Factors associated with and risk factors for depression in cancer patients – A systematic literature review

ObjectiveThe prevalence of depression in oncological patients is 3, 4-fold compared to the general population. However, the specific risk factors for these prevalence rates are not fully understood.MethodsA systematic literature review was conducted in nine electronic databases between 2005 and 2020. The quality of the eligible studies was appraised by two persons using the adapted 11-items Downs and Black checklist.ResultsAmong 2010 potentially relevant articles, 40 studies were eligible, with 27 studies of high quality and 13 studies of moderate quality. A total of 156 factors associated with depression were identified which were clustered into somatic, psychological, social and sociodemographic factors. Pre-existing depression and personality factors were the most consistent associated factors with depression in cancer patients, while for most somatic and treatment-related factors only modest associations were found.ConclusionsGrouped as bio-psycho-social associated factors, somatic factors showed a modest influence, whereas social relationship (support) and previous depression are unequivocally significantly associated with depression.     

Molecular analysis and risk factors for Escherichia coli producing extended-spectrum β-lactamase bloodstream infection in hematological malignancies

Introduction

Patients with hematologic malignancies have greater risk-factors for primary bloodstream infections (BSI).

Methods

From 2004–2009, we analyzed bacteremia caused by extended-spectrum beta-lactamase Escherichia coli (ESBL-EC) (n = 100) and we compared with bacteremia caused by cephalosporin-susceptible E. coli (n = 100) in patients with hematologic malignancies.

Objective

To assess the clinical features, risk factors, and outcome of ESBL-EC BSI in patients with hematologic malignancies, and to study the molecular epidemiology of ESBL-EC isolates.

Results

The main diagnosis was acute leukemia in 115 patients (57.5%). Death-related E. coli infection was significantly increased with ESBL-EC (34% vs. control group, 19%; p = 0.03). Treatment for BSI was considered appropriate in 64 patients with ESBL-EC (mean survival, 245±345 days), and in 45 control patients this was 443±613 (p = 0.03). In patients not receiving appropriate antimicrobial treatment, survival was significantly decreased in cases compared with controls (26±122 vs. 276±442; p = 0.001). Fifty six of the ESBL-EC isolates were characterized by molecular analysis: 47 (84%) expressed CTX-M-15, two (3.6%) SHV, and seven (12.5%) did not correspond to either of these two ESBL enzymes. No TLA-1 enzyme was detected.

Conclusions

Patients who had been previously hospitalized and who received cephalosporins during the previous month, have an increased risk of ESBL-EC bacteremia. Mortality was significantly increased in patients with ESBL-EC BSI. A polyclonal trend was detected, which reflects non-cross transmission of multiresistant E.coli isolates.     

Does the Hispanic health advantage extend to better management of hypertension? The role of socioeconomic status,sociobehavioral factors,and health care access

Hispanics in the United States (and foreign-born Hispanics in particular) have relatively favorable health given their lower socioeconomic status compared to, for example, non-Hispanic whites. This phenomenon is often called the Hispanic health paradox (HHP). This study examines whether the previously documented HHP in hypertension prevalence extends to its management using clinical and self-reported measures from the 2007–2012 National Health and Nutrition Examination Surveys. Multivariate models adjusting for demographic, socioeconomic, and sociobehavioral characteristics show an advantage among foreign-born Mexicans in hypertension prevalence relative to non-Hispanic whites (adjusted OR = 0.85). However, compared to non-Hispanic whites, foreign-born Mexicans were 38% less likely to receive treatment recommendations and, when advised to undergo treatment, were 60% less likely to adhere to treatment. Adjusting for health care access and utilization dramatically reduces disparities in hypertension control between foreign-born Mexicans and non-Hispanic whites, suggesting that insufficient systematic access to and use of quality health care erodes the HHP and contributes to the deterioration of health throughout the immigrant experience. Without appropriate interventions, particularly in health care access and utilization, poorer hypertension management among foreign-born Mexicans may negatively affect the Hispanic health profile, increase risk of cardiovascular disease-related mortality, and erode the Hispanic health advantage in the future.     

A study on risk factors for Parkinson?s disease in Indian population

Parkinson׳s disease is the second most common neurodegenerative disorder. The exact cause of selective dopaminergic neurodegeneration is unknown, but it is supposed that etiology of Parkinson׳s disease is multifactorial and consists of an interaction between environmental factors and genetic predisposition. To find out the association between environmental factors and risk of Parkinson׳s disease, a case control study was designed including 97 Parkinson׳s disease patients and 97 controls. Logistic regression analysis was used to determine the risk factors for Parkinson׳s disease. Results from the present study showed that gender, religion, education, place of living, occupation, dietary habits, tobacco chewing, smoking, alcohol intake, and head injury had no association with PD. However, chemical exposure and well water drinking were significantly associated with PD, which concluded that environmental factors could act as a risk factor for PD in some way.     

