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oai:open-archive.highwire.org:amjepid:129/6/10952015-05-11HighWireOUPamjepid:129:6
A PREVALENCE STUDY OF VITAMIN A DEFICIENCY AND XEROPHTHALMIA IN NORTHEASTERN THAILAND
BLOEM, MARTIN W.
WEDEL, MICHEL
EGGER, ROBBERT J.
SPEEK, ANDRIES J.
CHUSILP, KUSUMA
SAOWAKONTHA, SASTRI
SCHREURS, W. H. P.
ORIGINAL CONTRIBUTIONS
An epidemiologic survey of the prevalence of xerophthalmia and vitamin A deficiency was conducted in May and June 1985 in a multistage random sample of 1,772 children 1–8 years of age from 16 rural villages and the capital city of the Sakon Nakhon province in northeastern Thailand. Data of clinical eye examinations were available for 92% (<it>n</it> = 903) of the eligible children aged 1–5 years (<it>n</it> = 982); history of night blindness was obtained from a reliable source from 93% (<it>n</it> = 1,644) of the whole sample; and biochemical data were available for 60% (1,060) of the children examined. The distribution of clinical signs of xerophthalmia and serum retinol levels differed between the rural and urban areas. In the urban area, no signs of xerophthalmia or deficient serum retinol levels were found in the preschool children examined. The prevalence of night blindness in the rural area was 1.3% in children aged 1–5 years (95% confidence interval (Cl) 0.7–1.9); Bltot's spots were seen in 0.4% (95% Cl 0.1–1.0); 12.7% (95% Cl 9.9–15.5) showed deficient serum retinol levels (<0.35μmol/liter). Of the children aged 1–8 years, 9.6% (95% Cl 7.8–11.4) showed deficient serum retinol levels. In the rural area, the prevalence of night blindness, Bitot's spots, and deficient serum retinol levels indicates a problem of public health importance according to World Health Organization criteria.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1095
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oai:open-archive.highwire.org:amjepid:129/6/11042015-05-11HighWireOUPamjepid:129:6
ELEVATED INTRASCROTAL TEMPERATURE AND THE INCIDENCE OF TESTICULAR CANCER IN NONCRYPTORCHID MEN
KARAGAS, MARGARET R.
WEISS, NOEL S.
STRADER, CLIFTON H.
DALING, JANET R.
ORIGINAL CONTRIBUTIONS
The possibility that intrascrotal temperature is involved in the etiology of testicular cancer was investigated through a population-based case-control study conducted in western Washington State. A total of 323 men with germ cell tumors of the testis diagnosed between 1977 and 1984 and 658 randomly selected controls were interviewed with regard to type of shorts worn, use of long underwear, heat-resistant clothing, and hot tubs or saunas, and a history of vancocele. No association was found between testicular cancer and having worn tight-fitting underwear (jockey shorts) or having worn heat-resistant clothing on the job. A 50% increase in risk was observed for men who typically wore long underwear for more than three months out of the year, but this association was within the limits of chance given no true association. A smaller fraction of the men with cancer than controls had used a hot tub or sauna in the preceding five years, but the size of the case-control difference was not related to the frequency of use. The relative risk associated with a history of physician-diagnosed varicocele was 1.8 (95% confidence interval 0.9–3.4). There was little difference between men with seminomas and those with other germ cell tumors regarding any of the above exposures. Taken in aggregate, these results provide little or no support for the hypothesis that intermittent intrascrotal temperature elevation, to the degree encountered by US men today, plays a role in the etiology of germ cell testicular cancer. The possibility that risk increases after a continuous temperature increase, such as might result from a vancocele, needs to be evaluated further.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1104
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oai:open-archive.highwire.org:amjepid:129/6/11102015-05-11HighWireOUPamjepid:129:6
PERIPHERAL ARTERIAL DISEASE IN LARGE VESSELS IS EPIDEMIOLOGICALLY DISTINCT FROM SMALL VESSEL DISEASE: AN ANALYSIS OF RISK FACTORS
CRIQUI, MICHAEL H.
BROWNER, DEIRDRE
FRONEK, ARNOST
KLAUBER, MELVILLE R.
COUGHLIN, STEVEN S.
