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WILLIAM HENRY HOWELL: PHYSIOLOGIST AND PHILOSOPHER OF HEALTH
FEE, ELIZABETH
REVIEWS AND COMMENTARY
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/293
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oai:open-archive.highwire.org:amjepid:119/3/3012015-05-11HighWireOUPamjepid:119:3
A SEMIQUANTITATIVE SCORE SYSTEM FOR EPIDEMIOLOGIC STUDIES OF FETAL ALCOHOL SYNDROME
VITÉZ, MARTHA
KORÁNYI, GEORGE
GONCZY, EVA
RUDAS, THOMAS
CZEIZEL, ANDREW
ORIGINAL CONTRIBUTIONS
Vit�z, M., G. Kor�nyl, E. G�nczy, T. Rudas and A. Czeizel (National Institute of Hygiene, H-1966 Budapest, Gy�ll ut 2–6, Hungary). A semiquantitative score system for epidemiologic studies of fetal alcohol syndrome. <it>Am J Epidemiol</it> 1984; 119: 301–8. A total of 464 children of 323 women registered for alcoholism treatment in Budapest, Hungary, were studied in 1977–1979. A complex epidemiologic investigation was carried out using medical, psychological and anthropological data. The data were evaluated on the basis of a semiquantitative diagnostic scoring system for fetal alcohol syndrome. The score distribution curve for 301 children whose mothers imbibed during pregnancy was statistically significantly different from the score distribution curve for 163 children born to alcoholic mothers who remained abstinent during pregnancy and from the curve for a matched control group of 464 children. A significant difference was also found between the score distribution curves for the latter two groups. Twenty-five children of 301 drinkers (8.3%) scored below -30 points and were said to show typical manifestations of the syndrome. All of the mothers in this group imbibed large amounts of alcohol during pregnancy. A further 205 children of 464 alcoholic mothers (44.2%) scored between -30 and -10 points and were diagnosed as having an atypical form of the syndrome. Among the 205 children, 168 were the offspring of 301 drinkers (55.8%) and 37 were the offspring of 163 alcoholic females who were abstinent during pregnancy (22.7%). A stepwise discriminant analysis showed the best discriminating variables—in order of entry into the discriminant functions—to be current weight, nose-upper lip distance, behavioral disturbance (irritability), root of the nose, intelligence quotient, and palpebral fissure. The most important cause of fetal alcohol syndrome is the direct toxic effect of alcohol on the fetus.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/301
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oai:open-archive.highwire.org:amjepid:119/3/3092015-05-11HighWireOUPamjepid:119:3
PREMATURITY AND OCCUPATIONAL ACTIVITY DURING PREGNANCY
MAMELLE, NICOLE
LAUMON, BERNARD
LAZAR, PHILIPPE
ORIGINAL CONTRIBUTIONS
Mameile, N. (INSERM U.170, 69622 Villeurbanne Cedex, France), B. Laumon and P. Lazar. Prematurity and occupational activity during pregnancy. <it>Am J Epidemiol</it> 1984; 119: 309–22. The aim of this study was to determine the elements of fatigue in occupations which constitute possible risk factors for the course of a pregnancy, and, in particular, that could cause premature birth. In 1977–1978, a total of 3437 women in France were surveyed after giving birth in two maternity hospitals. One hospital was located in Lyon (a large city) and the other in Haguenau (a small town). Among 1928 working women, it was found that certain occupational categories are more prone to risk of prematurity than others. The authors carried out an analytical breakdown of the job into its diverse components which led them to define five sources of fatigue and to construct an index capable of detecting the strenuous working conditions. There is a significant relationship between the prematurity rate and the number of high fatigue scores observed in the job. When the number of scores varies from 0 to 5 the rate of premature births increases from 2.3% to 11.1%. This relationship remains significant after controlling for confounding factors.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/309
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oai:open-archive.highwire.org:amjepid:119/3/3232015-05-11HighWireOUPamjepid:119:3
A COMPARISON OF FREQUENCY AND QUANTITATIVE DIETARY METHODS FOR EPIDEMIOLOGIC STUDIES OF DIET AND DISEASE
CHU, SUSAN Y.
