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Paired determinations of blood carboxyhemoglobin concentration and carbon monoxide excretion rate in term and preterm infants.

Paired determinations of COHb and VeCO were performed on 30 term infants (38 to 42 weeks' gestation) and 26 preterm infants (28 to 37 weeks' gestation) during the first week of life. All subjects were breathing room air at the time of the study. Values of COHb were corrected for RAco by linear regression of COHb (percent saturation) vs RAco (ppm). Regression coefficients for term and preterm infants with no history of pulmonary impairment were nearly identical (COHb = 0.175 RAco + 0.45, r = 0.77, n = 25 for term infants; COHb = 0.168 RAco + 0.51, r = 0.82, n = 9 for preterm infants) and agreed well with theoretical values. For the group of term infants, linear regression of Veco (microliter/kg/hr) vs. COHbc, where COHbc = COHb - 0.17 RAco, resulted in VEco = 23.4 COHbc + 4.02, r = 0.75, n = 30. The corresponding relationship for preterm infants with no history of pulmonary impairment was VEco = 24.7 COHbc + 3.85, r = 0.61, n = 13. For a subpopulation of preterm infants with a history of pulmonary dysfunction, the correlation decreased significantly, with VEco = 4.34 COHbc + 17.6, r = 0.097, n = 11. These results demonstrate that (1) COHbc is a reasonable index of VEco and consequently of the heme catabolic rate in both term and preterm infants with no clinical history of pulmonary dysfunction and (2) inference of VEco from COHbc may be misleading in certain cases without a consideration of the factors relating these two variables.

Carbon Monoxide↗

Comparison of employees' white blood cell counts in a petrochemical plant by worksite and race.

To determine if employment within a petrochemical plant's quality control (QC) laboratory had any significant effect on the hematopoietic system, and in specific, the white blood cell (WBC) counts, all employees of the QC laboratory were evaluated retrospectively. Trend analysis, linear regression, and Students t tests were performed on all employees of the QC laboratory and on a simple random sample of the rest of this Caribbean petrochemical plant's male employees. Trend analyses revealed a downward trend in 82.6% of the QC laboratory workers and 76.7% in other plant workers. Linear regression and t tests revealed no statistically significant difference by worksite but a significant difference between blacks and whites. The result of the findings of the QC laboratory workers was consistent with that expected in both plant employees and the US general population. A recommendation is made that the Occupational Safety and Health Administration (OSHA) reconsider its WBC cutoff level in the benzene standard.

Adult↗

Predicting body weight from body measurements in Asian elephants (Elephas maximus).

Accurate estimates of body weight can be useful in the evaluations of feeding programs, nutritional status and general health, and in calculation of dose levels (such as for anesthesia)-thus providing a valuable tool for captive elephant management. We used body measurements of 75 Asian elephants (Elephas maximus) to predict body weight. Weight, heart girth, height at the withers, body length, and foot-pad circumference were measured. All possible linear regressions of weight on one, two, three, or four body measurements were calculated. The highest correlation with a single measurement was that between heart girth and weight (R2 = 0.90). The data were also divided into age groups (1-13, 18-28, 29-39, and 40-57 yr), and all possible linear regressions were calculated for each group (there were no elephants aged 14-17 yr). Adding body length or pad circumference to heart girth resulted in a slight increase in R2. We conclude that body weight in Asian elephants can be predicted from body measurements and that heart girth is the best predictor. A second body measurement might improve predictive accuracy for some age groups.

Age Factors↗

Is the transfusion requirement predictable in critically ill patients after admission to the intensive care unit?

