Implications for Sex and Lifestyle Modification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031362. [PMID: 35162385 PMCID: PMC8835126 DOI: 10.3390/ijerph19031362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/15/2022] [Accepted: 01/22/2022] [Indexed: 11/16/2022]
Abstract
Background: The association between the biomarkers of environmental exposure, oxidative stress, and health-related behaviors in community residents living in an endemic viral hepatitis area and near petrochemical industrial complexes remains unclear. From a health promotion perspective, healthcare providers must know what to do for residents concerned about their health and living environment, especially for individual-level and modifiable risk factors. Therefore, we aimed to explore the factors associated with urinary 1-hydroxypyrene (1-OHP) and malondialdehyde (MDA). Methods: A community-based, cross-sectional study was conducted between July 2018 and February 2019 in western coastal Yunlin County, Taiwan. All participants lived within a 10 km radius of a large petrochemical complex and did not work in the factory. This study was conducted with the local hospital through annual community health screening. Biological samples were collected and biomarkers determined and quantified in the central laboratory of the collaborating hospital. Results: A total of 6335 adult residents completed the study. The mean age was 47.7 (SD = 16) years. Out of the total population, 56.4% were female, 30.1% had metabolic syndrome (MetS), and 16.8% and 14.3% had hepatitis B virus antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) positivity, respectively. The median 1-OHP and MDA level was 0.11 and 0.9 μg/g creatinine with an interquartile range of 0.07–0.18, and 0.4–1.5, respectively. The MDA levels correlated with specific diseases. The multivariable ordinal logistic regression model revealed that female sex, smoking, betel nut use, HBsAg, and anti-HCV positivity were associated with higher 1-OHP levels. In men, MetS was associated with higher 1-OHP levels and regular exercise with lower 1-OHP levels. High MDA levels were associated with smoking, betel nut users, HBsAg, and anti-HCV positivity. Conclusions: The findings highlight the importance of initiating individualized health promotion programs for residents near petrochemical factories, especially for adults with substance-use and cardiometabolic risk factors. Furthermore, it is crucial to provide further treatment to patients with viral hepatitis.
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Affiliation(s)
- Cheng-Hsien Huang
- Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Tung-Jung Huang
- Department of Pulmonary Disease and Critical Care, Chang Gung Memorial Hospital, Yunlin 638, Taiwan;
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
| | - Yu-Chih Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Yunlin 638, Taiwan;
| | - Chia-Ni Lin
- Department of Laboratory Medicine, Chang-Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 333, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
- School of Nursing, Chang Gung University, Taoyuan 333, Taiwan
- Research Fellow, Department of Cardiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Correspondence: ; Tel.: +886-(5)-3628800 (ext. 2301); Fax: +886-(5)-3628866
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Lee CY, Wang WH, Lee CH, Ho MC. Betel Quid Dependence Effects on Working Memory and Remote Memory in Chewers with Concurrent Use of Cigarette and Alcohol. Subst Use Misuse 2022; 57:105-113. [PMID: 34678114 DOI: 10.1080/10826084.2021.1990338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The current study asked whether BQ dependence level could affect working memory (WM) and remote memory for the chewers with concurrent use of cigarettes and alcohol, a common phenomenon in Taiwan. METHODS The standardized neuropsychological tests (Wechsler Memory Scale III (WMS-III) and Remote Memory Test) were adopted to address the BQ chewers' verbal WM, spatial WM and remote memory. The Spatial Span Test and the Digit Span Test from WMS-III and the Remote Memory Test were adopted. The Betel Nut Dependency Scale (BNDS), the Fagerstrom Test for Nicotine Dependence (FTND), and the Alcohol Use Disorders Identification Test (AUDIT) were adopted to measure the dependence levels. RESULTS The BQ dependence level and Last BQ did not affect spatial WM, verbal WM, and remote memory. Last Cigarette is critical in affecting WM; namely, longer interval led to worse performance. Finally, higher alcohol dependence level could lead to better remote memory. CONCLUSIONS To our knowledge, there are no BQ studies addressing the effects of concurrent use of cigarettes and alcohol on memory. The current results suggest that cigarette smoking and alcohol drinking, rather than BQ chewing, are critical for memory performance.
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Affiliation(s)
- Chih-Ying Lee
- Clinical Psychology Department, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei-Han Wang
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Hung Lee
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital, Taichung, Taiwan
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Athukorala IA, Tilakaratne WM, Jayasinghe RD. Areca Nut Chewing: Initiation, Addiction, and Harmful Effects Emphasizing the Barriers and Importance of Cessation. JOURNAL OF ADDICTION 2021; 2021:9967097. [PMID: 34123457 PMCID: PMC8192186 DOI: 10.1155/2021/9967097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/05/2022]
Abstract
Areca nut is a highly addictive substance with carcinogenic properties and causes many harmful effects to the human body. Alkaloids are the major chemicals found in areca nut, and their mechanism of action has been studied for several years. About 600 million people around the world use areca nut, and its usage is higher in Asian countries. Areca nut chewers get used to the habit mainly due to social influence, stress, or lack of awareness. Some studies have reported a dependence syndrome related to areca nut chewing. Even though there are many ongoing research studies regarding tobacco addiction, less concern has been given to the areca nut addiction. There are only few studies related to areca nut cessation, and even those few cessation programs are mainly designed using tobacco cessation methodology. Sociocultural influence, behavioral factors, and accessibility are the main barriers to cessation. Behavior changing interventions proved to be more effective in areca nut cessation, but recently studies on pharmacological therapies are also emerging.
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Affiliation(s)
- I. A. Athukorala
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - W. M. Tilakaratne
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - R. D. Jayasinghe
- Centre for Research in Oral Cancer, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Lin YP, Tsai KZ, Chang CY, Su FY, Han CL, Lin GM. Tobacco Smoking and Association between Betel Nut Chewing and Metabolic Abnormalities Among Military Males: The CHIEF Study. Endocr Metab Immune Disord Drug Targets 2021; 21:298-304. [PMID: 32811419 DOI: 10.2174/1871530320999200818164616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/17/2020] [Accepted: 07/21/2020] [Indexed: 11/22/2022]
Abstract
AIM To investigate the effect of smoking and alcohol intake on the association between betel nut chewing and each metabolic abnormality. BACKGROUND Betel nut chewing has been associated with metabolic syndrome. OBJECTIVE Whether the association is affected by tobacco or alcohol use is not clarified so far. METHODS The authors conducted a cross-sectional study using 6,657 military males, aged 18-50 years in eastern Taiwan in 2013-2014. Metabolic syndrome was defined according to the International Diabetes Federation's ethnic criteria for Asians. The population was classified as non-betel nut chewers (N =5,749), current chewers with both tobacco and alcohol use (N =615), and current chewers without tobacco and/or alcohol use (N =293). Multiple logistic regression analyses were stepwise adjusted for the confounders including alcohol and tobacco use to determine the association of betel chewing with the metabolic abnormalities. RESULTS As compared to the non-current chewers, the current chewers with both tobacco/alcohol use and those without had a higher risk of metabolic syndrome (odds ratios (OR) and 95% confidence intervals: 2.46 (2.00-3.02), and 2.04 (1.53-2.73), respectively) after controlling for age, service specialty, total cholesterol levels ≥200 mg/dL and exercise frequency (model 1). The association did not change much in the two chewing groups after additionally adjusting for alcohol consumption (model 2) (OR: 2.49 (1.99-3.12), and 2.04 (1.52-2.73), respectively), whereas the relationship reduced significantly in the chewers with both tobacco/alcohol use rather than those without after further adjusting for smoking (model 3) (OR: 2.18 (1.71-2.78) and 2.02 (1.51-2.71), respectively). This was in parallel with the pattern for the association of betel nut chewing with serum triglycerides >150 mg/dL in the chewers with both tobacco/alcohol use and those without in model 1 (OR: 2.90 (2.40-3.51) and 1.90 (1.45-2.49), respectively, p =0.011), in model 2 (OR: 2.82 (2.30-3.46) and 1.89 (1.44-2.49), respectively, p =0.040), and in model 3 (2.26 (1.81-2.81) and 1.87 (1.42-2.45), respectively, p =0.76). CONCLUSION Our findings suggest that tobacco smoking but not alcohol intake could increase the relationship of betel nut chewing with metabolic syndrome, which is likely mediated by a synergic effect on increasing serum triglycerides levels.
