• Title/Summary/Keyword: Prospective Cohort Study

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Association of Biomarker Levels with Severity of Asbestos-Related Diseases

  • Park, Eun-Kee;Yates, Deborah H.;Creaney, Jenette;Thomas, Paul S.;Robinson, Bruce W.;Johnson, Anthony R.
    • Safety and Health at Work
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    • v.3 no.1
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    • pp.17-21
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    • 2012
  • Objectives: Asbestos-related diseases (ARDs) have increased globally over the decades, causing an economic burden and increased health care costs. It is difficult to predict the risk of development of ARDs and of respiratory disability among workers with a history of asbestos exposure. Blood based biomarkers have been reported as promising tools for the early detection of malignant mesothelioma. This study investigated whether serum soluble mesothelin-related peptide (SMRP) would reflect severity of disablement in compensable ARDs. Methods: SMRP levels were measured in a cohort of 514 asbestos-exposed subjects. Severity of ARDs was assessed by a Medical Authority comprising four specially qualified respiratory physicians. Severity of ARDs and SMRP levels were compared. Results: Mean (standard deviation) serum SMRP level in the population with compensable ARDs (n = 150) was 0.95 (0.65) nmol/L, and was positively associated with disability assessment (p = 0.01). Mean SMRP level in healthy asbestos-exposed subjects was significantly lower than those with pleural plaques (p < 0.0001) and in subjects with ARDs who received compensation (p < 0.01). Conclusion: This study indicates that serum SMRP levels correlate with severity of compensable ARDs. Serum SMRP could potentially be applied to monitor progress of ARDs. Further prospective work is needed to confirm the relationship between SMRP and disability assessment in this population.

Effectiveness of Autogenous Tooth Bone Graft Combined with Growth Factor: Prospective Cohort Study

  • Ahn, Kyo-Jin;Kim, Young-Kyun;Yun, Pil-Young;Lee, Bu-Kyu
    • Journal of Korean Dental Science
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    • v.6 no.2
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    • pp.50-57
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    • 2013
  • Purpose: Autogenous tooth bone graft is proven to be efficient. We evaluated the bone healing effect and clinical capabilities of autogenous tooth bone materials as a scaffold when growth factor is used together with this material. Materials and Methods: Subjects were those who needed implant placement and bone graft because of missing tooth or alveolar bone defect and who kept their autogenous tooth or needed extraction of other tooth. Group I included autogenous tooth bone graft with growth factor, whereas Group II had only autogenous tooth bone graft. We investigated the bone healing state through computed tomography taken just before surgery and 3 to 4 months after surgery to evaluate the effectiveness of bone graft. Group I had 9 patients, whereas Group II had 5 patients. We compared the pre- and post-operative increase of the Hounsfield unit and bone height by analyzing the computed tomography images. Result: Sinus bone grafts numbered 8 cases, and vertical ridge augmentation was performed together with 3 cases of these. Vertical ridge augmentation was performed in 2 cases, and horizontal ridge augmentation in 1 case alone. Socket graft was done in 3 cases. The post-operative mean value of the Hounsfield unit was 960 in Group I and 836.7 in Group II, but the increase was almost similar, i.e., 636.9 in Group I and 634.7 in Group II on the average. Increase of bone height was 7.6 mm in Group I and 11.1 mm in Group II on the average. This difference was attributable to the fact that most of the cases were sinus bone graft in Group II. Conclusion: In this study, we suggest the possibility of autogenous tooth bone graft materials as a scaffold besides their bone healing ability.

Human Kallikrein-2, Prostate Specific Antigen and Free-Prostate Specific Antigen in Combination to Discriminate Prostate Cancer from Benign Diseases in Syrian Patients

  • Bachour, Dala-Maria;Chahin, Emil;Al-Fahoum, Sahar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7085-7088
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    • 2015
  • Background: The high incidence of prostate cancer as the most common malignancy in males in many countries raises the question of developing reliable detection tests. The prostate specific antigen (PSA) test is the most widely used for screening for prostate cancer; however, its low specificity elevates the number of unnecessarily biopsies. Serum human kallikrein-2 (hK2) is considered as a promising marker, and especially its ratio to fPSA, for predicting the presence of malignancy to select the best choice referring to biopsy or surveillance. In this study, we investigated the role of hK2 and its combinations with other markers to discriminate prostate cancer from benign diseases in Syrian patients. Materials and Methods: In this prospective oriented cross-sectional cohort study, serum samples were collected from patients referred to many Hospitals in Damascus, Syria, between May 2011 and March 2012, and diagnosed with biopsy proven benign prostate hyperplasia (BPH) or prostate cancer (PCa). Serum was analyzed for hK2, PSA and fPSA, and the ratios of fPSA/PSA and hK2/fPSA were calculated. Results: We found that mean hK2/fPSA ratios were significantly higher (P=0.01) in prostate cancer patients than in the BPH or control groups. Also the ratio hk2/fPSA gave the largest area under the curve (AUC:0.96) which was significantly larger than for fPSA/PSA (AUC:0.41) indicative of higher specificity. Conclusions: Our results demonstrate that the ratio of hK2/fPSA might be superior to the use of fPSA/PSA alone. The hK2 could be shown to enhance the early detection of prostate cancer; especially the ratio hK2/fPSA improves specificity and hence may reduce the number of negative biopsies.