OBJECTIVE: In intensive care medicine the clinical decision to order and transfuse red blood cells (RBC) is usually based on hematocrit or hemoglobin levels. The intention of this study was to investigate whether clinical or laboratory variables, taken after the admission of patients to the intensive care unit (ICU), are able to predict the transfusion requirement of the following 72 h. DESIGN: The values of initially measured systolic blood pressure, hematocrit level, and the values of 2 scores of severity of disease (Acute Physiology And Chronic Health Evaluation [APACHE-II], Mortality Prediction Model [MPM]) were calculated after the admission of patients to the ICU. The decision for transfusion was based on specific criteria. The median values of the scores, those of the variables, and the median number of transfused RBC units of the surviving group were compared to the values of the group of patients who died during hospital stay. The quantity of RBC transfusions was compared to the variables and score values by linear regression analysis. Additionally, the values of the patients who did not receive blood transfusion were compared to those of patients who required RBC. Furthermore, the patient group with neurosurgical diseases was compared to the group without neurosurgical diseases. PATIENTS: 117 patients were prospectively and consecutively investigated in an 8-bed ICU of a university hospital. RESULTS: Nonsurvivors required significantly more units of RBC during the first 72 h (p < 0.05). Patients who did not require transfusion had a higher hematocrit and a lower APACHE-II value at admission (p < 0.001). In the MPM values no differences were found. Patients with neurosurgical diseases had a higher initial hematocrit value, and they required less units of RBC in comparison to patients without neurosurgical diseases. In the analysis of linear regression neither in the initially measured systolic blood pressure nor in the APACHE-II and MPM we found a strong linear correlation to the quantity of blood transfusion. CONCLUSIONS: A hematocrit value < or = 20% and a APACHE-II score > or = 20 at the time of admission to the ICU referred to a demand for blood transfusion. We believe that these parameters are useful as predictive instruments. The initially measured systolic blood pressure had no prognostic capacity. In the individual patient a number of factors should be taken into account to decide whether to transfuse or not.

APACHE↗

Bladder shape impact on the accuracy of ultrasonic estimation of bladder volume.

OBJECTIVE: Variations in bladder shape can lead to errors in ultrasonic estimation of the bladder volume. The purposes of this study were to compare the accuracies of various formulas to estimate bladder volume from sonographic measurements and to assess the impact of bladder shape on the accuracy of bladder volume estimation. STUDY DESIGN: Twenty-four healthy volunteers (13 men, 11 women) and 55 spinal cord injury patients (48 men, 7 women) underwent ultrasonographic measurements of dimensions before and after voiding. Bladder shape was classified as cuboid, ellipsoid, or triangular prism. Ten formulas from the literature were applied to estimate bladder volume, using the volume voided or catheterized as the standard, and then linear regression was used to obtain optimal correction coefficients for the whole data set as well as each of the three bladder shapes. SETTING: Rehabilitation hospital affiliated with a medical college. RESULTS: The most accurate of the 10 formulas tested was height (H) X transverse depth (Dt) x weight (W) x 0.7 (mean error 17.4%+/-11.6%). Linear regression analysis yield optimal correction coefficients of .72 for the whole data set and .89, .81, and .66 for cuboidal, ellipsoid, and triangular prism-shaped bladders, respectively. The mean error for the estimation of bladder volume using .72 as the correction coefficient was 16.9%+/-11.9% and decreased to 12.7%+/-10.1% (p < .0001, paired t test) when the bladder shape was taken into account. CONCLUSION: Using bladder shape for reference and applying the corresponding correction coefficient to volume calculations will improve the accuracy of the estimation.

Adult↗

Frequency of variable measurement in 16 pediatric intensive care units: influence on accuracy and potential for bias in severity of illness assessment.

OBJECTIVES: We evaluated: a) whether the frequency of variable measurement could influence the performance of the Pediatric Risk of Mortality (PRISM) score; b) whether measurement frequency of physiologic variables varied between individual pediatric intensive care units (ICUs), and c) if so, how much of this variability could be attributed to institution-level and patient-level factors. DESIGN: Prospective cohort. SETTING: Sixteen pediatric ICUs, chosen for their diversity. PATIENTS: Consecutive admissions (n = 5,415). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: First, the measurement frequency of the 14 physiologic variables in the PRISM score was included in the logistic regression model predicting mortality risk. Measurement frequency was not significant, alone or in its interaction with the PRISM score. Second, the presence or absence of measurement of each physiologic variable was included in the logistic model using indicator variables; none was significant. Finally, the contribution of the individual pediatric ICUs and patient factors in explaining the variability in the frequency of physiologic variable measurement were investigated with linear regression analysis. In this analysis, the separation of severity of illness from measurement frequency was accomplished by computing the PRISM score from the first 4 hrs and measurement frequencies from hours 5 through 24. Overall, 70.22% (r2) of the variability of measurement frequency could be explained by the factors included in the linear regression model. The individual ICUs accounted for a total of only 6.23% of the explained variability and no individual hospital accounted for > 1.44% of the variability. Other variables positively correlated with measurement frequency included the presence or absence of a pediatric intensivist, and whether the institution was a children's hospital or not. Variables negatively correlated with measurement frequency included larger ICUs and house officers assigned to the ICU. CONCLUSIONS: Although measurement frequency is associated with unit-level factors, their contribution to the overall variability is small and unlikely to influence the accuracy or reliability of the PRISM score. It is unlikely that there are routine biases associated with differences in measurement frequency of PRISM variables within the spectrum of care practices that now exist.

