The effect of probiotic supplementation on non-alcoholic fatty liver disease (NAFLD) fibrosis score in patients attending a tertiary hospital clinic in Cairo, Egypt.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic fat accumulation (> 5% of liver tissue) in the absence of alcohol abuse or other chronic liver diseases. NAFLD can progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). This study aimed to assess the efficacy of probiotic (lactobacillus) supplementation on NAFLD fibrosis score. METHODOLOGY: A double-arm randomized controlled trial was conducted in the family medicine clinic of a tertiary hospital, enrolling patients with sonographic evidence of NAFLD. Fifty patients were divided into two groups: the Probiotic group received lifestyle modification instructions along with daily probiotic supplementation for twelve weeks, with regular monthly follow-up visits. The Standard Treatment group received low-fat diet and lifestyle modification instructions only. RESULTS: The mean age of participants was 46.10 years (SD 10.11), with 70% females and 30% males. The study found a statistically significant difference in liver enzymes (ALT and AST) and BMI in the probiotic group before and after intervention. However, there was no significant difference in NAFLD fibrosis score between the two groups. CONCLUSION: Short-term probiotic treatment resulted in improvements in ALT, AST, and BMI in the probiotic group, but did not significantly affect NAFLD fibrosis score. Further research with larger sample sizes and longer follow-up periods is warranted. TRIAL REGISTRATION: The clinical trial was registered at Protocol Registration and Results System with number NCT06074094 (12/09/2021).

The role of colchicine in the management of COVID-19: a Meta-analysis.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) pandemic has robustly affected the global healthcare and economic systems and it was caused by coronavirus-2 (SARS-CoV-2). The clinical presentation of the disease ranges from a flu-like illness to severe pneumonia and death. Till September 2022, the cumulative number of cases exceeded 600 million worldwide and deaths were more than 6 million. Colchicine is an alkaloid drug that is used in many autoinflammatory conditions e.g., gout, familial Mediterranean fever, and Behçet's syndrome. Colchicine inhibits the production of superoxide and the release of interleukins that stimulate the inflammatory cascade. Colchicine decreases the differentiation of myofibroblast and the release of fibrotic mediators including transforming growth factor (TGF-ß1) that are related to the fibrosis. Moreover, colchicine has been used to traet viral myocarditis caused by CMV or EBV, interstitial pneumonia, and pericarditis resulting from influenza B infection. Additionally, colchicine is considered safe and affordable with wide availability. OBJECTIVE: The aim of the current study was to assess the evidence of colchicine effectiveness in COVID-19 treatment. METHODS: A comprehensive review of the literature was done till May 2022 and yielded 814 articles after ranking the articles according to authors and year of publication. Only 8 clinical trials and cohort studies fulfilling the inclusion criteria were included for further steps of data collection, analysis, and reporting. RESULTS: This meta-analysis involved 16,488 patients; 8146 patients in the treatment group and 8342 patients in the control group. The results showed that colchicine resulted in a significant reduction in the mortality rate among patients received colchicine in comparison with placebo or standard care (RR 0.35, 95%CI: 0.15-0.79). Colchicine resulted in a significant decrease in the need for O2 therapy in patients with COVID-19 (RR 0.07, 95%CI 0.02-0.27, P = 0.000024). However, colchicine had no significant effect on the following outcomes among COVID-19 patients: the need for hospitalization, ICU admission, artificial ventilation, and hospital discharge rate. Among the PCR confirmed COVID-19 patients, colchicine decreased the hospitalization rate (RR 0.75, 95%CI 0.57-0.99, P = 0.042). However, colchicine had no effect on mortality and the need for mechanical ventilation among this subgroup. CONCLUSION: Colchicine caused a significant clinical improvement among COVID-19 patients as compared with the standard care or placebo, in terms of the need for O2, and mortality. This beneficial effect could play a role in the management of COVID-19 especially severe cases to decrease need for oxygen and to decrease mortality among these patients.

What is the prevalence of chronic kidney disease among hypertensive non-diabetic Egyptian patients attending primary healthcare?

