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oai:open-archive.highwire.org:amjepid:146/9/6872015-05-11HighWireOUPamjepid:146:9
Tobacco as a Cause of Lung Cancer: Some Reflections
Wynder, Ernst L.
REVIEWS AND COMMENTARY
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/687
http://dx.doi.org/10.1093/oxfordjournals.aje.a009342
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/6952015-05-11HighWireOUPamjepid:146:9
Is Gulf War Syndrome Due to Stress? The Evidence Reexamined
Haley, Robert W.
ORIGINAL CONTRIBUTIONS
Medical policy-makers have concluded that stress from wartime trauma and deployment constitutes an important cause of the chronic physical symptoms observed in US veterans who served in the Persian Gulf War. The author reviewed scientific articles from peer-reviewed journals referenced in the final report of the Presidential Advisory Committee on Gulf War Veterans' Illnesses and conducted a MEDLINE literature search. All reported prevalence rates of post-traumatic stress disorder (PTSD) in Gulf War veterans were defined by critical cutpoints on psychometric scales constructed by summing veterans' responses on standardized symptom questionnaires rather than by clinical psychiatric interviews. Observed PTSD rates varied from 0% to 36% (mean, 9%). Correcting for measurement errors with previously determined values of the sensitivity (range 0.77 to 0.96) and specificity (range 0.62 to 0.89) of the psychometric tests yielded estimated true PTSD rates of 0% for 18 of the 20 reported rates. Mean scores on the Mississippi PTSD scale in all subgroups of Gulf War veterans were within the range of values for well-adjusted Vietnam veterans (50–89) and far below that of Vietnam veterans with psychiatrically confirmed PTSD (120–140). Most PTSD and “stress-related symptoms” reported in studies of Gulf War veterans appear to represent false-positive errors of measurement reflecting nonspecific symptoms of other conditions.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/695
http://dx.doi.org/10.1093/oxfordjournals.aje.a009343
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7042015-05-11HighWireOUPamjepid:146:9
Invited Commentary: How Would We Know a Gulf War Syndrome If We Saw One?
Wegman, David H.
Woods, Nancy F.
Bailar, John C.
ORIGINAL CONTRIBUTIONS
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/704
http://dx.doi.org/10.1093/oxfordjournals.aje.a009344
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7122015-05-11HighWireOUPamjepid:146:9
Dr. Haley Replies to Wegman et al.'s Invited Commentary on Gulf War Syndrome
Haley, Robert W.
ORIGINAL CONTRIBUTIONS
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/712
http://dx.doi.org/10.1093/oxfordjournals.aje.a009345
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7132015-05-11HighWireOUPamjepid:146:9
Sample Size Requirements in Case-Only Designs to Detect Gene-Environment Interaction
Yang, Quanhe
Khoury, Muin J.
Flanders, W. Dana
ORIGINAL CONTRIBUTIONS
With advances in molecular genetic technology, more studies will examine gene-environment interaction in disease etiology. If the primary purpose of the study is to estimate the effect of gene-environment interaction in disease etiology, one can do so without employing controls. The case-only design has been promoted as an efficient and valid method for screening for gene-environment interaction. The authors derive a method for estimating sample size requirements, present sample size estimates, and compare minimum sample size requirements to detect gene-environment interaction in case-only studies with case-control studies. Assuming independence between exposure and genotype in the population, the authors believe that the case-only design is more efficient than a case-control design in detecting gene-environment interaction. They also illustrate a method to estimate sample size when information on marginal effects (relative risk) of exposure and genotype is available from previous studies.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/713
http://dx.doi.org/10.1093/oxfordjournals.aje.a009346
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7212015-05-11HighWireOUPamjepid:146:9
Risk Factors for Inguinal Hernia in Women: A Case-Control Study
Liem, Mike S. L.
van der Graaf, Yolanda
Zwart, Reinder C.
