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It is unclear if body weight in early life affects cancer risk independently of adult body weight. To investigate this question for six obesity-related cancers, we performed univariable and multivariable analyses using i) Mendelian randomization (MR) analysis and ii) longitudinal analyses in prospective cohorts. Both the MR and longitudinal analyses indicated that larger body size at age 10 was associated with higher risk of endometrial (ORMR=1.61, 95%CI = 1.23-2.11) and kidney cancer (ORMR=1.40, 95%CI = 1.09-1.80). These associations were attenuated after accounting for adult body size in both the MR and cohort analyses. Early life BMI was not consistently associated with the other investigated cancers. The lack of clear independent risk associations suggests that early life BMI influences endometrial and kidney cancer risk mainly through pathways that are common with adult BMI.

Purpose: The aim of this retrospective review study is to evaluate Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score as an indicative parameter in early detecting cervical necrotizing fasciitis (CNF) from deep neck infections (DNI). Methods: We reviewed 12 cases of CNF and 538 cases of non-necrotizing deep neck infection hospitalized in our hospital over the last decade. Cervical necrotizing fasciitis was histologically confirmed. Results: Using an LRINEC score of 6 as a cutoff sensitivity was calculated at 100% (95% CI 99.9–100) and specificity 72.5% (95% CI 72.4–72.6). Negative predicted value (NPV) was 100% and positive predicted value (PPV) was 7.5%. C-reactive protein (CRP), white blood count (WBC), and glucose (Glu) levels have a higher correlation. Haemoglobin (Hb), sodium (Na), and creatinine (Cr) do not seem to have a big impact in our study. Conclusion: LRINEC score proves to be a useful “rule-out” tool that works on the safe side with high sensitivity and poor specificity. WBC, CRP, and Glu seem to be the most significant variables of the LRINEC score. Hb, Na, and Cr make the score safer. Decision for surgery must be based on medical history, clinical symptoms and signs, imaging findings, and laboratory tests and not according to the LRINEC score itself. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Background: Epidemiological evidence supports a positive association between circulating insulin-like growth factor-1 (IGF-1) concentrations and breast cancer risk, but both the magnitude and causality of this relationship are uncertain. We conducted observational analyses with adjustment for regression dilution bias, and Mendelian randomization (MR) analyses allowed for causal inference. Patients and Methods: We investigated the associations between circulating IGF-1 concentrations and incident breast cancer risk in 206 263 women in the UK Biobank. Multivariable hazard ratios (HRs) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. HRs were corrected for regression dilution using repeat IGF-1 measures available in a subsample of 6711 women. For the MR analyses, genetic variants associated with circulating IGF-1 and IGF-binding protein-3 (IGFBP-3) levels were identified and their association with breast cancer was examined with two-sample MR methods using genome-wide data from 122 977 cases and 105 974 controls. Results: In the UK Biobank, after a median follow-up of 7.1 years, 4360 incident breast cancer cases occurred. In the multivariable-adjusted models corrected for regression dilution, higher IGF-1 concentrations were associated with a greater risk of breast cancer (HR per 5 nmol/l increment of IGF-1 = 1.11, 95% CI = 1.07–1.16). Similar positive associations were found by follow-up time, menopausal status, body mass index, and other risk factors. In the MR analyses, a 5 nmol/l increment in genetically-predicted IGF-1 concentration was associated with a greater breast cancer risk (odds ratio = 1.05, 95% CI = 1.01–1.10; P = 0.02), with a similar effect estimate for estrogen-positive (ER+) tumours, but no effect found for estrogen-negative (ER−) tumours. Genetically-predicted IGFBP-3 concentrations were not associated with breast cancer risk (odds ratio per 1-standard deviation increment = 1.00, 95% CI = 0.97–1.04; P = 0.98). Conclusion: Our results support a probable causal relationship between circulating IGF-1 concentrations and breast cancer, suggesting that interventions targeting the IGF pathway may be beneficial in preventing breast tumorigenesis.