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Affiliation(s)
- Yen-Po Lin
- Department of Critical Care Medicine, Taipei Tzu Chi Hospital, New Taipei City, Taiwan
| | - Kun-Zhe Tsai
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
| | - Chih-Yu Chang
- Departments of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan; 5Songshan branch, National Defense Medical Center, Taipei, Taiwan
| | - Fang-Ying Su
- Institute of Statistics, National Chiao Tung University, Hsinchu City, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
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Tseng MF, Tsai SCS, Wu CY, Lin CC, Wong RH. The Effectiveness of Betel Quid Cessation among Workers through the Adoption of the Five Action Areas of the Ottawa Charter. Subst Use Misuse 2021; 56:718-727. [PMID: 33719852 DOI: 10.1080/10826084.2021.1892141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to increase workers' awareness of betel quid cessation. Methods: Using community and workplace resources, a workplace health promotion program was developed in accordance with the five action areas of the Ottawa Charter. Questionnaires were administered to examine the changes in the knowledge and attitudes of 714 workers in different occupations before and three months after the intervention. Results: Regardless of subjects' pre-intervention chewing status, their knowledge and attitude scores relating to betel quid cessation increased significantly after the intervention. The effect of occupation was significant on the post-intervention knowledge and attitude scores among chewers. Furthermore, 16 (11.6%) of the 138 study subjects who chewed betel quid before the intervention and had no willingness to quit, did quit betel quid chewing following the intervention. The factors contributing to an unwillingness to quit among chewers with no intention to quit before the intervention were examined. Workers in the electronic material manufacturing industry had a greater willingness to quit compared to those in the metal, machinery, and related trades (odds ratio [OR] = 0.15; 95% confidence interval [CI] = 0.02-0.94). Travel attendants, tour guides, cleaners, and helpers were the least willing to quit (OR = 21.29; 95% CI = 2.51-180.81). Conclusions: This study promoted workers' awareness of betel quid cessation by adopting the five action areas of the Ottawa Charter framework, the effectiveness of the intervention varied in different occupations. Workers with a high-income and better education level had a higher awareness of betel quid cessation.
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Affiliation(s)
- Ming-Feng Tseng
- Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Department of community health services, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Stella Chin-Shaw Tsai
- Department of Otolaryngology, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.,Department of Life Sciences, National Chung Hsin University, Taichung, Taiwan
| | - Chien-Yuan Wu
- Aging and Chronic Disease Control Division, Health Promotion Administration, Ministry of Health and Welfare, Taiwan
| | - Ching-Chiang Lin
- Department of Education and Research, Fooyin University Hospital, Pingtung, Taiwan.,Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Ruey-Hong Wong
- Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan.,Department of Occupational Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
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Chen YW, Chang WC, Yang CY, Lin YC, Lin CS, Kuo CS, Li YH. Pretreatment body mass index and serum uric acid and albumin levels as prognostic predictors in patients with oral squamous cell carcinoma. JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/jmedsci.jmedsci_325_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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15
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Das Gupta R, Jahan M, Hasan M, Sutradhar I, Sajal IH, Haider SS, Joshi H, Haider MR, Sarker M. Factors associated with tobacco use among Nepalese men aged 15–49 years: Data from Nepal demographic and Health Survey 2016. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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16
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Huang B, Zachar JJ. Social and behavioural determinants of areca nut consumption in adolescents. Oral Dis 2020; 26:1820-1826. [PMID: 32516860 DOI: 10.1111/odi.13467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of areca nut consumption and to identify social and behavioural determinants among a Taiwanese adolescent population. SUBJECTS AND METHODS A random sample of 5,343 high school students aged between 15-18 years in Kaohsiung, Taiwan, participated in the study. Participants underwent a clinical dental examination and completed a self-administered questionnaire. Data analyses were performed using multivariate logistic regression to establish a relationship between areca nut consumption as well as social and behavioural characteristics. RESULTS The prevalence of areca nut consumption was 3.0%. The chewing habit was more prevalent among older adolescents (p < .001, OR = 1.50, 95% CI: 1.26, 1.78), males (p < .001, OR = 17.91, 95% CI: 8.57, 37.40), pupils living with non-birth parent(s) (p = .003, OR = 2.13, 95% CI: 1.29, 3.50), children of family heads with primary (p = .001, OR = 2.90, 95% CI: 1.50, 5.59) or secondary level of education (p < .001, OR = 2.78, 95% CI: 1.74, 4.46), frequent risk takers (p < .001, OR = 1.35, 95% CI: 1.27, 1.43) and students of low physical fitness (p < .001, OR = 3.65, 95% CI: 1.81, 7.35). CONCLUSIONS Areca nut consumption has become an ongoing pertinent issue in adolescent health. Future investigations into neurocognitive influences of risk-taking behaviour on areca nut consumption and social dependence of the habit are indicated.
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Affiliation(s)
- Boyen Huang
- Department of Primary Dental Care, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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17
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Lu CW, Lin MS, Lin YS, Chang IJ, Tsai MH, Wei KL, Chen MY. Aminotransferase Ratio Is a Useful Index for Hepatosteatosis in Children and Adolescents: A Cross-Sectional Observational Study. Gastroenterol Nurs 2020; 42:486-495. [PMID: 31770351 DOI: 10.1097/sga.0000000000000389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) and childhood obesity are emerging global health issues. The aim of this study was to identify a simple predictor of NAFLD in children and adolescents. This community-based study was conducted from December 2012 to September 2013 in Taiwan and included 1,222 children between 10 and 19 years of age. After excluding alcohol consumption and hepatic-related lesions, NAFLD was diagnosed according to sonographic criteria. Potential confounding factors (including age, gender, and anthropometric and laboratory data) were tested by logistic regression analysis. The cutoff value was determined using receiver operating characteristic (ROC) curve analysis. In addition to older age, heavier weight, and wider waist, subjects with NAFLD had significantly higher blood pressure, lipid disturbances, and alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratios. The correlation between NAFLD and ALT/AST ratio remained significant even after adjusting for confounders (adjusted odds ratio [OR], 2.19; 95% confidence interval [CI], 1.24-3.87; p = .007). The risk score of having a fatty liver, based on ALT/AST ratio, was greater than 0.981 according to ROC curve analysis (sensitivity, 60.5%; specificity, 80.3%; area under the curve, 0.756; CI, 0.71-0.80; p < .001). Therefore, ALT/AST ratio may represent a powerful index of hepatosteatosis in children and adolescents.
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Affiliation(s)
- Cheng-Wei Lu
- Cheng-Wei Lu, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Shyan Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan. Yu-Sheng Lin, MD, Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan. I-Jen Chang, MD, Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. Ming-Horng Tsai, MD, Department of Pediatrics, Chang Gung Memorial Hospital, Yunlin, Taiwan. Kuo-Liang Wei, MD, Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Chiayi, Taiwan. Mei-Yen Chen, PhD, Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan; Research Fellow, Department of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan; and Department of Nursing, Chang Gung University, Taoyuan, Taiwan
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Hung LC, Kung PT, Lung CH, Tsai MH, Liu SA, Chiu LT, Huang KH, Tsai WC. Assessment of the Risk of Oral Cancer Incidence in A High-Risk Population and Establishment of A Predictive Model for Oral Cancer Incidence Using A Population-Based Cohort in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E665. [PMID: 31968579 PMCID: PMC7014279 DOI: 10.3390/ijerph17020665] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/18/2020] [Accepted: 01/19/2020] [Indexed: 12/13/2022]
Abstract
We aimed to assess the risk of oral cancer incidence in a high-risk population, establish a predictive model for oral cancer among these high-risk individuals, and assess the predictive ability of the constructed model. Individuals aged ≥30 years who had a habit of smoking or betel nut chewing and had undergone oral cancer screening in 2010 or 2011 were selected as study subjects. The incidence of oral cancer among the subjects at the end of 2014 was determined. The annual oral cancer incidence among individuals with a positive screening result was 624 per 100,000 persons, which was 6.5 times that of the annual oral cancer incidence among all individuals screened. Male sex, aged 45-64 years, divorce, low educational level, presence of diabetes, presence of other cancers, high comorbidity severity, a habit of smoking or betel nut chewing, and low monthly salary were high-risk factors for oral cancer incidence (p < 0.05). The area under the curve of the predictive model for oral cancer incidence was 0.73, which indicated a good predictive ability. Therefore, the oral cancer screening policy for the high-risk population with a habit of smoking and/or betel nut chewing is beneficial for the early diagnosis of oral cancer.
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Affiliation(s)
- Li-Chen Hung
- Department of Public Health, China Medical University, Taichung 40402, Taiwan;
- Department of Healthcare Management, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Chi-Hsuan Lung
- Department of Social Work, National Quemoy University, Quemoy 892, Taiwan;
| | - Ming-Hsui Tsai
- Department of Otolaryngology, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Shih-An Liu
- Department of ENT, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Li-Ting Chiu
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan; (L.-T.C.); (K.-H.H.)
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Wu PS, Chang TS, Lu SN, Su HJ, Chang SZ, Hsu CW, Chen MY. An Investigation of the Side Effects, Patient Feedback, and Physiological Changes Associated with Direct-Acting Antiviral Therapy for Hepatitis C. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244981. [PMID: 31817863 PMCID: PMC6950306 DOI: 10.3390/ijerph16244981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 01/08/2023]
Abstract
Background: Hepatitis C virus (HCV) infection is one of the major causes of liver cirrhosis and hepatocellular carcinoma globally. The advent of direct-acting antivirals (DAAs) with high cure rates provides an opportunity to reduce the rising HCV disease burden. However, few studies have explored the side effects and physiological benefits of DAA therapy in rural areas. The aim of this study was to investigate the subjective reports of discomfort, patient feedback about the course of treatment, and physiological changes after DAA treatment in HCV patients. Methods: A descriptive, prospective, comparative cohort study was conducted from January to August 2019 in western coastal Yunlin County, Taiwan. Data regarding demographic characteristics, subjective discomfort levels, and physiological responses were collected through face to face interviews and from medical records by a cooperating hospital. Results: Six-hundred-and-twenty-three participants with an active HCV infection were identified; 555 (89.1%) had completed treatment, and sustained virologic response was achieved in 99.6% (n = 553). The mean age was 64.9 (standard deviation = 13.1) years, and 35% of patients experienced discomfort during DAA treatment, including fatigue, itching, and dizziness. After three months of treatment, physiological markers, including body weight (p < 0.001), waist circumference (p < 0.05), blood pressure (p < 0.001), alanine aminotransferase (p < 0.001), and aspartate aminotransferase (p < 0.001), had significantly improved. Almost all participants provided positive feedback about the treatment experience and reported manageable side effects. Conclusions: The findings showed that, in an endemic rural area, DAA treatment had a high cure rate and improved physiological markers with few discomforts. These results can be used to reduce the barriers HCV patients face in adopting new medications.
