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Understanding of Tobacco and Lung Cancer Among Medical Students in Kathmandu University School of Medical Sciences (KUSMS)  [PDF]
Prashant Khatiwada,SR Kayastha,P Pant,KR Khanal,A Giri,P Khatiwoda,A Mali
Kathmandu University Medical Journal , 2012, DOI: 10.3126/kumj.v10i3.8022
Abstract: Background ?Often, lung cancer is diagnosed at terminal stages. Poor awareness about the symptoms or risk factors of lung cancer among medics may be one of the factors for delayed diagnosis. Objective ?We explored the knowledge of medical students and their behavior with the patients of lung cancer. Method ?Qualitative and quantitative approaches were used for data collection from 153 medical student of Kathmandu University School of Medical Sciences from December 2011 to May 2012. Results ?Among the results, eighty-nine students had over 80% knowledge of the 14 cancer warning signs, among them 83% knew the nine risk factors for lung cancer. Twenty-three students told lung cancer can be hereditary. Sixty five percent of all participants believed that lung cancer can be detected at early stage; of them 81% told that it can be treated. About 24% of the total students were current or ex-smokers and about half of them believed that lung cancer does not occur in light smokers. Only 10% have heard of Framework Convention on Tobacco Control in Nepal. Conclusion ?Study finds that all medical students who know about any cancers may not necessarily have knowledge about lung cancers. Their perception about the cause of lung cancer may be influenced by their smoking behavior and there was little knowledge of public health measures for smoking control. Awareness about national policies needs to be increased. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 60-65 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8022
Bronchogenic Carcinoma after Lung Transplantation: A Case Report and Literature Review  [PDF]
Yeming WANG,Jingyu CHEN
Chinese Journal of Lung Cancer , 2011,
Abstract: Background and objective Lung transplantation is an efficient therapeutic option for patients with end-stage pulmonary diseases, but less is known about lung cancer after lung transplantation. The aim of this study is to improve the awareness, diagnosis and treatment of bronchogenic carcinoma after lung transplantation with a case report and related literatures. Methods We reported a 65-year-old male with idiopathic pulmonary fibrosis (IPF) who underwent right lung transplantation under extracorporeal membrane oxygenation (ECMO) support in May 2007 in our hospital. The patient recovered smoothly and discharged from the hospital 46 days after the procedure with regular follow-up. Immunosuppression therapy was triple drug maintenance regimen including tacrolimus (Tac), mycophenolate mofetil (MMF) and steroids. Results Small cell lung cancer in the left lung with multiple osseous metastases was found 13 months after the lung transplantation. Symptoms were relieved a bit by administering chemotherapeutics (etoposide and cisplatin) for 4 cycles. However, the patient was succumbed to his illness within 11 months after the diagnosis of lung cancer. Conclusion Lung cancer after lung transplantation has been suggested as one of causes of late mortality with the risk factors such as chronic obstructive pulmonary disease (COPD), IPF, cigarette smoking history and immunosuppression etc. Early diagnosis and treatment are very important to improve the prognosis.
Public awareness of risk factors for cancer among the Japanese general population: A population-based survey
Manami Inoue, Motoki Iwasaki, Tetsuya Otani, Shizuka Sasazuki, Shoichiro Tsugane
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-2
Abstract: A nationwide representative sample of 2,000 Japanese aged 20 or older was asked about their perception and level of concern about various environmental and genetic risk factors in relation to cancer prevention, as a part of an Omnibus Survey. Interviews were conducted with 1,355 subjects (609 men and 746 women).Among 12 risk factor candidates, the attributable fraction of cancer-causing viral and bacterial infection was considered highest (51%), followed by that of tobacco smoking (43%), stress (39%), and endocrine-disrupting chemicals (37%). On the other hand, the attributable fractions of cancer by charred fish and meat (21%) and alcohol drinking (22%) were considered low compared with other risk factor candidates. For most risk factors, attributable fraction responses were higher in women than in men. As a whole, the subjects tended to respond with higher values than those estimated by epidemiologic evidence in the West. The attributable fraction of cancer speculated to be genetically determined was 32%, while 36% of cancer was considered preventable by improving lifestyle.Our results suggest that awareness of the attributable fraction of cancer causes in the Japanese general population tends to be dominated by cancer-causing infection, occupational exposure, air pollution and food additives rather than major lifestyle factors such as diet.In Japan, cancer has been recognized as a major component of the overall pattern of disease for decades. Thus, the importance of cancer prevention by lifestyle modification should now be strongly acknowledged.Internationally, several studies have estimated the proportion of total cancer deaths attributable to various risk factors based on epidemiologic evidence [1,2], and various international guidelines and recommendations derived from these have appeared [3-6]. Not surprisingly, domestic guidelines and recommendations for cancer prevention in Japan such as the 'Twelve recommendations for cancer prevention [7]' and 'Healthy Pe
