Pooling analysis reveals that galectin-1 is a reliable prognostic biomarker in various cancers

Galectin-1 is reported to be upregulated in various human cancers. However, the relationship between galectin-1 expression and cancer prognosis has not been systematically assessed. In this study, we searched PubMed, Web of Science, and Embase to collect all relevant studies and a meta-analysis was performed. We found that increased galectin-1 expression was associated with tumor size (odds ratio [OR] = 1.75; 95% confidence interval [CI]: 1.06–2.89; p = 0.029), clinical stage (OR = 3.89; 95% CI: 2.40–6.31; p < 0.001), and poorer differentiation (OR = 1.39; 95% CI: 1.14–1.69; p = 0.001), but not with age (OR = 1.07; 95% CI: 0.82–1.39; p = 0.597), sex (OR = 0.89; 95% CI: 0.74–1.07; p = 0.202), or lymph node metastasis (OR = 2.57; 95% CI: 0.98–6.78; p = 0.056). In addition, we found that high galectin-1 expression levels were associated with poor overall survival (HR = 2.12; 95% CI: 1.71–2.64; p < 0.001). The results were further validated using The Cancer Genome Atlas data set. Moreover, high galectin-1 expression was significantly associated with disease-free survival (hazard ratio [HR] = 1.60; 95% CI: 1.17–2.19; p = 0.003), progression-free survival (HR = 1.93; 95% CI: 1.65–2.25; p < 0.001), and cancer-specific survival (HR = 1.82; 95% CI: 1.30–2.55; p < 0.001). Our meta-analysis demonstrated that galectin-1 might be a useful common biomarker for predicting prognosis in patients with cancer.     

Elevated levels of serum chemerin in patients with obstructive sleep apnea syndrome

Context: Chemerin is implicated to be correlated with obesity and inflammation.

Objective: This study aims to investigate whether serum chemerin is associated with the presence of obstructive sleep apnea syndrome (OSAS).

Methods: A total of 132 patients with OSAS and 108 healthy subjects were enrolled in this study.

Results: Serum chemerin levels were significantly elevated in OSAS patients (120.93 ± 25.84 µg/L vs. 107.51 ± 20.41 µg/L). Multivariable logistic regression analysis revealed that serum chemerin levels were an independent determinant of the presence of OSAS (OR 1.030, 95% CI 1.016–1.045; p < 0.001). Serum chemerin levels in severe OSAS patients were significantly higher compared with those in mild and moderate OSAS patients (p = 0.015 and p = 0.020, respectively). Spearman correlation analysis indicated that serum chemerin levels were correlated with the severity of OSAS (r = 0.210, p = 0.016). Serum chemerin were positively correlated with waist circumference (r = 0.164, p = 0.008), body mass index (r = 0.158, p = 0.014), systolic blood pressure (r = 0.135, p = 0.037), homeostasis model assessment of insulin resistance (r = 0.140, p = 0.031), C-reactive protein (r = 0.202, p = 0.002), and apnea–hypopnea index (r = 0.152, p = 0.022).

Conclusion: Elevated serum chemerin levels could be an independent predicting marker of the presence and severity of OSAS.     

YKL-40 in patients with end-stage renal disease receiving haemodialysis

Purpose: This study aimed to determine serum YKL-40 in patients with end-stage renal disease (ESRD) on haemodialysis (HD) and to evaluate the prognostic value of serum YKL-40.

Methods: Patients >18?years on maintenance HD were included. Serum YKL-40 was measured using ELISA before and after a single HD treatment.

Results: A total of 306 patients were included. Median serum YKL-40 concentration was 238?µgL^?1 (IQR: 193–291?µgL^?1) before HD treatment and 198?µgL^?1 (IQR: 147–258?µgL^?1) after HD treatment, which corresponded to age-corrected 93th percentile in healthy subjects. All-cause mortality after 2.8?years was 35.9%. Patients with serum YKL-40 in the highest quartile compared with the lowest quartile had a univariate HR of 4.0 (95% CI: 2.2–7.3, p?p?=?0.01) in multivariate analysis. Time-dependent receiver operating characteristic curves showed that serum YKL-40 after HD treatment had significant higher area under the curves from 90?d (p?=?0.004) and throughout the rest of the follow-up period when compared to serum YKL-40 before HD treatment.