BARRETT-CONNOR, ELIZABETH
GABRIEL, SAM
ORIGINAL CONTRIBUTIONS
The authors used noninvasive techniques, including flow velocity by Doppler ultrasound, to accurately assess and distinguish between large and small vessel peripheral arterial disease in a population study in southern California, 1978–1981. In 565 men and women aged 38–82 years, there were 69 cases of large vessel peripheral arterial disease, 19 of which were severe, and 90 cases of isolated small vessel peripheral arterial disease. In cross-sectional multivariate analysis in men, large vessel peripheral arterial disease was significantly associated with age, pack-years of cigarettes smoked, systolic blood pressure, fasting plasma glucose, and marginally with obesity. Similar analysis in women revealed significant associations only for age and systolic blood pressure, although the associations for pack-years of cigarettes, obesity, and low density lipoprotein cholesterol were suggestive. By contrast, isolated small vessel peripheral arterial disease was not significantly associated with any of the major cardiovascular disease risk factors, including two measures of carbohydrate metabolism, fasting plasma glucose and glycosylated hemoglobin. These findings, coupled with our earlier report that large vessel peripheral arterial disease but not isolated small vessel peripheral arterial disease was independently predictive of subsequent mortality, suggest that large vessel peripheral arterial disease and isolated small vessel peripheral arterial disease are epidemiologically, as well as pathophysiologically, distinct entities.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1110
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oai:open-archive.highwire.org:amjepid:129/6/11202015-05-11HighWireOUPamjepid:129:6
THE EPIDEMIOLOGY OF SERUM SEX HORMONES IN POSTMENOPAUSAL WOMEN
CAULEY, JANE A.
GUTAI, JAMES P.
KULLER, LEWIS H.
LEDONNE, DOROTHEA
POWELL, JOHN G.
ORIGINAL CONTRIBUTIONS
Serum sex hormones may be related to the risk of several diseases in postmenopausal women. In the current report, the authors examined the epidemiology of serum sex hormones in 176 healthy, white postmenopausal women (mean age 58 years) recruited from the metropolitan Pittsburgh, Pennsylvania, area. The data were collected during 1982–1983; none of the women were on estrogen replacement therapy. Serum concentrations of estrone, estradiol, testosterone, and androstenedione were measured by a combination of extraction, column chromatography, and radiolmmunoassay. Neither age nor time since menopause was a significant predictor of sex hormones. The degree of obesity was a major determinant of estrone and estradiol. The estrone levels of obese women were about 40% higher than the levels of nonobese women. There was a weak relation between obesity and the androgens. Cigarette smokers had significantly higher levels of androstenedione than nonsmokers, with little difference in serum estrogens between smokers and nonsmokers. Both estrone and estradiol levels tended to decline with increasing alcohol consumption. Physical activity was an independent predictor of serum estrone. More active women had lower levels of estrone. There was a positive relation of muscle strength with estrogen levels. The data suggest interesting relations between environmental and lifestyle factors and serum sex hormones. These environmental and lifestyle factors are potentially modifiable and, hence, if associations between sex hor mones and disease exist, modification of these factors could affect disease risks.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1120
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Copyright (C) 1989, Oxford University Press
oai:open-archive.highwire.org:amjepid:129/6/11322015-05-11HighWireOUPamjepid:129:6
EDUCATIONAL ATTAINMENT AND BEHAVIORAL AND BIOLOGIC RISK FACTORS FOR CORONARY HEART DISEASE IN MIDDLE-AGED WOMEN
MATTHEWS, KAREN A.
KELSEY, SHERYL F.
MEILAHN, ELAINE N.
MULLER, LEWIS H.
WING, RENA R.
