bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between menopausal hormone therapy and melanoma: a systematic review and meta-analysis
Authors: Naldini G , Chiavarini M , Giacchetta I , Fabiani R 
Published: October 2020

Abstract

Background
Age-specific incidence rates of cutaneous Malignant Melanoma (MM) are higher in women during their reproductive years, while the rate of increase slows after menopause, supporting the speculation that hormones might influence the risk of developing cutaneous MM. The aim of our systematic review and meta-analysis is to summarize the evidence on the association between Menopausal Hormone Therapy (MHT) and the risk of MM.

Methods
Medline and Web of Science were systematically searched for eligible publications until December 2019. Our review and meta-analysis follow the PRISMA guidelines. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using a random effect model.

Results
The pooled analysis of all 19 studies (9 cohort and 10 case-control) showed a significant positive association of MHT with risk of MM (OR 1.19; 95% CI 1.13-1.26; I2=41.93%, p = 0.029). Excluding Uveal and intraocular MM (3 studies), MHT increased the risk of cutaneous MM (OR 1.19; 95% CI 1.13-1.26; I2=35.73%, p = 0.077). No significant publication bias could be detected. Stratifying by study design, MHT significantly increased the risk of cutaneous MM (OR 1.19; 95% CI 1.12-1.27; I2=42.52%, p = 0.107) in the cohort studies; no significant association was found in case-control studies.

Conclusions
This meta-analysis of available literature resulted in an increased risk of MM in women used MHT. Further investigations are necessary to increase the reliability of the results and estimate the relationship of other characteristics of MHT, such as type (opposed and unopposed estrogens) and route of administration, with MM.

Key messages
Menopausal Hormone Therapy (MHT) significantly increases the risk of Malignant Melanoma (MM). Further awareness of clinical practitioners should be raised on the potential association of MHT with MM.
Differences in body composition and grip between Japanese and Thai older people living in Thailand
Authors: Yoda T , Saengrut B , Rattanasathien R , Ishimoto Y , Saito T , Miyamoto K , Chunjai K , Pudwan R , Sirimuengmoon K , Katsuyama H 
Published: October 2020

Abstract

Background
Age-related muscle mass loss is one of the main risk factors for osteoporosis and fractures among older people. Thus, prevention of muscle mass loss in older people is an important issue. We examined ethnic group-related differences in body composition and grip strength among older people living in the same area.

Methods
We measured body composition and grip strength among local Thai older people living in Chiang Mai Province, as well as in Japanese older people who emigrated to Chiang Mai Province in their retirement. A self-reported questionnaire regarding socio-demographic status was also administered. Measurement items were averaged and compared by sex and ethnic group. Questionnaire items were also categorized by sex and ethnic group.

Results
A total of 119 older people participated, including 47 Japanese participants (26 men, 21 women) and 72 Thai participants (16 men, 56 women). The average age of Japanese participants was 71.1 years (standard deviation: 4.89), and the average age of Thai participants was 68.8 years (standard deviation: 5.61). Significant differences between ethnic groups were found in percentage of body fat in women (Japanese average: 32.9% vs. Thai average: 37.6%, p &lt; 0.05), skeletal muscle mass index (SMI) in men (Japanese average: 7.85 kg/m2 vs. Thai average: 7.31 kg/m2, p &lt; 0.05) and average grip strength in men (Japanese: 35.1 kg vs. Thai: 30.7 kg, p &lt; 0.05).

Conclusions
Our preliminary results suggest that Thai older people, particularly men, are weaker than Japanese older people. Decreased muscle mass is directly responsible for functional impairment, involving loss of strength, increased likelihood of falls, and loss of autonomy. Preventing muscle weakness among older people is important. In future studies, we plan to analyze and clarify the differences between Thai and Japanese older people to identify effective methods to prevent muscle mass decreases.

