2024-03-29T10:04:44Zhttp://open-archive.highwire.org/handler
oai:open-archive.highwire.org:amjepid:114/4/4512015-05-11HighWireOUPamjepid:114:4
THE EPIDEMIOLOGIC IMPORTANCE OF PSYCHOSOCIAL FACTORS IN LONGEVITY
COHEN, JUDITH BLACKFIELD
BRODY, JACOB A.
REVIEWS AND COMMENTARY
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/451
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/4622015-05-11HighWireOUPamjepid:114:4
ALCOHOL AND OTHER DISCRIMINANTS BETWEEN CASES OF SUDDEN DEATH AND MYOCARDIAL INFARCTION
FRASER, GARY E.
UPSDELL, MARTIN
ORIGINAL CONTRIBUTIONS
A register of acute coronary events in Auckland, New Zealand collected data on both cases of definite myocardial infarction not dying suddenly, and cases of sudden cardiac death. This paper compares these two syndromes with respect to several clinical and pathologic variables. The following variables discriminated between these two syndromes significantly: season of the year, painful prodromal symptoms, use of digoxin and/or furosemide, age, race, alcohol consumption over the previous one year. Possible biases and sources of confounding are discussed. Heavy alcohol consumers have a higher proportion of coronary events as sudden deaths. This proportionate increase is probably due, in part at least, to an absolute increase in the frequency of sudden death. The data are supportive of the idea that persons with a high alcohol consumption who also suffer myocardial infarction are more likely to die suddenly with the infarction. The rather conflicting data from many other studies are discussed. A model is proposed, based on reported data, that could explain the present findings and those previously reported by others.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/462
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/4772015-05-11HighWireOUPamjepid:114:4
HEART RATE: A RISK FACTOR FOR CANCER?
PERSKLY, VICTORIA
DYER, ALAN R.
LEONAS, JOLITA
STAMLER, JEREMIAH
BERKSON, DAVID M.
LINDBERG, HOWARD A.
PAUL, OGLESBY
SHEKELLE, RICHARD B.
LEPPER, MARK H.
SCHOENBERGER, JAMES A.
ORIGINAL CONTRIBUTIONS
The relationship between heart rate and cancer mortality was examined in 3 Chicago epidemiologic studies: 1233 white men originally age 40–59 followed 18 years from the Chicago Peoples Gas Company study; 1899 white men originally age 40–55 followed 17 years from the Chicago Western Electric Company study; 5784 white men originally age 45–64 followed 5 years from the Chicago Heart Association Detection Project in Industry. There was a significant association between heart rate and cancer mortality in both univariate and muftivariate analyses in men from the Gas Company study and in men from the Chicago Heart Association study, but there was no association between heart rate and cancer mortality in men from the Western Electric study. The relationship persisted in the Gas Company study but not in the Chicago Heart Association study after eliminating deaths within the first 2 years of follow-up. With cancer deaths broken down by site, mortality from lung and colon cancer in the Gas Company study and mortality from lung cancer in the Chicago Heart Association study were significantly associated with baseline heart rate on univariate analysis and on bivarlate analysis controlling for age. Only colon cancer in the Gas Company, however, remained associated with heart rate when other variables were controlled. Thus, in 2 of the 3 studios examined, heart rate appeared to be an independent risk factor for cancer mortality in men.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/477
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/4882015-05-11HighWireOUPamjepid:114:4
EPIDEMIOLOGY OF PULMONARY EMBOLISM: MORTALITY IN A GENERAL POPULATION
SAMKOFF, JUDITH S.
COMSTOCK, GEORGE W.