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Affiliation(s)
- Pin-Sheng Wu
- Formosa Plastics Group Health Care, Yunlin 638, Taiwan; (P.-S.W.); (S.-Z.C.)
| | - Te-Sheng Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (T.-S.C.); (S.-N.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Sheng-Nan Lu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi 613, Taiwan; (T.-S.C.); (S.-N.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsiang-Jou Su
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan;
| | - Shu-Zhi Chang
- Formosa Plastics Group Health Care, Yunlin 638, Taiwan; (P.-S.W.); (S.-Z.C.)
| | - Chia-Wen Hsu
- Formosa Plastics Group, Safety Health & Environment Center, Taipei 508, Taiwan;
| | - Mei-Yen Chen
- College of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
- Department of Cardiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- School of Nursing, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-(5)-3628800 (ext. 2301); Fax: +886-(5)-3628866
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Chang WC, Yang CY, Lin CS, Lin CK, Chen YW. Pretreatment body mass index as a prognostic predictor in patients with oral squamous cell carcinoma. Clin Oral Investig 2019; 24:2781-2788. [DOI: 10.1007/s00784-019-03141-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 10/30/2019] [Indexed: 01/06/2023]
Abstract
Abstract
Objectives
To evaluate whether low body mass index (BMI) is a potential adverse prognostic factor in patients with oral squamous cell carcinoma (OSCC).
Material and methods
This cross-sectional study included 320 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The pretreatment BMI was measured as a common indicator of the pretreatment nutritional status to calculate the overall survival in Kaplan-Meier method. The adverse histopathological features of margin status, depth of invasion (DOI), lymphovascular invasion (LVSI), perineural invasion (PNI), and extranodal extension (ENE) were analyzed using the Cox regression model.
Results
Low BMI (underweight), DOI > 5 mm, and ENE were identified as detrimental prognostic factors. On multivariate Cox regression analysis, the low BMI group (odds ratio [OR] = 1.683; 95% confidence interval [95% CI] 1.116–2.539; P = 0.022), DOI > 5 mm (OR = 2.399; 95% CI 1.459–3.943; P = 0.001), and ENE (OR = 2.467; 95% CI 1.540–3.951; P = 0.000) yielded reduced survival rate.
Conclusions
The lower BMI had an important and significant effect on the survival of patients with oral cancer and their surgical outcomes. In addition to the adverse histopathological features, a DOI > 5 mm and positive ENE were also identified as the most important prognostic factors.
Clinical relevance
Underweight patients with low BMI, DOI of > 5 mm, and positive ENE should receive more intensive nutritional supplementation and postoperative adjuvant therapy.
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Chang WC, Chang CF, Li YH, Yang CY, Su RY, Lin CK, Chen YW. A histopathological evaluation and potential prognostic implications of oral squamous cell carcinoma with adverse features. Oral Oncol 2019; 95:65-73. [PMID: 31345396 DOI: 10.1016/j.oraloncology.2019.06.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/16/2019] [Accepted: 06/07/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to evaluate the adverse clinicopathologic features of oral squamous cell carcinoma (OSCC), including margin status, depth of invasion, lymphovascular invasion, perineural invasion, and extranodal extension that significantly affect survival outcomes. MATERIALS AND METHODS This retrospective cross-sectional study included 341 patients with OSCC who underwent therapeutic surgical treatment in Taiwan. The Kaplan-Meier method was used to estimate survival outcomes. A multivariable Cox regression model was used to evaluate the associations of various clinicopathologic features with 5-year overall survival (OS) outcomes in patients with pN0 and pN+ tumors. RESULTS Overall, the patients had 5-year OS and progression-free survival rates of 60.0 and 47.9%, respectively. In the pN0 group, the multivariate analysis identified a positive margin (odds ratio [OR] = 16.3, 95% confidence interval [95% CI]: 3.7-72.3; P = 0.001), depth of invasion >5 mm (OR = 2.1, 95% CI: 1.2-3.7; P = 0.012), presence of lymphovascular space invasion (OR = 5.4, 95% CI: 1.3-22.0; P = 0.018), and presence of perineural invasion (OR = 4.3, 95% CI: 1.7-11.1; P = 0.002) as independent and significant prognosticators of OS. In the pN+ group, only the presence of extranodal extension independently predicted OS (OR = 1.7, 95% CI: 1.1-2.7; P = 0.0026). CONCLUSIONS When determining survival prognosis for patients with a pN0 status, we recommended including all adverse features. In contrast, extranodal extension was the most important prognostic factor for patients with a pN+ status.
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Affiliation(s)
- Wei-Chin Chang
- Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City, Taiwan, ROC; School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Ching-Fen Chang
- Department of Internal Medicine, China Medical University Hospital, Taichung City, Taiwan, ROC
| | - Yu-Hsuan Li
- Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City, Taiwan, ROC; School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Cheng-Yu Yang
- School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Ruei-Yu Su
- Department of Pathology, Division of Clinical Pathology, Tri-Service General Hospital, Taipei City, Taiwan, ROC; Department of Pathology and Laboratory Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, ROC; National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Chih-Kung Lin
- Department of Pathology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei City, Taiwan, ROC
| | - Yuan-Wu Chen
- Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, Taipei City, Taiwan, ROC; School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC.
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Huang CC, Lin CN, Chung CH, Hwang JS, Tsai ST, Wang JD. Cost-effectiveness analysis of the oral cancer screening program in Taiwan. Oral Oncol 2018; 89:59-65. [PMID: 30732960 DOI: 10.1016/j.oraloncology.2018.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 11/23/2018] [Accepted: 12/11/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We assess the incremental cost-effectiveness ratio (ICER) of the oral cancer (OC) screening program in Taiwan. MATERIALS AND METHODS We interlinked the Cancer Registry, Mortality Registry, National Vital Statistics, reimbursement database of National Health Insurance, and the National Oral Cancer Screening database of Taiwan. A total of 40,092 pathologically verified OC patients were identified and followed during 2002-2014. After stratification by stages, lifetime survival curves were estimated by a rolling extrapolation algorithm to obtain life expectancy (LE), expected years of life lost (EYLL), and lifetime medical costs (LMC). RESULTS The LE for stages I-IV were 19.5, 14.0, 11.9, and 7.7 life-years, respectively, while those of EYLL were 7.3, 12.2, 15.4, and 18.7 life-years, respectively. The LMC for stages I-IV were US$ 65,752, 60,086, 53,675, and 47,570, respectively. We assumed no life loss for stage 0 with LMC of US$ 5380 spent for the first year after diagnosis. During 2010-2013, 967 out of the 28,018 cases detected with abnormal oral pathology by screening were found to develop OC. The ICER of the screening program was US$ 28,516 per life-year saved, which could be improved to US$ 5579 per life-year saved if all cancers transformed from abnormal oral pathology were detected before stage I. CONCLUSION The ICER of the current OC screening program in Taiwan slightly exceeds 1 GDP (gross domestic product) per capita per life-year saved. Intensive follow-up and treatment for all patients with abnormal oral pathology would improve screening efficiency and effectiveness of prevention.
