Executive function predict the quality of life and negative emotion in older adults with diabetes: A longitudinal study.

AIMS: To investigate the influence of executive function (EF) on current and future quality of life (QoL) and negative emotion (NE) in older adults with diabetes. METHODS: A total of 128 older adults with diabetes were recruited. Independent variables (demographic information, health and medical conditions, cognitive function, life function) were collected in the first year. Dependent variables (QoL and NE) were collected for 3 years. Pearson's correlation coefficient analysis and stepwise multiple linear regression analysis were performed to identify the predictors of QoL and NE. RESULTS: EF was the strongest predictor for overall QoL and NE in all 3 years, and accounted for 23.0-36.2% and 11.1-17.1% of the variance, respectively. The second strongest predictor for overall QoL in all 3 years was pain interference, which accounted for 3.2-5.8% of the variance. Pain interference was also the second strongest predictor for NE in the second year, accounting for 5.5% of the variance. CONCLUSIONS: The present study revealed that EF is more predictive than pain for current and future QoL and NE in older adults with diabetes. We recommend that EF be included as an indicator for diabetes surveillance, and that prevention of EF decline be a part of diabetes management plans.

Increased expression of microRNA-93 correlates with progression and prognosis of prostate cancer.

MicroRNA-93 (miR-93) has been found to be up-regulated in multiple malignancies. miR-93 might promote the proliferation and invasion of prostate cancer cell. In the present study, we aimed to investigate the expression level of miR-93 in prostate cancer tissues and its clinical and prognostic value in patients with prostate cancer.A total of 103 paired prostate cancer tissues and adjacent normal tissues were obtained from male patients who underwent surgical treatment in the department of urology, Huizhou Third People's Hospital, Guangzhou Medical University between July 2014 and March 2018. The correlation between prostate cancer characteristics and miR-93 expression was examined by chi-square test. Patient survival was evaluated using the Kaplan-Meier method and compared using log-rank test. Univariate and multivariate Cox regression analyses were performed for survival data.Compared to noncancerous prostate tissues, the expression levels of miR-93 in prostate cancer tissues were significantly increased (P < .001). High level of miR-93 expression was significantly correlated with Gleason score (P = .018), lymph node involvement (P = .026), bone metastasis (P < .001), and Tumor Node Metastasis (TNM) stage (P < .001). The 5-year overall survival rate in the high expression group was lower than that in the low expression group (log-rank test, P = .031). Multivariate Cox regression analysis showed that miR-93 expression level (HR = 2.181, 95% CI: 1.092-6.829, P = .028) was an independent factor in predicting the overall survival of prostate cancer patients.The present study demonstrated that increased expression of miR-93 correlates with progression and prognosis of prostate cancer. These fndings suggest miR-93 may serve as a novel target for prostate cancer prognosis and therapy.

Geriatric syndromes and quality of life in older adults with diabetes.

AIM: To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS: Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS: Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS: Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.

Gender differences in the relationship between walking activity and sleep disturbance among community-dwelling older adult with diabetes in Taiwan.

This study explored the gender differences in the relationship between walking activity and sleep disturbances. A cross-sectional study of 201 community-dwelling older adults with diabetes was conducted in southern Taiwan. Using the Taiwanese version of the International Physical Activity Questionnaire, self-administered short version (IPAQ-SS), information on physical activity and sleep disturbance conditions was collected. Among older female adults with diabetes, 54.2% reported sleep disturbance significantly higher than males (38.1%). Logistic regression analysis suggested that for women, in addition to the active group, older adults in the low-active, high-walking group exhibited a significantly lower rate of sleep disturbance than did those who walked less.

Synergistic effects of the immune checkpoint inhibitor CTLA-4 combined with the growth inhibitor lycorine in a mouse model of renal cell carcinoma.

