Are dietary goals and guidelines enough?
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to C Bain.
Explore the source record for details and available documents.
In a population of slightly-more than one million persons, all cases of acute admission to hospital for cerebrovascular disease during 1984 were studied. Of the 2676 hospital admissions, 91% were of public-hospital patients. Of the 1908 patients who were aged more than 25 years and whose conditions were assigned the International classification of diseases' (ICD-9) codes (430-437) for cerebrovascular accidents, 1264 (1.8 patients per 1000 population of older than 25 years of age) cases were completed strokes, and 644 (1.0 patients per 1000 population of older than 25 years of age) cases were transient ischaemic attacks. There was no significant difference between the specific aetiological types of stroke that were diagnosed neuroradiologically and those that were diagnosed clinically. Among the cases of completed strokes, 54% of cases were thrombotic, 11% of cases were embolic, and 15% of cases were haemorrhagic, while nearly 20% of cases were unclassified. Twenty-one per cent of patients who were admitted to hospital with completed strokes died within two weeks of their admission, 28% of such patients were discharged home, 8% of such patients were transferred to full-maintenance care, and the remaining 43% of such patients were transferred for inpatient rehabilitation. The median length of stay for patients with completed strokes was 11.8 days compared with 6.2 days for patients with transient ischaemic attacks.
L. galizai develops in the gamasid B. bacoti in 11 days at 28 degrees C. Molts I and II take place respectively 5 and 7 days after feeding. The development is studied in the adult female mites; as for the laboratory filaria L. sigmodontis, the interstitial tissue is the main parasitized organ; microfilariae penetrate in the two cell types which constitute it: adipose cells and secretory cells (these secretory cells are described here for the first time). The filariae develop also in the salivary glands, the digestive wall, the genital envelopes and exceptionally in the coxal and vaginal glands. The filariae produce the formation of syncytia. Larvae which stay in the haemocele do not develop.
A case-control study of breast cancer, diet, and lactational history was carried out in Brisbane, Australia, between 1981 and 1985. Cases were recruited from both the private and the public health care sectors. The breastfeeding histories of 459 cases and 1,091 controls selected from the electoral roll were analyzed. An odds ratio of 0.85 (95% confidence interval 0.55-1.30) for any lactation versus no lactation was observed, with no suggestion of a monotonic trend with increasing duration. This estimate was only slightly altered by multiple logistic regression analysis. A statistically significant nonlinear association was noted for breastfeeding of the first liveborn child (chi 2 = 14.8, df = 6; p less than 0.05), with a slightly elevated odds ratio for lactations of less than one month, a lowered odds ratio for lactations of one month to three months, and a weakly elevated odds ratio in women breastfeeding for more than nine months. Results for premenopausal women were very similar to those for postmenopausal women. Taken together with other recent studies, these results suggest that lactation may play a modest direct or indirect part in reducing the risk of breast cancer.
The relation of the presence of moles (nevi) on all four limbs to risk of cutaneous malignant melanoma was explored among 98 incident cases aged 32-59 years at diagnosis and 190 age-matched controls drawn from the Nurses' Health Study, a prospective cohort of female nurses in the United States. Cases diagnosed during follow-up from 1976 to 1982 were included in this study. Participants reported counts of all moles and raised moles alone on postal questionnaires. Distributions of moles were similar for right and left sides on upper and lower limbs for cases and controls. Counts declined with increasing age for all women, from a median of 15 for the youngest tertile of controls (aged 36-46 years) to three for the oldest (aged 54-62 years). Cases had more moles than did controls (medians of 23 and 9, respectively, for total moles on all four limbs): The presence of any mole on a limb gave relative risks for melanoma ranging from 2.2 (95% confidence interval (CI) = 1.2-4.0) for one or more moles on an arm to 2.9 (95% CI = 1.6-5.3) for one or more moles on the lower limb. For raised moles, relative risks were 1.7 (95% CI = 1.0-2.7) for arm, 2.1 (95% CI = 1.3-3.5) for lower limb, and 3.5 (95% CI = 2.0-6.3) for leg (below knee). The highest site-specific risk (i.e., for any moles on the same limb as the melanoma vs. no moles on that limb) was for moles on the lower limb (relative risk = 5.0 (95% CI = 1.8-13.5)). There were positive and significant trends in overall and site-specific risk with increasing numbers of moles on all limbs when absolute mole counts were considered, e.g., for total moles on all four limbs combined, chi for trend = 4.0, one-sided p less than 0.001, with relative risk for more than 100 moles versus none of 6.0. Inclusion of sun exposure and other constitutional factors in logistic regression analyses did not alter these observed relations between the presence of moles and risk of melanoma.
