Biomedical subjects

Maurice P A Zeegers

Publications and source records attributed to Maurice P A Zeegers.

18 recordsLinked to original sources

PubMed2006

A meta-analysis demonstrates no significant differences between patient and population preferences.

BACKGROUND AND OBJECTIVES: To summarize and quantify mean differences between directly elicited patient and population health state evaluations (= preferences) and to identify factors explaining these differences. MATERIALS AND METHODS: Two meta-analyses of observational studies comparing directly elicited patient and population preferences for two stratified health state classifications: actual/hypothetical and hypothetical/hypothetical health states. RESULTS: Thirty-three articles comparing directly elicited patient and population preferences were included, yielding 78 independent preference estimates. These preference estimates served as input for the two stratified health state classifications. Data on health state assessments, elicitation methods, assessment method, and population characteristics was extracted by one reviewer, and checked by two other reviewers. These parameters were used to explain sources of heterogeneity. Overall, patients' actual health state preferences were not significantly higher than populations hypothetical health state preferences (summary mean difference [SMD] = -0.01, 95% confidence interval [CI] = -0.01, 0.03). Nor did preferences for hypothetical health states differ between patients and population (SMD -0.00, 95% CI = -0.02, 0.02). Most parameters substantially influenced the SMD, although the magnitude and direction differed for the two strata used (all P-values <.05). CONCLUSIONS: The actual/hypothetical and hypothetical/hypothetical meta-analyses demonstrated no significant differences between patient and population preferences, suggesting that both can be used to allocate scarce resources.

Consumer Behavior↗

PubMed2005

Cigarette smoking and colorectal cancer: APC mutations, hMLH1 expression, and GSTM1 and GSTT1 polymorphisms.

The contribution of cigarette smoking to sporadic colorectal cancer may differ according to molecular aspects of the tumor or according to glutathione S-transferase M1 (GSTM1) or glutathione S-transferase T1 (GSTT1) genotype. In the prospective Netherlands Cohort Study on Diet and Cancer, adjusted incidence rate ratios for 1986-1993 were computed for overall colorectal cancer, tumors with and without adenomatous polyposis coli (APC) mutations, and tumors with and without human mut-L homologue 1 (hMLH1) expression, according to cigarette smoking characteristics (661 cases, 2,948 subcohort members). Case-only analyses were performed to estimate odds ratios for interaction between cigarette smoking and GSTM1 and GSTT1 genotypes. In comparison with never smokers, a high smoking frequency increased the risk of colorectal cancer (for a five-cigarette/day increment, incidence rate ratio (IRR) = 1.07, 95% confidence interval (CI): 1.03, 1.12), and this association was stronger in 371 tumors without a truncating APC mutation (IRR = 1.11, 95% CI: 1.05, 1.17). Long-term smoking was associated with lack of hMLH1 expression in 56 tumors (for a 10-year increment, IRR = 1.17, 95% CI: 1.00, 1.37). No statistically significant interactions between smoking and GSTM1 or GSTT1 genotype were observed. These results indicate that cigarette smoking is associated with risk of colorectal cancer, and this association may depend on molecular characteristics of the tumor as defined by APC mutation and hMLH1 expression status.

Adaptor Proteins, Signal Transducing↗

PubMed2005

Physical activity and the risk of prostate cancer in the Netherlands cohort study, results after 9.3 years of follow-up.

