Does OSA Increase Risk for Cancer? Marriott, Ross J.; Singh, Bhajan; McArdle, Nigel ...
Chest,
October 2023, 2023-10-00, Letnik:
164, Številka:
4
Journal Article
Recenzirano
The relationship between OSA and cancer is unclear.
What is the association between OSA and cancer prevalence and incidence in a large Western Australian sleep clinic cohort (N = 20,289)?
OSA ...severity was defined by apnea-hypopnea index (AHI) and nocturnal hypoxemia (duration and percentage at oxygen saturation < 90%) measured by in-laboratory polysomnogram. Measures of potential confounding included age, sex, BMI, smoking status, socioeconomic status, and BP. Outcomes were determined from the Western Australian cancer and death registries. Analyses were confined within periods using consistent AHI scoring criteria: January 1, 1989, to July 31, 2002 (American Sleep Disorders Association criteria), and August 1, 2002, to June 30, 2013 (Chicago criteria). We examined associations of AHI and nocturnal hypoxemia with cancer prevalence using logistic regression and cancer incidence using Cox regression analyses.
Cancer prevalence at baseline was 329 of 10,561 in the American Sleep Disorders Association period and 633 of 9,728 in the Chicago period. Nocturnal hypoxemia but not AHI was independently associated with prevalent cancer following adjustment for participant age, sex, BMI, smoking status, socioeconomic status, and BP. Of those without prevalent cancer, cancer was diagnosed in 1,950 of 10,232 (American Sleep Disorders Association) and 623 of 9,095 (Chicago) participants over a median follow-up of 11.2 years. Compared with the reference category (no OSA, AHI < 5 events per hour), univariable models estimated higher hazard ratios for cancer incidence for mild (AHI 5-15 events per hour), moderate (AHI 15.1-30 events per hour), and severe (AHI > 30 events per hour) OSA. Multivariable analyses consistently revealed associations between age and, in some cases, sex, BMI, and smoking status, with cancer incidence. After adjusting for confounders, multivariable models showed no independent association between OSA severity and increased cancer incidence.
Nocturnal hypoxemia is independently associated with prevalent cancer. OSA severity is associated with incident cancer, although this association seems secondary to other risk factors for cancer development. OSA is not an independent risk factor for cancer incidence.
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There were controversial findings in terms of the association between the incidence of Benign Paroxysmal Positional Vertigo (BPPV) and climate changes, so the current systematic review plus ...meta-analysis is designed to discover this possible relationship.
Web of science, PubMed, Scopus, Google Scholar, Embase, and Cochrane library were systematically searched up to August 2023. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them.
In total, 15 studies including 16144 patients met the inclusion criteria. Ten studies reported the relation of BPPV to monthly mean temperature, 7 to monthly average humidity, 4 to monthly average rainfall, 6 to monthly sunlight time, and 2 to average solar radiation. The incidence of BPPV was associated significantly with atmospheric pressure (P: 0.003) and rainfall (P: 0.017). However, there was not any statistically significant correlation between incidence of BPPV and humidity, sunlight time, temperature, and solar radiation level (P > 0.05).
The incidence of BPPV was higher in cold months of a year in both northern hemisphere and southern hemisphere countries. Although it can be because of negative correlation with temperature, the current meta-analysis did not find any statistically significant negative correlation with temperature. In addition, the incidence of BPPV was associated significantly with atmospheric pressure (positive correlation) and rainfall (negative correlation).
BornAgain is a free and open‐source multi‐platform software framework for simulating and fitting X‐ray and neutron reflectometry, off‐specular scattering, and grazing‐incidence small‐angle scattering ...(GISAS). This paper concentrates on GISAS. Support for reflectometry and off‐specular scattering has been added more recently, is still under intense development and will be described in a later publication. BornAgain supports neutron polarization and magnetic scattering. Users can define sample and instrument models through Python scripting. A large subset of the functionality is also available through a graphical user interface. This paper describes the software in terms of the realized non‐functional and functional requirements. The web site https://www.bornagainproject.org/ provides further documentation.
BornAgain is a free and open‐source multi‐platform software framework for simulating and fitting X‐ray and neutron reflectometry, off‐specular scattering, and grazing‐incidence small‐angle scattering (GISAS). This paper concentrates on GISAS.
Introduction: Today, due to unhealthy lifestyle, we are facing an increase in non-communicable diseases, including cancers. The aim of this study was to determine the age-standardized and crud ...incidence rate of 5 common cancers in Jiroft University of Medical Sciences. Materials and Methods: This cross-sectional study was conducted on all diagnosed cases of cancer in the cities covered by Jiroft University of Medical Sciences in 2017. After eliminating duplicates, the crude and standardized age of 5 common cancers was calculated. SPSS software version 22 was used for data analysis. Results: In this study, 601 cancer patients in 2017 with a mean age of 55.53 ± 21.82 years were studied. Of these, 347 (57%) cases included cancers in males. The highest incidence of cancer was in the age group of 64-60 with a frequency of 76 (12.6%). The crude incidence and standardized age incidence of total cancers in the university-covered population were 88.21 and 110.89 per 100,000, respectively, and the most common cancers in the total population included breast, skin, lung, liver, brain and nervous system. Conclusion: Decreasing the age of cancer in population of study and high incidence in men as well as the difference of 5 common cancers in each region indicate that the risk factors are different in different regions. Therefore, it is necessary to conduct qualitative research, correct implementation of screening programs and early diagnosis and education of all groups in the community to identify risk factors and adjust and control them.