Child↗

Serum zinc and protein levels: lack of a correlation in hospitalized patients with AIDS.

Abnormally low serum zinc levels are associated with advanced states of malnutrition. Zinc levels are thought to parallel serum albumin, and repletion of zinc has reportedly led to increased albumin. We examined the correlation between zinc deficiency and serum proteins in hospitalized patients with AIDS. Over 500 inpatient consultations were performed by our Gastroenterology-Nutrition Consult Service from May 1992 to June 1994. We reviewed the medical records from all 228 AIDS patients in whom a serum zinc level was measured (by atomic absorption spectrophotometry). The correlation between serum zinc, albumin, prealbumin, and transferrin drawn on the same hospital day was analyzed by linear regression. The patients were stratified by the level of albumin, group A albumin < 2.0 g/dL, group B albumin 2.0-2.9 g/dL, and group C albumin > 3.0 g/dL, to allow comparison of the incidence of diarrhea and mean zinc level by chi square. Thirty-four patients had more than one serum zinc and albumin determination; the change over time was compared by linear regression. Serum zinc and albumin, prealbumin, and transferrin levels did not correlate strongly (r2 < or = 0.01). Furthermore, changes in zinc over time did not correlate with parallel changes in serum albumin (r2 < or = 0.01). In patients grouped by albumin, the proportion of patients with diarrhea did not differ significantly. The mean zinc levels were also not statistically significantly different. Serum zinc levels do not strongly correlate with serum proteins in hospitalized patients with AIDS. Serial measures of zinc over time also do not correlate strongly with changes in albumin. The incidence of diarrhea was not significantly different in patients with hypoalbuminemia or hypozincemia when compared with patients with near normal albumin or zinc. The relationship between zinc and serum proteins in AIDS patients is not linear. Zinc deficiency should be assessed in patients independent of the serum albumin.

Acquired Immunodeficiency Syndrome↗

Gender differences in relative dilatation of abdominal aortic aneurysms.

It has been postulated that gender differences in abdominal aortic aneurysm (AAA) rupture risk are due to variation in proportional dilatation. This study's purpose was to examine differences in relative dilatation of AAAs as related to rupture risk and repair thresholds. During a recent 20-month period (August 2003-March 2005), all patients receiving elective endovascular repair of an AAA underwent computer-generated computed tomographic measurements, including suprarenal aortic diameter (D1) and maximum aneurysm diameter (D3). As a measure of proportional dilatation, a D3/D1 ratio was calculated for each patient and compared between genders. Values for males and females were plotted separately (D3 vs. D3/D1), and the resulting linear regression equations allowed for the comparison of proportional dilatation of aneurysms between genders. In 129 patients (108 males, 21 females), mean D3 did not differ between genders (62 +/- 9.0 vs 63.4 +/- 10.8 mm, p = 0.89), while relative dilatation (D3/D1) was significantly greater in females compared to males (2.82 +/- 0.52 vs. 2.55 +/- 0.42, p = 0.02). Linear regression analysis allowed for comparison of D3 as a function of D3/D1 and correlated a 55 mm AAA in males with one of 52 mm in females. These differences became greater with increasing AAA diameters (e.g., 60 and 70 mm AAAs in a male were proportionally similar to 56 and 62 mm AAAs in a female). AAAs of equal diameter represent a greater proportional dilatation in females than in males. This supports the recommendation for a smaller aneurysm diameter (52 mm) threshold for repair in females rather than the commonly used 55 mm threshold in males. Also, these data suggest that the gender difference in rupture risk widens exponentially as aneurysm diameter, and thereby proportional dilatation, increases above this repair threshold.

