Prevalence of Prostate Cancer in High Boron-Exposed Population: A Community-Based Study

We investigated the possible relationship between boron exposure and prostate cancer (PCa) for men living and being employed at boron mines in villages with rich boron minerals. Out of 456 men studied, 159 were from villages with rich boron sources and boron levels in drinking water of >1?mg?L(-1) and these men formed the study group, while 63 from villages with rich boron sources and boron levels in drinking water of <1?mg?L(-1) were enrolled into control group?1. A further 234 subjects from other villages with no boron mines were considered as control group?2. Prostate specific antigen (PSA) levels could be obtained from a total of 423 men. Urinary boron concentration as an indicator of boron exposure in 63 subjects, prostatic volumes by transrectal ultrasonography in 39 subjects, and prostatic biopsies in 36 subjects were obtained for study and control groups. The daily boron exposure was calculated according to urinary boron levels. Although there was no significant difference among the groups in terms of total PSA levels, the number of subjects with tPSA ≥2.5 and tPSA ≥10.0?ng?dL(-1) prostatic volumes in men whose prostates were biopsied (p?相似文献   

The High Prevalence of Overweight and Obesity in Mexican Children

Objective: To establish the prevalence of overweight and obesity in Mexican children 10 to 17 years of age according to the percentiles from both the Centers of Disease Control and Prevention (CDC) and the International Obesity Task Force (IOTF). Research Methods and Procedures: Heights and weights were measured in children from nationally representative, randomly chosen households in the Mexican National Health Survey 2000. The study population consisted of 7862 boys and 8947 girls, 10 to 17 years of age. Measurements used were the percentage of children in the corresponding BMI categories for overweight and obesity specified by the CDC and the IOTF BMI percentiles. Results: The children were short, with mean Z scores for height by age varying from ? 0.62 ± 1.26 to ?1.12 ± 1.06 in boys and from ?0.45 ± 1.25 to ?1.19 ± 1.12 in girls. CDC‐based overweight prevalences varied by age from 10.8% to 16.1% in boys and 14.3% to 19.1% in girls, with obesity prevalences from 9.2% to 14.7% in boys and 6.8% to 10.6% in girls; these prevalences did not relate to stunting. IOTF‐based excess weight prevalences were similar, with higher overweight rates (boys, 15.4% to 18.8%; girls, 18.4% to 22.3%) but lower obesity rates (boys, 6.1% to 9%; girls, 5.9% to 8.2%). Discussion: Mexican children have one‐half the overweight/obesity prevalences of U.S. Mexican‐American children; however, there are higher rates in Northern Mexico, which is closer to the U.S. These escalating rates of excess weight demand new prevention, as well as management, policies.     

Prevalence of Farmer's Lung in Scotland: A Pilot Survey

In a survey of the farming population of Orkney, Ayrshire, and East Lothian the prevalence of farmer''s lung was estimated at 86 per 1,000 in both Orkney and Ayrshire and 23 per 1,000 in East Lothian. If cases with a negative farmer''s lung hay (F.L.H.) precipitin test are excluded these figures are reduced to 43, 36, and nil respectively, but those for Orkney and Ayrshire are still about 20 times higher than any figure previously reported for the prevalence of farmer''s lung in Britain.Regional variations in prevalence are probably related both to climatic conditions and to differences in agricultural methods, the latter often being dictated by economic circumstances. Nevertheless the prevalence of farmer''s lung could be reduced considerably by the energetic application of preventive measures, backed by financial incentives. The most important of these are efficient drying of hay and cereals before storage, more extensive use of silage, better ventilation of farm buildings, and the introduction of mechanical feeding systems. Individual farmworkers could be taught how to recognize the early symptoms of the disease and encouraged to wear respirators when handling mouldy fodder.     

High Prevalence of Anemia in Children and Adult Women in an Urban Population in Southern Brazil

This population-based study was designed to detect the prevalence of anemia in a healthy population of children (18 months to 7 years) and women (14 to 30 years) tested in 2006–2007 in the state of Rio Grande do Sul, Brazil as part of an effort to tackle this massive problem that still affects so many people in the XXI century. Anemia was defined according to the WHO. Capillary blood was measured and socioeconomic status was determined according to the Brazilian Association of Market Research Agencies. The median prevalence of anemia in 2198 children was 45.4% and in 1999 women 36.4%. Anemia decreased with age during childhood; although significantly more prevalent in lower classes individuals, it was also high in the upper classes. There are indirect evidences that the lack of iron supplementation and/or iron fortified food may play a role in it. Professionals and society wise measures of education have to be implemented in order to address possible biologic factors involved in childhood psychosocial development in southern Brazil.     

