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oai:open-archive.highwire.org:amjepid:131/1/12015-05-11HighWireOUPamjepid:131:1
RANDOM DIGIT DIALING FOR CONTROL SELECTION: A REVIEW AND A CAUTION ON ITS USE IN STUDIES OF CHILDHOOD CANCER
GREENBERG, E. R.
REVIEWS AND COMMENTARY
Random digit dialing is an effective method for creating a probability sample of households for telephone interviews. Epidemiologists have successfully used the technique to select controls for population-based case-control studies. However, a modified version of random digit dialing used in some institution-based studies of childhood cancer etiology involves a selection process which is biased against children from families with closely spaced births. The author discusses alternative approaches to reducing this bias in control group selection.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/1
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1042015-05-11HighWireOUPamjepid:131:1
EFFECT OF MATERNAL WORK ACTIVITY ON PRETERM BIRTH AND LOW BIRTH WEIGHT
TEITELMAN, ANNE M.
WELCH, LAURA S.
HELLENBRAND, KAREN G.
BRACKEN, MICHAEL B.
ORIGINAL CONTRIBUTIONS
The association of the prolonged standing required by certain jobs with the rate of preterm births and low birth weight deliveries was examined in New Haven, Connecticut, between 1980 and 1982. In a sample of 1,206 women, the rate of preterm births (births occurring <37 weeks from the last menstrual period) was higher among women with Jobs requiring prolonged standing (7.7%) compared with those with sedentary (4.27%) or active jobs (2.8%). The odds of preterm delivery in the standing group was 2.72 (95% confidence interval of 1.24–5.95). A significant association between standing on the Job and preterm birth was demonstrated when adjustment was made for the following variables in a logistic regression model: parity, smoking, education, caffeine use, marijuana use, race, gestational age at interview, and marital status. The low birth weight (<2,500 g) rate was higher among those in the standing group (5.5%) compared with those in the sedentary (4.0%) and active groups (4.0%), but this association was not significant when confounding factors were controlled.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/104
en
Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1142015-05-11HighWireOUPamjepid:131:1
PRENATAL EXPOSURE TO IONIZING RADIATION AND SUBSEQUENT DEVELOPMENT OF SEIZURES
DUNN, KIMBERLY
YOSHIMARU, HIROSHI
OTAKE, MASANORI
ANNEGERS, JOHN F.
SCHULL, WILLIAM J.
ORIGINAL CONTRIBUTIONS
Seizures are a frequent sequela of impaired brain development and can be expected to affect more children with radiation-related brain damage than children without such damage. This report deals with the incidence and type of seizures among survivors prenatally exposed to the atomic bombing of Hiroshima and Nagasaki, and their association with specific stages of prenatal development at the time of irradiation. Fetal radiation dose was assumed to be equal to the dose to the maternal uterus. Seizures here include all references in the clinical record to “seizure,” “epilepsy,” or “convulsion.” Histories of seizures were obtained at biennial routine clinical examinations starting at about the age of 2 years. These clinical records were used to classify seizures as febrile or unprovoked (without precipitating cause). No seizures were ascertained among subjects exposed 0–7 weeks after fertilization at doses higher than 0.10 Gy. The incidence of seizures was highest with irradiation at the eighth through the 15th week after fertilization among subjects with doses exceeding 0.10 Gy and was linearly related to the level of fetal exposure. This obtains for all seizures without regard to the presence of fever or precipitating causes, and for unprovoked seizures. When the 22 cases of severe mental retardation were excluded, the increase in seizures was only suggestively significant and only for unprovoked seizures. After exposure at later stages of development, there was no increase in recorded seizures.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/114
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1242015-05-11HighWireOUPamjepid:131:1
ACUTE GASTROINTESTINAL ILLNESS AND CHILD CARE ARRANGEMENTS
ALEXANDER, CHERYL S.
ZINZELETA, ELLEN M.
MACKENZIE, ELLEN J.
