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Cancer patients with terminal stage peritoneal carcinomatosis are often unable to eat, rendering total parenteral nutrition ( TPN) as the only option to avoid starvation. In this retrospective study, we reviewed the medical records of 46 patients with peritoneal carcinomatosis and compared them to the records of 51 patients who had gastrointestinal malignancy without evidence of peritoneal carcinomatosis. The factors evaluated include demographic data, cause of primary malignancy, ascites formation, anthropometric measurements, laboratory tests, and outcome measurements as well as factors associated with greater than 90-day survival. In-hospital mortality was observed in 31 of the 46 patients with peritoneal carcinomatosis, with a median survival time of 40 days (4-148 days) for all 46 patients. The median duration of TPN administration in the peritoneal carcinomatosis group was 24.1 ± 27.4 days (3-68 days). Severe infection related to TPN application was seen in 5/46 (10.7%) patients with peritoneal carcinomatosis and 6/51 (9.8%) patients without peritoneal carcinomatosis. The length of survival varied widely among terminal patients with peritoneal carcinomatosis. The average survival time in peritoneal carcinomatosis patients receiving TPN was short, indicating that the nutrition support of TPN was relatively suboptimal. Ascites was not a prognostic factor for peritoneal carcinomatosis, while body mass index was a predictor for 90-day survival. [ABSTRACT FROM AUTHOR]

Objective:This study aimed to investigate the metabolic risk factors of high hepatitis B viral load.Design:Large-scale, community-based cross-sectional study.Subjects:A total of 3587 hepatitis B virus (HBV)-infected participants without liver cirrhosis at study entry were investigated. High HBV viral load was defined as a serum level 104 copies per ml for hepatitis B e antigen (HBeAg) seronegatives or 108 copies per ml for HBeAg seropositives.Results:Among HBeAg seropositives (n=545), high HBV viral load was reversely associated with extreme obesity (odds ratio (OR), 0.30; 95% confidence interval (CI), 0.13-0.68; P=0.004) or central obesity (OR, 0.53; 95% CI, 0.34-0.82; P=0.004) after adjustment for gender, hypertriglyceridemia, hyperuricemia and history of hypertension. High HBV viral load remained significantly inversely associated with extreme obesity (OR, 0.17; 95% CI, 0.05-0.63; P=0.008) and central obesity (OR, 0.44; 95% CI, 0.25-0.78; P=0.005) in male HBeAg-seropositive participants in stratification analyses by gender. Among HBeAg seronegatives (n=3042), however, high HBV viral load was inversely associated with hypertriglyceridemia (OR, 0.74; 95% CI, 0.61-0.89, P=0.002) after adjustment for age, gender, high serum alanine aminotransferase level, and extreme obesity or central obesity. High HBV viral load was still inversely associated with hypertriglyceridemia in both female (OR, 0.70; 95% CI, 0.50-0.97; P=0.041) and male (OR, 0.75; 95% CI, 0.60-0.94; P=0.011) HBeAg-seronegative participants.Conclusion:Extreme obesity and central obesity were associated with a low prevalence of high HBV viral load in HBeAg seropositives, especially in men; while hypertriglyceridemia was associated with a low prevalence of high viral load in HBeAg seronegatives in both women and men. [ABSTRACT FROM AUTHOR]

Objective: To investigate age- and gender-related long-term renal outcome in patients with lupus nephritis (LN).Methods: This is a retrospective, chart review study of patients with LN at Chang Gung Memorial Hospital, Kaohsiung, between January 1986 and June 2004. All had undergone a renal biopsy that showed LN. The end point of outcome was chronic renal insufficiency (CRI), which was defined as ‘doubling of baseline serum creatinine lasting for at least 6 months with a value at least 2 mg/dl.’ The patients were categorized by age tertiles and gender. A 5-year survival curve was constructed to study the effect of age and gender on the outcome.Results: In total, 121 sets of patient data were evaluated. The study group included 104 women and 17 men. Of the study patients, 26 (21%) developed CRI after 5 years of follow-up. There was no significant difference among age groups in developing CRI (p = 0.23). In terms of gender, men had worse long-term renal outcome (p = 0.004) than women.Conclusions: The long-term renal outcome of the LN patients did not differ among age groups, but was worse in men. [ABSTRACT FROM PUBLISHER]