Routine data on mortality and hospital activity were used to estimate changes in coronary heart disease mortality, case fatality, and hospitalizations in the Australian state of Queensland over the decade 1971-1980. Acute myocardial infarction (International Classification of Diseases (ICD) 410) and other ischemic heart disease (ICD 411-414) were considered separately. For acute myocardial infarction, age-adjusted total mortality declined by about one fourth in both men and women; in-hospital mortality decreased somewhat more and deaths out of hospital correspondingly less. The age-adjusted case fatality ratio fell by the same amount (29%), in both sexes. Similar trends occurred at all ages. Admission rates decreased 11% in men and 18% in women. Similar patterns were evident for other ischemic heart disease except for admissions, which rose 23% among men and remained at the same level in women. These findings suggest that both declining incidence, particularly in the form of fewer deaths out of hospital, and improvements in care may have contributed to the general decline in coronary heart disease mortality in this community. Without direct measures of incidence or changing disease severity, the relative contributions of each factor cannot be examined.
We analyzed smoking behavior of 91,651 married female nurses, aged 30-55 years in 1976. The prevalence of smoking was similar among all birth cohorts. The largest percentage increase in starting to smoke occurred between ages 15 and 25 years; by age 25, 50 per cent had started smoking. The cessation rate was lowest in earlier birth cohorts and among nurses starting to smoke at earlier ages. The cessation rate increased substantially between 1963-73 compared with the period 1948-58.
Aromatic amines contained in permanent hair dyes can be absorbed percutaneously and are mutagenic and carcinogenic in some laboratory studies. Concern has been raised that use of these dyes may increase the risk of human cancers. Therefore, the present study examined the relationship between permanent hair dye use and incidence of breast cancer among 118,404 U.S. women aged 30-55 years who were followed prospectively for 6 years. Among women who had ever used permanent hair dyes, 353 developed breast cancer during 246,848 person-years of follow-up, while 505 cases occurred during 397,460 person-years among never users (age-adjusted rate ratio = 1.1; 95% confidence interval = 0.9-1.2). Identical rate ratios were observed when women who had ever used hair dyes were subdivided into current and past users. Adjustment for known determinants of breast cancer in multivariate models did not alter these relationships. The risk of breast cancer did not increase with more frequent use, longer duration of use, or interval since first use. On the basis of these data and previous findings, it appears unlikely that the use of permanent hair dyes causes any important increase in risk of breast cancer.
Explore the source record for details and available documents.
In 1976, information on oral contraceptive (OC) use as well as numerous risk factors for breast cancer was provided by 121,964 married female registered nurses aged 30 to 55 years. Ninety-two percent of women in the cohort completed follow-up questionnaires, and vital records were systematically searched to ascertain deaths among nonrespondents. After four years of follow-up, 592 incident cases of breast cancer were identified. Compared with never users, the age-adjusted relative risk (RR) of breast cancer, regardless of menopausal status, among all women who had ever used OCs was 1.0. Among premenopausal women compared with those who had never used OCs, the RR of breast cancer was 1.5 for current use of OCs in 1976 and 1.0 for past use. Among postmenopausal women, the RR for past use of OCs was 1.0. These estimates were essentially unaltered after controlling for other known risk factors for breast cancer in multiple logistic regression analysis. Furthermore, there was no modification of these effects by family history of breast cancer, age at first use, timing of the first birth, or other breast cancer risk factors. Data on past use of OCs provide substantial reassuring evidence that there is no large excess risk of breast cancer within a few years of cessation of pill use. The observed moderate elevation of breast cancer risk with current use was of borderline statistical significance. However, the observation was based on 29 cases and may reflect the effect of sampling variability, as most other studies have not observed a relationship between current use of OCs and breast cancer in women of this age.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Seventy two patients (39 women) with colonic adenomas were compared with 72 adenoma free controls (39 women) to investigate the possible association between previous cholecystectomy and the subsequent development of adenomas. Data were gathered retrospectively from medical records. Overall there was no significant association between colonic adenomas and previous cholecystectomy. When women are considered separately, however, eight cases and no controls had undergone cholecystectomy (odds ratio infinity lower 95% confidence limits 1.7, p greater than 0.01). No association between previous cholecystectomy and large bowel adenomas was found in men. Four of nine (44.4%) women with right sided colonic adenomas had undergone previous cholecystectomy compared with only three of 23 (13%) women with left sided adenomas.
