Neuropsychological function is improved among opioid dependent adults who adhere to opiate agonist treatment with buprenorphine-naloxone: a preliminary study

Background

Among persons with opioid use disorder (OUD), neuropsychological dysfunction is associated with depression, and better neuropsychological function is associated with opioid abstinence. However, it is unknown whether depressive symptomatology or adherence to opiate agonist treatment are associated with neuropsychological change over time.

Methods

We recruited 20 buprenorphine/naloxone-treated adults with OUD (M Age?=?45.2 years [SD?=?8.1]; 25% female) to complete baseline and 6 month visits containing a neuropsychological test battery and self-reported measures of depressive symptomatology and medication adherence.

Results

Depressive symptomatology was not significantly related to neuropsychological change (p’s?>?.05). Greater adherence to buprenorphine/naloxone was associated with improvements in learning, memory, and global functioning (r’s?=?.52–60; p’s?<?.05).

Conclusions

Among OUD patients, greater adherence to buprenorphine/naloxone is associated with improved neuropsychological functioning over time. In contrast, depressive symptomatology is not associated with neuropsychological functioning over time. Supporting adherence to buprenorphine/naloxone may improve and/or preserve learning and memory functioning in individuals treated for OUD.

Trial registration

NCT01108679. Registered 21 April 2010.

     

Association of long-term adherence to the mind diet with cognitive function and cognitive decline in American women

Objectives

There is increasing attention for dietary patterns as a potential strategy to prevent cognitive decline. We examined the association between adherence to a recently developed Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet with cognitive function and cognitive decline, taking into account the interaction between the apolipoprotein E ε4 genotype and the MIND diet.

Design

Population-based prospective cohort study.

Participants

A total of 16,058 older women aged 70 and over from the Nurses’ Health Study.

Measurements

Dietary intake was assessed five times between 1984 and 1998 with a 116-item Food Frequency Questionnaire. The MIND score includes ten brain-healthy foods and five unhealthy foods. Cognition was assessed four times by telephone from 1995 to 2001 (baseline) with the Telephone Interview for Cognitive Status (TICS) and by calculating composite scores of verbal memory and global cognition. Linear regression modelling and linear mixed modelling were used to examine the associations of adherence to the MIND diet with average cognitive function and cognitive change over six years, respectively.

Results

Greater long-term adherence to the MIND diet was associated with a better verbal memory score (multivariable-adjusted mean differences between extreme MIND quintiles=0.04 (95%CI 0.01-0.07), p-trend=0.006), but not with cognitive decline over 6 years in global cognition, verbal memory or TICS.

Conclusion

Long-term adherence to the MIND diet was moderately associated with better verbal memory in later life. Future studies should address this association within populations at greater risk of cognitive decline.

     

Season,dietary factors,and physical activity modify 25-hydroxyvitamin D concentration during pregnancy

Purpose

The objectives of this cross-sectional study were to define maternal and umbilical cord blood (UCB) 25-hydroxyvitamin D (25(OH)D) to characterize maternal factors modifying 25(OH)D during pregnancy and predict UCB 25(OH)D in two subgroups with Declined [Δ25(OH)D?<0 nmol/l] and Increased [Δ25(OH)D?>0 nmol/l] 25(OH)D concentration.

Methods

A complete dataset was available from 584 women. 25(OH)D was determined at gestational weeks 6–13 and in UCB. Baseline characteristics were collected retrospectively using questionnaires. Δ25(OH)D was calculated as UCB 25(OH)D?early pregnancy 25(OH)D. Dietary patterns were generated with principal component analysis. Multivariate regression models were applied.

Results

Vitamin D deficiency was scarce, since only 1% had 25(OH)D concentration?<50 nmol/l both in early pregnancy and in UCB. Shared positive predictors of UCB 25(OH)D in the subgroups of Declined and Increased, were early pregnancy 25(OH)D (P?<?0.001) and supplemental vitamin D intake (P?<?0.04). For the Increased subgroup summer season at delivery (P?=?0.001) and “sandwich and dairy” dietary pattern characterized with frequent consumption of vitamin D fortified margarine and milk products (P?=?0.009) were positive predictors of UCB 25(OH)D. Physical activity (P?=?0.041) and maternal education (P?=?0.004) were additional positive predictors in the Declined group

Conclusions

Maternal and newborn vitamin D status was sufficient, thus public health policies in Finland have been successful. The key modifiable maternal determinants for 25(OH)D during pregnancy, and of the newborn, were supplemental vitamin D intake, frequent consumption of vitamin D fortified foods, and physical activity.

