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Discharges during U.S. Army basic training: injury rates and risk factors.

This study examined injury rates and risk factors for discharge in a cohort of 756 men and 474 women in U.S. Army basic combat training (BCT) at Fort Jackson, South Carolina. Investigators systematically screened trainee medical records for injuries and collected medical recommendations to temporarily remove a trainee from BCT to allow recovery from an injury. The BCT unit provided Army Physical Fitness Test (APFT) scores and trainee demographic data. Discharges were identified by reviewing discharge packets and were confirmed through rosters from the BCT units. There were 102 men and 108 women discharged. Person-time injury incidence rates (for time-loss injuries) among discharged and nondischarged men were 1.87 and 0.45 cases/100 person-days, respectively (p < 0.01); the rates for discharged and nondischarged women were 1.95 and 1.01 cases/100 person-days, respectively (p < 0.01). Men had a higher risk of discharge if they had a time-loss injury (p < 0.01), but women did not (p = 0.28). Other discharge risk factors for both men and women included a medical recommendation for removal from training to recover from an injury, lower performance on any of the three APFT events, and lower educational level. Women with more body mass or a higher body mass index also had a marginally higher risk of discharge.

Female↗

Interleukin 10 (IL-10), not IL-4 or interferon-gamma production, correlates with progression of joint destruction in rheumatoid arthritis.

OBJECTIVE: Both interleukin 4 (IL-4) and IL-10, separately and in combination, and under in vitro and in vivo conditions in animals, have been reported to inhibit characteristics of rheumatoid arthritis (RA) and experimentally induced arthritis. We investigated if IL-10 and IL-4 production, as well as interferon-gamma (IFN-gamma) production, opposing IL-4, were related to RA disease variables. A method was chosen to exclude the influence of age and disease duration. METHODS: We selected RA patients with mild and severe disease. Inclusion criteria were erythrocyte sedimentation rate (ESR) < or = 28 mm/h and > or = 50, C-reactive protein (CRP) < or = 20 and > or = 30, Thompson joint score < or = 60 and > or = 100 and radiographic joint damage score, Sharp score < or = 30 and > or = 40. Age and disease duration were restricted: 30 to 70 years and 5 to 15 years, respectively. Peripheral blood mononuclear cells were isolated and the ex vivo 48 h production of T cell IL-10, IL-4, and IFN-gamma (after CD3-CD28 stimulation) was assessed and was correlated to clinical variables. RESULTS: Only IL-10 production differed significantly between the 2 groups of RA patients, being highest in the "mild" group. Taking all patients together, a strong negative correlation was found between IL-10 production and radiographic joint damage (r = -0.53, p < 0.001) as well as progression of joint damage (r = -0.56, p < 0.0001). Similar negative correlations, although less powerful, were found between IL-10 production and ESR, CRP, and Thompson joint score. No correlation was found for IFN-gamma, IL-4, or the ratio of the 2 with disease activity variables or joint damage. CONCLUSION: The findings suggest that the high IL-10 production found in patients with RA may be protective, especially against progression of joint destruction in RA.

Adolescent↗

[Spontaneous intracerebral hemorrhage: case histories].

Spontaneous intracerebral hemorrhage is a significant cause of morbidity and mortality. The disease primarily affects men between the age of 45 to 75 years. Arterial hypertension is the most frequent etiologic factor. Here is presented a case-record of 148 intracerebral hemorrhages observed during a five years period. Several clinical and radiological features have been correlated and analyzed from a statistical point of view. The most important prognostic factor is the state of consciousness. Either deep coma and a normal state of consciousness do not represent surgical indications.

Adult↗

Modulation of occlusal plane during puberty.

The biological significance of the occlusal plane is of tremendous importance in the study of the etiology, diagnosis and treatment of malocclusion. The purpose of this investigation was to correlate the changes on the occlusal plane of patients in treatment with functional appliances and the subjects with no need of treatment during the prepubertal and pubertal period. Data on the space between the upper and lower occlusal lines-Interocclusal Distance (IOD) was obtained periodically. Some remarks about which changes are naturally provoked or not are very useful in the treatment of malocclusions and the evaluation of the occlusal plane in cases that do not need treatment.

Adolescent↗

Periodontal findings in cases of incisor cross-bite.

