PubMed Health⌕ Search

Biomedical subjects

R Scragg

Publications and source records attributed to R Scragg.

At least 91 records · Page 5Linked to original sources
PubMed1991

Results from the first year of the New Zealand cot death study.

New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major identified risk factors. One hundred and sixty-two infants who died from SIDS were compared with 589 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 96% and 89% of subjects respectively. Data were available for all the variables in this study in 95% of those interviewed, thus 128 cases and 503 controls make up the subjects of this report. As expected we confirmed many risk factors for SIDS including: lower socioeconomic status, unmarried mother, young mother, younger school leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, nonattendant at antenatal classes, Maori, greater number of previous pregnancies, lower birth weight, shorter gestation, male infant, admission to neonatal intensive care unit. In addition, however, we identified three risk factors which are potentially amenable to modification. These were the prone sleeping position of baby (odds ratio = 3.53, 95% confidence interval 2.26, 5.54), maternal smoking (1-9 cigarettes/day OR = 1.87, 95% CI = 0.98, 3.54; 10-19/day OR = 2.64, 95% CI = 1.47, 4.74; 20+/day OR = 5.06, 95% CI = 2.86, 8.95) and breast feeding (OR = 2.93, 95% CI = 1.84, 4.67).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

The Auckland diet: results from a seven day food diary.

Dietary intakes of 113 men and women aged 50-66 years, sampled from the Auckland electoral roll, were measured by a prospective seven day dietary diary. The mean intakes of percentage of energy due to fat and saturated fat were 32% and 16% in men and 34% and 15% in women. Compared with earlier New Zealand dietary studies, which used different methods, there has been an apparent decrease in both the absolute amount and proportion of cholesterol and saturated fat. The absolute and relative amount of protein consumed appears to have remained stable while carbohydrate intake has increased. In comparison with current guidelines for dietary fat intake there remains a need for further improvement in the typical New Zealand adult diet.

Aged↗
PubMed1991

Fructosamine Test-Plus, a modified fructosamine assay evaluated.

We have evaluated Fructosamine Test-Plus, a commercial fructosamine assay based on the reduction of nitro-blue tetrazolium dye in alkaline buffer (Clin Chem 1985;31:1550-4), modified by including a detergent and uricase in the reagent, by changing the concentrations of buffer and dye, and by changing the approach to primary calibration. Specimens were from 2321 participants in a health screening survey in a local workforce. Compared with the original fructosamine method, the Fructosamine Test-Plus method was less affected by protein concentration in the sample and less subject to interference from hyperlipidemia. The changes have also extended the linearity of the assay in the pathological range. However, as a screening method for diabetes mellitus in a population with a disease prevalence of 2.28%, the performance of Fructosamine Test-Plus was similar to the original assay.

Adult↗
PubMed1990

Factors associated with development of diabetes mellitus: results from a cross sectional survey in Kawerau.

To determine risk factors for diabetes mellitus, a cross sectional study was performed on adult residents of Kawerau. Three thousand nine hundred and eighty-two adults (82.8% response rate) had a fructosamine screening test and undiagnosed diabetes was confirmed in 29 cases. Controls were 241 nondiabetic individuals randomly selected from residents with normal fructosamine result. Compared with controls, new diabetics were significantly older and more obese (p less than 0.05). After controlling for age and body mass index, we also found significant increases in systolic and diastolic blood pressure, 2 hour insulin, and fasting triglyceride levels. These results suggest that the above variables are associated with diabetes mellitus independent of age and obesity.

Alcohol Drinking↗
PubMed1990

Trends in cardiovascular risk factors in Auckland, 1982 to 1987.