ORIGINAL CONTRIBUTIONS
Epidemiologic investigations have shown that low socioeconomic status is related to ischemic coronary heart disease mortality in men and women as well as to major risk factors for coronary heart disease, predominantly in men. The present study investigated the associations between educational attainment and biologic and behavioral risk factors for coronary heart disease in a community sample of 2,138 middle-aged women residing in Allegheny County, Pennsylvania. The women were contacted between 1983 and 1985 to determine eligibility for a study of risk factor changes during the penmenopausal period. Eligibility criteria included age 42 to 50 years, premenopausal status, diastolic blood pressure <100 mmHg, and nonuse of medications known to influence risk factors. Among the 541 eligible participants, the less education the women reported, the more atherogenic was their risk factor profile, including higher systolic blood pressure, low density lipoprotein (LDL) cholesterol, apolipoprotein B, triglycerides, fasting and two-hour glucose values, two-hour insulin values, body mass indices, and lower high density lipoprotein (HDL) cholesterol and HDL/LDL ratio; the more often they reported being cigarette smokers, taking little physical exercise, and consuming alcohol less than one day a week; the more often they reported on standardized psychologic tests being Type B, angry, pessimistic, depressed, and dissatisfied with paid work, and having little social support and self-esteem (all <it>p</it> values <0.01). Similar associations were obtained between educational attainment and risk factors reported by the 1,588 nonparticipants during the telephone screening interview. These results suggest many biologic and behavioral factors by which women with little education are at elevated risk for coronary heart disease. To the extent that advanced education protects women against coronary heart disease, a potentially important public health intervention for women is education.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1132
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Copyright (C) 1989, Oxford University Press
oai:open-archive.highwire.org:amjepid:129/6/11452015-05-11HighWireOUPamjepid:129:6
SURROGATE MEASURES OF PHYSICAL ACTIVITY AND PHYSICAL FITNESS: EVIDENCE FOR SEDENTARY TRAITS OF RESTING TACHYCARDIA, OBESITY, AND LOW VITAL CAPACITY
BLAIR, STEVEN N.
KANNEL, WILLIAM B.
KOHL, HAROLD W.
GOODYEAR, NANCY
WILSON, PETER W. F.
ORIGINAL CONTRIBUTIONS
Studies on physical activity, physical fitness, and health have been hampered because of invalid, unreliable, or impractical measures of physical activity. This report examines the validity of sedentary traits (resting tachycardia, obesity, and low vital capacity) as predictors of physical fitness as assessed by a maximal treadmill exercise test. Study participants were women (<it>n</it> = 3,94.3) and men (<it>n</it> = 15,627) with at least one visit to the Cooper Clinic in Dallas, Texas. Association of the sedentary traits with physical fitness was examined by multiple regression analyses. Sedentary traits were associated with physical fitness in all age and sex groups, accounting for 12–40% of the variance in treadmill time. When smoking, a simple physical activity index, and sedentary traits were included in a model to predict physical fitness, <it>R</it>2 values ranged from 0.20 to 0.53 in women and 0.45 to 0.61 in men and were significant at <it>p</it> < 0.0001. These models account for approximately twice as much variance in physical fitness as has been reported previously. The addition of sedentary traits measurements to a simple physical activity index provides a valid estimate of physical fitness in epidemiologic studies.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1145
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oai:open-archive.highwire.org:amjepid:129/6/11572015-05-11HighWireOUPamjepid:129:6
RESPIRATORY SYMPTOMS, LUNG FUNCTION, AND MORTALITY IN A SCREENING CENTER COHORT
VOLLMER, WILLIAM M.
MCCAMANT, LYNN E.
JOHNSON, LARRY R.
BUIST, A. SONIA
ORIGINAL CONTRIBUTIONS
Numerous studies have documented the effects of smoking and reduced pulmonary function on all-cause mortality. The effects of respiratory symptoms are less well studied. This paper examines the joint effects of respiratory symptoms, lung function, and smoking using 11-year mortality data on 698 subjects aged 25 years and older. Copies of death certificates were obtained for all 120 confirmed deaths, and cause of death was coded by a nosologist using the rules of the <it>international Classification of Diseases</it>, Ninth Revision. Symptoms of cough/phlegm, wheeze, and dyspnea were significantly associated with all-cause mortality in separate univanate analyses. On a cause-specific basis, these associations appeared to hold for chronic obstructive pulmonary disease, lung cancer, and vascular disease. Further analysis indicated that, for both smokers and nonsmokers, the presence of chronic cough and/or sputum production was related to mortality only in the presence of wheezing. In addition, among smokers, the presence of both cough/phlegm and wheeze was significantly associated with mortality only among subjects with low initial lung function. Although the limited number of deaths and the nonrandom nature of the cohort limit the generalizability of our findings, it seems clear, based on these results and other published studies, that symptoms of cough, phlegm, and/or wheeze have important adverse health implications even in the absence of smoking and reduced lung function. More studies using common methodological approaches are needed.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1157
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oai:open-archive.highwire.org:amjepid:129/6/11702015-05-11HighWireOUPamjepid:129:6
HIGH INCIDENCE AND PREVALENCE OF RHEUMATOID ARTHRITIS IN PIMA INDIANS
PUENTE, ANTONIO DEL
KNOWLER, WILLIAM C.