The effect of cross-bite on periodontal health in the anterior teeth was investigated in 40 teenage subjects. The results have shown a relationship between the cross-bite in the anterior teeth and periodontal health as assessed by Plaque Index, Gingival index and pocket depth measurements. The periodontal status of the teeth in cross-bite revealed a more unfavorable condition compared to the well-aligned teeth. This was observed in both males and females. However, pocket depth on the lingual site for both sexes does not reach a significant difference between the cross-bite and the control teeth.

Child↗

[The epidemiology of proximal femur fracture at the Hospital da Horta (Azores)].

The aim of this study was to know the incidence of osteoporotic hip fracture in a defined area of the Azores. The catchment area included the islands of Faial, Pico, Flores and Corvo, with 11,617 subjects aged 50 or more: 5,373 males and 6,244 females. The time period of the survey was 1991 to 1993. Data was obtained from the records of the Orthopedic Department of Hospital Horta. Thirty seven fractures were diagnosed during the time survey: 12 in 1991, 13 in 1992 and 12 in 1993. The age-adjusted mean incidence rates of hip fracture for the population over 49 years old was 10.3/10,000: 5.6/10,000 in men and 14.4/10,000 in women. Most fractures occurred in women over the age of 65 years. The ratio of male to female cases was 1:3. The mean age of all patients was 77 +/- 8 years of age: 72 +/- 8 in males and 79 +/- 6 in females (p = 0.05). About 70 percent of these patients were treated surgically. The acute mortality rate was 8 percent and the mean age of the deceased patients, 82 +/- 6, was significantly higher than the mean age of the survivors, 73 +/- 6 (p = 0.01).

Age Distribution↗

Statistical power to detect occupationally related respiratory cancer risk in a cohort of female employees in the US man-made vitreous fiber industry.

The current update of the US man-made vitreous fiber production worker cohort includes women for the first time. Preliminary comparisons of 3,820 female and 27,767 male workers from 11 participating fibrous glass plants show different hiring patterns during World War II. The gender-specific person-year distributions are similar with respect to duration of employment and time since first employment. The current follow-up of 118,559 person-years for women provides an estimated 80% power to detect a threefold relative risk of respiratory cancer for women who worked more than 14 years in these plants, based on a Poisson regression analysis of the cohort rates. When women comprise a small fraction of the cohort, the statistical power may be inadequate to detect risks of the magnitude typically of interest in studies of men.

Aged↗

Limitations of the correlation coefficient in the validation of diet assessment methods. CODIAB-INSERM-ZENECA Pharma Study Group.

Dietary assessment methods usually are validated one against the other, using the correlation coefficient between the methods to assess agreement. The correlation coefficient, however, is only an indicator of relative agreement and depends on the range of intakes. As this dependence can lead to misinterpretation, we propose that the standard deviation of the difference between methods should be used as an indicator of absolute agreement and the standard deviation of their average as an indicator of the range of intakes. We illustrate this method in a validation study of a diet history against a 3-day diet record in 58 non-insulin-dependent diabetes mellitus patients. A re-analysis of studies from the literature validating food frequency questionnaires against diet records showed that the absolute agreement between methods is very consistent and that the differences in the correlation coefficients are mostly due to the selection of subjects.

Adult↗

The demographics of slipped capital femoral epiphysis. An international multicenter study.

One thousand six hundred thirty children with 1993 slipped capital femoral epiphyses were reviewed; 41.2% were girls and 58.8% were boys. There were 47.5% white, 24.8% black, 16.9% Amerindian, 7.4% Indonesian-Malay, 2.1% Native Australian/Pacific Islands, and 1.3% Indo-Mediterranean children. The diseased hip was unilateral in 77.7% and bilateral in 22.3% of the children, and chronic in 85.5% and acute in 14.5% of the children. Of the unilateral slips, 40.3% involved the right hip and 59.7% the left hip. The child's weight was greater than or equal to the ninetieth percentile in 63.2% of the children. The average age for the girls and boys was 12 and 13.5 years. The age at diagnosis decreased with increasing obesity. The youngest children were the Native Australian/Pacific Island children (11.8 years) and the oldest were the white and Indo-Mediterranean children (13 years). The Indonesian-Malay and Indo-Mediterranean children were the lightest in weight, and the black children the heaviest. The Indo-Mediterranean children had the highest proportion of boys (90.5%), and the Native Australian/Pacific Island children the lowest (50%). The highest percentage of bilaterality was in the Native Australian/Pacific Island children (38.2%), and the lowest in the Amerindian children (16.5%). The relative racial frequency of slipped capital femoral epiphysis compared with the white population was 4.5 for the Polynesian, 2.2 for the black, 1.05 for the Amerindian, 0.5 for the Indonesian-Malay, and 0.1 for the Indo-Mediterranean children. In children with unilateral involvement, the age at presentation was younger for those children in whom bilateral disease later developed (12 versus 12.9 years old). In 82% of the children with sequential bilateral slips, the second slip was diagnosed within 18 months of the first slip.

