Statin use and risk of hepatocellular carcinoma in a U.S. population

PurposeStatins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are medications widely prescribed to reduce cholesterol levels. Observational studies in high-risk populations, mostly in Asia, have suggested that statins are associated with a reduced risk of hepatocellular carcinoma (HCC). The current study sought to evaluate the association of statin use and HCC in a U.S.-based, low-risk, general population.MethodsA nested case–control study was conducted among members of the Health Alliance Plan HMO of the Henry Ford Health System enrolled between 1999 and 2010. Electronic pharmacy records of statin use were compared among tumor registry-confirmed cases of HCC (n = 94) and controls (n = 468) matched on age, sex, diagnosis date, and length of HMO enrolment.ResultsIn multivariate analyses, ever-use of statins was significantly inversely associated with development of HCC (Odds ratio (OR): 0.32, 95%CI: 0.15–0.67). No clear dose–response relationship was evident as statin use for <2 years (OR = 0.32, 95%CI = 0.13–0.83) and >2 years (OR = 0.31, 95CI% = 0.12–9.81) resulted in very similar ORs.ConclusionsThe use of statins among populations in low-risk HCC areas may be associated with decreased risk of HCC.     

Maturation and fecundity of a stock-enhanced population of striped bass in the Savannah River Estuary, U.S.A

The striped bass Morone saxatilis population in the Savannah River (south-eastern U.S.A.) collapsed in the 1980s, and recent eorts to restore the population have resulted in increased catch-per-unit-eort (CPUE) of striped bass in the Savannah River Estuary (SRE). The abundance of eggs and larvae, however, remain well below historic levels. The primary cause of the population decline was remedied, and environmental conditions seem suitable for striped bass spawning. Regression analysis of data derived from ultrasonic imaging of 31 striped bass resulted in a statistical model that predicted ovary volume well (r²=0.95). The enumeration of oocytes from ovarian tissue samples and the prediction of ovary volume allowed fecundity to be estimated without sacrificing the fish. Oocyte maturation in Savannah River striped bass seemed to progress normally, with oocytes developing to final stages of maturity in larger fish (>750 mm L _T). Additionally, fecundity estimates were comparable to a neighbouring striped bass population. The environmental cues needed to trigger development and release of striped bass oocytes into the SRE appeared to be present. If most of the striped bass females in the SRE are still young (<7 years), the ability to produce large numbers of eggs will be limited. As these young fish mature, egg production probably will increase and the density of striped bass eggs eventually will approach historic levels, provided suitable habitat and water quality are maintained.     

Health risks of consuming apples with carbendazim,imidacloprid, and thiophanate-methyl in the Chinese population: Risk assessment based on a nonparametric probabilistic evaluation model

The pesticides carbendazim (CA), imidacloprid (IM), and thiophanate-methyl (TH) are used extensively in apple production. However, the presence of pesticide residues in apples has been associated with a wide range of human health hazards. To assess whether apples are safe to consume, evaluating their potential health risk is of great significance. We tested apples from two dominant apple-producing areas for the presence of pesticide residues and constructed a statistical model to evaluate their health risks. Of the three commonly used pesticides, thirty-two samples (11.3% of all tested samples) were residue-free and 231 (81.9%) contained CA residues, which was the most frequently detectable pesticide, followed by TH (52.1%) and IM (39.0%). All of the samples were below the maximum residue limits. The probabilistic assessment results indicated that the pesticide intake risks for kids (aged 2–6 years) and children (aged 7–13 years) were significantly higher than those of other groups, so that they were the vital monitoring objects. Our findings indicate that consumption of apples with these three pesticides does not pose a health threat for the population. Nevertheless, we recommend an investigation into continuous monitoring and stricter regulations on fruits' quality and safety throughout China.     

The density and diversity of gymnamoebae associated with terrestrial moss communities (Bryophyta: Bryopsida) in a northeastern U.S. forest

Moss communities are commonly found in temperate forests and form a nearly continuous understory in some high latitude forests. However, little is known about the microbial component of these communities, especially the non-testate amoeboid protists. Fifty morphospecies of naked amoebae were identified in samples collected at eight sites in a northeastern North American forest. The mean number (+/-SE) of morphospecies found per sample site based on laboratory cultures was 17+/-2.1. The density of amoebae expressed as number/g dry weight of moss ranged from 3.5+/-0.04 x 10(3) to 4.3+/-0.2 x 10(4) and was positively correlated with the moss moisture content (r=0.9, P<0.001, df=26). Densities of gymnamoebae in the moss are generally higher than found in the surrounding soil, but this may be due in part to the greater weight of soil per unit volume compared with moss. The percentage of encysted forms was inversely related to the moisture content of the moss sample.     

The association of intestinal parasitosis and H. pylori infection in children and adults from a Mexican community with high prevalence of parasitosis

Background. ABSTExperimental evidences have suggested that a Th1 response is unable to eliminate H. pylori colonization; whereas a Th2 response, like the one induced by vaccination, reduces H. pylori infection in animal models. Some parasitic infections induce a polarized Th2 response, which theoretically would favor a reduced H. pylori prevalence. The aim of this work was to study the possible association between parasitic infections and H. pylori prevalence. Materials and Methods. The study population included 120 children and 188 adults from a low socioeconomic level village. H. pylori prevalence was determined in serum by ELISA; parasitic infections were identified in feces by microscopic examination; and total serum IgE levels, as an indirect indicator of some parasitic infections, were determined by ELISA. Results. In children, H. pylori prevalence was no different between those with and without intestinal parasitic infection. By contrast, adults with intestinal parasitic infection had a significantly lower H. pylori prevalence than adults without parasites (62.6% compared with 80.4%; p = 0.006, OR 2.45). Also in adults, but not in children, total IgE levels were significantly higher in those without H. pylori infection than in those with H. pylori infection (p < 0.001). Conclusions. Intestinal parasitic infections and serum IgE levels showed an age‐dependent association with H. pylori prevalence. In adults, but not in children, intestinal parasitic infections and increased IgE levels where associated with a reduced H. pylori prevalence.     