Purpose: The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. Methods: A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional hazard regression models adjusted for total energy intake, smoking status, body mass index, physical activity, diabetes and education were used to estimate hazard ratios and 95% confidence intervals for standardized dietary intakes. As in genome-wide association studies, correction for multiple comparisons was applied using the false discovery rate (FDR ' 5%) method and suggested results were replicated in an independent cohort, the Netherlands Cohort Study (NLCS). Results: A total of 5916 and 3842 incident cases of prostate cancer were diagnosed during a mean follow-up of 14 and 20 years in EPIC and NLCS, respectively. None of the dietary factors was associated with the risk of total prostate cancer in EPIC (minimum FDR-corrected P, 0.37). Null associations were also observed by disease stage, grade and fatality, except for positive associations observed for intake of dry cakes/biscuits with low-grade and butter with aggressive prostate cancer, respectively, out of which the intake of dry cakes/biscuits was replicated in the NLCS. Conclusions: Our findings provide little support for an association for the majority of the 92 examined dietary factors and risk of prostate cancer. The association of dry cakes/biscuits with low-grade prostate cancer warrants further replication given the scarcity in the literature. © 2019, The Author(s).

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Source at https://doi.org/10.1016/S2468-2667(17)30046-4. Background: No studies have estimated disability-adjusted life-years (DALYs) lost due to hip fractures using real-life follow-up cohort data. We aimed to quantify the burden of disease due to incident hip fracture using DALYs in prospective cohorts in the CHANCES consortium, and to calculate population attributable fractions based on DALYs for specific risk factors. Methods: We used data from six cohorts of participants aged 50 years or older at recruitment to calculate DALYs. We applied disability weights proposed by the National Osteoporosis Foundation and did a series of sensitivity analyses to examine the robustness of DALY estimates. We calculated population attributable fractions for smoking, body-mass index (BMI), physical activity, alcohol intake, type 2 diabetes and parity, use of hormone replacement therapy, and oral contraceptives in women. We calculated summary risk estimates across cohorts with pooled analysis and random-effects meta-analysis methods. Findings: 223 880 men and women were followed up for a mean of 13 years (SD 6). 7724 (3·5%) participants developed an incident hip fracture, of whom 413 (5·3%) died as a result. 5964 DALYs (27 per 1000 individuals) were lost due to hip fractures, 1230 (20·6%) of which were in the group aged 75–79 years. 4150 (69·6%) DALYs were attributed to disability. Current smoking was the risk factor responsible for the greatest hip fracture burden (7·5%, 95% CI 5·2–9·7) followed by physical inactivity (5·5%, 2·1–8·5), history of diabetes (2·8%, 2·1–4·0), and low to average BMI (2·0%, 1·4–2·7), whereas low alcohol consumption (0·01–2·5 g per day) and high BMI had a protective effect. Interpretation: Hip fracture can lead to a substantial loss of healthy life-years in elderly people. National public health policies should be strengthened to reduce hip fracture incidence and mortality. Primary prevention measures should be strengthened to prevent falls, and reduce smoking and a sedentary lifestyle.

Background No studies have estimated disability-adjusted life-years (DALYs) lost due to hip fractures using real-life follow-up cohort data. We aimed to quantify the burden of disease due to incident hip fracture using DALYs in prospective cohorts in the CHANCES consortium, and to calculate population attributable fractions based on DALYs for specific risk factors. Methods We used data from six cohorts of participants aged 50 years or older at recruitment to calculate DALYs. We applied disability weights proposed by the National Osteoporosis Foundation and did a series of sensitivity analyses to examine the robustness of DALY estimates. We calculated population attributable fractions for smoking, body-mass index (BMI), physical activity, alcohol intake, type 2 diabetes and parity, use of hormone replacement therapy, and oral contraceptives in women. We calculated summary risk estimates across cohorts with pooled analysis and random-effects meta-analysis methods. Findings 223 880 men and women were followed up for a mean of 13 years (SD 6). 7724 (3·5%) participants developed an incident hip fracture, of whom 413 (5·3%) died as a result. 5964 DALYs (27 per 1000 individuals) were lost due to hip fractures, 1230 (20·6%) of which were in the group aged 75–79 years. 4150 (69·6%) DALYs were attributed to disability. Current smoking was the risk factor responsible for the greatest hip fracture burden (7·5%, 95% CI 5·2–9·7) followed by physical inactivity (5·5%, 2·1–8·5), history of diabetes (2·8%, 2·1–4·0), and low to average BMI (2·0%, 1·4–2·7), whereas low alcohol consumption (0·01–2·5 g per day) and high BMI had a protective effect. Interpretation Hip fracture can lead to a substantial loss of healthy life-years in elderly people. National public health policies should be strengthened to reduce hip fracture incidence and mortality. Primary prevention measures should be strengthened to prevent falls, and reduce smoking and a sedentary lifestyle. Funding European Community's Seventh Framework Programme. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license