     

Effect of socio-demographic factors and obesity on blood pressure among adults based on health status in Gaza,Palestine

Aims

To identify risk factors of elevated blood pressure due to differences in socio-demographic factors, obesity, and health status.

Methods

Cross-sectional study. A total of 482 participants were chosen from Primary Healthcare Centers in Gaza City, Palestine, based on objective criteria.

Results

Systolic and diastolic blood pressure (SBP and DBP) showed significant differences according to different educational, menopausal, obesity, and health statuses, but no significant differences due to sex, marital status, and family size. Correlations of SBP with age, waist circumference, and weight were significant at P?=?0.001 (r _s?=?0.444, r _s?=?0.434, and r _s?=?0.323, respectively). Correlations of DBP with age, waist circumference, and weight were also significant at P?=?0.001 (r _s?=?0.170, r _s?=?0.374, and r _s?=?0.362, respectively). A total of 169 subjects out of 482 have SBP?≥130 mmHg and DBP?≥85 mmHg. By the multivariate logistic regression model, the odds ratio (OR) for obesity equaled 2.768 (95% CI: 1.183 to 6.475, P?=?0.019), OR for having a mother with one or more chronic diseases equaled 1.886 (95% CI: 1.185 to 3.003, P?=?0.007), and OR for a medium-sized family (6–10 members) equaled 0.611 (95% CI: 0.376 to 0.994, P?=?0.013).

Conclusion

Blood pressure increased by elevated body mass index and waist circumference; participants who have a mother with hypertension and/or diabetes are most likely to have higher blood pressure.

     

The association between maternal nutrition and lifestyle during pregnancy and 2-year-old offspring adiposity: analysis from the ROLO study

Aim

To examine the association between maternal nutrition and lifestyle factors and offspring adiposity, using baseline and 2-year postpartum follow-up data from a randomised control trial of low glycaemic index diet.

Subject and methods

Food diaries and lifestyle questionnaires were completed during pregnancy and infant feeding and maternal lifestyle questionnaires 2 years postpartum for 281 mother and infant pairs from the ROLO study. Maternal anthropometry was measured throughout pregnancy and infant and maternal anthropometry was measured 2 years postpartum.

Results

Maternal 2 year postpartum body mass index (BMI) was positively associated with offspring BMI-for-age z-score (B?=?0.105, p?=?0.015). Trimester 2 saturated fat intake was positively associated with offspring subscapular:triceps skinfold ratio (B?=?0.018, p?=?0.001). Trimester 1 glycaemic index was also positively associated with offspring sum of subscapular and triceps skinfolds (B?=?0.009, p?=?0.029).

Conclusions

Maternal BMI 2 years postpartum was positively associated with offspring BMI. Pregnancy saturated fat intake was positively and polyunsaturated fat negatively associated with offspring adiposity. While further research is necessary, pregnancy and the postpartum period may be early opportunities to combat childhood obesity.

     

Blood pressure is associated with tea consumption: A cross-sectional study in a rural,elderly population of Jiangsu China

Objectives

Tea has long been hypothesized to possess hypotensive effects. However, there is uncertainty regarding the association of tea consumption with arterial blood pressure (BP). We aimed to examine the association between tea consumption and BP components including systolic BP (SBP) and diastolic BP (DBP).

Design

Community-based, cross-sectional study of Suzhou City, Jiangsu Province, China.

Setting

Tea consumption has protective influence on BP and presence of hypertension.

Participants

4579 older adults aged 60 years or older from the Weitang Geriatric Diseases study.

Measurements

Detailed information regarding tea consumption was collected using a pre-designed questionnaire. BP components were measured at least 3 times with a minimum 5-minute interval, by well-trained research nurses.

