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Biomedical subjects

C W Heath

Publications and source records attributed to C W Heath.

At least 19 recordsLinked to original sources
PubMed1992

Risk factors for fatal colon cancer in a large prospective study.

BACKGROUND: Diet, physical activity, obesity, aspirin use, and family history may all modify the risk of colon cancer, but few epidemiologic studies are large enough to examine these factors simultaneously. PURPOSE: We prospectively assessed the relationship of diet and other factors to risk of fatal colon cancer. METHODS: Using data from Cancer Prevention Study II--an ongoing prospective mortality study--we studied 764,343 adults who, in 1982, completed a questionnaire on diet and other risk factors and did not report cancer or other major illness. We assessed mortality through August 1988 and identified 1150 deaths from colon cancer (611 men and 539 women). Multivariate analyses were used to compare these case patients with 5746 matched control subjects drawn from the cohort. RESULTS: Risk of fatal colon cancer decreased with more frequent consumption of vegetables and high-fiber grains (P for trend = .031 in men and .0012 in women). The relative risk (RR) for the highest versus lowest quintile of vegetable intake was 0.76 in men (95% confidence interval [CI] = 0.57-1.02) and 0.62 in women (95% CI = 0.45-0.86). Dietary consumption of vegetables and grains and regular use of aspirin were the only factors having an independent and statistically significant association with fatal colon cancer. Participants who consumed the least vegetables and grains and no aspirin had a higher risk compared with those who consumed the most vegetables and used aspirin 16 or more times per month. For men in the former category, the RR was 2.4 (95% CI = 1.1-5.3); for women, it was 2.9 (95% CI = 1.3-6.7). Weaker associations were seen for physical inactivity, obesity, total dietary fat, and family history. No associations were seen with consumption of red meat or total or saturated fat in either sex, but this finding must be interpreted cautiously. CONCLUSIONS: These findings support recommendations that increased consumption of vegetables and grains may reduce the risk of fatal colon cancer. Regular use of low doses of aspirin may prove to be an important supplemental measure.

Adult↗
PubMed1992

Stat bite.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1992

Epidemiologic studies of rheumatoid arthritis: future directions.

We (1) review the current status of epidemiologic studies of rheumatoid arthritis (RA); (2) consider the strengths and weaknesses of such studies and (3) offer suggestions regarding directions which future work might take. We will not examine any particular studies in great detail, but, instead, will focus on those broad aspects of epidemiologic work concerning RA which seem most important. In this process, it may be useful to draw comparisons with cancer epidemiology, since etiologic possibilities in cancer often resemble those seen in RA and similar methodologic issues are involved.

Arthritis, Rheumatoid↗
PubMed1991

Aspirin use and reduced risk of fatal colon cancer.

BACKGROUND AND METHODS: Experiments in animals and two epidemiologic studies in humans suggest that aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) may be protective against colon cancer. We tested this hypothesis in a prospective mortality study of 662,424 adults who provided information in 1982 on the frequency and duration of their aspirin use. Death rates from colon cancer were measured through 1988. The possible influence of other risk factors for colon cancer was examined in multivariate analyses for 598 case patients and 3058 matched control subjects drawn from the cohort. RESULTS: Death rates from colon cancer decreased with more frequent aspirin use in both men and women. The relative risk among persons who used aspirin 16 or more times per month for at least one year was 0.60 in men (95 percent confidence interval, 0.40 to 0.89) and 0.58 in women (95 percent confidence interval, 0.37 to 0.90). The risk estimates were unaffected when we excluded persons who reported at entry into the study that they had cancer, heart disease, stroke, or another condition that might influence both their aspirin use and their mortality. Adjustment for dietary factors, obesity, physical activity, and family history did not alter the findings significantly. No association was found between the use of acetaminophen and the risk of colon cancer. CONCLUSIONS: Regular aspirin use at low doses may reduce the risk of fatal colon cancer. Whether this is due to a direct effect of aspirin, perhaps mediated by the inhibition of prostaglandin synthesis, or to other factors indirectly associated with aspirin use is unclear.

Acetaminophen↗
PubMed1990

Mortality associated with the use of upper-body control holds by police.

A review of police records for the nine-year period from 1974 to 1982 identified 20 men who died following restraint by an upper-body control hold while in the custody of a large, urban police department. Using evidence from autopsy findings and police reports of events immediately preceding death, we concluded that control-hold use was associated with death in 19 of the 20 cases. This investigation points to three factors potentially associated with control hold-related death that deserve further investigation: Phencyclidine (PCP) use, sickle cell trait, and stress-related arrhythmias in the heart. PCP was detected in blood or other tissues from 6 of 17 decedents tested. Intravascular red blood cell sickling was found at autopsy in 4 of 14 black decedents (29%). Four decedents had some indication of cardiovascular abnormalities.

Adult↗
PubMed1989

Underreporting of AIDS cases in South Carolina, 1986 and 1987.

An evaluation of the completeness and accuracy of case reporting of the acquired immunodeficiency syndrome (AIDS) for the 18-month period from January 1, 1986, through June 30, 1987, was conducted for South Carolina. A total of 596,585 hospital discharge billing records were searched by computer for conditions defining AIDS. The resulting 1513 records were manually reviewed. Of these, 349 discharges for 163 individuals were classified as being definitely AIDS related, the clinical features of these cases meeting Centers for Disease Control criteria for AIDS diagnosis. Of these cases, 153 were reportable to the South Carolina AIDS registry at the time of their diagnosis. Comparison of this case list with registry records revealed that only 91 (59.5%) had been reported. Reporting was significantly poorer for cases among blacks (53.1%) than for cases among whites (71.6%). These findings may have important implications for the interpretation of AIDS surveillance data and for planning activities in which awareness of complete case counts may be critical.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Contact tracing to identify human immunodeficiency virus infection in a rural community.

