Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins : a retrospective cohort study

Abstract Background Ovarian cancer is one of the most lethal cancers and women with type 2 diabetes (T2D) have even poorer survival from it. We assessed the prognosis of ovarian cancer in women with type 2 diabetes treated with metformin, other forms of antidiabetic medication, or statins. Methods Study cohort consisted of women with T2D diagnosed with ovarian cancer in Finland 1998–2011. They were identified from a nationwide diabetes database (FinDM), being linked to several national registers. Patients were grouped according to their medication in the three years preceding ovarian cancer diagnosis. The Aalen–Johansen estimator was used to describe cumulative mortality from ovarian cancer and from other causes in different medication groups. Mortality rates were analysed by Cox models, and adjusted hazard ratios (HR) with 95% confidence intervals (95% CIs) were estimated in relation to the use of different forms of medication. Main outcome measures were death from ovarian cancer and death from other causes. Results During the accrual period 421 newly diagnosed ovarian cancers were identified in the FinDM database. No evidence was found for any differences in mortality from ovarian cancer or other causes between different antidiabetic medication groups. Pre-diagnostic use of statins was observed to be associated with decreased mortality from ovarian cancer compared with no such use (HR 0.72, 95% CI 0.56–0.93). Conclusions Our findings are inconclusive as regards the association between metformin and ovarian cancer survival. However, some evidence was found for improved prognosis of ovarian cancer with pre-diagnostic statin use, requiring cautious interpretation, though

Efficacy of disclosed food safety inspections in restaurants

Noncompliances that decrease food safety are commonly detected in food safety inspections at restaurants, and challenges in correcting the noncompliances have been reported. Disclosure of inspection results has been used as a tool to decrease the rate of noncompliances by increasing motivation to attain and maintain compliance with regulations. However, the efficacy of disclosed inspection results is not well understood. In addition, preannouncement of the inspection and inspection interval may have an impact on the efficacy of inspections. In this longitudinal retrospective study based on disclosed restaurant inspections in Finland from the years 2017-2018, we examined the stability of compliance, correction of noncompliances at the item level, association of preannouncement with item-specific grades and association of inspection interval with compliance. The results show that compliance (inspection result Excellent) was maintained between two consecutive inspections in 60.5% of the restaurants. The inspection result To be corrected (C) improved in 72.3% and Poor (D) in 33.3% of the restaurants to an Excellent (A) or Good (B) result. Still, some noncompliances in items crucial to food safety were not corrected. This demonstrates that disclosure alone is not sufficient; other measures are also needed in food control. The inspection interval did not reveal any significant association with the stability of compliance. The proportions of C and D grades were at minimum twofold in unannounced compared to preannounced inspections in most inspected items. Unannounced inspections are therefore necessary to receive an accurate impression of the inspected items on the premises.Peer reviewe

Semi-continuous gas and inorganic aerosol measurements at a boreal forest site : seasonal and diurnal cycles of NH3, HONO and HNO3

Makkonen, U., Virkkula, A., Hellén, H., Hemmilä, M., Sund, J., Äijälä, M., Ehn, M., Junninen, H., Keronen, P., Petäjä, T., Worsnop, D. R., Kulmala, M. & Hakola,Peer reviewe

Abnormal adherence junctions in the heart and reduced angiogenesis in transgenic mice overexpressing mutant type XIII collagen

Type XIII collagen is a type II transmembrane protein found at sites of cell adhesion. Transgenic mouse lines were generated by microinjection of a DNA construct directing the synthesis of truncated α1(XIII) chains. Shortened α1(XIII) chains were synthesized by fibroblasts from mutant mice, and the lack of intracellular accumulation in immunofluorescent staining of tissues suggested that the mutant molecules were expressed on the cell surface. Transgene expression led to fetal lethality in offspring from heterozygous mating with two distinct phenotypes. The early phenotype fetuses were aborted by day 10.5 of development due to a lack of fusion of the chorionic and allantoic membranes. The late phenotype fetuses were aborted by day 13.5 of development and displayed a weak heartbeat, defects of the adherence junctions in the heart with detachment of myofilaments and abnormal staining for the adherence junction component cadherin. Decreased microvessel formation was observed in certain regions of the fetus and the placenta. These results indicate that type XIII collagen has an important role in certain adhesive interactions that are necessary for normal development

Antidiabetic medication, statins and the risk of endometrioid endometrial cancer in patients with type 2 diabetes

Abstract Objective: To gain further evidence of an association between the incidence of endometrial cancer (EC) and the use of metformin, other antidiabetic medication (ADM) and statins in women with type 2 diabetes (T2D). Methods: A retrospective cohort of 92,366 women with newly diagnosed T2D was obtained from a diabetes register (FinDM). 590 endometrioid ECs were observed during the follow-up time. Poisson regression was utilized to estimate the hazard ratios (HRs) with 95% confidence intervals (95% CIs) of the endometrioid EC in relation to the use of metformin, other oral ADM, insulin and statins. Nested case-control analyses were performed, where up to 20 controls were matched for age and duration of DM for each EC case. The HRs were estimated by conditional logistic regression for never/ever and cumulative use of different forms of ADM and statins. Results: In the case-control analyses the use of metformin (HR 1.24, 95% CI 1.02–1.51) and other oral ADM (HR 1.25, 95% CI 1.04–1.50) was associated with an increased incidence of endometrioid EC compared to no ADM use. No difference was observed between metformin users and those using other oral ADMs. The use of statins was inversely related to the incidence of endometrioid EC (HR 0.78, 95% CI 0.65–0.94). Results from the full cohort analysis supported this finding. Conclusions: In our study the use of metformin or other oral forms of ADM was not associated with a lowered risk of endometrioid EC in women with T2D. Instead statins were observed to be inversely associated with endometrioid EC in this population