Family history of cancer and the risk of laryngeal cancer: a case-control study from Italy and Switzerland.

Only limited data is available on the relationship between family history of laryngeal and other neoplasms and laryngeal cancer risk. We investigated the issue using data from a multicentre case-control study conducted in Italy and Switzerland between 1992 and 2009 including 852 cases with histologically confirmed laryngeal cancer and 1970 controls admitted to hospital for acute, non neoplastic conditions. Unconditional logistic regression models adjusted for age, sex, study center, education, tobacco smoking, alcohol drinking and number of siblings were used to estimate the odds ratios (ORs) of laryngeal cancer. The multivariate OR was 2.8 (95% confidence interval [CI], 1.5-5.3) in subjects reporting a first-degree relative with laryngeal cancer, as compared to subjects with no family history. The OR was higher when the relative was diagnosed before 60 years of age (OR = 3.5, 95% CI 1.4-8.8). As compared to subjects without family history, non-smokers, and moderate drinkers, the OR was 37.1 (95% CI 9.9-139.4) for current smokers, heavy drinkers, with family history of laryngeal cancer. Family history of colorectal (OR = 1.5, 95% CI 1.0-2.3) and kidney (OR = 3.8, 95% CI 1.2-12.1) cancer were also associated to an increased risk of laryngeal cancer, while no significant increase in risk was found for family history of cancer at all sites, excluding the larynx (OR = 1.1).

Novel Macrocyclic Amidinoureas: Potent Non-Azole Antifungals Active against Wild-Type and Resistant Candida Species.

Novel macrocyclic amidinourea derivatives 11, 18, and 25 were synthesized and evaluated as antifungal agents against wild-type and fluconazole resistant Candida species. Macrocyclic compounds 11 and 18 were synthesized through a convergent approach using as a key step a ring-closing metathesis macrocyclization reaction, whereas compounds 25 were obtained by our previously reported synthetic pathway. All the macrocyclic amidinoureas showed antifungal activity toward different Candida species higher or comparable to fluconazole and resulted highly active against fluconazole resistant Candida strains showing in many cases minimum inhibitory concentration values lower than voriconazole.

Relationship of hyperactivity/inattention with adiposity and lifestyle characteristics in preschool children.

We performed a cross-sectional study in 450 nonreferred preschool children aged 4 to 6 years to assess the association between hyperactivity/inattention with adiposity and lifestyle characteristics. Measurements included scores of hyperactivity/inattention, adiposity, objectively measured physical activity, television viewing, and eating habits. Higher scores of hyperactivity/inattention were associated with lower percentage body fat, higher levels of physical activity, and less time spent in sedentary activity (all P ≤ .01). However, higher scores of hyperactivity/inattention were also associated with more television viewing and less healthy eating habits (all P ≤ .04). Except for some selected eating habits (P ≥ .07), those relationships remained significant after adjustment for age, sex, and sociodemographic confounders. To conclude, higher scores of hyperactivity/inattention are linked to different lifestyle characteristics that may in part contribute to a future development of overweight/obesity. Precise mechanisms explaining these associations and possible preventive approaches should be further investigated.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Produtividade e morfologia de vagens e sementes de variedades de fava no Estado da Paraíba

O objetivo deste trabalho foi avaliar a produtividade da fava (Phaseolus lunatus L.) e descrever a morfologia de suas vagens e sementes. Oito variedades de fava (Amarela-cearense, Boca-de-moça, Branquinha, Mororó, Olho-de-ovelha, Olho-de-peixe, Orelha-de-vó, Raio-de-sol) foram avaliadas em experimento de campo no período de julho a dezembro de 1999, em Bananeiras, PB. Todas as variedades apresentaram hábito de crescimento indeterminado trepador e vagens compridas, de forma oblonga e recurvada, com número de sementes variando de duas a quatro. A variedade com vagens de maior comprimento (89,9 mm) e maior peso de 100 sementes (79,5 g) foi a Orelha-de-vó. As variedades Olho-de-ovelha e Orelha-de-vó apresentaram a maior e menor produtividade média de 0,852 e 0,293 t ha-1 de sementes, respectivamente. Com base na variação do número de dias para florescimento e colheita, as variedades foram classificadas em precoce (Amarela-cearense, Olho-de-peixe e Orelha-de-vó), intermediária (Boca-de-moça, Branquinha, Mororó e Olho-de-ovelha) e tardia (Raio-de-sol). As variedades Olho-de-ovelha, Branquinha, Boca-de-moça, Amarela-cearense, Mororó e Olho-de-peixe são as mais promissoras para cultivos de sequeiro, com irrigação suplementar.