Methods

Data of 4579 older adults (response rate: 82%) aged 60 years or older from the Weitang Geriatric Diseases study were included in the analysis and we estimated the relationship of tea consumption and BP using linear regression models and the association between tea consumption and risk of hypertension using logistic regression models.

Results

In linear regression models, higher tea consumption frequency was found to be associated with lower systolic BP values, after adjusting for the effect of age, sex, education level, lifestyle-related factors, and cardiometabolic confounding factors in overall (coefficient =-1.49, P=0.0003), normotensive (coefficient =-0.91, P=0.017) and participants without anti-hypertensive treatment (coefficient =-1.26, P=0.027). Significant inverse association between diastolic BP and frequency of tea consumption was also observed in the overall subjects (coefficient =-0.74, P=0.003). In multivariate logistic analyses, habitual tea drinking was inversely associated with presence of hypertension [odds ratio (OR)=0.79, P=0.011], and there was a progressive reduction in risk associated with higher frequency of tea consumption (P for trend=0.011).

Conclusion

Habitual tea consumption was found to be associated with lower values of components of BP and a reduced likelihood of having hypertension in older adults. Given the widespread consumption of tea throughout China and the world, together with the major cardiovascular disease risk, our findings have important implications for human health.

     

Metabolic inflexibility in women with PCOS is similar to women with type 2 diabetes

Background

An ability to switch between primarily oxidizing fat in the fasted state to carbohydrate in the fed state, termed metabolic flexibility, is associated with insulin sensitivity. Metabolic flexibility has been explored previously in women with polycystic ovary syndrome (PCOS), yet the independent or synergistic contributions of androgen excess and/or insulin resistance is not yet known. Therefore, the purpose of this article was to characterize metabolic flexibility in women with PCOS compared to women of normal BMI, obesity, or type 2 diabetes (T2DM).

Methods

Eighty-six weight-stable women; thirty with either PCOS (n?=?30), or fifty-six with obesity (n?=?12), T2DM (n?=?27), or normal BMI (n?=?17) underwent a hyperinsulinemic euglycemic clamp and indirect calorimetry to measure insulin sensitivity and substrate oxidation via indirect calorimetry, respectively.

Results

All analyses were adjusted for differences in age, ethnicity, and BMI between groups. Women with PCOS were less metabolically flexible compared to healthy women with obesity (p?<?0.0001), normal BMI (p?<?0.0001), but after controlling for glucose disposal rate, were similar to women with T2DM (p?=?0.99). When dividing women with PCOS above and below the mean cutoff for insulin resistance, the insulin resistant women with PCOS had lower rates of non-oxidative glucose metabolism (p?=?0.0001), higher levels of percent free testosterone (p?=?0.04), a higher free androgen index (p?=?0.006), more visceral adipose tissue (p?=?0.02), and were less metabolically flexible (p?=?0.007).

Conclusions

Women with T2DM were as metabolically inflexible as women with PCOS. When stratifying women with PCOS into those who are metabolically flexible and inflexible, the women who are inflexible display greater amounts of visceral fat and androgen excess. The inability to alter substrate use given the physiological stimulus may lead to subsequent increases in adiposity in women with PCOS thereby further worsening the insulin resistance.

Trial registration number

Clinical Trials.gov, NCT01482286. Registered 30 November 2011.

     

Global output of research on the health of international migrant workers from 2000 to 2017

Background

Approximately 150 million international migrant workers work under conditions that increase their risk of illness and injuries. The current study aimed to assess and analyze the global output of research on the health of international migrant workers to promote national and international policies that could help improve the health of international migrant workers.

Methods

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to the health of migrant workers during the study period from 2000 to 2017.

Results

In total, 955 documents were retrieved. The mean number of authors per document was 4.5 while the mean number of citation per document was 10.2. The retrieved documents were mainly in health policy and systems (n?=?452; 47.3%), infectious diseases (n?=?252; 26.4%), and mental and psychosocial health (n?=?239; 25.0%). The health of Latino migrant farmworkers represented the largest cluster of keywords. The USA led (n?=?389; 40.7%) with regard to the number of publications followed by China (n?=?86; 9.0%) and the UK (n?=?66; 6.9%). Researchers from the USA and Spain dominated the field. There were limited international research collaboration and a limited number and size of research networks. The American Journal of Industrial Medicine was most active (7.1%; n?=?68) in publishing documents on health of migrant workers while the Wake Forest University was the most active (10.9%; n?=?104) institution in this topic.