BACKGROUND: The aim of the current study was to evaluate the relation between physical activity and prostate cancer risk with specific emphasis on interaction with body mass index (BMI) and baseline energy intake. METHODS: The association between prostate cancer and physical activity was evaluated in the Netherlands Cohort Study, conducted among 58,279 men ages 55 to 69 years at entry. Information regarding baseline nonoccupational physical activity, history of sports participation, and occupational physical activity was collected with a questionnaire in 1986. After 9.3 years, 1,386 incident prostate cancer cases were available for case-cohort analyses. Multivariate incidence rate ratios (RR) and corresponding 95% confidence intervals (95% CI) were calculated using Cox regression analyses. RESULTS: Neither baseline nonoccupational physical activity (RR, 1.01; 95% CI, 0.81-1.25 for >90 versus <30 minutes per day), history of sports participation (RR, 1.04; 95% CI, 0.90-1.22 for ever versus never participated), nor occupational physical activity (RR, 0.91; 95% CI, 0.70-1.18 for >12 versus <8 KJ/min energy expenditure in the longest held job) showed an inverse relation with prostate cancer risk. We found an increased risk of prostate cancer for men who were physically active for >1 hour per day in obese men (BMI > 30) and men with a high baseline energy intake. DISCUSSION: The results of this current study do not support the hypothesis that physical activity protects against prostate cancer in men.

Cohort Studies↗

PubMed2004

Genetic risk of atherosclerotic renal artery disease: the candidate gene approach in a renal angiography cohort.

It is largely unknown to what extent genetic abnormalities contribute to the development of atherosclerotic renal artery disease. Among the potential candidate genes, those of the renin-angiotensin system and the endothelial nitric oxide synthase (eNOS) rank high because of their importance in the atherosclerotic process. We investigated the association of polymorphisms in these genes (the angiotensinogen Met235Thr, the angiotensin-converting enzyme insertion/deletion, the angiotensin II type-1 receptor A1166C, and the eNOS Glu298Asp) with the presence or absence of atherosclerotic renovascular disease in 456 consecutive hypertensive patients referred for renal angiography on the suspicion of renovascular hypertension. Nondiseased normotensive (n=200) and hypertensive (n=154) patients from a family practice served as external controls. Renal artery disease was present in 30% of our angiography group. The Asp allele of the eNOS Glu298Asp polymorphism was associated with atherosclerotic renal artery stenosis with an odds ratio of 1.44 (95% confidence interval 1.00 to 2.09) versus hypertensives with angiographically proven patent arteries, of 1.89 (1.24 to 2.87) versus hypertensive family practice controls, and of 2.09 (1.29 to 3.38) versus normotensive family practice controls. However, this allele also differed significantly between patients with patent renal arteries and normotensive and hypertensive controls. No differences were found with respect to the other genetic polymorphisms. We hypothesize that the Asp allele of the Glu298Asp polymorphism may predispose to the development of atherosclerotic lesions but that renal artery involvement depends on other factors, also.

Aged↗

PubMed2004

Alcohol and ovarian cancer risk: results from the Netherlands Cohort Study.

OBJECTIVE: To study alcohol consumption in relation to ovarian cancer risk in a prospective cohort study. METHODS: The Netherlands Cohort Study on diet and cancer was initiated in 1986. A self-administered questionnaire on dietary habits and other risk factors for cancer was completed by 62,573 postmenopausal women. Follow-up for cancer was established by annual record linkages with the Netherlands Cancer Registry. After 9.3 years of follow-up, 214 incident invasive epithelial ovarian cancer cases and 2211 subcohort members with complete data on alcohol intake were available for analysis. All incidence rate ratios (RRs) were corrected for age, use of oral contraceptives, parity, height, body mass index, energy intake and current cigarette smoking. RESULTS: The RRs of ovarian cancer for women who consumed up to 5, 15 and >15 g of alcohol per day were 1.13 (95% confidence interval, 95% CI = 0.79-1.63), 0.85 (95% CI = 0.53-1.37) and 0.92 (95% CI = 0.55-1.54), respectively, compared to non-drinkers. Alcohol consumption in the form of wine, beer or liquor was not associated with ovarian cancer risk. CONCLUSION: These data do not suggest a major association between alcohol intake and ovarian cancer risk in this population.

Aged↗

PubMed2004

Founder mutations among the Dutch.