Assessing awareness of colorectal cancer symptoms: Measure development and results from a population survey in the UK
Emily Power, Alice Simon, Dorota Juszczyk, Sara Hiom, Jane Wardle
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-366
Abstract: Items were taken from the literature and reviewed by expert groups. A series of three validation studies assessed reliability and validity of the measure. To establish test-retest reliability, 49 people over 50 years of age completed the Bowel/Colorectal CAM on two occasions (range 9-14 days, mean 13.5 days). Construct validity was assessed by comparing responses from bowel cancer experts (n = 16) and the lay public (n = 35). Lastly, a brief intervention study tested sensitivity to change with participants (n = 70) randomly allocated to be given a control leaflet or an intervention leaflet and their responses were compared.1520 respondents completed the Bowel/Colorectal CAM in a population survey carried out by TNS-British Market Research Bureau International (TNS-BMRB) in March 2010.Internal reliability (Cronbach's alpha = 0.84) was high. Test-retest reliability was over r = 0.7 for warning signs, risk factors and age people are first invited for screening, but lower (between 0.6 and 0.7) for other items (lifetime risk, awareness of bowel cancer screening, age at risk). Bowel cancer experts achieved higher scores than equally educated controls (54.7 [4.3] vs. 42.9 [5.7]; P < 0.001) demonstrating the measure has construct validity and intervention participants showed higher knowledge than controls (51.4 [5.9] vs. 42.9 [5.7]; P < 0.001) suggesting the measure is sensitive to change.Respondents recalled on average, one CRC sign and one risk factor. There was particularly low prompted awareness of the signs 'lump in the abdomen' (64%) and 'tiredness' (50%) and several lifestyle risk factors for CRC, e.g. exercise (37%).Respondents from more affluent groups had consistently higher knowledge of signs and risk factors compared to those from more deprived groups.The Bowel/Colorectal CAM meets accepted psychometric criteria for reliability and construct validity and should therefore provide a useful tool for assessment of CRC awareness. The population survey revealed low aw
Awareness and Prevalence of Myocardial Infarction and Hypertension in General Population of Surat City
Snehal Gandhi, Nisarg Chaudhari, Rushik Bhuva, Kallol Mallick, Bipin Vasava
National Journal of Community Medicine , 2010,
Abstract: The study used a cross-sectional survey, which was carried out in Surat population. The objective of this study was to examine the levels of awareness of myocardial infarction in Surat population. A total of 100 populations were randomly selected and were examined. From those, 100 (59 male and 41 female), 25a€“75 years of age, were included in the analysis. Every population was examined and questioner was filled in individual risks for myocardial infraction was assessed using self-reported information. In Surat, only a few years ago, there were very few data about hypertension prevalence and no data at all about hypertension awareness, treatment, and control. Therefore, the aim of the present study was to estimate the levels of prevalence, awareness, treatment, and control of hypertension in a general population.
Prevalence of gastroesophageal reflux symptoms in a large unselected general population in Japan  [cached]
Hatsushi Yamagishi, Tomoyuki Koike, Shuichi Ohara, Shigeyuki Kobayashi, Ken Ariizumi, Yasuhiko Abe, Katsunori Iijima, Akira Imatani, Yoshifumi Inomata, Katsuaki Kato, Daisuke Shibuya, Shigemitsu Aida, Tooru Shimosegawa
World Journal of Gastroenterology , 2008,
Abstract: AIM: To examine the prevalence of gastroesophageal reflux disease (GERD) symptoms in a large unselected general population in Japan.METHODS: In Japan, mature adults are offered regular check-ups for the prevention of gastric cancer. A notice was sent by mail to all inhabitants aged > 40 years. A total of 160 983 Japanese (60 774 male, 100 209 female; mean age 61.9 years) who underwent a stomach check up were enrolled in this study. In addition, from these 160 983 subjects, we randomly selected a total of 82 894 (34 275 male, 48 619 female; mean age 62.4 years) to evaluate the prevalence of abdominal pain. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a 1 mo period.RESULTS: The respective prevalences of the symptoms in males and females were: heartburn, 15.8% vs 20.7%; dysphagia, 5.4% vs 7.8%; and abdominal pain, 6.6% vs 9.6%. Among these symptoms, heartburn was significantly high compared with the other symptoms, and the prevalence of heartburn was significantly more frequent in females than in males in the 60-89-year age group. Dysphagia was also significantly more frequent in female patients.CONCLUSION: The prevalence of typical GERD symptoms (heartburn) was high, at about 20% of the Japan population, and the frequency was especially high in females in the 60-89 year age group.