Conclusion

The volume of global research output on the health of migrant workers was low. There was inadequate research on non-communicable diseases and maternal health of migrant workers. International research collaboration and the number of research networks were limited. Role of several world regions, particularly Arab region with 11% of international migrant workforce was also limited. There is an urgent need to prioritize research on migrant workers, especially female migrant workers in regions with low research contribution.

     

Serum antioxidant capacity,biochemical profile and body composition of breast cancer survivors in a randomized Mediterranean dietary intervention study

Purpose

Increasing evidence suggests that Mediterranean Diet (MD) is correlated with reduced risk of breast cancer (BC) and cancer mortality, since it modifies patients’ serum antioxidant capacity, body composition and biochemical parameters. The aim of the study was to investigate whether a dietary intervention based on MD has a beneficial effect on these factors.

Methods

In this intervention study, seventy female BC survivors were randomly assigned to (1) the intervention group (personalized dietary intervention based on MD) and (2) the control group (received the updated American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and ad libitum diet). Both groups were assessed twice [beginning, end of study (after 6 months)] regarding their anthropometric and biochemical parameters, serum vitamin C, vitamin A, a-tocopherol and CoQ10 levels, dietary intake and adherence to MD. An additional intermediate analysis was conducted on participants’ body composition and biochemical profile.

Results

Concerning the intervention group, body weight, body fat mass, waist circumference, body mass index as well as HDL-cholesterol were significantly decreased (P < 0.2%). An increase was observed in the vitamin C levels in blood (P < 0.2%). In the control group, body weight, body fat mass and serum total cholesterol rose (P < 0.2%). At the end of the study the two groups were significantly different considering blood glucose, vitamin C, polyunsaturated fatty acids, vitamin A and a-tocopherol levels.

Conclusions

This randomized dietary intervention based on MD managed to ameliorate serum antioxidant capacity, body composition, adherence to MD and glycemic profile of postmenopausal BC survivors.

     

Health and well-being benefits of spending time in forests: systematic review

Background

Numerous studies have reported that spending time in nature is associated with the improvement of various health outcomes and well-being. This review evaluated the physical and psychological benefits of a specific type of exposure to nature, forest therapy.

Method

A literature search was carried out using MEDLINE, PubMed, ScienceDirect, EMBASE, and ProQuest databases and manual searches from inception up to December 2016. Key words: “Forest” or “Shinrin -Yoku” or “Forest bath” AND “Health” or “Wellbeing”. The methodological quality of each randomized controlled trials (RCTs) was assessed according to the Cochrane risk of bias (ROB) tool.

Results

Six RCTs met the inclusion criteria. Participants’ ages ranged from 20 to 79 years. Sample size ranged from 18 to 99. Populations studied varied from young healthy university students to elderly people with chronic disease. Studies reported the positive impact of forest therapy on hypertension (n?=?2), cardiac and pulmonary function (n?=?1), immune function (n?=?2), inflammation (n?=?3), oxidative stress (n?=?1), stress (n?=?1), stress hormone (n?=?1), anxiety (n?=?1), depression (n?=?2), and emotional response (n?=?3). The quality of all studies included in this review had a high ROB.

Conclusion

Forest therapy may play an important role in health promotion and disease prevention. However, the lack of high-quality studies limits the strength of results, rendering the evidence insufficient to establish clinical practice guidelines for its use. More robust RCTs are warranted.

     

Association between the Mediterranean-style dietary pattern score and physical performance: Results from TRELONG study

Objectives

To determine the association between Mediterranean-Style Dietary Pattern Score and physical performance.

Design

Data analysis of a longitudinal study of a representative, age stratified, population sample.

Setting

The TREVISO LONGEVA (TRELONG) Study, in Treviso, Italy.