Geurts, Ingrid
van Vroonhoven, Theo J. M. V.
behalf of the Coala Trial Group,
ORIGINAL CONTRIBUTIONS
Potential risk factors for inguinal hernia in women were investigated and the relative importance of these factors was quantified. In women, symptomatic but nonpalpable hernias often remain undiagnosed. However, knowledge on this subject only concerns hernia and operation characteristics, which have been obtained by review of case series. Virtually nothing is known about risk factors for inguinal hernia. The authors performed a hospital-based case-control study of 89 female patients with an incident inguinal hernia and 176 agematched female controls. Activity since birth with two validated questionnaires was measured and smoking habits, medical and operation history, Quetelet index (kg/m2, and history of pregnancies and deliveries were recorded. Response for cases was 81% and for controls 73%. Total physical activity was not associated with inguinal hernia (univariate odds ratio (OR) = 0.8, 95% confidence interval (Cl) 0.6–1.1), but high present sports activities was associated with less inguinal hernia (multivariate OR = 0.2, 95% Cl 0.1–0.7). Obesity (Quetelet index >30) was also protective for inguinal hernia (OR = 0.2, 95% Cl 0.04–1.0). Independent risk factors were positive family history (OR – 4.3, 95% Cl 1.9–9.7) and obstipation (OR – 2.5, 95% Cl 1.0–6.7). In particular, smoking, appendectomy, other abdominal operations, and multiple deliveries were not associated with inguinal hernia in females. The protective effect of present sports activity may be explained by optimizing the resistance of the abdominal musculature protecting the relatively small inguinal weak spot in the female. The individual predisposition for inguinal hernia may be quantified by these risk factors, and, with this in mind, the authors advise that further evaluation might be needed for the patient with unexplained inguinal pain.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/721
http://dx.doi.org/10.1093/oxfordjournals.aje.a009347
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7272015-05-11HighWireOUPamjepid:146:9
Alcohol Consumption and Changes in Blood Pressure among African Americans: The Pitt County Study
Curtis, Amy B.
James, Sherman A.
Strogatz, David S.
Raghunathan, T. E.
Harlow, Siobán
ORIGINAL CONTRIBUTIONS
The Pitt County Study is a longitudinal investigation of anthropometric, psychosocial, and behavioral predictors of hypertension in African Americans who were aged 25–50 years at baseline in 1988. At baseline, a strong dose-response gradient was observed for alcohol consumption and blood pressure for both sexes. The current study investigated whether baseline alcohol consumption or, alternatively, changes in drinking status predicted 5-year changes in blood pressure among the 652 women and 318 men who satisfied all inclusion criteria for the longitudinal analyses. In multivariate regression analyses, baseline alcohol consumption was not significantly associated with changes in blood pressure or hypertension incidence (systolic/diastolic blood pressure ≥160/95 mmHg) by 1993. Change in drinking status, however, was significantly associated with changes in systolic pressure. The systolic pressure increase among individuals who initiated alcohol consumption was 6.2 mmHg (95% confidence interval (Cl) 1.1–6.4) greater than abstainers, while that for individuals who reported drinking at both time points was 3.8 mmHg (95% Cl 1.3–11.1) greater. Blood pressure increases for persons who discontinued drinking were comparable to those of abstainers. Results were independent of baseline age, body mass index, blood pressure, and sex. Social and economic disadvantage in 1988 was significantly associated with continuation and initiation of alcohol consumption by 1993.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/727
http://dx.doi.org/10.1093/oxfordjournals.aje.a009348
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7342015-05-11HighWireOUPamjepid:146:9
Incidence of Invasive Cancers Following Squamous Cell Skin Cancer
Levi, Fabio
Randimbison, Lalao
Vecchia, Carlo La
Erler, Georges
Te, Van-Cong
ORIGINAL CONTRIBUTIONS
