A study of risk factors for tuberculous meningitis among patients with tuberculosis in China: An analysis of data between 2012 and 2019

PurposeThe present study aimed to explore the risk factors for tuberculous meningitis (TBM) among patients with tuberculosis (TB).MethodsThis retrospective study was conducted on patients with TB who were hospitalized in Beijing Chest Hospital between January 2012 and December 2019. Demographic and clinical data of patients with TB were extracted from electronic medical records using a standardized data collection system. Logistic regression was used to analyze the risk factors associated with TBM.ResultsOf the total number of 22,988 cases enrolled, 3.1% were cases of TBM, which included 127 definite and 581 probable TBM, respectively. Multivariate analysis showed that definite TBM was significantly associated with patients aged < 30 years [adjusted odds ratio (aOR) = 3.015, 95% confidence interval (CI): (1.451–6.266)], who were farmers [aOR = 1.490, 95%CI: (1.020–2.177)], with miliary pulmonary TB [aOR = 105.842, 95%CI: (71.704–156.235)], and with malnutrition [aOR = 2.466, 95%CI: (1.110–5.479)]. Additionally, probable TBM was significantly associated with patients aged < 30 years [aOR = 2.174, 95% CI: (1.450–3.261)], aged 30–59 years [aOR = 1.670, 95% CI: (1.222–2.282)], who were farmers [aOR = 1.482, 95%CI: (1.203–1.825)], with miliary pulmonary TB [aOR = 108.696, 95%CI: (87.122–135.613)], and with a digestive system TB [aOR = 2.906, 95%CI: (1.762–4.793)].ConclusionAn age of < 30 years, being a farmer, and having miliary pulmonary TB were risk factors for TBM among patients with TB. Further screening of patients with TB with aforementioned characteristics could facilitate clinicians to identify patients with TBM at an early stage

Cancer incidence and general mortality in a cohort of Florida firefighters

Firefighters are exposed to a complex mixture of chemical and physical hazards in the course of their work; some of these hazards have been identified as known or suspected carcinogens. Prior studies have indicated possible increased occupational risks of cardiovascular disease as well as brain, lymphopoietic, bladder, kidney, and possibly lung cancers among firefighters. Because most of the previous firefighter studies are based on mortality, the full extent of firefighters\u27 cancer risk is not yet known. This retrospective cohort study of cancer incidence and general mortality was conducted among a group of Florida professional firefighters certified between 1972 and 1999. In addition, proportional mortality ratio (PMR) studies were performed for professional and volunteer firefighters.A total of 1,022 cancer cases and 1,449 deaths were identified in this cohort of 35,777 male (505,612 person-years) and 2,165 female (19,866 person-years) Florida professional certified firefighters. The firefighters were consistently healthier than the general Florida population. The risk of cardiovascular, respiratory, digestive, and genitourinary diseases, external causes, overall cancer, and some site-specific cancers (such as lung cancer and buccal/pharynx cancers) was significantly decreased. Among male professional firefighters, the incidence of bladder cancer [SIR = 1.29 (95% confidence interval = 1.01--1.62)], testicular cancer [1.60 (1.20--2.09)], and thyroid cancer [1.77 (1.08--2.73)] was significantly elevated, as was thyroid cancer mortality [SMR = 4.82 (1.30--12.30)]. In a subcohort restricted to the male professional firefighters certified between 1972 and 1976, the incidence of bladder cancer [SIR = 1.49 (1.13--1.94)], colon cancer [1.47 (1.13--1.87)], prostate cancer [1.35 (1.15--1.56)], and skin cancer [1.61 (1.22--2.08)] was significantly increased. Female firefighters had mortality patterns similar to those experienced by Florida women for all diseases but atherosclerotic heart disease [SMR = 3.85 (1.66--7.58)]; elevated cancer incidence risk for kidney [SIR = 6.25 (1.26--18.3)] and thyroid [3.97 (1.45--8.65)] was also observed. Thyroid cancer incidence was also significantly increased among male Hispanic firefighters [SIR = 11.10 (2.99--28.50)].In conclusion, this study found a significantly increased risk of thyroid, prostate, colon, and bladder cancer among male firefighters. The increase in bladder cancer risk does not appear to be related to tobacco usage. The presence of carcinogens in the firefighting environment warrants further investigation in this population