Participants

In 2010, 123 men and 181 women, age 77 years and over (mean age 86.3 ± 6.8 years).

Measurements

Performing a logistic regression in a multivariate analysis, hand grip strength and Short Physical Performance Battery (SPPB) were tested in relation to Mediterranean-Style Dietary Pattern Score (MSDPS).

Results

The hand grip mean value was 10.9 kg (± 9.5) and the SPPB score was 6.3 (± 3.8). The MSDPS mean value in this study sample was 38.1/100 (± 8.1). A significant association (p=0.036) between a high adherence to the Mediterranean diet (fourth quartile) and higher performance lower limbs (SPPB>7) was found. No correlation was reported for the hand grip strength.

Conclusion

We found an association statistically significant between a high adherence to the Mediterranean diet and higher physical performance.

     

Incorporating environmental variables as precursor background variables of the theory of planned behavior to predict quitting-related intentions: a comparative study between adult and young adult smokers

Background

As previous studies suggest that the theory of planned behavior (TPB) is open to the inclusion of further predictors, identifying a number of additional background variables within the context of the TPB may help improve the predictive power of the theory. The purpose of this study is to incorporate environmental variables as precursor background variables of the TPB to predict quitting-related intentions.

Methods

This study consists of two sub-studies. Sub-study 1 and 2 analyzed different data sets and were conducted using the similar methodology for the comparison. A total of 395 Texas adult smokers (sub-study 1) and 379 university student smokers (sub-study 2) were analyzed using multiple structural equation modeling.

Results

The extent of agreement with regulating smoking in public places had positive indirect effects on intention to quit through subjective norm among both Texas adult smokers (β?=?0.03, p?<?.01) and university students (β?=?0.01, p?<?.05), and through attitude among Texas adult smokers only (β?=?0.02, p?<?.01). The number of smokers among 5 closest friends had negative indirect effect on intention to take measures to quit through subjective norm among Texas adult smokers (β?=???0.02, p?<?.05).

Conclusions

The results of this study indicate that environmental variables need to be considered as precursor background variables of the TPB to predict quitting-related intentions.

     

Cytological evaluation of breast lesions in symptomatic patients presenting to Kenyatta National Hospital,Kenya: a retrospective study

Background

Palpable breast lump, breast pain, and nipple discharge are common symptoms of breast disease. Breast cytology (fine-needle aspiration, nipple discharge smear, and touch preparation) accurately identifies benign, atypical, and malignant pathological changes in breast specimens. This study aims to determine the types of breast lesions diagnosed by breast cytology and assess the clinical adequacy of narrative reporting of breast cytology results.

Methods

Medical records of 390 patients presenting to breast or general surgery clinics in Kenyatta National Hospital, Nairobi, Kenya, between January 2010 and March 2014 were evaluated retrospectively.

Results

Of the 390 diagnosed breast lesions, 89.7 % (n?=?350) occurred in females, while 10.3 % (n?=?40) occurred in males, giving rise to a female-to-male ratio of 8.8:1. Neoplastic breast lesions (n?=?296) comprised 75.9 %, while non-neoplastic breast lesions (n?=?94) comprised 24.1 % of all diagnosed breast lesions. The neoplastic lesions were classified as 72.3 % (n?=?214) benign and 27.7 % (n?=?82) malignant, resulting in a benign-to-malignant ratio of 2.6:1. Fibroadenoma (n?=?136) and gynecomastia (n?=?33) were the most frequently diagnosed breast lesions for women and men, respectively.

Conclusions

Breast cytology effectively diagnosed neoplastic and non-neoplastic breast lesions. Neoplastic breast lesions occurred more frequently in women whereas non-neoplastic lesions occurred more frequently in men. To address the limitations associated with narrative reporting of breast cytology results, a synoptic reporting format incorporating the United Kingdom’s National Health Service Breast Screening Programme’s diagnostic categories (C1 to C5) is recommended for adoption by this hospital.

     

Iodine nutrition and thyroid nodules among children and adolescents in a coastal area of China

Aim

This study aims to assess iodine nutritional status and investigate the prevalence of thyroid nodules in children and adolescents in Ningbo city, China.