Subclinical Thyroid Dysfunction and the Risk of Heart Failure in Older Persons at High Cardiovascular Risk.

Context: Subclinical thyroid dysfunction is common in older people. However, its clinical importance is uncertain. Objective: Our objective was to determine the extent to which subclinical hyperthyroidism and hypothyroidism influence the risk of heart failure and cardiovascular diseases in older people. Setting and Design: The Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) is an prospective cohort study. Patients: Patients included men and women aged 70-82 yr (n = 5316) with known cardiovascular risk factors or previous cardiovascular disease. Main Outcome Measures: Incidence rate of heart failure hospitalization, atrial fibrillation, and cardiovascular events and mortality according to baseline thyroid status were evaluated. Euthyroid participants (TSH =0.45-4.5 mIU/liter) were compared with those with subclinical hyperthyroidism (TSH <0.45 mIU/liter) and those with subclinical hypothyroidism (TSH ≥4.5 mIU/liter, both with normal free T(4)). Results: Subclinical hyperthyroidism was present in 71 participants and subclinical hypothyroidism in 199 participants. Over 3.2 yr follow-up, the rate of heart failure was higher for subclinical hyperthyroidism compared with euthyroidism [age- and sex-adjusted hazard ratio (HR) = 2.93, 95% confidence interval (CI) = 1.37-6.24, P = 0.005; multivariate-adjusted HR = 3.27, 95% CI = 1.52-7.02, P = 0.002). Subclinical hypothyroidism (only at threshold >10 mIU/liter) was associated with heart failure (age- and sex-adjusted HR = 3.01, 95% CI = 1.12-8.11, P = 0.029; multivariate HR = 2.28, 95% CI = 0.84-6.23). There were no strong evidence of an association between subclinical thyroid dysfunction and cardiovascular events or mortality, except in those with TSH below 0.1 or over 10 mIU/liter and not taking pravastatin. Conclusion: Older people at high cardiovascular risk with low or very high TSH along with normal free T(4) appear at increased risk of incident heart failure.

Ihmisperäisten biologisten näytteiden käyttö lääketieteellisessä tutkimuksessa

English summary: Use of human biological samples in medical research (s. 852)

Tietokoneohjelmien rajapintojen tekijänoikeussuoja

English summary: Copyright protection of computer program interfaces (s. 852-853)

Erythème borrélien de la face [Borrelial erythema of the face]

BACKGROUND: Borrelial infection is characterized by various skin manifestations that are usually classified into three main types: chronic migratory erythema, borrelial lymphocytoma and acrodermatitis chronica atrophicans. We report an unusual case of borrelial cutaneous infection presenting as a mediofacial erythema that cannot be included in any of these three categories. CASE REPORT: A 51-year-old woman presented with infiltrated erythema of the middle of the face extending to the neck and chin. Medical history and physical examination revealed no signs of rosaceae. Infection with Borrelia was suspected on skin biopsy examination, which showed an inflammatory dermal infiltrate containing numerous plasma cells. The diagnosis of B.afzelii infection was confirmed by serology and polymerase chain reaction on the skin biopsy, both of which were positive for B.afzelii. DISCUSSION: Borrelial erythema of the face may represent a special form of cutaneous borrelial infection, which must be considered in the differential diagnosis of facial erythema, especially in areas of endemic borreliosis.