ORIGINAL CONTRIBUTIONS
This report describes the basic epidemiologic characteristics of fatal pulmonary embolism as it was recognized in the adult white population of Washington County, Maryland, from 1963 to 1975. Demographic and personal characteristics considered are age, sex, marital status, educational level, adequacy of housing, cigarette smoking, and religious service attendance. There were 316 deaths with pulmonary embolism mentioned on the death certificate during the 12 years of this study. Death was attributed to pulmonary embolism in 55 Instances (17%) and to other thromboembolic diseases in 41 cases (13%). Age and educational level were the only sociodemographic variables significantly associated with risk of fatal pulmonary embolism. Mortality rose logarithmically with age up to age 75. Persons with less than 8 years of schooling had the highest rates, but the association with educational level was not linear. There was a suggestion that cigarette smoking was also associated with the certified presence of pulmonary embolism at death. Heart disease and cancer were mentioned on the death certificates of persons dying with pulmonary embolism less often than on death certificates in general, casting doubt on an etiologic association.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/488
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/4972015-05-11HighWireOUPamjepid:114:4
EXOGENOUS ESTROGENS AND ENDOMETRIAL CANCER: A CASE-CONTROL STUDY AND ASSESSMENT OF POTENTIAL BIASES
SPENGLER, ROBERT F.
CLARKE, E. AILEEN
WOOLEVER, C. ALLAN
NEWMAN, ALICE M.
OSBORN, RICHARD W.
ORIGINAL CONTRIBUTIONS
Eighty-eight cases with newly diagnosed carcinoma of the endometrium and 177 age-matched neighborhood controls were interviewed to test the hypothesis that exogenous estrogens lead to an increased risk of endometrial cancer. Forty-five per cent of the cases and 22% of the controls reported a history of estrogen use which yielded an odds ratio of 2.9 (confidence interval (Cl) 1.7–5.1). Women with five or more years of estrogen use had an odds ratio of 8.6 (Cl 3.2–23.0). Approximately 80% of the estrogen users hqd used conjugated equine estrogens. For these women the odds ratio was 4.0 (Cl 1.9–8.4) for daily dosages of more than 1 mg of estrogen. Several sources of bias which might affect the estrogen association were investigated. These included comparability of cases and controls, selection procedures, difference between estrogen users and nonusers, exclusion of controls who had hysterectomy, source of estrogen information, and differential recall. The concept of medical surveillance was evaluated by access to medical care and prior history of dilatation and curettage. The strong association between exogenous estrogen use and endometrial cancer remained after consideration for the effects of these biases.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/497
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5072015-05-11HighWireOUPamjepid:114:4
INDEPENDENT RISK FACTORS OF BENIGN AND MALIGNANT BREAST LESIONS
SOINI, I.
AINE, R.
LAUSLAHTI, K.
HAKAMA, M.
ORIGINAL CONTRIBUTIONS
The purpose of this study is to evaluate the risk factors of benign breast disease and to compare them with the known risk factors of breast cancer in order to make inferences on the relationship between benign breast disease and breast cancer. All benign breast lesions diagnosed from the population of the city of Tampere, Finland in 1974–1977 were reclassified by two pathologists into two groups of dysplasias and two groups of tumors. In the risk analysis of 422 age-matched pairs no group of benign lesions had risk factors consistently similar to those of breast cancer. It is therefore likely that either benign breast disease is not associated with breast cancer or it is an independent risk factor, not associated with the other high risk indicators of breast cancer.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/507
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5152015-05-11HighWireOUPamjepid:114:4
A SURVEY DIAGNOSTIC TOOL FOR SENILE DEMENTIA
PFEFFER, R. I.
KUROSAKI, T. T.
HARRAH, C. H.
CHANCE, J. M.
BATES, D.
DETELS, R.
BUTZKE, C.
ORIGINAL CONTRIBUTIONS
To validate a senile dementia survey diagnostic tool, 195 individuals aged 61–91 and referred by their physicians as normal or mildly demented were examined. The etlologic diagnosis used as criterion was the consensus of two experienced neurologists, assisted by clinical and laboratory data from referring physicians and by neuropsychologic evaluation of questionably affected persons. Agreement between the neurologists was high, as indicated by a weighted Kappa coefficient of 0.97 (95% confidence interval (Cl) (0.94, 1.00)). Agreement between the instrument and criterion diagnosis was also excellent (k = 0.93; 95% Cl (0.88, 0.98)). Used alone as a screening diagnostic tool, the cognitive function portion of the instrument was much more sensitive (0.929) than previously used brief tests and was acceptably specific (0.800). Because normals complete this cognitive test in 15–20 minutes, it should be a major advance in population-based studies of senile dementia and normal aging.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/515
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5282015-05-11HighWireOUPamjepid:114:4
RATES OF SYMPTOMS OF DEPRESSION IN A NATIONAL SAMPLE
EATON, WILLIAM
KESSLER, LARRY G.