PETTITT, DAVID J.
BENNETT, PETER H.
ORIGINAL CONTRIBUTIONS
A longitudinal epidemiologic study has been conducted to estimate the incidence and prevalence of rheumatoid arthritis in an American Indian population, the Pima and Papago Indians of Arizona. Clinical, serologic, and radiologic data were collected during biennial examinations of subjects aged 20 years or more during the period 1967–1986. Rheumatoid arthritis was diagnosed by criteria for the active and the inactive disease. Age-adjusted to the 1980 US population at least 20 years of age, the prevalence of classical and definite rheumatoid arthritis in 1984 was 5.3% (3.23% in males and 6.95% in females), a rate appreciably higher than that reported in studies in Rochester, Minnesota, and in Hiroshima and Nagasaki, Japan. Among Pimas, during the study period, 70 incident cases of rheumatoid arthritis occurred. The age-adjusted incidence rate was 42.2 cases per 10,000 person-years (29.7 in males and 51.8 in females), 10.3 times as high as the age-adjusted rate in Rochester (4.1/10,000 person-years), and 5.7 times as high as in Japan (7.4/10,000 person-years). Rates generally increased with age. No secular trend was found. On the basis of both prevalence and incidence data, this study confirms that rheumatoid arthritis does not have uniform occurrence in different populations. This has to be taken into account in the search for the factors related to the differences in risk of disease.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1170
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oai:open-archive.highwire.org:amjepid:129/6/11792015-05-11HighWireOUPamjepid:129:6
MORTALITY OF A RESIDENTIAL COHORT EXPOSED TO RADON FROM INDUSTRIALLY CONTAMINATED SOIL
KLOTZ, JUDITH B.
PETIX, JULIE R.
ZAGRANISKI, REBECCA T.
ORIGINAL CONTRIBUTIONS
A historical cohort mortality study was conducted in three neighborhoods of Essex County, New Jersey, to investigate the mortality patterns of persons who had inhabited 45 homes documented to be contaminated by radon gas emanating from radium processing waste. Residency history and vital status were collected for 752 persons, comprising 91% of the subjects enumerated who had resided in the index homes for at least one year during the years 1923–1983. Standardized mortality ratios (SMR) were used to compare the death rates of the study group with the death rates of the United States and New Jersey. While there were no statistically significant excesses of lung cancer for the cohort or its subgroups, an elevated mortality rate for lung cancer was found for white males in the comparison of lung cancer mortality rates in the United States (SMR = 1.5, 95% confidence interval (Cl) 0.7–2.7) and New Jersey (SMR = 1.7, 95% Cl 0.8–3.2). No excess of lung cancer was observed in females or nonwhites. The small size of the cohort and the inability to collect smoking histories or complete occupational data limited the study. Nevertheless, the degree of excess lung cancer among white males was in agreement with both the attributable and relative risk estimates per unit of exposure derived for radon from mining studies.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1179
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oai:open-archive.highwire.org:amjepid:129/6/11872015-05-11HighWireOUPamjepid:129:6
TEN-YEAR MORTALITY STUDY OF THE POPULATION INVOLVED IN THE SEVESO INCIDENT IN 1976
BERTAZZI, PIER ALBERTO
ZOCCHETTI, CARLO
PESATORI, ANGELA C.
