• Title/Summary/Keyword: high risk population

Search Result 838, Processing Time 0.025 seconds

Association of the Nutritional Status and Essential Amino Acids Intake in Hemodialysis Patients (혈액투석환자에서 영양상태와 필수아미노산 섭취의 관련성 연구)

  • Kim, Hye-Jin;Kim, Su-An;Sohn, Cheong-Min
    • Journal of Nutrition and Health
    • /
    • v.39 no.7
    • /
    • pp.617-623
    • /
    • 2006
  • The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

Overexpression of Phospholipase A2 Group IIA in Esophageal Squamous Cell Carcinoma and Association with Cyclooxygenase-2 Expression

  • Zhai, Yan-Chun;Dong, Bin;Wei, Wen-Qiang;He, Yan;Li, Xin-Qing;Cormier, Robert T.;Wang, Wei;Liu, Fen
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.21
    • /
    • pp.9417-9421
    • /
    • 2014
  • Background: Esophageal cancer is one of the most frequently occurring malignancies and the seventh leading cause of cancer-related deaths in the world. The esophageal squamous cell carcinoma (ESCC) is the most common histological type of esophageal cancer worldwide. Materials and Methods: Our goal in this study was to detect phospholipase A2 Group IIA (PLA2G2A) and cyclooxygenase-2 (COX-2) immuno-expression in ESCC in a high-risk population in China. Results: Positive expression of PLA2G2A protein was observed in 57.2% (166/290) of the cases, while COX-2 was found in 257 of 290 samples (88.6%), both PLA2G2A and COX-2 being expressed in 153 cases (52.8%), with a significant agreement (Kappa=0.091, p=0.031).Overexpression of PLA2G2A was significantly correlated with the depth of invasion (p=0.001). Co-expression of PLA2G2A and COX-2 not only significantly correlated with the depth of invasion (p=0.004) but also with TNM stage (p=0.04). Conclusions: Our results showed that in patients with ESCC, PLA2G2A overexpression and PLA2G2A co-expression with COX-2 is significantly correlated with advanced stage. The biological role and pathophysiologic regulation of PLA2G2A and COX-2 overexpression in ESCC deserve further investigation.

A Study of Stress, Stress Coping Style and Health Symptoms in 6th Grade Elementary School Children (초등학교 아동의 스트레스 생활사건과 대처방식, 건강문제에 관한 연구)

  • Cho Nam Jin;Park In Sook
    • Child Health Nursing Research
    • /
    • v.4 no.2
    • /
    • pp.193-206
    • /
    • 1998
  • The purpose of this study was to examine the stressors and stress coping styles of 6th grade el ementary school children and to explore the relationship between stressful life events and health symptoms and the effects of coping style which is theoretically considered to mediate the relationship between stress and health symptoms. The study subjects consisted of 329 in 6th grade elementary school children in Cheong-Ju city. Of the 329 subjects, 171 were boys and 158 were girls. For this study, three kinds of questionnaires were adopted as follows ; 1) Feel Bad Scale (FBS) by Lewis et al., 2) lazarus-Folkman's Way of coping questionnaire 3) Hee Sun Shin's Health Symptom questionnaire (HSQ) The researcher visited the school and collected data in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done for 10 days (from 5th to 15th of July 1997) . The data were analyzed by descriptive statistics, correlation analysis, multiple regression analysis using the SAS statistical program. The results of this study were as follows : 1. The mean score for the FBS was 211.37(range : 77-427), The most severe stressors perceived by children were parental divorce and other's smash or steal of my things. The most frequently experienced stressful life events were conflict with siblings and being scolded for other's fault. 2. The most frequently used stress coping style was the active coping (M=17.85), followed by passive (M=13.64) and magical one (M=13.42). 3. The mean score for the HSQ was 23.30(range : 0-72) The most frequently complained health symptoms were headache and having much worry about everything. 4. There was a significant relationship between stressful life events and health symptoms (r=.60, p<.001). Also, stressful life events were positively related with passive coping(r=.27, p<.001) and magical coping (r=.38, p<.001). Health symptoms were positively correlated with passive coping(r=.33, p<.001) and magical coping (r=.41, p<.001). 5. Stepwise multiple regression analysis revealed that the most powerful predictor was the variable of stressful life events. Health concerns, magical coping style, passive coping style and active coping style accounted for 49.15% of the variance in health symptoms. This study revealed that stressful life events correlated with health symptoms in 6th grade elementary school children and passive coping and magical coping had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress.