Subject and methods

A cross-sectional survey was conducted in Ningbo, China, in 2011. Salt iodine, urine iodine concentration (UIC) and thyroid nodules (by ultrasonography) were measured in 329 participants aged 6–17 years.

Results

The median UIC of all participants was 167.23 μg/L. No significant differences in UICs were observed between boys and girls (Z?=??1.06, P?=?0.29), children and adolescents (Z?=??1.88, P?=?0.06), iodized salt users and noniodized salt users (Z?=??0.10, P?=?0.92). A total of 114 nodules with maximum diameters between 1.5 and 12 mm were found among 51 (15.50 %) participants, the prevalence of thyroid nodules between children and adolescents has no significant difference (χ ²?=?0.29, P?=?0.59), and there were no significant differences in age (t?=?1.56, P?=?0.12), gender (χ ²?=?0.13, P?=?0.72), type of salt (χ ²?=?0.14, P?=?0.71), family history of thyroid diseases (P?=?0.46, Fisher’s exact test) and UICs (Z?=??1.12, P?=?0.26) between the participants with thyroid nodules and those without.

Conclusion

The iodine nutrition was adequate in children and adolescents in Ningbo city, but the prevalence of thyroid nodules among children and adolescents was high.

     

Chairing the internal medicine department- analysis of current state and future trends in Israel

Background

Professional skills and academic records of the highest degree are essential requirements for the chairmanship of internal medicine departments. Whether the new generation and future successors of Israeli chairmen is endowed with these attributes is not known.

Purpose

To determine whether there is a lack of future suitable successors for the current heads of internal medicine departments in Israel and to compare the demographic, academic and professional characteristics of the older and newer generations of department heads.

Methods

An online anonymous questionnaire was nationally distributed during 2016 to all active heads of internal medicine departments in Israel (n?=?101). First round was followed by two runs of personal phone calls to promote participation.

Results

Sixty-seven (67%) of chairmen responded. The vast majority of current chairs of internal medicine departments are males (N?=?59, 88%) over 50 years of age (N?=?58, 86%) with established academic background with lecturer degree or higher (N?=?57, 85%).Only 19 (28%) of current heads assigned a future successor. Comparison of chairmen who did and did not assigned successors demonstrated that assignment of successors was associated with higher academic status (P?<?0.02) and longer chairmanship (p?<?0.01) but not with mean age of current chairmen (p?<?0.08). Nevertheless, most assignments (55%) were done by chairmen in the 61 to 67 years age group. As compared to current chairmen, the designated successors have lesser academic status (p?<?0.01) and are characterized by a higher female prevalence (P?<?0.03).

Conclusions

Significant demographic, professional and academic differences exist between the current chairs of internal medicine departments in Israeli hospitals and their future successors. This underscores the need for reassessment of the availability and requirements of this crucial position.

     

Evidence on the longitudinal construct validity of major generic and utility measures of health-related quality of life in teens with depression

Purpose

To examine the longitudinal construct validity in the assessment of changes in depressive symptoms of widely used utility and generic HRQL instruments in teens.

Methods

392 teens enrolled in the study and completed HRQL and diagnostic measures as part of the baseline interview. HRQL measures included EuroQol (EQ-5D-3L), Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3), Quality of Well-Being Scale (QWB), Pediatric Quality of Life Inventory (PEDS-QL), RAND-36 (SF-6D), and Quality of Life in Depression Scale (QLDS). Youth completed follow-up interviews 12 weeks after baseline. Sixteen youth (4.1%) were lost to follow-up. We examined correlations between changes in HRQL instruments and the Children’s Depression Rating Scale-Revised (CDRS-R) and assessed clinically meaningful change in multi-attribute utility HRQL measures using mean change (MC) and standardized response mean (SRM) among youth showing at least moderate (20%) improvement in depression symptomology.