GUERCILENA, STEFANO
SANARICO, MAURIZIO
RADICE, LAURA
ORIGINAL CONTRIBUTIONS
In 1976, an accidental explosion in a plant near Seveso, Italy, caused the contamination of a populated area by 2,3,7,8-tetrachlorodibenzo-<it>p</it>-dloxin (TCDD). The area was subdivided into three zones (A, B, and R) having decreasing mean levels of TCDD soil contamination. This study examines the mortality between 1976 and 1986 among the subjects, aged 20–74 years, who were resident In the area since the accident (<it>n</it> = 556 in zone A, <it>n</it> = 3,920 in zone B, <it>n</it> = 26,227 in zone R). Subjects' exposure was classified by residence. A referent cohort of 167,391 subjects who lived in the immediate surroundings was concurrently examined. Vital status ascertainment was successful for over 99% of the subjects. Increased mortality from cardiovascular causes was found; incident-related stressors were considered more relevant to increased mortality than was TCDD exposure. Mortality from several cancers was elevated. The increases in billary cancer (females), brain cancer, and lymphatic and hemopoietlc neoplasms (particularly leukemia in males) did not appear to result from chance, confounding, or information/comparison bias. However, no definite patterns related to exposure classification were apparent. Merely suggestive increases in soft tissue tumors and melanoma were also noted. Liver and breast cancer mortality tended to be below expectations. Interpretation is hampered by the short observation period, small number of deaths from certain causes, and poor exposure definition. Further research is in progress.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1187
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oai:open-archive.highwire.org:amjepid:129/6/12012015-05-11HighWireOUPamjepid:129:6
EFFECT OF PARENTS' OCCUPATIONAL EXPOSURES ON RISK OF STILLBIRTH, PRETERM DELIVERY, AND SMALL-FOR GESTATIONAL-AGE INFANTS
SAVITZ, DAVID A.
WHELAN, ELIZABETH A.
KLECKNER, ROBERT C
ORIGINAL CONTRIBUTIONS
Epidemiologic research on the effects of parental occupational exposures on fetal development has been limited. The National Natality and Fetal Mortality surveys obtained applicable data on probability samples of live births and fetal deaths which occurred in the US in 1980 among married women. Analyses were conducted for case groups of stillbirths (2,096 mothers, 3,170 fathers), preterm deliveries (<37 weeks completed gestation) (363 mothers, 552 fathers), and small-for-gestational-age infants (218 mothers, 371 fathers) compared with controls. Occupational exposures were defined by industry of employment and by imputed exposures based on a job-exposure linkage system. For stillbirth, maternal work in the rubber, plastics, and synthetics industry (odds ratio (OR) = 1.8, 95% confidence Interval (Cl) 0.8–4.0) and lead exposure (OR = 1.6, 95% Cl 0.8–3.1), and paternal employment in the textile industry (OR = 1.9, 95% Cl 1.2–2.9), had the largest odds ratios. Preterm birth was most strongly associated with maternal lead exposure (OR = 2.3, 95% Cl 0.7–7.0), corroborating previous findings. Twofold increased risk of preterm delivery was found with paternal employment in the glass, clay, and stone; textile; and mining industries. Paternal exposures to x-rays and polyvinyl alcohol were associated with 1.5-fold increase in risk. The occupation of the mother was not associated with delivery of a small-for-gestatlonal-age infant, in contrast to paternal employment in the art (OR = 2.6, 95% Cl 1.2–5.6) and textile industries (OR = 2.5, 95% Cl 1.3–4.7). Several toxic agents were associated with risk elevation of 1.3 or greater for fathers, most notably benzene (OR = 1.5, 95% Cl 1.1–2.3). In spite of limitations in the exposure data, the size of the exposed populations, and possible confounding, the results in this study encourage further evaluation of the effects of maternal exposure to lead and possibly solvents, as well as paternal exposure in the textile industry and to x-rays and benzene.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1201
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oai:open-archive.highwire.org:amjepid:129/6/12192015-05-11HighWireOUPamjepid:129:6
THE TUCSON CHILDREN'S RESPIRATORY STUDY: I. DESIGN AND IMPLEMENTATION OF A PROSPECTIVE STUDY OF ACUTE AND CHRONIC RESPIRATORY ILLNESS IN CHILDREN
TAUSSIG, LYNN M.
WRIGHT, ANNE L.
MORGAN, WAYNE J.