Conclusion: YKL-40 was highly elevated in patients with ESRD on HD, and dialysis reduced serum YKL-40 concentrations approximately one-sixth. YKL-40 measured after dialysis was independently associated with mortality in HD patients.     

Elevated levels of urinary 17-ketosteroids in central Indian children residing near sewage treatment plant and solid waste disposal plant: A preliminary study

Urinary excretion of 17-ketosteroid (17-KS) was assessed in male pre-pubertal subjects aged (8–11 years; n = 90). Children living near sewage treatment plant and solid waste disposal plant (Group P) showed significantly higher levels of urinary 17-KS (Group P: 3.27 ± 1.63 µg/mL/CRE; p < 0.01) than children living in cleaner area (0.50 ± 0.53 µg/mL/CRE; Group C). Occurrence of urinary dibutyl phthalate in representative subjects of Group P (odds ratio: 9; p < 0.05; 95% of Confidence interval (CI) 1.93–72.99) was higher compared to Group C. Urinary concentrations of Cd (0.85 µg/g CRE ± 0.11), Mn (24.25 µg/g CRE ± 6.11) and Pb (12.39 µg/g CRE ± 2.86) in Group P were significantly (p < 0.01) higher than those found in Group C (Cd (0.28 µg/g CRE ± 0.03), Mn (13.33 µg/g CRE ± 3.20) and Pb (5.67 µg/g CRE ± 0.53)). Analyses of ambient air samples (PM₁₀) in polluted area revealed major occurrence of phthalates, whereas derivatives of trifluoromethyl, dione, etc. were identified in PM_2.5 fraction. Metal (Cd, Co, Mn and Pb) concentrations in ambient air (24 h, PM₁₀) were higher in polluted area compared to cleaner area. We conclude that elevated levels of urinary 17-KS in Group P could be attributed to higher exposure of these subjects to Endocrine disrupting chemicals (EDCs) compared to Group C.     

Air quality modeling for health risk assessment of ambient PM10, PM2.5 and SO2 in Iran

In this study, we have estimated the number of total mortality (T-mortality), cardiovascular morbidity (CV-mortality), respiratory mortality (R-mortality), hospital admissions due to cardiovascular diseases (HA-CVD), respiratory diseases (HA-RD), chronic obstructive pulmonary diseases (COPD) and acute myocardial infarction (AMI) due to exposure to particulate matter less than 10 µm (PM₁₀), 2.5 µm (PM_2.5) and sulfur dioxide (SO₂) in western Iran in 2016. The World Health Organization (WHO) method was used to assess the mortality and morbidity among the exposed people. The results showed that about 3.9% CM (95% CI: 2.9–7.8%), 3.9% HA-RD (95% CI: 2.4–7.8%) and 4.4% HA-CVD (95% CI: 3.0–6.8%) for ambient PM₁₀ and about 7.3% TM (95% CI: 4.2–9.7%), 12.1% CM (95% CI: 3.5–14.6%) and 3.0% RM (95% CI: 0–6.3%) for PM_2.5 are respectively attributed to concentrations exceeding 10 µg/m³. Furthermore, 3.2% HA-COPD (95% CI: 0–5.04%) and 4.2% AMI (95% CI: 1.6–4.3%) can be attributed to SO₂ concentrations greater than 10 µg/m³, respectively. To reduce the adverse health effect of PM, health advices provided by health authorities should be given to general population especially vulnerable people such as people with chronic lung and heart pathologies, elderly and children during the dusty days.     

