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G A Colditz

Publications and source records attributed to G A Colditz.

At least 343 records · Page 19Linked to original sources
PubMed1994

Intake of fat, meat, and fiber in relation to risk of colon cancer in men.

Some evidence suggests that diets high in animal fat or red meat may increase the risk of colon cancer, whereas high intake of fiber or vegetables may be protective. Frequently, intake of red meat has been a stronger risk factor than total fat. Because data from prospective cohort studies are sparse, we examined fat, meat, fiber, and vegetable intake in relation to risk of colon cancer in a cohort of 47,949 U.S. male health professionals who were free of diagnosed cancer in 1986. At baseline, these men, 40 to 75 years of age, completed a validated food frequency questionnaire and provided detailed information on other lifestyle and health-related factors. Between 1986 and 1992, 205 new cases of colon cancer were diagnosed in these men. Intakes of total fat, saturated fat, and animal fat were not related to risk of colon cancer. However, an elevated risk of colon cancer was associated with red meat intake (relative risk, 1.71; 95% confidence interval, 1.15-2.55 between high and low quintiles; P = 0.005 for trend). Men who ate beef, pork, or lamb as a main dish five or more times per week had a relative risk of 3.57 (95% confidence interval, 1.58-8.06; P = 0.01 for trend) compared to men eating these foods less than once per month. The association with red meat was not confounded appreciably by other dietary factors, physical activity, body mass, alcohol intake, cigarette smoking, or aspirin use. Other sources of animal fat, including dairy products, poultry, and fish as well as vegetable fat, were slightly inversely related to risk of colon cancer. No clear association existed between fiber or vegetable intake and risk of colon cancer. These data support the hypothesis that intake of red meat is related to an elevated risk of colon cancer.

Adult↗
PubMed1994

Validation of the Gail et al. model for predicting individual breast cancer risk.

BACKGROUND: The Gail et al. model is considered the best available means for estimating an individual woman's risk of developing breast cancer. Such estimates are useful in decision making on the part of women, in designing prevention trials, and in targeting screening and prevention efforts. PURPOSE: Our purpose was to evaluate the ability of the model to accurately predict individual breast cancer risk, using a large population independent of the one from which the model was derived. METHODS: We compared the number of cancer cases predicted by the model to the actual number of cases observed in the Nurses' Health Study. The study population was 115,172 women who did not have breast cancer at the beginning of the study. Questionnaires were sent to participants every 2 years, seeking data on risk factors and diagnoses of breast cancer. Follow-up compliance was 95% over the 12-year study period. RESULTS: The model over-predicted absolute breast cancer risk by 33% (95% confidence interval [CI] = 28%-39%), with the overprediction more than twofold among premenopausal women (95% CI = 1.9-2.2), among women with extensive family history of breast cancer (95% CI = 1.1-3.9), and among women with age at first birth younger than 20 years (95% CI = 1.3-4.7). The correlation coefficient between observed and predicted risk was 0.67, indicating that the model is less than satisfactory for ranking individual levels of breast cancer risk. Overprediction occurred at all deciles of predicted risk. CONCLUSIONS: The model's performance is unsatisfactory for estimating breast cancer risk for individual women aged 25-61 years who do not participate in annual screening. Lower mammography screening rates in the Nurses' Health Study may account for some, but not all, of the discrepancy between observed and predicted cases. IMPLICATIONS: A recent modification of the model by the tamoxifen trial investigators is likely to have provided accurate power calculations. This modified form of the model should be useful for planning other large, population-based studies.

Adult↗
PubMed1994

Reproductive risk factors in a prospective study of breast cancer: the Nurses' Health Study.

