Biomedical subjects

C Osmond

Publications and source records attributed to C Osmond.

At least 145 records · Page 8Linked to original sources

PubMed1992

Predicting mortality from cancer of the uterine cervix from 1991-2001.

STUDY OBJECTIVE: The aim was to provide benchmarks by which to judge the success of behaviour change and the cervical cancer screening programme in England and Wales in reducing mortality from this disease over the next decade. DESIGN: Log-linear models and cervical cancer mortality data by age and marital status from 1959-88 were used to predict future mortality in England and Wales. MEASUREMENTS AND MAIN RESULTS: Recombining "predicted" deaths in marital status groups for 1984-88 gave a closer agreement to total mortality observed in those years than predictions based on past trends from 1959-83 among women of all statuses combined. Mortality for 1989-2003 was then predicted, using the data for 1959-1988. CONCLUSIONS: The reaggregated marital status forecasts of mortality provide an upper boundary which future observed mortality should not cross if primary and secondary prevention measures are working effectively. The method allows swift comparison of observation with expectation and therefore the rapid evaluation of the overall performance of preventive strategies.

Adult↗

PubMed1992

The environment in childhood and risk of motor neuron disease.

To investigate a possible link between subclinical infection with poliovirus in childhood and increased risk of motor neuron disease in adult life, environmental determinants of infection in early life were compared in 98 cases of motor neuron disease and 335 age and sex matched controls. A weak but consistent relation was found between motor neuron disease and factors in the childhood environment known to increase likelihood of enteric infection. Relative risks associated with spending the first 10 years of life in a house without domestic amenities such as a bathroom, running hot water or flushing lavatory, living in overcrowded conditions, frequent changes of address or having a sibling with paralytic poliomyelitis were all greater than unity, although only those for absence of running hot water and frequent changes of address were statistically significant.

Adolescent↗

PubMed1992

The interaction between immunoglobulin E and smoking in airflow obstruction in the elderly.

Airflow obstruction and serum immunoglobulin E (IgE) were assessed in 250 men and women 65 to 91 yr of age who had been selected from a larger general population sample according to reported respiratory symptoms. After allowance for age and sex, serum IgE and smoking interacted synergistically as risk factors for airflow obstruction such that on average an IgE > or = 81 IU/ml in current smokers was associated with a FEV1/FVC ratio 14.4 percentage points (95% CI, 8.8 to 19.9) less than in lifelong nonsmokers with an IgE < or = 10 IU/ml. This synergistic interaction was apparent in subjects who showed no evidence of airway lability (i.e., no hyperresponsiveness to inhaled methacholine or, if bronchial hyperresponsiveness could not be tested, no clear improvement in airflow obstruction after inhalation of salbutamol). The findings suggest that the role of IgE in the pathogenesis of airflow obstruction is not confined to asthmatics.

Age Factors↗

PubMed1991

Fetal and infant growth and impaired glucose tolerance at age 64.

OBJECTIVE: To discover whether reduced fetal and infant growth is associated with non-insulin dependent diabetes and impaired glucose tolerance in adult life. DESIGN: Follow up study of men born during 1920-30 whose birth weights and weights at 1 year were known. SETTING: Hertfordshire, England. SUBJECTS: 468 men born in east Hertfordshire and still living there. MAIN OUTCOME MEASURES: Fasting plasma glucose, insulin, proinsulin, and 32-33 split pro-insulin concentrations and plasma glucose and insulin concentrations 30 and 120 minutes after a 75 g glucose drink. RESULTS: 93 men had impaired glucose tolerance or hitherto undiagnosed diabetes. They had had a lower mean birth weight and a lower weight at 1 year. The proportion of men with impaired glucose tolerance fell progressively from 26% (6/23) among those who had weighted 18 lb (8.16 kg) or less at 1 year to 13% (3/24) among those who had weighed 27 lb (12.25 kg) or more. Corresponding figures for diabetes were 17% (4/23) and nil (0/24). Plasma glucose concentrations at 30 and 120 minutes fell with increasing birth weight and weight at 1 year. Plasma 32-33 split proinsulin concentration fell with increasing weight at 1 year. All these trends were significant and independent of current body mass. Blood pressure was inversely related to birth weight and strongly related to plasma glucose and 32-33 split proinsulin concentrations. CONCLUSIONS: Reduced growth in early life is strongly linked with impaired glucose tolerance and non-insulin dependent diabetes. Reduced early growth is also related to a raised plasma concentration of 32-33 split proinsulin, which is interpreted as a sign of beta cell dysfunction. Reduced intrauterine growth is linked with high blood pressure, which may explain the association between hypertension and impaired glucose tolerance.