Simple rules for a “simple” nervous system? Molecular and biomathematical approaches to enteric nervous system formation and malformation

We review morphogenesis of the enteric nervous system from migratory neural crest cells, and defects of this process such as Hirschsprung disease, centering on cell motility and assembly, and cell adhesion and extracellular matrix molecules, along with cell proliferation and growth factors. We then review continuum and agent-based (cellular automata) models with rules of cell movement and logistical proliferation. Both movement and proliferation at the individual cell level are modeled with stochastic components from which stereotyped outcomes emerge at the population level. These models reproduced the wave-like colonization of the intestine by enteric neural crest cells, and several new properties emerged, such as colonization by frontal expansion, which were later confirmed biologically. These models predict a surprising level of clonal heterogeneity both in terms of number and distribution of daughter cells. Biologically, migrating cells form stable chains made up of unstable cells, but this is not seen in the initial model. We outline additional rules for cell differentiation into neurons, axon extension, cell-axon and cell–cell adhesions, chemotaxis and repulsion which can reproduce chain migration. After the migration stage, the cells re-arrange as a network of ganglia. Changes in cell adhesion molecules parallel this, and we describe additional rules based on Steinberg's Differential Adhesion Hypothesis, reflecting changing levels of adhesion in neural crest cells and neurons. This was able to reproduce enteric ganglionation in a model. Mouse mutants with disturbances of enteric nervous system morphogenesis are discussed, and these suggest future refinement of the models. The modeling suggests a relatively simple set of cell behavioral rules could account for complex patterns of morphogenesis. The model has allowed the proposal that Hirschsprung disease is mostly an enteric neural crest cell proliferation defect, not a defect of cell migration. In addition, the model suggests an explanations for zonal and skip segment variants of Hirschsprung disease, and also gives a novel stochastic explanation for the observed discordancy of Hirschsprung disease in identical twins.     

Is hyperglycemia risky enough to justify the increased risk of hypoglycemia linked with tight diabetes control?

There is an ongoing debate about the possible disadvantages of human insulin use with respect to a possibly lower awareness of hypoglycemia than is associated with animal insulin usage. Participants in this debate have not, however, discussed a major contributory factor to this life-threatening acute complication of diabetes, the pressure on patients to achieve normal levels of blood glucose. This pressure stems from the view that hyperglycemia is the major causative factor in the long-term diabetic complications. However, the evidence that supranormal levels of tissue and plasma glucose contribute to the diabetic tissue damage is not as strong as the arguments on behalf of this position. Indeed, elevated glycemia may be no more than a crude index of other, unknown metabolic derangements which may be causative agents in diabetes-associated tissue damage. Intensive efforts to "normalize" glycemia lack experimental and clinical justification, distract attention from other possible mechanisms, and may impose an unnecessary risk on the insulin-dependent diabetic population since intensive "normalization" of glycemia lowers hypoglycemia awareness, and thus increases risk of hypoglycemia, irrespective of the type of insulin used.     

Perinatal and early life risk factors for childhood brain tumors: Is instrument-assisted delivery associated with higher risk?

BackgroundThe childhood peak of brain tumors suggests that early-life exposures might have a role in their etiology. Hence, we examined in the Greek National Registry for Childhood Hematological Malignancies and Solid tumors (NARECHEM-ST) whether perinatal and early-life risk factors influence the risk of childhood brain tumors.MethodsIn a nationwide case-control study, we included 203 cases (0–14 years) with a diagnosis of brain tumor in NARECHEM-ST (2010–2016) and 406 age-, sex-, and center-matched hospital controls. Information was collected via interviews with the guardians and we analyzed the variables of interest in multivariable conditional logistic regression models.ResultsInstrument-assisted delivery was associated with higher (OR: 7.82, 95%CI: 2.18–28.03), whereas caesarean delivery with lower (OR: 0.67, 95%CI: 0.45-0.99) risk of childhood brain tumors, as compared to spontaneous vaginal delivery. Maternal alcohol consumption during pregnancy (OR: 2.35, 95%CI: 1.45–3.81) and history of living in a farm (OR: 4.98, 2.40–10.32) increased the odds of childhood brain tumors. Conversely, higher birth order was associated with lower risk (OR for 2nd vs. 1st child: 0.60, 95%CI: 0.40-0.89 and OR for 3^rd vs. 1^st: 0.34, 95%CI: 0.18-0.63). Birth weight, gestational age, parental age, history of infertility, smoking during pregnancy, allergic diseases, and maternal diseases during pregnancy showed no significant associations.ConclusionsPerinatal and early-life risk factors, and specifically indicators of brain trauma, exposure to toxic agents and immune system maturation, might be involved in the pathogenesis of childhood brain tumors. Larger studies should aim to replicate our findings and examine associations with tumor subtypes.     

