Data collected before the routine application of prenatal screening are of unique value in estimating the natural live-birth prevalence of Down syndrome. However, much of these data are from births from over 20 years ago and they are of uncertain quality. In particular, they are subject to varying degrees of underascertainment. Published approaches have used ad hoc corrections to deal with this problem or have been restricted to data sets in which ascertainment is assumed to be complete. In this paper we adopt a Bayesian approach to modelling ascertainment and live-birth prevalence. We consider three prior specifications concerning ascertainment and compare predicted maternal-age-specific prevalence under these three different prior specifications. The computations are carried out by using Markov chain Monte Carlo methods in which model parameters and missing data are sampled. 相似文献
ABSTRACTThe paper considers the case of vegetovascular dystonia, one of the most typical and common “Soviet” diseases. This syndrome emerged in Soviet medicine after World War II, and very quickly become a popular diagnosis among physicians. The author describes how the construct of vegetovascular dystonia was formed and developed, what changes it underwent, and what affected those changes. The concept and history of vegetovascular dystonia can provide an understanding of Soviet medicine and health science in general. 相似文献
The Rowlands Parental Alienation Scale (RPAS) was administered to 592 parents along with measures of convergent and discriminant validity. The scale was designed to capture the eight domains of parental alienating behavior posited in the literature. Factor analysis extracted only six factors, one of which was not included in the original eight: (a) campaign of denigration towards the alienated parent, (b) the independent thinker phenomenon, (c) reflexive support, (d) presence of borrowed scenarios, (e) spread of animosity to extended family, and (f) lack of positive affect towards the alienated parent. Parents who reported either that a court evaluation or court findings had confirmed the presence of parental alienation scored significantly higher on all six RPAS factors as well as on the overall RPAS score. 相似文献
Objective: Interleukin 18 (IL-18) is an adipokine associated with obesity. Data about the relationship of IL-18 to the metabolic syndrome (MS) are still scarce. Low testosterone (T) levels are common in men with MS, but we did not find data about the levels of IL-18 in men with low T. The aim of this study was to determine the levels of IL-18 in men with MS with or without low T. Patients and methods: A total of 251 men were included in the study. Of them 218 had MS (IDF 2005) and they were divided according to their morning total testosterone (TT) level (cutoff 10.4?nmol/l) into two groups: MS-low T (N?=?84) and MS-normal T (N?=?134). The control group consisted of 33 men without MS and low T. IL-18 was determined in serum using enzyme-linked immunosorbent assay. A small group of eight men with MS and low T levels received testosterone therapy for three months and physical and laboratory parameters were monitored at the end of that period.Results: MS men were at mean age (±SD)?=?53.77?±?9.59 years; body mass index (BMI)?=?34.0?±?6.3?kg/m2; and TT?=?12.59?±?5.66?nmol/l. The control group was at age?=?52.12?±?5.2 years (NS); BMI?=?25.6?±?2.4?kg/m2 (p?.001); and TT?=?17.8?±?5.68?nmol/l (p?.001), respectively. The levels of IL-18 were higher in the MS group – 345?pg/ml compared to the control one – 264?pg/ml (p?.01). There was no significant difference between MS-low T (330.6?pg/ml) and MS-normal T (350.2?pg/ml) subgroups. The MS-normal T differed more significantly from the control group (p?.001). Significant correlation of testosterone with IL-18 levels was not found. IL-18 correlated with parameters of obesity, lipids, fasting blood sugar (p?.05) and the number of criteria for MS (p?.001). Three months on T treatment showed improvement in obesity parameters and only in one patient IL-18 had clear reduction while the rest showed no change.Conclusions: In this study, higher IL-18 levels were found in the presence of MS compared to healthy men, but they did not differ between men having MS with or without LOH. 相似文献
Objective: This study set out to assess effects of testosterone replacement therapy (TRT) on parameters of metabolic syndrome and vascular function in obese hypogonadal males with type 2 diabetes mellitus (DM2).Study design: Fifty-five obese hypogonadal diabetic males on oral hypoglycemic treatment were enrolled into this one-year, double-blind, randomized, placebo-controlled clinical study. Group T (n?=?28) was treated with testosterone undecanoate (1000?mg i.m. every 10?weeks) while group P (n?=?27) received placebo.Methods: Anthropometrical and vascular measurements – flow-mediated dilatation (FMD) and intima media thickness (IMT) – biochemical and hormonal blood sample analyses were performed at the start of the study and after one year. Derived parameters (BMI, HOMA-IR, calculated free testosterone (cFT) and bioavailable testosterone (BT)) were calculated.Results: TRT resulted in reduction of HOMA-IR by 4.64?±?4.25 (p?.001), HbA1c by 0.94?±?0.88% points (p?.001), and an increase in FMD by 2.40?±?4.16% points (p?=?.005).Conclusion: TRT normalized serum testosterone levels, improved glycemic control and endothelial function while exerting no ill effects on the study population. 相似文献
Objective: The objective of this study is to investigate the impact of metabolic status on associations of serum vitamin D with hypogonadism and lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH).