Aged↗

PubMed1991

Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease.

OBJECTIVE: To examine whether birth weight, infant weight, and childhood respiratory infection are associated with adult lung function and death from chronic obstructive airways disease. DESIGN: Follow up study of men born during 1911-30 whose birth weights, weights at 1 year, and childhood illnesses were recorded at the time by health visitors. SETTING: Hertfordshire, England. SUBJECTS: 5718 men born in the county during 1911-30 and a subgroup of 825 men born in the county during 1920-30 and still living there. MAIN OUTCOME MEASURES: Death from chronic obstructive airways disease, mean forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and respiratory symptoms. RESULTS: 55 men died of chronic obstructive airways disease. Death rates fell with increasing birth weight and weight at 1 year. Mean FEV1 at age 59 to 70 years, adjusted for height and age, rose by 0.06 litre (95% confidence interval 0.02 to 0.09) with each pound (450 g) increase in birth weight, independently of smoking habit and social class. Bronchitis or pneumonia in infancy was associated with a 0.17 litre (0.02 to 0.32) reduction in adult FEV1 and with an increased odds ratio of wheezing and persistent sputum production in adult life independently of birth weight, smoking habit, and social class. Whooping cough in infancy was associated with a 0.22 litre (0.02 to 0.42) reduction in adult FEV1. CONCLUSIONS: Lower birth weight was associated with worse adult lung function. Intrauterine influences which retard fetal weight gain may irrecoverably constrain the growth of the airways. Bronchitis, pneumonia, or whooping cough in infancy further reduced adult lung function. They also retarded infant weight gain. Consistent with this, death from chronic obstructive airways disease in adult life was associated with lower birth weight and weight at 1 year. Promoting lung growth in fetuses and infants and reducing the incidence of lower respiratory tract infection in infancy may reduce the incidence of chronic obstructive airways disease in the next generation.

Adult↗

PubMed1991

The effect of maternal anaemia and iron deficiency on the ratio of fetal weight to placental weight.

OBJECTIVE: To examine the maternal influences which determine large placental weight and a high ratio of placental weight to birthweight. These are known predictors of adult blood pressure. DESIGN: Retrospective analysis of routine obstetric and haematology department records for a large cohort of pregnant women. SETTING: John Radcliffe Hospital, Oxford. SUBJECTS: 8684 pregnant women who were delivered between January 1987 and January 1989 and whose records could be linked to the results of two or more pregnancy blood counts. MAIN OUTCOME MEASURES: Placental weight and the ratio of placental weight to birthweight. RESULTS: Large placental weight was associated with a low maternal haemoglobin and a fall in maternal mean cell volume during pregnancy. The highest ratio of placental weight to birthweight occurred in the most anaemic women with the largest falls in mean cell volume. Large placental weight and a high ratio of placental weight to birthweight were also independently associated with a high maternal body mass index. Maternal smoking reduced placental weight, but increased the ratio of placental weight to birthweight. CONCLUSIONS: Anaemia and iron deficiency during pregnancy are associated with large placental weight and a high ratio of placental weight to birthweight. This points to maternal nutritional deficiency as a cause for discordance between placental and fetal growth. This may have important implications for the prevention of adult hypertension, which appears to have its origin in fetal life.

Anemia↗

PubMed1991

Fetal heart rate and intrauterine growth.

OBJECTIVE: To assess whether fetal heart rate in early and late pregnancy relates to size at birth. DESIGN: Prospective study of fetal heart rates in early and late pregnancy. SETTING: Princess Anne Hospital, Southampton. SUBJECTS: 63 primigravid women. MAIN OUTCOME MEASURES: Anthropometric measurements made on the newborn infant. RESULTS: There were no differences in heart rate between the sexes at 18 weeks gestation but by 36 weeks the boys had rates which were 4.4 beats lower than those of the girls. Higher fetal heart rate at 18 weeks was associated with lower ponderal index, smaller head circumference and smaller mid-arm circumference. There were no trends in fetal heart rate at 36 weeks with any birth measurements. CONCLUSION: Babies born at term who have a pattern of neonatal measurements which reflect growth retardation have raised heart rates in early pregnancy. Influences which impair fetal growth appear to take effect early in gestation.

Anthropometry↗

PubMed1991

Maternal and fetal influences on blood pressure.