How is smoking distributed in relation to socioeconomic status? Evidence from Brazil in the years 2013 and 2019

The present study aimed to analyze income-related inequality in tobacco consumption in Brazil using data from the National Health Survey at two points in time (2013 and 2019). This study contributes to the growing literature analyzing socioeconomic inequalities in tobacco use by investigating income-related inequalities in the consumption of different tobacco products in Brazil. The inequality measure is the concentration index with an Erreygers correction (EI), and the analysis of its decomposition allows the identification of the factors that determine such inequality. There is inequality in smoking concentrated in the poorest persons, and this pattern also occurs for manufactured cigarettes and roll-your-own cigarettes (RYO), while inequality in smoking cessation is concentrated among the wealthiest. Smoking inequalities were greater in men, older age groups, and RYO. In terms of evolution, the overall results indicated a small decline in smoking inequality. For the decomposition analysis, the results show that the main factors that affect tobacco inequality in terms of concentration in the poorest are education, income, and having private health insurance. The region variable, by contrast, has a positive contribution, since the wealthiest regions have individuals who are more likely to smoke. These results have important implications that serve as a basis for formulating public health policies. For example, greater inequalities for men and older individuals can be targeted by public policies with a special focus on these cases.     

Traditional Chinese medicine, a solution for reducing dual stroke risk factors at once?

Based on genome wide association studies (GWAS), the activities of phosphodiesterase 4D (PDE4D) and 5-Lipoxygenase activating protein (ALOX5AP) were suggested as two of the major factors involved in ischemic stroke risks. Uncontrolled PDE4D activities often lead to cAMP-induced stroke and cardiovascular diseases. Overexpression of ALOX5AP, on the other hand, had been shown to play a major role in inflammation pathway that could induce the development of atherosclerosis and stroke. To eliminate the risk factors that lead to stroke, we reported the identification and analysis of dual-targeting compounds that could reduce PDE4D and ALOX5AP activities from traditional Chinese medicine (TCM). We employed world's largest TCM database, TCM Database@Taiwan, for in silico drug identification. We also introduced machine learning predictive models, as well as pharmacophore model, for characterizing the drug-like candidates. Both myristic acid and pentadecanoic acid were identified. The follow-up analysis on molecular dynamics simulation further determined the major roles of the carboxyl group for forming stable molecular interactions. Intriguingly, the carboxyl group demonstrated different bonding patterns with PDE4D and ALOX5AP, through electrostatic interaction and hydrogen bonds, respectively. In addition, the large volume occupied by the ligand hydrophobic regions could achieve inhibition through occupying the vacant spaces in the binding site. These pharmacophores held true for both candidates against each protein targets. Hence, we proposed the presence of the carboxyl group and hydrophobic regions as potent dual targeting features that inhibit both PDE4D and ALOX5AP activities.     

Strategies for reducing coronary risk factors in primary care: which is most cost effective?

OBJECTIVE--To examine the relative cost effectiveness of a range of screening and intervention strategies for preventing coronary heart disease in primary care. SUBJECTS--7840 patients aged 35-64 years who were participants in a trial of modifying coronary heart disease risk factors in primary care. DESIGN--Effectiveness of interventions assumed and the potential years of life gained estimated from a risk equation calculated from Framingham study data. MAIN OUTCOME MEASURE--The cost per year of life gained. RESULTS--The most cost effective strategy was minimal screening of blood pressure and personal history of vascular disease, which cost 310 pounds-930 pounds per year of life gained for men and 1100 pounds-3460 pounds for women excluding treatment of raised blood pressure. The extra cost per life year gained by adding smoking history to the screening was 400 pounds-6300 pounds in men. All strategies were more cost effective in men than in women and more cost effective in older age groups. Lipid lowering drugs accounted for at least 70% of the estimated costs of all strategies. Cost effectiveness was greatest when drug treatment was limited to those with cholesterol concentrations above 9.5 mmol/l. CONCLUSIONS--Universal screening and intervention strategies are an inefficient approach to reducing the coronary heart disease burden. A basic strategy for screening and intervention, targeted at older men with raised blood pressure and limiting the use of cholesterol lowering drugs to those with very high cholesterol concentrations would be most cost effective.     