BACKGROUND: Although chronic kidney disease (CKD) is considered the major cause of morbidity and mortality in hypertension, the recognition and prevention of CKD remain deficient. CKD is one of the major health challenges in Egypt. CKD affects approximately 13% of the adult population, resulting in significant morbidity, mortality, and health care costs. Patients with more progressive stage 3 or stage 4 CKD experience a high rate of cardiovascular events and death compared to earlier stages of CKD. AIM: This study was performed to determine the prevalence and risk factors of CKD among hypertensive non-diabetic patients attending primary health care (PHC) centers in Cairo. METHODOLOGY: The study type is a cross-sectional study. Study setting: Two PHC centers: Saraya El-kobba and El-Sharabya. Sampling method: Recruitment of participants was done in one day weekly. Any known essential hypertensive patients aged 18 or more registered in the two PHC centers in Cairo. RESULTS: The prevalence of CKD was 33% among the hypertensive non-diabetic patients. Among CKD participants, the prevalence is more common in females (59.7%) than males (40.3%), in those who completed primary education and in the illiterates and low socioeconomic class. Surprisingly, it is more common in patients with positive family history of CKD and patients with ischemic heart disease and the antihypertensive drugs use. CONCLUSION: CKD has a high prevalence among hypertensive non-diabetic patients, and it has a significant morbidity and mortality among those patients.

Nutritional rehabilitation of malnourished children: are nutritional supplements a must?

OBJECTIVE: Malnutrition threatens children worldwide. The objective of the current study was to highlight the role of nutritional screening, evaluate the effectiveness of nutritional intervention program, and whether nutritional supplements have surplus benefit. PATIENTS AND METHODS: Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) was used to screen 3640 clinically stable 2-5 years old children recruited from the outpatient clinics, Children's Hospital, Ain Shams University. A total of 100 patients at high risk of malnutrition were enrolled. Full nutritional assessment was done and according to the distribution of the calories in the daily meal plan, the patients were randomly divided into two groups each comprised 50 patients. Group A received tailored nutritional dietary rehabilitation plan including dietary supplements, while Group B received only dietary advice. Anthropometric measurements, laboratory tests, as well as STAMP scoring were reassessed after the nutritional rehabilitation programs. RESULTS: Nutritional screening revealed that 5.14% were at high risk of malnutrition. Both studied groups showed significant improvement in caloric intake and all anthropometric measurements upon nutritional rehabilitation, except for the height z scores. Patients who received nutritional supplements showed significantly better changes regarding weight, BMI, caloric intake, and hemoglobin. Regarding STAMP categories during follow up, Group A had only 6% of the patients still in the high-risk category and 76% were at low risk compared to 14% high risk and only 54% were at low risk in Group B. CONCLUSIONS: Nutritional screening in pediatric outpatient facilities can lead to implementing prompt nutritional rehabilitation, which can reflect on the patients' overall health. Tailored nutritional plan can accomplish good response in terms of improvement of caloric intake, anthropometric measurements and laboratory parameters. Adding a nutritional supplement to the dietary plan during nutritional rehabilitation isn't a must but it ensures superior goal achievement.

Awareness and attitude of primary healthcare patients towards telehealth in Cairo, Egypt.

BACKGROUND: Telehealth is delivering health care services remotely from healthcare facilities using telecommunications and virtual technology. Egypt is aiming to reach Universal Health Coverage; this increases the demand for telehealth in routine health services. Telehealth helps in increasing access to areas with no available medical services as patients can be monitored remotely. OBJECTIVE: To measure the awareness of telehealth among attendees of primary health care units and their acceptance of applying telehealth. METHODOLOGY: This was a cross-sectional study among attendees of primary health units. Ethical issues were considered. RESULTS: A sample size was calculated to be 162 and 170 valid Arabic interview questionnaires were filled by attendees. The awareness percentage of telehealth among attendees was 64.7% while the willingness to implement telehealth was 78%. Both awareness and willingness were significantly associated with age groups, residence, socioeconomic status, and presence of computer with internet access. Age, residence, and possession of a PC were the only adjusted predictive factors for knowledge about telehealth among patients in the multivariable analysis. CONCLUSION: Large percentages of attendees to primary health care centers are aware of telehealth and are willing to implement it. The major cause of refusal to implement telehealth was ignorance of using telecommunication devices and the desire to be in close contact with the physicians.

Validation of a modified cow's milk-related symptom score (CoMISS) for screening of lactose intolerance in adults.