Many genetic disorders demonstrate mutations that can be traced to a founder, sometimes a person who can be identified. These founder mutations have generated considerable interest, because they facilitate studies of prevalence and penetrance and can be used to quantify the degree of homogeneity within a population. This paper reports on founder mutations among the Dutch and relates their occurrence to the history and demography of the Netherlands. International migration, regional and religious endogamy, and rapid population growth played key roles in shaping the Dutch population. In the first millenniums BC and AD, the Netherlands were invaded by Celts, Romans, Huns, and Germans. In more recent times, large numbers of Huguenots and Germans migrated into the Netherlands. Population growth within the Netherlands was slow until the 19th century, when a period of rapid population growth started. Today, the Dutch population numbers 16 million inhabitants. Several different classes of founder mutations have been identified among the Dutch. Some mutations occur among people who represent genetic isolates within this country. These include mutations for benign familial cholestasis, diabetes mellitus, type I, infantile neuronal ceroid lipofuscinosis, L-DOPA responsive dystonia, and triphalangeal thumb. Although not related to a specific isolate, other founder mutations were identified only within the Netherlands, including those predisposing for hereditary breast-ovarian cancer, familial hypercholesterolemia, frontotemporal dementia, hereditary paragangliomas, juvenile neuronal ceroid lipofuscinosis, malignant melanoma, protein C deficiency, and San Filippo disease. Many of these show a regional distribution, suggesting dissemination from a founder. Some mutations that occur among the Dutch are shared with other European populations and others have been transmitted by Dutch émigrés to their descendents in North America and South Africa. The occurrence of short chromosomal regions that have remained identical by descent has resulted in relatively limited genetic heterogeneity for many genetic conditions among the Dutch. These observations demonstrate the opportunity for gene discovery for other diseases and traits in the Netherlands.

Alleles↗

PubMed2004

A prospective study of occupation and prostate cancer risk.

A wide variety of occupations has been associated with prostate cancer in previous retrospective studies. Most attention has been paid to farming, metal working, and the rubber industry. Today, these results cannot be affirmed with confidence, because many associations could be influenced by recall bias, have been inconsistent, or have not been confirmed satisfactory in subsequent studies. This study was conducted to investigate and confirm these important associations in a large prospective cohort study. The authors conducted a prospective cohort study among 58,279 men. In September 1986, the cohort members (55-69 years) completed a self-administered questionnaire on potential cancer risk factors, including job history. Related job codes were clustered in professional groups. These predefined clusters were investigated in 3 time windows: 1) profession ever performed, 2) longest profession ever held, and 3) last profession held at baseline. Follow up for incident prostate cancer was established by linkage to cancer registries until December 1993. A case-cohort approach was used based on 830 cases and 1525 subcohort members. To minimize false-positive results, 99% confidence intervals (99% CI) were calculated. Although moderately decreased prostate cancer risks were found for electricians, farmers, firefighters, woodworkers, textile workers, butchers, salesmen, teachers, and clerical workers, none of the relative risks (RR) were found to be statistically significant. For road transporters, metal workers, and managers, no association with prostate cancer risk was found. Although the RR for railway workers, mechanics, welders, chemists, painters, and cooks was moderately increased, these estimates were not statistically significant. For men who reported to have ever worked in the rubber industry, we found a substantially increased prostate cancer risk, but not statistically significant (RR, 4.18; 99% CI = 0.22-80.45). For policemen, we found a substantial and marginally statistically significant increased prostate cancer risk, especially for those who reported working as a policeman for most of their occupational life (RR, 3.91; 99% CI = 1.14-13.42) or as the last profession held at baseline (RR, 4.00; 99% CI = 1.19-13.37). Most of the previously investigated associations between occupation and prostate cancer risk could not be confirmed with confidence in this prospective study. The lack of statistical significance for rubber workers could be caused by the scarcity of rubber workers in this cohort and subsequent lack of power. The results for policemen were substantial and statistically significant, although a conservative value for significance level was used.

Aged↗

PubMed2004

The contribution of risk factors to blood pressure heritability estimates in young adults: the East flanders prospective twin study.