Contributions of astrocytes to epileptogenesis following status epilepticus: Opportunities for preventive therapy?

Status epilepticus (SE) is a life threatening condition that often precedes the development of epilepsy. Traditional treatments for epilepsy have been focused on targeting neuronal mechanisms contributing to hyperexcitability, however, approximately 30% of patients with epilepsy do not respond to existing neurocentric pharmacotherapies. A growing body of evidence has demonstrated that profound changes in the morphology and function of astrocytes accompany SE and persist in epilepsy. Astrocytes are increasingly recognized for their diverse roles in modulating neuronal activity, and understanding the changes in astrocytes following SE could provide important clues about the mechanisms underlying seizure generation and termination. By understanding the contributions of astrocytes to the network changes underlying epileptogenesis and the development of epilepsy, we will gain a greater appreciation of the contributions of astrocytes to dynamic circuit changes, which will enable us to develop more successful therapies to prevent and treat epilepsy. This review summarizes changes in astrocytes following SE in animal models and human temporal lobe epilepsy and addresses the functional consequences of those changes that may provide clues to the process of epileptogenesis.     

Are there risk factors for acute renal failure in adult patients using deoxycholate amphotericin B?

BackgroundDeoxycholate amphotericin B (DAB) is a nephrotoxic drug and the incidence of acute kidney injury (AKI) is high.AimsThe aim of this study was to describe the incidence of AKI in patients under DAB therapy and determine risk factor to predict the AKI.MethodsThe data of this retrospective study included previously hospitalized patients treated with intravenous DAB for at least five days. Clinical and laboratorial data were evaluated and AKI was classified in stages using Acute Kidney Injury Network criteria. Univariated test followed by a multivariable analysis was performed to determine risk factor and Kaplan–Meier survival estimates were calculated to evaluate the role of AKI in the outcome.ResultsOne hundred six patients were included in the final analysis. AKI occurred in 51.9% and dialysis was necessary in 4.7%. The occurrence of AKI was not associated with any risk factor. The mortality of the patients was neither associated with AKI nor with dialysis. Other nephrotoxic drugs were not risk factors for AKI.ConclusionsThe incidence of AKI in patients using DAB is high and we cannot predict the chance of AKI using clinical or laboratorial data.     

Is there evidence for a shift in fish growth and recruitment success linked to climate change?

This study investigated whether a putative shift in climate regime in the North Atlantic in the 1990s coincided with changes in the growth and recruitment of roach Rutilus rutilus in the north-east of England. The relationships between R. rutilus growth and recruitment and the environment were significantly different before and after the putative shift in climate regime. Water temperature, river discharge, growth, recruitment success and the Gulf Stream Index co-varied until the late 1990s, indicating a gradual progression between periods of warm-and-dry and cold-and-wet summers. Since the late 1990s, there has been an increased prevalence of warm-and-wet summers, and recruitment success has oscillated between extremes on an almost annual basis. The north wall (northern boundary) of the Gulf Stream has been undergoing a displacement south since the late 1990s, and the speed and amplitude of the change appears to support the hypothesis that there was a regime shift in the climate of the North Atlantic Ocean. It is possible that a continued displacement south of the north wall of the Gulf Stream will lead to further increases in river discharge, reductions in water temperature and reduced fish growth and recruitment success in the long term.     

Unpacking the link between family socioeconomic status and civic engagement during the transition to adulthood: Do work values play a role?

We investigated whether the link between family-of-origin socioeconomic status (SES) and civic engagement in young adulthood is mediated by youth’s work values, that is, the desired characteristics of their current or future jobs. We used data from a Finnish study: 2004 (age 16–18, N_T1?=?1,301); 2011 (age 23–25, N_T2?=?1,096); and 2014 (age 25–27, N_T3?=?1,138). A higher family SES in 2004 predicted youth’s higher civic engagement in 2014. A higher family SES also predicted a lower importance of extrinsic job rewards (e.g., good pay) in 2011, but it was unrelated to the importance of intrinsic job rewards (e.g., learning opportunities). Extrinsic work values, in turn, predicted lower civic engagement in 2014, above and beyond sociodemographic and personality characteristics. Intrinsic work values predicted higher civic engagement. Thus, extrinsic, but not intrinsic, work values partly mediated the link between family SES and youth civic engagement.