Statin exposure and the risk of dementia in individuals with hypercholesterolaemia

OBJECTIVES

This study aimed to examine the association between statin exposure and dementia risk in individuals with hypercholesterolaemia using data from the NHIS-HEALS database between 2002 and 2015.

METHODS

Subjects were classified into statin exposure and statin nonexposure groups according to medication possession ratio. Dementia was defined as those with primary diagnostic dementia codes such as F00-F03, G30, G31.1, G31.9 or G31.82. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate the prospective association between statin exposure and dementia risk.

RESULTS

During the follow-up period (median follow-up 11.7 years), 711 cases of dementia occurred, accounting for 11.5% of the total study population (statin exposure group, 8.2%; statin nonexposure group, 12.9%). Compared to the statin nonexposure group, fully adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) for overall dementia in the statin exposure group were 0.63 (0.43-0.91) and 0.62 (0.50-0.78) in men and women, respectively. Compared to the statin nonexposure group, the HRs (95% CIs) for Alzheimer's disease and related dementia, vascular dementia and other types of dementia in the statin exposure group were 0.54 (0.32-0.91), 2.45 (0.69-8.68) and 0.59 (0.32-1.07), respectively, in men and 0.53 (0.38-0.73), 1.29 (0.42-3.96) and 0.70 (0.51-0.96), respectively, in women.

CONCLUSIONS

Hypercholesterolaemic individuals exposed to statin had a lower risk of overall dementia and Alzheimer's disease and related dementia in both sexes, and a lower risk of other types of dementia in women, than subjects who were not exposed to statins.

The importance of dermoscopy for the diagnosis of acquired bilateral telangiectatic macules: the angioid streak pattern reveals underlying chronic liver disease

BACKGROUND

Acquired bilateral telangiectatic macules (ABTM) are a newly recognized disease entity, which manifest as multiple telangiectatic pigmented macules confined mostly to the upper arms.

OBJECTIVES

To evaluate clinical and dermoscopic features in a group of 50 patients with ABTM and to determine the diagnostic usefulness of dermoscopy in ABTM.

METHODS

Patients were selected from two tertiary teaching hospitals in Korea [Pusan National University Hospitals (Busan and Yangsan)]. Fifty patients (41 males and 9 females; mean age 48.1 years; range 26-78 years) with ABTM were included in the study. The dermoscopic findings were graded using a 4-point scale: none (0), mild (1), moderate (2) and severe (3). In addition, the results of 23 patients with and 27 patients without chronic liver disease (CLD) were compared to determine whether the presence of CLD affects dermoscopic findings.

RESULTS

Three distinct dermoscopic patterns were observed; brown pigmentations, telangiectasia (linear-irregular vessels) and an angioid streak pattern. Brown pigmentation in the group without CLD had higher severity score than those in CLD group (mean score: 2.00 vs. 1.48, P = 0.033). However, mean telangiectasia severity score was higher in the CLD group (2.14 vs. 1.39, P < 0.001). The angioid streak pattern was more severe and more common in patients with CLD than in those without [1.37 vs. 0.35 (P < 0.001) and 63.0% vs. 26.1%, respectively].

CONCLUSIONS

Detailed observations with dermoscopy can provide first clues of the presence of ABTM and underlying chronic liver disease.

Tacrolimus-induced apoptotic signal transduction pathway

Tacrolimus (FK506) has been widely used as an immunosuppressant. We examined the effects of FK506 on expression of apoptotic signal transduction pathway proteins of Jurkat human T lymphocytes. We investigated the effects of FK506 on apoptosis, cell viability, caspase family protein activity, Western blotts of Bcl-2, Bak, Fas, Fas-L, CDK4, and cyclin D1, as well as reactive oxygen species (ROS) generation and mitochondrial membrane potential transition. Cells were cultured in the presence or absence of FK506. Flow cytometric analysis was performed after staining with propidium iodide. Viability of Jurkat cells was decreased by the addition of FK506 in dose- and time- dependent manner. FK506-induced cytotoxicity was characterized by G0/G1 phase cell cycle arrest. FK506-induced cell death was confirmed by apoptosis characterized by nuclear fragmentation and caspase-3 protease activation. FK506 induced no change in catalytic activity of caspase-6, -8, and -9 proteases. No change in expression of Bcl-2 protein was noted but we confirmed increased expression of Bak protein. No changes of expressions of Fas and Fas-L were seen. Increased expressions of CDK4 and cyclin D1 were identified. In addition, pharmacological scavenging study of ROS, including H2O2, revealed that cytotoxicity was achieved by generation of ROS, which might modulate Bak protein expression and mitochondrial dysfunction. In conclusion, FK506-induced cell death was apoptotic, characterized by nuclear fragmentation and caspase-3 activation. FK506 induced G0/G1 phase cell cycle arrest via expression of CDK4 and cyclin D1. Apoptosis was also achieved by generation of H2O2, which modulated Bak protein expression and mitochondrial dysfunction.