The heritability of blood pressure estimated in previous studies may be confounded by the influence of potential blood pressure risk factors. We applied the classical twin design to estimate the contribution of these covariates to blood pressure heritability. The study consisted of 173 dizygotic and 251 monozygotic twin pairs aged 18-34 years, randomly selected from the East Flanders Prospective Twin Survey. In a standardized examination, blood pressure and anthropometry was measured, a questionnaire was completed, and a fasting blood sample was taken. In univariate and bivariate modeling, diastolic and systolic heritability were estimated both unadjusted and adjusted for potential risk factors. Also, covariate interaction was modeled. Bivariate analysis gave heritability estimates of 0.63 (95%CI 0.55-0.59), 0.74 (95%CI: 0.68-0.79), and 0.78 (95%CI: 0.70-0.84) for diastolic, systolic, and cross-trait heritability, respectively. The remaining variances could be attributed to unique environmental influences. These heritability estimates did not change substantially in univariate analyses or after adjustment for risk factors. A sex-limitation model showed that the heritability estimates for women were significantly higher than for men, but the same genetic factors were operating across sexes. Sex and cigarette smoking appeared to be statistically significant interaction terms. The heritability of blood pressure is relatively high in young adults. Potential risk factors of blood pressure do not appear to confound the heritability estimates. However, gene by sex by smoking interaction is indicated.

Adolescent↗

PubMed2003

The association between stressful life events and breast cancer risk: a meta-analysis.

Breast cancer is the most prevalent cancer in women in Western societies. Studies examining the relationship between stressful life events and breast cancer risk have produced conflicting results. The purpose of this meta-analysis was to identify studies on this relationship, between 1966 and December 2002, to summarize and quantify the association and to explain the inconsistency in previous results. Summary odds ratios and standard errors were calculated, using random effect meta-regression analyses, for the following categories: stressful life events, death of spouse, death of relative or friend, personal health difficulties, nonpersonal health difficulties, change in marital status, change in financial status and change in environmental status. The presence of publication bias has been explored, and sensitivity analyses were performed to identify heterogeneity, using calculation of the percentage of variability due to heterogeneity, meta-regression analyses and stratification. Only the categories stressful life events (OR = 1.77, 95% CI 1.31-2.40), death of spouse (OR = 1.37, 95% CI 1.10-1.71) and death of relative or friend (OR = 1.35, 95% CI 1.09-1.68) showed a statistically significant effect. Publication bias was identified in both stressful life events (p = 0.00) and death of relative or friend (p = 0.02). Sensitivity analyses resulted in the identification of heterogeneity in all categories, except death of spouse. The results of this meta-analysis do not support an overall association between stressful life events and breast cancer risk. Only a modest association could be identified between death of spouse and breast cancer risk.

Breast Neoplasms↗

PubMed2003

The association between smoking, beverage consumption, diet and bladder cancer: a systematic literature review.

In this paper the association between smoking history, beverage consumption, diet and bladder cancer incidence is systematically reviewed. A rating system has been used to summarise the level of scientific evidence (i.e. convincing, probable, possible, and no evidence) and the level of association (i.e. substantially increased, (RR> or =2.5), moderately increased (1.5< or =RR<2.5), slightly increased (1.2< or =RR<1.5), no association (0.8< or =RR<1.2), slightly decreased (0.7< or =RR<0.8), moderately decreased (0.4< or =RR<0.7), and substantially decreased (RR<0.4)). There is convincing evidence that cigarette smoking status, frequency and duration substantially increase the risk of bladder cancer. However, the evidence is not clear for other forms of smoking. A small increased risk for cigar, pipe, and environmental smoking is only possible. There is possible evidence that total fluid intake is not associated with bladder cancer. Although there is convincing evidence for a positive association between alcohol consumption and bladder cancer risk in men, the risk is small and not clinically relevant. Coffee and tea consumption are probably not associated with bladder cancer. The authors conclude that total fruit consumption is probably associated with a small decrease in risk. There is probably no association between total vegetable intake, vitamin A intake, vitamin C intake and bladder cancer and a possibly moderate inverse association with vitamin E intake. Folate is possibly not associated with bladder cancer. There probably is a moderate inverse association between selenium intake and bladder cancer risk.