A modification of the model of Pike et al. (Nature 1983;303: 767-70) was applied to 91,523 women in the Nurses' Health Study who did not report prevalent cancer initially and who were followed for 14 years (1,212,855 person-years and 2,341 incident breast cancers). The model took into account current age, age at all births, age at menopause, and age at menarche in predicting the annual and cumulative incidence of breast cancer. The authors found that ages both at first birth and at subsequent births have long-term influence on breast cancer incidence. The incidence density for parous women was greater than for nulliparous women for 20-30 years after the time of the first birth. However, cumulative incidence up to age 70 years was about 20% lower, 10% lower, or 5% higher for parous versus nulliparous women if their first birth was at age 20, 25, or 35 years, respectively. The authors also observed a significantly lower incidence after each additional birth as well as after menopause for women of the same age. Overall, the effect of reproductive factors (other than age at menarche) appears to influence cumulative incidence to age 70 years by a maximum of approximately 50% when women with multiple births with an early age at first birth are compared with women with a single birth at a late age.

Adult↗
PubMed1994

Efficacy of BCG vaccine in the prevention of tuberculosis. Meta-analysis of the published literature.

OBJECTIVE: To quantify the efficacy of BCG vaccine against tuberculosis (TB). DATA SOURCES: MEDLINE with index terms BCG vaccine, tuberculosis, and human. Experts from the Centers for Disease Control and Prevention and the World Health Organization, among others, provided lists of all known studies. STUDY SELECTION: A total of 1264 articles or abstracts were reviewed for details on BCG vaccination, concurrent vaccinated and unvaccinated groups, and TB outcome; 70 articles were reviewed in depth for method of vaccine allocation used to create comparable groups, equal surveillance and follow-up for recipient and concurrent control groups, and outcome measures of TB cases and/or deaths. Fourteen prospective trials and 12 case-control studies were included in the analysis. DATA EXTRACTION: We recorded study design, age range of study population, number of patients enrolled, efficacy of vaccine, and items to assess the potential for bias in study design and diagnosis. At least two readers independently extracted data and evaluated validity. DATA SYNTHESIS: The relative risk (RR) or odds ratio (OR) of TB provided the measure of vaccine efficacy that we analyzed. The protective effect was then computed by 1-RR or 1-OR. A random-effects model estimated a weighted average RR or OR from those provided by the trials or case-control studies. In the trials, the RR of TB was 0.49 (95% confidence interval [CI], 0.34 to 0.70) for vaccine recipients compared with nonrecipients (protective effect of 51%). In the case-control studies, the OR for TB was 0.50 (95% CI, 0.39 to 0.64), or a 50% protective effect. Seven trials reporting tuberculous deaths showed a protective effect from BCG vaccine of 71% (RR, 0.29; 95% CI, 0.16 to 0.53), and five studies reporting on meningitis showed a protective effect from BCG vaccine of 64% (OR, 0.36; 95% CI, 0.18 to 0.70). Geographic latitude of the study site and study validity score explained 66% of the heterogeneity among trials in a random-effects regression model. CONCLUSION: On average, BCG vaccine significantly reduces the risk of TB by 50%. Protection is observed across many populations, study designs, and forms of TB. Age at vaccination did not enhance predictiveness of BCG efficacy. Protection against tuberculous death, meningitis, and disseminated disease is higher than for total TB cases, although this result may reflect reduced error in disease classification rather than greater BCG efficacy.

BCG Vaccine↗
PubMed1994

A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. men.