KOLONEL, LAURENCE N.
HANKIN, JEAN H.
LEE, JAMES
ORIGINAL CONTRIBUTIONS
Chu, S. Y., L. N. Kolonel (Cancer Center of Hawaii, U. of Hawaii, Honolulu, HI 96813), J. H. Hankin and J. Lee. A comparison of frequency and quantitative dietary methods for epidemiologic studies of diet and disease. <it>Am J Epidemiol</it> 1984; 119: 323–34. Agreement between frequency and quantitative dietary methods was assessed for the ability of frequency intake data to substitute for quantitative intake data in diet-disease investigations. Frequency and quantitative Intakes of 342 male subjects participating in an ongoing case-control study in Hawali during 1981–1982 were obtained using a recall interview method designed to assess usual dietary habits. The extent of agreement between frequency and quantitative intakes of various dietary components (44 food items, 20 food groups, 8 nutrients) was determined at the group and individual subject levels, and with regard to specific study objectives. The results showed that for studies based on aggregate data, frequency and quantitative dietary methods will give reasonably comparable results in analyses Involving food items. However, for similar studies involving food groups and nutrients, and for all studies based on individual data, frequency dietary methods cannot be relied on to yield the same diet-disease associations as would corresponding quantitative methods.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/323
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oai:open-archive.highwire.org:amjepid:119/3/3352015-05-11HighWireOUPamjepid:119:3
THE PIMA INFANT FEEDING STUDY: BREAST FEEDING AND GASTROENTERITIS IN THE FIRST YEAR OF LIFE
FORMAN, M. R.
GRAUBARD, B. I.
HOFFMAN, H. J.
BEREN, R.
HARLEY, E. E.
BENNETT, P.
ORIGINAL CONTRIBUTIONS
Forman, M. R. (CDC, Atlanta, GA 30333), B. I. Graubard, H. J. Hoffman, R. Beren, E. E. Harley and P. Bennett The Pima infant Feeding Study: breast feeding and gastroenteritis in the first year of life. <it>Am J Epidemiol</it> 1984; 119: 335–49. In 1978, a retrospective study of infant feeding was conducted among 257 Pima indian women of reproductive age, who were residing on the Gila River Reservation, Arizona. With data on infant feeding patterns from 683 infants born 1950–1977 to the Pima indian women, infants were classified into one of five feeding groups based on the duration breast-fed and time of introduction and duration bottle-fed. History of severe diarrhea/diarrhea with dehydration/ diarrhea and vomiting was abstracted from the infant's medical record and classified as a case of gastroenteritis. The risk of developing a first such episode during the first year of life was compared between the exclusively bottle-fed and each of the other four feeding groups. The odds ratio of gastroenteritis during the first year was significantly less than unity for infants exclusively breast-fed for four months before adjustment (odds ratio = 0.49) and after adjustment for adverse social conditions and seasonality (odds ratio = 0.51). Similarly, univariate analysis and multiple logistic regression analysis of gastroenteritis from birth through four months revealed estimates of the odds ratio that were significantly less than unity for infants exclusively breast-fed for four months (odds ratio = 0.33 and 0.30, respectively). Although a trend of decreasing gastroenteritis with increasing breast feeding was noted across all other feeding groups, the rates of first episodes of gastroenteritis did not significantly differ among all other feeding groups and the bottle-fed. Thus, exclusive breast feeding for four months is associated with reduced risk of early first episodes of gastroenteritis among infants in a less developed community in the United States.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/335
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oai:open-archive.highwire.org:amjepid:119/3/3502015-05-11HighWireOUPamjepid:119:3
SEASONAL AND RACIAL INCIDENCE OF INFANTILE GASTROENTERITIS IN SOUTH AFRICA
ROBINS-BROWNE, ROY M.
