Lung cancer, fruit, green salad and vitamin pills.
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Biomedical subjects
Publications and source records attributed to E C Hammond.
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The matched group analysis method in prospective studies is a variation of matched pairs analysis with the advantage of sampling error avoided in the choosing of pairs of subjects. An example is shown in which comparisons are given of mortality in triads of cases classified by the tar and nicotine level of the cigarettes they smoked and matched on 10 variables. The method can also be used in retrospective and autopsy studies.
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To test the hypothesis that the reduction in tar and nicotine content of cigarette smoke that began in the 1950s should be reflected by the histologic changes in the bronchial epithelium of cigarette smokers, 20, 424 sections taken at autopsy from the bronchial tubes of 445 men (non-lung-cancer deaths) were examined microscopically in random order. There were 211 men who died in 1955-1960, of whom 154 smoked regularly, and 234 men who died in 1970-1977, of whom 181 were regular smokers. Changes studied included basal-cell hyperplasia, loss of cilia and occurrence of cells with atypical nuclei. In both periods studied these histologic changes occurred far less frequently in nonsmokers than in cigarette smokers and increased in frequency with amount of smoking, adjusted for age. Sections with advanced histologic changes in those dying in 1955-1960 occurred in 0 per cent of nonsmokers, in 2.6 per cent of those smoking one to 19 cigarettes a day, in 13.2 per cent of those smoking 20 to 39 and in 22.5 per cent of those smoking 40+ cigarettes a day. In those who died in 1970-1977 the percentages were 0, 0.1, 0.8, and 2.2, respectively.
Prospective epidemiologic data of the American Cancer Society disclosed that reported usual sleep durations among groups who complained of insomnia and sleeping pill use "often" overlapped with those of groups who had no complaints. Reports of insomnia were not consistently associated with increased mortality when several factors were controlled; however, men who reported usually sleeping less than four hours were 2.80 times as likely to have died within six years as men who reported 7.0 to 7.9 hours of sleep. The ratio for women was 1.48. Men and women who reported sleeping ten hours or more had about 1.8 times the mortality of those who reported 7.0 to 7.9 hours of sleep. Those who reported using sleeping pills "often" had 1.5 times the mortality of those who "never" used sleeping pills. These results do not prove that mortality could be reduced by altering sleep durations or by reducing hypnotic prescribing. Rather, studies are needed to determine the causes of these mortality risk factors.
A comprehensive autopsy survey of the large bowel showed that adenomas were very common lesions occurring in about one-half of the 518 cases studied. The great majority were small adenomatous polyps (tubular adenomas), 86.7% measuring less than 10 mm in diameter. Adenomas with a more complex tubulovillous pattern were larger with a mean diameter of 19.0 mm. There was no apparent incresae in mean size of adenomas with age. Nineteen clinically unsuspected cancers were discovered. Fourteen (8 in situ and 6 invasive) cancers had areas of residual benign adenoma. Five invasive cancers had no residual benign component. No in situ carcinomas or small (less than 10 mm) invasive cancers not containing residual adenoma were found. The results suggest that, although adenomas of the large bowel are very common, the vast majority are simple adenomatous polyps which do not undergo progressive growth and malignant change. Conversely, it appears that cancers may arise from benign adenomas which have the characteristics of large size and a more complex villous architecture.
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Vascular changes in the coronary arteries and intramyocardial arteries and arteriole were studied in 1,056 men in relation to the effects of cigarette smoking and to age. The analysis was based on both macroscopic and microscopic studies, and the pathologist was unaware of the identity of the cases. The macroscopic study found a greater association with atheroma than a previous study taken from autopsies. The microscopic study found moderate and advanced fibrous intimal thickening of the coronary arteries to be more frequent in smokers and related to the amount or degree of cigarette smoking. The increase in fibrous intimal thickening was greater for intramyocardial arteries than for subepicardial arteries. The most marked difference by smoking habits was found in the myocardial arterioles. Advanced hyaline thickening was found in 90.7 percent of those smoking two or more packs of cigarettes per day, in 48.4 percent of those smoking less than one pack per day, and not in any of those who never smoked regularly.
Over 1 000 000 men and women answered a confidential questionnaire and were traced for up to six years afterwards. Among other questions each person was asked how often he or she took aspirin-"never", "seldom," or "often." Coronary heart disease death rates were no lower among people who took aspirin often than among those who did not do so.