Biomedical subjects
M J Ashley
Publications and source records attributed to M J Ashley.
Smoking, alpha 1-antitrypsin and decreased fertility in women.
There is epidemiologic evidence that smoking by women is associated with decreased fertility. Little is known about the biological mechanism(s) that might underlie a direct association. The effect of smoking on genital secretions, including levels of alpha 1-antitrypsin (AlAT), has not been studied. Low midcycle levels of AlAT appear to favour fertility by facilitating sperm migration and/or penetration. Smoking increases serum levels of functional AlAT. Since AlAT is produced only in the liver, levels in other tissues may reflect serum levels. It is postulated that smoking-induced increases in serum AlAT result in higher levels of AlAT in genital secretions, including those at midcycle, thereby impeding fertility. Support of an effect of serum AlAT levels on fertility is provided by studies of AlAT deficient persons, in whom fertility seems to be enhanced. An adverse effect of smoking on fertility through an increase in genital tract AlAT levels would be reversible.
A population survey in Ontario regarding restrictive measures on smoking: relationship of smoking status to knowledge, attitudes and predicted behaviour.
A population survey of Ontario residents regarding knowledge of the health effects of smoking, attitudes towards restrictive measures, and predicted behaviour was carried out. Telephone responses of 490 current, 290 former, and 581 never smokers were compared. For both active and passive smoking, never smokers were most knowledgeable about health effects, former smokers being less knowledgeable, and current smokers least so. While a majority of each smoking status group supported some restriction on smoking in all 13 settings examined, there were consistent differences among the groups as to degree. Never and former smokers were in close agreement and were more restrictive in their attitudes than current smokers. Prohibition was more strongly favoured by all groups for health and day care facilities, schools, stores, and local transit systems than for other settings. While a majority of smokers thought there would be compliance with restrictions, non-smokers were less optimistic. Smokers were less likely than non-smokers to see a role for governments in enactment; municipal involvement was favoured over other levels by all groups. No group indicated much support for enforcement by police. These findings remained when multivariate analyses controlling for inter-group differences in sociodemographic characteristics were carried out.
The significance of a dual skin test with PPD and PPD-B in humans after BCG vaccination.
Dual skin tests with tuberculin purified protein derivative (PPD) and with one of the following antigens prepared from mycobacteria other than M. tuberculosis, such as PPD-Y, PPD-G, PPD-B, PPD-F, etc., are performed to establish the frequency of "atypical" mycobacterial infection in a given population. However, most of this work has been done in areas where BCG vaccination was rarely implemented, if at all. The purpose of this study was to assess the significance of a dual skin test using PPD and PPD-B in a population which had been vaccinated with BCG. It was found that in a population with a high level of sensitivity to PPD, median skin reaction 12 mm, only 7% of the subjects tested gave a greater response to PPD-B than to PPD, whereas in a population with a low level of sensitivity to PPD, median skin reactions 3 mm, 36% of the subjects gave a greater response to PPD-B than to PPD. It would appear, therefore, that in a population vaccinated with BCG and with a low level of sensitivity to PPD, a relatively high percentage of positive reactors, those with an induration of 5 mm or more to either PPD or PPD-B, gave a larger skin reaction to PPD-B than to PPD. To avoid erroneous conclusions as to whether or not there is a high frequency of atypical infection in a given population, the authors suggest that the BCG status of those tested with PPD and PPD-B be taken into consideration when interpreting the results of an epidemiological survey that includes an atypical antigen such as PPD-B.
Does a family history of allergy predict immediate skin test reactivity?
The value of a family history of allergy in predicting atopy was assessed in men employed in lumber mills, grain handling and railway industries in British Columbia. Detailed family and personal histories of allergy were available for 1434 men, 1426 of whom underwent prick skin testing with two common environmental allergens and one control solution. Those with a family history of allergy had 2.06 times the odds of immediate skin test reactivity as those without a family history and 1.65 (p less than 0.01) times the odds after adjustment for personal history and age. The odds of skin test reactivity in workers with a personal history of allergy were 4.76 times those of workers without such a history and 4.34 after adjustment for family history and age. Almost half (47%) of the workers with both a family and a personal history of allergy had positive results of skin testing, compared with only 10% of the workers without either history. It was therefore concluded that a family history of allergy is an independent predictor of atopy.
Alcohol consumption and blood pressure: analysis of data from the Canada Health Survey.