HARRISON, H. ROBERT
RAY, C. GEORGE
THE GROUP HEALTH MEDICAL ASSOCIATES,
ORIGINAL CONTRIBUTIONS
The Tucson Children's Respiratory Study, Tucson, Arizona, has been established as a long-term, longitudinal, prospective study of the risk factors for acute lower respiratory tract illnesses in early childhood and for chronic obstructive airways disease in later life. A total of 1,246 newborns were enrolled into the study between May 1980 and January 1984, representing 78% of eligible infants. Cord blood for immunologic studies, neonatal blood specimens for blood counts and differentials, and blood specimens at nine to 15 months of age for immunologic studies, blood counts, and differentials have been obtained on the majority of enrolled children. Pre-illness physiologic and more detailed immunologic studies have also been done on large subgroups of subjects. The majority of lower respiratory tract illnesses suffered by these children in the first three years of life have been assessed in detail for etiologic agents by means of culture and serologic techniques; 1,052 illnesses have been evaluated thus far. The type of illness and nature of etiologic agents are very similar to those reported in other epidemiologic studies. Thus, this group of enrolled infants and their family members constitute an appropriate population for the long-term study of risk factors for acute and chronic respiratory disorders.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1219
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oai:open-archive.highwire.org:amjepid:129/6/12322015-05-11HighWireOUPamjepid:129:6
THE TUCSON CHILDREN'S RESPIRATORY STUDY: II. LOWER RESPIRATORY TRACT ILLNESS IN THE FIRST YEAR OF LIFE
WRIGHT, ANNE L.
TAUSSIG, LYNN M.
RAY, C. GEORGE
HARRISON, H. ROBERT
HOLBERG, CATHARINE J.
THE GROUP HEALTH MEDICAL ASSOCIATES,
ORIGINAL CONTRIBUTIONS
Lower respiratory tract illnesses occurring during the first year of life in 1,179 healthy infants enrolled in the Children's Respiratory Study, Tucson, Arizona, are described. The children, who use the pediatricians of a health maintenance organization, were enrolled into the study between May 1980 and January 1984. Data were collected on signs, symptoms, and diagnosis for each illness; nasopharyngeal and throat swabs were collected at the acute visit for viral, chlamydial, and mycoplasmal cultures. The cumulative incidence of illness in the first year of life was 32.88 per 100 children. Of the 348 initial lower respiratory tract illnesses occurring in these infants, 60% were diagnosed as bronchiolitis. At least one infecting agent was identified in 66% of the specimens collected at the time of the first illness. Respiratory syncytial virus was the most common isolate; 12 other agents were also identified. There was a strong (p < 0.0001) relation between agent identified, symptoms reported, and diagnosis; bronchiolitis was predominantly associated with respiratory syncytlal virus and croup with parain fluenza viruses. Sex and ethnicity were unrelated to illness experience or to characteristics of the first illness. Lower respiratory tract illness occurrence in the Children's Respiratory Study appears to be similar to patterns observed elsewhere, suggesting that diagnoses (and infecting agents) have changed little over the past decades.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1232
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oai:open-archive.highwire.org:amjepid:129/6/12472015-05-11HighWireOUPamjepid:129:6
ASSOCIATION OF CHLAMYDIA TRACHOMATIS AND MYCOPLASMA HOMINIS WITH INTRAUTERINE GROWTH RETARDATION AND PRETERM DELIVERY: INVESTIGATORS OF THE JOHNS HOPKINS STUDY OF CERVICITIS AND ADVERSE PREGNANCY OUTCOME
ORIGINAL CONTRIBUTIONS
The authors conducted a prospective study of risk factors for intrauterine growth retardation (birth weight less than a standard (race- and sex-adjusted) 10th percentile for gestational age) and preterm birth (birth prior to 37 weeks gestation) in a high-risk, inner-city, obstetric population, with special interest in pathogens colonizing the maternal genital tract. A total of 801 women within 22 to 30 weeks of gestation were enrolled and interviewed. Subjects were cultured for <it>Gardnerella vaginalls</it>, group B streptococcus, <it>Trichomonas vaginalis, Neisseria gonorrhoeae, Bacteroides fragills, Mycoplasma hominis, Ureaplasma urealyticum, Chiamydia trachomatis</it>, and <it>Candida albicans</it>, and they were followed to delivery. Intrauterine growth retardation and preterm delivery occurred in 8% and 13% of these pregnancies, respectively. After adjustment for other important risk factors, colonization with C. trachomatis was significantly associated both with intrauterine growth retardation (odds ratio = 2.4, 90% confidence interval 1.32–4.18) and preterm delivery (odds ratio = 1.6, 90% confidence interval 1.0 1–2.50). Colonization with <it>C. albicans</it> was significantly associated with intrauterine growth retardation (odds ratio = 1.9, 90% confidence interval 1.20–3.14); colonization with <it>M. hominis</it> was significantly associated with preterm birth (odds ratio = 2.0, 90% confidence interval 1.42–2.93). These associations support the probable role of infection in preterm and intrauterine growth retardation births and suggest the need for carefully designed intervention studies.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1247
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oai:open-archive.highwire.org:amjepid:129/6/12582015-05-11HighWireOUPamjepid:129:6
HOSPITAL-ACQUIRED PNEUMONIA: ATTRIBUTABLE MORTALITY AND MORBIDITY
LEU, HSIEH-SHONG
KAISER, DONALD L.
