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Biomedical subjects

I Romieu

Publications and source records attributed to I Romieu.

At least 73 records · Page 4Linked to original sources
PubMed1989

Oral contraceptives and the risk of rheumatoid arthritis: a meta-analysis of a conflicting literature.

Since an original report suggesting a protective effect of oral contraceptives on rheumatoid arthritis incidence, 12 studies from four countries have shown conflicting results. Using the method of DerSimonian and Laird all available studies (including two completed but not as yet published) were evaluated. Overall, the relative risk of oral contraceptive use on the development of RA were less than unity. When summary statistics for case-control studies were examined, a small protective effect was noted, but was not statistically significant.

Arthritis, Rheumatoid↗
PubMed1988

Choice of non-steroidal anti-inflammatory drug in persons treated for dyspepsia.

Prior use of analgesics among 1327 new users of cimetidine over the age of 65 at Group Health Cooperative of Puget Sound was much more common than among 5308 members of similar age and sex who had never taken cimetidine. The excess included not only most non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin, but also extended to paracetamol. New users of cimetidine who had not received analgesics in the preceding 2 years were preferentially given recently introduced NSAIDs if an NSAID was subsequently prescribed. Review of prior studies of analgesic use and ulcer diseases reveals a regular association between ulcer and preceding use of paracetamol, a drug for which no causal association to ulcer is thought to exist. General increases in use of analgesics by elderly dyspeptic patients may have given rise to artefact in reported associations between manifestations of ulcer disease and NSAIDs.

Acetaminophen↗
PubMed1988

Energy intake and other determinants of relative weight.

The relationships of relative weight to energy intake and to physical activity were studied among 141 females aged 34-59 y. As observed in previous studies Quetelet index (wt/ht2) was inversely related to energy intake (r = -0.11). However, obese women tended to be older (r = 0.16), exercise less (r = -0.30), and drink less alcohol (r = -0.16) than nonobese women. Older women had lower energy intake (r = -0.23) and exercised less (r = -0.12) than younger women. Energy intake and physical activity were positively related (r = 0.23). After adjustment for age, physical activity, alcohol, and smoking, the inverse correlation between relative weight and energy intake was significantly reduced (p = 0.04) from r = -0.11 to r = -0.02. Obese women reported higher intakes of total fat, and relative weight was significantly correlated with intakes of total fat (r = 0.20) and saturated fatty acids (r = 0.16). These data highlight the importance of considering factors that may confound the relationship between energy intake and obesity, and they suggest that fat intake may play a role in obesity that is independent of total energy intake.

Adult↗
PubMedDate not supplied

Questionnaire assessment of antioxidants and retinol intakes in Mexican women.

BACKGROUND: In order to assess intake of antioxidants and retinol, we evaluated the validity and reproducibility of a semiquantitative food frequency questionnaire. METHODS: Data were collected from 110 women, aged 15-54 years, who resided in the southern part of Mexico City. Study participants were asked to complete the food frequency questionnaire before and after completing four series of 4 days of 24-h diet recalls. We obtained the 24-h recalls at 3-month intervals designed to account for seasonal variability. In addition, we measured serum blood levels of retinol and various carotenoids at 3 and 9 months after baseline. RESULTS: Intraclass correlation coefficients for intake of energy-adjusted daily nutrients, assessed by the questionnaires 1 year apart, ranged from 0.23 for lutein/zeaxanthin to 0.50 for total carotenes. Correlation coefficients between energy-adjusted nutrient intakes were measured by means of the sixteen 24-h dietary recalls, and the second questionnaire ranged from 0.09 for lutein/zeaxanthin to 0.45 for total carotenes. These correlations were higher after adjusting for day-to-day variations in diets ranging from 0.11 for lutein/zeaxanthin to 0.49 for vitamin C. Correlation coefficients between intake and biochemical measures were 0.32 for alpha-carotene, 0.34 for beta-carotene, and 0.40 for total carotene after adjusting for age, body mass index, cholesterol and triglyceride plasma levels, smoking status, and caloric intake. CONCLUSIONS: These data support the ability of our food frequency questionnaire to provide valid information on the relative intake of these nutrients and to confirm its usefulness in epidemiological studies of diet-disease relations. However, its application outside Mexico City or in different age or gender populations will require additional modifications and validation efforts.

Adolescent↗
PubMedDate not supplied

Vehicular traffic as a determinant of blood-lead levels in children: a pilot study in Mexico City.