Associations between respiratory symptoms, lung function and gastro-oesophageal reflux symptoms in a population-based birth cohort
Robert J Hancox, Richie Poulton, D Robin Taylor, Justina M Greene, Christene R McLachlan, Jan O Cowan, Erin M Flannery, G Peter Herbison, Malcolm R Sears, Nicholas J Talley
Respiratory Research , 2006, DOI: 10.1186/1465-9921-7-142
Abstract: Information on respiratory symptoms, asthma, atopy, lung function and airway responsiveness was obtained at multiple assessments from childhood to adulthood in an unselected birth cohort of 1037 individuals followed to age 26. Symptoms of gastro-oesophageal reflux and irritable bowel syndrome were recorded at age 26.Heartburn and acid regurgitation symptoms that were at least "moderately bothersome" at age 26 were significantly associated with asthma (odds ratio = 3.2; 95% confidence interval = 1.6–6.4), wheeze (OR = 3.5; 95% CI = 1.7–7.2), and nocturnal cough (OR = 4.3; 95% CI = 2.1–8.7) independently of body mass index. In women reflux symptoms were also associated with airflow obstruction and a bronchodilator response to salbutamol. Persistent wheezing since childhood, persistence of asthma since teenage years, and airway hyperresponsiveness since age 11 were associated with a significantly increased risk of heartburn and acid regurgitation at age 26. There was no association between irritable bowel syndrome and respiratory symptoms.Reflux symptoms are associated with respiratory symptoms in young adults independently of body mass index. The mechanism of these associations remains unclear.An association between symptoms of asthma and gastro-oesophageal reflux is now well-recognised, with a number of studies reporting a much higher prevalence of reflux symptoms in patients with asthma than in control subjects [1]. Objective measurements using endoscopy and oesophageal pH monitoring confirm a high prevalence of reflux in asthma [2,3].The association between gastro-oesophageal reflux and asthma could have several explanations [4]. Reflux may precipitate asthma, either via a vagal reflex initiated by gastric fluid in the oesophagus, or by micro-aspiration of gastric contents into the trachea. Conversely, asthma may promote reflux due to the increased pressure swings in the thorax during respiration [5,6]. During 24 hour monitoring of oesophageal pH and asthma symptom
Depressive Symptoms in a General Population: Associations with Obesity, Inflammation, and Blood Pressure  [PDF]
Yüksel Do?an,Altan Onat,Hasan Kaya,Erkan Ayhan,Günay Can
Cardiology Research and Practice , 2011, DOI: 10.4061/2011/740957
Abstract: To determine whether obesity, inflammation, or conventional risk factors are related to depressive symptoms (DeprSy) in the general population. Responses to 3 questions served to assess sense of depression. Body mass index (BMI), C-reactive protein (CRP), and other epidemiologic data of participants were available. In 1940, individuals who consulted a psychiatrist in the preceding year, or felt depressed (together DeprSy), 248 were female. Logistic regressions for adjusted associations of BMI with DeprSy were not significant as was serum CRP level. Diabetes and, in men, fasting glucose concentrations were associated with DeprSy. Systolic blood pressure (SBP) was robustly inversely associated with DeprSy in diverse models at ORs of 0.74 (95%CI 0.63; 0.89) independent of confounders, including antihypertensive and lipid-lowering medication. The use of antidepressants could not explain the reduced BP. Women are predisposed to depression with which, not BMI and CRP, but SBP is inversely associated. Anti-inflammatory substances produced in depressed persons might explain the slightly lower BP. 1. Introduction Evidence is available for the association of both obesity and depressive disorder with increased risk of coronary heart disease (CHD) incidence [1], mortality [2], hypertension [3] and diabetes [4]. Obesity is a greater risk factor than depression for metabolic complications and cardiovascular disease [5]. Depression and severity of depressive symptoms (DeprSy) are both important and independent risk factors for the development and progression of cardiovascular disease in the general population, as well as in patients with cardiovascular disease [6]. However, among 1794 participants of the population-based Canadian Nova Scotia Health Survey, increased inflammation explained only a very small proportion of the association between depression and incident CHD [7]. There may be a link between obesity and depression, but whether depression leads to obesity or obesity causes depression is unclear. A study that confirmed that obesity plays a pivotal role in inflammatory processes relevant to cardiovascular risk in women with polycystic ovary syndrome did not support a correlation of depression with chronic low-grade inflammation in this syndrome [8]. Underlying mechanisms such as chronic inflammation have been extensively investigated as candidate pathways that subsequently link obesity and depression in an attempt to explain how each confers vulnerability to the other and subsequently elevate as the risk for physical illness [9]. A number of cytokines were