Key messages
There were significant differences in average % body fat between older Japanese and Thai women. There were significant differences in average SMI and grip strength between older Japanese and Thai men.
Factors associated with oral health inequalities in Korean adolescents
Authors: Shin B 
Published: October 2020

Abstract

Aim
The purpose of this study was to identify factors related to socioeconomic differences in oral health behavior and oral symptom experience in Korean adolescents using the 2017 Korea Youth Risk Behavior Web-Based Survey(KYRBS).

Methods
From the national 2017 KYRBS, which was approved by the Research Ethics Review Committee of the Korea Centers for Disease Control and Prevention, 61,874 adolescents aged 12-18 years were selected as participants of the present study. Toothbrushing, gum bleeding and toothache experience were selected as dependent variables, and subjective socioeconomic status (SES) was used as a measure of SES. For statistical analysis, complex samples logistic regression analysis was performed using SAS 9.3 (PROC SURVEYLOGISTIC).

Results
The Odds Ratio (OR) for toothbrushing variable in the highest SES group was 1.78 (95% CI: 1.68-1.88). The OR for the bleeding gums in the lowest SES group was 1.28 (95% CI: 1.21-1.36). Academic factors accounted for 19% of socioeconomic differences in toothbrushing, and psychological factors accounted for 36-49% of socioeconomic differences in oral symptoms.

Conclusions
Adolescent oral health inequalities were associated with a variety of factors including health behaviors, psychological factors, family and academic factors. Thus, oral health promotion of adolescents can be achieved by integrating relevant factors, which can be effective when based on schools.

Key messages
Social gradient in oral health behavior and oral symptoms of Korean adolescents persist when adjusted for behavioural, psychosocial and material factors. Because oral health in adolescents is linked to overall health, health promotion can be achieved when oral health inequalities are integrated and mediated within the overall health domain.
ECG abnormalities and arterial function by HIV status among high-risk populations in Rakai, Uganda
Authors: Enriquez R , Ekström A M , Gigante B , autiainen Lagerström S R , Kigozi G , Nalugoda F , Ssekubugu R , Nordenstedt H 
Published: October 2020

Abstract

Background
People living with HIV (PLHIV) are at increased risk for cardiovascular disease (CVD). In Sub-Saharan Africa, where a majority of PLHIV live, population-based data on major CVD events such as stroke and myocardial infarction are difficult and expensive to collect. The use of proxy measures of future CVD events that are easier to collect, could be a feasible way to better study CVD in such settings. This study aimed to determine the acceptability of incorporating ECG and arterial function measurements into a population-based cohort study and to assess the prevalence of ECG abnormalities and arterial stiffness.

Methods
A pilot study was conducted within the Rakai community cohort study in Uganda on two high-risk CVD groups; one determined by age (35-49) and Framingham CVD risk scores and the other by age alone (50+). Data on ECG, arterial function, blood pressure, and HIV status were collected. The acceptability of incorporating ECG and arterial function measurements was established as an acceptance rate difference of no more than 5% to blood pressure measurements.

Results
A total of 118 participants were enrolled, 57 PLHIV and 61 HIV negative. Both arterial function and ECG measurements were well accepted (2% difference), but the completeness of arterial function measurements captured was suboptimal (63%). Left ventricular hypertrophy (LVH) and arterial stiffness (&gt; 10 m/s) were common in both PLHIV and HIV negative participants across the two high-risk populations. Prevalence rates ranged from 30% to 53% for LVH and 25% to 58% for arterial stiffness.

Conclusions
The incorporation of ECG and arterial function measurements into routine activities of a population-based cohort was acceptable. LVH and arterial stiffness were common in these high-risk for CVD populations, indicating the need for future research. The use of these proxy measures might be recommended when data on CVD events cannot be collected.