The authors describe the incidence of new primary cancers among 4,639 cases of squamous cell skin cancer (SCC) diagnosed between 1974 and 1994 in the cancer registries of the Swiss cantons of Vaud and Neuchâtel (total person-years at risk = 23,152). Overall, 729 metachronous cancers were observed versus 527.6 expected, corresponding to a standardized incidence ratio (SIR) of 1.4 (95% confidence interval (Cl) 1.3–1.5). After exclusion of skin cancers, however, 384 second primary neoplasms were observed versus 397.2 expected (SIR = 1.0). Excesses were observed for cancers of the lip (SIR = 3.1) and lung (SIR = 1.3), for basal cell (SIR = 4.3) and melanomatous skin cancers (SIR = 3.3), and non-Hodgkin's lymphomas (SIR = 1.7). Rates were elevated for cancers of the salivary glands (SIR = 4.3) and for Hodgkin's disease (SIR = 2.7), and, below age 65 years, for cancers of the lung (SIR = 1.6), breast (SIR = 1.5), and prostate (SIR % 1.8), for Hodgkin's disease (SIR = 15.8), as well as for all neoplasms except skin (SIR = 1.2; 95% Cl 1.0–1.5). The cumulative risk of basal cell skin cancer reached 17% after 15 years. The authors believe that the excesses for basal cell carcinomas and melanomas of the skin following SCC, and possibly of lymphomas, were likely attributable to common phenotypic characteristics and exposure to UV radiation. The elevated rates of lung cancer are suggestive for a role of tobacco as a cause of squamous cell skin cancer.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/734
http://dx.doi.org/10.1093/oxfordjournals.aje.a009349
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7402015-05-11HighWireOUPamjepid:146:9
Relation between Very Low Birth Weight and Developmental Delay among Preschool Children Without Disabilities
Schendel, Diana E.
Stockbauer, Joseph W.
Hoffman, Howard J.
Herman, Allen A.
Berg, Cynthia J.
Schramm, Wayne F.
ORIGINAL CONTRIBUTIONS
The authors examined the relation between very low birth weight (VLBW: <1,500 g) and possible developmental delay (DELAY) in the absence of frank developmental disability among young children. The prevalence of DELAY in a population-based cohort (Missouri resident births born from December 1989 through March 1991) of singleton VLBW children (n = 367) was compared with the prevalence of DELAY among both moderately low birth weight (MLBW: 1,500–2,499 g; n = 553) and normal birth weight (NBW: ≥2,500 g; n = 555) singleton control children. DELAY was defined by nine measures of performance on the Denver Developmental Screening Test II at a median adjusted age of 15 months (range: 9–34 months). Subjects were asymptomatic for disabling conditions at developmental follow-up. Apparently well VLBW children were consistently at greater risk for both moderate and severe measures of DELAY and for DELAY across four functional areas than were either the MLBW (adjusted odds ratios: 1.4–2.7) or NBW children (adjusted odds ratios: 2.1–6.3). The greatest prevalence of DELAY tended to be among appropriate-for-gestational age VLBW children who were also the most premature. This study supports developmental follow-up of nondisabled VLBW children because of the significantly elevated risk for DELAY among apparently normal infants.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/740
http://dx.doi.org/10.1093/oxfordjournals.aje.a009350
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7502015-05-11HighWireOUPamjepid:146:9
Air Pollution and Mortality in Philadelphia, 1974-1988
Kelsall, J. E.
Samet, J. M.
Zeger, S. L.
Xu, J.
ORIGINAL CONTRIBUTIONS
Analyses involving data from many locations throughout the world have now been conducted to assess the association between air pollution and mortality. To date, six independent analyses of mortality data for Philadelphia, Pennsylvania, have been reported. In this new analysis of Philadelphia data for 1974–1988, Poisson regression models were developed to estimate the increased risk of daily mortality associated with air pollution while controlling for longer-term time trends and season and for weather. Model development was based on prior understanding of the effects of these factors on mortality and on consideration of model fit. The authors found moderate correlations of daily concentrations of total suspended particles (TSP), sulfur dioxide (SO<inf>2</inf>), nitrogen dioxide (NO<inf>2</inf>), and carbon monoxide (CO), and only slight correlations of ozone (O<inf>3</inf>) with other pollutants. When included individually in the model, the means of current and previous days' levels of TSP, SO<inf>2</inf> and O<inf>3</inf> had statistically significant effects on total mortality; pollutant increases of an interquartile range (34.5 μg/m3 12.9 ppb, and 20.2 ppb, respectively) were associated with increases in mortality of around 1% for TSP and SO<inf>2</inf> and of around 2% for O<inf>3</inf>. The effects of TSP and SO<inf>2</inf> were diminished when both pollutants were simultaneously included in the model, whether pairwise or in the full multi-pollutant model. These analyses confirm the association between TSP and mortality found in previous studies in Philadelphia and show that the association is robust to consideration of other pollutants in the model.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/750
http://dx.doi.org/10.1093/oxfordjournals.aje.a009351
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7632015-05-11HighWireOUPamjepid:146:9
Can We Measure Prior Postmenopausal Estrogen/Progestin Use?: The Postmenopausal Estrogen/Progestin Interventions Trial
Greendale, Gail A.