Alcohol Drinking↗

PubMed2003

Energy restriction and the risk of spontaneous mammary tumors in mice: a meta-analysis.

Our meta-analysis was aimed at providing a systematic review of the literature regarding the effect of energy restriction on spontaneous mammary tumors in mice and at providing a more precise pooled (summary) estimate of the risk of mammary tumors. A sensitivity analysis was conducted to obtain insight in potential heterogeneity between the animal studies. A literature search was conducted with the following terms to identify relevant articles: animal studies, mammary tumors, fat restricted, dietary carbohydrates, energy restriction and calorie restriction. A criteria list for the assessment of quality items (i.e., study characteristics) in animal experiments was developed that was intended to quantitatively assess potential factors that underlie heterogeneous results of different animal experiments. Incidence figures were used to calculate the risk difference. The pooled risk difference was calculated by random effects meta regression analysis. Fourteen animal experiments were included in this meta-analysis. Publication bias could not be identified. The pooled risk difference for the 14 studies was -0.55 with a narrow 95% confidence interval (-0.69; -0.41), implying that the energy-restricted animal groups developed 55% less mammary tumors than the control groups. No heterogeneity could be detected between the studies based on study characteristics that included the age of mice at the start of intervention, duration of intervention, allocation of the mice, use of ad libitum control group, fertility of the mice and the type of energy-providing nutrient (fat, carbohydrate or protein). This meta-analysis confirms that energy restriction in itself consistently protects against the development of mammary tumor in mice, irrespective of the type of restricted nutrient or other study characteristics.

Animals↗

PubMed2003

Empiric risk of prostate carcinoma for relatives of patients with prostate carcinoma: a meta-analysis.

BACKGROUND: Although narrative reviews have concluded that there is strong support for familial clustering of prostate carcinoma, the association has never systematically been quantified in reviews. The purpose of this meta-analysis was to summarize and quantify the recurrence risk ratio with emphasis on the degree of relation, the specific relationship of the family member, the number of affected family members, and the age at diagnosis. METHODS: Publications were identified through computerized database searches for epidemiologic studies published up to December 2002. In addition, references cited in original and review papers were examined. Three blinded reviewers extracted both qualitative and quantitative information from each paper. Using random effects meta-regression analyses, the authors calculated summary recurrence risk ratios (S(lambda)). The reviewers also evaluated changes in S(lambda) according to differences in study methodology. RESULTS: Thirty-three epidemiologic studies were included in the current review. S(lambda) was 2.53 (95% confidence interval, 2.24-2.85) for first-degree family members. S(lambda) appeared to be greater for men with an affected brother than for men with an affected father. S(lambda) for men who had second-degree relatives with prostate carcinoma was only slightly elevated. The nature of the familial clustering is such that S(lambda) increases with decreasing age of the patient and family members, with increasing genetic relatedness of the affected relative, and with increasing number of individuals affected within a family. CONCLUSIONS: The studies that were reviewed consistently demonstrate that family history is a significant risk factor for development of prostate carcinoma.

Age Distribution↗

PubMed2003

Regression-based sib pair linkage analysis for binary traits.

The Haseman-Elston (HE) regression method offers a mathematically and computationally simpler alternative to variance-components (VC) models for the linkage analysis of quantitative traits. However, current versions of HE regression and VC models are not optimised for binary traits. Here, we present a modified HE regression and a liability-threshold VC model for binary-traits. The new HE method is based on the regression of a linear combination of the trait squares and the trait cross-product on the proportion of alleles identical by descent (IBD) at the putative locus, for sibling pairs. We have implemented both the new HE regression-based method and have performed analytic and simulation studies to assess its type 1 error rate and power under a range of conditions. These studies showed that the new HE method is well-behaved under the null hypothesis in large samples, is more powerful than both the original and the revisited HE methods, and is approximately equivalent in power to the liability-threshold VC model.