BACKGROUND: Epidemiologic studies of men consistently demonstrate a positive association between tobacco smoking and risk of colorectal adenomas, precursors of cancer, but have not consistently shown an association between smoking and colorectal cancer. We hypothesized that smoking acts as an initiator of colorectal neoplasia and that the association with cancer has been obscured because the time is long between onset of smoking and diagnosis of cancer. PURPOSE: Our purpose was to examine the association between cigarette smoking and risk of colorectal adenoma and colorectal cancer in men and to estimate the minimum induction period between the start of smoking and the diagnosis of cancer. METHODS: Using data from the ongoing Health Professionals Follow-up Study, we assessed the relative risk (RR) of small adenoma, large adenoma (> or = 1 cm), and cancer according to pack-years of smoking. Current and lifetime histories of smoking and other confounding factors were assessed by questionnaire at baseline and at 2-year intervals. Between 1986 and 1992, we documented 238 new cases of colorectal cancer among 47,935 U.S. males and 626 new cases of colorectal adenomas among 12,854 of the men who had a sigmoidoscopy or colonoscopy. RESULTS: Smoking during the prior two decades was associated with the prevalence of small adenomas (RR = 2.96; 95% confidence interval [CI] = 1.47-5.98; for > or = 35 pack-years versus 0 pack-years within the 20 years preceding the endoscopy, P trend = .04) but not with large adenomas (RR = 0.46; 95% CI = 0.11-1.94; P trend = .56). However, smoking more than 20 years in the past was associated with large adenomas (RR = 2.38; 95% CI = 1.56-3.63; P trend = .004 for smoking > or = 16 pack-years versus 0 pack-years). Smoking was related to risk of colorectal cancer only after allowing for an induction period of at least 35 years (RR = 1.94; 95% CI = 1.13-3.35; P trend = .008 for smoking > or = 16 versus 0 pack-years more than 35 years in the past). CONCLUSIONS: Smoking in the prior 20 years has a strong relation to small colorectal adenomas, smoking at least 20 years in the past is related to larger adenomas, and the induction period for colorectal cancers is at least 35 years. IMPLICATIONS: Our results highlight the need to intensify efforts to prevent smoking, especially among the young, and suggest a reduced threshold for screening for colorectal cancer among long-term smokers.

Adenoma↗
PubMed1994

A prospective study of cigarette smoking and risk of colorectal adenoma and colorectal cancer in U.S. women.

BACKGROUND: A positive correlation between smoking and colorectal cancer has been reported for men, but not for women, who began smoking in substantial numbers in the late 1940s and early 1950s. We hypothesized that smoking acts as an initiator of colorectal neoplasia and that an association with cancer in women has been missed because of the long period between initiation and diagnosis of cancer. PURPOSE: Our purpose was to assess the association between smoking and risk of colorectal adenoma and colorectal cancer in women and to estimate the minimum induction period between the onset of smoking and cancer diagnosis. METHODS: Our data came from the ongoing Nurses' Health Study, in which current and lifetime smoking histories and other potential confounding factors were assessed by questionnaire at baseline and at 2-year intervals. We documented 586 new cases of colorectal cancer from 1976 to 1990 from a group of 118,334 women and 564 new cases of adenoma among 12,143 women who had a first colonoscopy or sigmoidoscopy between 1980 and 1990. We then assessed the relative risk (RR) of small adenoma, large adenoma (> or = 1 cm), and colorectal cancer in terms of pack-years of smoking. RESULTS: The amount smoked in the prior 20 years was related to the prevalence of small adenomas (multivariate RR = 1.45; 95% confidence interval [CI] = 1.25-1.68; P < .0001) and less strongly with large adenomas (RR = 1.31; 95% CI = 1.17-1.47; P < .0001), adjusting for age, intake of saturated fat, dietary fiber, folate, and alcohol, body mass, family history of colorectal cancer, and pack-years of cigarettes smoked within the prior 20 years. Pack-years of cigarettes smoked more than 20 years in the past was associated with risk of large adenoma (multivariate RR for a 20 pack-year increment = 1.29; 95% CI = 1.01-1.64; P trend = .04), but not of small adenoma (RR = 1.11; 95% CI = 0.93-1.34). Cigarette smoking was unrelated to colorectal cancer until 35 years after smoking began, but then became progressively more strongly related with time. Among women who had started smoking more than 10 cigarettes per day 35-39 years in the past, the RR for cancer was 1.47 (95% CI = 1.07-2.01), progressing to 1.63 (95% CI = 1.14-2.33) after 40-44 years and 2.00 (95% CI = 1.14-3.49) after 45 years. CONCLUSIONS: Because the minimum induction period for colorectal cancer appears to be at least 35 years, an association between smoking and colorectal cancer in women may just now be showing up. IMPLICATIONS: Our findings suggest that cigarette smoking may be a previously unrecognized, preventable cause of colorectal cancer among women.

Adenoma↗
PubMed1994

Smoking cessation and time course of decreased risks of coronary heart disease in middle-aged women.