MORI, MOTOMI
WOOLSON, ROBERT F.
WENZEL, RICHARD P.
ORIGINAL CONTRIBUTIONS
A total of 1,001 consecutIve episodes of nosocomlal pneumonia in 901 patients was identified by routine surveillance at the University of Virginia Medical Center between 1979 and 1983 (8.6 episodes/1,000 admissions). When only initial episodes were examined, 890 patients comprised the study sample. The overall case fatality rate was 30%. Stepwlse logistic regression Indicated that time from admission to pneumonia (<it>p</it> = 0.0006), age (<it>p</it> <0.0001), prior use of mechanical ventilation (<it>p</it> = 0.0032), and neoplastic disease (<it>p</it> = 0.0062) were associated with mortality. Multiple regression analysis indicated that the factors associated with increased length of hospitalization included posttracheostomy status (<it>p</it> = 0.0001), prior mechanical ventilation (<it>p</it> = 0.0001), immunosuppressive or leuko penic status (<it>p</it> = 0.0009), nasogastric intubation (<it>p</it> = 0.0003), and prior bacte remia (<it>p</it> = 0.0 127). A sampled, individually matched cohort study (<it>n</it> = 74 pairs) was conducted to determine the proportion of mortality in cases that was attributable to infections (33%) and to determine excess hospital stay (seven days) among the patients with nosocomial pneumonia. Excess stay was statisti cally significant (<it>p</it> < 0.0001), but proportional mortality was only marginally significant (p = 0.0892). Our findings suggest that nosocomial pneumonia ac counts for approximately 33% of the crude mortality and contributes significantly to the economic burden associated with prolonged hospitalization.
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1258
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oai:open-archive.highwire.org:amjepid:129/6/12682015-05-11HighWireOUPamjepid:129:6
THE INCIDENCE OF ACTIVE TUBERCULOSIS IN A LARGE URBAN AREA
ENARSON, DONALD A.
WANG, JIE-SIU
DIRKS, JOHN M.
ORIGINAL CONTRIBUTIONS
The author8 reviewed all cases of active tuberculosis newly reported to a population-based registry between 1970 and 1985 to compare a large urban area with the mostly rural remainder of the province of British Columbia, Canada. Although incidence rates have declined steadily in the rural area, they have not done so in the urban area. Within the urban area, there was a striking relation between tuberculosis incidence and socioeconomic level. Incidence rates in those born in Canada were observed to be higher for men than for women and higher for men who had never married than for those who had ever married, a difference no longer present within census tract groups. The greatest difference in incidence was between unemployed and employed men. Cases in the poorest census tracts more commonly had advanced, infectious pulmonary disease and were more likely to be alcoholics. The incidence of tuberculosis in the poorest census tracts did not decline as rapidly as In other areas. The characteristics of the disease in the poorest urban census tracts suggest the possibility of selective migration of persons at risk for tuberculosis and of continuing transmission of the disease and call for imaginative case-finding and treatment programs to address this problem.
Oxford University Press
1989-06-01 00:00:00.0
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COFFEE, DIETARY HABITS, AND SERUM CHOLESTEROL AMONG MEN AND WOMEN 35-49 YEARS OF AGE
SOLVOLL, KAR
SELMER, RANDI
LøKEN, ELIN B.
FOSS, OLAV P.