James, Margaret K.
Espeland, Mark A.
Barrett-Connor, Elizabeth
for the PEPI Investigators,
ORIGINAL CONTRIBUTIONS
The objective of this study was to assess: 1) the accuracy of a single self-report question about postmeno pausal estrogen use; and 2) the performance and repeated measures agreement of a standardized hormone use interview. Women (n = 863) in the Postmenopausal Estrogen/Progestin Interventions Trial (PEPI) completed a self-report baseline questionnaire (BQ) at enrollment and a History of Hormone Use interview (HHU) at the 3-month follow-up visit (HHU <inf>3mos</inf>). A subsample of 101 women completed a second HHU interview 3 years later (HHU<inf>3yrs</inf>. As determined by the HHU<inf>3mos</inf> 479 (56%) of women had ever used postmenopausal estrogen and 261 (30%) had ever used postmenopausal progestin. The mean number of years since last estrogen or progestin use was 2.2 and 1.3 years, respectively. Overall, there was 95% agreement between self-reported estrogen use on the BQ and the HHU<inf>3mos</inf> (kappa = 0.91). Using the HHU<inf>3mos</inf> as the criterion standard, the BQ misclassified 2.3% of women as false positives and 6.3% as false negatives. The average duration of estrogen use in the false-negative classifications was 1.9 years (range: 1–9 years). On the HHU<inf>3mos</inf> 39.7% of participants could not recall at least one of the specific details of estrogen use (preparation, dose, route, or starting or stopping year); similar patterns of recall were found for progestin use. Factors associated with discordant reporting of ever-use of ERT (BQ VS. HHU<inf>3mos</inf>) or incomplete reporting of estrogen/progestin use on the HHU<inf>3mos</inf> were: route of administration, recency of hormone use, duration of hormone use, and race. Age, years since menopause, education, income, and hysterectomy status were not related to discordant and/or incomplete reporting. Agreement between the HHU<inf>3mos</inf> and HHU<inf>3yrs</inf> for ever-use of estrogen was 85.2% (kappa = 0.71). In sum, a single self-report question was adequate to ascertain ever-use of postmenopausal estrogen. When a structured interview form was used, details of postmenopausal estrogen and progestin use were not well remembered. Some features of hormone use and participant characteristics were associated with completeness of recalled hormone use, which suggests the potential for differential misclassification.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/763
http://dx.doi.org/10.1093/oxfordjournals.aje.a009352
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7712015-05-11HighWireOUPamjepid:146:9
Reliability of Reported Age at Menopause
Hahn, Robert A.
Eaker, Elaine
Rolka, Henry
ORIGINAL CONTRIBUTIONS
Age at menopause is an important epidemiologic characteristic whose reliability of reporting in the US population is not known. The authors examined four hypotheses about the reliability of reported age at menopause in the United States: 1) women with hysterectomy-induced menopause more reliably report their age at menopause than women who have undergone natural menopause; 2) reliability declines with time since menopause; 3) reliability declines with age; and 4) women with higher educational levels report their age at menopause more reliably than women with less education. The authors used linear regression models among 2,545 women in the First National Health and Nutrition Examination Survey and Followup Study (1971–1984) and compared responses at first and follow-up interviews. Among women who had undergone a natural menopause, 44% reported their age at menopause within one year from the first to second interviews; among women who had undergone a hysterectomy-induced menopause, 59– reported their age at menopause within one year from first to follow-up interviews. Only hysterectomy status and years from menopause to follow-up interview were significantly associated with the absolute difference between age at menopause reported at first and follow-up interviews. The authors conclude that caution in studies involving age at menopause may enhance our understanding of this critical event in the lives of women.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/771
http://dx.doi.org/10.1093/oxfordjournals.aje.a009353
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7762015-05-11HighWireOUPamjepid:146:9
Risk Factors for Diarrheal Duration
Mirza, Nazrat M.