To study maternal and fetal influences on blood pressure in childhood 405 children aged 4 years who were born and still resident in the Salisbury health district were visited at home for blood pressure and growth measurements. Information on the pregnancy, delivery, and baby was abstracted from the routine obstetric notes. Similar to recent findings in adults, the child's systolic pressure was inversely related to birth weight and positively related to placental weight. Systolic pressure at 4 years increased by 1.2 mm Hg for every SD decrease in the ratio of head circumference to length at birth, and by 1.1 mm Hg for every SD decrease in ponderal index at birth. Mothers whose haemoglobin concentrations fell below 100g/l during pregnancy had children whose systolic pressures were on average 2.9 mm Hg higher than the children of mothers with higher haemoglobin concentrations. Patterns of placental weight, birth weight, head circumference, and length that are associated with high blood pressure in adults are also associated with higher blood pressure in 4 year old children. Identification of the intrauterine influences that lead to these patterns of fetal growth could lead to the primary prevention of hypertension.

Birth Weight↗

PubMed1991

Osteoarthritis of the hip and osteoporosis of the proximal femur.

A negative association has been reported between osteoarthritis and osteoporosis. There are, however, few population based data to support this association. In this study the bone density in the upper femur was compared with the presence and severity of hip osteoarthritis in 314 subjects undergoing radiography for non-skeletal indications. There was a statistically significant negative association between the two disorders. This relation may reflect differences in the cause of these two major musculoskeletal conditions.

Adult↗

PubMed1991

Ischaemic heart disease in England and Wales around the year 2000.

STUDY OBJECTIVE: The aim was to predict death rates from ischaemic heart disease in England and Wales during the next 20 years. STUDY DESIGN: Age and sex specific death rates for 1968-1987 were used to predict national and regional trends until 2007. SETTING: The nine standard regions of England and Wales. RESULTS: There will be a large fall in deaths from ischaemic heart disease. The fall will be greater in men and women below 65 years of age. There will, however, be a sharp worsening of the north/south divide. The largest fall in any region will be in Wales. CONCLUSION: The campaign to change the national diet should give highest priority to the norther regions. Because infant growth is inversely related to adult risk of ischaemic heart disease, the poor growth of young children in some northern areas is a cause for concern.

Adult↗

PubMed1991

A population survey of respiratory symptoms in the elderly.

Reversible airways obstruction is not uncommon in the elderly, but may be overlooked because of the high prevalence of other disorders with a similar presentation. In a search for patterns of symptoms which might predict treatable airways obstruction, we carried out a survey of men and women aged 65 yrs and over. Postal questionnaires were completed by 2,161 subjects selected at random from the lists of three general practices. Almost 60% of the sample complained of one or more respiratory symptoms. Smoking was a more important risk factor than age, sex or social class, and was associated particularly with wheeze, morning phlegm and chest tightness on waking. Several groups of symptoms tended to cluster in the same individuals. The two most closely related were chest tightness and breathlessness in response to animals, dust and feathers. Responses to irritants tended to cluster according to the symptom produced (cough, breathlessness or wheeze) rather than the provoking stimulus (smoke, cold air, household chemicals or traffic fumes). There was no evidence for the existence of the "bronchial irritability syndrome" which has been linked with asthma in younger adults. The relationship of symptoms to respiratory function and bronchial reactivity will be reported in a further publication.

Age Factors↗

PubMed1990

Fetal and placental size and risk of hypertension in adult life.

OBJECTIVE: To study the effect of intrauterine growth and maternal physique on blood pressure in adult life. DESIGN: A follow up study of infants born 50 years previously whose measurements at birth were recorded in detail. SETTING: Preston, Lancashire. SUBJECTS: 449 Men and women born in hospital in Preston during 1935-43 and still living in Lancashire. MAIN OUTCOME MEASURES: Placental weight, birth weight, and blood pressure at age 46 to 54 years. RESULTS: In both sexes systolic and diastolic pressures were strongly related to placental weight and birth weight. Mean systolic pressure rose by 15 mm Hg as placental weight increased from less than or equal to 1 lb (0.45 kg) to greater than 1.5 lb and fell by 11 mm Hg as birth weight increased from less than or equal to 5.5 lb to greater than 7.5 lb. These relations were independent so that the highest blood pressures occurred in people who had been small babies with large placentas. Higher body mass index and alcohol consumption were also associated with higher blood pressure, but the relations of placental weight and birth weight to blood pressure and hypertension were independent of these influences. CONCLUSIONS: These findings show for the first time that the intrauterine environment has an important effect on blood pressure and hypertension in adults. The highest blood pressures occurred in men and women who had been small babies with large placentas. Such discordance between placental and fetal size may lead to circulatory adaptation in the fetus, altered arterial structure in the child, and hypertension in the adult. Prevention of hypertension may depend on improving the nutrition and health of mothers.

Alcohol Drinking↗

PubMed1990

Stomach cancer and migration within England and Wales.