ORIGINAL CONTRIBUTIONS
This paper is an analysis of data on symptoms of depression in a nation wide sample of adults, collected during the National Center for Health Statistics' first Health and Nutrition Examination Survey. The data are analyzed by a statistical adjustment procedure which assesses the impact of the major sociodemographic variables simultaneously, instead of one by one, which avoids a former major source of confusion. The measure of depression is the Center for Epidemiologic Studies Depression (CES-D) Scale. With the exception of race, the study replicates earlier findings. The adjustment procedure facilitates generalization of the results to other populations which are not demographically comparable, such as to smaller locales in the United States, or to populations defined by some criterion variable. Comparison of results is made with earlier work that used the identical measure of depression in two separate locales.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/528
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5392015-05-11HighWireOUPamjepid:114:4
THE RELATION OF ELECTRONIC FETAL MONITORING PATI TO INFANT OUTCOME MEASURES IN A RANDOM SAMPLE OF TERM SIZE INFANTS BORN TO HIGH RISK MOTHERS
MURPHY, JAMES R.
HAVERKAMP, ALBERT D.
LANGENDOERFER, SHARON
ORLEANS, MIRIAM
ORIGINAL CONTRIBUTIONS
In the rush to use a new medical technology the fact that relative risk is not a measure of the predictive validity of a variable is sometimes forgotten. In the present paper both the relative risk and predictive value of electronic fetal monitoring patterns are examined to see whether they are associated with problematic neonatal outcomes. It is shown that nonreassuring or ominous patterns are not good predictors of problematic neonatal outcomes. This suggests either that there is no risk associated with these patterns or if in fact there is such a risk, it is moderated by some as yet unknown variables between the time that the pattern is seen and the actual birth of the infant. This fact has implication for the management of labor and delivery using electronic monitoring equipment, since it appears that the use of such equipment will lead to a significant increase in the cesarean section rate. If this increase in the cesarean section rate comes about because of the assumed predictive value of a nonreassuring or ominous pattern, it may represent an unnecessary increase in cost and risk of delivery.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/539
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5482015-05-11HighWireOUPamjepid:114:4
SPONTANEOUS ABORTION OVER TIME: COMPARING OCCURRENCE IN TWO COHORTS OF WOMEN A GENERATION APART
WILCOX, ALLEN J.
TRELOAR, ALAN E.
SANDLER, DALE P.
ORIGINAL CONTRIBUTIONS
A prospective study of menstrual cycles and reproductive outcomes has been in progress since 1935. Data from this study are used to describe the risk of spontaneous abortion in two time periods 26 years apart Out of the total of 3889 women who have enrolled in this study, two cohorts of women are selected for analysis: cohort one consists of 2070 university students who entered the study in 1935–1944, and cohort two consists of 1375 students a generation later, 1961–1970. Cohort one has contributed 2408 pregnancies, and cohort two, 1493 pregnancies. Overall spontaneous abortion risk for the two cohorts is 16.9% and 13.1%, respectively. However age-specific risks of spontaneous abortion do not differ for the two groups, nor is there a difference in the gestational duration of spontaneously aborted pregnancies.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/548
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5542015-05-11HighWireOUPamjepid:114:4
THE SEROEPIDEMIOLOGY OF HEPATITIS IN PAPUA NEW GUINEA: I. A LONG-TERM STUDY OF HEPATITIS A
HAWKES, ROYLE A.
BOUGHTON, CLEMENT R.
