Suicide rates among patients with cancers of the digestive system

Objective: Previous studies have suggested that suicide rates are elevated among cancer patients relative to the general population. In this analysis, we comprehensively evaluated characteristics associated with higher suicide rates among patients with cancers of the digestive system. Methods: Using the United States Surveillance, Epidemiology, and End Results database, we identified all patients diagnosed with digestive system cancers during 2000 to 2014. Patients were classified as having died of suicide if their cause of death in Surveillance, Epidemiology, and End Results was listed as “suicide and self-inflicted injury.” Suicide rates were compared to age-, sex-, and race-adjusted rates in the general population. Results: A total of 881 suicides were identified among 856 293 patients diagnosed with digestive system cancers. The suicide rate in this population was 32.8 per 100 000 person-years and was nearly twice that in the general population (standardized mortality ratio [SMR] = 1.91; 95% CI, 1.79-2.04). Suicide rates were significantly elevated for all cancer sites but were highest for esophageal (SMR = 5.03), pancreatic (SMR = 5.28), stomach (SMR = 2.84), and liver (SMR = 2.14) cancers. Standardized mortality ratios for suicide were highest within the first 5 years of diagnosis and increased with age at diagnosis for all sites except colon and stomach. Conclusions: Patients with cancers of the digestive system have a higher incidence of suicide than the general population. Suicide rates among esophageal and pancreatic cancer patients are more than 5 times general population rates. The involvement of psychiatrists and other mental health professionals may be a critical component of cancer care for these high-risk patient subgroups

Effect of protease on growth performance and carcass characteristics of growing-finishing pigs

No Abstrac

A simply connected surface of general type with p_g=0 and K^2=2

In this paper we construct a simply connected, minimal, complex surface of general type with p_g=0 and K^2=2 using a rational blow-down surgery and Q-Gorenstein smoothing theory.Comment: 19 pages, 6 figures. To appear in Inventiones Mathematica

Changes in cardiovascular disease risk and risk factors among women with and without breast cancer

Background: Cardiovascular disease (CVD) risk is an important health concern among survivors of breast cancer. However, few studies to date have examined whether trajectories of CVD risk and major risk factors are worse among women with a breast cancer diagnosis compared with those without. Methods: Changes in weight, body mass index, waist circumference, systolic blood pressure, and 10-year CVD risk were compared between women with (813 women) and without (1049 women) an incident breast cancer diagnosis while they were enrolled in the National Institute of Environmental Health Sciences Sister Study cohort. Blood pressure and adiposity measures were collected by trained examiners at an enrollment visit (≥1 year before breast cancer diagnosis) and a second home visit 4 to 11 years later (≥1 year after breast cancer diagnosis). The non–laboratory-based Framingham risk score, a measure of 10-year general CVD risk, was calculated at both the enrollment and second visits. All analyses were stratified by menopausal status at the time of enrollment. Results: Women who were premenopausal at the time of enrollment experienced moderate increases in weight, waist circumference, systolic blood pressure, and CVD risk over the study period. Those who were postmenopausal at the time of enrollment demonstrated little change in weight, but were found to have increases in waist circumference, systolic blood pressure, and CVD risk. In both groups, changes over time did not differ significantly according to breast cancer status. Neither chemotherapy nor endocrine therapy were found to be associated with greater increases in CVD risk or risk factors. Conclusions: In the current study cohort, changes over time in CVD risk, adiposity measures, and blood pressure were similar between women who developed an incident breast cancer and those who did not

Cardiovascular disease risk factors and oxidative stress among premenopausal women

Oxidative stress is one hypothesized mechanism linking anthropometric, behavioral, and medical risk factors with cardiovascular disease (CVD). We evaluated cross-sectional associations between CVD risk factors and biomarkers of oxidative stress, and investigated these biomarkers as predictors of incident diabetes and hypertension among premenopausal women. F 2 -isoprostane (F 2 -IsoP) and metabolite (15-F 2t -IsoP-M), reliable biomarkers of oxidative stress, were measured in urine samples collected at enrollment from 897 premenopausal women (ages 35–54) enrolled in the Sister Study cohort without a CVD history. Blood pressure, waist circumference, and body mass index (BMI) were measured at enrollment by trained study personnel. Diabetes and cigarette smoking were self-reported via enrollment questionnaires. Over a maximum follow-up of 11.5 years, participants self-reported incident diabetes and hypertension diagnoses on mailed questionnaires. In cross-sectional analyses, both F 2 -IsoP and 15-F 2t -IsoP-M were positively associated with BMI, waist circumference, diastolic blood pressure, and current smoking. F 2 -IsoP was elevated among those with diabetes, and 15-F 2t -IsoP-M increased with higher systolic blood pressure. Prospective analyses suggested an increased hypertension risk among those with elevated 15-F 2t -IsoP-M (highest vs. lowest quartile: hazard ratio=2.34; 95% CI: 1.20–4.56). Our results suggest that urinary F 2 -IsoP and 15-F 2t -IsoP-M are positively associated with adiposity measures, blood pressure, and cigarette smoking. Further investigation is warranted to evaluate 15-F 2t -IsoP-M as a predictor of hypertension

Cryptococcal Meningoencephalitis Presenting as Cerebell itis - A case report -

, , We herein report an elderly patient with cryptococcosis in the nervous system who presented with cerebellar dysfunction and showed cerebellar parenchymal lesion with adjacent focal meningeal enhancement on the brain CT and the serial brain MRls. The cerebellar lesion suggests cryptococcal inflammatory reaction or a cerebellar infarction from the arteritis of a branch of the left superior cerebellar artery. This clinical and neuroimaging finding of cerebellitis has not been reported in cryptococcosis. We think cryptococcosis would be included in the differential diagnosis of cerebellitis

Dietary factors and serum antimüllerian hormone concentrations in late premenopausal women

Objective: To study the associations between dietary factors and circulating antimüllerian hormone (AMH) concentrations among late premenopausal women. Design: AMH concentrations were measured in serum samples collected at enrollment from 296 women (aged 35−45 years) in the Sister Study cohort. Usual dietary intakes in the past 12 months were assessed using a validated food frequency questionnaire. Dietary exposures of interest included macronutrients, dietary fat subtypes, fiber, and glycemic index. Multivariable linear regression was used to evaluate associations between dietary variables and serum AMH concentrations. We also used nutrient density models to examine isocaloric replacement of macronutrients. Setting: Not applicable. Patients: Women aged 35−45 years. Interventions: Not applicable. Main outcome measures: Serum AMH concentrations in nanograms per milliliter (ng/mL). Results: AMH concentrations were positively associated with percentage of energy from carbohydrates (β per 5% calories = 0.141 [95% CI 0.023, 0.259]; P trend =.019), and inversely associated with percentage of energy from fat (β per 5% calories = −0.152 [95% CI −0.299, −0.004]; P trend =.044). In analyses of dietary fat subtypes, AMH decreased with increasing monounsaturated fatty acids (P trend =.082) and polyunsaturated fatty acids (P trend =.043), particularly ω-6 fatty acids (P trend =.044), whereas no strong trend was observed for saturated fatty acids. Protein and alcohol intake were not strongly associated with AMH. Conclusions: Our cross-sectional analyses in a sample of late premenopausal women suggest that dietary fat intake may be inversely associated with circulating AMH concentrations. Further research in prospective studies is warranted to evaluate dietary factors as potential modifiers of ovarian reserve