Rates of stomach cancer vary from place to place within England and Wales. To determine whether this reflects influences acting earlier or later in life, we have analysed mortality from the disease by county of birth and county of death. Among 749,035 men and women who died during 1969-72 in a different county from that in which they were born, proportional mortality from stomach cancer was more closely related to county of birth than of death. This association with place of birth was found in migrants both out of and into high-risk areas. We conclude that studies seeking to explain local differences in the incidence of stomach cancer within England and Wales should focus on the environment of patients in their youth.

England↗

PubMed1990

Poor housing in childhood and high rates of stomach cancer in England and Wales.

In a search for aetiological processes which might explain the association of stomach cancer with poverty, we have related mortality from the disease in the local authority areas of England and Wales during 1968-78 to indices of living standards derived from the 1971, 1951 and 1931 censuses. We have also analysed recently released data from a national survey of overcrowding carried out in 1936. Geographical differences in stomach cancer were most closely related to occupationally derived indices of socio-economic structure from the 1971 census, and to measures of domestic crowding from the 1931 census and 1936 survey. Unlike other indices of poor living standards, levels of past domestic crowding in north-west Wales were consistent with its previously unexplained high death rates from stomach cancer. We conclude that overcrowding in the home during childhood may be a major determinant of stomach cancer, and might act by promoting the transmission of causative organisms.

Adult↗

PubMed1990

Risk of death from cardiovascular disease and chronic bronchitis determined by place of birth in England and Wales.

STUDY OBJECTIVE: The aim of the study was to examine the relation between place of birth within England and Wales and cause of death. DESIGN: The study was a population survey using data provided by the Office of Population Censuses and Surveys which, for a trial period between 1969 and 1972, coded place of birth on death certificates. SETTING: The survey involved almost 2 million people who died in England and Wales between April 1969 and December 1972. MAIN RESULTS: Persons born in northern counties and industrial towns, and in Wales, had increased risk of ischaemic heart disease and stroke, which persisted whether or not they had moved to other parts of the country. A low risk of cardiovascular disease among people born in and around London went with them when they moved. People born in cities and large towns had an increased and persisting risk of chronic bronchitis. CONCLUSIONS: These findings are evidence that past geographical differences in fetal and infant growth, and in exposure to respiratory infection in early childhood, partly determine today's differences in adult death rates.

Bronchitis↗

PubMed1989

Weight in infancy and death from ischaemic heart disease.

Environmental influences that impair growth and development in early life may be risk factors for ischaemic heart disease. To test this hypothesis, 5654 men born during 1911-30 were traced. They were born in six districts of Hertfordshire, England, and their weights in infancy were recorded. 92.4% were breast fed. Men with the lowest weights at birth and at one year had the highest death rates from ischaemic heart disease. The standardised mortality ratios fell from 111 in men who weighed 18 pounds (8.2 kg) or less at one year to 42 in those who weighed 27 pounds (12.3 kg) or more. Measures that promote prenatal and postnatal growth may reduce deaths from ischaemic heart disease. Promotion of postnatal growth may be especially important in boys who weigh below 7.5 pounds (3.4 kg) at birth.

Adult↗

PubMed1989

Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease.

In national samples of 9921 10 year olds and 3259 adults in Britain systolic blood pressure was inversely related to birth weight. The association was independent of gestational age and may therefore be attributed to reduced fetal growth. This suggests that the intrauterine environment influences blood pressure during adult life. It is further evidence that the geographical differences in average blood pressure and mortality from cardiovascular disease in Britain partly reflect past differences in the intrauterine environment. Within England and Wales 10 year olds living in areas with high cardiovascular mortality were shorter and had higher resting pulse rates than those living in other areas. Their mothers were also shorter and had higher diastolic blood pressures. This suggests that there are persisting geographical differences in the childhood environment that predispose to differences in cardiovascular mortality.

Adult↗

PubMed1989

Geographical relation between Alzheimer's disease and aluminum in drinking water.

In a survey of eighty-eight county districts within England and Wales, rates of Alzheimer's disease in people under the age of 70 years were estimated from the records of the computerised tomographic (CT) scanning units that served these districts. Rates were adjusted to compensate for differences in distance from the nearest CT scanning unit and for differences in the size of the population served by the units. Aluminium concentrations in water over the past 10 years were obtained from water authorities and water companies. The risk of Alzheimer's disease was 1.5 times higher in districts where the mean aluminium concentration exceeded 0.11 mg/l than in districts where concentrations were less than 0.01 mg/l. There was no evidence of a relation between other causes of dementia, or epilepsy, and aluminium concentrations in water.

Adult↗