Countries with high circumcision prevalence have lower prostate cancer mortality / 亚洲男科学杂志(英文版)

The present study determined the relationship of male circumcision (MC) prevalence with prostatic carcinoma mortality rate in the 85 countries globally for which data on each were available. MC prevalence in different countries were obtained from a WHO report and allocated to WHO categories of 81%-100%, 20%-80%, and 0%-19%. Prostatic carcinoma mortality data were from Globoscan, gross national income per capita as well as male life expectancy were from a World Bank report, and percentages of Jews and Muslims by country were from the Pew Research Institute and the North American Jewish Data Bank. Negative binomial regression was used to estimate prostatic carcinoma mortality rate ratios. Compared to countries with 81%-100% MC prevalence, prostatic carcinoma mortality rate was higher in those with MC prevalence of 0%-19% (adjusted OR [adjOR] =1.82; 95% CI 1.14, 2.91) and 20%-80% (adjOR = 1.80; 95% CI, 1.16, 2.78). Higher Muslim percentage (adjOR = 0.92 [95% CI 0.87, 0.98] for each 10% increase) and longer life expectancy (adjOR = 0.82 [95% CI 0.72, 0.93] for each 5 additional years) were associated with lower prostatic carcinoma mortality. Higher gross national income per capita (adjOR = 1.10 [95% CI 1.01, 1.20] for double this parameter) correlated with higher mortality. Compared with American countries, prostatic carcinoma mortality rate was similar in Eastern Mediterranean countries (adjOR = 1.02; 95% CI 0.58, 1.76), but was lower in European (adjOR = 0.60; 95% CI 0.50, 0.74) and Western Pacific countries (adjOR = 0.54, 95% CI 0.37, 0.78). Thus, prostate cancer mortality is significantly lower in countries in which MC prevalence exceeds 80%.

Cardiovascular disease risk factors in menopausal Jamaican black women after hysterectomy and bilateral oophorectomy: an observational study / Factores de riesgo de la enfermedad cardiovascular en mujeres negras jamaicanas en la menopausia tras histerectomía y ooforectomía bilateral: un estudio observacional

OBJECTIVE: To determine differences in prevalence of cardiovascular risks and diseases in black Jamaican postmenopausal women who had hysterectomy (hysgroup) compared with those without (control). METHOD: Eight hundred and nine (809) women (hysterectomized (HYSGRP) = 403; non-hysterectomized (controls) = 406) were enrolled. Sociodemographic information and lifestyle history, measured blood pressure, waist hip ratio, body mass index, fasting blood glucose, total and HDL cholesterol were obtained. RESULTS: Of the 809 women, complete cardiovascular risk data were available in 341 controls and 328 in the HYSGRP group. There was no difference in mean age, blood pressure and body mass indices between the subjects excluded and the subjects in the data analytical sample. A significantly lower proportion ofwomen in the control group exercised, attained post-secondary education and were of higher parity. Systolic (mean difference with 95% CI; 6 (3, 9) mmHg and diastolic (3 (1, 5) mmHg) blood pressure were lower in the HYSGRP compared with controls but total cholesterol (0.2 (0.07 to 0.4) mmol/L was greater. HDL cholesterol was not different between both groups 1.3 mmol/L (SD 0.3) vs 1.3 mmol/L [SD 0.4] (p = 0.8435). There was no difference in the prevalence of diabetes, hypertension and high waist-hip ratio in hysterectomized women compared with controls adjusting for hormone replacement therapy usage, cigarette smoking, exercise and educational status. Within the HYSGRP, there was also no difference in cardiovascular disease or risk in women who had bilateral oophorectomy compared with women who had at least an ovary preserved at time ofoperation. CONCLUSION: Hysterectomy was not associated with an increased risk of cardiovascular disease. This must be taken cautiously since data did not allow for analysis on duration of menopause.