VERNON, ANDREW
MARKOWITZ, RICKA K.
ORIGINAL CONTRIBUTIONS
This study uses data from the 1981 National Health Interview and the 1981 Child Health Supplement to assess the extent to which family day care homes and child care centers pose a risk of acute gastrointestinal illness among preschool children. The study uses a nationally representative sample of children 0–5 years of age (<it>n</it>=4,845). Acute gastrointestinal illness was identified from parental reports of acute illness in a 2-week period. Information on type and duration of child care, as well as a variety of sociodemographic and environmental factors (e.g., crowding, seasonality), were obtained. The authors hypothesize that risk of acute gastrointestinal illness would vary by group size. Center attendees were thought to have the greatest exposure to infectious agents, followed by children in day care homes, and lastly by those receiving care in their own homes. Risk models were estimated separately for children <3 years of age and for children aged 3–5 years. Our results show that an elevated risk of acute gastrointestinal illness associated with child care is confined to children <3 years of age who regulaily attend centers/nursery schools (odds ratio=3.49, 95% confidence interval 0.99–4.77), controlling for other confounding variables. For children aged 3–5 years, low socioeconomic status, poverty, and seasonality are stronger predictors of acute gastrointestinal illness than is center care. Family day care appears to be unrelated to the risk of illness for both age groups.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/124
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1322015-05-11HighWireOUPamjepid:131:1
ASSESSMENT OF VITAL STATISTICS AND SURVEILLANCE DATA FOR MONITORING TETANUS MORTALITY, UNETED STATES, 1979-1984
SUTTER, ROLAND W.
COCHI, STEPHEN L.
BRINK, EDWARD W.
SIROTKIN, BARRY I.
ORIGINAL CONTRIBUTIONS
Reported tetanus cases and tetanus deaths have declined substantially since widespread implementation of tetanus immunization. However, preventable morbidity and mortality continue to occur. During 1979–1984, 74–95 cases of tetanus were reported annually to the Centers for Disease Control (CDC) and 20–31 deaths were reported annually by the National Center for Health Statistics (NCHS). To evaluate further the health impact of tetanus, the authors assessed the completeness of national tetanus mortality data. They reviewed tetanus case report forms received at CDC from the states and NCHS multiple-cause-of-death tapes for 1979–1984. COC reports recorded 129 deaths and NCHS modality tapes 197 deaths. Year of death, state, age, and sex were used to match CDC and NCHS deaths, identifying 78 deaths reported to both sources. Using the meth odology of Chandra Sekar and Deming, the authors estimated the actual number of tetanus deaths for 1979–1984 to be 326 (95% confidence interval 291–361). Based on this estimate, the completeness of reporting to CDC was 40%, to NCHS 60%, and to the combined systems 76%. To evaluate the reasons for underreporting, the authors contacted 14 states that had reported ≥10 cases of tetanus to CDC during 1979–1984 to obtain death certificates for all tetanus deaths and additional information on all tetanus cases. Thirteen states submitted 108 death certificates for review. Coding and other systematic errors did not explain the low reporting efficiency. Failure to list tetanus as a cause of death on the death certificate was the primary reason for nonreporting of tetanus deaths to NCHS. These results suggest that NCHS tetanus modality data may not be as complete as previously assumed and that tetanus mortality, and probably morbidity, are higher than previous reports have indicated.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/132
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1432015-05-11HighWireOUPamjepid:131:1
PREVALENCE SURVEY OF CYTOMEGALOVIRUS INFECTION IN CHILDREN IN CHENGDU
LIU, Z.
WANG, E.
TAYLOR, W.
YU, H.
WU, T.
WAN, Z.
HUANG, Y.
NI, Z.
SACKETT, D.