Adolescent↗

Factors correlated with caraniomandibular disorders in young and older adults.

This study was conducted to examine prevalence of craniomandibular disorders in young adults compared with that in older subjects. In addition, the relationship between various oral conditions and this dysfunction was studied. No difference was found in the incidence of craniomandibular disorders between the groups. Classification according to the Helkimo index showed significant difference in complaints of craniomandibular disorders symptoms between the groups. Most of the older patients did not complain of mild disorders. The results suggest that conditions such as the number of teeth, presence or absence of dentures, and the type of denture worn are not important factors in the pathogenesis of craniomandibular disorders.

Adult↗

Improving procedures for recording suicide statistics.

OBJECTIVE: To explore the changing relationship between rates of suicide and undetermined death in Britain and Ireland. DESIGN: Longitudinal analysis of the official statistics relating to unnatural deaths in England and Wales and the Republic of Ireland between 1976 and 1992. MAIN OUTCOME MEASURES: Male and female rates of suicide and undetermined deaths for Ireland and England and Wales, age adjusted to the standard world population. Ratio of undetermined deaths to suicide. RESULTS: The official Irish male suicide rate is now much higher than that of England and Wales while the female rates are broadly similar. The rate of undetermined deaths has risen amongst English males and remained stable for females but has significantly fallen off among both Irish males and females. The proportion of deaths classified as 'undetermined' is now very much less in Ireland than in England and Wales. DISCUSSION: National plans for suicide prevention in either country cannot be properly audited unless improved procedures are put in place to increase the validity and reliability of the official suicide figures. Each country could beneficially learn from the other in this regard.

Adolescent↗

Waist-hip ratio and blood pressure correlation in an urban Indian population.

Truncal obesity judged by increased waist-hip ratio (WHR) is an important risk factor for atherosclerosis. One of the mechanisms postulated by which truncal obesity increases coronary risk is high blood pressure (BP). Studies of correlation of WHR with systolic and diastolic BP have shown conflicting results. A study on 443 persons (250 males, 193 females) for WHR measurement during a comprehensive cardiovascular survey in an urban population of Rajasthan was undertaken. The mean WHR in males was 0.90 +/- 0.07 and in females 0.87 +/- 0.08. The median value was 0.91 in males and 0.88 in females. Correlational analysis of WHR with anthropometric and clinical parameters showed that in males there was a positive relationship of WHR with weight (r = 0.11), body mass index (r = 0.13) and systolic (r = 0.11) and diastolic BP (r = 0.11) but not with age and height. In females no significant relationship was seen with these variables. When classified according to the US Fifth Joint National Committee (JNC-V) recommendations for diagnosis of truncal obesity (WHR males > 0.95, females > 0.85) it was seen in 42 (17%) males and 131 (68%) females. Sub-analysis of these two groups showed that mean values of systolic and diastolic BP were not significantly different in truncally obese subjects. However, stratified analysis after classifying WHR in four groups (WHR < 0.85, 0.85-0.89, 0.90-0.95 and > 0.95) showed that in males there was a significantly rising trend of weight, body mass index, systolic and diastolic BP with increasing WHR. WHR of > or = 0.85 was associated with higher systolic and diastolic BP.

Adult↗

Prevalence of malocclusion traits in an Australian adult population.

The prevalence of certain malocclusion traits in an Australia adult population was examined in a sample of 113 female and 103 male adult subjects aged between 18 and 64 years (average age = 38.1 years). If cross-sectional studies of younger population groups are to be used for research into the long-term physiological effects of malocclusion, it is essential to know if certain and specific malocclusion traits are stable over time. In this cross-sectional study, the prevalence of many malocclusion traits did not change; however, with advancing age, the incidence of posterior crowding, posterior rotations, posterior crossbite and anterior irregularity increased significantly.

Adolescent↗

Blood lead in U.K. children--time for a lower action level?