Angioplasty↗

Spontaneous human lymphocyte-mediated cytotoxicity against tumor target cells. II. Is the complement receptor necessarily present on the killer cells?

The effect of various lymphocyte depletion techniques on SLMC effector cell activity against the cell line K562 could be attributed to the effects that these procedures had on the proportions of Fc/C3 receptor-bearing cells in the preparations. depletion of cytotoxic activity by removal of Fc receptor-bearing cells could be augmented by the presence of complement on the 7S-EA indicator cells used for rosette depletion. Two methods of assessing the presence of surface receptors on cytotoxic cells are presented: (1) linear regression analysis of spontaneous cytotoxicity plotted as a function of the proportions of receptor-bearing cells remaining after various depletion techniques; and (2) the use of a mathmatical formula to estimate the proportion of cytotoxic cells with any particular receptor, based on the effects of receptor-bearing cell depletion. Linear regression analysis of cytotoxicity vs the proportions of SRBC, Fc or C3 receptor-bearing cells demonstrated that all cytotoxic cells had the Fc receptor, but that cytotoxicity could still occur in the absence of cells with the C3 receptor. This indicated that the C3 receptor is not necessary for the demonstration of SLMC activity. The mathematical formula to predict cytotoxicity after depletion of C3 receptor-bearing lymphocytes showed, however, that a significant proportion of the Fc receptor-positive killer cells were also C3 receptor-positive. No direct evidence was found to support a role for T cells in SLMC, although E rosette depletion resulted in lower than expected cytotoxicity in view of the number of Fc receptor-bearing cells remaining in the preparation.

Antibodies, Neoplasm↗

Correlation between standing height, sitting height, and arm span as an index of pulmonary function in 6-10-year-old children.

The present study evaluates the relationships of pulmonary volumes and flows and the anthropometric variables of standing height, sitting height, and arm span in 100 6-10-year-old children. To be included in the study, all children were required to be healthy and above the 3rd percentile of the curve of Tanner et al. (Arch Dis Child 1966;41:454-471; Arch Dis Child 1966;41:613-635) for height and weight. Standing height, sitting height, and arm span were measured according to standard protocol. The pulmonary function measurements were: tidal volume, minute respiratory volume, respiratory rate, expiratory reserve volume, inspiratory capacity, vital capacity, residual volume (RV), functional residual capacity, total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 sec of FVC (FEV(1)), forced expiratory flow measured between 25-75% of FVC, and FEV(1)/FVC and RV/TLC ratios. Simple linear regression best expressed the correlation between pulmonary function and the anthropometric variables. Significant correlations between anthropometric and pulmonary function measurements were observed, with FVC and FEV(1) showing the highest and RV the lowest r(2) values. There was a significant positive correlation between standing height and arm span according to linear regression and Bland-Altman comparison (Bland and Altman, Lancet 1968;8:307-310). Our results suggest that when an accurate determination of standing height cannot be obtained, arm span could be used interchangeably, using the same regression equation. However, for patients with limb deformities, regression equations of pulmonary function measurements in relation to sitting height may be a better choice for estimating pulmonary function.

Anthropometry↗

The contractile mechanism of beraprost sodium, a stable prostacyclin analog, in the isolated canine femoral vein.