ORIGINAL CONTRIBUTIONS
Cytomegalovirus (CMV) is a common worldwide perinatal infection. Although usually asymptomatlc, it may cause deafness in up to 15% of these infants. A cross-sectional study was performed to determine the age-specific prevalence of CMV seropositivity in Chinese children and to determine if any risk factors for infection could be identified. In a two-stage sampling procedure, nine districts were randomly selected from 70 citizenship districts in Chengdu, Sichuan Province, People's Republic of China. Then, 1,950 households were randomly selected from 11,886 households and interviewed. Blood was obtained from all children aged less than seven years and assayed using an enzyme-linked immunosorbent assay method. A subgroup of sera was retested at the research laboratory and also sent to the National Reference Laboratory in Beijing. Kappa values for the test agreement with the reference laboratory and retesting within the study laboratory were 0.94 and 0.86, respectively. Seropositivity averaged 52% in those aged less than one year and 60% in those between four and seven years. A higher rate of seropositivity was observed in urban versus rural children (odds ratio (OR)=2.55), breast feeding in urban areas only (OR=1.87), and day care versus home care setting (OR=1.59). High CMV seroprevalence, even in the first year of life, was observed in this population of well children in Chengdu, China. An association was observed between seroprevalence and residence, method of feeding, and day care attendance.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/143
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/152015-05-11HighWireOUPamjepid:131:1
MONTH OF BIRTH AND TESTICULAR CANCER RISK IN DENMARK
PRENER, ANNE
CARSTENSEN, BENDIX
ORIGINAL CONTRIBUTIONS
On the basis of 40 years of national cancer registration, the authors analyzed the distribution of birth dates of patients with testicular cancer in the Danish male population, which has a particularly high incidence of this cancer. No significant peaks were identified, except for men with enibryonal carcinomas born between 1950 and 1959, for whom a significant 12-month cycle was observed. This result differs from those of earlier studies. The number of cases of embryonal carcinomas in the 1950–1959 birth cohort is small, but it is possible that an etiologic factor that varies with season was present at that time. For all testicular cancers and for the three histologic subgroups analyzed, the authors found significant 2-month cycles. The biologic relevance of a 2-month cycle is not clear. It is concluded that there is littie evidence to support the hypothesis of a systematic variation in month of birth among men with testicular cancer.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/15
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1512015-05-11HighWireOUPamjepid:131:1
MATCHING AND EFFICIENCY IN COHORT STUDIES
GREENLAND, SANDER
MORGENSTERN, HAL
ORIGINAL CONTRIBUTIONS
Contrary to the impression given in some textbooks, matching can reduce the efficiency of a cohort study, even when it produces no sample-size reduction and even if the matching variable is a confounder. The authors illustrate this along with some additional points regarding cohort matching. First, the impact of matching on efficiency can be in opposite directions for different measures of effect; as a consequence, criteria for deciding whether to match must depend on whether one wishes to estimate relative or absolute effects. Second, the commonly drawn analogy between blocking in randomized trials and matching in cohort studies is misleading when one considers the impact of matching on covartate distributions. Third, the conditions for efficiency overmatching in a cohort study are different from the conditions in a case-control study. It appears that, under an additive model, matching will usually increase the efficiency of both risk-difference and risk-ratio estimation, and the power of the Mantel-Haenszel test. Under a multiplicative model, the impact of matching is not as consistently beneficial. The authors present some approximate criteria which allow one to use a priori information to predict whether cohort matching is likely to improve efficiency.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/151
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1602015-05-11HighWireOUPamjepid:131:1
NATIONAL SOURCES OF VITAL STATUS INFORMATION: EXTENT OF COVERAGE AND POSSIBLE SELECTIVITY IN REPORTING
BOYLE, COLEEN A.