Key messages
It is acceptable to incorporate ECG and arterial function measurements into a population-based cohort in Uganda. High prevalence rates of LVH and arterial stiffness were found in people with high risk for CVD.
Characterization of death from colorectal cancer in Mato Grosso State/Legal Amazon/Brazil, 2000-2016
Authors: Caló R S , Souza B S N , Galvão N D , Souza R A G , Oliveira J C S , Alves M R , Cabral J F , Atanaka M , Assis J V M , silva S M 
Published: October 2020

Abstract

Background
Colorectal cancer has been one of the cancers that most contributed to mortality, in both sexes in the world. In Brazil, cancer is among the top five causes of death and colorectal cancer is ranked on the fifth position. Of the Federative Units belonging to the Legal Amazon, Mato Grosso stands out for the higher adjusted incidence of colorectal cancer for both sexes. Thus, the objective is to characterize deaths from colorectal cancer, according to sociodemographic variables in Mato Grosso from 2000 to 2016.

Methods
A descriptive study was carried out, using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths of all ages were selected, whose basic cause was identified by the codes from the International Classification of Diseases: (C.18) colon cancer, (C.19) rectosigmoid junction cancer, (C.20) rectal cancer or (C.21) anus cancer.

Results
Between 2000 and 2016, 31,607 deaths from cancer were registered. Of these, 1,750 (5.6%) were due to colorectal cancer. An increased number of deaths was observed at the end of the period, with a variation from 46 deaths in 2000 from 173 in 2016. Highest frequency was verified in men (51.3%), people aged 60 years or older (59.7%), black (54.6%), married (52.3%) and those with primary education (55.2%). According to Brazilian occupation classification options or those answers filled out on the death certificate, highest frequency were for “Retired” (26.2%), “Housewife” (23.1%), Agricultural/Forestry and Fisheries” (11.3%) and “Production of Industrial Goods and Services” (10.3%).

Conclusions
This study evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State, and identified priority groups for interventions through public health policies which should include screening and early diagnosis to cope with the disease.

Key messages
Evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State. Identified priority groups for interventions through public health policies.
Mortality trends for all causes of cancer in Mato Grosso State, Brazil
Authors: Vieira Gomes C , da Silva Nalin de Souza B , de Lima D V , de Souza Andrade A c , de Souza Oliveira J C , Gomes de Souza R A , Dreyer Galvão N , Aguilar L B , de Lima Neto G S , Ferreira Montenegro L H 
Published: October 2020

Abstract

Background
Cancer is the second leading cause of death in Brazil, being the most common breast, lung, colorectal, cervix and pancreas among women and lung, prostate, colorectal, stomach and esophagus among men. The mortality trends for all causes of cancer in Brazil have been increased, with variations between sexes and regions. The objective was to analyze standardized mortality trend rates for all causes of cancer in Mato Grosso State, Brazil, from 2000 to 2015.

Methods
This is a descriptive, ecological, time-series study using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths from cancer of all ages were selected, whose basic cause was identified by the letter “C” from the 10th revision of International Classification of Diseases. The direct method of standardization was performed with the 1960 world population and expected deaths were estimated. To estimate the trend, the annual percentage variation (APV) was calculated using the ratio regression coefficient/2000 mortality rate, for the state and its five macroregions.

Results
From 2000 to 2015, 28.525 deaths from cancer occurred in the state residents. There was an increasing trend in the mortality rates for all causes of cancer, with APV of 0.81% (p = 0.001). Considering the macroregions, the south (APV = 1.12%; p = 0.01), north (APV = 1.51%; p = 0.01) and east (APV = 1.82%; p = 0.01) had an increasing trend and the west (APV = 0.51%; p = 0.44) and the center-north (APV = 0.46%; p = 0.12) had a stable trend.

Conclusions
Mato Grosso follows the Brazilian cancer mortality increased trend. Variation in mortality rates found among different macroregions of the state and no decreased rates reveal regional disparities and the importance of cancer control and prevention in the state.

Key messages
Mortality rate for all causes of cancer increased in Mato Grosso State, Brazil, from 2000 to 2015. Variation in mortality trends by macroregions of the Mato Grosso State reveals regional disparities and the importance of cancer control and prevention in the state.
Evaluation of sustainability of non-communicable diseases risk factor program in Malaysia
Authors: Shanmuganathan S , Mustapha F I , Wilson A 
Published: October 2020

Abstract

Background
Non-communicable diseases (NCDs) in Malaysia have risen substantially over the last two decades. We aimed to (i) evaluate the sustainability of the existing NCDs risk factor program implemented under the National Strategic Plan and (ii) identify challenges and factors impeding the sustainability of the NCDs program.