This paper examines trends in Auckland over a five year period (1982-87) in the major cardiovascular risk factors: serum total cholesterol, blood pressure and cigarette smoking; trends in body mass index are also presented. The data came from two independent random samples of European people aged 40-64 years chosen from the central Auckland electoral rolls in 1982 (915 men and 476 women) and 1986-88 (503 men and 359 women); response rates were over 80% in both surveys. In the five year period self reported smoking declined by 22% in men and 10% in women; the decline was particularly marked in upper socioeconomic men and women aged 55-64 years. There were no consistent changes in either blood pressure or body mass index levels. Serum cholesterol levels, after adjustment for the change in laboratory methods, declined by approximately 1% in both men and women. Cardiovascular risk factor levels remain high in Auckland; comprehensive population based prevention programmes, such as Heartbeat (New Zealand), are urgently required in New Zealand.

Adult↗
PubMed1990

Previous pet ownership and Paget's disease.

The relationship between pet ownership and Paget's disease (PD) of bone was investigated in 112 patients with PD who were matched with a similar number of community-based controls. There was a significantly increased frequency of dog ownership by patients with PD aged less than 60 years. Multivariate logistic regression analysis revealed that there was a significant age-related increase in risk of PD associated with past or present ownership of either dogs or cats, with younger patients having the greatest risk. These results suggest that slow virus infection of osteoclasts by paramyxoviruses acquired from pets may contribute to the development of Paget's disease in the younger patient.

Age Factors↗
PubMed1990

Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study.

The relation between the plasma level of 25-hydroxyvitamin D3, the main metabolite of sun-induced vitamin D, and myocardial infarction (MI) was investigated in a community-based case-control study. Some 179 MI patients presenting to hospital within 12 hours of the onset of symptoms were individually matched with controls by age, sex and date of blood collection. MI patients had significantly lower mean 25-hydroxyvitamin D3 levels than controls (32.0 versus 35.5 nmol/L; p = 0.017), with the case-control differences being greatest in winter and spring. The relative risk of MI for subjects with 25-hydroxyvitamin D3 levels equal to or above the median was 0.43 (95% confidence limits = 0.27, 0.69) compared to subjects below the median. The decrease in MI risk associated with raised vitamin D3 levels was observed in all seasons. These results provide support for the hypothesis that increased exposure to sunlight is protective against coronary heart disease.

Adult↗
PubMed1990

Decreased blood selenium and risk of myocardial infarction.

The relationship between whole blood selenium levels and risk of acute myocardial infarction was investigated in a community-based control study in Auckland, New Zealand. A pilot study in 14 patients admitted to hospital within 4 hours of onset of symptoms demonstrated that selenium levels were stable in the first 16 hours after admission for an acute myocardial infarction. Some 252 cases (199 men, 53 women) presenting to hospital within 20 hours of onset of acute myocardial infarction were compared with 838 controls (500 men, 338 women), group-matched for age and sex. Myocardial infarction patients had significantly lower mean selenium levels: 82.8 and 87.9 micrograms/l in male cases and controls (p = 0.003) and 82.1 and 88.5 micrograms/l in female cases and controls (p = 0.02) respectively. The relative risks of myocardial infarction in participants with selenium levels below the median level (85 micrograms/l) in comparison with participants above the median were 1.6 (95% CL 1.1-2.2) and 1.7 (95% CL 0.9-3.5) in men and women respectively. The effects of a low selenium level on risk of myocardial infarction were confined to cigarette smokers. These results suggest the hypothesis that a decreased blood selenium in the presence of cigarette smoking is a risk factor for coronary heart disease.

Adult↗
PubMed1989

Changes in plasma vitamin levels in the first 48 hours after onset of acute myocardial infarction.

To establish whether plasma vitamin measurements made after acute myocardial infarction (AMI) can be used in case-control studies of coronary artery disease, the short-term effect of AMI on plasma concentrations of 25-hydroxyvitamin D3, beta-carotene, vitamin E and retinol was investigated. Sequential measures of these vitamins were made during the first 48 hours after AMI in 13 patients admitted to the hospital within 4 hours after the onset of symptoms. Plasma levels of 25-hydroxyvitamin D did not change significantly during the first 12 hours after onset of symptoms. Beta-carotene levels increased significantly (p less than 0.05) during the first 12 hours and then decreased, whereas levels of vitamin E and retinol progressively decreased during the first 48 hours by 26 and 25%, respectively. These results suggest that, of these vitamins, only plasma measurements of 25-hydroxyvitamin D3 collected within 12 hours of onset of symptoms may provide reliable information for case-control studies of AMI.