  • PDF

P53 and MDM2 Over-expression and Five-year Survival of Kidney Cancer Patients Undergoing Radical Nephrectomy - Iranian Experience

  • Abolhasani, Maryam;Salarinejad, Sareh;Asgari, Mojgan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.12
    • /
    • pp.5043-5047
    • /
    • 2015
  • Background: Relatively little is known with certainty about the status and role of p53 or MDM2 in predicting prognosis and survival of renal cell carcinoma. The present study aimed to determine the value of P53 and MDM2 over-expression, alone and simultaneously, to predict five-year survival of patients with kidney cancer in Iran. Materials and Methods: Patients with kidney cancer referred to Hasheminejad Kidney Center between 2007 and 2009, underwent radical nephrectomy and had pathology reports of clear cell, papillary or chromophobe renal cell carcinoma were included in our cohort study. Other histological types of renal cell carcinoma were not included. The patients with missed, incomplete or poor quality paraffin blocks were also excluded. Overall ninety one patients met the inclusion and exclusion criteria. To assess the histopathological features of the tumor, immunohistochemical (IHC) staining of formalin fixed, paraffin-embedded tumor samples were performed. The five-year survival was determined by the patients' medical files and telephone following-up. Results: In total, 1.1% of all samples were revealed to be positive for P53. Also, 20.8% of all samples were revealed to be positive for MDM2.The patients were all followed for 5 years. In this regard, 5-year mortality was 30.5% and thus 5-year survival was 85.3%. According to the Cox proportional hazard analysis, positive P53 marker was only predictor for patients' 5-year survival that the presence of positive p53 increased the risk for long-term mortality up to 2.8 times (HR=2.798, 95%CI: 1.176-6.660, P=0.020). However, the presence of MDM2 could not predict long-term mortality. In this regard, analysis by the ROC curve showed a limited role for predicting long-term survival by confirming P53 positivity (AUC=0.610, 95%CI: 0.471-.750, P=0.106). The best cutoff point for P53 to predict mortality was 0.5 yielding a low sensitivity (32.0%) but a high specificity (97.9%). In similar analysis, measurement of MDM2 positivity could not predict mortality (AUC=0.449, 95%CI: 0.316-.583, P=0.455). Conclusions: The simultaneous presence of both P53 and MDM2 markers in our population is a rare phenomenon and the presence of these markers may not predict long-term survival in patients who undergoing radical nephrectomy.

Sensitive and Noninvasive Detection of Aberrant SFRP2 and MGMT-B Methylation in Iranian Patients with Colon Polyps

  • Naini, M Alizade;Mokarram, P;Kavousipour, S;Zare, N;Atapour, A;Zarin, M Hassan;Mehrabani, G;Borji, M
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.4
    • /
    • pp.2185-2193
    • /
    • 2016
  • Background: The pathogenesis of sporadic colorectal cancer (CRC) is influenced by the patient genetic background and environmental factors. Based on prior understanding, these are classified in two major pathways of genetic instability. Microsatellite instability (MSI) and CPG island methylator phenotype (CIMP) are categorized as features of the hypermethylated prototype, and chromosomal instability (CIN) is known to be indicative of the non-hypermethylated category. Secreted frizzled related protein 2 (SFRP2), APC1A in WNT signaling pathway and the DNA repair gene, O6-methylguanine-DNA methyltransferase (MGMT), are frequently hypermethylated in colorectal cancer. Detection of methylated DNA as a biomarker by easy and inexpensive methods might improve the quality of life of patients with CRC via early detection of cancer or a precancerous condition. Aim: To evaluate the rate of SFRP2 and MGMT hypermethylation in both polyp tissue and serum of patients in south Iran as compared with matched control normal population corresponding samples. Materials and Methods: Methylation-specific PCR was used to detect hypermethylation in DNA extracted from 48 polypoid tissue samples and 25 healthy individuals. Results: Of total polyp samples, 89.5% had at least one promoter gene hypermethylation. The most frequent methylated locus was SFRP2 followed by MGMT-B (81.2 and 66.6 percent respectively). Serologic detection of hypermethylation was 95% sensitive as compared with polyp tissue. No hypermethylation was detected in normal tissue and serum and its detection in patients with polyps, especially of serrated type, was specific. Conclusions: Serologic investigation for detection of MGMT-B, SFRP2 hypermethylation could facilitate prioritization of high risk patients for colonoscopic polyp detection and excision.

