Blood group in relation to oral Fordyce's granules and serum cholesterol level.

BACKGROUND: The ABO and Rh systems are the most commonly used blood-group systems used to classify blood group globally. A number of studies have shown that ABO blood groups may be associated with an increased serum cholesterol levels which in turn may be related to the presence of oral Fordyce spots or granules. Oral Fordyce's granules are ectopic sebaceous glands within the oral cavity and are visible through epithelium. The aim of this study was to assess the relationship between ABO and Rhesus blood groups and the presence of oral Fordyce's granules and serum cholesterols level by gender. METHODS: Following ethical approval and informed consent, 124 subjects were recruited into this cross-sectional study. Clinical oral examination assessed the number of Fordyce's granules and blood samples were collected to determine the serum cholesterol and ABO/Rh blood-group systems of individual subjects. RESULTS: Blood group AB+ showed the highest mean of oral Fordyce's granules number and serum cholesterol level but this was not statistically significant compared to other blood groups. Female subjects in this study who were AB+ were had significantly higher serum cholesterol levels than males. CONCLUSION: This study indicates an association between ABO blood group, serum cholesterol level and mean number of oral Fordyce's granules. A larger sample size in a future study is required to ascertain whether number of Fordyce's granules is an important measure of serum cholesterol, but the study does show that for AB+ individuals, females may have higher serum cholesterol than males.

Instrumental Activities of Daily Living Scales to Detect Cognitive Impairment and Dementia in Low- and Middle-Income Countries: A Systematic Review.

BACKGROUND: The largest proportion of people with dementia worldwide live in low- and middle- income countries (LMICs), with dementia prevalence continuing to rise. Assessment and diagnosis of dementia involves identifying the impact of cognitive decline on function, usually measured by instrumental activities of daily living (IADLs). OBJECTIVE: This review aimed to identify IADL measures which are specifically developed, validated, or adapted for use in LMICs to guide selection of such tools. METHODS: A systematic search was conducted (fourteen databases) up to April 2020. Only studies reporting on development, validation, or adaptation of IADL measures for dementia or cognitive impairment among older adults (aged over 50) in LMICs were included. The QUADAS 2 was used to assess quality of diagnostic accuracy studies. RESULTS: 22 papers met inclusion criteria; identifying 19 discrete IADL tools across 11 LMICs. These were either translated from IADL measures used in high-income countries (n = 6), translated and adapted for cultural differences (n = 6), or newly developed for target LMIC populations (n = 7). Seven measures were investigated in multiple studies; overall quality of diagnostic accuracy was moderate to good. CONCLUSION: Reliability, validity, and accuracy of IADL measures for supporting dementia diagnosis within LMICs was reported. Key components to consider when selecting an IADL tool for such settings were highlighted, including choosing culturally appropriate, time-efficient tools that account for gender- and literacy-bias, and can be conducted by any volunteer with appropriate training. There is a need for greater technical and external validation of IADL tools across different regions, countries, populations, and cultures.

Exposure-lag response of smoking prevalence on lung cancer incidence using a distributed lag non-linear model.

The prevalence of smokers is a major driver of lung cancer incidence in a population, though the "exposure-lag" effects are ill-defined. Here we present a multi-country ecological modelling study using a 30-year smoking prevalence history to quantify the exposure-lag response. To model the temporal dependency between smoking prevalence and lung cancer incidence, we used a distributed lag non-linear model (DLNM), controlling for gender, age group, country, outcome year, and population at risk, and presented the effects as the incidence rate ratio (IRR) and cumulative incidence rate ratio (IRRcum). The exposure-response varied by lag period, whilst the lag-response varied according to the magnitude and direction of changes in smoking prevalence in the population. For the cumulative lag-response, increments above and below the reference level was associated with an increased and decreased IRRcum respectively, with the magnitude of the effect varying across the lag period. Though caution should be exercised in interpretation of the IRR and IRRcum estimates reported herein, we hope our work constitutes a preliminary step towards providing policy makers with meaningful indicators to inform national screening programme developments. To that end, we have implemented our statistical model a shiny app and provide an example of its use.

The relationship between inflammatory bowel disease and Helicobacter pylori across East Asian, European and Mediterranean countries: a meta-analysis.

BACKGROUND: The current literature suggests a protective benefit of Helicobacter pylori (H. pylori) infection against inflammatory bowel disease (IBD). Here we assessed whether this effect varied by IBD subtype-Crohn's disease (CD) or ulcerative colitis (UC)-and geographic region: East Asia, Europe (non-Mediterranean) or Mediterranean region. METHODS: A database search was performed up to July 2019 inclusive for all studies that compared H. pylori infection in IBD patients vs. non-IBD controls. The relative risk (RR) was used to quantify the association between IBD and H. pylori, and the effects were combined across studies using a mixed-effects meta-regression model, which included IBD subtype and geographic region as categorical moderator variables. RESULTS: Our meta-regression model exhibited moderate heterogeneity (I2=48.74%). Pooled RR depended on both region (P=0.02) and subtype (P<0.001). Pooled RRs were <1 for all subtype and region combinations, indicative of a protective effect of H. pylori against IBD. The pooled RR was 28% (9%, 50%; P=0.001) greater for UC vs. CD and 43% (4%, 96%; P=0.02) greater for Mediterranean countries vs. East Asia. The pooled RR was 18% (-13%, 60%; P=0.48) greater for Europe vs. East Asia and 21% (-13%, 68%; P=0.42) greater for Mediterranean vs. Europe, though these differences were not statistically significant. CONCLUSIONS: The protective effect of H. pylori on IBD varied by both subtype (more protection against CD vs. UC) and region (East Asia more protected than Mediterranean regions). Variation due to these effects could provide insight into IBD etiology.