The major determinants of blood-lead levels were studied in 90 children who attended an outpatient pediatric clinic in Mexico City. All children, who were from 1-10 y of age, were from homes for which socioeconomic status had been categorized as medium to high. Blood-lead levels ranged from 0.17 (standard deviation [SD] = 0.008) to 1.21 (SD = 0.06 mumol/l). The main determinant of blood-lead levels was place of residence. Children who lived on private streets (i.e., low-traffic areas) had a significantly lower blood-lead level than children who lived on large avenues and who resided close to main roads (p = .0001, r2 = .27). This observation documented high exposure levels among children who live in Mexico City and suggested that leaded fuel used in Mexico could play an important role in determining blood-lead levels in this population.

Automobile Driving↗
PubMedDate not supplied

Effects of intermittent ozone exposure on peak expiratory flow and respiratory symptoms among asthmatic children in Mexico City.

In a panel study of Mexican children (5-13 y of age) with mild asthma, the authors studied the relationship between ozone exposure and the course of childhood asthma. Decrements in peak expiratory flow rate were associated with ozone, and respiratory symptoms were associated with both ozone level and ambient particulate matter (< 10 microm) level. After the authors adjusted for minimum temperature and autocorrelation in the data, they determined that an increase of 50 ppb in a daily ozone 1-h maximum was related to an 8% increase in cough (95% confidence interval = 2, 15); a 24% increase in phlegm (95% confidence interval = 13, 35); and an 11% increase in low respiratory symptoms index (95% confidence interval = 5, 19). The authors concluded that children with mild asthma who resided in the south of Mexico City were affected adversely by the high ozone ambient levels observed in this area.

Acute Disease↗
PubMedDate not supplied

A survey of personal exposures to benzene in Mexico City.

Benzene is a widely distributed environmental contaminant that causes leukemia. It is an important component in gasoline, it is used frequently as a solvent or chemical feedstock in industry, and it is emitted as a product of incomplete combustion. In Mexico City, investigators suspect that benzene exposure might be elevated and may pose a risk to the population; however, no published data are available to confirm or disconfirm this suspicion. We, therefore, conducted a survey in 3 occupational groups in Mexico City. Forty-five volunteers who used portable passive monitors measured their personal exposure to benzene during a workshift. None of the participants smoked during the monitoring period. Benzene exposure was significantly higher among service-station attendants (mean = 359.5 microg/m3 [standard deviation = 170.4 microg/m3]) than among the street vendors (83.7 microg/m3 and 45.0 microg/m3, respectively) and office workers (45.2 microg/m3 and 13.3 microg/m3, respectively). However, the benzene exposure levels observed among office workers were substantially higher than levels reported elsewhere for general populations. Our results highlight the need for more complete studies by investigators who should assess the potential benefits of setting environmental standards for benzene in Mexico.

Adolescent↗
PubMedDate not supplied

Particulate air pollution and daily mortality: can results be generalized to Latin American countries?

OBJECTIVE: Recently, a series of reports, based on ecological analyses of routinely collected data, have shown positive associations between measures of particle concentration and daily mortality counts in various cities of the US and Europe. MATERIAL AND METHODS: We reviewed the process of generalization of these results to Latin American countries addressing possible differences in air pollution mixtures, exposure profiles, and population susceptibility. RESULTS: A limitation to the process of generalization is the lack of a well-established biological mechanism by which particles may act on daily mortality. Also, sources and levels of ambient air pollution as well as population characteristics and habits vary widely between Northern communities of Europe and the US, and Latin American countries, which impairs the process of generalization. However, results of studies conducted in Latin American countries suggest a similar effect to that observed in Northern countries of Europe and the US. CONCLUSIONS: Despite uncertainty about the mechanism, there is sufficient evidence that particles are harmful for health. Control measures of particle emission are urgently needed in Latin American countries. Given the potential of misclassification of exposure, the dose-response relationship observed in Northern Europe and the US may not be adequate for Latin American populations. There is a need for a new generation of epidemiological studies including a specific assessment of exposure to fine particles and of events surrounding death.

Air Pollution↗
PubMedDate not supplied

Validity and reproducibility of a food frequency questionnaire to assess dietary intake of women living in Mexico City.