Qualidade de uva 'Isabel' tratada com cloreto de cálcio em pós-colheita e armazenada sob atmosfera modificada

Uvas 'Isabel' foram tratadas após a colheita com cloreto de cálcio (CaCl2) e submetidas a atmosfera modificada para avaliação da manutenção de sua qualidade durante o armazenamento, a 12±1 ºC e 85±2% de UR. O experimento foi conduzido em delineamento inteiramente casualizado, em esquema fatorial 5 x 2 x 5, com 3 repetições, sendo cinco doses de CaCl2 (0,0; 0,5; 1,0; 2,0 e 4,0%), dois tipos de atmosfera [ambiente e modificada (AM)] e cinco períodos, durante o armazenamento refrigerado. As avaliações foram acidez titulável (AT), sólidos solúveis (SS), relação SS/AT, pH, ácido ascórbico, incidência de podridão, perda de massa, aparência do engaço e índice de degrana. A AM reduziu a perda de massa, a incidência de podridão e manteve a aparência verde do engaço, ampliando a vida útil de uva 'Isabel' em seis dias. Doses de CaCl2 entre 0,5 e 2,0% reduziram a incidência de podridão. A aplicação de CaCl2 associado à AM reduziu a degrana em uva 'Isabel' durante o armazenamento refrigerado.

Conservação pós-colheita de manga 'Tommy Atkins' orgânica sob recobrimentos bio-orgânicos

O objetivo deste trabalho foi avaliar a conservação pós-colheita de manga 'Tommy Atkins' orgânica destinada à exportação, colhida com Boas Práticas Agrícolas (CBP) e sem Boas Práticas Agrícolas (SBP), sob recobrimentos bio-orgânicos. Manga colhida na maturidade comercial foi recoberta com extrato de erva-doce a 1,5% (CBP+ED, SBP+ED), com extrato de erva-doce adicionada à fécula de mandioca a 3,0% (CBP+ED+F, SBP+ED+F) e Controle (sem recobrimento, CBP e SBP), armazenada a 10±0,5 ºC e 85±2% UR. O uso de BPA manteve a qualidade. O recobrimento com ED comprometeu a aparência da manga pela incidência de manchas na casca; recobrimento associando F + ED manteve a qualidade e retardou o amadurecimento.

Prevalence and management of familial hypercholesterolaemia in patients with acute coronary syndromes.

AIMS: We aimed to assess the prevalence and management of clinical familial hypercholesterolaemia (FH) among patients with acute coronary syndrome (ACS). METHODS AND RESULTS: We studied 4778 patients with ACS from a multi-centre cohort study in Switzerland. Based on personal and familial history of premature cardiovascular disease and LDL-cholesterol levels, two validated algorithms for diagnosis of clinical FH were used: the Dutch Lipid Clinic Network algorithm to assess possible (score 3-5 points) or probable/definite FH (>5 points), and the Simon Broome Register algorithm to assess possible FH. At the time of hospitalization for ACS, 1.6% had probable/definite FH [95% confidence interval (CI) 1.3-2.0%, n = 78] and 17.8% possible FH (95% CI 16.8-18.9%, n = 852), respectively, according to the Dutch Lipid Clinic algorithm. The Simon Broome algorithm identified 5.4% (95% CI 4.8-6.1%, n = 259) patients with possible FH. Among 1451 young patients with premature ACS, the Dutch Lipid Clinic algorithm identified 70 (4.8%, 95% CI 3.8-6.1%) patients with probable/definite FH, and 684 (47.1%, 95% CI 44.6-49.7%) patients had possible FH. Excluding patients with secondary causes of dyslipidaemia such as alcohol consumption, acute renal failure, or hyperglycaemia did not change prevalence. One year after ACS, among 69 survivors with probable/definite FH and available follow-up information, 64.7% were using high-dose statins, 69.0% had decreased LDL-cholesterol from at least 50, and 4.6% had LDL-cholesterol ≤1.8 mmol/L. CONCLUSION: A phenotypic diagnosis of possible FH is common in patients hospitalized with ACS, particularly among those with premature ACS. Optimizing long-term lipid treatment of patients with FH after ACS is required.