Associations between chronotype,morbidity and mortality in the UK Biobank cohort

Later chronotype (i.e. evening preference) and later timing of sleep have been associated with greater morbidity, including higher rates of metabolic dysfunction and cardiovascular disease (CVD). However, no one has examined whether chronotype is associated with mortality risk to date. Our objective was to test the hypothesis that being an evening type is associated with increased mortality in a large cohort study, the UK Biobank. Our analysis included 433 268 adults aged 38–73 at the time of enrolment and an average 6.5-year follow-up. The primary exposure was chronotype, as assessed through a single self-reported question-defining participants as definite morning types, moderate morning types, moderate evening types or definite evening types. The primary outcomes were all-cause mortality and mortality due to CVD. Prevalent disease was also compared among the chronotype groups. Analyses were adjusted for age, sex, ethnicity, smoking, body mass index, sleep duration, socioeconomic status and comorbidities. Greater eveningness, particularly being a definite evening type, was significantly associated with a higher prevalence of all comorbidities. Comparing definite evening type to definite morning type, the associations were strongest for psychological disorders (OR 1.94, 95% CI 1.86–2.02, p = < 0.001), followed by diabetes (OR 1.30, 95% CI 1.24–1.36, p = < 0.001), neurological disorders (OR 1.25, 95% CI 1.20–1.30, p = < 0.001), gastrointestinal/abdominal disorders (OR 1.23, 95% CI 1.19–1.27, p = < 0.001) and respiratory disorders (OR 1.22, 95% CI 1.18–1.26, p = < 0.001). The total number of deaths was 10 534, out of which 2127 were due to CVD. Greater eveningness, based on chronotype as an ordinal variable, was associated with a small increased risk of all-cause mortality (HR 1.02, 95% CI 1.004–1.05, p = 0.017) and CVD mortality (HR 1.04, 95% CI 1.00–1.09, p = 0.06). Compared to definite morning types, definite evening types had significantly increased risk of all-cause mortality (HR 1.10, 95% CI 1.02–1.18, p = 0.012). This first report of increased mortality in evening types is consistent with previous reports of increased levels of cardiometabolic risk factors in this group. Mortality risk in evening types may be due to behavioural, psychological and physiological risk factors, many of which may be attributable to chronic misalignment between internal physiological timing and externally imposed timing of work and social activities. These findings suggest the need for researching possible interventions aimed at either modifying circadian rhythms in individuals or at allowing evening types greater working hour flexibility.     

Serum superoxide dismutase,a potential predictor for radiation pneumonitis following chemoradiotherapy in non-small cell lung cancer patients

Purpose: To explore serum superoxide dismutase (SOD) for predicting radiation pneumonitis (RP) in non-small cell lung cancer patients following chemoradiotherapy.

Methods: Serum levels for SOD were measured by enzyme-linked immunosorbent assays prior to radiation therapy (Pre-RT) and post 40 Gy/4 weeks during the treatment (Pos-RT).

Results: SOD concentrations after delivery of 40 Gy/4 weeks was associated with the development of RP. The best predictive ability of SOD was observed for a cut-off value of 56 unit/ml, with a sensitivity of 0.80 (95% CI 0.28–0.99), and a specificity of 0.67 (95% CI 0.43–0.65) (p = 0.040).

Conclusion: Serum SOD may be a potential predictor for RP, which need to be further verified.     