Renal cell carcinoma (RCC) management has undergone a major transformation over the past decade; immune checkpoint inhibitors are currently undergoing clinical trials and show promising results. However, the effectiveness of immune checkpoint inhibitors in patients with metastatic RCC (mRCC) is still limited. Lycorine, an alkaloid extracted from plants of the Amaryllidaceae family, is touted as a potential anti-cancer drug because of its demonstrative growth inhibition capacity (induction of cell cycle arrest and inhibition of vasculogenic mimicry formation). Moreover, T cell checkpoint blockade therapy with antibodies targeting cytotoxic T-lymphocyte associated protein 4 (CTLA-4) has improved outcomes in cancer patients. However, the anti-tumor efficacy of combined lycorine and anti-CTLA-4 therapy remains unknown. Thus, we investigated a combination therapy of lycorine hydrochloride and anti-CTLA-4 using a murine RCC model. As a means of in vitro confirmation, we found that lycorine hydrochloride inhibited the viability of various RCC cell lines. Furthermore, luciferase-expressing Renca cells were implanted in the left kidney and the lung of BALB/c mice to develop a RCC metastatic mouse model. Lycorine hydrochloride and anti-CTLA-4 synergistically decreased tumor weight, lung metastasis, and luciferin-staining in tumor images. Importantly, the observed anti-tumor effects of this combination were dependent on significantly suppressing regulatory T cells while upregulating effector T cells; a decrease in regulatory T cells by 31.43% but an increase in effector T cells by 31.59% were observed in the combination group compared with those in the control group). We suggest that a combination of lycorine hydrochloride and anti-CTLA-4 is a viable therapeutic option for RCC patients.

Lycorine induces apoptosis of bladder cancer T24 cells by inhibiting phospho-Akt and activating the intrinsic apoptotic cascade.

Lycorine, an alkaloid extracted from Amaryllidaceae genera, exhibits antitumor activities against several human solid-tumor and leukemia cells with extensive influence on various cell signaling molecules. However, the effect of lycorine on bladder cancer has not yet been investigated. In this study, we demonstrated that lycorine induced apoptosis in human bladder cancer T24 cells, an effect that is mediated via inhibition of phospho-Akt expression and the consequent activation of caspase-3 and Bax in vitro. In an in vivo experiment, T24 cells were subcutaneously implanted in the right rear flank of nu/nu mice. Lycorine treatment for 14 days significantly inhibited tumor growth compared with that in controls. Collectively, our findings suggest that lycorine suppressed the Akt pathway and activated the intrinsic apoptotic cascade, leading to the apoptosis of bladder cancer cells. We suggest that lycorine can be a viable therapeutic option for bladder cancer patients.

Programmed death ligand 1 expression in bladder rhabdomyosarcoma and its association with clinicopathological features.

The aim of this study was to detect PD-L1 expression in bladder rhabdomyosarcoma and its association with clinicopathological features and patient prognosis. PD-L1 expression was detected in paraffin-embedded sections obtained from 34 patients with bladder rhabdomyosarcoma via immunohistochemistry. Immunohistochemistry results were statistically analyzed to determine their association with patient clinicopathological features and survival outcomes. PD-L1-positive staining was observed in 47.1% (16/34) of patients. Metastatic tumor cells in the lymph nodes of two patients were positive for PD-L1 expression. PD-L1 expression was significantly different with regard to muscularis invasion, but the expression did not affect patient survival outcomes. We confirmed PD-L1 expression in bladder rhabdomyosarcoma, suggesting that PD-1/PD-L1 inhibitors are potential therapeutic agents for patients with bladder rhabdomyosarcoma.

[Antitumor activity of lycorine in renal cell carcinoma ACHN cell line and its mechanism].

