Schizophrenia patients had markedly premature mortality, and the leading causes were ischemic heart disease and cancer, which appeared to be underdiagnosed. Preventive interventions should prioritize primary health care tailored to this population, including more effective risk modification and screening for cardiovascular disease and cancer.

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BackgroundThe epidemiology of metastatic gastric cancer is unexplored because cancer registries seldom cover metastatic involvement apart from “present or not”. We used a novel approach by utilizing Swedish registers to assess metastatic spread in gastric cancer. To our knowledge, this is the first nationwide description of metastases in gastric cancer.ResultsThe most common sites of metastasis were liver (in 48% of metastatic cancer patients), peritoneum (32%), lung (15%), and bone (12%). Metastases to the lung, nervous system, and bone were more frequent in cardia cancer and men, whereas non-cardia cancer more frequently metastasized within the peritoneum. Signet ring adenocarcinomas more frequently metastasized within the peritoneum, bone and ovaries, and less frequently to the lungs and liver compared with generic adenocarcinoma. The liver and the peritoneum were commonly single metastases while lung metastases occurred frequently together with liver metastases. The median survival in metastatic gastric cancer was 3 months, worst among those with bone and liver metastases (2 months).MethodsA total of 7,559 patients with gastric cancer were identified. Metastatic patterns and survival depending on sex, age, stage, anatomical location (cardia and non-cardia), and histological type were assessed.ConclusionsThe patterns of metastasis differ notably depending on histological type. Cardia cancer exhibits a completely different metastatic behavior than non-cardia cancer. Awareness of the differing patterns may guide in tailored diagnosis of metastases. Survivors from cardia cancer would benefit from increased surveillance of extraperitoneal metastases. Bone metastases should be considered in patients with signet ring adenocarcinoma if symptoms emerge.

Summary Background Elevated blood pressure and glucose, serum cholesterol, and body mass index (BMI) are risk factors for cardiovascular diseases (CVDs); some of these factors also increase the risk of chronic kidney disease (CKD) and diabetes. We estimated CVD, CKD, and diabetes mortality attributable to these four cardio-metabolic risk factors for all countries and regions between 1980 and 2010. Methods We used data on risk factor exposure by country, age group, and sex from pooled analysis of population-based health surveys. Relative risks for cause-specific mortality were obtained from pooling of large prospective studies. We calculated the population attributable fractions (PAF) for each risk factor alone, and for the combination of all risk factors, accounting for multi-causality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific PAFs by the number of disease-specific deaths from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all inputs to the final estimates. Findings In 2010, high blood pressure was the leading risk factor for dying from CVDs, CKD, and diabetes in every region, causing over 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths; and cholesterol for 10%. After accounting for multi-causality, 63% (10.8 million deaths; 95% confidence interval 10.1–11.5) of deaths from these diseases were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7.1 million deaths; 6.6–7.6) in 1980. The mortality burden of high BMI and glucose nearly doubled between 1980 and 2010. At the country level, age-standardised death rates attributable to these four risk factors surpassed 925 deaths per 100,000 among men in Belarus, Mongolia, and Kazakhstan, but were below 130 deaths per 100,000 for women and below 200 for men in some high-income countries like Japan, Singapore, South Korea, France, Spain, The Netherlands, Australia, and Canada. Interpretations The salient features of the cardio-metabolic epidemic at the beginning of the twenty-first century are the large role of high blood pressure and an increasing impact of obesity and diabetes. There has been a shift in the mortality burden from high-income to low- and middle-income countries.

The genetic changes that occur in cancer, whether these be mutations or alterations in levels of gene expression, become evident as changes in the phenotype of a specific cell type. In characterizing these phenotypic changes in malignancy, it is therefore important to work with the appropriate cells or cell lines. Breast cancers show the phenotype of the luminal epithelial cell (1), which can be cultured from milk, and cell lines have been developed from these milk cells which retain the luminal phenotype (2). One of these cell lines (MTSV1-7) has been used to look at the effect of overexpression of various oncogenes and proto-oncogenes on the behavioral properties of this cell type (3, 4).Overexpression of the c-ErbB2 receptor has been observed in a proportion of breast cancers and found to correlate with a poor prognosis (5), making signaling from this receptor an important parameter for investigation. To study the function of c-ErbB2 in human mammary epithelial cells, the receptor was overexpressed in MTSV1-7 cells to produce the ce-1 cell line (3). Unlike other receptors in the ErbB family, the c-ErbB2 homodimer has no known ligand, although c-ErbB2 can function as a heterodimeric receptor for the heregulin family of ligands with c-ErbB3 or c-ErbB4 or for EGF with c-ErbB1 (6 -9). Signaling from c-ErbB2 in overexpressing cells is, however, thought to be constitutive, operating through autophosphorylation of the homodimer, which forms because of overexpression (10).To look for genes whose expression is reversibly regulated by c-ErbB2 signaling as a homodimer, we have down-regulated c-ErbB2 phosphorylation using an antibody that has been shown to inhibit signaling from the receptor in breast cancer cell lines (11). In the humanized form (12), the antibody is under investigation in the clinic for the treatment of breast cancer (13). cDNAs prepared from ce-1 cells, treated or untreated with the antibody 4D5, were used to differentially screen filters from a fetal brain library using a computerized analysis (14), and a partial clone was isolated representing a novel sequence. Clones covering the full-length sequence (6.4 kb) 1 of the novel PLU-1 gene 2 were subsequently isolated by screening a breast cancer cDNA library.

IMPORTANCE Bipolar disorder is associated with premature mortality, but the specific causes and underlying pathways are unclear. OBJECTIVE To examine the physical health effects of bipolar disorder using outpatient and inpatient data for a national population. DESIGN, SETTING, AND PARTICIPANTS National cohort study of 6 587 036 Swedish adults, including 6618 with bipolar disorder.

The present study assessed subsequent cancer risks in type 2 diabetes patients first hospitalized for this disease at age >39 years. Twenty-four cancer types showed an elevated risk when follow-up was started after the last hospitalization for type 2 diabetes. No additional risk was found in familial diabetics.