Rabeprazole Can Overcome the Impact of CYP2C19 Polymorphism on Quadruple Therapy

Objectives: The prospective study was designed to clarify the impact of CYP2C19 on quadruple therapies and survey the efficacies of rabeprazole‐based quadruple therapy for Helicobacter pylori infection after failure of standard triple therapies. Patients and Methods: From January 2007 to March 2009, 1055 H. pylori‐infected patients received standard triple regimens (proton‐pump inhibitor (PPI), clarithromycin, and amoxicillin). Helicobacter pylori eradication was achieved in 865 (81.9%) subjects. One hundred ninety eradication‐failure patients were enrolled and randomly assigned to receive a 7‐day eradication therapy. Ninety‐six patients were treated with esomeprazole‐based quadruple rescue therapies (EB), while 94 patients were treated with rabeprazole‐based quadruple rescue therapies (RB). Follow‐up endoscopy was done 16 weeks later to assess the treatment response. Patients’ responses, CYP2C19 genotypes, and antibiotics resistances were also examined. Results: Intention‐to‐treat analysis revealed that RB had better eradication rates than EB (EB: 72.9%; 95% CI: 64.9–80.9% and RB: 78.7%; 95% CI 72.5–84.9%) (p value = .543). Per‐protocol results were EB = 75.3%; 95% CI: 70.3–80.3% and RB = 85.1%; 95% CI: 80.6–89.6% (p value = .0401). Both regimens had similar compliance (p value = 0.155) and adverse events (p value = 0.219). We also surveyed those patients without resistance of any antibiotics. RB still showed better outcome than EB. Our data showed that esomeprazole‐based regimen and CYP2C19 Hom EM genotype were important predictors for eradication failure. Conclusions: In quadruple therapy, rabeprazole‐based regimens had better efficacy than esomeprazole‐based regimens. CYP2C19 polymorphism also played an important role in quadruple therapy. It seems advisable to change PPI to rabeprazole in second‐line quadruple therapy.     

Promoter methylation as biomarkers for diagnosis of melanoma: A systematic review and meta-analysis

Melanoma is one of the most common skin cancer that is characterized by rapid growth, early metastasis, high malignant, and mortality. Accumulating evidence demonstrated that promoter methylation of tumor-suppressor genes is implicated in the pathogenesis of melanoma. In the current study, we performed a meta-analysis to identify promising methylation biomarkers in the diagnosis of melanoma. We carried out a systematic literature search using Pubmed, Embase, and ISI web knowledge database and found that gene promoter methylation of 50 genes was reported to be associated with the risk of melanoma. Meta-analysis revealed that hypermethylation of claudin 11 (CLDN11; odds ratio [OR], 16.82; 95% confidence interval [CI], 1.97–143.29; p = 0.010), O-6-methylguanine-DNA methyltransferase (MGMT; OR, 5.59; 95% CI, 2.51–12.47; p < 0.0001), cyclin-dependent kinase inhibitor 2A (p16; OR, 6.57; 95% CI, 2.19–19.75; p = 0.0008), retinoic acid receptor β (RAR-β2; OR, 24.31; 95% CI, 4.58–129.01; p = 0.0002), and Ras association domain family member (RASSF1A; OR, 9.35; 95% CI, 4.73–18.45; p < 0.00001) was significantly higher in melanoma patients compared with controls. CLDN11 (OR, 14.52; 95% CI, 1.84–114.55; p = 0.01), MGMT (OR, 8.08; 95% CI, 1.84–35.46; p = 0.006), p16 (OR, 9.44; 95% CI, 2.68–33.29; p = 0.0005), and RASSF1A (OR, 7.72; 95% CI, 1.05–56.50; p = 0.04) hypermethylation was significantly increased in primary melanoma compared with controls. Methylation frequency of CLDN11 (OR, 25.56; 95% CI, 2.32–281.66; p = 0.008), MGMT (OR, 4.64; 95% CI, 1.98–10.90; p = 0.0004), p16 (OR, 4.31; 95% CI, 1.33–13.96; p = 0.01), and RASSF1A (OR, 10.10; 95% CI, 2.87–35.54; p = 0.0003) was significantly higher in metastasis melanoma compared with controls. These findings indicated that CLDN11, MGMT, p16, RAR-β2, and RASSF1A hypermethylation is a risk factor and a potential biomarker for melanoma. CLDN11, MGMT, p16, and RASSF1A promoter methylation may take part in the development of melanoma and become useful biomarkers in the early diagnosis of the disease.     