INTRODUCTION: Lactose intolerance (LI) is the failure to digest foods and beverages containing the lactose present in milk. LI can present by many digestive symptoms. OBJECTIVE: To validate the modified CoMiSS score for prediction of LI, that was confirmed by a stool acidity test. PATIENTS AND METHODS: A cross-sectional study, was conducted at Ain Shams University Hospitals/Gastrointestinal Clinics, and included one hundred adult participants during the period from December 2018 to December 2019. Enrolled patients had one or more gastrointestinal symptoms and were subjected to a stool acidity test (fecal PH test) as a reference test and modified CoMiSS as an index test. RESULTS: The mean age of participants was 35.30 ± 10.714 years old; 55% were females, and their mean body mass index (BMI) was 23.08 ± 2.080 kg/m2, with no significant relation between LI and patients` gender or BMI. Out of the studied participants 24% had positive stool PH, LI diagnosed according to modified CoMISS was present among 19% of them. The mean value of modified CoMISS Score was significantly higher in positive cases (12.37) compared to negative LI participants (2.33) as p < .001. Area under ROC Curve was 0.998, at the selected cut-off value 8, the sensitivity was 89.5% and specificity was 100% thus, levels of questionnaire scoring of 8 or higher would indicate presence of lactose intolerance. CONCLUSION: Modified CoMiSS is a simple, fast, and easy-to-use tool that can predict LI, with a cut-off value of >8, the Area under the ROC Curve was 0.998, sensitivity 89.5%, and specificity was 100%.

The "new normal" for medical education during and post-COVID-19.

After outbreaks in more than 110 countries, the World Health Organization declared COVID-19 a global pandemic on the March 11, 2020, heralding unprecedented challenges in medical education. Our aim is to provide a descriptive overview of the impact of COVID-19 on medical education worldwide and to assess its future repercussions. Worldwide, medical students were removed from clerkship training. Clinical skills and practical procedure training transitioned to being online, and in some cases, postponed. Medical educators scrambled to convert the curriculum into online formats. Access to Internet, technology, and computer education posed resource allocation challenges in developing countries and further widened the disparities in medical education. Even in countries where the framework and funding were available to support the online transition, debatably, this arrangement can lead to disparities in clinical skills, bedside manner, and field experience among pre- and post-COVID-19 medical graduates. Challenges extend beyond undergraduate medical education to include the medical licensing process of international and national postgraduates. The international community of medical educators needs to collaborate to drive the future of medical education, as the world adapts to the "new normal."

Comparison of hemoglobin level and neutrophil to lymphocyte ratio as prognostic markers in patients with COVID-19.

BACKGROUND: Anemia can negatively affect the outcome of many diseases, including infections and inflammatory conditions. AIM: To compare the prognostic value of hemoglobin level and the neutrophil/lymphocyte ratio (NLR) for prediction of coronavirus disease 2019 (COVID-19) severity. METHODS: In this retrospective cohort study, clinical data from patients with laboratory-confirmed COVID-19 were collected from hospital records from 10 April 2020 to 30 July 2020. RESULTS: The proportions of patients with mild, moderate, and severe COVID-19 differed significantly in association with hemoglobin levels, neutrophil counts, lymphocyte counts, NLR, and total leukocyte counts. Patients with severe COVID-19 had significantly lower hemoglobin levels than those with moderate or mild COVID-19. There were statistically significant negative associations between hemoglobin and D-dimer, age, and creatinine. The optimal hemoglobin cut-off value for prediction of disease severity was 11.6 g/dL. Using this cut-off value, hemoglobin had higher negative predictive value and sensitivity than NLR (92.4% and 51.3%, respectively). The specificity of hemoglobin as a prognostic marker was 79.3%. CONCLUSION: Both NLR and hemoglobin level are of prognostic value for predicting severity of COVID-19. However, hemoglobin level displayed higher sensitivity than NLR. Hemoglobin level should be assessed upon admission in all patients and closely monitored throughout the disease course.

Is There a Benefit of Vitamin D Supplementation in Deficient Children and Adolescents Suffering from Obesity? A Meta-Analysis.

This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Ten studies were retrieved, but only 6 were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the 2 studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the 6 retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation.

Attitudes, beliefs and practice of Egyptian healthcare workers towards seasonal influenza vaccination.