Introduction: With the increase of the population's average age, Alzheimer's disease (AD) is becoming one of the most disabling diseases worldwide. Recently, neurodevelopment processes have been involved in the AD etiopathogenesis. Genetic studies in this field could contribute to our knowledge and suggest new molecular targets for possible treatments. Methods: Our primary aim was to investigate the associations among single nucleotide polymorphisms (SNPs) within neurodevelopment related genes (BDNF, ST8SIA2, C15orf32, NCAPG2, ESYT2, WDR60, LOC154822, VIPR2, GSK3B, NR1I2, ZNF804A, SP4) and AD. A number of exploratory analyses was also performed to evaluate the associations with the presence of behavioral and psychiatric symptoms of dementia (BPSD), as well as with variations in hematological parameters. Two independent samples were investigated, one of 228 Greek subjects and one sample of 229 Italian subjects, including 156 Alzheimer's Disease patients CE patients and 301 healthy controls. All patients were affected by late onset AD (LOAD). Results: None of the analyzed SNPs was associated with AD in our samples. In the exploratory analyses, several genetic variants were associated with inflammation parameters in the Greek sample and in the merged one, suggesting a relationship among these genes and the modulation of inflammation and the immune response. Other exploratory analyses showed associations among several SNPs and psychiatric symptomatology in the Greek sample, suggesting a possible modulation of these variants on psychiatric comorbidities in AD. Conclusions: Although we failed to find a direct relationship between AD and the genetic variants investigated, possible connections with inflammation and psychiatric symptoms were suggested. (C) 2016 Elsevier B.V. All rights reserved.

Museums are changing fast, yet they still need to respond to the challenges posed by a society that changes at an even faster pace. Human mobility, multi-culturalism and increasing economic assymetries create an environment, in which the role of museums as public spaces emerges as particularly complex. In this paper, we discuss issues of social inclusion in heritage museums from a conceptual point of view. In particular, we examine the conceptual barriers posed to accessibility and participation by current spatial, communicative, social and sensorial approaches in museum practice and suggest possible ways to shift such obstacles. Some of these ways may necessitate paradigmatic changes in museum policies. The paper draws on various aspects of social and communication theory. © ICOM 2017

Aim: Personality traits, including hostility, play an important role in the development of cardiovascular disease. Moreover, abnormalities in blood pressure circadian pattern, such as a lack of nocturnal BP fall, are related with target organ damage and increased cardiovascular risk. The aim of this study was to investigate the impact of hostility and its dimensions on dipping status, in newly diagnosed hypertensive patients. Methods: The study population consisted of 114 newly diagnosed untreated essential hypertensives. All participants underwent 24-hour ambulatory blood pressure monitoring (ABPM) in order to assess dipping status. Hostility was assessed by Hostility and Direction of Hostility Questionnaire (HDHQ). The study population was divided in terms of dipping status in two groups, “dippers” and “non-dippers.” Results: The statistical analysis revealed that dippers presented significantly higher score of extrapunitiveness (13.2 + 4.9 vs 11.4 + 3.9, p = 0.032), as well as significantly higher score of the dimension “urge to act out hostility (AH)” (4 + 3 vs 3 + 2, p = 0.025) compared to non-dippers. Multivariate regression analysis revealed extrapunitiveness as the only independent predictor of dipping status. The odds ratio (OR) for dipping status associated with each point increase in extrapunitiveness was 0.912 (95% CI: 0.832–0.992; p = 0.048). Conclusion: The present findings may suggest that hostility and its features affect the circadian variation of blood pressure in hypertensive patients, providing a promising objective for future investigations linking psychological factors and dipping status in essential hypertension.

Due to their non-stationarity, ERP signals are difficult to study. The concept of cointegration might overcome this problem and allow for the study of the co-variability between whole ERP signals. In this context cointegration factor is defined as the ability of an ERP signal to co-vary with other ERP signals. The aim of the present study was to investigate whether the cointegration factor is dependent on different EMF conditions and gender, as well as the locations of the electrodes on the scalp. The findings revealed that women have a significantly higher cointegration factor than men, while all subjects have increased cointegration factors in the presence of EMF. The cointegration factor is location dependent, creating a distinct cluster of high coin- tegration capacity at the central and lateral electrodes of the scalp, in contrast to clusters of low cointegration capacity at the anterior and posterior electrodes There seem to be distinct similarities of the present findings with those from standard methodologies of the ERPs. In conclusion cointegration is a promising tool towards the study of functional interactions between different brain locations.