BACKGROUND: We examined prospectively the relation of time since stopping smoking with risk of coronary heart disease in middle-aged women. METHODS: The study was based on 12 years' follow-up data (1976 through 1988) from the Nurses' Health Study, an ongoing prospective cohort study, in which information on smoking habits was updated every 2 years by a mailed questionnaire. The study population consisted of 117,006 female registered nurses aged 30 to 55 years in 1976 who were free of coronary heart disease, stroke, and cancer at baseline. The outcome measure used was incident coronary heart disease, defined as nonfatal myocardial infarction plus fatal coronary heart disease. RESULTS: A total of 970 incident cases of coronary heart disease (215 among participants who never smoked, 214 among former smokers, and 541 among current smokers) occurred during 1.37 million person-years of follow-up. The multivariate relative risk of total coronary heart disease among current smokers compared with participants who never smoked was 4.23 (95% confidence interval, 3.60 to 4.96). Risk of coronary heart disease was highest among smokers who started smoking before the age of 15 years (relative risk, 9.25; 95% confidence interval, 5.27 to 16.23). The relative risk among former smokers was 1.48 (95% confidence interval, 1.22 to 1.79). On stopping smoking, one third of the excess risk of coronary heart disease was eliminated within 2 years of cessation. Thereafter, the excess risk returned to the level of those who never smoked during the interval 10 to 14 years following cessation. CONCLUSION: Women who stop smoking will experience an immediate benefit as well as a further longer-term decline in excess risk of coronary heart disease to the level of those who never smoked.

Adult↗
PubMed1994

Calcium, vitamin D, dairy foods, and the occurrence of colorectal adenomas among men and women in two prospective studies.

A high intake of calcium, vitamin D, or specific dairy products is thought to reduce the incidence of colorectal cancer. The association of these nutrients and foods with the occurrence of colorectal adenomas, precursors of cancer, was studied in two large US cohort studies. Cases were patients with a diagnosis of adenomatous polyps of the left colon or rectum (331 men, 1986-1990; 350 women, 1980-1988), and controls were persons with endoscopic findings negative for adenoma (9,159 men and 8,585 women). After adjustment for age, total energy, family history of colorectal cancer, body mass index, alcohol consumption, folate, intake of saturated fat and fiber, indications for endoscopy, and previous endoscopy, total calcium intake was not associated with the risk for adenoma (relative risk (RR), highest vs. lowest quintile of intake: men, 1.13, 95% confidence interval (CI) 0.76-1.66; women, 1.17, 95% CI 0.81-1.69). Total vitamin D intake was unrelated to the risk for adenoma in men (RR = 1.29, 95% CI 0.87-1.93). An inverse nonsignificant association was observed in women in the 1980-1988 analyses (RR = 0.68, 95% CI 0.41-1.13, trend p = 0.09), mainly attributable to the intake of multivitamin supplements, but an analysis of 4-year data (1984-1988) using a more detailed dietary assessment showed no association with vitamin D (RR = 1.04, 95% CI 0.65-1.67). Milk consumption and intake of total fermented dairy products were not related to adenoma risk. In conclusion, the occurrence of colorectal adenoma was neither related to calcium intake nor to milk consumption, whereas vitamin D from supplements but not diet was slightly, but not significantly, inversely associated with risk among women only.

Adenoma↗
PubMed1994

Tests of the linear-no threshold theory for lung cancer induced by exposure to radon.

The linear theory used to extrapolate the cancer risk of radon exposure from high levels where direct data are available to low levels encountered in homes is tested by comparing lung cancer rates, m, and average radon levels, r, in numerous U.S. states and counties. It is shown that most problems normally associated with ecological studies do not apply here. The data show a very strong tendency for lung cancer rates, corrected for smoking prevalence (S), to decrease with increasing r, in sharp contrast to the opposite behavior predicted by the theory. It is shown that even a perfect negative r-S correlation cannot explain this discrepancy. Actual r-S correlations are only a few percent. Several other possible explanations for the discrepancy are explored, but none can reduce it by more than about 25%.