FERGUSON, VICKI
ORIGINAL CONTRIBUTIONS
Sera from 988 subjects in four ecologic zones of the Sepik district and 219 subjects from four widely spaced altitudes of the Bismarck range in Papua New Guinea were tested for antibody to the hepatitis A virus (anti-HAV) by radioimmunoassay. The Sepik district subjects, mostly children between three months and six years of age when first sampled in 1963, were re-bled on four occasions over the ensuing nine years. The Bismarck range population was sampled only in 1964. In the Sepik district, anti-HAV was detected infrequently before the age of three years and showed maximum increase in prevalence rates between 7-10 years, with little increase thereafter. Antibody acquisition rates also indicated peak transmission in this age group, with fewer conversions between three months and six years of age and in adulthood. There was a consistent, though unexplained tendency for HAV infections to occur more frequently in proximity to the Sepik river than in areas farther away, and in the lower altitudes of the Bismarck range. As determined by serial samples, anti-HAV detected in 1963–1964 was still present in 1972 in 118 out of 119 subjects.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/554
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5632015-05-11HighWireOUPamjepid:114:4
THE SEROEPIDEMIOLOGY OF HEPATITIS IN PAPUA NEW GUINEA: II. A LONG-TERM STUDY OF HEPATITIS B
HAWKES, ROYLE A.
BOUGHTON, CLEMENT R.
FERGUSON, VICKI
VALE, TREVOR G.
ORIGINAL CONTRIBUTIONS
Sera from 862 young children and 206 oider subjects, living in four zones of the Sepik district in New Guinea, and obtained in March, August, December 1963, May 1964 and again in 1972, were tested for the hepatitis B virus (HBV) markers, surface antigen and antibody (HBsAg and anti-HBs) and core antibody (anti-HBc). This population was augmented by a group of adult women living at various altitudes in the Bismarck range area, upon whose sore the same tests were performed. There was a slight tendency for males to exceed females in HBV infections and in propensity to chronic carriage of HBsAg. HBV infections increased cumulatively with age in all ecoioglc zones studied, with no significant increase in prevalence after early adulthood. in the Sepik district, the HBV status of the population was reiatlvety the same in 1963 and 1972. Overall, 64% of markers of HBV infection persisted over a nine-year period; anti-HBc was more persistent than anti-HBs. Most HBsAg positive subjects detected were chronic carriers, 74% of whom retained de tectable antigen for at least nine years. The study provided no evidence to support the hypothesis that mosquitoes are important vectors of HBV. The proportion of HBV infected subjects with chronic HBsAg was about 15%, simliar to that found in Caucasians in other studies. This casts some doubt on the theory that tropical populations are especially predisposed to chronic HBV infection.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/563
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5742015-05-11HighWireOUPamjepid:114:4
SATURDAY NIGHT FEVER: A COMMON-SOURCE OUTBREAK OF RUBELLA AMONG ADULTS IN HAWAII
MARKS, JAMES S.
SERDULA, MARY K.
HALSEY, NEAL A.
GUNARATNE, METHSIRI V. H.
CRAVEN, ROBERT B.
MURPHY, KEVIN A.
KOBAYASHI, GLEEN Y.
WIEBENGA, NED H.
ORIGINAL CONTRIBUTIONS
During the summer of 1977, an epidemic of rubella occurred among adults in Hawaii. The highest attack rate was in women 20–24 years old (226/100,000), with almost total sparing of young schoolchildren. A case-control investigation implicated a specific discotheque as a common place of exposure for persons with onset of disease during the epidemic peak (x2= 12.9 <it>p</it> < 0.001). A piano player/singer at the discotheque was the apparent source of the virus transmission. The large number of cases linked to this musician suggests that airborne transmission occurred while he was singing rather than by direct person-to-person contact. Rubella vaccine was given to 6523 women in public clinics held during the epidemic. Despite screening for pregnancy and birth control usage, 23 women (3.5/1000) became pregnant within three months after receiving the vaccine. Eleven of 12 women who reportedly contracted natural rubella while pregnant elected to terminate their pregnancies; the 12th had a normal appearing infant. The susceptibility rate for all adults tested for rubella hemagglutination inhibition antibody was 36.9%, a rate similar to that found in earlier surveys in Hawaii. The occurrence of this epidemic confirms the changing epidemiology of rubella with respect to age distribution and supports the view that vaccination of young children may not be sufficient to protect adult women from exposure to rubella, especially in areas where a high proportion of adults remain susceptible.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/574
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5842015-05-11HighWireOUPamjepid:114:4
NORWALK-RELATED VIRAL GASTROENTERITIS DUE TO CONTAMINATED DRINKING WATER
TAYLOR, JOHN W.