The vascular contractile mechanism of prostacyclin (PGI2) was investigated using beraprost sodium (BPS), a stable PGI2 analog. Ring strips without endothelium isolated from canine femoral veins and arteries were used. BPS induced a dose-dependent contraction without precontraction and after precontraction with norepinephrine (NE) or 60 mM K+ in the veins. In contrast, BPS induced a dose-dependent relaxation after precontraction with U46619, a thromboxane A2 (TXA2) analog, or prostaglandin F2 alpha (PGF2 alpha) in the veins. In the arteries, BPS induced contraction at higher concentrations after precontraction with NE. However, BPS relaxed arteries dose-dependently after precontraction with PGF2 alpha. By pretreatment with 13-azaprostanoic acid (13-APA), a TXA2/endoperoxide receptor antagonist, the dose-response curve of BPS in the veins was shifted to the right. Schild plot analysis resulted in a linear regression with a slope of 0.86 +/- 0.13, which was not significantly different from unity, and the pA2 value for 13-APA against BPS was 7.10 +/- 0.06. By pretreatment with BPS, the dose-response curve of U46619 in the veins was shifted to the right. Kaumann plot analysis resulted in a linear regression with a slope of 0.89 +/- 0.09, which was not significantly different from unity, and the pA2 value for BPS against U46619 was 5.68 +/- 0.04. These findings indicate that BPS is a partial agonist for the TXA2/endoperoxide receptors.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

A novel two-site binding equation presented in terms of the total ligand concentration.

For the most frequently used two-site model, an exact binding equation is presented in terms of the total ligand concentration. This equation has been extended to analyze the spectroscopic titration experiment where the dilution of protein solution cannot be neglected, the displacement study, and the effect of non-specific binding. Thus, with a non-linear regression program, all unknown binding parameters can be determined correctly by fitting these equations to the experimental data without any data transformation. As an example of the use of the new equations, the experimental data for receptor-insulin binding were taken from literature and reanalyzed by using a non-linear regression data analysis program.

Binding Sites↗

Quantitative estimation of left ventricular ejection fraction from mitral valve E-point to septal separation and comparison to magnetic resonance imaging.

This study tested the hypothesis that the mitral valve E point-to-septal separation (EPSS) can be used to quantify the left ventricular (LV) ejection fraction (EF) on a continuous scale rather than simply as "normal" or "reduced." After excluding 5 patients with mitral valve prostheses, asymmetric septal hypertrophy, or significant aortic insufficiency, EPSS was measured in 42 patients by 3 independent observers on a cardiac magnetic resonance image identical to the echocardiographic parasternal long-axis view. In each patient, the reference standard LVEF was calculated from the magnetic resonance short-axis cross-sectional stack images by Simpson's rule and ranged from 11% to 72%. For all 42 patients, linear regression revealed the relation magnetic resonance imaging (MRI) LVEF = 75.5 - 2.5. EPSS (millimeters). Correlation between EPSS and the MRI LVEF for the 3 observers agreed closely, ranging from r = 0.78 to r = 0.82 (SEE 9 to 10), with similar regression coefficients. After blinded segmental wall motion scoring of the gated magnetic resonance cine images of the left ventricle in each patient, correlations, SEEs, and regression coefficients were found to be very similar in the 21 patients with the most homogenous wall motion, compared with the 21 patients with the most heterogenous wall motion. In conclusion, clinically useful quantitative prediction of the LVEF as a continuous variable can be obtained from the EPSS with a simple linear regression equation in a substantial portion of patients and may be a useful adjunct for assessment of LV function.

Echocardiography↗

Effect of temperature on development of the forensically important holarctic blow fly Protophormia terraenovae (Robineau-Desvoidy) (Diptera: Calliphoridae).

Immature development times of the blow fly Protophormia terraenovae (Robineau-Desvoidy, 1830) were studied in the laboratory at five different constant temperatures (15, 20, 25, 30, 35 degrees C). The minimal duration of development from oviposition to adult emergence was inversely related to temperature, ranging from 9.19+/-0.3 days at 35 degrees C to 37.78+/-2.96 days at 15 degrees C. From linear regression of development rates at the five studied constant temperature regimes, it followed that the minimum development threshold (t(L)) for total immature development is 8.95 degrees C ( approximately 9 degrees C) and the overall thermal constant (K) for P. terraenovae is 240.2+/-9.3 day-degrees (DD) above the threshold. Linear regression of developmental rates from oviposition to pupariation resulted in a minimum development threshold of 9.8 degrees C. However, it is possible that developmental time from oviposition to adult eclosion might be different in various regions of the world, and that the thermal constant of a holarctic species like P. terraenovae is not same everywhere. Additionally, as the present paper shows, studies characterizing variation in these parameters between geographically distinct populations of the same species would be of great value for future forensic entomological casework.