1. Blood lead measurements in samples collected from 660 London schoolchildren during 1991 to 1992 suggest that the blood lead values in children in the U.K. are decreasing. 2. Geometric mean values for blood lead were 0.18 (range 0.05-0.71) micromol/l [3.7 (1. 0-15.0) microgram/dl]. Analysis of variance showed differences between ethnic groups, sex and schools. An age-matched subset of 148 children was compared with 136 children from an earlier study in 1986 and 1987. Trend analysis of the geometric mean lead values showed a negative slope (b=-0.484, P<0.0001), with maximum values of 0.81, 1.00, 0.71 and 0.43 micromol/l (17, 21, 15 and 9 microgram/dl) for the years 1986, 1987, 1991 and 1992 respectively. 3. It is recommended that children in the U.K. being investigated for anaemia, pica, recurrent abdominal pain or a high-risk environment should have blood lead values measured and that the action level for blood lead in children should be decreased from 1.19 micromol/l to 0.48 micromol/l (from 25 microgram/dl to 10 microgram/dl). 4. Guidance is offered to clinicians and other health professionals investigating excessive lead exposure.

Adolescent↗

Variations in angioplasty and bypass surgery.

OBJECTIVES: This article describes rates of and times to revascularization procedures for heart attack patients. DATA SOURCE: The data are from Statistics Canada's Person-Oriented Information Data Base. Hospital discharge records for heart attack patients were linked for fiscal years 1992/93 and 1993/94. ANALYTICAL TECHNIQUES: Hospital patients admitted between April 1 and September 30, 1993 with a primary diagnosis of acute myocardial infarction (AMI) were followed for six months to determine what percentage underwent percutaneous transluminal coronary angioplasty and/or coronary artery bypass graft surgery. Analyses of time-to-procedure were performed for those patients who had not been hospitalized for AMI in the previous 12 months. MAIN RESULTS: Approximately 24,000 Canadians were discharged from hospital during the first half of fiscal year 1993/94 with a diagnosis of AMI. Within six months, 8.7% had an angioplasty and 6.7% had a bypass; overall, 14.9% were revascularized. Women were less likely than men to have a bypass, but angioplasty rates did not differ significantly. The rate of revascularization declined with age. After adjusting for age and sex, rates were higher in the western provinces.

Adult↗

Signs and symptoms of temporomandibular disorders in 19-year-old individuals who have undergone orthodontic treatment.

Fifty-five per cent of the 1554 19-year old subjects in Halmstad, Sweden, born in 1975, have received orthodontic treatment. Among these, 520 have been treated by specialists (specialist group) and 340 by general practitioners after consultation with specialists (consultation group). The aims were to study the prevalence of signs and symptoms of temporomandibular disorders (TMD) in these two groups on a long-term basis, to identify any possible difference between the groups, and to compare the results with those from a previously presented epidemiological study (control group). From the population of orthodontically treated subjects, a sample was randomly selected to represent the two groups, and 260 subjects agreed to attend for investigation, the participation rate being 77%. The investigation consisted of a questionnaire and clinical examination focusing on function and dysfunction of the masticatory system. Severe signs and symptoms of TMD were rare, the prevalence did not differ significantly between the two orthodontic groups, and the results were similar in the control group. The prevalence of several signs and symptoms was more common in females than in males. No significant correlation between TMD signs and symptoms and occlusal contact recordings was found. It was concluded that the vast majority of the 19-year old individuals who had undergone orthodontic treatment had well-functioning masticatory systems, and severe signs and symptoms of TMD were rare.

Adult↗

Urinary 1-hydroxypyrene as a marker of exposure to pyrene: an epidemiological survey on a general population group.

Urinary levels of 1-hydroxypyrene in a general adult population group are studied. Experimental data are not normally distributed; statistical analysis required a base 10 logarithmic transformation of data. The concentrations of urinary 1-hydroxypyrene measured were expressed as microgram g-1 urinary creatinine and are comparable with those reported by other authors, both for smoker and non-smoker subgroups. Multiple regression analysis shows that, for smokers, the number of cigarettes smoked per day and the body mass index (BMI) significantly influence the levels of urinary 1-hydroxypyrene expressed as microgram g-1 urinary creatinine, whereas no personal or behavioural variable (age, sex, alcohol consumption, dietary intake of pyrene, BMI) modified the 1-hydroxypyrene levels for non-smokers.

Adult↗