OBJETIVO: Determinar las diferencias en la prevalencia de riesgos y enfermedades cardiovasculares en mujeres negras jamaicanas menopáusicas con histerectomía, en comparación con las que no tuvieron esta operación (control). MÉTODO: Se enrolaron ochocientas nueve (809) mujeres (histerectomizadas (HYSGRP) = 403; no histerectomizadas (controles) = 406). Se obtuvo información sobre datos demográficos e historia del estilo de vida, mediciones de la presión arterial, índice cintura/cadera, glucemia en ayunas, así como el colesterol total y HDL. RESULTADOS: De 809 mujeres, había disponible datos completos sobre el riesgo cardiovascular en 341 controles, y 328 en el grupo HYSGRP. No hubo diferencias significativas en relación con la edad promedio, la presión arterial, y el índice de masa corporal entre los sujetos excluidos y los sujetos en las muestras del análisis de datos. Una proporción significativamente menor de mujeres en el grupo de control practicado, tuvo educación post-secundaria y fueron de paridad más alta. La presión arterial sistólica (diferencia promedio con 95% CI; 6 (3 a 9 mmHg)) y la presión arterial diastólica (3 (1 a 5 mmHg)) fueron más bajas en el grupo de la histerectomía HYSGRP en comparación con el grupo de control, pero el colesterol (0.2 (0.07 a 0.4)) fue mayor. El colesterol HDL no fue diferente entre los dos grupos: 1.3 mmol/L (SD 0.3) frente a 1.3 mmol/L [SD 0.4] (p = 0.8435). No hubo diferencia en cuanto a laprevalencia de la diabetes, la hipertensión, y el alto índice cintura/cadera en las mujeres histerectomizadas, en comparación con los controles ajustándose en relación con el uso de la terapia de reemplazo hormonal, el hábito defumar, el ejercicio, y el nivel educacional. Dentro del grupo HYSGRP tampoco hubo diferencias con respecto a las enfermedades cardiovasculares o riesgos en mujeres operadas de ooforectomía bilateral, en comparación con las mujeres a las que se les preservó por lo menos un ovario en el momento de la operación. CONCLUSIÓN: La histerectomía no estuvo asociada con un aumento de riesgo de la enfermedad cardiovascular. No obstante, esta conclusión debe tomarse con cautela, ya que los datos no permitieron el análisis en el período de duración de la menopausia.

Loss expression of active fragile sites genes associated with the severity of breast epithelial abnormalities / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>WWOX and FHIT are two candidate tumor suppressor genes located in active fragile sites, the damage of which has been associated with the development of breast cancer. The association of the expression of these genes and the development of breast cancer has not been fully explored. We evaluated mRNA and protein expression of WWOX and FHIT in breast tissue with normal histological appearances, atypical ductal hyperplasia, ductal carcinoma in situ, and invasive cancer to see if a progressive decline in expression was present.</p><p><b>METHODS</b>Reverse transcription-polymerase chain reaction and Western blotting were used to evaluate the specimens for mRNA and protein expression, including 28 specimens with normal tissue, 28 specimens with atypical ductal hyperplasia, 33 specimens with ductal carcinoma in situ, and 51 specimens with invasive ductal carcinoma.</p><p><b>RESULTS</b>Compared with in situ and invasive cancer specimens, both normal and atypical hyperplasia specimens had greater rates of detectable mRNA (WWOX rate ratio = 2.95, 95% CI 1.24 - 7.08; FHIT rate ratio = 4.58, 95% CI 1.82 - 11.81) and Western blotting detectable protein (WWOX rate ratio = 4.12, 95% CI 1.63 - 10.73; FHIT rate ratio = 3.76, 95% CI 1.44 - 10.06). For both proteins, differences between normal and atypical hyperplasia specimens and between in situ and invasive carcinoma specimens were explainable by chance (P > 0.05 for each analysis). Within each histological category, differences among fractions of specimens showed that FHIT and WWOX mRNA and protein expression were explainable by chance (P > 0.05 for each analysis).</p><p><b>CONCLUSION</b>Expression of FHIT and WWOX decreases along with breast tissue progress from a normal histological appearance to atypical ductal hyperplasia, in situ cancer, and the final invasive cancer.</p>

A review of medicinal plant research at the University of the West Indies, Jamaica, 1948-2001

This review summarizes research carried out on Jamaican medicinal plants at the Faculty of Pure and Applied Science, The University of the West Indies (UWI), Mona, Jamaica, between 1948 and 2001. The plants identified as being medicinal are listed along with their folk use and a summary of the scientific research done at UWI leading to the identification of natural products (NPs) and determination of their bioactivity. Natural product research on Jamaican medicinal plants began with the inception of UWI in 1948, leading to many postgraduate degrees being awarded (22 MPhil and 31 PhD). At least 334 plant species growing in Jamaica have been identified as having medicinal qualities, 193 of these have been tested for their bioactivity. Crude extracts from 80 of these plants have reasonable bioactivity and natural products (NP) have been identified from 44 plants. At least 29 of these NPs were found to be bioactive. Only 31 of the plants tested at UWI are endemic to Jamaica. Of these 23were bioactive, as compared to 11of the non-endemics. Based on these results, patents have been obtained and drugs have been developed. This review represents the first attempt to gather this information together in one place.