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Affiliation(s)
- Cheng-Chih Huang
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Head and Neck Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Ni Lin
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chia-Hua Chung
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | | | - Sen-Tien Tsai
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Head and Neck Collaborative Oncology Group, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jung-Der Wang
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Departments of Internal Medicine and Environmental and Occupational Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
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Huang TC, Ciudad P, Manrique OJ, Agko M, Chen SH, Tang PYB, Sabbagh MD, Chen HC. Staged inset of free flaps for complex microsurgical head and neck reconstruction to ensure total flap survival. Microsurgery 2018; 38:844-851. [PMID: 30488493 DOI: 10.1002/micr.30370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 05/18/2018] [Accepted: 06/20/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Tony C.T. Huang
- Division of Plastic Surgery; Mayo Clinic; Rochester Minnesota
| | - Pedro Ciudad
- Department of Plastic and Reconstructive Surgery; China Medical University Hospital; Taichung Taiwan
- Department of Biological Science and Technology; China Medical University; Taichung Taiwan
| | | | - Mouchammed Agko
- Department of Plastic and Reconstructive Surgery; China Medical University Hospital; Taichung Taiwan
| | - Shih-Heng Chen
- Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital, Chang Gung University, College of Medicine; Taoyuan City Taiwan
| | - Phoebe Yueh-Bih Tang
- Department of Plastic Surgery; Far Eastern Memorial Hospital; New Taipei City Taiwan
| | - M. Diya Sabbagh
- Division of Plastic Surgery; Mayo Clinic; Rochester Minnesota
| | - Hung-Chi Chen
- Department of Plastic and Reconstructive Surgery; China Medical University Hospital; Taichung Taiwan
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Huang CY, Lin YS, Kang BH, Chang KP, Chi CC, Lin MY, Su HH, Chang TS, Lee HP, Lee CC. Log margin-to-thickness ratio improves disease-specific survival prediction in oral cancer: A single cancer centre database. Clin Otolaryngol 2018; 44:63-69. [DOI: 10.1111/coa.13237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/15/2018] [Accepted: 10/02/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Chien-Yu Huang
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Yaoh-Shiang Lin
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Otolaryngology, Head and Neck Surgery; Tri-Service General Hospital; Taipei Taiwan
| | - Bor-Hwang Kang
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Otolaryngology, Head and Neck Surgery; Tri-Service General Hospital; Taipei Taiwan
| | - Kuo-Ping Chang
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Otolaryngology, Head and Neck Surgery; Tri-Service General Hospital; Taipei Taiwan
| | - Chao-Chuan Chi
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Ming-Yee Lin
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Hsing-Hao Su
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Ting-Shou Chang
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Otolaryngology, Head and Neck Surgery; Tri-Service General Hospital; Taipei Taiwan
| | - Huai-Pao Lee
- Department of Pathology and Laboratory Medicine; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
- School of Medicine; National Defense Medical Center; Taipei Taiwan
- Department of Otolaryngology, Head and Neck Surgery; Tri-Service General Hospital; Taipei Taiwan
- Institute of Hospital and Health Care Administration; National Yang-Ming University; Taipei Taiwan
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Lin MS, Huang TJ, Lin YC, Jane SW, Chen MY. The association between smoking and cardiometabolic risk among male adults with disabilities in Taiwan. Eur J Cardiovasc Nurs 2018; 18:106-112. [PMID: 30114974 DOI: 10.1177/1474515118795602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Individuals with disabilities have health needs similar to the general population. Smoking and metabolic syndrome have emerged as major cardiovascular risks that contribute to systemic inflammation and mortality. However, few studies have focused on the association between smoking and cardiometabolic risks in adult men with disabilities. AIMS This study explored the prevalence of smoking and its association with cardiometabolic risk and associated factors among male adults with disabilities. METHODS This study was part of a nurse-led health-promotion program designed to examine the health needs in health programs for adults with disabilities. A community-based, cross-sectional study was conducted between July 2013-December 2014, in Chiayi County, Taiwan. RESULTS Of the total of 964 male participants enrolled in this study, 874 (90.7%) participants had complete data sets. The prevalence of cigarette smoking and metabolic syndrome were 42%, and 33.3%, respectively. More than half (62.7%) had high blood pressure and 43.5% had central obesity. Compared with non-smokers, smokers tended to engage in less frequent regular exercise ( p<0.001), eat fewer vegetables and fruit ( p<0.05), and drink less water ( p<0.05). After adjusting for potential confounding variables, multivariable logistic regression analysis showed that smoking was an independent factor for cardiometabolic risk. CONCLUSION The present findings show a high prevalence of cigarette smoking, unhealthy lifestyle, and cardiometabolic risk among adult men with disabilities. Clinicians and primary healthcare providers should reduce the consequences thereof by initiating innovative health promotion programs.
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Affiliation(s)
- Ming-Shyan Lin
- 1 Department of Cardiology, Chang Gung Memorial Hospital, Taiwan
| | - Tung-Jung Huang
- 2 Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan.,3 Department of Respiratory Care, Chang Gung University of Science and Technology, Taiwan
| | - Yu-Chen Lin
- 4 Department of Health Promotion, Chiayi Bureau of Health, Taiwan
| | - Sui-Whi Jane
- 5 Department of Nursing, Chang Gung University of Science and Technology, Taiwan
| | - Mei-Yen Chen
- 1 Department of Cardiology, Chang Gung Memorial Hospital, Taiwan.,5 Department of Nursing, Chang Gung University of Science and Technology, Taiwan.,6 Department of Nursing, Chang Gung University, Taiwan
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Ho KY, Li HCW, Lam KKW, Chan SSC, Wang MP, Chan VWF, Xia VW, Lam TH. Exploratory study on the relationship between smoking and other risk behaviours among young smokers. J Clin Nurs 2018; 27:2859-2867. [PMID: 29633459 DOI: 10.1111/jocn.14375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the relationship between smoking and other risk behaviours among Chinese young people in Hong Kong. BACKGROUND There is growing concern about coexisting risk behaviours in young smokers. Information about smoking and other risk behaviours is crucial for developing interventions to promote smoking abstinence and adoption of healthy lifestyles. The relationship between smoking and other risk behaviours among Chinese young people in Hong Kong has not been explored. DESIGN This is a mixed-method retrospective population-based study. METHODS A retrospective population-based study was conducted with 1,147 young smokers through Youth Quitline between November 2011-July 2016. Attitudes, behaviours and experiences related to smoking and risk behaviours among Chinese young smokers were examined in semi-structured qualitative interviews with 30 participants randomly selected from the retrospective population-based study. RESULTS In total, 45.5% participants reported engaging in at least one other risk behaviour. The interviews revealed that drinking alcohol may have a significant impact on quitting smoking. In addition, smoking may be a gateway for more serious risk behaviours during adolescence. Low health awareness may explain the unhealthy lifestyles among young smokers. CONCLUSIONS This study bridges a gap in existing literature by exploring relationships between smoking and other risk behaviours among young people in Hong Kong. RELEVANCE TO CLINICAL PRACTICE Given the interrelationships between smoking and other risk behaviours, a holistic approach should be used to promote smoking cessation and healthy lifestyles among young smokers. If young smokers improve their health and quit smoking at the same time, their physical and mental development will benefit as a secondary outcome.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | | | | | - Man Ping Wang
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | | | - Viveka Wei Xia
- School of Nursing, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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A Scientific and Socioeconomic Review of Betel Nut Use in Taiwan with Bioethical Reflections. Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0028-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Tham J, Sem G, Sit E, Tai MCT. The ethics of betel nut consumption in Taiwan. JOURNAL OF MEDICAL ETHICS 2017; 43:739-740. [PMID: 28265049 DOI: 10.1136/medethics-2016-103990] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/20/2017] [Accepted: 02/13/2017] [Indexed: 06/06/2023]
Abstract
The ethics of betel nut use in Taiwan are examined in this article. It first presents scientific facts about the betel quid, its consumption and negative health consequences and then analyses the cultural background and economic factors contributing to its popularity in Asia. Governmental and institutional attempts to curb betel nut cultivation, distribution and sales are also described. Finally, the bioethical implications of this often ignored subject are considered.
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Affiliation(s)
- Joseph Tham
- School of Bioethics, Pontificio Ateneo Regina Apostolorum, Rome, Italy
| | - Geoffrey Sem
- Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Eugene Sit
- Faculty of Medicine, University of Hong Kong, Hong Kong, SAR China
| | - Michael Cheng-Tek Tai
- Department of Bioethics and Medical Humanities, Chung Shan Medical University, Taichung, Taiwan
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Lymph node density as a prognostic predictor in patients with betel nut-related oral squamous cell carcinoma. Clin Oral Investig 2017; 22:1513-1521. [PMID: 29038963 PMCID: PMC5866838 DOI: 10.1007/s00784-017-2247-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/10/2017] [Indexed: 11/04/2022]
Abstract
Objectives Lymph node metastasis in oral squamous cell carcinoma (OSCC) is a poor prognostic factor. The histopathologic stage (e.g., pN) is used to evaluate the severity of lymph node metastasis; however, the current staging system insufficiently predicts survival and recurrence. We investigated clinical outcomes and lymph node density (LND) in betel nut-chewing individuals. Material and methods We retrospectively analyzed 389 betel nut-exposed patients with primary OSCC who underwent surgical resection in 2002–2015. The prognostic significance of LND was evaluated by overall survival (OS) and disease-free survival (DFS) using the Kaplan-Meier method. Results Kaplan-Meier analyses showed that the 5-year OS and DFS rates in all patients were 60.9 and 48.9%, respectively. Multivariate analysis showed that variables independently prognostic for OS were aged population (hazard ratio [HR] = 1.6, 95% confidence interval [95% CI] = 1.1–2.5; P = .025), and cell differentiation classification (HR = 2.4, 95% CI = 1.4–4.2; P = .002). In pathologic N-positive patients, a receiver operating characteristic (ROC) curve for OS was used and indicated the best cutoff of 0.05, and the multivariate analysis showed that LND was an independent predictor of OS (HR = 2.2, 95% CI = 1.3–3.7; P = .004). Conclusions Lymph node density, at a cutoff of 0.05, was an independent predictor of OS and DFS. OS and DFS underwent multiple analyses, and LND remained significant. The pathologic N stage had no influence in the OS analysis. Clinical relevance LND is a more reliable predictor of survival in betel nut-chewing patients for further post operation adjuvant treatment, such as reoperation or adjuvant radiotherapy.