Association Between Gamma-Glutamyltransferase and Hypertension Incidence in Rural Prehypertensive Adults (농촌지역 고혈압 전단계 성인의 혈청 Gamma-Glutamyltransferase와 고혈압 발생률간의 관련성)

  • Hwang, Jun-Hyun;Shin, Ji-Yeon;Chun, Byung-Yeol;Lee, Duk-Hee;Kim, Keon-Yeop;Park, Wee-Hyun;Chae, Shung-Chull
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.1
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    • pp.18-25
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    • 2010
  • Objectives: Prehypertension is associated with a higher risk of developing hypertension compared with normotension. Yet, factors predicting the development of hypertension among prehypertensive people are ill-understood. This prospective cohort study was performed to examine if serum gamma-glutamyltrasferase (GGT) within a normal range can predict the future risk of hypertension among prehypertensive adults. Methods: Study subjects were 293 prehypertensive persons >30-years-of-age who participated in a community-based health survey in 2003 and who were followed up in 2008. Sex-specific quartiles of baseline serum GGT were used to examine association with 5-year hypertension incidence. Results: Baseline serum GGT within normal range predicted the risk of developing hypertension for 5 years only in prehypertensive women. Adjusted relative risks were 1.0, 3.7, 3.6, and 6.0 according to quartiles of baseline serum GGT (P for trend <0.01). This pattern was similarly observed in non-drinkers. However, serum GGT was not associated with incident hypertension in men. Different from serum GGT, baseline serum alanine aminotransferase, another well-known liver enzyme, did not predict the risk of incident hypertension in both genders. Conclusions: Even though baseline serum GGT within normal range strongly predicted the future risk of hypertension, it was observed only in women, Although underlying mechanisms of this association are currently unclear, serum GGT can be used to select a high risk group of hypertension in prehypertensive women.

Clinical performance and failures of zirconia-based fixed partial dentures: a review literature

  • Triwatana, Premwara;Nagaviroj, Noppavan;Tulapornchai, Chantana
    • The Journal of Advanced Prosthodontics
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    • v.4 no.2
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    • pp.76-83
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    • 2012
  • PURPOSE. Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS. An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS. There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION. The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.

Relationship between Warning Signs and Sasang Constitution(SC) in Early Stroke Patients (급성기 중풍환자의 사상체질과 중풍 경고증상, 전조증상과의 상관성 연구)

  • Choi, In-Young;Kim, Yong-Hyung;Choi, Dong-Jun;Han, Chang-Ho;Lee, Won-Chul;Jun, Chan-Yong;Cho, Ki-Ho;Choi, Sun-Mi
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.733-740
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    • 2007
  • Objective : This study investigated the relationship between warning signs and Sasang constitution (SC) in acute stroke patients. Methods : From October in 2005 to March in 2007, 629 acute stroke patients were studied. Patients were hospitalized within 14 days after the onset ofstroke at one of 3 oriental medical hospitals in Seoul and Kyong-gi province. We assessed the type of SC of acute stroke patients by Questionnaire for Sasang Constitution Classification II (QSCC II). We investigated warning signs (motor weakness, blindness, dysarthria, sensory disturbance, finger dullness, facial & eyelid spasm, neck stiffness), general characteristics, etc. Results : This study showed a higher proportion of Tae-eum & So-eum experience upper extremity sensory disturbance but So-yangexperience lower extremity sensory disturbance. Smoker So-eumexperience 1st & 2nd finger dullness more than non-smoker So-eum. So-eum women experience motor weakness more than So-eum men. Conclusion : Besides these results, we could observe almost no relationship between warning signs and Sasang constitution (SC) in acute stroke patients. More data from prospective cohort studies will help people better understand the relationship between warning signs and Sasang constitution (SC) in acute stroke patients.