El presente trabajo resume la investigación sobre plantas medicinales jamaicanas, llevada a cabo en la Facultad de Ciencias Puras y Aplicadas de la Universidad de West Indies (UWI), Mona, Jamaica, entre 1948 y 2001. Las plantas identificadas como medicinales se enumeran junto con su uso popular y un resumen de la investigación científica realizada en UWI, la cual condujo a la identificación de los productos naturales y la determinación de su bioactividad. La investigación de productos naturales que tuvo por objeto las plantas medicinales jamaicanas, comenzó con la fundación de UWI en 1948, y en el transcurso de su desarrollo, condujo a la obtención de numerosos grados científicos. (Para el año 2001, en la Facultad de Ciencias Puras y Aplicadas se habían defendido 22 maestrías y 31 doctorados asociados con dicha investigación.) Por lo menos 334 especies de plantas que crecen en Jamaica han sido identificadas como poseedoras de propiedades medicinales, 193 de las cuales han sido sometidas a prueba para determinar su bioactividad. Los extractos crudos de 80 de estas plantas poseen una bioactividad razonable, y se han identificado productos naturales (PN) en 44 plantas. Se halló que por lo menos 29 de estos PN son bioactivos. Sólo 31 de las plantas sometidas a prueba en UWI eran endémicas de Jamaica. De éstas, el 23% resultó ser bioactivo, en comparación con el 11% en el caso de las plantas no endémicas. Sobre la base de estos resultados, se han obtenido patentes, y se han desarrollado medicamentos. Este resumen representa un primer intento por compilar esta información en un solo trabajo.

Exploring knowledge and attitudes about emergency contraceptive pills among university students in Jamaica. A qualitative approach

Emergency contraceptive pills (ECPs) are an important option for university students who may be at high risk for unplanned pregnancies. In the Caribbean, little research has been carried out on university student's knowledge and opinions of this method. This study uses qualitative methodology to explore knowledge and opinions on ECPs among university students attending The University of the West Indies (UWI) Mona campus. We conducted eight focus groups (n = 71) with female and male university students at The University of the West Indies, Kingston, Jamaica, in March 2000. The group discussions lasted approximately two hours. We tape-recorded discussions and then transcribed and analyzed them by coding responses according to themes. General knowledge of ECPs was high, but students lacked specific information about the method such as its time frame and its mechanism of action. Most students supported the method, especially after learning correct information. However, several students were concerned about its side effects and the potential for abuse or irresponsible use by young adults. Although the university students in this study lacked detailed information about ECPs, their opinion toward the method was favourable. We suggest further research to investigate the prevalence of misinformation about the method among other groups of Jamaicans

Ovarian hyperstimulation syndrome associated with clomiphene citrate

Ovarian hyperstimulation is a recognized complication of ovulation induction with gonadotrophins. The syndrome is becoming more common as the number of women undergoing in-vitro fertilization increases. It is rarely seen in conjunction with clomiphene citrate usage. This case report is of moderate to severe ovarian hyperstimulation in a patient who was treated with clomiphene citrate because of infertility secondary to anovulation. She presented with amenorrhoea for five weeks, lower abdominal pain and a positive urinary human chorionic gonadotrophin (hCG) test. Pelvic ultrasonography was suggestive of a possible ectopic pregnancy with a differential diagnosis of a ruptured ovarian cyst. Diagnostic laparoscopy was done followed by laparotomy. Oophorectomy was performed because the ovary was thought to be complex with solid areas. However, conservative management with avoidance of laparotomy is the recommendation in confirmed cases of ovarian hyperstimulation but this requires a high level of suspicion in patients who have ovulation induction.