Socio-cultural predictors of injuries: life-course experience of hospitalised injuries during the past century in the Velestino study.

Retrospective reviews provide unique opportunity to assess changing approaches to trauma in recent history and identify modifiable behaviours through the lessons of the past. The objective of this paper is to depict the nearly one-century long, life-course injury experience of seniors residing in Velestino, an agricultural Greek town, and comment on neglected determinants and transitional patterns following historical and socio-cultural events in the area. The life-course experience of non-fatal injuries, requiring hospitalisation, has been reported by N = 643 study participants, aged 65-102 years. Injuries were grouped and assessed in three ways: chronologically, by body part and by type. Overall, 124 injuries have been recorded over the past 70 years; the majority sustained by men (58.6%), and the highest number of injuries occurred during the recent decades, 1980s-1990s. For the age groups 26-45 and 46-65 years old, traffic (37.5% and 22.2%) and occupational (25.0% and 22.2%) events have been the commonest cause of injury, whereas injuries occurring at home were primary hazard (25.8%) for the elderly. Moreover, meaningful historical connections with warfare and migration movements were made. In retrospect, socio-cultural factors emerge as important predictors of certain injuries, pointing to the number of factors that should be taken into account when designing injury-prevention programmes

Cigarette smoking and risk of lymphoma in adults: a comprehensive meta-analysis on Hodgkin and non-Hodgkin disease

The aim of the present meta-analysis was to examine comprehensively the association between smoking and lymphoma [Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL)] in adults. Eligible studies were identified, and pooled-effect estimates (odds ratios and relative risks) were calculated for ever, current and former smoking, separately by lymphoma subtype and gender. Metaregression analysis with percentage of male patients, mean age, duration (years of smoking), intensity (pack-years and cigarettes per day) and years since quitting was carried out. Out of the 50 eligible articles, 41 used a case-control design (20 143 NHL cases, 4340 HL cases and 61 517 controls), whereas nine used a cohort design (5748 incident NHL cases, 334 HL cases, total cohort size comprising 1 530 833 smokers). Ever smoking was associated with increased risk for NHL [pooled-effect estimate = 1.05, 95% confidence interval (CI): 1.00-1.09] mainly because of the association with T-NHL (pooled-effect estimate = 1.23, 95% CI: 1.09-1.38). Ever smoking was also associated with increased risk for HL (pooled-effect estimate = 1.15, 95% CI: 1.02-1.30); sizeable associations were observed regarding both nodular sclerosis and mixed cellularity subtypes. Although male study arms pointed to predominantly increased risk for HL, metaregression did not confirm the male preponderance. Dose-response patterns were particularly evident for HL. Cigarette smoking seems to be associated with increased lymphoma risk, especially HL and T-NHL. Further well-designed studies seem to be needed so as to investigate the risk thoroughly, especially for T-NHL subentities, and the extent to which confounding may interfere with gender-related disparities. European Journal of Cancer Prevention 22:131-150 (c) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Serum folate and B12 levels in association with cognitive impairment among seniors: results from the VELESTINO study in Greece and meta-analysis.

OBJECTIVE: To summarize existing evidence on the effect of serum folate and vitamin B12 levels on cognitive impairment among elders via a meta-analysis, also including unpublished data from a cross-sectional study of seniors ( > 65 years) residing in Velestino, Greece. METHOD: Serum measurements and Mini-Mental State Examination (MMSE) assessments were available for 593 Velestinians. In addition, 12 studies availing data on folate blood levels (N = 9,747) and 9 on B12 (N = 8,122) were identified following a search algorithm; pooled effect estimates were derived. RESULTS: Cognitive impairment (MMSE < 24) among Velestenians was associated with lower education level in both genders; decreased social activity, depressive symptoms and low folate levels in males; older age in females. Meta-analyses showed an adverse effect of low-folate levels on cognition (OR: 1.66, 95% CI: 1.40-1.96); B12 was nonsignificantly associated (OR: 1.11, 95% CI: 0.88-1.40). DISCUSSION: Low folate levels are associated with cognitive impairment of seniors; underlying pathophysiological mechanisms should be further explored

Epidemiological patterns and preventability of traumatic hand amputations among adults in Greece