Caulfield, Laura E.
Black, Robert E.
Macharia, William M.
ORIGINAL CONTRIBUTIONS
To identify child feeding behavior and household hygiene practices that are risk factors for prolonged diarrheal illness, a longitudinal community study was conducted over a 14-month period among 920 children aged 3–37 months who lived in an urban slum settlement in Nairobi, Kenya. Morbidity surveillance was done by home visits every third day in the absence of diarrhea and daily during diarrheal illness until termination of the episode. In-home observations were made to characterize maternal hygiene, cooking, and child feeding practices. Overall, 1,496 episodes of diarrhea were detected. The average diarrheal incidence was 3.5 episodes/child-year, and the incidence of diarrhea ≥14 days was 3 episodes/100 child-years. Cox regression was used to examine the independent effects of covariates on time to recovery from a diarrheal episode. Adjusted behavioral factors that were observed to influence recovery from diarrhea included: uncovered water containers (rate ratio (RR) = 0.77, 95% confidence interval (Cl) 0.64–0.94); giving no fluids (as opposed to oral rehydration solutions (ORS)/sugar salt solutions (SSS)) (RR = 1.42, 95% Cl 1.14–1.77); and administration of diluted cow's milk during the first 3 days of an episode (RR = 1.23, 95% Cl 1.00–1.52). These associations remained significant after adjusting for diarrheal severity. The authors recommend, among other measures, improvement of water storage and promotion of continued feeding with cereal-milk mix during diarrhea.
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/776
http://dx.doi.org/10.1093/oxfordjournals.aje.a009354
en
Copyright (C) 1997, Oxford University Press
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RE: "ASSESSING THE DIRECTION OF CAUSALITY IN CROSS-SECTIONAL STUDIES"
Kulkarni, Pandurang M.
Wang, Suojin
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/786-a
http://dx.doi.org/10.1093/oxfordjournals.aje.a009356
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7862015-05-11HighWireOUPamjepid:146:9
RE: "PERINEAL POWDER EXPOSURE AND THE RISK OF OVARIAN CANCER"
Muscat, Joshua E.
Wynder, Ernst L.
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/786
http://dx.doi.org/10.1093/oxfordjournals.aje.a009355
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7872015-05-11HighWireOUPamjepid:146:9
THE AUTHORS REPLY
Flanders, W. Dana
Lin, Lillian
Pirkle, James
Caudill, Sam
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
text/html
http://aje.oxfordjournals.org/cgi/content/short/146/9/787
http://dx.doi.org/10.1093/oxfordjournals.aje.a009357
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/788-a2015-05-11HighWireOUPamjepid:146:9
RE: "THE FAILURE OF ACADEMIC EPIDEMIOLOGY: WITNESS FOR THE PROSECUTION"
Cole, Thomas B.
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/788-a
http://dx.doi.org/10.1093/oxfordjournals.aje.a009359
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/7882015-05-11HighWireOUPamjepid:146:9
RE: "MICRONUTRIENTS AND THE RISK OF COLORECTAL ADENOMAS"
ERRATUM
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/788
http://dx.doi.org/10.1093/oxfordjournals.aje.a009358
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/786a1997-11-01HighWireOUPamjepid:146:9
Re: "Perineal powder exposure and the risk of ovarian cancer"
Muscat, JE
Wynder, EL
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/786a
en
Copyright (C) 1997, Oxford University Press
oai:open-archive.highwire.org:amjepid:146/9/786b1997-11-01HighWireOUPamjepid:146:9
Re: "Assessing the direction of causality in cross-sectional studies"
Kulkarni, PM
Wang, S
LETTERS TO THE EDITOR
Oxford University Press
1997-11-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/146/9/786b
en
Copyright (C) 1997, Oxford University Press