Results

Spearman’s correlation coefficients demonstrated moderate correlation between changes in CDRS-R and the HUI2 (r?=?0.38), HUI3 (r?=?0.42), EQ-5D-3L (r?=?0.36), SF-6D (r?=?0.39), and PEDS-QL (r?=?0.39) and strong correlation between changes in CDRS-R and QWB (r?=?0.52) and QLDS (r?=???0.71). Effect size results are also reported. Among multi-attribute utility measures, all showed clinically meaningful improvements in the sample of youth with depression improvement (HUI2, MC?=?0.20, SRM?=?0.97; HUI3, MC?=?0.32, SRM?=?1.17; EQ-5D-3L, MC?=?0.08, SRM?=?0.51; QWB, MC?=?0.11, SRM?=?0.86; and SF-6D, MC?=?0.12, SRM?=?1.02).

Conclusions

Findings support the longitudinal construct validity of included HRQL instruments for the assessment of change in depression outcomes in teens. Results of this study can help inform researchers about viable instruments to include in economic evaluations for this population.

     

Associations of the <Emphasis Type="Italic">PON1</Emphasis> rs662 polymorphism with circulating oxidized low-density lipoprotein and lipid levels: a systematic review and meta-analysis

Background

Several meta-analyses have demonstrated that the rs662 polymorphism in Paraoxonase 1 gene (PON1) gene is associated with coronary heart disease (CHD). However, it is still uncertain whether this polymorphism is associated with the plasma levels of oxidized low-density lipoprotein (Ox-LDL) and lipids. This meta-analysis is aimed to clarify the relationships between the rs662 polymorphism and plasma levels of Ox-LDL and lipids.

Methods

By searching in PubMed, Google Scholar, Web of Science, Cochrane Library, Wanfang, VIP and CNKI databases, 5 studies (1369 subjects) and 85 studies (46,740 subjects) were respectively identified for Ox-LDL association analysis and lipid association analysis. Standardized mean difference (SMD) was used to estimate the effects of the rs662 polymorphism on plasma Ox-LDL and lipid levels.

Results

The carriers of the variant R allele had higher levels of Ox-LDL (SMD?=?0.23, 95% CI?=?0.10–0.36, P?<? 0.01), triglyceride (TG) (SMD?=?0.06, 95% CI?=?0.01–0.11, P?=?0.02), total cholesterol (TC) (SMD?=?0.04, 95% CI?=?0.00–0.07, P?=?0.05) and low-density lipoprotein cholesterol (LDL-C) (SMD?=?0.04, 95% CI?=?0.00–0.08, P?=?0.04) than the non-carriers.

Conclusions

This meta-analysis suggests that the association between the PON1 rs662 polymorphism and CHD may partly be mediated by abnormal Ox-LDL and lipid levels caused by the R allele.

     

Systematic review of caregiver responses for patient health-related quality of life in adult cancer care

Purpose

In surveys and in research, proxies such as family members may be used to assess patient health-related quality of life. The aim of this research is to help cancer researchers select a validated health-related quality of life tool if they anticipate using proxy-reported data.

Methods

Systematic review and methodological appraisal of studies examining the concordance of paired adult cancer patient and proxy responses for multidimensional, validated HRQOL tools. We searched PubMed, CINAHL, PsycINFO and perused bibliographies of reviewed papers. We reviewed concordance assessment methods, results, and associated factors for each validated tool.

Results

A total of 32 papers reporting on 29 study populations were included. Most papers were cross-sectional (N?=?20) and used disease-specific tools (N?=?19), primarily the FACT and EORTC. Patient and proxy mean scores were similar on average for tools and scales, with most mean differences <10 points but large standard deviations. Average ICCs for the FACT and EORTC ranged from 0.35 to 0.62, depending on the scale. Few papers (N?=?15) evaluated factors associated with concordance, and results and measurement approaches were inconsistent. The EORTC was the most commonly evaluated disease-specific tool (N?=?5 papers). For generic tools, both concordance and associated factor information was most commonly available for the COOP/WONCA (N?=?3 papers). The MQOL was the most frequently evaluated end-of-life tool (N?=?3 papers).

Conclusions

Proxy and patient scores are similar on average, but there is large, clinically important residual variability. The evidence base is strongest for the EORTC (disease-specific tools), COOP/WONCA (generic tools), and MQOL (end-of-life-specific tools).