BACKGROUND: Seasonal influenza vaccination is highly recommended for healthcare workers (HCWs) every year to protect them and reduce the risk of disease transmission at workplaces. Relatively few studies addressed influenza vaccination in the Eastern Mediterranean Region. OBJECTIVES: The main objective of this study was to explore the attitudes, beliefs and practice of Egyptian HCWs towards seasonal influenza vaccine. METHODS: This is a nationwide cross-sectional study. Data were collected through self-administered structured questionnaire. A sample of 3534 HCWs (physicians and nurses) was collected from different levels of healthcare facilities. RESULTS: The proportion of seasonal influenza vaccine uptake during the last season was 30.7% while the percentage of ever vaccinated was 46.8%. The most identified reason for non-compliance was lack of trust about vaccine efficacy and its adverse events. Around 80% of participants expressed positive attitude towards influenza vaccine and the vast majority (98%) agreed to uptake the vaccine during pandemic. There was significant positive association between attitude score and influenza vaccine uptake. Raising awareness about vaccine and ensuring vaccine availability were the main suggestions by HCWs to improve vaccine uptake. CONCLUSIONS: Although there was positive attitude towards influenza vaccine, yet vaccination coverage was suboptimal particularly among those working in university hospitals. Educational messages and operational strategies addressing motivators and barriers that emerged from this study are needed to optimize vaccine uptake.

Effect of COVID-19 Lockdown on Young Egyptian Soccer Players.

The present study was designed to highlight the physical and psychological health hazards that a young Egyptian soccer team faced during the first COVID-19 wave lockdown. The study included 37 young Egyptian male soccer players. History taking and anthropometric measurements were taken. Two questionnaires were filled covering the athletes'` sleep habits and quality of life (QoL). Finally, the mothers were asked to fill in a questionnaire concerned with depression, anxiety, and stress. More than 50% of the enrolled athletes gained weight during the lockdown especially those without compliance to home exercises. The mothers' anxiety score correlated positively with the increased body mass index (BMI) of the athletes. The athletes mean QoL Score worsened significantly and significant negative correlation was found between the increased BMI and the change of QoL. The increased BMI was significantly reported among the athletes who didn't do home exercises and had a negative correlation with their QoL change throughout the lockdown. The mothers' anxiety had a possible reflection on their youngsters' weight gain. These findings highlight the need for weight control when outdoors physical activity is restricted during pandemics with better compliance to home exercising schedules and less screen time.

Awareness and attitude of healthcare workers towards Telehealth in Cairo, Egypt.

BACKGROUND: Telehealth is delivering health care services remote from health-care facilities using telecommunications. Egypt is aiming for Universal Health Coverage; this increases the demand for telehealth in routine health services. OBJECTIVE: To measure the awareness of telehealth health care workers of primary health care units and to evaluate the effect of an orientation programme on primary health care workers' awareness and acceptance of the application of telehealth. METHODOLOGY: This was an intervention study amongst health care workers. A self-administrated valid questionnaire for health care workers was designed, the questionnaire consists of different domains of knowledge in addition to advantages, disadvantages, security and necessity perceptions. Each domain consists of Likert scale questions of 5 points. The questions were scored as the worst answer (1) and the best (5). A total of 109 questionnaires were filled by participants who spent at least 6 months in primary health care units. Then the health care workers attended an orientation programme and the questionnaire was re-filled once more. A total of 104 was recollected. Ethical issues were considered. RESULTS: 50.5% of the health care workers were aware of telehealth; 66.7% of health care workers with master's degree were aware of telehealth in comparison to 31.8% amongst those with a diploma, 64.3% of physicians were aware of telehealth, while 29.6 of nurses were aware [Correction added on 08 April 2021 after first online publication: '9.6%' has been amended to '29.6%' in the preceding sentence]. The score of knowledge and attitude increased from 130 ± 23.538 to 156.49 ± 18.456 after the educational programme. CONCLUSION: Half of the health care workers were aware of telehealth; the orientation improved the Healthcare Workers' knowledge and attitude.

Screening and early detection of chronic kidney disease at primary healthcare.

