The epidemiology of corticosteroid-induced osteoporosis a meta-analysis

While most molecular epidemiology studies are still using conventional disease diagnosis and classification systems, it is increasingly recognized that disease evolution represents inherently heterogeneous processes differing from person to person. Conceptually, each individual has a unique disease process different from any other individual (“the unique disease principle”), [20] [21] considering uniqueness of the exposome (a totality of endogenous and exogenous / environmental exposures) and its unique influence on molecular pathologic process in each individual. Studies to examine the relationship between an exposure and molecular pathologic signature of disease (particularly cancer ) became increasingly common throughout the 2000s. However, the use of molecular pathology in epidemiology posed unique challenges including lack of research guidelines and standardized statistical methodologies, and paucity of interdisciplinary experts and training programs. [22] Furthermore, the concept of disease heterogeneity appears to conflict with the long-standing premise in epidemiology that individuals with the same disease name have similar etiologies and disease processes. To resolve these issues and advance population health science in the era of molecular precision medicine , “ molecular pathology ” and “epidemiology” was integrated to create a new interdisciplinary field of “ molecular pathological epidemiology ” (MPE), [23] [24] defined as “epidemiology of molecular pathology and heterogeneity of disease”. In MPE, investigators analyze the relationships between; (A) environmental, dietary, lifestyle and genetic factors; (B) alterations in cellular or extracellular molecules; and (C) evolution and progression of disease. A better understanding of heterogeneity of disease pathogenesis will further contribute to elucidate etiologies of disease. The MPE approach can be applied to not only neoplastic diseases but also non-neoplastic diseases. [25] The concept and paradigm of MPE have become widespread in the 2010s. [26] [27] [28] [29] [30] [31] [32]

Overall, genital talc use was associated with an OR (95% CI) of (, ), with a trend for increasing risk by talc-years. Women who used talc were more likely to be older, heavier, asthma sufferers, and regular analgesic users--none of which was a confounder. Dose-responses were more apparent for premenopausal women, especially nonsmokers and those heavier or postmenopausal users of menopausal hormones (hormone therapy [HT]). Subtypes of ovarian cancer more likely to be associated with talc included invasive serous and endometrioid tumors and borderline serous and mucinous tumors. Premenopausal women and postmenopausal HT users with these subtypes who had accumulated >24 talc-years had ORs (95% CI) of (, ) and (, ), respectively.

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The epidemiology of corticosteroid-induced osteoporosis a meta-analysis

the epidemiology of corticosteroid-induced osteoporosis a meta-analysis

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