Recent epidemiologic studies report a significant association between alcohol consumption and elevations in both systolic (SBP) and diastolic (DBP) blood pressures. To test this hypothesis, we conducted a multivariate analysis of physical examination and other data on 721 men and 697 women aged 20 or more collected during the Canada Health Survey in 1978-1979. SBP and DBP were considered as separate dependent variables in multiple regression models with the following independent variables: age, alcohol consumption (measured as a 7-day recall history and as an average frequency of consumption), serum cholesterol, plasma glucose, physical activity, Quetelet index, parental history of hypertension, cigarette consumption, income, education, and exogenous hormonal use in women. In both weighted and unweighted multiple regression analyses, we could not demonstrate for either sex, a significant association between alcohol consumption (as recorded and following quadratic and logarithmic transformations) and either SBP or DBP. For both sexes, only age and Quetelet index were highly significantly (P less than 0.0001) and consistently associated with both SBP and DBP. No other independent variables were consistently associated, for either sex, with SBP and DBP. Further, the dose-response patterns noted by other investigators suggesting either a positive and linear relationship or a curvilinear relationship were not found in either our univariate or multivariate analyses. Rather, the alcohol-blood pressure curves showed no consistent patterns of any kind in either sex. These findings do not support recent claims that alcohol consumption is a determinant of elevations in either SBP or DBP.
A descriptive study of the relationship of intraoral air pressure to EMG activity of the levator palatini during CV syllables.
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Regulation of alcohol consumption. Individual appetite and social policy.
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The health risks of passive smoking. The growing case for control measures in enclosed environments.
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Alcohol consumption, ischemic heart disease and cerebrovascular disease. An epidemiological perspective.
Epidemiological data on alcohol consumption, ischemic heart disease and cerebrovascular disease are examined. Alcohol consumption is positively associated with cerebrovascular disease. Data on the relationship between alcohol consumption and ischemic heart disease are conflicting and incomplete. The evidence suggests that over a range of consumption, the limits of which have not been established, the relationship is negative. However, consumption at the high levels usually associated with alcoholism carries an elevated risk.
Smoking or health in the '80s?
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Alcohol use during pregnancy: a challenge for the '80s.
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Smoking habits, knowledge, and attitudes of final year university students in the health professions.
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The physical disease characteristics of inpatient alcoholics.
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Morbidity patterns in hazardous drinkers: relevance of demographic, sociologic, drinking, and drug use characteristics.
A profile of the demographic, sociologic, drug use, and drinking characteristics of a large group of inpatient alcoholics has been constructed as background for discussion of the clinical significance of these factors as determinants of physical morbidity in hazardous drinkers. Factors specifically considered include sex, skid row status, social class, and abnormal use of drugs of dependence, the amount of alcohol consumed and duration of drinking, drinking pattern, and type of beverage. While heavy drinking is of primary importance, the physical disease profile found in hazardous drinkers is modified by certain host and environmental characteristics. The implications for treatment planning and preventive programs are considered.
Non-respiratory tuberculosis in Canada. Epidemiologic and bacteriologic features.
Of the total cases of tuberculosis reported in Canada between 1970-1974, approximately one-sixth (3671 cases) involved primarily non-respiratory organs. Common diagnostic entities were genitourinary tuberculosis (1516 cases), lymphadenitis (1083 cases), bone and joint tuberculosis (555 cases), gastrointestinal tuberculosis (155 cases) and meningitis (138 cases). The remainder (224 cases) involved a wide variety of organs. Between 1967 and 1977 the morbidity rates of most non-respiratory manifestations steadily declined, the decline in meningitis being particularly marked. In contrast, lymphadenitis did not decline to the same extent, reflecting changing immigration patterns. The major diagnostic entities differed in their age and sex patterns and in their contribution to total cases by birthplace and ethnic group. In particular, the preponderance of lymphadenitis in females, and in the Asian-born was striking. Mycobacterium bovis was isolated infrequently and bacillary resistance to antituberculosis drugs was also uncommon. In a substantial proportion of cases, active tuberculosis was present concurrently at another site, or there was historical or radiologic evidence of previous active tuberculosis. Despite this additional evidence, delay and failure of diagnosis were common. An increased clinical awareness of tuberculosis is required, particularly in view of the often enigmatic presentation of non-respiratory disease.
Pi phenotypes in North American workers: racial differences and comparisons with reported frequencies.
The distribution of Pi phenotypes among Caucasian and Asian workers in British Columbia, Canada were found to differ significantly. Among Caucasians the frequency of the M allele was 0.9428, very similar to frequencies reported in other North American Caucasian populations. Among Asians only the M allele was found, further confirming the rarity of other alleles in such populations. The distribution of phenotypes in the Caucasian population agreed with the predictions of the Hardy-Weinberg law.