Effect of a DanJeon Breathing Exercise Program on the quality of life in patients with kidney transplants

This quasi-experimental study attempted to show that nursing intervention using the DanJeon Breathing Exercise Program (DJBEP) improved the quality of life of recipients after kidney transplantation. DJBEP progressed in three steps. We prospectively included 29 outpatient volunteers: experimental group: n = 15; control group: n = 14. DJBEP derived from the Roy's adaptation model decreased both the stress and the uncertainty of kidney transplantation recipients. It has also been shown to restore serum cholesterol and serum creatinine levels and enhance strength and flexibility. Simultaneously, self-esteem was enhanced, and eventually adaptation was promoted both physiologically and psychologically. The quality of life of kidney transplantation recipients was enhanced. DJBEP played an effective role as a nursing intervention to promote the quality of life of kidney transplant patients by increasing their physiological and psychological status.

A novel application of an anaerobic membrane process in wastewater treatment

The applications of membrane processes in anaerobic biological wastewater treatment still have some limitations due to severe membrane scaling and fouling, although they have been proven to achieve superior COD removal and biomass retention. An innovative anaerobic membrane process for wastewater treatment was conducted to control the membrane scaling problems. The process comprises an anaerobic reactor, an aerobic reactor, and a membrane separation tank. Anaerobic sludge from a full-scale UASB reactor treating food wastewater was inoculated to anaerobic and aerobic reactor to purify synthetic wastewater consisting of glucose and sodium acetate. The anaerobic reactor was operated in a sludge bed type without three-phase separator. The aerobic reactor can eliminate residual organics from the anaerobic reactor effluent using facultative microorganisms. To provide solid-liquid separation, hollow fiber ultrafiltration module was submerged in the separation tank. The results clearly show that the anaerobic membrane process combined methanogenic and aerobic COD reduction is a stable system. No fatal scaling was found after two months of operation even without chemical cleaning for the membrane. It was also found that inorganic precipitates formed in the aerobic reactor were reduced due to CO2 stripping in aerobic reactor. Another important finding was that the inorganic precipitates were entrapped into facultative aerobes floc. The ash/SS ratio of aerobes floc increased from 0.17 to 0.55 after 50 days of operation, which confirms this phenomenon. Based on our investigation, the new process can control scaling effectively to extend the membrane application in anaerobic treatment.

Young adult attachment styles and perceptions of elder abuse: a cross-cultural study

In this cross-cultural study of young adults' judgments of the abusiveness and typicality of caregivers abusive behaviors toward an elderly person, data were collected from 100 Caucasian-American and 115 Korean college students. All participants completed Bartholomew's four-category measure of attachment styles as well as Mills' Elderly Caregiving Questionnaire. The Korean college students judged material and physical maltreatment of an elderly person as significantly less abusive and psychological maltreatment as significantly more abusive than the Caucasian American students did. There were no gender differences in judgments of either the abusiveness or the typicality of the various forms of elder maltreatment. Multiple regression analyses revealed that both culture and insecure attachment contributed significantly to judgments of the abusiveness and typicality of aggressive and neglectful behaviors committed by a caretaker against an elderly person.

Broadcasting health programmes among audience and professionals in Korea: perceptions and needs

Mass media has become an essential part of modern society, and it should be noted that mass media plays an important role in delivering information even in the area of health. This study was intended to investigate the perceptions of and needs for broadcasting health programmes among audience and related professionals in Korea, which will serve to help in the development of valuable health programmes. Data were collected through a series of self-administered questionnaire surveys conducted on two types of subjects sampled from residents in the areas around Seoul, Korea, and health or broadcasting professionals working on health programmes. There were some discrepancies in the perceptions of and needs for health programmes between audience and professionals, especially the main audience age group and image, needs for topics and mode of health programme. In conclusion, in order to enhance current health programmes which focus on aspects of diagnosis and treatment of diseases, the range of health programmes should be expanded to fulfill various needs.