Grizzly bear population vital rates and trend in the Northern Continental Divide Ecosystem,Montana

We estimated grizzly bear (Ursus arctos) population vital rates and trend for the Northern Continental Divide Ecosystem (NCDE), Montana, between 2004 and 2009 by following radio-collared females and observing their fate and reproductive performance. Our estimates of dependent cub and yearling survival were 0.612 (95% CI = 0.300–0.818) and 0.682 (95% CI = 0.258–0.898). Our estimates of subadult and adult female survival were 0.852 (95% CI = 0.628–0.951) and 0.952 (95% CI = 0.892–0.980). From visual observations, we estimated a mean litter size of 2.00 cubs/litter. Accounting for cub mortality prior to the first observations of litters in spring, our adjusted mean litter size was 2.27 cubs/litter. We estimated the probabilities of females transitioning from one reproductive state to another between years. Using the stable state probability of 0.322 (95% CI = 0.262–0.382) for females with cub litters, our adjusted fecundity estimate (m_x) was 0.367 (95% CI = 0.273–0.461). Using our derived rates, we estimated that the population grew at a mean annual rate of approximately 3% (λ = 1.0306, 95% CI = 0.928–1.102), and 71.5% of 10,000 Monte Carlo simulations produced estimates of λ > 1.0. Our results indicate an increasing population trend of grizzly bears in the NCDE. Coupled with concurrent studies of population size, we estimate that over 1,000 grizzly bears reside in and adjacent to this recovery area. We suggest that monitoring of population trend and other vital rates using radioed females be continued. © 2011 The Wildlife Society.     

Athletes’ rest-activity circadian rhythm differs in accordance with the sport discipline

The correct expression of circadian rhythmicity is crucial for the body homeostasis. The rest-activity circadian rhythms (RARs) are involved in the control of the sleep-wake cycle and altered RARs could lead to a compromised health status. Many studies focused on examining sleep behavior and circadian rhythms in physically active subjects or athletes but, unexpectedly, no data on RARs are available. Therefore, we studied the existence of the RAR in athletes and the possible difference in RAR’s characteristics among sport disciplines. The study had a prospective observational design and RARs were recorded for five consecutive training days through actigraphy (Actiwatch 2 actigraph; Philips Respironics, OR, USA) in 43 athletes (mean age: 25.6 ± 3.2 years). Athletes competed in three different disciplines and had different training schedules and competition levels: professional triathletes (N = 10; 6 females and 4 males) had 2 morning (08:30–12:00) and 1 afternoon (15:00–17:00) training sessions, professional volleyball players (N = 19; 12 females and 7 males) used to train once in the morning (09:00–11:30) and once in the afternoon (15:00–18:00), and non-professional soccer players (N = 14; all males) trained always late in the evening (20:30–22:30). To determine the existence of RARs, the activity counts (A.C.) data were analyzed using the single and the population mean cosinor method; a one-way analysis of variance (ANOVA) followed by the Tukey–Kramer post-hoc test was used for the comparison of RAR characteristics among soccer, volleyball and triathlon athletes. Partial eta squared (?_p²) was used to determine the magnitude of the effect for significant outcomes (α = 0.05) in ANOVA. The presence of a significant RAR both for each of the 43 athletes (p < 0.001) and for the three categories of athletes (p < 0.001) was observed. RARs differed among sport disciplines: the Midline Estimating Statistic of Rhythm (MESOR) was significantly higher in triathletes (mean: 347 A.C. with 95% Confidence Interval [CI]: 314–379) compared to both volleyball (mean: 188 A.C. with 95% CI: 173–203; p < 0.001) and soccer players (mean: 289 A.C. with 95% CI: 267–312; p < 0.01) with ?_p² = 0.72. Amplitude (A) values showed the same significant trend of MESOR data (ANOVA: p < 0.001; ?_p² = 0.65) while the acrophase (Φ) occurred at 18:28 for soccer players, significantly later than triathlon (15:20 h; p < 0.001) and volleyball players (16:24 h; p < 0.001) (ANOVA: p < 0.001; ?p2 = 0.84). The higher training duration and intensity reached by triathlon athletes in the morning sessions caused a phase advance of their RAR’s acrophase Φ and higher MESOR and A amplitude compared to volleyball players and triathletes. Therefore, different sport disciplines require different training schedules, training loads and intensities that translate into different RARs. Strength coaches and medical staff of professional teams should strongly consider actigraphy as a practical and powerful tool to monitor RARs, sleep behavior, and the activity levels of their athletes; highlighting potential circadian disruptions through actigraphy could be helpful to prevent musculoskeletal injuries.     