Defining the Study Population for an Observational Study to Ensure Sufficient Overlap: A Tree Approach

The internal validity of an observational study is enhanced by only comparing sets of treated and control subjects which have sufficient overlap in their covariate distributions. Methods have been developed for defining the study population using propensity scores to ensure sufficient overlap. However, a study population defined by propensity scores is difficult for other investigators to understand. We develop a method of defining a study population in terms of a tree which is easy to understand and display, and that has similar internal validity as that of the study population defined by propensity scores.     

High Prevalence of the BIM Deletion Polymorphism in Young Female Breast Cancer in an East Asian Country

Background

A rapid surge of female breast cancer has been observed in young women in several East Asian countries. The BIM deletion polymorphism, which confers cell resistance to apoptosis, was recently found exclusively in East Asian people with prevalence rate of 12%. We aimed to evaluate the possible role of this genetic alteration in carcinogenesis of breast cancer in East Asians.

Method

Female healthy volunteers (n = 307), patients in one consecutive stage I-III breast cancer cohort (n = 692) and one metastatic breast cancer cohort (n = 189) were evaluated. BIM wild-type and deletion alleles were separately genotyped in genomic DNAs.

Results

Both cancer cohorts consistently showed inverse associations between the BIM deletion polymorphism and patient age (≤35 y vs. 36-50 y vs. >50 y: 29% vs. 22% vs. 15%, P = 0.006 in the consecutive cohort, and 40% vs. 23% vs. 13%, P = 0.023 in the metastatic cohort). In healthy volunteers, the frequencies of the BIM deletion polymorphism were similar (13%-14%) in all age groups. Further analyses indicated that the BIM deletion polymorphism was not associated with specific clinicopathologic features, but it was associated with poor overall survival (adjusted hazard ratio 1.71) in the consecutive cohort.

Conclusions

BIM deletion polymorphism may be involved in the tumorigenesis of the early-onset breast cancer among East Asians.     

Children at High Risk for Overweight: A Classification and Regression Trees Analysis Approach

Objective: Early identification of children at high risk for childhood overweight is a major challenge in fighting the obesity epidemic. We tried to identify the most powerful set of combined predictors for childhood overweight at school entry. Research Methods and Procedures: A classification and regression trees analysis on risk factors for childhood overweight in 4289 children 5 to 6 years of age participating in the obligatory school entry health examination 2001/2002 in Bavaria, Germany, was performed. Parental questionnaires asked for children's weight at birth and 2 years, breastfeeding history, maternal smoking in pregnancy, parental education, parental overweight/obesity, nationality, and number of older siblings. Overweight was defined according to sex‐ and age‐specific BMI cut‐points proposed by the International Obesity Task Force. Results: Prevalence of overweight was 11% among the entire study population. Although high early weight gain >10, 000 grams was found in about one‐half of the overweight children, its positive predictive value reached only 25%, indicating that one of four children with a high early weight gain is overweight at school entry. The best reliable set of predictors included high early weight gain and obese parents and accounted for a likelihood ratio of 3.6, with a corresponding positive predictive value of 40%, and was found in 4% of all children. Discussion: A combination of predictors available at 2 years of age could improve predictability of overweight at school entry. However, corresponding low positive predictive values indicate a precision of the prediction that might be insufficient for targeting intervention programs for identified high‐risk children.     