Cost-utility of cognitive behavioral therapy versus U.S. Food and Drug Administration recommended drugs and usual care in the treatment of patients with fibromyalgia: an economic evaluation alongside a 6-month randomized controlled trial

Introduction

Cognitive behavioral therapy (CBT) and U.S. Food and Drug Administration (FDA)-recommended pharmacologic treatments (RPTs; pregabalin, duloxetine, and milnacipran) are effective treatment options for fibromyalgia (FM) syndrome and are currently recommended by clinical guidelines. We compared the cost-utility from the healthcare and societal perspectives of CBT versus RPT (combination of pregabalin + duloxetine) and usual care (TAU) groups in the treatment of FM.

Methods

The economic evaluation was conducted alongside a 6-month, multicenter, randomized, blinded, parallel group, controlled trial. In total, 168 FM patients from 41 general practices in Zaragoza (Spain) were randomized to CBT (n = 57), RPT (n = 56), or TAU (n = 55). The main outcome measures were Quality-Adjusted Life Years (QALYs, assessed by using the EuroQoL-5D questionnaire) and improvements in health-related quality of life (HRQoL, assessed by using EuroQoL-5D visual analogue scale, EQ-VAS). The costs of healthcare use were estimated from patient self-reports (Client Service Receipt Inventory). Cost-utility was assessed by using the net-benefit approach and cost-effectiveness acceptability curves (CEACs).

Results

On average, the total costs per patient in the CBT group (1,847€) were significantly lower than those in patients receiving RPT (3,664€) or TAU (3,124€). Patients receiving CBT reported a higher quality of life (QALYs and EQ-VAS scores); the differences between groups were significant only for EQ-VAS. From a complete case-analysis approach (base case), the point estimates of the cost-effectiveness ratios resulted in dominance for the CBT group in all of the comparisons performed, by using both QALYs and EQ-VAS as outcomes. These findings were confirmed by bootstrap analyses, net-benefit curves, and CEACs. Two additional sensitivity analyses (intention-to-treat analysis and per-protocol analysis) indicated that the results were robust. The comparison of RPT with TAU yielded no clear preference for either treatment when using QALYs, although RPT was determined to be more cost-effective than TAU when evaluating EQ-VAS.

Conclusions

Because of lower costs, CBT is the most cost-effective treatment for adult FM patients. Implementation in routine medical care would require policymakers to develop more-widespread public access to trained and experienced therapists in group-based forms of CBT.

Trial registration

Current Controlled Trials ISRCTN10804772. Registered 29 September 2008.

Electronic supplementary material

The online version of this article (doi:10.1186/s13075-014-0451-y) contains supplementary material, which is available to authorized users.     

Effects of a genetic variant rs13266634 in the zinc transporter 8 gene (SLC30A8) on insulin and lipid levels before and after a high-fat mixed macronutrient tolerance test in U.S. adults

BackgroundThe common C-allele of rs13266634 (c.973C>T or p.Arg325Trp) in SLC30A8 (ZNT8) is associated with increased risk of type 2 diabetes. While previous studies have examined the correlation of the variant with insulin and glucose metabolism, the effects of this variant on insulin and lipid responses after a lipid challenge in humans remain elusive. The goal of this study was to determine whether the C-allele had an impact on an individual’s risk to metabolic syndromes in U.S. adults.MethodWe studied the genotypes of rs13266634 in 349 individuals aged between 18 and 65 y with BMI ranging from 18.5 to 45 kg/m². The subjects were evaluated for insulin, glucose, HbA1c, ghrelin, and lipid profiles before and after a high-fat mixed macronutrient tolerance test (MMTT).ResultsWe found that the effects of variants rs13266634 on glucose and lipid metabolism were sex-dimorphic, greater impact on males than on females. Insulin incremental area under the curve (AUC) after MMTT was significantly decreased in men with the CC genotype (p < 0.05). Men with the CC genotype also had the lowest fasting non-esterified fatty acid (NEFA) concentrations. On the other hand, the TT genotype was associated with a slower triglyceride removal from the circulation in men after MMTT. The reduced triglyceride removal was also observed in subjects with BMI ≥ 30 carrying either the heterozygous or homozygous T-allele. Nevertheless, the SNP had little effect on fasting or postprandial blood glucose and cholesterol concentrations.ConclusionWe conclude that the CC genotype negatively affects insulin response after MMTT while the T-allele may negatively influence lipolysis during fasting and postprandial blood triglyceride removal in men and obese subjects, a novel finding in this study.     

Evaluation of the enantiomers of 1-octen-3-ol and 1-octyn-3-ol as attractants for mosquitoes associated with a freshwater swamp in Florida, U.S.A

Field studies were conducted at wooded wetlands in Gainesville, FL, U.S.A., to assess responses of natural populations of adult mosquitoes (Diptera: Culicidae) to American Biophysics MM-X and Coleman MD-2500 traps baited with enantiomers of 1-octen-3-ol, a naturally occurring compound, and 1-octyn-3-ol, a closely related synthetic compound. Overall, the same species of mosquitoes were attracted by all enantiomers, although the (R)-(+) isomer of octenol generally attracted more species, and it is the isomer produced in greatest proportion in nature. Traps baited with the R-enantiomer caught greater numbers of mosquitoes than those baited with the S-enantiomer of each compound, whereas traps baited with S-enantiomers were equally or slightly less attractive than those baited with carbon dioxide only.