Growth hormone and outcome in patients with intracerebral hemorrhage: a pilot study

Background: Endocrine alterations of the hypothalamic-pituitary-axis are one of the first measurable physiological changes in cerebral insults. During acute stress, human growth hormone (GH) is stimulated and has shown to have a prognostic value in various diseases. Within this pilot study, we evaluated the prognostic value of GH in patients with acute intracerebral hemorrhage (ICH).

Methods: In a prospective observational study in 40 consecutive patients with ICH, GH was measured on admission. The prognostic value of GH to predict 30-day mortality and 90-day functional outcome was assessed. Favorable functional outcome was defined as Barthel Index score >85 points and Modified Rankin Scale <3 points.

Results: GH levels were increased in patients who died within 30 days as compared to survivors (0.45 (IQR 0.20–1.51) vs. 1.51 (IQR 0.91–4.08) p?=?0.03), and in patients with an unfavorable functional outcome as compared to patients with a favorable functional outcome after 90 days 0.28 (IQR 0.16–0.61) vs. 0.78 (IQR 0.31–1.99) p?=?0.03). For mortality prediction, receiver-operating-characteristics revealed an area under the curve (AUC) on admission for GH of 0.78 (95% CI 0.60–0.96), which was in the range of the Glasgow Coma Score (GCS) (AUC 0.82 (95% CI 0.59–1.00) p?=?0.80). For functional outcome prediction, GH had an AUC of 0.71 (95% CI 0.54–0.87), which was statistically not different from the GCS (AUC 0.81 (95% CI 0.68–0.94) p?=?0.36).

Conclusions: In our small cohort of patients with acute ICH, elevated GH level were associated with increased mortality and worse outcome. If confirmed in a larger study, GH levels may be used as an additional prognostic factor in ICH patients. (ClincalTrials.gov number NCT00390962).     

Neutrophil-to-eosinophil ratio as a biomarker for clinical outcomes in advanced stage melanoma patients treated with anti-PD-1 therapy

Neutrophil-to-lymphocyte ratios (NLR) and eosinophil counts are associated with improved survival in melanoma patients treated with immune checkpoint inhibitors, but no study has investigated neutrophil-to-eosinophil ratios (NER) as a predictive indicator in this population. In this retrospective study evaluating anti-PD-1 treated patients with advanced melanoma, progression-free survival (PFS), overall survival (OS), objective response rates (ORR), and risk of high-grade (grade ≥3) immune-related adverse events (irAEs) were compared between groups defined by median pretreatment NLR and NER as well as median NLR and NER at 1-month post-treatment. Lower baseline NLR and NER were associated with improved OS [HR: 0.504, 95% CI: 0.328–0.773, p = .002 and HR: 0.442, 95% CI: 0.288–0.681, p < .001, respectively] on univariate testing. After accounting for multiple covariates, our multivariate analysis found that lower pretreatment NER was associated with better ORR (by irRECIST) (OR: 2.199, 95% CI: 1.071–4.582, p = .033) and improved OS (HR: 0.480, 95% CI: 0.296–0.777, p = .003). Baseline NLR, 1-month NLR, and 1-month NER were not associated with ORR, PFS, or OS outcomes; but 1-month NER correlated with lower risk of grade ≥3 irAEs (OR: 0.392, 95% CI: 0.165–0.895, p = .029). Our findings suggest baseline NER merits additional investigation as a novel prognostic marker for advanced melanoma patients receiving anti-PD-1-based regimens.     