The Effect of Dietary Glycemic Index on Weight Maintenance in Overweight Subjects: A Pilot Study

Evidence suggests that a low‐glycemic index (LGI) diet has a satiating effect and thus may enhance weight maintenance following weight loss. This study was conducted at Hammersmith Hospital, London, UK, and assessed the effect of altering diet GI on weight‐loss maintenance. It consisted of a weight‐loss phase and a 4‐month randomized weight maintenance phase. Subjects were seen monthly to assess dietary compliance and anthropometrics. Appetite was assessed bimonthly by visual analogue scales while meal challenge postprandial insulin and glucose concentrations were assessed before and after the intervention. Following a median weight loss of 6.1 (interquartile range: 5.2–7.1) % body weight, subjects were randomized to a high‐glycemic index (HGI) (n = 19) or LGI (n = 23) diet. Dietary composition differed only in GI (HGI group: 63.7 ± 9.4; LGI group: 49.7 ± 5.7, P < 0.001) and glycemic load (HGI group: 136.8 ± 56.3; LGI group: 89.7 ± 27.5, P < 0.001). Groups did not differ in body weight (weight change over 4 months, HGI group: 0.3 ± 1.9 kg; LGI group: −0.7 ± 2.9 kg, P = 0.3) or other anthropometric measurements. This pilot study suggests that in the setting of healthy eating, changing the diet GI does not appear to significantly affect weight maintenance.     

Prevalence of Uncomplicated Obesity in an Italian Obese Population

Objective: The existence of healthy obese subjects has been suggested but not clearly reported. We sought to address the prevalence of uncomplicated obesity and adverse risk factors in a large Italian obese population. Research Methods and Procedures: This was a cross‐sectional study of a population of consecutive Italian obese subjects. We studied 681 obese subjects (514 women and 167 men), with a mean age of 41.1 ± 13.9 years (range, 16 to 77 years), mean BMI of 40.2 ± 7.6 kg/m² (range, 30 to 89.8 kg/m²), and a history of obesity for 20.5 ± 7 years (range, 10.5 to 30 years). Anthropometric, metabolic, cardiac, and obesity‐related risk factors were evaluated. Results: The prevalence of uncomplicated subjects was 27.5%, independent of BMI and duration of obesity. The youngest group of obese subjects showed a higher, but not statistically significantly higher, prevalence of uncomplicated obesity. No statistical difference for the prevalence of impaired fasting glucose, glucose intolerance, high triglycerides, high total cholesterol, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol among BMI categories (from mild to extremely severe obesity degree) was found. Obese subjects with BMI >50 kg/m² showed a higher prevalence of high blood pressure only when they were compared with the group with a BMI of 30 to 35 kg/m² (p < 0.01). Obese subjects with BMI >40 kg/m² showed a higher prevalence of hyperinsulinemia than subjects with BMI 30 to 35 kg/m² (p < 0.01). Discussion: This study shows that a substantial part of an Italian obese population has uncomplicated obesity, and the prevalence of adverse risk factors in this sample is unexpectedly low and partially independent of obesity degree. Uncomplicated obesity could represent a well‐defined clinical entity.     

Prevalence of Overweight and Obesity and Their Associations with Socioeconomic Status in a Rural Han Chinese Adult Population

Background

The purpose of this study is to describe the prevalence of overweight, general obesity, and abdominal obesity and examine their associations with socioeconomic status in a rural Chinese adult population.

Methods

This cross-sectional study was performed on 15,236 participants ≥ 35 years of age (6,313 men [41.4%] and 8,923 women [58.6%]). Each participant’s weight, height, waist circumference (WC), and hipline circumference (HC) were measured, and demographic and socioeconomic data were collected using questionnaires.

Results

The mean body mass index (BMI) values were 23.31 ± 2.96 and 23.89 ± 3.23 kg m^-2 and the mean WC values were 79.13 ± 8.43 and 79.54 ± 8.27 cm for men and women, respectively. The age-standardized prevalence rates of overweight (BMI ≥ 24.0 kg m^-2), general obesity (BMI ≥ 28.0 kg m^-2), and abdominal obesity (WC ≥ 85 cm for men and ≥ 80 cm for women) were 32.0%, 6.7%, and 27.0% for men and 35.1%, 9.7%, and 48.3% for women, respectively. All gender differences were statistically significant (p < 0.001). In addition, the age-specific prevalence rates of general and abdominal obesity slowly decreased among men but sharply increased among women as age increased (p < 0.001). In subsequent logistic regression analysis, educational level was negatively associated with both general obesity and abdominal obesity among women but positively associated with abdominal obesity among men. No significant correlation was found between obesity and income.