OBJECTIVE: To investigate the antitumor effect of lycorine on renal cell carcinoma ACHN cells and explore the possible mechanism. METHODS: We used flow cytometry to examine the effect of lycorine on ACHN cell cycle and apoptosis. The cell proliferation, migration and invasion were assessed with MTS assay, wound healing assay, and Transwell assay, respectively. Colony forming assay was performed, and the mRNA and protein levels of Bax, Bcl-2, survivin, caspase-3, cyclin D1 and CDK4 were measured with qRT-PCR and Western blotting. RESULTS: Lycorine obviously inhibited the proliferation of ACHN cells with an IC(50) of 24.34 µmol/L. Lycorine also induced apoptosis of ACHN cells, caused cell cycle arrest at G(0)/G(1) phase, and suppressed the colony forming ability of the cells in a dose-dependent manner. The migration and invasion of ACHN cells were significantly inhibited by 5 µmol/L lycorine. Lycorine up-regulated the mRNA levels of CDK4, Bax, caspase-3 while down-regulated the levels of survivin, Bcl-2 and Cyclin D1; the protein levels of CDK4 and Bax were increased and cyclin D1, Bcl-2 and surviving expressions were decreased, but caspase-3 expression showed no significant changes following the treatment. CONCLUSION: Lycorine has obvious antitumor effect against ACHN cells, suggesting its value as a new therapeutic agent for renal cell carcinoma.

Impact of increasing alanine aminotransferase levels within normal range on incident diabetes.

BACKGROUND/PURPOSE: Abnormal alanine aminotransferase level (ALT) levels might be associated with type 2 diabetes, but whether higher ALT levels within the normal range predict the risk is unknown. METHODS: We followed a community-based cohort of 3446 individuals who were ≥35 years old without diabetes and hepatitis B or C in southern Taiwan for 8 years (1997-2004) to study the risk for type 2 diabetes with different normal ALT levels. RESULTS: Among the 337 incident diabetes cases, 16.0% were from those with ALT levels <10 IU/L, 44.5% with ALT levels 10-19 IU/L, 30.0% with ALT levels 20-39 IU/L, and only 9.5% with ALT levels ≥40 IU/L. A cumulative hazard function test showed that the higher the ALT levels, the greater the cumulative incidence rate of diabetes (p < 0.001, log-rank test). A multiple Cox proportional hazards analysis showed that increasing age, lower educational levels, higher body mass index levels (≥25 vs. <25), and higher ALT levels (vs. the reference group, ALT <10 IU/L), from hazard ratio (HR) = 1.8, for ALT = 10-19, HR = 3.7 for ALT = 20-39, to HR = 4.5 for ALT ≥40, were significant factors for developing diabetes (p < 0.001). The hazard ratios of higher ALT levels in the participants without alcohol consumption were similar to or higher than those in the total cohort. CONCLUSION: Higher ALT levels, even within the normal range, are strong predictors of type 2 diabetes independently of body mass index levels with a dose-response relationship.

The impact of type 2 diabetes on the development of hepatocellular carcinoma in different viral hepatitis statuses.

BACKGROUND: The risk of type 2 diabetes on the development of hepatocellular carcinoma remains inconclusive in different hepatitis statuses. METHODS: We prospectively followed a community-based cohort with 5,929 persons in southern Taiwan from January 1997 through December 2004, made up of 4,117 seronegative, 982 anti-hepatitis C virus-positive [HCV(+)], 696 hepatitis B surface antigen-positive [HBsAg(+)], and 134 coinfected persons. Before the study, 546 participants had developed diabetes. Hepatocellular carcinoma diagnoses were from the National Cancer Registry. RESULTS: After 50,899 person-years of follow-up, 111 individuals had developed hepatocellular carcinoma. The highest risk of hepatocellular carcinoma, compared with seronegative individuals without diabetes, was in anti-HCV(+) individuals with diabetes [incidence rate ratio (IRR), 76.0], then coinfected (IRR, 46.0), anti-HCV(+) without diabetes (IRR, 26.1), HBsAg(+) with diabetes (IRR, 21.4), and seronegative with diabetes (IRR, 7.2; P < 0.001). Anti-HCV(+) (n = 132) and seronegative individuals (n = 352) with diabetes had a higher cumulative incidence rate of hepatocellular carcinoma than those without diabetes (log-rank test, P < 0.001). Multivariate Cox proportional hazards analysis showed that gender, age, body mass index > or =30, HBsAg(+) [hazards ratio (HR), 12.6], anti-HCV(+) (HR, 18.8), coinfection (HR, 25.9), and diabetes [HR, 2.7; 95% confidence interval (95% CI), 1.7-4.3] were independent predictors of hepatocellular carcinoma (P < 0.05). After stratifying hepatitis status in multivariate Cox analysis, diabetes was significant for seronegative (HR, 5.4; 95% CI, 1.7-17.1) and anti-HCV(+) individuals (HR, 3.1; 95% CI, 1.7-5.4). Body mass index > or =30 was significant for HBsAg(+) individuals (HR, 3.3; 95% CI, 1.3-8.1). CONCLUSION: Type 2 diabetes is a strong independent predictor of hepatocellular carcinoma in anti-HCV(+) and seronegative individuals but not in HBsAg(+) individuals.