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Huang YJ, Jiann BP. Association of Areca Nut Chewing With Risk of Erectile Dysfunction. Sex Med 2017; 5:e163-e168. [PMID: 28778677 PMCID: PMC5562500 DOI: 10.1016/j.esxm.2017.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/23/2017] [Accepted: 05/07/2017] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Areca nut chewing has been shown to increase the risk of cardiovascular disease, but its association with erectile dysfunction (ED) has not been investigated. AIM To investigate the association between areca nut chewing and risk of ED. METHODS Consecutive men at public health centers for oral malignancy screening or health checkup were invited to complete a questionnaire. MAIN OUTCOME MEASURE The Sexual Health Inventory for Men (SHIM). RESULTS Of the 2,652 respondents, 1,038 (mean age = 43.8 ± 11.1 years) were eligible for the areca nut chewing group and 1,090 non-areca nut chewers were selected as the age-matched control group. In the areca nut group, the mean duration of chewing was 13.2 ± 9.6 years, 61.7% consumed more than 10 portions per day, and 76.2% used it with betel leaf, 16.7% used it with betel inflorescence, and 7.1% used it with betel leaf and inflorescence. Smoking, alcohol drinking, obesity, hypertension, and diabetes were more predominant in areca nut chewers compared with controls. ED defined by self-report and by SHIM score was more prevalent in areca nut chewers than in controls (13.7% vs 9.8% and 48.7% vs 43.3%, respectively; P < .05 for the two comparisons). Areca nut use with betel inflorescence was associated with a higher risk of ED (odds ratio = 2.25, 95% confidence interval = 1.55-3.28) with a dose-dependent effect, whereas using it with betel leaf was not (odds ratio = 1.00, 95% confidence interval = 0.79-1.26) after adjustment of possible confounders. CONCLUSION Areca nut chewing with betel inflorescence was associated with an increased risk of ED. These findings warrant further studies. Huang Y-J, Jiann B-P. Association of Areca Nut Chewing With Risk of Erectile Dysfunction. Sex Med 2017;5:e163-e168.
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Affiliation(s)
- Yung-Jui Huang
- Department of Surgery, Kaohsiung Veterans General Hospital and Graduate School of Human Sexuality, Shu-Te University, Kaohsiung, Taiwan
| | - Bang-Ping Jiann
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Consumption of Energy Drinks among Undergraduate Students in Taiwan: Related Factors and Associations with Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090954. [PMID: 28837085 PMCID: PMC5615491 DOI: 10.3390/ijerph14090954] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 08/15/2017] [Accepted: 08/17/2017] [Indexed: 01/22/2023]
Abstract
Background: This study aimed to investigate the consumption of energy drinks and associated factors among undergraduate students in Taiwan. Methods: Data came from a cross-sectional survey conducted in 2015. Eligible participants completed a self-administered questionnaire assessing use and perceptions of energy drinks, tobacco, alcohol, and betel nut. Results: Among 606 surveyed undergraduate students, 24.8% reported consuming energy drinks in the past 30 days. The major reasons for use included keeping alert at work (48.7%), being curious about the products (32.0%), enjoying the flavor (31.3%), or preparing for school exams (26.7%). Among energy drink users, half have never read the nutrition label, and 15.3% reported that they had ever mixed energy drinks with alcohol. Most participants showed negative attitudes toward using tobacco, alcohol, or betel nut, while 54.1% reported positive attitudes toward consuming energy drinks. Being male, living away from parents’ home, tobacco use, alcohol use, and positive perceptions of energy drink’s effects significantly predicted energy drink consumption. Conclusions: In addition to exploring motivations of energy drink consumption in undergraduate students in Taiwan, the study findings indicated that energy drink consumption might relate to the use of tobacco and alcohol, which should be taken into account in substance use prevention programs.
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Ciudad P, Agko M, Manrique OJ, Date S, Kiranantawat K, Chang WL, Nicoli F, Lo Torto F, Maruccia M, Orfaniotis G, Chen HC. The retrograde transverse cervical artery as a recipient vessel for free tissue transfer in complex head and neck reconstruction with a vessel-depleted neck. Microsurgery 2017; 37:902-909. [PMID: 28753219 DOI: 10.1002/micr.30193] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 05/17/2017] [Accepted: 06/09/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck. METHODS Between July 2010 and June 2016, nine patients with a vessel-depleted neck underwent secondary head and neck reconstruction using the retrograde TCA as recipient vessel for microanastomosis. The mean age was 49.6 years (range, 36 to 68 years). All patients had previous bilateral neck dissections and all, except one, had also received radiotherapy. Indications included neck contracture release (n = 3), oral (n = 1), mandibular (n = 3) and pharyngoesophageal (n = 2) reconstruction necessitating free anterolateral thigh (n = 3) and medial sural artery (n = 1) perforator flaps, fibula (n = 3) and ileocolon (n = 2) flaps respectively. RESULTS There was 100% flap survival rate with no re-exploration or any partial flap loss. One case of intra-operative arterial vasospasm at the anastomotic suture line was managed intra-operatively with vein graft interposition. There were no other complications or donor site morbidity during the follow-up period. CONCLUSIONS In a vessel-depleted neck, the reverse flow of the TCA may be a reliable option for complex secondary head and neck reconstruction in selected patients.
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Affiliation(s)
- Pedro Ciudad
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.,Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Mouchammed Agko
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Oscar J Manrique
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan.,Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN, United Sates
| | - Shivprasad Date
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Kidakorn Kiranantawat
- Division of Plastic and Maxillofacial Surgery, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wei Ling Chang
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Fabio Nicoli
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Federico Lo Torto
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Michele Maruccia
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Georgios Orfaniotis
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Chi Chen
- Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan
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Chen YT, Chen HW, Wu CF, Chu LJ, Chiang WF, Wu CC, Yu JS, Tsai CH, Liang KH, Chang YS, Wu M, Ou Yang WT. Development of a Multiplexed Liquid Chromatography Multiple-Reaction-Monitoring Mass Spectrometry (LC-MRM/MS) Method for Evaluation of Salivary Proteins as Oral Cancer Biomarkers. Mol Cell Proteomics 2017; 16:799-811. [PMID: 28235782 PMCID: PMC5417822 DOI: 10.1074/mcp.m116.064758] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 02/22/2017] [Indexed: 11/06/2022] Open
Abstract
Multiple (selected) reaction monitoring (MRM/SRM) of peptides is a growing technology for target protein quantification because it is more robust, precise, accurate, high-throughput, and multiplex-capable than antibody-based techniques. The technique has been applied clinically to the large-scale quantification of multiple target proteins in different types of fluids. However, previous MRM-based studies have placed less focus on sample-preparation workflow and analytical performance in the precise quantification of proteins in saliva, a noninvasively sampled body fluid. In this study, we evaluated the analytical performance of a simple and robust multiple reaction monitoring (MRM)-based targeted proteomics approach incorporating liquid chromatography with mass spectrometry detection (LC-MRM/MS). This platform was used to quantitatively assess the biomarker potential of a group of 56 salivary proteins that have previously been associated with human cancers. To further enhance the development of this technology for assay of salivary samples, we optimized the workflow for salivary protein digestion and evaluated quantification performance, robustness and technical limitations in analyzing clinical samples. Using a clinically well-characterized cohort of two independent clinical sample sets (total n = 119), we quantitatively characterized these protein biomarker candidates in saliva specimens from controls and oral squamous cell carcinoma (OSCC) patients. The results clearly showed a significant elevation of most targeted proteins in saliva samples from OSCC patients compared with controls. Overall, this platform was capable of assaying the most highly multiplexed panel of salivary protein biomarkers, highlighting the clinical utility of MRM in oral cancer biomarker research.
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Affiliation(s)
- Yi-Ting Chen
- From the ‡Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan;
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- ¶Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- ‖Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Hsiao-Wei Chen
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Feng Wu
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Lichieh Julie Chu
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- **Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Wei-Fang Chiang
- ‡‡Department of Oral & Maxillofacial Surgery, Chi-Mei Medical Center, Liouying, Taiwan
- §§School of Dentistry, National Yang Ming University, Taipei, Taiwan
| | - Chih-Ching Wu
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- ¶¶Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- ‖‖Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jau-Song Yu
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- ¶Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- **Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Cheng-Han Tsai
- ¶Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kung-Hao Liang
- **Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Sun Chang
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- ¶Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- ‖‖Department of Otolaryngology - Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Maureen Wu
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Ting Ou Yang
- §Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
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Rane PP, Narayanan P, Binu V, Unnikrishnan B. Prevalence of Tobacco and Alcohol Consumption among Fishermen in Udupi Taluk' Karnataka, India: a Cross-Sectional Study. Asian Pac J Cancer Prev 2017; 17:1733-7. [PMID: 27221846 DOI: 10.7314/apjcp.2016.17.4.1733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stress associated with fishing is known to trigger consumption of alcohol and tobacco among fishermen. This study aimed to assess the prevalence of tobacco and alcohol consumption among fishermen in Udupi Taluk in the state of Karnataka, India, and to study associations with health status and job stress. MATERIALS AND METHODS The study was conducted among 825 fishermen in Udupi Taluk of Karnataka between January-June 2015, using a two stage cluster sampling procedure. Associations between variables of interest were assessed using multivariable analysis and logistic regression models. RESULTS The prevalences of consumption of tobacco, alcohol and either of these substances were 64.2%, 45.6% and 86.9% respectively. There was a positive association between alcohol and any form of tobacco consumption with income but none with respondent's job stress and health status. CONCLUSIONS Our study concluded that fishermen with poor health status are seen more among tobacco and alcohol users.