Conclusions

These results suggest a high prevalence of obesity which might differ by gender and age, and an inverse association among women and a mixed association among men noted between education and obesity in our locality. Preventive and therapeutic programs are warranted to control this serious public health problem. The gender-specific characteristics of populations at high-risk of developing obesity should be taken into consideration when designing interventional programs.     

Factors Associated with Variations in Population HIV Prevalence across West Africa: Findings from an Ecological Analysis

Background

Population HIV prevalence across West Africa varies substantially. We assess the national epidemiological and behavioural factors associated with this.

Methods

National, urban and rural data on HIV prevalence, the percentage of younger (15–24) and older (25–49) women and men reporting multiple (2+) partners in the past year, HIV prevalence among female sex workers (FSWs), men who have bought sex in the past year (clients), and ART coverage, were compiled for 13 countries. An Ecological analysis using linear regression assessed which factors are associated with national variations in population female and male HIV prevalence, and with each other.

Findings

National population HIV prevalence varies between 0 4–2 9% for men and 0 4–5.6% for women. ART coverage ranges from 6–23%. National variations in HIV prevalence are not shown to be associated with variations in HIV prevalence among FSWs or clients. Instead they are associated with variations in the percentage of younger and older males and females reporting multiple partners. HIV prevalence is weakly negatively associated with ART coverage, implying it is not increased survival that is the cause of variations in HIV prevalence. FSWs and younger female HIV prevalence are associated with client population sizes, especially older men. Younger female HIV prevalence is strongly associated with older male and female HIV prevalence.

Interpretation

In West Africa, population HIV prevalence is not significantly higher in countries with high FSW HIV prevalence. Our analysis suggests, higher prevalence occurs where more men buy sex, and where a higher percentage of younger women, and older men and women have multiple partnerships. If a sexual network between clients and young females exists, clients may potentially bridge infection to younger females. HIV prevention should focus both on commercial sex and transmission between clients and younger females with multiple partners.     

Development of a Fetal Weight Chart Using Serial Trans-Abdominal Ultrasound in an East African Population: A Longitudinal Observational Study

Objective

To produce a fetal weight chart representative of a Tanzanian population, and compare it to weight charts from Sub-Saharan Africa and the developed world.

Methods

A longitudinal observational study in Northeastern Tanzania. Pregnant women were followed throughout pregnancy with serial trans-abdominal ultrasound. All pregnancies with pathology were excluded and a chart representing the optimal growth potential was developed using fetal weights and birth weights. The weight chart was compared to a chart from Congo, a chart representing a white population, and a chart representing a white population but adapted to the study population. The prevalence of SGA was assessed using all four charts.

Results

A total of 2193 weight measurements from 583 fetuses/newborns were included in the fetal weight chart. Our chart had lower percentiles than all the other charts. Most importantly, in the end of pregnancy, the 10^th percentiles deviated substantially causing an overestimation of the true prevalence of SGA newborns if our chart had not been used.

Conclusions

We developed a weight chart representative for a Tanzanian population and provide evidence for the necessity of developing regional specific weight charts for correct identification of SGA. Our weight chart is an important tool that can be used for clinical risk assessments of newborns and for evaluating the effect of intrauterine exposures on fetal and newborn weight.     

Relationships of Psychiatric Disorders with Overweight and Obesity in an Adult General Population**

Objective: To explore relationships of smoking and risk drinking status, nicotine and alcohol dependence, and anxiety, depressive, and somatoform disorders with overweight and obesity. Research Methods and Procedures: A probability sample was drawn that was representative for the adult general population, 18 to 64 years of age, in one region of Germany; the participation rate was 70.2%. After excluding those who were pregnant or had a current eating disorder according to the DSM‐IV, 4063 individuals remained. Overweight and obesity were defined according to the BMI that was assessed in the face‐to‐face in‐home standardized interview (Composite International Diagnostic Interview) on psychiatric disorders. Results: Men with a former nicotine dependence had higher odds of being overweight than men who never had a nicotine dependence (adjusted odds ratio, 1.5; confidence interval, 1.1 to 2.1). Men at current risk for drinking and current alcohol‐dependent or abusing men had lower odds of being overweight compared with men who never were alcohol dependent, abusing, or at risk for drinking (adjusted odds ratio, 0.3; confidence interval, 0.8 to 0.9). Effect sizes were small. No relationship of overweight with depressive, anxiety, or somatoform disorders was found in the multivariate analysis. Discussion: There is a relationship between being overweight and nicotine and alcohol dependence or abuse among men but not among women. Even though one reason for women to refrain from quitting smoking is the fear of weight gain, these results do not support this. This information could help convince women to try to quit smoking.     