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Anti-Diabetic Medications Do Not Influence Risk of Lung Cancer in Patients with Diabetes Mellitus: a Systematic Review and Meta-analysis

  • Nie, Shu-Ping;Chen, Hui;Zhuang, Mao-Qiang;Lu, Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6863-6869
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    • 2014
  • Objectives: Several preclinical and observational studies have shown that anti-diabetic medications (ADMs) may modify the risk of lung cancer. We performed a systematic review and meta-analysis evaluating the effect of metformin, sulfonylureas (SUs), thiazolidinediones (TZDs), and insulin on the risk of lung cancer in patients with diabetes mellitus (DM). Materials and Methods: We conducted a systematic search of Pubmed and Web of Science, up to August 20, 2013. We also searched the Conference Proceedings Citation Index (CPCI) and China National Knowledge Infrastructure (CNKI) for abstracts from major meetings. Fixed or random effect pooled measures were selected based on heterogeneity among studies, which was evaluated using Q test and the I2 of Higgins and Thompson. Meta-regression was used to explore the sources of between-study heterogeneity. Publication bias was analyzed by Begg's funnel plot and Egger's regression test. Associations were assessed by odds ratios (ORs) with 95% confidence intervals (CIs). Results: A total of 15 studies (11 cohort, 4 case-control) were included in this meta-analysis. In observational studies no significant association between metformin (n=11 studies; adjusted OR=0.99, 95%CI: 0.87-1.12), SUs (n=5 studies; adjusted OR=0.98, 95%CI: 0.79-1.22), or TZDs (n=7 studies; adjusted OR=0.92, 95%CI: 0.75-1.13), insulin (n=6 studies; adjusted OR=1.13, 95%CI: 0.79-1.62) use and risk of developing lung cancer was noted. There was considerable inherent heterogeneity between studies not explained by study design, setting, or location. Conclusions: Meta-analysis of existing studies does not support a protective or harmful association between ADMs use and risk of lung cancer in patients with DM. There was considerable heterogeneity across studies, and future, well-designed, prospective studies would be required for better understanding of any association.

Cost-Effectiveness Analysis of Granisetron-Based versus Standard Antiemetic Regimens in Low-Emetogenic Chemotherapy: A Hospital-based Perspective from Malaysia

  • Keat, Chan Huan;Ghani, Norazila Abdul
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7701-7706
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    • 2013
  • Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

Egg consumption is associated with a lower risk of type 2 diabetes in middle-aged and older men

  • Lee, Jieul;Kim, Jihye
    • Nutrition Research and Practice
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    • v.12 no.5
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    • pp.396-405
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    • 2018
  • BACKGROUND/OBJECTIVES: This prospective study examined gender-specific associations between egg intake and the risk of developing type 2 diabetes using data from a large-scale cohort study. SUBJECTS/METHODS: A total of 7,002 Korean adults (40-69 years) without type 2 diabetes at baseline were analyzed. Dietary intake was evaluated by a food frequency questionnaire administered at baseline (2001-2002) and the second follow-up examination (2005-2006). Type 2 diabetes was diagnosed as a fasting glucose concentration ${\geq}126mg/dL$ or current use of glucose-lowering medications or insulin injection. Multivariate Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes according to egg consumption or cholesterol intake. RESULTS: During a 14-year follow up period, 857 subjects developed type 2 diabetes. In men, frequent egg intake (2- < 4 servings/week) was associated with a 40% lower risk of developing type 2 diabetes than infrequent egg intake (0- < 1 serving/week) (HR = 0.60, 95% CI: 0.37-0.97), whereas no association between egg intake and incidence of type 2 diabetes was observed in women (HR = 0.61, 95% CI: 0.27-1.37). There was no association between cholesterol intake and risk of incident type 2 diabetes in either men or women. CONCLUSIONS: Egg consumption was inversely related to the risk of incident type 2 diabetes in men, but not in women, suggesting gender differences in the relationship between diet and disease risk.

Can Granisetron Injection Used as Primary Prophylaxis Improve the Control of Nausea and Vomiting with Low-Emetogenic Chemotherapy?

  • Keat, Chan Huan;Phua, Gillian;Kassim, Mohd Shainol Abdul;Poh, Wong Kar;Sriraman, Malathi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.469-473
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    • 2013
  • Background: The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetron injection as the primary prophylaxis in addition to dexamethasone and metochlopramide. Materials and Methods: This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 without granisetron) were randomly selected from the full patient list generated using the e-Hospital Information System (e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomiting in both acute and delayed phases) were identified through patient diaries which were adapted from the MASCC Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sickness and previous chemotherapy history were controlled using the multiple logistic regression analyses. Results: Both groups showed significant difference with LEC regimens (p<0.001). No differences were found in age, gender, ethnic group and other baseline characteristics. The granisetron group indicated a higher complete response rate in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groups showed similar complete control and complete response rates for acute nausea, delayed nausea and delayed emesis. Conclusions: Granisetron injection used as the primary prophylaxis in LEC demonstrated limited roles in CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costly alternative to protect patients from uncontrolled acute emesis.