Association between thyroxine levels at birth and choanal atresia or stenosis among infants in Texas, 2004–2007

BACKGROUND: The causes of choanal atresia or stenosis (CA) are largely unknown. Infant thyroxine (T₄) levels collected during newborn screening may be proxy measures for a risk factor present during the critical period of development. Therefore, we conducted a case‐control study to examine the association between newborn T₄ levels and CA. METHODS: Data for cases with CA and controls were obtained from the Texas Birth Defects Registry for the period of 2004 to 2007. Information on infant T₄ levels at birth was obtained from the Texas Newborn Screening Program. Controls (n = 3570) were drawn from unaffected births in Texas for the same period and frequency matched to cases (n = 69) on year of birth, then linked to the newborn screening database. Logistic regression was used to evaluate the association between continuous and categorical infant T₄ levels and nonsyndromic CA. RESULTS: After adjustment for gestational age and year of birth, infant T₄ levels were inversely associated with CA (adjusted odds ratio [AOR], 0.85; 95% confidence interval [CI], 0.80–0.90). We observed a linear trend (p < 0.001) across quartiles of T₄; compared to infants with low levels, AORs for CA were 0.50 (95% CI, 0.28–0.91), 0.39 (95% CI, 0.20–0.75), and 0.15 (95% CI, 0.06–0.40) for infants with medium‐to‐low, medium, and high levels, respectively. CONCLUSIONS: Our findings suggest a role of low thyroid hormone levels in the development of CA, or that low newborn T₄ levels are potential proxy measures of a risk factor present during the critical period. Birth Defects Research (Part A), 2012. © 2012 Wiley Periodicals, Inc.     

Time preference of headache attack and chronotype in migraine and tension-type headache

ABSTRACT

Migraine attacks have a time preference of headache attack (TPHA). Chronotype is the propensity for an individual to sleep at a particular time during a 24-h period. However, limited evidence exists regarding the association between TPHA and chronotype in individuals with migraine or tension-type headache (TTH). The aim of the present study is to investigate TPHA and chronotype in individuals with migraine and TTH, which are two of the most common primary headaches. One hundred sixty-nine first-visit migraine and TTH participants were consecutively enrolled. Information on sleep onset time and wake up time on workdays and free days, and TPHA were investigated with a face-to-face interview using a questionnaire booklet. Chronotype was assessed, using the midpoint of sleep on free days, corrected for sleep extension on free days (MSFsc), by subtracting one-half of the average weekly sleep duration. Headache frequency per month, headache intensity, impact of headache, sleep quality, daytime sleepiness, insomnia severity, and mood status were also assessed. Time preference of headache attack was reported for 45.5% and 44.8% of participants with migraine and TTH, respectively. Migraineurs with TPHA had an earlier MSFsc than did migraineurs without TPHA (1:18 a.m. ± 282 min vs. 4:18 a.m. ± 186 min; p = .022). Among migraineurs with TPHA, a later MSFsc was associated with a later preferential time of attack (β = 1.3, 95% confidence interval [CI] = 0.6–2.1, p = .004). A later MSFsc was significantly correlated with a higher headache frequency per month among migraineurs with TPHA (β = 1.9, 95% CI = 0.3–3.4, p = .023), but was not significantly correlated among migraineurs without TPHA (β = 1.4, 95% CI ?1.7–4.4, p = .332). Among TTH participants with TPHA, MSFsc was not significantly associated with a preferential time of attack (β = ?0.2, 95% CI = ?1.0 to 0.6, p = .611). Headache frequency was not associated with MSFsc among TTH participants with TPHA (β = 0.2, 95% CI = ?1.2 to 1.6, p = .792) or among TTH participants without TPHA (β = 0.4, 95% CI = ?0.5 to 1.3, p = .354). In conclusion, approximately one-half of participants with migraine and TTH reported having TPHA. Migraineurs with TPHA had an earlier chronotype than did migraineurs without TPHA. A later chronotype was associated with increased headache frequency and a later time of attack among migraineurs with TPHA. Among participants with TTH, TPHA and headache frequency were not significantly associated with chronotype.     

Association of p53 Arg72Pro polymorphism with gastric cancer: a meta-analysis

Background: p53 tumor suppressor gene Arg72Pro polymorphism has been associated with gastric cancer. However, results were inconsistent. We performed this meta-analysis to estimate the association between p53 Arg72Pro polymorphism and gastric cancer.