DECOUFLÉ, PIERRE
ORIGINAL CONTRIBUTIONS
The completeness of death reporting and characteristics of deaths not found by the Social Security Administration, Internal Revenue Service, Veterans Administration, and National Death Index were investigated in a follow-up study (1965–1983) of mortality among 18,313 randomly selected Vietnam-era veterans. Over all, 97% of all known deaths identified by these means had been found by the National Death Index (for the years 1979–1983), 83% by the Social Security Administration files, 80% by the Veterans Administration file, and only 23% by the Internal Revenue Service file. Coverage by the Veterans Administration file differed considerably by time period of death; 28% of deaths occurring in 1965–1971 appeared in the Veterans Administration system compared with 87% in 1972–1983. Social Security Administration coverage varied somewhat over time—87% in the period from 1965–1981 and 64% in 1982–1983. Deaths not found by the National Death Index or the Veterans Administration file occurred more frequently among those with certain characteristics, such as nonwhite racial background, nonhonorable discharge, and low rank at discharge. There were no such differences for deaths found by the Social Security Administration. Importantly, these characteristics were strong predictors of subsequent mortality. Thus, in studies of mortality, there is a potential for bias when certain reporting sources are used to the exclusion of others.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/160
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1692015-05-11HighWireOUPamjepid:131:1
NESTED CASE-CONTROL AND CASE-COHORT METHODS OF SAMPLING FROM A COHORT: A CRITICAL COMPARISON
LANGHOLZ, BRYAN
THOMAS, DUNCAN C.
ORIGINAL CONTRIBUTIONS
The recently developed case-cohort method of sampling from a cohort is compared with the nested case-control method. Corrected asymptotic relative efficiency results show that the case-cohort design for single “disease” outcomes offers less improvement for intervention trials for which there is no random censoring than originally suggested. Furthermore, simulation results indicate that if there is moderate random censoring or staggered entry, the case-cohort method can do substantially worse than the nested case-control method.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/169
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1772015-05-11HighWireOUPamjepid:131:1
SAMPLE SIZE REQUIREMENTS FOR INTERVAL ESTIMATION OF THIS ODDS RATIO
SATTEN, GLEN A.
KUPPER, LAWRENCE L.
ORIGINAL CONTRIBUTIONS
Sample sizes are calculated for unmatched case-control (or cohort) studies where the goal is interval estimation of the odds ratio. The procedure used gives the smallest sample size for which a 100(1-α)% confidence interval for the log odds ratio will not exceed a specified width with specified probability (1-γ). Tables of sample sizes for various choices of parameter values are presented. Considerable disagreement is found with a published method which has as its basis expected cell counts.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/177
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1852015-05-11HighWireOUPamjepid:131:1
MORTALITY AND AIR POLLUTION J LONDON: A TIME SERIES ANALYSIS
SCHWARTZ, JOEL
MARCUS, ALLAN
ORIGINAL CONTRIBUTIONS
The relation between air pollution and mortality in London was examined for the winters of 1958–1972. The data exhibited a high degree of autocorrelation, requiring analyses using autoregressive models. There was a highly significant relation between mortality and either particulate matter or sulfur dioxide (after controlling for temperature and humidity), both overall and in each individual year. Graphic analysis revealed a nonlinear relation with no threshold, and a steeper exposure-response curve at lower air pollution levels. in models with both pollutants, particulate matter remained a significant predictor with about a 10% reduction in its estimated coefficients, while sulfur dioxide was insignificant, with a large drop in its estimated coefficient The authors conclude that particulates are strongly associated with mortality rates in London, and the relation is likely causal.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/185
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1952015-05-11HighWireOUPamjepid:131:1
RE. "AN AUTOPSY OF EPIDEMIOLOGIC METHODS: THE CASE OF "POPPERS" IN THE EARLY EPIDEMIC OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)"
Marmor, Michael
Dubin, Neil
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/195
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1962015-05-11HighWireOUPamjepid:131:1
RE. "AN AUTOPSY OF EPIDEMIOLOGIC METHODS: THE CASE OF "POPPERS" IN THE EARLY EPIDEMIC OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)"
Hessel, Patrick A.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/196
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1972015-05-11HighWireOUPamjepid:131:1
RE. "AN AUTOPSY OF EPIDEMIOLOGIC METHODS: THE CASE OF "POPPERS" IN THE EARLY EPIDEMIC OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)"
Kramer, Michael D.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/197
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1982015-05-11HighWireOUPamjepid:131:1
RE. "AN AUTOPSY OF EPIDEMIOLOGIC METHODS: THE CASE OF "POPPERS" IN THE EARLY EPIDEMIC OF THE ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS)"
Grimson, Roger C.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/198
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/1992015-05-11HighWireOUPamjepid:131:1
THE FIRST AUTHOR REPLIES
Vandenbroucke, Jan P.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/199
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/202015-05-11HighWireOUPamjepid:131:1
SERUM PLANT STEROLS AND CHOLESTEROL PRECURSORS REFLECT CHOLESTEROL ABSORPTION AND SYNTHESIS IN VOLUNTEERS OF A RANDOMLY SELECTED MALE POPULATION
MIETTINEN, TATU A.