The National Central Cancer Registry of China (NCCR) was the only available source of cancer monitoring in China, even though only about 70% of cancer registration sites were qualified by now. In ...this study, based on a national large prospective cohort-the China Kadoorie Biobank (CKB), we aimed to provide additional cancer statistics and compare the difference of cancer burden between urban and rural areas of China. A total of 497,693 cancer-free participants aged 35-74 years were recruited and successfully followed up from 2004 to 2013 in 5 urban and 5 rural areas across China. Except for traditional registration systems, the national health insurance system and active follow-up were used to determine new cancer incidents and related deaths. The mortality-to-incidence ratio (MIR) was used to compare the differences of cancer burden between urban and rural areas of China. We found that cancer mortality coincided well between our cohort and NCCR, while the incidence was much higher in our cohort. Based on CKB, we found the MIR of all cancers was 0.54 in rural areas, which was approximately one-third higher than that in urban areas with 0.39. Cancer profiles in urban areas were transiting to Western distributions, which were characterized with high incidences of breast cancer and colorectal cancer; while cancers of the esophagus, liver and cervix uteri were still common in rural areas of China. Our results provide additional cancer statistics of China and demonstrate the differences of cancer burden between urban and rural areas of China.
In this paper, we provide initial results to the development a final area of (s, t-fuzzy type incidence graphs, namely t^,s^) -fuzzy incidence for complementary fuzzy incidence graphs. We apply the ...results to problems involving human trafficking. We are particularly interested in the role played by countries’ vulnerability and their government’s response to human trafficking.
Numerous studies have reported an association between fine particulate matter (PM2.5) and human health. Often these relationships are influenced by environmental factor that varies spatially and/or ...temporally. To our knowledge, there are no studies in Canada that have considered energy generation and fuel sales as PM2.5 effects modifiers. Determining exposure and disease-specific risk factors over space and time is crucial for disease prevention and control. In this study, we evaluated the association of PM2.5 with diabetes, asthma, and High Blood Pressure (HBP) incidence in Canada. Then we explored the impact of the energy generation and fuel sales on association changes. We fit an age-period-cohort as the study design, and we applied an over-dispersed Poisson regression model to estimate the risk. We conducted a sensitivity analysis to explore the impact of variation in clean energy rates and fuel sales on outcomes changes. The study included 117 health regions in Canada between 2007 and 2014. Our findings showed strong association of PM2.5 with diabetes, asthma, and HBP incidence. A two-year increase of 10μg/m3 in PM2.5 was associated with an increased risk of 5.34% (95% CI: 2.28%; 12.53%) in diabetes incidence, 2.24% (95% CI: 0.93%; 5.38%) in asthma incidence, and 8.29% (95% CI: 3.44%; 19.98%) in HBP incidence. Our sensitivity analysis findings suggest higher risks of diabetes, asthma and HBP incidence when there is low clean energy generation. On the other hand, we found lower risk when we considered high rate of clean energy generation. For example, considering only diabetes incidence, we found that the risk in health regions with low rates of clean electricity is approximately 700% higher than the risk in health regions with high rates of clean electricity. Furthermore, our analysis suggested that the risk in regions with low fuel sales is 66% lower than the risk is health regions with low rates of clean electricity. Our study provides support for the creation of effective environmental health public policies that take into account the risk factors present in Canadians health regions.
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•Clean energy and fuel sales are strong modifiers to the association of PM2.5 with diabetes, asthma, and HBP incidence.•Dirty energy generation (e.g. coal), and gasoline combustion from traffic may be damaging human health.•Our study provides support for the creation of effective environmental health public policies.
Abstract Objective The objective of this systematic literature review was to evaluate the incidences and risks for adverse events (AEs) associated with oral and parenteral corticosteroids. An ...assessment was performed to estimate the costs of such AEs. Methods A systematic review of literature published from 2007 to 2009 was conducted to identify the incidence rates and risk ratios of corticosteroid-related AEs. The review protocol was developed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The literature search was expanded to include additional search terms for psychiatric conditions, infections, and peptic ulcers. Costs obtained from a separate narrative literature review were applied to AEs likely to affect third-party payers in the United States. Results A total of 357 publications were identified from the primary (n = 323) and secondary (n = 34) searches. Of these, 310 were excluded because they did not evaluate AEs related to corticosteroids, were an excluded publication type, or for other reasons. A final list of 47 studies were used for data extraction. Across patient populations, the most frequently reported corticosteroid-associated AEs were psychiatric events, infections, gastric conditions, and fractures. Corticosteroid-associated AEs reported to occur at an incidence >30% were sleep disturbances, lipodystrophy, adrenal suppression, metabolic syndrome, weight gain, and hypertension. Vertebral fractures were reported at an incidence of 21% to 30%. Dose-response relationships were documented for fractures, acute myocardial infarction, hypertension, and peptic ulcer. The costs of managing AEs that may occur with corticosteroids can be substantial. The literature reported 1-year per-patient costs of up to $26,471.80 for nonfatal myocardial infarction, and per-event costs as high as $18,357.90 for fracture. The findings from the present review should be interpreted cautiously due to several limitations, including the retrospective design of most of the studies identified, risk for confounding due to underlying disease activity or patient population, and the relatively small number of studies that reported each AE association. As this cost analysis was preliminary, a comprehensive pharmacoeconomic analysis should be undertaken to confirm the findings. Conclusion Based on the findings from this review, systemic corticosteroids are a common cause of AEs that may be costly to payers.
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