ORIGINAL CONTRIBUTIONS
Robins-Browne, R. M. (Dept. of Microbiology, U. of Melbourne, Parkville, Victoria 3052, Australia). Seasonal and racial incidence of infantile gastroenteritis in South Africa. <it>Am J Epidemiol</it> 1984; 119: 350–5. The etiology of summer diarrhea, which formerly caused extensive mortality in children living in industrialized countries, was never discovered. This condition no longer occurs in developed countries, having been replaced by winter diarrhea, which is associated with a low mortality. Summer epidemics of diarrhea still take place in black South African infants, whereas, in white South African children, the pattern of diarrhea is similar to that seen in children in industrialized countries today. In 1977–1980, the author studied the records of patients less than two years of age admitted for treatment of dehydrating diarrhea to two teaching hospitals in Johannesburg, the Johannesburg General and Baragwanath Hospitals, which serve the needs of white and black patients, respectively. The incidence of severe diarrhea (I.e., diarrhea necessitating hos-pitalization) showed highly significant seasonallty (<it>p</it> < 0.001) and distinctive patterns by race. Dehydrating diarrhea in black children was strongly associated with warm weather, while diarrhea in white children occurred more regularly throughout the year, with a peak incidence in late fall. Laboratory studies have shown that bacteria, in particular “classical” enteropathogenic <it>Escherichia coli</it>, are the leading cause of diarrhea In black South African children, and that diarrhea in white children is largely attributable to rotaviruses. The association of enteropathogenic <it>E. coli</it> with diarrhea in black children suggests that these bacteria were responsible for earlier outbreaks of summer diarrhea. The finding that the etiology of diarrhea varies according to socioeconomic class has important implications for diarrhea control programs.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/350
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oai:open-archive.highwire.org:amjepid:119/3/3562015-05-11HighWireOUPamjepid:119:3
PSYCHOSOCIAL PROCESSES AND GENERAL SUSCEPTIBILITY TO CHRONIC DISEASE
REED, DWAYNE
McGEE, DANIEL
YANO, KATSUHIKO
ORIGINAL CONTRIBUTIONS
Reed, D. (Honolulu Heart Program, Honolulu, HI 96817), D. McGee and K. Yano. Psychosocial processes and general susceptibility to chronic disease. <it>Am J Epidemiol</it> 1984; 119: 356–70. The concept of general susceptibility to disease has developed as a unifying explanation for the findings that a variety of diseases are associated with certain social and cultural situations. This hypothesis was tested in a prospective study of 4251 men of Japanese ancestry in Hawaii who answered a psycho-social questionnaire in 1971. The seven-year incidence rates of coronary heart disease, stroke, cancer, and all deaths during the period December 1971-January 1979 were analyzed for association with individual questions and five summary scores measuring geographic and generational mobility, soclo-cultural and spousal inconsistency, and social networks. Among all questions and summary scores measuring mobility and inconsistency, there was only one statistically significant association with any disease, and this association was in the opposite direction to that predicted by the hypothesis. The measures of social networks were not associated with either the incidence of stroke, cancer, or all diseases combined, but were associated with coronary heart disease, as reported in detail earlier (Reed et al., <it>Am J Epidemiol</it> 1983; 117: 384–96). The authors examined the joint interaction of the postulated stressful processes of mobility and inconsistency with the protective effects of social networks, with special attention to the men in the highest levels of mobility and inconsistency. They found no significant associations, and thus there was no support for the hypothesis that social networks are especially protective among persons in the highest levels of mobility and inconsistency. The inclusion of known health hazards, cigarette smoking, and high systolic blood pressure levels did not alter these findings.
Oxford University Press
1984-03-01 00:00:00.0
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oai:open-archive.highwire.org:amjepid:119/3/3712015-05-11HighWireOUPamjepid:119:3
HEIGHT AND WEIGHT, MAMMOGRAPHIC FEATURES OF BREAST TISSUE, AND BREAST CANCER RISK
BRISSON, JACQUES
MORRISON, ALAN S.
KOPANS, DANIEL B.
SADOWSKY, NORMAN L.
KALISHER, LESTER
TWADDLE, JOHN A.
MEYER, JACK E.
HENSCHKE, CLAUDIA I.