Patients and methods: A total of 612 men underwent physical examination, biochemical/hormonal blood testing, and transrectal prostate ultrasound. Moreover, the subjects filled out standard questionnaires for identification and grading of LUTS and hypogonadism symptoms. Parameters were statistically compared with independent t-tests and correlation analyses.
Results: Vitamin D levels positively correlated with total testosterone (TT) but not with prostate volume or International Prostate Symptom Score (IPSS). Patients with metabolic syndrome had significantly lower vitamin D levels, which were not correlated with TT, prostate volume, or IPSS. However, vitamin D was positively correlated with TT, and negatively correlated with prostate volume and quality-of-life IPSS in subjects without metabolic syndrome.
Conclusion: The clinical usefulness of vitamin D for treatment of hypogonadism or LUTS/BPH varies according to metabolic status. 相似文献
Objectives: Metabolic syndrome (MtS) and kidney stone are two common aging diseases with male dominant. This is the first study regarding the potential impact of MtS and its components on kidney stone in aging Chinese population.Methods: A total of 694 males with a mean age of 55.6 years were enrolled. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. Subjects were classified as having a disease of kidney stones according to diagnosis by a physician with available medical records or evidence from ultrasonography judged by an investigator of urologist.Results: Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with kidney stone had significantly higher prevalence of MtS (p?=?0.04, OR?=?1.74, 95% CI: 1.0 1–3.00). The presence of MtS had significant correlation with kidney stone (p?=?0.01, OR?=?1.83, 95% CI: 1.1 4–2.93), which were associated with the increment of MtS components (p?0.01). After adjusting for age and testosterone level, abnormal blood pressure (BP) was the most significantly independent component of MtS for kidney stone among the MtS components (p?0.01, OR?=?2.81, 95% CI: 1.46–5.39).Conclusions: In aging Taiwanese males, the presence of MtS and its components are strongly associated with kidney stone. Abnormal BP is the most significant risk component of MtS for kidney stone. 相似文献
Introduction: Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin. Some studies suggest a possible link between low total testosterone (TT) levels and the presence of MetS.Aim: To analyze the strength and independence of associations between TT and MetS components in non-diabetic men.Methods: In this cross-sectional study, 143 non-diabetic men older than 40 were analyzed.Main outcomes measure: Blood samples were collected to evaluate metabolic profile and TT levels. MetS was defined as the presence of three or more of the following characteristics: fasting blood glucose levels?≥?100?mg/dL, triglyceride?≥?150?mg/dL, HDL-c?40?mg/dL, hypertension or blood pressure?≥?130/85?mmHg, and waist girth?>?102?cm.Results: Mean age of the study population was 61.5?±?8.61 years old. MetS was present in 47.9% of the individuals. Thirty-four men had low TT and MetS was observed in 23 (70%) against 50 (46%) in those with normal TT (≥?300?ng/dL) (OR 4.94, p?0.01), adjusted to confounder’s factors. In multiple linear regression analysis, only waist circumference (Beta: ?0.395; p?=?0.03) and HDL-c (Beta: 0.19; p?=?0.04) remained significantly correlated with TT levels.Conclusions: Low TT levels were associated with MetS diagnosis. Abdominal obesity was the MetS component independently correlated to low TT levels. 相似文献