Hepatitis C virus infection and the development of type 2 diabetes in a community-based longitudinal study.

The temporal relation of hepatitis C virus (HCV) infection to the development of type 2 diabetes remains unknown. The authors followed 4,958 persons aged > or =40 years without diabetes (3,486 seronegative, 812 anti-HCV+, 116 with hepatitis B virus/HCV coinfection, and 544 hepatitis B surface antigen (HBsAg)+) from a community-wide cohort in southern Taiwan for 7 years (1997-2003) to study the risk of diabetes associated with HCV infection. A total of 474 participants developed diabetes. The 7-year cumulative incidence was 7.5% for HBsAg+, 8.6% for seronegative, 14.3% for anti-HCV+, and 14.7% for coinfected participants. Compared with HCV- persons, HCV+ persons had a higher cumulative incidence of diabetes (log-rank test, p < 0.0001). A multivariate Cox proportional hazards model showed that anti-HCV+ (hazard ratio = 1.7, 95% confidence interval: 1.3, 2.1), coinfection (hazard ratio = 1.7), overweight, obesity, and increasing age were significantly associated with diabetes (p < 0.05). Gender, educational level, HBsAg+ status, alcohol consumption, and smoking were not significant. After stratification by age and body mass index, the risk ratio for diabetes in anti-HCV+ participants increased when age decreased and body mass index levels increased (p < 0.001). Results show that HCV infection is an independent predictor of diabetes, especially for anti-HCV+ persons who are younger or have a higher body mass index.

Impact of influenza vaccination on major cause-specific mortality.

The efficacy of influenza vaccination is not well understood for major cause-specific mortality except pneumonia. For 10 months we followed the mortality data of 35,637 vaccinated elderly (>65 years old) in a county with 102,698 elderly in southern Taiwan. A multivariate Cox model showed that vaccination was significantly associated with lower mortality for all causes, [hazards ratio (HR)=0.56], stroke (HR=0.35), renal disease (HR=0.40), diabetes mellitus (HR=0.45), pneumonia (HR=0.47), COPD (HR=0.55), malignancy (HR=0.74), and heart diseases (HR=0.78), p<0.05. Influenza vaccination was strongly associated with reducing major cause-specific mortality.

Reducing major cause-specific hospitalization rates and shortening hospital stays after influenza vaccination.