Plasma Nuclear Factor Kappa B and Serum Peroxiredoxin 3 in Early Diagnosis of Hepatocellular Carcinoma

  • Ismail, Saber;Mayah, Wael;Battia, Hassan El;Gaballah, Hanaa;Jiman-Fatani, Asif;Hamouda, Hala;Afifi, Mohamed A.;Elmashad, Nehal;Saadany, Sherif El
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.4
    • /
    • pp.1657-1663
    • /
    • 2015
  • Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-${\kappa}B$) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-${\kappa}B$ and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-${\kappa}B$) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-${\kappa}B$ and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-${\kappa}B$) as a target for treatment of liver fibrosis and HCC must be widely evaluated.

Breast Cancer in Young Women from a Low Risk Population in Nepal

  • Thapa, Bibhusal;Singh, Yogendra;Sayami, Prakash;Shrestha, Uttam Krishna;Sapkota, Ranjan;Sayami, Gita
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.9
    • /
    • pp.5095-5099
    • /
    • 2013
  • Background: The overall incidence of breast cancer in South Asian countries, including Nepal, is low compared to Western countries. However, the incidence of breast cancer among young women is relatively high. Breast cancer in such cases is characterized by a relatively unfavorable prognosis and unusual pathological features. The aim of this study was to investigate clinico-pathological and biological characteristics in younger breast cancer patients (<40 years) and compare these with their older counterparts. Materials and Methods: Nine hundred and forty four consecutive female breast cancer patients, admitted to the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal between November 1997 and October 2012, were retrospectively analyzed. Results: Out of the 944 female breast cancer patients, 263 (27.9%) were <40 years. The mean age was $34.6{\pm}5.0$ years among younger patients compared to $54.1{\pm}9.9$ for those ${\geq}40$ years. The mean age at menarche was also significantly lower ($13.5{\pm}1.5$ vs $14.2{\pm}1.5$ years p=0.001) while the mean duration of symptoms was significantly longer (7.6 vs 6.5 months p=0.004). Family history of breast cancer was evident in 3.0% of the young women versus 0.3% in the older one. Mammography was performed less frequently in younger patients (59.7%), compared to older (74.4%), and was of diagnostic benefit in only 20% of younger patients compared to 85% of older ones. At diagnosis, the mean tumor diameter was significantly larger in young women ($5.0{\pm}2.5$ vs $4.5{\pm}2.4cm$, p=0.005). Axillary lymph nodes were positive in 73% of younger patients and 59% of older patients. In the younger group, the proportion of stage III or IV disease was higher (55.1% vs 47.1%, $p{\leq}0.05$). The proportion of breast conserving surgery was higher in young patients (25.1% vs 8.7%) and a higher proportion of younger patients receive neoadjuvant chemotherapy (9.9% vs 2.8%). The most common histological type was ductal carcinoma (93.1% vs 86%). The proportion of histological grade II or III was higher in younger patients (55.9% vs 24.5%). Similarly, in the younger group, lymphatic and vascular invasion was more common (63.2% vs 34.3% and 39.8% vs 25.4%, respectively). Patients in the younger age group exhibited lower estrogen and/or progesterone receptor positivity (34.7% vs 49.8%). Although statistically not significant, the proportion of triple negative tumors in younger age group was higher (22.4% vs 13.6%). Conclusions: Breast cancer in young Nepalese women represents over one quarter of all female breast cancers, many being diagnosed at an advanced stage. Tumors in young women exhibit more aggressive biological features. Hence, breast cancer in young women is worth special attention for earlier detection.

The Relation of Biochemical Examination, Metabolic Syndrome and Life Style of the Gallbladder Polyp in Health Examination Examinees (건강검진 수진자에서 담낭용종과 생화학적검사, 대사증후군 및 생활습관의 관련성)