TILVIS, REIJO S.
KESÄNIEMI, Y. ANTERO
ORIGINAL CONTRIBUTIONS
To investigate the regulation of serum levels of cholesterol precursor sterols and plant sterols, these noncholesterol sterols, fatty acids, and various parame ters of cholesterol metabolism were analyzed in 63 volunteers from a randomly selected Finnish male population sample of 100 subjects, aged 50 years, who had normal dietary habits. Serum levels of cholesterol precursors, desmosterol and lathosterol (in terms of μg/mg cholesterol), were negatively related to both the fractional and absolute absorption of dietary cholesterol and serum high density lipoprotein (HOL) cholesterol, and positively related to overall cholesterol synthesis and serum very low density lipoprotein (VLDL) cholesterol. Serum levels of the plant sterols, campesterol and sitosterol, exhibited positive correlations with the polyunsaturated/saturated fatty acid ratio of dietary fat, the linoleic acid contents of plasma and dietary lipids, the amount of dietaryplant sterois (as indicated by fecai output), fractional and absolute absorption of dietary cholesterol, and HDL cholesterol, but were inversely related to the overall cholesterol synthesis and VLDL cholesterol. Stepwise multiple regression analysis revealed that the serum level of campesterol was associated with fractional cholesterol absorption, dietary plant sterols, and biliary cholesterol secretion, and that of sitosterol with dietary plant sterols, cholesterol synthesis, tractional cholesterol absorption, and biliary cholesterol secretion. Thus, the serum non-cholesterol sterols are significant indicators of cholesterol absorption and synthesis even under basal conditions and, since gas liquid chromatographic determination of these sterols is quite simple, their measurement may be valuable for monitoring cholesterol metabolism in large-scale epidemiologicstudies.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/20
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oai:open-archive.highwire.org:amjepid:131/1/2002015-05-11HighWireOUPamjepid:131:1
RE. "GENERAL RELATIVE RISK REGRESSION MODELS FOR EPIDEMIOLOGIC STUDIES"
Chavance, Michel
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/200
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/202-a2015-05-11HighWireOUPamjepid:131:1
RE. "SEROLOGIC RESPONSE TO ORAL POLIO VACCINE AND ENHANCED-POTENCY INACTIVATED POLIO VACCINES"
Arya, S. C.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/202-a
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oai:open-archive.highwire.org:amjepid:131/1/2022015-05-11HighWireOUPamjepid:131:1
THE AUTHORS REPLY
Moolgavkar, Suresh H.
Venzon, David J.
LETTERS TO THE EDITOR
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/202
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oai:open-archive.highwire.org:amjepid:131/1/322015-05-11HighWireOUPamjepid:131:1
HIGH DENSITY LIPOPROTEIN CHOLESTEROL AS A PREDICTOR OF CARDIOVASCULAR DISEASE MORTALITY IN MEN AND WOMEN: THE FOLLOW-UP STUDY OF THE LIPID RESEARCH CLINICS PREVALENCE STUDY
JACOBS, DAVID R.
MEBANE, IRMA L.