Age Distribution↗
PubMed1994

Adolescent body mass index and infertility caused by ovulatory disorder.

OBJECTIVE: Our aim was to examine the association between body mass index at age 18 and subsequent primary ovulatory infertility. STUDY DESIGN: A nested case-control study was conducted within a cohort of 116,678 female registered nurses residing in 14 U.S. states. Cases comprised 2527 married nulliparous nurses unable to become pregnant for at least 1 year because of ovulatory disorder; controls comprised 46,718 married parous nurses with no history of infertility. The risk of ovulatory infertility for women at different levels of body mass index at age 18 was compared with that for women whose body mass index at age 18 was 20 to 21.9 (median for the cohort). Logistic regression was used to adjust for age at infertility or first birth, year of birth, age at menarche, physical activity during ages 18 to 22, smoking at ages 15 to 19, ethnicity, alcohol use at ages 18 to 22, use of oral contraceptives before age 22, and diagnosis of diabetes mellitus. RESULTS: Multivariate relative risks for infertility were: 1.2 (body mass index < 16), 1.1 (body mass index 16 to 17.9), 1.0 (body mass index 18 to 19.9), 1.0 (referent body mass index 20 to 21.9), 1.1 (body mass index 22 to 23.9), 1.3 (body mass index 24 to 25.9), 1.7 (body mass index 26 to 27.9), 2.4 (body mass index 28 to 29.9), 2.7 (body mass index 30 to 31.9), and 2.7 (body mass index > or = 32). The relative risks for all categories of body mass index above 23.9 were statistically significantly elevated. Greater body mass index at age 18 was a predictor of ovulatory infertility in women with and without a diagnosis of polycystic ovary syndrome. CONCLUSION: These findings suggest that elevated body mass index at age 18, even at levels lower than those considered to be obese, is a risk factor for subsequent ovulatory infertility.

Adolescent↗
PubMed1994

Long-term benefits and risks of alternative methods of fertility control in the United States.

A risk-benefit analysis of five alternative approaches to fertility control among US women over the age of 30 was performed: tubal ligation, vasectomy, intrauterine device, barrier method (condom), and combined oral contraceptives. Taken into account were age-specific probabilities of contraceptive failure, fecundability, spontaneous abortion, reproductive mortality (ectopic pregnancy, delivery, or induced abortion), life table mortality, and mortality from specific cancer sites (ovarian, endometrial, breast, and prostate) and cardiovascular disease. Relative to women using no contraceptive precautions, the use of any method of contraception between the ages of 30 and 50 was associated with net benefit in terms of averted deaths. However, when duration of observation was extended up to age 80, we predicted an excess of about 880 deaths from prostate cancer per 100,000 users of vasectomy. Other methods continued to be associated with net benefit, ranging from 130 to 360 deaths averted per 100,000 users. It was concluded that the non-reproductive risks and benefits of contraceptive methods continue to be relevant long after the reproductive years. The balance of risks and benefits may differ in other countries with different cause-specific and life table mortality rates.

Adult↗
PubMed1994

Dual effect of parity on breast cancer risk.

This study examined whether breast cancer risk increased for a short period after childbirth, but decreased after a longer period of time. Data from an international case-control study on breast cancer conducted in the 1960s were used to study the modifying effect of age at enrolment on the relationship between parity and breast cancer risk, comparing first uniparous with nulliparous women, and then biparous versus uniparous women. The statistical analysis was performed by modelling through multiple logistic regression, adjusting for study site, age at menarche, menopausal status and obesity index. Comparing uniparous with nulliparous women, an early age at birth seems to be protective for all periods after birth, whereas a late age at birth imparts a higher risk than nulliparity in the period immediately after birth, which declines with the passage of time. The modification effect by age was not apparent when biparous women with different age at second birth were compared with uniparous women. The results support the hypothesis that pregnancy oestrogens impart a transient increase of maternal breast cancer risk when the full-term pregnancy occurs late in a woman's life.