Introduction: Hand/finger amputations though rare account for significant disability and health-related costs; yet, information on underlying causes, springing mostly from physicians’ reports, is rather anecdotal. We sought to draw attention to the high preventable fraction of hand/finger amputations among adults in Greece. Patients and Methods: Data on external cause of injury and short-term outcome, recorded over nine years in the Emergency Department Injury Surveillance System (EDISS) were analysed, whereas sample weights were used for nationwide extrapolations. Results: Hand/finger injuries accounted for 20.4% (N = 57,986) among 284,705 injuries recorded in patients &gt; 14-year-old (3% annual probability); 728 (1.3%) resulted in amputations; the estimated incidence rate (IR) was 39.3/100,000 person-years, reaching a high 92.6/100,000 among males aged 4564 years. As expected, the vast majority of victims were males (90%), frequently young immigrants; similar to two-thirds sustained occupational injuries during working hours. Objects most frequently involved included: machinery (57% overall/69% occupational), means of transport (10.4%), materials (9.5%), parts of buildings/furniture (5%). Wood-working was the most common risk factor (20% overall/28% occupational) whereas 6% of victims accepted own inattention. 30% of amputations were hospitalised whereas 10% transferred to specialised units. Discussion: Specialised registries reveal the magnitude and specific causes of disabling hand injuries and point to tailored national injury prevention programs; specifically in Greece, as they occur in more controlled occupational environments among middle-aged males, woodworkers, and are caused mainly by machinery. Conclusions: Increased management of safety in the workplace could play a role in reduction in hand amputations. (C) 2012 Elsevier Ltd. All rights reserved

Thyroid function tests at delivery and risk for postpartum depressive symptoms

Postpartum depression (PPD) is a common childbirth complication, which can have negative effects on both the newly delivered woman and her family. This condition is under-diagnosed and inadequately treated, while a biological diagnostic test is not yet available. Furthermore, postpartum thyroid dysfunction is common among new mothers, and some evidence point to an association between PPD and thyroid function disturbances. The aim of this study was to evaluate the possible association between serum levels of thyroid hormones at the time of delivery, and the later development of depressive symptoms, using data from a population based cohort of Swedish women. Blood samples were collected during delivery from 347 participating women, delivering at Uppsala University Hospital. The participating women filled in at least one of three structured questionnaires, containing the Edinburgh Postnatal Depression Scale (EPDS), at five days, six weeks and six months postpartum. A cut-off of 12 or more was applied on the EPDS, to identify cases of self-reported PPD and controls. Using a binary logistic regression model (adjusting for previous psychiatric contact, smoking during pregnancy, pre-pregnancy body mass index (BMI) and sleep), having a thyroid stimulating hormone (TSH) level over the clinical cut-off level of 4.0 mU/L was associated with increased risk for depressive symptoms at six months postpartum (OR 11.30, 95% CI 1.93-66.11). A ROC analysis revealed that the predictive variable (PV) had significant predictive ability for PPD at 6 months postpartum, given that the AUC was 0.764, and at a PV cut-off value of 6.33, the sensitivity and specificity were 76.2% and 69.4%, respectively. If these findings are replicated in future studies, they can have important clinical implications, since TSH determination is an inexpensive routine blood test, and its inclusion in a biological screening test for PPD involving other parameters would be tempting. (C) 2012 Elsevier Ltd. All rights reserved

Folate and B12 serum levels in association with depression in the aged: a systematic review and meta-analysis

Objectives: To systematically review and meta-analyse existing evidence on the association between folate/B12, and depression among the aged people. Methods: Following PRISMA/STROBE guidelines, the Medline abstracts were retrieved using an algorithm comprising relevant MeSH terms. Publications on the association of folate/B12 serum measurements with depression were abstracted independently by two reviewers and included in both gender and gender-specific meta-analyses, following recarculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies. Results: Both gender data were contributed by 11 folate-related (7949 individuals) and 9 B12-related studies (6308 individuals), whereas gender-specific data by 4 folate-related (3409 individuals) and 3 B12-related studies (1934 individuals). A statistically significant overall association between both exposures of interest (low folate and B12 levels) and depression was observed (ORfolate: 1.23, 95%CI: 1.07-1.43, ORB12:1.20, 95%CI:1.02-1.42). Gender-specific estimates pointed to a statistically significant positive association between low B12 levels and depression only among women (OR:1.33, 95%CI:1.02-1.74); the gender specific associations of low folate levels with depression were, however, non-significant and of counter-direction (ORfemales: 1.37, 95% CI: 0.90-2.07; ORmales: 0.84, 95% CI: 0.57-1.25). Conclusion: Low folate and B12 serum levels seem to be associated with depression in the aged. The gender-specific analyses are confined to a positive association of low B12 with depression among older women and call for further research in this direction

Targeting cancer stem cells by disulfiram and copper sensitizes radioresistant chondrosarcoma to radiation