Methods
A mixed-method approach using a combination of the Program Sustainability Assessment Tool
with 40-item instrument assessing 8 domains (organizational capacity, program adaptation, program evaluation, communications, strategic planning, funding stability, environmental support and partnerships) and 5 open-ended questions were administered to 80 key managers from district directors of chronic disease programs in Malaysia. The mean score for each of the 8 sustainability domains and the overall mean sustainability score were determined. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 25.

Results
Seven domains scored a mean of ≥ 4. The domains of communications (cross-site mean, 4.5 on a scale of 1-7) and organizational capacity (mean, 4.4) had the highest ratings. Funding stability had the lowest rating (mean, 3.8). The overall mean sustainability score was 4.2. Open-ended responses revealed challenges by program leaders, including implementation difficulties, factors impede planning for NCDs sustainability program, lack of financial, staff support and staff training which are largely consistent with the scaled domains.

Conclusions
Capacity issues affecting the sustainability of NCDs program in Malaysia are qualitatively similar to other countries. Future work should aim at improving funding stability and integrating evidence-based public health strategies to sustain implemented NCDs program.

Key messages
Researchers could utilize this tool to assess program design and strategies promoting sustainability during implementation process for long term program sustainment. Investments in leadership support for integrating program evaluation into implementation and greater funding flexibility may enhance sustainability of evidence-based public health program for NCDs.
Project on monitoring persistence of body mass index of school aged children
Authors: Majer M , Musil V , Sović S , Musić Milanović S , Jureša V , Kujundžić Tiljak M 
Published: October 2020

Abstract

Issue
Childhood obesity is one of the most important public health issues today. In Croatia every third school aged child are overweight. Monitoring of nutritional status of school aged children in Croatia is a part of routine health examinations provided by School health service, while Project on tracking BMI from early school aged to adolescence provided insight into the risk of overweight in adolescence. Risk assessment for overweight is important in planning interventions in Croatia, as well in other countries.

Description of the Problem
Objective of the project was to collect and analyze anthropometric data of representative sample of Croatian school aged children, to determine tracking of BMI from early school age to adolescence and to assess the risk for overweight in adolescence. Longitudinal follow up included period from first to eight grade of primary school. Data of date of birth, body weight and height were obtained from medical records, and BMI was evaluate according to the national reference values.

Results
Project included 641 participant (49.8% girls) with the data of three measurements within health examination in primary school. Normal weight in all free measurements were 226 (71%, CI95% 66-76%) girls, and 192 (60%, CI95% 54-65%) boys, while overweight were 18 (6%, CI95% 4-9%) girls and 26 boys (8%, CI95% 5-12%), respectively. Probabilities of being overweight in eight grade for girls and boys normal weight in first grade were 10% (CI95% 7-14%) and 13% (CI95% 10-18%), while for overweight in first grade probabilities were 63% (CI95% 46-78%) and 69% (CI95% 54-81%), respectively. Risk of being overweight in eighth grade started increasing at 75th BMI centile value in first grade.

Lessons
Project showed importance of monitoring persistence of BMI of school age children. Intervention should target normal weight children as well, in order to maintain normal weight during the lifespan.

Key messages
Monitoring of nutritional status and risk assessment for overweight is important in planning interventions. Intervention should target not only overweight children, but normal weight children as well.
Smoking abstinence 1 year after acute coronary syndrome in Tunisian adults
Authors: Abroug H , El Hraiech A , Ben Fredj M , Kacem M , Zemni I , Benasrallah C , Wafa Dhouib W , Rania Bannour R , Mehrez O , Sriha A 
Published: October 2020

Abstract

Background
In Tunisia, coronary heart disease(CHD) is the first cause of mortality, accounting one third (33.23%) of total deaths in 2017. Although smoking cessation is the most effective CHD prevention strategy, quitting smoking is difficult and two thirds of patients return to smoking within 1 year of their acute coronary syndrome (ACS). The present study aimed to evaluate the smoking cessation rate and to assess predictors of smoking abstinence in patients with ACS, one year after hospital discharge.