This report describes a contact investigation conducted in rural South Carolina to identify, counsel, and educate persons infected with or exposed to the human immunodeficiency virus (HIV). Starting with one HIV antibody-positive man and his 19 sex contacts, we identified 83 sex contacts of HIV antibody-positive men. Of these, 64 were residents of the county and 63 (98%) agreed to be tested for evidence of HIV infection. Eight (13%) were HIV antibody positive. Thirty-six initially HIV antibody-negative men were reevaluated at a six-month follow-up visit, and three had seroconverted during this time. Of 25 men who reported practicing anal receptive intercourse, 13 (52%) were HIV antibody positive vs none of 43 men who reported strictly anal insertive intercourse. Comparing reported numbers of sexual contacts for the six-month periods before and after our initial investigation, the mean numbers of named sex contacts decreased by 82% for antibody-positive men and 54% for antibody-negative men. None of the men reported using condoms before entering the study; at the six-month follow-up visit, four (80%) of five of the antibody-positive men and 25 (69%) of 36 of the antibody-negative men reported using condoms at least some of the time.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Investigation of cancer case clusters: possibilities and limitations.

Discovery of meaningful biologic events through investigation of individual cancer case clusters is limited by the greater likelihood that any given cluster, otherwise unspecified, will be a random event and by restrictions arising from the necessarily retrospective nature of any studies undertaken. In the face of long and variable latencies, it is difficult to document potential oncogenic exposures and to estimate dosage. Since case numbers are usually small, statistical assessments may have only limited value. This, however, encourages greater attention to be given to case features and clinical details from which patterns of case associations within clusters can occasionally be seen. When similar epidemiologic case patterns are repeatedly encountered in different cluster situations (as was apparent with parish and school associations, reviewed here, in several communities in the United States), some biologic basis for such case clustering may be suspected. Similar suspicions are aroused when additional cases of rare cancer are observed in community settings to which case clustering has already drawn attention.

Demography↗
PubMed1985

Unexplained deaths in a children's hospital. An epidemiologic assessment.

During a nine-month period, July 1980 through March 1981, the mortality rate for patients on the cardiology ward of a children's hospital was 43.1 deaths per 10,000 patient-days, as compared with 11.0 deaths per 10,000 patient-days during the preceding 54 months. Twenty-five (76 per cent) of 33 infant deaths during this nine-month period occurred between midnight and 6:00 a.m., as compared with 1 of 10 infant deaths during a separate 27-month period (P less than 0.001). Although nearly all deaths occurred in patients with serious congenital heart disease, epidemic-period deaths were more likely to have an unexpected timing and a clinical pattern consistent with digoxin toxicity. In four patients, forensic and clinical digoxin measurements suggested that an intravenous overdose of digoxin had been administered shortly before death. Although a review of nursing schedules revealed a strong association (relative risk, 64.6) between infant deaths and the duty times of a particular nurse, the cause of the epidemic remains unclear. The study led to suggestions that the hospital strengthen central control over procedures for dispensing medicines and implement a system for monitoring the occurrence of deaths by time and place within the hospital.

Digoxin↗
PubMed1979

Cohort study of Michigan residents exposed to polybrominated biphenyls: epidemiologic and immunologic findings.

Polybrominated biphenyls (PBB) were dispersed widely in Michigan by a 1973 shipping accident in which PBB was introduced into cattle feed. Human exposure resulted principally from ingestion of contaminated dairy food products. To determine whether PBB exposure has or will cause acute or chronic illness, a prospective cohort study of 4545 persons has been undertaken. Three exposure groups were sought; all persons living on PBB-quarantined farms; persons who had received food directly from such farms; workers (and their families) engaged in PBB manufacture. Enrollment rates were 95.6, 95.1 and 78.0%. Also enrolled were 725 persons with low-level PBB exposure. All were queried concerning 17 symptoms and conditions related possibly to PBB. Venous blood was drawn on 3639 and analyzed for PBB by gas chromatography. Mean serum PBB levels were 26.9 ppb in quarantined farm families, 17.1 in recipients, 43.0 ppb in workers, and 3.4 ppb in the low exposure groups. No associations were found between serum PBB levels and symptom prevalence rates. To evaluate peripheral lymphocyte function, T and B cell quantitation and in vitro responses to 3 nonspecific mitogens were studied in 34 persons with highest PBB levels (mean, 787 ppb), and in 56 with low values (mean, 2.8 ppb). No statistically significant differences in lymphocyte number or function were noted.

Adolescent↗
PubMed1978

Lung cancer after employment in shipyards during World War II.

A case-control study, undertaken to identify reasons for the exceptionally high rate of lung cancer among male residents of coastal Georgia, revealed a significantly increased risk associated with employment in area shipyards during World War II. The summary relative-risk estimate, adjusted for smoking, other occupations, age, race and county of residence was 1.6 (95 per cent confidence limits = 1.1 to 2.3). A synergistic relation was found between shipyard employment and cigarette smoking. These findings suggest that asbestos and possible other shipyard exposures during wartime employment account for part of the excess mortality from lung cancer in certain coastal areas of the United States.

Aged↗