  • Park, Yoen-Hwa;Kang, Jae-Sun;Lee, Hea-Nam
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.17 no.2
    • /
    • pp.386-393
    • /
    • 2016
  • The incidence of gallbladder polyps are increasing due to the extended use of ultrasonography. Although there are various reports on the risk of gallbladder polyps, there are few studies of the relationships among the presence of metabolic syndrome including serum biochemistry, lifestyle and the development of gallbladder polyps. The aim of this study was to determine association of the presence of metabolic syndrome, including serum biochemistry, with the development of gallbladder polyps in the Korean population. Among the health examination examinees, 596 people, who underwent abdominal ultrasonography from January, 2013 to December 2013, were included in this study. Physical measurements also taken, such as height, weight, blood pressure, waist measurement, and BMI. The general characteristics including age, sex, smoking, and drinking as the related factors were checked. At the same time, various blood tests were performed and the fasting blood sugar was analyzed through blood-gathering to determine the presence of metabolic syndrome. Regarding the factors associated with gallbladder polyps, the results showed that being male, smoking, non-drinking were significantly high. In addition, testing positive for HBsAg and an increasing BMI was apparently higher the group with metabolic syndrome than the non-metabolic syndrome group. The highest predictive factors for gallbladder polyps was being male (1.8 times), followed by metabolic syndrome (2.3 times) and testing positive for HBsAg (2.6 times).

An epidemiologic study on the seropositive rate of hepatitis A virus among a selected group of children and adults in Busan (부산지역 소아 및 성인의 A형 간염 바이러스 항체 양성률에 대한 역학적 조사)

  • Kwon, Young Ok;Choi, Im Jeong;Jung, Jin Wha;Park, Ji Hyun
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.3
    • /
    • pp.262-267
    • /
    • 2007
  • Purpose : The prevalence of hepatitis A virus (HAV) in a certain community reflects that community's living standards and hygienic conditions. And the pattern of HAV infection differs over time and geography. Recently, a shift in prevalence has been observed in cases from chilhood to adulthood. We studied the HAV antibody prevalence in the general population in Busan. Methods : From October 2004 to March 2005, total 472 subjects were tested for HAV antibodies. All samples were collected from patients in Maryknol Hospital. Results : The overall seropositive rate was 22.8% (108/472). The seropositive rates were 1.7% in subjects aged 2-5 years, 1.7% in 6-10 years, 0% in 11-20 years, 40.5% in 21-30 years, 82.1% in 31-40 years, 94.7% in 41-50 years, and 100% in subjects aged over 50 years. There was no significant gap between gender groups. Conclusion : As the socioeconomic conditions in Korea have improved, the HAV seropositive rate in school-aged children has dramatically decreased in the last 20 years. But, the seropositive rate of HAV didn't differ according to gender. The seropositive rate of HAV in the pediatric group was very low, which suggests the increasing possibility of clinical HAV infection in adults in the near future. Therefore, we should actively prevent the spread of hepatits A virus. In order to do that, we need to reorganize our lifestyle and personel hygiene and carry out active and passive immunization to high risk groups.

Monitoring for the Resistance of Strobilurin Fungicide Against Botrytis cinerea Causing Gray Mold Disease (Strobilurin계 살균제에 대한 잿빛곰팡이병균 Botrytis cinerea의 저항성 검정)

  • Kim, Ah Hyeong;Kim, Seon Bo;Han, Ki Don;Kim, Heung Tae
    • The Korean Journal of Pesticide Science
    • /
    • v.18 no.3
    • /
    • pp.161-167
    • /
    • 2014
  • This study was conducted to investigate the resistance of Botrytis cinerea to azoxystrobin, which belongs to strobilurin fungicides. The sensitivity of B. cinerea isolates, which were collected from infected pepper, strawberry, cucumber and tomato by a single spore isolation, to the fungicide was tested through a agar dilution method on PDA amended with fungicides and $100{\mu}g\;mL^{-1}$ of salicylhydroxamic acid (SHAM). All isolates of B. cinerea tested in this study were classified as a sensitive and a resistant group by $1.0{\mu}g\;mL^{-1}$ of $EC_{50}$ value to azoxystrobin. While the sensitive isolates accounted for 46.5% of B. cinerea population, the resistant ones did for 53.5%. According to the regions isolating B. cinerea, the highest isolation frequency was showed as 81.1% in Chungnam among the all. Among 4 host plants as pepper, strawberry, cucumber and tomato, the highest isolation frequency was obtained in strawberry, while the lowest was done in pepper. The isolate resistant to azoxystrobin showed the cross resistance to other fungicides included into strobilurins as kresoxim-methyl and trifloxystrobin. In spite of an excellent efficacy of strobilurins, it should be taken care to use them in the field, because of the high risk in the fields.