Data Interpretation, Statistical↗

PubMed2003

Benefits and risks of pharmacological smoking cessation therapies in chronic obstructive pulmonary disease.

Smoking cessation is the most effective way to reduce the risk of developing chronic obstructive pulmonary disease (COPD) or to reduce its progression. However, little is known about the efficacy and safety of different pharmacological smoking cessation therapies used for the treatment of patients with COPD who smoke. The aim of this review was to evaluate the benefits and risks of pharmacological smoking cessation therapies in COPD. We conducted an extensive computer-aided literature search which resulted in the identification of four papers that met the inclusion criteria and contributed to this review. In two studies the efficacy of nicotine polacrilex (nicotine gum) was assessed. In one study, which did not have a control group, the efficacy of nicotine nasal spray was evaluated. The fourth study, a placebo-controlled trial, evaluated the efficacy of bupropion sustained release. The results of these studies indicated that nicotine gum, nicotine nasal spray and bupropion have a good safety profile and seem to increase abstinence rates in smokers with COPD. The incidence and nature of specific adverse effects occurring in patients with COPD seem to be comparable with the adverse effects reported by healthy smokers. However, the efficacy seems to depend on the follow-up period used to define success (i.e. abstinence rates decline with longer follow-up), as well as the intensity and duration of the concomitant psychosocial intervention. This review indicates that for a continuation of the effect of pharmacological smoking cessation therapies, the combination of pharmacotherapy (to reduce craving and withdrawal) and a relapse-prevention programme, in which attention is focused on the behavioural aspects of smoking and smoking cessation, seems to increase abstinence, especially when the psychosocial intervention is prolonged for a longer period. Also, the characteristics of the smokers who are motivated to quit must be taken into account in order to increase the number of successful attempts to quit smoking and prevent relapses. We therefore recommend using a holistic approach in which the possible coexistence of multiple problems (which are known to affect the success of smoking cessation strategies) is integrated.

Administration, Buccal↗

PubMed2003

Toenail selenium levels and the subsequent risk of prostate cancer: a prospective cohort study.

Results of a randomized controlled trial have suggested a protective effect of selenium against prostate cancer. Few other prospective studies have been conducted to confirm or refute this. The association between prostate cancer and baseline toenail selenium level was evaluated in the Netherlands Cohort Study, conducted among 58,279 men, aged 55-69 years at entry. In September 1986, the cohort members completed a questionnaire on risk factors for cancer and provided toenail clippings for determination of baseline selenium status. After 6.3 years of follow-up, 540 incident prostate carcinoma cases and 1,211 subcohort members with complete toenail selenium data were available for case-cohort analyses. In multivariate survival analysis, an inverse association between toenail selenium level and prostate cancer risk was observed. Incidence rate ratios in increasing selenium quintiles were 1.00 (ref), 1.05, 0.69, 0.75, and 0.69 (95% confidence interval, 0.48-0.99), respectively (P-trend=0.008). This association persisted after exclusion of cases diagnosed during early follow-up. The inverse association was more pronounced in ex-smokers than current smokers, and unclear in never-smokers. Analysis of effect modification by intake of antioxidant vitamins C, E, and the carotenoids alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein/zeaxanthin showed a strong, significant interaction with beta-cryptoxanthin, and to a lesser extent with vitamin C. These results confirm the hypothesis that higher selenium intake may reduce prostate cancer risk. Future research on optimum dose level is needed.

Aged↗

PubMed2002

A prospective study on active and environmental tobacco smoking and bladder cancer risk (The Netherlands).