Aged↗
PubMed1988

An analysis of the seasonal variation of coronary heart disease and respiratory disease mortality in New Zealand.

The seasonal variation of coronary heart disease mortality rates in New Zealand is analysed by age, sex and race using monthly national mortality data for the period 1970-83. A 35% variation from the winter peak to summer low is found in the crude mortality rate, but the size of the seasonal variation is age-dependent, being more pronounced in the elderly, and more so in males than in females. The hypothesis that respiratory infections are linked to coronary heart disease, and that their seasonal occurrence explains the seasonal variation in coronary rates, is examined by an analysis of the association between coronary disease and respiratory disease mortality rates. By partial correlation analysis and by examining the residual correlation after filtering the seasonal variation from both series, it is suggested that the season acts as a confounding factor to cause an apparent association between the two rates. After controlling for season there is a tenuous relationship, but it is apparent only in the elderly.

Adult↗
PubMed1988

Fructosamine concentrations in general population of Kawerau.

We measured fructosamine concentrations in nonfasted serum from 7094 residents (82.8% of the estimated population) of Kawerau, New Zealand, including 65 known diabetic patients (prevalence of 0.92%). Fructosamine results showed a trimodal frequency distribution, with cutting points corresponding to 5th and 95th percentile values. Forty-two diabetic individuals had levels that exceeded the 95th percentile. These individuals had more severe metabolic abnormalities, characterized by lower plasma C-peptide and elevated fasting plasma glucose concentrations. Mean fructosamine values also showed a significant increase with age and a highly significant age-ethnic interaction that paralleled the higher frequency of diabetes in older age groups and among elderly Maori people. However, as a screening method in the general population, fructosamine measurement was diagnostically deficient because of a weak correlation with serum albumin. Arithmetic correction for albumin concentration in the sample did not increase the diagnostic usefulness of the test.

Adult↗
PubMed1987

Alcohol and exercise in myocardial infarction and sudden coronary death in men and women.

The relation of alcohol consumption and regular leisure time physical activity with nonfatal myocardial infarction and sudden coronary death in men and women of Auckland, New Zealand, was examined in a large population-based case-control analysis. Within each sex, alcohol drinkers had decreased relative risks of both myocardial infarction and sudden coronary death compared with nondrinkers. Similarly, physical activity was associated with decreased relative risks of myocardial infarction and sudden coronary death in both women and men, but only in those subjects who had been exercising for five or more years. After controlling for hypertension, cigarette smoking, and alcohol consumption, 43% (95 confidence interval (CI) = 26-60) of coronary events could be explained by lack of exposure to physical activity. This compares with the per cent of coronary events in the study population attributable to hypertension (22%; 95% CI = 17-27) or cigarette smoking (31%; 95% CI = 25-38). Although the estimation of the attributable risk for a continuous variable is affected by the cut-point used to define exposure, from a public health viewpoint, regular leisure time physical activity may be as important as the above-mentioned major coronary heart disease risk factors.

Adult↗
PubMed1986

Cigarette smoking and risk of premature stroke in men and women.

A case-control study was carried out of the relation between cigarette smoking and hypertension and stroke. A total of 132 cases of stroke (79 in men, 53 in women) identified as a part of a population based register were compared with 1586 controls (1017 men, 569 women) from a survey of cardiovascular risk factors conducted in the same population. Cigarette smokers had a threefold increase in the risk of stroke compared with current non-smokers. This association remained significant after adjusting for hypertension. Those who both smoked and had hypertension had an increased risk of stroke of almost 20-fold compared with those who neither smoked nor had hypertension. Overall, in this population roughly 37% of stroke events may be attributed to cigarette smoking and 36% to hypertension.