BACKGROUND: The impact of influenza vaccination on major cause-specific hospitalization and the duration of hospital stay is rarely reported. Our purpose was to study the effect of vaccine efficacy on major disease-specific hospitalization and the duration of hospital stays among elderly persons. SUBJECTS AND METHODS: From 1 January through 30 June 2001, we prospectively observed 35,637 vaccinated elderly persons (age, >or=65 years) and 53,094 unvaccinated elderly persons in Kaohsiung County, Taiwan, by computerized linkage to the National Health Insurance database. Of these persons, 21,347 had been assigned a high-risk status by the Department of Health, Taiwan. Univariate and multivariate logistic regression were used for determining vaccine efficacy in hospitalization. Multiple linear regression analyses were performed for determining the length of hospital stays. RESULTS: In both high-risk and low-risk groups, vaccination was associated with reducing the rates of hospitalization for all causes (20% vs. 23%), lung diseases, congestive heart failure (43% vs. 32%), renal disease, and liver disease (P<.05). It was also significant for stroke, hypertension, diabetes, neoplasm, and injury in low-risk patients (P<.05). Multivariate logistic regression showed that vaccination was significantly associated with reducing the rate of hospitalization (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.86-0.92), but those with high-risk status had an increased risk of hospitalization (OR, 3.69; 95% CI, 3.56-3.82). Multiple linear regression analysis showed that vaccination decreased the duration of all-cause hospital stays (coefficient, -2.4 days; 95% CI, -2.7 to -2.1 days) and of hospitalization due to lung disease (coefficient, -4.9 days; 95% CI, -6.0 to -3.8 days). CONCLUSION: Influenza vaccination may reduce hospitalization rates and shorten hospital stays not only for lung diseases but also for other common diseases in high-risk and low-risk elderly populations.

Strong association of hepatitis C virus (HCV) infection and thrombocytopenia: implications from a survey of a community with hyperendemic HCV infection.

BACKGROUND: The role of hepatitis C virus (HCV) infection in thrombocytopenia (defined as a platelet count of <100,000 platelets/ mu L) is unknown. Our aim was to study the association between HCV infection and thrombocytopenia in a community where hepatitis B virus (HBV) and HCV infections are hyperendemic. METHODS: A community-wide survey of subjects > or =40 years old who had undergone a preventive health examination between April 1997 and July 2000 in A-Lein Township, Kaohsiung County, Taiwan. Serum blood platelet counts and HBV surface antigen (HBsAg) and antibody to HCV (anti-HCV) levels were measured. Abdominal sonography was performed on viral hepatitis-positive participants. RESULTS: Among the 1690 subjects, 70% were seronegative, 17.4% were anti-HCV positive, 9.2% were HBsAg positive, and 3.4% were coinfected with HCV and HBV. The mean platelet count in subjects with anti-HCV (180,000 platelets/microL) was lower than in those with HBsAg (201,000 platelets/microL) and in those without anti-HCV and HBsAg (234,000 platelets/microL) (P<.001). The prevalence of thrombocytopenia was 1.3% among seronegative subjects, 1.9% among HBsAg-positive subjects, 5.2% among coinfected subjects, and 10.2% among anti-HCV-positive subjects. Multiple logistic regression analysis revealed that anti-HCV positivity (odds ratio, 6.0; 95% confidence interval, 3.2-11.2), an alanine aminotransferase level of > or =40 U/L, and age of > or =65 years were significantly associated with thrombocytopenia. The prevalence of thrombocytopenia among anti-HCV-positive subjects increased as the severity of liver disease increased, but, in HBsAg-positive subjects, thrombocytopenia presented only in those with advanced liver disease. CONCLUSIONS: HCV infection is strongly associated with thrombocytopenia, which is correlated with hepatocellular damage and hepatic fibrosis. It is advisable to further check the hepatic condition of the patient, especially for HCV infection, if thrombocytopenia is present.

Correlation of osteoporosis screening by quantitative ultrasound of calcaneus and Osteoporosis Self-Assessment Tool for Asians in Taiwanese.