BANGDIWALA, SHRIKANT I.
CRIQUI, MICHAEL H.
TYROLER, HERMAN A.
FOR THE LIPID RESEARCH CLINICS PROGRAM,
ORIGINAL CONTRIBUTIONS
With data from the Lipid Research Clinics Prevalence Study used as a baseline, an average of 8.4 years of mortality follow-up has been completed for 8,825 male and female participants who were at least 30 years of age at the time of the study. The participants were examined at 10 North American sites during 1972–1976. Univariate findings for high density lipoprotein (HDL) cholesterol in the 7,589 persons initially free of coronary heart disease indicate an inverse relation with cardiovascular disease mortality for men and women. Controlling for age, low density lipoprotein (LDL) cholesterol, triglycerides, body mass index, systolic blood pressure, and smoking, multivarlate analysis results indicate inverse relations between HDL cholesterol and cardiovascular disease mortality. In men, the cardiovascular disease mortality rate ratio for HDL cholesterol increments of 10 mg/dl was similar to the cardiovascular disease mortality rate ratio for LDL cholesterol increments of 30 mg/dl. In women, HDL cholesterol is more closely related to cardiovascular disease than is LDL cholesterol. HDL cholesterol is inversely related to both coronary heart disease and other cardiovascular disease mortality in both sexes, though the relation of HDL cholesterol with coronary heart disease mortality in women approached statistical significance only for the combined end point of suspect and definite cases. No relation was observed in either sex group between HDL cholesterol and noncardiovascular disease mortality. This study, only the second large prospective study evaluating the role of HDL cholesterol in women, confirms both the importance and the independence in both men and women of HDL cholesterol in the epidemiology of coronary heart disease and other cardiovascular disease mortality.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/32
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oai:open-archive.highwire.org:amjepid:131/1/482015-05-11HighWireOUPamjepid:131:1
THE EPIDEMIOLOGY OF IDIOPATHIC DILATED CARDIOMYOPATHY IN A BIRACIAL COMMUNITY
COUGHLIN, STEVEN S.
SZKLO, MOYSES
BAUGHMAN, KENNETH
PEARSON, THOMAS A.
ORIGINAL CONTRIBUTIONS
An epidemiologic study of idiopathic dilated cardiomyopathy was carried out in order to identity possible risk factors for this often fatal cause of heart failure in young adults. Possible associations with black race and other genetic and environmental factors were examined by comparing newly diagnosed cases ascertained from four Baltimore hospitals (<it>n</it>=95) with neighborhood controls (<it>n</it>=95), matched on sex and 5-year age intervals. Matched and unmatched relative odds and conditional logistic regression coefficients were obtained to describe the associations. Statistically significant, independent associations were observed between idiopathic dilated cardiomyopathy and black race, low annual income, and history of asthma (<it>p</it> <0.05). The black predominance (relative odds=2.7, 95% confidence interval 2.0–3.4) was not explained by income, alcohol consumption, cigarette usage, body mass index, hypertension, or asthma. A possible interactive eftect was observed between black race and history of asthma and other atopic diseases. Thus, blacks, especially those with a history of hypersensitivity, may represent a high-risk subgroup in need of preventive care or early intervention.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/48
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oai:open-archive.highwire.org:amjepid:131/1/572015-05-11HighWireOUPamjepid:131:1
CARDIOVASCULAR RISK FACTORS AND IMPAIRED GLUCOSE TOLERANCE: THE SAN LUIS VALLEY DIABETES STUDY
BURCHFIEL, CECIL M.
HAMMAN, RICHARD F.
MARSHALL, JULIE A.
BAXTER, JUDITH
KAHN, LOUISE B.
AMIRANI, JEFFREY J.