Adult↗
PubMed1994

Reproducibility and validity of a self-administered physical activity questionnaire.

BACKGROUND: The reproducibility and validity of self-administered questionnaires on physical activity and inactivity were examined in a random (representative) sample of the Nurses' Health Study II cohort and a random sample of African-American women in that cohort. METHODS: Repeat questionnaires were administered 2 years apart. Past-week activity recalls and 7-day activity diaries were the referent methods; these instruments were sent to participants four times over a 1-year period. RESULTS: The 2-year test-retest correlation for activity was 0.59 for the representative sample (n = 147) and 0.39 for the African-American sample (n = 84). Correlations between activity reported on recalls and that reported on questionnaire were 0.79 and 0.83 for the representative and African-American samples, respectively. Correlations between activity reported in diaries and that reported on questionnaire were 0.62 and 0.59, respectively. Test-retest coefficients for inactivity were 0.52 and 0.55, respectively. Correlations between inactivity reported in diaries and that reported on questionnaire were 0.41 and 0.44, respectively. CONCLUSION: The simple, short questionnaires on activity and inactivity used in the Nurses' Health Study II are reasonably valid measures for epidemiological research.

Adult↗
PubMed1994

Does coffee drinking increase the risk of coronary heart disease? Results from a meta-analysis.

BACKGROUND: The association between coffee drinking and risk of coronary heart disease remains controversial despite many epidemiological studies. A meta-analysis was carried out on these studies to resolve some of the uncertainties. Particular attention was paid to details of study design. METHODS: Eight case-control studies and 15 cohort studies were analysed. Weighted, fixed effects linear regression of log relative risks (or odds ratios) was used to pool the study results. The pooling procedures were performed separately by study design, sex, coronary heart disease end points, smoking habit, and period of study. RESULTS: The pooled case-control odds ratio (for the effect of drinking five cups of coffee/day v none) was 1.63 (95% confidence interval (95% CI) 1.50 to 1.78). The pooled cohort study relative risk (five cups/day v none) was 1.05 (95% CI 0.99 to 1.12). The discrepancy between the pooled case-control and cohort study results could not be attributed to differences in the end points chosen, period of study, or to confounding by smoking status or sex. CONCLUSIONS: The cohort study data suggest very little excess risk of coronary heart disease among habitual coffee drinkers. The case-control data do not rule out an increased risk of heart disease among a subgroup of people who acutely increase their coffee intake. Further epidemiological studies are needed to assess the risk of drinking boiled or decaffeinated coffee.

Case-Control Studies↗
PubMed1994

Prospective study of phobic anxiety and risk of coronary heart disease in men.

BACKGROUND: To examine prospectively the association between self-reported symptoms of phobic anxiety and subsequent risk of coronary heart disease, a 2-year follow-up study was conducted of a cohort of 33,999 US male health professionals, aged 42 to 77 years in 1988, who were free of diagnosed cardiovascular disease at baseline. Levels of phobic anxiety were assessed using the Crown-Crisp index, a short, diagnostic self-rating scale used for common phobias. Main outcomes were incidents of coronary heart disease consisting of nonfatal myocardial infarction (MI) and fatal coronary heart disease (CHD). METHODS AND RESULTS: One hundred sixty-eight incident cases of CHD occurred during 2 years of follow-up (128 cases of nonfatal MI and 40 cases of fatal CHD). The age-adjusted relative risk of fatal CHD among men with highest levels of phobic anxiety (scoring 4 or higher on the Crown-Crisp index) was 3.01 (95% confidence interval, 1.31 to 6.90) compared with men with the lowest levels of anxiety (scoring 0 or 1 on the phobia index). Risk of fatal CHD increased with levels of phobic anxiety (P trend = .002). When fatal CHD was further categorized into sudden and nonsudden coronary death, the excess risk was confined to sudden death (relative risk among men scoring 3 or higher on the phobia index was 6.08; 95% confidence interval, 2.35 to 15.73). No association was found between phobic anxiety and risk of nonfatal MI. These findings remained essentially unchanged after adjusting for a broad range of cardiovascular risk factors. CONCLUSIONS: The specificity, strength, and dose-response gradient of the association, together with the consistency and biological plausibility of the experimental and epidemiologic evidence, support a strong causal association between phobic anxiety and fatal CHD.