Chronic kidney disease (CKD) represents a global public health concern and results in poor health outcomes. While the burden of CKD is accurately well defined in developed countries, increasing evidence indicates that the CKD burden may be even greater in developing countries. Primary care has an essential role in the early identification of CKD and the prompt integrated management between primary and secondary CKD care, with participation of the patient, should be done in high quality. Systematic screening for CKD in at-risk individuals is strongly indicated for timely intervention when needed and to perceive the impact of such policies on CKD incidence. Furthermore, failure to recognize a patient in stages 1-3 of CKD may result in high incidence of CKD complications and kidney failure, often leaving the patient unsuitable for different renal replacement therapies, such as dialysis and transplantation. Therefore, primary care early referral and consultation with a nephrologist can give a better chance for different dialysis procedures and minimize the rate of hospitalization and mortality.

Vitamin D level in a sample of Egyptian females of childbearing age attending a family medicine center.

BACKGROUND: Vitamin D deficiency is now recognised as a pandemic. The normal range of Vitamin D in the Arab countries is much lower than the international standards. Several Arab countries have published studies assessing serum Vitamin D levels among women--to date there is no national study assessing Vitamin D levels among Egyptian women. OBJECTIVE: The aim of the study is to measure Vitamin D level among Egyptian women of childbearing age. PATIENTS AND METHODS: We included 100 healthy adult females of childbearing age, who were attending a family medicine center in Cairo, Egypt. A validated interview questionnaire was conducted with participants, thereafter BMI and serum 25 (OH) Vitamin D levels were measured. RESULTS: The age of the included women ranged from 19 to 49 years old with a mean age of 34 ± 8.47 years. Only 39% of participants were employed and 61% were housewives. About 76% of participants were married, 20% unmarried and 4% divorced. Most of participants (82%) wore hijab; only 9% wore niqab and 9% wore no scarf. Only 44% of participants had normal levels of Vitamin D (˃20-150 ng/mL). About 43% of the participants were Vitamin D deficient and 13% were Vitamin D insufficiency. CONCLUSION: Vitamin D deficiency and insufficiency are prevalent among Egyptian women of childbearing age. A routine monitoring screening for Vitamin D deficiency and Vitamin D health education are required to minimise risk factors among women of childbearing age.

Surgical versus Non-Surgical Management of Obstructive Sleep-disordered Breathing in Children: A Meta-analysis.

BACKGROUND: Obstructive sleep-disordered breathing (OSDB) is a term for several chronic conditions in which partial or complete cessation of breathing occurs many times throughout the night, resulting in fatigue or daytime sleepiness that interferes with a person's functions and reduces the quality of life. OBJECTIVE: Comparing the effectiveness of surgical versus non-surgical treatment of OSDB in children in clinical trials through a meta-analysis study. PATIENTS AND METHODS: A number of available studies and abstracts concerning the surgical versus non-surgical treatment of OSDB in children were identified through a comprehensive search of electronic databases. Data were abstracted from every study in the form of a risk estimate and its 95% confidence interval. RESULTS: The current study revealed that there was a statistically significant improvement in the surgically treated patients rather than non-surgically treated patients regarding the quality of life. CONCLUSION: The current meta-analysis reports a significant clinical improvement in the surgical (adenotonsillectomy) group as compared to the non-surgical group, in terms of disease specific quality of life, and healthcare utilization in spite of the availability of only one study.

Subtipo Persecutorio Del Trastorno Delirante: Estudio De Series De 129 Casos / Persecutory Subtype Of Delusional Disorder. Descriptive Study Of 129 Cases

Resumen Objetivo. El objetivo de este estudio es conocer las características demográficas, factores ambientales, factores de riego psicosociales, y clínicas del subtipo persecutorio en un grupo de pacientes con trastorno delirante (TD). Metodología. Estudio epidemiológico retrospectivo sobre un Registro de Casos en el Dispensario de Psiquiatría e Higiene Mental de Córdoba sobre pacientes con TD según criterios DSM-IV-TR. Aquellos pacientes que cumplieron con los criterios de inclusión definidos constituyeron nuestra muestra final de 261 casos, de ellos 129 casos presentaban el subtipo persecutorio. Las variables sobre las que se recogió información en base a protocolos, fueron agrupadas con el orden siguiente: I. Variables de los datos sociodemográficos y generales. II. Variables de los Factores de riesgo del TD (familiares y personales). III. Variables del Cuadro Clínico y el Diagnostico del TD (Presentación, sintomatología delirante, funcionalidad y discapacidad, utilización de los recursos sanitarios, tratamiento, problemas psicosociales, evolución y curso). Resultados. La proporción hombres versus mujeres en el subtipo persecutorio fue de 1,04. Solo el 5,4% de estos pacientes tenía estudios primarios. Un 65,9%, al realizar la primera consulta psiquiátrica, se encontraba casado y el 50,4% convivían en el hogar. Un 14,7% consumió previamente alcohol y un 0,8% otras sustancias. Las ideas de referencia y de persecución se presentaron el 98,4% y en el 99,2% de los casos respectivamente. Conclusiones. Son necesarios futuros estudios prospectivos para investigar los factores de riesgo del subtipo persecutorio del TD.