Animals↗

Lazaroids--not nitric oxide synthetase inhibitors--improve hemodynamics after thermal injury in anesthetized guinea pigs.

Our objective was to study the effects of a lipid peroxidation inhibitor (U74389G) and nitric oxide synthetase inhibitor (NG-methyl-L-arginine) on hemodynamic stability in burn shock. The design was a prospective, placebo control, randomized, and masked multigroup study in a research laboratory of a university hospital. We used 24 guinea pigs (N = 24), and induced burn shock by a scalding thermal injury (75 degrees C) to 35% of their body surface area. Hemodynamics and gas exchange were observed for 90 minutes after the burn injury in the four groups: no burn, burn-control, burn-U74 (10 mg/kg U74389G), and burn-LNMA (20 mg/Kg NG-methyl-L-arginine). The percentage of mean arterial pressure, normalized for the initial value at 30 minutes after the burn injury, decreased in all groups over time but was not significantly different in any group. The normalized percentage of flow also decreased over time in all groups with the slope of the linear regression significantly less in the burn-U74 group (-0.32 95% CI, -0.05, -0.15) and the no burn group (-0.37 95% CI, -0.48, -0.26), compared with the burn-control group (-0.66 95% CI, -0.77, -0.56) and the burn-LNMA group (-0.66 95% CI, -0.77, -0.56). The slope of the linear regression for the normalized percentage of systemic vascular resistance was significantly more marked in the burn-control group (2.45 95% CI, 1.35, 3.54) and the burn-LNMA group (1.22 95% CI, 0.89, 1.55) compared with the no burn group (0.16 95% CI, 0.11, 0.44) or the burn-U74 group (0.34 95% CI, 0.06, 0.74). The burn shock resulted in hemodynamic instability as measured with increased systemic vascular resistance, decreased cardiac output, and mean arterial pressure. Use of a lazaroid (U74389G), not a nitric oxide synthetase inhibitor (NG-methyl-L-arginine), altered the clinical course after thermal injury. These data suggest the importance of lipid peroxidation and free radicals as secondary mediators in the evolution of burn shock.

Analysis of Variance↗

Catheterization-Doppler discrepancies in nonsimultaneous evaluations of aortic stenosis.

Prior validation studies have established that simultaneously measured catheter (cath) and Doppler mean pressure gradients (MPG) correlate closely in evaluation of aortic stenosis (AS). In clinical practice, however, cath and Doppler are rarely performed simultaneously; which may lead to discrepant results. Accordingly, our aim was to ascertain agreement between these methods and investigate factors associated with discrepant results. We reviewed findings in 100 consecutive evaluations for AS performed in 97 patients (mean age 72 +/- 10 yr) in which cath and Doppler were performed within 6 weeks. We recorded MPG, aortic valve area (AVA), cardiac output, and ejection fraction (EF) by both methods. Aortic root diameter, left ventricular end-diastolic dimension (LVIDd) and posterior wall thickness (PWT) were measured by echocardiography and gender, heart rate, and heart rhythm were also recorded. An MPG discrepancy was defined as an intrapatient difference > 10 mmHg. Mean pressure gradients by cath and Doppler were 36 +/- 22 mmHg and 37 +/- 20 mmHg, respectively (P = 0.73). Linear regression showed good correlation (r = 0.82) between the techniques. An MPG discrepancy was found in 36 (36%) of 100 evaluations; in 19 (53%) of 36 evaluations MPG by Doppler was higher than cath, and in 17 (47%) of 36, it was lower. In 33 evaluations, EF differed by >10% between techniques. Linear regression analyses revealed that EF difference between studies was a significant predictor of MPG discrepancy (P = 0.004). Women had significantly higher MPG than men by both cath and Doppler (43 +/- 25 mmHg versus 29 +/- 15 mmHg [P = 0.001]; 42 +/- 23 mmHg versus 32 +/- 15 mmHg [P = 0.014], respectively). Women exhibited discrepant results in 23 (47%) of 49 evaluations versus 13 (25%) of 51 evaluations in men (P = 0.037). After adjustment for women's higher MPG, there was no statistically significant difference in MPG discrepancy between genders (P = 0.22). No significant interactions between MPG and aortic root diameter, relative wall thickness (RWT), heart rate, heart rhythm, cardiac output, and time interval between studies were found. In clinical practice, significant discrepancies in MPG were common when cath and Doppler are performed nonsimultaneously. No systematic bias was observed and Doppler results were as likely yield lower as higher MPGs than cath. EF difference was a significant predictor of discrepant MPG. Aortic root diameter, relative wall thickness, heart rate, heart rhythm, cardiac output, presence or severity of coronary artery disease, and time interval between studies were not predictors of discrepant results.