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Affiliation(s)
- Prasad Pramod Rane
- Kasturba Medical College, Mangalore, 2Department of Public Health, Mangalore, India E-mail :
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Yang TY, Lin HR. Taking actions to quit chewing betel nuts and starting a new life: taxi drivers' successful experiences of quitting betel nut chewing. J Clin Nurs 2016; 26:1031-1041. [PMID: 27681205 DOI: 10.1111/jocn.13599] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To understand taxi drivers' successful experiences of quitting betel nut chewing. BACKGROUND Previous studies verified that betel nut chewing significantly increases the risk of oral cancer. In Taiwan, taxi drivers work for approximately 10-13 hours per day, and 31·7-80% of them choose to chew betel nuts for their invigorating qualities, which enable them to work more hours and receive more income. DESIGN A qualitative research design was used. METHODS This study used the grounded theory method with purposive sampling to perform in-depth interviews with male taxi drivers who had successfully quit betel nut chewing for more than six months. RESULTS The interviewed participants were 25 taxi drivers aged 45-67 who had chewed betel nuts for an average of 30·9 years. A constant comparative analysis of the 25 interviews revealed six categories, namely the first experience of chewing betel nuts, a part of work and life, perceiving the impact of betel nuts, trying to change, acting to quit betel nut chewing and starting a new life. CONCLUSIONS During the cessation process, taxi drivers tended to be affected by their addiction to chewing betel nuts and the temptation of friends' invitations to chew betel nuts. However, their recognition of the physical effects of betel nut chewing and their sense of responsibility and commitment to family were the critical factors affecting their determination to quit betel nut chewing. Their willpower to not to chew betel nuts and the source of their motivation to exercise self-control also contributed to their success. RELEVANCE TO CLINICAL PRACTICE Healthcare personnel should understand the experiences and perceptions of betel nut chewers, strengthen their understanding of the effects of betel nut chewing on physical health during the cessation period and support their self-efficacy and quitting behaviours with the assistance of significant others.
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Affiliation(s)
- Tsui-Yun Yang
- Department of Nursing, School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hung-Ru Lin
- School of Nursing & Dean of Academic Affairs, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Lee KF, Tsai YT, Lin CY, Hsieh CB, Wu ST, Ke HY, Lin YC, Lin FY, Lee WH, Tsai CS. Cancer Incidence among Heart, Kidney, and Liver Transplant Recipients in Taiwan. PLoS One 2016; 11:e0155602. [PMID: 27196400 PMCID: PMC4873185 DOI: 10.1371/journal.pone.0155602] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/02/2016] [Indexed: 12/20/2022] Open
Abstract
Population-based evidence of the relative risk of cancer among heart, kidney, and liver transplant recipients from Asia is lacking. The Taiwan National Health Insurance Research Database was used to conduct a population-based cohort study of transplant recipients (n = 5396), comprising 801 heart, 2847 kidney, and 1748 liver transplant recipients between 2001 and 2012. Standardized incidence ratios and Cox regression models were used. Compared with the general population, the risk of cancer increased 3.8-fold after heart transplantation, 4.1-fold after kidney transplantation and 4.6-fold after liver transplantation. Cancer occurrence showed considerable variation according to transplanted organs. The most common cancers in all transplant patients were cancers of the head and neck, liver, bladder, and kidney and non-Hodgkin lymphoma. Male recipients had an increased risk of cancers of the head and neck and liver, and female kidney recipients had a significant risk of bladder and kidney cancer. The adjusted hazard ratio for any cancer in all recipients was higher in liver transplant recipients compared with that in heart transplant recipients (hazard ratio = 1.5, P = .04). Cancer occurrence varied considerably and posttransplant cancer screening should be performed routinely according to transplanted organ and sex.
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Affiliation(s)
- Kwai-Fong Lee
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Biobank Management Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Ting Tsai
- Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Chih-Yuan Lin
- Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Chung-Bao Hsieh
- Division of General Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Sheng-Tang Wu
- Division of Urology, Tri-Service General Hospital, Taipei, Taiwan
| | - Hung-Yen Ke
- Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Chang Lin
- Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Feng-Yen Lin
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Division of Cardiology, Department of Internal Medicine and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Hwa Lee
- Department of Pathology, Taipei Medical University Shuang-Ho Hospital, New Taipei, Taiwan
- Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Sung Tsai
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
- Division of Cardiovascular Surgery, Tri-Service General Hospital, Taipei, Taiwan
- Division of Cardiovascular Surgery, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Adel M, Liao CT, Lee LY, Hsueh C, Lin CY, Fan KH, Wang HM, Ng SH, Lin CH, Tsao CK, Huang SF, Kang CJ, Fang KH, Wang YC, Chang KP, Fang TJ, Yang LY, Yen TC. Incidence and Outcomes of Patients With Oral Cavity Squamous Cell Carcinoma and Fourth Primary Tumors: A Long-term Follow-up Study in a Betel Quid Chewing Endemic Area. Medicine (Baltimore) 2016; 95:e2950. [PMID: 27015170 PMCID: PMC4998365 DOI: 10.1097/md.0000000000002950] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.We retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3-4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P < 0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P = 0.0442).Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.
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Affiliation(s)
- Mohamad Adel
- From the Division of Surgical Oncology, Department of Surgery (MA), Al-Azhar University Hospital, Al-Azhar Faculty of Medicine, Cairo, Egypt; Department of Otorhinolaryngology, Head and Neck Surgery (MA, C-TL, S-FH, C-JK, K-HF, YCW, K-PC, T-JF); Head and Neck Oncology Group (C-TL, L-YL, CH, C-YL, K-HF, H-MW, S-HN, C-HL, C-KT, S-FH, C-JK, K-HF, Y-CW, K-PC, T-JF, LYY, T-CY), Chang Gung Memorial Hospital and Chang Gung University; Department of Pathology (L-YL, CH); Department of Radiation Oncology (C-YL, K-HF); Department of Medical Oncology (H-MW); Department of Diagnostic Radiology (S-HN); Department of Plastic and Reconstructive Surgery (C-HL, C-KT); Biostatistics and Informatics Unit, Clinical Trial Center (LYY); and Department of Nuclear Medicine and Molecular Imaging Center (T-CY), Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC
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Chang CC, Lin MS, Chen YT, Tu LT, Jane SW, Chen MY. Metabolic syndrome and health-related behaviours associated with pre-oral cancerous lesions among adults aged 20-80 years in Yunlin County, Taiwan: a cross-sectional study. BMJ Open 2015; 5:e008788. [PMID: 26685025 PMCID: PMC4691787 DOI: 10.1136/bmjopen-2015-008788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To explore the associations of health-related behaviours, metabolic syndrome and risk factors in adults with pre-oral cancerous (POC) lesions in rural, disadvantaged communities with a high prevalence of oral cancer. DESIGN A cross-sectional observational study. SETTING Community-based health survey in the western coastal area of Yunlin County, Taiwan. PARTICIPANTS 5161 adult residents participated in this study. OUTCOME MEASURES Assessed parameters included oral leukoplakia, oral submucous fibrosis, fasting blood glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure and waist circumference. Statistical analyses included descriptive statistics, χ(2) tests and multivariate binary logistic regression. RESULTS A high percentage of participants were found to have metabolic syndrome (40%) and POC lesions (7.3%). Participants with POC lesions tended to be male (p<0.001), betel nut chewers (p<0.001) and cigarette smokers (p<0.001); have a low level of education (p<0.001); seldom undergo dental check-ups (p<0.01); irregularly participate in physical activity (p<0.01) and have metabolic syndrome (p<0.01). CONCLUSIONS Although male sex and disadvantaged socioeconomic status are non-modifiable factors associated with POC and metabolic syndrome in adults, several factors, notably health behaviours, are modifiable. Clinicians can reduce the incidence and consequences of POC by developing programmes for early detection, encouraging regular dental check-ups, and initiating individualised, health-promoting behaviour modification programmes for reducing risky behaviours associated with oral cancer.
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Affiliation(s)
- Chang-Cheng Chang
- Division of Plastic Surgery, Head and Neck Cancer Team, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Ming-Shyan Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
| | - Yu-Tsung Chen
- Department of Dermatology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Liang-Tse Tu
- Division of Dentistry, Cancer Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Su-Whi Jane
- Nursing Department, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Mei-Yen Chen
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
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The Experiences of Tobacco Use among South-Western Taiwanese Adolescent Males. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:10522-35. [PMID: 26343695 PMCID: PMC4586625 DOI: 10.3390/ijerph120910522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 08/07/2015] [Accepted: 08/24/2015] [Indexed: 02/02/2023]
Abstract
Most smokers start young. Initiation of cigarette smoking at an earlier age leads to more life-years for tobacco use, makes quitting harder, and increases the risk of serious health consequences. Despite these challenges, research focusing on smoking behavior among adolescent boys in Taiwan is rare. Although the Taiwanese government enacted the Tobacco Hazards Prevention Act in 2009, aimed at prevention and reducing the rate of smoking, the percentage of high school students who smoke has continued to increase. In 2006, 7.5% of adolescent boys engaged in smoking. By 2012 the rate had increased to 24.6%. This paper explores the experiences that contribute to adolescent Taiwanese boys making the decision to smoke. A phenomenological approach to inquiry was used as the philosophical foundations for this study with twelve adolescent boys who engaged in smoking behaviors. Data was gathered through two face-to-face semi-structured interviews and a focus group. Data analysis was performed using Colaizzi's analysis method. Findings indicated that decisions to begin smoking were motivated by curiosity and as a means of establishing friendships while decisions to continue smoking were linked to the addictive nature of smoking and as a means of coping with stress and passing the time. The findings can be used to inform the prevention of tobacco use and to reduce the high smoking rates among adolescent boys.
