Non-steroidal anti-inflammatory drug use and brain tumour risk: a case-control study within the Clinical Practice Research Datalink.

PURPOSE: The aetiology of primary brain tumours is largely unknown; the role of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin use and glioma risk has been inconclusive, but few population-based studies with reliable prescribing data have been conducted, and the association with meningioma risk has yet to be assessed. METHODS: The UK Clinical Practice Research Datalink was used to assess the association between aspirin and non-aspirin NSAID use and primary brain tumour risk using a nested case-control study design. Conditional logistic regression analysis was performed on 5,052 brain tumour patients aged 16 years and over, diagnosed between 1987 and 2009 and 42,678 controls matched on year of birth, gender and general practice, adjusting for history of allergy and hormone replacement therapy use in the glioma and meningioma models, respectively. RESULTS: In conditional logistic regression analysis, excluding drug use in the year preceding the index date, there was no association with non-aspirin NSAID use (OR 0.96, 95 % CI 0.81-1.13) or glioma risk comparing the highest category of daily defined dose to non-users; however, non-aspirin NSAID use was positively associated with meningioma risk (OR 1.35, 95 % CI 1.06-1.71). No association was seen with high- or low-dose aspirin use irrespective of histology. CONCLUSIONS: This large nested case-control study finds no association between aspirin or non-aspirin NSAID use and risk of glioma but a slight increased risk with non-aspirin NSAIDs and meningioma.

Increased diagnosis and detection rates of carcinoma in situ of the breast.

The purpose of this study was to identify trends in the diagnosis of carcinoma in situ (CIS) of the breast in the United Kingdom (UK) and the Republic of Ireland (ROI) and to examine the impact of mammography. Data on cases of newly diagnosed CIS of the breast and mode of detection (screen detected or not) were obtained, where available, from regional cancer registries between 1990 and 2007. Age-standardised diagnosis rates for the UK and the ROI, and regional screen detected diagnosis rates were compared by calculating the annual percentage change (APC) over time. The APC of the diagnosis rate amongst women aged 50-64 years (original screening age group) showed a significant 5.9% increase in the UK (1990-2007) and 11.5% increase in the ROI (1994-2007). The rate of diagnosis (50-64 years) stabilized in the UK between 2005 and 2007 and was substantially higher than in other western populations with national screening programmes. The APC of the diagnosis rate amongst those aged 65-69 years showed a significant 12.4% increase in the UK (1990-2007) and 10.3% increase in the ROI (1994-2007). amongst women aged 50-74 years in the UK, approximately 4,300 cases of CIS (≈90% ductal carcinoma in situ) were diagnosed in 2007. Our analyses have shown that screen detected CIS contributed primarily to the increase in diagnosis of CIS of the breast. The high diagnosis rate of screen detected CIS of the breast underlines the need for further research into lesion and patient characteristics that are related to progression of CIS to invasive disease to better target treatment.

Serum albumin in Down Syndrome with and without Alzheimer's Disease.

AIMS: We investigated whether or not serum albumin concentrations in Down Syndrome were lower than those of a cohort of similarly moderately- to-severely-disabled institutionalised patients without Down Syndrome and, if so, whether or not this could be ascribed to the presence of liver disease. We also sought to determine the influence of Down Syndrome, age, liver disease, and Alzheimer's Disease on the serum albumin concentration. METHODS: We performed a cross-sectional study on 205 institutionalised patients with Learning Disabilities (47 with Down Syndrome, 158 without), and used multiple regression techniques to determine the relative effects of age, liver disease, and the presence or absence of Down Syndrome on the serum albumin concentration. Among Down Syndrome patients. We also sought to determine the association between serum albumin concentration and the presence of Dementia of Alzheimer's Type. RESULTS: Down Syndrome patients had lower serum albumin levels than non-Down Syndrome patients. Serum albumin concentrations declined with age at a similar rate in both groups, such that the effect on serum albumin of having Down Syndrome was equivalent to an additional 44 years of age. The serum albumin concentration in Down Syndrome patients with Alzheimer's Disease was greater than that in Down Syndrome patients without Alzheimer's Disease. CONCLUSIONS: Down Syndrome is associated with a low serum albumin concentration, independently of the presence of liver disease. The advent of Alzheimer's Disease in Down Syndrome is not associated with a further fall, and may be associated with a rise, in serum albumin concentrations.

Suicide and religiosity--Masaryk's theory revisited.

BACKGROUND: The relationship between suicide rates and the religious climate of a community is a matter of controversy. Rising suicide rates have been attributed in part to a decline in religious observance, but contradictory evidence has also been adduced. METHODS: We compared national suicide rates, classified according to gender, age, and urban-rural location,with the results of a national survey on religious belief and practice conducted during the same year. The survey consisted of four questions dealing with different dimensions of religiosity, some of which might be considered as internal and central, others more external and social. RESULTS: Suicide rates were higher for males than for females, and for younger than for older age groups. Religiosity was, in contrast, higher among females and in rural areas. Suicides were more frequent in rural areas, which also had greater religiosity. External, social dimensions of religiosity differed more than core beliefs. CONCLUSIONS: There is evidence of an inverse relationship between religiosity and suicide when age and gender are considered, but not according to location. Possible reasons for this are discussed.