Aged↗

[Estimated relative and absolute risk for cardiovascular disease according to alcohol consumption increase in Japanese general population].

To calculate the estimated relative and absolute risks for cardiovascular diseases according to alcohol consumption increase, we performed a cross-sectional study of men aged 40-79 years using the data from the National Survey of Circulatory Disorders 1990 in Japan. First, we investigated the association between alcohol intake and two types of biochemical variables: serum lipids and blood pressure, by using analysis of variance. Then, concerning the subjects aged 40-59 years, linear regression analyses between alcohol intake and these biochemical markers were done to calculate regression coefficients adjusted for confounding factors. Finally, we substituted these regression coefficients for previously reported regression coefficients in Cox proportional hazard models to calculate relative and absolute risks for coronary heart disease and stroke. Alcohol intake positively correlated to systolic and diastolic blood pressure (SBP and DBP) and high-density lipoprotein cholesterol (HDLC). However, there was no relation between alcohol intake and serum total cholesterol. Linear regression coefficients of SBP, DBP and HDLC were 2.25, 1.43, 2.70, respectively. We used two proportional hazard regression formulas of Japanese population: one for coronary disease (Circulation 89, 2533-39) and the other for stroke (NIPPON DATA80, a 14-year cohort study of randomly selected Japanese). The estimated relative risks of coronary heart disease and stroke were 0.89 and 1.06 for 1 "go" (23 g of ethanol) increment of alcohol intake. The results indicate that the mortality rates shift from 0.44 to 0.39 per 1,000 person-years for coronary heart disease and from 0.76 to 0.81 per 1,000 person-years for stroke in the representative Japanese population aged 40-59 years. The absolute risk of cardiovascular disease may be unchanged if we assume 23 g increment of ethanol intake in Japan because the risk reduction in coronary heart disease was nearly equal to the risk increment in stroke.

Adult↗

[Time trend of mortality rates of cerebrovascular diseases in Hong Kong].

OBJECTIVE: To describe the time trend of mortality rates of cerebrovascular diseases (CVD) in Hong Kong for the period of 1976 to 1995, and to compare them with those in the more developed countries around the world. METHODS: Mortality rates of CVD were standardized directly using world standard population in 1961. Annual percent changes of mortality rates of CVD were estimated with a non-linear regression. Birth-cohort analysis was carried out at an interval of five-year of age to compare their age-specific mortality rates of CVD in different birth cohorts. Time trend of cause-specific mortality rates of CVD both in males and females was fitted with a simple linear regression model. RESULTS: Considerable downward trend of CVD mortality was observed during the past twenty years. Mortality rates among men and women decreased by 50.96% and 37.85% in 1995, as compared to those in 1976, respectively. Although in general, a greater trend in CVD mortality was observed during the last 10 years, as compared with that in the previous 10 years, an annual increase in CVD mortality of 1.34% was found among males aged 35 to 44 years during the latter 10 years. CVD mortality for both males and females decreased steadily by 1% per year. CVD mortality for females will catch up with that for males by the year of 2013, if such a trend continues. Birth-cohort analysis showed that those born more recently at the same age-group had lower mortality of CVD (except for those born after 1955). Data from hospital admission showed that improvement in the treatment for CVD could have contributed partly to the decrease in its mortality. CONCLUSION: Time trend of mortality of CVD in Hong Kong was similar to that in many other economically developed areas around the world.

Adult↗