Adult↗
PubMed1994

Prevention of deep-vein thrombosis following total hip replacement surgery with enoxaparin versus unfractionated heparin: a pharmacoeconomic evaluation.

OBJECTIVE: To compare the use of healthcare services in patients receiving enoxaparin, a low molecular weight heparin versus those receiving unfractionated heparin as prophylaxis against deep-vein thrombosis (DVT) following total hip replacement surgery. DESIGN: Economic evaluation undertaken in conjunction with a randomized, open-label, parallel group, Phase III clinical trial. SETTING: 32 US acute-care hospitals. PATIENTS: 607 patients undergoing elective total hip replacement. INTERVENTIONS: Enoxaparin 30 mg q12h, enoxaparin 40 mg qd, or unfractionated heparin 5000 units q8h started within 24 hours following surgery and continued for 7 days. MAIN OUTCOME MEASURES: (1) Use of selected tests and treatments for DVT; (2) use of selected tests and treatments related to postoperative bleeding; (3) length of stay in hospital; and (4) readmissions to hospital within 14 days. RESULTS: Although the use of selected tests and treatments related to DVT or postoperative bleeding did not differ significantly between the three treatment groups, mean length of stay in the hospital (following the start of study therapy) was shorter among patients receiving enoxaparin 30 mg (9.5 days; p = 0.01) or 40 mg (9.9 days; p < 0.05) than those receiving unfractionated heparin (11.3 days). There was also a trend toward fewer hospital readmissions in both of the enoxaparin groups. CONCLUSIONS: Compared with unfractionated heparin, use of enoxaparin following total hip replacement may decrease the risk of DVT and length of hospital stay.

Adult↗
PubMed1994

The relation of smoking, age, relative weight, and dietary intake to serum adrenal steroids, sex hormones, and sex hormone-binding globulin in middle-aged men.

The relationships of cigarette smoking, age, relative weight, and dietary intake to serum dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), androstenedione, cortisol, 3-alpha-androstanediol, 3-alpha-androstanediol-glucuronide, testosterone, albumin-bound testosterone, free testosterone, dihydrotestosterone (DHT), and sex hormone-binding globulin (SHBG) were examined cross-sectionally in 1241 randomly sampled middle-aged U.S. men. Compared with nonsmokers and independent of relative weight (body mass index) and age, cigarette smokers had increased serum levels of DHEA (18% higher, P = 0.0002), DHEAS (13% higher, P = 0.0007), cortisol (5% higher, P = 0.01), androstenedione (33% higher, P = 0.0001), testosterone (9% higher, P = 0.009), DHT (14% higher, P = 0.004), and SHBG (8% higher, P = 0.004). Androstenedione, total plasma testosterone, albumin-bound testosterone, DHT, and SHBG decreased with increasing relative weight. Age was positively associated with serum SHBG and negatively associated with albumin-bound testosterone, DHEA, and DHEAS. An association was found between alcohol intake and DHEA (r = 0.15; P = 0.0001), cortisol (r = 0.10; P = 0.0007), and 3-alpha-androstanediol-glucuronide (r = 0.08; P = 0.0004). Cortisol was the only hormone that was associated with carbohydrate intake (r = -0.09; P = 0.002). The only hormones associated with dietary lipids were DHT (for vegetable fat, r = 0.07; P = 0.02), cortisol (for total fat, r = 0.08; P = 0.007), and SHBG (for animal fat, r = -0.06; P = 0.05). In addition, SHBG was positively associated with dietary (r = 0.07; P = 0.008) and crude (r = 0.08; P = 0.007) fiber. These data suggest that serum adrenal steroid and sex hormone concentrations in middle-aged men are more influenced by cigarette smoking, age, and obesity than by dietary intake; however, serum adrenal steroids were influenced by alcohol intake.

Adrenal Glands↗