Prevalence of Hypertension in Indian Tribes: A Systematic Review and Meta-Analysis of Observational Studies

Introduction

In India there is an increasing trend in hypertension prevalence among the general population. Studies have shown that tribal populations in India are also experiencing this burden.

Objective

The aim was to estimate the pooled prevalence of primary hypertension among adult tribal populations of India.

Methods

A systematic search was conducted in MEDLINE, IndMed, Web of Science, Google Scholar and major journals for studies published between 1981 and 2011. Two authors independently reviewed the studies, did quality assessment and extracted data in pre-coded spread-sheets. Pooled estimates of prevalence of hypertension were calculated using DerSimonian-Laird random effects model. Subgroup and sensitivity analyses and meta-regression were performed.

Results

Twenty studies or 53 subpopulations with 64 674 subjects were included in final review. The pooled estimate of hypertension prevalence was 16.1% (95% CI: 13.5, 19.2). There was significant heterogeneity among the studies (I² = 99% and Q = 4624.0, df  = 53, p<0.001). Subgroup analyses showed that year of study, acculturation status, special features, and BP measurement techniques significantly influenced prevalence, but after meta-regression analyses, ‘decade of study’ remained the only covariate that significantly and independently influenced prevalence (R² = 0.57, Q = 119.2, df  = 49, p value <0.001).

Conclusion

An increasing trend was found in the prevalence of hypertension in adult tribal populations across three decades. Although acculturation was probably the underlying agent that caused this increase, other unmeasured factors that need further research were also important. Concerned policy makers should focus on the changing health needs of tribal communities.     

Prevalence of the Metabolic Syndrome in a Bulgarian Female Population Referred for Bone Density Testing

Objective: To investigate the prevalence of the metabolic syndrome in Bulgarian women referred for bone density screening. Research Methods and Procedures: This was a cross‐sectional clinical study. Subjects were 444 consecutive 30‐ to 75‐year‐old Bulgarian women recruited from the outpatients referred for bone density testing (mean age, 52.67 ± 15.19 years; mean BMI, 26.10 ± 5.71 kg/m²). Height (centimeters), weight (kilograms), and blood pressure were measured. BMI and waist‐to‐hip ratio were calculated. Fasting plasma glucose, blood lipids, and immunoreactive insulinemia (Bayer Corp.‐Diagnostics Div., Tarrytown, NY) were determined. Body composition was analyzed by bioimpedance on a leg‐to‐leg analyser (Tanita TBF‐215; Tanita Corporation, Tokyo, Japan). Results: Of all women, 56.76% had a BMI > 25 kg/m², 45.95% had a waist circumference > 88 cm, and 64.64% had a waist‐to‐hip ratio > 0.8; 59.90% had hypertension; 4.05% had fasting plasma glucose > 7.0 mM, and 42.79% had fasting morning immunoreactive insulinemia = 16 UI/liter; 23.65% had hypercholesterolemia; and 26.35% had hypertriglyceridemia. The prevalence of the metabolic syndrome in this sample, as defined by the National Cholesterol and Education Program‐Adult Treatment Panel III, was 34.91%, and by the modified World Health Organization definition was 37.16%. Discussion: We concluded that Bulgarian women 30 to 75 years old referred for bone density testing have a high prevalence of the metabolic syndrome. Therefore, large‐scale prevention programs are needed in this field.     