ORIGINAL CONTRIBUTIONS
Cardiovascular risk factor patterns were examined cross-sectionally in 856 Hispanic and Anglo subjects aged 20–74 years enrolled in the population-based San Luis Valley Diabetes Study of Colorado. Risk factor levels and prevalence were compared for 279 individuals with non-insulin-dependent diabetes mellitus, 89 with impaired glucose tolerance, and 4.88 with normal glucose tolerance. Sex-specific comparisons of continuous risk factors were made by diabetic status and ethnicity, adjusting for age using two-way analysis of covanance; similar comparisons of discrete variables were made using logistic regression. A number of vascular, metabolic, lipid, obesity-related, family history, and lile-style risk factors for cardiovascular disease were examined. In general, biologic risk factors tended to be more strongly associated with diabetic status, while life-style risk factors varied more by ethnicity. Age-adjusted levels of systolic and diastolic blood pressure, hypertension history, triglyceride, and body mass index were lowest among normal subjects, intermediate for those with impaired glucose tolerance, and highest in subjects with non-insulin-dependent diabetes mellitus, while the trend was reversed for high density lipoprotein (HDL) cholesterol and its subfractions. Hispanics had lower serum uric acid levels and greater central obesity than Anglos; they were less likely to have a Type A personality, less physically active at work, and more likely to be a current smoker than Anglos. Hispanic males had a lower body mass index and a higher HDL cholesterol level than Anglo males. These results indicate that an adverse cardiovascular risk factor pattern is present not only in subjects with non-insulin-dependent diabetes mellitus but also in subjects with impaired glucose tolerance who are at increased risk of developing diabetes. This suggests that an adverse risk factor pattern may develop concurrently with or prior to the onset of impaired glucose tolerance. Future prospective studies will help to clarify the temporal sequence involved in the development of adverse cardiovascular risk factor patterns and impaired glucose tolerance.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/57
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/62015-05-11HighWireOUPamjepid:131:1
A CASE-CONTROL STUDY OF ALCOHOLIC BEVERAGE CONSUMPTION AND BREAST CANCER
ROSENBERG, LYNN
PALMER, JULIE R.
MILLER, DONALD R.
CLARKE, E. AILEEN
SHAPIRO, SAMUEL
ORIGINAL CONTRIBUTIONS
In many studies, moderate alcohol consumption has been associated with increases in the risk of breast cancer of about 50–100%. The authors examined recent alcoholic beverage consumption in relation to the risk of breast cancer in a case-control study of women aged <70 years, conducted in Toronto, Ontario, Canada, from 1982 to 1986: 607 breast cancer cases identified in a cancer hospital were compared with 1,214 controls matched to the cases on neighbor hood and decade of age. The subjects were interviewed at home. Confounding factors were controlled by conditional logistic regression. The relative risk estimates for women who consumed alcohol, relative to women who drank less than one alcoholic beverage (drink) per month, were close to 1.0: for women who drank at least one alcoholic beverage per day, the multivanate estimate was 0.9 (95% confidence interval 0.6–1.2). Among subgroups of women, including those at low baseline risk, there was also no association. For a subset of cases compared with hospital controls, once again there was no association. The relative risk (RR) estimate was elevated for women who drank at least one beer daily (RR=1.7) and reduced for women who drank at least one glass of wine daily (RR=0.7), but neither estimate was statistically significant. The results suggest that recent alcohol consumption does not influence the risk of breast cancer. Selection bias cannot be ruled out, however. In addition, because deter minants of alcohol use are not well understood, control of confounding may have been incomplete in the present study and in other observational studies of alcohol and breast cancer.
Oxford University Press
1990-01-01 00:00:00.0
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/712015-05-11HighWireOUPamjepid:131:1
TIME-SPACE CLUSTERING OF TEENAGE SUICIDE
GOULD, MADELYN S.