Stroke awareness in the general population: knowledge of stroke risk factors and warning signs in older adults
Anne Hickey, Ann O'Hanlon, Hannah McGee, Claire Donnellan, Emer Shelley, Frances Horgan, Desmond O'Neill
BMC Geriatrics , 2009, DOI: 10.1186/1471-2318-9-35
Abstract: Randomly selected community-dwelling older people (aged 65+) in Ireland (n = 2,033; 68% response rate). Participants completed home interviews. Questions assessed knowledge of stroke warning signs and risk factors, and personal risk factors for stroke.Of the overall sample, 6% had previously experienced a stroke or transient ischaemic attack. When asked to identify stroke risk factors from a provided list, less than half of the overall sample identified established risk factors (e.g., smoking, hypercholesterolaemia), hypertension being the only exception (identified by 74%). Similarly, less than half identified established warning signs (e.g., weakness, headache), with slurred speech (54%) as the exception. Overall, there were considerable gaps in awareness with poorest levels evident in those with primary level education only and in those living in Northern Ireland (compared with Republic of Ireland).Knowledge deficits in this study suggest that most of the common early symptoms or signs of stroke were recognized as such by less than half of the older adults surveyed. As such, many older adults may not recognise early symptoms of stroke in themselves or others. Thus, they may lose vital time in presenting for medical attention. Lack of public awareness about stroke warning signs and risk factors must be addressed as one important contribution to reducing mortality and morbidity from stroke.Speedy access to acute medical services, particularly thrombolysis, is an important predictor of stroke outcome [1-4]. Rapid access to services requires that there is understanding of the warning signs for stroke. Knowledge of risk factors and warning signs in the general population has consistently been found to be poor, with knowledge levels poorest in groups that have the highest risk of stroke, e.g., those aged over 75 [5-10]. Even among those aware that they have a risk factor for stroke, knowledge of stroke warning signs has been found to be no better than for those without
Respiratory symptoms and occupation: a cross-sectional study of the general population
Roel Vermeulen, Dick Heederik, Hans Kromhout, Henri?tte A Smit
Environmental Health , 2002, DOI: 10.1186/1476-069x-1-5
Abstract: The study subjects (aged 20–59) were all inhabitants of Doetinchem, a small industrial town, and came from a survey of a random sample of 1104 persons conducted in 1993. A total of 274 cases with respiratory symptoms (subdivided in asthma and bronchitis symptoms) and 274 controls without symptoms were matched for age and sex. Relations between industry and occupation and respiratory symptoms were explored and adjusted for smoking habits and social economic status.Employment in the 'construction' (OR = 3.38; 95%CI 1.02 – 11.27), 'metal' (OR = 3.17; 95%CI 0. 98 – 10.28), 'rubber, plastics and synthetics' (OR = 6.52; 95%CI 1.26 – 53.80), and 'printing' industry (OR = 3.96; 95%CI 0.85 – 18.48) were positively associated with chronic bronchitis symptoms. In addition, the 'metal' industry was found to be weakly associated with asthma symptoms (OR = 2.59; 95%CI 0.87 – 7.69). Duration of employment within these industries was also positively associated with respiratory symptoms.Respiratory symptoms in the general population are traceable to employment in particular industries even in a contemporary cohort with relatively young individuals.Respiratory diseases such as asthma, bronchitis and emphysema form a major health problem in the general population in many western countries [1,2]. The evidence that these diseases are caused by exogenous factors other than tobacco smoke, and that occupational exposures are amongst these causes, is growing [3]. As the working population smokes less, the relative importance of occupational exposures causing respiratory diseases is likely to increase. The contribution of occupational exposure to respiratory diseases has been estimated at 11–19% for males and 4–5% for females [1,2,4,5].The relationships between occupation and occupational exposures and respiratory symptoms in community-based studies have been studied since the late 1970s. In many of these general population studies, an association with exposure to dust, gases and fumes has b
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