TRYGG, KERSTIN
ORIGINAL CONTRIBUTIONS
The relations between coffee and dietary habits and between coffee, dietary habits, and serum cholesterol were examined in 11,912 men and 12,328 women aged 35–49 years in the Cardiovascular Disease Risk Factor Study in Oppland, southern Norway, 1976–1978. Dietary data are based on results from a self-administered questionnaire. In both sexes, the dietary pattern of persons with a high coffee consumption differed from that of persons with a low coffee con sumption: Heavy coffee drinkers had a higher consumption of bread, potatoes, and butter or margarine per slice of bread and more frequent use of hard margarine; men had a higher consumption of eggs and a lower consumption of skim milk. These results suggest a higher total food and fat consumption and a lower ratio of polyunsaturated to saturated fatty acids among heavy coffee drinkers. However, only 20% of the variation in coffee consumption was explained by dietary and lifestyle variables. The study confirmed a positive relation between serum cholesterol and use of butter or hard margarine (p < 0.001) and between serum cholesterol and coffee consumption (p < 0.001). Bread consumption and mIlk consumption were negatively correlated to serum cholesterol. The negative association with skim milk was significant only in women (p < 0.01).
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1277
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FAMILIAL FACTORS RELATED TO LUNG FUNCTION IN ChILDREN AGED 6-10 YEARS: RESULTS FROM THE PAARC EPIDEMIOLOGIC STUDY
KAUFFMANN, FRANCINE
TAGER, IRA B.
MU{small tilde}OZ, ALVARO
SPEIZER, FRANK E.
ORIGINAL CONTRIBUTIONS
Familial factors related to lung function between six and 10 years of age have been studied among 1,160 children whose both parents were examined In 1975 In the French PAARC (Pollution Atmosphenque et Affections Resplratoires Chro niques) Cooperative Study. The three indices FVC (forced vital capacity), FEV (forced expiratory volume in one second), and FEF<inf>25–75</inf> (forced expiratory flow between 25 and 75 per cent of the vital capacity) were studied after adjustment for sex, town, age, and height (and weight for children's FVC and FEy Maternal (but not paternal) smoking was associated with a significant decrease in FE<inf>1</inf> and FEF<inf>25–75</inf> but not In FVC. Familial resemblance was observed for all Indices between children and parents and between siblings. None of the environmental factors considered (i.e., parental smoking or education) or body habitus explained the familial resemblance observed. Conversely, after taking into account the aggregation between siblings, associations between children's lung function and parental characteristics (smoking, lung function) remained significant Parental-children correlations exhibited an Increasing temporal trend with increasing age of the children. All but one correlation for FVC, FEV<inf>1</inf> and FEF<inf>25–75</inf> residuals of children with mothers' residuals were higher in the oldest age group compared with the youngest age group at the 0.10 level. Furthermore, correlations between siblings of opposite sex were significantly lower than correlations between siblings of like sex, especially for FEV<inf>1</inf>/FVC and FEF<inf>25–75</inf>/FVC. Results suggest that different growth patterns between boys and girls may be a critical factor in the study of lung function familial resemblance.
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1289
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ASSOCIATION OF OBESITY AND OVARIAN CANCER IN A CASE-CONTROL STUDY
FARROW, DIANA C.
WEISS, NOEL S.
LYON, JOSEPH L.
DALING, JANET R.
BRIEF REPORTS
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1300
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DIETARY INTAKE OF CAROTENE IN NONSMOKERS WITH AND WITHOUT PASSIVE SMOKING AT HOMIE
SIDNEY, STEPHEN
CAAN, BETFE J.
FRIEDMAN, GARY D.
BRIEF REPORTS
Oxford University Press
1989-06-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1305
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RE: EXACT REPRODUCTION OF SURVEY INSTRUMENT
Peterman, Thomas A.
Aral, Sevgi O.
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1310
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THE AUTHORS REPLY
Wingo, Phyllis A.
Chu, Susan Y.
Lee, Nancy C.
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1311-a
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RE: "THE EVALUATION OF THE DATA COLLECTION PROCESS FOR A MULTICENTER, POPULATION-BASED CASE-CONTROL DESIGN"
Longnecker, Matthew P.
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1311
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RE: "TOTAL ENERGY INTAKE: IMPLICATIONS FOR EPIDEMIOLOGIC ANALYSES"
Pike, Malcolm C.
Bernstein, Leslie
Peters, Ruth K.
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1312
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THE FIRST AUTHOR REPLIES
Howe, Geoffrey R
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1314-a
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THE AUTHORS REPLY
Willett, Walter C.
Stampfer, Meir J.
LETTERS TO THE EDITOR
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1314
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INDEX
INDEX
Oxford University Press
1989-06-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/129/6/1316
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