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Lin KM, Chiou JY, Ko SH, Tan JY, Huang CN, Liao WC. Modifiable Lifestyle Behaviors Are Associated With Metabolic Syndrome in a Taiwanese Population. J Nurs Scholarsh 2015; 47:487-95. [PMID: 26287819 DOI: 10.1111/jnu.12163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore associations between metabolic syndrome and modifiable lifestyle behaviors among the adult population in Taiwan. DESIGN This cross-sectional study analyzed data from a nationally representative sample that participated in the 2005-2008 Nutrition and Health Survey in Taiwan. The sample (2,337 participants older than 19 years) provided data on demographic characteristics, modifiable lifestyle behaviors, anthropometric measurements, and blood chemistry panel. METHODS These data were analyzed by descriptive statistics, univariate logistic regression, and multivariate logistic regression to determine factors associated with metabolic syndrome. FINDINGS Metabolic syndrome had a prevalence of 25.2%, and this prevalence increased with age. In univariate regression analysis, metabolic syndrome was associated with age, living with family members, educational level, and modifiable lifestyle behaviors (smoking, drinking, betel quid chewing, and physical activity). Individuals with a smoking history and currently chewing betel quid had the highest risk for metabolic syndrome. CONCLUSIONS The risk for metabolic syndrome might be reduced by public health campaigns to encourage people to quit smoking cigarettes and chewing betel quid. Implementing more modifiable lifestyle behaviors in daily life will decrease metabolic syndrome in Taiwan. CLINICAL RELEVANCE Considering that betel quid chewing and tobacco smoking interact to adversely affect metabolic syndrome risk, public health campaigns against both behaviors seem to be a cost-effective and efficient health promotion strategy to reduce the prevalence rate of metabolic syndrome.
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Affiliation(s)
- Kuei-Man Lin
- Doctoral Candidate, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, and Lecturer, Department of Nursing, HungKuang University, Taichung, Taiwan
| | - Jeng-Yuan Chiou
- Associate Professor, School of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Shu-Hua Ko
- Associate Professor, HungKuang University, Department of Nursing, Taichung City, Taiwan
| | - Jung-Ying Tan
- Assistant Professor, HungKuang University, Department of Nursing, Taichung City, Taiwan
| | - Chien-Ning Huang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan and Professor, Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wen-Chun Liao
- Professor, School of Nursing, Chung Shan Medical University; Research consultant, Department of Nursing, Chun Shan Medical University Hospital, Taichung, Taiwan
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Chien SH, Liu CJ, Hong YC, Teng CJ, Hu YW, Ku FC, Yeh CM, Chiou TJ, Gau JP, Tzeng CH. Development of second primary malignancy in patients with non-Hodgkin lymphoma: a nationwide population-based study. J Cancer Res Clin Oncol 2015; 141:1995-2004. [PMID: 25971624 DOI: 10.1007/s00432-015-1979-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 04/23/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND With the improved survival of non-Hodgkin lymphoma (NHL) patients, development of second primary malignancy (SPM) has become an increasingly important issue in these long-term survivors. METHODS We conducted a retrospective study to analyze NHL patients diagnosed between January 1997 and December 2010 in Taiwan. Standardized incidence ratios (SIRs) were applied to compare the risk of SPMs in NHL patients and the general population. Multivariate analysis was performed to determine the independent predictors of SPM. RESULT NHL patients have a significantly greater risk of developing SPM [SIR 1.43; 95 % confidence interval (CI) 1.32-1.55; p < 0.001). A significantly high SIR was noted for leukemia, myeloma, and neoplasms of the bone and soft tissue, thyroid, central nervous system, skin, stomach, head and neck, liver and biliary tract, and the lungs and mediastinum. Multivariate analysis revealed that age ≥60 years [hazard ratios (HR) 2.04], being male (HR 1.22), comorbidities of chronic obstructive pulmonary disease (HR 1.34), liver cirrhosis (HR 1.50), hepatitis C infection (HR 1.94) and therapy containing radiotherapy (HR 1.38) were the significant predictors for SPM occurrence. The median follow-up time and survival time were 3.37 and 9.45 years, respectively. CONCLUSION This Taiwanese population-based study provides updated data about the risk of SPM in NHL patients, demonstrating an approximately 1.5 time greater risk of SPM compared to the general population. A high risk of SPM for myeloma and hepatocellular carcinoma is unique to Asian patients.
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Affiliation(s)
- Sheng-Hsuan Chien
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan
| | - Chia-Jen Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Chung Hong
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Hematology and Oncology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chung-Jen Teng
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Oncology and Hematology, Department of Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Yu-Wen Hu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fan-Chen Ku
- Department of Hematology and Oncology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Chiu-Mei Yeh
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Tzeon-Jye Chiou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jyh-Pyng Gau
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan.
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Cheng-Hwai Tzeng
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Road, Sec. 2, Taipei, 11217, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Arora D, Marya CM, Menon I, Oberoi SS, Dhingra C, Anand R. Cross sectional survey on association between alcohol, betel- nut, cigarette consumption and health promoting behavior of industrial workers in Ghaziabad. Asian Pac J Cancer Prev 2015; 16:139-44. [PMID: 25640341 DOI: 10.7314/apjcp.2015.16.1.139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The work force in industries are at risk of developing unduly high rates of health and behaviour related problems including abuse of alcohol, betel nut and cigarette (alcohol, betel nut and cigarette consumption). This study describes the relationships between alcohol, betel nut and cigarette consumption and health promoting behaviour among industrial workers. MATERIALS AND METHODS A cross sectional survey was conducted on workers in various industries of Ghaziabad city with concerned authority permission. A sample size of 732 workers was calculated based on pilot study. Through Simple random sampling 732 workers in 20 to 50 years age group with informed consent were interviewed through structured, pretested, validated questionnaire in vernacular language by one calibrated investigator. Data on socio demography, alcohol, betel nut and cigarette consumption pattern and health behaviour were collected. The association between health promoting behaviour and alcohol, betel nut and cigarette consumption was analysed by Logistic regression and Chi-square test through SPSS 16 at p<0.05 and 95%CI as significant. RESULTS Total prevalence of alcohol, betel nut and cigarette consumption in study population was 88%. The prevalence of individual alcohol, betel nut and cigarette consumption were 82%, 68% and 79% respectively. Combined alcohol, betel nut and cigarette prevalence in study population was 58%. Alcohol and cigarette users were significantly higher (p<0.001) in 30 to 40 years age group with lower level of education having poor attitude towards health promoting behaviour, poor oral hygiene practices and rare indulgence in regular physical exercise. CONCLUSIONS This study stimulate further research on exploring methods to prevent initiation of health risk behaviour and promote healthy behaviour with cessation help for the current alcohol, betel nut and cigarette users.
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Affiliation(s)
- Dimple Arora
- Department of Public Health Dentistry, Sudha Rustogi College of Dental Sciences and Reserch, Faridabad, India E-mail :
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Surgical site infections among high-risk patients in clean-contaminated head and neck reconstructive surgery: concordance with preoperative oral flora. Ann Plast Surg 2014; 71 Suppl 1:S55-60. [PMID: 24284742 DOI: 10.1097/sap.0000000000000046] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Salivary contamination of surgical wounds in clean-contaminated head and neck surgery with free flap reconstruction remains a major cause of infection and leads to significant morbidity. This study investigates the correlation between intraoral flora and surgical site infections (SSIs) among high-risk head and neck cancer patients undergoing resection and free flap reconstruction. METHODS One hundred twenty-nine patients were identified as being at high risk for infective complications based on cancer stage, tumor size, comorbid factors, and extent of reconstruction. All patients had intraoral swab cultures before surgery. Patients with culture-confirmed SSI after surgery were chosen for analysis, using the κ index and its 95% confidence interval for concordance analysis. All patients received clindamycin and gentamicin for antibiotic prophylaxis for 5 days. Antibiotic susceptibility testing of all isolates was obtained and analyzed. RESULTS Thirty-seven patients experienced SSI, or an infection rate of 28.3%, occurring at a mean of 9.3 postoperative days. The overall concordance between oral flora and SSI was fair to moderate (κ index of 0.25), but detailed analysis shows a higher concordance for known and opportunistic pathogens, such as Pseudomonas aeruginosa and Enterococcus faecalis, compared to typical oral commensals. Antibiotic susceptibility tests show rapid and significant increases in resistance to clindamycin, indicating a need for a more effective alternative. CONCLUSIONS Predicting pathogens in SSI using preoperative oral swabs did not demonstrate a good concordance in general for patients undergoing clean-contaminated head and neck surgery, although concordance for certain pathogenic species seem to be higher than for typical intraoral commensals. The rapid development of resistance to clindamycin precludes its use as a prophylactic agent.