BACKGROUND AND PURPOSE: The Osteoporosis Self-Assessment Tool for Asians (OSTA) index, originally developed for use in postmenopausal Asian populations, is an inexpensive, simple tool based on age and body weight. Calcaneal quantitative ultrasound (QUS) is another simple and low-cost instrument used to prescreen osteoporotic subjects. This study investigated the correlation between these 2 screening methods. METHODS: OSTA indices were calculated in a total of 3,456 women aged 40 to 95 years (mean, 59.5 +/- 11.7 years) selected from a national epidemiological survey of calcaneal QUS in Taiwan. Age was multiplied by -0.2 and body weight by 0.2. Both values were truncated to yield integers, which were then added together, and compared to the QUS results. RESULTS: When the risk category was defined as OSTA index < or = -1, and low QUS value as t-score < or = -2.5, the sensitivity and the specificity of the index were 84.0% and 61.0%, respectively, and the area under the curve was 0.81. According to the OSTA research group's classification, the high-risk subgroup (index < -4) represented 10.7% of the women 40 years or older, the intermediate-risk subgroup (index -1 to -4) 35.0%, and the low-risk subgroup (index > -1) 54.3%. The prevalence of low QUS values was high among the high-risk category (48.5%), and significantly trended downwards among the moderate- and low-risk categories (21.1% vs 4.4%). As the age of the population increased, there was an increasing false-negative rate (p < 0.001) when using OSTA > -1 to predict the normal QUS value. CONCLUSIONS: The OSTA index, a simple and free risk assessment tool, can be used to estimate the prevalence of low QUS values in Asian women and may help to increase awareness and prevention of low bone mineral density.

Differing risk factors for premature birth in adolescent mothers and adult mothers.

BACKGROUND: Although the survival rate of premature infants has improved, the prevalence of premature birth has not changed or has even increased. The purpose of this study is to analyze the demographic, psychosocial support, family planning, and health behavior risk factors for premature birth. METHODS: This county-based, cross-sectional study collected information on 1,146 first-time mothers, including 556 adolescents (< 20 years old) and 590 adults (20-34 years old). Univariate and multivariate logistic regression analyses were used to study risk factors associated with premature birth. RESULTS: The prevalence of premature birth was 11.4% for adolescent mothers and 8.4% for adult mothers. Younger adolescent mothers (< 18 years old) (14.5%), fewer than 10 prenatal visits (12.5% vs. 6.7%), hypertension (33.3% vs. 8.9%), weight gain less than 10 kg (14.6% vs. 8.8%), drinking alcohol (23.1% vs. 9.5%), unintended pregnancy (13.6% vs. 7.4%), no parental support (16.8% vs. 9.1%), and victim of domestic violence (16.0% vs. 9.3%) were associated with a higher risk of premature birth (p < 0.05). In multivariate logistic regression analysis stratified by mother's age, prenatal visits less than 10 times (OR 2.68; 95% CI [1.38, 5.21]) and drinking alcohol (OR 25.0; 95% CI [1.35-460.49]) were significantly associated with premature birth for adult mothers but unintended pregnancy (OR 2.34; 95% CI [1.28, 4.27]) was the only significant factor for adolescent mothers. CONCLUSIONS: Differing risk factors for premature birth were found between adolescent and adult mothers. Effective family planning before gestation, alcohol abstinence, and regular prenatal visits for screening psychosocial, medical, and obstetric conditions during pregnancy are mandatory for the prevention of premature birth.

Community-based study of hepatitis C virus infection and type 2 diabetes: an association affected by age and hepatitis severity status.

Past studies of the relation between hepatitis C virus (HCV) infection and type 2 diabetes conflict. The authors aimed to elucidate the relation by using a large community-based sample with a wide range of liver conditions. Between October 1997 and February 1998, 2,327 consecutive subjects (aged > or =35 years) were enrolled at the public health facility in Taiwan. Blood sugar, hepatitis B surface antigen, and antibody for HCV (anti-HCV) were tested. Abdominal sonography was performed on viral-hepatitis-positive subjects. In univariate analysis, older age, lower educational levels, sedentary work, body mass index of > or 25 kg/m2, and anti-HCV positivity were significantly associated with type 2 diabetes (p<0.05), but smoking, alcohol consumption, gender, and hepatitis B surface antigen status were not. In multivariate logistic regression, anti-HCV positivity was strongly associated with type 2 diabetes in subjects aged 35-49 years (odds ratio (OR)=3.3, 95% confidence interval (CI): 1.4, 8.0) and 50-64-years (OR=1.6, 95% CI: 1.1, 2.5). Sonographic evidence of fatty liver (OR=2.4, 95% CI: 1.2, 4.8) and chronic liver disease (OR=2.0, 95% CI: 1.0, 4.2) in anti-HCV-positive subjects was moderately associated with type 2 diabetes after age and gender adjustment. Data suggest that HCV infection is moderately associated with type 2 diabetes; the association was strongest for subjects aged 35-49 years and increased with severity of the liver condition.

