Risk of cutaneous malignant melanoma in relation to use of sunbeds: further evidence for UV-A carcinogenicity

In a population-based, matched, case–control study from southern Sweden of 571 patients with a first diagnosis of cutaneous malignant melanoma and 913 healthy controls aged 16–80 years, the association between sunbed use and malignant melanoma was evaluated. A total of 250 (44%) cases and 372 (41%) controls reported ever having used sunbeds. A significantly elevated odds ratio for developing malignant melanoma after regular exposure to sunbeds was found, adjusted for hair colour, raised naevi, skin type and number of sunburns (odds ratio (OR) 1.8, 95% confidence interval (CI) 1.2–2.7). A dose–response relationship between total number of sunbed uses and melanoma risk was only found up to the level of 250 times. The OR was higher in individuals younger than age 36 years (adjusted OR 8.1, 95% CI 1.3–49.5 for regular vs never use). The association seemed to be true only for subjects with black/dark brown or light brown hair and among females. Lesions of the extremities showed the strongest association of increased risk with sunbed use. An increased risk was related to commercial exposure and to exposure during the winter. The results substantiate the hypothesis that exposure to sunbeds might increase the risk of developing malignant melanoma. © 2000 Cancer Research Campaig

Risk of malignant melanoma in relation to drug intake, alcohol, smoking and hormonal factors.

In a population-based, matched case-control study from southern Sweden of 400 patients with a first diagnosis of malignant melanoma and 640 healthy control subjects aged 15-75 years, the association between commonly prescribed drugs, alcohol, smoking and malignant melanoma was evaluated. In addition, the relation between reproductive and hormonal factors and melanoma in women was studied. It was found that certain specific types of prescribed drugs, i.e. beta-blockers, hydralazines and benzodiazepines, may increase the risk of melanoma development. However, these associations were diminished, at least for benzodiazepines, after controlling for host factors. As these findings are unconfirmed, and may be due to chance or confounding, further studies are warranted. The risk of malignant melanoma was not influenced by alcohol consumption or smoking habits. Our results do not suggest an association between oral contraceptives and melanoma. Furthermore, reproductive factors were not independent risk factors for melanoma. However, increasing number of live births seemed to be protective (P for trend = 0.01). There is a need for further research to be able to draw firm conclusions on the relation between number of live births and melanoma. The results based on histopathological re-examinations and those based on tumour registry data were essentially the same

Gender Differences in Takotsubo Cardiomyopathy as a Secondary Diagnosis: Higher Hospital Charges, More Procedures, and Longer Length of Stays

Background The incidence of Takotsubo Cardiomyopathy (TC) has risen steadily over the past decade, with current estimates of 15-30 cases per 100,000 per year. Historically, men diagnosed with TC have worse outcomes compared to women. The relationship between total hospital charges, number of procedures performed, and length of stay (LOS) between genders has not been previously reported with TC as a secondary diagnosis. Methods National Inpatient Sample (NIS) data from 2009-2015 was used to identify encounters of adult patients (≥18 years) undergoing coronary angiography that were ultimately given a secondary diagnosis of TC (International Classification of Diseases – 9 code 429.83). Demographics, comorbidities and outcomes including hospital mortality, total charges, and LOS were assessed and stratified by gender. Continuous variables were described using means and compared using independent two-sample t-tests. Total charges and LOS were described using medians and compared using Wilcoxon rank sum test. TC encounters were propensity matched by age, number of chronic conditions, number of procedures performed, and severity of illness. A discharge weight was included in all analyses to account for the complex sample design of the NIS. Results During 2009-2015, 1,448 men and 9,404 women with secondary TC were identified in the dataset, corresponding to a national estimate of 7,124 men and 46,163 women. The median hospital charges were $54,655 for men and$45,455 for women (p Conclusion Compared to women, men with a secondary diagnosis of TC are more likely to have a greater number of procedures, leading to a longer LOS and ∼$10,000 more in hospital charges. Greater awareness of TC as a potential secondary diagnosis is warranted among men

Infant Illness Severity and Perinatal Post-traumatic Stress Disorder after Discharge from the Neonatal Intensive Care Unit

Background Risk factors for perinatal posttraumatic stress disorder (PTSD) among parents of an infant in the NICU have varied in previous literature. The relationships between perception of illness severity and objective measures of illness severity with PTSD are not well understood. Aims To determine if PTSD among parents after an infant NICU discharge can be predicted by 1) objective measures of infant illness severity or 2) perceptions of infant illness severity. Study design A prospective, observational study. Subjects Parent/infant dyads who were in the NICU for ≥14 days. Outcome measures Objective measures of illness severity were obtained from the electronic health record. Perceptions of illness were measured by the response to the question, “How sick is your child/patient?” on a 5-point Likert scale. The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was completed by parents three months after discharge. Results One hundred ninety-four dyads participated in the study, 86% of parents completed follow up screening. 25% of parents screened positive for PTSD. Parents perceived infants to be sick more often than hospital caregivers. In bivariate analysis many objective measures of illness severity were associated with PTSD. Parent perceptions of illness were also associated with PTSD after adjusting for objective measures of illness (OR 3.2, 95% CI 1.1–6.1, p = 0.008). Conclusions PTSD in parents after NICU discharge is multifactorial. Objective illness risk factors can be used to screen parents at risk. Hospital caregivers should strive to understand parents\u27 perception of illness and improve communication to potentially decrease PTSD after discharge

A Bell Inequality Analog in Quantum Measure Theory

One obtains Bell's inequalities if one posits a hypothetical joint probability distribution, or {\it measure}, whose marginals yield the probabilities produced by the spin measurements in question. The existence of a joint measure is in turn equivalent to a certain causality condition known as ``screening off''. We show that if one assumes, more generally, a joint {\it quantal measure}, or ``decoherence functional'', one obtains instead an analogous inequality weaker by a factor of $\sqrt{2}$. The proof of this ``Tsirel'son inequality'' is geometrical and rests on the possibility of associating a Hilbert space to any strongly positive quantal measure. These results lead both to a {\it question}: ``Does a joint measure follow from some quantal analog of `screening off'?'', and to the {\it observation} that non-contextual hidden variables are viable in histories-based quantum mechanics, even if they are excluded classically.Comment: 38 pages, TeX. Several changes and added comments to bring out the meaning more clearly. Minor rewording and extra acknowledgements, now closer to published versio