OBJECTIVE: In a prospective cohort study among 120,852 adult subjects the authors investigated the associations between cigarette, cigar, pipe, environmental tobacco smoking (ETS), and bladder cancer. METHODS: In 1986 all subjects completed a questionnaire on cancer risk factors. Follow-up for incident bladder cancer was established by linkage to cancer registries until 1992. The case-cohort analysis was based on 619 cases and 3346 subcohort members. RESULTS: Compared with lifelong non-smokers the age- and sex-adjusted incidence rate ratios (RR) for ex- and current cigarette smokers were 2.1 (95% CI 1.5-3.0) and 3.3 (95% CI 2.4-4.6), respectively. The RR for smoking duration was 1.03 (95% CI: 1.02-1.04) per 1-year increment. The RR per 10 cigarettes/day was 1.3 (95% CI 1.2-1.4). Tar and nicotine exposure increased bladder cancer risk only weakly. It appeared that associations of cigarette smoking characteristics with bladder cancer risk were largely attributable to cigarette smoking duration only. Smoking cessation, age at first exposure, filter-tip usage, cigar and pipe smoking, and ETS were no longer associated with bladder cancer risk after adjustment for frequency and duration of smoking. CONCLUSIONS: The authors conclude that current cigarette smokers have a three-fold higher bladder cancer risk than non-smokers. Ex-smokers experience a two-fold increased risk. About half of male bladder cancer and one-fifth of female bladder cancer was attributable to cigarette smoking. Other smoking types (cigar, pipe, or ETS) were not associated with increased risks.

Adolescent↗

PubMed2002

The modified Stroop paradigm as a measure of selective attention towards pain-related stimuli among chronic pain patients: a meta-analysis.

Although the modified Stroop paradigm is considered to be a prominent paradigm for investigating selective attention in emotional disorders, relatively few studies have applied this paradigm to examine selective attention in chronic pain patients. Moreover, the results from these studies are not robust. The purpose of this article is to review the evidence for attentional bias in chronic pain patients, by means of a meta-analysis. Data from five studies were pooled and summarized into a mean difference (MD). Significant MD estimations (in milliseconds) were found for both sensory pain words (MD=26.7; 95% confidence interval (CI) 10.0-42.9) and affective pain words (MD=28.1; 95% CI 0.4-55.8). Meta-regression analysis indicated that methodological quality did not significantly affect the pooled MD estimation for both sensory pain words and affective pain words. Thus, the results from the present meta-analysis on studies applying the modified Stroop paradigm suggest that chronic pain patients selectively attend to both pain sensory and pain affective stimuli. Furthermore, the MD estimation did not depend on the methodological quality, tentatively indicating that even though studies differed in methodology, the results were rather consistent. Implications of the results are discussed.

Attention↗

PubMed2002

Prediagnostic toenail selenium and risk of bladder cancer.

The association between several cancers and selenium status has been investigated in epidemiological studies. However, few results concerning bladder cancer have been reported thus far. The association between toenail selenium status and subsequent bladder cancer incidence was investigated in a prospective cohort study among 120,852 men and women aged 55-69 years at baseline (September 1986). The cohort members completed a questionnaire on risk factors for cancer and provided toenail clippings for determination of baseline selenium status. Follow-up for incident cancer was established by record linkage to cancer registries until December 1992. The multivariable case-cohort analysis was based on 431 bladder cancer cases and 2,459 subcohort members, for whom toenail selenium levels were available. The age-, sex- and smoking-adjusted rate ratios (95% confidence intervals) for increasing quintiles of toenail selenium were 1.00 (reference), 1.09 (0.80-1.48), 0.55 (0.38-0.79), 0.63 (0.43-0.91), and 0.67 (0.46-0.97), respectively (P-trend < 0.01). Analyses with selenium as a continuous variable supported these findings. An inverse association between toenail selenium and bladder cancer risk was most pronounced among ex-smokers (P-trend < 0.01); was similar for subjects with high versus low intakes of beta-carotene, vitamin C, and vitamin E; and was mainly confined to invasive transitional cell carcinomas of the urinary bladder, irrespective of tumor morphology. We conclude that the evidence is in favor of an inverse association between selenium and bladder cancer risk.

Aged↗