Methods: An electronic search of PubMed was conducted to select studies. Studies containing available genotype frequencies of Arg72Pro were chosen, and the association was assess by pooled odds ratio (ORs) with 95% confidence interval (CIs).

Results: The meta-analysis suggested that the p53 Arg72Pro was associated with the gastric cancer risk (Additive model: OR = 1.149, 95% CI = 1.045–1.263, p = 0.004; Dominant model: OR = 1.18, 95% CI = 1.049–1.328, p = 0.006; Recessive model: OR = 1.202, 95% CI = 1.013–1.427, p = 0.035) in Asian subgroup.

Conclusion: This meta-analysis suggests that p53 Arg72Pro polymorphism is associated with increased risk of gastric cancer in Asians.     

Hyperuricemia and gout are associated with cancer incidence and mortality: A meta-analysis based on cohort studies

The association between hyperuricemia or gout and cancer risk has been investigated in various published studies, but their results are conflicting. We conducted a meta-analysis to investigate whether hyperuricemia or gout was associated with the cancer incidence and mortality. Linear and nonlinear trend analyses were conducted to explore the dose–response association between them. The pooled relative risk (RR) and 95% confidence interval (CI) were used to evaluate cancer risk. A total of 24 articles (33 independent studies) were eligible for inclusion. When compared participants with the highest SUA (hyperuricemia) levels and those with the lowest SUA levels, the pooled RR was 1.08 (95% CI, 1.04–1.12), it was significantly associated among males but not among females (males, RR = 1.07; 95% CI, 1.03–1.11; females, RR = 1.06; 95% CI, 0.96–1.17). Hyperuricemia increased total cancer mortality (RR = 1.15; 95% CI, 1.05–1.26), but a significant association was observed in females rather than in males (females: RR = 1.26; 95% CI, 1.09–1.45; males, RR = 1.02; 95% CI, 0.80–1.30). Linear relationships of SUA levels with overall cancer incidence (p for nonlinearity = 0.238) and overall cancer mortality (p for nonlinearity = 0.263) were identified. However, 1 mg/dL increment in SUA levels was weakly significant in overall cancer incidence (RR = 1.01; 95% CI, 1.01–1.01) but not associated with overall cancer mortality (RR = 1.01; 95% CI, 0.99–1.03). Gout was significantly associated with increased cancer incidence (RR = 1.19; 95% CI, 1.12–1.25). In conclusion, Hyperuricemia or gout was associated with higher cancer incidence and mortality. Though a potential linear relationship between them was found, we'd better treat this result with caution.     

A prospective,randomized study of quadruple therapy and high-dose dual therapy for treatment of Helicobacter pylori resistant to both metronidazole and clarithromycin

Background and Aim. Failure of primary anti‐H. pylori therapy results in a high rate of antimicrobial resistance. Here, we investigated the efficacy of high‐dose dual therapy and quadruple therapy as salvage treatments for eradication of H. pylori resistant to both metronidazole and clarithromycin. Patients and Methods. Patients with at least one treatment failure and infected with H. pylori resistant to both metronidazole and clarithromycin, were randomized to receive either omeprazole 4 × 40 mg and amoxicillin 4 × 750 mg; or omeprazole 2 × 20 mg, bismuthcitrate 4 × 107 mg, metronidazole 4 × 500 mg and tetracycline 4 × 500 mg. Both regimens were given for 14 days. In cases of persistent infection, a cross‐over therapy was performed. Results. Eighty‐four patients were randomized. Cure of H. pylori infection was achieved in 31 patients after dual therapy and in 35 patients after quadruple therapy (per protocol: 83.8% (95% CI, 67.9–93.8) and 92.1% (95% CI, 78.6–98.3), respectively (p = 0.71); intention to treat: 75.6% (95% CI: 59.7–87.6) and 81.4% (95% CI: 66.6–91.6), respectively (p = 0.60)). Cross‐over therapy was performed in six of nine patients, four of whom were cured of the infection. Conclusion. Both high‐dose dual therapy and quadruple therapy are effective in curing H. pylori infection resistant to both metronidazole and clarithromycin in patients who experienced previous treatment failures.