COLE, PHILIP
ORIGINAL CONTRIBUTIONS
Brisson, J. (Dept. of Epidemiology, Harvard School of Public Health, Boston, MA 02115), A. S. Morrison, D. B. Kopans, N. L. Sadowsky, L. Kalisher, J. A. Twaddle, J. E. Meyer, C. I. Henschke and P. Cole. Height and weight, mam-mographic features of breast tissue, and breast cancer risk. <it>Am J Epidemiol</it> 1984; 119: 371–81. A case-control study was conducted to evaluate the association of body size with morphologic features of breast tissue visible on mammograms, and to analyze the interrelations of these factors with breast cancer risk. The cases were 362 women with newly diagnosed breast cancer identified in 1978–1979 in three large hospital-based xeromammography units in Boston, Massachusetts, and one unit in Livingston, New Jersey. The controls were 686 women referred to these units in the same period for a “routine” mammogram. The parenchymal pattern (N1, P1, P2, DY) and the per cent of the breast showing nodular densities were the principal mammographic features assessed. Among controls, body weight was strongly but inversely associated with the per cent of women who had the high risk P2 or DY patterns and with the mean per cent of the breast showing nodular densities. Body weight and the amount of nodular densities were both directly related to breast cancer risk. The strengths of the relations of body weight and of nodular densities to risk were each increased when the other factor was taken into account.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/371
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oai:open-archive.highwire.org:amjepid:119/3/3822015-05-11HighWireOUPamjepid:119:3
LEGIONNAIRES' DISEASE: THE EPIDEMIOLOGY OF TWO OUTBREAKS IN BURLINGTON, VERMONT, 1980
KLAUCKE, DOUGLAS N.
VOGT, RICHARD L.
LARUE, DENISE
WITHERELL, LINDEN E.
ORCIARI, LILLIAN A.
SPITALNY, KENNETH C.
PELLETIER, RAYMOND
CHERRY, WILLIAM B.
NOVICK, LLOYD F.
ORIGINAL CONTRIBUTIONS
Klaucke, D. N., R. L. Vogt (Vermont Dept. of Health, Burlington, VT 05401), D. LaRue, L. E. Witherell, L. A. Orclari, K. C. Spitalny, R. Pelletier, W. B. Cherry and L. F. Novick. Legionnaires’ disease: the epidemiology of two outbreaks in Burlington, Vermont, 1980. <it>Am J Epidemiol</it> 1984; 119: 382–91. Eighty-five cases of Legionnaires' disease were diagnosed in two major outbreaks at a large regional medical center in Burlington, Vermont, in the summer of 1980. Cases in both outbreaks were positive for <it>Legionelia pneumophlia</it>, serogroup 1 by culture, serology, or direct fluorescent antibody tests. All cases had spent time in the city of Burlington in the 10 days before the onset of symptoms. Cases in both outbreaks were both hospital- and community-acquired. A case-control study identified no common in-hospital exposure, including shower use, that was associated with illness. Cases without previous exposure to the hospital were more likely to occur in persons with residences in neighborhoods Just downwind of cooling tower A, but not throughout the municipal water system. Epidemiologic and environmental studies supported the association of this cooling tower, located 150 m from the hospital, with both outbreaks. Maintenance employees who worked with tower A had higher <it>Legionelia</it> titers than those who worked with a comparison tower located 1.6 km away. Aerosolization of <it>L. pneumophlia</it> by tower A and airborne spread to the hospital and community are postulated. The distance of airborne transmission of <it>L. pneumophlia</it> in these consecutive outbreaks is greater than previously reported.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/382
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oai:open-archive.highwire.org:amjepid:119/3/3922015-05-11HighWireOUPamjepid:119:3
FAILURE TO ACQUIRE EPSTEIN-BARR VIRUS INFECTION AFTER INTIMATE EXPOSURE TO THE VIRUS
CHANG, R. SHIHMAN
LE, CHINH T.