Gastrointestinal stromal tumours (GISTs) are considered to derive from the interstitial cells of Cajal or their precursors and are defined by their expression of c-kit protein (CD117) that is positive in 95% percent of cases. These are rare mesenchymatous tumours, while they represent the most common mesenchymal tumours of the alimentary tract. The majority of GISTs develop in the stomach and small intestine and more rarely in the rectum, colon, esophagus and mesentery; only 3-5% of all GISTs are located in the duodenum. The presenting symptoms include early satiation, dysphagia, bloating, abdominal pain and gastrointestinal bleeding, either acute or chronic. Surgery remains the mainstay of treatment for localized, non-metastatic, resectable GISTs. We present a case of duodenal gastrointestinal stromal tumour of the third portion of the duodenum that presented with acute upper gastrointestinal bleeding treated with segmental duodenal resection.

Lymphoepithelioma-like gastric carcinoma (LELGC) has special clinicopathologic features that differentiate it from the common gastric adenocarcinoma. LELGC is a rare neoplasm of the stomach with an incidence of 1-4% of all gastric cancers and is characterized by desmoplastic stroma uniformaly infiltrated by abundant lymphocytes and plasma cells. LELGC is closely associated with the Epstein-Barr virus (EBV), with 80-100% of LELGC being EBV-positive. LELGC has a male predominance, occurs in elderly people and is usually located in the upper and middle portion of the stomach. We report a rare case of lymphoepithelioma-like gastric carcinoma located in the lesser curvature at the border of the gastric body to the pyloric antrum.

Objectives: Sudden sensorineural hearing loss (SSHL) remains a challenge for the clinician. In the majority of cases, no definite cause can be found and the prognosis is variable. Methods: The present study assessed 114 patients suffering from idiopathic SSHL, with regard to the prognostic value of demographic, epidemiologic, neurotologic and audiometric factors. In addition, the relationship between the identification of wave V in auditory brainstem responses and the final hearing outcome was investigated. All patients received 75 mg/day intravenous prednisolone, divided into three daily doses, for 10 days, with gradual tapering of the dose over the next 10 days. Results: The results (after one year follow up) revealed the following factors to be related to a better hearing outcome: younger age; male sex; less time elapsed between the onset of hearing loss and the beginning of treatment; and an upward-sloping or cupeloid audiogram contour. The detection of wave V early in recovery and within the first month of medical treatment might also constitute a significant favourable factor in respect to hearing recovery. Conclusions: The present study revealed that there are certain factors that affect prognosis in idiopathic SSHL. This is very important in counselling patients and may affect current clinical practice.

The aim of this study was the evaluation of distortion product otoacoustic emissions (DPOAEs) before and after noise exposure from shooting, and the comparison of DPOAEs with pure-tone audiometry. Thirteen young male police officers were exposed to impulse noise from shooting, without using earplugs. Standard pure-tone audiometry, tympanometry, and DPOAEs were performed before exposure and at one hour post- and 24 hour post-exposure. In the one hour post-exposure testing mean pure-tone thresholds were elevated in the 1-8 kHz frequency zone and DPOAE levels were reduced at several frequencies. DPOAEs were more affected at 3 kHz or lower, whereas pure-tone thresholds were more affected at higher frequencies. After the final examination, non-significant partial shifts at high frequencies on both tests remained. Pure-tone audiometry was overall more sensitive, but DPOAEs provided additional information about the cochlear status of certain ears. These data suggest that besides behavioral testing, DPOAEs may play a role as a fast, objective, and easy to perform test for monitoring subjects exposed to impulse noise. © 2005 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.

Ceruminous adenocarcinoma is a rare malignant neoplasm of the glandular structures of the external auditory canal. The true incidence and behavior of these rare tumors are still unclear due to confusing terminology, classification and histological definitions. Therefore, the ENT surgeon faces major difficulties in choosing the method of management - conservative or more radical surgery - with the addition or not of radiotherapy. We report a 57-year-old male patient with a recurrence of a previously excised ( maybe partially) and irradiated ceruminous adenocarcinoma of the right external auditory canal. Aggressive surgery was considered as the treatment of choice. However, the patient refused this approach and, as a consequence, a conservative excision was performed but with histologically confirmed healthy margins. To our surprise, the patient showed an excellent response and he is disease free 3 years following the last operation. Although recurrences usually occur within months after inadequate management, some may happen even 7 years post treatment. Therefore, routine long-term follow-up was advised. Copyright (C) 2003 S. Karger AG, Basel.