Skin Cancer and Non-Hodgkinʼs Lymphoma

BACKGROUNDThe incidence rates of melanoma and non-Hodgkinʼs lymphoma (NHL) have increased substantially worldwide over the past several decades. It has been hypothesized that ultraviolet light exposure through sunlight may be a common environmental risk factor shared by both skin cancer and NHL. OBJECTIVEThe purpose of this study was to better understand the association between skin cancer and NHL and to evaluate its implication in clinical practice. METHODSWe reviewed the current literature on the link between the two malignancies and on the role of ultraviolet light in the development of NHL. Publications were selected using a PUBMED search with the terms “non-Hodgkinʼs lymphoma” and “skin cancer.” Epidemiologic studies in English and published after 1995 were the focus. CONCLUSIONSLarge population-based studies support an increased risk of subsequent NHL among patients with skin cancers (both melanoma and nonmelanoma skin cancers) and a risk of skin cancer development in patients with NHL, although support for a direct relationship between ultraviolet light and the incidence of NHL is weak and inconsistent. Given their increased risk of developing skin cancers, patients with a history of NHL may benefit from a full-body examination during their visits

Skin Cancer and Non‐Hodgkin's Lymphoma: Examining the Link

Background The incidence rates of melanoma and non‐Hodgkin's lymphoma (NHL) have increased substantially worldwide over the past several decades. It has been hypothesized that ultraviolet light exposure through sunlight may be a common environmental risk factor shared by both skin cancer and NHL. Objective The purpose of this study was to better understand the association between skin cancer and NHL and to evaluate its implication in clinical practice. Methods We reviewed the current literature on the link between the two malignancies and on the role of ultraviolet light in the development of NHL. Publications were selected using a PUBMED search with the terms “non‐Hodgkin's lymphoma” and “skin cancer.” Epidemiologic studies in English and published after 1995 were the focus. Conclusions Large population‐based studies support an increased risk of subsequent NHL among patients with skin cancers (both melanoma and nonmelanoma skin cancers) and a risk of skin cancer development in patients with NHL, although support for a direct relationship between ultraviolet light and the incidence of NHL is weak and inconsistent. Given their increased risk of developing skin cancers, patients with a history of NHL may benefit from a full‐body examination during their visits. SHASA HU, MD, DANIEL G. FEDERMAN, MD, FANGCHAO MA, MD, PHD, AND ROBERT S. KIRSNER, MD, PHD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS

Sociodemographic Correlates of Visual Acuity Impairment in Hispanic Children and Adolescents

Sociodemographic correlates of visual impairment were examined in 6- to 19-year-old Hispanic children and adolescents using data from the Hispanic Health and Nutrition Examination Survey. Mexican American and Puerto Rican children whose parents had 0 to 6 years of education were more likely to remain visually impaired even when tested with their glasses or contact lenses, if any (i.e., with usual correction) than children whose parents reported 12 to 17 years of education. Mexican Americans residing below versus at or above the poverty line were more likely to remain visually impaired even with the usual correction. Mexican Americans enrolled in the Medicaid program or who were without health insurance were more likely to remain visually impaired than Mexican Americans with private health insurance. When tested without glasses or contact lenses, Cuban Americans and Mexican Americans born outside of the mainland United States had lower rates of visual impairment compared to those born in the United States; however, children in this latter group were more likely to remain visually impaired with usual correction than U.S.-born Mexican Americans. These findings suggest that Hispanic children from economically disadvantaged households and those born outside the United States may not be receiving optimal eye care that could improve visual function