Community-based survey of low quantitative ultrasound values of calcaneus in Taiwan.

This study investigated prevalence and associated-factors of low quantitative ultrasound (QUS) values by screening calcaneal QUS parameters--broadband ultrasound attenuation (BUA) and speed of sound (SOS)--in population samples of three different Taiwanese communities. The study included 6,322 subjects (2,631 male and 3,691 female), aged 31 yr old or more in Shih-Pai (a metropolitan area in northern Taiwan),Yu-Chi (a mountain area in central Taiwan), and A-Lein (a seaside area in southern Taiwan). The overall response rate was 50.2%. The correlation between BUA and SOS was 0.684, p<0.001. From those who responded, we selected 403 subjects aged 31-40 yr as the reference (the young group), and their BUA was 65.34+/-7.91 dB/MHz. The t-score was calculated from the BUA data of our reference group. The percentile of -2.5

High-dose interferon-alpha 2b plus ribavirin combination therapy for GB virus-C/hepatitis G virus infection--a study in patients with chronic hepatitis C.

BACKGROUND/AIMS: The efficacy of interferon-alpha and ribavirin combination therapy for GB virus C/hepatitis G virus infection is not well understood. We previously conducted a double-blind, placebo-controlled trial using high-dose interferon-alpha 2b with or without ribavirin for patients with interferon-alpha-relapsed chronic hepatitis C. METHODOLOGY: Fifty-two patients were randomly assigned and completed the 24-week treatment of interferon-alpha 2b (6 million units three times per week) plus ribavirin (1000 to 1200 mg/daily), or plus a matched placebo. Patients were then followed for an additional 24 weeks. RESULTS: Of the 52 patients, 5 patients (9.6%) had hepatitis G virus viremia before or during enrollment. Two patients received interferon-alpha 2b alone and three patients received interferon-alpha 2b and ribavirin combination therapy. At the end of treatment, all of the 5 patients had undetectable hepatitis G virus RNA in sera. Early loss of hepatitis G virus RNA at week 4 of treatment was observed in the 2 patients on combination therapy. Hepatitis G virus RNA reappeared at the end of follow-up in these 5 patients. CONCLUSIONS: In conclusion, interferon-alpha 2b and ribavirin combination therapy could induce earlier loss of hepatitis G virus RNA than interferon-alpha 2b alone. Either interferon-alpha 2b alone or interferon-alpha 2b and ribavirin combination therapy achieved transient but not sustained virological response to hepatitis G virus viremia.

Comparison of hepatitis B virus and hepatitis C virus prevalence and risk factors in a community-based study.

We performed a community-based study of 12 villages of southern Taiwan's A-Lein Township to investigate the epidemiology of hepatitis B and hepatitis C virus (HCV) infections. Of 6,095 patients, 13.8% were positive for hepatitis B surface antigen positive (HBsAg(+)) and 17.0% were positive for anti-HCV (anti-HCV(+)). Infection was found to be inversely related to educational level and to be directly related to the frequency of the receipt of parenteral injection for medical purposes. Risk factors for HBsAg positivity were male sex, age < or = 50 years, and a family history of hepatocellular carcinoma. Risk factors for HCV seropositivity were lower education level, frequent parenteral injections, blood transfusion, menial occupations, smoking, and age > 50 years. Therefore, risk factors for HBsAg(+) and anti-HCV(+) were different in these Taiwanese communities. Safe medical injections and improved health education for high-risk groups are imperative for preventing HCV transmission.