ORIGINAL CONTRIBUTIONS
Chang, R. S. (U. of California, School of Medicine, Davis, CA 95616), and C. T. Le. Failure to acquire Epstein-Barr virus infection after intimate exposure to the virus. <it>Am J Epidemiol</it> 1984; 119: 392–5. In 1981, 54 Epstein-Barr virus-seronegstive pregnant women in the Sacramento-Davis area of California were observed prospectively for an average duration of 12.1 months for Epstein-Barr virus-seroconversion. Only one se-roconverted. Two of the 54 women remained negative for Epstein-Barr virus antibody 4.5–5.0 months after their husbands were proved to be Epstein-Barr virus excreters. Short of experimental pharyngeal introduction of the virus into human volunteers, these data provide the most direct evidence possible that the intimate exposure of Epstein-Barr virus-seronegative adults to the virus does not necessarily result in infection.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/392
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oai:open-archive.highwire.org:amjepid:119/3/3962015-05-11HighWireOUPamjepid:119:3
RISK FACTORS FOR DIABETES IN THREE PACIFIC POPULATIONS
KING, HILARY
ZIMMET, PAUL
RAPER, L. ROBIN
BALKAU, BEVERLEY
ORIGINAL CONTRIBUTIONS
King, H. (World Health Organization Collaborating Centre for the Epidemiology of Diabetes Mellitus, Melbourne, Victoria 3162, Australia), P. Zimmet, L. R. Raper and B. Balkau. Risk factors for diabetes in three Pacific populations. <it>Am J Epidemiol</it> 1984; 119: 396–409. The association between the prevalence of diabetes and three suspected risk factors—overweight, physical inactivity, and urbanization—has been studied in 5519 subjects from three Pacific populations: Melanesians and migrant Asian indians in Fiji in 1980, and Micronesians in the Republic of Kiribati (formerly the Gilbert Islands) In 1981. Associations were found to be inconsistent between populations, and between the sexes within populations. In some cases, overweight was strongly associated with prevalence; in others, the principal variable associated with diabetes appeared to be physical inactivity. More than one factor was associated with increased risk in Micronesians, and some evidence of interaction between factors also emerged. Although longitudinal studies will be required for the complete elucidation of risk factors for diabetes, these findings suggest that risk factors may be heterogeneous in their effect upon different populations, and that an assessment of risk variables operating in a given target community may be of value in the initial phase of a diabetes prevention or control program.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/396
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oai:open-archive.highwire.org:amjepid:119/3/4102015-05-11HighWireOUPamjepid:119:3
PSYCHOSOCIAL PREDICTORS OF MORTALITY AMONG THE ELDERLY POOR: THE ROLE OF RELIGION, WELL-BEING, AND SOCIAL CONTACTS
ZUCKERMAN, DIANA M.
KASL, STANISLAV V.
OSTFELD, ADRIAN M.
ORIGINAL CONTRIBUTIONS
Zuckerman, D. M., S. V. Kasl (Yale U. School of Medicine, New Haven, CT 06510) and A. M. Ostfeld. Psychosocial predictors of mortality among the elderly poor: the role of religion, well-being, and social contacts. <it>Am J Epidemiol</it> 1984; 119: 41–23. Mortality data during a two-year follow-up were obtained on some 400 elderly poor residents of New Haven, Hartford, and West Haven, Connecticut, in 1972–1974. These subjects were cases and controls in a study of the health effects of residential relocation. Initial data collection included a detailed health history, sociodemographic and background variables, and a variety of behavioral and psychological data. The variables selected for analysis in this report were: religious beliefs, social contacts, feelings of well-being, and affective states. Stepwise logistic regressions were used to determine the role of these psychosocial variables in predicting mortality, while controlling for case/control status, demographic variables, and health status (measured by an index maximally predictive of mortality in this sample). Three psychosocial variables were significant predictors: religiousness, happiness (as rated by the interviewers), and presence of living offspring. The first two reduced the risk of mortality primarily among the elderly who were in poor health, while the third one did not interact with health status.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/410
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oai:open-archive.highwire.org:amjepid:119/3/4242015-05-11HighWireOUPamjepid:119:3
FAMILIAL CLUSTERING OF HEPATITIS B INFECTIONS IN GORILLAS
LINNEMANN, CALVIN C.
KRAMER, LYNN W.