Objective. The objective of this study is to investigate the demographic, environmental, psychosocial and clinical characteristics of the persecutory subtype in a group of patients with delusional disorder (DD). Methodology. Retrospective descriptive study of DD cases registered at Psychiatry and Mental Hygiene Clinic of Cordoba according to DSM-IV-TR criteria was conducted. We obtained a sample of 261 DD patients who met the inclusion criteria; of them 129 cases has persecutory subtype. Data and variables collected were divided into 4 groups: I. Socio-demographic and general data. II. DD risk factors (personal and family). III. DD clinical picture and diagnosis (presentation, symptoms, disability, use of health care resources, treatment, and evolution). Results. The proportion of males versus females of the persecutory subtype was of 1.04. Only 5.4% of patients had primary level of education. At the first visit of the psychiatry clinic, 65.9% of the patients were married and about half of them shared home. About 14.7% of patients had a past history of alcohol consumption, and only 0.8% consumed other drugs. Ideas of reference and of persecution were found in 98.4% and 99.2% respectively. Conclusions. It is necessary to conduct future prospective studies to investigate the risk factors associated with the persecutory subtype of DD.

A data mining approach to investigate food groups related to incidence of bladder cancer in the BLadder cancer Epidemiology and Nutritional Determinants International Study.

At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case-control and one nested case-cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.

The association between coffee consumption and bladder cancer in the bladder cancer epidemiology and nutritional determinants (BLEND) international pooled study.

BACKGROUND: Inconsistent results for coffee consumption and bladder cancer (BC) risk have been shown in epidemiological studies. This research aims to increase the understanding of the association between coffee consumption and BC risk by bringing together worldwide case-control studies on this topic. METHODS: Data were collected from 13 case-control comprising of 5,911 cases and 16,172 controls. Pooled multivariate odds ratios (ORs), with corresponding 95% confidence intervals (CIs), were obtained using multilevel logistic regression models. Furthermore, linear dose-response relationships were examined using fractional polynomial models. RESULTS: No association of BC risk was observed with coffee consumption among smokers. However, after adjustment for age, gender, and smoking, the risk was significantly increased for never smokers (ever vs. never coffee consumers: ORmodel2 1.30, 95% CI 1.06-1.59; heavy (> 4 cups/day) coffee consumers vs. never coffee consumers: ORmodel2 1.52, 95% CI 1.18-1.97, p trend = 0.23). In addition, dose-response analyses, in both the overall population and among never smokers, also showed a significant increased BC risk for coffee consumption of more than four cups per day. Among smokers, a significant increased BC risk was shown only after consumption of more than six cups per day. CONCLUSION: This research suggests that positive associations between coffee consumption and BC among never smokers but not smokers.

Breast Cancer and Deodorants/Antiperspirants: a Systematic Review.

BACKGROUND: Over the last decade, the possible association between underarm deodorants/ antiperspirants use and breast cancer risk has raised important interest in the scientific community. The objective of our systematic review is to estimate the pooled risk of deodorants/antiperspirants use for breast cancer. METHODS: All observational studies that evaluated the association between breast cancer risk and deodorants/antiperspirants use were reviewed. We have only identified two case-control studies, carried out between 2002 and 2006. RESULTS: The first study was conducted in USA and investigated the possible relationship between use of products applied for underarm perspiration and the risk for breast cancer in women aged 20-74 years. This population-based case-control study gathered information by in-person interview. The second study was conducted in Iraq and investigated the possible relationship between use of antiperspirants and the risk for breast cancer in women attending a teaching hospital. This study also gathered information by in-person interview. There was no risk of antiperspirants use in the pooled risk (odds ratio 0.40, 95% confidence interval 0.35-0.46). CONCLUSION: Our comprehensive search has identified an insufficient number of studies to conduct a quantitative review and obtain reliable results. Further prospective studies are strongly needed.