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Hsieh YC, Lee CH, Tu SH, Wu CH, Hung CS, Hsieh MC, Chuang CW, Ho YS, Chiou HY. CHRNA9 polymorphisms and smoking exposure synergize to increase the risk of breast cancer in Taiwan. Carcinogenesis 2014; 35:2520-5. [PMID: 25142973 DOI: 10.1093/carcin/bgu179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Previous studies indicated that smoking exposure is associated with an increased risk of breast cancer, and α9-nicotine acetylcholine receptors (α9-nAChRs) are involved in breast tumorigenesis. However, no studies have explored the joint effect of α9-nAChRs (CHRNA9) genes and cigarette smoking exposure on breast cancer risk. A case-control study was conducted on 737 breast cancer patients and 719 age-matched healthy controls. Three single-nucleotide polymorphisms (SNPs) of CHRNA9 located in the promoter region were genotyped and compared between cases and controls to identify those SNPs associated with breast cancer susceptibility. A dual-luciferase reporter assay was used to analyze the promoter activities of these SNPs of the CHRNA9 gene. After a Bonferroni correction, the G allele of the CHRNA9 rs7329797 SNP was significantly associated with an increased risk of developing breast cancer compared with A/A genotype carriers (odds ratio, 1.8; 95% confidence interval, 1.2-2.6). A multiplicative interaction between passive smoking exposure and the CHRNA9 rs73229797 SNP on the risk of breast malignancy was observed. A functional assay further showed that rs73229797 was associated with increased promoter activity of the CHRNA9 gene. Our findings support a significant interaction effect existing between the CHRNA9 gene and smoking exposure on the risk of breast cancer development.
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Affiliation(s)
- Yi-Chen Hsieh
- PhD Program for Neural Regenerative Medicine and Graduate Institute of Medical Sciences, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan, Department of Surgery, Cathay General Hospital, Taipei 10630, Taiwan, Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei 23561, Taiwan, Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan, Department of Surgery, Taipei Medical University-Wan Fang Hospital, Taipei 11696, Taiwan and School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei 11031, Taiwan
| | - Chia-Hwa Lee
- Graduate Institute of Medical Sciences, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Shih-Hsin Tu
- Department of Surgery, Cathay General Hospital, Taipei 10630, Taiwan
| | - Chih-Hsiung Wu
- Department of Surgery, Taipei Medical University-Shuang Ho Hospital, Taipei 23561, Taiwan
| | - Chin-Sheng Hung
- Department of Surgery, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Mao-Chih Hsieh
- Department of Surgery, Taipei Medical University-Wan Fang Hospital, Taipei 11696, Taiwan and
| | - Ching-Wen Chuang
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei 11031, Taiwan
| | - Yuan-Soon Ho
- Graduate Institute of Medical Sciences, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Hung-Yi Chiou
- School of Public Health, College of Public Health and Nutrition, Taipei Medical University, 250 Wu-Hsing St., Taipei 11031, Taiwan
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Khanal V, Adhikari M, Karki S. Social determinants of tobacco consumption among Nepalese men: findings from Nepal Demographic and Health Survey 2011. Harm Reduct J 2013; 10:40. [PMID: 24359118 PMCID: PMC3880042 DOI: 10.1186/1477-7517-10-40] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 12/16/2013] [Indexed: 12/23/2022] Open
Abstract
Background In the 20th century, 100 million people across the globe lost their lives due to consumption of tobacco. Every year 15,000 deaths in Nepal are attributable to tobacco smoking and using other products of tobacco. This study aimed to establish the proportion and the social determinants of tobacco use among Nepalese men based on the Nepal Demographic and Health Survey (NDHS), 2011. Methods This study used the NDHS 2011 data. The prevalence of cigarette smoking, other forms of tobacco 16 smoking and use of tobacco in any form is reported as a percentage (%). The significance of association of the statistically significant variables established using Chi-square test was further tested by using multiple logistic regression. Results Of the 4121 participants, the prevalence of consuming any form of tobacco was 51.9% [95% confidence interval (CI) (49.6%- 54.3%)]; chewing/sniffing tobacco was 34.8% (95% CI: 32.4%- 37.3%) and tobacco smoking was 33.6% (95% CI 31.3%-36.0%). Men with no education [Odds Ratio (OR) 3.477; 95% CI (2.380-5.080)], from an older age group (36–49) [OR 2.399; 95% CI (1.858-3.096)] who were from a manual occupation [OR 1.538; 95% CI (1.188-1.985)], who were married[OR 1.938; 95% CI ( 1.552-2.420)], and who were from the Terai region [OR 1.351; 95% CI (1.083-1.684)] were more likely to consume tobacco. Men who watched television at least once a week [OR 0.642; 95% CI (0.504-0.819)] were less likely to consume tobacco. Conclusions The current study showed that over half of Nepalese men consume tobacco. There is an urgent need to fully implement Nepal’s Tobacco Control and Regulation Act which will ban smoking in public places; enforced plain packaging and display of health warnings over 75% of the packaging, and has banned selling of tobacco products to those under 18 years of age. There is a need to increase the social unacceptability of tobacco in Nepal by raising awareness through different electronic and cultural media. Anti-tobacco campaigns should focus on those who are less educated, have manual occupations, are in poorer economic groups, and are from the Terai region of Nepal.
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Affiliation(s)
- Vishnu Khanal
- Sanjeevani College of Medical Sciences, Butwal, Nepal.
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Petti S, Masood M, Scully C. The magnitude of tobacco smoking-betel quid chewing-alcohol drinking interaction effect on oral cancer in South-East Asia. A meta-analysis of observational studies. PLoS One 2013; 8:e78999. [PMID: 24260143 PMCID: PMC3832519 DOI: 10.1371/journal.pone.0078999] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/22/2013] [Indexed: 02/03/2023] Open
Abstract
Tobacco smoking, betel quid chewing and alcohol drinking are oral cancer risk factors. Observational studies unanimously report that oral cancer risk in smoking-drinking-chewing exposed subjects is exceptionally high. However, none of them assessed the fractions of this risk attributable to the three individual risk factors and to the smoking-drinking-chewing interaction. The present study sought to assess the magnitude of the smoking-drinking-chewing interaction effect on oral cancer. A meta-analysis of observational South-East Asian studies which reported oral cancer odds ratios (ORs) stratified for smoking-drinking-chewing exposures was performed. The pooled ORs were estimated and controlled for quality, heterogeneity, publication bias and inclusion criteria. The smoking-drinking-chewing interaction effect was estimated through the pooled Relative Excess Risk due to Interaction (RERI, excess risk in smoking-drinking-chewing exposed individuals with respect to the risk expected from the addition of the three individual risks of smoking, drinking and chewing). Fourteen studies were included with low between-study heterogeneity. The pooled ORs for smoking, drinking, chewing, smoking-drinking-chewing, respectively were 3.6 (95% confidence interval −95% CI, 1.9–7.0), 2.2 (95% CI, 1.6–3.0), 7.9 (95% CI, 6.7–9.3), 40.1 (95% CI, 35.1–45.8). The pooled RERI was 28.4 (95% CI, 22.9–33.7). Among smoking-drinking-chewing subjects, the individual effects accounted for 6.7% (smoking), 3.1% (drinking), 17.7% (chewing) of the risk, while the interaction effect accounted for the remaining 72.6%. These data suggest that 44,200 oral cancer cases in South-East Asia annually occur among smoking-drinking-chewing exposed subjects and 40,400 of these are exclusively associated with the interaction effect. Effective oral cancer control policies must consider concurrent tobacco smoking, alcohol drinking, betel quid chewing usages as a unique unhealthy lifestyle.
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Affiliation(s)
- Stefano Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
- * E-mail:
| | - Mohd Masood
- Centre of Studies for Community Dentistry, Faculty of Dentistry, Universiti Teknologi Mara, Shah Alam, Malaysia
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Investigating the association between oral hygiene and head and neck cancer. Oral Oncol 2013; 49:1010-7. [PMID: 23948049 DOI: 10.1016/j.oraloncology.2013.07.004] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This analysis examined the association between oral hygiene and head and neck cancer (HNC) and whether this association differed by the consumption of alcohol, betel quid, or cigarette and by the genetic polymorphisms of inflammation-related genes. MATERIALS AND METHODS Interviews regarding dental care and oral health were conducted with 317 HNC cases and 296 controls. Genotyping was performed for 6 single nucleotide polymorphisms in IL6, IL10 and PTGS2. RESULTS A positive association was observed between HNC and no regular dental visits (odds ratio (OR)=2.86, 95% confidence interval (CI): 1.47-5.57), brushing teeth <2times/day (OR=1.51, 95% CI: 1.02-2.23), frequent gum bleeding (OR=3.15, 95% CI: 1.36-7.28), and loss of >20 teeth (OR=2.31, 95% CI: 1.05-5.07). Analysis with dental care score (range: 0-4, 4=worst dental care), which combined regular dental visits, toothbrushing, and use of dental floss and mouthwash, showed a positive trend with HNC risk, particularly among alcohol drinkers and cigarette smokers. Multifactor dimensionality reduction analysis divided the study subjects into high- and low-risk group based on combinations of dental care score and IL6 rs1800796 genotypes. Compared to the low-risk group, the high-risk group had an OR of HNC=2.16 (95% CI: 1.44-3.25). CONCLUSIONS This study observed a positive association between poor oral hygiene and HNC, which appeared to differ by alcohol or cigarette consumption and the genotypes of IL6 rs1800796. Further investigations are needed to determine whether poor oral hygiene is a cause for HNC or a surrogatemarker of an unhealthy lifestyle that increases the risk of HNC.
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