ASKEY, P. ANNE
ORIGINAL CONTRIBUTIONS
Linnemann, C. C, Jr. (Division of infectious Diseases, U. of Cincinnati, Cincinnati, OH 45267), L. W. Kramer and P. A. Askey. Familial clustering of hepatitis B infections in gorillas. <it>Am J Epidemiol</it> 1984; 119: 424–30. Two families of gorillas, comprising 13 animals, were studied in 1980–1982 for hepatitis virus infections. It was found that 27% of them had evidence of hepatitis B infection, and 23% evidence of hepatitis A infection. The four parents had been born in the wild and all of them had been Infected with hepatitis B. The two patriarchs were positive for hepatitis B surface antigen (HBsAg) and one had hepatitis Be antigen (HBeAg). The two matriarchs had antibody to hepatitis B surface antigen. Three of the four parents had antibody to hepatitis A virus. The two gorillas with HBsAg were retested two years later and shown to be chronic carriers of HBsAg, subtype adw. Both were HBeAg positive at this time. Six of the nine children in the first generation born in captivity had antibody to hepatitis B, but none of them had antibody to hepatitis A. Two gorillas were documented by seroconversion to become infected with hepatitis B, indicating gorilla-to-gorilla transmission. During the course of this study, a recently employed keeper who had the most direct contact with the gorillas experienced an asymptomatic seroconversion to hepatitis B. This study indicates that hepatitis B in gorilla families in captivity may be a model of its behavior in human families, and that close, continuing contact with gorillas may be an occasional source of human infection.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/424
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oai:open-archive.highwire.org:amjepid:119/3/4312015-05-11HighWireOUPamjepid:119:3
EFFECTIVENESS OF GLYCOSYLATED HEMOGLOBIN, FASTING PLASMA GLUCOSE, AND A SINGLE POST LOAD PLASMA GLUCOSE LEVEL IN POPULATION SCREENING FOR GLUCOSE INTOLERANCE: THE ISRAEL STUDY OF GLUCOSE INTOLERANCE, OBESITY AND HYPERTENSION
MODAN, MICHAELA
HALKIN, HILLEL
KARASIK, AVRAHAM
LUSKY, AYALA
ORIGINAL CONTRIBUTIONS
Modan, M. (Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel), H. Halkin, A. Karasik and A. Lusky. Effectiveness of glycosylated hemoglobin, fasting plasma glucose, and a single post load plasma glucose level in population screening for glucose intolerance: the Israel Study of Glucose intolerance, Obesity and Hypertension. <it>Am J Epidemiol</it> 1984; 119: 431–44. Five shortcut methods of population screening for glucose intolerance (impaired glucose tolerance and non-insulin-dependent diabetes mellitus) were assessed for effectiveness: 1) glycosylated hemoglobin concentration (HbA1), 2) fasting plasma glucose level, 3) combinations of fasting plasma glucose and HbA1, 4) plasma glucose one hour post oral glucose load, and 5) plasma glucose two hour post oral glucose load. In a sample of the Israeli Jewish population aged 40–70 years, 2040 participants in the Israel Study of Glucose intolerance, Obesity and Hypertension, who were not known to be diabetic, underwent an oral glucose tolerance test based on three blood samples (fasting, one hour, and two hour post oral glucose load). In 1058 of the subjects, HbA1 was also measured, and was found to increase significantly (<it>p</it> < 0.001) with increasing glucose intolerance, but with extensive overlap of ranges, even between normals and newly found diabetics. Fasting plasma glucose was more effective than HbA1 in screening for both impaired glucose tolerance and diabetes by its higher specificity and predictive value of a positive test at comparable sensitivity levels. Combinations of HbA1 and fasting plasma glucose did not improve prediction over fasting plasma glucose alone. As observed in other studies, the screening effectiveness of fasting plasma glucose was also unsatisfactory, either post load glucose level being more effective. Plasma glucose level two hour post load was better for detection of diabetes alone. Plasma glucose level one hour post load was more effective at detecting the total group of glucose intolerance, but did not discriminate well between impaired tolerance and diabetes. A cost-risk-benefit evaluation suggests that a full three-sample oral glucose tolerance test is the best method in screening for both intolerance categories.
Oxford University Press
1984-03-01 00:00:00.0
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oai:open-archive.highwire.org:amjepid:119/3/4452015-05-11HighWireOUPamjepid:119:3
APPLICATION OF SIMULATION TECHNIQUES FOR ESTIMATING DURATION OF MULTIPLE SCLEROSIS DERIVED FROM PREVALENCE-FORMED COHORTS
CLARK, VIRGINIA A.