The effect of exogenous hormones and reproductive factors on the risk of melanoma in women was investigated in a case-control study. Data from 91 women, aged from 15 to 81 years, and 91 matched controls were analysed in relation to use of oral contraceptives (OC), parity, age at the birth of the first child, and calculated length of ovulatory life. When potential confounding factors (including pigmentary characteristics and the lifetime exposure to sunlight were taken into account, there was no increase in risk of melanoma in relation to OC use, parity, or age at the birth of the first child. An unexplained association between melanoma and ovulatory life of greater length than 20 years was observed. The general findings of this study suggest that neither hormonal nor reproductive factors increase the risk of melanoma in women.
We investigated the relationship between cutaneous malignant melanoma and multiple sunburns in the Queensland population. Interview data were gathered from 236 case-control pairs concerning their lifetime experience of severe sunburns, their occupational and recreational sun exposure, and their skin type. Excluding the lentigo maligna melanoma subtype, an association between multiple sunburns and melanoma was evident. After controlling for other major risk factors there was a significant dose-response relationship (P less than 0.05): the estimated relative risk associated with 2-5 sunburns in life was 1.5, and with 6 or more was 2.4. This observation extends the hitherto circumstantial evidence of a causal relationship between exposure to solar ultraviolet radiation and melanoma, and suggests that precautionary measures could prevent the development of this disease in a proportion of cases in fair-skinned populations.
The aim of this study was to evaluate the reproducibility and validity of a 61-item semiquantitative food frequency questionnaire used in a large prospective study among women. This form was administered twice to 173 participants at an interval of approximately one year (1980-1981), and four one-week diet records for each subject were collected during that period. Intraclass correlation coefficients for nutrient intakes estimated by the one-week diet records (range = 0.41 for total vitamin A without supplements to 0.79 for vitamin B6 with supplements) were similar to those computed from the questionnaire (range = 0.49 for total vitamin A without supplements to 0.71 for sucrose), indicating that these methods were generally comparable with respect to reproducibility. With the exception of sucrose and total carbohydrate, nutrient intakes from the diet records tended to correlate more strongly with those computed from the questionnaire after adjustment for total caloric intake. Correlation coefficients between the mean calorie-adjusted intakes from the four one-week diet records and those from the questionnaire completed after the diet records ranged from 0.36 for vitamin A without supplements to 0.75 for vitamin C with supplements. Overall, 48% of subjects in the lowest quintile of calorie-adjusted intake computed from the diet records were also in the lowest questionnaire quintile, and 74% were in the lowest one of two questionnaire quintiles. Similarly, 49% of those in the highest diet record quintile were also in the highest questionnaire quintile, and 77% were in the highest one or two questionnaire quintiles. These data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
Although higher relative weight is generally considered to increase the risk of breast cancer, several case-control studies have suggested that the reverse may be true among premenopausal women. The association between Quetelet's index (a measure of relative weight calculated as weight/height) and the subsequent incidence of breast cancer was therefore examined during four years of follow-up among a cohort of 121,964 US women who were 30-55 years of age in 1976. In contrast to women who had experienced natural menopause or bilateral oophorectomy, the incidence of breast cancer among premenopausal women decreased with higher levels of relative weight. Age-adjusted relative risks for increasing quintiles of Quetelet's index were 1.00, 0.90, 0.90, 0.73, and 0.66 (Mantel extension test for trend = -2.82, p = 0.005). This inverse association was not explained by known risk factors for breast cancer and was somewhat stronger when Quetelet's index was computed using reported weight at age 18 years. The excess incidence of breast cancer among lean premenopausal women, however, was limited to tumors that were less than 2.0 cm in diameter, were not associated with metastases to lymph nodes, and were well-differentiated. These findings suggest that the apparent excess risk of breast cancer among lean premenopausal women may result at least in part from easier, and thus earlier, diagnosis of less aggressive tumors.
Explore the source record for details and available documents.