OBJECTIVE: To assess the reproducibility and validity of a 116 item semi-quantitative food frequency questionnaire (FFQ), designed to assess the relation between dietary intake and chronic diseases. MATERIAL AND METHODS: To test the reproducibility of the FFQ questionnaire, the FFQ was administered twice to 134 women residing in Mexico City at an interval of approximately one year; to assess the validity we compared results obtained by the FFQs with those obtained by four 4-day 24-hour recalls at three month intervals. Validity and reproducibility were evaluated using regression analysis and Pearson and intraclass correlation coefficients of log-e and calorie-adjusted nutrient scores. RESULTS: Mean values for intake of most nutrients assessed by the two food frequency questionnaires were similar. However, means for the 24-hr recall were significantly lower. Intraclass correlation coefficients for nutrient intakes, assessed by questionnaires, administered one year apart, ranged from 0.38 for cholesterol to 0.54 for crude fiber. Correlation coefficients between energy-adjusted nutrient intakes, measured by diet recalls, and the first FFQ ranged from 0.12 for polyunsaturated fatty acids to 0.67 for saturated fatty acids. Regression coefficients between 24-hr recall and FFQ,s were all significant were significant for all nutrients, except for polyunsaturated fat, folic acid, vitamin E and Zinc. CONCLUSIONS: These data indicate that this semi-quantitative FFQ is reproducible and provides a useful estimate by which to categorize individuals by level of past nutrient intake. However, its application outside Mexico City or in different age and gender populations will require additional modifications and validation efforts.

Diet↗
PubMedDate not supplied

[Evolution of air pollution and impact on control programs in 3 megacities in Latin America].

The present work discusses the problems of atmospheric pollution of three Megacities of Latin America (Mexico City, Sao Paulo and Santiago). The environmental pollution control programs implemented by the Government are revised and the evolution of pollution levels during the period of 1988-1995 at Santiago de Chile and Sao Paulo, but until 1997 at Mexico City, in order to evaluate the impact of these programs. During this period, a decreasing trend is observed in the three cities in the levels of PTS, PM10, SO2, NO2, CO and O3, although most of these contaminants still exceed the air quality standards. It must be emphasized that the largest impact has been on the levels of SO2. We recommend the development of sustainable transport policies; in this context, various strategies were proposed by the Organization for Economic Cooperation and Development (OECD) in the European Conference of Ministers of Transport. Additionally, public participation is important when decisions are taken on transport policies.

Air Pollution↗
PubMedDate not supplied

[Relationship between emergency consultations for respiratory diseases and air pollution in Juarez City, Chihuahua].

OBJECTIVE: To assess the relationship of < or = 10 microns particles (PM10) and atmospheric ozone concentrations, with the daily number of emergency visits due to asthma and acute respiratory diseases, among children aged under 15, living in Ciudad Juarez, Chihuahua, Mexico. MATERIAL AND METHODS: Between 1998 and 1999, an ecologic study was conducted. Atmospheric data were obtained from the Environmental Protection Agency (EPA), from eight monitoring stations located in Ciudad Juarez, Chihuahua, and EI Paso, Texas. From July 1997 to December 1998, data from emergency room visits for respiratory illness were abstracted from existing medical records of two Mexican Institute of Social Security (IMSS) hospitals in Ciudad Juarez. Diagnoses were classified into two groups: a) asthma, and b) upper respiratory infections (URI), according to the International Classification of Diseases (ICD-9 and/or IDC-10). Statistical analysis was carried out using the Poisson regression time series method. RESULTS: During the study period, the mean 24-hour PM10 level was 34.46 micrograms/m3 (SD = 17.99) and the mean ozone level was 51.60 ppb (SD = 20.70). The model shows that an increase of 20 micrograms/m3 in the mean 24-hour exposure to PM10 was related to an increase of 4.97% (95% CI 0.97-9.13) in emergency visits for asthma, with a 5-day lag, as well as to an increase of 9% (95% CI 1.8-16.8) when a cumulative 5-day exposure was considered. URI increased 2.95% as a cause of emergency room visits, for each 20 micrograms/m3 increase in the mean 24-hour exposure to PM10. The impact of PM10 on emergency visits for asthma was greater on days with ozone ambient levels exceeded 49 ppb (median value). CONCLUSIONS: A positive association was found between environmental PM10 and ozone concentrations and the daily number of emergency room visits due to asthma and acute respiratory diseases, even with levels lower than the Mexican standard levels. Also, a synergic effect between PM10 and O3 was found.

Acute Disease↗
PubMedDate not supplied

[Prevalence of asthma and other allergic diseases in school children from Juarez City, Chihuahua].