VISSCHER, BARBARA R.
DETELS, ROGER
VALDIVIEZO, NORA L.
MALMGREN, ROBERTA M.
DUDLEY, JAN P.
ORIGINAL CONTRIBUTIONS
Clark, V. A. (UCLA School of Public Health, Los Angeles, CA 90024), B. R. Visscher, R. Detels, N. L. Valdiviezo, R. M. Malmgren and J. P. Dudley. Application of simulation techniques for estimating duration of multiple sclerosis derived from prevalence-formed cohorts. <it>Am J Epidemiol</it> 1984; 119: 445–55. Comparisons of the average duration of multiple sclerosis derived from a prevalence survey of cases alive in 1970 in a low-risk area (Los Angeles County, California) and a high-risk area (King and Pierce Counties, Washington) suggest that patients in the high-risk area had a longer duration of disease than patients in the low-risk area. Because this finding was unexpected and because the underlying population of these two areas has been increasing at different rates, two simulation models were developed to estimate the duration of multiple sclerosis from a prevalence survey, taking into account the effects of changes in the population over time. Comparison of the durations derived from the two simulation studies suggested that underestimation of true backward recurrence time from the simulation studies was similar for the two study areas. Thus, the observed differences in duration between the two areas probably reflect the course of disease rather than differences in rate of growth of the two populations. These studies demonstrate the usefulness of simulation studies in estimating disease duration from cohorts derived from prevalence surveys of non-stable populations.
Oxford University Press
1984-03-01 00:00:00.0
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oai:open-archive.highwire.org:amjepid:119/3/4562015-05-11HighWireOUPamjepid:119:3
A CASE-CONTROL STUDY OF ASBESTOS IN DRINKING WATER AND CANCER RISK
POLISSAR, LINCOLN
SEVERSON, RICHARD K.
BOATMAN, EDWIN S.
ORIGINAL CONTRIBUTIONS
Polissar, L (Fred Hutchinson Cancer Research Center, Seattle, WA 98104), R. K. Severson and E. S. Boatman. A case-control study of asbestos in drinking water and cancer risk. <it>Am J Epidemiol</it> 1984; 119: 456–71. The authors conducted a case-control, interview-based study of the risk of developing cancer from asbestos in drinking water. The Everett, Washington area was selected for the study because of the unusually high concentration of chrysotile asbestos in the drinking water it draws from the Sultan River (200 � 106 fibers/liter). Through a population-based tumor registry, the authors identified 382 individuals with cancer of the buccal cavity, pharynx, respiratory system, digestive system, bladder, or kidney, diagnosed between 1977 and 1980, and then interviewed them or their next-of-kin. The authors conducted similar interviews of a control group of 462 individuals. Finally, interviews were validated in several ways, including comparing the collected data with that from secondary sources. Estimates of exposure to asbestos in drinking water were based on residence and workplace history, and on individual water consumption. Four different measures of exposure were used. Cancer risk was estimated by logistic regression and other methods. The authors found no convincing evidence for cancer risk from imbibed asbestos. Exposure was similar between cases and controls. Confidence intervals for relative odds for almost all sites included unity. Out of 84 dependent estimates of risk by sex, site, and exposure measure, 63 indicated a protective effect and 21 indicated an increased risk. In instances where relative odds differed appreciably from unity for both males and females, the effect was protective. The relative odds of cancer for 20 years of exposure to Sultan River drinking water varied from 0.92 to 0.99 for females and 0.82 to 1.01 for males for all study sites grouped. For cancer of the digestive system, the corresponding range was 1.03 and 1.08 for females and 0.85 to 1.00 for males. There were six statistically significant associations (<it>p</it> < 0.05). All involved male stomach (eight cases) and male pharynx (four cases), and indicate elevated risk. This number of significant associations is close to that expected (for the number of comparisons made). The female risks for these two sites indicate a protective effect, and it is concluded that the male results are probably due to chance.
Oxford University Press
1984-03-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/119/3/456
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