GARY, G. WILLIAM
GREENBERG, HARRY B.
ORIGINAL CONTRIBUTIONS
An explosive outbreak of gastrointestinal illness clinically compatible with infection by an agent serologically related to Norwalk virus agent occurred in an elementary school in May 1978. Seroconversion by radiolmmunoassay to the Norwalk antigen was noted in two of three III persons, but no viral particles were identified in stool. Illness developed in 72% of students and teachers at the school, and 32% of household contacts of these ill persons. Of household contacts of persons exposed at school but not clinically ill, 11% developed illness. This value, however, was not statistically diflerent from the level of illness observed concurrently in household contacts of students at an unaffected school nearby. Epidemiologic investigation implicated water as the mode of transmission. Average consumption of one or more glasses per day was strongly associated with illness (<it>p</it> < 0.00000001). Among soccer team members with limited school contact, water consumption at the school was as sociated with a 14-fold greater risk of illness (<it>p</it> < 0.000001). Drinking water was most likely contaminated by back-siphonage through a cross-connection between the school's well and septic tank. This contamination occurred approximately 24 to 36 hours before the outbreak developed.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/584
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/5932015-05-11HighWireOUPamjepid:114:4
CONFOUNDING: ESSENCE AND DETECTION
MIETTINEN, OLLI S.
COOK, E. FRANCIS
ORIGINAL CONTRIBUTIONS
Confounding is examined from first principles. in follow-up studies a confounder is a predictor of diagnosing the illness–by being either a risk indicator or a determinant of diagnostic errors; in addition, it shows different distributions between the exposed and nonexposed series. In case-referent studies confounding can arise in two ways. A priori confounders are correlates of exposure in the joint source population of cases and reference subjects; also, they are determinants of diagnosing the illness or have different selection implications between cases and referents. In addition, factors bearing on the accuracy of exposure information are confounders if distributed differently between cases and referents. Criteria based singularly on relationships in the data can be misleading. Similarly, a change in the estimate and even a change in the parameter as a result of control is not a criterion rooted in first principles of confounding and can lead to a false conclusion.
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/593
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/6042015-05-11HighWireOUPamjepid:114:4
AGE-SPECIFIC SECULAR CHANGES IN ORAL CONTRACEPTIVE USE
Shapiro, Samuel
Stone, Dennis
Neff, Edgar R.
LETTERS TO THE EDITOR
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/604
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/6052015-05-11HighWireOUPamjepid:114:4
RE: "REPLACEMENT ESTROGENS AND BREAST CANCER": VARIANCE ESTIMATES IN COHORT STUDIES WITH SAMPLING FOR COVARIATES
Walker, Alexander M.
LETTERS TO THE EDITOR
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/605
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/6062015-05-11HighWireOUPamjepid:114:4
RE: "RISK FACTORS FOR BENIGN BREAST DISEASE"
Lance, Larrie L.
LETTERS TO THE EDITOR
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/606
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/6072015-05-11HighWireOUPamjepid:114:4
ON THE AMERICAN COLLEGE OF EPIDEMIOLOGY
Davis, Robert
LETTERS TO THE EDITOR
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/607
en
Copyright (C) 1981, Oxford University Press
oai:open-archive.highwire.org:amjepid:114/4/6082015-05-11HighWireOUPamjepid:114:4
DR. LILIENFELD REPLIES
Lilienfeld, Abraham M.
LETTERS TO THE EDITOR
Oxford University Press
1981-10-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/114/4/608
en
Copyright (C) 1981, Oxford University Press