OBJECTIVE: To assess the prevalence and severity of asthma and allergic diseases in schoolchildren residing in Ciudad Juarez, Chihuahua. MATERIAL AND METHODS: A cross-sectional study was conducted from April 1998 to May 1999, among 6,174 children from 53 schools in Ciudad Juarez, Chihuahua. The method used was the one recommended by the International Study of Asthma and Allergies in Childhood (ISAAC) to determine the prevalence and severity of asthma, rhinitis, and eczema. Parents were asked to answer a standardized questionnaire on current and cumulative prevalence of asthma, rhinitis, and eczema. A sample stratified by level of pollution was selected. RESULTS: The cumulative prevalence of medically diagnosed asthma and wheezing was 6.8% (95% CI 6.2, 7.4) and 20% (95% CI 19.7, 21.8), respectively. The prevalence of wheezing in the last 12 months was higher in the group aged 6-8 years than in those aged 11-14 years (9.7% vs. 5.8%, p < 0.01). The prevalence of medically diagnosed rhinitis was 5.0% (95% CI 4.5, 5.6). The prevalence of medically diagnosed eczema was 4.9% (4.3, 5.4). The prevalence of eczema symptoms in the last 12 months was 12.7% in the 6-8 years group and 13.3% in the 11-14 year group, respectively. Severe symptoms of asthma were significantly higher in the 6-8 years group and during the autumn months. CONCLUSIONS: The prevalence of medically diagnosed and symptomatic asthma was relatively low in comparison with findings from others studies that use similar methods, but the prevalence rates of rhinitis and eczema were higher.

Asthma↗
PubMedDate not supplied

[Study of the validity and reproducibility of passive ozone monitors].

The aim of this study was to evaluate the validity and reproducibility between ozone measurements obtained with passive ozone monitors and those registered with a continuous ozone monitor, to determine the applicability of passive monitors in epidemiological research. The study was carried out during November and December 1992. Indoor and outdoor classroom air ozone concentrations were analyzed using 28 passive monitors and using a continuous monitor. The correlation between both measurements was highly significant (r = 0.089, p < 0.001), indicating a very good validity. Also, the correlation between the measurements obtained with two different passive monitors exposed concurrently was very high (r = 0.97, p < 0.001), indicating a good reproducibility in the measurements of the passive monitors. The relative error between the concentrations measured by the passive monitors and those from the continuous monitor tended to decrease with increasing ozone concentrations. The results suggest that passive monitors should be used to determine cumulative exposure of ozone exceeding 100 ppb, corresponding to an exposure period greater than five days, if used to analyze indoor air.

Air Pollution, Indoor↗
PubMedDate not supplied

[Environmental exposure factors and the concentrations of blood lead in Mexico City children].

Risk factors that contribute to high blood lead concentrations were determined in 113 infants, aged 3 to 7 years old, that attended pediatric consultation at the American British Cowdray Hospital (ABC) from May 1991 to October 1992. The range of blood lead concentrations was 4 to 45 micrograms/dl, with an average value of 15.6 micrograms/dl (DE = 7.0), and a geometric mean of 14.2 micrograms/dl (IC 95% = 11.9-16.5). Seventy six percent of the children presented blood lead concentrations of over 10 micrograms/dl. The main predictors of blood lead levels were the use of glazed pottery for cooking rice (ANOVA, p = 0.0000) and the storage of food in glazed pottery (t-test, p = 0.005). There was a significant association between the use of glazed pottery for cooking rice and blood lead concentrations (tendency p = 0.000). The attributable risk of this population due to the use of glazed pottery was 81 per cent. This study sustains the need to develop and enforce public health policies for programs of lead poisoning prevention.

Adolescent↗
PubMedDate not supplied

[Reproductive risk factors and sexual history associated with cervical cancer in Mexico].

Uterine cervical cancer is one of the principal public health problems in Mexico. The national mortality rate for cervical cancer in 1991 is estimated at 9.5 per 100,000 women, representing 4,194 deaths. In the period from August 1990 to December 1992, a case-control study was carried out that included 630 cases of histologically confirmed cervical cancer in eight Mexico City hospitals (two for people with no social security cover, four of the social security system and two private). As controls, 1,005 women were chosen from a random sampling of houses in the Mexico City metropolitan area. The main cervical cancer risk factors found in this study, adjusted for a multivariate model, were multiple normals births (with five births OR of 1.93 and 95% C.I. of 1.22-2.73) and a history of two or more sex partners (the OR with four or more sex partners was 5.56 and a C.I. of 2.3-13.4). In addition, there was an estimated lower risk of disease related to starting a sex life after 25 years of age (OR 0.41 with C.I. of 0.25-0.69) and to having cesareans as compared versus one normal birth (OR 0.28 and C.I. of 0.13-0.61). The information obtained is relevant since it identifies Mexican women with a high-risk of developing cervical cancer which can be used in planning programs for the early detection of cancer in this population.

Adult↗