Adult↗
PubMed1986

Resuscitation outside hospital in Auckland.

All resuscitation attempts outside hospital attended by the Auckland life support unit ambulances during 1983 were reviewed. There were 405 attempted resuscitations during the 12 month period. Of the 344 patients who arrested before the life support unit arrived, 189 (55%) had cardiopulmonary resuscitation initiated by bystanders and 34 (10%) by conventional ambulance personnel. Sixty one patients suffered their arrest after the arrival of the life support unit. One hundred and ninety two patients (47% of the total 405 patients) died at the scene of collapse, 95 patients (24%) died in accident and emergency departments and 46 (11%) died in hospital. Eighteen of the 213 patients successfully resuscitated and transported to hospital had complications related to cardiopulmonary resuscitation. Of the 72 patients discharged, 65 (90%) were alive one year after discharge. Of all patients in whom resuscitation was attempted, 75% were males. This male predominance was present in all age groups and disease categories except subarachnoid haemorrhage and stroke. Myocardial infarction and other ischaemic heart disease accounted for the great majority of cases, followed by asthma and a variety of other conditions. Below 30 years of age the causes of collapse were predominantly noncardiac, and with age increasing above 30 years there was increasing likelihood of a cardiac cause for the collapse.

Adolescent↗
PubMed1986

Trends in tuberculosis incidence in the Auckland region, 1974-1983.

The trends in incidence of tuberculosis in the three Auckland health districts were examined comparing the rates among Maoris, Pacific Islanders and Europeans. There was a continued falling incidence during the period 1974 to 1983, particularly in Maoris and Pacific Islanders. The age-specific rates were studied and related to case finding activities and BCG vaccination. Neonatal BCG vaccination offered to Maoris and Pacific Islanders was not shown to have any impact on incidence rates. Most childhood cases of tuberculosis were discovered by active public health screening activities, while the majority of adult cases were detected by routinely available general practitioner and hospital medical services.

Adolescent↗
PubMed1986

A case-control study of deaths from asthma.

A population based case control-study was initiated in 1981 to identify risk factors for death from asthma. Over a two year period all deaths in the Auckland population possibly due to asthma, in people less than 60 years of age, were investigated. From the 47 people who died from asthma 44 who had useful reversibility of airways obstruction (records showing greater than 20% variability of peak flow or a history indicating equivalent variability of shortness of breath) before death were selected as cases for the study. Both hospital and community based controls were used. The cases were more likely than were the community controls to have had severe disease, a hospital admission or visits to a hospital emergency department in the previous year (odds ratios 4.4, 16.0, 8.5 respectively). The asthmatic patients who died were more likely than either group of controls to have had a previous life threatening asthma attack. Poor management of the disease and poor compliance on the part of the patient increased the risk of death. In addition, use of three or more types of asthma drug within the past year was associated with an increased risk of dying that was independent of disease severity. Of interest was a similarity between asthmatic patients admitted to hospital and those who died. Nevertheless, a history of a previous life threatening attack and a recent admission to hospital identified a group at high risk.

Acute Disease↗
PubMed1985

Risk factors for coronary heart disease: a case-control study.

Risk factors for myocardial infarction and sudden death have been examined in caucasians using data from a population-based register of coronary disease and an electoral roll sample of adult Aucklanders. The risk factors studied were past history of treatment for hypertension, cigarette smoking, body mass index, serum cholesterol and in men a history of vasectomy. A total of 625 myocardial infarction cases and 185 sudden death cases were compared with 1586 controls aged 35-64 years. In univariate and multivariate analyses in both sexes a history of treatment for hypertension and cigarette smoking were each associated with more than doubling of the risk for myocardial infarction and sudden death. Both men and women with a very high body mass index were at increased risk for myocardial infarction, and serum cholesterol was associated with an increased risk of myocardial infarction in men. Approximately one half of the myocardial infarction events and over half of the sudden death events occurring in this population were attributable to hypertension and smoking.

Adult↗