Overcoming the radiosensitivity of chondrosarcoma (CS), the second most common primary bone tumor, is needed. Radioresistance is attributed to cancer stem cells (CSCs) in many malignancies. Disulfiram (DSF), an FDA-approved anti-alcoholism drug, complexed with Cu (DSF/Cu) can radiosensitize epithelial CSCs. This prompted us to investigate the radiosensitizing effect of DSF/Cu on CS CSCs (CCSCs). The radiosensitizing effects of DSF/Cu on CCSCs were investigated in vitro using cell lines SW1353 and CS-1. Stemness was identified independently by flow cytometry for CCSCs (ALDH+CD133+), sphere-forming ability, and Western blot analysis of stemness gene protein expression. The radiosensitizing effect of DSF/Cu was studied in an orthotopic CS xenograft mouse model by analyzing xenograft growth and residual xenografts for stemness. CCSCs were found to be resistant to single-dose (IR) and fractionated irradiation (FIR). IR and FIR increased CS stemness. Combined with DSF/Cu in vitro and in vivo, IR and FIR eliminated CS stemness. RT + DSF/Cu was safer and more effective than either RT ± DSF in inhibiting growth of orthotopic CS xenografts. In conclusion, DSF/Cu radiosensitizes CCSCs. These results can be translated into clinical trials for CS patients requiring RT for improved outcomes. •Overcoming radioresistance in chondrosarcoma (CS) is an unmet clinical need.•Chondrosarcoma stem cells (CCSCs) are radioresistant and induced by radiation.•Disulfiram combined with copper (DSF/Cu) radiosensitizes CCSCs in vitro and in vivo.•DSF/Cu expands the therapeutic index of radiation in an orthotopic CS mouse model.•The first example of mesenchymal originated CSCs radiosensitized by DSF/Cu

Traumatic hand amputations among children in Greece: epidemiology and prevention potential

Background Traumatic hand and finger amputations frequently lead to permanent disability. Objective To investigate their epidemiological characteristics and estimate the prevention potential among children 0-14 years old, through a cross-sectional survey. Methods Nationwide extrapolations were produced based on data recorded between 1996 and 2004 in the Greek Emergency Department Injury Surveillance System and existing sample weights. Incident and injury related characteristics were analysed to identify preventable causes. Results Among 197 417 paediatric injuries, 28 225(14%) involved the hand and fingers resulting in 236 amputations (similar to 1% of hand injuries). The annual probability to seek emergency department care for a hand injury was 3%. The estimated incidence rate (IR) of hand amputations was 19.7/100 000 person-years. Over 50% concerned children 0-4 years old (male: female=2:1), peaking at 12-24 months. Male preschoolers suffered the highest IR (38.7/100 000). Migrant children were overrepresented among amputees. Of all amputations, 64% occurred in the house/garden and 14% in day-care/school/sports activities, usually between 08:00 and 16:00 (61%). Doors were the product most commonly involved (55% overall; 72% in day-care/school/gym) followed by furniture/appliances (15%) and machinery/tools (7%). Crushing was the commonest mechanism. Inadequate supervision and preventive measures were also frequently reported. 5% of the amputees were referred to specialised units for replantation/reconstructive surgery. Conclusions The majority of paediatric hand and finger amputations could be prevented in Greece, particularly among preschoolers, by a single product modification, namely door closure systems, coupled with improved supervision. Paediatricians should incorporate this advice into their routine child-safety counselling. This country-specific profile supports the need for maintaining similar databases as an indispensable tool for assisting decision-making and preventing disabling and costly injuries

Serum Folate and B12 Levels in Association With Cognitive Impairment Among Seniors: Results From the VELESTINO Study in Greece and Meta-Analysis

Objective: To summarize existing evidence on the effect of serum folate and vitamin B12 levels on cognitive impairment among elders via a meta-analysis, also including unpublished data from a cross-sectional study of seniors ( &gt; 65 years) residing in Velestino, Greece. Method: Serum measurements and Mini-Mental State Examination (MMSE) assessments were available for 593 Velestinians. In addition, 12 studies availing data on folate blood levels (N = 9,747) and 9 on B12 (N = 8,122) were identified following a search algorithm; pooled effect estimates were derived. Results: Cognitive impairment (MMSE &lt; 24) among Velestenians was associated with lower education level in both genders; decreased social activity, depressive symptoms and low folate levels in males; older age in females. Meta-analyses showed an adverse effect of low-folate levels on cognition (OR: 1.66, 95% CI: 1.40-1.96); B12 was nonsignificantly associated (OR: 1.11, 95% CI: 0.88-1.40). Discussion: Low folate levels are associated with cognitive impairment of seniors; underlying pathophysiological mechanisms should be further explored