WALLENSTEIN, SYLVAN
KLEINMAN, MARJORIE
ORIGINAL CONTRIBUTIONS
The occurrence of time-space clusters was examined in national mortality data on suicide among adolescents aged 15–19 years obtained from the National Center for Health Statistics Mortality Detail Files for 1978–1984. The analyses indicated that overall significant time-space clustering occurred among 15–19 year olds. The authors thus believe that they have documented for the first time that outbreaks of suicide occur more frequently than expected by chance alone. The occurrence of suicide dusters among teenagers appeared to vary considerably by state and year of investigation. There is some indication that there has been an increase In teenage clusters in more recent years.
Oxford University Press
1990-01-01 00:00:00.0
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http://aje.oxfordjournals.org/cgi/content/short/131/1/71
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/792015-05-11HighWireOUPamjepid:131:1
RELIABILITY OF PERSONAL INTERVIEW DATA IN A HOSPITAL-BASED CASE-CONTROL STUDY
KELLY, JUDITH P.
ROSENBERG, LYNN
KAUFMAN, DAVID W.
SHAPIRO, SAMUEL
ORIGINAL CONTRIBUTIONS
Responses to interview questions were compared for concordance among 492 individuals interviewed more than once in a hospital-based case-control surveil lance system in the United States, Canada, and Israel between 1976 and 1982. Reliability of the data was determined using the Kappa statistic and the intraclass correlation coefficient Reliability was good to excellent for demographic factors, such as birthplace, and for medical conditions/procedures that require hospitalization or continuing medical care, such as hysterectomy. Reliability was fair to good for less serious or less well-defined medical conditions/procedures, such as cystic breast disease, and for current habits, such as daily coffee consumption. Regarding medication use, reliability was poor to fair for drugs taken intermittently, such as aspirin and penicillin, and good to excellent for drugs taken on a regular basis, such as oral contraceptives. As expected, medications were reported more consistently when duration of use was prolonged. The data were also analyzed according to two intervals between interviews (<1 year and ≥1 year). For most factors, reliability was not materially affected by interval. Where differences were observed, reliability tended to be better when the second interview followed the first by less than 1 year. These results suggest that structured interviews administered to hospital patients by trained personnel can elicit reliable data on demographic and medical history factors.
Oxford University Press
1990-01-01 00:00:00.0
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Copyright (C) 1990, Oxford University Press
oai:open-archive.highwire.org:amjepid:131/1/912015-05-11HighWireOUPamjepid:131:1
SELF-EVALUATED HEALTH AND MORTALITY AMONG THE ELDERLY IN NEW HAVEN, CONNECTICUT, AND IOWA AND WASHINGTON COUNTIES, IOWA, 1982-1986
IDLER, ELLEN L.
KASL, STANISLAV V.
LEMKE, JON H.
ORIGINAL CONTRIBUTIONS
The ability of global self-evaluations of health to predict survival in follow-up studies is tested in two samples of elderly, noninstitutlonalized adults. Data from the Yale Health and Aging Project, New Haven, Connecticut (<it>n</it>=2,812), and the 65+ Rural Health Study, Iowa and Washington counties, Iowa (<it>n</it>=3,673), were used to investigate the association between 1982 self-evaluated global health status (excellent, good, fair, poor) and survivorship from 1982 to 1988. Despite extensive controls for physical health status in the form of measures of disabilities and chronic conditions, sociodemographic characteristics, and health risk behaviors at the beginning of the follow-up period, and the use of analytic techniques which take into account the stratified sample design of the New Haven data, poor self-perceptions of health significantly increase the risk of mortality. Adjusted odds ratios for the extreme categories (“poor” as compared with “excellent”) for New Haven men and women were 5.33 (95% confidence interval (Cl) 1.93–14.75) and 2.99 (95% Cl 1.30–6.91), respectively; for Iowa men and women they were 4.84 (95% Cl 2.22–10.57) and 3.16 (95% Cl 1.49–6.71). Respondents reporting “fair” and “good” health also show elevated risks of mortality in dose-response fashion. Self-perceptions of health status appear to be a factor of unique pro spective significance in mortality studies.
Oxford University Press
1990-01-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/131/1/91
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Copyright (C) 1990, Oxford University Press