Prevalence of Overweight and Obesity in Elderly People in Spain

Objective: To estimate the prevalence of obesity and overweight in the older adult population in Spain by sex, age, and educational level. Research Methods and Procedures: A cross‐sectional study was carried out in 2001 in a sample of 4009 persons representative of the noninstitutionalized population ≥60 years of age. Anthropometric measurements (BMI and waist circumference) were obtained using standardized techniques and equipment. Overweight was considered at a BMI of 25 to 29.9 kg/m² and obesity at a BMI of ≥30 kg/m². Central obesity was considered at a waist circumference of >102 cm in men and >88 cm in women. Results: The mean BMI was 28.2 kg/m² in men and 29.3 kg/m² in women. The prevalence of overweight and obesity in men was 49% and 31.5%, respectively. The corresponding percentages in women were 39.8% and 40.8%. The prevalence of obesity was higher in persons with no education than in those with third level education (i.e., university studies), especially among women (41.8% vs. 17.5%). The prevalence of central obesity was 48.4% in men and 78.4% in women. Differences by educational level were seen in only women, in whom the prevalence of central obesity was 80.9% in those with no education and 59% in those with third‐level education. Discussion: The prevalence of overweight and obesity in the Spanish adult elderly population is very high. Some other populations show similar prevalences, especially in Mediterranean countries. Socioeconomic conditions in Spain during the years these cohorts were born may partly explain the high‐frequency of obesity.     

Prevalence,Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies

Introduction

Multimorbidity is a major concern in primary care. Nevertheless, evidence of prevalence and patterns of multimorbidity, and their determinants, are scarce. The aim of this study is to systematically review studies of the prevalence, patterns and determinants of multimorbidity in primary care.

Methods

Systematic review of literature published between 1961 and 2013 and indexed in Ovid (CINAHL, PsychINFO, Medline and Embase) and Web of Knowledge. Studies were selected according to eligibility criteria of addressing prevalence, determinants, and patterns of multimorbidity and using a pretested proforma in primary care. The quality and risk of bias were assessed using STROBE criteria. Two researchers assessed the eligibility of studies for inclusion (Kappa  = 0.86).

Results

We identified 39 eligible publications describing studies that included a total of 70,057,611 patients in 12 countries. The number of health conditions analysed per study ranged from 5 to 335, with multimorbidity prevalence ranging from 12.9% to 95.1%. All studies observed a significant positive association between multimorbidity and age (odds ratio [OR], 1.26 to 227.46), and lower socioeconomic status (OR, 1.20 to 1.91). Positive associations with female gender and mental disorders were also observed. The most frequent patterns of multimorbidity included osteoarthritis together with cardiovascular and/or metabolic conditions.

Conclusions

Well-established determinants of multimorbidity include age, lower socioeconomic status and gender. The most prevalent conditions shape the patterns of multimorbidity. However, the limitations of the current evidence base means that further and better designed studies are needed to inform policy, research and clinical practice, with the goal of improving health-related quality of life for patients with multimorbidity. Standardization of the definition and assessment of multimorbidity is essential in order to better understand this phenomenon, and is a necessary immediate step.     

Epidemiology of Overweight and Obesity in a Greek Adult Population: the ATTICA Study

Objective: To evaluate the status of overweight and obesity in a Greek random sample. Research Methods and Procedures: From 2001 to 2002, 1514 men (20 to 87 years old) and 1528 women (20 to 89 years old) were enrolled into the study. Among several sociodemographic, lifestyle, and bioclinical factors, anthropometric characteristics were also recorded. Overweight and obesity were defined according to the World Health Organization classification. Results: The prevalences of overweight and obesity were 53% and 20% in men and 31% and 15% in women (p for gender differences < 0.05). The age‐adjusted peak prevalence of obesity was observed in men older than 40 years old and women between 50 and 59 years old (Bonferonni α < 0.001). Central obesity prevailed in 36% of men and 43% of women (p for gender differences < 0.001). Obesity varied from 10% in rural to 25% in urban areas, but this difference was explained mainly by differences in occupational status (p = 0.9). Moreover, obese and overweight participants were older, less educated, more frequently sedentary, consumed higher quantities of alcoholic beverages, and were devoted to an unhealthier diet as compared with those of normal weight (all p < 0.05). A positive association was also observed between BMI and diastolic and systolic blood pressures, total cholesterol, triglycerides, and glucose levels (all p < 0.001). Discussion: Overweight and obesity seem to be a great health problem in the Greek population, especially in middle‐aged and older adults. Unfavorable lifestyle habits, low education, and the classical cardiovascular risk factors were associated with the prevalence of these health conditions.