Methods
A prospective cohort study was conducted in the Cardiology Department and Smoking Cessation Service at University Hospital of Monastir, Tunisia from January 2015 to December 2017. During their hospitalization, all patients in the sample received individual therapeutic education including a motivational interview. The follow-up were carried out by clinic visits every two weeks. Logistic regression analysis was used to evaluate the independent predictors of smoking abstinence. The statistical analysis was conducted with SPSS software, version 21.0. A p value of &lt; 0.05 was considered statistically significant.

Results
A total of 288 smoking patients were included in our study. All participants were male and the mean age was 55 ± 11 years. More than half (55.4%) of patients had a high level of nicotine dependence. Successful smoking cessation rate was 35.7 % [95% confidence interval (CI): 29.4-42.5%]. Independent predictors of smoking abstinence were: therapeutic adherence (odds ratio(OR): 13.8, p &lt; 0.001), the level of nicotinic dependence (OR: 0.26, p = 0.02), the length of stay in the ICU (OR: 8.31, p = 0.001) and diabetic status (OR: 4.54, p = 0.01).

Conclusions
This study for smoking cessation highlights the importance to generalize our protocol for all Tunisian patient with cardiovascular risk.

Key messages
Smoking cessation is the most effective coronary heart disease prevention strategy. More efforts are required to improve smoking cessation in patients with cardiovascular risk.
Factors associated with diabetic foot among type 2 diabetes in the region of Monastir (Tunisia)
Authors: Abroug H , Ben Fredj M , Kacem M , Bennasrallah C , Dhouib W , Mehrez O , Zemni I , Bannour R , Sriha A 
Published: October 2020

Abstract

Background
The diabetic foot (DF) has actually a high rate of disability leading to impaired quality of life and even mortality. Glycemic control among Tunisian adults with diabetes mellitus remains poor. However the relationship between glycemic control and foot complication have not been clearly established. The aim of the present study was to assess the relationship between diabetic foot lesions and glycemic control and the diabetic duration in the people with DT2.

Methods
A cross-sectional survey was conducted in five Primary Health care Centers (PHC) in the region of Monastir (Tunisia) from March 2016 to April 2017. Data were collected using interviewer administered structured questionnaire. Validated questionnaire was used to assess diabetic foot diseases.nA multivariate logistic regression analysis was conducted to assess the relationship between glycemic control, diabetic duration and the DF lesions. A p-value of &lt; 0.05 was considered statistically significant.

Results
In total 383 patients were recruited, of whom 258 (67.9%) were men. The mean age of participants was 60.7±11.3. Poor glycemic control (HbA1c ≥ 7.0%) increased the risk of abnormal patellar reflex (aOR=7.07; CI95% 1.65-30.1; p = 0.03) and calf claudication (aOR=7.07; CI95% 1.65-30.1). The long duration of diabetes (10 years and more) was a significant factor associated with an abnormal Achill reflex (aOR=2.31; CI95% 1.12-4.76; p = 0.02), a needle-stick perceptual disorder(aOR=2.08; CI95% 1.14-3.78; p = 0.01), a vibration sensibility perceptual disorder (aOR=2.02; CI95% 1.01-4.08; p = 0.04), a negative monofilament test (aOR=2.69; CI95% 1.04-5.16; p = 0.003), an absent dorsalis pedis artery pulsation(aOR=2.35; CI95% 1.09-5.05;p=0.02) and an absent posterior tibial artery pulsation (aOR=3.06; CI95% 1.28-7.28; p = 0.01).

Conclusions
This study identified that disease duration and poor glycemic control are significant risk factors related to DF development in the current T2DM population.

Key messages
Disease duration and poor glycemic control are significant risk factors related to DF development in the T2DM population in the region of Monastir. Prevention programs should be focused on patient education about modifiable risk factors in particular glycemic control and adequate and regular foot care.