The prevalence and risk factors of hypertension vary in ethnic groups. This study aimed to estimate the hypertension prevalence and to compare risk factors associated with hypertension in women of four ethnic groups in Taiwan. The study subjects were participants in the Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH) enrolled in 2002. In this analysis, only 2810 women who were at age of 20–80 years old and whose father and mother had same ethnic background (Minnan, Hakka, Aborigines or Mainland Chinese) were included. Results showed that there were significant ethnic differences in the prevalence of hypertension, obesity indices, fasting glucose, dyslipidaemia, hyperuricaemia, history of alcohol drinking and tobacco smoking and socioeconomic status. Aborigines had the highest prevalence of hypertension (28.6%) and diabetes mellitus (8.9%), whereas the Minnan group had the second highest prevalence of hypertension (19.2%) and diabetes mellitus (7.9%). Both age and central obesity were associated with an increased prevalence of hypertension except central obesity in Mainland Chinese in all four ethnic groups. Compared with the Mainland Chinese as the referent, the multivariate-adjusted odds ratio (OR) (95% CI) was 1.19 (0.63–2.26), 1.92 (1.15–3.21) and 2.03 (1.00–4.12) for Hakka, Minnan and Aborigines, respectively. Elevated body mass index (27.0 vs <24.0 kg m−2) and central obesity were significantly associated with hypertension showing multivariate-adjusted OR (95% CI) of 1.68 (1.18–2.38) and 1.95 (1.48–2.57), respectively. In addition, dyslipidaemia, hyperuricaemia and diabetes associated with higher OR for hypertension in Minnan women. In conclusion, there were ethnic variations in hypertension prevalence and determinants in Taiwanese women.Journal of Human Hypertension (2009) 23, 160–167; doi:10.1038/jhh.2008.120; published online 2 October 2008 [ABSTRACT FROM AUTHOR]

Abstract: Background: The Acute Physiology and Chronic Health Evaluation II classification system has been extensively used for predicting the patient mortality in various diseases. However, its utilisation on the pyogenic liver abscess has not yet been well studied. Aims: The purpose of this study was to validate this system on this high death rate disease. Patients: A retrospective study was conducted to assess 314 patients with pyogenic liver abscesses admitted to tertiary medical centre in past 12 years. Methods: The outcome measurement was the in-hospital mortality. A multiple logistic regression model was used to assess the association between mortality and Acute Physiology and Chronic Health Evaluation II score while controlling for the potential confounding factors. Results: The overall in-hospital mortality was 8.3%. The mean Acute Physiology and Chronic Health Evaluation II score of the expired patients was higher (P <0.0001). The mortality rate increased rapidly when Acute Physiology and Chronic Health Evaluation II score ≥15. After controlling for the potential confounding factors, patient with high admission Acute Physiology and Chronic Health Evaluation II score ≥15 had a higher chance of in-hospital mortality (P <0.01). In addition, the primary liver cancer history is also a risk factor (P =0.03). Conclusions: The Acute Physiology and Chronic Health Evaluation II score and the primary liver cancer history predict the in-hospital mortality of the pyogenic liver abscess patient. [Copyright &y& Elsevier]

Neuroblastoma is a malignancy commonly diagnosed during infancy or early childhood, raising speculation about the role of perinatal factors and risk of disease. Using a case-control design, cases included 155 infants and children aged 0-5 years with histologically confirmed neuroblastoma diagnosed and reported to the New York State Cancer Registry between 1976 and 1987. Controls were randomly selected from the State's Livebirth Registry and were frequency matched to cases on year of birth (n = 310). Medical records of cases were used to verify histology and stage of disease. Data on perinatal factors were ascertained from birth certificates and standardised telephone interviews with mothers. Unconditional logistic regression was used to estimate (un)adjusted odds ratios (OR) and 95% confidence intervals (CI). Both preterm (< 37 weeks) and post-term (> 42 weeks) birth were associated with a reduction in risk (OR = 0.4 [CI = 0.1, 0.9] and OR = 0.3 [CI = 0.1, 0.7] respectively) after controlling for confounders in unconditional logistic regression analysis. Elevated risk factors included: smoking during pregnancy (OR = 1.6; CI = 0.9, 2.8), contracted pelvis (OR = 2.3; CI = 0.6, 9.8), birth injury (OR = 2.9; CI = 0.3, 24.9) and 1-min Apgar Score < or =3 (OR = 6.0; CI = 0.9, 38.6); all confidence intervals included one. These data suggest that extremes in gestation may be associated with a reduced risk, although aetiological mechanisms remain unknown. [ABSTRACT FROM AUTHOR]